The American journal of tropical medicine and hygiene
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Am. J. Trop. Med. Hyg. · Mar 1986
Case ReportsJamestown Canyon virus (California serogroup) is the etiologic agent of widespread infection in Michigan humans.
In a sample population of 780 Michigan residents tested for neutralizing antibodies to California serogroup viruses, 216 (27.7%) had specific neutralizing antibody to Jamestown Canyon virus. An additional eight (1.0%) had specific neutralizing to trivittatus virus; none had specific neutralizing antibody to La Crosse virus. Significantly more male residents than female residents of the Lower Peninsula had antibody to Jamestown Canyon virus. ⋯ Among 128 sera with specific neutralizing antibody to Jamestown Canyon virus, only two (1.6%) were found to have significant hemagglutination-inhibiting antibody titers with La Crosse virus, while 23 of 44 (52%) had significant titers with Jamestown Canyon virus; a single serum had significant antibody by complement fixation tests with both La Crosse and Jamestown Canyon viruses. This study confirms earlier speculation that complement fixation and hemagglutination-inhibition tests with La Crosse virus (the only tests for California serogroup virus infections performed by most state diagnostic laboratories) fail to detect antibody to Jamestown Canyon virus. ASPEX computer-drawn maps demonstrated that the distribution of persons with antibody to Jamestown Canyon virus and residing in Michigan's Lower Peninsula is closely correlated with the estimated distribution of white-tailed deer in that part of the state, further supporting the hypothesis that white-tailed deer are the primary vertebrate host for Jamestown Canyon virus.
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Am. J. Trop. Med. Hyg. · Jan 1986
Dengue in Puerto Rico, 1977: public health response to characterize and control an epidemic of multiple serotypes.
The largest and most extensive documented dengue epidemic in Puerto Rico struck an estimated 355,000 Puerto Rican residents from July-December 1977. The mixed epidemic of dengue types 2 and 3 coincided with a Caribbean pandemic of dengue type 1, first introduced into the western hemisphere in early 1977 and into Puerto Rico in the fall of that year. ⋯ Despite co-circulation of multiple dengue serotypes, a risk factor associated with severe and fatal dengue hemorrhagic fever (DHF) in Southeast Asia, hospital and death certificate surveillance disclosed no cases of DHF in Puerto Rico. The epidemic serves as a reminder that when preventive measures are impossible or infeasible, developed countries with high living standards may be susceptible to large scale epidemics of infectious diseases.
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Am. J. Trop. Med. Hyg. · Sep 1984
Case ReportsSpider (Latrodectus hesperus) poisoning through the conjunctiva. A case report.
Spider poisoning is usually a result of the direct bite, envenomation through the chelicera, of the spider. Reported is an unusual case in which poisoning occurred through the conjunctiva when a fragment from a smashed black widow spider (Latrodectus hesperus) flew into a patient's eye. In addition to an immediate local reaction involving the periorbital tissues, the patient experienced systemic effects.
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Am. J. Trop. Med. Hyg. · May 1984
Randomized Controlled Trial Clinical TrialDoxycycline prophylaxis of travelers' diarrhea in Honduras, an area where resistance to doxycycline is common among enterotoxigenic Escherichia coli.
Daily doxycycline (DX), known to be effective prophylaxis against travelers' diarrhea (TD) in areas of the world where enterotoxigenic Escherichia coli (ETEC) are sensitive to the drug, has not been extensively studied in geographic areas where antibiotic resistance is common. Therefore we studied 44 U. S. ⋯ From the PL group, ETEC from 7 of 13 stool samples (54%) were resistant to DX, whereas from the DX group, ETEC from 10 of 11 stool samples were resistant (P less than 0.05). TD that developed in persons taking DX was also found to be less severe, as judged by length of illness (P less than 0.01) and frequency of stools (P less than 0.05). This study demonstrates that DX 1) significantly prevents TD even in areas where antibiotic resistance is common, although it does not prevent TD caused by docycycline -resistant ETEC, and 2) significantly diminishes the severity of illness.
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Am. J. Trop. Med. Hyg. · Mar 1984
Febrile illness in Malaysia--an analysis of 1,629 hospitalized patients.
We studied 1,629 febrile patients from a rural area of Malaysia, and made a laboratory diagnosis in 1,025 (62.9%) cases. Scrub typhus was the most frequent diagnosis (19.3% of all illnesses) followed by typhoid and paratyphoid (7.4%); flavivirus infection (7.0%); leptospirosis (6.8%); and malaria (6.2%). ⋯ In rural Malaysia, therapy with chloramphenicol or a tetracycline would be appropriate for undiagnosed patients in whom malaria has been excluded. Failure to respond to tetracycline within 48 hours would usually suggest a diagnosis of typhoid, and indicate the need for a change in therapy.