ABSTRACT
From 1977-1986, a total of 331 laboratory confirmed cases of human brucellosis were reported in Texas. The annual number of cases ranged from 13 in 1977 to 84 in 1983. Males accounted for 66% of the cases. Cases ranged in age from one to 92 years, with 57% between the ages of 20 and 49 years. Brucella melitensis infections accounted for 66% of the bacteriologically confirmed cases. Infection with Brucella canis was identified in four patients. Annual incidence rates were higher in Hispanics in each age and sex group when compared with whites and blacks. Epidemiologic features of cases reported during 1977-1981 are dissimilar to features of cases reported during 1982-1986. In the first five years, a majority of cases (82%) were males, and a majority (54%) were white. Exposure to cattle or swine was reported for 72% of the cases. In the second five years, a majority (72%) of cases were Hispanic, and only 55% were males. Ingestion of unpasteurized goat milk products was reported for 67% of the cases during 1982-1986.
Subject(s)
Brucellosis/epidemiology , Milk , Adolescent , Adult , Black or African American , Age Factors , Aged , Animals , Brucellosis/ethnology , Child , Child, Preschool , Cohort Studies , Disease Reservoirs , Female , Goats , Hispanic or Latino , Humans , Infant , Male , Middle Aged , Sex Factors , Swine , Texas , White People , ZoonosesABSTRACT
In the period August 30-October 7, 1986, 347 persons in adjacent west Texas counties (Ector and Midland) contracted culture-confirmed Shigella sonnei gastroenteritis. A case-control study showed an increased risk of acquiring shigellosis in Ector County with eating at outlets of fast-food Restaurant A, and in Midland County with eating at Restaurant B or C. A second case-control study, of persons who had eaten at Ector County outlets of Restaurant A, showed an increased risk of acquiring shigellosis with eating foods containing shredded lettuce and tomatoes, which were served together (odds ratio = 68.8; 95% confidence interval 8.5-293.1). All implicated restaurants received shredded lettuce produced at one lettuce-shredding plant; two implicated restaurants did not receive tomatoes from the lot delivered to other implicated restaurants. The lettuce-shredding plant distributed shredded lettuce and intact lettuce; restaurants that received only intact lettuce were not involved in the outbreak. Investigation at the lettuce-shredding plant suggested that a food handler might have been the source of contamination and that the method of processing might have allowed cross-contamination to occur. In the laboratory, the outbreak strain of S. sonnei multiplied rapidly on shredded lettuce at 22 C and survived on refrigerated shredded lettuce for at least seven days. This outbreak, one of the largest outbreaks of Shigella infections in the United States in the last decade, indicates that a large, geographically widespread shigellosis outbreak can result from contaminated shredded lettuce that is distributed commercially.
Subject(s)
Disease Outbreaks , Dysentery, Bacillary/epidemiology , Vegetables/adverse effects , Adolescent , Adult , Aged , Child , Child, Preschool , Dysentery, Bacillary/etiology , Epidemiologic Methods , Female , Food Microbiology , Humans , Infant , Male , Middle Aged , Restaurants , Shigella sonnei/isolation & purification , TexasABSTRACT
An outbreak of diarrhea occurred in a day-care center in San Marcos, Tex, in August 1984. At the time of this study, the center was caring for 81 children aged 2 months through 5 years. A single stool specimen was collected from each of 50 children (62%). Cryptosporidium oocysts and Giardia lamblia cysts were each identified in stool specimens from 18 children. Three children had both parasites present in the same stool specimen. Echovirus 30 was identified in 19 of 25 stools cultured. Although three pathogens were circulating simultaneously in this group of children, only the presence of Cryptosporidium oocysts was associated with the occurrence of a diarrheal illness. Cryptosporidium may be a common cause of diarrhea in children who attend day-care centers.
Subject(s)
Child Day Care Centers , Cryptosporidiosis/epidemiology , Diarrhea/parasitology , Disease Outbreaks , Animals , Child, Preschool , Diarrhea, Infantile/parasitology , Feces/parasitology , Female , Giardiasis/epidemiology , Humans , Infant , Male , TexasABSTRACT
A point source outbreak of Vibrio cholerae O1 El Tor Inaba infections occurred aboard an oil rig south of Port Arthur, Texas, in September 1981. Sixteen crew members had V. cholerae O1 infections as determined by serology or stool specimens; 15 were symptomatic. The high percentage of symptomatic infections was attributed in part to the ingestion of a large number of V. cholerae O1 organisms by susceptible individuals. Symptoms included diarrheal stools (100%), weakness (60%), abdominal cramps (53%), nausea (40%), and vomiting (27%). Only one of the three patients who sought medical attention was diagnosed by his physician as having cholera. Physicians who treat patients who live near or travel to the Gulf Coast should consider cholera in patients with watery stools. If cholera is suspected, laboratories should use thiosulfate-citrate-bile salts-sucrose (TCBS) agar in addition to routine enteric media for processing stool specimens.
