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Detecting pediatric nosocomial infections: how do infection control and quality assurance personnel compare?

Abstract

OBJECTIVE: To compare how well infection control (IC) and quality assurance (QA) personnel in a specialty setting identify the presence, type (nosocomial or community-acquired), and (if nosocomial) site of infection.

METHODS: In 1994, we mailed a survey that included 21 pediatric case histories to IC and QA personnel in pediatric settings in the United States (children’s hospitals and medical school-affiliated hospitals with pediatric wards of 30 beds).… Read more

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Nosocomial infections among neonates in high-risk nurseries in the United States. National Nosocomial Infections Surveillance System

Abstract

BACKGROUND: Nosocomial infections result in considerable morbidity and mortality among neonates in high-risk nurseries (HRNs).

PURPOSE: To examine the epidemiology of nosocomial infections among neonates in level III HRNs.

METHODS: Data were collected from 99 hospitals with HRNs participating in the National Nosocomial Infections Surveillance system, which uses standard surveillance protocols and nosocomial infection site definitions.… Read more

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Epidemiology of nosocomial fungal infections, with emphasis on Candida species

Abstract

Currently, about 180 hospitals participate in the National Nosocomial Infections Surveillance (NNIS) system. From January 1980 through April 1990, 27,200 fungal isolates causing nosocomial infections were reported from these hospitals; Candida species accounted for 19,621 (72.1%) of these isolates. Immunocompromised patients are at particularly high risk for candidemia.… Read more

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Tuberculosis in health care workers at a hospital with an outbreak of multidrug-resistant Mycobacterium tuberculosis

Abstract

OBJECTIVE: Investigate reports of tuberculosis in health care workers employed at a hospital with an outbreak of multidrug-resistant Mycobacterium tuberculosis.

DESIGN: Case series of tuberculosis in health care workers, January 1, 1989, through May 31, 1992. Antimicrobial susceptibility testing and restriction fragment length polymorphism analysis of M tuberculosis isolates.… Read more

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Epidemic nosocomial pneumonia in the intensive care unit

Abstract

The changing and expanding spectrum of pathogens associated with nosocomial pneumonia (NP) will require modification in our approach to both endemic and epidemic NP in the ICU. Knowledge of specific pathogens, modes of transmission, and sources or reservoirs of epidemic NP is crucial to the recognition, control, and prevention of these infections in ICU patients.… Read more

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Respirators, recommendations, and regulations: the controversy surrounding protection of health care workers from tuberculosis

Abstract

Recent nosocomial outbreaks of tuberculosis have increased concern about the occupational acquisition of tuberculosis by health care workers. The Centers for Disease Control and Prevention (CDC), Department of Health and Human Services, and the Occupational Safety and Health Administration, Department of Labor, have issued recommendations and regulations in an effort to decrease health care workers’ risk for exposure to patients with infectious tuberculosis.… Read more

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Latex sensitivity among perioperative nurses

Abstract

To estimate the prevalence, risk factors, and clinical spectrum of adverse reactions to natural rubber latex-containing products among a national sample of perioperative nurses, the investigators administered a self-reporting questionnaire to a convenience sample of 2,200 members of the Association of Operating Room Nurses, Inc.… Read more

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Infectious diseases and death among nursing home residents: results of surveillance in 13 nursing homes

Abstract

An increasing proportion of the U.S. population resides in nursing homes (NHs). No surveillance system exists for infections in these facilities. To determine the incidence and types of infections in NH residents, and to identify predictors of death among residents with infections, we initiated a surveillance system at 13 NHs in California during a 6-month period from October 1989 through March 1990.… Read more

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Bacterial contamination of platelets at a university hospital: increased identification due to intensified surveillance

Abstract

BACKGROUND: A cluster of bacterial contamination of platelets occurred at a university hospital in a one-month period. This unusual clustering allowed us to examine the likely mechanism of contamination and clinical sequelae.

METHODS: We reviewed medical records of patients receiving random donor platelet transfusions to determine numbers of platelets transfused, reactions reported, and episodes of bacterial contamination.… Read more

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Infectious diseases and mortality among US nursing home residents

Abstract

Data collected in the 1985 National Nursing Home Survey were analyzed to identify risk factors for infections and mortality and to explore their relationship in US nursing homes. An infection was recorded in 166,609 (14%) discharges. Risk of pneumonia was found to be higher among bedbound patients (54.5 vs 13.1 per 100 discharges); urinary tract and other infections were most frequent among residents with indwelling catheters (6.6 vs 1.0 per 100 discharges).… Read more

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Educating Young Adults About HIV and AIDS: the Impact of Direct Response Television Public Service Advertising

ABSTRACT Limited resources combined with a desire to reach as many people as possible often make direct response public service announcements an important tool in educational campaigns. To understand the impact of direct-response TV PSAs, and find ways to increase their effectiveness, this study examined 1) the effects of a highly targeted HIV prevention message on young adults’ knowledge, perceptions, and intentions; and 2) whether altering two PSA elements, the telephone number used and the length of time it was displayed, would affect viewers’ recall and intention responses.  … Read more

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Potential use of mass media to reach urban intravenous drug users with AIDS prevention messages

Abstract

To access the potential of using the mass media to reach urban intravenous drug users (IVDUs) with AIDS prevention messages,

we: 1) questioned 353 participants in a Baltimore IVDU cohort study on their media use and sources of AIDS information, 2) analyzed data on Baltimore AIDS public service announcement (PSA) airings during a 3-month period, and 3) discussed with media executives their willingness to air a variety of potential AIDS messages.… 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

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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Nosocomial infections in surgical patients in the United States, January 1986-June 1992. National Nosocomial Infections Surveillance (NNIS) System

Abstract

OBJECTIVES: To describe the distribution of nosocomial infections among surgical patients by site of infection for different types of operations, and to show how the risk of certain adverse outcomes associated with nosocomial infection varied by site, type of operation, and exposure to specific medical devices.… 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

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.” Items were recoded with scores from 3 for the most correct response to 0 for the most incorrect response for each of three items related to true and each of eight items related to false transmission.… Read more

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

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

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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Predominant pathogens in hospital infections

Abstract

To determine the distribution of pathogens causing nosocomial infections in United States hospitals, we analysed data from the National Nosocomial Infections Surveillance (NNIS) System. From October 1986 to December 1990, amongst hospitals conducting hospital-wide surveillance, the five most commonly reported pathogens were Escherichia coli (13.7%), Staphylococcus aureus (11.2%), enterococci (10.7%), Pseudomonas aeruginosa (10.1%), and coagulase-negative staphylococci (9.7%).… Read more

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

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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Paid advertising for AIDS prevention–would the ends justify the means?

Abstract

An examination by the Centers for Disease Control and the Research Triangle Institute concluded that “hard-to-reach” populations could be reached with AIDS prevention messages through the broadcast and print media and that a study should be undertaken to assess whether paid placement of these messages could have an effect on HIV-related behaviors.… Read more

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

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

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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Secular trends in nosocomial primary bloodstream infections in the United States, 1980-1989. National Nosocomial Infections Surveillance System

Abstract

More than 25,000 primary bloodstream infections (BSIs) were identified by 124 National Nosocomial Infections Surveillance System hospitals performing hospital-wide surveillance during the 10-year period 1980-1989. These hospitals reported 6,729 hospital-months of data, during which time approximately 9 million patients were discharged.… Read more

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Nosocomial infections in elderly patients in the United States, 1986-1990. National Nosocomial Infections Surveillance System

Abstract

We analyzed 101,479 nosocomial infections in 75,398 adult patients (greater than 15 years) that were reported to the National Nosocomial Infections Surveillance (NNIS) system between 1986 and 1990 by 89 hospitals using the NNIS hospital-wide surveillance component. Overall, 54% of the infections occurred in elderly patients (greater than or equal to 65 years).… Read more

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Comparison of rates of nosocomial infections in neonatal intensive care units in the United States. National Nosocomial Infections Surveillance System

Abstract

To determine nosocomial infection (NI) rates among neonatal intensive care units (NICUs) that are useful for interhospital comparison, we analyzed data reported in 1986-1990 from 35 hospitals that have level III NICUs and used standard National Nosocomial Infections Surveillance protocols and NI site definitions.… Read more

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Nosocomial infection rates in adult and pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System

Abstract

To determine which intensive care unit (ICU) infection rate may be best for interhospital and intrahospital comparisons and to assess the influence of invasive devices and type of ICU on infection rates, we analyzed data from the National Nosocomial Infections Surveillance System.… Read more

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Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System

Abstract

To perform a valid comparison of rates among surgeons, among hospitals, or across time, surgical wound infection (SWI) rates must account for the variation in patients’ underlying severity of illness and other important risk factors. From January 1987 through December 1990, 44 National Nosocomial Infections Surveillance System hospitals reported data collected under the detailed option of the surgical patient surveillance component protocol, which includes definitions of eligible patients, operations, and nosocomial infections.… Read more

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The National Nosocomial Infections Surveillance System: plans for the 1990s and beyond

Abstract

The National Nosocomial Infections Surveillance (NNIS) System is an ongoing collaborative surveillance system among the Centers for Disease Control (CDC) and United States hospitals to obtain national data on nosocomial infections. This system provides comparative data for hospitals and can be used to identify changes in infection sites, risk factors, and pathogens, and develop efficient surveillance methods.… Read more

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Universal precautions and mortuary practitioners: influence on practices and risk of occupationally acquired infection

Abstract

Embalming, the most common funeral practice in the United States, may expose the embalmer to infectious diseases and blood. We surveyed the 860 members of the National Selected Morticians in 1988 to estimate the incidence of self-reported occupational contact with blood and infectious disease, assess morticians’ knowledge of acquired immunodeficiency syndrome (AIDS), determine their adherence to universal precautions, and identify predictors of practices designed to reduce risk of occupational exposure to infections.… Read more

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Evaluating the “America Responds to AIDS” Campaign

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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National nosocomial infections surveillance system (NNIS): description of surveillance methods

Abstract

The National Nosocomial Infections Surveillance System (NNIS) is an ongoing collaborative surveillance system sponsored by the Centers for Disease Control (CDC) to obtain national data on nosocomial infections. The CDC uses the data that are reported voluntarily by participating hospitals to estimate the magnitude of the nosocomial infection problem in the United States and to monitor trends in infections and risk factors.… Read more

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

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

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

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

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

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

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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Pyrogenic reactions associated with the reuse of disposable hollow-fiber hemodialyzers

Abstract

We investigated 18 pyrogenic reactions (PRs) that occurred between July 1 and 13, 1987, in 16 patients receiving long-term hemodialysis at one dialysis center in Illinois. We defined a case of PR as the onset of chills or fever (oral temperature, greater than or equal to 37.8 degrees C) in a patient who was afebrile and had no signs or symptoms of infection before a dialysis treatment.… Read more

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Human immunodeficiency virus infection in hemophilic children

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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Racial differences in care of patients with hemophilia

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

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

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

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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The epidemiology of Pseudomonas cepacia in patients with cystic fibrosis

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

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

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

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

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

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