Screening of males for Chlamydia trachomatis and Neisseria gonorrhoeae infections at STD clinics in three US cities -- Indianapolis, New Orleans, Seattle.

We assessed prevalence and risk factor data for men routinely screened for Chlamydia trachomatis and Neisseria gonorrhoeae in STD clinics in four US cities from May 1995-March 1999. Data were analysed separately for 'test-visits' (self-reported symptoms, clinical signs or sexual contact to an STD) and 'screen-visits' (STD screen only) for 32,595 men with 45,390 visits. Among test-visits in Seattle, Indianapolis and New Orleans, 8.7% (807/9285), 15.3% (1305/8519), and 10.1% (1551/15,296) of men were positive for C. trachomatis, and 10.2% (773/7543), 24.9% (2108/8478), and 30.4% (4746/ 15,629) for N. gonorrhoeae. Among screen-visits, 2.1% (88/4103), 7.3% (130/1790), and 5.6% (292/5183) of men were positive for C. trachomatis, and 1.8% (46/2576), 1.7% (31/ 1786), and 5.2% (274/5235) for N. gonorrhoeae. Positivity for screen-visits was particularly high among young men (15-24 years), and those reporting > 1 sex partner in the past 60 days. Substantial variation among sites in positivity warrants local determination of prevalence and risk factors to inform screening strategies.

Relationship between home food-handling practices and sporadic salmonellosis in adults in Louisiana, United States.

Salmonellosis is the leading cause of death caused by foodborne bacterial pathogens in the United States. Approximately 90% of salmonella infections are sporadic, but most of what is known about salmonellosis has come from outbreak investigations. We studied the risk for sporadic salmonellosis among 115 persons aged > or = 15 years reported to the Louisiana Office of Public Health during May 1998-April 1999, compared with 115 age-matched controls. Significantly more case-patients than controls had chronic underlying medical conditions [adjusted odds ratio (aOR) = 4.3; 95% confidence interval (CI) = 2.2-8.7]. Although reported consumption of specific food items likely to contain salmonella was not associated with illness, inconsistent handwashing between preparation of meat and non-meat items was associated with illness (aOR = 8.3; CI = 1.1-61.8). Enhanced measures to provide a consistently safe food supply and promote safer food preparation in households will depend on prevention of sporadic salmonellosis.

Initially unrecognized distribution of a commercially cooked meat product contaminated over several months with Salmonella serotype Infantis.

An outbreak of salmonellosis occurred among 63 wedding participants. The outbreak was investigated through cohort, laboratory, and environmental studies. Consumption of rice-dressing made from a commercially cooked, meat-based, rice-dressing mix was strongly associated with illness. Nineteen patient isolates, six company/grocery store isolates cultured from the rice-dressing mix, and one environmental isolate from a pump in the production line were of an identical outbreak strain of Salmonella Infantis characterized by pulsed-field gel electrophoresis. In the production line, cooked rice-dressing mix tested negative for S. Infantis before and positive after contact with the contaminated pump. The dressing-mix had an estimated 200 colony-forming units of salmonella per gram of product, and > 180,000 pounds were distributed in 9 states for > or = 2 months before contamination was recognized. Food manufacturers should be required to use systematic, hazard analysis critical control point risk management practices for all processed meat products, validated by periodic microbiologic monitoring of the end product.

Usefulness of partner notification for syphilis control.

BACKGROUND AND OBJECTIVES: In the United States, the recent syphilis epidemic has been followed by the lowest rates in 40 years. Syphilis control in the United States traditionally emphasizes partner notification; however, its role in elimination efforts remains undefined. GOAL OF THE STUDY: To describe and compare outcome measures of partner notification during and after the epidemic. STUDY DESIGN: Descriptive analysis of data obtained from interview records of patients with early syphilis in Louisiana during 1993 through 1996. RESULTS: Of 12,927 patients with early syphilis, 3,245 (25%) were identified through partner notification. A total of 7,120 (55%) patients named at least one infected contact. Patients named a mean of 2.3 contacts, resulting in 29,248 named contacts; of these, 22,825 (78%) were examined. A total of 9,374 (41%) of examined contacts were infected, including 18% who were newly identified as infected. No substantial differences were found between epidemic and postepidemic years. CONCLUSION: Partner notification is successful in identifying and treating a large number of infected persons. However, complementary strategies will be needed to eliminate syphilis.