Impact of the human immunodeficiency virus epidemic on mortality in children, United States.

To assess the effect of the human immunodeficiency virus (HIV) epidemic on mortality in US children younger than 15 years of age and to identify associated causes of death, the authors examined final national mortality statistics for 1988, the most recent year for which such data are available. In 1988, there were 249 deaths attributed to HIV/acquired immunodeficiency syndrome (AIDS) in children younger than 15 years of age. Associated causes of death listed most frequently on 270 death certificates with any mention of HIV/AIDS included conditions within the AIDS surveillance case definition (30%), pneumonia (excluding Pneumocystis carinii pneumonia) (17%), septicemia (10%), and noninfectious respiratory diseases (8%). The impact of HIV/AIDS as a cause of death was most striking in the 1-through 4-year-old age group and in black and Hispanic children, particularly in the Northeast. By 1988 in New York State, HIV/AIDS was the first and second leading cause of death in Hispanic and black children 1 through 4 years of age, accounting for 15% and 16%, respectively, of all deaths in these age-race groups. With an estimated 1500 to 2000 HIV-infected children born in 1989, the impact of HIV on mortality in children will become more severe.

Prevalence of the human immunodeficiency virus among university students.

BACKGROUND AND METHODS: To estimate the magnitude of the human immunodeficiency virus (HIV) epidemic among university students, we conducted a blinded HIV-seroprevalence survey at 19 universities throughout the United States. HIV-antibody testing was performed on blood collected for routine medical purposes at the student health centers of the participating institutions. At each campus, from 250 to 1000 blood specimens were collected consecutively and tested for HIV antibodies by enzyme-linked immunosorbent assay and Western blot analysis. Nonidentifying demographic data were linked with the test results. RESULTS: Of 16,863 specimens in the sample, 30 (0.2 percent) were positive for antibodies to HIV. Positive specimens were found at 9 of the 19 schools. All were from students over 18 years old; 19 (63 percent) were from students over 24. All but 2 of the 30 infected students were men. The seroprevalence rate for men was 0.5 percent (95 percent confidence interval, 0.3 to 0.7), and for women it was 0.02 percent (95 percent confidence interval, 0.002 to 0.066). Seroprevalence increased with age--from 0.08 percent (95 percent confidence interval, 0.04 to 0.15) for students 18 to 24 years old to 1.0 percent (95 percent confidence interval, 0.2 to 2.9) for those 40 or older. CONCLUSIONS: HIV infection is present on U.S. university campuses, although the rate appears to be far lower than that of populations known to be at high risk. The potential clearly exists, however, for the further spread of HIV infection in this population, and preventive measures are needed.

Chemical correlates of pathogenicity of oils related to the toxic oil syndrome epidemic in Spain.

The identity of the etiologic agent that caused the 1981 epidemic of toxic oil syndrome in Spain has not been established, and toxicologic study of oil specimens from the outbreak has been hampered by uncertainty about which oils were actually capable of causing illness. To identify chemical characteristics associated with pathogenicity, the authors compared specimens collected during the Spanish government's oil recall program in June and July 1981 from affected and unaffected households in the two contiguous towns of Alcorcón and Leganés (Madrid Province). Oils were blind-coded for laboratory analysis, and personnel with no knowledge of the laboratory results determined whether illness was present in a family. Contamination with free aniline and oleyl, linoleyl, and palmityl anilides was strikingly more frequent and extensive in oils collected from the case (affected) families. There was a clear-cut dose-response effect, with increasing concentrations of aniline and anilides associated with increasing risk of illness. Differences in fatty acid and sterol compositions among oils indicated more rapeseed oil admixture in the case group, but these indicators of rapeseed oil admixture did not contribute significantly to risk after the degree of aniline/anilide contamination had been taken into account. The authors conclude that the presence of relatively high levels of aniline and fatty acid anilides in oil specimens collected during the epidemic in the two towns studied indicates a high probability of the current or prior presence of the etiologic agent of toxic oil syndrome. Although these data do not necessarily indicate that any of the compounds measured actually caused the illness, further toxicologic work should concentrate on oils with substantial concentrations of the marker compounds.

Transfusion-associated AIDS: serologic evidence of human T-cell leukemia virus infection of donors.

An assay for antibodies to membrane antigens of cells infected by human T-cell leukemia virus was used to examine serum from persons who donated blood to 12 patients with acquired immunodeficiency syndrome (AIDS) associated with blood transfusions. The occurrence of positive results in the assay was significantly greater among donors to the AIDS patients (9 of 117; 7.7 percent) than among random donors (1 of 298; 0.3 percent). Of 12 sets of donors examined, 9 sets included a donor whose serum gave positive results for the presence of the antibodies. In six of these nine sets, the seropositive donor was an individual who was also identified as a possible source of AIDS transmission when epidemiologic and immunologic criteria were used.