Timothy J. Dondero

An outbreak of Legionnaires' disease associated with a contaminated air-conditioning cooling tower.

In August and September 1978, an outbreak of Legionnaires disease occurred in Memphis, Tennessee. Of the 44 ill, 39 had been either patients, employees, visitors, or passers-by at one Memphis hospital (Hospital A) during the 10 days before. Assuming an incubation period of between two and 10 days, the onset of cases correlated precisely with the use of Hospital As auxiliary air-conditioning cooling tower. L. pneumophila was recovered from two samples of water from the tower. Infection appeared to have occurred both outside and within the hospital. A significant association was demonstrated between acquisition of Legionnaires disease and prior hospitalization in those areas of Hospital A that received ventilating air from air intakes near the auxiliary cooling tower. Tracer-smoke studies indicated that contaminated aerosols from the tower could easily reach these air intakes, as well as the street below, where four passers-by had been before they contracted Legionnaires disease. This represents a common-source outbreak in which the source of L. pneumophila infection and airborne transmission were identified.

Seroprevalence Rates of Human Immunodeficiency Virus Infection at Sentinel Hospitals in the United States

Abstract Background and Methods. To evaluate the epidemiology of infection with human immunodeficiency virus type 1 (HIV–1) in selected urban communities in the United States, we instituted active surveillance at sentinel hospitals by anonymous testing of samples of blood specimens for HIV–1 antibody. To reflect better the rates of HIV–1 seroprevalence in the communities served by the sentinel hospitals, we excluded specimens from all patients with diagnoses that are often associated with HIV infection. Results. From January 1988 to June 1989, 89,547 specimens were tested at 26 hospitals in 21 cities. The overall rate of HIV–1 seroprevalence was 1.3 percent, but it ranged from 0.1 to 7.8 percent according to hospital (median, 0.7 percent). The age distribution of persons seropositive for HIV–1 was similar across hospitals and closely paralleled that of persons with the acquired immunodeficiency syndrome (AIDS). In areas of low seroprevalence, HIV–1 infections were highly concentrated among men. However, t...

Heterosexually Acquired Infection with Human Immunodeficiency Virus (HIV): A View from the III International Conference on AIDS

Excerpt Although most cases of the acquired immunodeficiency syndrome (AIDS) in the United States continue to occur in homosexual or bisexual men and intravenous drug abusers, concern about widespr...

Legionnaires' Disease in Kingsport, Tennessee

Abstract In August and September 1977 a discrete cluster of 27 serologically or pathologically confirmed cases of Legionnaires disease, plus six highly presumptive cases were identified in the are...

Cutaneous myiasis in visitors to Central America.

Six cases of cutaneous myiasis occurred in three groups of visitors to Guatemala between February and May 1978. Attack rates ranged from 12% to 50%. Furuncular lesions were generally multiple and involved both exposed and usually unexposed areas of the body. Parasitic fly larvae recovered from two patients were identified as the botfly, Dermatobia hominis. Botfly infestation is endemic in areas of Central and South America and is acquired indirectly through the bite of carrier arthropods, including mosquitoes. Although reports of cases in North Americans visiting endemic areas are rare, the condition is probably much more common in such persons than it is currently believed to be. A history of travel to Central or South America should suggest the diagnosis.

Indochinese Refugees and Infectious Disease

Excerpt To the editor: Certain issues raised in the Bay Area Medical Volunteers letter on the health of Indochinese refugees (1) should be clarified. One of their major concerns is the prevalence ...