CANADA: Ruling Gives AIDS Sufferer Grounds for Refugee Claim: Federal Court Decision Has Immigration Experts Divided

A federal judge has suspended the deportation of an HIV- positive Nigerian women and her toddler, ruling that the "discrimination and stigmatization faced by Nigerians living with HIV-AIDS" could be grounds for obtaining refugee status in Canada. Immigration experts are divided on whether the case, which Justice Michel Shore sent to another panel for reconsideration, will make it easier for HIV-positive Africans to make successful asylum claims.
Joy Omoregbe was eight months pregnant when she came to Canada in 2000, claiming she was fleeing a Nigerian chief who had raped her repeatedly. If she is forced to return, she will be treated as "immoral and loose" and will be denied health care, she said. "Because HIV is seen as a curse from God that strikes sinners, many people do not care about people with HIV-AIDS," her affidavit said. "They are ostracized, discriminated against and are even victims of violence."
HIV-positive refuges seeking asylum for other reasons are often permitted to stay in Canada, but the very fact of having HIV has not been considered a legitimate reason. Almost a decade ago, the UN High Commission on Refugees recognized that AIDS patients could be eligible for asylum in limited cases, but there have rarely been successful claims in Canada or elsewhere. Denial of health care would have to be selective in order to fall within international refugee conventions.
David Matas, a leading Canadian immigration lawyer, said the case could be significant. "The bottom line is that in principle, if you've got AIDS and you're going to be ostracized, discriminated against and stigmatized because of it, you can be a refugee," noted Matas. But Janet Dench, executive director of the Canadian Council for Refugees, said Omoregbe's argument is a long shot: "Many people suffer discrimination, which is quite painful, but that is not going to automatically lead to you being found to be a refugee."

UNITED STATES: Antibiotic Can Trigger Cardiac Deaths

The antibiotic erythromycin dramatically increases the risk of cardiac arrest, especially when it is taken with certain newer drugs, according to a new study published today. Erythromycin has been commonly prescribed for 50 years to treat numerous illnesses, including syphilis.
Because of some reports of patient deaths, cardiologists have known that erythromycin alone carried a slight risk, mostly for those who took it intravenously. Family doctors, however, were less likely to know about the risk, said Dr. Muhamed Saric, a cardiologist and director of the electrocardiology lab at the University of Medicine and Dentistry of New Jersey in Newark.
The risk of cardiac death was more than five times higher in patients who took erythromycin with other drugs that increase its concentration in the blood, according to lead author Wayne A. Ray, professor of preventive medicine at Vanderbilt University School of Medicine in Nashville. "This is an unacceptably high risk," Ray said.
The new study is the first to systematically document that risk. It focused on erythromycin pills, which are usually sold as generics, together with certain treatments for infection, and calcium channel blockers for high blood pressure.
The danger seems to arise from the other drugs slowing erythromycin's breakdown. This increases its concentration, trapping salt inside resting heart muscles cells, delaying the time until the next heartbeat starts, and sometimes triggering an abnormal and potentially fatal heart rhythm.
In addition to the blood pressure drugs verapamil (Verelan, Isoptin) and diltiazem (Cardizem, Tiazac), other drugs posing a risk with erythromycin, Ray said, include the antibiotic clarithromycin (Biaxin), fluconazole (Diflucan), ketoconazole (Nizoral), and itraconazole (Sporanox). Pills and injections - but not topical forms of the drugs - were associated with the risk. Ray cautioned that taking erythromycin with protease inhibitors or grapefruit juice should also be avoided because they can boost blood levels of the antibiotic.
The report, "Oral Erythromycin and the Risk of Sudden Death from Cardiac Causes," was published in the New England Journal of Medicine (2004;351(11):1089-1096).

MICHIGAN: Staffs to Face TB Tests

Employees in an office center containing 17 Michigan government departments, including local offices for the governor and attorney general, are receiving e-mail messages informing them that a fellow employee has been diagnosed with TB. State officials learned Thursday about the infected employee at the Cadillac Place building in Detroit's New Center, said T.J. Bucholz, spokesperson for the state Department of Community Health.
"The individual has been tested by the Detroit Department of Health. The individual has tested positive and is on leave and recovering," Bucholz said Monday. Testing is currently limited to employees who worked closely with the unnamed employee, he said. "There will be broader testing if our investigation warrants that." All employees on the building floor the infected person worked on were informed Friday of the infection, as were all state department heads with offices in the building, he said.
Gov. Jennifer Granholm will be tested as a precautionary measure, said Liz Boyd, spokesperson for the governor's office, which was notified on Friday about the case. Attorney General Mike Cox was unaware of the case, said spokesperson Stu Sandler. Cox spends a lot of time at the office, but was last week attending the Republican National Convention in New York City.