Showing papers by "Centers for Disease Control and Prevention published in 1975"
TL;DR: Until there are more data bearing on this question, this possible risk of diazepam ingestion in the first trimester of pregnancy should be considered when prescribingdiazepam for women in their reproductive years.
259 citations
TL;DR: The risk of pertussis occurring in adults providing medical care for children should be recognised, and employees with symptoms should be removed from the hospital environment.
164 citations
TL;DR: The significant increases in cases of nosocomial spticmia caused by Klebsiella, Enterobacter, and Serratia in recent years might be attribuatble in part to fluid-related spesis accompanying the expanding use of parenteral therapy.
Abstract: Septicemia caused by contaminated infusion fluid is a newly appreciated hazard of intravenous infusion therapy. Microorganisms of the tribe Klebsielleae (Klebsiella, Enterobacter, and Serratia) have predominated in these infections. Members of this tribe found to possess a selecive ability over common non-Klebsielleae microbial pathogens to proliferate rapidly in commerical parential fluids contaning clucose at room temperautre. Fifty-one Klebsielleae strains, washed twice before inoculation of approximately 1 organism/ml, attained a mean normalized 24 hr concentration of 1.11 x 10-5 organisms/ml in 5% dextrose in water at 25 C. In contrast, 48 of 49 non-Klebsielleae bacterial strains (clinical isolates of Staphylococcus, Proteus, Escherichia coli, Herelea, and Pseudomonas aeruginosa) slowly died (mean 24-hr concentration, 0.2 organism/ml). Five Candida albicans strains frew only very slowly (31.3 organisms/ml). Even with concentrations exceeding 10-6 organisms/ml, microbial presence was never visibly detectable. The significant increases in cases of nosocomial spticmia caused by Klebsiella, Enterobacter, and Serratia in recent years might be attribuatble in part to fluid-related spesis accompanying the expanding use of parenteral therapy.
156 citations
TL;DR: This outbreak and the finding of salmonella of other serotypes in chocolates produced by another manufacturer suggest that chocolate-related salmonellosis may be a significant public-health problem.
145 citations
TL;DR: The black-white lipoprotein fraction differences in Evans County are consistent with a negative, coronary risk factor role of elevated HDL cholesterol, which has been postulated based on other experimental and prevalence studies.
143 citations
TL;DR: Direct patient contact, apart from blood exposure, did not appear operative as a major factor in hepatitis B transmission in this population and occupational categories and work areas with highest risk for acquisition of nosocomial hepatitis B were those with greatest blood exposure.
Abstract: To identify occupational categories and work areas of possible risk for acquisition of nosocomial hepatitis B by hospital personnel, serologic sampling for hepatitis B surface antigen (HBSAg) and antibody (anti-HBS) by radioimmunoassay was carried out in 513 employees of a large metropolitan hospital serving predominantly indigent patients. HBSAg was detected in 0.7%, HBSAg and anti-HBS in 0.4%, and anti-HBS in 13.3% of the study population. No significant difference in seropositivity was noted between sexes. Furthermore, neither exposure to patients with hapatitis nor previous blood transfusion correlated with serologic evidence of hepatitis B infection. However, frequency and intensity of exposure to blood products was associated with serologic evidence of infection: 18.9% of those with frequent blood contact were positive for HBSAg or anti-HBS, compared with 11.4% of those without blood product exposure (p less than .05). Direct patient contact, apart from blood exposure, did not appear operative as a major factor in hepatitis B transmission in this population. Accordingly, occupational categories and work areas with highest risk for acquisition of nosocomial hepatitis B were those with greatest blood exposure.
129 citations
TL;DR: The increased risk of hepatitis among dentists, however, may be related to the omission of adequate prophylatic measures, particularly when treating high-risk patients such as drug abusers.
Abstract: To characterize some epidemiologic characteristics of viral hepatitis among dentists, information was obtained with a mailed questionnaire from 434 dentists and 787 attorneys in Dade County, Florida. Dentists had a significantly higher incidence of hepatitis than did lawyers, 6.7% vs 2.4%, with the highest rate among oral surgeons (21%). The incidence of hepatitis B antigenemia among asymptomatic dentists was not significantly higher than that of volunteer blood donors. Twenty-two percent of dentists with hepatitis reported treating more than ten drug addicts per year, as compared with 10% of those dentists without hepatitis. No differences were noted between dentists with and without hepatitis in methods of sterilization, the wearing of gloves during procedures, or the use of disposable needles. The increased risk of hepatitis among dentists, however, may be related to the omission of adequate prophylactic measures, particularly when treating high-risk patients such as drug abusers. (JAMA232:1228-1230, 1975)
129 citations
TL;DR: These arm circumference to height categories and the QUAC stick survey technique for which they were devised appear to be valid tools for identifying nutritionally disadvantaged individuals and populations at high risk of death.
128 citations
Journal Article•
TL;DR: The pattern of infection and virus shedding in M. natalensis is ideal for maintenance of the virus in nature; together with the epidemiological field data this emphasizes the incidental nature of the exposure and infection of man.
Abstract: Experimental Lassa virus infections of squirrel monkeys, guinea-pigs, and the African multimammate rat, Mastomys natalensis, were studied virologically and pathologically. In the monkeys, early viral lymphoreticulotropism, hepatotropism, nephrotropism, and viraemia were noted. At the time of death, viral titres in nearly all target organs were associated with necrotic changes: splenic lymphoid necrosis, renal tubular necrosis, myocarditis, arteritis, and hepatocytic regeneration. In convalescent monkeys, organ titres diminished slowly, and viraemia persisted at 28 days. At this time, renal and splenic regeneration was occurring and a new lesion, choriomeningitis, was present.Guinea-pigs infected with Lassa virus developed respiratory insufficiency with pulmonary oedema, alveolar hyaline membranes, myocarditis, and focal calcification of myocardial fibres and hepatocytes. Dying animals contained Lassa virus in virtually every organ tested, whereas survivors at 56 days were free of virus and had high complement-fixing antibody titres.Infection of neonatal Mastomys did not cause any clinical disease or pathological lesions despite the presence of virus in the blood, lymph nodes, liver, spleen, lung, brain, urine, and throat secretions throughout the 74-day study. Infected adult Mastomys also remained normal but had virus in many organs. In one animal, virus persisted until the termination of the study at 103 days. Several animals developed a mild meningoencephalitis. The pattern of infection and virus shedding in M. natalensis is ideal for maintenance of the virus in nature; together with the epidemiological field data this emphasizes the incidental nature of the exposure and infection of man.
121 citations
TL;DR: This occurrence of venereal transmission is the first report of person-to-person spread of P. pseudomallei infection in American citizens, and a Vietnam veteran from Mississippi developing chronic prostatitis during service in Vietnam was isolated from prostatic secretions.
Abstract: Melioidosis, the clinical manifestation of infection with Pseudomonas pseudomallei, has occurred infrequently in American citizens; almost all reported cases have been in Vietnam veterans, usually associated with respiratory disease. A Vietnam veteran from Mississippi developed chronic prostatitis, with no other clinical manifestations, during service in Vietnam, and P. pseudomallei was isolated from prostatic secretions 2 years after his return to the United States. The patient had had sexual contact with four women including his wife since his return from Vietnam. Vaginal and cervical cultures and serum samples were obtained from the four women, and serum samples and cultures of semen were obtained from the patient. Vaginal swabs and semen cultures were negative for P. pseudomallei. The patient and his wife had hemagglutination titers (greater than 640) diagnostic of P. pseudominallei infection. This occurrence of venereal transmission is the first report of person-to-person spread of P. pseudomallei infection.
113 citations
TL;DR: The results obtained with this assay system were compared to those obtained by the standardized Bauer-Kirby disk diffusion test, and each of these two methods was compared to the agar dilution technique as discussed by the authors.
Abstract: Seven laboratories participated in a collaborative study to evaluate the Autobac 1 system. Results obtained with this assay system were compared to those obtained by the standardized Bauer-Kirby disk diffusion test, and each of these two methods was compared to the agar dilution technique. Comparison of the Autobac 1 and the disk diffusion results from the seven laboratories showed an overall average of 91.5% interpretive agreement with the 17 antimicrobial agents tested. The distribution in the levels of Autobac 1/disk diffusion agreement was such that with 13 antimicrobial drugs agreement was 90% or higher; with three, between 85 and 90%; and with one, 77% (nitrofurantoin). Comparison of the Autobac 1 and disk diffusion tests with the International Collaborative Study agar dilution test showed that both methods gave levels of agreement with the International Collaborative Study agar dilution technique that were generally high and equivalent. The average overall agreement between the agar dilution test and each of the other two methods was approximately 90%. Disagreements that did occur tended to involve organisms that were drug susceptible by the Autobac 1 system but intermediate or resistant by the other two methods. This was in part due to the narrow intermediate interpretive zone of the Autobac 1 test. In reproducibility studies with the Autobac 1 and disk diffusion methods, no significant differences were observed between the interpretive reproducibility of the two methods. Images
TL;DR: Five patients who developed acute watery diarrhoea while travelling in Mexico in October, 1974, were found to have enterotoxigenic Escherichia coli in their stool which produced heat-stable enterotoxin (S.T.) without producing heat-labile enterot toxin (L.T.).
TL;DR: Susceptibility tests on Pseudomonas species probably should be done with Muller-Hinton broth supplemented with physiological concentrations of calcium and magnesium to better approximate the in vivo activity of these antibiotics.
Abstract: The effect of calcium and magnesium on the susceptibility of 13 species of Pseudomonas to tetracycline, gentamicin, polymyxin B, and carbenicillin was measured. The majority of the minimum inhibitory concentrations (MICs) of these antibiotics was increased if these cations were added to the test media. The increases in MICs caused by calcium or magnesium were similar, but the combination of both ions generally caused a greater change than either alone. Although the MIC of polymyxin B was most affected by calcium and magnesium, its interpretive susceptibilities (i.e., whether susceptible or resistant) were least changed. Susceptibility tests on Pseudomonas species probably should be done with Muller-Hinton broth supplemented with physiological concentrations of calcium and magnesium to better approximate the in vivo activity of these antibiotics. When the susceptibility tests were performed with Mueller-Hinton agar, the MICs were slightly less than those obtained with Mueller-Hinton broth supplemented with both cations but greater than those obtained with Mueller-Hinton broth supplemented with individual cations.
TL;DR: Minimal inhibitory concentrations for selected antibiotics were determined, under these conditions, by using a conventional twofold dilution scheme for the antibiotics and a “categorization three-tube method” in which two or three clinically significant concentrations of each antibiotic were used.
Abstract: A broth-dilution method for performing antimicrobial susceptibility tests on anaerobic bacteria has been proposed. The medium used in the test was Schaedler broth, with incubation in a glove box with an atmosphere of 5% CO(2), 10% H(2), and 85% N(2), or in the GasPak system. Minimal inhibitory concentrations for selected antibiotics were determined, under these conditions, by using a conventional twofold dilution scheme for the antibiotics and a "categorization three-tube method" in which two or three clinically significant concentrations of each antibiotic were used. Minimal inhibitory concentrations obtained by both methods were very similar. The categorization method could be used routinely to test the antimicrobial susceptibility of anaerobic bacteria.
TL;DR: The pathologic effects and chemical identification of tetrachlorodibenzodioxin are described and exposure was related to the spraying of contaminated waste oil on riding arenas for dust control.
Abstract: Tetrachlorodibenzodioxin was identified as the apparent cause of an outbreak of poisoning in humans, horses, and other animals. Exposure was related to the spraying of contaminated waste oil on riding arenas for dust control. The contamination resulted from improper disposal of a toxic industrial waste. The pathologic effects and chemical identification of tetrachlorodibenzodioxin are described.
TL;DR: The cellular fatty acid compositions of strains of Pseudomonas aeruginosa, P. cepacia, and P. maltophilia were determined by gas-liquid chromatography and a variety of acids was detected, including branched and straight-chain acids, cyclopropane, and hydroxy acids.
TL;DR: It is suggested that exposure to VCM in industrial settings can produce hepatic fibrosis with angiosarcoma as a late manifestation and conventional liver function tests may not be sensitive indicators of such liver impairment, at least in its early stages.
Abstract: A total of 13 cases of ASL have been documented to date among VC workers in four different plants in the United States. In this particular industrial population, this number of cases represents at least a 400-fold increase over expected incidence for this extremely rare tumor. The first case occurred in 1961. Average age at diagnosis is 48.2 years. Average length of time between initial VC work and diagnosis has been 20.3 years. A detailed review of 7 cases associated with one plant revealed that clinical features varied from little or no overt illness prior to diagnosis to advanced liver disease with portal hypertension and marked splenomegaly. Portal fibrosis was present in all 7 of these ASL cases as well as in 4 additional cases with non-malignant liver disease among VC workers at the same plant. These findings suggest that exposure to VCM in industrial settings can produce hepatic fibrosis with angiosarcoma as a late manifestation. Conventional liver function tests may not be sensitive indicators of such liver impairment, at least in its early stages.
TL;DR: A tendency toward greater environmental contamination by cutaneous diphtheria than by respiratory diptheria might be related to the greater contagiousness cases.
Abstract: Twenty-four people with diptheria and 48 carriers were found in an isolated, circumscribed, rural area during a one-month period. Four patients had cutaneous lesions, which were similar to those of typical impetigo, form which Corynebacterium diptheriae was isolated. These cases constituted an epidemiologic focus from which the other cases were infected. Ten of 52 classroom contacts of two patients with skin infections harbored C. diphtheriae in the pharynx, while only eight of 132 classroom contacts of eight respiratory cases were similarly infected. Respiratory carriage of C. diphtheriae in five of 12 Head start classroom contacts of another patient with cutaneous infection with C. diptheriae in the classroom situation. A tendency toward greater environmental contamination by cutaneous diphtheria than by respiratory diptheria might be related to the greater contagiousness cases.
TL;DR: The results of this investigation give additional support to the concept that nosocomial transmission of group B streptococci can occur and may be effectively interrupted by control measures in the nursery.
TL;DR: These findings represent the first reported recovery of the presumed etiologic agent of hepatitis A from a naturally occurring community outbreak of disease in the United States.
Abstract: During investigation of a food-borne outbreak of hepatitis A among university students in a southwestern metropolitan community, immune electron microscopic examination of a concentrated stool suspension pooled from seven acutely ill individuals revealed viruslike particles 17-nm in diameter. These particles were initially coated by antibody contained in the convalescent-phase serum of one of the ill students as well ad by antibody in convalescent plasma of a prison volunteer originally infected with the MS-1 strain of hepatitis A virus. Rises in titer of antibody to this particle were demonstrated by immune electron microscopy in acute and convalescent sera from student patients as well as in pre-inoculation and convalescent sera from the prison volunteer. Two chimpanzees inoculated intravenously with the concentrated preparation of pooled human stools developed viral hepatitis. During acute illness their feces contained particles morphologically identical to those in the inoculum. These findings represent the first reported recovery of the presumed etiologic agent of hepatitis A from a naturally occurring community outbreak of disease in the United States.
TL;DR: During the fall and winter of 1973, 145 cases of epidemic keratoconjunctivitis were diagnosed in Nashville, Tennessee, and regardless of etiology, the secondary attack rate in households was significantly higher among the contacts of those patients who had severe disease for greater than 28 days than among the contact of Patients who had milder disease of shorter duration.
Abstract: During the fall and winter of 1973, 145 cases of epidemic keratoconjunctivitis were diagnosed in Nashville, Tennessee. Of the 74 cases studied virologically and/or serologically, 62% were caused by adenovirus type 8, and 28% were caused by adenovirus 19. Whereas adenovirus type 8 was isolated only from conjunctival scrapings, adenovirus type 19 was isolated from nose and throat swabs as well as from conjunctivae. The two viruses produced clinically indistinguishable eye disease and household secondary attack rates that were not statistically different. Regardless of etiology, the secondary attack rate in households was significantly higher among the contacts of those patients who had severe disease for greater than 28 days than among the contacts of patients who had milder disease of shorter duration.
TL;DR: A new antigen/antibody system, "e" and anti-e, was described in 1972 and their presence was correlated with the clinical status, S.P.G.T. levels and liver biopsies of HBsAg carriers.
TL;DR: An epidemic of Coxsackie B4 virus infection in an isolated group of islands in the Bering Sea in 1967 provided an opportunity to test the suggestion that infection with this virus might be associated with an increased incidence of diabetes.
TL;DR: Improved surveillance of shigellosis in day-care centres will be an aid in efforts toward controlling this increasingly important public-health problem.
TL;DR: The surface of the particle was found to be composed of 32 large morphological units or capsomeres, which conforms to a T = 3 morphology similar to that described for viruses of the orbivirus group.
TL;DR: This outbreak re-emphasises that people with infected lesion should not handle food and that foods must be stored at temperatures low enough to inhibit the growth of bacteria.
TL;DR: The data suggest that there may be more than one mechanism of CMV transmission and that venereal or intimate salivary contact may be a significant mode of spread in adults.
Abstract: A seroepidemiologic study of prevalence of antibody to cytomegalovirus (CMV) was simultaneously done in four populations: group I, nuns working as nurses or school teachers; group II, women admitted to a upper socioeconomic private hospital; group III, women admitted to a lower socioeconomic county hospital, and group and IV women attending a veneral disease clinic. Groups II, III and IV, were not statistically different and showed an abrupt rise in antibody prevalence during your adulthood. Group I, however, did not show the expected abrupt rise in antibody prevalence during young adulthood, and the prevalence in this group was singificantly lower than that in the other three groups at all but the oldest age range. These differences could not be accounted for by race, socioeconomic status or respiratory exposure to CMV. The data suggest that there may be more than one mechanism of CMV transmission and that venereal or intimate salivary contact may be a significant mode of spread in adults.
TL;DR: The results showed that even a harsh environment such as that found on top of Stone Mountain may serve as an ecological niche for the survival and transmission of salmonellae.
Abstract: The incidence of salmonellae in contrasting environments was compared in this study. Samples collected from or near surface waters in a lush hardwood forest yielded four salmonellae serotypes from six culturally positive samples. A total of 76 samples collected from the top of a granite outcropping over a 3-month period yielded 10 positive samples. Only two salmonellae serotypes were isolated, and one of these was isolated only once. The nature of the sample material had no significant effect on the detection of salmonellae from the two sampling sites. However, the presence or absence of visible moisture in the sample significantly affected the recovery of salmonellae. The results showed that even a harsh environment such as that found on top of Stone Mountain may serve as an ecological niche for the survival and transmission of salmonellae.
TL;DR: Until the safety of minocycline can be reestablished, rifampin is recommended for meningococcal disease prophylaxis, and alternative drugs are encouraged for other indications.
Abstract: Several recent reports have indicated that minocycline, a drug effective for meningococcal disease prophylaxis, is associated with a high incidence of vestibular side effects. In January 1975, a questionnaire on adverse reactions was completed by all 29 staff members of a North Georgia hospital who had taken minocycline at the recommended dosage after exposure to a suspected meningococcal meningitis case and by 25 age-, sex-, and occupation-matched non-treated controls. In the treated group 86% experienced moderate to severe vestibular symptoms; 84% of the symptomatic persons experienced their onset after one or two doses of 100 mg. Fifty-two percent of the treated staff members stopped taking the medication because of these effects. The symptoms resolved within 48 h after affected persons discontinued the medication. Until the safety of minocycline can be reestablished, rifampin is recommended for meningococcal disease prophylaxis, and alternative drugs are encouraged for other indications.
TL;DR: The hypothesis that well-defined ts lesions can be utilized as specific markers of attenuation which can be transferred to new, potentially epidemic, antigenic variants of influenza A virus is supported.