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Biomedical subjects

H F Hull

Publications and source records attributed to H F Hull.

70 records · Page 4Linked to original sources
PubMed1984

Herpes simplex viral pneumonitis in childhood.

We report two cases of herpes simplex pneumonia in children. One patient had Down syndrome, and the other was immunosuppressed by cancer therapy. Both had interstitial pneumonitis with nonspecific physical, radiographic, and laboratory findings, and both died. The diagnosis of herpes simplex pneumonia was made by isolation of herpes simplex virus from autopsy lung cultures as well as by demonstration of antigen in the tissue with an immunoperoxidase procedure. Inasmuch as herpes simplex pneumonia is a potentially treatable infection, early virologic studies are recommended in immunocompromised children with progressive pneumonitis of undetermined cause.

Antigens, Viral↗
PubMed1984

Animal bites as an occupational hazard among animal control officers.

One hundred-and-two full-time animal control officers (ACOs) in New Mexico were surveyed to learn about animal bite risks in this little-studied occupational group. The overall bite rate was 2.57 per working-year (175-500 times population-based rate estimates). A "high risk" ACO subset (seven officers involved in 67 per cent of bite incidents) was discovered. Evaluation of animal bite data can contribute to prevention of occupational injuries among the estimated 10,000 full-time ACOs in this country.

Adult↗
PubMed1984

A pseudo-outbreak of influenza A associated with use of laboratory stock strain.

In November 1982, when influenza type A(H3N2) viruses were spreading in the United States, influenza A(H1N1) viruses were reportedly isolated from 10 hospitalized patients in New Mexico, only two of whom had influenza-like illnesses. Reference stock influenza A/Fort Monmouth (FM)/1/47(H1N1) virus had been used to prepare fluorescent antibody test slides in the laboratory reporting the isolates. After investigation, it was concluded that the isolates from the patients' cultures were a result of laboratory contamination. When an unexpected cluster of unusual virus isolates is reported, the possibility of laboratory contamination should be considered.

Adult↗
PubMed1984

Low prevalence of hepatitis B infections among residents of an institution for the mentally retarded in New Mexico.

Residential institutions for the mentally retarded are considered high-risk settings for hepatitis B (HB) infection. Accordingly, HB vaccine is recommended for susceptible clients and selected staff of such facilities. However, a serologic screening program among 364 residents of Los Lunas Hospital and Training School (LLHTS) in New Mexico found only 11 residents to be anti-HBc positive (3%) and only one of these residents was also HBsAg-positive (0.3%). The unexpectedly low prevalence of HB infections at LLHTS probably reflects infrequent HB introductions into the institution. Using these serologic data, a vaccination program was instituted to prevent HB infection among LLHTS residents, thereby eliminating the need for mass screening and HB vaccination of LLHTS employees. Serologic screening among residents of other smaller institutions for the mentally retarded is recommended before design of HB prevention programs for clients and staff.

Hepatitis B↗
PubMed1983

Neonatal herpes simplex virus infection in King County, Washington. Increasing incidence and epidemiologic correlates.

The incidence of neonatal herpes simplex virus (HSV) infection in King County, Washington, has increased progressively from a rate of 2.6 per 100,000 live births to King County residents during the years 1966 through 1969 to 4.8, 7.4, and 11.9 cases per 100,000 live births for the years 1970 through 1973, 1974 through 1977, and 1978 through 1981, respectively. Detailed interviews of the parents of newborns with neonatal HSV-2 infection revealed clinically symptomatic genital herpes in the mother or father in 65% of the parents and serological and/or cultural evidence of HSV-2 infection in the mother in the other 35% of cases. Clinically symptomatic first episodes of genital herpes during pregnancy occurred in four of the mothers who were delivered of newborns with neonatal HSV-2 infection; two of the mothers were symptomatic at the time of birth. The other 16 interviewed mothers who delivered newborns with neonatal HSV-2 infection all had serological and/or cultural evidence of past HSV-2 infection but were asymptomatic at term. All six newborns with neonatal HSV-1 infection acquired the disease from nongenital sources, and two newborns seemed to have acquired the disease from nonmaternal sources. These data indicate that detailed interviews of the parents are often useful in increasing the clinician's index of suspicion for neonatal HSV infection. The increased prevalence of genital HSV infection in the United States seems to be associated with a concomitant increase in neonatal HSV infection.

Adolescent↗
PubMed1983

Measles mortality and vaccine efficacy in rural West Africa.

Measles mortality and measles vaccine efficacy were determined during outbreaks in three Gambian villages. There were 146 cases of measles among 1073 children younger than 11 years. 30% of the children had been vaccinated against measles. The attack rate in unvaccinated children aged 9-47 months was 43% compared with 6% for children of the same age with documented measles vaccination. Vaccine efficacy was 37% for children vaccinated at 6-8 months of age and 89% for children vaccinated at 9 months or older. 5% of measles cases died before the initial investigation of the outbreaks and a further 10% of cases died during the ensuing 9 months. Only 1% of children who did not contract measles died in the 9 months after the outbreaks. Case-fatality rates were highest for measles patients less than 1 year old (64%) and fell with age. Measles remains a significant source of acute and delayed mortality in unvaccinated African populations.

Africa, Western↗
PubMed1983

Toxic shock syndrome related to nasal packing.

While toxic shock syndrome (TSS) is generally considered to be a tampon-related illness, an increasing number of reported cases have been related to surgical wounds. At least one case has been reported following nasal surgery with nasal packing. We report two additional cases of TSS associated with nasal packing. Because nasal packing is in some ways analogous to the use of tampons for menstrual hygiene, and nasal carriage of Staphylococcus aureus is frequent, the scarcity of TSS cases reported to occur following nasal packing is surprising. Otorhinolaryngologists are urged to report TSS cases associated with nasal packing to their state and local health departments or the Centers for Disease Control to aid in the understanding of the pathogenesis of this disease.

Adult↗
PubMed1983

Risk of pregnancy among adolescent schoolgirls participating in a measles mass immunization program.

A large measles vaccination program in the Albuquerque, New Mexico public schools in 1981, conducted according to US Public Health Service guidelines, was studied to determine rates of pregnancy among adolescent vaccinees. Pre-vaccination counseling of 1,922 clinic attendees prevented seven pregnant girls from being vaccinated. Despite counseling, of 1,913 female vaccinees age 13-18 years old, two were pregnant at the time of vaccination (1.05 pregnancies per 1,000 vaccinees) and an additional four girls became pregnant in the three months after vaccination (2.1 pregnancies per 1,000 vaccinees). Data supporting low or absent fetal risks from measles and rubella vaccine, combined with the low pregnancy rate among vaccinees documented in this study, support the reasonableness of the recommended strategy for measles and rubella vaccination of secondary schoolgirls.

Adolescent↗
PubMed1983

New Haemophilus influenzae type b control strategy: premature commitment to prophylaxis?

Recent promulgation of an official policy on prevention of secondary cases of Haemophilus influenzae type b disease illustrates the challenges and frustrations inherent in the policy-making process. Despite evidence that H influenzae type b disease is "contagious" in households and probably also in day care centers and despite demonstration that rifampin eradicates nasopharyngeal H influenzae type b carriage, the single field study of rifampin use to prevent secondary cases of H influenzae type b disease remains unpublished and has yet to receive broad critical scrutiny. Promulgation of the rifampin strategy prior to publication of this critical study is unfortunate, as public and private providers are now committed to a policy that will be difficult to evaluate or alter. Now that the strategy has been issued, the central question regarding rifampin prophylaxis has changed from "Is this strategy effective?" to "Can this strategy be shown to be ineffective?" When policies are issued prior to publication of key supporting data, or when such studies are either missing or highly controversial, the policy-making committee might publish, along with its recommendations, explicit criteria for continuation, modification, or withdrawal of the new policy. This structured reassessment approach could accommodate the critical need to proceed with disease control recommendations--even though based on incomplete information--yet underscore the policy's tentative nature and provide direction for future assessment and study.

Academies and Institutes↗
PubMed1975

Glucorrhea revisited. Prolonged promulgation of another plastic pearl.

Glucose oxidase test strips were used to evaluate the presence of glucose in nasal secretions and tears in a group of normal children. Substantial amounts of glucose were present in 15 of 17 samples of nasal discharge and 10 of 15 samples of tears. The use of glucose oxidase test strips for diagnosis of cerebrospinal fluid rhinorrhea, therefore, is without merit.

Cerebrospinal Fluid Rhinorrhea↗
PubMedDate not supplied

Increased measles mortality in households with multiple cases in the Gambia, 1981.

Analysis of previously collected data from measles outbreaks in three Gambian villages demonstrated that an age of less than 3 years was the primary risk factor for death in the months following measles infection. No association was found between overall measles mortality and size of household or number of measles cases in a household. When the analysis was confined to patients less than 3 years of age (i.e., those most likely to die), measles mortality was strongly associated with the occurrence of more than five measles cases in a household. Intensive exposure to measles virus may, therefore, be a secondary risk factor for death following measles. Reducing measles mortality by altering social patterns and elevating socioeconomic status to reduce exposure to the virus is beyond the scope of most public health programs. Age-appropriate immunization, therefore, remains the principal strategy for preventing death following measles.

Age Factors↗
PubMedDate not supplied

Status of measles in The Gambia, 1981.

Measles registries were instituted in all rural health facilities in The Gambia during January through December 1981. House-to-house surveillance of three infected villages revealed a 7% acute case-fatality rate. Infected villages were followed up until December 1981. Finger-prick specimens of blood, complete measles history, and vaccination status of 380 children aged six months to five years were studied. Data on children from the area with the lowest coverage for measles vaccination in 1980 were collected and analyzed. Of the 60% of children who were vaccinated, 75% seroconverted, while 8% reported measles infection after immunization. The Gambia's immunization program is composed of static immunization units with outreach stations and rural health workers in immunization services. The strong faith of mothers in the maternal and child health services coupled with the commitment of the health workers in The Gambia is helping to provide important leadership in the struggle to attain global control and eradication of measles by the year 2000.

Antibodies, Viral↗
PubMedDate not supplied

Prevention of Haemophilus influenzae type b infections in day care: a public health perspective.

The availability of new data regarding the risk of invasive Haemophilus influenzae type b (Hib) among day care attendees allows the formulation of a practical public health approach to this problem. It is now clear that day care attendees are at significantly increased risk for development of primary invasive Hib disease. While the risk of secondary Hib disease for most is low, risk is substantially increased when young day care attendees are exposed to a primary case to a degree analogous to that of household contacts. Because risk for primary Hib disease is increased among day care attendees, immunization of these children with Hib polysaccharide vaccine is of the highest priority and may be appropriate for children as young as 18 months of age. In light of new data documenting the efficacy of rifampin in prevention of secondary disease, the use of this medication is indicated when unvaccinated day care attendees younger than two years old have had significant contact with a primary case.

Age Factors↗
PubMedDate not supplied

Presentation of neonatal herpes simplex virus infections: implications for a change in therapeutic strategy.

To identify clinical signs of disease that might lead to more rapid recognition in treatment, we reviewed the time from onset of illness to diagnosis of 42 consecutive cases of neonatal herpes simplex virus (HSV) infection seen between 1965 and 1984. The first signs of illness included mucocutaneous lesions in 14, central nervous system signs in 20, fever in 6 and respiratory insufficiency in 2 infants. The median time from onset of illness to presentation to medical personnel was 1 day. The median time from presentation to medical personnel to obtaining viral cultures was 3 days (range, 1 to 11) and was similar in infants who did and did not have mucocutaneous lesions. Viral cultures were performed within 24 hours of admission on 8 of 13 noncongenitally infected infants born between 1982 and 1984 compared to 5 of 24 seen between 1965 and 1981 (P less than 0.03). However, a greater than 72-hour delay between presentation to medical personnel and obtaining viral diagnostic studies occurred in 33, 40 and 14% of infants born in the years 1965 to 1977, 1978 to 1981 and 1982 to 1984. Involvement of additional organ systems by HSV was noted in 57% of infants between the time from presentation to medical personnel and diagnosis. Neonatal HSV infection was often severe by the time patients presented to medical personnel, and the disease usually progressed rapidly. To achieve a better therapeutic outcome for infants with neonatal herpes, consideration should be given to the initiation of antiviral therapy on presumptive clinical and epidemiologic grounds. Future strategies for therapy of neonatal herpes should be directed at preventing the acquisition of disease.

Female↗
PubMedDate not supplied

Persistence of high-risk sexual activity among homosexual men in an area of low incidence of the acquired immunodeficiency syndrome.

Before 1985 only five cases of the acquired immunodeficiency syndrome (AIDS) had been diagnosed in New Mexico, and there was no information regarding prevalence of antibody to the human immunodeficiency virus (HIV). Of 166 gay and bisexual men tested in 1985 in New Mexico, 20% were found to have antibody to HIV. Of 153 responding participants, 107 (70%) reported practicing receptive anal intercourse in the last 12 months, and only 13% of the 107 reported the regular use of condoms. High-risk sexual activity may have persisted in part because of underestimation of the local risk of acquiring HIV infection. Voluntary serologic testing and education of members of high-risk groups should be stressed in areas where the incidences of AIDS and of seropositivity to HIV are low but where high-risk sexual activity may still be prevalent.

Acquired Immunodeficiency Syndrome↗