Avian Influenza and US TV News

To the Editor: Scholars have routinely noted ways in which scientific inquiry is isolated from public life and popular attention and have bemoaned relatively low levels of scientific literacy among lay audiences (1–3). While public understanding of science in the United States and elsewhere undoubtedly is not at the level desired by most scientists, apparent interest and hunger to learn are high for certain issues. These issues represent public communication opportunities.

2,552 respondents who met those criteria and who answered all relevant questions.
Participants represented a reasonable cross-section of the general US population of television news viewers. Participants were 18-90 years of age (mean age 52, SD = 15.45). Educational attainment was mixed: 37% reported having completed at least a 4-year undergraduate degree, and 63% had completed <4-year degree. The final sample was 87% Caucasian, 8% African American, and 2% Asian; 8% also identified themselves as Hispanic or Latino. Approximately 54% of the sample was female, and 11% reported that they work for an organization directly involved in science.
When offered a 7-point scale that ranged from "not at all important" to "very important" to describe the priority that local television news should assign to addressing the "direct impact" of avian flu on one's own life and the lives of others, ≈80 % chose >5. Approximately 42% of respondents chose the highest level, indicating it was very important for local television news to cover this angle of the story. Regarding deeper perspectives on the story, ≈81% of respondents chose >5 on the 7-point scale of importance when asked about potential coverage of how avian flu spreads and why scientists are finding it difficult to contain; 41% of respondents thought that it was "very important" that television reporters explicitly discuss that aspect of the issue. Moreover, 69% of respondents, by offering >5 on the 7-point scale, thought the television news should focus on the connection of avian flu to other issues, such as business and travel. Clearly, we are living in a time in which news audiences would tolerate much more than the soundbites and superficial coverage often offered with regard to infectious disease research.
Equally as striking are the demographic characteristics of those who believe that local television news should cover the process of scientific discovery in this arena. We conducted a simple regression analysis to predict 1 of the items noted above, i.e., perceived importance of television news discussion of how avian flu spreads and of the efforts of scientists. We used formal employment with a scientific institution, level of educational attainment (a 5-level variable treated here as interval), and reported conversation with others about science in recent months as predictors. Educational attainment actually bore a negative relationship to interest in such coverage, β = −0.14, p<0.01, and formal affiliation with a scientific institution bore no statistically significant relationship, p>0.10. (Past conversation about science bore a positive relationship, β = 0.06, p<0.01.) Results suggested a prime opportunity for public communication efforts not just because of issue timeliness but also because of apparent widespread hunger for information among the US television news viewers. Health and science communication professionals could address this interest and desire to boost popular awareness of epidemiologic and medical inquiry.

Resistance to Dihydroartemisinin
To the Editor: The emergence of widespread resistance to chloroquine and sulfadoxine-pyrimethamine in Africa has caused a sharp rise in deaths from malaria. The World Health Organization therefore urgently recommends replacement of these drugs, particularly with combinations that include an artemisinin compound (AC) (1). In 2006, although >40 countries have adopted artemisinin-based combination therapies as their firstline treatment for malaria, only a few of these countries actually use these combination therapies because of limiting factors such as high cost (2). When used as monotherapy, ACs are associated with high rates of recrudescence, possibly because of their short elimination half-lives (3). Most artemisinin-based combination therapies contain, in addition to ACs, a partner drug against which resistance has already developed (e.g., mefloquine, amodiaquine, lumefantrine); reports of relatively low efficacy of the combination artesunate-amodiaquine have been recently published (4). In 2005, Jambou et al. claimed to have found the first cases of in vitro Plasmodium falciparum resistance to ACs (5).
We assessed the in vitro susceptibility to dihydroartemisinin (dhART), the biologically active metabolite of artemisinin derivatives, of P. falciparum isolates from travelers returning to France from various African countries during 2004-2006. In addition, we searched for polymorphism in the P. falciparum adenosine triphosphatase-6 (PfATPase6) gene, which was reported to be associated with in vitro artemether resistance (5). We also studied polymorphism (a 3bp indel) in the gene of the ABC transporter G7, which was reported in 2005 to be associated with in vitro response to artesunate (6).
DNA sequencing of 900-bp and 240-bp PCR products, including the 769 and the 243/263 PfATPase6 codons, respectively, was performed in a subsample of 154 isolates. All isolates had the S769 wild codon except 1 susceptible isolate (IC 50 = 0.83 nmol/L), which had a S769N mutant type codon (Table). We found no polymorphism in codon 263. This position may be scrutinized to monitor anticipated artemisinin resistance, according to a recently published structure-function study (8). Conversely, we found 2 isolates that had IC 50 values of 4.2 nmol/L and