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Biomedical subjects

C O Tacket

Publications and source records attributed to C O Tacket.

88 records · Page 5Linked to original sources

Equine antitoxin use and other factors that predict outcome in type A foodborne botulism.

The use of trivalent equine antitoxin in treating foodborne botulism has not been adequately assessed. One hundred thirty-two cases of type A foodborne botulism reported to the Centers for Disease Control in the period from 1973 to 1980 are reviewed to evaluate the effect of antitoxin therapy and other factors on the outcomes of patients with botulism. The fatality rates were higher in patients over 60 years old and in those who were index patients (the first or only patient in an outbreak). The clinical course was longer in patients over 60 years old, patients whose incubation period was less than 36 hours, and index patients. Patients who had received trivalent equine antitoxin had a lower fatality rate and a shorter course than those who did not receive antitoxin, even after controlling for age and incubation period. Patients who received antitoxin in the first 24 hours after onset had a shorter course but about the same fatality rate as those who received antitoxin later. These results suggest that trivalent antitoxin has a beneficial effect on survival and shortens the course of patients with type A botulism.

Age Factors↗

Clinical features and an epidemiological study of Vibrio vulnificus infections.

Vibrio vulnificus, a recently described halophilic Vibrio species, has been isolated from the blood, wounds, and other skin lesions of patients with primary sepsis or wound infections. Because no study of risk factors for infections with V vulnificus has been reported, a case-control study was performed with the 30 patients from whom V vulnificus isolates were recently submitted to the Centers for Disease Control (Atlanta, Georgia). Patients with primary sepsis were more likely than controls to have eaten raw oysters recently (P less than .01) and to have a history of liver disease (P less than .02). Persons with liver disease should be warned that raw oysters are an important source of this life-threatening infection. Patients with wound infections were more likely than controls to have had recent exposure of the skin to salt water or shellfish (P less than .05). Physicians should therefore consider V vulnificus in the differential diagnosis of severe wound infections with these exposures.

Disease Susceptibility↗

Wound infections caused by Vibrio vulnificus, a marine vibrio, in inland areas of the United States.

Vibrio vulnificus is a halophilic marine vibrio which may produce infection in wounds exposed to seawater or raw shellfish. The Centers for Disease Control has received two isolates from wounds exposed to inland waters, a New Mexico creek and an Oklahoma reservoir. Halophilic organisms were recovered from both the creek and the reservoir, and the water in both sites was found to be brackish. Both clinical isolates of V. vulnificus grew in salt concentrations as low as those found in the creek and reservoir. These cases illustrate the potential for pathogenic halophilic Vibrio species to live in brackish inland waters and produce infections in patients living in inland areas of the United States.

Adolescent↗

Usefulness of plasmid profiles for differentiation of Shigella isolates in Bangladesh.

We studied the plasmid profiles of 136 Shigella isolates in Bangladesh to determine whether plasmid profiles could be used for differentiation of strains for epidemiological studies. Many different plasmid patterns were observed within each species, indicating that many genetically different strains of Shigella are responsible for illness in Bangladesh.

Anti-Bacterial Agents↗

Yersinia enterocolitica pharyngitis.

During the investigation of a large multistate outbreak of milk-borne yersiniosis, 14 patients who presented with pharyngitis had Yersinia enterocolitica isolated from the throat. Their illness was characterized by sore throat and fever without enteritis; 3 needed hospitalization. All patients tested had leukocytosis and an elevated convalescent-phase serum titer against the outbreak strain. In contrast to patients with enteritis, who were children, all patients with pharyngitis were adults. Thus, Y. enterocolitica may be responsible for some sporadic cases of pharyngitis in which the throat culture is negative for other pathogens.

Adolescent↗

Illness caused by Vibrio damsela and Vibrio hollisae.

Vibrio damsela was isolated from six wound infections in otherwise healthy persons. In five of the six cases the wounds were known to have been exposed to salt or brackish water at the time of the injury. Vibrio hollisae was isolated from an index stool culture in nine cases in which no other enteric pathogen was identified. All nine patients had diarrhoea and abdominal pain; one patient had bloody diarrhoea. Six of the nine patients were known to have eaten raw seafood in the five days before they became ill. These data suggest that both V. damsela and V. hollisae can produce diseases with distinct clinical and epidemiological characteristics.

Abdomen↗

Panophthalmitis caused by Vibrio parahaemolyticus.

We report a case of Vibrio parahaemolyticus panophthalmitis which resulted from contamination of a wound with water from a pond in inland Georgia. The pond was on the property of an oil refinery which receives crude oil from southern Mississippi. Cultures of the pond water 5 years later did not yield V. parahaemolyticus, but did yield non-O1 V. cholerae and had 0.28% sodium chloride content. V. parahaemolyticus may have been introduced into the pond along with oil transported from the Gulf of Mexico, and growth of this halophilic species may have been supported by salt from spilled crude oil.

Accidents, Occupational↗

Diarrhea associated with Vibrio fluvialis in the United States.

We report the isolation in the United States of Vibrio fluvialis from the stools of a patient who had severe watery diarrhea without fever and who subsequently died. V. fluvialis, a known enteric pathogen in other parts of the world, should be suspected in patients with watery diarrhea, especially in coastal areas.

Aged↗

Extension of the volunteer challenge model to study South American cholera in a population of volunteers predominantly with blood group antigen O.

The volunteer challenge model was used to study the virulence of strains of Vibrio cholerae O1 El Tor recently isolated from cases of cholera in South America. Fifteen of the 24 volunteers (62%) were of blood group O, the group most prevalent in South America and the group at increased risk of more severe cholera. Two El T or Inaba strains and 2 El Tor Ogawa strains were given to volunteers at a dose of 1-2 x 10(6) colony-forming units. All 4 strains caused diarrhoea in 67-83% of volunteers. Volunteers with blood group antigen O had an increased attack rate for diarrhoea (P = 0.015) and a marginally increased mean diarrhoeal stool volume (P = 0.08) after challenge. One-third of the volunteers with blood group O, and none of the volunteers with other blood groups, developed severe diarrhoea (> 5 L) (P = 0.01). This study established a model of South American cholera that can be used to predict field efficacy of candidate vaccines among populations with a high prevalence of blood group antigen O.

ABO Blood-Group System↗

Host-Salmonella interaction: human trials.

Human clinical trials, including experimental challenges of volunteers with pathogenic Salmonella enterica serovar Typhi, small phase I and II trials that monitor the immune responses to vaccines, and large-scale controlled field trials that assess vaccine efficacy under conditions of natural challenge, have helped elucidate the interactions between Salmonella typhi and human hosts.

Antibodies, Bacterial↗

Progress in vaccines against typhoid fever.

The widely available heat-phenol-inactivated whole cell typhoid vaccine, which provides approximately 65% protection, has limited usefulness because of the adverse reactions it evokes. In contrast, several new typhoid vaccines promise protection without reactogenicity. Attenuated oral vaccine Ty21a has been evaluated in three field trials of efficacy in Santiago, Chile, involving 530,000 schoolchildren. Three doses of Ty21a in an enteric-coated formulation given within one week provided 69% efficacy for at least four years. Fewer doses conferred less protection, while adding a fourth dose significantly enhanced protection; increasing the interval between doses did not improve protection. Large-scale vaccination with Ty21a appeared to cause a herd-immunity effect. Ty21a has reached the stage of being a practical tool for public health. With respect to other vaccines, the safety and immunogenicity of an auxotrophic (Aro-,Pur-) Salmonella typhi mutant (strain 541Ty) has recently been evaluated. Lastly, parenteral purified Vi polysaccharide of S. typhi was safe and immunogenic and provided 64%-72% protection (for at least 17-21 months) in controlled field trials in Nepal and South Africa.

Chile↗

A voluntary serosurvey and behavioral risk assessment for human immunodeficiency virus infection among college students.

The authors conducted a voluntary serosurvey and educational campaign among 3394 undergraduate students attending the University of Maryland at College Park to determine the prevalence of and risk factors for human immunodeficiency virus type 1 (HIV-1) infection. Two students were seropositive (0.06%, 95% confidence interval 0-0.15%). Both were homosexual men with multiple sexual partners. Despite the low prevalence of infection, potential risk factors for transmission of HIV-1 were common, as assessed by a self-administered anonymous questionnaire. These included a previous sexually transmitted disease (12.6%), male homosexual intercourse (4.8% of men), heterosexual anal intercourse (25.3%), heterosexual intercourse with a person at risk (an HIV-1 infected person, a bisexual man, a parenteral drug user, a female prostitute, or a hemophiliac) (5.2%), multiple sexual partners (21% reported 10 or more lifetime partners), and intravenous drug use (1.3%). Assessment of the efficacy of our program by comparing responses on pre- and post-test questionnaires showed gains in knowledge about heterosexual transmission of HIV-1 and an increase in the reported frequency of condom use 1-2 months after participating in the survey. The authors conclude that HIV-1 infections are occurring among college students but in our study group remain confined to persons with known high-risk behavior; however, practices that may support transmission are common, and programs designed to diminish these behaviors among college students are needed.

Adolescent↗

Shigellosis in day care centers: use of plasmid analysis to assess control measures.

Spread of shigellosis within day care centers is difficult to control, and illness may spread into the community. We investigated two sequential outbreaks of diarrhea caused by multiply resistant Shigella sonnei in children at day care centers in 2 neighboring counties in Florida. We used plasmid analysis to identify a single epidemic strain causing both outbreaks and to assess the control measures used. One of the control measures, keeping ill children from attending the center, did not prevent spread of illness in the community.

Child Day Care Centers↗