Reduction in hepatitis B virus seroprevalence among U.S.-born children of foreign-born Asian parents -- benefit of universal infant hepatitis B vaccination.

We demonstrate that after implementation of recommendations for universal infant hepatitis B vaccination, HBV infection prevalence among children of foreign-born Asian parents in Georgia declined dramatically; horizontal transmission of infection within households has occurred infrequently; and the vast majority of infants and children have received the recommended hepatitis B vaccinations. These results provide evidence of the success of the hepatitis B infant vaccination program and highlight its potential impact on reducing chronic HBV infection morbidity and mortality among U.S. populations at high risk.

Canine and human factors related to dog bite injuries.

OBJECTIVE: To identify physical traits of biting dogs and characteristics of injured persons and dog owners associated with bite situations for use in public health prevention activities. DESIGN: Retrospective cohort study. STUDY POPULATION: Licensed dog and dog bite report data from June 30, 2002, to July 1, 2003, that were obtained from Animal Control Services of Multnomah County, Oregon. PROCEDURES: To determine the canine and human factors associated with dog bite injuries, the number of bites, dog and injured person characteristics, and the overall canine population were evaluated. Dog owner characteristics at the block group level were defined by use of geographic information system software through 2000 census information based on place of residence. RESULTS: During the study period, 636 dog bites were reported to Animal Control Services, and 47,526 dogs were licensed in Multnomah County. Risk factors associated with biting dogs included breed (terrier, working, herding, and nonsporting breeds), being a sexually intact male, and purebred status. Male children aged 5 to 9 years had the highest rate of injury (178 bites/100,000 children). Biting dogs were more likely than nonbiting dogs to live in neighborhoods where the residents' median incomes were less than the county median income value ($41,278). CONCLUSIONS AND CLINICAL RELEVANCE: Dog bites continue to be a source of preventable injury. Prevention programs should target owners of sexually intact male and purebred dogs and owners who live in lower income neighborhoods.

Vaccine effectiveness against medically attended, laboratory-confirmed influenza among children aged 6 to 59 months, 2003-2004.

OBJECTIVES: Influenza is a leading cause of illness among children. Studies rarely have measured influenza vaccine effectiveness among young children, particularly when antigenic match between vaccine and circulating viruses is suboptimal. We assessed vaccine effectiveness against medically attended, laboratory-confirmed influenza for children who were aged 6 to 59 months during the 2003-2004 influenza season. METHODS: In a case-control study that was conducted in a single pediatric practice, case patients who were aged 6 to 59 months and had laboratory-confirmed influenza were age matched 1:2 to eligible control subjects. Vaccination status was ascertained as of the date of the case patient's symptom onset. Conditional logistic regression was used to calculate vaccine effectiveness, adjusting for underlying medical conditions and health care usage. RESULTS: We identified 290 influenza case patients who were seen for medical care from November 1, 2003, to January 31, 2004. Vaccine effectiveness among fully vaccinated children, compared with unvaccinated children, was 49%. Partially vaccinated children who were aged 6 to 23 months had no significant reduction in influenza (vaccine effectiveness: -70%), but partially vaccinated children who were aged 24 to 59 months had a significant (65%) reduction in influenza, compared with unvaccinated children. CONCLUSIONS: Full vaccination provided measurable protection against laboratory-confirmed influenza among children who were aged 6 to 59 months during a season with suboptimal vaccine match. No vaccine effectiveness was identified with partial vaccination among children who were aged 6 to 23 months, affirming that children need to be fully vaccinated to obtain protective effects. These results strengthen the evidence of the vaccine's ability to reduce substantially the burden of disease in this age group.

Retrospective case series of suspected intentional paraquat poisonings: diagnostic findings and risk factors for death.

We investigated a cluster of canine poisonings around the 4th of July weekend in 2003 in dogs that visited a local park. Medical records review and personal interviews were performed on 17 suspect cases; 14 dogs met the case definition criteria. The 13/14 dogs were allowed off-leash at some point during their visit to the park; 7 owners noted their dog had either eaten something at the park or vomited up meat-like material within 1 h after their walk. Eleven of the 14 dogs died or were euthanized. Urine samples from 4 dogs were positive for trace amounts of paraquat and 1 vomitus sample tested positive. Tachypnea was a significant risk factor for death of the dogs. Oral or gastrointestinal ulcers were significantly correlated with recovery.