Salmonella outbreak in an American child development center in Germany.

In July 1993, an outbreak of Salmonella occurred in a U.S. Army child care center in Heidelberg, Germany. Sixteen children and 4 staff members had confirmed positive cultures; the center had an average census of 135 children during the time of the outbreak. Rectal swabs were done on all the children in rooms with symptomatic children or staff or in rooms with confirmed cases. A total of 246 rectal swabs was done initially, with 216 representing paired specimens. A case was defined as a staff member, child, or family member of an ill staff member or child who attended the center with diarrhea or abdominal pain with at least one of the following symptoms: diarrhea, fever, nausea, loss of appetite, abdominal pain, vomiting, or lethargy. The attack rate for the children was 40 of 86 (47%), and the attack rate for staff was 15 of 47 (32%). No associations were found when looking at the attack rates in each of the 10 rooms in the center. Complete environmental investigation revealed that the cook was preparing food 1 day before it was served. In addition, he was running the dishwasher without a sufficient amount of soap. Although food was not available for testing, the source of the Salmonella outbreak appears to be uncooked or inadequately cooked and prepared food with some person-to-person transmission.

Early single-photon emission computed tomography in mild head trauma. A controlled study.

Although computed tomography (CT) and magnetic resonance imaging scans often appear normal after mild head trauma, many patients experience attentional or other cognitive disturbances that are difficult to quantify by neuropsychological testing in the absence of a premorbid profile. Within 2 days of mild head trauma, 14 patients with normal-appearing brain CTs were studied with single-photon emission computed tomography (SPECT). They were compared to 15 normal control subjects and to 12 patients with mild human immunodeficiency virus (HIV) encephalopathy. Ten of 14 head trauma patients were separated from the normal control subjects by both independent readers, blinded to the clinical diagnosis. None of the SPECT results from normal control subjects were "read" as trauma. Trauma could not be differentiated from HIV encephalopathy. The observed percentage agreement between raters was 0.83 (kappa = 0.72). SPECT is more sensitive than CT in detecting brain injury after mild head trauma.