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J J Witte

Publications and source records attributed to J J Witte.

At least 19 recordsLinked to original sources
PubMed1992

Heterosexually transmitted human immunodeficiency virus infection among pregnant women in a rural Florida community.

BACKGROUND: In the United States, an increasing proportion of women infected with the human immunodeficiency virus (HIV) live in nonmetropolitan areas. Little is known, however, about the risk factors for HIV transmission in women outside large cities. METHODS: We interviewed and tested 1082 (99.8 percent) of 1084 consecutive pregnant women who registered for prenatal care at a public health clinic in western Palm Beach County, Florida. This rural agricultural area of about 36,000 people is known to have a high prevalence of HIV infection. RESULTS: The seroprevalence of HIV was 5.1 percent (52 of 1011 women). Black women who were neither Haitian nor Hispanic had the highest rate of infection (8.3 percent [48 of 575]). Only 4 of 1009 women (0.4 percent) reported ever injecting drugs, and the 4 were HIV-seronegative; however, 14 of 43 users of "crack" cocaine (33 percent) had HIV infection. At prenatal registration, 131 of 983 women (13 percent) tested positive for gonorrhea, chlamydial infection, or syphilis. By multivariate logistic-regression analysis, HIV infection was found to be independently associated with having used crack cocaine (odds ratio, 3.3; P < 0.001), having had more than two sexual partners (odds ratio, 4.6; P < 0.001), being black but neither Hispanic nor Haitian (odds ratio, 11; P < 0.001), having had sexual intercourse with a high-risk partner (odds ratio, 5.6; P < 0.001), and testing positive for syphilis (odds ratio, 3.1; P = 0.015). Nevertheless, 11 of the 52 HIV-infected women (21 percent) reported a total of only two to five sexual partners and no known high-risk partners, had never used crack cocaine, and had no positive tests for sexually transmitted disease. CONCLUSIONS: In the rural community we studied, most of the women with HIV infection acquired it through heterosexual contact. The increasing seroprevalence of HIV and the increasing incidence of syphilis and use of crack cocaine mean that other women may be at similar risk of acquiring heterosexually transmitted HIV infection.

Adult↗
PubMed1992

Pediatric tuberculosis and human immunodeficiency virus infection in Palm Beach County, Florida.

OBJECTIVE: To describe the factors underlying an increasing incidence of tuberculosis in children. DESIGN: Descriptive case review. SETTING: Palm Beach County, Fla. PARTICIPANTS: Forty-four children with suspected and confirmed pediatric tuberculosis from 1985 through 1989. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: From 1988 through 1989, tuberculosis was confirmed in 15 children and suspected in another 16 compared with data from 1985 through 1987 in which the disease was confirmed in nine children and suspected in four. Pediatric tuberculosis occurred primarily in blacks younger than 5 years; the increase in the number of cases reported in 1988 and 1989 occurred only in blacks. One child in whom tuberculosis was confirmed during the recent period was infected with the human immunodeficiency virus (HIV); however, among children with suspected tuberculosis, four of the nine children tested were seropositive for HIV. There was no evidence of increased transmission of tuberculosis to children by HIV-seropositive adults compared with transmission by HIV-seronegative adults with TB. New adult tuberculosis cases in the county increased annually, from 92 cases in 1986 to 169 in 1989, of whom at least 36% were infected with HIV. CONCLUSIONS: The largest effect of the HIV epidemic on tuberculosis in children appeared to be indirect, through an increase in the number of adults with active tuberculosis serving as potential sources of tuberculosis infection for children. A direct effect of HIV infection in the progression of tuberculous disease in children is likely, but was not detected in this investigation. Case-finding for tuberculosis among children will need to increase, particularly in areas heavily affected by acquired immunodeficiency syndrome, but may be complicated by the difficulty of diagnosing tuberculosis in HIV-infected children.

Adolescent↗
PubMed1991

Epidemiology of AIDS in Florida.

Florida is third in the nation in the cumulative number of AIDS cases. The epidemic in the state has grown steadily since 1981, clustering initially in metropolitan South Florida but dispersing to other urban and nonurban areas. Heterosexually transmitted AIDS is fast increasing and is more than twice as common in Florida than the United States; however, homosexual/bisexual men and intravenous drug-using men and women continue to represent the majority of new cases. Special serologic studies of the prevalence of HIV infection provide a timely view of the dynamics and characteristics of the epidemic in various segments of the state's population. Data from a large, ongoing serosurvey suggest that about one in every 220 childbearing women is HIV-infected, a finding consistent with Florida's rank of second nationally in the number of pediatric AIDS cases.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Influenza and pneumococcal pneumonia immunization. Protecting our high risk population.

Pneumonia and influenza (P & I) constitute Florida's sixth leading cause of death. The P & I death rate in 1987, 10.5 per 100,000, was the highest since 1978. Major target groups for one or both vaccines used in prevention, as recommended by the Immunization Practices Advisory Committee (ACIP), include persons with chronic diseases of the heart or lungs, residents of nursing homes and other chronic care facilities, and persons aged 65 and older. Despite well-defined recommendations, vaccine coverage rates in Florida are as low as 30% in persons greater than or equal to 65 years of age. Knowledge and attitude surveys demonstrate that low coverage among various population groups may be due largely to insufficient awareness and/or negative attitudes regarding pneumococcal and influenza vaccines. Conversely, recommendations by physicians and other health care providers are strongly associated with receiving either vaccine. If the incidence of P & I is to decrease substantively in Florida, much wider use of the vaccines must occur. Because so many high-risk patients depend on private physicians for health care, their role is critical to the success of Florida public health strategies to reverse P & I trends.

Adult↗
PubMed1989

Multiple sclerosis in Key West, Florida.

In 1984, a press release by a Miami, Florida, neurologist described a possible cluster of persons with multiple sclerosis in Key West, Florida. The authors examined the cluster using prevalence rates, which are recognized as having a latitudinal gradient for multiple sclerosis, being generally high at high latitudes and low at low latitudes. Case ascertainment showed 32 definite or probable cases among residents of the study area (latitude, 24.5 degrees N) on September 1, 1985, a prevalence rate of 70.1/100,000 population--14 times the rate estimated for this latitude by modeling techniques based on US and international data, 7-44 times the rate for areas at similar latitudes (Mexico City, Mexico; Hawaii; New Orleans, Louisiana; and Charles County, South Carolina), and 2.5 times the expected rate for all US latitudes below 37 degrees N. This finding could not be explained by changes in diagnostic criteria, case ascertainment bias, immigration of people from high-risk areas, an unusual population structure, a large percentage of related cases, or better survival. Prevalent cases (n = 22) were more likely than general population controls (n = 76), matched by sex and 10-year age group, to have: lived longer in Key West, been a nurse, ever owned a Siamese cat, had detectable antibody titers to coxsackievirus A2 and poliovirus 2, and ever visited a local military base (Fleming Key). Key West has an unusually high prevalence of multiple sclerosis that may be related to these risk factors.

Adult↗
PubMed1989

AIDS: the HIV epidemic. A time of transition.

The surveillance of clinical cases of acquired immune deficiency syndrome (AIDS) in the United States began in June 1981 when the first case was reported. Since then, state and federal public health officials have continuously monitored progression of the epidemic by the number of persons reported with diagnosed clinical AIDS. The human immunodeficiency virus (HIV) that causes AIDS was identified in 1983 and an antibody test was licensed by the Food and Drug Administration in 1985. Recent studies have shown that the time from HIV infection to development of clinical AIDS is an average of seven or more years. Consequently, the reported cases of clinical AIDS reflect the severity of the epidemic an average of seven years ago or more, not now, and certainly not in the future. The AIDS epidemic is in reality an HIV epidemic. The number of persons with HIV infections is a better measure of the present status and future course of the disease. This paper discusses the development of HIV prevalence and incidence studies and illustrates the use of these data to predict the future number of persons with clinical AIDS and the economic impact of the epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Tuberculosis and acquired immunodeficiency syndrome--Florida.

Florida reported 1858 cases of the acquired immunodeficiency syndrome (AIDS) and 8455 cases of tuberculosis from January 1, 1981, through October 31, 1986. Of the patients with AIDS, 159 (8.6%) also had tuberculosis, and 154 (1.8%) of the patients with tuberculosis also had AIDS. Among patients with both diagnoses, tuberculosis was diagnosed before AIDS by more than 1 month in 50%, was diagnosed within 1 month before or 1 month after the diagnosis of AIDS in 30%, and was diagnosed more than 1 month after the AIDS diagnosis in 20%. Compared with patients with AIDS only, patients with both diagnoses were also more likely to be Haitian, black (other than Haitian), or Hispanic. Compared with patients with tuberculosis only, patients with both diagnoses were more likely to be younger, male, Haitian, black (other than Haitian), and Hispanic, have extrapulmonary tuberculosis and negative tuberculin skin tests, and have noncavitary chest roentgenograms. These data suggest that patients with AIDS may have an increased risk of tuberculosis and that patients with both diagnoses differ in important demographic and clinical characteristics from patients with AIDS only or tuberculosis only.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Transmission of HIV in Belle Glade, Florida: lessons for other communities in the United States.

The high cumulative incidence of AIDS and the large percentage of AIDS patients with no identified risks in Belle Glade, Florida, were evaluated through case interviews and neighborhood-based seroepidemiologic studies. It was found that of 93 AIDS patients reported between July 1982 and 1 August 1987, 34 could be directly linked to at least one other AIDS patient or to a person with AIDS-related complex by sexual contact, sharing of needles during intravenous drug abuse (or both), or perinatal exposure; of 877 randomly selected adults, 28 had antibodies to HIV; no person over age 60 and none of 138 children aged 2 to 10 years had antibodies to HIV; no clustering of infected persons within households occurred, except in sex partners; and HIV-seropositive adults were more likely than HIV-seronegative adults to be from Haiti, have a lower income, report sex with intravenous drug abusers, and have a history of previous treatment for sexually transmitted diseases. The presence of antibodies to five arboviruses prevalent in South Florida or the Caribbean did not correlate significantly with HIV infection. The high cumulative rate of AIDS in Belle Glade appears to be the result of HIV transmission through sexual contact and intravenous drug abuse; the evidence does not suggest transmission of HIV through insects.

Acquired Immunodeficiency Syndrome↗
PubMed1977

Antibody persistence after primary immunization with trivalent oral poliovirus vaccine.

Five years after primary infant immunization with trivalent oral poliovirus vaccine, employing either a three-dose primary series as recommended by the U.S. Public Health Service Advisory Committee on Immunization Practices (ACIP) or a four-dose series as recommended by the Committee on Infectious Diseases of the American Academy of Pediatrics. 115 children were serologically tested for persistence of neutralizing antibodies by the microneutralization test. Of the 57 individuals immunized according to the ACIP recommendation, antibody persistence was demonstrated in 92% for type 1 poliovirus, 98% for type 2, and 84% for type 3. Of those 58 individuals originally receiving a four-dose primary infant immunization series, the persistence of antibody was 98% to type 1, 98% to type 2, and 87% to type 3. Twenty-one of 24 negative sera showed neutralizing ability when tested by a more sensitive plaque reduction test. Thus, individuals completing either immunization schedule demonstrated satisfactory persistence of neutralizing antibody to all three poliovirus types over a five-year period.

Antibodies, Viral↗
PubMed1977

Immunization.

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Immunization↗