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The aim of this research was to evaluate a school-based AIDS education program in Eastern Europe. Four evaluation segments were undertaken: process and outcome evaluations of the training of AIDS educators and of the educational activities for students. While most AIDS education curricula focus on the content of the education, findings demonstrate that other aspects also need to be considered. (Contains 24 references.) (GCP)

A comparison of New York's traditional communicable disease surveillance system for diarrhea-associated hemolytic uremic syndrome with hospital discharge data showed a sensitivity of 65%. Escherichia coli O157:H7 was found in [...]

We analyzed the diversity (Simpson's Index, D) and distribution of Listeria monocytogenes in human listeriosis cases in New York State (excluding New York City) from November 1996 to June 2000 [...]

This report summarizes the spread of a raccoon rabies epizootic into New York in the 1990s, the species of animals affected, and human postexposure treatments (PET). A total of 57,008 [...]

Characteristics of coccidioidomycosis, a systemic fungal disease caused by Coccidioiodes immitis, has been studied in New York State using hospital discharge records and state mycology laboratory data. Only sporadic cases have been reported in NY and elsewhere in the US outside the Southwest. Findings indicate the disease may be more common in residents of New York than had been thought and show acquisition to be travel-related. Greater awareness of the disease among healthcare providers would be helpful in its diagnosis and in prevention of associated illnesses and death in places where it is not endemic., Coccidioidomycosis, a systemic fungal disease caused by Coccidioides immitis, is endemic in the southwestern United States and in parts of Mexico and Central and South America. Only sporadic cases have [...]

Incentives appear to improve immunization rates among children enrolled in the Special Supplemental Food Program for Women, Infants, and Children (WIC). Of 836 children eligible for the measles vaccine enrolled in a study, 74% received immunizations before the study concluded. The group was assigned to nearby WIC clinics using one of three strategies: referral, voucher or escort. Immunization rates were 5.5 times higher among children who were escorted by a health professional to the pediatric clinic than among children receiving simple referrals for immunizations. Children at escort sites were usually vaccinated within 14 days compared to 45 for referral sites and 26 for voucher sites. Families who were required to return monthly rather than every two months to pick up their WIC vouchers until their child was immunized also were much more likely to vaccinate the child. WIC is a government-sponsored program serving low-income families.

The prevalence of chlamydial infection and associated risk factors were studied in 1531 women from ten clinics in New York State excluding New York City. Overall Chlamydia infection rates were 13.6%; 17.6% in eight high risk family planning and STD clinics, and 5.7% in two low risk college and private clinics. Risk factors for Chlamydia infection included: age |is less than~20 years (odds ratio 1.6), use of oral contraceptives (odds ratio 2.0), a history of having more than one sexual partner (odds ratio 1.7) and, in one clinic where data was available, inflammation on Papanicolaou smears (odds ratio 2.1). These data helped secure funding for Chlamydia preventive services and permitted development of a risk profile (score card) of Chlamydia for each age group. Use of such score card can be most helpful in assigning which patients could benefit most from Chlamydia cultures, especially in those areas where testing in unavailable or too costly to screen all patients.

Lyme disease is caused by the spirochete Borrelia burgdorferi, and is passed from one person or animal to another by the bite of the pinhead-sized tick Ixodes dammini. Although it was first described in 1977 in Lyme, Connecticut, the disease is not new nor is it limited to Lyme: New York State accounted for over half the reported cases in 1988. This article describes the spread of Lyme disease in New York State from 1977 to 1989. Between 1977 and 1981, 150 cases were reported; between 1986 and 1989, the number grew to 8,357 (of which 4,174 met the case definition, presented in a table). The number of confirmed cases of Lyme disease reported in 1989 was 1,942. As these figures increased, so, too, did the number of hospital discharges related to Lyme disease. The range of Ixodes dammini during the years studied is plotted. Before 1986, Lyme disease transmission in New York State took place in only four counties (Suffolk, Nassau, Westchester, Putnam): later, four adjacent counties were known sites of transmission (Rockland, Orange, Dutchess, Ulster). The considerable increase in the incidence of Lyme disease results in part from increased awareness, better diagnostic techniques, overdiagnosis and better reporting, as well as a true increase in the number of cases. As the range of infected and uninfected Ixodes dammini has expanded beyond its original range in Connecticut and Long Island, the Lyme disease rate has climbed. It is likely that reported rates underestimate the incidence of the disease. Physicians and patients alike should be aware of the symptoms, diagnosis and treatment of Lyme disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Data are presented from surveys of the AIDS epidemic in New York State, a region where some of the first AIDS cases in the country were reported. Between 75 and 85 percent of the AIDS cases in New York City are believed to be ultimately reported; reporting rates are even higher (95 percent) in New York State outside the city. Results of AIDS surveillance by both the state and New York City Departments of Health are presented for cases in different parts of the state; for men and women; by age; by race/ethnicity; by exposure groups; and among young adults and newborns (human immunodeficiency virus, or HIV, seroprevalence). Of the 26,576 reported cases of AIDS, 17,531 (66 percent) have died; 90 percent of the patients diagnosed before 1985 have died. Eighty-four percent of the AIDS patients in New York State live in New York City; 87 percent of the statewide cases (adults or adolescents) are male. Most cases occur among people between 20 and 49 years of age, and among bisexual/homosexual males or intravenous drug users. Drug users make up 39 percent of the cases in the state, a higher proportion than they do in the rest of the country (16 percent). The proportion of AIDS patients in New York State who are black or Hispanic is also higher than in the country as a whole (60 percent versus 37 percent). AIDS is the leading cause of death among men aged 30 to 49 and in women aged 20 to 39 in New York City, and in minority group members aged 30 to 39 in regions outside New York City. The AIDS cases identified in this state represent 23 percent of the cases reported in the US (through November 1989). (Consumer Summary produced by Reliance Medical Information, Inc.)

Results are presented from a study of human immunodeficiency virus (HIV) infection rates and the risk factors for HIV infection among female prisoners in New York State. Of interest too were associations between HIV infection and syphilis, hepatitis B, and tuberculosis. The New York State correctional system, the third largest in the US, houses 44,637 inmates in 56 facilities. Roughly 1,800 are female, of whom 77 percent are admitted from New York City (69 percent) or from the counties nearest New York City (8 percent). Blacks, Hispanics, and whites make up 47 percent, 34 percent, and 16 percent of the female inmate population, respectively. Women who entered the system between September and December 1988 were included in the study. Information was collected concerning prisoners' demographic characteristics, fertility, history of drug abuse, and HIV risk factors; in addition, prisoners were tested for syphilis and other diseases. Blood samples were analyzed in a way that did not allow linkage of a result to a particular prisoner. Ninety of the 480 women studied (18.8 percent) tested positive for HIV infection; of these, 53 were Hispanic, 31 black, and 6 white. The majority (40 percent) were between 20 and 39 years of age, and 82 (24 percent) were from New York City. The highest seropositivity rates were found in women aged 30 to 39 (25 percent). Approximately 68 percent reported histories of intravenous drug use, and 7 percent had had sexual contact with a person at risk for HIV infection. Seroprevalence (the rate of positive test results) was higher among less educated women, and almost one third of those born in Caribbean countries tested positive. There was a correlation between positive results from the syphilis test and positive results from HIV testing. The seroprevalence in the current study and in another one concerning male prisoners (17.4 percent) indicates that the prison problem is more severe than was thought. Additional medical care is needed in New York State for its many affected prisoners. (Consumer Summary produced by Reliance Medical Information, Inc.)

Data are summarized concerning the seroprevalence (incidence of positive blood tests) of human immunodeficiency virus (HIV) in newborn infants in New York State, with reference to rates in different geographic regions and among infants with different sociodemographic characteristics. These included birthweight (defined as low if it was less than 2,500 grams); maternal education (defined as low if a mother had fewer than 12 years of education); race/ethnicity; and evidence of drug abuse by the mother. Results from tests of blood samples analyzed between January 1, 1988 and August 31, 1989 were included. They showed that HIV seropositivity in infants was strongly associated with maternal drug use - in particular, use of cocaine. This could imply increased heterosexual transmission of HIV, since the use of sex to obtain drugs is well documented for syphilis and crack cocaine. HIV seropositivity was also correlated with the remaining three variables, which, in turn, were correlated with one another. The variables that best predicted an infant's HIV status were low birthweight and drug use by the mother. In New York State, the best predictor of HIV seropositivity was race/ethnicity: blacks and Hispanics were disproportionately affected. The geographic distributions of HIV seropositivity and the other variables in New York City and State are presented. The results suggest that preventive measures in New York City should focus not only on areas that already have high HIV or AIDS rates, but also on areas where drug use is common and birthweights are low. Such information is helpful in planning effective intervention strategies. (Consumer Summary produced by Reliance Medical Information, Inc.)

We reviewed medical records of 238 hospitalized patients with Escherichia coli O157:H7 diarrhea to identify risk factors for progression to diarrhea-associated hemolytic uremic syndrome (HUS). Data indicated that young age, [...]

The introduction of a vaccine against Haemophilus influenzae type b (Hib) has greatly reduced the incidence of Hib disease in young children, especially because of its required use for children in daycare. Hib causes a potentially deadly meningitis, and children under two attending daycare centers are at increased risk. Data were gathered on the number of cases of Hib infection among children under five years old in New York State (excluding New York City). The annual incidence fell from 30 per 100,000 (216 cases) in 1987 to 3 per 100,000 (42 cases) in 1991. However, the fall is due to reductions in cases among whites. Incidence among blacks did not change, suggesting poorer delivery of vaccine to this group. The greatest fall for children attending daycare was between 1989 and 1990 with 31 cases per 100,000 dropping to 9 per 100,000. A law mandating Hib immunization in children at 18 months old who attended daycare took effect in January of 1990.

ABSTRACT: Haemophilus influenzae type b commonly causes illness in young children, among whom transmission is known to occur. Most adults are believed to be immune to H influenzae type b and outbreaks of disease among adults appear to be uncommon. From July 14 to Aug 12, 1985, a cluster of six cases of acute febrile illness with cultures positive for H influenzae, biotype II (five cases) or untyped H influenzae (one case), occurred among adults in a nursing home and an adjoining hospital. All six case-patients had personal contact with at least one other case-patient. Among the 46 nursing home residents, men were more likely than women to become ill (44% vs 0%). This cluster of disease suggests that elderly adults may be more susceptible to H influenzae infection than is generally recognized and that outbreaks among adults may result from person-to-person transmission.