Widespread West Nile virus activity, eastern United States, 2000.

In 1999, the U.S. West Nile (WN) virus epidemic was preceded by widespread reports of avian deaths. In 2000, ArboNET, a cooperative WN virus surveillance system, was implemented to monitor the sentinel epizootic that precedes human infection. This report summarizes 2000 surveillance data, documents widespread virus activity in 2000, and demonstrates the utility of monitoring virus activity in animals to identify human risk for infection.

Effect of HIV/AIDS versus other causes of death on premature mortality in New York City, 1983-1994.

This study examined years of potential life lost (YPLL) before age 65 years to assess the relative impact of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) versus other leading causes of death on premature mortality in New York City, New York, between 1983 and 1994. Most causes of death showed substantial year-to-year variation in YPLL, with the exception of HIV/AIDS. The YPLL attributed to HIV/AIDS increased monotonically from 11,866 in 1983 to 167,317 in 1994, a nearly 15-fold increase. The rank order of the relative contribution of HIV/AIDS to total YPLL changed from the eighth leading cause of death to the leading cause. YPLL from heart disease, which ranked second in 1983, declined to fourth in 1994, homicide was unchanged, and chronic liver disease declined from fifth to ninth rank. The annual YPLL attributed to malignant neoplasms was similar to that for heart disease, but peaked in 1984, and the reduction over the subsequent decade was about 13%. Total YPLL was 78% greater among males than among females in 1983 and was nearly twice as high in 1994. Premature mortality decreased steadily for non-Hispanic whites, from 150,967 to 135,027 years for the years 1983-1994, while increasing 20% among blacks (from 179,176 to 215,826 years) and 48% among Hispanics (from 89,869 to 132,869 years). Among blacks and Hispanics, homicide contributed more years of YPLL than did either heart disease or malignant neoplasms in every year of observation. The HIV/AIDS epidemic and mortality associated with violence have become important public health challenges to the health and well-being of New Yorkers.

Trends in age at the first medical evaluation of human immunodeficiency virus infection among infants born to infected mothers. New York City Pediatric Spectrum of HIV Disease Clinical Consortium.

OBJECTIVE: To evaluate the trends in age at the first medical evaluation of human immunodeficiency virus (HIV) infection among infants enrolled in the Pediatric Spectrum of Disease study born to mothers infected with HIV. DESIGN: Retrospective study based on medical chart review. SETTING: Nine pediatric centers in New York City. PARTICIPANTS: Infants (N = 925) born between January 1988 and December 1991 to mothers infected with HIV; the infants were examined for HIV infection by age 2 years and were receiving medical care. RESULTS: In each successive birth cohort, an increasing proportion of infants was examined by 3 months of age (from 35% in 1988 to 76% in 1991, chi 2 = 38.1, P < .001). The median age at the first evaluation persistently declined among the cohort evaluated by 24 months. The median age decreased from 6 months in 1988 to less than 1 month in 1991. The proportion of infants who were examined because of HIV-related symptoms decreased in each successive birth cohort (1988, 65%; 1989, 59%; 1990, 42%; and 1991, 25%). CONCLUSIONS: An increasing proportion of newborns exposed to HIV are being examined within the first 3 months of life in 9 leading pediatric HIV centers in New York City. Prenatal HIV counseling and testing of mothers are optimal procedures because they benefit mothers, they allow the use of zidovudine to reduce the chance of HIV infection in the infants, and they allow mothers with HIV to be counseled about the potential risks of breast-feeding. The family and the pediatrician must have knowledge of the infants' HIV status as early in life as possible to allow the necessary postnatal interventions, including Pneumocystis carinii pneumonia prophylaxis, which reduces morbidity and may prolong survival.

Simultaneous transmission of Borrelia burgdorferi and Babesia microti by individual nymphal Ixodes dammini ticks.

Nymphal Ixodes dammini ticks, selected from a group of ticks in which 22 of 31 (71%) contained dual Borrelia burgdorferi and Babesia microti infections, simultaneously transmitted B. burgdorferi and B. microti to 4 of 7 (57%) hamsters exposed to individual ticks.