Showing papers on "Outbreak published in 1985"
TL;DR: The hypothesis that human listeriosis can be a foodborne disease is supported and questions about the ability of pasteurization to eradicate a large inoculum of L. monocytogenes from contaminated raw milk are raised.
Abstract: Between June 30th and August 30th, 1983, 49 patients in Massachusetts acquired listeriosis. Seven cases occurred in fetuses or infants and 42 in immunosuppressed adults; 14 patients (29 per cent) died. Of 40 Listeria monocytogenes isolates available for testing, 32 were serotype 4b. Two case-control studies, one matching for neighborhood of residence and the other for underlying disease, revealed that the illness was strongly associated with drinking a specific brand of pasteurized whole or 2 per cent milk (odds ratio = 9, P less than 0.01 for the neighborhood-matched study; odds ratio = 11.5, P less than 0.001 for the illness-matched study). The association with milk was further substantiated by four additional analyses that suggested the presence of a dose-response effect, demonstrated a protective effect of skim milk, associated cases with the same product in an independent study in another state, and linked a specific phage type with the disease associated with milk. The milk associated with disease came from a group of farms on which listeriosis in dairy cows was known to have occurred at the time of the outbreak. Multiple serotypes of L. monocytogenes were isolated from raw milk obtained from these farms after the outbreak. At the plant where the milk was processed, inspections revealed no evidence of improper pasteurization. These results support the hypothesis that human listeriosis can be a foodborne disease and raise questions about the ability of pasteurization to eradicate a large inoculum of L. monocytogenes from contaminated raw milk.
1,099 citations
TL;DR: Data related to AIDS were used to illustrate the potential usefulness of a network approach in evaluating the infectious agent hypothesis when studying a disease or disease outbreak of unknown etiology and in developing strategies to limit the spread of an infectious agent transmitted through personal relationships.
457 citations
TL;DR: African swine fever was first described in 1921 by Montgomery, who reported several disease outbreaks of domestic pigs in Kenya since 1910 with a mortality close to 100%.
Abstract: African swine fever (ASF) was first described in 1921 by Montgomery, who reported several disease outbreaks of domestic pigs in Kenya since 1910 with a mortality close to 100%. Montgomery recognized the viral nature of the disease, its likely transmission by wild swine which probably acted as virus carriers, and the lack of protection by passive immunization [1]. ASF is a menace to the pig population in the world because there is no vaccine, the virus multiplies in ticks and mutates easily, and different virus isolates can produce diseases with different clinical forms or no disease at all. The control and eradication of ASF require rapid diagnosis, drastic slaughter, and quarantine.
429 citations
TL;DR: In July 1984, an outbreak of gastroenteritis occurred in a suburban community in Texas and Cryptosporidium was identified as the etiologic agent.
Abstract: In July 1984, an outbreak of gastroenteritis occurred in a suburban community in Texas. A random telephone survey of 100 of 1791 households in the community identified an attack rate of 34...
311 citations
TL;DR: Apparent contrasts in symptoms associated with hepatitis A infection in adults and children suggest a basic age-dependent difference in immune response to such infection.
Abstract: Hepatitis A virus infection is often described as mild or asymptomatic, particularly in children. The failure of most adults who are found to be immune to remember symptoms of an illness suggestive of hepatitis A virus supports this belief. In 1982, two large outbreaks occurred in well documented populations of military personnel. These outbreaks were each extensively studied epidemiologically and serologically. It was found that 28/29 (96.6%) hepatitis A infections recognized prior to immune serum globulin in Outbreak A and 35/46 (76.1%) infections in Outbreak A were symptomatic. Symptomatic cases failed to occur beyond eight days of immune serum globulin administration to these predominantly susceptible groups. Between 40 and 70% of patients were icteric. Apparent contrasts in symptoms associated with hepatitis A infection in adults and children suggest a basic age-dependent difference in immune response to such infection.
304 citations
TL;DR: The large and sudden increase in numbers of airborne fungal spores around the time of the outbreak suggests that they may have been partly contributory, although a direct causal effect has not yet been established.
234 citations
TL;DR: An outbreak of polychlorinated biphenyl (PCB) poisoning from the consumption of contaminated rice oil, covering four counties in central Taiwan, was investigated and 2061 persons were determined to be PCB poisoning victims.
Abstract: An outbreak of polychlorinated biphenyl (PCB) poisoning from the consumption of contaminated rice oil, covering four counties in central Taiwan, was investigated. There were 1843 cases by the end of 1980. The highest frequency of incidence occurred during the period from March to July 1979. The severity of clinical manifestations varied. Most patients showed symptoms of mild or moderate severity. The major age group affected was between 11 and 20 years old. Most of the victims were students and factory workers. The amount of PCB intake in each victim was estimated to be 0.7 to 1.84 g and the latent period from the time of intake to the onset of clinical manifestations was approximately 3 to 4 months. The patients' blood PCB concentrations ranged from 3 ppb to 1156 ppb; 44.27% of 613 patients had levels of 51 to 100 ppb and 27.6% PCB blood levels over 100 ppb. In the course of 3.5 years, 2061 persons were determined to be PCB poisoning victims. Now, except for a few severe cases, their skin symptoms are very much improved. Thirty-nine babies showing hyperpigmentation were born from PCB-poisoned mothers. The fatality rate was high: eight of them died. Another 24 deaths were reported among the PCB-poisoned group, almost half of them (12) from hepatoma, liver cirrhosis or liver diseases with hepatomegaly.
232 citations
TL;DR: The association with milk was substantiated by four additional analyses that suggested the presence of a dose–response effect, demonstrated a protective effect of skim milk, associated cases with the same product in an independent study in another state, and linked a specific phage type with the disease associated with milk.
209 citations
Journal Article•
TL;DR: Problems were encountered in diagnosing the disease, which presents initially with influenza-like symptoms, differing only in severity from influenza, but petechiae and other manifestations of a bleeding tendency distinguished it from influenza in the later phase of the disease.
Abstract: Crimean-Congo haemorrhagic fever (CCHF) is a rare disease in South Africa. From 1981 to September 1984, 8 sporadic primary cases were reported. An outbreak of CCHF in a large university hospital is described; of 8 patients diagnosed 2 died (the index and a secondary case). Four patients were seriously ill and 2 had a mild illness. Problems were encountered in diagnosing the disease, which presents initially with influenza-like symptoms, differing only in severity from influenza. However, petechiae and other manifestations of a bleeding tendency distinguished it from influenza in the later phase of the disease. Special investigations, especially those revealing leucopenia and thrombocytopenia, were critically important in early diagnosis. The dilemma of handling this highly contagious disease is that definite virological diagnosis is time-consuming and is conducted in only one high-security laboratory 1600 km distant. A further case was admitted 3 months later from a different locality and confirmed virologically but no secondary cases could be confirmed or traced.
144 citations
TL;DR: The outbreak was halted by changing the treatment for all patients and their contacts to spectinomycin, and by intensive epidemiologic case-finding efforts, and indicates a need for reassessment of current surveillance procedures.
Abstract: From February through November of 1983, 199 cases of penicillin-resistant Neisseria gonorrhoeae infection were identified in a localized epidemic in Durham, North Carolina. The isolates did not produce beta-lactamase but were unusually resistant to penicillin (minimum inhibitory concentration, 2.0 to 4.0 μg per milliliter), and 15 of 16 patients treated with 4.8 million units of penicillin G procaine plus 1.0 g of probenecid did not respond to therapy. Recognition of the outbreak was impeded by a lack of routine surveillance for resistance other than that mediated by beta-lactamase. All epidemic isolates had a single serotype, auxotype, and antibiotic-susceptibility profile. The outbreak was halted by changing the treatment for all patients and their contacts to spectinomycin, and by intensive epidemiologic case-finding efforts. The emergence of such resistant strains poses potential major public health problems and indicates a need for reassessment of current surveillance procedures. (N Engl J Med 1985; ...
124 citations
TL;DR: Use of available mouse monoclonal antibodies enabled unequivocal identification of the virus responsible for 22 of the outbreaks as similar to the avian paramyxovirus type 1 (A/PMV-1) virus causing neurotropic disease in pigeons during 1983 and 1984.
Abstract: During February to July 1984, 23 outbreaks of Newcastle disease were confirmed in chickens in Great Britain. Use of available mouse monoclonal antibodies enabled unequivocal identification of the virus responsible for 22 of the outbreaks as similar to the avian paramyxovirus type 1 (A/PMV-1) virus causing neurotropic disease in pigeons during 1983 and 1984. Epidemiological investigations presented evidence that 19 of these outbreaks occurred either directly or indirectly as a result of spread from diseased pigeons infesting food stores at Liverpool docks. Virus was isolated from carcases of pigeons found among the food and samples of the food itself. The remaining outbreak was shown to involve a virus unrelated to the virus infecting pigeons.
TL;DR: The first documented case of concurrent human infection with 2 d Dengue viruses is reported and does not support the hypothesis that double infection with dengue viruses leads to more severe hemorrhagic disease.
Abstract: The first documented case of concurrent human infection with 2 dengue viruses is reported. Dengue 1 and 4 viruses were isolated from the serum of a 16-year-old male during the 1982 outbreak in Puerto Rico. The illness was mild and does not support the hypothesis that double infection with dengue viruses leads to more severe hemorrhagic disease.
Journal Article•
TL;DR: During the outbreak of Crimean-Congo haemorrhagic fever at Tygerberg Hospital 8 patients were diagnosed positive and 2 patients who died were diagnosed late, did not receive hyperimmune serum, and eventually developed multi-organ failure.
Abstract: During the outbreak of Crimean-Congo haemorrhagic fever (CCHF) at Tygerberg Hospital 8 patients were diagnosed positive. CCHF was diagnosed in another patient several months later. The treatment of these 9 cases is outlined. When it became evident that CCHF could present with a spectrum of severity, treatment was adjusted according to each patient's requirements. The essential components consisted of correction of haematological abnormalities combined with hyperimmune serum; the latter is particularly important for the severely ill patient with no antibodies to CCHF. The antiviral agents ribavirin and interferon were used but evidence to substantiate their application in future cases was inconclusive. Interferon was discontinued because of severe side-effects, many of which simulated the clinical features of CCHF. Objective improvement after corticosteroid treatment was noted in only 1 patient, but some of her symptoms could have been due to a transfusion reaction. Antibiotics were not routinely used. The 2 patients who died were diagnosed late, did not receive hyperimmune serum, and eventually developed multi-organ failure. The course of CCHF can probably be modified if the diagnosis is made early, if antiserum is given, and if the haematological abnormalities are promptly corrected.
TL;DR: The low prevalence of lethal H5N2 avian influenza virus in wild birds and small rodents strongly indicated that these animals were not responsible for dissemination of the disease among poultry farms during the outbreak.
Abstract: Wildlife surveillance was conducted for influenza viruses in conjunction with the 1983-84 lethal H5N2 avian influenza epizootic in domestic poultry in Pennsylvania, New Jersey, Maryland, and Virginia. Virus-isolation attempts made on cloacal and tracheal swabs from 4,466 birds and small rodents within the quarantined areas and 1,511 waterfowl in nearby Maryland yielded only a single H5N2 isolate from a pen-raised chukar in Pennsylvania. Antibodies against hemagglutinin type 5 and/or neuraminidase type 2 were found in 33% of the aquatic birds tested; however, this finding could not be used to confirm previous H5N2 avian influenza virus activity because of the possibility of prior infections with multiple influenza subtypes. The low prevalence of lethal H5N2 avian influenza virus in wild birds and small rodents strongly indicated that these animals were not responsible for dissemination of the disease among poultry farms during the outbreak.
TL;DR: This outbreak illustrates that glandular tularemia can be a mild disease and that both type A and type B strains can be tick-borne and coexist in the same ecosystem.
Abstract: Between June 1 and July 15, 1984, twenty persons with glandular tularemia were identified on the Lower Brule and Crow Creek Indian reservations in South Dakota. The median age of the patients was 6 years (range, 2 to 20 years). The clinical illness was mild, consisting of fever, headache, and lymphadenopathy. All lymphadenopathy was in the head and neck area. Dermacentor variabilis ticks were identified as the vector. Although the mild clinical illness suggested Francisella tularensis , type B, was the agent, both type A and type B strains of F tularensis were isolated from ticks collected from dogs in the area. Tularemia is generally thought to be a severe systemic illness in North America. This outbreak illustrates that it can be a mild disease and that both type A and type B strains can be tick-borne and coexist in the same ecosystem. ( JAMA 1985;254:2922-2925)
TL;DR: In one egg-associated outbreak, one of the isolates of Campylobacter recovered from hens at the implicated egg farm was serotypically identical to an isolate recovered from an ill person, underscore the hazard of eating undercooked or raw foods of animal origin such as raw milk.
Abstract: During 1980-1982, 23 foodborne outbreaks of diseases caused by Campylobacter were reported to the Centers for Diseases Control through the National Foodborne Surveillance Program, which collects reports from state and territorial epidemiologists throughout the United States. These outbreaks involved 748 ill persons, of whom 4% were hospitalized. For outbreaks with six or more ill persons, the median attack rate was 41%, the mean or median incubation periods ranged from 66 to 120 hours, and the mean duration of symptoms ranged from three to seven days. Raw milk was implicated or suspected in 14 outbreaks. In four of the other outbreaks, food handling errors were identified, and in five outbreaks, poultry, eggs, or beef were implicated or suspected. In three of four outbreaks in which Campylobacter was recovered from cows at the implicated dairies, some isolates from cows were serotypically identical to isolates from ill persons. In one egg-associated outbreak, one of the isolates of Campylobacter recovered from hens at the implicated egg farm was serotypically identical to an isolate recovered from an ill person. These findings underscore the hazard of eating undercooked or raw foods of animal origin such as raw milk. Raw milk contaminated by infected cows is a major cause of foodborne campylobacteriosis in the United States.
TL;DR: A large outbreak of epidemic polyarthritis (EPA) caused by Ross River virus (RRV) occurred in New South Wales in the summer of 1983/1984 and the cost of the epidemic was estimated at about $3 million.
Abstract: A large outbreak of epidemic polyarthritis (EPA) caused by Ross River virus (RRV) occurred in New South Wales in the summer of 1983/1984. The total number of cases was unknown, but 1196 cases were confirmed by laboratory tests. Most patients came from the area west of the dividing range, with especially large numbers in the Murrumbidgee irrigation area. Cases were reported from October 1983 to June 1984, with 60% of cases occurring in January and February. The seasonal pattern was similar throughout the state. Men and women were affected in approximately equal numbers, with the highest frequencies in the 30-39 years' age group. Clinical illness was uncommon in young children. Based on a detailed study of 118 patients from Griffith, arthralgia, lethargy, rash and headache were the most common symptoms. The average period of incapacity (defined as inability to resume normal duties) was about six weeks. On this basis, the cost of the epidemic was estimated at about $3 million. There were 257 cases of EPA in the Griffith Shire and it was calculated that approximately 340 RRV infections occurred in the shire. The implication is that, in this outbreak, most RRV infections resulted in clinical illness.
TL;DR: This outbreak demonstrates the ability of drug-resistant Salmonella to spread from the animal to the human reservoir and, in a suitable host, produce a fatal infection.
Abstract: In early 1983, an outbreak of illness caused by raw milk contaminated with multiple-antimicrobial-resistant Salmonella typhimurium occurred in Arizona. One of the cases involved a 72-year-old woman who died with Salmonella enteritis and sepsis that had not responded to treatment with chloramphenicol. The S typhimurium isolates from this patient, from other ill persons, and from raw milk were resistant to ampicillin, chloramphenicol, kanamycin sulfate, streptomycin, sulfonamide, and tetracycline. These resistances were mediated by a 105-megadalton R plasmid. During the epidemic period, 43% of the S typhimurium isolates submitted to the Arizona Department of Health Services were resistant to chloramphenicol, and 80% of these possessed the same plasmid resistance. Although there was evidence of spread of the S typhimurium in the community, there was no evidence of spread of this Salmonella R plasmid to the normal flora of patients or their family members a median of 14 weeks after the infection. This outbreak demonstrates the ability of drug-resistant Salmonella to spread from the animal to the human reservoir and, in a suitable host, produce a fatal infection. ( JAMA 1985;253:2058-2060)
TL;DR: Since outbreaks account for such a small proportion of nosocomial infections, infection control programs should be sufficiently staffed and managed so that most of the effort is directed toward the surveillance and control of endemic infection problems, but with adequate resources remaining to respond to outbreaks when they occur.
Abstract: A statistical algorithm was used to identify potentially important clusters among nosocomial infections reported each month by 7 community hospitals. Epidemiologic review and on-site investigations distinguished outbreaks of clinical disease from factitious clusters. In 1 year, 8 outbreaks were confirmed. They involved 82 patients--approximately 2% of patients with nosocomial infections and 0.09% of all discharges. One true outbreak occurred for every 12,000 discharges--at least 1 outbreak per year for the average community hospital. Five (63%) outbreaks were recognized independently by the hospitals' infection control personnel. Four (50%) resolved spontaneously; the hospitals' own control measures were necessary in 2; and 2 resolved only after an outside investigation. Organized surveillance appears necessary to detect some outbreaks, and control measures are needed to stop many. Since, however, outbreaks account for such a small proportion of nosocomial infections, infection control programs should be sufficiently staffed and managed so that most of the effort is directed toward the surveillance and control of endemic infection problems, but with adequate resources remaining to respond to outbreaks when they occur.
TL;DR: Control of the outbreak was achieved by more strict isolation of 'negative' patient contacts as well as colonized/infected patients and increasing the level of staffing on the separate isolation unit.
TL;DR: One hundred thirty cases of Q fever were seen in the Basque region of Spain between 1981 and 1984, and a seasonal peak coincided with lambing time in the region.
Abstract: One hundred thirty cases of Q fever were seen in the Basque region of Spain between 1981 and 1984. Approximately 40% of these were related to epidemic outbreaks, and the remainder were isolated cases. The large majority of cases occurred in young men and women between 20 and 40 years of age. A seasonal peak coincided with lambing time in the region. Treatment had favorable outcome in each case, and no chronic disease was seen.
TL;DR: An investigation of reports of LD in tourists visiting the US Virgin Islands prompted an investigation of risk factors for development of LD, and several new Legionella species were isolated from the potable water system at the hotel.
Abstract: • Outbreaks of legionnaires' disease (LD) in tourists visiting Italian and Spanish resorts have been recently reported. An unusual number of reports of LD in tourists visiting the US Virgin Islands prompted an investigation of risk factors for development of LD in this area. Twenty-seven cases of LD were identified between 1979 and 1982 through press reports, personal communication, the national LD surveillance system, a review of hospital records, and a mail survey. Twenty-four of 27 persons with the disease had visited St Croix and 12 of them had stayed at a single hotel in 1981. Available evidence suggested that infection was due to Legionella pneumophila serogroup 1; L pneumophila serogroups 1 and 3 and several new Legionella species were isolated from the potable water system at the hotel. Following hyperchlorination of the potable water system, no further cases of LD in hotel visitors have been identified to date. ( Arch Intern Med 1985;145:2076-2079)
TL;DR: Cryphonectria cubensis, recorded for the first time in India, is responsible for causing severe stem cankers in Eucalyptus grandis in Kerala.
Abstract: SUMMARY
Cryphonectria cubensis, recorded for the first time in India, is responsible for causing severe stem cankers in Eucalyptus grandis in Kerala. Disease outbreaks are localised and vary in severity with host species, at times affecting up to 30% of the trees in a stand. Infection usually occurs on the main stem 1 to 1 ·5 m above ground and occasionally near ground level. There is evidence of tree to tree spread of the disease from the primary infection foci. The disease also affects coppicing by stumps after harvest. Details on the incidence and epidemiology of the disease are presented.
Journal Article•
TL;DR: Rened educational efforts combined with a comprehensive immunization program would significantly improve the control of botulism in high-risk populations.
Abstract: Sixty-one outbreaks of food-borne botulism involving a total of 122 cases, of which 21 were fatal, were recorded from 1971 to 1984 in Canada. Most occurred in northern Quebec, the Northwest Territories or British Columbia. Of the 122 victims 113 were native people, mostly Inuit. Most of the outbreaks (59%) were caused by raw, parboiled or "fermented" meats from marine mammals; fermented salmon eggs or fish accounted for 23% of the outbreaks. Three outbreaks were attributed to home-preserved foods, and one outbreak was attributed to a commercial product. The causative Clostridium botulinum type was determined in 58 of the outbreaks: the predominant type was E (in 52 outbreaks), followed by B (in 4) and A (in 2). Renewed educational efforts combined with a comprehensive immunization program would significantly improve the control of botulism in high-risk populations.
TL;DR: This is the first outbreak of campylobacter enteritis reported in Australia in which C. jejuni has been isolated from both human and food sources and the isolates serologically confirmed as identical.
TL;DR: Investigation of water systems exhibiting positive coliform results during the first year detected no outbreaks, and the designation of one individual to whom all water-related public complaints and health department inquiries were directed was directed.
Abstract: The Colorado Department of Health conducted intensive surveillance for waterborne diseases during the three-year period July 1, 1980-June 30, 1983. Eighteen outbreaks of waterborne illness were investigated. Outbreaks involved from 15 to 1,500 ill persons. Giardia lamblia was confirmed or suspected as the agent in nine outbreaks, rotavirus in one, and no agent could be identified in eight. Seventeen outbreaks occurred on surface-water systems; none of these had adequate chemical pretreatment and filtration. Investigation of water systems exhibiting positive coliform results during the first year detected no outbreaks. Activities important to effective surveillance included educational outreach programs to local health agencies, physicians and the public, and the designation of one individual to whom all water-related public complaints and health department inquiries were directed.
TL;DR: Comparison detection rates for direct and immune electron microscopy and for PAGE proved to be the most sensitive detection method for these new rotaviruses.
Abstract: Studies are reported on two outbreaks of epidemic diarrhea in China involving 19,007 patients. The first outbreak occurred in the northern part of the Guangxi Autonomous Region and extended south from
TL;DR: In November 1982, Meade County, Kentucky health officials noted a sudden increase in the incidence of hepatitis A and the most important risk factor identified was household use of untreated water from a single spring.
Abstract: In November 1982, Meade County, Kentucky health officials noted a sudden increase in the incidence of hepatitis A. Using a standardized interview of 73 cases (68 serologically confirmed), and 85 controls (all negative for antibody to hepatitis A virus), the most important risk factor identified was household use of untreated water from a single spring. A dose-response relationship was found for consumption of unboiled spring water. Water samples taken from the spring during the outbreak were contaminated with fecal coliforms.
TL;DR: The survival of viruses inclusive of etiological agents of foot-and-mouth disease, African swine fever, swine vesicular disease and hog cholera virus is reviewed in this paper and new research approaches are suggested.