ABSTRACT
A protocol was developed in 1984 by the Missouri Department of Health to provide a systematic method for responding to citizen reports of cancer clusters. This protocol integrates public health and environmental expertise and includes two stages: the preliminary review and the investigation. The preliminary review is focused on problem definition and hypothesis generation. Cancer mortality and incidence data are reviewed. Information is gathered and verified through the efforts of citizens, local health officials, environmental staff, and the cancer program staff. Epidemiologic factors evaluated include type of cancer, temporal and spatial relations, population at risk, community profile, and possible environmental and occupational factors. The investigation is an expanded analytic study. Resources are focused on cancer inquiries that appear most likely to involve manageable common exposures. Program experience and protocol development highlights, including surveillance system improvement and educational programming, are described.
Subject(s)
Clinical Protocols , Community Participation , Neoplasms/epidemiology , Public Health/methods , Causality , Cluster Analysis , Environmental Exposure , Environmental Monitoring , Epidemiological Monitoring , Health Education , Humans , Incidence , Neoplasms/etiology , Neoplasms/mortality , Program Evaluation , Public Health/standards , Registries , Risk FactorsABSTRACT
An acute epidemic of headache, mucosal irritation, fatigue, odd taste, and dizziness involving several hundred state government employees occurred in June 1986 in an office building in Missouri that housed 2,500 employees. A survey of 305 ill and 131 well employees demonstrated that ill employees were more likely to have perceived unusual odors and inadequate air flow in their work areas. The building has eight floors, seven of which are divided in half by an atrium, and 17 separate air handling systems. A total of 87% of the ill employees were concentrated in only three of the "half floors." Extensive investigation revealed no toxic substances or other direct causes for the illnesses, but several factors were identified that may have reduced air quality in the affected areas. These included a low proportion of outside air, associated with crowding, blocked vents, smoking, and use of office chemicals. This pattern of illness suggests epidemic anxiety state triggered by poor air quality.
Subject(s)
Air Pollutants, Occupational/adverse effects , Disease Outbreaks , Occupational Diseases/epidemiology , Air Pollutants, Occupational/analysis , Female , Humans , Male , Missouri , Occupational Diseases/etiology , Tobacco Smoke Pollution/adverse effects , Tobacco Smoke Pollution/analysis , VentilationABSTRACT
A descriptive epidemiologic study was designed to test an impression that infections of Echinococcus granulosus in dogs, sheep, and human beings were concentrated in central Utah, and to determine when and how the parasite was introduced into the state, which factors were involved in the distribution of the cestode, and which factors increased either a person's risk of infection of the number of people at risk. Data were secured by review of available records, interviews, questionnaires, and field observations. It was found that 37 of 39 infections in human beings, and seven of eight counties with endemic hydatid disease in dogs and sheep, are located in central Utah. Possible factors responsible for the increasing number of people at risk were use of local people as herders, the existence of community herds, and specific dog management practices. Determinants such as trailing sheep between seasonal pastures, association of sheepmen from several counties on winter range, and sheep marketing practices undoubtedly influence distribution of infections in dogs and sheep.
Subject(s)
Agricultural Workers' Diseases/epidemiology , Dog Diseases/parasitology , Echinococcosis/epidemiology , Sheep Diseases/parasitology , Adolescent , Adult , Aged , Agricultural Workers' Diseases/transmission , Animals , Dog Diseases/epidemiology , Dogs , Echinococcosis/transmission , Epidemiologic Methods , Female , Humans , Male , Middle Aged , Sheep , Sheep Diseases/epidemiology , Surveys and Questionnaires , UtahABSTRACT
Efficacy of an injectable formulation of praziquantel (given IM at a dosage of 5 mg/kg of body weight) against immature Echinococcus multilocularis was studied in 18 experimentally infected dogs and 22 experimentally infected cats. There were no worms recovered at necropsy from any of the treated hosts. However, whereas E multilocularis worms were recovered from all nontreated control dogs (n = 9; min-max 15-1,840, mean 483), such tapeworms were recovered from only k6 of the 11 nontreated control cats (min-max 2-820; overall mean 123.4). The study demonstrates 100% clearance of E multilocularis by praziquantel in experimentally infected dogs and cats, and shows that cats are not as suitable as experimental hosts for this parasite as are dogs.
Subject(s)
Cat Diseases/drug therapy , Dog Diseases/drug therapy , Echinococcosis/veterinary , Isoquinolines/therapeutic use , Praziquantel/therapeutic use , Animals , Cats , Dogs , Echinococcosis/drug therapy , Female , MaleABSTRACT
The suitability of dogs and cats as hosts of Echinococcus multilocularis was studied in animals which had each been infected orally with approximately 15,000 protoscolices. Twenty-one days after injection, the mean number of immature worms recovered from 12 dogs was 874.7 and from 12 cats was 101.7. The mean length of the worms was 1.21 mm in dogs and 1.00 mm in cats. The number and length of worms recovered from dogs were significantly greater (alpha = 0.01).
