"Do It Now!" Yakima, Wash, and the campaign against rural typhoid.

In 1911, Yakima, in western Washington, suffered a typhoid epidemic that turned the nation's attention to a crisis in public health. The response exemplified the ideals of the "new public health" as a more proactive, scientific, federal commitment to the problems of rural America. A US Public Health Service investigation led by Dr Leslie Lumsden found a typhoid mortality rate of nearly 5 times the national average. The cause was bad sanitation. Typhoid rates dropped dramatically as the community adopted pragmatic solutions. Lumsden helped organize a "Do It Now" sanitation campaign and one of the country's first city-county health units. Yakima provided a model for other rural areas and small towns across the country. This episode in one of the country's most productive fruit-growing regions raised serious questions regarding the geographic dynamics of disease. For Lumsden and other like-minded health officials, the countryside represented a dangerous reservoir of disease, a particular threat to the nation's agriculturally dependent urban populations. Yakima showed that the country needed a more comprehensive public health system that addressed urban and rural problems.

Application of an immunofluorescence assay for Crohn's disease using primed nude mouse lymph nodes to a United States/Mexican border population.

Previous studies using an indirect immunofluorescence (IF) technique found that sera from patients with Crohn's disease (CD) frequently contained antibody that recognized an antigen(s) in CD tissue filtrate-primed lymphoid tissue from athymic nude (nu/nu) mice. The present study examined the reproducibility of this IF assay in a different laboratory setting and used patients with infectious diarrhea. We examined the immunoreactivity of 113 sera from eight patients with Crohn's disease, 11 with ulcerative colitis, 62 patients with infectious diarrhea, 22 nondiarrheal disease controls, and ten normal adults. Sera were absorbed with nu/+BALB/c mouse serum proteins coupled to Sepharose 4B to remove nonspecific binding. All sera were coded and tested against at least 2 of 4 lymph nodes from nu/nu mice that were previously inoculated with either CD tissue filtrate or with a passaged CD-induced nu/nu lymphoma. Reference positive CD sera and negative control sera were run in parallel during each assay. Sera from three CD patients consistently showed positive IF. None of the sera from patients with infectious diarrhea, other disease controls, or normals were positive. These results demonstrate the reproducibility of the IF assay using CD tissue-primed nude mouse lymph nodes and the preferential immunoreactivity of CD sera.