Minnesota Department of Health--Suggestions for medical screening of Southeast Asian refugees.
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Biomedical subjects
Publications and source records attributed to A G Dean.
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Results from a prospective sero-epidemiological study initiated in Uganda in 1971 indicate that children with high antibody titres to Epstein-Barr virus structural antigens are at high risk of developing Burkitt's lymphoma. These findings strongly support a causal relationship between the Epstein-Barr virus and Burkitt's lymphoma but suggest that the oncogenic potential of the virus is realised only in exceptional circumstances.
An outbreak of histoplasmosis occurred at a county courthouse in Arkansas in July, 1975. Fifty cases were identified by symptoms and positive complement fixation (CF) tests and 18 others by the clinical findings alone. Only three positive CF tests (greater than or equal to 1:8) were found in a control group of 55 unexposed persons of the same age. The attack rate for 84 courthouse employees was 52%. Histoplasma capsulatum was isolated from the sputum of two cases, and from bird droppings which had been dumped from the roof of the courthouse two weeks before the epidemic's peak. Window air conditioners apparently helped to distribute infectious particles throughout the building. Nine exposed people had pulmonary calcifications and a negative tuberculin test that were taken as presumptive evidence of previous histoplasmosis. Five (55%) of these became ill. Exposed persons without pulmonary calcifications had an attack rate of 85%. The reinfected cases during convalescence had higher serum CF titers but not larger histoplasmin skin test diameters than the rest of the cases. A microdroplet aerosol of cooking oil was used to simulate air flow patterns during the exposure, and the results agreed with the hypothesized means of infection.
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Antibody titers for viral capsid antigens of all four human herpesviruses were measured by immunofluorescence in the sera of 16 Burkitt's lymphoma (BL) PATIENTS, 16 AGE-, SEX-, AND LOCALITY-MATCHED CONTROLS, AND 136 FAMILY MEMBERS FROM THE West Nile District of Uganda. Among family members, titers greater than 1:4 were found in 98% for herpes simplex virus (HSV), 86% for varicella-zoster virus (VZV), 100% FOR CYTOMEGALOVIRUS (CMV), AND 94% FOR Epstein-Barr (EBV). Titers in patients averaged approximately equal to 2 logs (fourfold) higher than those in matched controls for EBV, VZV, and CMV (P EQUALS 0.001); titers for HSV were only slightly higher in cancer patients. The mothers of patients had someuhat higher EBV titers (0.05 smaller than or equal to P SMALLER THAN OR EQUAL TO 0.01) than the mothers of controls, but no other differences between patient and control families were found. By immunofluorescence, a method which apparently has not been used for all four human herpesviruses in BL patients, the patients had elevated antibody titers not only to EBV but also to CMV and VZV. The elevated titers to three of the four human herpesviruses were not due to serologic cross reactions.