Showing papers by "Centers for Disease Control and Prevention published in 1977"
TL;DR: "Lynne arthritis" is thought to be a previously unrecognized clinical entity, the epidemiology of which suggests transmission by an arthropod vector.
Abstract: An epidemic form of arthritis has been occurring in eastern Connecticut at least since 1972, with the peak incidence of new cases in the summer and early fall. Its identification has been possible because of tight geographic clustering in some areas, and because of a characteristic preceding skin lesion in some patients. The authors studied 51 residents of three contiguous Connecticut communities -- 39 children and 12 adults -- who developed an illness characterized by recurrent attacks of asymmetric swelling and pain in a few large joints, especially the knee. Attacks were usually short (median: 1 week) with much longer intervening periods of complete remission (median: 2.5 months), but some attacks lasted for months. To date the typical patient has had three recurrences, but 16 patients have had none. A median of 4 weeks (range: 1-24) before the onset of arthritis, 13 patients (25%) noted an erythematous papule that developed into an expanding, red, annular lesion, as much as 50 cm in diameter. Only 2 of 159 family members of patients had such a lesion and did not develop arthritis (P less than 0.000001). The overalll prevalence of the arthritis was 4.3 cases per 1,000 residents, but the prevalence among children living on four roads was 1 in 10. Six families had more than 1 affected member. Nine of 20 symptomatic patients had low serum C3 levels, compared to none of 31 asymptomatic patients (P less than 0.005); no patient had iridocyclitis or a positive test for antinuclear antibodies. Neither cultures of synovium and synovial fluid nor serologic tests were positive for agents known to cause arthritis. "Lynne arthritis" is thought to be a previously unrecognized clinical entity, the epidemiology of which suggests transmission by an arthropod vector.
1,150 citations
302 citations
TL;DR: Investigation revealed overlapping epidemics of shigellosis and giardiasis, with 54% of the children infected with Giardia lamblia in a day-care center, and fecal-oral transmission of the parasite from child to child in the centers and from infected children to other family members.
Abstract: In August and September 1975, an outbreak of diarrhea occurred in children 1 to 3 1/2 years old attending a day-care center. An investigation revealed overlapping epidemics of shigellosis and giardiasis, with 54% of the children infected with Giardia lamblia. At two other centers 29% and 38% of the children had G. lamblia infection, but none had Shigella. The prevalence of G. lamblia in the day-care children was significantly higher than the 2% prevalence in age-matched children not in day-care centers. Epidemiologic data suggested fecal-oral transmission of the parasite from child to child in the centers and from infected children to other family members.
156 citations
TL;DR: For men aged 50–69 triglyceride levels were higher in Puerto Rico than in Albany or Framingham, despite much lower levels of serum cholesterol, and the 95th percentile for triglyceride varied greatly by age and population.
150 citations
TL;DR: This investigation suggests the relative insensitivity of current methods for identifying persons infected with E. coli by the culturing of randomly selected isolates or by measuring serologic responses, and documents one mode of transmission of this pathogen.
Abstract: In June and July 1975, Gastrointestinal illness occurred in more than 200 staff members and 2000 visitors to an American national park. In was characterized by prolonged diarrhea, cramps, nausea, and vomiting, lasted a median duration of 8 days, and was significantly associated with consumption of park water (P less than 0.001), which had been contaminated by raw sewage. Enterotoxigenic Escherichia coli serotype 06:K15:H16 was isolated from 20 of 49 ill park residents and from the park's water supply, but not from 71 residents who had never been ill or had been well for at least 4 days. No other bacterial, viral, or parasitic pathogens were isolated from ill or well persons. This outbreak is the first waterborne epidemic of diarrheal illness shown to be due to enterotoxigenic. E. coli, and this study documents one mode of transmission of this pathogen. This investigation also suggests the relative insensitivity of current methods for identifying persons infected with this organism, either by the culturing of randomly selected isolates or by measuring serologic responses.
138 citations
TL;DR: An epidemic of acute febrile respiratory disease occurred among persons who had been in Philadelphia during July and August, 1976, and patients were divided into two groups: those who attended the Penn...
Abstract: AN epidemic of acute febrile respiratory disease occurred among persons who had been in Philadelphia during July and August, 1976. Patients were divided into two groups: those who attended the Penn...
136 citations
TL;DR: Children may be exposed through various mechanisms to toxins of industrial origin throughamination of the home environment by soiled work clothing, which has an important mechanism of such exposure and has b...
Abstract: Children may be exposed through various mechanisms to toxins of industrial origin. Contamination of the home environment by soiled work clothing is an important mechanism of such exposure and has b...
125 citations
TL;DR: Because live measles vaccine is highly effective in preventing measles illness and a high proportion of children in the United States have received measles vaccine, these data are consistent with the observed downward trend in SSPE incidence since 1969.
Abstract: Histories obtained in 350 of 375 clinically cofirmed cases of subacute sclerosing panencephalitis (SSPE) reported to a national registry showed that 292 patients had measles and 58 had no history of measles Forty of the latter patients received live, attenuated measles virus vaccine In patients with a history of measles, measles illness occurred before age 2 years in 46%, and a mean of 70 years before onset of SSPE In contrast, there was no relationship of SSPE with age at vaccination in 35 of the 40 patients historically associated with measles vaccine, and SSPE occurred a mean of 33 years after vaccination Based on estimated national measles morbidity data and national measles vaccine distribution data, the risk of SSPE following measles vaccination (05 to 11 cases/106) appears to be less than the risk following measles (52 to 97 cases/106) Because live measles vaccine is highly effective in preventing measles illness and a high proportion of children in the United States have received measles vaccine, these data are consistent with the observed downward trend in SSPE incidence since 1969
124 citations
TL;DR: A historical and world-wide review of medical and engineering literature discloses that typhoid fever, infectious hepatitis, fascioliasis, and cholera are the diseases that are most frequently transmitted by foods contaminated by sewage or irrigation water in agricultural or aquacultural practices.
122 citations
TL;DR: Nineteen (11%) of 181 nosocomial epidemics investigated by the Center for Disease Control during 1956-75 were actually false outbreaks, and errors in specimen processing, surveillance artefacts, or clinical misdiagnosis had resulted in real clusters of false infections or artefactual clusters of real infections.
102 citations
TL;DR: Since their recognition early in 1976, penicillinase (beta-lactamase)-producing Neisseria gonorrhoeae (P.P.N.G.) have been isolated in more than 15 countries, and most strains isolated in or epidemiologically linked with the Far East are relatively resistant to tetracycline in vitro, are phenotypically wild-type or proline-dependent auxotypes, and carry a plasmid with a molecular weight with a
TL;DR: Levels of arsenic, lead, and cadmium absorption levels were determined in 1774 children 1-5 years old living in 19 USA towns with primary nonferrous metal smelters and compared with data on 258 children of the same age in three communities without Smelters.
Abstract: Arsenic, lead, and cadmium absorption levels were determined in 1774 children 1-5 years old living in 19 USA towns with primary nonferrous metal smelters. Results were compared with data on 258 children of the same age in three communities without smelters. Increased systemic absorption of arsenic, as reflected by urine arsenic content, was noted in children near 10 of 11 copper smelters. Blood lead levels were also modestly elevated near two copper smelters. Near lead and zinc smelters, elevated levels of lead and cadmium in hair provided evidence of external exposure to these elements. Levels of lead in blood were not, however, elevated near any of three lead smelters and were elevated near only two of five zinc smelters. Blood cadmium levels were high near one lead and two zinc smelters. The apparent sources of exposure (except in one community with elevated levels of arsenic in drinking water) were air, soil, and dust contaminated by smelting operations. While the full biologic significance of these findings is not known exposure of children to toxic heavy metals emitted by smelters should be reduced to a minimum.
TL;DR: In Portugal, a cholera epidemic caused by Vibrio cholerae El Tor Inaba with 2467 bacteriologically confirmed hospitalized cases and 48 deaths was reported in 1974 as discussed by the authors.
Abstract: In April-November 1974, Portugal had a cholera epidemic caused by Vibrio cholerae El Tor Inaba with 2467 bacteriologically confirmed hospitalized cases and 48 deaths. Most of the country was affected, with 17 of the 18 districts reporting cases. V. cholerae was isolated from 42 per cent of shellfish tested during the epidemic, and an epidemiologic study found that a history of consumption of raw or poorly cooked cockles was significantly more common among cholera patients than among paired controls. Water from a spring and a brand of commercially bottled water were also found to be vehicles of transmission of cholera. Although night soil was sometimes used on gardens, consumption of raw fruits and vegetables was not associated with illness.
TL;DR: In an attempt to standardize the procedure for the enzyme-linked immunospecific assay, several parameters were examined and it was determined that horseradish peroxidase was the enzyme of choice and that several brands of polystyrene tubes and plates could be used.
Abstract: In an attempt to standardize the procedure for the enzyme-linked immunospecific assay, several parameters were examined. It was determined that horseradish peroxidase was the enzyme of choice and that several brands of polystyrene tubes and plates could be used. The test was considerably shortened by omitting long incubation steps previously used for eliminating background fixation of conjugate. The reproducibility of the procedure proved to be excellent, but reactivity curves indicated that use of a single dilution is not adequate for quantitative tests. A "standard" procedure was proposed.
TL;DR: Investigation of a poisoning outbreak that involved three riding areas and killed fifty-seven horses, five colts, and numerous other animals found the most prominent lesion was a centrilobular fibrosis of the liver that arose in the wall of the central veins resembled the chronic form of veno-occlusive disease of the Liver in humans.
Abstract: We describe epidemiological and laboratory investigation of a poisoning outbreak that involved three riding arenas and killed fiftyseven horses, five colts, and numerous other animals. The outbreak was traced to the spraying of the arenas with salvage oil contaminated with tetrachlorodibenzodioxin, trichlorophenol, and polychlorinated biphenyls. The contamination of the salvage oil resulted from the improper disposal of toxic industrial waste. In the tissues of the horses available for study, the most prominent lesion was a centrilobular fibrosis of the liver that arose in the wall of the central veins. This lesion resembled the chronic form of veno-occlusive disease of the liver in humans.
TL;DR: The demonstration of a familial sex-linked gammaglobulin deficiency and the failure to document a defect in cell-mediated immunity in this child extends the risk of vaccine associated poliomyelitis to virtually all forms of immunodeficiency.
TL;DR: During a cholera epidemic, Vibrio cholerae was isolated from two springs which supplied mineral water to a spa and to a commercial water bottling plant and found that cholERA attack rates were 10-fold greater among visitors to the spa than among non-visitors.
Abstract: During a cholera epidemic, Vibrio cholerae was isolated from two springs which supplied mineral water to a spa and to a commercial water bottling plant. Epidemiologic investigation found that cholera attack rates were 10-fold greater among visitors to the spa than among non-visitors. A subsequent matched-pair case-control study which excluded persons who had visted the spa showed that a history of consumption of the bottled non-carbonated water was significantly more common among bacteriologically confirmed cholera cases than among paired controls.
TL;DR: The scope of this review is limited to the basic biochemical constituency of the bunyaviruses and the structure-function relationships of their proteins and nucleic acids.
Abstract: Introduction. The scope of this review is limited to the basic biochemical constituency of the bunyaviruses and the structure-function relationships of their proteins and nucleic acids. The complex antigenic relationships among bunyaviruses have been reviewed elsewhere (Casals, 1971; Murphy, Harrison & Whitfield, 1973; Murphy, 1975; Porterfield et al. 1973/4, 1975/6), and extensive ecological and epidemiological information can be found in several other timely reviews (Proceedings of the Symposium on Arboviruses of the California Complex and the Bunyamwera Groups, 1969; Henderson & Coleman, 1970; Sudia et al. 1971; Parkin, Hammon & Sather, 1972; Berge, 1975).
The family Bunyaviridae is a newly defined taxonomic group of arboviruses which contain lipid envelopes and segmented RNA genomes. Previously, about 90 viruses had been assigned to 11 serogroups, and these were brought together on the basis of distant serological cross-reactions to form the Bunyamwera serological supergroup.
TL;DR: Early attempts to control the diarrhea at home and in the outpatient department by the use of oral fluid rehydration, isolation of patients with severe symptoms requiring hospitalization, and strict attention by hospital personnel to hand washing between examination of patients may limit nosocomial spread of the disease.
TL;DR: It is recommended to use the live antigen for routine serological typing in clinical microbiology laboratories for "in house" epidemiology and reserving the heated antigen for reference and research typing (and for those few cases where results cannot be obtained using theLive antigen).
Abstract: A practical slide agglutination test, with commercial antisera (Difco) and live antigens (antigens of live bacteria) taken directly from 24-h antimicrobial susceptibility plates, has been established for serotyping Pseudomonas aeruginosa. Until recently, the lack of both a standard antigenic scheme and a source of commercial antisera has made serological typing of this organism impractical. A simplified procedure with 17 unabsorbed antisera and live antigens prepared from materials readily available in most clinical microbiology laboratories makes epidemiological typing of this organism possible in hospital laboratories. The distribution of each serotype examined in this study was determined by using 425 consecutive patient isolates from six different hospitals. The distribution of O antigen groups (live antigen) was as follows: O1, 11.5%; O2, 1.6%; O3, 3.8%; O4, 7.8%; O5, 4.2% O6, 27.1%; O7,8, 5.9%; O9, 6.8%; O10, 2.4%; O11, 8.2%; O12 through O17, each less than 1%. Ten and six-tenths percent of the above agglutinated in two antisera, 3.3% agglutinated in more than two antisera, and 5.2% did not agglutinate in any antisera. A comparison of live and heated antigens shows that 93.2% were typable with the live antigen, and 94.5% were typable with the heated antigen. When both antigens were used, we typed 96.3% of 725 isolates. The reproductibility and specificity of the serological procedure were examined. We recommend using the live antigen for routine serological typing in clinical microbiology laboratories for "in house" epidemiology and reserving the heated antigen for reference and research typing (and for those few cases where results cannot be obtained using the live antigen). The application of serotyping in the study of outbreaks of P. aeruginosa is also presented.
TL;DR: Acanthamoeba culbertsoni was isolated from a sewage-spoil dump site near Ambrose Light, New York Bight and a second species, AcanthamoebA hatchetti, n.
Abstract: Acanthamoeba culbertsoni was isolated from a sewage-spoil dump site near Ambrose Light, New York Bight. A second species, Acanthamoeba hatchetti, n. sp., was isolated from Brewerton Channel, Baltimore Harbor, Maryland. Both species killed laboratory mice after infection by the intranasal route.
TL;DR: This outbreak, the largest yet identified in North America, extends the known range of a principal vector and establishes the North Rim as an endemic source of tick-borne relapsing fever.
Abstract: During the 1973 summer season, 27 employees and 35 overnight guests at the North Rim, Grand Canyon National Park, Arizona, acquired febrile illnesses compatibel with relapsing fever. Sixteen cases were confirmed by finding Borrelia spirochetes in peripheral blood smears or inoculated Swiss mice. Retrospective surveys of 278 employees and 7247 guests at the park revealed that acquisition of illness was significantly associated with the persons sleeping in rustic log cabins and acquiring bites of "unknown" insects. From rodent nesting materials found in the walls and attics of cabins where cases had occurred, infective Ornithodoros hermsi ticks were recovered. Exceptional activity of ticks in human populations appeared to have resulted from a decreased population of the ticks' usual rodent hosts. Vector control activities consisted of spraying the cabins with residual insecticide, removing nesting materials, and "rodent proofing." This outbreak, the largest yet identified in North America, extends the known range of a principal vector and establishes the North Rim as an endemic source of tick-borne relapsing fever.
TL;DR: Comparisons of the epidemiologic and demographic characteristics, the hospital course, the outcome, and the laboratory abnormalities of the clinically diagnosed and the pathologically confirmed cases revealed no significant differences.
Abstract: Between December 15, 1973, and June 30, 1974, a total of 379 cases of Reye9s syndrome was reported to the Center for Disease Control. One hundred forty-seven (40%) were confirmed by either autopsy or biopsy, while 232 were diagnosed by clinical and laboratory parameters. Comparisons of the epidemiologic and demographic characteristics, the hospital course, the outcome, and the laboratory abnormalities of the clinically diagnosed and the pathologically confirmed cases revealed no significant differences. In the epidemiologic setting of influenza B outbreaks, children who have the acute onset of noninflammatory encephalopathy associated with elevated serum transaminase levels, hypoprothrombinemia, and elevated blood ammonia levels should be considered to have Reye9s syndrome. Further evaluation of diagnostic criteria is needed, however, for sporadically occurring, nonepidemic cases of noninflammatory encephalopathy associated with hepatic dysfunction.
TL;DR: The minimal inhibitory concentrations of cefuroxime against the Enterobacteriaceae were consistently lower than those of cephalothin, but Pseudomonas species and enterococci were resistant to high concentrations of both drugs.
Abstract: Cefuroxime, a new parenteral cephalosporin was compared with cephalothin by broth microdilution susceptibility testing against 5,887 routine clinical bacterial isolates in four large clinical laboratories. The minimal inhibitory concentrations (MICs) of cefuroxime against the Enterobacteriaceae were consistently lower than those of cephalothin. This was most striking among the Enterobacter species, which were generally susceptible to cefuroxime (MIC ≤ 8 μg/ml), but resistant to cephalothin. Similar results occurred with Haemophilus species, Acinetobacter anitratus, meningococci, and Aeromonas hydrophilia, but Pseudomonas species and enterococci were resistant to high concentrations of both drugs. Streptococci showed slightly greater susceptibility to cefuroxime than to cephalothin. By contrast, staphylococci were more susceptible to cephalothin. Bacteroides fragilis was resistant to cefuroxime, but other anaerobes were generally susceptible.
TL;DR: In this paper, the authors compared 13 recombinant influenza A clones derived at 25°C from the A/AA/6/60-cold variant (by crosses with 4 different wild type strains) were compared with a set of 5-FU inducedts-mutants.
Abstract: The genetic and biological properties of 13 recombinant influenza A clones derived at 25°C from the A/AA/6/60-cold variant (by crosses with 4 different wild type strains) were compared with a set of 5-FU inducedts-mutants. The 5-FU mutants had previously been placed into 7 complementation-recombination groups; the A/AA/6/60-cold parent (PI-7) and the 12 cold recombinant clones which werets were shown to share a lesion with only one of these groups. The parental strain and 5 recombinant clones were evaluated for replication in the lungs and nasal turbinates of hamsters. Each virus appeared to be attenuated; genetic stability correlated with the level of viral replication in the hamster lung, i.e., viruses which grew best showed a tendency to revert to thets+ phenotype. Characterization of thets+ revertants for the presence of the cold adaptation property revealed that these viruses exhibited a spectrum of cold adaptation properties. Two viruses, PI-7 (the parental cold variant) and the CR6 recombinant (A/Queensland/6/72) did not revert in either the lungs or nasal turbinates of hamsters.
TL;DR: The results strongly support the likelihood that an influenza-infected pig was the initial source of virus containing the hemagglutinin genes present in the viruses ultimately isolated from recruits infected at Fort Dix, New Jersey in 1976.
TL;DR: A 27-year-old farmer in the Oklahoma panhandle was pinned under his overturned tractor for 2 hr and received superficial and deep lacerations and contracted an infection of a pelvic wound with an organism that had cultural and biochemical characteristics identical to those of Pseudomonas pseudomallei.
Abstract: A 27-year-old farmer in the Oklahoma panhandle was pinned under his overturned tractor for 2 hr and received superficial and deep lacerations. He contracted an infection of a pelvic wound with an organism that had cultural and biochemical characteristics identical to those of Pseudomonas pseudomallei. Identical organisms were recovered from soil taken from the site of the accident. The organism isolated from the wound proved to be less virulent in guinea pigs than usual laboratory strains of P. pseudomallei; fatty acid analysis showed a distinctly different pattern from that of laboratory strains of P. pseudomallei. The infecting organism may be a variant of P. pseudomallei or a new species of Pseudomonas.
TL;DR: Three hundred sixty-three patients representing two groups of consecutive medical admissions to a large city hospital were evaluated on admission to determine what factors might predict "non-medical" or social stay.
Abstract: Three hundred sixty-three patients representing two groups of consecutive medical admissions to a large city hospital were evaluated on admission to determine what factors might predict "non-medical" or social stay. Periodic follow-up determined when patients were ready for discharge and when their social stay began. A composite index, the 4-Score, was derived as a simple indicator of risk for subsequent social stay; it is defined as the number of positive answers to the questions: 1) Is the patient 80 years old or more? 2) Will the patient have to live somewhere new at discharge? 3) Is there any disorientation? AND 4) If so, is the disorientation chronic? Eighteen per cent of the total inpatient hospital days of this group of patients could be attributed to social stay. The 56 patients with a 4-Score of two or more on admission had on average a week each of social stay while the 307 patients with a score of less than two averaged only one social day each.
TL;DR: The apparent frequency of human infections and the declining levels of antibodies to swine influenza virus in the human population suggest that influenza viruses of swine may be a potential sources of epidemic disease for humans.
Abstract: Influenza in swine was first recognized as an epizootic disease in 1918. During that same year influenza virus in humans caused the worst pandemic on record. The virus of swine influenza was isolated in 1930. Swine influenza virus was first isolated from humans in 1974. Since then, including the cases at Fort Dix, there have been a total of nine viral isolations from humans in the United States. Serologic evidence of infections with swine influenza virus in humans has also been obtained. Evidence for transmission of swine influenza virus to humans before 1974 is minimal and circumstantial. Recent recognition of infections with swine influenza virus may be the result of better surveillance, increased numbers of susceptible humans, or increased viral infectivity for humans. Nevertheless, the apparent frequency of human infections and the declining levels of antibodies to swine influenza virus in the human population suggest that influenza viruses of swine may be a potential sources of epidemic disease for humans.