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Biomedical subjects

R C Holman

Publications and source records attributed to R C Holman.

At least 109 records · Page 6Linked to original sources
PubMed1984

Multiple sclerosis unrelated to dog exposure.

We conducted a case-control study to evaluate the possible association between exposure to dogs and MS. Seventy cases were compared with 70 age- and sex-matched neighborhood controls and 57 cases with 57 age- and sex-matched clinic controls. No association was found, by age groups or by time periods before onset of MS, between MS and presence of any dog, a small dog, a medium or large dog, or an indoor dog in the household. There was a significant negative association between MS and presence of cats in the household and MS and presence of medium and large dogs in the household, and a significant positive association, for several age groups and time periods, between MS and a history of canine distemper in a household dog. The basis for these significant associations is not clear. This study adds weight to the evidence against an association between exposure to small or indoor dogs and MS.

Adolescent↗
PubMed1983

Kawasaki syndrome in the United States 1976 to 1980.

Review of 523 confirmed cases of Kawasaki syndrome reported to the Centers for Disease Control (CDC), during the period from July 1976 through December 1980, disclosed a previously unrecognized seasonal variation, with a peak incidence between February and May. A significantly higher incidence in black children, compared with white children, was also noted. Earlier reports of a higher incidence in children younger than 5 years of age, males, and children of Asian ancestry were confirmed. Frequently reported complications included joint involvement (27%) and cardiac abnormalities (22%); 1.2% of patients died. Four outbreaks (mean duration, 3.8 months) were investigated by the CDC, but no evidence of person-to-person transmission or a point source of exposure was found. These data suggest that some cases may be caused by an exogenous agent or toxin that is most prevalent in the late winter and spring. In addition, host, environmental, or other cofactors are likely to be important determinants of susceptibility.

Age Factors↗
PubMed1983

National surveillance for Guillain-Barré syndrome: January 1978-March 1979.

Between January 1, 1978, and March 31, 1979, 1,034 cases of Guillain-Barré syndrome (GBS) were reported to the Centers for Disease Control by the 1,813 American Academy of Neurology sentinel physicians who participated in the national GBS surveillance program. A direct correlation was observed between increasing age and the age-specific attack (incidence) rates. Based on the cases observed and the total US population, age-adjusted attack rates were statistically higher in males (0.52 per 100,000) than in females (0.40). Rates for whites were 0.44 and those for blacks 0.28 per 100,000; although the difference is statistically significant, uncertainties as to the true denominators by race preclude acceptance of these differences as valid. Sixty-seven percent, or 682 of the patients, reported that they had had an antecedent illness within 8 weeks before onset of GBS, and among them the peak period of onset of GBS was in the second week after the onset of the prior illness. There were also 52 patients (5%) who had undergone surgery and 45 (4.5%) who had received vaccinations, both within the 8 weeks before onset of GBS. However, the high proportions of antecedent illness in these groups (45% of those operated and 53% of those vaccinated) made attribution of GBS to the procedures tenuous. Risk of GBS in patients who reported receiving a swine influenza vaccination in 1976 was no greater than in those who reported that they did not receive this vaccine.

Adolescent↗
PubMed1983

Epidemiologic characteristics of mortality from diabetes with acidosis or coma, United States, 1970-78.

Deaths due to diabetes with acidosis or coma (DAC) in the United States from 1970 through 1978 were analyzed to determine epidemiologic characteristics associated with mortality likely to be due to diabetic ketoacidosis (DKA), a complication of diabetes mellitus considered largely preventable. Annual age-adjusted rates for DAC deaths decreased during the study period, and the secular trend was significant in all regional, race, and sex groups examined. General population-based mortality rates increased linearly with age, were higher in non-Whites than in Whites among persons aged greater than 14, were higher in females, and increased significantly with age in both races and both sexes. By region, rates were lowest in the West. DAC mortality rates specific to estimated diabetic populations decreased annually from 1970 to 1978 in all race and sex groups, and were highest at age greater than or equal to 65, but did not show significant linear increases with age, except in non-Whites. These results indicate declining secular trends, as well as age, race, sex, and regional differences in the risk of such deaths. Further studies are warranted to determine factors contributing to these differences.

Adolescent↗
PubMed1982

An outbreak of Norwalk gastroenteritis associated with swimming in a pool and secondary person-to-person transmission.

In June 1977 an outbreak of acute gastroenteritis affected 103 students and teachers at an elementary school in Ohio. The illness typically lasted 24 hours or less and was characterized by vomiting (86%) and cramping (70%), but more than half of the persons involved also reported having nausea, diarrhea, and headache. Similar illness frequently followed in household members (29%) of families with primary cases. Investigation revealed that 70% of the children and teachers who swam in a pool at an all day outing June 1 (4 classrooms) and 55% of those who swam during a similar outing June 2 (2 classrooms) had the onset of acute illness from 12--48 hours later. None of the children who attended the outings but did not swim had a similar illness. The evidence suggested that the primary outbreak was caused by contaminated water in the pool and that person-to-person spread of illness followed. Results of a microbiologic study of pool water were negative for bacterial and viral pathogens. Throat washings, stool specimens, and paired blood samples studied for evidence of pathogens were negative initially, but subsequent serologic studies suggested that infection by Norwalk virus was the cause of the outbreak. The pool chlorinator which was inadvertently unconnected at the time of the school visits was reconnected and an underground leak in the water supply pipes was corrected. No more cases were reported after the pool was drained, cleaned, and reopened.

Disease Outbreaks↗
PubMed1982

Waterborne gastroenteritis due to the Norwalk agent: clinical and epidemiologic investigation.

An outbreak of gastroenteritis occurred at a Pennsylvania summer camp in July 1978. Symptoms included abdominal pain (81 per cent), nausea (72 per cent), and vomiting (53 per cent); upper respiratory infection symptoms occurred in 35 per cent of the campers. Illness was associated with consumption of five or more glasses of water or water-containing beverages. Stool cultures from affected persons were negative for bacterial pathogens; however, a fourfold or greater rise to the Norwalk agent was demonstrated in serum samples of three of three ill persons tested and in none of eight controls (p < .02). Campers ill during the first session who were also present during the second session did not become ill during the second session (p < .001). (Am J Public Health 1982; 72:72-74.)

Adolescent↗
PubMed1982

Herpes Simplex keratitis: epidemiologic aspects.

Review of medical records of 141 patients with acute epithelial herpes simplex keratitis (HSK) showed that recurrences, but not initial episodes, were more likely to happen from November through February than during other months of the year (P less than .04). Other findings included a high male to female ratio in patients older than 40 years of age (1.67:1.0; P less than .03) and a median time interval between episodes (in patients with recurrent disease) of 1.5 years. Although we identified no risk factors for frequent recurrences or for severe disease, our data support the hypothesis that nonherpetic viral respiratory infections may trigger recurrences of HSK.

Adolescent↗
PubMed1981

Guillain-Barré syndrome and the 1978-1979 influenza vaccine.

An ongoing surveillance program was intensified to determine whether an increased risk of acquiring vaccine-related Guillain-Barré syndrome (GBS) (similar to that observed after vaccination with the A/New Jersey swine-influenza vaccine in 1976) existed for the approximately 12.5 million adults (greater than or equal to 18 years old) vaccinated in the 1978-1979 influenza campaign. In the contiguous United States (excluding Maryland) 544 cases of GBS with onset between September 1, 1978, and March 31, 1979, were reported, including 12 adults who had been vaccinated within eight weeks before the onset of GBS and 393 who had not. The relative risk of vaccine-associated GBS for adults reported in this surveillance was 1.4 (95% confidence limits, 0.7 to 2.7)--significantly below the risk (6.2) associated with A/New Jersey vaccine for the equivalent eight-week period. In contrast to the A/New Jersey vaccine, the 1978-1979 influenza vaccine was not associated with a statistically significant excess risk of GBS.

Adolescent↗
PubMed1981

Kawasaki syndrome: description of two outbreaks in the United States.

Investigation of two outbreaks of Kawasaki syndrome (KS) in the United States in 1979 and in 1980 revealed no evidence of person-to-person transmission or of a common-source exposure among patients. Questionnaire data showed that KS was more likely to occur in children of middle and upper socioeconomic status than in those of lower status (P less than 0.05 and P less than 0.001 for the respective outbreaks) and that patients with KS had a higher incidence of an antecedent, primarily respiratory illness than did controls matched for age, sex, and race (83% of patients in the first outbreak vs. 30% of one control group, P less than 0.01, and vs. 36% of another control group, P less than 0.02; and 56% of patients in the second outbreak vs. 32% of their controls, P less than 0.02). However, laboratory studies did not identify an etiologic agent for either KS or for the antecedent illness that may be a risk factor for KS.

Adolescent↗
PubMed1981

Guillain-Barré syndrome: its epidemiology and associations with influenza vaccination.

The epidemiology of Guillain-Barré syndrome (GBS) and the associations of GBS with influenza vaccination are described based on review of three types of epidemiological data: case-control studies, incidence rate studies of GBS in well-defined populations, and surveillance data from a sentinel neurologist surveillance system of GBS in the United States. These data indicate that the crude annual incidence rate of GBS per 100,000 people ranges from 0.6 to 1.9 in different populations in widely scattered areas of the world. In general, incidence rates are higher with advancing age until about 75 years, higher for men than women, and higher for whites than blacks. No specific HLA antigen has been significantly associated with GBS in general, although HLA AW 30 and AW 31 have been associated with chronic relapsing polyneuritis. Important trigger agents of GBS include nonspecific respiratory and gastrointestinal infections and cytomegalovirus infection. Influenza infection and influenza vaccinations are not generally important trigger agents. A major exception to this is the occurrence of just under 1 excess case of GBS per 100,000 A/New Jersey influenza vaccinations administered in the United States, 1976-1977. A significant excess risk of GBS was not observed after administration of influenza vaccine in 1978-1979 and 1979-1980. The differences between the contents of and immunological reaction to A/New Jersey influenza vaccine and the more recent influenza vaccines deserve further study.

Adolescent↗
PubMed1981

Epidemic keratoconjunctivitis caused by adenovirus type 8: epidemiologic and laboratory aspects of a large outbreak.

During late 1977 and early 1978, 192 cases of epidemic keratoconjunctivitis occurred in a community in central Georgia. In 86 of these cases, the patient had been exposed to a single ophthalmologist's office (physician A) 3-22 days before onset of illness. Patients considered as cases were more likely to have had invasive ophthalmologic procedures than non-cases (p < 0.001), and a linear relationship existed between the number of procedures performed and the attack rate (r = 0.91, p < 0.05). Adenovirus type 8 (AV8) was identified as the responsible pathogen by culture and/or antibody determination for 20 of these patients. Group-specific AV hexon antigen and type specific dodecon antigen were identified in four of seven ophthalmic solutions obtained from physician A's office. The outbreak stopped after proper control techniques were initiated.

Adenoviridae Infections↗
PubMed1981

Rapid antibody response to human diploid rabies vaccine.

The speed of antibody response to two administration schedules of human diploid cell strains rabies vaccine (HDCV) was measured in two groups of veterinary students as a preliminary study to the use of interferon inducers plus vaccine for rabies treatment. When four doses of HDCV were administered in three days instead of four doses in 14 days, 94.7 per cent of those injected had antibody by the seventh day, versus 31.6 per cent in the 14-day group. The maximum titer was lower and antibody fell more quickly in the group with the shorter time interval between doses. This study shows the feasibility of inducing the same rapid antibody response in humans as that noted in rhesus monkeys where the mortality from rabies virus challenge was markedly reduced after treatment with interferon inducers and HDCV.

Adult↗
PubMed1979

A waterborne outbreak of gastroenteritis with secondary person-to-person spread. Association with a viral agent.

In December, 1976, an outbreak of gastroenteritis occurred at a resort camp in Colorado. Data obtained by questionnaire from 760 persons indicated that 418 (55%) had had gastroenteritis at the camp or within a week of leaving it, with peak onset within a two-day period. Symptoms included vomiting (81%), diarrhoea (65%), and fever (49%); median duration of illness was twenty-four hours. The attack-rate increased with consumption of water or ice-containing beverages. The camp water supply was found to be inadequately chlorinated and contaminated by a leaking septic tank. Although routine laboratory tests did not reveal bacterial, viral, or parasitic pathogens, immune electron microscopy detected virus-like particles in two of five diarrhoeal stool filtrates. Oral administration of one of these bacteria-free filtrates to two volunteers induced a gastrointestinal illness similar to that observed in the camp visitors.

Camping↗
PubMedDate not supplied

Incidence of Rocky Mountain spotted fever among American Indians in Oklahoma.

OBJECTIVE: Although the state of Oklahoma has traditionally reported very high incidence rates of Rocky Mountain spotted fever (RMSF) cases, the incidence of RMSF among the American Indian population of the state has not been studied. The authors used data from several sources to estimate the incidence of RMSF among American Indians in Oklahoma. METHODS: The authors retrospectively reviewed an Indian Health Service (IHS) hospital discharge database for 1980-1996 and available medical charts from four IHS hospitals. The authors also reviewed RMSF case report forms submitted to the Centers for Disease Control and Prevention (CDC) for 1981-1996. RESULTS: The study data show that American Indians in the IHS Oklahoma City Area were hospitalized with RMSF at an annual rate of 48.2 per million population, compared with an estimated hospitalization rate of 16.9 per million Oklahoma residents. The majority of cases in the IHS database (69%) were diagnosed based on clinical suspicion rather than laboratory confirmation. The incidence of RMSF for Oklahoma American Indians as reported to the CDC was 37.4 cases per million, compared with 21.6 per million for all Oklahoma residents (RR 1.7, 95% confidence interval [CI] 1.5, 2.1). CONCLUSIONS: Rates derived from the IHS database may not be comparable to state and national rates because of differences in case inclusion criteria. However, an analysis of case report forms indicates that American Indians n Oklahoma have a significantly higher incidence of RMSF than that of the overall Oklahoma population. Oklahoma American Indians may benefit from educationa campaigns emphasizing prevention of tick bites and exposure to tick habitats.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

Creutzfeldt-Jakob disease in the United States, 1979-1994: using national mortality data to assess the possible occurrence of variant cases.

After a cluster of Creutzfeldt-Jakob disease (CJD) cases among unusually young patients was reported recently from the United Kingdom, we examined trends and the current incidence of CJD in the United States. We found that the age-adjusted CJD death rate in the United States is similar to published estimates of the crude incidence of CJD worldwide and has continued to be stable from 1979 through 1994. The number of CJD deaths in persons

Adolescent↗