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Biomedical subjects

D W Fraser

Publications and source records attributed to D W Fraser.

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

Legionnaires' disease outbreak at an Atlanta, Georgia, Country Club: evidence for spread from an evaporative condenser.

During July 1978 an outbreak of Legionnaires' disease characterized by high fever, prostration, and pneumonia occurred at an Atlanta, Georgia, country club. All eight cases involved club members whose primary club activity was golfing. The degree of golfing activity during the likely exposure period was a risk factor for acquiring the illness. Legionella pneumophila was isolated from the evaporative condenser within the clubhouse. The fact that the stream of air blowing from the exhaust duct of the evaporative condenser was directed toward a nearby practice green and the 10th and 16th tees supports the hypothesis that this outbreak represents airborne dissemination of L. pneumophila from the evaporative condenser to an outdoor site where susceptible golfers contracted the illness.

Aged↗
PubMed1980

Pneumococcal bacteremia in Charleston County, South Carolina.

To describe the epidemiology of pneumococcal bacteremia in a large population, this study reviewed medical records for residents of Charleston County, South Carolina, who had pneumococci isolated from blood cultures during the period 1974-1976. The overall incidence of documented pneumococcal bacteremia was 8.5 cases per 100,000 population per year. It was highest for those in the first two years of life (35 per 100,000 per year) and those in their sixties (21 per 100,000 per year). The incidence was more than five times higher in blacks than in whites and within races appeared to be independent of socioeconomic status or population density. Seventy-three per cent of the cases occurred in persons with another medical problem. These data on the incidence of documented pneumococcal bacteremia underestimate the true incidence of bacteremia to the extent that blood cultures were not performed under optimal circumstances for all persons with compatible clinical syndromes. The data suggest that certain groups would benefit from vaccination against pneumococcal disease if the vaccines are shown to be safe and effective for these groups.

Adolescent↗
PubMed1980

An explosive outbreak of Mycoplasma pneumoniae infection in a summer camp.

An outbreak of Mycoplasma pneumoniae infection occurred in the summer of 1978 in a boys' camp in northern Wisconsin and affected 139 of 196 persons (71%); 115 (59%) had laboratory evidence of infection. In 77% of the cases, onset of disease occurred within three weeks after arrival at camp, in contrast to the usually indolent spread of the disease. Attack rates decreased with increasing age. The sensitivity of serology for detecting M pneumoniae disease may have been as low as 79%. There was shorter duration of cough in those treated with erythromycin within four days after onset of symptoms.

Adolescent↗
PubMed1979

Atypical Legionella-like organisms: fastidious water-associated bacteria pathogenic for man.

A group of related bacteria designated atypical Legionella-like organisms (ALLO) has been identified. ALLO, like L. pneumophila, are fastidious gram-negative rods that grow well on charcoal yeast extract (CYE) agar and produce ground glass colonies and browning of modified yeast extract agar. Unlike L. pneumophila, ALLO do not grow well on Feeley-Gorman (FG) agar, and on CYE agar they fluoresce under longwave ultraviolet light. ALLO and L. pneumophila have a similar predominance of branched-chain forms among total cellular fatty acids but have distinctive fatty-acid profiles. 2 patients with culture-verified ALLO pneumonia and 10 with pneumonia of uncertain aetiology who seroconverted to ALLO offer evidence that ALLO may be a cause of community-acquired pneumonia. Like L. pneumophila, ALLO appear to be water-associated; both persons with culture-verified ALLO infection were exposed to fresh water or its contents before becoming ill, and two strains of ALLO were isolated from water or wet environments.

Adult↗
PubMed1979

Pertussis vaccine--an analysis of benefits, risks and costs.

Using decision analysis, we estimated the benefits, risks and costs of routine childhood immunization against pertussis. Without an immunization program, we predict that there would be a 71-fold increase in cases and an almost fourfold increase in deaths (2.0 to 7.6) per cohort of one million children. With a vaccination program, we predict 0.1 case of encephalitis associated with pertussis and five cases of post-vaccination encephalitis; without a program, there would be only 2.3 cases of encephalitis associated with pertussis. Community vaccination would reduce by 61 per cent the costs related to pertussis. Our analysis supports continuation of vaccination in routine childhood immunization programs, but suggests the need for more reliable data on complications from the vaccine, further study of the epidemiology of pertussis and development of a less toxic vaccine.

Child↗
PubMed1979

Aspergillosis and other systemic mycoses. The growing problem.

To measure the incidence in the United States of systemic mycoses necessitating hospitalization, we reviewed discharge records of 1,875 hospitals participating in the Professional Activity Study of the Commission on Professional and Hospital Activities. Projected incidence rates in 1976 ranged from 23.0 per million for histoplasmosis to 0.2 per million for blastomycosis. High prevalences of leukemia or lymphoma (5.9% to 10.2%) or of other malignancies (9.9% to 13.2%) were recorded in patients with aspergillosis, candidasis, or cryptococcosis. High prevalences of chronic obstructive lung disease (9.6% to 9.9%) were recorded in those with aspergillosis or histoplasmosis. Marked increases from 1970 to 1976 were found in the incidence of aspergillosis (158%), actinomycosis (92%), cryptococcosis (78%), and coccidioidomycosis (74%). Increasing numbers of persons with immunosuppressive conditions, migration of susceptible persons into hyperendemic areas, and aging of the population contributed to the increases.

Adolescent↗
PubMed1979

Nonpneumonic, short-incubation-period Legionellosis (Pontiac fever) in men who cleaned a steam turbine condenser.

Pontiac fever affected ten men who had cleaned a steam turbine condenser with compressed air. Previous epidemics of Pontiac fever and Legionnaires' disease--both caused by Legionella Pneumophila (proposed sp. nov.)--involved "airborne spread" from air-conditioning cooling towers or evaporative condensers. Aerosols of contaminated water in heat-rejection systems appear to be important sources of epidemic legionellosis.

Adolescent↗
PubMed1979

Haemophilus influenzae meningitis. A national study of secondary spread in household contacts.

To determine the risk of severe Haemophilus influenzae illness among household contacts of patients with H. influenzae meningitis, we studied prospective data obtained in 19 states from January 1, 1977, to June 30, 1978. H. influenzae meningitis was reported in 1403 patients, and 1147 (82 per cent) of the exposed families were investigated for the occurrence of H. influenzae disease within 30 days after its onset in the index patient. During this interval, nine of 1687 household contacts (0.5 per cent) under the age of six years had systemic disease confirmed to be caused by H. influenzae Type b. The risk in children less than one year of age was 6 per cent, and the risk in those less than four years of age was 2.1 per cent. None of 2624 contacts above the age of five was affected. In the 30 days after onset of meningitis, the risk of this infection alone, aside from other types of serious H. influenzae disease, is 585 times greater in household contacts than the age-adjusted risk in the general population. The risk of H. influenzae disease in household contacts under six years of age is similar to the risk of secondary meningococcal disease in all household contacts--indicating a need for effective antimicrobial prophylaxis.

Adolescent↗
PubMed1979

Legionellosis.

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Animals↗