John R. Herbold

Human immunodeficiency virus infections among civilian applicants for United States military service, October 1985 to March 1986: Demographic factors associated with seropositivity

During the six months from October 1985 through March 1986, blood samples from 306,061 civilian applicants for military service from the United States were tested for antibody to the human immunodeficiency virus (HIV). Four hundred sixty subjects were positive for the antibody as determined by Western (immune) blot reactivity. The mean prevalence of HIV infection in this population of teenagers and young adults was thus 1.50 per 1000. According to multivariate analysis, the following demographic factors were found to be significant independent predictors of a positive HIV-antibody test: age (adjusted odds ratio = 1.10 per year), black race (adjusted odds ratio = 2.04), male sex (adjusted odds ratio = 1.84), residence in a densely populated county (adjusted odds ratio = 1.05 per 1000 per square mile), and residence in a metropolitan area with a high incidence of the acquired immunodeficiency syndrome (adjusted odds ratio = 1.53). Antibody-positive applicants were identified in 43 of the 50 states. Counties with high prevalence rates for HIV (greater than 5 per 1000) were located in New York State (four counties), New Jersey (three counties), California (two counties), Maryland (two counties), and Texas, Colorado, and Washington, D.C.

Discrete-time deterministic and stochastic models for the spread of rabies

Discrete spatial and temporal models for the spread and control of rabies are developed, analyzed and simulated. First, a deterministic model is formulated, then an analogous stochastic model. The models are structured with respect to space (m patches), age (juveniles and adults) and disease state. For each patch there are six state variables corresponding to either juveniles or adults and their disease state: susceptible, infected, or vaccinated. The models have seven stages which repeat every year. The impact of different vaccination strategies on the dynamics of the deterministic and stochastic models are compared. In particular, the relationships among the vaccination proportion, the width of the vaccination barrier, the initial number infected, and the transmissibility of the disease are examined. An estimate for the probability of disease elimination is given for the stochastic model. It is shown that in some cases where the deterministic model predicts disease persistence, the stochastic model predicts a high probability of disease elimination.

Progress toward eliminating drug and alcohol abuse among U.S. military personnel

Since 1970, the Department of Defense has set forth a series of policies and programs to combat drug and alcohol abuse among military personnel. The goal of the current policy is one of zero tolerance toward drug and alcohol abuse. Programmatic areas to help attain this goal are assessment, deterrence and detection, treatment and rehabilitation, and education and training. Progress toward eliminating drug and alcohol abuse among military personnel is traced by examining efforts in each of these programmatic areas. The authors conclude that the dramatic decreases in drug use and more stable patterns of alcohol use since 1980 indicate that military policy and programs to eliminate drug abuse have been highly successful, but that military efforts to eliminate alcohol abuse should be intensified.

Substance use and health among U.S. military personnel: findings from the 1985 Worldwide Survey.

The relationship between substance use (alcohol, drugs, and tobacco) and health (health practices, number of illnesses, number of physician visits, and days hospitalized) was examined using data from the 1985 Worldwide Survey of Alcohol and Nonmedical Drug Use Among Military Personnel. Substance users, particularly heavy users, were less likely than nonusers to engage in health practices and were more likely to experience illness, physician visits, and hospitalizations. Significant effects on the number of illnesses were observed for heavy drinkers compared with abstainers, drug users other than marijuana only users compared with nonusers, and those who smoked one or more packs of cigarettes per day compared with nonsmokers. The potential of substance use programs in improving health status and health promotion programs in reducing substance use among military personnel is discussed.

Relationship between incidence of gastric dilatation-volvulus and biometeorologic events in a population of military working dogs.

OBJECTIVEnTo calculate the monthly incidence of gastric dilatation-volvulus (GDV) in a population of military working dogs during a 5-year period and determine whether there was an association with synoptic climatologic indices.nnnSAMPLE POPULATIONnMedical records of all military working dogs housed at Lackland Air Force Base,Tex, from Jan 1, 1993 to Dec 31, 1997.nnnPROCEDUREnConfirmed cases of GDV were identified from evaluation of medical records and used to calculate incidence of GDV. Factor analysis of local climatologic data was used to classify each day into 1 of 8 meteorologically homogeneous types of days for this location. Occurrence of GDV was compared with frequency of occurrence of synoptic climatologic days.nnnRESULTSn48 cases of GDV were identified from January 1993 through December 1997 Mean monthly incidence was 2.5 cases/1,000 dogs at risk (range, 0 to 18.5 cases/1,000 dogs; median, 2.5 cases/1,000 dogs). A seasonal increase in incidence of GDV was detected, because half of the episodes were during November, December, and January. An association with a specific synoptic climatologic day was not detected.nnnCONCLUSIONS AND CLINICAL RELEVANCEnSeasonal fluctuations in incidence of GDV may be associated with external factors that precipitate physiologic changes resulting in GDV. Although a specific cause-effect relationship was not documented, clinicians must be alert for the potential of seasonal variation in incidence of GDV and accordingly heighten their index of suspicion for the condition, particularly in populations of dogs that are predisposed to development of GDV.

Demography of HIV infections among civilian applicants for military service in four counties in New York City

During the period October 1, 1985, through July 31, 1986, serum specimens from 9,498 civilian applicants for military service from four New York City counties (New York, Kings, Queens, and Bronx) were tested for antibodies to the human immunodeficiency virus (HIV). Ninety-seven (1.03%) specimens were positive as confirmed by Western blot. Antibody prevalence was strongly associated with age. Among recruit applicants who were less than 18, 18–21, 22–25, and greater than 25 years old, HIV seroprevalence rates were 0.23%, 0.31%, 1.30%, and 2.95%, respectively. Among applicants of different racial groups, the rates of seroprevalence were as follows: whites, 19/2,553, 0.74%; blacks, 56/4,869, 1.15%; and others including Hispanic, 22/2,076, 1.06%. Rates among male applicants (84/7,938, 1.06%) and female applicants (13/1,560, 0.83%) were not significantly different (p = 0.45).

Surge capacity volunteer perspectives on a field training exercise specifically designed to emphasize likely roles during a disaster response.

Experience gained from involvement in a number of emergency response activities since September 2001 in Texas indicated that the likely roles of statewide medical reserve corps units typically included aspects such as crowd control, registration and tracking, and information management. The need for training specifically focused on these likely roles became apparent. A novel field training exercise was developed that specifically focused on these likely roles. The exercise centered on a scenario involving the surreptitious placement of radioactivity in high traffic areas across the country, resulting in the contamination of large numbers of individuals. Because the source of the contamination was unknown, surge capacity contamination screening and data collection centers became necessary. Feedback collected from drill participants was measured to be overwhelmingly positive, with the vast majority of participants indicating a marked improvement in their understanding of their likely roles in a disaster of this type. The approach used in this training effort may be of use to other disaster surge capacity organizations as part of their strategic planning efforts as a means of ensuring that individuals involved in response activities possess familiarity with their likely roles during a wide scale public health disaster event.

Emerging zoonotic diseases: An opportunity to apply the concepts of nidality and one-medicine

The use of animals as sentinels of human disease revolves around the concept of nidality. That is, an agent of disease occupies a particular ecologic niche and alterations in that niche will change the function of that agent relative to traditional host-agent-environment relationships. Nidality is a derivation of the root word nidus. Nidus is defined as a nest or breeding place, particularly a place where microbes such as bacteria, fungi, viruses, as well as other organisms and larger parasites, are located and multiply. Application of the concept of nidality and development of prevention strategies has most frequently been associated with military campaigns and interruption of tick-borne infections.Modern usage of the phrase “one-medicine” was popularized in the United States and Europe by Calvin Schwabe and the concept is attributed to Rudolph Virchow. It is applied today to the study of zoonotic disease and interventions in rural agricultural communities that share close living arrangements between people and their families, their pastoral work environment, and the animals for which they care.Integration of the two concepts of one-medicine and nidality provides an opportunity to apply a systems approach (i.e. general systems theory) to dealing with emerging zoonotic diseases in today’s global agricultural and industrial settings.