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Biomedical subjects

R L Vogt

Publications and source records attributed to R L Vogt.

At least 37 records · Page 2Linked to original sources

Elevated levels of immunoglobulin A to Giardia lamblia during a waterborne outbreak of gastroenteritis.

During an outbreak of diarrheal illness among residents of a trailer park in rural Vermont, 37 (30%) of 122 residents met the case definition of outbreak-related giardiasis. Convalescent-phase sera from 24 residents and 20 nonresident control subjects were tested by enzyme-linked immunosorbent assay for immunoglobulin G (IgG), IgM, and IgA antibodies to Giardia lamblia. Residents showed higher levels of parasite-specific antibody than did nonresident controls for IgG and IgA but not IgM. Nine residents with giardiasis had a higher median level of G. lamblia-specific IgA but not IgG or IgM than 15 healthy residents (0.61 versus 0.16 optical density units; P = 0.004). Moreover, parasite-specific IgA levels were higher in those consuming tap water than in those who did not (0.31 versus 0.08 optical density units; P = 0.03) and increased with increasing water consumption. Levels of serum antibody to G. lamblia, particularly IgA, may be useful in determining exposure to G. lamblia-contaminated water and illness from G. lamblia during waterborne outbreaks of diarrheal illness.

Adult↗

Characterization of an outbreak of Clostridium perfringens food poisoning by quantitative fecal culture and fecal enterotoxin measurement.

Published criteria for implicating Clostridium perfringens as the cause of food-poisoning outbreaks include finding a median fecal C. perfringens spore count of greater than 10(6)/g among specimens from ill persons. We investigated a food-poisoning outbreak with the epidemiologic characteristics of C. perfringens-related disease in a nursing home in which the median fecal spore count for ill patients (2.5 X 10(7)/g) was similar to that for well patients (4.0 X 10(6)/g), making the etiology of the outbreak uncertain. All ill and well patients tested had eaten turkey, the implicated food item. C. perfringens enterotoxin was detected by reverse passive latex agglutination in fecal specimens from six of six ill and none of four well patients who had eaten turkey (P = 0.005), suggesting that this organism had caused the outbreak. This investigation suggests that detection of fecal C. perfringens enterotoxin is a specific way to identify this organism as the causative agent in food-poisoning outbreaks.

Aged↗

Investigation of possible health effects of community exposure to fermenting wood chips.

We conducted a case-control study of emergency room (ER) patients to evaluate whether asthma is caused by living near a wood-chip fueled power plant that released wood-chip fermentation products. Only eight (29 per cent) of 28 asthma patients seen in the ER during an 11-week period lived within 1.5 miles of the plant compared with 18 (34 per cent) of 54 control patients matched for severity of diagnosis and seen during the same period (Mantel-Haenszel odds ratio controlling for age = 0.96).

Adult↗

Risk factors for secondary transmission in households after a common-source outbreak of Norwalk gastroenteritis.

In November 1984, a foodborne outbreak of Norwalk gastroenteritis occurred in a K-12 public school in northern Vermont. The outbreak offered an opportunity to systematically study in detail secondary transmission rates in households. Eating salad at Tuesday's school-sponsored Thanksgiving Banquet was associated with illness among students and staff members (p less than 0.025). Seven of 11 serum pairs from ill persons showed a fourfold or greater rise in antibody titer to Norwalk virus compared with one of nine controls (p = 0.028). The study of secondary household transmission revealed that households with persons with primary illness were 5.5 times more likely to experience secondary illness than households with well school children or adults. As the number of individuals with primary illness in the household increased, the secondary illness rates increased. Pre-school children were twice as likely as adults to develop secondary illness.

Adult↗

Elemental mercury exposure among children of thermometer plant workers.

Because evidence of mercury exposure was found among workers of a mercury thermometer-manufacturing plant in March 1984, the Vermont Department of Health studied the workers' children for both exposure to mercury and evidence of mercury toxicity. The median urine mercury level of 23 workers' children was 25 micrograms/L. This was significantly higher than the level (5 micrograms/L) among 39 children randomly selected from nonworkers' households in the same community (P less than .001). Mercury-in-air levels measured in workers' homes were higher than those measured in control homes. A significant correlation was found between the urine mercury levels of the workers' children and the urine mercury levels of their working parents. No child had frank mercury toxicity. No evidence of neurologic toxicity among exposed children was discovered by a pediatric neurologist who examined these and unexposed children without knowledge of their exposure status. This is the first report demonstrating mercury exposure in children of mercury workers. Although toxic effects of mercury were not demonstrated at these levels of exposure, children of mercury workers are at risk for mercury exposure and potential mercury toxicity.

Adult↗

Tuberculosis in employees at a Vermont furniture plant.

In a case-contact investigation of a patient (A) with smear- and culture-positive pulmonary tuberculosis, we found that co-workers in one room of a furniture factory had a higher prevalence of significant reactions to 5 Tu PPD tuberculin than other furniture factory workers. One co-worker also had active pulmonary tuberculosis. It was concluded that Patient A probably transmitted mycobacteria in a well-ventilated, spacious work setting; and that Patient A's disease and the subsequent outbreak could have been prevented.

Employment↗

Duration of whirlpool-spa use as a risk factor for Pseudomonas dermatitis.

Pseudomonas dermatitis occurred among 16 of 49 whirlpool-spa bathers in a Vermont hotel during a weekend in November 1983. Pseudomonas aeruginosa, serotype 0:4, was isolated from a patient and the whirlpool-spa water. Since duration of whirlpool-spa use had been previously postulated as a risk factor for dermatitis, a historical cohort study was designed to test this hypothesis. Each bather was carefully interviewed about the duration in minutes of whirlpool-spa and swimming pool exposure on the weekend. Total duration of whirlpool-spa use was significantly associated with rash illness both on contingency and logistic regression analysis. Females were also found to be at increased risk, after controlling for the study hypothesis. Duration of whirlpool-spa use was an important determinant of risk for Pseudomonas dermatitis in this outbreak.

Dermatitis↗

Premarital rubella vaccination program.

A two-year Vermont program identified 494 (7 per cent) of 6,982 premarital female serologies that were seronegative (less than 1:8) to rubella by hemagglutination inhibition (HI) titer. All 494 susceptible patients and their physicians were notified of their results by letter. The State Health Department received reports that a total of 194 (39 per cent) of the susceptible patients had received rubella vaccinations as a result of their notifications. Intensive follow-up of susceptibles appears to be important factor in the success of premarital rubella screening programs.

Female↗