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PubMed2003

A serosurvey of leptospirosis in Connecticut peridomestic wildlife.

Recently, leptospirosis has gained attention as a re-emerging infection in domestic dogs in the northeastern United States. In order to gain insight into the epizootiology of leptospirosis in this region, 109 small wild mammals (31 raccoons (Procyon lotor), 30 skunks (Mephitis mephitis), 28 opossums (Didelphis virginiana), and 20 gray squirrels (Sciurus carolinensis)) collected between February 27 and September 17, 2001 were tested for serologic evidence of exposure to five common Leptospira serovars (serovars pomona, icterohemorrhagiae, canicola, hardjo, grippotyphosa). Evidence of exposure to leptospirosis was detected in 36% of raccoons tested; icterohemorrhagiae was the predominant reactive serovar in these animals. Sera from 13% of skunks showed evidence of exposure to serovar grippotyphosa. One squirrel exhibited high antibody titers to serovars grippotyphosa and canicola. All 28 opossums examined tested negative to the five Leptospira serovars. Results from this serosurvey suggest that common peridomestic wildlife species should be considered as potential sources of leptospirosis to dogs and humans in Connecticut. Additional investigation is warranted to clarify their role in the epidemiology of this zoonotic disease in the northeastern United States.

Agglutination Tests↗
PubMed2000

Distribution of methicillin-resistant Staphylococcus aureus clones among health care facilities in Connecticut, New Jersey, and Pennsylvania. .

A previous surveillance study conducted in 12 hospitals in New York City in 1996 identified a unique multidrug-resistant genetic lineage of methicillin-resistant Staphylococcus aureus (MRSA) that was widespread and accounted for as much as 42% of all the MRSA isolates. The purpose of the study described here was to determine possible geographic spread of this New York clone of MRSA to neighboring states. Single-patient MRSA isolates (258) from 29 health care facilities in Connecticut (CT), New Jersey (NJ), and Pennsylvania (PA) were collected during the calendar year 1998. DNA typing, consisting of fingerprinting of chromosomal macrorestriction patterns generated by SmaI digestion followed by pulsed-field gel electrophoresis (PFGE), identified 22 patterns. PFGE type A, closely related to the PFGE type of the previously identified New York clone, accounted for 154 (60%) of 258 isolates. The clone was detected in all facilities, was predominant in 19 of the 29 health care centers, and accounted for 92% of the MRSA isolates collected in PA. The overwhelming majority of MRSA with PFGE type A was also resistant to erythromycin, ciprofloxacin, and clindamycin. One of the two most common PFGE subtypes detected in the three states sampled (PFGE subtype A1) had an identical PFGE pattern to that of the previously described vancomycin-resistant strain of S. aureus (VISA) recently detected in a hospital in Westchester, NY. The second most frequent MRSA clone with PFGE type E and accounting for 26% (68/258 isolates), also described earlier in the 12 New York City hospitals, was resistant not only to erythromycin, ciprofloxacin, and clindamycin, but also to gentamicin and sulfamethoxazole-trimethoprim as well. The unique multidrug resistance pattern of this second clone and its geographic distribution accounted for the differences observed in the frequency of multidrug resistance among MRSA isolates recovered in the three states. The pandemic Iberian clone recently detected in New York City was not detected among the 258 MRSA isolates recovered in CT, NJ, and PA.

Bacterial Typing Techniques↗
PubMed2006

Modeling the spatial distribution of mosquito vectors for West Nile virus in Connecticut, USA.

The risk of transmission of West Nile virus (WNV) to humans is associated with the density of infected vector mosquitoes in a given area. Current technology for estimating vector distribution and abundance is primarily based on Centers for Disease Control and Prevention (CDC) light trap collections, which provide only point data. In order to estimate mosquito abundance in areas not sampled by traps, we developed logistic regression models for five mosquito species implicated as the most likely vectors of WNV in Connecticut. Using data from 32 traps in Fairfield County from 2001 to 2003, the models were developed to predict high and low abundance for every 30 x 30 m pixel in the County. They were then tested with an independent dataset from 16 traps in adjacent New Haven County. Environmental predictors of abundance were extracted from remotely sensed data. The best predictive models included non-forested areas for Culex pipiens, surface water and distance to estuaries for Cx. salinarius, surface water and grasslands/agriculture for Aedes vexans and seasonal difference in the normalized difference vegetation index and distance to palustrine habitats for Culiseta melanura. No significant predictors were found for Cx. restuans. The sensitivity of the models ranged from 75% to 87.5% and the specificity from 75% to 93.8%. In New Haven County, the models correctly classified 81.3% of the traps for Cx. pipiens, 75.0% for Cx. salinarius, 62.5% for Ae. vexans, and 75.0% for Cs. melanura. Continuous surface maps of habitat suitability were generated for each species for both counties, which could contribute to future surveillance and intervention activities.

Aedes↗
PubMed2004

Hair-coloring product use and risk of non-Hodgkin's lymphoma: a population-based case-control study in Connecticut.

A population-based case-control study was conducted in Connecticut in 1996-2002 to test the hypothesis that lifetime hair-coloring product use increases non-Hodgkin's lymphoma risk. A total of 601 histologically confirmed incident female cases and 717 population-based controls were included in the study. An increased risk of non-Hodgkin's lymphoma was observed among women who reported use of hair-coloring products before 1980 (odds ratio = 1.3, 95% confidence interval (CI): 1.0, 1.8). The odds ratios were 2.1 (95% CI: 1.0, 4.0) for those using darker permanent hair-coloring products for more than 25 years and 1.7 (95% CI: 1.0, 2.8) for those who had more than 200 applications. Follicular type, B-cell, and low-grade lymphoma generally showed an increased risk. On the other hand, the authors found no increased risk of non-Hodgkin's lymphoma overall and by subtype of exposure and disease among women who started using hair-coloring products in 1980 or later. It is currently unknown why an increased risk of non-Hodgkin's lymphoma was found only among women who started using hair-coloring products before 1980. Further studies are warranted to show whether the observed association reflects the change in hair dye formula contents during the past two decades or indicates that recent users are still in their induction and latent periods.

Adult↗
PubMed2004

Diet and nutrient intakes and risk of non-Hodgkin's lymphoma in Connecticut women.

A population-based case-control study (601 cases and 717 controls) was conducted in 1995-2001 among Connecticut women to evaluate the relation between diet and nutrient intakes and the risk of non-Hodgkin's lymphoma (NHL). When the highest quartile of intake was compared with the lowest, the authors found an increased risk of NHL associated with animal protein (odds ratio = 1.7, 95% confidence interval: 1.2, 2.4) and saturated fat (odds ratio = 1.9, 95% confidence interval: 1.1, 2.3) but a reduced risk for polyunsaturated fat (odds ratio = 0.6, 95% confidence interval: 0.4, 0.9) and no relation for vegetable protein and monounsaturated fat. An increased risk was also observed for higher intakes of retinol, eggs, and dairy products. On the other hand, a reduced risk was found for higher intakes of dietary fiber and for several fruit and vegetable items. Risk of NHL associated with diet and nutrient intakes appeared to vary based on NHL subtype. An association between dietary intake and NHL risk is biologically plausible because diets high in protein and fat may lead to altered immunocompetence, resulting in an increased risk of NHL. The antioxidant or inhibiting nitrosation reaction properties of vegetables and fruits may result in a reduced risk. Further investigation of the role of dietary intakes on the risk of NHL is warranted.

Adult↗
PubMed2004

Blood transfusion and risk of non-Hodgkin's lymphoma in Connecticut women.

The incidence and mortality rates of non-Hodgkin's lymphoma have been increasing worldwide. Allogeneic blood transfusion has been suggested as a risk factor for non-Hodgkin's lymphoma, but the results from epidemiologic studies have been inconsistent. Data from a population-based case-control study of Connecticut women were analyzed to evaluate this relation. A total of 601 histologically confirmed, non-Hodgkin's lymphoma incident cases identified between 1996 and 2000 and 717 randomly selected controls were included in this study. Allogeneic blood transfusion was not associated with the increased risk of non-Hodgkin's lymphoma overall (odds ratio = 1.0, 95% confidence interval: 0.7, 1.3) or by subtype of the disease. The risk also did not vary by number of allogeneic blood transfusions, age at first transfusion, or time since first transfusion. When the reason for blood transfusion was considered, an increased risk of non-Hodgkin's lymphoma was found only for allogeneic blood transfusion for reason of anemia. In summary, the authors' findings do not support the hypothesis that allogeneic blood transfusion increases the risk of non-Hodgkin's lymphoma.

Adult↗
PubMed2004

Menstrual and reproductive factors and risk of non-Hodgkin's lymphoma among Connecticut women.

Several recent studies have suggested a potential role of menstrual and reproductive factors in the risk of non-Hodgkin's lymphoma. To further examine the relation, the authors analyzed data from a population-based case-control study of non-Hodgkin's lymphoma in Connecticut women between 1996 and 2000. A total of 601 histologically confirmed cases and 717 randomly selected population-based controls were included in this study. An in-person interview was conducted using a standardized and structured questionnaire to collect information on menstrual and reproductive factors and potential confounding factors. Compared with nulliparous women, women who had four or more pregnancies during their lifetime were found to have a significantly reduced risk of non-Hodgkin's lymphoma (odds ratio (OR) = 0.6, 95% confidence interval (CI): 0.4, 0.9). Risk appeared to decrease with increasing number of pregnancies (p(trend) = 0.03). The authors also observed an increased risk of non-Hodgkin's lymphoma overall (OR = 1.5, 95% CI: 1.0, 2.2) and of diffuse non-Hodgkin's lymphoma (OR = 1.7, 95% CI: 1.1, 2.7) for women who started their first menstrual period at age 15 or more years compared with those who started their first menstrual period before age 12 years. These findings support a reduced risk of non-Hodgkin's lymphoma associated with multiple pregnancies and an increased risk of non-Hodgkin's lymphoma associated with later age at menarche.

Adolescent↗
PubMed2004

Serum polychlorinated biphenyls, cytochrome P-450 1A1 polymorphisms, and risk of breast cancer in Connecticut women.

Recent epidemiologic studies have suggested that genetic polymorphisms in the cytochrome P-450 1A1 gene (CYP1A1) may affect the relation between environmental exposure to polychlorinated biphenyls (PCBs) and breast cancer risk. The authors report results from a case-control study evaluating the potential effect of gene-environment interaction between CYP1A1 and serum PCB levels on breast cancer risk among Caucasian women in Connecticut. The study included 374 case women with histologically confirmed breast cancer and 406 noncancerous controls with information on both serum PCB level and CYP1A1 genotype (1999-2002). Compared with women who had the homozygous wild-type CYP1A1 m2 genotype, significantly increased risks of breast cancer were found for women with the CYP1A1 m2 variant genotype (odds ratio (OR) = 2.1, 95% confidence interval (CI): 1.1, 3.9), especially postmenopausal women (OR = 2.4, 95% CI: 1.1, 5.0). Risks associated with the CYP1A1 m2 variant genotype were highest for all women (OR = 3.6, 95% CI: 1.5, 8.2) and postmenopausal women (OR = 4.3, 95% CI: 1.6, 12.0) with higher serum PCB levels (611-2,600 ng/g). The CYP1A1 m1 and m4 genotypes were not associated with breast cancer risk independently or in combination with PCB exposure. In summary, the CYP1A1 m2 genetic polymorphism was associated with increased risk of female breast cancer and may modify the relation between PCB exposure and breast cancer risk.

Adult↗
PubMed1991

Nursing home length of stay and spenddown in Connecticut, 1977-1986.

A study of lifetime nursing home use was conducted with data from Connecticut for a 9-year period, 1977-1986. By linking stays for individuals, we were able to make life table estimates of the total amount of time after age 65 expected to be spent by persons in nursing homes. Because these data were linked to Medicaid eligibility records, it was possible to determine the total amount of nursing home use that is paid for by Medicaid and to produce estimates of the risk of Medicaid spenddown. The lifetime risk of spenddown in nursing homes was estimated to be 21.5%, with a 14.4% incidence of spenddown in any given episode. The amount of time it took to spend down was longer than reported in several other studies.

Aged↗
PubMed1994

Serotypes responsible for invasive Streptococcus pneumoniae infections among children in Connecticut.

Active prospective surveillance to identify the serotypes of Streptococcus pneumoniae responsible for invasive infections among children in Connecticut was conducted from July 1984 through March 1993. S. pneumoniae isolates (722) recovered from normally sterile sites (98% from blood, 7% from both blood and cerebrospinal fluid) were serotyped by the Quellung reaction; 70% of the isolates were from children < 2 years old. Serotype 14 caused 29% of the infections. Seven serotypes (4, 6B, 9V, 14, 18C, 19F, and 23F) were responsible for 84% of the invasive infections overall and for 86% of the invasive infections among children < 2 years old. Formulations of polysaccharide-protein conjugate pneumococcal vaccines designed to prevent invasive infections in children in the United States should include these commonly isolated serotypes.

Adolescent↗
PubMed1995

Cat-scratch disease--Connecticut, 1992-1993.

A prospective population-based surveillance system was established to characterize the epidemiology of cat-scratch disease (CSD) among residents of Connecticut who were reported to the state health department with a diagnosis of suspected CSD. During 1992 and 1993, 246 persons met the case definition, for an average statewide annual incidence of 3.7/100,000 persons. The median age of patients with CSD was 14 years (range, 1-64), and 52% were female. The age-specific attack rate was highest among persons < 10 years of age (9.3/100,000) and decreased with increasing age. Symptoms in addition to adenopathy were noted by 74% of case-patients. Eleven percent of all case-patients were hospitalized. There were no deaths. Most patients with clinically diagnosed CSD developed an immunologic response to Bartonella species. Our data suggest that although CSD is primarily a disease of younger persons, the age spectrum is wider than was commonly appreciated.

Adolescent↗
PubMed1992

Third-year evaluation of host-targeted permethrin for the control of Ixodes dammini (Acari: Ixodidae) in southeastern Connecticut.

The impact of commercially available permethrin-treated cotton balls targeted at Ixodes dammini Spielman, Clifford, Piesman & Corwin on white-footed mice, Peromyscus leucopus, was evaluated for a third year at five residential sites in south-central Connecticut. Each site had been treated twice each year from 1989 through 1991 with sufficient product to treat 0.4 ha of mouse habitat, and results were compared with five untreated sites. There were no significant differences in the number of host-seeking nymphs or adults of I. dammini, the vector of the Lyme disease spirochete, Borrelia burgdorferi, in 1991 between the treated and untreated sites. The rate of infection in host-seeking nymphs by B. burgdorferi at the treated sites (15.3% of 600) was comparable with that at the untreated sites (16.5% of 454). Only 16.3% of 86 P. leucopus captured at the treated sites were infested with I. dammini subadults compared with 66.9% of 118 from the mice at the untreated sites. The impact of permethrin-treated cotton during the third year of treatment was similar to that observed for the first 2 yr and did not reduce the risk of exposure to spirochete-infected, host-seeking nymphs and adults of I. dammini.

Animals↗
PubMed1997

Microhabitat-independent regional differences in survival of unfed Ixodes scapularis nymphs (Acari:Ixodidae) in Connecticut.

The effects of habitat and microclimate on survival of unfed nymphal black-legged ticks, Ixodes scapularis Say (approximately I. damnini Spielman, Clifford, Piesman & Corwin), were studied under natural conditions in southcentral and northwestern Connecticut. At both coastal and inland locations, survival of 3 groups of 20 wild-caught questing nymphs placed in nylon mesh bags was monitored in each of 3 different habitats (field, forest canopy, and forest/field edge) during summer 1995. Simultaneously, soil temperature, ground-level air temperature, and relative humidity were measured continuously within each habitat at both sites. The number of ticks surviving in each habitat was monitored weekly. Average daily survival rates of nymphs were related inversely to soil temperature but were not related to air temperature or humidity. Overall, nymphal ticks at the inland site survived significantly longer than those at the coastal site; however, no significant differences in mortality rates were found among habitats. These results suggest that inland environmental conditions are suitable for lengthy survival of unfed nymphal I. scapularis in regions where this tick is not yet abundant.

Animals↗
PubMed1976

Epidemiology of renal cell carcinoma in Connecticut, 1935-1973.

Data on over 3,700 patients with renal cell carcinoma, reported to the Connecticut Tumor Registry from 1935 through 1973, were used to assess incidence, survival, and associations of risk with demographic characteristics. Incidence increased over time among men, but not among women; a birth cohort effect suggesting increasing incidence rate over time was demonstrated for men. A comparison of male and female age-specific incidence rates indicated that, in the 15- to 39-year-old age group, men were three times more likely than women to develop the disease; after age 40, renal cell carcinoma was diagnosed in men twice as often as in women. Survival probability has increased from 1940 to the present time. A high density of persons per square mile was associated with a higher-than-expected incidence. No trends in incidence according to socioeconomic status were observed.

Adenocarcinoma↗
PubMed2002

Survival of breast cancer patients in Connecticut in relation to socioeconomic and health care access indicators.

The purpose of this study of 16,931 black and white Connecticut women diagnosed with invasive breast cancer in 1988-1995 was to examine survival in relation to surrogate or proxy indicators of both socioeconomic status (SES) and access to primary care. Patients were followed through 1998, and the risk of death was elevated for the lowest (vs. highest) SES category independent of stage at diagnosis and other characteristics, especially among patients diagnosed before age 65 years. The health care access indicator was not associated with risk of death when other patient characteristics (including the SES variable and stage at diagnosis) were taken into account. Unexplained elevations, relative to the rest of the state, in risk of death were found for patients diagnosed while living in two of the state's four largest cities.

Adult↗
PubMed2002

Effects of increasing syringe availability on syringe-exchange use and HIV risk: Connecticut, 1990-2001.

Syringe-exchange programs (SEPs) in Connecticut operate with caps on the number of syringes exchanged per visit. We investigated the effects of legislation increasing the cap on drug injectors' access to clean syringes through the SEPs in New Haven and Hartford. The mixed design of this study included longitudinal and cross-sectional data from individuals and ecological data from program operations. Five parameters-syringe return rate, syringes per visit to the SEP, syringe reuse rate, syringe human immunodeficiency virus (HIV) prevalence, and syringe sharing-were monitored through syringe tracking and testing of SEP syringes and by interviewing injectors. Two increases in the cap-from 5 to 10 and then from 10 to 30-had little effect on the five parameters that measured injectors' access to clean syringes. In contrast, access to clean syringes increased when the New Haven SEP first began operations, when syringes first became available at pharmacies in Hartford, and when the agency running the Hartford SEP changed. Legislation providing piecemeal increases in the cap may not, by themselves, be sufficient to increase injectors' access to clean syringes and decrease the risk of human immunodeficiency virus transmission in this population.

Connecticut↗
PubMed1976

Community studies of lung disease in Connecticut: organization and methods.

We have obtained data on respiratory symptoms, enviornmental exposures, and lung function in 3730 residents, aged seven years and over, of a rural and an urban community in Connecticut. We used newly developed computerized techniques of data acquisition. The respondents represent 66.3% of the total populations available for study in the defined geographic areas (75.2% in the rural and 54.7% in the urban community). Door-to-door surveys in defined areas within each community provided information on the nonrespondents. Data on 92% of all residents were obtained in the door-to-door survey areas. Comparisons of respiratory symptoms and smoking habits between respondents and nonrespondents in the door-to-door survey areas, and between respondents living in the door-to-door survey areas and elsewhere in the two towns, led to the conclusion that the data on the respondents are an accurate reflection of the lung disease experienced by the total populations of the two communities.

Adolescent↗
PubMed1976

The descriptive epidemiology of primary intracranial neoplasms: the Connecticut experience.

The age-specific incidence pattern for tumors of the brain and cranial meninges in Connecticut over a 30-year period shows an early peak followed by a taller and sharper peak with a maximum in the 55-65 year age group. This overall curve reflects the pattern shown for glioblastoma, the tumor accounting for the majority of the histologically confirmed cases. The reported rates are probably underestimates of the actual rates. The various histologic types of brain tumors reveal sufficiently distinct epidemiologic patterns to be considered as separate diseases.

Adolescent↗