Outbreaks of acute gastroenteritis associated with Norwalk-like viruses in campus settings.

Norwalk-like viruses (NLVs) are transmitted by fecally contaminated food, water, fomites, and person-to-person contact. They are a leading cause of acute gastroenteritis epidemics in industrialized countries. NLV outbreaks are characterized by a 12- to 48-hour incubation period; nausea, vomiting, and diarrhea for 24 to 72 hours; and high secondary attack rates. NLV infections spread rapidly on college and university campuses because of close living quarters, shared bathrooms and common rooms, many food handlers, popular self-service salad bars in dining halls, and person-to-person contact through sports and recreational activities. The illness is generally mild and self-limited but an outbreak can strain the resources of campus health services and cause high absenteeism among both students and staff. Treatment is primarily through antiemetic medication and oral rehydration. Prevention and control of NLV outbreaks rests on promoting hand washing; enforcement of strict hygiene in all food preparation areas; and prompt, rigorous cleaning of potentially contaminated areas where someone has been ill.

The Storey of college health hygiene. Thomas A. Storey, MD (1875-1943) and the promotion of hygiene.

The word hygiene originally defined a comprehensive plan for preserving individual and community health in all its dimensions. In the latter half of the 19th century, Dr Edward Hitchcock Jr established a system of hygiene at Amherst College that became the model for campus hygiene programs. Dr Thomas A. Storey of Stanford University, an advocate of teaching hygiene to college students, wrote articles and textbooks and was active on national committees that promoted college hygiene programs. Storey was one of the founders of the American Student Health Association, later renamed the American College Health Association, which in its early years chose promotion of hygiene as a major objective. As the 20th century progressed, the profession of health education emerged. With its emergence came the realization that health education, once viewed as primarily a matter of delivering health information to students, required an appreciation of human behavior as well. By 1950, the word hygiene had given way to health in most contexts in recognition of this new paradigm.

The evolution of medical services for students at colleges and universities in the United States.

Factors contributing to the establishment of the earliest college health programs are reviewed. The author considers the evolution of these programs for two periods: the first 100 years (1860-1960) and the next 30 years (1960-1990). The changing emphases in college health programs during these two periods are seen as responses to contemporaneous events, including the development of vaccines and other advances in science and medicine, the emergence of intercollegiate athletics--first as a significant element in the college experience and subsequently as a major business--and the expansion of higher education in response to the arrival of the baby boomers in the mid-1960s. Contemporary healthcare reform is briefly reviewed, and the author concludes with an assessment of the probable impact of current healthcare reform proposals on the future of college health programs and on campus-controlled health centers.

The history of sections in the American College Health Association.

The founders of the American College Health Association (ACHA) recognized the importance of regional groups (affiliates) and worked actively to foster their formation and continued existence. In 1932, D. F. Smiley, MD, described the concept of establishing ACHA regions and suggested combining institutional membership in both the national and regional organizations. Significant affiliate representation in the association's governance structure finally became a reality in 1987, when regional representatives became permanent members of the board of directors. Standing committees of the association were transformed into the present ACHA sections in 1957, and a new category for individual membership established for college health professionals interested in participating in educational activities of the new sections. In many ways, the changes in the association's governance that occurred in 1987 are reminiscent of the original structure of the 1920-1970 era, when the organization was much smaller and essentially an association of college health center directors.

College health 2050.

On May 31, 2040, Kunta Kinte Sanchez O'Shaunessey-Chan, MOND, president of the North American College Health Association (NACHA), gave the keynote address at the opening session of the annual meeting held in the Marriott Conference Center, Saskatoon, Saskatchewan. He recounted important events of the past 50 years that have shaped the college health field of today, and he predicted important trends for the next decade. Although his speech was given in Spanish, it was simultaneously translated into English, French, and 15 other languages requested by attendees. The English version follows.

Successful treatment of naturally occurring influenza A/USSR/77 H1N1.

Forty-five university students with proved influenza A/USSR/77 H1N1 infection were randomly treated with either amantadine hydrochloride (14 students), rimantadine hydrochloride (19 students), or placebo (12 students). By 48 hours after initiation of therapy, amantadine and rimantadine recipients had significantly less fever and greater improvement compared with subjects given the placebo. Minor reversible CNS side effects at the end of the five-day course of therapy were observed in one third of the amantadine-treated subjects. However, both amantadine and rimantadine recipients returned to classes earlier and shed smaller amounts of virus than placebo recipients. Thus, both drugs exerted a notable therapeutic effect. Hence, during an influenza outbreak, five days of empirical therapy with amantadine or rimantadine for persons with an influenza-like syndrome should ameliorate clinical symptoms and might decrease spread of virus.

Purification of large quantities of coxiella burnetii rickettsia by density gradient zonal centrifugation.

The purification of large quantities of inactivated, phase II Coxiella burnetii by isopycnic zonal centrifugation for use as diagnostic antigen and as a vaccine is described. The fractionation of egg yolk sac-derived C. burnetii vaccine resulted in the separation of two distinct populations of organisms, each devoid of microscopically and serologically recognizable components of egg yolk sac. One population of organisms, characterized by an equilibrium density of 1.240, was rod shaped (1.0 by 0.5 mumole) with a thick, densely strained wall and prominent central body. The second population, with an equilibrium density of 1.280, had a coccobacillary shape (approximately 1 mumole in diameter), granular, sometimes fibrillar cytoplasm, thin cellular walls, and lacked a prominent nucleoid.