Epidemiology

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Hemophilia growth and development study. Design, methods, and entry data

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Abstract

PURPOSE: The study design, research questions, and baseline data are presented from a multicenter longitudinal epidemiologic investigation of the impact of human immunodeficiency virus (HIV) infection on three areas of functioning in children and adolescents with hemophilia: physical growth and sexual maturation, immune function, and neurological and neuropsychological functioning.… Read more

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Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980-1990. National Nosocomial Infections Surveillance System

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Abstract

To identify pathogens causing nosocomial fungal infections and the secular trend in their incidence in US hospitals, data from the National Nosocomial Infections Surveillance System, 1980-1990, were analyzed. During that period, 30,477 fungal infections were reported. The rate rose from 2.0 to 3.8 infections/1000 discharges.… Read more

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Using indices to differentiate dimensions of knowledge regarding modes of HIV transmission in the U.S. population, 1987-1989

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Abstract

The number of HIV-infected individuals is increasing, making it important for the public to understand not only how HIV is transmitted but also the lack of transmission risk associated with casual contact. Using CDC’s National Center for Health Statistics National Health Interview Survey, we divided modes of transmission items into two areas of knowledge: “True Transmission” and “False Transmission.”… Read more

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Hospital outbreak of multidrug-resistant Mycobacterium tuberculosis infections. Factors in transmission to staff and HIV-infected patients

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Abstract

OBJECTIVE: To describe transmission of multidrug-resistant (MDR) Mycobacterium tuberculosis infection among patients and health care workers (HCWs) in a ward and clinic for human immunodeficiency virus (HIV)-infected patients in a hospital, four studies were conducted.

METHODS: Case patients and control patients were persons who had been treated in the HIV ward or clinic, whose clinical course was consistent with tuberculosis and who had at least one positive culture for M tuberculosis between January 1, 1988, and January 31, 1990, resistant to at least isoniazid and rifampin (case patients), or whose isolates were susceptible to all drugs tested (control patients).… Read more

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Antimicrobial susceptibility patterns of common and unusual species of enterococci causing infections in the United States. Enterococcal Study Group

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Abstract

We collected 705 isolates of enterococci (1 per patient) from cultures of a variety of anatomic sites from patients at eight tertiary-care hospitals in six geographic regions of the United States. A total of 632 (90%) Enterococcus faecalis, 58 (8%) E.… Read more

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Recall of AIDS public service announcements and their impact on the ranking of AIDS as a national problem

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Abstract

The efficacy of two public service announcements from Phase V of the “America Responds to AIDS” (ARTA) campaign was assessed at two sites. Participants were randomly assigned to view a local news program, one with an ARTA public service announcement appearing six times and the other with no AIDS public service announcements.… Read more

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The pediatrician’s role in encouraging parent-child communication about the acquired immunodeficiency syndrome

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Abstract

OBJECTIVE: We explored whether communication from pediatrician to parent to child might assist in education about and prevention of human immunodeficiency virus (HIV) infection by comparing parents of children aged 10 through 17 years who did discuss acquired immunodeficiency syndrome (AIDS) with their children with parents of children aged 10 through 17 years who did not discuss AIDS with their children.… Read more

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Outbreak of invasive group A streptococcal infections in a nursing home. Lessons on prevention and control

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Abstract

OBJECTIVE: Nine outbreaks of group A streptococcal (GAS) infections in nursing homes were reported to the Centers for Disease Control (Atlanta, Ga) during the past two winters. We conducted an intensive epidemiologic and laboratory investigation of one of these outbreaks to determine clinical characteristics, risk factors for transmission and infection, and methods of control and prevention.… Read more

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Risk factors for epidemic Xanthomonas maltophilia infection/colonization in intensive care unit patients

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Abstract

OBJECTIVE: To determine risk factors for and modes of transmission of Xanthomonas maltophilia infection/colonization.

DESIGN: Surveillance and cohort study.

SETTING: A 470-bed tertiary trauma-referral community hospital.

PATIENTS: From January 1, 1988 to March 17, 1989, 106 intensive care unit patients developed X maltophilia infection/colonization.… Read more

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A system for evaluating the use of media in CDC’s National AIDS Information and Education Program

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Abstract

The National AIDS Information and Education Program (NAIEP) commissioned the National Academy of Sciences to design a prototypical system of research for use in the evaluation of the agency’s media campaign. It consists of four types of evaluation: formative, efficacy, process, and outcome.… Read more

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Human immunodeficiency virus transmission from hemophilic men to their heterosexual partners

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Lawrence DN, Jason JM, Holman RC, Murphy JJ. In: Heterosexual transmission of AIDS: Alexander, N.J., Gabelnick, H.L. and Spieler, J.M. (Eds.), xiv + 440 pp., illus. Wiley-Liss, New York, 1990.

ISBN 0-471-562080-4

DOI: 10.1016/0022-1759(91)90137-5… Read more
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Nosocomial outbreaks: the Centers for Disease Control’s Hospital Infections Program experience, 1980-1990. Epidemiology Branch, Hospital Infections Program

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Abstract

From January 1980 to July 1990, the Hospital Infections Program of the Centers for Disease Control conducted 125 on-site epidemiologic investigations of nosocomial outbreaks. Seventy-seven (62%) were caused by bacterial pathogens, 11 (9%) were caused by fungi, 10 (8%) were caused by viruses, five (4%) were caused by mycobacteria, and 22 (18%) were caused by toxins or other organisms.… Read more

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Evaluating the “America Responds to AIDS” Campaign

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Abstract

Social marketing is “the design, implementation, and control of programs seeking to increase the acceptability of a social idea or practice in a target group.” It has existed in the United States for over a century and at various times has focused on such health-related behaviors as tobacco use, alcohol and drug use, control of hypertension, cancer screening, seat belt use, and-recently-behaviors placing a person at risk for HIV infection or a sexually transmitted disease.… Read more

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Mycobacterium gordonae pseudoinfection associated with a contaminated antimicrobial solution

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Abstract

At Yale-New Haven Hospital, 46 specimens submitted for mycobacterial culture during an 8-week period in 1989 were positive for Mycobacterium gordonae, a nontuberculous acid-fast bacterium (AFB) of low pathogenicity. The specimens were submitted from 34 patients who came from various inpatient and outpatient services.… Read more

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Comparison of species distribution and antimicrobial susceptibility of aerobic actinomycetes from clinical specimens

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Abstract

To compare the species distribution and antimicrobial susceptibility of aerobic actinomycetes, we evaluated 366 isolates referred to the Centers for Disease Control from October 1985 through February 1988. We used conventional biochemical tests to identify the various species. Four species accounted for 191 (52%) of aerobic actinomycete isolates: Nocardia asteroides (98 isolates), Actinomadura madurae (42 isolates), Streptomyces griseus (28 isolates), and Nocardia brasiliensis (23 isolates).… Read more

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Relationship of partially purified factor concentrates to immune tests and AIDS. The Hemophilia-AIDS. Collaborative Study Group

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Abstract

We evaluated those members of a cohort of 203 hemophilic men providing all necessary information at their 1984 and 1985 evaluations, to determine whether non-heated or less than 80 degrees C dry heat-treated partially purified factor products were associated with 1) the development of AIDS in human immunodeficiency virus (HIV)-infected persons or 2) abnormal immune test results in participants seroconverting or remaining HIV seronegative.… Read more

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Concordance of polymerase chain reaction with human immunodeficiency virus antibody detection

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Abstract

To evaluate the correlation of detection of human immunodeficiency virus (HIV) by polymerase chain reaction (PCR) with detection of HIV antibody, 271 simultaneous serum and peripheral blood mononuclear cell samples were examined from 242 persons whose activities placed them at increased risk for HIV infection: 142 from homosexual men, 86 from hemophilic men, and 43 from heterosexual partners of HIV-infected persons.… Read more

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Age and human immunodeficiency virus infection in persons with hemophilia in California

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Abstract

Thirteen hemophilia centers provide comprehensive care to approximately 90 percent of persons with hemophilia in California. For 1987, these centers reported patient human immunodeficiency virus (HIV) antibody status, age group, level of clotting factor deficiency, and hemophilia type on 1,438 persons with hemophilia A and B; HIV serologic status was known for 860 persons (59.8 percent) of whom 537 (62.4 percent) were HIV-antibody-positive.… Read more

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Pregnancies in human immunodeficiency virus-infected sex partners of hemophilic men. The Hemophilia-AIDS Collaborative Study Group

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Abstract

We investigated 24 completed pregnancies of 20 healthy, human immunodeficiency virus (HIV)-seropositive sex partners of 20 seropositive hemophilic men. One woman had recurrent herpes simplex type 2 infection; no woman was known to use illicit drugs or to have other purported cofactors for vertical HIV transmission.… Read more

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Absence of human T-cell lymphotropic virus type I coinfection in human immunodeficiency virus-infected hemophilic men

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Abstract

Concern for transmission of human T-cell lymphotropic virus, type 1 (HTLV-1) infection to recipients of infected cellular blood products has prompted development of tests to eliminate blood units with HTLV-I antibodies. Most hemophilic men from the United States became infected with human immunodeficiency virus (HIV) before HIV donor screening and before blood products were processed to inactivate the virus.… Read more

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Prevalence of human immunodeficiency virus type 1 DNA in hemophilic men and their sex partners. Hemophilia-AIDS Collaborative Study Group

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Abstract

Polymerase chain reaction (PCR) was used to detect human immunodeficiency virus (HIV)-1 DNA in peripheral blood mononuclear cells to assess in hemophilic men whether any were HIV-seropositive but uninfected or seronegative but infected and in seronegative sex partners of seropositive hemophilic men whether any were infected.… Read more

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Geographic variability of hemophilia-associated AIDS in the United States: effect of population characteristics. Hemophilia-Associated AIDS Study Group

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Abstract

National AIDS surveillance suggests that approximately 3.5% of all hemophilic patients in the United States have developed AIDS as of February 1988; however, the cumulative incidence of AIDS among seropositive patients at individual hemophilia treatment centers (HTCs) has been reported to be as high as 12%.… Read more

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Epidemic iatrogenic Acinetobacter spp. meningitis following administration of intrathecal methotrexate

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Abstract

We report the first outbreak of Acinetobacter species meningitis in a group of children with acute leukaemia following the administration of intrathecal chemotherapy. Eight of twenty patients receiving methotrexate injections on a single day developed signs and symptoms of meningitis within 18 h of treatment, and cases were clustered by time of administration.… Read more

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Duration of human immunodeficiency virus infection before detection of antibody

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Abstract

To estimate the duration and frequency of the period of HIV infection without detectable antibody, modelling techniques were applied to results of detection of HIV DNA by means of the polymerase chain reaction (PCR) and to data from cases in published reports.  … Read more

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Infectious disease-related deaths of low birth weight infants, United States, 1968 to 1982

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Abstract

Infant mortality rates in the United States are higher than in any other developed country. Low birth weight (LBW) is the primary determinant of infant mortality.

 

Despite city, state, and federal programs to prevent LBW, decreases in infant mortality in the 1980s appear to be largely secondary to improved survival of LBW infants rather than to a decline in the rate of LBW births.… Read more

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Risk of developing AIDS in HIV-infected cohorts of hemophilic and homosexual men

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Abstract

The latency period and/or incidence of the acquired immunodeficiency syndrome (AIDS) may differ in persons infected with the human immunodeficiency virus by different routes or having different “cofactors.” We compared 79 hemophilic men in Pennsylvania and 117 homosexual and bisexual men in California, all having known dates of infection and long postinfection observation periods, to examine these hypotheses.… Read more

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Sex practice correlates of human immunodeficiency virus transmission and acquired immunodeficiency syndrome incidence in heterosexual partners and offspring of U.S. hemophilic men

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Abstract

We assessed the risk of human immunodeficiency virus (HIV) transmission from heterosexual seropositive hemophilic men to their female sex partners through an HIV serosurvey and questionnaire study conducted during 1984-1987. Five percent of 21 female partners of asymptomatic men and 11% of 35 partners of HIV-symptomatic (acquired immunodeficiency syndrome [AIDS], AIDS-related complex [ARC], peripheral generalized lymphadenopathy [PGL]) hemophilic men had been infected when first tested.… Read more

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HIV and hemophilic children’s growth

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Abstract

The acquired immune deficiency syndrome (AIDS) often has profound effects on growth; however, the effects of human immunodeficiency virus (HIV) on asymptomatic children’s growth are unknown. Before heat inactivation/HIV donor screening of factor concentrates, many hemophilic children became infected with HIV.… Read more

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Human immunodeficiency virus infection in hemophilic children

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Abstract

The following groups were compared: (1) children less than 18 years old who have hemophilia-associated acquired immunodeficiency syndrome (AIDS) with other children with AIDS and with adults who have hemophilia-associated AIDS and (2) asymptomatic HIV-infected hemophilic children with asymptomatic HIV-infected hemophilic adults.… Read more

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Comparative evaluation of selective media for isolation of Pseudomonas cepacia from cystic fibrosis patients and environmental sources

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Abstract

Pseudomonas cepacia has recently emerged as an important pathogen affecting cystic fibrosis (CF) patients. We evaluated three selective media to assess their comparative potential for identification of patients colonized with P. cepacia and for efficacy of detection of P. cepacia in environmental fluids.… Read more

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Biotyping coagulase-negative staphylococci

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Abstract

The biochemical profiles obtained with Staph-Ident (Analytab Products, Plainview, N.Y.) panels were combined with the results of adherence and synergistic hemolysis tests to define biotypes among 1,064 clinical isolates representing eight species of coagulase-negative staphylococci. The 672 isolates of Staphylococcus epidermidis were aligned in 69 of 144 potential biotypes in our scheme because of 18 different biochemical profiles and the eight physiologic subtypes.… Read more

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Characteristics of coagulase-negative staphylococci that help differentiate these species and other members of the family Micrococcaceae

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Abstract

One hundred reference strains and 1,240 clinical isolates representing 26 species of the family Micrococcaceae were used to evaluate the potential of tests for synergistic hemolysis, adherence to glass, pyroglutamyl-beta-naphthylamide hydrolysis, and susceptibility to a set of five antimicrobial agents for differentiating these species and strains within the species.… Read more

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Description of case-mix adjusters by the Severity of Illness Working Group of the Society of Hospital Epidemiologists of America (SHEA)

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Abstract

Hospitals, insurance companies, and federal and state governments are increasingly concerned about reducing patient cost expenditures while maintaining high quality patient care. One method of reducing expenditures has been to tie hospital reimbursement with a prospective payment system based on diagnosis-related groups (DRGs).… Read more

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Racial differences in care of patients with hemophilia

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Abstract

Hemophilia treatment centers were first established in the mid­-1970s to provide optimal and coordinated medical care to patients with the disorder. Our study suggests that blacks with hemophilia may be receiving less coordinated care and less appropriate blood­ product therapy than whites with hemophilia.… Read more

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CDC definitions for nosocomial infections, 1988

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Abstract

The Centers for Disease Control (CDC) has developed a new set of definitions for surveillance of nosocomial infections. The new definitions combine specific clinical findings with results of laboratory and other tests that include recent advances in diagnostic technology; they are formulated as algorithms.… Read more

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Hemophilia-associated AIDS in the United States, 1981 to September 1987

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Abstract

Between January 1, 1981 and September 4, 1987, 407 cases of hemophilia-associated acquired immunodeficiency syndrome (AIDS) had been reported to the Centers for Disease Control. The number of cases diagnosed each year nearly doubled, except in 1986, when cases increased only 50 per cent.… Read more

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Potential effect of revising the CDC surveillance case definition for AIDS

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Abstract

The Centers for Disease Control (CDC) revised the surveillance case definition for acquired immunodeficiency syndrome (AIDS) in August, 1987. To determine the impact of this revision, information was extracted from the medical charts of the 630 patients receiving comprehensive medical care as of 1980 at 6 haemophilia treatment centres, and who were therefore likely to have been infected with human immunodeficiency virus (HIV).… Read more

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An outbreak of necrotizing enterocolitis. Association with transfusions of packed red blood cells

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Abstract

Of 187 newborns admitted to a 33-bed, level III neonatal intensive care unit between January 1, 1985 and June 23, 1985, 33 developed necrotizing enterocolitis during their hospital stay. Twenty of the 33 newborns (61%) had onset of symptoms between April 1 and June 23, suggesting clustering during this period.… Read more

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The epidemiology of Pseudomonas cepacia in patients with cystic fibrosis

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Abstract

Pseudomonas cepacia has emerged as an important nosocomial pathogen colonizing and infecting the respiratory tract of patients with cystic fibrosis (CF). Although assessment of outcomes associated with P. cepacia colonization has been difficult, controlled studies have shown that colonized patients experience more adverse outcomes compared with those not colonized.… Read more

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The Epidemiology of AIDS

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Abstract

Cases of the acquired immune deficiency syndrome (AIDS) were first reported in June and July of 1981, as clusters of Kaposi’s sarcoma and Pneumocystis carinii pneumonia among homosexual men. Since then, epidemiologic surveillance has been used by investigators and public health professionals to identify that an outbreak existed, to characterize the outbreak, and to determine and predict its extent and course.… Read more

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Hemophiliac patient’s knowledge and educational needs concerning acquired immunodeficiency syndrome

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Abstract

The Patient Knowledge Assessment Study (PKAS) was conducted among 107 male hemophilic patients, aged 15 to 67 years, at 19 hemophilia treatment centers (HTC). Participants were given a 30-item questionnaire concerning the cause of acquired immunodeficiency syndrome (AIDS), the groups at risk, and modes of transmission.… Read more

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Infectious diseases: preventable causes of infant mortality

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Abstract

After almost a century of improvement, the rate of decrease in US infant mortality rates began to level off during the period of 1982 to 1984. Rates actually increased in some states. Because much of the decline in infant mortality in this century can be attributed to advances in infectious disease treatment and prevention programs, we evaluated the current impact of infectious diseases on infant mortality.… Read more

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The epidemiology of nosocomial Pseudomonas cepacia infections: endemic infections

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Abstract

Pseudomonas cepacia has recently emerged as an important nosocomial pathogen. We analyzed a national nosocomial infections database, the National Nosocomial Infections Surveillance (NNIS) system, to describe the epidemiology of endemic nosocomial P. cepacia infections. Between 1980 and 1985, the P.… Read more

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The epidemiology of nosocomial epidemic Pseudomonas cepacia infections

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Abstract

Pseudomonas cepacia has occasionally been identified as an epidemic and endemic nosocomial pathogen. In outbreaks, usually one clinical site predominates but many may be involved. Detailed investigations have usually implicated a contaminated liquid reservoir or moist environmental surface as the source.… Read more

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The course of the epidemic of acquired immunodeficiency syndrome in the United States hemophilia population

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Abstract

The time course of the epidemic of acquired immunodeficiency syndrome (AIDS) as it has occurred in the US hemophilia population is examined using surveillance data collected by the Centers for Disease Control (CDC). These data indicate that the epidemic course in hemophiliacs is distinguishable from that in the homosexual/bisexual and intravenous drug-using populations in at least one respect–the epidemic in the hemophilia population is characterized by a lack of consistent increase in the number of new AIDS cases in successive time intervals.… Read more

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Colonization of the respiratory tract with Pseudomonas cepacia in cystic fibrosis. Risk factors and outcomes

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Abstract

Between 1981 and 1983, some 85 patients with cystic fibrosis at Rainbow Babies and Childrens Hospital, Cleveland, developed colonization or infection of the respiratory tract with Pseudomonas cepacia. Twenty-nine (34 percent) of the colonized patients died; four were female patients with fulminant bacteremia with P cepacia prior to death.… Read more

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Effects of exposure to factor concentrates containing donations from identified AIDS patients. A matched cohort study

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Abstract

We compared recipients of eight lots of factors VIII and IX voluntarily withdrawn from distribution because one donor was known to have subsequently developed the acquired immunodeficiency syndrome with a nonexposed cohort matched by age, sex, and factor use. The factor VIII recipient cohorts did not differ in prevalence of antibody to human immunodeficiency virus (HIV) (exposed, 75%; nonexposed, 86%), T-cell subset numbers (median: exposed, 619 T-helper cells per cubic millimeter; nonexposed, 659 T-helper cells per cubic millimeter), T-helper to T-suppressor ratios, or immunoglobulin levels.… Read more

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The Role of Parvovirus B19 in Aplastic Crisis and Erythema Infectiosum (Fifth Disease)

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Abstract

In 1984, simultaneous outbreaks of aplastic crisis and erythema infectiosum occurred in northeastern Ohio. Sera were analyzed from 26 patients with aplastic crisis: 24 had IgM specific for parvovirus B19, five had Bl9-like particles by electron microscopy, and 13 had DNA from B19; no sera from 33 controls had evidence of recent infection with B19 (P< .0001).… Read more

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HTLV-III/LAV-seronegative, virus-negative sexual partners and household contacts of hemophiliacs

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Abstract

Public concern about the transmissibility of human T-cell lymphotropic virus type III/ lymphadenopathy-associated virus (HTLV-III/LAV) has been heightened by several reports suggesting the existence of an antibody-negative, virus-positive state in some asymptomatic sex partners of persons who are antibody-positive.  We recently evaluated 88 household members and/or sex partners of persons with hemophilia and found that only two nonhemophiliacs were HTLV-III/LAV antibody-positive.  … Read more