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Biomedical subjects

A F Kaufmann

Publications and source records attributed to A F Kaufmann.

At least 19 recordsLinked to original sources
PubMed1999

Principles for emergency response to bioterrorism.

The recent occurrence of a series of anthrax-related hoaxes illustrates the need to educate emergency services personnel about how to best ensure patient and worker safety in the case of suspected exposure to biological threat agents. There are very few data to support the methods being used or the variation in current care. Emergency physicians, first responders, and hazardous materials response teams need a standardized approach to the management of patients who may have been exposed to biological threat agents. Currently recommended hospital infection control procedures seem appropriate for the level of risk involved with aerosolized biological threat agents. Such recommendations include standard and transmission-based precautions. These groups need a working knowledge of the isolation and infection control measures recommended for the treatment of patients exposed to those biological threat agents at outlined in the Centers for Disease Control and Prevention Guideline for Isolation Precautions in Hospitals.

Biological Warfare↗
PubMed1999

Further determination of DNA relatedness between serogroups and serovars in the family Leptospiraceae with a proposal for Leptospira alexanderi sp. nov. and four new Leptospira genomospecies.

DNA relatedness was determined among 303 strains of Leptospira and Leptonema. Included in the analysis were reference strains from 228 well-characterized and recognized serovars. The study included 268 serovars from 29 named and one or more unnamed serogroups. The strains clustered into 17 DNA hybridization groups, representing 12 previously described species (292 strains) and five new genomospecies (11 strains). The largest groups included Leptospira interrogans (91 strains from 82 serovars), Leptospira santarosai (65 strains from 59 serovars), Leptospira borgpetersenii (49 strains from 43 serovars), Leptospira kirschneri (29 strains from 26 serovars) and Leptospira noguchii (20 strains from 20 serovars). The new genomospecies include Leptospira genomospecies 1 (two strains, serovars pinagchang and sichuan), Leptospira genomospecies 2 (six strains, serovars lushui, manhao 3, manzhuang, nanding, mengla and yunnan), Leptospira genomospecies 3 (one strain, serovar holland), Leptospira genomospecies 4 (one strain, serovar hualin) and Leptospira genomospecies 5 (one strain, serovar saopaulo). With the exception of Ballum, all serogroups with greater than one serovar studied were genetically heterogeneous. Phenotypic tests, including optimal growth temperature, lipase activity and growth inhibition by copper sulfate or 2,6-diaminopurine, were of little use in differentiating DNA relatedness groups. The name Leptospira alexanderi sp. nov. is proposed for Leptospira genomospecies 2 (type strain L 60T = ATCC 700520T, serovar manhao 3).

Animals↗
PubMed1993

Hantavirus infection--southwestern United States: interim recommendations for risk reduction. Centers for Disease Control and Prevention.

This report provides interim recommendations for prevention and control of hantavirus infections associated with rodents in the southwestern United States. It is based on principles of rodent and infection control and contains specific recommendations for reducing rodent shelter and food sources in and around the home, recommendations for eliminating rodents inside the home and preventing them from entering the home, precautions for preventing hantavirus infection while rodent-contaminated areas are being cleaned up, prevention measures for persons who have occupational exposure to wild rodents, and precautions for campers and hikers.

Animals↗
PubMed1993

Outbreak of leptospirosis associated with swimming.

Between July 7 and 18, 1991, five boys from a small town in rural Illinois experienced the onset of an acute febrile illness subsequently confirmed as leptospirosis by serologic tests. A cohort study found that swimming in a small swimming hole, Steel Tunnel Pond, was associated with disease (P < 0.01), the attack rate being 28%. Leptospira interrogans serovar grippotyphosa was isolated from urine cultures from two of the case patients and from a culture of Steel Tunnel Pond water. A high seroprevalence for grippotyphosa was found in animals near the pond. Drought conditions had been present in the month before the outbreak, creating an environment in the pond which probably facilitated transmission of the organism from area animals to humans. Although leptospirosis is infrequently reported in humans in the United States, it is endemic in animals and the potential for outbreaks exists, especially when environmental conditions are favorable.

Adolescent↗
PubMed1989

Evaluation of serologic tests for diagnosis of anthrax after an outbreak of cutaneous anthrax in Paraguay.

An outbreak of at least 21 cases of cutaneous anthrax occurred in rural Paraguay. A case-control study revealed that disease was associated with touching the raw meat of an ill cow (odds ration = 16.5, P = .02). Serum drawn from 12 cases and 16 colony and 2 noncolony controls 6 w after the outbreak were analyzed by electrophoretic-immunotransblots (EITB) to detect serum antibodies to the protective antigen (PA) and lethal factor components of anthrax toxin. Serum was also tested by enzyme-linked immunosorbent assay (ELISA) for the presence of antibodies to poly-D-glutamic acid capsule. Of 12 cases, 11 had a positive PA screen, for a sensitivity of 91.7% (76.1%-100%, 95% confidence interval [CI]) whereas none of the 18 controls was positive for a specificity of 100% (84.8%, one-sided binomial 95% CI). Only 6 (50%) of 12 cases (21.7%-78.3%, 95% CI) had positive lethal factor titers; all controls were negative. At a cutoff of greater than or equal to 1:32 for antibodies to capsule, 11 (91.7%) of 12 (76.1%-100%, 95% CI) were positive; 16 (88.9%) of 18 controls (74.5%-100%, 95% CI) were negative. These data suggest that the EITB for detection of antibody to PA, and ELISA for detection of anticapsule antibodies are both sensitive for the retrospective diagnosis of anthrax. Both tests were specific, but EITB may be more so than ELISA.

Animals↗
PubMed1989

Determination by enzyme-linked immunosorbent assay of immunoglobulin G (IgG), IgM, and IgA to Brucella melitensis major outer membrane proteins and whole-cell heat-killed antigens in sera of patients with brucellosis.

An enzyme-linked immunosorbent assay was used to compare Brucella melitensis major outer membrane proteins (MOMP) and whole-cell heat-killed antigens (HK) in measuring antibrucella immunoglobulin G (IgG), IgM, and IgA in sera of brucellosis patients and controls. Antibodies to MOMP were generally similar to those against HK, and the correlation coefficients between the two antigens and IgG, IgM, and IgA in patients varied between 0.73 and 0.94. Both antigens are comparably suitable in detecting antibrucella immunoglobulin isotypes for the serologic diagnosis of patients with brucellosis, with high (greater than or equal to 95%) sensitivity and specificity.

Agglutination Tests↗
PubMed1986

Enzyme-linked immunosorbent assay with major outer membrane proteins of Brucella melitensis to measure immune response to Brucella species.

We developed an enzyme-linked immunosorbent assay (ELISA) system to measure human immunoglobulin G (IgG) and IgM response to the major outer membrane proteins of Brucella melitensis. The ELISA was more sensitive in detecting antibody than a standard microagglutination (MA) test with B. abortus antigen. Of 101 sera from persons with suspected brucellosis, 79 (78.2%) gave ELISA IgM titers greater than or equal to the B. abortus MA titer without 2-mercaptoethanol (2ME), which measures both IgM and IgG. Of the 101 sera, 97% gave ELISA IgG titers greater than or equal to the MA with 2ME titer. A total of 58 sera, drawn from 11 human patients from 1 to 29 weeks after onset of brucellosis, gave higher geometric mean titers for the ELISA IgG test than for the MA with 2ME test. These 58 sera also gave ELISA IgM geometric mean titers that were greater than or within one doubling dilution of the geometric mean titers of MA without 2ME. In addition to detecting antibody response to B. abortus, B. melitensis, and B. suis, the ELISA was sensitive to antibody response to human and canine infections with B. canis. The B. canis antibody response is not detected by the MA test with B. abortus antigen. The ELISA, with a standard preparation of major outer membrane proteins of B. melitensis as antigen, appears to be useful in measuring antibody response in humans to infections by all species of Brucella known to infect humans.

Agglutination Tests↗
PubMed1985

Borreliosis in dogs from southern Connecticut.

Blood samples were obtained from dogs in tick-infested regions of southern Connecticut to assess canine exposure to Borrelia burgdorferi, the etiologic agent of Lyme disease in human beings. An indirect fluorescent antibody test detected immunoglobulin (Ig)M antibodies at titers of 1:64 to 1:512 in 22 of 84 serum samples previously shown to be positive with a polyvalent rabbit anti-dog total Ig conjugate. Analyses of paired serum samples from 20 seropositive dogs revealed temporal differences in titers; changes occurred during brief (1 month) or extended (greater than 4 years) sampling periods. Clinical records for 52 seropositive dogs indicated a history of intermittent lameness in 19 of these. Limb/joint disorders typically developed in dogs without IgM antibodies, suggesting manifestation during later phases of illness. A microscopic-agglutination test was used to assess cross reactivity between B burgdorferi and 20 serovars of Leptospira interrogans and biflexa. Analyses of 63 dog serum specimens with antibodies to B burgdorferi and a series of reference rabbit sera revealed minor antigenic relatedness. There was geographic clustering of dogs with antibodies to B burgdorferi in areas of south-central and southeastern Connecticut, where human Lyme disease also occurs.

Animals↗
PubMed1984

Unpasteurized milk. The hazards of a health fetish.

Meaningful differences in nutritional value between pasteurized and unpasteurized milk have not been demonstrated, and other purported benefits of raw milk consumption have not been substantiated. Conversely, the role of unpasteurized dairy products in the transmission of infectious diseases has been established repeatedly. To effectively counsel patients attracted by the health claims made for raw milk, practicing physicians must understand both the rationale used by proponents of raw milk and the magnitude of the risk involved in drinking raw milk.

Animals↗
PubMed1984

Psittacosis. A diagnostic challenge.

In the absence of recognized pneumonitis, psittacosis is unlikely to be considered as a cause of infection in patients with febrile illnesses. To identify findings useful in the diagnosis of psittacosis, the clinical and roentgenographic characteristics of 46 cases that occurred in two outbreaks among workers in turkey processing plants were reviewed. Headache (96% of patients), chills (93% of patients), and fever (89% of patients) were the most common symptoms; a nonproductive cough occurred in 65% of patients. Rales or rhonchi were detected in only six (18%) of 33 patients examined, but 21 (72%) of 29 patients receiving a chest film had roentgenographic evidence of pneumonia. We conclude that few diagnostically useful symptoms or signs occur in patients with psittacosis but that roentgenographically confirmed pneumonitis may occur commonly in patients with little clinical evidence of pneumonitis. A history of exposure to birds, in an individual with a flu-like illness, appears to be the single best clue to the diagnosis of psittacosis.

Acute Disease↗
PubMed1983

Clinically mild tularemia associated with tick-borne Francisella tularensis.

Between May 9 and July 3, 1979, 12 cases of glandular or ulceroglandular tularemia occurred in residents of the Crow Indian Reservation in southcentral Montana; only 13 cases had been reported from this geographic area in the preceding 25 years. The illness was mild, characterized by fever and cervical or occipital adenopathy. Systemic symptoms were self-limited although residual lymphadenopathy was common. Francisella tularensis was isolated from ticks (Dermacentor variabilis), the suspected vector. The strains of F tularensis did not ferment glycerol and thus were identified as type B rather than the more virulent type A. None of 83 adults hospitalized in an urban area 50 miles from the reservation had agglutination titers of antibody to F tularensis of greater than or equal to 1:40 compared with eight of 77 patients at the reservation hospital (P less than 0.01). Mild tularemia in reservation residents may have gone unrecognized; similar illness due to type B F tularensis may occur elsewhere.

Adult↗
PubMed1983

Human Campylobacter infection associated with certified raw milk.

Between May 27 and June 18, 1981, 50 individuals in 30 households in suburban Atlanta, Georgia, had a gastrointestinal illness caused by Campylobacter jejuni. Epidemiologic evidence strongly associated consumption of unpasteurized milk with illness. A culture survey confirmed fecal carriage of C. jejuni by cows in the implicated dairy and in a control dairy, but failed to document presence of the organism in the milk. The standard plate counts and leukocyte counts (two indicators of microbiologic quality of milk), facilities, and operating procedures at the implicated dairy were all within accepted levels for production of Grade A raw milk in Georgia. Inasmuch as the parameters used by regulatory officials to determine the wholesomeness of milk were not violated at the implicated dairy, the only means available to ensure the public's health would be proper pasteurization before consumption.

Adult↗
PubMed1983

Granulomatous pleuritis caused by Francisella tularensis: possible confusion with tuberculous pleuritis.

Granulomatous pleuritis, diagnosed by pleural biopsy, is rarely caused by disease processes other than tuberculosis. We present a case of granulomatous pleuritis caused by Francisella tularensis that occurred in a 55-yr-old male sheep shearer with an exudative, lymphocytic, pleural effusion. Confirmation of the diagnosis was made by elevated serum agglutination titers against F. tularensis and detection of the organism in a pleural biopsy specimen by the glucose oxidase immunoenzyme technique. We conclude that F. tularensis, not previously described as a cause of granulomatous pleuritis, must be considered in the differential diagnosis of granulomas found in pleural biopsy specimens.

Biopsy↗
PubMed1982

Peripatetic plague.

Cases of plague continue to occur in various parts of the world, including the western United States, where plague is endemic among the wild rodent population. In 1980, a case of plague acquired in New Mexico and hospitalized in Nebraska illustrated the problem of plague occurring in persons traveling from the state in which they become infected to another state. Nine cases of plague in travelers were identified among the 166 cases of plague reported in the United States from 1950 to 1980. Physicians should be aware of natural plague foci in the western United States and should obtain a travel history from patients with an illness clinically compatible with plague.

Adolescent↗
PubMed1982

Mycotic infections of the alimentary tract of nonhuman primates: a review.

Lesions of candidiasis, mucormycosis (phycomycosis), entomophthoramycosis, geotrichosis, cryptococcosis, paracoccidioidomycosis and coccidioidomycosis have been reported in the alimentary tract of nonhuman primates. Candidiasis and mucormycosis were reported most often. Both Old and New World monkeys and great apes are susceptible; infection is rare in prosimians. Ulcers and necrosis of the mucosa of the alimentary tract are the principal gross lesions. A granulomatous inflammatory process occurs in which the fungi are visible histologically on hematoxylin and eosin (HE)-stained sections, but they are seen and characterized better when stained with periodic acid-Schiff (PAS) or Gomori methenamine silver (GMS) techniques. Cultural or immunofluorescence studies, or both, are necessary for specific identification of the fungi. Immunosuppression is suggested as a predisposing factor in certain mycotic diseases.

Animals↗