Field evaluation of rapid HIV serologic tests for screening and confirming HIV-1 infection in Honduras.

Objective: To determine the ability of simple, rapid tests to identify HIV-1 antibody-positive specimens in field settings using the World Health Organization's (WHO) alternative testing strategies.

Design: Three-phase evaluation of simple, rapid assays using banked specimens and prospectively collected serum specimens at regional hospitals and rural clinics.

Methods: Seven test (Retrocell, Genie, HIVCHEK, SUDS HIV-1, Testpack, Serodia HIV-1, and HIV-1/2 RTD) were evaluated and results compared with standard enzyme immunoassay (EIA) and Western blot results (phase 1).

Epidemic dermatitis due to contact with a moth in Cozumel, Mexico.

In early December 1989, an outbreak that was initially thought to be scabies was investigated among employees of tourist hotels in Cozumel, Mexico. Of 417 employees interviewed, only 19 (4.6%) met a case definition for scabies dermatitis, while 91 (21.

Protective effect of antibiotics on mortality risk from acute respiratory infections in Mexican children.

A case-control study of mortality from acute respiratory infections (ARI) among children under five years of age was conducted in Naucalpan, an urban-suburban area of Mexico City, and in rural localities of Tlaxcala, Mexico. The study found that ARI deaths tended to occur in the poorest neighborhoods; 78% of the deceased study subjects were infants under six months old; and 68% of the deaths occurred at home. Comparison of the data for cases (fatalities) and control children who had severe ARI but recovered showed that failure to receive antibiotics was associated with death (odds ratio 28.

Epidemic transmission of enterically transmitted non-A, non-B hepatitis in Mexico, 1986-1987.

Outbreaks of acute hepatitis occurred in Huitzililla and Telixtac, two rural villages 70 miles south of Mexico City, Mexico, in late 1986. The first outbreak began in Huitzililla in June of that year, 1 month after the start of the rainy season. A census revealed 94 icteric case subjects, for an attack rate of 5%; two women died.

The epidemiology of HIV transmission among paid plasma donors, Mexico City, Mexico.

Screening of blood product donations for antibody to HIV began in Mexico in May 1986. From June to October 1986, the HIV cumulative seroprevalence increased from 6.3 to 9.

[Tuberculosis surveys in Guerrero and new estimates of the magnitude of tuberculosis infection in Mexico].

Tuberculosis infection surveys are carried out by tuberculin skin test (Mantoux) which is a simple, cheap, valid and reliable procedure for the estimation of prevalence and incidence rates. In 1987 a survey was undertaken in children of 6-7 years old who attended the elementary school and who were not vaccinated (BCG) in the region of Iguala, México. Out of 6,095 children of such age group, just 531 were not vaccinated, thus the prevalence figure was 2.

Aetiological agent of enterically transmitted non-A, non-B hepatitis.

Virus-like particles (VLPs) with a mean diameter of 32 nm were recovered from the stools of three acute phase cases of enterically transmitted non-A, non-B hepatitis (ET-NANBH) occurring in the Soviet Union, North Africa and North America. VLPs from two of these cases were studied in detail and were shown to react specifically with antibody in acute phase sera obtained from other cases of ET-NANBH in Asia, the Soviet Union, North Africa and North America. Partially purified VLPs were found to sediment at 183S in sucrose gradients and to cross-react with antibody in acute phase sera from geographically isolated cases of ET-NANBH.

Monitoring system for adverse events following immunization.

The Monitoring System for Adverse Events Following Immunization (MSAEFI) has collected data from the public sector nationwide on adverse events occurring during the 4-week period following administration of vaccine. From 1979 to 1984, 6483 reports were received. Although rates of reporting have increased throughout the 6-year period, increases were larger for less serious events (209%) than for more serious events (53%).

An outbreak of influenza A in a nursing home.

An outbreak of influenza A occurred in an elderly population in a Maryland nursing home between December 8, 1980 and January 13, 1981 and involved 76 of the 170 residents. Throat swabs from two of 10 acutely ill residents yielded influenza A virus similar to the A/Taiwan/1/79 strain. Fourfold or greater increases in the titer of complement-fixing (CF) or hemagglutination-inhibiting (HI) antibodies were detected in paired sera from four of five ill residents and from none of four well residents.

Impact of revaccinating children who initially received measles vaccine before 10 months of age.

Two hundred fifty-four infants who had received measles vaccine at less than 10 months of age were revaccinated at greater than or equal to 15 months of age, and their immune responses were compared with 129 control infants who received their first doses of measles vaccine at greater than or equal to 15 months of age. Sera were collected at the time of revaccination (study infants) or primary vaccination (control infants), 3 weeks, and 8 months later and tested for antibody by hemagglutination inhibition (HI), enzyme-linked immunosorbent assay (ELISA), and cytopathic effect neutralization (CPEN). Of the 121 study infants who were initially HI negative, 116 (95.

Health impact of measles vaccination in the United States.

As a result of intensive efforts to vaccinate children, measles and its attendant complications of encephalitis and death have declined more than 99% from the prevaccine era. Similarly, subacute sclerosing panencephalitis has declined markedly. Measles vaccine has been demonstrated to be extremely safe, as well as extremely effective.

History of convulsions and use of pertussis vaccine.

Data on 2062 reports from the Monitoring System for Adverse Events Following Immunization, Centers for Disease Control (CDC), were analyzed to compare the risk of a personal or family history of convulsions in children who had a neurologic adverse event after receipt of diphtheria-tetanus-pertussis (DTP) vaccine with those who had a nonneurologic adverse event. Children with a neurologic event after DTP vaccine had a 7.2 times higher risk for personal history of convulsions (95% confidence limits 4.

Clinical mumps vaccine efficacy.

From February 5 through April 23, 1982, 110 cases of mumps were reported among 357 students in a middle school in Ashtabula County, Ohio, an overall attack rate of 31%. Vaccine efficacy was calculated using a variety of case definitions, case surveillance systems, and vaccination-status ascertainment methods to evaluate their effects on the estimated vaccine efficacy. From data collected at the school for case ascertainment and vaccination status, clinical vaccine efficacy was initially estimated at 37%.

Fetal risk associated with rubella vaccine: an update.

One hundred nineteen women susceptible to rubella received RA27/3 vaccine, 94 received either Cendehill or HPV-77 vaccine, and one received a vaccine of unknown strain in the three months before or after their estimated date of conception. They gave birth to 216 living infants free of abnormalities compatible with the congenital rubella syndrome (CRS). The maximum theoretical risk for CRS for these infants was 1.

Outbreaks of group A streptococcal abscesses following diphtheria-tetanus toxoid-pertussis vaccination.

Two outbreaks of group A streptococcal abscesses following receipt of diphtheria-tetanus toxoid-pertussis (DTP) vaccine from different manufacturers were reported to the Centers for Disease Control (CDC) in 1982. The clustering of the immunization times of cases, the isolation of the same serotype of Streptococcus from all cases in each outbreak, and the absence of reported abscesses associated with receipt of the same lots of vaccine in other regions of the country, suggest that each outbreak was probably caused by contamination of a single 15-dose vial of vaccine. The preservative thimerosal was present within acceptable limits in unopened vials from the same lot of DTP vaccine in each outbreak.

Adverse events following immunization with DTP vaccine.

The Monitoring System for Adverse Events Following Immunization became fully operational in late 1978 in all 50 States, New York City and Washington, D.C. This system compiles information on adverse events temporally associated (within four weeks) to the administration of a vaccine.

The opportunity and obligation to eliminate rubella from the United States.

The licensure of rubella vaccines in the United States in 1969 offered the opportunity to prevent the devastating consequences of congenital rubella infection, including miscarriages, therapeutic abortions, and congenital rubella syndrome (CRS), with its average lifetime cost of more than $220,000 per case. With the widespread use of vaccine, rubella transmission in the United States has been reduced to record low levels. Epidemics of rubella and CRS, previously reported every six to nine years, have not occurred, and since 1980, following decreases of rubella incidence rates in the postpubertal population, the endemic incidence rates of CRS have also begun to decrease.

Severe local reactions to live measles virus vaccine following an immunization program.

A cluster of nine severe local reactions occurred in a Pennsylvania school district following a mass measles immunization program in February 1981. A case-control study showed that the nine cases had a statistically significant increased history of having received killed measles vaccine previously (p less than .001, Fisher's exact test) and a statistically significant higher geometric mean measles antibody titer (p less than .

Streptococcal abscesses following diphtheria-tetanus toxoid-pertussis vaccination.

Abscesses developed in seven children who received diphtheria-tetanus toxoid-pertussis vaccine at a clinic in Indiana. Epidemiologic investigation revealed that all seven children had received vaccine from the same multidose vial and had been vaccinated by the same nurse at the office of one physician. Group A beta-hemolytic Streptococcus was isolated from abscesses in six of the seven children.

Prevention of rubella transmission in medical facilities.

The widespread use of rubella vaccine in the United States has dramatically decreased the number of rubella cases and has prevented epidemics. Nevertheless, outbreaks of rubella continue to occur in medical facilities and have become important in the transmission of the disease. Control of outbreaks requires isolation of infectious patients, assignment of immune staff only to infectious patients, exclusion from work of infectious personnel, special follow-up of pregnant women and exposed persons, and the rapid vaccination of susceptible staff.