Sexually transmitted diseases in sexually abused children.

Over a 4-year period, 409 cases of suspected sexual abuse of children were reviewed to study sexually transmitted disease (STD). Sexually transmitted disease was identified in 54 (13%) of the 409 children: 46 cases of gonorrhea, six cases of syphilis, four cases of trichomoniasis, and three cases of condyloma acuminata. Nine of the 46 children with cultures positive for gonorrhea did not have a history of discharge. Four of the six children with syphilis also had a gonococcal infection. One child with syphilis had condyloma. Only one child had clinical features of syphilis. Sexually transmitted disease was more likely to be transmitted by an extended family member or a nonfamily member than by a father/stepfather (P less than .001). Laboratory tests that identify sexually transmitted disease may aid in the diagnosis of sexual abuse.

Genital tract papillomavirus infection in children.

Genital tract papillomas in five children were examined for the presence of human papillomavirus (HPV) DNA by molecular hybridization. Papillomavirus DNA was detected in each sample and was identified as HPV-6 (three cases), HPV-6 or HPV-11 (one case), or HPV-16 (one case). These viruses are the same as are responsible for genital papillomas (condylomata) of adults. The transmission of adult genital tract viruses to children occurs primarily by a venereal route but may occur by a nonvenereal route.

Analysis of plume emissions after papovavirus irradiation with the carbon dioxide laser.

This study was undertaken to evaluate potential inhalation hazards to operating room personnel after irradiation of tumors with the carbon dioxide laser. Cellular debris was analyzed for viability using labeled nucleotides and labeled glucose. In this way the plume was investigated for the presence of material with oncogenic potential. Most surgeons who have ablated venereal warts or certain tumors with the carbon dioxide laser have worried about possible hazards of inhaling the vapor that is produced as a result of their work. We utilized three methods to determine whether viable particles exist in the laser plume. Fortunately, it is most comforting that the metabolic studies, DNA and RNA studies and cytologic studies seem to indicate that the plume is biologically inactive.

Anogenital warts in childhood.

Fifteen children with anogenital warts are presented. Twelve cases were referred for assessment of sexual abuse which was established in six cases, strongly suspected in one, and excluded in three. In two, the source was unclear. Papillomavirus typing was carried out by HPV DNA dot and Southern blot hybridization using mixed HPV 6/11, 16/18, and 2/3 DNA probes on 15 specimens from 12 of the children. Seven biopsy specimens were positive for HPV 6 or 11 and one hybridized with both HPV 6/11 and 16/18 mixed sets of probes. Two specimens were positive for HPV 2, and a further two hybridized with both HPV 18 and 2. Three wart specimens could not be typed with the available genital or skin probes. The viruses causing genital tract papillomata are the same for children and adults. The identification of HPV 16/18 raises the concern of potential oncogenicity and stresses the need for long-term assessment. The diagnosis of sexual abuse was made on history rather than examination, as only two cases showed additional physical signs of sexual abuse. It is advocated that the presence of anogenital warts alone be sufficient grounds to pursue the possibility of sexual abuse. Nonsexual transmission, although possible, is far less likely.

[Sexual transmissibility of papillomaviruses]. / Untersuchungen zur sexuellen Ubertragbarkeit von Papillomviren.

Papillomavirus infections in the genitoanal region are detectable by the demonstration of type-specific HPVDNA (DNA-DNA hybridization, in situ hybridization on cell smears) or by a peroxidase-antiperoxidase assay using formalin-fixed paraffin sections for demonstration of common structural antigens of papillomaviruses. Using these methods an epidemiological study on sexual partners with genitoanal papillomavirus infections has been initiated.