Alexander Duncan Langmuir was recruited by the late Joseph Mountin, as I (1. H. S.) was after World War II, with the challenge to explore new areas that related to public health. Mountin was a leader who gained fame by challenging the old order and anticipating future needs (1). He foresaw the need for an agency such as the Communicable Disease Center (now the Centers for Disease Control and Prevention (CDC)) to service the states. In 1942, the Office of Malaria Control in War Areas was established by the Public Health Service in Atlanta, Georgia, to devise methods to reduce the incidence of malaria in our troops. This office also cooperated actively with the states in an intensive campaign to control malaria throughout the South where it was endemic. On January 1, 1946, following the war, a disease investigation and training center, the CDC, replaced the Office of Malaria Control in War Areas. The establishment of the CDC was the fulfillment of Mountin's foresight. He believed that the Public Health Service should have a field office that could provide state health agencies with the technical help of consultants with highly specialized knowledge and skills, and it came to be. Mountin's challenge to me (1. H. S.) in 1945 was succinct: "What are you veterinarians going to do for public health now that the war is over?" Further questioning by Mountin led to an order from him that I should prepare a list of zoonotic/animal diseases that affect human health. The resulting chart (2) inevitably led Mountin to ask what control measures could be put into effect. It was apparent that the epidemiology of most zoonotic diseases was not known, and control was not understood. Mountin summarized the situation by saying, "It appears that we have a lot of

When the practice of quarantine was first introduced in Europe, outbreaks of diseases such as smallpox, cholera, plague, and yellow fever that were thought to be introduced by travelers from abroad led to the creation of many draconian regulations. Ships arriving in ports were kept at a distance and travelers were detained in isolation for 40 days before they were allowed to proceed to their destinations. 1 The fear of imported disease contributed to provincialism and stifled trade and travel. How fortunate we are today that this fear has been removed. Liberal international health regulations have replaced harsh quarantine measures. Smallpox has been eradicated from the world and cholera, plague, and yellow fever are now mainly limited to rural areas of developing countries. International trade has burgeoned and long-distance mass air travel, one of the most extraordinary phenomena of our times, has transformed society. In 1981, an estimated 290 million

Our well-being depends on our association with animals that share our environment. From cereals, pastures, and crop residues that cannot be digested by human beings, cattle, sheep, and goats produce valuable proteins and fats. Cattle, buffalo, horses, camels, yaks, and llamas still provide most of the world's draft power.1 Fish and game animals supply a large amount of protein for people in developing countries. Nonfood animal products, such as wool, leather, and insulin, help to clothe and sustain us. And pet animals provide us with companionship and an outlet for the expression of kindness and love, without the risk of . . .

Treatment of Sexually Transmitted Bacterial and Protozoal Enteric Infections Get access A. Eugene Washington, A. Eugene Washington Search for other works by this author on: Oxford Academic PubMed Google Scholar Myron G. Schultz, Myron G. Schultz Search for other works by this author on: Oxford Academic PubMed Google Scholar Mitchell L. Cohen, Mitchell L. Cohen Search for other works by this author on: Oxford Academic PubMed Google Scholar Dennis D. Juranek, Dennis D. Juranek Search for other works by this author on: Oxford Academic PubMed Google Scholar Robert L. Owen Robert L. Owen Search for other works by this author on: Oxford Academic PubMed Google Scholar Reviews of Infectious Diseases, Volume 4, Issue Supplement_4, November-December 1982, Pages S864–S876, https://doi.org/10.1093/clinids/4.Supplement_4.S864 Published: 01 November 1982

A communitywide outbreak of gastrointestinal illness due to Giardia lamblia infection occurred in the city of Berlin, New Hampshire, during April and May 1977. The clinical, epidemiologic, and laboratory aspects of this outbreak are described here. In 213 predominantly symptomatic cases of G. lamblia infection diagnosed at a local hospital laboratory in a 6-week period, illness was characterized by prolonged diarrhea (median duration 10 days) and 13% of symptomatic infections required hospitalization. Treatment with either quinacrine or metronidazole was generally followed by symptomatic improvement. A communitywide survey of the city residents revealed that the majority (76%) of G. lamblia infections occurring during the epidemic period were asymptomatic and ran a self-limited course without treatment. No significant secondary, person-to-person spread occurred and no enteric pathogens other than G. lamblia were implicated. Water was epidemiologically implicated as the most likely source of infection with Giardia cysts being demonstrated in samples of treated water as well as raw source water. Evidence supported the occurrence of two simultaneous outbreaks in this city which is supplied by two largely independent water supply systems. Inspection of the two water treatment facilities revealed several defects which permitted untreated (raw) water to mix with treated water. Human or beaver could have been responsible for contaminating source water with Giardia in this outbreak. A marked reduction in both clinical and subclinical giardiasis was apparent two months after onset of the outbreak, apparently as a result of measures applied to interrupt waterborne transmission of Giardia.

Journal Article Occurrence of Malaria Acquired during Travel Abroad among American Civilians, 1970–1976 Get access Carlos E. López, Carlos E. López Parasitic Diseases Division, Bureau of Epidemiology Please address requests for reprints to Dr. Carlos E. López, Parasitic Diseases Division, Bureau of Epidemiology, Center for Disease Control, Atlanta, Georgia 30333 Search for other works by this author on: Oxford Academic PubMed Google Scholar Trenton K. Ruebush, II, Trenton K. Ruebush, II Parasitic Diseases Division, Bureau of Epidemiology Search for other works by this author on: Oxford Academic PubMed Google Scholar Myron G. Schultz Myron G. Schultz Parasitic Diseases Division, Bureau of Epidemiology Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 139, Issue 2, February 1979, Pages 255–260, https://doi.org/10.1093/infdis/139.2.255 Published: 01 February 1979

A 65-year-old man infected with Babesia microti failed to respond to therapy with oral chloroquine phosphate. He was then successfully dreated with diminazene aceturate, an experimental anti-protozoal agent. After his recovery from babesiosis, the patient developed acute idiopathic polyneuritis (Landry-Guillain-Barré Syndrome), which was probably related to his diminazene therapy.

Between Jan 1 and Oct 31, 1975, a cluster of ten cases of pneumocystis pneumonia occurred in children with acute lymphocytic leukemia (ALL) at the James Whitcomb Riley Hospital for Children in Indianapolis. The risk of infection appeared to be related to the intensity of chemotherapy. Furthermore, illness developed in nine of the ten patients between 30 and 100 days after initiation of therapy, suggesting a period of heightened susceptibility to infection. An indirect immunofluorescent test was used to detect antipneumocystis antibodies in serum samples collected from patients with pneumocystis pneumonia and their contacts. Members of the Riley Hospital staff who had close contact with infected children had a higher prevalence of elevated antibody titers (7/12) than other staff members (2/22; P = .004) or parents of infected patients (0/8; P = .01). This suggests that transmission of pneumocystis may occur within the hospital environment.

Three hundred fifty residents of Rome, New York, had laboratory-confirmed cases of giardiasis between 1 November 1974 and 7 June 1975. A random household survey showed an overall attack rate for giardiasis (defined as a diarrheal illness of 5 days or more) of 10.6%. A significant association was discovered between having giardiasis and using city water and between having illness and drinking 1 or more glasses of water a day. The presence of human settlements in the Rome watershed area suggested that the water supply could have been contaminated by untreated human waste. The infectivity of municipal water was confirmed by producing giardiasis in specific pathogen-free dogs fed sediment samples of raw water obtained from an inlet of a city reservoir. A microscopic examination of the water sediments uncovered a Giardia lamblia cyst in one sample. This was the first time that a G. lamblia cyst has been found in municipal water in an epidemic and the first time that such water has been shown to infect laboratory animals.

With the growth of international travel, exotic diseases have assumed increasing importance to the physician. They can be effectively prevented by the use of commonsense measures. The physician should be prepared to offer advice on food, drink, and use of prophylactid drugs and to give needed immunizations to patients planning to travel. The biggest pitfall in diagnosis of exotic disease is failure to connect a history of travel with the signs and symptoms. An answer to the simple question, "Where have you been?" should arouse suspicion of the correct diagnosis.

Journal Article Malaria Surveillance in the United States, 1974 Get access Peter K. Shaw, Peter K. Shaw Parasitic Diseases Branch Bureau of Epidemiology Search for other works by this author on: Oxford Academic PubMed Google Scholar Richard E. Brodsky, Richard E. Brodsky Parasitic Diseases Branch Bureau of Epidemiology Search for other works by this author on: Oxford Academic PubMed Google Scholar Myron G. Schultz Myron G. Schultz Parasitic Diseases Branch Bureau of Epidemiology Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 133, Issue 1, January 1976, Pages 95–101, https://doi.org/10.1093/infdis/133.1.95 Published: 01 January 1976

In 1974, seven cases of human echinococcosis were diagnosed in Arizona and New Mexico. A retrospective survey of Arizona and New Mexico hospitals obtained data on ten additional cases reported for the 5-year period 1969 through 1973. Sixteen cases were diagnosed as Echinococcus granulosus infections and one as E. multilocularis infection. The latter infection was in an Eskimo from Alaska, where E. multilocularis is endemic. All of the 16 E. granulosus cases were probably acquired autochthonously; 14 were diagnosed in American Indians of the Navajo (8 cases), Zuni (4 cases), and Santo Domingo (2 cases) tribes; the remaining 2 cases were diagnosed in non-Indian women. This is the first published account of echinococcosis autochthonous to Arizona and New Mexico. Evidence suggests that the infection may have been introduced only relatively recently to the areas populated by the American Indians and that parasite transmission to humans is increasing.

The nutritional status of 30 children infected with Ascaris lumbricoides was compared with that of 30 uninfected controls matched for age, race, sex, and family income. Statistically significant evidence of an adverse effect of ascariasis on serum albumin levels and plasma vitamin C levels was found, but no child had inadequate levels of these nutrients. Suggestive evidence of an adverse effect of the infection on weight for height and on riboflavin nutriture was also found. There were no significant differences between infected and control children with respect to seven other laboratory measurements.

The 161A strain of Naegleria isolated from a human nasal swab and reported earlier was further studied for its growth pattern, cyst-wall appearance, cytopathic effect on primary monkey kidney cells, and pathogenicity in mice. Results obtained in the study establish the pathogenic status of this strain. This constitutes the first isolation of a pathogenic Naegleria from a human nasal cavity.

The most serious consequences of infection with the large roundworm, Ascaris lumbricoides, are complications requiring surgical intervention, particularly intestinal obstruction caused by a bolus of worms. A study was conducted to estimate the incidence of this complication among infected children in an area of the southeastern United States where ascariasis is endemic. A chart review at three rural Louisiana public hospitals revealed that 21 patients had been hospitalized with intestinal obstruction secondary to ascariasis over a 3-year period. The prevalence of ascariasis in three parishes (counties) served by these hospitals was calculated from the results of 2,360 stool examinations performed by the State Health Department and one hospital laboratory. The prevalence of ascariasis in 1- to 5-year-old children was similar to that in 6- to 12-year-olds and ranged from 8% to 28% in the three parishes. Prevalence rates were three times higher for blacks than for whites. It was found that most cases of intestinal obstruction occur in children in the 1- to 5-year age group and that this incidence approximates two such complications per 1,000 infected children per year.

In March, 1973, a large feedlot near Phoenix, AZ, reported an increased incidence of bovine cysticercosis. Approximately 10% of cattle sent to slaughter from January to April, 1973, were infected with the cysticercus stage of Taenia saginata. One employee who worked at the feed mill and loaded hay in the fields was also found to be infected with T saginata. Recommendations for control of similar epizootics included educating employees about mode of transmission and improved personal hygiene, the inauguration of a surveillance program that included examination of employees prior to employment and periodically thereafter, maintenance of animal source and destination records, restriction of unauthorized personnel to critical areas, and periodic microbiologic assay of water supply.