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Biomedical subjects

D W Fraser

Publications and source records attributed to D W Fraser.

At least 109 records · Page 6Linked to original sources
PubMed1978

Management of household contacts of leprosy patients.

We describe an approach to the management of household contacts of leprosy patients and the rationale on which it is based. Initially, all household contacts should be interviewed and examined for symptoms and signs consistent with leprosy and appropriate diagnostic measures taken. Contacts of untreated lepromatous and dimorphous (borderline) leprosy patients are at relatively high risk of disease and should be examined annually for at least 5 years. Dapsone prophylaxis has been shown to prevent secondary cases in contacts up to 25 years old and should be used in these and possibly in older persons. Insufficient data exist to support a recommendation for the use of BCG at present.

Adult↗
PubMed1978

Spread of Haemophilus influenzae. Secondary illness in household contacts of patients with H influenzae meningitis.

To determine the risk of severe secondary illness in household contacts of patients with Haemophilus influenzae meningitis, telephone interviews were conducted with contacts of patients with reported cases. Four probable or proved secondary cases of severe disease were identified for a secondary attack rate of 0.4%. The secondary attack rate for household contacts of patients 2 years of age and younger was 4.9%. Until safe, effective prophylactic measures become available, physicians should explain to parents that any person who becomes ill in the month after a household case of H influenzae meningitis should be brought to the attention of a physician for appropriate evaluation and treatment.

Child, Preschool↗
PubMed1977

Legionnaires' disease: description of an epidemic of pneumonia.

An explosive, common-source outbreak of pneumonia caused by a previously unrecognized bacterium affected primarily persons attending an American Legion convention in Philadelphia in July, 1976. Twenty-nine of 182 cases were fatal. Spread of the bacterium appeared to be air borne. The source of the bacterium was not found, but epidemiologic analysis suggested that exposure may have occurred in the lobby of the headquarters hotel or in the area immediately surrounding the hotel. Person-to-person spread seemed not to have occurred. Many hotel employees appeared to be immune, suggesting that the agent may have been present in the vicinity, perhaps intermittently, for two or more years.

Adolescent↗
PubMed1977

Legionnaires' disease: isolation of a bacterium and demonstration of its role in other respiratory disease.

To identify the etiologic agent of Legionnaire's disease, we examined patients' serum and tissue specimens in a search for toxins, bacteria, fungi, chlamydiae, rickettsiae and viruses. From the lungs of four of six patients we isolated a gram-negative, non-acid-fast bacillus in guinea pigs. The bacillus could be transferred to yolk sacs of embryonated eggs. Classification of this organism is incomplete. We used yolk-sac cultures of the bacillus as antigen to survey suspected serum specimens, employing antihuman-globulin fluorescent antibody. When compared to controls, specimens from 101 to 111 patients meeting clinical criteria of Legionnaires' disease showed diagnostic increases in antibody titers. Diagnostic increases were also found in 54 recent sporadic cases of severe pneumonia and, retrospectively, in stored serum from most patients in two other previously unsolved outbreaks of respiratory disease. We conclude that Legionnaires' disease is caused by a gram-negative bacterium that may be responsible for widespread infection.

Adult↗
PubMed1977

Lassa fever: response to an imported case.

In February, 1976, a Peace Corps worker returned to the United States from Sierra Leone with an undiagnosed illness later recognized as Lassa fever. To assess the risk of transmission and to contain a potential outbreak, we identified 552 contacts as having had exposure to the patient before the start of strict isolation procedures, and maintained intensive surveillance on these contacts for 21 days. At the end of the surveillance period, no illness had developed in contacts. One month later, a serologic survey among 29 of the contacts judged to be at high risk gave no evidence of infection. In response to the importation of this communicable and highly fatal disease, procedures for the isolation of the patient, the identification, surveillance and management of contacts and the handling of laboratory specimens were developed and implemented. These procedures could be adapted to future introductions of highly contagious diseases.

Adult↗
PubMed1977

An epidemic of disease due to serogroup B Neisseria meningitidis in Alabama: report of an investigation and community-wide prophylaxis with a sulfonamide.

An epidemic of disease due to sulfonamide-sensitive serogroup B Neisseria meningitidis occurred in 1975-1976 in southwestern Alabama. Ten cases occurred in a circumscribed area and resulted in an annual attack rate of 20 cases per 100,000 population. None of the cases were in siblings, and none of the patients had had direct contact with each other. A case-control household study suggested that crowding and person-to-person transmission via carriers may have been contributing risk factors. Seven of the patients were from a triracial ethnic group concentrated in a small isolated rural community within the epidemic area. When three additional cases occurred in this community, a program of community-wide prophylaxis was undertaken as an epidemic control measure, and a large portion of the population participated. No serious side effects were reported. Carrier surveys before and after treatment indicated that compliance with the drug regimen was good and that the drug regimen was associated with a sharp reduction in carriage of N. meningitidis. No cases occurred in the treated population in the five months after treatment.

Adolescent↗
PubMed1977

Lack of observed association between armadillo contact and leprosy in humans.

In 1971 it was discovered that the nine-banded armadillo (Dasypus novemcinctus) could be infected in the laboratory with Mycobacterium leprae, and would manifest disease similar to the lepromatous form of leprosy in man. In 1975 several wild armadillos captured in Louisiana were found to have a disease identical to the M. laprae infection in laboratory animals. To determine if there is a significant association between contact with armadillos and presence of leprosy in humans, the armadillo contact of persons with indigenous leprosy in Louisiana was compared to the contact of matched controls. No difference in the nature or frequency of contact was found. If this infection of wild armadillos is of recent onset, an association with human leprosy in enzootic areas may not be detectable for several years.

Adult↗
PubMed1975

Lymphocytic choriomeningitis in university hospital personnel. Clinical features.

Clinical manifestations of lymphocytic choriomeningitis (LCM) virus infection in 15 patients are described. These patients were University Hospital personnel who had had contact with hamsters, subsequently shown to harbor the virus. Fever with striking myalgias, headache and rigors were the most common symptoms. Only 2 of the 15 patients had clinically overt and documented aseptic meningitis. Leuikpenia was observed in 10 of 11 patients and thrombocytopenia in 8 of 8 patients tested. A biphasic illness was seen in eight patients. In a patient who has been exposed to laboratory animals, particularly to hamsters, a nonspecific influenza-like febrile illness accompanied by leukopenia and thrombocytopenia may represent LCM virus infection.

Animals↗
PubMed1975

Outbreak of lymphocytic choriomeningitis virus infections in medical center personnel.

An outbreak of lymphocytic choriomeningitis (LCM) virus infections occurred in Medical Center personnel at the University of Rochester in 1972-1973. A total of 48 infections was discovered, 31 in staff of the radiation therapy area, 12 in the staff of the Vivarium facility, and 5 in other individuals who worked in the Medical Center. Twenty-one of the infections were associated with recent febrile illness with myalgia. Epidemiologic and virologic studies indicated that the source of the infection was Syrian hamsters which were used in tumor research; the tumor cell lines themselves were shown to be contaminated with LCM virus and probably represented the original source of contamination of the Rochester facility. Infection occurred not only through direct contact with infected animals but also from mere presence in the room where the animals were held. This outbreak emphasizes the need for restricting access to animal quarters and for surveillance of hamsters and tumor cell lines and indicate the necessity of separating animal facilities from patient-care facilities.

Animals↗
PubMed1975

Laboratory studies of a lymphocytic choriomeningitis virus outbreak in man and laboratory animals.

Investigation of an outbreak of prolonged febrile illness in medical center personnel at the University of Rochester School of Medicine and Dentistry revealed lymphocytic choriomeningitis (LCM) virus to be the causative agent. Syrian or golden hamsters (Mesocricetus auratus) were found to be the only animals involved in maintaining the virus and were the source of human infections. Isolations of LCM virus were made from autopsy specimens of 13 of 46 (28%) golden hamsters. Virus isolations were made from 22 of 28 (79%) frozen specimens of 11 tumor lines transplanted repeatedly in golden hamster cheek pouches. No virus isolations were made from 86 autopsied laboratory mice, laboratory rats, Chinese hamsters (Cricetulus griseus), or laboratory rabbits or from 10 tumor cell lines transplanted in laboratory mice. Complement-fixation testing of 301 animal sera from the vivarium also revealed involvement primarily of golden hamsters. The probable source of virus introduction into the Rochester facilities was found to be two LCM-contaminated tumor lines sent from a biological supplier to Rochester in 1969.

Animals↗