A historical prospective mortality study of workers in copper and zinc refineries.

Earlier health studies of workers in electrolytic refinery operations have raised concern that workers may experience excess morbidity and premature death as a result of hazardous occupational exposures. This study was designed to determine if the refinery operation is associated with any excess mortality patterns. A cohort of 4,802 male workers exposed for at least one year during 1946-1975 was assembled from nine U.

Illness after influenza vaccination reported through a nationwide surveillance system, 1976-1977.

In 1976, the Center for Disease Control coordinated nationwide surveillance for illnesses after influenza vaccination as part of an effort to vaccinate the nation against influenza A/New Jersey/76. For the 48,161,019 persons vaccinated in 1976, a total of 4733 reports of illness were received which included reports of 223 deaths. When Guillain-Barré syndrome was reported in vaccine recipients, an investigation was begun to examine this possible association.

The epidemiology of influenza B in a rural setting in 1977.

An epidemic of influenza B began in January, 1977, in two rural parishes in northeastern Louisiana and quickly spread to involve 29% of their population with clinical influenza. This epidemic was investigated using a standard questionnaire and a random sample of 4.2% of the population.

Fatal Rocky Mountain spotted fever.

Forty-four fatal cases of Rocky Mountain spotted fever (RMSF) occurring in 1974 were compared with 50 nonfatal cases of similar age, sex, date of onset, and place of occurrence. Diagnosis and initiation of treatment in fatal cases were substantially delayed compared with nonfatal cases. Several reasons for this delay were identified: (1) the rash appeared later in the course of illness in the fatal cases, often not until the patient was terminal, (2) a history of tick bite was less often obtained during life or obtained late in the clinical course in fatal cases, and (3) initial nonspecific symptoms or unexpected symptoms led to an initial diagnosis of more common diseases.

Excess mortality and influenza surveillance in Taiwan.

Excess mortality has proven to be a useful epidemiologic tool for influenza surveillance in the temperate zone. A retrospective analysis of the epidemiology of influenza in Taiwan was undertaken to explore the usefulness of this technique in the tropical--subtropical zone. Excess mortality similar to that observed during influenza epidemics in the temperate zone was noted during periods of previously recognized influenza epidemics in Taiwan.

A comparison of a WI-38 vaccine and duck embryo vaccine for preexposure rabies prophylaxis.

Two types of rabies vaccine, WI-38 vaccine (WRV) and Duck Embryo Vaccine (DEV) were compared in rabies preexposure prophylaxis. Once group of veterinary students received four doses of DEV, a second group received four doses of WRV, and a third group received two doses of WRV. Adverse reactions were found to be similar for all three gorups.

Swine influenza virus infections in humans.

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.

Reye's syndrome: clinical progression and evaluation of therapy.

The hospital course and therapy of 369 patients with Reye's syndrome were evaluated. Eighty-three percent of patients had deepening coma during hospitalization. Stage of coma on admission, evidence of increased intracranial pressure, and blood ammonia levels greater than 300 microgram/100 ml were all significantly associated with increasing mortality.

Lassa fever: response to an imported case.

In February, 1976, a Peace Corps worker returned to the United States from Sierra Leone with an undiagnosed illness later recognized as Lassa fever. To assess the risk of transmission and to contain a potential outbreak, we identified 552 contacts as having had exposure to the patient before the start of strict isolation procedures, and maintained intensive surveillance on these contacts for 21 days. At the end of the surveillance period, no illness had developed in contacts.

Influenza B-associated Reye's syndrome: incidence in Michigan and potential for prevention.

Prospective surveillance for Reye's syndrome in Michigan revealed the occurrence of 46 cases between December 15, 1973 and June 1, 1974. In an attempt to determine the incidence of influenza B-associated Reye's syndrome, a randomized point-prevalence survey of 1,041 schoolchildren was done in a county in Michigan where there had been simultaneous outbreaks of influenza B and Reye's syndrome. Of the children tested, 20% had titers of hemagglutination-inhibiting antibody to influenza virus B/Hong Kong/5/72 of greater than or equal 1:20.

A nationwide outbreak of Reye's Syndrome. Its epidemiologic relationship of influenza B.

Between December 15 and June 30, 1974, 379 cases of confirmed Reye's syndrome were reported to the Center for Disease Control. Of these, 316 occurred during February and March 1974. A simultaneous surveillance system for influenza B indicated that this clustering of cases of Reye's syndrome correlated both temporally and geographically with influenza B outbreaks.

Serum neutralizing antibody after rabies postexposure prophylaxis.

One hundred seventy-seven persons submitted specimens for serum neutralizing antibody titer detreminations 30 to 90 days after starting postexposure rabies prophylaxis. Ninety-two percent of those who received duck embryo vaccine alone developed adequate antibody titers. However, 23% of those who received equine antirabies serum plus duck embryo vaccine failed to develop an adequate antibody titer; one of these inadequate responders subsequently died of rabies.

Rocky Mountain spotted fever: epidemiology of an increasing problem.

Reported cases of Rocky Mountain spotted fever in the United States have been increasing since 1960 and reached an all-time high of 754 cases in 1974. Detailed clinical and epidemiologic information was obtained on 1522 (55%) of the 2757 cases reported in the 5-year period 1970 through 1974. Fifty-one percent of cases were confirmed by one or more laboratory test.

Clinical use of human globulin immune to rabies virus.

Studies of human globulin immune to rabies virus before licensure showed that it suppressed active antibody responses when individuals received 16 doses of duck embryo vaccine but not when they received 23 doses of duck embryo vaccine. Prospective surveillance of use of human globulin immune to rabies virus since licensure in 1974 has revealed that 40% of persons who receive 14-16 doses of duck embryo vaccine have low or undetectable antibody responses 30-90 days after initiation of the series. Ten percent of individuals receiving 21-23 doses of duck embryo vaccine have inadequate antibody responses, a percentage not significantly different from that found in recipients of 14 doses of vaccine alone.

Dealing with possible rabies exposure.

When a patient has come in contact with a domestic or wild animal that may be rabid, the physician must decide whether postexposure rabies prophylaxis is warranted. Among the factors that must be weighed are the animal species involved, the epizootiology of rabies, and the circumstances surrounding the exposure.