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Biomedical subjects

S L Ludwig

Publications and source records attributed to S L Ludwig.

8 recordsLinked to original sources
PubMed2001

Health assessment of U.S. military personnel deployed to Bosnia-Herzegovina for operation joint endeavor.

In anticipation of U.S. forces deploying to Bosnia-Herzegovina, plans were established to conduct medical surveillance of all military service members. This surveillance would provide the Department of Defense with an overview of the hospitalization and outpatient morbidity experience of U.S. forces. Standardized collection of medical data from all U.S. camps using 14 diagnostic categories based on International Classification of Diseases, 9th Revision, codes began in March 1996. Special assessments for hantavirus and tick-borne encephalitis (TBE) infection risk were also conducted. The average disease and nonbattle injury rate for U.S. forces was 7.1 per 100 soldiers per week. Injuries accounted for 28% of medical visits, whereas undefined/other visits accounted for 33%. The majority of remaining visits were for respiratory (14%), dermatologic (10%), and gastrointestinal (6%) complaints. There was one confirmed and one suspected case of hemorrhagic fever with renal syndrome; only 0.1% of individuals (2 of 1,913) tested seroconverted to hantavirus during deployment. No cases of TBE were reported, and the overall low seroconversion rate (0.42%, 4 seroconversions among 959 unimmunized personnel) reflected a very low risk of infection with TBE-related viruses. Operation Joint Endeavor and follow-on Operations Joint Guard and Joint Forge have been extremely healthy deployments.

Bosnia and Herzegovina↗
PubMed1999

Reemergence of adenovirus type 4 acute respiratory disease in military trainees: report of an outbreak during a lapse in vaccination.

From 23 April to 13 May 1995, an outbreak of acute respiratory disease (ARD) hospitalizations occurred in basic training soldiers at Fort Jackson, South Carolina. Weekly hospitalization rates for the most affected military unit reached 11.6%. Virus isolation and serologic studies from a sample of patients identified the agent as adenovirus type 4. Prior to starting vaccinations against adenovirus types 4 and 7 in 1971, these serotypes were the major causes of ARD in basic trainees. No outbreaks were reported when the vaccines were used. A logistical error temporarily interrupted vaccine production, and newly arriving trainees received no adenovirus vaccines from the summer of 1994 through late March 1995. This outbreak occurred in unvaccinated soldiers. The sole manufacturer has permanently stopped adenovirus vaccine production. All type 4 vaccine supplies are now depleted. This outbreak demonstrates continued susceptibility of military recruits to adenovirus type 4 and warns of future outbreaks.

Adenoviridae Infections↗
PubMed1998

Prevalence of antibodies to adenovirus serotypes 4 and 7 among unimmunized US Army trainees: results of a retrospective nationwide seroprevalence survey.

The 1996 production halt of adenovirus types 4 and 7 vaccines prompted concerns about the resurgence of large respiratory disease outbreaks among US military basic trainees. This serosurvey was conducted to assess the current susceptibility of the trainee population to these viruses. A stratified, random sample (n=303) of trainees' sera was tested using a quantitative colorimetric microneutralization assay to demonstrate antibody titers considered to provide immunologic protection against each adenovirus type. Results were analyzed for relationships between susceptibility and 4 demographic factors-gender, race, prior military service, and age. Results showed that 66% and 73% of trainees were susceptible to serotypes 4 and 7, respectively. Nearly 90% were susceptible to at least one serotype. Susceptibility was significantly (P<.05) related to lack of prior military service and younger age. Consistent with a serosurvey conducted 20 years ago, these results demonstrated significant susceptibility to two vaccine-preventable causes of disease. These findings may have civilian implications.

Adenovirus Infections, Human↗
PubMed1996

Epidemiology and control of acute respiratory diseases with emphasis on group A beta-hemolytic streptococcus: a decade of U.S. Army experience.

OBJECTIVE: To summarize the experiences of the U.S. Army regarding prevention and control, and frequencies, rates, trends, and determinants of febrile acute respiratory diseases (ARDs), particularly Group A beta-hemolytic streptococcus (GABHS). METHODOLOGY: Since 1966, the U.S. Army has conducted routine surveillance of ARDs among basic trainees. Since 1985, all trainees with fever and respiratory tract symptoms have been cultured for GABHS: Field investigations were conducted when outbreaks of acute respiratory or GABHS-associated illnesses were detected. Mass plus tandem benzathine penicillin prophylaxis were used to interdict and control training center GABHS outbreaks. RESULTS: During the period 1985 to 1994, there were 65,184 hospitalizations for acute febrile respiratory illnesses among Army trainees. The crude hospitalization rate was 0.45 per 100 trainees per week. The rate consistently declined over the period. Incremental declines were temporally associated with increased use of adenovirus immunizations and broader use of benzathine penicillin prophylaxis. During the period, 10,789 of 59,818 (18%) pharyngeal cultures were positive for GABHS: GABHS outbreaks were associated with diverse clinical manifestations including streptococcal toxic shock, acute rheumatic fever, and pneumonia. The emergence of mucoid colony morphology in clinical isolates was a consistent indicator of circulating virulent strains with epidemic potential. Outbreak-associated M types were M1, M3, M5, and M18. In response to six GABHS outbreaks, mass plus tandem benzathine penicillin chemoprophylaxis produced rapid and sustained GABHS control. ARD and GABHS recovery rates were lowest when benzathine penicillin prophylaxis was widely used. CONCLUSIONS: ARD rates among Army trainees have consistently declined to unprecedented levels. GABHS has reemerged as an important threat to military trainees. Benzathine penicillin chemoprophylaxis is safe and effective for interdicting and preventing GABHS outbreaks in closed, healthy young adult populations.

Chlamydophila pneumoniae↗
PubMed1978

Aetiology of antimicrobial-agent-associated colitis.

Clostridium difficile was isolated from the faeces of a patient with clindamycin-associated pseudomembranous colitis (P.M.C.). The presence of a preformed faecal toxin and the toxigenicity of both the faecal isolate of C. difficile and a reference strain of C. difficile were demonstrated by tissue-culture assay. The toxin of both strains of C. difficile and that in the patient's faeces were neutralised by heating and by incubation with antitoxin to C. sordellii, but not by incubation with antitoxin to C. histolyticum, C. oedematiens (novyi), C. welchii (C. perfringens) or C. septicum. These data implicate the toxin of C. difficile as a major, and perhaps the sole, cause of antimicrobial-agent-associated P.M.C. of man and suggest that the neutralisation of the faecal toxin of P.M.C. by C. sordellii antitoxin, as described by other investigators, may be a non-specific phenomenon.

Aged↗