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Biomedical subjects

D D Juranek

Publications and source records attributed to D D Juranek.

At least 73 records · Page 4Linked to original sources
PubMed1980

Human toxocariasis in a rural community.

A questionnaire and serologic survey of a Pennsylvania community revealed that 23 (54%) of 43 study participants had antibody titers to Toxocara canis (enzyme-linked immunosorbent assay test [ELISA]) in the range defined as positive (greater than or equal to 1:32). Age-specific seropositivity rates were highest among adults (greater than or equal to 18 years). Positive titers ranged from 1:32 to 1:512. Seropositivity did not cluster by family, and seropositivity rates were significantly higher than those of a control group. Physical examination and laboratory tests designed to detect clinical signs of toxocariasis were performed on individuals with positive ELISA titers. Nine of 23 had a history of pica, seizures, or chronic pulmonary symptoms; however, physical examination revealed no abnormalities. Although medical examination and laboratory tests revealed a few abnormalities, neither the visceral larva migrans syndrome nor the ocular lesions characteristic of those produced by Toxocara sp were observed in any individual. We conclude that although certain populations may have high seropositivity rates to Toxocara antigens, indicating previous infection, clinical diseases may be uncommon.

Adolescent↗
PubMed1980

Waterborne giardiasis: a communitywide outbreak of disease and a high rate of asymptomatic infection.

A communitywide outbreak of gastrointestinal illness due to Giardia lamblia infection occurred in the city of Berlin, New Hampshire, during April and May 1977. The clinical, epidemiologic, and laboratory aspects of this outbreak are described here. In 213 predominantly symptomatic cases of G. lamblia infection diagnosed at a local hospital laboratory in a 6-week period, illness was characterized by prolonged diarrhea (median duration 10 days) and 13% of symptomatic infections required hospitalization. Treatment with either quinacrine or metronidazole was generally followed by symptomatic improvement. A communitywide survey of the city residents revealed that the majority (76%) of G. lamblia infections occurring during the epidemic period were asymptomatic and ran a self-limited course without treatment. No significant secondary, person-to-person spread occurred and no enteric pathogens other than G. lamblia were implicated. Water was epidemiologically implicated as the most likely source of infection with Giardia cysts being demonstrated in samples of treated water as well as raw source water. Evidence supported the occurrence of two simultaneous outbreaks in this city which is supplied by two largely independent water supply systems. Inspection of the two water treatment facilities revealed several defects which permitted untreated (raw) water to mix with treated water. Human or beaver could have been responsible for contaminating source water with Giardia in this outbreak. A marked reduction in both clinical and subclinical giardiasis was apparent two months after onset of the outbreak, apparently as a result of measures applied to interrupt waterborne transmission of Giardia.

Adolescent↗
PubMed1980

Toxoplasma gondii isolated from amniotic fluid.

A pregnant woman contracted toxoplasmosis from exposure to oocysts shed by cats. She underwent amniocentesis for a therapeutic abortion, and Toxoplasma gondii was isolated from the amniotic fluid and placenta. This method may be useful in determining whether the fetus is infected in cases of toxoplasmosis acquired during pregnancy.

Abortion, Therapeutic↗
PubMed1980

Babesiosis in post-splenectomy hosts.

Two persons who had been splenectomized later contracted babesiosis, one on Cape Cod and one near Islip, Long Island, areas where human cases of babesiosis had not been previously identified. One of the patients received pentamidine, but parasitemia persisted after therapy. No deaths have been recorded for persons who had had splenectomies and were later infected with Babesia microti. Until more effective therapy is available, such patients should be treated conservatively.

Animals↗
PubMed1980

Municipal waterborne giardiasis: an epidemilogic investigation. Beavers implicated as a possible reservoir.

In March 1976, 128 persons in Camas, Washington, had laboratory-confirmed giardiasis. A questionnaire survey of 498 Camas residents revealed that 3.8% had clinical giardiasis, while none of 318 residents in a control town were ill. No associations between illness and sex, pet ownership, travel, time spent in wilderness areas, public gatherings, or food preference were found. Giardia cysts were recovered from raw water entering the city water treatment system via two streams and also from two storage reservoirs containing chlorinated and filtered stream water. Failure to remove Giardia cysts was attributed to the water plants' inadequate flocculation, coagulation, and sedimentation combined with deterioration of the filter media. Investigation of the watershed revealed no signs of human fecal contamination. Animal trapping in the watershed area yielded three beavers (Castor canadensis) infected with Giardia that were infective for specific pathogen-free beagle pups.

Animals↗
PubMed1980

An outbreak of toxoplasmosis linked to cats.

Clinical, serologic, and epidermiologic evidence documents an outbreak of toxoplasmosis involving ten of 30 members of an extended family. The index patient had unusual clinical manifestations including brain abscesses, progressive chorioretinitis, seizures, neurologic deficits, hepatosplenomegaly, pneumonitis, and eosinophilia. Toxoplasmosis was confirmed by demonstrating the organism in brain tissue and cerebrospinal fluids; clinical and serologic evidence also indicated infection with Toxocara (viscd children. Of the 11 such children, seven (68%) were seropositive, six of whom had high acute-phase titers (greater than or equal to 1024) to Toxoplasma and a disease consistent with acute toxoplasmosis. All six of the latter group required specific chemotherapy. Geophagia was associated statistically with acute toxoplasmosis among the children; it also increased the risk of infection with Toxocara and enteroparasites. Two school-aged children and two adults had serologic evidence of acute toxoplasmosis, but only one of the group was symptomatic. Epidemiologic evidence indicates that this outbreak was probably caused by ingesting oocysts from cat feces. We suggest that the severe and unusual clinical manifestations of the index patient resulted from simultaneous infection with Toxoplasma and Toxocara.

Adult↗
PubMed1980

Methods for detecting Babesia microti infection in wild rodents.

We compared various methods for detecting Babesia microti infection in white-footed mice (Peromyscus leucopus) captured in enzootic regions of Massachusetts. The most sensitive method tested involved inoculating blood from wild rodents into hamsters. One month postinoculation proved to be the optimal time for microscopically examining blood of inoculated hamsters. With this method, as few as 300 organisms produced patent infection. Prior splenectomy of hamsters did not increase susceptibility to infection. For direct study of captured animals, a Giemsa-stained, thin blood-film prepared from the animal's tail was the most convenient method tested. However, this method detected only 61% of infections identified by hamster inoculation.

Animals↗
PubMed1979

Epidemic toxoplasmosis associated with infected cats.

In October, 1977, an outbreak of toxoplasmosis occurred in patrons of a riding stable in Atlanta, Georgia; 37 became ill with toxoplasmosis or had serologic evidence by indirect fluorescent-antibody test of acute infection with Toxoplasma gondii (titer greater than or equal to 1:4096 or a positive fluorescent-antibody test for toxoplasma antibodies). Forty-nine additional patrons did not become ill. Two of the three adult cats from the stable were seropositive for toxoplasma, which was also recovered from the tissues of two kittens and four mice trapped near the stable. Patrons who spent most of their time at the end of the stable where a cat had defecated had the highest incidence of infection. Patrons who attended the stable daily had a higher attack rate than those who attended less frequently. No common meals were consumed, and dietary histroy eliminated meat as the source of infection. The data suggest that toxoplasma oocysts were the source of the infection.

Acute Disease↗
PubMed1978

Giardiasis in American travelers to Madeira Island, Portugal.

A high incidence of diarrhea was reported in a group of approximately 1,400 Americans who traveled to the Portuguese island of Madeira in October 1976. A mail questionnaire survey revealed that 39% of the responding 859 travelers experienced diarrhea; in 42% of these diarrhea lasted for longer than 1 week. The most frequent accompanying symptoms were abdominal cramps (75%), abdominal distention (72%), nausea (70%), and weight loss (40%). Of all travelers surveyed, 33% developed an illness resembling giardiasis with a median incubation period of 4 days. Of 35 ill patients who had a stool culture, enteric pathogens were recovered from 4 (3 Shigella and 1 Salmonella). On the other hand, of 58 ill patients whose stools were examined for parasites, Giardia lamblia was recovered from 27 (47%). Analysis of the epidemiologic data showed that drinking tap-water on the island was significantly associated with illness; eating ice cream or raw vegetables on the island was also implicated. There was no evidence of continuing transmission of giardiasis in American tourists visiting Madeira 8--12 months after the outbreak.

Aged↗
PubMed1977

Epidemiology of lice.

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Black or African American↗
PubMed1976

Autochthonous dermal leishmaniasis in Texas.

Over a 2-year period two cases of dermal leishmaniasis of special interest were recognized in Texas. The first occurred in 1972 in a 74-year-old woman who had residences in Dilworth and Gahzales, Gonzales County, and the other was in a 56-year-old man from Kenedy, Karnes County, in 1974. Both cases were biopsy- and culture-positive, and the second patient exhibited anti-Leishmania antibodies by indirect immunofluorescent antibody and direct agglutination tests. Epidemiologic investigation revealed no association between the two cases and suggested that both patients had acquired their infections locally in southern Texas. Moreover, serologic evidence of Leishmania infection was uncovered in a neighbor of the second case and in 3 dogs living nearby. Potential sylvatic reservoirs and arthropod vectors of the disease are resident in the area. Epidemiologic data suggest that dermal leishmaniasis is endemic in south-central Texas.

Adolescent↗
PubMed1976

Taenia saginata cysticerci in muscles of beef cattle.

Minute dissection of carcasses infected with Taenia saginata cysts revealed that heart and masticatory muscles were more heavily and more frequently infected with Taenia saginata cysts than were any other muscle groups. Increasing the number of inspection cuts in the heart and masseter muscles, while omitting cuts in such sites as the diaphragm, during meat inspection would increase the efficiency in detecting beef cysticercosis. Complete dissection of cattle found to have a single viable or dead cyst by routine inspection revealed dead or viable cysts in portions of the carcass not routinely examined. These findings justify the recent change in routine meat inspection procedures whereby all carcasses with a single cyst (whether viable or dead) are now cooked or refrigerated, instead of having the offending cysts excised.

Animals↗