[Patient's money and valuables: does the hospital have an obligation to safeguard them?].
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Biomedical subjects
Publications and source records attributed to W Schell.
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Lyme disease recently has been recognized in Wisconsin. Trapping studies were conducted at four geographically separate and ecologically distinct regions in Wisconsin to elucidate the distribution and host preferences of Ixodes dammini on small and medium sized mammals, and the occurrence of antibodies to Borrelia burgdorferi in these wild mammals. Peak I. dammini larval activity occurred from June-September. Nymphs were most active from May-August. White-footed mice (Peromyscus leucopus) and chipmunks (Tamias striatus) were important hosts for immature ticks. Mean numbers of I. dammini per mouse were highest in regions of high prevalence of Lyme disease. Antibody to B. burgdorferi was detected in sera of 60/371 (16%) white-footed mice, 5/104 (5%) chipmunks, 3/5 (60%) gray squirrels (Sciurus carolinensis), 0/8 raccoons (procyon lotor), and 0/12 opossum (Didelphis virginiana); antibody prevalence correlated positively with I. dammini occurrence, and seropositive animals were not detected in areas where I. dammini were not found. Two of 15 recaptured P. leucopus had greater than or equal to 4-fold changes in antibody titer. B. burgdorferi was cultured from blood of a P. leucopus captured in west-central Wisconsin, and was observed by direct immunofluorescence in 9/23 (39%) I. dammini nymphs. In Wisconsin, I. dammini has increased in numbers and has significantly expanded its range since its first recognition in 1968.
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During the summer and fall of 1978, active surveillance for encephalitis in southwestern Wisconsin and southeastern Minnesota resulted in the detection of the largest number of cases of California encephalitis group (CEG) virus infections ever documented in that region, where CEG virus is known to be endemic. A total of 75 laboratory-confirmed and eight presumptive cases of CEG virus infections were identified as a result of serologic testing completed in the Wisconsin and Minnesota State Laboratories. Cases included 46 residents of Wisconsin, 25 of Minnesota, 10 residents of Iowa and two from Illinois. The outbreak peaked during the last half of August and the first half of September. Eighty percent of patients were less than 10 years of age; only one case was documented in an adult (greater than or equal to 18 years). The clinical picture in patients ranged from mild aseptic meningitis to encephalitis with coma; convulsions occurred in 31% (22/72) of patients. One patient, a 3-year-old girl, died. The high incidence of infection detected in this investigation may be representative of the endemic incidence of CEG illness in the region and suggests that CEG infections in children residing in endemic areas in Wisconsin and Minnesota may be a greater public health problem than previously recognized.
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