SWINE BRUCELLOSIS and human health

Swine brucellosis is caused by Brucella suis, a strain of bacteria which also cau ses human brucellosis, or undulant fever. T his disease is an imp 0 r tan t public health problem which affects thousands of farmers, livestock handlers, meat processors, and butchers .. The U. S. Department of Agriculture estimates that 6.15 percent of the 1.8 million swine herds in the Nation are infected with brucellosis. This represents about 131,000 in f e c ted herds on farms, where some 579,000 farm people come into daily c ontact with these herds. The infection rate among these rural persons varies considerably in different areas. The highest incidence of human brucellosis of swine origin is found in the major pork producing regions. In some areas the infection rate among hog producers is estimated to be as high as 20 percent. Brucellosis is also a health problem among livestock handlers who move swine and other animals from the farm to shipping points and to processors. The disease problem among persons processing pork has been of serious concern to public health authorities in the Midwest and Southeastern United States. The highest incidence of human infection has been found in those plants handling only swine. Veterinary and lay meat inspectors are other groups in which infection is frequently seen. The incidence of brucellosis among veterinarians has always been higher than in any other group. Attack rates in the past have exceeded 950 per 100,000 among rural practitioners (5)

Transactions of the Plague Control Conference of the United States Public Health Service and Twelve Western States

The plague problem is potentially of grave public health importance. The history of this disease over a period of centuries shows that it has several times assumed epidemic proportions, especially in cities. History also shows that when the disease appears in bubonic form contracted from rat fleas, it sooner or later may assume the pneumonic type and be spread from person to person with fatal results. From the evidence presented to the conference it appears that complete control of plague is not economically feasible without a great increase in Federal, State, and local expenditures. It is recommended that funds are made available for adequate survey and control work, an educational campaign to bring about greater appreciation of the dangers inherent in infected rodents habitat, and rat-proofing and eradicative measures to be taken in all cities and population centers

Menominee Tribe Health Care Program Planning

Federal legislation authorized the Menominee Indian Tribe of Wisconsin to obtain benefits and services from the Health Services Administration. IHS has developed a health care program for the Tribe that is based on an analysis of their health needs. This study was undertaken to research and evaluate Tribal health services, design a health care plan, and implement an adequate health care delivery program.Information was collected on tribal health problems through existing service records and other supporting data. An analysis of health problems and services was done in three areas: 1) health and socioeconomic problems; 2) health service resources; and 3) a comparison of problems and services. This was followed by the development of alternatives. The final health care plan included provisions for services. facilities, staffing, financial considerations. and implementation.Primary outpatient care is available to serve the Tribe in four counties. The utilization and availability of primary care facilities is not adequate. Barriers to the services include lack of transportation, and a lack of educational programs to teach the procedures for obtaining health care. A general prejudice against treatment at the health care facilities exists. Secondary in-patient care is available to any tribal member within thirty minutes travel time. Long-term care is also available, however, services are fragmented. The major health care problems for the Menominee Tribe are perinatal mortality, infant mortality, congenital abnormalities, otitis media, respiratory diseases, dental diseases, infectious and communicable diseases, accidents, diabetes, alcoholism, vision problems, obesity, and drug abuse. Health problems are directly related to thesocioeconomic status of the Tribe including poverty, lack of work, lack of health insurance, low educational attainment, lack of telephones, lack of central heating, lack of plumbing, lack of transportation, illegitimacy, overcrowded housing, outmigration, and multi-parity.Facilities should be consolidated and centralized. Specifications for the facilities, staffing requirements and square footage necessary are listed. Financial recommendations were proposed with the major one being an incorporated, nonprofit health care organization, enabling the Menominees to own and operate the outpatient facility. Alternatives to service delivery in three basic areas--program alternatives, facility-related alternatives, and financial alternative--were discussed in detail

Promoting health, preventing disease: objectives for the nation

Based on a conference held June 13-14, 1979, in Atlanta, Ga, organized by the Center for Disease Control and the Health Resources Administration."Fall 1980.

Guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus

In 1994, the U.S. Public Health Service (USPHS) and the Infectious Diseases Society of America (IDSA) recognized that, although strategies were available to reduce the frequency of opportunistic infections in patients who have human immunodeficiency virus (HIV) infection, information regarding prevention of both exposure and disease often was published in journals not regularly reviewed by health-care providers. In response, USPHS/IDSA developed comprehensive guidelines for health-care providers and patients that consolidated information pertaining to the prevention of opportunistic infections in persons infected with HIV. The resulting USPHS/IDSA guidelines were published in 1995 in the MMWR, Clinical Infectious Diseases, and the Annals of Internal Medicine, with an accompanying editorial in the Journal of the American Medical Association. The response to the 1995 guidelines (e.g., the many requests for reprints and observations from health-care providers) suggests that they have served as a valuable reference against which local policies regarding prevention of opportunistic infections could be compared. Because recommendations were rated on the basis of the strength of the evidence supporting them, readers were able to assess for themselves to which areas adherence was most important. In the United States, opportunistic infections continue to produce morbidity and mortality among the estimated 650,000\ue2\u20ac\u201c900,000 persons who are infected with HIV, especially among the estimated 200,000\ue2\u20ac\u201c250,000 persons who are severely immunosuppressed (i.e., persons who have a CD4+ T-lymphocyte count of <200 cells/mL). However, surveillance data indicate that the incidence of opportunistic infections has been changing in the United States. In HIV-infected men who have sex with men, Pneumocystis carinii pneumonia (PCP), toxoplasmic encephalitis, fungal infections, and disseminated Mycobacterium avium complex (MAC) disease have decreased in incidence. Prophylactic regimens against opportunistic pathogens and more potent antiretroviral drugs appear to be important factors influencing this decline in incidence. However, these decreases have not been observed among HIVinfected injecting-drug users, suggesting that more emphasis should be placed on providing currently recommended chemoprophylactic agents to all persons who have HIV infection and who meet appropriate criteria for prophylaxis for opportunistic infections. The surveillance data also indicate that the incidence of some opportunistic infections is not decreasing among either men who have sex with men or injectingdrug users, indicating that preventive strategies need to be developed and applied to a wider spectrum of opportunistic infections. Because much new data concerning the prevention of opportunistic disease have emerged since 1994, the USPHS and the IDSA reconvened a working group on November 7-8, 1996, to determine which recommendations needed to be changed. Participants included representatives from federal agencies, universities, and professional societies, as well as community health-care providers and patient advocates. Most attention was focused on recent data related to chemoprophylaxis against disseminated MAC disease, cytomegalovirus (CMV), and fungal infections and to immunization against Streptococcus pneumoniae. However, data concerning all the common acquired immunodeficiency syndrome (AIDS)-associated pathogens were reviewed, as appropriate. Factors considered in revising guidelines included: Incidence of disease; Severity of disease in terms of morbidity and mortality; Level of immunosuppression at which disease is most likely to occur; Feasibility, efficacy, and cost of preventive measures; Impact of intervention on quality of life; Toxicities, drug interactions, and the potential for drug resistance to develop. Consultants reviewed published manuscripts, abstracts, and material presented at professional meetings. However, guidelines were revised only if complete manuscripts providing data were available for review. A review of the data that served as the basis for the revisions, as well as the additional information discussed at the meeting but not deemed appropriate to justify a revision of the recommendations, will be published elsewhere. The guidelines developed by the USPHS/IDSA working group were made available for public comment by an announcement in the Federal Register and in the MMWR, and the final document was approved by the USPHS and the IDSA, as well as by the American College of Physicians, the American Academy of Pediatrics, the Infectious Diseases Society of Obstetrics and Gynecology, the Society of Healthcare Epidemiologists of America, and the National Foundation for Infectious Diseases.Preface -- How to use the information in this report -- Categories reflecting strength and quality of evidence -- Disease-specific recommendations -- Immunologic categories for hiv-infected children -- Drug regimens for adults and adolescents -- Drug regimens for children -- Prevention of exposure recommendations -- Costs of drugs and vaccines -- References.June 27, 1997.The following CDC staff member prepared this report: Jonathan E. Kaplan, M.D., National Center for Infectious Diseases Division of AIDS, STD, and TB Laboratory Research and National Center for HIV, STD, and TB Prevention Division of HIV/AIDS Prevention, Surveillance, and Epidemiology in collaboration with Henry Masur, M.D., National Institutes of Health, King K. Holmes, M.D., Ph.D., University of Washington, USPHS/IDSA Prevention of Opportunistic Infections Working Group.Includes bibliographical references (p. 45-46)

Guidelines for testing and counseling blood and plasma donors for human immunodeficienty virus type 1 antigen

The Public Health Service (PHS) has recommended a multifaceted approach to blood safety in the United States that includes stringent donor selection practices and the use of screening tests. Blood donations in the United States have been screened for antibody to human immunodeficiency virus type 1 (HIV-1) since March 1985 and type 2 (HIV-2) since June 1992. An estimated one in 450,000 to one in 660,000 donations per year (i.e., 18-27 donations) are infectious for HIV but are not detected by currently available screening tests. Because maintaining a safe blood supply is a public health priority, the Food and Drug Administration (FDA) recommended in August 1995 that all donated blood and plasma also be screened for HIV-1 p24 antigen, effective within 3 months of licensure of a test labeled for such use. Donor screening for p24 antigen is expected to reduce the number of otherwise undetected infectious donations by approximately 25% per year. Routine testing for p24 antigen in settings other than blood and plasma centers as a method for diagnosing HIV infection is discouraged because the estimated average time from detection of p24 antigen to detection of HIV antibody is 6 days, and not all recently infected persons have detectable levels of p24 antigen. Among children > or = 18 months of age and adults, diagnostic testing for HIV infection, including confirmatory testing, should routinely be performed with FDA-licensed assays for antibodies to HIV-1; p24-antigen tests alone should not be used for diagnosing HIV infection. This report provides PHS guidelines for a) interpreting p24-antigen-assay results, b) counseling and follow-up of blood donors who have positive or indeterminate p24-antigen-test results, and c) using p24-antigen testing in settings other than blood banks.Introduction -- P24-antigen\ue2\u20ac\u201ctest algorithm and interpretation of test results -- donor counseling, follow-up, and deferral -- implications for other HIV test sites -- Conclusions -- References.March 1, 1996.The following CDC staff members prepared this report: Eve M. Lackritz, Robert S. Janssen, Helene D. Gayle, Division of HIV/AIDS Prevention, National Center for Prevention Services; Charles A. Schable, Harold W. Jaffe, Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases.Includes bibliographical references (p. 8-9)

Benchmarking Home Health Care and Public Health Nursing Services

Purpose The Billings Area Indian Health Service (IHS) serves approximately 60,021 American Indians living in Montana and Wyoming. For many eligible American Indians in the Billings Area, home health care services are not available. The aims of this project are: 1) develop a current profile of existing public health nursing and home health care services on each reservation in the Billings Area IHS; 2) develop a profile of successful home health programs on reservations in the United States; and 3) integrate the two profiles to identify factors contributing to success and failure in home care programs. Methods Benchmarking, a key tool in Total Quality Management (TQM), was used in this project. Several phases are undertaken in a benchmarking process: planning, analysis, integration, action, and maturity. This project focused on the first three phases. Initially, the project team decided what to benchmark - skilled home health care. Next, profiles of the eight Billings Area IHS Service Units were developed. The project team then visited four sites across the U.S. where tribes provided home health care services to tribal members with partner agencies. Results The user populations of the Billings Area Service Units range from 3,700 to 10,400. The proportion of the population that is elderly has been used as an indicator of home health care need. The populations are relatively young with a high percentage of residents under age 5 and a relatively low percentage of residents over the age of 55. The leading causes of persons using home health care include heart disease, musculoskeletal disease, injuries and poisoning, cancer, respiratory disease and endocrine disorders. The availability of home health care resources on the Service Units varies widely. All Billings Service Units have public health nursing services, however, most the Public Health Nurses are only able to provide minimal home health care services. Tribal home health care partnerships developed by Fort Belknap in Montana, Cherokee Nation in Oklahoma, and the Navajo Nation in New Mexico, were reviewed with respect to service agreements, clients, and budget implications. Conclusion For any new skilled home health care service venture to be successful, the following components must be present: 1) commitment; 2) support; 3) communication; 4) leadership; and 5) autonomy. Prior to implementing a strategy of home health care services, several issues must be considered. These issues include: 1) size of service population; 2) geographic location of service population; 3) availability of collaborator agencies; 4) availability of skilled home health care professionals; 5) administrative capacity; 6) technology infrastructure 7) tribal support; and 8) community networks

Ohio River Pollution Survey

Ohio River Pollution Survey of 1939 that includes a survey of the 1924 water treatment plant and map of the water and sewer systems

Rural Health Research in Progress in the Rural Health Research Centers Program

This book describes the research and policy analysis projects underway in the Rural Health Research Centers Program of the Federal Office of Rural Health Policy (ORHP), Health Resources and Services Administration, U.S. Department of Health and Human Services. The objective of this program is to produce research and policy analyses that will be useful in the development of national and state policies to assure access to quality physical and behavioral health services for rural Americans.https://digitalcommons.usm.maine.edu/facbooks/1134/thumbnail.jp