Electronic matching of HIV/AIDS and hepatitis C surveillance registries in three states.

Objectives: Both HIV and hepatitis C virus (HCV) can be transmitted through percutaneous exposure to blood in similar high-risk populations. HCV and HIV/AIDS surveillance databases were matched in Colorado, Connecticut, and Oregon to measure the frequency of co-infection and to characterize coinfected people.

Methods: We defined a case of HCV infection as a person with a reactive antibody for hepatitis C, medical diagnosis, positive viral-load test result, or positive genotype reported to any of three state health departments from the start of each state's hepatitis C registry through June 30, 2008.

Diagnosis of acute HIV infection in Connecticut.

Acute HIV infection (AHI) is the earliest stage of HIV disease, when plasma HIV viremia, but not HIV antibodies, can be detected. Acute HIV infection often presents as a nonspecific viral syndrome. However, its diagnosis, which enables linkage to early medical care and limits further HIV transmission, is seldom made.

Surveillance programs for chronic viral hepatitis in three health departments.

Although chronic hepatitis B and chronic hepatitis C are diseases of public health importance, only a few health departments nationally have chronic viral hepatitis under surveillance; these programs rely primarily on direct reporting by medical laboratories. We conducted an evaluation to determine if lessons from these programs can guide other health departments. Between December 2002 and February 2003, we visited the Connecticut Department of Public Health, the Multnomah County Health Department in Portland, Oregon, and the Minnesota Department of Health to determine the capacity of their chronic hepatitis registries to monitor trends and provide case management.

Blood exposures and hepatitis C virus infections among emergency responders.

Background: Blood exposures in the workplace may put first responders, a group which includes firefighters, emergency medical technicians, and paramedics, at increased risk for hepatitis C virus (HCV) infection. To determine the prevalence of antibody to HCV (anti-HCV) and risk factors for infection among first responders, we analyzed data from prevalence surveys conducted among first responders in Atlanta, Ga, in 1991; Connecticut in 1992; and Philadelphia, Pa, in 1999.

Methods: Serum or blood samples from participants of the 3 surveys were tested for anti-HCV.

Impact of intrapartum antibiotics on the care and evaluation of the neonate.

Background: Management of infants whose mothers receive intrapartum antibiotic prophylaxis (IAP) is controversial. In 1996 consensus guidelines for prevention of neonatal Group B streptococcal disease included an algorithm for management of infants whose mothers received IAP. To assess practices for testing and treatment of infants, we evaluated a population-based sample of deliveries to see whether excessive evaluation and treatment occurs after IAP.

A population-based comparison of strategies to prevent early-onset group B streptococcal disease in neonates.

Background: Guidelines issued in 1996 in the United States recommend either screening of pregnant women for group B streptococcal colonization by means of cultures (screening approach) or assessing clinical risk factors (risk-based approach) to identify candidates for intrapartum antibiotic prophylaxis.

Methods: In a multistate retrospective cohort study, we compared the effectiveness of the screening and risk-based approaches in preventing early-onset group B streptococcal disease (in infants less than seven days old). We studied a stratified random sample of the 629,912 live births in 1998 and 1999 in eight geographical areas where there was active surveillance for group B streptococcal infection, including all births in which the neonate had early-onset disease.

Integrated monitoring of a new group B streptococcal disease prevention program and other perinatal infections.

Objective: To determine levels of prenatal screening for several infections, intrapartum recognition of risk factors, and prophylaxis against mother-to-child transmission of group B streptococcus.

Methods: Review of stratified random sample of hospital records for deliveries in Connecticut during 1996. SUDAAN analysis was used to adjust for the complex survey design, and weighting adjusted for the probability of being sampled and nonresponse.