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PubMed2005

An outbreak of viral meningitis associated with a public swimming pond.

From July to October 2001, 215 cases of aseptic meningitis occurred among the inhabitants of the German city of Kassel and neighbouring counties. A matched case-control study identified bathing in a public, nature-like pond during the beginning of the outbreak as a risk factor for disease [matched odds ratio (mOR) 44.8, 95% confidence interval (CI) 3.9-515.6]. Among bathers, patients with meningitis spent more time in the water (mOR 18.8, 95% CI 2.0-174.1) and swallowed water more frequently (mOR = 7.3, 95% CI 0.7-81.8). Of 30 cerebrospinal fluid samples tested, echovirus 30 was cultured from 16, and echovirus 13 from seven. An echovirus 30 sequence obtained from one pond water sample showed a 99% nucleotide and 100% amino-acid homology with patient isolates. This outbreak demonstrates the potential of nature-like swimming ponds to cause widespread community infection with substantial public health impact.

Adolescent↗
PubMed1998

A survey of risk factors for cryptosporidiosis in New York City: drinking water and other exposures.

We conducted a survey to determine the prevalence of known and theoretical exposure risks for cryptosporidiosis among selected New York City residents. Subjects were recruited from outpatients attending either a practice for persons with HIV infection (n=160), or other medical practices (n=153), at The New York Hospital-Cornell Medical Center. Despite a greater concern for waterborne infection, 82% of HIV-infected subjects reported consuming municipal tap water compared to 69% of subjects from other medical clinics (OR 2.1, 95% Cl 1.2-3.6, P=0.006). Although 18% and 31% of subjects, respectively, denied any tap water consumption at home or work, all but one from each cohort responded positively to having at least one possible alternate source of tap water ingestion such as using tap water to brush teeth or drinking tap water offered in a restaurant. 78% and 76% of subjects, respectively, had at least one potential risk for exposure other than municipal water consumption, such as swimming in pools or contact with animals. Our findings indicate that it is possible to stratify the population into subsets by the amount of tap water consumed. This suggests that an observational epidemiologic study of the risk of contracting cryptosporidiosis from everyday tap water consumption is feasible.

Adult↗
PubMed1980

Analysis of 139 spinal cord injuries due to accidents in water sports.

Between 1967 and 1978, a total of 2587 patients received primary treatment in the Spinal Cord Injury Centre at the University of Heidelberg. In 212 cases the paralysis was caused by sports or diving accidents. Injuries resulting from accidents in water sports totalled 139, 131(61.7 per cent) of which could be classified as actual diving accidents. These 131 cases consisted of 129 tetraplegias and only 2 paraplegias. In 5 cases, the tetraplegia resulted from high diving and in 3 cases from scuba-diving. The subjects of the analysis are causes of accidents, segmental diagnosis of neurological deficiency symptoms and prognosis.

Accidents↗
PubMedDate not supplied

Unexpected result in the etiological approaching to an anemic case: a leech infestation.

One of the causes of the childhood anemia is gastrointestinal system bleeding, which rarely results from parasites. The authors report on a 3-year-old boy with severe anemia and a history of hematemesis. While they were investigating the cause of the anemia and the hematemesis, a leech showing itself in the nasal passage led to a quick and exact treatment. Leeches should be considered for differential diagnosis of anemia and gastrointestinal system bleeding in the children.

Anemia↗
PubMed2005

Cervicofacial lymphadenitis in children caused by Mycobacterium haemophilum.

BACKGROUND: Nontuberculous mycobacterial (NTM) lymphadenitis in children is most often caused by Mycobacterium avium. In a prospective, multicenter trial of the optimal treatment, 23.7% of the NTM cervicofacial lymphadenitis cases in children were caused by Mycobacterium haemophilum. In this article, we describe the epidemiological and clinical features of M. haemophilum cervicofacial lymphadenitis. METHODS: The diagnosis of Mycobacterium avium or M. haemophilum infection was established by culture or polymerase chain reaction. Demographic characteristics and data regarding clinical presentation and possible environmental exposure were compared for patients infected with M. avium and those infected with M. haemophilum. RESULTS: Ninety-four (69.9%) of 135 infections were caused by M. avium, 32 (23.7%) by M. haemophilum, and 9 (6.4%) by other NTM species. The median age of the M. haemophilum-infected children was 72 months, compared with 41 months for the M. avium-infected children (P < .001), with an equal distribution for both sexes. Involvement of multiple lymph nodes was frequently observed among the M. haemophilum-infected patients (56% of patients). Extranodal localizations were only observed in M. haemophilum-infected patients. Children with M. haemophilum infection were more likely to have a non-Dutch background (P = .001), and in most cases, they had a history of contact with swimming water (P = .03), whereas M. avium-infected patients were more likely to have a history of playing in sandpits (P = .01). In a multivariate analysis, only older age and a non-Dutch background were predisposing risk factors for M. haemophilum infection, compared with M. avium infection. CONCLUSION: Higher age, non-Dutch background, and involvement of multiple cervicofacial lymph nodes with extranodal localizations distinguished M. haemophilum infection from M. avium infection.

Aging↗
PubMed1996

Effectiveness of water exercise on postural mobility in the well elderly: an experimental study on balance enhancement.

BACKGROUND: The fear of falling may cause elderly people to limit their movement. As movement errors are known to facilitate the acquisition of motor skills, the elderly may inadvertently cause the loss of postural skills by constraining their movements, and hence avoid potential movement errors. It was hypothesized that by having elderly individuals exercise in a risk-free environment-water was utilized in this experiment-their postural capabilities would improve. METHODS: Four groups of elderly subjects (80 +/- 5.8 years old) were placed into four groups: Water Exercisers; Land Exercisers; Water Sitters; and Land Sitters. Each group met twice per week for 45 minutes for 5 weeks of simple exercises or socializing in the designated medium. The distance each individual could reach (Functional Reach, FR) was measured at the end of each week. RESULTS: Initially, each group was at risk (FR < 10 inches) for falling Statistical testing showed that the Water Exercisers (WE) increased their FR almost every week; the Land Exercisers (LE) increased only during the first week; and the Water Sitters (WS) and Land Sitters (LS) did not increase at all. The FRs after 5 weeks were 13.4 +/- 1.6 (WE), 11.3 +/- 1.5 (LE), 9.6 +/- 1.3 (WS), and 9.3 +/- 0.71 (LS) inches for each group, respectively. CONCLUSIONS: The data showed that the postural capabilities in these elderly people, as measured by the FR, were enhanced by the production of movement errors that was facilitated in a water environment (in the case of the Water groups) or the initiation of a novel exercise program (Land Exercisers). Alternative explanations, and implication of these results, are discussed.

Accidental Falls↗
PubMedDate not supplied

A simple, reliable method for the determination of chlorinated volatile organics in human breath and air using glass sampling tubes.

A method for determining chloroform, 1,1,1-trichloroethane, carbon tetrachloride, and trichloroethene in breath samples was developed. It consisted of collecting samples in 40-ml. glass-silanized tubes that were 16-in. long and had a 0.64-in. diameter. The ends tapered, resulting in a tube with a 1/4-in. diameter that was 1 3/4-in. long; each end had a shutoff valve attached. One end had a strip of rubber tube attached to the shutoff valve for collecting the breath sample, and the other end contained a 1/4-in. Swagelok nut with a rubber septum for withdrawing the sample. Samples were withdrawn using a pressure-lock, gastight syringe, and they were injected onto a gas chromatograph fitted with an electron-capture detector. The analytes were stable for at least 22 days in these tubes. The method detection limit was determined to be 0.03, 0.08, 0.04, and 0.04 pg/ml. for chloroform, 1,1,1-trichloroethane, carbon tetrachloride, and trichloroethene, respectively. Precision, based on 13 injections, was determined to be 13% for 0.09 pg chloroform, 13% for 0.21 pg 1,1,1-trichloroethane, 8% for 0.16 pg carbon tetrachloride, and 14% for 0.1 pg trichloroethene. In all, the proposed method is a sensitive and reliable one for determining volatile organic compounds in breath and a method that can also be applied to air sampling.

Air Pollutants↗