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Biomedical subjects

R A Goodman

Publications and source records attributed to R A Goodman.

At least 55 records · Page 3Linked to original sources
PubMed1984

Epidemic keratoconjunctivitis: report of an outbreak in an ophthalmology practice and recommendations for prevention.

In Fall 1981, an outbreak of acute infectious conjunctivitis with keratitis (EKC) occurred in patients who had visited a private ophthalmology clinic just prior to onset of illness. Among an estimated 2,200 patient visits to the office from August 10 to October 15, 1981 for problems unrelated to infectious conjunctivitis, 39 (1.8%) persons subsequently developed EKC. The median incubation period was 6.5 days (range, 1 to 14 days). A case-control study was done to identify risk factors associated with contracting EKC; patients with EKC were more likely than control patients to have been examined by one or the other of two of the four ophthalmologists at the clinic and to have undergone procedures such as tonometry or foreign body removal. Adenovirus was isolated from conjunctival swabs from four of five persons with conjunctivitis; three were type 8 and one was type 7. Recognition of the problem and improved handwashing practices were associated with terminating the outbreak. This outbreak illustrates the potential for transmission of adenovirus infection during the provision of eye care. Infection control practitioners should be familiar with measures for the prevention of such infections among ophthalmology patients.

Adenoviridae Infections↗
PubMed1984

Infectious diseases and child day care.

The number of day care centers and home care facilities has steadily increased in the United States. Recent interest has focused on the possible relationship between attendance at child day care facilities and the occurrence of certain infectious diseases. A variety of infectious agents have been reported as causes of illness among children and staff in day care programs. In general, however, concurrent risks for these infections among children attending and those not attending day care programs have not been established by prospective studies. A review is made of the pathogens that have been associated with infections in day care settings, patterns of occurrence of infectious diseases in day care facilities, aspects of control and prevention of these diseases, and controversies related to infectious diseases in child day care facilities. Aspects of this problem that warrant further research are outlined.

Child Day Care Centers↗
PubMed1983

Pseudomonas aeruginosa serotype 0:9. New cause of whirlpool-associated dermatitis.

In a five-day period, dermatitis developed in nearly one fourth of the guests staying at a large Georgia hotel. Dermatitis was associated with use of the hotel's whirlpool (p less than 0.001) and indoor swimming pool (p less than 0.001). Attack rates were highest among persons more frequently exposed to the whirlpool, in persons under 10 years of age, and during periods of heaviest bather load. Pseudomonas aeruginosa was isolated from skin lesions of 13 of 20 patients from whom culture specimens were taken. Ten isolates were serotype 0:9. The whirlpool's water grew P. aeruginosa serotype 0:9; however, the whirlpool's automatic chlorinator was functioning properly, the pH of the water was 7.2, and the free chlorine level was 0.6 mg/liter. This is the first report of a whirlpool-associated outbreak caused by P. aeruginosa serotype 0:9. Our findings suggest that this strain may not be readily sensitive to recommended chlorine concentrations.

Adolescent↗
PubMed1983

Fecal coliforms on environmental surfaces in two day care centers.

A survey of environmental surfaces in two Atlanta area day care centers was conducted to determine the prevalence of fecal coliform bacteria, considered a marker for the presence of fecal contamination which might contain pathogenic parasites, bacteria, or viruses. Fecal coliforms were found in 17 (4.3%) of 398 representative samples of building surfaces, furniture, and other objects. These surfaces may be involved in the chain of transmission of enteric diseases among children. Therefore, disinfection of inanimate objects, in addition to good handwashing, may be important in controlling the spread of enteric diseases in day care centers.

Child Day Care Centers↗
PubMed1983

Hepatitis B and dental personnel: transmission to patients and prevention issues.

Hepatitis B virus (HBV) infection is considered an occupational risk for dental professionals. The Centers for Disease Control have participated in eight investigations regarding dental professionals who were suspected of transmitting HBV infection to their patients. This article summarizes the findings of the investigations, the postulated mechanism of transmission of HBV, control measures suggested, and follow-up of the dental practice for those dentists who were chronic carriers of hepatitis B surface antigen. The approach by the centers for managing dental professionals who are HBsAg positive and those dental professionals who are HBsAg positive and implicated as transmitting HBV infection to patients are outlined. If HBV transmission cannot be interrupted, by suggested measures, then more restrictive measures should be decided on by state or local health officials, or both. These could include removal of the practitioner's license. HBV-infected dental personnel can transmit HBV infection to their patients. The measures suggested for the HBV carrier are designed to allow the dental practitioner to continue practice, but, at the same time, give maximum protection to the patient.

Dental Care↗
PubMed1983

Gnat sore eyes: seasonal, acute conjunctivitis in a southern state.

In late summer 1981, a widespread outbreak of acute bacterial conjunctivitis occurred in southeast Georgia, affecting primarily grade-school children. This outbreak was similar to previously described seasonal conjunctivitis in the South. As suggested in previous studies, the eye gnat, Hippelates pusio, may serve as a mechanical vehicle in the transmission of the suspected causative agent, a possible Haemophilus species. The 1981 Georgia outbreak illustrates that "gnat sore eyes" is not obsolete and apparently can occur unpredictably during warm months in the southern states. Physicians and other health-care workers should be aware of the unique clinical and epidemiologic features of acute seasonal conjunctivitis.

Acute Disease↗
PubMed1982

Impact of influenza A in a nursing home.

Outbreaks of influenza A in the institutionalized elderly have been reported only rarely. Such an outbreak occurred in a nursing home in the period Dec 12, 1980, through Jan 21, 1981. Thirty (25%) of the 120 residents had onset of influenza-like illness during the outbreak. Influenza A/Bangkok/79-like (H3N2) virus was isolated from throat swab specimens from five of eight acutely ill patients. Thirteen persons were hospitalized; nine persons died (case-fatality ratio, 30%). This outbreak documents that mortality associated with an influenza outbreak can be substantial in a closed population of the elderly. Because nursing home residents are an easily accessible high-risk population, control and prevention of influenza should be a high priority in nursing homes.

Acute Disease↗
PubMed1982

Mortality data analysis using a multiple-cause approach.

Death certificates are the primary source for information used to define general mortality patterns in the United States. Analyses of mortality data generally are restricted to one of the conditions listed on the certificate--the underlying cause of dealth. We review principles related to the use of mortality data and describe a study using mortality tapes ("multiple-cause tapes") that list all conditions recorded on dealth certificates. Using multiple-cause tapes, we found that the number of deaths associated with seven infectious diseases in 1968, 1969, and 1970 was from 24% (diphtheria) to 81% (rubella) greater than that officially reported. Multiple-cause tapes also permitted a review of the association of deaths attributed to measles and varicella and known complications of these diseases. these observations confirm the usefulness of multiple-cause tapes in analyzing mortality data and emphasize the importance of examining all conditions listed on the death certificate.

Death Certificates↗
PubMed1982

Nosocomial hepatitis A transmission by an adult patient with diarrhea.

Hepatitis A occurred in five registered nurses, a licensed practical nurse, and a recently discharged patient at a community hospital; one of these seven was asymptomatic. All had been exposed to a woman with confirmed hepatitis A who had undergone elective cholecystectomy and who had had vomiting, diarrhea, and fecal incontinence during the eight days before onset of jaundice. Of the 107 hospital workers identified as having at least some exposure to the source patient, 58 (54.2 percent) had no pre-existing antibody to hepatitis A virus (anti-HAV) and were considered susceptible. Six persons, including the five clinically ill registered nurses, had IgM-specific anti-HAV. The infection attack rate was 5.6 percent for all exposed hospital workers but 10.3 percent for the 58 who were serosusceptible. Risk of infection was highest for persons with documented or probable contact with the source patient and for registered nurses. Among hospital personnel, the prevalence of anti-HAV increased with age but varied inversely with socioeconomic status. Hospital personnel and patients may be at risk for hepatitis A infection when exposed to patients who are in the prodromal stage of hepatitis A. Vomiting, diarrhea, and fecal incontinence may increase the risk of transmission.

Adult↗
PubMed1982

Gastroenteritis due to Norwalk virus: an outbreak associated with a municipal water system.

An outbreak of gastroenteritis lasting for one week in August 1980 affected approximately 1,500 persons in a community in northern Georgia. Investigation included a telephone survey of the community, a survey of textile plant employees and junior high and high school students and staff, and a neighborhood door-to-door survey. An association between gastrointestinal illness and consumption of drinking water was shown for community residents, students, and school staff. Attack rates (0-68%) determined in 10 neighborhoods increased significantly (P less than 0.001) with proximity to a textile plant, the site of one of two known cross-connections between an industrial water system (which contained fecal coliform bacteria) and the community water system. A fourfold rise in titer of antibody to Norwalk virus was found in 12 of 19 serum pairs from patients. Norwalk virus illness associated with drinking water from a large municipal water system has not been documented previously. Norwalk virus may be an important cause of waterborne morbidity in the United States.

Antibodies, Viral↗
PubMed1982

Hospitalizations for measles, 1970-78.

The National Hospital Discharge Survey of the National Center for Health Statistics was analyzed for measles hospitalizations. From 1970-1978 there were an estimated 52,301 hospitalizations for measles, or approximately 5,800 per year. The median patient age was three years, and the median length of stay was four days. Forty-one per cent of the discharges listed respiratory complications, 10 per cent listed otitis media, and 3 per cent listed neurologic complications. Based on this analysis, hospitalizations for measles accounted for 314,063 hospital days during the period 1970-1978.

Adolescent↗
PubMed1982

A cluster of cases of Reye syndrome associated with chickenpox.

In the spring of 1980, four confirmed, and three possible cases of Reye syndrome, each associated with a chickenpox prodromal illness, were identified in Las Cruces, NM. One patient, a 5-year-old girl, died. Cases tended to occur in one section of the community, among children attending two of the 16 elementary schools. A telephone survey of parents with school-aged children (6 to 9 years old) suggested that a significantly greater attack rate of chickenpox occurred in children attending those two schools. Based upon this survey and the expected distribution of chickenpox among children less than 15 years of age, the incidence of Reye syndrome following chickenpox infection in the county in which Las Cruces is located was estimated to be 2.5/10,000 cases of chickenpox; these data reveal a four- to ninefold greater incidence of Reye syndrome than that following influenza B infections, which was previously estimated based upon a cluster of five cases in a county in Michigan. Additional investigations of Reye syndrome clusters are needed in an effort to identify and study suspected risk factors and to better define the relationship between Reye syndrome and viral infections.

Chickenpox↗
PubMed1981

An outbreak of influenza B in an elderly population.

An outbreak of influenza B occurred in an elderly population residing in a Minnesota nursing home between April 24 and May 21, 1979 and involved 129 (35.9%) of the 359 residents. Throat swabs from 11 and 19 acutely ill residents yielded influenza B virus similar to the B/Singapore/79 strain. Fourfold or greater increases in titer of complement-fixing or hemagglutination-inhibiting antibodies were detected in paired sera from 18 of the 19 persons affected and from three of 16 unaffected residents. Three hundred thirty-three (93%) of the 359 residents had received trivalent influenza virus vaccine in November 1978. The attack rate was age-specific and increased with age (z = 2.69; P = 0.007). Increasing susceptibility to influenza B with age in the elderly has not been previously demonstrated in this infrequently studied population. Increased risk for becoming ill was also found to be statistically associated with decreasing levels of care required and residence in closed wards and temporally associated with taking meals in the facility's dining areas.

Aged↗