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Biomedical subjects

J J Witte

Publications and source records attributed to J J Witte.

At least 37 records · Page 2Linked to original sources
PubMed1988

Transmission of HIV in Belle Glade, Florida: lessons for other communities in the United States.

The high cumulative incidence of AIDS and the large percentage of AIDS patients with no identified risks in Belle Glade, Florida, were evaluated through case interviews and neighborhood-based seroepidemiologic studies. It was found that of 93 AIDS patients reported between July 1982 and 1 August 1987, 34 could be directly linked to at least one other AIDS patient or to a person with AIDS-related complex by sexual contact, sharing of needles during intravenous drug abuse (or both), or perinatal exposure; of 877 randomly selected adults, 28 had antibodies to HIV; no person over age 60 and none of 138 children aged 2 to 10 years had antibodies to HIV; no clustering of infected persons within households occurred, except in sex partners; and HIV-seropositive adults were more likely than HIV-seronegative adults to be from Haiti, have a lower income, report sex with intravenous drug abusers, and have a history of previous treatment for sexually transmitted diseases. The presence of antibodies to five arboviruses prevalent in South Florida or the Caribbean did not correlate significantly with HIV infection. The high cumulative rate of AIDS in Belle Glade appears to be the result of HIV transmission through sexual contact and intravenous drug abuse; the evidence does not suggest transmission of HIV through insects.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Epidemic campylobacteriosis associated with a community water supply.

In May 1983, an estimated 865 cases of epidemic gastrointestinal disease occurred in Greenville, Florida. Surveillance of pharmacy sales of antidiarrheal medicines suggested that the outbreak was confined to Greenville and its immediate vicinity. Surveys demonstrated that the gastrointestinal illness attack rates inside and outside the city limits were 56 per cent (72/128) and 9 per cent (7/77), respectively (relative risk (RR) = 6.2); consumption of city water was associated with illness (RR = 12); and as water consumption increased, the attack rate also increased (p less than 0.001). Four adults were hospitalized and one outbreak-related case of Guillain-Barre' syndrome was identified. Campylobacter jejuni was isolated from specimens from 11 ill persons; serologic studies showed the development of Campylobacter-specific antibodies. Fecal coliforms were found in water samples, but Campylobacter was not recovered from water. The city water plant, a deep well system, had numerous deficiencies including an unlicensed operator, a failure of chlorination, and open-top treatment towers. Birds were observed perching on the open-top treatment tower. Of 38 birds trapped seven weeks later, 37 per cent harbored C. jejuni; however, plasmid and serotyping studies showed that strains were not the same as the common strain from ill persons. This outbreak suggests that water systems that are unprotected from contact with birds may become contaminated and a source of outbreaks of human campylobacteriosis.

Adult↗
PubMed1981

Prophylaxis of varicella in high-risk children: dose-response effect of zoster immune globulin.

Immunodeficient patients who were presumed to be susceptible received zoster immune globulin prophylaxis after exposure to varicella. The highest clinical attack rate (35.9%) was seen in household contacts; the lowest attack rate (0%) was observed in children exposed at school. Among household contacts, 48 of 100 patients who received high titer ZIG (reciprocal complement fixation titer greater than or equal to 2,560) developed fourfold rises in serum CF antibody between pre- and 48-hour post-treatment specimens, compared to only one of 34 patients treated with lower titer ZIG lots (P less than 0.001). Patients who developed fourfold antibody rises were significantly less likely to contract clinical varicella (P less than 0.01). Patients who received high titer ZIG also had significantly lower risks of death (P = 0.025) and complications (P = 0.006). Among ZIG-treated patients who contracted clinical varicella, 80% developed mild disease (less than 100 pox), and the median incubation period was prolonged. Immunodeficient children exposed to varicella benefit from ZIG prophylaxis and higher titer ZIG is of greatest benefit.

Adolescent↗
PubMed1977

Antibody persistence after primary immunization with trivalent oral poliovirus vaccine.

Five years after primary infant immunization with trivalent oral poliovirus vaccine, employing either a three-dose primary series as recommended by the U.S. Public Health Service Advisory Committee on Immunization Practices (ACIP) or a four-dose series as recommended by the Committee on Infectious Diseases of the American Academy of Pediatrics. 115 children were serologically tested for persistence of neutralizing antibodies by the microneutralization test. Of the 57 individuals immunized according to the ACIP recommendation, antibody persistence was demonstrated in 92% for type 1 poliovirus, 98% for type 2, and 84% for type 3. Of those 58 individuals originally receiving a four-dose primary infant immunization series, the persistence of antibody was 98% to type 1, 98% to type 2, and 87% to type 3. Twenty-one of 24 negative sera showed neutralizing ability when tested by a more sensitive plaque reduction test. Thus, individuals completing either immunization schedule demonstrated satisfactory persistence of neutralizing antibody to all three poliovirus types over a five-year period.

Antibodies, Viral↗
PubMed1977

Immunization.

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Immunization↗
PubMed1977

Current status of rubella in the United States, 1969-1975.

Implementation of the rubella immunization policy in the United States has resulted in marked decreases in the number of reported cases of both rubella and CRS. Emphasis on immunization of one- to 12-year-old children has resulted in a dramatic reduction in reported rubella in this age group. Accordingly, the proportion of reported cases occurring in adolescents and young adults has increased. Therefore, it seems appropriate to place more emphasis on immunizing susceptible adolescent and adult females as an adjunct to routine immunization in early childhood. This joint strategy should result in a further decrease in the incidence of rubella and CRS.

Adolescent↗
PubMed1977

Epidemiologic studies of measles, measles vaccine, and subacute sclerosing panencephalitis.

Histories obtained in 350 of 375 clinically cofirmed cases of subacute sclerosing panencephalitis (SSPE) reported to a national registry showed that 292 patients had measles and 58 had no history of measles. Forty of the latter patients received live, attenuated measles virus vaccine. In patients with a history of measles, measles illness occurred before age 2 years in 46%, and a mean of 7.0 years before onset of SSPE. In contrast, there was no relationship of SSPE with age at vaccination in 35 of the 40 patients historically associated with measles vaccine, and SSPE occurred a mean of 3.3 years after vaccination. Based on estimated national measles morbidity data and national measles vaccine distribution data, the risk of SSPE following measles vaccination (0.5 to 1.1 cases/106) appears to be less than the risk following measles (5.2 to 9.7 cases/106). Because live measles vaccine is highly effective in preventing measles illness and a high proportion of children in the United States have received measles vaccine, these data are consistent with the observed downward trend in SSPE incidence since 1969.

Adolescent↗
PubMed1976

Rubella immunization. Persistence of antibody four years after a large-scale field trial.

A long-term comparative field trial of three live, attenuated rubella vaccines (HPV-77 DE-5, HPV-77 DK-12, and Cendehill) was initiated in 1969 on the islands of Kauai and Hawaii in the state of Hawaii. Rubella hemagglutination-inhibition (HI) tests on prevaccination serum specimens from 7,931 children in the two study areas indicated an overall susceptibility to rubella of nearly 70%. The rates of seroconversion of 5,153 seronegative subjects to HPV-77 DE-5, HPV-77 DK-12, and Cendehill vaccine were 97.5%, 99.9%, and 99.8%, respectively. Over the subsequent four-year follow-up period, during which time natural exposure to rubella was minimal, the percent decline of geometric mean titers did not vary substantially among the three vaccine groups and measured about twofold for all three. A total of only 28 vaccines (0.7%) who seroconverted to one of the vaccines in 1969 lost all measurable antibody by 1974. Measurable antibody persisted in more than 98% of all vaccinees over the four-year period. Reinfection, thought possibly to be an important factor in maintaining titers, did not occur frequently in the study population and could not be related to outbreaks of disease.

Age Factors↗
PubMed1976

Serologic response to revaccination with two rubella vaccines.

Three years after receiving rubella vaccine, 1,060 elementary school children living on the island of Maui, Hawaii, were revaccinated with either HPV-77 DE-5 or RA 27/3 rubella vaccine given subcutaneously or intranasally in order to compare the effectiveness of these two vaccines in raising antibody titers. RA 27/3 was the more effective booster vaccine, producing fourfold or greater titer rises in 20.1% of recipients, including 80% of children with hemagglutination-inhibiting antibody titers less than or equal to 1:40 at the time of revaccination, intranasal revaccination was not significantly more effective than subcutaneous revaccination, although it did elicit higher titers in children who responded. Responses differed according to the vaccine that children had received three years earlier. Because antibody titers have persisted in vaccinated children, routine administration of a second dose of rubella vaccine is not currently recommended.

Administration, Intranasal↗