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M R Bomgaars

Publications and source records attributed to M R Bomgaars.

6 recordsLinked to original sources

Therapeutic abortions following rubella infection in pregnancy: the potential impact on the incidence of congenital rubella syndrome.

In 1977, a large rubella outbreak occurred in Hawaii. Because attack rates were high among women of childbearing age, we conducted extensive surveillance efforts to detect both pregnancies complicated by rubella and cases of congenital rubella syndrome (CRS). Initial surveillance included a survey of physicians and hospitals, review of fetal death and birth certificates, and cord blood screening for rubella-specific IgM of infants born following the epidemic. Two years after the outbreak, the medical community was again surveyed to identify affected children who were missed initially. No case of CRS was identified either shortly after the outbreak or in the ensuing two years. In addition, none of the 5,605 cord serum samples obtained was found to contain rubella-specific IgM antibody. Through active surveillance, we received 12 reports of rubella in pregnant women, of whom 11 elected to terminate their pregnancies. The extensive use of therapeutic abortion by exposed women may have prevented the birth of infants with CRS. Surveillance for rubella-related abortions is an important component in assessing the health impact of rubella in a community.

Abortion, Therapeutic↗

Immigration and leprosy in Hawaii, 1960-1981.

The 140-year-old epidemic of leprosy among the people of Hawaii reached its peak at about the beginning of this century and has been subsiding ever since. A preliminary review of new cases in Hawaii in the past 15 years showed 49 among those born in Hawaii, plus 360 new immigrant cases (largely from the Philippines and Samoa), 130 of whom were of the borderline lepromatous or lepromatous (BL/L) form. Since 1970 all new cases have been treated as ambulatory patients in their home communities. A detailed review of all 95 new Hawaii-born cases in the past 21 years showed a continuing rapid decline in incidence among ethnic Hawaiian people, with a fall in the proportion of BL/L cases from its former plateau around 40% to only 20% in the last seven years. The new immigrant BL/L cases have apparently not caused a significant secondary outbreak among the Hawaiians but have caused a modest increase among groups. Among these recent non-Hawaiian secondary cases, the proportion of BL/L cases has also recently dropped so sharply that the risk of significant tertiary spread is minor. The possible role of improved nutrition in Hawaii as an influence on these recent leprosy patterns is suggested.

Adult↗