Spatial dispersion of adult mosquitoes (Diptera: Culicidae) in a sylvatic focus of Venezuelan equine encephalitis virus.

We studied the spatial localization of mosquitoes in sylvatic focus of Venezuelan equine encephalitis virus in western Venezuela to identify mosquito species potentially involved in the hypothesized transport of viruses out of enzootic foci. The following criteria were used to identify species with potential for virus export: (1) common in the forest and surrounding area, (2) feeding on a wide range of vertebrates; (3) long dispersal capabilities, and (4) established vectorial competence for enzootic or epizootic VEE viruses. CDC traps baited with light/CO2 were operated for four and 12-h intervals to collect mosquitoes at four stations along two forest/open area transects from September to November 1997. We collected 60,444 mosquitoes belonging to 11 genera and 34 species. The most common species were Aedes serratus (Theobald), Ae. scapularis (Rondani), Ae. fulvus (Wiedmann), Culex nigripalus Theobald, Cx, (Culex) "sp", Cx. mollis Dyar & Knab, Cx. spissipes (Theobald), Cx. pedroi Sirivanakarn and Belkin, Psorophora ferox (Humboldt), Ps. albipes (Theobald), and Ps. cingulata (F.). Very few mosquitoes were captured during the (day in the open area outside the forest, suggesting that any virus export from the forest may occur at night. The following mosquitoes seemed to be mostly restricted to the forest habitat: Ae. serratus, Ps. ferox, Ps. albipes, sabethines, Cx. spissipes, Cx. pedroi, Cx. dunni Dyar, and Ae. fulvus. The main species implicated its potential virus export were Cx. nigripalpus, Ae. scapularis, and Mansonia titillans (Walker).

Growing pains: status of emergency medicine in Nicaragua.

Nicaragua is one of the poorest nations in the Western Hemisphere. The health of the population suffers as a result of poor nutrition, epidemic diseases, natural and manmade disasters, sporadic violence, urban industrial growth, and inadequate government funding for even basic medical equipment and supplies. Within this environment, emergency services development has been recognized as an important and cost-effective public health intervention. In recent years, government and nongovernmental agencies working together have had a dramatic positive impact on the quality of emergency care provided.

Probabilistic health risk assessment for exposures to estuary sediments and biota contaminated with polychlorinated biphenyls, polychlorinated terphenyls and other toxic substances.

A Latin Hypercube probabilistic risk assessment methodology was employed in the assessment of health risks associated with exposures to contaminated sediment and biota in an estuary in the Tidewater region of Virginia. The primary contaminants were polychlorinated biphenyls (PCBs), polychlorinated terphenyls (PCTs), polynuclear aromatic hydrocarbons (PAHs), and metals released into the estuary from a storm sewer system. The exposure pathways associated with the highest contaminant intake and risks were dermal contact with contaminated sediment and ingestion of contaminated aquatic and terrestrial biota from the contaminated area. As expected, all of the output probability distributions of risk were highly skewed, and the ratios of the expected value (mean) to median risk estimates ranged from 1.4 to 14.8 for the various exposed populations. The 99th percentile risk estimates were as much as two orders of magnitude above the mean risk estimates. For the sediment exposure pathways, the stability of the median risk estimates was found to be much greater than the stability of the expected value risk estimates. The interrun variability in the median risk estimate was found to be +/- 1.9% at 3000 iterations. The interrun stability of the mean risk estimates was found to be approximately equal to that of the 95th percentile estimates at any number of iterations. The variation in neither contaminant concentrations nor any other single input variable contributed disproportionately to the overall simulation variance. The inclusion or exclusion of spatial correlations among contaminant concentrations in the simulation model did not significantly effect either the magnitude or the variance of the simulation risk estimates for sediment exposures.

Cervical cancer control: a study of morbidity and mortality trends over a twenty-one-year period.

Data from a 21-year period are presented to evaluate the effects of a mass cytologic screening program on uterine cancer morbidity and mortality in Louisville, Jefferson County, Kentucky. The success of screening was greatest in the younger age groups. There was a fall-off after age 45 years, especially in those age 60 years or older. Women at highest risk for cervical cancer, in the low socioeconomic quartile, had a better initial screening rate than the two middle-income quartiles, and had the highest rate of all women for subsequent rescreening. The greatest decrease in both morbidity and mortality was in women under the age of 50 years. Women age 30-39 and 50-59 years benefitted the most, as measured by mortality, with a decrease of 70.8 and 69.0%, respectively. There was no change in mortality rates for those age 70 years or older. Although the average annual age-adjusted rate increased from 13.2 to 15.3/100,000 women over the 21-year period.