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Reports on the monitoring of illness and injury after Hurricane Katrina in Hancock, Harrison and Jackson counties in Mississippi from September 5 to October 11, 2005. Impact of the hurricanes on health facilities; Request of the Mississippi Department of Health to the U.S. Center for Disease Control to help conduct active surveillance at hospital emergency departments; Public health activities affected in the region.

Describes several outbreaks of hepatitis B virus (HBV) infections among residents in long-term care facilities in the U.S. in 2003 and 2004. Recommended practices for preventing patient-to-patient transmission of hepatitis viruses from diabetes-care procedures; Details of performing serological tests on specimens from nursing home residents in Mississippi; Number of HBV infections that occur each year in the U.S.

The article describes the surveillance activities conducted by the Mississippi Department of Health and the Centers for Disease Control and Prevention in response to the aftermath of Hurricane Katrina in coastal counties of Mississippi. The organizations collected data from emergency departments and federal Disaster Medical Assistance Team operation sites to monitor potential outbreaks of infectious disease or other injuries. The article presents the methods of data collections as well as the limitations of the findings.

The article presents a report by the U.S. Centers for Disease Control and Prevention of the only case of human rabies in 2005, and the first in Mississippi since 1956. The report describes the case of a previously healthy 10 year old boy who died of encephalitis, which was later attributed to rabies. The child presented a fever that was first evaluated by a pediatrician who diagnosed a viral illness. Two days later, the boy was taken to the emergency room for continued febrile illness. All tests were within normal levels. He returned to the emergency room in the evening as his symptoms had worsened. He was admitted to the hospital and suspected to have encephalitis. After admission, his neurologic condition deteriorated rapidly and he died 10 days later. The report is followed by an editorial note from the CDC.

A large outbreak of adenovirus type 4-associated acute respiratory disease (ARD) occurred at Fort Jackson, South Carolina, in 1997. A laboratory-based ARD surveillance program was initiated at Fort Gordon, Georgia, where advanced individual training was heavily populated with Fort Jackson soldiers. Adenovirus type 4 was isolated from 50% of 147 trainees hospitalized with ARD. Most (88%) introduced cases were in trainees from Fort Jackson.

This paper describes the implementation of the Medical Image Access System for Intensive Care Units (MIAS/ICU). MIAS/ICU is a distributed computer system that integrates the collection of computed radiography images with information from the Hospital Information System (HIS) to allow caregivers in two Intensive Care Units (ICUs) at University Medical Center (Tucson, AZ, USA) to view digital chest radiographs on dual-monitor workstations within minutes of the time the exposures are made. The system uses entirely "off-the-shelf" hardware components and software based on widely followed standards. MIAS/ICU is based on an innovative modular software architecture that allows simple incremental expansion of the system, along with enhanced portability among platforms.

The relationship between splenomegaly and visceral leishmaniasis (VL) was investigated during a cross-sectional study in 2,941 individuals in Baringo District, Kenya, where both malaria and VL are endemic. Spleen size was correlated with presence of malaria parasites in thick blood films and with evidence of present or past Leishmania donovani infection as determined by serology and history. Marked splenomegaly (Hackett grade 3 or greater) significantly correlated with present or previous leishmanial infection (chi 2 = 53.5; p < 0.001) whereas moderate splenomegaly (Hackett grade 1 or 2) significantly correlated with malaria parasitaemia (chi 2 = 73.03; p < 0.001). The presence of antimalarial antibodies did not contribute to the differentiation of the cause of splenomegaly. The diagnostic significance of splenomegaly in this population is discussed.

Characteristics of workstations for use in digital radiological imaging have been investigated for many years. However, much of this investigation has focused on the workstation in isolation, and has often been directed almost entirely at user interface issues. Certainly these issues are critical, but with the increasing use of commercial workstations it is important to look at the workstation in the context of the medical information environment and examine some important underlying characteristics required to meet the demands of digital radiology. This article examines the role of storage components in these workstations both architecturally and operationally. Both aspects are viewed with consideration of their impact on the internals of the workstation and its interaction with the external information system. By considering these aspects of the workstation it is apparent that local storage and image preloading are required to support diagnostic viewing. Additional operational and architectural strategies are required to efficiently manage information within the workstation.

The establishment of a communications network requires the definition of addressing schemes to identify systems attached to the network. When it is anticipated that such a network will interconnect to, or communicate with, other similar networks it is beneficial to define standardized addressing schemes. This paper discusses the need for the standardization of network service access point (NSAP) addresses in picture archiving and communications systems (PACS) which use the open systems interconnect (OSI) communications protocols. Possible methods for establishing the necessary hierarchy of address registration authorities are discussed, along with the corresponding address formats.

An implementation and evaluation of a prototype multivendor communications system which complies with the American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) standard for communications in digital radiology is discussed. The system allows communications between interfaces from different manufacturers within a networked environment. The implementation includes network software compatible with the International Standards Organization's Open Systems Interconnect standard. The experience of the implementation effort and the evaluation of the system provide the basis for a critique of the ACR-NEMA standard. It is concluded that the ACR-NEMA standard is not well suited for application to the networked environment of picture archiving and communications systems. Two possible solutions are recommended for this problem. The first is a major revision of the existing standard. The second is the development of a family of network communications standards for digital radiology.

The records of 108 patients treated for bacterial endocarditis were reviewed. Six were diagnosed at autopsy and had not been treated for endocarditis. Of the 102 treated patients, 32 died during the first 30 days and 32 more were dead by 365 days. Although some reports indicate a much greater survival rate, our findings are more in keeping with those reports giving a rather poor long-term outlook for patients with endocarditis.

Because leptospirosis has been an important cause of morbidity in U.S. soldiers training in the Republic of Panama, we conducted a randomized, double-blind, placebo-controlled field trial during the fall of 1982 to determine whether doxycycline was an effective chemoprophylactic agent against this infection. Doxycycline (200 mg) or placebo was administered orally on a weekly basis and at the completion of training to 940 volunteers from two U.S. Army units deployed in Panama for approximately three weeks of jungle training. Twenty cases of leptospirosis occurred in the placebo group (an attack rate of 4.2 per cent), as compared with only one case in the doxycycline group (attack rate, 0.2 per cent, P less than 0.001), yielding an efficacy of 95.0 per cent. This study demonstrated the value of doxycycline as a prophylactic drug against leptospirosis.