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Biomedical subjects

C B Hall

Publications and source records attributed to C B Hall.

At least 163 records · Page 9Linked to original sources
PubMed1978

Control of nosocomial respiratory syncytial viral infections.

We evaluated methods to control the spread of respiratory syncytial virus (RSV) on our infants' ward during a community outbreak of RSV infection. Methods included isolation and cohorting of infected infants, strict handwashing, use of gowns, and the cohorting of staff to the ill infants. Of 123 infants studied, 36 were admitted with RSV infections. Of the remaining 87 contact infants, eight (19%) acquired nosocomial RSV disease. Three of the eight developed pneumonia and one died. Of the 43 staff members, 24 (56%) became infected and 82% were symptomatic. Four acquired repeated infections within weeks of the initial infection. Studies a year previously had revealed that 45% of contact infants and 42% of the staff had acquired nosocomial RSV infections. Thus, the employed procedures appeared to have decreased the transmission of RSV to infants but not to the staff. Staff may continue to be infected by large droplets from close contact with ill infants or by self-inoculation of contaminated secretions.

Antisepsis↗
PubMed1977

The return of Boston exanthem. Echovirus 16 infections in 1974.

Although the "Boston exanthem" has been seen rarely over the past 20 years, in the summer of 1974 we identified ten children, aged 1 week to 7 years with echovirus 16 infections. Seven of the children had rashes, and in four, the illness suggested roseola infantum. Five of these children were neonates, all with illnesses severe enough to mimic sepsis. In addition information obtained on echovirus 16 isolations occurring in 1974 elsewhere in the country showed an additional 27 isolations from eight states. It is postulated that more outbreaks of the Boston exanthem or other echovirus 16 illnesses will appear during the next several years, before the virus again "disappears".

Boston↗
PubMed1977

Parainfluenza viral infections in children: correlation of shedding with clinical manifestations.

Children presenting with acute respiratory disease to a private group practice in the fall of 1975 were studied to: (1) evaluate the efficacy in a pediatric office of a simple technics of obtaining nasal washes for the diagnosis of parainfluenza virus infections and (2) to determine the quantities of virus shed in relation to clinical characteristics. The nasal wash technic proved feasible for an office or clinic. Parainfluenza virus type 1 was recovered from 26 (74%) of 35 children with croup and from 40 (56%) of the total 72 children presenting with any form of respiratory illness. Virus was recovered significantly more often from children with croup and from those of younger age. The mean quantity of virus in 26 nasal washes was 2.97 log10 TCID50/ml. The shedding of greater quantities was correlated with younger age and the more frequent occurrence of laryngitis, pharyngitis, and fever.

Acute Disease↗
PubMed1977

Response of children with cardiac disease to the bivalent influenza A vaccines.

During the recent nationwide trials of influenza vaccine, 121 children with cardiac disease, aged three to 18 years, were evaluated with respect to their immune response and reaction rate after administration of a whole-virus or split-virus bivalent influenza A/New Jersey/76-A/Victoria/75 vaccine given as a single dose or two divided doses. The serologic response of the cardiac children did not differ significantly from that of the total group of high-risk children or normal children who recived the same vaccine. The major reaction to the vaccines was fever, which occurred in one-fourth to one-half of children receiving the whole-virus vaccines. The split-virus vaccines were generally well tolerated. The reaction index of the cardiac children was slightly lower than that of the normal children receiving the same vaccine during the single-dose trial but higher during the two-dose trial. The second dose was generally better tolerated than the first dose. Reactions in the children with cardiac disease could not be adequately evaluated according to specific diagnoses or functional disabilities.

Adolescent↗
PubMed1977

Trial of bivalent influenza A vaccine in high-risk infants.

A vaccine trial involving 50 high-risk infants, aged six to 36 months, was performed for evaluation of the safety of a split-virus bivalent influenza A vaccine. After immunization, 18% of the infants developed a fever of greater than or equal to 100 F and 7% had fever of greater than or equal to 102 F. Other reactions to the vaccine were few. However, the reaction index of these high-risk infants to the bivalent vaccine was higher than those of older children receiving the same vaccine and normal infants receiving the monovalent vaccine. Forty-one percent of the infants responded with a titer of hemagglutination-inhibiting antibody of greater than or equal to 1:20 to the A/Victoria/75 component of the bivalent vaccine, and 35% responded to the A/New Jersey/8/76 component. This result suggested that this vaccine used in two doses would be an effective vaccine for infants. The infants generally tolerated the vaccine well. Nevertheless, the rapid development of fever would be of concern in the infant whose underlying disease was marginally compensated.

Antibodies, Viral↗
PubMed1976

Aqueductal stenosis and hydrocephalus: rare sequelae of mumps virus infections.

A case of a rare acquired form of aqueductal stenosis and hydrocephalus developing as a late sequela of mumps virus infection of the central nervous system is presented. The experimental studies of mumps induced aqueductal stenosis in hamsters and mice and the four previously reported cases in the literature are reviewed.

Animals↗
PubMed1976

Respiratory syncytial virus infections within families.

To examine intrafamily spread of respiratory syncytial virus infections and their associated illnesses, 36 families with 188 members were studied during an outbreak of such infections. Nurses visited every three to four days to obtain specimens for viral isolation and interview household members. The virus infected 44.4 per cent of families, and 21.9 per cent of all members. All age groups had appreciable attack rates (with a range of 16.8 per cent in adults to 29.4 per cent in infants). In infected families, 45.9 per cent of members became infected, including 10 of 16 infants. Secondary attack rate for all ages was 27 per cent, and that for infants 45.4 per cent. An infant's older sibling appeared most likely to introduce the virus into the family. Associated acute respiratory illnesses occurred in 94.9 per cent of cases, and appeared more severe than those not associated with respiratory syncytial virus. When the virus was introduced into a family the high attack rate produced an illness of age-related severity.

Adolescent↗
PubMed1976

Respiratory syncytial virus and influenza. Practical community surveillance.

Concurrent and sequential outbreaks of infection with respiratory syncytial virus (RSV) and influenza A virus were studied, utilizing a local surveillance system for infectious diseases that involved weekly reports from primary care physicians. The patterns of illness in the community and in hospital admissions were relatively specific for these two viruses, and differed according to whether RSV and influenza A virus occurred together or separately. This surveillance system appeared to be a practical and accurate indicator of the activity of RSV and influenza A virus in the community. Such a system may serve as a valuable means of relatively early detection of the local arrival of these viruses, and recognition of these illness patterns might aid the physician in diagnosis.

Adolescent↗
PubMed1976

Respiratory syncytial virus infections in infants: quantitation and duration of shedding.

Infants hospitalized with respiratory syncytial virus infection were studied to delineate the quantitative shedding patterns and duration of shedding of RSV. Nasal wash specimens collected daily from 19 infants contained a mean maximal titer of 4.34 log10 50% tissue culture infective doses per milliliter. On admission, the mean titer was 4.14 log10 TCID50, with no consistent decline until after Day 6. The mean duration of shedding for 23 patients until they were virus negative was 6.7 days with a range of 1 to 21 days. Quantities of RSV shed were significantly greater in infants less than one month of age and in infants with evidence of pulmonary consolidation on chest roentgenogram. Shedding extended for a significantly longer time in infants with lower respiratory tract disease than in those with clinical manifestations limited to the upper respiratory tract.

Child, Preschool↗
PubMed1975

Nosocomial respiratory syncytial virus infections.

We studied the frequency and severity of respiratory syncytial virus infections acquired nosocomially on an infants' ward during a community outbreak. Every three or four days all infants and staff were examined, and specimens were obtained for viral isolation. During two months, 14 of 44 contact infants acquired the virus. All were ill, and four had pneumonia. Infected infants had a significantly longer mean hospital stay (21.5 days) than uninfected ones (9.2 days, P less than 0.001). Risk of nosocomial infection could not be related to age or to underlying disease, but was linked to length of hospitalization: 45 per cent of infants hospitalized for one week or more became infected, and the percentage increased with length of stay. Ten of 24 staff members also acquired the virus and appeared to play a major role as virus carriers. Nosocomial respiratory syncytial virus infection poses a major risk for hospitalized infants and adds to hospital costs.

Adult↗
PubMed1975

Clinically useful method for the isolation of respiratory syncytial virus.

A simple method for the isolation of respiratory syncytial virus (RSV) is reported; it is relatively rapid and results in a high frequency of recovery of virus. A nasal secretion specimen with high titers of virus is inoculated at the bedside onto susceptible cell lines to avoid loss of viral infectivity due to liability of the virus. During an outbreak of RSV, viral specimens were obtained by this method from all young children admitted to the hospital with lower respiratory tract disease. RSV or influenza A virus was recovered from 89% of these 45 children. RSV was isolated from 87% of those with pneumonia. RSV was recovered 60% less often from specimens obtained simultaneously by conventional nasopharyngeal swabs. Identification of RSV cytopathic effect was more rapid with use of the bedside nasal wash method and was accomplished in an average of four days. Hence, this information was available to the clinicician when it was still useful in the management of the patient's illness.

Animals↗
PubMed1975

Quantitative shedding patterns of respiratory syncytial virus in infants.

Quantitative shedding patterns of respiratory syncytial virus in 40 infants hospitalized with acute disease of the lower respiratory tract were determined for elucidation of the pathophysiology of infection with the virus. Nasal wash specimens were collected on admission and daily thereafter and were tested for the presence and quantities of respiratory syncytial virus. The following pattern of shedding was observed. (1) The virus was shed for prolonged periods. For the first seven days of hospitalization, 92%-100% of the infants tested continued to shed virus. At discharge 87% were still shedding the virus. (2) Respiratory syncytial virus was present in high titer in the nasal secretions obtained at the time of admission. The mean titer in these samples was 5.0 log10 TCID50. (3) The titer of respiratory syncytial virus did not fall during the first few days of hospitalization, despite clinical improvement of the infants. Neither peak nor admission titers of virus could be correlated with age or with the severity of disease. However, the mean admission titer in patients with bronchiolitis appeared to be significantly higher than that in those with pneumonia.

Acute Disease↗