The impact of influenza vaccination on respiratory illness at a boarding school.

We studied the impact of influenza vaccine during an outbreak of influenza at a 989-student boarding school in January to March, 1989. By February 6, 120 (17%) of 690 students completing survey questionnaires had been ill with fever and respiratory symptoms. Eighty-seven students had received influenza vaccine in the previous 18 months; these students had an attack rate half that of the unvaccinated students (9% v 19%; vaccine efficacy = 50%, confidence interval = 0%-70%).

Communitywide outbreak of Legionnaires' disease associated with a grocery store mist machine.

From 10 October through 13 November 1989, 33 patients were hospitalized with legionnaires' disease in Bogalusa, Louisiana. A case-control study revealed case-patients were more likely than controls to have shopped at grocery store A (93% vs. 52%; odds ratio [OR], 11.

An outbreak of hepatitis A associated with swimming in a public pool.

A multistate outbreak of hepatitis A was traced to a campground in Louisiana. Among 822 campers during one weekend, 20 developed hepatitis A. Case-patients ranged in age from 4 to 36 years; the highest attack rate (6.

Variations in the use of cesarean delivery for dystocia: lessons about the source of care.

Aggregate data show variations in the use of cesarean delivery according to the source of care, which suggests that rising cesarean rates are at least in part attributable to nonmedical factors. In the research presented here, the likelihood of cesarean delivery is examined for low-risk, primiparous women with physicians who practice in a single hospital but are from three practice organizations--a health maintenance organization (HMO), private practice, and a hospital clinic--while controlling for a wide spectrum of clinical factors. Maternal age was found to be a dominant factor in determining the decision for a cesarean delivery, independent of clinical risk and physicians' practice organization.

Comparative trial of dapsone versus trimethoprim/sulfamethoxazole for primary prophylaxis of Pneumocystis carinii pneumonia.

The purpose of this study was to compare the efficacy and safety of dapsone and trimethoprim/sulfamethoxazole in the primary prophylaxis of Pneumocystis carinii pneumonia (PCP) in patients infected with the human immunodeficiency virus (HIV) and having less than 200 CD4-positive cells per ml. This was a prospective, randomized, open-label study, using dapsone (100 mg p.o.

Bacterial pneumonia in the HIV-infected patient.

The incidence of bacterial pneumonia is increased in human immunodeficiency virus (HIV) infection, and bacteremia and recurrences occur frequently. Streptococcus pneumoniae and Haemophilus influenzae are the most common pathogens, but several other organisms have now been identified as etiologies. Several abnormalities in B-cells and humoral immunity, and possibly neutropenia and white blood cell dysfunction, predispose to bacterial pneumonia.

Evaluation of an intervention program in the control of an urban outbreak of shigellosis.

Community-wide outbreaks of shigellosis are a persistent public health problem. We evaluated the effect of a household-based intervention program on the control of an urban outbreak of S. sonnei gastroenteritis.

Unsuspected Chlamydia trachomatis infection in heterosexual men attending a sexually transmitted diseases clinic: evaluation of risk factors and screening methods.

To characterize the problem of unsuspected Chlamydia trachomatis infection in heterosexual men attending a sexually transmitted diseases (STD) clinic, the authors assessed risk factors for infection and the value of screening for infection by gram-stained smears and urinalysis in 438 men who did not have conventional clinical indications for chlamydial treatment at their initial visit. Evaluations included urethral swabs for gram-stained smears and Neisseria gonorrhoeae and C. trachomatis cultures and microscopy of first-catch urine sediment.

Immediate hypersensitivity reaction to single-dose parenteral ceftriaxone therapy for gonorrhea.

The authors describe a case of immediate hypersensitivity reaction after single-dose intramuscular administration of ceftriaxone for gonococcal urethritis. This reaction is the only one that was witnessed in 4,587 patients who were treated with ceftriaxone in our sexually transmitted diseases clinic during the past 3 years. This article emphasizes that although the frequency of such events is low (less than .

Prevalence of markers for hepatitis B and hepatitis D in a municipal house of correction.

Following an outbreak of hepatitis B (HBV) in a municipal house of correction, HBV markers were detected in 173/406 (43 percent) inmates and 10/129 (8 percent) staff. Of the 173 HBV-infected inmates, 14 (8 percent) had hepatitis D (HDV) markers compared to 0/10 staff members. Intravenous drugs use (IVDU) was most strongly associated with HBV marker presence.

A 62-dose, 6-month therapy for pulmonary and extrapulmonary tuberculosis. A twice-weekly, directly observed, and cost-effective regimen.

Study Objective: To evaluate the efficacy and toxicity of a 62-dose, four-drug, 6-month, and directly observed regimen for treatment of pulmonary and extrapulmonary tuberculosis.

Design: An open, nonblinded clinical trial, with intended follow-up of patients for 36 months after the completion of therapy.

Setting: A metropolitan tuberculosis clinic in a public health department.

Oral health policy issues for women and children.

A meaningful national oral health policy is essential to have an impact on the oral health of women and children in our country. The federal government must exert strong leadership to promote oral health as an integral component of total health. The public and private sectors of the dental and health professions must work together in developing, promoting, and supporting this policy on the local, state, and national level to make an impact on the oral health of the people of our nation.

Vibrio gastroenteritis in Louisiana: a prospective study among attendees of a scientific congress in New Orleans.

The incidence of diarrhea associated with infection by Vibrio species was investigated among attendees at the 1986 Interscience Conference on Antimicrobial Agents and Chemotherapy held in New Orleans. Twelve percent of respondents reported diarrhea; the risk of diarrhea was significantly higher in those who ate raw or cooked oysters (relative risk = 1.5, P = .

Pulmonary non-Hodgkin's lymphoma in AIDS.

Whereas extralymphatic involvement is common in lymphomas associated with HIV infection, there have been few reports of pulmonary lymphoma. In 648 cases of AIDS reported in Colorado, 40 have had non-Hodgkin's lymphoma. Of these, four have had documented pulmonary involvement and are reported in detail.

Late-stage diagnosis of breast cancer in women of lower socioeconomic status: public health implications.

To assess the success of breast cancer control activities in Connecticut, we examined data from the Connecticut Tumor Registry, determining differences in breast cancer stage at time of diagnosis over time and in selected subgroups. From 1982 to 1985, the percentage of women with cancer confined to the breast increased from 54.0 percent to 61.