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Biomedical subjects

B G Weniger

Publications and source records attributed to B G Weniger.

49 records · Page 3Linked to original sources

A high rate of neurological complications following Semple anti-rabies vaccine.

A fatal case of encephalitis due to Semple (phenolized sheep-brain) anti-rabies vaccine prompted a search for neurological complications among 722 recipients of 2 vaccine batches administered in Bangkok, Thailand in June and July 1984. A review of all patients admitted with neurological symptoms from June through August 1984 to the 5 major teaching hospitals in Bangkok found 6 cases (0.83%), including the index case, who had received the vaccine. Rabies infection was ruled out in all 6 cases. 4 patients had meningitis, and 2 had meningo-encephalitis. Only the index case was fatal; the other patients recovered without neurological sequelae. The rate of neurological complications after receiving Semple vaccine was therefore a minimum of 8.31 cases per 1000 persons vaccinated (1:120). This complication rate was about 25 times higher than the overall complication rate of 0.33 per 1000 (1:3018) determined from 14 previous reports. The fatality rate was 1.39 per 1000 (1:722), about 15 times higher than the rate of 0.09 per 1000 (1:10805) calculated from the previous studies. It is urgent to find economically feasible alternatives to Semple vaccine.

Adolescent↗

Polymicrobial aetiology of travellers' diarrhoea.

Of 35 US Peace Corps volunteers in Thailand, 20 (57%) had a total of 30 episodes of diarrhoea during their first 6 weeks in the country. Enteric pathogens were associated with 90% of the episodes. A single pathogen was identified in 17 (57%) episodes, 2-4 pathogens were identified in 10 (33%) episodes, and there were 15 symptomless infections. Enterotoxigenic Escherichia coli (ETEC) was identified in 37% of these episodes, and various salmonella serotypes were isolated in 33%. Infections with 9 other enteric pathogens were also identified: Campylobacter jejuni (17%), Plesiomonas shigelloides (13%), Aeromonas hydrophila (10%), Blastocystis hominis (7%), Norwalk virus (7%), Vibrio parahaemolyticus (3%), non-O1 Vibrio cholerae (3%), Vibrio fluvialis (3%), and rotavirus (3%). In total, 56 enteric infections were documented in 35 volunteers.

Adult↗

Prevalence of HTLV-III/LAV antibody in selected populations in Thailand.

Antibody to the human T-lymphotropic virus, type III/lymphadenopathy-associated virus (HTLV-III/LAV) by ELISA test was detected in one (1%) of 101 male homosexual prostitutes (confidence limit 95%:0.03-5.4%, in two (2%) of 100 thalassemia patients, and in none (C.L. 95%:0-3.6%) of 100 female prostitutes, 99 parenteral drug abusers, 100 male VD patients, 100 consecutive blood donors in serum collected from February through June 1985. Serum from the positive homosexual subject was strongly positive on repeated ELISA testing, and was also positive by Western Blot test. The two thalassemia patients, who were repeatedly weakly-positive by ELISA, were negative by Western Blot test and presumed to be false positive reactors. Prevalence of HTLV-III/LAV virus in sexually-active homosexuals in Thailand in 1985 appears to be similar to the 1% rate among homosexuals in San Francisco in 1978 at the start of the AIDS epidemic there.

Acquired Immunodeficiency Syndrome↗

Human bubonic plague transmitted by a domestic cat scratch.

Bubonic plague was transmitted to a 10-year-old girl in Oregon by a scratch wound inflicted by a domestic cat. The cat probably was infected by contact with infected wild rodents or their fleas. Yersinia pestis was identified in Diamanus montanus fleas collected from an abandoned burrow near the patient's home. Domestic cats may infect humans with Y pestis by inoculation from a scratch.

Animals↗

Diphyllobothriasis associated with salmon consumption in Pacific Coast states.

A review of requests for niclosamide ( Niclocide or Yomesan ) made to the Centers for Disease Control Parasitic Diseases Drug Service indicated that an outbreak of diphyllobothriasis occurred in west coast states in 1980, and in the Los Angeles area in 1981. Our investigation of 52 infections that occurred in 1980 implicates fresh salmon (Oncorhynchus spp.) as the host for the Diphyllobothrium parasite in 82% of the persons interviewed. We describe here common symptoms of the infection, methods of fish preparation employed by infected individuals, and epidemiologic data. We suggest that changes in fish marketing practices and the popularity of uncooked or slightly cooked fresh salmon were responsible for this epidemic. We recommend that salmon be either cooked or frozen before it is eaten.

Alaska↗

Fecal coliforms on environmental surfaces in two day care centers.

A survey of environmental surfaces in two Atlanta area day care centers was conducted to determine the prevalence of fecal coliform bacteria, considered a marker for the presence of fecal contamination which might contain pathogenic parasites, bacteria, or viruses. Fecal coliforms were found in 17 (4.3%) of 398 representative samples of building surfaces, furniture, and other objects. These surfaces may be involved in the chain of transmission of enteric diseases among children. Therefore, disinfection of inanimate objects, in addition to good handwashing, may be important in controlling the spread of enteric diseases in day care centers.

Child Day Care Centers↗

An outbreak of waterborne giardiasis associated with heavy water runoff due to warm weather and volcanic ashfall.

From mid-June through early August 1980, an outbreak of gastrointestinal illness in Red Lodge, Montana affected approximately 780 persons, as estimated from attack rates of 33 per cent and 15 per cent in urban and rural residents, respectively. Giardia lamblia was identified in stool specimens from 51 per cent of 47 persons with a history of untreated gastrointestinal illness and in 13 per cent of 24 specimens from asymptomatic persons (p = .00045, Fisher's Exact Test). The epidemic curve was bimodal with peaks in mid-June and mid-July. Each peak occurred about three weeks after an episode of very heavy water runoff resulting from warm sunny weather and snow darkened by ashfall from the Mt. St. Helens volcanic eruption of May 18, 1980. Unfiltered and inadequately chlorinated surface water was supplied by the city water system, which was implicated as the vehicle of transmission in the outbreak. Water systems providing unfiltered surface water are more likely to become contaminated during periods of heavy water runoff.

Disasters↗

Transfusion malaria in the United States, 1972-1981.

Twenty-six cases of transfusion-induced malaria were reported in the United States from 1972 through 1981. In nine patients malaria was due to Plasmodium malariae; eight, P. falciparum; eight, P. vivax; and one, P. ovale. Four patients died. The estimated rate of transfusion malaria for this period was 0.25 cases per million donor units collected. Of the 18 cases in which a specific infective blood donor could be identified, at least nine of the donors should have been rejected for blood donation because of recent residence or travel to a malarious area. Among 17 patients for whom the national origin of the implicated blood donor was reported, 12 were born in malarious countries. We propose minor changes in donor procedures and standards, including stricter criteria for donors born in malarious countries. Potential donors should be deferred for 3 years after an unexplained febrile illness occurring 1 year after exposure to malaria.

Adolescent↗

Dried blood spots collected on filter paper: an international resource for the diagnosis and genetic characterization of human immunodeficiency virus type-1.

The collection of dried blood spots (DBS) on filter paper provides a powerful approach for the development of large-scale, population-based screening programs. DBS methods are particularly valuable in developing countries and isolated rural regions where resources are limited. Large numbers of field specimens can be economically collected and shipped to centralized reference laboratories for genetic and (or) serological analysis. Alternatively, the dried blood can be stored and used as an archival resource to rapidly establish the frequency and distribution of newly recognized mutations, confirm patient identity or track the origins and emergence of newly identified pathogens. In this report, we describe how PCR-based technologies are beginning to interface with international screening programmes for the diagnosis and genetic characterization of human immunodeficiency virus type 1 (HIV-1). In particular, we review recent progress using DBS specimens to resolve the HIV-1 infection status of neonates, monitor the genetic evolution of HIV-1 during early infancy and establish a sentinel surveillance system for the systematic monitoring of HIV-1 genetic variation in Asia.

AIDS Serodiagnosis↗

Epidemiologic analysis of a cluster of homicides of children in Atlanta.

Between July 1, 1979, and March 15, 1981, there were 22 unsolved homicides and two unsolved disappearances of Atlanta children. Using epidemiologic methods, we attempted to identify factors that had put children at an increased risk of homicide. That all victims in this cluster were black, killed away from home, and that asphyxiation was overrepresented suggests that the cluster was discrete. The cluster was not homogeneous in relation to location of the victim's area of residence or location of the body; however, the median distance of 9.3 miles from home to body suggests that in some cases a motor vehicle was involved. A neighborhood-based study of the male victims and age- and sex-matched controls showed that victims more often ran errands for money (relative risk, 7.9) and were more often alone on the streets or in shopping centers; therefore, they may have been more approachable than other children in the neighborhood.

Adolescent↗