Tuberculosis in a correctional facility.

BACKGROUND: After the identification of five suspected cases of tuberculosis (TB) in a Nassau County (New York) jail during a 3-week period, an epidemiologic investigation was begun to document the number of cases of TB infection and disease associated with the jail, the characteristics of current or former inmates with TB disease, and the factors contributing to TB transmission in the jail. METHODS: The county TB register was matched against the inmate files of the jail. Medical records from hospitals, the health department, and the jail were then reviewed. All inmates in the jail were skin tested during a mass screening. RESULTS: From January 1, 1988, through March 16, 1990, of 205 TB cases in the county, 49 (24%) were associated with the jail. Forty of the cases occurred among current or former inmates, one in a corrections officer, and eight among community contacts of inmates. The 40 inmates with TB were predominantly nonwhite (75%), unmarried (80%) men (90%), with a median age of 32 years. Twenty-three (58%) had a history of injecting drug use, and 14 (35%) were known to be seropositive for the human immunodeficiency virus. Thirty (75%) of the inmates had culture-confirmed pulmonary TB. Five (29%) of 17 Mycobacterium tuberculosis isolates had the same phage type and DNA fingerprint, which was consistent with transmission of infection within the jail. The mass screening revealed that 374 (20%) of 1855 inmates were tuberculin positive. CONCLUSIONS: Without an effective program of TB control, jails can act as reservoirs of disease for inmates and staff, and for the community into which the inmates are released.

Injury prevention practices as depicted in G-rated and PG-rated movies.

BACKGROUND: Previous studies on alcohol, tobacco, and violence suggest that children's behavior can be influenced by mass media; however, little is known about the effect of media on unintentional injuries, the leading cause of death among young persons in the United States. OBJECTIVE: To determine how injury prevention practices are depicted in G-rated (general audience) and PG-rated (parental guidance recommended) movies. DESIGN: Observational study. SETTING: The 25 movies with the highest domestic box-office grosses and a rating of G or PG for each year from 1995 through 1997. Movies that were predominantly animated or not set in the present day were excluded from analysis. SUBJECTS: Movie characters with speaking roles. MAIN OUTCOME MEASURES: Safety belt use by motor vehicle occupants, use of a crosswalk and looking both ways by pedestrians crossing a street, helmet use by bicyclists, personal flotation device use by boaters, and selected other injury prevention practices. RESULTS: Fifty nonanimated movies set in the present day were included in the study. A total of 753 person-scenes involving riding in a motor vehicle, crossing the street, bicycling, and boating were shown (median, 13.5 person-scenes per movie). Forty-two person-scenes (6%) involved falls or crashes, which resulted in 4 injuries and 2 deaths. Overall, 119 (27%) of 447 motor vehicle occupants wore safety belts, 20 (18%) of 109 pedestrians looked both ways before crossing the street and 25 (16%) of 160 used a crosswalk, 4 (6%) of 64 bicyclists wore helmets, and 14 (17%) of 82 boaters wore personal flotation devices. CONCLUSIONS: In scenes depicting everyday life in popular movies likely to be seen by children, characters were infrequently portrayed practicing recommended safe behaviors. The consequences of unsafe behaviors were rarely shown. The entertainment industry should improve its depiction of injury prevention practices in G-rated and PG-rated movies.

Age-specific incidence of chickenpox.

Because licensure of a chickenpox (varicella) vaccine is likely soon, it is important to ascertain the age-specific incidence of chickenpox. Increasing vaccine coverage and a resulting decrease in transmission may result in an accumulation of susceptible adults, followed by a shift of incidence into those older age groups in future years. Valid baseline age-specific incidence will make it possible to detect this phenomenon. Two studies were conducted in Kentucky to assess age-specific incidence of chickenpox. The first assessed chickenpox occurrence in two consecutive school-year cohorts of children from a geographically representative sample of Kentucky primary schools. The second gathered information from household members of those persons interviewed in the Behavioral Risk Factor Surveillance System telephone survey. The age-specific rates are remarkably similar between studies. Rates peak during the preschool and kindergarten years (ages 3-6). Approximately 20 percent of children remain susceptible to chickenpox after age 8 in both studies. The results from these two surveys will be valuable baselines for comparison with findings in incidence studies that will be performed after vaccine licensure.

The epidemiology of Lyme disease in Kentucky, 1985-1990.

Lyme Disease has become the most common vector-borne disease in the United States. To assess the extent of the disease in Kentucky, all case reports were reviewed for 1985-1990. A total of 51 cases met the current case definition. Epidemiologic features were similar to those reported nationally. Although the recognized tick vectors for Lyme Disease have still not been identified in Kentucky, physicians should educate their patients on the risk of Lyme Disease and measures to prevent tick bites. Reporting cases of Lyme Disease will continue to be important so that trends in the disease's occurrence in Kentucky can be monitored.

Roller coaster related fatalities, United States, 1994--2004.

OBJECTIVE: To determine the number of fatalities related to roller coasters and examine factors common to multiple incidents. METHODS: A case was defined as the death of a person, which was associated with a roller coaster in the United States between 15 May 1994 and 14 May 2004. Cases were identified from four DATA SOURCES: (1) Consumer Product Safety Commission, (2) Lexis-Nexis, (3) Medline, and (4) Safer parks. RESULTS: Forty people, ranging in age from 7 to 77 years, were killed in 39 separate incidents. Twenty nine (73%) deaths occurred among roller coaster patrons. Eleven fatalities resulted from external causes related to injuries from falls or collisions. Eighteen people died from medical conditions that might have been caused or exacerbated by riding a roller coaster; 15 were the result of intracranial hemorrhages or cardiac problems. Eleven (28%) deaths involved employees; all were caused by injuries. CONCLUSIONS: Approximately four deaths annually in the United States are associated with roller coasters. Prevention of roller coaster fatalities is dependent on establishing an effective surveillance system for amusement ride injuries, engineering rides to better protect both patrons and employees, improving training and supervision of employees regarding safety precautions, and posting cautionary notices near roller coasters for people with specified medical conditions. Further research is needed on roller coaster related deaths resulting from intracranial hemorrhages and cardiac problems.

Injury prevention practices as depicted in G and PG rated movies: the sequel.

OBJECTIVE: To determine whether the depiction of injury prevention practices in children's movies released during 1998-2002 is different from an earlier study, which found that characters were infrequently depicted practicing recommended safety behaviors. METHODS: The top 25 G (general audience) and PG (parental guidance suggested) rated movies per year from 1998-2002 comprised the study sample. Movies or scenes not set in the present day, animated, documentary, or not in English were excluded; fantasy scenes were also excluded. Injury prevention practices of motor vehicle occupants, pedestrians, bicyclists, and boaters were recorded for characters with speaking roles. RESULTS: Compared with the first study, the proportion of scenes with characters wearing safety belts increased (27% v 35%, p<0.01), the proportion of scenes with characters wearing personal flotation devices decreased (17% v 0%, p<0.05), and no improvement was noted in pedestrian behavior or use of bicycle helmets. CONCLUSIONS: Despite a modest increase in safety belt usage, appropriate injury prevention practices are still infrequently shown in top grossing G and PG rated movies. The authors recommend that the entertainment industry incorporate safe practices into children's movies. Parents should call attention to the depiction of unsafe behaviors in movies and educate children to follow recommended safety practices.

Shigellosis in Kentucky, 1986 through 1989.

A marked increase in the number of cases of shigellosis was reported in Kentucky in 1988. To examine reasons for this increase, we reviewed the 389 cases of shigellosis reported from 1986 through 1989. Ninety-three percent (285/305) of cases due to known species were due to Shigella sonnei. Sixty-two percent (243/389) of cases occurred in children less than 10 years of age. The annual incidence for blacks (6.8 cases per 100,000) was nearly four times that for whites (1.8 per 100,000). The increased number of cases in 1988 was due to outbreaks in five areas of the state, which accounted for 85% (200/234) of the cases. Three of the five outbreaks involved day-care centers. The primary mode of transmission appeared to be person-to-person; there was no evidence of a common source of infection from food or water. To prevent future outbreaks, cases of shigellosis need to be reported promptly to ensure appropriate investigation and control by local health departments.