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Electrically induced deaths involving water immersion.

The diagnosis of low-voltage electrocution is aided by the presence of electrical burns. When the victim is immersed in water, however, the cooling effect of the water prevents heating of the tissues and eliminates the usual entry and exit points. Cases are described here in which electrical shock and water immersion combined to bring about fatal results. Although electrical shock was instrumental in bringing about these deaths, the actual cause of death in two of the cases was not electrocution, but drowning. The cases demonstrate the need for thorough site investigation, which will assist the pathologist at autopsy and also serve the community by preventing similar deaths at the same death scene.

Accidents, Home↗

Swimming and birth weight.

BACKGROUND: Swimmers can be exposed to high levels of trihalomethanes, byproducts of chlorination disinfection. There are no published studies on the relation between swimming and birth weight. We explored this relation in a large birth cohort, the Avon (England) Longitudinal Study of Parents and Children (ALSPAC), in 1991-1992. METHODS: Information on the amount of swimming per week during the first 18-20 weeks of pregnancy was available for 11,462 pregnant women. Fifty-nine percent never swam, 31% swam up to 1 hour per week, and 10% swam for longer. We used linear regression to explore the relation between birth weight and the amount of swimming, with adjustment for gestational age, maternal age, parity, maternal education level, ethnicity, housing tenure, drug use, smoking and alcohol consumption. RESULTS: We found little effect of the amount of swimming on birth weight. More highly educated women were more likely to swim compared with less educated women, whereas smokers were less likely to swim compared with nonsmokers. CONCLUSIONS: There appears to be no relation between the duration of swimming and birth weight.

Adult↗

Prevention of drowning in infants and children.

Drowning is among the leading causes of death in children under 5 years of age. Yet it need not be, as most drowning is often preventable. The author discusses this important topic for all nurses and parents.

Accidents, Home↗

Reducing illness transmission from disinfected recreational water venues: swimming, diarrhea and the emergence of a new public health concern.

Recreational water-related illnesses are associated with swimming in contaminated water venues. The transmission of diarrheal illness in disinfected settings is influenced by several factors which include: chlorine resistance in waterborne pathogens; poor facility maintenance of disinfectant levels; and lack of healthy swimming habits. Health care providers can help to disseminate healthy swimming messages to their patients and help to prevent and control this emerging public health concern.

Adolescent↗

Seasonality in symptom severity influenced by temperature or grass pollen: results of a panel study in children with eczema.

Although seasonal variations are well known in many patients with eczema, no systematic population-based panel study evaluating seasonality and quantifying the influence of factors like climate and pollen on symptom variations has been conducted so far. Thirty-nine children with eczema, who had been identified in 1996 in a cross-sectional study on 1673 6-y-olds in Augsburg (Germany), participated in the study. Between March and September 1999, they daily recorded itch, extent, and possibly triggering factors on quantitative scales. Daily temperature, humidity, radiation, and pollen concentration were measured. Mixed linear models, taking the time series structure and confounding into account, were used for analysis. Seasonal patterns were significantly different between children: twenty-one had symptoms mainly in winter. They were affected by changes in outdoor temperature: itch was reduced by 22% (95% confidence interval (CI): 16%-27%) and extent by 65% (CI: 54%-72%) per 15 degrees C temperature increase. Eighteen children exhibited more symptoms in summer and especially during days with high grass-pollen exposure when itch was 16% higher (CI: 8%-24%) and extent 19% (CI: 2%-39%). This effect was stronger for children sensitized against pollen. Consideration of the individual type of eczema may help to arrange appropriate preventive and therapeutic measures.

Allergens↗

Molecular epidemiological analysis of Cryptosporidium spp. in the United Kingdom: results of genotyping Cryptosporidium spp. in 1,705 fecal samples from humans and 105 fecal samples from livestock animals.

Cryptosporidium present in 1,705 fecal samples from humans and 105 from livestock animals were analyzed by PCR-restriction fragment length polymorphism of the Cryptosporidium oocyst wall protein. Overall, genotype 1 (human exclusive type) was detected in 37.8% of the samples from humans, genotype 2 (broad host range) was detected in 61.5%, a third genotype designated genotype 3 (Cryptosporidium meleagridis) was detected in 0.3%, and both genotypes 1 and 2 were recovered from 0.4%. All samples from livestock yielded genotype 2. Among 469 patients infected during eight drinking water-related outbreaks, five outbreaks were predominantly due to genotype 1, and three were due to genotype 2. Fifty-four samples were collected from patients involved with five swimming pool-associated outbreaks: two outbreaks were due to genotype 1, one was due to genotype 2, and the remaining two involved both genotypes 1 and 2. Among 26 family outbreaks and 1 children's nursery outbreak (2 to 3 members per group), the same genotype was recovered from the different members of each outbreak: 13 were due to genotype 1, and 14 were due to genotype 2. In eighteen patients reporting contact with animals and/or farms, genotype 1 was recovered from one patient and genotype 2 was recovered from the remaining 17. Among the sporadic cases, there were distinct geographical and temporal variations in the distribution of the genotypes. The spring peak in cases was due to genotype 2. Genotype 1 was significantly more common in patients infected during the late-summer-autumn peak and in those with a history of foreign travel.

Animals↗

Outbreak of tuberculosis after minimal exposure to infection.

The identification of a case of respiratory tuberculosis in a swimming-baths attendant whose sputum was smear positive was followed by intensive contact tracing of children aged 8-11 years who had visited the baths. An outbreak was discovered that otherwise might not have been detected. Out of 3764 children, 108 (2.9%) had evidence of infection: there were 16 cases of tuberculosis, of which 11 were symptomless but showed lesions on chest radiography, and a further 92 with tine test grade 3 or 4 without clinical or radiological signs. The contact of these children with the index case was apparently minimal. Early detection, isolation, and treatment of infectious cases of respiratory tuberculosis and vigorous contact tracing should be given more priority in tuberculosis control.

Adult↗

Foot infections in swimming baths.

A 10% random sample of all bathers at a public swimming bath were examined for tinea pedis and verruca.The overall incidence of tinea pedis was 8.5% and of verruca 4.8%. The incidence of tinea pedis in 205 male adults was 21.5%, in 288 boys 6.3%, in 60 adult females 3.3%, and in 220 girls 0.9%. The incidence of verruca in juveniles ranged from 4.2% in boys to 10.5% in girls.It was clear that both infections spread within the baths, and since a relatively small proportion of users admitted to taking precautions to avoid contracting or developing infections it seems advisable that more publicity about recommendations on foot care should be provided.

Adolescent↗