Outbreak of acute pulmonary histoplasmosis in members of a wagon train.

In August 1980, an outbreak of acute pulmonary histoplasmosis occurred among participants in a wagon train as it traveled through eastern Tennessee. Of the 85 people on the train 69 (81 percent) had evidence of infection with Histoplasma capsulatum. Fifty-four people had symptomatic disease. The source of infection was traced to the site of a former winter blackbird roost in Charleston, Tennessee, that had been partially cleared five years earlier to make a park. Fourteen of 25 soil samples from this site were culture-positive for H. capsulatum. This is the first reported outbreak to involve a large migrant group. The outbreak is unusual in that exposure occurred without excavation, construction or tree-cutting at the site.

Incidence of endometrial cancer in relation to the use of oral contraceptives.

Female residents of King and Ierce Counties in the state of Washington in whom endometrial cancer was diagnosed during 1975--77 were interviewed concerning prior use of oral contraceptives. Their responses were compared with those of a random sample of women from the same population. Women who had taken Oracon (0.1 mg of ethinyl estradiol and 25 mg of dimethisterone) were estimated to have a risk of endometrial cancer 7.3 times that of other women (P = 0.007). This elevation in risk was not seen in users of other sequential preparations. Women who had used combined oral contraceptives had only 50 per cent of the incidence of endometrial cancer of nonusers (P = 0.05), although the protective effect was not evident among those who subsequently took menopausal estrogens for more than two years. These associations suggest that development of neoplasia in the endometrium can be extremely sensitive to hormonal factors: if an oral contraceptive, like Oracon, emphasizes the estrogenic component, promotion of cancer can result; if like combined preparations, the contraceptive emphasizes the progestational component, protection against cancer can result.

PIP: Interviews concerning prior use of oral contraceptives (OCs) were conducted among female residents of King and Pierce Counties in the state of Washington in whom endometrial cancer was diagnosed during 1975-1977. Their responses were compared with those of a random sample of women from the same population. Women who had taken Oracon (0.1 mg of ethinyl estradiol and 25 mg of dimethisterone) were estimated to have a risk of endometrial cancer of 7.3 times that of other women (P=0.007). This elevation in risk was not observed in users of other sequential preparations. Women who had used combined OCs had only 50% of the incidence of endometrial cancer of nonusers, although the protective effect was not evident among those who subsequently took menopausal estrogens for more than 2 years. It is likely that the use of Oracon predisposed women to the development of endometrial cancer. THese associations suggest that development of neoplasis in the endometrium can be very sensitive to hormonal factors. If an OC, like Oracon, emphasizes the estrogenic component, promotion of cancer can be the result. If, like combined preparations, the contraceptive emphasizes the progestational component, protection against cancer can be the result.