Biomedical subjects
Publications and source records attributed to D G Addiss.
Using DNA sequencing and phylogenetic analysis, we identified four distinct Cryptosporidium genotypes in HIV-infected patients: genotype 1 (human), genotype 2 (bovine) Cryptosporidium parvum, a genotype identical to C. felis, and one identical to a Cryptosporidium sp. isolate from a dog. This is the first identification of human infection with the latter two genotypes.
In this study we documented unexpected moderate-to-severe iodine deficiency in Haitian schoolchildren although they live in a coastal community where presumably they have access to iodine-containing seafood. This fact combined with the lack of an iodized salt supply and endemic lymphatic filariasis makes community distribution of diethylcarbamazine-fortified, iodized salt an attractive strategy for elimination of lymphatic filariasis and iodine deficiency disorders in this area of Haiti. Combining lymphatic filariasis elimination with other public health interventions is one strategy to increase its public health benefit and maximize the impact of limited public health resources.
To determine the prevalence of, and identify risk factors for, Chlamydia trachomatis infection, we studied 380 women attending four Wisconsin family planning clinics in October 1985. The patients completed self-administered sexual history questionnaires, were examined by nurse clinicians and had specimens taken for direct fluorescent antibody (DFA) testing for C. trachomatis. Of 335 women with adequate specimens, 10.7 percent had positive DFA tests. Selective screening criteria were developed based on the following risk factors for C. trachomatis: Age less than 20 years and recent exposure to either a new sexual partner or a partner with more than one partner; a partner with symptoms of urethritis; a diagnosis of cervicitis; and inflammatory changes on Pap smear. Thirty-six percent of patients met one or more of these screening criteria, and the criteria had a sensitivity of 72 percent.
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BACKGROUND: Recent waterborne outbreaks have established Cryptosporidium as an emerging enteric pathogen, but foodborne transmission has rarely been reported. In October 1993, an outbreak of cryptosporidiosis occurred among students and staff attending a 1-day school agricultural fair in central Maine. DESIGN: Environmental/laboratory investigation and cohort study. PARTICIPANTS: Attendees of the fair and their household members. MAIN OUTCOME MEASURES: Clinical or laboratory-confirmed cryptosporidiosis. Clinical cryptosporidiosis was defined as 3 days of either diarrhea (three loose stools in a 24-hour period) or vomiting. RESULTS: Surveys were completed for 611 (81%) of the estimated 759 fair attendees. Among attendees who completed the survey, there were 160 (26%) primary cases. Cryptosporidium oocysts were detected in the stools of 50 (89%) of 56 primary and secondary case patients tested. The median incubation period was 6 days (range, 10 hours to 13 days); the median duration of illness was 6 days (range, 1 to 16 days). Eighty-four percent of primary case patients had diarrhea and 82% had vomiting. Persons drinking apple cider that was hand pressed in the afternoon were at increased risk for cryptosporidiosis (154 [54%] of 284 exposed vs six [2%] of 292 unexposed; relative risk, 26; 95% confidence interval, 12 to 59). Cryptosporidium oocysts were detected in the apple cider, on the cider press, and in the stool specimen of a calf on the farm that supplied the apples. The secondary household transmission rate was 15% (53/353). CONCLUSIONS: This is the first large cryptosporidiosis outbreak in which foodborne transmission has been documented. It underscores the need for agricultural producers to take measures to avoid contamination of foodstuffs with infectious agents common to the farm environment.
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