Rubella screening and vaccination program for US Air Force trainees: an analysis of findings.

A preventive medicine program of rubella control for trainees at the Air Force Military Training Center, Lackland AFB, Texas, was begun in October 1977. Incoming trainees were screened for rubella susceptibility, and female trainees were additionally screened for pregnancy. During the period October 1977 to December 1978, an overall rubella susceptibility rate of 17.3 per cent was determined for 71,387 trainees entering basic training. Flights (50 persons each) to which these trainees are assigned varied widely in susceptibility from 0.0-47.7 per cent. Comparisons of susceptibility rates for trainees for for geographic areas and states indicated the highest overall percentage of susceptibles were from the Pacific geographic area with California showing the highest susceptibility (24.5 per cent). Race specific susceptibility rates were found to differ significantly between Whites and Blacks, 17.6 vs 14.8 per cent, respectively. The immunization program was effective as judged by a dampening of the incidence of clinical rubella at the basic training center and at other secondary training centers.

Colonization and infection of newborn infants caused by bacteriophage-group II Staphylococcus aureus strains.

A staphylococcal strain which exhibited weak lytic reaction with group II phages was isolated from a newborn infant with a skin infection. Subsequent investigations established that this weakly reacting strain was responsible for an endemic level of infection and colonization within the hospital nursery. The use of consistently appearing weak lytic reactions in the evaluation of this episode is described.

Epidemiologic features and phage types associated with nosocomial infections caused by Staphylococcus epidermidis.

An apparent problem with increased numbers of nosocomial infections caused by Staphylococcus epidermidis at a large hospital was studied in a clinical-epidemiological investigation. Thirty-six cases of S. epidermidis infection were confirmed on the thoracic surgery, general surgery, nursery and pediatric services during a 3-year period. Nine cases were fatal and six of these occurred in patients following cardiovascular surgery with implanted prothesis. The majority of cases (25/36) occurred following cardiovascular surgery. The median onset of infection was six days from the date of surgery, suggesting infection during the intraoperative period. Although the number of cases studied remains small, two phage types, 71/108/275a/459 and 407-2, did predominate among these clinical infections. Interestingly, during this same time interval these same types predominated among surgical staff members closely associated with these patients. Resistance to antimicrobials was high among isolates tested, with more than 50% of the strains resistant to six or more antimicrobial agents.

Epidemiologic Surveillance for Staphylococcus epidermidis infections related to cardiopulmonary bypass.

Epidemiologic investigation of 20 Staphylococcus infections among valvular and aortocoronary bypass graft patients indicated a broad spectrum of clinical illness in these two groups. The highest infection rate (9.3%) and case specific mortality rate (54.5%) were noted among those patients undergoing cardiovalvular replacement surgery with protheses. The median onset of infection was 6 days suggesting infection during the intraoperative period. Using the epidemiologic data from this investigation, a transmission pattern was formulated and a series of control measures designed to interdict the routes of transmission were instituted wigh marked success. These measures significantly reduced the incidence of S. epidermidis infections among these high risk patients.

New Staphylococcus aureus phage type 94/96(292) associated with a fatal septicemia.

A fulminating septicemia due to Staphylococcus aureus phage type 94/96(292) resulting in the death of a patient with no previous history of illness. This newly characterized strain is identified by an additional typing reaction with experimental phage 292. The prevalence of this strain is discussed.

Epizootic staphylococcal infections in subhuman primates after surgical operation.

In late October, 1974, Staphylococcus aureus postoperative wound infection was recorded in a nonhuman primate (Macaca mulatta) which had recently undergone surgical operation. Infection in a second monkey appeared approximately 2 weeks later, and a clustering of 6 cases appeared over the next 3-week period. The clinical spectrum included septicemia in 2 monkeys and skin infection at the surgical incision site of several others. Investigation revealed a uniform and consistent association of a phage group II S aureus strain characterized as 3A/55/71. This strain was also found to be enzootic among other postoperative monkeys sharing or having shared a common postsurgical care unit with infected monkeys. Epizootiologic studies indicated that this unusually virulent S aureus strain probably was introduced by an infected monkey which underwent surgery earlier in the month and that additional monkeys became infected by animal-to-animal transmission. After appropriate control sanitary measures were instituted, no new infections occurred.

Evaluation of agar-gel double diffusion for the diagnosis of adenovirus infection.

Agar-gel double diffusion was compared to the Laboratory Branch complement fixation test. The efficacy of the agar-gel double diffusion test for the semiquantitation of group-specific adenovirus antibody and its usefulness as a serodiagnostic aid for the evaluation of adenovirus infection was determined.

Experimental pneumococcal infection in embryonated eggs previously infected with influenza C virus.

Cumulative mortality rates for embryonated eggs, compiled for a variety of pneumococcal strains, indicated a uniformly high degree of virulence. Based on median lethal dose values for combined infection with influenza C virus and single infection with pneumococcus, it is difficult to conclude that pneumococcal virulence is enhanced in combined infection. However, there was a significant increase in mortality during the first 24 hr following combined infection. A significantly greater in vitro growth rate for pneumococcus was shown in amniotic fluid from virus-infected embryonated eggs. Microscopy study of selected embryos revealed the absence of a discernible inflammatory reaction during the first 24 hr. From 48 through 96 hr after inoculation, inflammatory reactions were restricted to the upper and lower respiratory tract and consisted of a polymorphonuclear leukocyte infiltration in response to the localization of pneumococci in the paranasal sinuses, bronchi, alveolar ducts, and alveolar spaces. Extensive, severe inflammatory reactions were more frequently encountered in the combined infection. The various phases from early exudation to eventual resolution, which characterize pneumococcal pneumonia in the human host, were in clear evidence following both the single and combined infection of the chick embryo.

Apparent spontaneous induction of Staphylococcus aureus isolated from clinical sources.

Apparent spontaneous induction in staphylococcal strains from two clinical specimens was described. One of the two phages associated with these strains was found useful in typing otherwise untypable strains.

Isolation and characterization of transducing bacteriophage BP1 for Bacterium anitratum (Achromobacter sp.).

A small transducing phage has been isolated against a strain of Bacterium anitratum. The particle has a head dimension of 450 A and a tail approximately 200 A long. The latent period is 16 min and the average burst size is 98. The intact particle has an absorption maximum and minimum at 260 and 237 mmu, respectively. The sedimentation coefficient (S(20)) is 460. The phage contains double-stranded DNA with an S degrees (20,w) of 32.8. Molecular weight estimates of the deoxyribonucleic acid ranged from 2.33 x 10(7) to 2.66 x 10(7) based on sedimentation velocity studies. The percentage guanine plus cytosine compositions of the deoxyribonucleic acid, determined by melting temperature and cesium chloride equilibrium centrifugation, were 40.7 and 42.0, respectively.