Op-Ed Contributor: Labs, Washed Away





BEDPAN ALLEY is the affectionate name given to a stretch of First Avenue in Manhattan that is packed with more hospitals than many cities possess. This stretch also happened to be right in the flood zone during Hurricane Sandy. Water damage and power failures closed down all three of the New York University teaching hospitals — Bellevue Hospital, Tisch Hospital and the Manhattan V.A. Two months later, they are still not admitting patients, though two are on schedule to begin doing so shortly.




The harrowing evacuation of hundreds of patients made headlines nationwide. The disruption of regular medical care for tens of thousands of outpatients was a clinical nightmare that is finally easing. And the education of hundreds of medical students and residents is being patched back together.


All academic medical centers, however, rest on a tripod — patient care, education and research. The effect of the hurricane on the third leg of that tripod — research — has gotten the least attention, partly because rescuing cell cultures just isn’t as dramatic as carrying an I.C.U. patient on a ventilator down flights of stairs in the dark.


But, of course, there is an incontrovertible link between those cell cultures and that patient. For every medication that a patient takes, someone researched the basic chemistry of the drug, someone designed the clinical trial to test its efficacy, and of course a volunteer stepped forward to be the first to take the pill. Scientific research has engineered the impressive advancements of medical treatment, and every patient is a beneficiary.


When the hospitals were hit by Hurricane Sandy, hundreds of experiments were obliterated by the loss of power. Precious biological samples carefully frozen over years were destroyed. Temperature-sensitive reagents and equipment were ruined. Medications and records for patients in clinical trials were rendered inaccessible. And sadly, many laboratory mice and rats perished (though 600 cages of animals were rescued during the night by staff members who used crowbars on inaccessible doors and carried the cages out through holes cut in the ceiling).


On a slushy, rainy day earlier this month, I sat in on a meeting of N.Y.U.’s research community. Hundreds of scientists packed the chilly lecture hall to discuss what the future might hold. It was clear that the damage to laboratories and samples would not be amenable to easy repair. Some 400 researchers were being relocated to a patchwork of temporary sites so that they could restart their work.


But scientists can’t just walk in to a new space with a lab coat and a notebook; they need centrifuges, deep-freezes, lab animals, electron microscopes, incubators, autoclaves, gamma counters, PET scanners. They come with graduate students, lab techs, post-docs and collaborating investigators. For clinical researchers, there are also the patients enrolled in their clinical trials, with their medications and voluminous records.


Even beyond their eagerness to get back to work, researchers felt a sense of loss, not just in time, money, momentum, samples and grants, but of a part of their lives. Some senior scientists lost decades of archived samples. Others lost irreplaceable mice with genetic mutations for studying how coronary plaques resolve, the role of inflammation in lymphoma and the development of neural networks. At the other end of the spectrum were post-docs whose nascent careers were suddenly up in the air. Some were in tears.


Walking down First Avenue after the meeting, I passed a young researcher pushing a cart laden with cages, transporting lab rats to their new home. There was a blanket over the cages to protect them from the rain, but it kept slipping. She slogged up the wet avenue, one hand pushing the cart, the other struggling to keep the cover over her charges.


The logistical efforts to relocate and reignite such a vast research enterprise are staggeringly complicated. But the administration has cataloged each person’s research needs to match them with available space elsewhere, and hundreds of researchers have successfully rekindled their investigations despite the prodigious challenges.


Bellevue and Tisch are returning to their clinical operations and will be able to admit patients shortly. But even after the hospital wards and clinics are bustling at full capacity, the ribbon won’t feel ready to snip until the researchers are restored to their homes as well. For many patients, the thrum of research within a medical center is invisible. But it is an integral — and very human — part of a hospital. When a hurricane disrupts research, it is a loss that resonates well beyond the laboratories.


Danielle Ofri, an associate professor at New York University School of Medicine, is the editor of the Bellevue Literary Review and the author, most recently, of “Medicine in Translation: Journeys With My Patients.”



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Feds call for new safety review of airport scanners









Responding to critics, the Department of Homeland Security is launching another safety study of full-body scanners used to screen passengers at the nation's airports.


The Department of Homeland Security, which oversees the Transportation Security Administration, plans to award a contract to the National Academy of Sciences to perform the review.


But the nonprofit group of scientists will only be asked to review previous studies on the safety of a particular type of scanner used by the TSA.





The study comes in response to pressure from TSA critics, including Sen. Susan Collins (R-Maine), who introduced a bill this year to test the safety of the scanners.


[Updated, 3:35 p.m. Dec. 20: In a statement, Collins said she welcomes the new review.


"While TSA has told the public that the amount of radiation emitted from these machines is small, passengers and some scientific experts have raised questions about the impact of repeated exposure to this radiation," she said.] 


In an interview, TSA Administrator John Pistole said several previous studies have already shown the scanners do not expose passengers to dangerous levels of radiation, even for frequent travelers.


But he said he welcomes another study to address the concerns of members of Congress. "After all, they fund us," he said of the Senate and House.


The TSA uses two types of full-body scanners, both of which help the agency look for objects hidden under the clothes of passengers. About half of those scanners expose passengers to X-rays to see through their clothes, with the rest using non-ionizing radio frequency energy, known as millimeter waves.


The scanners that use X-rays, or backscatter technology, have received the most criticism from passenger advocates and scientists, including professors from UC San Francisco. The European Union last year banned the use of backscatter scanners at European airports over health concerns.


The Department of Homeland Security posted an advisory last week, saying it was awarding the National Academy of Science a contract to convene a committee to review whether exposure to backscatter scanners complies with health standards. The academy also is asked to determine whether the design of the machines and the procedures used by TSA staff prevent overexposure of radiation to travelers and the workers.


The proposal does not say when the academy should complete its review.


ALSO:


How new TSA body scans will work


TSA scanners pose negligible risk to passengers, new test shows


LAX's controversial full-body scanners out; new, faster scanners in


Follow Hugo Martin on Twitter at @hugomartin





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FBI: Video shows escaped bank robbers getting into cab

There have been more developments today in the story of two men who escaped a Chicago prison yesterday.









Two fugitive bank robbers who slid down the side of a high-rise federal jail on a rope constructed from bedsheets made their getaway by hopping a cab a few blocks away, authorities said Wednesday as they continued the manhunt for the elusive convicts.


Federal agents obtained surveillance video of Joseph "Jose" Banks and Kenneth Conley jumping into a taxi at Congress Parkway and Michigan Avenue at about 2:40 a.m., FBI spokeswoman Joan Hyde said. The video showed the two wearing light-colored clothing.


The break helped investigators pinpoint the timing of the bold nighttime escape from some 15 stories above the street at the Metropolitan Correctional Center.








Banks and Conley, both convicted bank robbers awaiting sentencing, were last accounted for at 10 p.m. Monday during a routine bed check.


Hours after the pair fled south in the cab, they banged on Conley's mother's door in far southwest suburban Tinley Park but were quickly sent on their way, according to a family member.


The two were last seen walking away from the home about 7 a.m., Hyde said.


FBI agents were analyzing the video for more leads, including the identity of the cab company and the number of the taxi.


The FBI also announced on Wednesday a $50,000 reward for information leading the capture of the two fugitives. Banks, 37, was described as black, 5 feet 8 inches tall and weighing 160 pounds, while Conley, 38, is white, 6 feet and 185 pounds. Conley has a tattoo of a devil on his shoulder and a sun tattoo on his back.


With the pair on the loose for a second day, new details were emerging about Conley, the lesser known of the two.


Unlike Banks, who was considered by the FBI as one of the most prolific bank robbers in Chicago history, Conley was facing sentencing on just one bank holdup.


According to court records, Conley has a long criminal history. He has been convicted in Cook County of offenses ranging from retail theft to weapons violations and was sentenced to eight years in prison for an armed robbery in 1996.


Conley also was sentenced to six years in prison in San Diego County for petty theft with a prior conviction, according to California records. Less than a year after his parole in 2010, Conley robbed a bank in suburban Homewood of less than $4,000 cash, the heist that landed in him in the MCC.


Federal court records show Conley had been involuntarily committed at a hospital not long after the May 2011 bank robbery and that he was arrested at the Tinley Park Mental Health Center for violating his California parole.


A brother of Conley's who asked that his name not be printed said he wasn't home when Conley and Banks arrived at the family home early Tuesday, but he spoke to his mother and sister minutes after the pair's visit.


He said Conley turned up at the Tinley Park home with a man whom family members later identified as Banks.


"He was pounding on the door, and the doorbell was going crazy," said his brother.


Conley came in, looking frazzled and wearing a white shirt and gray pants, the brother said. "He said, 'Hey, I'm out on bond,' which we thought was strange, because usually the family gets some notice."


They asked him to leave, although one brother gave him a winter coat.


"Do I think he's capable of doing something dangerous?," the brother said. "I don't know. I hope he just turns himself in."


Banks, too, has a criminal history, court records show. He was sentenced to three years in prison each for a 1994 burglary and a 1995 attempted burglary.





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Miss USA Olivia Culpo is crowned Miss Universe






LAS VEGAS (AP) — A 20-year-old Boston University sophomore and a self-described “cellist-nerd” brought the Miss Universe crown back to the United States for the first time in more than a decade when she won the televised contest Wednesday.


Olivia Culpo beat out 88 other beauty queens to take the title from Leila Lopes of Angola during the two-hour competition at the Planet Hollywood casino on the Las Vegas Strip.






Culpo wore a tight navy blue mini-dress with a sequined bodice as she walked on stage for the competition’s opening number. Later in the night, she strutted in a purple and blue bikini, and donned a wintery red velvet gown with a plunging neckline.


Culpo’s coronation ends a long losing spell for the U.S. in the competition co-owned by Donald Trump and NBC. An American had not won the right to be called Miss Universe since Brook Lee won the title in 1997.


Culpo was good enough during preliminary competitions to be chosen as one of 16 semifinalists who moved on to compete in the pageant’s finale. Her bid lasted through swimsuit, evening wear, and interview competitions that saw cuts after each round.


She won over the judges, even after tripping slightly during the evening gown competition. Telecasters pointed it out but also noted her poised recovery.


Minutes before the middle child of five was crowned, she was asked whether she had she had ever done something she regretted.


“I’d like to start off by saying that every experience no matter what it is, good or bad, you’ll learn from it. That’s just life,” she said. “But something I’ve done I’ve regretted is probably picking on my siblings growing up, because you appreciate them so much more as you grow older.”


Miss Philippines, Janine Tugonon, came in second, while Miss Venezuela, Irene Sofia Esser Quintero, placed third.


All the contestants spent the past two weeks in Sin City, where they posed in hardhats at a hotel groundbreaking, took a painting lesson, and pranked hotel guests by hiding in their rooms.


Culpo was the first Miss USA winner from Rhode Island when she took the national crown in Las Vegas in June.


She grew up in Cranston with two professional musicians for parents and has played the cello alongside world-renowned classical musician Yo-Yo Ma. On her Miss Universe page, she said she hopes to pursue a career in film or television, and cites Audrey Hepburn as a role model because of her “generosity, intelligence and grace.”


With Culpo’s promotion, Miss Maryland Nana Meriwether becomes the new Miss USA.


The Miss Universe pageant was back in Las Vegas this year after being held in Sao Paulo in 2011. It aired live on NBC and was streamed to more than 100 countries.


Organizers had considered holding the 61st annual Miss Universe in the popular Dominican Republic tourist city of Punta Cana, but Miss Universe Organization President Paula Shugart said that country’s financial crisis proved to be too much of an obstacle.


The panel of 10 judges included singer Cee Lo Green, “Iron Chef” star Masaharu Morimoto and Pablo Sandoval of the San Francisco Giants.


Asked on the red carpet whether he found playing in the World Series or judging the beauty pageant to be more difficult, Sandoval said both were hard.


Sharply dressed women and men, including a large contingent from South America, held banners and cheered on their favorite contestants.


The pageant started as a local revue in Long Beach, Calif., organized by Catalina Swimwear. It is not affiliated with the Miss America pageant and unlike that contest, does not include a talent section.


Contestants in the pageant cannot have been married or have children. They must be younger than 27 and older than 18 by Feb. 1 of the competition year.


As Miss Universe, Culpo will receive an undisclosed salary, a wardrobe fit for a queen, a limitless supply of beauty products, and a luxury apartment in New York City.


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U.N. Suspends Polio Campaign in Pakistan After Killings of Workers


B.K. Bangash/Associated Press


A Pakistani woman administered polio vaccine to an infant on Wednesday in the slums of Islamabad. Militants have killed eight polio workers over three days.







LAHORE, Pakistan — The front-line heroes of Pakistan’s war on polio are its volunteers: young women who tread fearlessly from door to door, in slums and highland villages, administering precious drops of vaccine to children in places where their immunization campaign is often viewed with suspicion.




Now, those workers have become quarry. After militants stalked and killed eight of them over the course of a three-day, nationwide vaccination drive, the United Nations suspended its anti-polio work in Pakistan on Wednesday, and one of Pakistan’s most crucial public health campaigns has been plunged into crisis.


The World Health Organization and Unicef ordered their staff members off the streets, while government officials reported that some polio volunteers — especially women — were afraid to show up for work.


At the ground level, it is those female health workers who are essential, allowed privileged entrance into private homes to meet and help children in situations denied to men because of conservative rural culture. “They are on the front line; they are the backbone,” said Imtiaz Ali Shah, a polio coordinator in Peshawar.


The killings started in the port city of Karachi on Monday, the first day of a vaccination drive aimed at the worst affected areas, with the shooting of a male health worker. On Tuesday four female polio workers were killed, all gunned down by men on motorcycles in what appeared to be closely coordinated attacks.


The hit jobs then moved to Peshawar, the capital of Khyber-Pakhtunkhwa Province, which, along with the adjoining tribal belt, constitutes Pakistan’s main reservoir of new polio infections. The first victim there was one of two sisters who had volunteered as polio vaccinators. Men on motorcycles shadowed them as they walked from house to house. Once the sisters entered a quiet street, the gunmen opened fire. One of the sisters, Farzana, died instantly; the other was uninjured.


On Wednesday, a man working on the polio campaign was shot dead as he made a chalk mark on the door of a house in a suburb of Peshawar. Later, a female health supervisor in Charsadda, 15 miles to the north, was shot dead in a car she shared with her cousin.


Yet again, Pakistani militants are making a point of attacking women who stand for something larger. In October, it was Malala Yousafzai, a schoolgirl advocate for education who was gunned down by a Pakistani Taliban attacker in the Swat Valley. She was grievously wounded, and the militants vowed they would try again until they had killed her. The result was a tidal wave of public anger that clearly unsettled the Pakistani Taliban.


In singling out the core workers in one of Pakistan’s most crucial public health initiatives, militants seem to have resolved to harden their stance against immunization drives, and declared anew that they consider women to be legitimate targets. Until this week, vaccinators had never been targeted with such violence in such numbers.


Government officials in Peshawar said that they believe a Taliban faction in Mohmand, a tribal area near Peshawar, was behind at least some of the shootings. Still, the Pakistani Taliban have been uncharacteristically silent about the attacks, with no official claims of responsibility. In staying quiet, the militants may be trying to blunt any public backlash like the huge demonstrations over the attack on Ms. Yousafzai.


Female polio workers here make for easy targets. They wear no uniform but are readily recognizable, with clipboards and refrigerated vaccine boxes, walking door to door. They work in pairs — including at least one woman — and are paid just over $2.50 a day. Most days one team can vaccinate 150 to 200 children.


Faced with suspicious or recalcitrant parents, their only weapon is reassurance: a gentle pat on the hand, a shared cup of tea, an offer to seek religious assurances from a pro-vaccine cleric. “The whole program is dependent on them,” said Mr. Shah, in Peshawar. “If they do good work, and talk well to the parents, then they will vaccinate the children.”


That has happened with increasing frequency in Pakistan over the past year. A concerted immunization drive, involving up to 225,000 vaccination workers, drove the number of newly infected polio victims down to 52. Several high-profile groups shouldered the program forward — at the global level, donors like the Bill and Melinda Gates Foundation, the United Nations and Rotary International; and at the national level, President Asif Ali Zardari and his daughter Aseefa, who have made polio eradication a “personal mission.”


On a global scale, setbacks are not unusual in polio vaccination campaigns, which, by dint of their massive scale and need to reach deep inside conservative societies, end up grappling with more than just medical challenges. In other campaigns in Africa and South Asia, vaccinators have grappled with natural disaster, virulent opposition from conservative clerics and sudden outbreaks of mysterious strains of the disease.


Declan Walsh reported from Lahore, and Donald G. McNeil Jr. from New York. Ismail Khan contributed reporting from Peshawar, Pakistan.



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Chicago electric bills set to rise $1 a month next year









In the new year Chicago area residents can expect to pay about $1 more per month on average to have ComEd deliver electricity to their homes.

The new rates, approved Wednesday by the Illinois Commerce Commission, affect all 3.7 million residential electricity customers in ComEd's service territory, including those who have switched to other suppliers. ComEd, which owns the wires that flow into homes, delivers electricity and is responsible for fixing outages regardless of which company supplies the power.

The rate "update" is the second under a law enacted in 2011 that changed the way electricity delivery rates are determined. Rather than intensely debated court-like proceedings, electric rates are now set according to a fill-in-the blank formula. The formula devised by the ICC in May, however, has been controversial. ComEd has taken the regulators to court over 12 items that amount to $100 million per year for the utility.

For now, ComEd must use the formula.

Consumers saw lower bills through 2012 with thhe first electricity rates set under the law. Despite Wednesday's hike, customer bills remain lower than they were before the Energy Infrastructure and Modernization Act was passed. That law allows ComEd to charge customers to modernize the electric grid and recover those costs each year.

ComEd will file for another rate update in May to take effect in January 2014.

Separately, the ICC approved an electricity procurement plan by the Illinois Power Agency -- the government agency that procures electricity on behalf of ComEd and Ameren for  customers who continue to have their electricity both supplied and delivered by their legacy utility -- that has it not purchasing additional power in the New Year. The agency said that with about 1.5 million residential electricity customers recently fleeing for alternative electricity suppliers,  it has enough power on hand to serve the customers who remain.

At the same time, the plan helps a so-called clean coal plant slated for Morgan County, Ill. clear a major financial hurdle by requiring the state's electric utilities to purchase electricity from the power plant for 20 years. The federally-backed FutureGen project, long stalled, would mean retrofitting a coal plant in Merdosia in order to largely prevent carbon dioxide and other pollutants from entering the atmosphere. The plant is not expected to generate electricity until 2017 but its backers needed to prove the plant would have customers ready to purchase the electricity in order to receive government approval to move forward with preliminary design, pre-construction and engineering work.  

jwernau@tribune.com

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Field Museum to cut staff, may reduce hours of operation









Battered by the recession and a high debt load, the Field Museum on Tuesday announced plans to cut staff, overhaul its operations and limit the scope of its research.

A comprehensive plan being drawn up by museum officials also could include changes to its hours of operation and the admission price for special exhibits. Staff reductions would be aimed at curators and scientists, according to museum officials.

"This may turn out to involve shrinking certain areas of inquiry," said John Rowe, chairman of the museum's board of trustees.

The Field Museum is both an international research institution and a vital cultural attraction for residents and tourists, drawing about 1.3 million visitors in 2011.

The natural history museum is home to Sue, the best-preserved Tyrannosaurus rex in the world and a Chicago icon. In the bowels of the museum and all around the world, Field scientists also are discovering new plants and animals—more than 200 last year alone—along with preserving rain forests and studying artifacts.

That complex, dual mission comes at a price, however, one that has grown increasingly difficult to cover amid the persistent economic downturn.

The cost-cutting plan announced Tuesday comes on the heels of a previous effort that included reducing operating costs by $5 million, mostly through staff cuts. Those measures were not enough to shore up an institution that in the past decade has doubled its bond debt and run multiple operating deficits amid flat revenues and shrinking government subsidies.

In April, the museum tapped former University of Oregon president Richard Lariviere to become president and CEO. Lariviere, who started in October, said he wants to use the cost-cutting measures as an opportunity to refocus the museum's mission.

"If we wrestle these issues to the ground successfully, our future is rosy," he said during a meeting with the Tribune's editorial board.

The effort will take shape between now and July 1, with input from the museum's staff and board members, who signed off on the approach Monday. The goal is to trim another $5 million in costs and, during the next few years, add $100 million to the museum's endowment.

Although the price of special exhibits may rise slightly, Lariviere said the average museum patron should feel little or no change in the short term. Over the long run, he said, the museum will rely more on its own collection, use technology to enhance its interaction with visitors and be more selective in choosing special exhibits it brings in from the outside.

Though the recession contributed significantly to the museum's financial struggles, its debt load is also to blame. The museum has more $170 million in outstanding bonds, which is "very high" compared with the Field's endowment of about $300 million, Lariviere said.

Those bonds cost the Field more than $7 million a year out of an operating budget of less than $70 million. The debt — along with the operating losses that the museum has seen in the past decade — has drawn the attention of Moody's Investors Service, which described the museum's finances as "imbalanced."

The high debt load means the museum is not able to borrow any more money, which affects its ability to shore up operations.

"Our credit cards are maxed out," Lariviere said.

He also suggested that it's possible the museum would seek to restructure its debt, taking advantage of historically low interest rates.

Despite the financial pressures, Lariviere said the museum benefits from a healthy endowment fund and loyal donors.

He and other museum officials outlined the broad strokes of their plan to staff members Tuesday. Those include shrinking its museum's staff and overhauling its management structure, he said.

Currently the museum is organized much like a university, with researchers divided into academic departments. Under Lariviere's plan, that structure would be simplified into four broad areas: science and education, programming, fundraising and operations.

He views those changes as a chance to better leverage the Field's world-renowned scientific collections to shed light on some of the most pressing questions of the day. Among them: climate change.

"Those kinds of climatological shifts, those kinds of questions related to the environment, are going to be one of the sweet spots of the museum going forward," Lariviere said.

The idea is to monetize the museum's one-of-a-kind collection while relying less on bringing in exhibitions from other institutions, which costs more money. "We've got to find a way to get more bang out of the exhibits," Lariviere said.

Museum officials said they also expect to cut research staff as they seek to narrow the scope of its mission, in part because support staffing already has been reduced.

Those cuts have been so drastic that Lariviere said it's now more of a crisis when a housekeeping staffer calls in sick than when a curator does.

With operational staff cut to the bone, Rowe said, "We have to get (savings) out of focusing our scientific work, but not eliminating it, out of reprioritizing our exhibitions and making certain that we are doing the right thing."

However, he acknowledged, those moves are likely to stir controversy inside the museum. "Over the next five months, we've got to come up with a more descriptive, positive agenda."

hgillers@tribune.com

jgrotto@tribune.com

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Leak reveals Polaroid’s Android-powered camera with interchangeable lenses






Samsung’s (005930) Galaxy Camera and Nikon’s (NINOY) Coolpix S800c are just the beginning of a swath of Android-powered cameras. Newly leaked images and specs point to Polaroid reviving its camera business with what could be the world’s first Android camera with interchangeable lenses. With no official name yet, the tentatively named IM1836 camera will reportedly feature a 18.1-megapixel sensor, 3.5-inch touchscreen, pop-up flash, Wi-Fi, HDMI and Android 4.0.


[More from BGR: A guide to all the insane predictions made by Google’s new engineering director]






The Galaxy Camera and Coolpix S800c do a fine job taking pictures that are considerably better than what you get from a smartphone, but they still can’t match a mirrorless camera with a good lens. At first glance, Polaroid’s camera looks to be a rebadged Nikon 1 J2, but the resemblance only runs skin deep, as PhotoRumors reports the camera only takes MicroSD cards.


[More from BGR: How not to fix Apple Maps]


Polaroid might not be a major player, but as more companies start incorporating Android into their cameras, there’s going to be a shift in the features consumers expect from them. In the next few years, novelty features such as Wi-Fi, cellular data and photo editing apps will be the norm and we’ll laugh at how we ever lived without them.


This article was originally published by BGR


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Cassadee Pope wins Season 3 of ‘The Voice’






NEW YORK (AP) — Cassadee Pope, who was country singer Blake Shelton‘s protege on the third season of NBC‘s “The Voice,” has won the show’s competition.


The 23-year-old singer is stepping out into a solo career after performing with a band called Hey Monday. Her victory over Scottish native Terry McDermott and long-bearded Nicholas David was announced at the end of a two-hour show Tuesday.






“The Voice” has grown into a hit for NBC and was the key factor in the network’s surprising success this fall.


The show’s status was affirmed by the stream of hitmakers who performed on the finale. They included Rihanna, Bruno Mars, the Killers, Smokey Robinson and Peter Frampton.


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Attackers in Pakistan Kill Anti-Polio Workers


Athar Hussain/Reuters


Relatives of Nasima Bibi, a worker in a polio vaccination drive, at a hospital morgue in Karachi.







ISLAMABAD, Pakistan — Gunmen shot dead five female health workers who were immunizing children against polio on Tuesday, causing the Pakistani government to suspend vaccinations in two cities and dealing a fresh setback to an eradication campaign dogged by Taliban resistance in a country that is one of the disease’s last global strongholds.




“It is a blow, no doubt,” said Shahnaz Wazir Ali, an adviser on polio to Prime Minister Raja Pervez Ashraf. “Never before have female health workers been targeted like this in Pakistan. Clearly there will have to be more and better arrangements for security.”


No group claimed responsibility for the attacks, but most suspicion focused on the Pakistani Taliban, which has previously blocked polio vaccinators and complained that the United States is using the program as a cover for espionage.


The killings were a serious reversal for the multibillion-dollar global polio immunization effort, which over the past quarter century has reduced the number of endemic countries from 120 to just three: Pakistan, Afghanistan and Nigeria.


Nonetheless, United Nations officials insisted that the drive would be revived after a period for investigation and regrouping, as it had been after previous attacks on vaccinators here, in Afghanistan and elsewhere.


Pakistan has made solid gains against polio, with 56 new recorded cases of the diseases in 2012, compared with 192 at the same point last year, according to the government. Worldwide, cases of death and paralysis from polio have been reduced to less than 1,000 last year, from 350,000 worldwide in 1988.


But the campaign here has been deeply shaken by Taliban threats and intimidation, though several officials said Tuesday that they had never seen such a focused and deadly attack before.


Insurgents have long been suspicious of polio vaccinators, seeing them as potential spies. But that greatly intensified after the C.I.A. used a vaccination team headed by a local doctor, Shakil Afridi, to visit Osama bin Laden’s compound in Abbottabad, reportedly in an attempt to obtain DNA proof that the Bin Laden family was there before an American commando raid on it in May 2011.


In North Waziristan, one prominent warlord has banned polio vaccinations until the United States ceases drone strikes in the area.


Most new infections in Pakistan occur in the tribal belt and adjoining Khyber-Pakhtunkhwa Province — some of the most remote areas of the country, and also those with the strongest militant presence. People fleeing fighting in those areas have also spread the disease to Karachi, the country’s largest city, where the disease has been making a worrisome comeback in recent years.


After Tuesday’s attacks, witnesses described violence that was both disciplined and well coordinated. Five attacks occurred within an hour in different Karachi neighborhoods. In several cases, the killers traveled in pairs on motorcycle, opening fire on female health workers as they administered polio drops or moved between houses in crowded neighborhoods.


Of the five victims, three were teenagers, and some had been shot in the head, a senior government official said. Two male health workers were also wounded by gunfire; early reports incorrectly stated that one of them had died, the official said.


In Peshawar, the capital of Khyber-Pakhtunkhwa Province, gunmen opened fire on two sisters participating in the polio vaccination program, killing one of them. It was unclear whether that shooting was directly linked to the Karachi attacks.


In remote parts of the northwest, the Taliban threat is exacerbated by the government’s crumbling writ. In Bannu, on the edge of the tribal belt, one polio worker, Noor Khan, said he quit work on Tuesday once news of the attacks in Karachi and Peshawar filtered in.


“We were told to stop immediately,” he said by phone.


Still, the Pakistani government has engaged considerable political and financial capital in fighting polio. President Asif Ali Zardari and his daughter Aseefa have been at the forefront of immunization drives. With the help of international donors, including the Bill and Melinda Gates Foundation, they have mounted a huge vaccination campaign aimed at up to 35 million children younger than 5, usually in three-day bursts that can involve 225,000 health workers.


The plan seeks to have every child in Pakistan immunized at least four times per year, although in the hardest-hit areas one child could be reached as many as 12 times in a year.


Declan Walsh reported from Islamabad, and Donald G. McNeil Jr. from New York. Salman Masood contributed reporting from Islamabad, and Zia ur-Rehman from Karachi, Pakistan.



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