Epidemic of gynecomastia among illegal Haitian entrants.

Gynecomastia may occur as a normal physiologic development at certain ages or as a result of a variety of pathological conditions. An outbreak of gynecomastia was investigated at two processing centers of the Immigration and Naturalization Service (INS) between December 2, 1981, and May 14, 1982. At the Fort Allen Service Processing Center, Puerto Rico, gynecomastia was initially detected in 77 of 540 Haitian male entrants (14 percent) and in only 6 of 186 male employees of the center (3 percent) who were 18-50 years old; the difference in prevalence was statistically significant. At the Krome North Service Processing Center in Miami, Fla., gynecomastia was initially detected in 52 of 512 Haitian males 18-50 years old (10 percent). Two case-control studies did not demonstrate an association between gynecomastia and a number of factors that might have been related to an exogenous estrogen or to a substance with an estrogenic effect. Estrogen or estrogen-like substances were not found in food, water, or environmental samples. When the populations were rescreened several months later, 76 of the persons with gynecomastia detected in the first screening had had total or partial remission. Persons with remission had arrived earlier--a mean of 21.6 days for those at Fort Allen and 36.7 for those at Krome--than did those with newly detected gynecomastia and those with continuing cases. The difference in arrival dates was significant (P less than .005 for Fort Allen and P less than .001 for Krome). These results, in view of nutritional deprivation in Haiti, suggest that these cases may have been an outbreak of refeeding gynecomastia.

Acute hemorrhagic conjunctivitis in Southeast Asian refugees arriving in the United States--isolation of enterovirus 70.

During July-September 1980, an epidemic of acute hemorrhagic conjunctivitis (AHC) occurred in several refugee camps and transit centers in Southeast Asia. Of 2,356 refugees examined in Bangkok, 200 (8.5%) had conjunctivitis, including 116 (58%) with hemorrhagic signs. Because increasing numbers of refugees were arriving in the United States with conjunctivitis, a program of surveillance and control was implemented. Enterovirus 70, not previously reported from patients in the Western Hemisphere, was cultured from four arriving refugees. A fourfold rise in titer to enterovirus 70 was found in 10 others, either in the United States or Thailand. After control measures were instituted, the prevalence of the United States or Thailand. After control measures were instituted, the prevalence of conjunctivitis in arriving refugees declined from 49.8 per 1,000 to 3.8 per 1,000. Follow-up of cases after arrival in the United States revealed only one possible secondary case. Extensive epidemics of AHC in the Western Hemisphere are most likely to occur following importation into the humid, coastal areas of Central and South America.

The National Clinical and Public Health Laboratory Survey--1977.

In May 1976, the Laboratory Management Consultation Office, Center for Disease Control, conducted a survey of the clinical and public health laboratories in the U.S.A. in order to update data from a 1971 census of clinical and public health laboratories. The 1971 data were published in the January/February 1973 issue of Cadence of the Clinical Laboratory. The combined data from the 1971 census and the 1976 survey provide an extensive data base which will allow long-range planning toward improving laboratory service in the U.S.A.