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D D Juranek

Publications and source records attributed to D D Juranek.

At least 55 records · Page 3Linked to original sources
PubMed1990

Recommendations for collection of laboratory specimens associated with outbreaks of gastroenteritis.

Recent discoveries have implicated a number of "new" (i.e., previously unrecognized) infectious agents as important causes of outbreaks of gastroenteritis. Unfortunately, the ability to detect these agents in an outbreak can be limited by two factors: 1) the lack of appropriate assays-many of which are still in developmental stages and are not readily available to clinical laboratories, and 2) inadequately or improperly collected specimens. At CDC, many newly developed assays are being used for research and for outbreak investigations. The information in this report is especially intended for public health agencies that collaborate with CDC in investigating outbreaks of gastroenteritis. The report provides an update on guidelines and recommendations for the proper collection of specimens to be sent to CDC, gives general background information concerning some recently discovered pathogens, lists some of the tests available at CDC, and provides a list of CDC contacts. The guidelines and the general information provided on causes of outbreaks of gastroenteritis can be also used by public health workers for investigations when specific testing is available and appropriate.

Adult↗
PubMed1988

Giardia transmission in a swimming pool.

In the fall of 1985, an outbreak of giardiasis occurred among several swimming groups at an indoor pool in northeast New Jersey. Nine clinical cases were identified, eight of whom had Giardia positive stool specimens. All were female; seven were adults (greater than 18 years) and two were children. The attack rate was highest (39 per cent, 5/13) for the ladies lap group who had exposure on one day. These cases had no direct contact with children or other risk factors for acquiring Giardia. Infection most likely occurred following the ingestion of swimming pool water contaminated with Giardia cysts. The source of Giardia contamination was a handicapped child who had a fecal accident in the pool. He was a member of a group that swam at the same time as the ladies lap group. A stool survey of the handicapped group showed that of the 20 persons tested, nine were positive for Giardia, including the specimen from this child. Examination of the pool records showed that no chlorine levels had been taken on the day of the fecal accident and that on the following day the chlorine level was zero. This is the second report of Giardia transmission among swimming pool attendees. It emphasizes the need to maintain appropriate chlorine levels in swimming pools and to institute measures to clear pools after a fecal accident.

Adult↗
PubMed1987

Effect of azotemia in dogs on the pharmacokinetics of pentamidine.

We used a new high-performance liquid-chromatography assay to study the pharmacokinetics of pentamidine isethionate given intravenously to 10 dogs before and after surgically induced renal failure. The presurgery peak serum concentration of pentamidine averaged 867 ng/ml and by 6 hr had fallen to 30 ng/ml. After surgery the peak and 6-hr concentrations were 780 ng/ml and 28 ng/ml. Mean total body clearance of pentamidine before surgery was 46.7 ml/min per kg, of which only 2.0 ml/min per kg was due to renal clearance had fallen 80%--to 0.4 ml/min per kg. Two dogs with azotemia and two control dogs received 14 daily infusions of pentamidine. Kinetic parameters measured after the last dose were not significantly different from those after the first dose, and the amount of pentamidine recovered from tissues was similar for dogs with azotemia and controls. In summary, because renal clearance of pentamidine accounted for such a small proportion of total body clearance, none of the parameters measured was affected significantly by moderate azotemia.

Amidines↗
PubMed1987

Shedding of oocysts in immunocompetent individuals infected with Cryptosporidium.

In June 1985, we investigated an outbreak of cryptosporidiosis at a day-care center in Florida. Through day-care center-wide stool screening, 33% (28/84) of the children and 22% (4/18) of the staff members submitting stool specimens were found to have cryptosporidiosis. Children 12-35 months of age and their teachers were at highest risk. All but 1 of the Cryptosporidium-positive patients reported diarrhea, which lasted between 1-44 days. Serial stool specimens were obtained from 8 infected individuals (5 children and 3 adults). Duration of oocyst shedding ranged from 8 to more than 50 days and continued in 5 individuals after diarrhea ceased. No relationship was found between duration of oocyst shedding and the age of the patient or duration or severity of diarrhea. Results of the investigation indicate that infected individuals may continue to excrete oocysts and, therefore, may remain infectious for days or weeks after gastrointestinal symptoms disappear.

Adult↗
PubMed1985

Case-control study of waterborne giardiasis in Reno, Nevada.

An outbreak of Giardia lamblia gastroenteritis occurred in Reno, Nevada, in 1982, during which 324 laboratory-confirmed infections were reported. During the outbreak, Reno was supplied in part by surface water that was chemically coagulated, settled, and chlorinated, but was not filtered. Giardia cysts were recovered from the water supply, and a beaver infected with Giardia was found in one of the reservoirs. A case-control study indicated that, during the outbreak but not afterwards, persons with giardiasis drank more municipal water than did controls. Corrective measures, which included removing the infected beaver and increasing the chlorine concentration, were followed by a rapid decrease in reports of giardiasis.

Adolescent↗
PubMed1985

Human and sylvatic Trypanosoma cruzi infection in California.

In August 1982, a 56-year-old woman from Lake Don Pedro, California, developed acute Chagas' disease (American trypanosomiasis). She had not traveled to areas outside the United States with endemic Chagas' disease, she had never received blood transfusions, and she did not use intravenous drugs. Trypanosoma cruzi cultured from the patient's blood had isoenzyme patterns and growth characteristics similar to T. cruzi belonging to zymodeme Z1. Triatoma protracta (a vector of Trypanosoma cruzi) infected with T. cruzi were found near the patient's home, a trypanosome resembling T. cruzi was cultured from the blood of two of 19 ground squirrels (Spermophilus beecheyi), and six of 10 dogs had antibody to T. cruzi. A serosurvey of three groups of California residents revealed antibody to T. cruzi by complement fixation in six of 237 (2.5 per cent) individuals living near the patient and in 12 of 1,706 (0.7 per cent) individuals living in a community 20 miles northeast of the patient's home, but in only one of 637 (0.2 per cent) blood donors from the San Francisco Bay area. This is the first case of indigenously acquired Chagas' disease reported from California and the first case recognized in the United States since 1955. This investigation suggests that transmission of sylvatic Trypanosoma cruzi infection to humans occurs in California but that Chagas' disease in humans is rare.

Adolescent↗
PubMed1984

Evaluation of serologic tests for Pneumocystis carinii antibody and antigenemia in patients with acquired immunodeficiency syndrome.

Sera from 68 patients with acquired immunodeficiency syndrome and 135 controls were used to evaluate the indirect immunofluorescence and enzyme-linked immunosorbent assays for detection of antibodies to Pneumocystis carinii and a counterimmunoelectrophoresis assay for detection of circulating Pneumocystis antigen. None of these assays was helpful in the diagnosis of P. carinii pneumonia. An improved assay for antigenemia is needed to differentiate between clinical and subclinical infection.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Fecal coliforms on environmental surfaces in two day care centers.

A survey of environmental surfaces in two Atlanta area day care centers was conducted to determine the prevalence of fecal coliform bacteria, considered a marker for the presence of fecal contamination which might contain pathogenic parasites, bacteria, or viruses. Fecal coliforms were found in 17 (4.3%) of 398 representative samples of building surfaces, furniture, and other objects. These surfaces may be involved in the chain of transmission of enteric diseases among children. Therefore, disinfection of inanimate objects, in addition to good handwashing, may be important in controlling the spread of enteric diseases in day care centers.

Child Day Care Centers↗
PubMed1983

An outbreak of waterborne giardiasis associated with heavy water runoff due to warm weather and volcanic ashfall.

From mid-June through early August 1980, an outbreak of gastrointestinal illness in Red Lodge, Montana affected approximately 780 persons, as estimated from attack rates of 33 per cent and 15 per cent in urban and rural residents, respectively. Giardia lamblia was identified in stool specimens from 51 per cent of 47 persons with a history of untreated gastrointestinal illness and in 13 per cent of 24 specimens from asymptomatic persons (p = .00045, Fisher's Exact Test). The epidemic curve was bimodal with peaks in mid-June and mid-July. Each peak occurred about three weeks after an episode of very heavy water runoff resulting from warm sunny weather and snow darkened by ashfall from the Mt. St. Helens volcanic eruption of May 18, 1980. Unfiltered and inadequately chlorinated surface water was supplied by the city water system, which was implicated as the vehicle of transmission in the outbreak. Water systems providing unfiltered surface water are more likely to become contaminated during periods of heavy water runoff.

Disasters↗
PubMed1983

Atypical crusted "Norwegian" scabies: report of nosocomial transmission in a community hospital and an approach to control.

During August, 1981, a person with an unrecognized case of atypical Norwegian scabies was admitted to a community hospital in Chariton, Iowa. Twenty cases of symptomatic scabies were reported among hospital staff; mites were recovered from four. Subsequent evaluation confirmed scabies transmission to family and friends of this patient before hospitalization; twelve cases of symptomatic scabies, three of them slide positive, were identified in this group. The patient was treated sequentially with 1 percent lindane lotion, 10 percent crotamiton lotion, and 6 percent sulfur ointment to successfully eradicate the infestation. Secondary cases in the hospital and community were treated with 10 percent crotamiton which also was used to prophylactically treat exposed contacts. Control measures and patient management are presented.

Administration, Topical↗
PubMed1981

Reservoir hosts of human babesiosis on Nantucket Island.

The host range of Babesia microti was studied on Nantucket Island in order to identify the enzootic reservoir of this human pathogen. White-footed mice (Peromyscus leucopus) were more frequently parasitized than were other indigenous animals. Infection was ubiquitous in locations where deer were abundant. Mice were most frequently parasitemic during spring and summer and adults more frequently than juveniles. Parasitemia, which was rarely intense, was sustained for as long as 4 months. Mice lived as long as 10 months, and juveniles were most abundant during early summer. Prevalence of zoonotic infection, in certain locations, appeared to be inversely correlated with abundance of mice. B. microti was present solely in regions harboring deer.

Animal Population Groups↗
PubMed1981

Epidemiology of human babesiosis on Nantucket Island.

Between 1969 and 1977, 14 persons with parasitologically confirmed Babesia microti infections and seven persons with antibody titers to B. microti greater than or equal to 1:1,024 were identified on Nantucket Island, Massachusetts. Nineteen of these 21 persons were interviewed. About half were permanent residents of Nantucket; the others spent most of their summers on the island. There were 12 women and seven men. Patients ranged in age from 23 to 86 years; all of those with parasitologically confirmed infections were at least 49 years old. Fifteen patients had illnesses characterized by fever, chills, myalgia and fatigue. Five reported being bitten by a tick from 7 to 28 days before the onset of illness. Most cases occurred during July or August. There appeared to be no association between B. microti infection and direct contact with wild or domestic animals or specific outdoor activities. The unusual age distribution of patients with parasitologically confirmed B. microti infections may result because older persons tend to have more severe illnesses and thus are more likely to come to medical attention.

Adolescent↗
PubMed1981

Babesiosis.

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Amidines↗
PubMed1981

Characterization of Toxoplasma gondii isolates from an outbreak of toxoplasmosis in Atlanta, Georgia.

Toxoplasma gondii was isolated from tissue of 5 of 7 cats and of 4 of 4 field mice trapped in a riding stable in Atlanta where an outbreak of toxoplasmosis had occurred in persons. Dye-test antibodies were not found in serum of 4 cats and 4 field mice shown to be infected with T gondii by mouse inoculation. The pathogenicity and infectivity of the 9 isolates of T gondii from cats and mice were compared in mice with the same characteristics of an isolate from a person who acquired toxoplasmosis in association with the stable. Oocysts of all 10 isolates were more pathogenic than cysts of the same isolates. Epidemiologic implications of isolates from cats and mice are discussed.

Animals↗