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Biomedical subjects

W L Atkinson

Publications and source records attributed to W L Atkinson.

29 records · Page 2Linked to original sources
PubMed1992

Infection with human T lymphotropic virus types I and II in sexually transmitted disease clinics in Baltimore and New Orleans.

Patients attending sexually transmitted disease (STD) clinics in Baltimore (n = 4880) and New Orleans (n = 1054) were surveyed in 1987 to estimate the prevalence of human T lymphotropic virus (HTLV)-I/II infection. In Baltimore, 0.4% (95% confidence interval [CI], 0.2-1.1) were HTLV-I/II-seropositive and 4.9% were human immunodeficiency virus (HIV-1)-positive. In New Orleans, 1.8% (CI, 1.2-2.9) of sera were HTLV-I/II-seropositive and 5.1% were HIV-1-seropositive. In both cities, HTLV-I/II prevalence increased significantly with age, and the New Orleans age- and sex-adjusted HTLV-I/II prevalence was significantly higher than that of Baltimore (P less than .001). In Baltimore, almost all HTLV-I/II seropositivity was associated with a history of parenteral drug use or sexual contact with partners who were drug users or male homosexuals. In addition, individuals in both cities who were seropositive for HIV-1 or syphilis were significantly more likely to be HTLV-I/II-seropositive.

Adolescent↗
PubMed1992

Epidemiology of measles in the United States in 1989 and 1990.

During 1989 and 1990 measles incidence increased sharply in the United States. We compared cases reported during these years with those reported between 1981 and 1988. Incidence increased 462% in 1989, and incidence in 1990 (11.2/100,000) was the highest in more than a decade. Although all ages were affected the greatest increases were in children < 5 years and in adults. Incidence was 7- to 10-fold higher among racial/ethnic minority preschoolers than whites, and 80% of vaccine-eligible preschool age cases were unvaccinated. Complications occurred in 9418 (20.5%) cases, most frequently in young children and adults. Large urban outbreaks affecting predominantly unvaccinated preschoolers were common; 47% of all cases reported in 1990 were associated with 5 outbreaks. Reasons for the increased incidence are not clear. Current information suggests no change in vaccination coverage among preschool age children or in vaccine efficacy. Continued surveillance and evaluation of epidemiologic and laboratory data are necessary. The most pressing need is to improve age-appropriate vaccination among preschool age children.

Age Factors↗
PubMed1992

The resurgence of measles in the United States, 1989-1990.

After almost a decade of relatively few reported cases, a major resurgence of measles occurred in the United States in 1989-1990. The increase primarily involved unvaccinated racial and ethnic minority children less than five years of age residing in inner-city areas. Outbreaks of measles among vaccinated school-aged children continued to occur but had less impact than outbreaks among preschool-aged children. Efforts to prevent measles must be aimed at improving age-specific measles vaccination coverage among preschool-aged children, and implementation of a two-dose measles strategy among school-aged children.

Adolescent↗
PubMed1991

Transmission of measles in medical settings--United States, 1985-1989.

Measles cases reported to the Centers for Disease Control from 1985 to 1989 were analyzed to determine the characteristics of measles cases transmitted in medical settings. A total of 1,209 medial setting cases were identified, which represented 3.5% of all reported cases. Of medical setting cases, 66% (795) were in known or presumed patients and 28% (341) were in health care workers. The largest groups of health care workers with measles were nurses (101, 29.6%) and physicians (65, 19.1%). Health care workers acquired measles from patients (90.6%) and other health care workers (9.4%), and transmitted measles to patients, other health care workers, and family members. Of 333 (97.7%) health care workers with known measles vaccination status, 232 (68.0%) were eligible for vaccine; only 46 (19.8%) had received a documented dose. Twenty-nine percent of health care workers with measles were born before 1957, older than the age for routine measles vaccination. The relative risk of measles for physicians and nurses was 8.4 (95% confidence interval [CI], 6.6, 10.8) and 2.1 (95% CI, 1.8, 2.7) respectively, compared with nonhealth care workers of the same ages. In 1989 the Immunization Practices Advisory Committee (ACIP) recommended that health care workers be required to document two doses of measles vaccine or other evidence of measles immunity at the time of employment. Implementation of ACIP recommendations for health care workers and appropriate isolation precautions for known and suspected patients with measles could reduce the transmission of measles in medical settings.

Adolescent↗
PubMed1991

Prevalence of measles antibodies in asymptomatic human immunodeficiency virus-infected adults.

One hundred five asymptomatic human immunodeficiency virus-seropositive adults were screened for measles antibody. Ages ranged from 21 to 59 years (mean, 35.7). CD4+ lymphocyte counts (range, 76-1137/mm3), percentage of CD4+ cells (6-42), CD4:CD8 ratio (0.08-1.3), measles antibody titers by EIA, and undocumented history of prior measles or immunization were obtained. Forty-six patients gave a history of measles but no immunization, 18 of immunization but no measles, 26 of immunization and measles, and 15 of neither measles nor vaccination. Only one patient (less than 1%) lacked levels of antibody considered protective. Neither the presence nor the level of antibody were predictable from patient age, history of measles or immunization, CD4+ lymphocyte count, percentage of CD4+ cells, or CD4:CD8 ratio. Nearly all subjects had antibody to measles, regardless of immunization or measles history. Whether these antibodies are truly protective is unknown.

Adult↗
PubMed1991

Measles returns.

Explore the source record for details and available documents.

Adolescent↗
PubMed1991

Needle-sharing among intravenous drug users in New Orleans.

We studied needle sharing among intravenous drug users in New Orleans, where needles are not controlled by prescription. Three hundred and eighty self-identified intravenous drug users were interviewed regarding needle-sharing practices, frequency of drug use, and drug(s) of choice. Overall, 65.8% admitted they regularly used needles which had been used by others. No significant differences in needle sharing were found by sex, race, frequency of injection, or drug of choice. A survey of pharmacies found that 85.5% have self-imposed restrictions on the sale of needles and syringes. Legal availability of injection equipment may not be equivalent to actual availability to the consumer.

Adult↗
PubMed1986

Amantadine prophylaxis during an institutional outbreak of type A (H1N1) influenza.

In January 1984, an outbreak of influenza caused by A/Victoria/7/83-like virus, a new H1N1 variant, occurred in an institution for mentally handicapped children and adults. During the first 18 days of the outbreak, 35 (81%) of 43 residents in two housing modules became ill, nearly all of whom had received influenza vaccine the previous autumn. Amantadine hydrochloride prophylaxis was initiated in two other housing modules and was continued for 28 days. While factors influencing the risk of introduction and secondary spread of influenza virus were comparable in all four modules, only ten (16%) of 63 residents who received amantadine were infected, only one of whom became symptomatic. Most side effects associated with amantadine were mild, but residents with active, preexisting major-motor seizure disorders demonstrated an increase in seizure activity compared with the previous eight-month period; those who took the maximum daily dose of amantadine hydrochloride (200 mg) and those who were also taking anticonvulsants other than phenobarbital were at highest risk.

Adolescent↗
PubMedDate not supplied

Worldwide measles prevention.

Prior to measles vaccine use, measles accounted for over 2.5 million deaths annually. Measles epidemiology in the developed countries is different from that in less developed countries. Whereas in the developing world, measles is a disease primarily of young children, particularly infants in urban areas, in the developed world, school-age children > 5 years old play a greater role. Prevention of measles in developing countries has relied principally on a single dose of Schwarz strain vaccine at age 9 months (> 85% efficacy); 80% coverage has prevented > 1.6 million deaths. However, problems have been encountered because of the narrow window to deliver vaccines between the time an infant becomes susceptible and exposure to disease. Recent studies suggest that some strains of measles vaccines given at potencies 10-100 times higher than standard vaccines may achieve good efficacy in infants aged 4-6 months, but safety of these vaccines has been questioned. Widespread use of standard vaccines in the West has resulted in dramatic reductions in measles incidence but has not prevented outbreaks among the 2-5% of persons not protected by a single dose. Such outbreaks often appear after extended periods either without measles or with low measles incidence. A single dose appears adequate to control measles well but inadequate to eliminate the disease. Many developed countries have adopted two-dose schedules. Measles immunization has dramatically reduced measles occurrence, but improved control is necessary to prevent the estimated 1 million deaths still occurring each year.

Child↗