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We tested infants and preschool-age children from the New Orleans Health Department programs for tuberculosis contact investigation and for tuberculin skin testing. About 7.8% (34 of 438) of the contacts and about 0.78% (107 of 13,797) of those given skin tests were tuberculosis-infected. Both programs, we concluded, detected enough recent tuberculous infection to be worthwhile as screening procedures.
The New Orleans Health Department still investigates the contacts and suspected contacts of patients with tuberculosis, although it has stopped some tuberculosis control programs as unproductive. To determine whether contact investigation is worthwhile, in 1974 we sampled 1,110 men, women, infants, and children who had proved (391) or suspected (719) contact with a tuberculous patient. Nineteen percent (215 out of 1,110) of these contacts examined had tuberculous infections (reflected by positive skin tests). Seven (0.63%) also had pulmonary tuberculosis. We concluded that contact investigation effectively identified residents of New Orleans who were at risk of tuberculosis and the program should be continued.
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Residents returning home after natural disasters face numerous physical, mental, and social challenges. Seven weeks after Hurricane Katrina struck the New Orleans area in Louisiana, causing levees to break and large sections of the city to flood, local authorities had reopened most of Jefferson Parish and much of Orleans Parish to residents. To identify health-related needs among returning parish residents, state and local public health and mental health agencies and CDC conducted an assessment of living conditions, access to basic services, and physical and mental health status. This report describes the results of that assessment, which determined that, approximately 7 weeks after Hurricane Katrina made landfall, 20.2% of housing units lacked water, 24.5% had no electricity, 43.2% had no telephone service, and 55.7% of households contained one or more members with a chronic health condition. In addition, 49.8% of adults exhibited levels of emotional distress, indicating a potential need for mental health services. As a result of these findings, the Louisiana Office of Mental Health established a crisis-counseling program to provide interventions and support to hurricane survivors. Community assessments after natural disasters can identify health-related needs and guide public health interventions.
Monthly sampling of tire pile populations of Aedes albopictus (Skuse) in Orleans Parish, New Orleans, LA, was done in 1995 to determine prevalence of ascogregarine parasites and changes in wing length. Prevalence of Ascogregarina taiwanensis (Lien & Levine) infection was 100% in midsummer and decreased in the fall and spring (60-70%). Wing lengths were longest in the spring and fall and shortest in midsummer. We evaluated the effect of A. taiwanensis infections under high and deficient levels of leaf litter nutrients on mortality, development time, wing length, and reproductive potential of a New Orleans strain of Ae. albopictus. Parasitism and deficient nutrients caused a 35% increase in the rate of larval mortality and significantly extended the development time of females. Parasitized adults were 5% smaller and produced 23% fewer eggs than unparasitized siblings. In addition, abnormal Malpighian tubule morphology and melanization of ascogregarines were seen in adults from nutrient-deficient microcosms. We conclude that ascogregarine infections affect the dynamics of Ae. albopictus by increasing the mortality of immature stages when nutrients supplies are scarce, and by decreasing the reproductive capacity of females under high nutrient conditions.
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Abdominal aortas from 78 Guatemalan men and 79 New Orleans white men were examined for lipid composition and for the extent of grossly visible atherosclerotic lesions. In the specimens examined, atherosclerotic lesions were more extensive in New Orleans than in Guatemala, confirming findings of studies performed 10 and 20 years earlier. Lipid accumulation differed greatly between the geographic locations with new Orleans specimens having more chemically determined lipids. Differences in lipid accumulation between New Orleans and Guatemala are more striking when expressed in terms of content (milligrams per 100 square centimeters than when expressed as concentration (milligrams per gram of dry defatted weight). Chemical analyses indicate that lipid accumulation in the aorta results principally from the atherosclerotic process rather than from aging. In the 15- to 24-year age group, the gross extent of fatty streaks was similar in both populations, but content and concentration of free cholesterol was significantly higher in New Orleans specimens than in Guatemalan specimens. This finding might be related to the more extensive development of raised lesions at later ages in New Orleans subjects.
In New Orleans, the elementary school system is divided into attendance districts with established boundaries that define student enrollment among schools. This study concerns environmental quality as defined by amount of soil metals (Pb, Zn, Cd, Ni, Mn, Cu, Co, Cr, and V) in attendance district elementary school communities (n = 111) paired with learning achievement as measured by individual test scores (n = 32,741) of students enrolled at each school. The Louisiana Educational Assessment Program (LEAP) 4th grade scores measure learning achievement for English language arts, social studies, mathematics, and science. The best fit between environmental quality and higher learning achievement is found to be inversely associated with the sum of the metals or multiple metal accumulations (MMA) in New Orleans communities. The P values for MMA partitions for ELA, SOC, MAT, and SCI are 0.57 x 10(-7), 0.29 x 10(-8), 0.41 x 10(-6), and 0.17 x 10(-8), respectively. Efforts to prevent childhood metal exposure should improve New Orleanians' learning achievement as measured by the LEAP scores and thereby enhance the socioeconomic situation in contaminated communities. This study establishes global relationships between LEAP scores in schools and soil metal concentrations in school neighborhoods. However, these data do not allow relating of the LEAP scores with metal levels for individual students.
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Rates for pediatric cancer in the Greater New Orleans area were compared with rates from the National Cancer Institute's SEER (Surveillance, Epidemiology, and End Results) Program. The same patterns observed nationally were seen in New Orleans over a 10-year period. Rates were comparable with the exception of cancers of the brain and central nervous system for which New Orleans children displayed higher rates. Using the large number of cases in the SEER Program, three etiological patterns of childhood cancer were apparent based on the age at diagnosis.
In New Orleans, LA prior to hurricane Katrina 20-30% of inner-city children had elevated blood Pb levels > or =10 microg/ dL and 10 census tracts had a median surface soil level of Pb >1000 mg/kg (2.5 times the U.S. standard). This project tests the feasibility of transporting and grading contaminated properties (n = 25) with 15 cm (6 in.) of clean Mississippi River alluvium from the Bonnet Carré Spillway (BCS) (median soil Pb content 4.7 mg/kg; range 1.7-22.8). The initial median surface soil Pb was 1051 mg/kg (maximum 19 627). After 680 metric tons (750 tons) of clean soil cover was emplaced on 6424 m2 (69 153 ft2), the median surface soil Pb decreased to 6 mg/kg (range 3-18). Interior entrance wipe samples were collected at 10 homes before and after soil treatment and showed a decreasing trend of Pb (p value = 0.048) from a median of 52 microg/ft2 to a median of 36 microg/ft2 (25th and 75th percentiles are 22 and 142 microg/ft2 and 12 and 61 microg/ft2, respectively). Average direct costs for properties with homes were $3,377 ($1.95 per square foot), with a range of $1,910-7,020, vs $2,622 ($0.61 per square foot), with a range of $2,400-3,040 for vacant lots. Approximately 40% (86,000) of properties in New Orleans are in areas of >400 mg Pb/kg soil and estimated direct costs for treatment are between $225.5 and $290.4 million. Annual costs of Pb poisoning in New Orleans are estimated at approximately $76 million in health, education, and societal harm. Urban accumulation of Pb is an international problem; for example, the new Government of Norway established a policy precedence for an isolated soil cleanup program at daycare centers, school playgrounds, and parks to protect children. New Orleans requires a community-wide soil cleanup program because of the extent and quantity of accumulated soil Pb. The post-Katrina benefits of reducing soil Pb are expected to outweigh the foreseeable costs of Pb poisoning to children returning to New Orleans.
Last year, the city of New Orleans, LA, was spared what could have been one of the greatest tragedies to ever befall a major American city. In September, Hurricane Georges, which had caused hundreds of deaths and massive destruction in the Caribbean, was heading straight toward New Orleans. The vicious storm had the strength to potentially submerge the low-lying city, protected only by levees. Although New Orleans escaped serious damage when Georges veered off at the last moment, the threat posed by the hurricane resulted in a massive evacuation. More than 1.5 million people were ordered or urged to vacate the city and coastal Louisiana, though not all complied. About 10,000 people took shelter in the Superdome, home of the New Orleans Saints, while thousands more filled other designated shelters in the city. At local hospitals, people took refuge in offices, waiting rooms, conference rooms, hallways, and any other space available. In this report, we'll give details on how six hospitals and health facilities prepared to meet the hurricane, how they fared during the emergency, and how their disaster plans worked. Three of them are covered in this month's issue.