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Biomedical subjects

C T Caraway

Publications and source records attributed to C T Caraway.

10 recordsLinked to original sources
PubMed1983

Cholera on a Gulf Coast oil rig.

A single case of severe diarrhea on a floating Texas oil rig was followed two days later by what proved to be the largest outbreak of cholera in the United States in over a century. After isolation of toxigenic Vibrio cholerae El Tor Inaba of the typical United States phage type from the index patient's stool, the ensuing investigation detected 14 additional cases of cholera and one asymptomatic infection serologically. Infection was associated with eating rice on the oil rig on a particular day (P = 0.03) when an open valve permitted the rig's drinking-water system to be contaminated by canal water containing sewage (including that from the index patient) discharged from the rig. The rice had been rinsed in the contaminated water after cooking, and before being served it had been maintained at a temperature that allows V. cholerae 01 to multiply. Toxigenic V. cholerae 01 is persisting in the United States, and large common-source outbreaks of cholera can occur if proper sanitation is not maintained.

Adult↗
PubMed1983

Isolation of nontoxigenic Vibrio cholerae O1 from a human wound infection.

Vibrio cholerae serotype O1 organisms that do not produce cholera toxin and, in fact, lack the genetic material encoding the enterotoxin have recently been detected in coastal regions of the United States. Although these organisms have been assumed to be nonpathogenic, they have been considered a potential reservoir of toxigenic V. cholerae. In 1979, nontoxigenic V. cholerae O1 was isolated from a leg wound of an accident victim residing in New Orleans. The only known risk factors of the patient, besides his debilitated condition, were alcoholism and the consumption of raw oysters before recognition of his wound infection. Coincident with the identification of the isolate from the leg wound, an identical nontoxigenic V. cholerae O1 isolate was cultured from the sewage system serving the residence of this patient. Nontoxigenic V. cholerae O1 seems to be capable of multiplying in human tissue and may produce extraintestinal infection. This indigenous inhabitant of temperate coastal regions may not be avirulent and may be of public health significance.

Cholera↗
PubMed1980

Cholera--a possible endemic focus in the United States.

In September and October 1978, after a case of cholera had been discovered in southwestern Louisiana, 10 more Vibrio cholerae O-Group 1 infections were detected in four additional clusters. All 11 infected persons had recently eaten cooked crabs from five widely separated sites in the coastal marsh, and a matched-triplet case-control study showed a significant relation between cholera and eating such crabs (P = 0.007). V. cholerae O1 was isolated from estuarine water, from fresh shrimp, from a leftover cooked crab from a patient's refrigerator, and from sewage in six towns, including three without identified cases. All isolates in Louisiana and an isolate from a single unexplained case in Texas in 1973 were biotype El Tor and serotype inaba; they were hemolytic and of a phage type unique to the United States--suggesting that the organism persisted undetected along the Gulf Coast for at least five years.

Adolescent↗
PubMed1979

Viral hepatitis associated with day-care centers.

From September 1976 through March 1978, we investigated 11 outbreaks of non-B viral hepatitis associated with Louisiana day-care centers. The outbreaks included 168 cases, most of which were erroneously considered "sporadic" cases of non-B viral hepatitis prior to the investigations. Thirteen percent of all non-B viral hepatitis cases reported in the New Orleans metropolitan area during 1977 were associated with one of the outbreaks. Most of the cases in each outbreak and 85% overall were in older, usually adult, contacts of children attending the day-care centers. Within the household, parents appeared to be at greatest risk, particularly those who had 1- to 2-year-old children in the day-care center. Day-care center outbreaks of non-B hepatitis are easily overlooked and may be more widespread than is currently appreciated.

Adolescent↗
PubMed1976

Oyster-associated hepatitis: lessons from the Louisiana experience.

An outbreak of oyster-associated hepatitis occurring in Louisiana during the months of October and November 1973 has been shown to be related directly to two similar outbreaks occurring at the same time in Houston, Texas and Calhoun, Georgia. Oysters incriminated in all three outbreaks were traced to approved oyster growing areas along the east Louisiana coast. Although no entirely satisfactory explanation could be found for the mode of contamination of these oysters, the epidemiologic and enviornmental data are most consistent with the conclusion that Mississippi River flooding provided the necessary source of fecal pollution into the oyster growing areas. These data also support recent experimental evidence indicating the under natural conditions shellfish eliminate bacteria and viruses differently and may retain certain enteroviruses for as long as two months after these organisms have disappeared from surrounding waters.

Animals↗
PubMed1975

Oyster-associated hepatitis. Failure of shellfish certification programs to prevent outbreaks.

During October and November 1973, outbreaks of hepatitis A associated with consumption of raw oysters occurred in Houston and in Calhoun, Ga. The oysters implicated in both outbreaks had been harvested in two Louisiana bays. Although the bays had been contaminated with polluted Mississippi River water two months before the oysters were harvested, at the time of harvesting the bays met national sanitation standards for shellfish growing and were certified for oyster fishing. These epidemics raise serious questions about the adequacy of shellfish sanitation monitoring systems currently in use.

Certification↗