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A prospective study was undertaken in Jerusalem to quantitate the HBsAg prevalence rate in pregnant women, to assess the effect of ethnic origin on HBsAg prevalence rates, and to determine the impact of HBsAg carrier state on hepatitis B virus horizontal transmission in the family. Of the 6,572 women screened at the time of delivery, 42 (0.64%) were found to be HBsAg positive. Although the percentage of Moslem women was 3.4% of the total study population, they accounted for 23.8% of the HBsAg positive mothers. This resulted in a prevalence rate of 4.48% as compared to only 0.5% in the Jewish population (P < 0.01). Nine percent of siblings born to HBsAg positive mothers and 29% of the husbands were found to be horizontally infected.

Coxsackie infections in 14 infants born in a single neonatal unit were studied. The clinical presentation was mild nonspecific disease in eight infants and an overwhelming multiorgan disease in six. Three infants with systemic disease died. Vertical transmission of the virus from a colonized mother was documented in five mothers who infected seven infants. The remaining seven infants were infected horizontally, presumably from infected personnel. Coxsackie B1 was isolated in four of the cases and type B3 in two cases of systemic disease. Intravenous gammaglobulin combined with human leukocyte interferon was utilized in three cases of overwhelming disease and two infants of these infants survived.

The style with which parents touch their newborn infant was studied. Our method was to film mothers and fathers holding their awake infants and to code detailed features of their tactile behavior using time-sampling analysis to measure frequency of events and continuous event recording to measure duration. The results show that both mothers and fathers made tactile contact with their infant for an equal amount of time and frequency, but that mothers touch/stroke their infants more than they pat/shake them. Fathers did not show any preference for either tactile style. Mothers preferentially targeted the infant's hand and face more than the body, while fathers preferred to touch the infant's hand. These results suggest that mothers' propensity to "caretake" their infants and fathers' tendency to play with their infant are reflected in the fine details of their parental behavior.

A study in 1984 of the colonization rates of Group B beta hemolytic streptococci (GBS) in 257 Jewish and 189 Arab parturient women revealed rates of 5.4 and 1.6% respectively. In 1987, a study of 116 Jewish women noted a rte of 3.5%. GBS colonization rates in the newborns of the three groups were 1.8, 1.3 and 1.1% respectively. No statistically significant differences were noted between any of the maternal or neonatal groups. A review of the period 1982-87 revealed a GBS neonatal sepsis attack rate of 0.2/1,000 live births. These data confirm the persistent low incidence of GBS colonization and disease in the Jerusalem area.

The cerebrohepatorenal syndrome of Zellweger (CHRS) is a rare, fatal disorder in newborn infants. Recent research points to a primary absence of tissue peroxisomes, with resulting biochemical defects, as the basic pathology of the condition. We report on an infant with classic neurological and dysmorphic features of CHRS. Increased serum levels of pipecolic acid, bile acid precursors and very-long-chain fatty acids (VLCFA) together with total histological absence of liver peroxisomes confirmed the diagnosis. To our knowledge, this is the first case in Israel to be fully documented by biochemical and ultrastructural techniques. A high index of suspicion is essential among clinicians if further cases are not to be overlooked.

A retrospective study on the incidence of congenital rubella (CR) in the past 10 years in the Jerusalem area was conducted. After the 1972 epidemic, which resulted in 48 cases of congenital rubella, few sporadic cases of CR appeared each year, and in the 1978-79 period the number of CR cases was relatively small. Immunity to rubella in different categories of population (children 3 months to 18 years, college students, nurses in pediatric, newborn and intensive care units, student nurses, and women of childbearing age) was determined by hemolysis in gel (HIG) and hemagglutination inhibition (HI) methods. Susceptibility was defined as an absence of antibody at a dilution of 1:16 in HI, and hemolysis of less than 7 mm in the HIG test. Compared with previous studies on the incidence of antibodies to rubella in women of childbearing age, a mild decrease in the percentage of sero-negative women was found.

A technique for the rapid identification and quantification of Group B streptococci (GBS) utilizing timed coagglutination and selective broth media was designed. A prospective study of 283 mothers and 121 newborns based on this methodology revealed a GBS colonization rate of 5.3 and 4.1%, respectively. A retrospective study of 19,875 births revealed a GBS attack rate of 0.2 per 1,000 live births. Both the low colonization and the low attack rates confirm previous anecdotal reports of a low incidence of GBS colonization and disease in Israel. The technique described herein can aid in identifying those infants at risk for invasive disease.

We studied the epidemiology of cytomegalovirus (CMV) infection in women and neonates in the Jerusalem area. During the 6-month period from January to June 1982, we recorded the presence of antibody to CMV in pregnant and parturient Jewish and Arab women from West and East Jerusalem, respectively, in 18- to 22-year-old female students at a religious college, in female university students, in 18- to 22-year-old student nurses, and in the nursing staff of the Neonatal Intensive Care Unit in our hospital. In the 18- to 22-year-old age-group, the religious college students not working in a medical setting had the lowest rate of seropositivity. No difference in the rate of CMV infection was found between Jewish and Arab parturient women. In five cases of congenital CMV infection, representing different clinical aspects of the disease, a comparative study of diagnostic procedures for congenital CMV infection was performed.