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 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In late October 1986, an outbreak of influenza-like illness was detected at the Naval Air Station in Key West, Florida. Between October 10 and November 7, 1986, 60 active duty personnel reported experiencing a respiratory illness characterized by fever, cough, sore throat, and myalgia. Influenza A/Taiwan/1/86 (H1N1) virus was recovered from three symptomatic patients. Forty-one (68%) of 60 case-patients belonged to a 114-person squadron that had traveled to Puerto Rico for a temporary assignment from October 17-28, 1986. Among squadron members, the attack rate for persons previously vaccinated with the 1986-1987 trivalent influenza vaccine and for those unvaccinated was the same (37%). Transmission of infection among squadron personnel appeared to have commenced in Key West and continued in a barracks in Puerto Rico and aboard two DC-9 aircraft that transported the squadron back to Key West on October 28. There was no evidence that the outbreak spread to the surrounding civilian communities in Puerto Rico or Key West. This was the first reported outbreak of respiratory illness due to influenza A/Taiwan/1/86 (H1N1) in the continental United States in the 1986-1987 influenza season.
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PMID:An outbreak of influenza A/Taiwan/1/86 (H1N1) infections at a naval base and its association with airplane travel. 291 44

All clinical isolates of influenza A viruses from patients in Huntington, West Virginia, during the decade 1978-1988 were tested, and 65 of 65 H1N1 and 176 of 181 H3N2 viruses were susceptible to the antiviral action of amantadine and rimantadine. The five resistant viruses were obtained from three members of a family undergoing therapy or prophylaxis with rimantadine. Resistant influenza emerged during treatment with rimantadine and spread to two family contacts, causing typical influenza with fever, myalgia, and cough of 5 days' or less duration. Genetic characterization of the resistant viruses when compared to the susceptible virus isolated on day 1 from the index case revealed a single amino acid change in the transmembrane portion of the M2 protein. In vitro studies showed that rimantadine was significantly more active than amantadine against both H1N1 and H3N2 viruses. Although this resistant influenza was transmitted and caused illness in one family, the absence of naturally occurring resistant viruses suggests that the emergence of new strains of influenza A each few years may prevent the widespread emergence of resistant influenza A virus.
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PMID:Resistance of influenza A virus to amantadine and rimantadine: results of one decade of surveillance. 291 66

The clinical symptoms and signs were assessed in 20 consecutive patients developing infection with the human immunodeficiency virus (HIV). All were male homosexuals and all presented with a glandular-fever-like illness. Changes in laboratory values were compared with findings in 40 HIV negative male homosexual controls. In the 10 patients for whom date of exposure to the virus could be established the incubation period was 11-28 days (median 14). One or two days after the sudden onset of fever patients developed sore throat, lymphadenopathy, rash, lethargy, coated tongue, tonsillar hypertrophy, dry cough, headache, myalgia, conjunctivitis, vomiting, night sweats, nausea, diarrhoea, and palatal enanthema. Twelve patients had painful, shallow ulcers in the mouth or on the genitals or anus or as manifested by oesophageal symptoms; these ulcers may have been the site of entry of the virus. During the first week after the onset of symptoms mild leucopenia, thrombocytopenia, and increased numbers of banded neutrophils were detected (p less than 0.0005). The mean duration of acute illness was 12.7 days (range 5-44). All patients remained healthy during a mean follow up period of 2.5 years. Heightened awareness of the typical clinical picture in patients developing primary HIV infection will alert the physician at an early stage and so aid prompt diagnosis and help contain the epidemic spread of AIDS.
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PMID:Clinical picture of primary HIV infection presenting as a glandular-fever-like illness. 314 67

Ivermectin treatment was evaluated for efficacy and side effects in 40 patients in South India who had microfilaremia and bancroftian filariasis. Ivermectin was administered once orally at four dose levels (range, 25 to 200 micrograms/kg), and at each it was found to be completely effective in clearing blood microfilariae within five to 12 days. In most patients, microfilariae reappeared by three months; by six months the levels averaged 14% to 32% of pretreatment values in the four study groups, and all groups showed equivalent efficacy. Detailed monitoring identified some side effects in almost all patients: usually fever, headache, light-headedness, myalgia, sore throat, or cough that occurred most prominently 18 to 36 hours after treatment. These were most frequent and severe in patients with the greatest microfilaremia, but only when treated with the two higher doses of ivermectin (100 and 200 micrograms/kg). The low-dose (25 micrograms/kg) ivermectin group, despite equivalent efficacy in parasite killing, had clinical reaction scores that were minimal and that were not correlated with parasitemia. Since efficacy and side effects of ivermectin therapy compare favorably with those reported for treatment with the standard antifilarial drug diethylcarbamazine citrate, the major advantage of single-oral-dose administration makes ivermectin the best candidate to replace diethylcarbamazine as the treatment of choice for bancroftian filariasis.
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PMID:Ivermectin for the treatment of Wuchereria bancrofti filariasis. Efficacy and adverse reactions. 328 45

Experimental and clinical experience with compounds containing antimony have shown that the trivalent compounds are generally more toxic than the pentavalent ones. APT can cause severe pain and tissue necrosis and is therefore not given by intramuscular or subcutaneous injection. APT has the actions and uses of AST, but it is less soluble and more irritating than the sodium salt which is therefore more suitable for intravenous use. Trivalent antimony compounds are toxic when used topically. Adverse effects are similar for all trivalent compounds, and include nausea, vomiting, weakness and myalgia, abdominal colic, diarrhoea, and skin rashes, including pustular eruptions. Hypersensitivity reactions also occur. Respiratory symptoms include cough, dyspnoea, and chronic lung changes. Cardiotoxicity is the most important and may produce arrhythmias, myocardial depression and damage, Stokes-Adams attacks, heart failure, and cardiac arrest. Hepatic damage and necrosis, as well as blood dyscrasias, may occur. Toxic effects on the kidney may follow chronic use. Continuous treatment with small doses of antimony may give rise to symptoms of subacute poisoning, similar to those of chronic arsenic poisoning, due to accumulation of antimony in the body, especially if trivalent compounds are used, because of their long biological half-lives. Reproductive disorders and chromosome damage have been reported; antimony compounds are, therefore, potentially toxic to reproduction and have mutagenic, and oncogenic potential. Antimony compounds should, therefore, not be used during pregnancy or in the presence of hepatic, renal, or heart disease. Pentavalent antimony preparations especially the organic compounds, together with non-metallic synthetic preparations, such as the diamidines, have now replaced APT for use in leishmaniasis. Because of the toxicity of antimony compounds, investigations have been undertaken to reduce their adverse effects by combining them with chelating agents. These preparations appear to have reduced the toxic effects of antimony without affecting the efficacy of the preparations. Liposome-encapsulated antimony products have, more recently, been shown to be much less toxic because of the reduced dose of the antimony compound required for effective therapy. The historical uses of antimony were based on the belief that the topical and systemic adverse effects, for example, skin eruptions and diarrhoea and vomiting, were signs that the condition being treated was responding by being brought to the surface to relieve congestion at the diseased area. There is no evidence in topical use, but there is evidence that such use can cause severe reactions.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Toxicity of antimony and its compounds. 330 36

An acute febrile illness associated with unloading silos occurs more frequently than any other farm associated respiratory illness in mid state New York. This report describes 29 cases of organic dust toxic syndrome (also known as pulmonary mycotoxicosis) occurring in 24 men and one woman with a mean age of 29 years. In 16 instances more than one worker was exposed to the dust, and in 12 of these shared exposures more than one worker became ill. Patients presented 5.3 (SD 3.3) hours after inhalation of organic dust and mould with fever (79%), myalgia (76%), chest tightness (72%), cough (66%), and headache (59%). The mean temperature was 38.7 degrees C and the mean white blood cell count 13.2 X 10(9)/l. In contrast to patients with allergic alveolitis, nearly all these patients had normal breath sounds, chest radiographs, and arterial oxygen saturation. Tests for precipitating antibodies to farmer's lung disease antigens gave negative results in all 26 episodes in which they were done; of these, 10 had no evidence of precipitating antibodies to an aqueous extract of the silage associated with their own illness. Organic dust toxic syndrome appears to be a common and substantial respiratory hazard to young farm workers. Despite being frequently mis-diagnosed as farmer's lung, organic dust toxic syndrome is clearly a distinctly different disease process.
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PMID:Organic dust toxicity (pulmonary mycotoxicosis) associated with silo unloading. 359 53

An explosive outbreak of a febrile respiratory illness occurred among members of a college fraternity. The preponderant signs and symptoms were muscle aches, cough, and low-grade fever. All illnesses occurred within 1.3 to 13 hours of attendance at a party where there was a dense airborne dust from straw that had been laid on the floor. Of the 67 fraternity members who attended the party and answered a questionnaire, 55 became ill (attack rate, 82%). Risk of illness was higher for those who spent more time at the party. Duration of illness ranged from 4.5 hours to seven days. Results of serological studies did not demonstrate an allergic or viral cause for these illnesses. The clinical and epidemiologic features of this outbreak were characteristic of organic dust toxic syndrome, an acute respiratory illness caused by inhalation of molds growing on hay, silage, or other agricultural products.
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PMID:An outbreak of organic dust toxic syndrome in a college fraternity. 362 5

The clinical findings during a major epidemic of Q-fever which affected 415 people in the Val de Bagnes (Valais, Switzerland) in the autumn of 1983 are reported. Q-fever symptoms were evident in 191 cases but inconspicuous or absent in 224 cases. The symptoms most frequently reported were prolonged high fever, headaches, severe exhaustion, loss of appetite, cough and myalgia. Amongst disorders which accompany acute Q-fever, pneumonia and granulomatous hepatitis are very frequent, while myopericarditis and glomerulonephritis are less frequently observed. Endocarditis, a later complication of Q-fever, is a severe illness which more frequently affects patients with underlying valvular lesions. New serological techniques now permit more rapid and more accurate diagnosis of both acute and chronic Q-fever.
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PMID:[Clinical aspects observed during an epidemic of 415 cases of Q fever]. 389 64

Interferons are produced in response to viral infections. Among the biochemical changes they cause in cells is the induction of the enzyme (2'-5')-oligo-isoadenylate synthetase. The activity of this enzyme can be measured and this can indicate exposure and response of cells to interferon. The efficacy of such an assay of peripheral blood of pregnant women may aid in establishing screening guidelines for potentially teratogenic viral infections. The blood of 44 primigravidas with complaints of fever, myalgia, cough, vaginal discharge and/or costovertebral angle tenderness was assayed for activity of the enzyme (2'-5')-oligo-isoadenylate synthetase and compared to assays of the enzyme activity in a group of 37 healthy primigravidas which served as a control group. It was found that the group with viral infections had an increase in enzyme activity from twice to 15 times the normal value, with characteristic rises of enzyme activity in several viruses known or suspected to cause human defects. Several general guidelines are proposed to assist the obstetrician in determining a viral etiology of acute illness in pregnancy, It is suggested that the assay of enzyme activity of (2'-5')-oligo-isoadenylate synthetase may provide a simple tool for rapid diagnosis of viral infections in pregnancy.
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PMID:Identification of viral infections in pregnancy by assay of (2'-5')-oligo-isoadenylate synthetase. 398 79

An illness among office workers, consisting of cough, fever, chills, muscle aches, and chest tightness was associated with water leaks from a cafeteria. Mean single breath carbon-monoxide diffusing capacity (DLCO) of cases differed significantly from that of non-cases. There was a significant decrease in the percent of predicted DLCO with increasing number of symptoms. Testing for precipitating antibodies to microbial agents found in the building revealed no differences between cases and non-cases. DLCO is an appropriate cross-sectional instrument for field investigations of building-associated respiratory disease.
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PMID:Pulmonary disease associated with cafeteria flooding. 400 48


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