ABSTRACT
We report 32 cases of culture-proven influenza A (A/Sydney) caused by virus imported into mainland US military barracks from Puerto Rico in July 1999. Despite the fact that the shelf life of the influenza vaccine is 18 months and that the outbreak strain was a component of the previous year's vaccine, no vaccine was available from manufacturers, owing to US Food and Drug Administration regulations. Formal consideration should be given to extending the date of expiration and to maintaining a supply of the influenza vaccine year-round.
Subject(s)
Disease Outbreaks , Influenza A virus , Influenza, Human/epidemiology , Humans , Influenza Vaccines , Influenza, Human/physiopathology , Influenza, Human/prevention & control , United States/epidemiologyABSTRACT
PURPOSE: To describe our evaluation of basic trainees exposed to influenza A and our experience with mass prophylaxis. METHODS: Using a structured interview, 101 individuals were evaluated for symptoms of influenza A. Nasopharyngeal wash specimens were obtained from symptomatic troops; amantadine prophylaxis was prescribed for all. Diagnosis was confirmed using a rapid influenza assay or shell vial culture. After completing prophylaxis, the group was reevaluated to determine medication compliance and perceived side effects. RESULTS: At baseline, 80 trainees reported symptoms. Three additional cases of influenza were identified, two using the rapid assay. Reported compliance with amantadine prophylaxis was 46.5%. CONCLUSIONS: Nonspecific complaints that could be consistent with viral infection were numerous in this basic trainee cohort. The rapid assay allowed us to expediently identify additional patients, who were then removed from the cohort to limit further transmission. Compliance with prophylaxis was poor; thus, directly observed therapy is recommended.
Subject(s)
Amantadine/therapeutic use , Antiviral Agents/therapeutic use , Immunoenzyme Techniques/methods , Influenza A virus , Influenza, Human/diagnosis , Influenza, Human/prevention & control , Military Personnel/psychology , Patient Compliance/psychology , Aerospace Medicine/methods , Humans , Influenza, Human/complications , Inservice Training , Mass Screening/methods , Military Medicine/methods , Nasal Lavage Fluid/virology , Surveys and Questionnaires , TexasABSTRACT
Areas of Concern such as the Niagara and Detroit Rivers contain a myriad of point and non-point sources. These are difficult and expensive to monitor and often present unique analytical problems and so are subject to analytical error. The Niagara River Toxics Committee (NRTC) and the Upper Great Lakes Connecting Channels Study Modeling Committee designed programs to indirectly monitor these sources by upstream/downstream sampling at the head and mouth of the rivers. These two studies are compared and the data analysis problems that were encountered are discussed. Upstream/downstream samples were paired to obtain differential loadings wherever possible, but when some results were reported as below the detection limit, a maximum likelihood estimate was used. The resulting differential loading, adjusted for non-point sources, is the total point source load to the river minus any losses due to volatilization, settling or degradation.
