Human immunodeficiency virus-associated cytomegalovirus infection with multiple small vessel cerebral infarcts in the setting of early immune reconstitution.

Cytomegalovirus (CMV) infection is an important cause of neurologic disease in the context of advanced human immunodeficiency virus (HIV) infection and is recognized as a cause of immune reconstitution inflammatory syndrome (IRIS) after initiation of highly active antiretroviral therapy (HAART). Central nervous system vasculitis secondary to CMV has only rarely been described in the context of HIV, despite the established ability of CMV to infect microvascular endothelial cells in the brain. However, we report a case that demonstrates the association between CMV and multiple small vessel cerebral infarct lesions after initiation of HAART.

Has the United States population been adequately vaccinated to achieve rubella elimination?

Mathematical models indicate that elimination of rubella virus transmission requires maintenance of approximately 90% rubella immunity among children. To evaluate whether rubella vaccination coverage among US preschool and school-age children is at levels consistent with rubella elimination, we reviewed data from 3 sources: (1) the Biologics Surveillance, which documents the net number of vaccine doses sold (1970-2004); (2) state immunization surveys of school entrants 5-6 years of age (1980-2005); and (3) the National Immunization Survey of children 19-35 months of age (1995-2004). Vaccine biologics data show that the net number of rubella vaccine doses sold was at least equivalent to the number of children born each year during 1970-2004.

Inadequate syphilis screening among women with prenatal care in a community with a high syphilis incidence.

Objectives And Goal: This study was designed to evaluate the extent to which pregnant women in a community with a high syphilis incidence were screened for syphilis according to standard recommendations of twice during prenatal care and at labor and delivery.

Study Design: Labor and delivery records from 4 hospitals in Miami-Dade County, Florida, were abstracted to obtain maternal and prenatal care characteristics and syphilis screening practices.

Results: Of the 1991 women, records indicated that 1655 (83%) were screened at least once during prenatal care, 220 (11%) were screened twice during prenatal care before delivery, and 184 (9%) were screened twice during prenatal care and at delivery.

Low postpartum rubella vaccination rates in high-risk women, Miami, Florida, 2001.

Objective: To evaluate adherence to the Advisory Committee on Immunization Practices' recommendations on postpartum rubella vaccination in hospitals with a high proportion of foreign-born Latina mothers, the highest risk group for congenital rubella syndrome.

Methods: In four large hospitals in Miami-Dade County, maternal medical records for births in 2001 were randomly selected. Using demographic information from birth certificates, vaccination information from medical records, and policy information from a hospital survey, postpartum rubella vaccination rates were characterized among women eligible for vaccination (non-immune and not screened) through univariate and multivariable analyses.

Congenital rubella syndrome burden in Morocco: a rapid retrospective assessment.

Background: WHO recommends that countries considering introduction of rubella vaccine into their immunisation programme assess their burden of congenital rubella syndrome, to determine whether vaccination is warranted. However, few guidelines exist for such assessments in developing countries. We retrospectively estimated the burden of congenital rubella syndrome in Morocco, and assessed our methods of rapid case finding.

Lack of SARS transmission among public hospital workers, Vietnam.

The severe acute respiratory syndrome (SARS) outbreak in Vietnam was amplified by nosocomial spread within hospital A, but no transmission was reported in hospital B, the second of two designated SARS hospitals. Our study documents lack of SARS-associated coronavirus transmission to hospital B workers, despite variable infection control measures and the use of personal protective equipment.