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Biomedical subjects

C P Pattison

Publications and source records attributed to C P Pattison.

At least 19 recordsLinked to original sources

Proposed link between Helicobacter pylori and sudden infant death syndrome.

Helicobacter pylori may be linked to sudden infant death syndrome (SIDS) through synthesis of inflammatory cytokines, particularly interleukin-1, which can produce fever, activation of the immune system, and increased deep sleep. A relatively minor respiratory or enteric infection, together with overwrapping and prone sleep position could then induce terminal hypoxemia. Alternatively, H. pylori produces large amounts of urease which, if aspirated in gastric juice, could reach the alveolae, react with plasma urea, and produce ammonia toxicity leading to respiratory arrest. Epidemiological similarities between H. pylori and SIDS are presented along with possible transmission mechanisms for H. pylori which support this hypothesis.

Helicobacter Infections↗

Tick-borne relapsing fever: an interstate outbreak originating at Grand Canyon National Park.

During the 1973 summer season, 27 employees and 35 overnight guests at the North Rim, Grand Canyon National Park, Arizona, acquired febrile illnesses compatibel with relapsing fever. Sixteen cases were confirmed by finding Borrelia spirochetes in peripheral blood smears or inoculated Swiss mice. Retrospective surveys of 278 employees and 7247 guests at the park revealed that acquisition of illness was significantly associated with the persons sleeping in rustic log cabins and acquiring bites of "unknown" insects. From rodent nesting materials found in the walls and attics of cabins where cases had occurred, infective Ornithodoros hermsi ticks were recovered. Exceptional activity of ticks in human populations appeared to have resulted from a decreased population of the ticks' usual rodent hosts. Vector control activities consisted of spraying the cabins with residual insecticide, removing nesting materials, and "rodent proofing." This outbreak, the largest yet identified in North America, extends the known range of a principal vector and establishes the North Rim as an endemic source of tick-borne relapsing fever.

Adult↗

Viral hepatitis--a primer: 1. Epidem.iology.

Hepatitis A is most often transmitted by the fecal-oral route under conditions of crowding, poor hygiene, and prolonged exposure to infected persons. Direct spread of hepatitis B via person-to person contact has only recently been proved. Hepatitis B is usually transmitted indirectly proved. Hepatitis B is usually transmitted indirectly by percutaneous routes, and the increase in drug abuse has brought about a change in its epidemiologic pattern.

Adolescent↗

Viral hepatitis--a primer. 2. Prevention and control.

The clinical differentiation of hepatitis A from hepatitis B is often impossible, and only a finding of hepatitis B surface antigen in blood allows the presence of hepatitis B to be definitely diagnosed. Heaptitis A is most easily contracted via the fecal-oral route, while hepatitis B is usually transmitted percutaneously, especially by inoculation with contaminated instruments. Because viral hepatitis has a long incubation period, controlling its spread is difficult. Prevention and control have traditionally depended on general public health measures, and for hepatitis A, passive immunization with immune serum globulin. Promising research is now being conducted to develop vaccines for both active and passive immunization against hepatitis B.

Disinfection↗

An outbreak of type B hepatitis associated with transfusion of plasma protein fraction.

An outbreak of type B hepatitis followed transfusion with a single lot of plasma protein fraction (PPF) at a 1200-bed hospital in June and July 1973. Of 51 recipients of the product, 31 were available as a study population and 19 (61%) had an illness compatible with hepatitis. Epidemiologic and serologic investigations provided firm evidence that this material was the vehicle for transmission of disease to its recipients. Recipients of four other PPF lots from the same manufacturer were studied. Two of these lots were also associated with extremely high clinical hepatitis attack rates (45% and 55%). The other two lots, which had been prepared from donor plasma contributing to the composition of the initially-studied PPF lot, failed to produced clinical illness, although one of these lots was associated with a high prevalence of hepatitis B seropositivity in recipients. Thus, a broad spectrum of clinical and serologic responses was evident in PPF produced from similar donor plasma and pasteurized in the same bulk container. This study is the first to incriminate heat-treated PPF in transmission of type B hepatitis and suggests the need for further studies of the effect of pasteurization cycles on inactivation of hepatitis B virus.

Antibodies, Viral↗

Dental infection with hepatitis B.

We performed a prospective study to assess the risk of patients acquiring infection following routine professional contact with two dentists incubating type B viral hepatitis. Serum samples from patients exposed during the six weeks before onset of hepatitis in the dentists were tested for hepatitis B surface antigen and for antibody to the antigen shortly after illness developed and again six months later. Household members of exposed patients served as a control group. None of the exposed patients or controls became ill with hepititis, and none developed antigen. Three of the 237 exposed patients developed antibody, as did four of the 245 controls. The difference between exposed patients and controls was not significant. These results do not support the hypothesis that these two dentists transmitted infection to their patients.

Carrier State↗

An outbreak og gastroenteritis due to E. coli 0142 in a neonatal nursery.

A nursery outbreak of gastroenteritis casued by Escherichia coli 0142/K86/H6 is described. Over a period of nine months, 59 epidemiologically linked cases of diarrhea occurred, including 21 intractable cases with four deaths. The epidemic strain, which was not agglutinated by commerical diagnostic antisera, was isolated from the hands of personnel in five instances directly incriminated hand carriage as the mode of spread. Acquisition of illness, which was especially high among low-birth-weight infants less than 17 days old, did not correlate with any treatment modality investigated and appeared to be related to a host factor. Noninvasive small intestinal colonization, production of enterotoxin, and multiple antibiotic resistance of the epidemic strain were demonstrated and helped to explain the intractability of clinical illness in many infants, despite intensive parenteral antibiotic therapy. Surveys of fecal coliforms on the hands of nursery personnel revealed no change in prevalence after introduction of a policy of "triple" handwashing with 3 percent hexachlorophene soap, but a significant decrease occurred during the use of disposable gloves. The frequent occurrence of E. coli 0142 in throat swabs of affected infants suggested that pharyngeal colonization may serve as an important diagnostic clue in E. coli diarrhea.

Age Factors↗

Hepatitis A: report of a common-source outbreak with recovery of a possible etiologic agent. I. Epidemiologic studies.

From the end of October to the end of December 1973, an epidemic of hepatitis A affected 40 students at a state university, 11 employees of two restaurants, and 11 other residents in a southwestern metropolitan community. Two distinct epidemic waves of illness occurred, and investigation implicated two local restaurants as sources of infection, one for each epidemic wave. An index patient who prepared food was identified at each restaurant, and the two restaurants were linked by the fact that the index patient who worked at the second restaurant had patronized the first restaurant. Foods implicated as vehicles of transmission included 'guacamole,' green salad, spaghetti, and hamburger. The findings represent a rare example of a 'double' common-source outbreak with two distinct epidemic waves related to two separate eating establishments.

Arizona↗

Epidemiology of hepatitis B in hospital personnel.

To identify occupational categories and work areas of possible risk for acquisition of nosocomial hepatitis B by hospital personnel, serologic sampling for hepatitis B surface antigen (HBSAg) and antibody (anti-HBS) by radioimmunoassay was carried out in 513 employees of a large metropolitan hospital serving predominantly indigent patients. HBSAg was detected in 0.7%, HBSAg and anti-HBS in 0.4%, and anti-HBS in 13.3% of the study population. No significant difference in seropositivity was noted between sexes. Furthermore, neither exposure to patients with hapatitis nor previous blood transfusion correlated with serologic evidence of hepatitis B infection. However, frequency and intensity of exposure to blood products was associated with serologic evidence of infection: 18.9% of those with frequent blood contact were positive for HBSAg or anti-HBS, compared with 11.4% of those without blood product exposure (p less than .05). Direct patient contact, apart from blood exposure, did not appear operative as a major factor in hepatitis B transmission in this population. Accordingly, occupational categories and work areas with highest risk for acquisition of nosocomial hepatitis B were those with greatest blood exposure.

Adult↗