Epidemiologic and clinical characteristics of rabies in cats.

The epizootic of rabies in raccoons in Maryland has been accompanied by 129 confirmed cases of rabies in cats from Jan 1, 1983 to Sept 30, 1992 and only 12 cases in dogs. An epidemiologic and clinical study of rabies in cats was conducted for the period Jan 1, 1983 to May 31, 1986. Only 3 of 31 rabid cats had a history of being currently vaccinated against rabies, and 13 were of unknown ownership. A history of prior wound or injury within 6 months of onset of signs of rabies was reported in 11 of the cats and most of these had a wound in a hind limb. The median interval between reporting of a wound and a development of rabies was 4 to 6 weeks. Rabies in cats is difficult to diagnose in the early stages and, of the 14 cats examined by a veterinarian, only 3 were believed to have rabies on initial examination. Major signs of rabies in cats reported by veterinarians included behavior change, gait abnormality, strange or unusual look in the eyes, and a wound within the preceding 6 months. Owners reported increased frequency of vocalization as an early sign. Postexposure treatment was given to 194 human beings including 63 veterinarians or their personnel. The estimated cost of postexposure biologics was +68,000.

Epizootic of rabies in raccoons in Maryland from 1981 to 1987.

The epizootic of rabies in raccoons entered Maryland in 1981 and systematically moved through the state affecting raccoons in all counties except those of the lower Eastern Shore. A precoded surveillance form was provided to all county and city health departments and data were requested for each animal head submitted for testing for the year 1985. The disease persisted and, in 1987, all counties previously reporting rabies in raccoons also had documented cases in other species. The incidence of rabies in raccoons increased in late winter and peaked in March. Most human exposures occurred during daylight hours and in private yards. Agricultural areas were similarly affected by rabid animals. Analysis of vaccination status of animals exposed to rabid animals gave estimations of statewide vaccination rates for dogs (70%) and cats (28%). The danger of rabies in cats was emphasized by the large number of animals exposed by each rabid cat. The spillover of rabies in raccoons to other species persisted in all jurisdiction through 1992, with periodic upsurges of disease at 3- to 4-year intervals as the raccoon population is replenished. Rabies was not diagnosed in any human beings.

The epidemiology of rodent and lagomorph rabies in Maryland, 1981 to 1986.

Records from the Maryland Public Health Department were screened for confirmed rodent and lagomorph rabies between 1981 and 1986. Questionnaires were designed for collection of information about events that led to the exposure of human and/or domestic animals to rabid rodent or lagomorphs. These species comprised 1.2% of all the reported rabies in the state. Woodchucks (Marmota monax) constituted 80.0% of all the reported rodent/lagomorph rabies cases in Maryland. The majority showed aggressive behavior (55.0%). Woodchucks exposed 15 persons (75.0% of all the exposures by rodents/lagomorphs). Domestic animal and human rabies exposure due to rodents and lagomorphs represents a small but significant number of the total exposure to rabid animals.

The epidemiology of AIDS in Maryland, 1981-1987.

From 1981 through 1987, a total of 1,068 AIDS cases were diagnosed in Maryland; 62.8 percent occurred in the homosexual/bisexual male cohort followed by intravenous drug abusers, 21.8 percent. Time trends suggest that proportionally fewer cases of AIDS will occur among homosexual/bisexual males and transfusion patients, and more cases will appear among intravenous drug abusers and heterosexuals.

Dysgonic fermenter-2: a clinico-epidemiologic review.

In the literature to date, there have been 44 confirmed cases of infection with the Dysgonic Fermenter-2 (DF-2) bacterium. DF-2 infections appear to demonstrate a strong association with dog bites (or recent exposure to dogs) and have a predilection for patients with defective host defenses although immunocompetent individuals are also susceptible. Recently, the first two cases of documented DF-2 infection following cat bite have been reported. Of the cases reported, 42 of the 44 blood cultures grew DF-2. In one of the two cases where blood culture failed to grow DF-2, the bacterium was isolated at the time of operation from an infected myxoma of the tricuspid valve. In the other case, the organism was isolated from the eyelid margin of a case of angular blepharitis. Peripheral blood smears also afford an effective and practical clinical tool for early diagnosis; 9 of 10 patients for whom smears were done tested positive. This paper reviews the epidemiologic, microbiological, and clinical features of this relatively new illness and also offers general guidelines to physicians for clinical management. Health professionals, especially those providing care for high risk groups, should be alerted to this potentially fatal infection.

Antibody response after a two-year intradermal booster of rabies human diploid cell vaccine.

A study was undertaken to evaluate the effectiveness of a low dose of rabies human diploid cell vaccine administered intradermally for preexposure booster inoculation. Seventy-six volunteers received a 0.1-ml dose of rabies human diploid cell vaccine intradermally, approximately 2 years after their primary series. Though only 25 (32.9%) had a titer less than 0.5 IU/ml before the booster, all had a postbooster titer of greater than or equal to 4.0 IU/ml 3 weeks later. Five of 73 (6.8%) reported an allergic reaction after the booster.

The early kinetics of the neutralizing antibody response after booster immunizations with human diploid cell rabies vaccine.

Persons immunized in developing countries were recently shown to have low titers after pre-exposure immunization with human diploid cell rabies vaccine (HDCV). An investigation into the response to HDCV boosters was conducted to determine if immunologic sensitization had occurred and if there was a response difference in persons immunized in and outside of the United States. Intramuscular (im) booster doses of vaccine were administered to 113 persons previously immunized outside the United States and 47 persons immunized in the United States. The post-exposure booster regimen of a single 1.0-ml im booster, as recommended by the World Health Organization for all but the most severe bites, produced a one-dilution (5-fold) rise in antibody titer in 14 (11%) of 123 persons tested 5 days after booster and in 56 (89%) of 63 persons studied 7 days after booster. Persons immunized in the United States and those immunized outside the United States had similar responses. Persons with low pre-booster titers were more likely to exhibit a 5-fold rise in antibody titer 5 days after booster (P = 0.03) than persons with higher pre-booster titers. The post-exposure booster regimen of 2 1.0-ml im doses (one each on days 0 and 3), recommended in the United States, produced a more rapid response than the single booster regimen in only some persons; a 5-fold response occurred in 6 (50%) of 12 persons 5 days after booster.(ABSTRACT TRUNCATED AT 250 WORDS)

An outbreak of influenza A in a nursing home.

An outbreak of influenza A occurred in an elderly population in a Maryland nursing home between December 8, 1980 and January 13, 1981 and involved 76 of the 170 residents. Throat swabs from two of 10 acutely ill residents yielded influenza A virus similar to the A/Taiwan/1/79 strain. Fourfold or greater increases in the titer of complement-fixing (CF) or hemagglutination-inhibiting (HI) antibodies were detected in paired sera from four of five ill residents and from none of four well residents. One hundred (62.9 per cent) of 159 residents with known vaccination histories had been vaccinated with trivalent influenza virus vaccine in October and November 1980. Crude illness attack rates and mortality rates were similar in vaccinees and nonvaccinees. Various risk factors and hypotheses were examined in an attempt to explain the apparent lack of vaccine efficacy.

An outbreak of Norwalk-related gastroenteritis at a boys' camp.

An acute gastrointestinal tract illness affected 213 (52%) of 407 campers and 64 (53%) of 121 staff members attending a boys' camp in the Catoctin Mountains of Maryland during the summer of 1981. Nausea was the predominant symptom for ill campers and staff members (73%), but more staff members experienced diarrhea (49%) than did campers (9%). Twenty-three individuals had more than one episode of illness compatible with the case definition. Eight of nine paired blood specimens from ill staff members showed a fourfold increase in antibody titer to Norwalk virus by radioimmunoassay. Environmental inspections and laboratory tests failed to implicate a common source of exposure.