Analysis of the 1998 outbreak of leptospirosis in Missouri in humans exposed to infected swine.

Objective: To determine the extent of leptospirosis in persons exposed to infected swine, confirm the source of disease, define risk factors for infection, and identify means for preventing additional infections during an outbreak in Missouri in 1998.

Design: Cross-sectional study.

Sample Population: 240 people and 1,700 pigs.

A community waterborne outbreak of salmonellosis and the effectiveness of a boil water order.

Objectives: A 1993 large water-borne outbreak of Salmonella typhimurium infections in Gideon, Mo, a city of 1100 with an unchlorinated community water supply, was investigated to determine the source of contamination and the effectiveness of an order to boil water.

Methods: A survey of household members in Gideon and the surrounding township produced information on diarrheal illness, water consumption, and compliance with the boil water order.

Results: More than 650 persons were ill; 15 were hospitalized, and 7 died.

Lyme and/or Lyme-like disease in Missouri.

Missouri patients who fulfill the strict CDC surveillance definition for Lyme disease have been reported in significant numbers since 1987, although there are no viable Missouri human cultures of Borrelia burgdorferi. The Missouri erythema migrans rashes are indistinguishable from those in other areas, and the clinical syndrome appears similar to Lyme disease nationally. The authors suspect atypical B.

Syphilis in Missouri: a continuing problem.

Syphilis has re-emerged as a significant public health problem in the United States and Missouri. Reported cases of primary and secondary (P&S) syphilis and congenital syphilis in Missouri have been increasing since the late 1980s, and a major outbreak of these diseases continues in the St. Louis area.

An update on the epidemiology of AIDS in Missouri.

It has been 13 years since the initial report from the Centers for Disease Control and Prevention (CDC) describing the condition that came to be known as the acquired immunodeficiency syndrome (AIDS). Because of the public health significance of the AIDS epidemic, an elaborate national surveillance system, involving CDC along with state and local health departments, came to be established. The surveillance system now provides detailed information about the epidemiology of AIDS in this country.

Risk factors for transmission of Mycobacterium tuberculosis in a primary school outbreak: lack of racial difference in susceptibility to infection.

Recent data have suggested that there are racial differences in the susceptibility to infection by Mycobacterium tuberculosis. An opportunity to test this suggestion was afforded by an outbreak of tuberculosis in a racially mixed elementary school in St. Louis County, Missouri.

A waterborne outbreak in Missouri of Escherichia coli O157:H7 associated with bloody diarrhea and death.

Objective: To describe and determine the source of a large outbreak of Escherichia coli O157:H7 (ECO157) infections in Missouri.

Design: A case-control study and a household survey.

Setting: A small city in a rural Missouri township that had an unchlorinated water supply.

Report of an illness outbreak at the Harry S Truman State Office Building.

An acute epidemic of headache, mucosal irritation, fatigue, odd taste, and dizziness involving several hundred state government employees occurred in June 1986 in an office building in Missouri that housed 2,500 employees. A survey of 305 ill and 131 well employees demonstrated that ill employees were more likely to have perceived unusual odors and inadequate air flow in their work areas. The building has eight floors, seven of which are divided in half by an atrium, and 17 separate air handling systems.

A pilot epidemiologic study of possible health effects associated with 2,3,7,8-tetrachlorodibenzo-p-dioxin contaminations in Missouri.

In 1971, 2,3,7,8-tetrachlorodibenzodioxin (TCDD)-containing waste oils were sprayed for dust control on residential, recreational, and work areas in Missouri. In several of these areas, the magnitude and the extent of this environmental contamination were not known until late 1982 or 1983. In the first phase of the investigation, a group of persons considered to be at highest risk of exposure and an appropriate comparison group were selected from reviews of Health Effects Survey screening questionnaires.

Person-to-person transmission in an outbreak of enteroinvasive Escherichia coli.

In the summer of 1981, an outbreak of diarrhea occurred in students and staff at a school for mentally retarded adults and children in Columbia, Missouri. Forty-one (48%) of 86 students and 38 (28%) of 137 staff members in the two dormitories with the lowest functioning students were ill. Enteroinvasive Escherichia coli 0124:H30 was isolated from 20 persons including six staff members, 13 students, and the ill mother of one of the students.

The public health response to 2,3,7,8-TCDD environmental contamination in Missouri.

In 1971, waste oil containing 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was sprayed for dust control on a number of residential, recreational, and work areas in Missouri. In several of them, the level and extent of environmental contamination were not known until late 1982 or 1983. Extrapolation from existing toxicological data indicated the potential for substantial adverse health effects in highly exposed populations.

Nosocomial meningitis due to Citrobacter diversus in neonates: new aspects of the epidemiology.

Two term neonates born within four days of each other at a small hospital developed sepsis and meningitis caused by a unique strain of Citrobacter diversus not previously reported to cause meningitis. Eleven (27.5%) of 40 other infants admitted to the nursery during the epidemic period developed rectal or umbilical colonization by C.

Morbidity and mortality associated with the July 1980 heat wave in St Louis and Kansas City, Mo.

The morbidity and mortality associated with the 1980 heat wave in St Louis and Kansas City, Mo, were assessed retrospectively. Heat-related illness and deaths were identified by review of death certificates and hospital, emergency room, and medical examiners' records in the two cities. Data from the July 1980 heat wave were compared with data from July 1978 and 1979, when there were no heat waves.

Measles vaccine efficacy: influence of age at vaccination vs. duration of time since vaccination.

To evaluate the recent decision of the Advisory Committee on Immunization Practice to increase the recommended age for initial measles vaccination from 12 to 15 months, we carried out a case control study of vaccine failure in a recent measles epidemic. Compared to children vaccinated at ages 15 months or older, we found an increased risk of vaccine failure among those vaccinated at 12 to 14 months (relative risk = 19.2, 95% confidence interval = 4.