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PubMed2004

Epidemiology of West Nile virus in Connecticut: a five-year analysis of mosquito data 1999-2003.

Two hundred and ten isolations of West Nile virus (WNV) were obtained from 17 mosquito species in six genera in statewide surveillance conducted in Connecticut from June through October, 1999-2003. Culex pipiens (86), Culex salinarius (32), Culex restuans (26), Culiseta melanura (32), and Aedes vexans (12) were implicated as the most likely vectors of WNV in the region based on virus isolation data. Culex pipiens was abundant from July through September and is likely involved in early season enzootic transmission and late season epizootic amplification of the virus in wild bird populations. Epidemic transmission of WNV to humans in urban locales is probable. The abundance of Cx. restuans in June and July and isolations of WNV in early July suggest that this species may play an important role as an enzootic vector involved in early amplification of WNV virus among wild birds. Its involvement as a bridge vector to humans is unlikely. Culex salinarius was the most frequently captured Culex species and was abundant in August and September when virus activity was at its height. Frequent isolations of WNV from this species in September when the majority of human cases were reported in union with its abundance at this time of the year, demonstrated vector competence, and broad feeding habits, make Cx. salinarius a likely bridge vector to humans, horses and other mammals. Multiple isolations WNV from Cs. melanura collected in more rural locales in late August and September, provide supportive evidence to suggest that this predominant avian feeder may play a significant role in epizootic amplification of the virus among wild bird populations in these environs. Aedes vexans was the only species of Aedes or Ochlerotatus from which multiple isolations of WNV were made in more than one year and was among the most frequently trapped and abundant species throughout the season. Since Ae. vexans predominately feeds on mammals it is unlikely to play a significant role in epizootic amplification of WNV, however, because of its abundance and aggressive mammalian and human biting behavior it must receive strong consideration as a bridge vector to humans and horses. The occasional virus isolations obtained from Aedes cinereus (4), Uranotaenia sapphirina (3), Ochlerotatus canadensis (2), Ochlerotatus trivittatus (2), Ochlerotatus sollicitans (2), Ochlerotatus sticticus (2), Psorophora ferox (2), Anopheles punctipennis, Anopheles walkeri, Ochlerotatus cantator, Ochlerotatus taeniorhynchus, and Ochlerotatus triseriatus in conjunction with their inefficient vector competency and host feeding preferences indicate that these species likely play a very minor role in either the enzootic maintenance or epizootic transmission of WNV in this region. The principal foci of WNV activity in Connecticut were identified as densely populated (>3,000 people/mi2) residential communities in coastal Fairfield and New Haven Counties, and in the case of 2002, similar locales in proximity of the city of Hartford in central Hartford County. In almost all instances we observed a correlation both temporally and spatially between the isolation of WNV from field-collected mosquitoes and subsequent human cases in these locales. In most years the incidence of human cases closely paralleled the number of virus isolations made from mosquitoes with both peaks falling in early September. We conclude that the isolation of WNV from field-collected mosquitoes is a sensitive indicator of virus activity that is associated with the risk of human infection that habitually extends from early August through the end of October in Connecticut.

Aedes↗
PubMed2005

A survey of environmental contamination with ascarid ova, Wallingford, Connecticut.

Few studies have been conducted in the United States to quantify the potential risk associated with encountering zoonotic ascarid ova in the environment. In an effort to raise awareness and to better understand the risk of acquiring visceral larva migrans in south central Connecticut, this environmental survey was conducted to determine the prevalence of ascarid ova (Toxocara canis, Toxocara cati, Baylisascaris columnaris, and Baylisascaris procyonis) in public areas of Wallingford, Connecticut, to compare prevalence levels among these public areas, and to determine what host species are primarily responsible for environmental contamination. A preliminary study was conducted to determine if ascarid ova of different species could be identified by size and appearance utilizing light microscopy alone; results did not support the differentiation of species via these methods. To determine the prevalence of environmental contamination with ascarid ova, samples of approximately 250 g of soil were collected from park green areas, playgrounds, public housing areas, parkways, and a school. Ova were detected in 46 (14.4%) of 319 samples collected. Ova were collected from three of the 60 (5.0%) park green area samples, 11 of the 40 (27.5%) playground samples, six of the 98 (6.1%) public housing samples, and 26 of the 96 (27.1%) parkway samples. Public areas of Wallingford, Connecticut are frequently contaminated by potentially infectious ascarid ova. Of particular concern is the high degree of contamination of playgrounds and the potential risk these areas pose to children's health.

Animals↗
PubMed1998

Multiple isolations of eastern equine encephalitis and highlands J viruses from mosquitoes (Diptera: Culicidae) during a 1996 epizootic in southeastern Connecticut.

Thirty-six isolations of eastern equine encephalitis virus were obtained from 8 species of mosquitoes collected from 5 September through 18 October 1996 during an epizootic in southeastern Connecticut. These included Culiseta melanura (Coquillett) (19 isolates), Culex pipiens L. (8), Culiseta morsitans (Theobald) (3), Aedes sollicitans (Walker) (2), Aedes cantator (Coquillett) (1), Aedes trivittatus (Coquillett) (1), Aedes vexans (Meigen) (1), and Coquillettidia perturbans (Walker) (1). Isolations from Ae. cantator and Ae. trivittaus are new to North American records, and those from Ae. cantator and Ae. sollicitans represent the first infections of human-biting, salt-marsh mosquitoes with eastern equine encephalitis virus in Connecticut. With one exception, eastern equine encephalitis-infected Cs. melanura were found at all sites where eastern equine encephalitis virus was isolated. The large number of eastern equine encephalitis isolations from Cs. melanura and the collection of infected mosquitoes in residential woodlots and coastal salt marshes away from traditional red maple or white cedar swamp habitats, reaffirm the importance of local populations of this mosquito for viral amplification and dispersal from swamp foci. Highlands J virus was more widespread geographically, but fewer isolations of this virus were made from fewer species of mosquitoes. These included Cs. melanura (8 isolates), Cx. pipiens (5), Ae. vexans (3), Aedes canadensis (Theobald) (1), Ae. cantator (1) and Cs. morsitans (1). No human or horse cases of eastern equine encephalitis were reported, although this represents the largest number of isolations for eastern equine encephalitis ever recovered from field-collected mosquitoes in Connecticut.

Alphavirus↗
PubMed1976

Uterine cervical carcinoma in Connecticut, 1935-1973: evidence for two classes of invasive disease.

The Connecticut Tumor Registry recorded 5,781 women with carcinoma in situ (CIS) and 7,614 with invasive cervical cancer from 1935 to 1973. True incidence rates for invasive disease were calculated. CIS rates indicated newly diagnosed cases, but true CIS incidence is unknown. Starting in 1945-49, the incidence of invasive cervical declined about 20% in Connecticut before CIS screening could have influenced the disease to that extent. Continuing declines in invasive disease rates after 1955 in Connecticut were probably attributable largely to screening. The persistent occurrence of invasive disease in screened populations and the rapid progression of cancer, with early death among some women with apparently localized disease at diagnosis, suggested that a second class of invasive cervical cancer may exist. Cancers in this class may develop and progress rapidly without a practical possibility of detection in the premalignant stage by cytologic methods. Other screening methods, e.g., metabolic, hormonal, immunologic, or virologic, may be required to control this disease.

Adult↗
PubMed1979

Rocky mountain spotted fever in Connecticut: human cases, spotted-fever group rickettsiae in ticks, and antibodies in mammals.

Three parameters were used in 1976 and 1977 to assess the status of Rocky Mountain spotted fever (RMSF) in Connecticut--compilation and review of clinical data on suspected human cases for the 13-year period 1965--1977, examination of tick tissues for spotted fever-group rickettsiae by the hemolymph test and direct immunofluorescence, and analyses of mammalian sera for antibodies against Rickettsia rickettsii. There were six presumptive RMSF cases which probably originated in Connecticut. Four of these cases occurred in areas where the American dog tick, Dermacentor variabilis, abounds. A total of 2994 ticks were examined by the hemolymph test. Rickettsia-like organisms were observed in 67 (2.9%) of 2330 D. variabilis and two (0.6%) of 351 Ixodes sp. near scapularis. Fewer than one-half of these organisms stained positively with spotted fever-group conjugate. Microagglutination tests on 1093 mammalian sera indicated that eight (16%) of 49 raccoons, 14 (2.6%) of 549 white-tailed deer, eight (1.7%) of 470 white-footed mice, and one of two gray squirrels had agglutinins in titers greater than or equal to 1:8 against R. rickettsii. Spotted fever-group rickettsiae are present at low frequency in inland as well as coastal regions of Connecticut.

Adult↗
PubMed1997

Carcinogenic potential of silicone breast implants: a Connecticut statewide study.

To clarify the carcinogenic potential of silicone breast implants, 680 implant procedures performed on women in Connecticut with no prior history of cancer were correlated with the subsequent development of primary breast and nonbreast cancers. Neoplastic events after the placement of silicone breast implants during the 13-year interval from October 1, 1980, through September 30, 1993, were quantified using a retrospective, linked-registry method. ICD-9-CM discharge codes contained in the Uni formed Hospital Discharge Data Sets (UHDDS) from 34 hospitals across Connecticut were linked to procedure codes for unilateral and bilateral implants, and to medical histories for new malignancies after the implant procedures. Data were cross-linked to the Connecticut Tumor Registry to confirm the clinical history of each cancer. The rates of breast and nonbreast cancers in patients with silicone breast implants were compared with those of a control population drawn from the UHDDS of 1022 women undergoing sterilization by tubal ligation between 1981 to 1985. Ages (mean +/- SD) were similar in the implant group (34 +/- 10 years) and in the sterilization group (32 +/- 6 years). The mean follow-up in the implant group (4.6 years) was also similar to that of the control group (5.4 years). Compared with the control group, the implant group demonstrated lower rates of breast cancer (0.59 versus 0.88 percent, p = 0.35) and nonbreast cancer (0.59 versus 2.7 percent, p = 0.001). Correspondingly, the implant group had a lower relative risk of breast cancer (relative risk = 0.67, 95 percent, confidence interval = 0.20 to 2.17) and nonbreast cancer (relative risk = 0.21, 95 percent, confidence interval = 0.07 to 0.60). Based on these data, it was concluded that silicone breast implants are not carcinogenic, because they are not associated with increased rates of either breast or nonbreast cancers. The validity and threats to the conclusions are discussed, and the results are placed into context with similar findings from other studies.

Adult↗
PubMed1998

Impact of the change in Connecticut syringe prescription laws on pharmacy sales and pharmacy managers' practices.

We assessed the impact of the 1992 change in Connecticut syringe prescription laws on pharmacy sales and pharmacy managers' sales practices. A mail survey was conducted in 1994 of all current pharmacy managers in the five largest cities in Connecticut (Hartford, New Haven, Waterbury, Bridgeport, and Stamford) and a random sample of those practicing in all other areas. Of these, 89.3% of the pharmacies in the five largest cities and 85.1% in the other areas had ever sold syringes without a prescription since the July 1992 law went into effect. Most pharmacists identified safety issues as very important in their personal decision about the sale of syringes without a prescription. Although the purpose of the change in the prescription law was to provide expanded access to sterile syringes by injection drug users (IDUs), only 31.4% of the managers who were allowed to sell in all instances and 18.1% of those who sold at their discretion were very willing to sell syringes to IDUs. In the logistic regression model of pharmacies with a sell-in-all-instances policy, the perceived benefit of the sale of syringes on health and community well-being was the only influence independently associated with managers support for nonprescription sales. Overall, managers reported they did not know what other pharmacists thought (40.4%) or did (42.9%) regarding the sale of syringes. When pharmacists had discretion over syringe sales, managers' beliefs about what other Connecticut pharmacists thought and did about the nonprescription sale of syringes remained a significant influence on the degree of support for sales. Most pharmacies implemented and maintained policies permitting the sale of syringes without a prescription. Several issues, including risk of discarded contaminated syringes around pharmacies and in the community and reluctance to sell to IDUs, reduced pharmacists willingness to sell syringes. Efforts to incorporate pharmacists as active partners in HIV prevention in IDUs should promote the sale of syringes without a prescription to IDUs as acceptable public health practice.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Dental caries in preschool Beijing and Connecticut children as described by a new caries analysis system.

A total of 625 children, 3-4 yr old, 426 from Connecticut Head Start programs and 199 from Beijing area nursery schools, were clinically examined for dental caries. Results were analyzed using the traditional dmfs index as well as a new "Caries Analysis System". This new system differentiated between caries patterns and examined the percentage of affected children (Prevalence), the degree to which these children were affected (Severity) and the proportion of total caries each disease pattern represented (Distribution). The Caries Analysis System revealed differences in caries experience and patterns among the racial/ethnic groups that the dmfs index did not. The Beijing children experienced the greatest Prevalence of all caries patterns; however, the Severity and Distribution of the caries patterns were similar to those of the Connecticut children. Within the group of Connecticut children, White children had the lowest Prevalence but the greatest Severity when compared with the Black and Hispanic children.

Child, Preschool↗
PubMed1976

Photochemical air pollution: transport from the New York City area into Connecticut and Massachusetts.

Photochemical air pollution resulting from primary emissions in the New York City metropolitan area is transported by prevailing winds on a 300-kilometer northeast trajectory through Connecticut and as far as northeastern Massachusetts. As a result, southwestern Connecticut has the highest ozone concentrations in the region and there is a substantial increase in ozone concentrations in Massachusetts. The ozone concentrations of air entering the New York City metropolitan area are often already above the federal standard of 0.08 part per million, but the concentration distribution is well below concentration distributions at downwind sites in Connecticut.

Air Pollution↗
PubMed2000

Detection of Ehrlichia chaffeensis DNA in Amblyomma americanum ticks in Connecticut and Rhode Island.

Ehrlichia chaffeensis, the causative agent of human monocytic ehrlichiosis, is transmitted by Amblyomma americanum ticks, which are most abundant in the southern United States. Because serologic evidence suggests that residents of Connecticut are exposed to E. chaffeensis, A. americanum ticks were collected in Connecticut and Rhode Island for PCR analysis to detect E. chaffeensis DNA. Eight of 106 (7.6%) A. americanum ticks from Connecticut and 6 of 52 (11.5%) from Rhode Island contained E. chaffeensis DNA. Thus, E. chaffeensis is present in ticks in southern New England and transmission of E. chaffeensis may occur there.

Animals↗
PubMed2005

The dental safety net in Connecticut.

BACKGROUND: Many poor, medically disabled and geographically isolated populations have difficulty accessing private-sector dental care and are considered underserved. To address this problem, public- and voluntary-sector organizations have established clinics and provide care to the underserved. Collectively, these clinics are known as "the dental safety net." The authors describe the dental safety net in Connecticut and examine the capacity and efficiency of this system to provide care to the noninstitutionalized underserved population of the state. METHODS: The authors describe Connecticut's dental safety net in terms of dentists, allied health staff members, operatories, patient visits and patients treated per dentist per year. The authors compare the productivity of safety-net dentists with that of private practitioners. They also estimate the capacity of the safety net to treat people enrolled in Medicaid and the State Children's Health Insurance Program. RESULTS: The safety net is made up of dental clinics in community health centers, hospitals, the dental school and public schools. One hundred eleven dentists, 38 hygienists and 95 dental assistants staff the clinics. Safety-net dentists have fewer patient visits and patients than do private practitioners. The Connecticut safety-net system has the capacity to treat about 28.2 percent of publicly insured patients. CONCLUSIONS: The dental safety net is an important community resource, and greater use of allied dental personnel could substantially improve the capacity of the system to care for the poor and other underserved populations.

Child↗
PubMed1983

Health maintenance organizations; North Central Connecticut Health Maintenance Organization--Health Resources and Services Administration.

On August 10, 1982, the Office of Health Maintenance Organizations (OHMO) notified Kaiser Foundation Health Plan, Inc. (KFHP), One Kaiser Plaza, Oakland, California 94612, that North Central Connecticut Health Maintenance Organization (NCC/HMO), 99 Ash Street, East Hartford, Connecticut 06101, a federally qualified health maintenance organization (HMO), had successfully reestablished compliance with its assurances to the Secretary that it (1) maintain a fiscally sound operation, (2) maintain satisfactory administrative and managerial arrangements, and (3) obtain the required contractual provisions with health professionals providing basic health services to its members. The reestablishment of compliance took effect on July 1, 1982, and was based primarily on the completion of an agreement between NCC/HMO and KFHP under which KFHP assumed the operation of NCC/HMO. This notice also reports a name change for NCC/HMO to Kaiser Foundation Health Plan of Connecticut, Inc. (KFHPC).

California↗
PubMed2001

Human West Nile virus surveillance--Connecticut, New Jersey, and New York, 2000.

West Nile virus (WNV), a mosquitoborne arbovirus identified in New York in 1999, has become enzootic in the northeastern United States, affecting humans, birds, horses, and other mammals. Although no human WNV infection was identified in Connecticut or New Jersey in 1999, 62 persons with WNV illness, including seven deaths, were detected in New York City (NYC) and nearby New York counties. In 2000, these jurisdictions implemented active surveillance (AS) and enhanced passive surveillance (EPS) to detect human illness; 21 persons were identified with acute WNV infection (14 in New York, six in New Jersey, and one in Connecticut), including two deaths (one each in New York and New Jersey). This report summarizes the human WNV surveillance systems in Connecticut, New Jersey, New York, and NYC and recommends EPS for hospitalized patients with encephalitis of unknown etiology for the continental United States.

Connecticut↗
PubMedDate not supplied

Internet usage by pediatric dental practices in Connecticut.

PURPOSE: The aim of this study was to determine Internet usage by pediatric dental practices in Connecticut. METHODS: A seven-item anonymous survey was mailed to all the 64 pediatric dentists in private practice in Connecticut. Each survey form was mailed along with a stamped and pre-addressed return envelope. Frequency distribution analyses and chi-square tests were performed. RESULTS: The survey had a response rate of 73%. More than three-fourths of the pediatric dental practices were connected to the Internet. Seventy-two percent of the practices submitted third-party claims electronically. Almost all of the respondents did not use email to communicate with patients or to discuss individual patient issues with other health care providers. Only two-fifths of the practices had a World Wide Web site. CONCLUSIONS: Most of the pediatric dental practices in Connecticut were connected to the Internet. Electronic third-party claims submission was the predominant Internet service used by these practices.

Chi-Square Distribution↗
PubMed2002

2002 Connecticut health policymaker survey.

In Spring 2002, Connecticut health policymakers in executive and legislative branches of government were surveyed to assess their needs for health policy information and their perceptions of upcoming health challenges facing Connecticut citizens; a similar survey was conducted in 2000. Policymakers receive information from a wide variety of sources; most often from within state government--state agencies and legislative staff--and from health advocacy organizations/coalitions. The most trusted sources of information are legislative staff, journals/publications, and state agencies. The areas of greatest need for information were: health-care financing, the uninsured, prescription drug coverage, long-term care, and mental health/substance abuse. Between 2000 and 2002, concerns over the costs of health care have increased significantly. Connecticut policymakers prefer to receive information in short, one, or two-page fact sheets.

Connecticut↗
PubMed2003

Knowledge, attitudes, and behaviors about West Nile virus--Connecticut, 2002.

Since West Nile virus (WNV) was first recognized in the United States in 1999, the geographic distribution has widened progressively, and the resulting human morbidity and mortality has increased. The cornerstones of WNV control and prevention are 1) surveillance with sustained and integrated mosquito control to detect the presence of WNV in areas where humans are at risk and 2) public education on the use of personal protective behaviors (PPBs) and peridomestic mosquito control to reduce the risk for mosquito bites. In Connecticut, strategies to improve public education and WNV-risk awareness consist of issuing graded warnings after assessing local surveillance findings during the transmission season. In 2002, three of the 17 Connecticut patients with confirmed WNV infection reported having used any PPBs. To assess knowledge, attitudes, and behaviors about WNV during the transmission season, the Connecticut Department of Public Health added questions about WNV to its Behavioral Risk Factor Surveillance System (BRFSS) survey conducted during August-November 2002. This report summarizes the results of that analysis, which indicate that general awareness of WNV and knowledge of elderly persons being at risk for more severe illness were high; however, awareness of local surveillance findings was poor, and belief in the local presence of WNV did not predict the use of PPBs. The findings underscore the need for continued public education about the risk for WNV infection and the use of PPBs and the need for regular systematic evaluations of knowledge, attitudes, and behaviors to refine and improve public health messages effectively.

Adult↗
PubMed2005

The demographics, histopathology and patterns of treatment of anal cancer in Connecticut: 1980-2000.

OBJECTIVES: Examine the epidemiology and clinical characteristics of anal cancer in the State of Connecticut. MATERIALS AND METHODS: The Department of Health Connecticut Tumor Registry resources were utilized for the years 1980-2000. RESULTS: A total of 646 anal cancers (410 females, 236 males) were diagnosed (mean age: 63.4 years). The most prominent histological type was squamous cell carcinoma, followed by adenocarcinoma and cloacogenic carcinoma. Females predominated in both the first and second decade of the study period. Black males accounted for 2.3% of all cases during the first decade, compared to 5% during the second decade. Surgery alone was the most common treatment modality, followed by radiation alone and a combination of surgery and radiation therapy. Chemotherapy data were not available although it is currently considered an important part of therapy. CONCLUSIONS: Anal cancer incidence in Connecticut increased in the 21-year period 1980 to 2000, affecting the rate for African-American men more than other race-specific and gender-specific population subgroups. Anal cancer affects women more often than men. Squamous cell carcinoma is the most common histological type.

Adenocarcinoma↗
PubMedDate not supplied

Occupational disease in Connecticut: 2002.

Data on chronic work-related conditions were compiled for Connecticut for 2002 from physician reports to the Occupational Disease Surveillance System (ODSS), the Workers' Compensation (WC) Commission, and the Bureau of Labor Statistics (BLS)/ ConnOSHA survey. Physicians reported 2,082 cases of occupational disease in Connecticut in 2002, approximately half of the estimate of 4,388 cases using the BLS/ ConnOSHA methodology. Cases in the ODSS included 921 (44%) reports of musculoskeletal disorders (MSD), 476 adult lead poisonings (based on lab reporting), 338 skin disorders, and 283 respiratory and lung conditions. There were increased reports in both the ODSS and WC systems over 2001 figures. Emerging conditions included vibration-related MSD, a mold-related respiratory outbreak, and Lyme Disease/tick bites among outdoor workers. Only 86 physicians from 29 clinics reported cases indicating widespread under-reporting of occupational disorders among community physicians despite Connecticut statutes mandating reporting of work-related disease.

Connecticut↗