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Biomedical subjects

W H Barker

Publications and source records attributed to W H Barker.

At least 55 records · Page 3Linked to original sources
PubMed1982

Pneumonia and influenza deaths during epidemics: implications for prevention.

Pneumonia and influenza (P&I) deaths among adults during epidemics of influenza A (H3N2) virus are reviewed and risks of such deaths according to age and presence of chronic disease are estimated from medical records of a large group practice. Thirty-eight deaths occurred among 310 persons hospitalized with P&I. Flu-like symptoms occurred in 30 patients (79%), 26 patients (68%) were older than 65 years, 36 patients (95%) had chronic disease, and approximately half were medically stable before the terminal episode. These values were similar to those of P&I deaths during nonepidemic periods. Pneumonia and influenza death rates ranged from fewer than ten to more than 600 per 100,000 among healthy vs chronically ill adults. Highest rates (870 per 100,000) occurred in persons with both cardiovascular and pulmonary disease. Application of these findings to influenza vaccination strategies in clinical practice is discussed.

Adolescent↗
PubMed1982

Pap smear screening and invasive cervical cancer.

Possible failures of Pap smear screening were assessed among 63 cases of invasive cervical cancer that occurred in a group practice population between 1965 and 1975. Review of medical records revealed 33 (53 percent) cases with no history of Pap smears within two years prior to diagnosis. Among the 30 patients with recent Pap screening, 11 (17 percent) had negative smears; these could only be explained as false negatives or unusually rapid progression of disease. The remaining 19 (30 percent) had abnormal smear results, a number of whom received suboptimal follow-up care. Similar experiences have been reported from several other health care settings. Implications for preventive practices are discussed.

Adult↗
PubMed1981

Underestimation of the role of pneumonia and influenza in causing excess mortality.

Underestimation of pneumonia and influenza (P&I) mortality during influenza epidemics was explored in 38 P&U associated deaths among a population of adults during two influenza A (H3N2) epidemics. Pneumonia or influenza was mentioned on 32 (84 per cent) of the death certificates. However, based on rules for assigning cause of death, only nine (24 per cent, SE = 7) and 23 (61 per cent, SE = 8) of the cases would have been included in P&I mortality statistics compiled by the National Center for Health Statistics and the Center for Disease Control, respectively.

Aged↗
PubMed1980

Influenza vaccination of elderly persons. Reduction in pneumonia and influenza hospitalizations and deaths.

Effectiveness of influenza vaccination in reducing pneumonia and influenza hospitalizations and deaths among elderly members of a prepaid health plan was analyzed retrospectively. Two epidemics caused by the H3N2 subtype of type A influenza were studied. Vaccine derived from the H2N2 subtype of influenza A virus failed to protect against the Hong Kong (H3N2) virus during the 1968-1969 epidemic. Vaccine derived from the A/Hong Kong/68 (H3N2) virus yielded an estimated 72% (31% to 100%) reduction in hospitalization and 87% (52% to 100%) reduction in mortality during the 1972-1973 epidemic caused by A/England/72 (H3N2). These findings are consistent with those reported in vaccinated young persons, and hence it appears they may be broadly generalized.

Age Factors↗
PubMed1980

Impact of epidemic type A influenza in a defined adult population.

The authors studied the occurrence of excess morbidity and mortality among subsets of the adult population (persons over 14 years of age) of a large prepaid group practice during two epidemics of type A influenza (1968-1969 and 1972-1973). The experience from 1970-1971, a nonepidemic years, was used as a reference for estimating excesses. Ambulatory visits for influenza and influenza-related acute respiratory disease increased by 5-7 visits per 100 persons (30-50% excess) and pneumonia and influenza (P&I) hospitalization rates increased by 79-86 per 100,000 (140-150% excess) over the rates in the nonepidemic period. There were 11-13 excess deaths per 100,000 population, most of which involved persons over 65 years of age. Excess rates of ambulatory visits were similar for all adult age groups. Excess rates of persons hospitalized with P&I ranged from 23-25 per 100,000 among non-high risk persons aged 15-44 years to 150-172 per 100,000 among persons over age 65 years without underlying "high risk" conditions and 476-636 per 100,000 persons over 65 with underlying "high risk" conditions. These data provide a basis for increasing the precision of clinical and public decision-making regarding the prevention of serious consequences of epidemic influenza.

Adolescent↗
PubMed1977

Medical oncology.

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Curriculum↗
PubMed1977

Type B botulism outbreak caused by a commercial food product. West Virginia and Pennsylvania, 1973.

In the week of May 7, 1973, seven persons contracted botulism after eating together. The most common symptoms were vomiting, constipation, dry mouth, dysphagia, and dysphonia. All were treated with trivalent botulinal antitoxin, and none died. Serum specimens obtained from all seven patients were negative for botulinal toxin, but stool specimens from three patients were positive for type B toxin. Electromyographic studies performed on five patients documented the neurophysiologic abnormalities of botulism. Commercially canned peppers in oil were implicated epidemiologically, and type B toxin was identified in leftover peppers. The processor voluntarily recalled the pepper product, and no further cases were reported.

Botulinum Antitoxin↗
PubMed1977

Foodborne disease outbreaks of chemical etiology in the United States, 1970-1974.

In the United States between 1970 and 1974 there was an increase each year both in the absolute number of foodborne diseases outbreaks of chemical etiology reported to the Center for Disease Control and in the proportion of these outbreaks in the total reported foodborne disease outbreaks. Nearly half (48.9%) of these foodborne disease outbreaks of chemical origin were caused by toxic fish or shellfish. Of the rest, 16.5% were caused by poisonous mushrooms, 10.9% by heavy metal poisoning, 7.2% by excessive use in food of monosodium glutamate (the etiologic agent of Chinese Restaurant Syndrome) and 16.5% by miscellaneous chemicals. Practices that contributed to the occurrence of these outbreaks included the inadvertent selection for consumption of toxic fish, shellfish, or mushrooms, storage of fish at improper temperatures, storage of acidic liquids in metal containers, and addition of excessive amounts of monosodium glutamate to foods. Commercially-processed foods were responsible for outbreaks of scombroid fish poisoning, shellfish poisoning, and heavy metal poisoning. Because outbreaks of chemical etiology due to contaminated commercial products do occur, prompt recognition and reporting of outbreaks to public health personnel are essential so that epidemiologic investigations can be conducted and effective control measures promptly initiated.

Animals↗
PubMed1975

International outbreak of Salmonella Eastbourne infection traced to contaminated chocolate.

Between Dec. 4, 1973, and Feb. 15, 1974, 80 cases of infection due to Salmonella eastbourne, previously a rare isolated serotype in the United States, were reported from twenty-three States. An additional 39 cases were reported from seven Provinces in Canada during a similar period. A telephone case-control study implicated Christmas-wrapped chocolate balls manufactured by a Canadian company as the vehicle of transmission. S. eastbourne was subsequently isolated from several samples of leftover chocolate balls obtained from homes where cases occurred. Investigation of the factory revealed that the contaminated Christmas and Easter chocolates, and a few chocolate items for year-round sale, had been produced between May and October, 1973. Bacteriological testing of samples taken at the plant implicated cocoa beans as the probable source of the salmonella organisms which, in the low-moisture chocolate, were able to survive heating during production. This outbreak and the finding of salmonella of other serotypes in chocolates produced by another manufacturer suggest that chocolate-related salmonellosis may be a significant public-health problem.

Cacao↗
PubMed1975

Waterborne shigellosis at a public school.

In November 1972 an outbreak of gastrointestinal illness occurred at a public school in Stockport, Iowa. One hundred ninety-four (72%) of 269 pupils and 14 (16%) of 23 staff members were affected. The etiologic agent was a strain of Shigella sonnei resistant to multiple antimicrobials. Waterborne transmission of shigellosis was documented epidemiologically and by isolation of the organism from the school water system. Ninety-seven (14%) of 698 of the students' household contacts developed diarrhea, and possible secondary cases also occurred in 3 (9%) of 32 household contacts of school staff.

Disease Outbreaks↗
PubMed1975

Perspectives on acute enteric disease epidemiology and control.

This paper reviews the major epidemiologic features of the acute enteric diseases and outlines a plan for their prevention and control in developing countries. Annual mortality from enteric diseases ranges from 10 per 1000,000 in highly developed countries to as much as 500 per 100,000 in developing countries. Most agents of enteric disease are spread by one of two routes: direct person-to-person contact or ingestion of contaminated vehicles (food or water). An effective control program should therefore focus on common epidemiologic factors, rather than on agent-specific remedies such as vaccines or antibiotics. The major operational components of such a program should include oral fluid replacement therapy, improvements in environmental sanitation, health education to promote personal hygiene and proper food handling, and epidemiologic surveillance to monitor public health needs and evaluate the impact of health measures.

Acute Disease↗
PubMed1974

Letter: Cholera.

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Chloramphenicol↗