Critique of the public methadone programs in Connecticut.
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An increased incidence of rubeola among first-grade Danbury school children in 1973 led to a study of seroimmunity to rubeola in a random sample of 60% of the first- and second-grade school children (299) from whom blood samples had been obtained in October 1972 during a voluntary meningococcal vaccination program. Immunization histories derived from physicians' statements on school entry were obtained from school health department records and included date of immunization. Seventy-five percent of the study group had received measles vaccine. Of those immunized prior to 11 months of age only half had an hemagglutinating inhibiting titer (HAI) of greater than or equal to 5 five to seven years later. This antibody level correlates with immunity. Eighty-five to ninety percent of those immunized during or after the 11th month had an antibody titer of greater than or equal to 5. Seventy-one percent of those never immunized also had an HAI titer of greater than or equal to 5 indicating natural infection had occurred. As a result of this investigation, a community-wide program was initiated to vaccinate those who were more than 1 year old as well as reimmunize those who had been vaccinated before the 11th month in accord with current U.S. Public Health Service recommendations for measles immunization.
There has been a near doubling of the mean age (10.7 to 19.0 years) of Yale-New Haven Hospital patients with transfusion-dependent homozygous beta thalassemia between 1973 and 1994. This change is, in part, a result of improved transfusion procedures and effective chelation therapy with deferoxamine mesylate. A concomitant trend has been a decrease in the number of births of new cases resulting in fewer thalassemia major patients less than 10 years of age in 1985 and 1994 compared to a decade earlier. Identification of individuals at risk of having children with thalassemia major by extensive screening for heterozygous thalassemia and the availability of prenatal diagnosis may have contributed to this change. Thalassemia major has become a disease of adolescents and young adults. The increasing age has resulted in "new" issues in thalassemia major patients such as sexuality and marriage as well as economic problems involving health-care insurance and employment.
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