Group A streptococcal meningitis in an infant: report of a case associated with a community outbreak due to M-type 4 organisms.
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Alaska↗
Biomedical subjects
D H Barrett
Publications and source records attributed to D H Barrett.
Type A and type B botulism in the North: first reported cases due to toxin other than type E in Alaskan Inuit.
Botulism outbreaks shown to be due to type A and type B toxin occurred in Alaska, a region previously known for only type E botulism. The outbreak due to type A toxin involved three people, two of whom died. The outbreak due to type B toxin involved nine people, none of whom died. Both outbreaks were in Inuit villages, and native foods were incriminated. The occurrence of these outbreaks strongly suggests that Clostridium botulinum, types A and B are indigenous to Alaska. The outbreaks underscore the need for initial treatment of patients with antitoxin that is trivalent (ABE), even in Arctic regions.
Adolescent↗
Epidemiology of hepatitis B in two Alaska communities.
In 1973, epidemiologic and serologic data related to hepatitis B infection were collected from the residents of two remote Alaskan Eskimo villages located in an area of high hepatitis incidence. A total of 418 sera were tested by solid-phase radioimmunoassay for heaptitis B surface antigen (HBsAg) and antibody to that antigen (anti-HBs). The overall infection prevalence of 54.8% in the two villages included a 13.9% prevalence of HBsAg and a 40.9% prevalence of anti-HBs. Families containing an individual with HBsAg had significantly higher infection prevalence than those without an antigen carrier. Larger households had higher proportions of infected members than smaller households. The data suggest that efficient transmission of hepatitis B virus occurs within the household setting in these villages by other than classically established parenteral routes.
Adolescent↗
Relation of e antigen to hepatitis B virus infection in an area of hyperendemicity.
A study of the e determinant of hepatitis B surface antigen in an area of hepatitis B hyperendemicity revealed that the presence of e antigen or of antibody to e in the sera of individuals was specifically related to evidence of past or present infection with hepatitis B virus. Among asymptomatic long-term carriers of hepatitis B surface antigen, presence of the e antigen was associated with elevated levels of aspartate and alanine aminotransferases in serum; this observation suggested that the e antigen might be a marker for persisting hepatic dysfunction. Higher levels of DNA polymerase found in carriers of the surface antigen with e antigen suggested that these individuals might have a higher level of circulating Dane particles and thus, perhaps, a higher level of hepatitis B virus infectivity.
Adolescent↗
Hepatitis B surface antigen in saliva, impetiginous lesions, and the environment in two remote Alaskan villages.
A study was conducted in an area of hepatitis B hyperendemicity to determin whether contact with infective bodily secretions or contaminated environmental surfaces could be involved in the transmission of the hepatitis B virus. Hepatitis B surface antigen was detected in gingival swab, saliva, and impetiginous lesion exudate samples from children. Hepatitis B surface antigen also was found in swab samples of surfaces frequently touched or placed in the mouth. In the absence of classical exposure to infectious blood or blood products, these findings suggested that, in a crowded home environment, saliva and cutaneous exudates containing hepatitis B virus may play a role in the transmission of hepatitis B.
Alaska↗
Self-reported postwar injuries among Gulf War veterans.
OBJECTIVE: From September 1995 to May 1996, the authors conducted a telephone survey of Iowa military personnel who had served in the regular military or activated National Guard or Reserve during the Gulf War period. To assess the association between military service in a combat zone and subsequent traumatic injury requiring medical consultation, the authors analyzed veterans' interview responses. METHODS: Using data from the larger survey, the authors compared rates of self-reported postwar injuries requiring medical consultation in a sample of Iowa Gulf War veterans to the rates in a sample of Iowa military personnel who served at the same time, but not in the Persian Gulf. RESULTS: Of 3695 veterans, 605 (16%) reported a traumatic injury in the previous three months requiring medical consultation. Self-reported injuries were associated with service in the Persian Gulf (odds ratio 1.26; 95% confidence interval 1.02, 1.55). CONCLUSION: This finding is consistent with the results of earlier studies of traumatic injury mortality rates among war veterans.
Adult↗
Endemic food-borne botulism: clinical experience, 1973-1986 at Alaska Native Medical Center.
Clinical features are described for 35 cases of endemic food-borne botulism managed at a single medical center over 14 years. Important diagnostic findings included dryness of mucous membranes (90%), weakness (84%), and abnormal pupillary reaction (79%). Sensory examination was normal. Dizziness, dyspnea, and weakness of the extremities were significantly more common in patients requiring assisted ventilation. Transitory neurological deterioration occurred in 38% of patients despite the early administration of trivalent (ABE) equine antitoxin. The short course of respiratory failure suggests that toxin effect is unusually ephemeral with a mean intubation interval of only 8.6 days. Rapid recovery of strength without relapsing respiratory failure followed extubation. Tracheostomy was associated with a high complication rate and was abandoned. Extremely thick, tenacious sputum probably contributed to the high nosocomial pneumonia rate. Empirical antibiotic use to eliminate persistent C. botulinum was associated with unacceptably high nosocomial infection rates (p less than .01). Unexpected significant elevations of blood leukocyte and neutrophil band forms were noted.
Alaska↗