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Entomologic investigations of an epidemic of St. Louis encephalitis in Pine Bluff, Arkansas, 1991.

An epidemic of St. Louis encephalitis (SLE) occurred in Jefferson County, Arkansas during July-August 1991. At least 26 human cases were involved, with 25 cases in the town of Pine Bluff. Twelve isolates of SLE virus were obtained from mosquitoes collected in Pine Bluff between August 13 and 24: 11 from pools of Culex pipiens quinquefasciatus, resulting in a minimum infection rate of 1.6 per 1,000 (n = 6,768) for this subspecies, and one isolate from a pool of 22 mosquitoes identified as Cx. (Culex) spp. Three of the SLE-positive pools, two from Cx. p. quinquefasciatus and one from Cx. (Cux.) spp., also yielded isolates of Flanders virus. Larval surveys resulted in the collection of seven species in four genera from 28 larva-positive habitats and the identification of one significant site of Cx. p. quinquefasciatus production. Ecologic assessments conducted at 12 randomly selected residences resulted in the identification of 17 larva-positive habitats, for an average mosquito-positive habitat rate of 1.4 per residence, and a Cx. p. quinquefasciatus larva-positive habitat rate of 0.6 per residence. Aedes albopictus and Cx. p. quinquefasciatus were the species most frequently encountered in larval surveys in residential neighborhoods.

Aedes↗

Avian hosts of St. Louis encephalitis virus in Pine Bluff, Arkansas, 1991.

An investigation of the extent of St. Louis encephalitis (SLE) virus activity in the avian population in Pine Bluff, Arkansas was conducted from August 30, 1991 through September 5, 1991, following an SLE epidemic that resulted in 25 human cases. A total of 363 birds of 33 species were captured with ground-level mist nets at four sites along the northern edge of the city. No viruses were isolated from the serum of these birds, but 91 birds (25%) of 11 species had detectable neutralizing antibody against the TBH-28 strain of SLE virus in the constant-virus, serum-dilution, plaque-reduction neutralization test in Vero cell culture. No antibody to eastern equine encephalitis virus was detected. The prevalence of antibody to SLE virus varied among the sites from 11% to 44%, but the prevalence at each site was influenced by the avian species composition. The two most abundant species captured in the city, the American robin (43%) and house sparrow (42%), also had the highest prevalence of antibody. Nine other bird species were serologically positive but at significantly lower rates than for the abundant species. The antibody prevalence was higher in immature birds (27%) than in adult birds (15%), but the antibody titers were higher in adult birds than in immature ones. The overall SLE antibody prevalence and the prevalence for house sparrows were significantly higher than the average prevalence for avian hosts studied during previous SLE epidemics. Therefore, house sparrows would be a good choice for a local sentinel species.

Animals↗

Tick avoidance behaviors associated with a decreased risk of anti-tick salivary gland protein antibody seropositivity in military personnel exposed to Amblyomma americanum in Arkansas.

During April through September 1990, 399 military personnel who originated from either Fort Chaffee, Arkansas (n = 236) or Fort Wainwright, Alaska (n = 163) were studied during maneuvers in tick-infested areas at Fort Chaffee. Study subjects completed a questionnaire and had pre- and post-maneuvers serum specimens analyzed for antibodies to several rickettsial and ehrlichial agents and to Amblyomma americanum (lone star tick) salivary gland proteins (anti-tick saliva antibodies [ATSA], a biologic marker of tick exposure). Military rank/grade and home station were associated with pre-maneuvers ATSA seropositivity by enzyme-linked immunosorbent assay (ELISA). Fort Wainwright personnel were more likely to show at least a 50% increase in ATSA levels, compared with subjects from Fort Chaffee, from the pre- to the post-maneuvers specimen (adjusted odds ratio [AOR] = 2.7, 95% confidence interval [CI] = 1.2-6.1). Subjects from Fort Wainwright who did not report use of bed netting were at an increased risk of post-maneuvers ATSA seropositivity (AOR = 4.1, 95% CI = 1.5-11.5). In contrast, subjects from Fort Chaffee who did not report tucking pants into socks were at increased risk of post-maneuvers ATSA seropositivity (AOR = 2.8, 95% CI = 1.1-7.1). Subjects from Fort Chaffee who reported an attached tick bite during maneuvers were more likely to be ATSA-seropositive in the post-maneuvers specimen (AOR = 2.5, 95% CI = 1.2-5.2). Western blot assays revealed large differences in tick salivary gland proteins that were recognized on the post-maneuvers specimen among three randomly selected individuals, and small differences within a single individual who reported a tick bite during maneuvers, comparing pre- and post-maneuvers specimens. The ATSA ELISA seropositivity was not associated with seroconversion to the tick-borne infectious agents.

Adolescent↗

Survey for rabies, leptospirosis, toxoplasmosis and tularemia in striped skunks (Mephitis mephitis) from three public use areas in northwestern Arkansas.

During a skunk eradication program in late August, 1979, 53 striped skunks (Mephitis mephitis) were removed from three public use areas on Beaver Lake, Benton and Carroll counties in northwestern Arkansas. None of the 53 animals were positive for rabies (fluorescent antibody technique) and only one of 45 (2.2%) was positive for rabies antibodies. Twenty-one of 45 animals (46.6%) tested were positive for leptospirosis; 10 of 45 (22.2%) were positive for toxoplasmosis; and none were positive for tularemia. High populations of striped skunks in public use areas could be a potentially important reservoir for several diseases affecting both humans and other animals.

Animals↗

Lesions associated with pulmonary parasites in bobcats (Felis rufus) from Arkansas.

Two of five bobcats (Felis rufus) from southwestern Arkansas had natural pulmonary infections of Paragonimus kellicotti and Filaroides rostratus. Pairs of P. kellicotti were found in spherical cyst-like structures approximately 1 cm in diameter. Filaroides rostratus were seen as serpentine pale white areas on the pleural surface and also firmly embedded in fibrous capsules in the pulmonary parenchyma. Histologic lesions associated with the presence of these parasites consisted primarily of a verminous bronchitis. Clinical signs or compromised pulmonary function were not associated with these infections.

Animals↗

An analysis of the formality of relationships between hospitals and home care providers in Arkansas.

A survey was made of 43 hospitals in Arkansas to assess the degree of formality between these hospitals, hospital-based home care units (either the hospital's own or another hospital's), and public health units. The most formal arrangements are between hospitals and their own home care units. In decreasing degrees of formality are relationships between hospitals without home care units and other hospital-based units, between hospitals without home care units and public health units, and between hospitals with home care units and public health units.

Arkansas↗

Childhood blood lead screening in Arkansas: recommendations for health care providers.

Multiple studies documenting regional differences in prevalence of elevated blood lead levels suggest that children are not at equal risk for lead exposure. In late 1997, the Centers for Disease Control and Prevention (CDC) published guidelines to help states and communities make decisions regarding screening practices. To apply these guidelines to Arkansas Department of Health blood lead data for the 8,883 screens completed in state fiscal year 1997, along with 1990 Census Bureau housing and poverty statistics, were compiled and reviewed. Based upon CDC criteria and other available information, conservative recommendations for blood lead screening are presented for each county in the state. Lead toxicity in children remains a significant public health concern in certain regions of the country. Between 1991-1994, it was estimated about 930,000 U.S. children one to five years old had lead levels > or = 10 micrograms/dL. Children most at risk include minorities, those residing in large central cities, and those living in poverty. Blood lead levels (BLL's) as low as 10 micrograms/dL have been linked with possible IQ deficits as well as learning and behavior problems. To date, no study has demonstrated benefit from reduction of blood lead levels in the 10-24 micrograms/dL range. Nonetheless, in 1991 the Centers for Disease Control and Prevention (CDC) published guidelines for screening and followup designed to detect lead levels this low, presumably in order to prevent additional exposure and perhaps shorten the duration of toxicity. These guidelines essentially called for universal screening of one- and two-year old children regardless of socioeconomic status or previous population-based results of lead screening in their locale. [table: see text] Since release of the controversial 1991 guidelines, several reports of lead toxicity prevalence surveys from diverse communities have demonstrated extreme variation in the magnitude of the problem. For example, in 1994 only 0.6% of Alaska Medicaid recipients six years or younger had lead levels > or = 10 micrograms/dL, with the highest being 11 micrograms/dL.

Arkansas↗

Determining consumer preferences for a cash option: Arkansas survey results.

As long-term care (LTC) expenditures have risen, policymakers have sought ways to control costs while maintaining consumer satisfaction. Concurrently, there is increasing interest within the aging and disability communities in consumer-directed care. The Cash and Counseling Demonstration and Evaluation (CCDE) seeks to increase consumer direction and control costs by offering a cash allowance and information services to persons with disabilities, enabling them to purchase needed assistance. The authors present results from a telephone survey conducted to assess consumer preferences for a cash option in Arkansas and describe how findings from the four-State CCDE can inform consumer information efforts and policymakers.

Arkansas↗

Drowning among personal watercraft passengers: the ability of personal flotation devices to preserve life on Arkansas waterways, 1994-1997.

Personal flotation devices (PFD) are promoted and in many states are required for safe boating practices and to prevent drowning. Primary use of PFDs is associated with water sports (water skiing, tubing, etc.), boating and other water activities. Their purpose is to preserve life and prevent drowning. However, their effectiveness to prevent drowning and near-drowning has not been well established. The purpose of this investigation was to determine the effectiveness of PFDs to prevent drowning and near-drowning of individuals involved in personal watercraft (PWC) crashes. Methods include the 48-month collection of PWC crash data from the Arkansas Game and Fish Commission for 1994-1997. Information on PFD use, swimming experience, whether passengers were ejected from the watercraft and crash cause was queried. Results show that 38% were not swimmers, 98% wore a PFD and 54% were ejected from the PWC. Alcohol was a causal factor in six crashes and one death. It is estimated that PFDs saved 38 Arkansans who could have drowned. This study highlights one example of the effectiveness of PFDs to prevent mortality and morbidity.

Accidents↗

The use of instant medical history in a rural clinic. Case study of the use of computers in an Arkansas physician's office.

This study evaluated the acceptance of using computers to take a medical history by rural Arkansas patients. Sex, age, race, education, previous computer experience and owning a computer were used as variables. Patients were asked a series of questions to rate their comfort level with using a computer to take their medical history. Comfort ratings ranged from 30 to 45, with a mean of 36.8 (SEM = 0.67). Neither sex, race, age, education, owning a personal computer, nor prior computer experience had a significant effect on the comfort rating. This study helps alleviate one of the concerns--patient acceptance--about the increasing use of computers in practicing medicine.

Arkansas↗

Emergence of subtype strains of the Arkansas serotype of infectious bronchitis virus in Delmarva broiler chickens.

Infectious bronchitis virus (IBV) field isolates of the Arkansas (Ark) serotype were identified by reverse transcription-polymerase chain reaction (RT-PCR) as the most common serotype isolated from 1993 to 1997. These isolates were recovered from broiler flocks with respiratory disease raised on the Delmarva peninsula in spite of Ark vaccination in the region. For the purposes of investigating this apparently paradoxical finding, five RT-PCR Ark-positive field isolates recovered in 1995 and 1996 were selected for further characterization. The isolates were compared with Ark reference strains by reciprocal virus neutralization (VN) in embryonated eggs, S-1 gene sequence analysis, and challenge of immunity studies in specific-pathogen-free (SPF) chickens. Antigenic (VN) comparisons and S-1 gene analysis confirmed that the five RT-PCR Ark-positive field isolates were of the Ark serotype but also revealed that the viruses could be readily distinguished from Ark reference strains. Four of the isolates (Ark/213/96, Ark/15C/96, Ark/1529/95, Ark/1534/95) were found to have higher antigenic relatedness percentages to each other (95%-100%) than to Ark reference strains DPI (52%-72%) and Georgia variant (Georgia var) (53%-68%) by VN. Another isolate, Ark/1535/95, was found to differ antigenically from the other four RT-PCR Ark-positive field isolates (34%-61%), Ark DPI (44%), and Georgia var (43%) strains. The trends in the S-1 gene sequencing results were similar to those observed for the VN findings. Isolates Ark/213/96, Ark/15C/96, Ark/1529/95, and Ark/1534/95 demonstrated a higher degree of predicted S-1 amino acid similarity to each other (96.5%-98.7%) than to Ark DPI (92.4%-93.7%), Ark 99 (93.2%-94.7%), and Georgia var (89.3%-90.8%). Ark/1535/95 S-1 amino acid similarity values were lower compared with those of the other four RT-PCR Ark-positive field isolates (93.4%-94.8%), Ark DPI (91.9%), Ark 99 (93.0%), and Georgia var (88.7%). Furthermore, the isolates could be distinguished from the Ark reference strains by a characteristic sequence polymorphism, a six-nucleotide deletion encoding amino acids 57 (Asp) and 58 (Asp) in hypervariable region 1 of S-1. On the basis of the VN and sequencing findings, isolates Ark/213/96, Ark/15C/96, Ark/1529/95, and Ark/1534/95 were considered to be a single subtype of the Ark serotype. The fifth isolate, Ark/1535/95, may constitute another subtype of the Ark serotype. Vaccination of SPF chickens with a high-titering commercially available live vaccine containing the Ark DPI strain provided solid protection (>90%) against challenge with the RT-PCR Ark-positive field isolates. Immunization of SPF chickens with Ark/213/96 produced 100% protection against challenge with the homologous strain, as well as isolates Ark/1535/95 and Ark 99 but lower levels of protection against Ark DPI (58%) and Georgia var (55%). Primers for RT-PCR were designed to distinguish between the Ark subtypes and the Ark reference strains on the basis of the characteristic six-nucleotide deletion identified in the S-1 gene of the Ark subtypes. Retrospective analysis of RT-PCR Ark-positive isolates found that the Ark subtypes existed as early as 1992 in Delmarva broilers and became prevalent by 1995. With RT-PCR, restriction fragment length polymorphism analysis, and DNA sequencing techniques, the presence of Ark subtype viruses was demonstrated in two commercial Ark DPI strain vaccines and in our Ark DPI laboratory stocks that were the original source of the virus used for vaccine development. The demonstration of the Ark subtype and reference strains in the Ark DPI strain is evidence of the existence of IBV quasispecies. Factors possibly influencing the emergence of the Ark subtype in commercial broilers are discussed.

Animals↗

Efficacy of VectoLex WDG against Anopheles quadrimaculatus and Psorophora columbiae larvae in Arkansas and Mississippi rice.

In 1999, an aerial application of VectoLex WDG (water-dispersible granules) at 1.68 and 0.56 kg/ha, applied against sentinel 3rd-stage larvae of Psorophora columbiae installed in 0.42-ha rice plots 48 h after treatment, provided no control at 72 and 96 h after treatment. Less than 10% reduction was obtained at both rates 8 and 9 days after treatment against larvae of Ps. columbiae installed at 7 days after treatment. In a later test, VectoLex WDG manually applied at 5.04 and 1.68 kg/ha to small rice plots containing sentinel 3rd-stage larvae of Ps. columbiae and Anopheles quadrimaculatus obtained 90 and 97% control of Ps. columbiae at both rates, respectively, 24 h after treatment. A 2nd installation of Ps. columbiae at 24 h after treatment resulted in 7% and no control at both rates, respectively, even in the presence of larval carcasses from the 1st installation. VectoLex WDG was not effective against Ps. columbiae after 24 h atter treatment at either rate. Poor control was obtained at both rates against An. quadrimaculatus 24 h and 48 h after treatment for both installations. Two types of commercial rice fields containing native populations of larvae of An. quadrimaculatus were used for field tests in Cleveland, MS. In 1999, VectoLex WDG, aerially applied at 1.68 and 0.56 kg/ha to 0.2-ha plots in a contoured rice field, produced 81 and 85% reductions in early (neonate and 1st- and 2nd-stage) larvae and 94 and 76% reductions in late (3rd- and 4th-stage) larvae 2 days after treatment, respectively. At 2 days after treatment, means for all 4 developmental groupings (early larvae, late larvae, pupae, and combined stages) were significantly higher in untreated plots. Both VectoLex WDG rates did not differ significantly from one another. At 8 days after treatment, untreated plots contained significantly greater mean numbers of early larvae, late larvae, and combined stages, whereas both VectoLex WDG treatments were not significantly different. In 2000, VectoLex WDG applied at 1.68 kg/ha to two 0.40-ha plots in a precision-leveled field yielded 59 and 100% reductions of early and late larvae, respectively, 2 days after treatment. Reduction of late larvae remained 100% at 8 days after treatment. The numbers of late larvae, pupae, and combined stages were significantly greater in the untreated plot 2 days after treatment. At 8 days after treatment, numbers of early larvae and combined stages were significantly higher in the VectoLex WDG plot, whereas numbers of late larvae were significantly higher in the untreated plot. The differences in susceptibility of Ps. columbiae and An. quadrimaculatus to VectoLex WDG could be attributed to species differences in larval feeding behavior, body positioning in the water column, and developmental time. In tests in Arkansas, Ps. columbiae were controlled more quickly, usually within 24 h of exposure, whereas the percent reduction for An. quadrimaculatus in both tests in Cleveland, MS, suggests that control of this species within the region tested required from 48 h up to 8 days of exposure.

Agriculture↗

Arkansas: State supports availability of contraceptives to all persons.

With Governor Dale Bumpers' approval on March 7, Arkansas formally adopted as a state policy the availability of "all medically acceptable contraceptive procedures, supplies and information ... through legally recognized channels to each and every person desirous of the same regardless of sex, race, age, income, number of children, marital status, citizenship or motive (Act 235, Laws 1973)." The new law further declares that the dissemination of contraceptive information in state and county health and welfare departments, in medical facilities, and at institutions of higher learning is consistent with the state's public policy. The newly enacted bill, sponsored by Representative Boyce Alford, specifically gives any persone 18 and older the authority to consent to voluntary sterilization. Persons under 18 may also consent to the operation if they are married. It gives any institution, doctor, or pharmacist the right to refuse to furnish contraceptive information or supplies and it does not require them to refer the patient elsewhere for services. The bill passed the legislature by votes of 62-0 in the House on February 7 and 26-1 in the Senate on February 20.

Americas↗

Operational note effects of fipronil and lambda-cyhalothrin against larval Anopheles quadrimaculatus and nontarget aquatic mosquito predators in Arkansas small rice plots.

The effects of fipronil and lambda-cyhalothrin, applied at rates labeled for control of the rice water weevil, Lissorhoptrus oryzophilus, on 3 nontarget indigenous insect species in Arkansas rice are described. Three replicates of untreated control checks and fipronil- and lambda-cyhalothrin-treated plots containing 3 sentinel cages each were performed. Ten 4th-stage larvae of Anopheles quadrimaculatus, 10 adult Tropisternus lateralis, or 10 adult Notonecta indica were placed within individual cages in small rice plots treated with ICON 6.2 FS (fipronil) at 0.025 lb active ingredient (AI)/acre (0.028 kg/ha) or KARATEZ 2.08 CS (lambda-cyhalothrin) at 0.03 lb AI/acre (0.033 kg/ha) applied over vegetation and water with a single-boom sprayer. At 24 h after treatment in fipronil plots, significantly higher control of An. quadrimaculatus and T. lateralis (69 and 48% control, respectively) was achieved, compared to N. indica (18%). In lambda-cyhalothrin plots 24 h after treatment, 100% reductions of both T. lateralis and N. indica were highly significant (P < 0.05) from the lower level of control in An. quadrimaculatus (10%). At 48 h after treatment, no significant, differences existed between all species within fipronil plots, with An. quadrimaculatus, T. lateralis, and N. indica obtaining 41, 10, and 7% control, respectively. Significantly higher (P < 0.05) control was obtained in lambda-cyhalothrin plots 48 h after treatment, with 93 and 53% control of T. lateralis and N. indica, respectively, compared to 7% control of An. quadrimaculatus. A marked difference in susceptibility was found between selected nontarget organisms used in this study. When using lambda-cyhalothrin to control adult L. oryzophilus, populations of nontarget beneficial insects, such as T. lateralis and N. indica, could be adversely affected, whereas nontarget pestilent species, such as An. quadrimaculatus, could proliferate. Fipronil achieved higher percentages of control against An. quadrimaculatus, compared to lambda-cyhalothrin, and was less harmful to both nontarget predators.

Agriculture↗

The relationship between life expectancy and socioeconomic status in Arkansas: 1970 and 1990.

Life Expectancy at Birth is estimated for county populations in Arkansas in 1970, 1980 and 1990. Counties are grouped into quintiles at each time point according to the percent of persons below the poverty level. Comparisons are made between mean life expectancy in the highest and lowest socioeconomic group at each point in time as well as between the same group at 1970 and 1990. It is hypothesized that the high socioeconomic populations will experience an increase in mean life expectancy over the low socioeconomic populations between 1970 and 1990. Statistical analysis supports the hypothesis. These findings conform to those from earlier research in Ohio and may reflect a continuing deterioration in the relative standard of living of lower income groups in the United States subsequent to 1970.

Adolescent↗

Bone mineral density levels of college-aged women in northwest Arkansas.

Osteoporosis has affected more than 20 million American, women, completely altering their way of life. Osteoporosis is highly preventable if steps are taken to build healthy bone; however, many college students do not have lifestyle habits that have a positive effect on their bones. For this study, a questionnaire was used to investigate childhood dairy consumption, high school sport participation, dieting behaviors, eating behaviors and bone mineral density levels of college women at the University of Arkansas in Fayetteville. Eighty percent of the participants were Caucasian or of Asian descent, while 20% were of other races; 34% of the participants consumed three or more servings of milk a day as children, while current calcium consumption was at an average of 16 servings a week. Many of the participants were active in high school, as 67% participated in high school sports. Fifty-two percent of the college women in the sample had dieted in the past year, and 44% perceived they were not at a desirable weight. Forty-five percent skip more than three meals a week. Of the participants, two had osteoporosis and 23 had osteopenia. Clearly, development of osteoporosis is not limited to older adults, and college women are in need of education related to bone health.

Adult↗

Farm injuries in Arkansas 1990-2000.

Despite the shortcomings of a newspaper injury surveillance system to capture agricultural injury data, there is merit to reviewing the types of injuries occurring on Arkansas farms. Over an 11-year period, 482 cases of injuries were identified by a newspaper clipping service and entered into a database. These cases exclude injuries on ATVs. A total of 46% of the cases were fatal. Prevention starts with knowing what the hazards are and taking some action to prevent injury. This paper describes the injuries over an 11-year period and concludes with short prevention messages.

Accident Prevention↗