A cohort of 839 young girls at the ages of 14 and 15 years was screened for total antibodies to herpes simplex virus (HSV) and, if positive, for specific antibodies to HSV-2, by means of a sensitive, enzyme-linked immunosorbent assay (ELISA). The cohort was followed from 1972-1987. Blood samples were obtained on six occasions during these 16 years. In total, 2270 blood samples were taken. The number of sero-converting girls was studied in relation to calendar time. Two methods were constructed for the statistical analyses. The first of these gave an estimate of the sero-prevalence at different points in time. This analysis showed that the sero-prevalence which was 23% against HSV-1 in 1972 had increased to 36% in 1976. At the end of the study in 1987, 50% of the cohort had sero-converted against HSV-1. The proportion of girls who had sero-converted against HSV-2 was 0.4% in the 14-15-year-olds and had reached 22% by the end of the study. The second statistical method used all the available information implicit in the observations so as to obtain a maximum-likelihood (ML) estimate of the prevalence. The ML estimates were slightly more precise, but the two estimates did not differ significantly. The observations were further analysed by the Mantel-Haenszel test in order to see if there was any dependence between positivity to HSV-1 and HSV-2 respectively but none was found.
OBJECTIVE: To describe trends and patterns in the AIDS epidemic among Scandinavian women with AIDS. SUBJECTS AND METHODS: All women with AIDS reported to national surveillance units in Denmark, Norway and Sweden in 1980-1990 were included for analyses. RESULTS: The number of heterosexually infected female AIDS cases increased over time. AIDS-defining diseases varied with transmission categories, a variation similar to that found among heterosexual Danish male AIDS cases. Heterosexually infected women were more frequently diagnosed with Pneumocystis carinii pneumonia than with oesophagus candidiasis compared with intravenous drug using women. Twenty-five out of 56 heterosexually infected women reported having a male partner who was bisexual or from a Pattern II country, while one in four did not recognize any risk in their sex partner(s). Survival time increased between 1980 and 1990 and did not differ from survival in male AIDS cases. In a proportional hazards model, age, year of diagnosis and the duration of known HIV-positivity before development of AIDS had an independent impact on survival. The number of women known to be HIV-positive for more than 1 year before diagnosis of AIDS increased over time, although the number of women tested for HIV close to the development of AIDS was especially high among heterosexually infected women. CONCLUSION: Increasing numbers of heterosexually infected women are being diagnosed with AIDS in Scandinavia.
In February 1976 an outbreak of gastroenteritis occurred among 819 aircraft passengers to and from Gran Canaria. 360 of them had gastroenteritis and 88 were hospitalized. Fecal specimens were collected from 710 of the passengers and 344 of them were positive for Salmonella typhimurium phage type 15. Food served on the flight was the source of infection. The repeated incidences of this kind support the necessity of laying down rules and recommendations for the control of air catering services.
In 1979-1980, a distinct outbreak of hepatitis A occurred among homosexual men in Stockholm, Sweden, city and county area. The epidemic comprised 145 known cases. It began in December 1979 and progressed in waves during the following 10 months, with three distinct peaks separated by about six-week intervals. Actually, the incidence of hepatitis A in the Stockholm area showed a fivefold increase during 1980 as compared to the previous year. Clinical serologic, and social characteristics were studied more closely in 98 of the 145 homosexual men. Verification of hepatitis A was made by a solid-phase radioimmunoassay technique for detection of antibody to hepatitis A virus of the immunoglobulin M class. In addition, 64% of the men showed findings consistent with a prior hepatitis B (antibody to hepatitis B core antigen and/or antibody to hepatitis B surface antigen) and 34% were Treponema pallidum immobilization-positive from a prior or concomitant syphilis. Employment in risk professionals was common; thus, 19% worked in restaurants or otherwise handled food and 20% were engaged in medical care as compared to the 1% occupied in either branch of work among the general population in Sweden. Sexual habits with multiple partners and oral-anal sexual contacts were judged to be of major importance in the spread of this epidemic. Some spread of hepatitis A to the general population probably occurred due to the risk occupations of many homosexual men.
In the middle of June 1980 an explosive outbreak of campylobacter enteritis occurred among the staff of a poultry abattoir in southern Sweden. In all 37 cases of acute gastroenteritis originating from the abattoir were reported and Campylobacter jejuni was isolated from the stools in 24 of them. When the outbreak occurred, a large proportion of the ordinary staff had been replaced by inexperienced teenagers working during their holidays. A specially big slaughter had also taken place the same week as these inexperienced workers had started. The holiday workers contracted the disease to a greater extent (71%) than the ordinary staff (29%). An overall screening revealed 5 asymptomatic carriers among the ordinary staff. In 3 cases secondary spread was found.
During an outbreak of diphtheria among alcoholics in Göteborg, Sweden, a study was made of the diphtheria-antitoxin antibodies in serum samples from 8 clinical cases and 36 carriers of toxin-producing Corynebacterium diphtheriae. 33/36 carriers were antibody-positive and had antitoxin titres greater than 0.01 IU/ml, a level which is regarded as relative protective, while only 1/8 clinical cases had such a titre. This patient presented a mild illness with no complications. The results of the study of this outbreak stress the importance of maintaining adequate antibody levels against diphtheria in highly developed societies.
The inactivated poliovirus vaccine is heat stabile, gives high serum IgG concentrations but less pronounced mucosal immunity and must be given as repeated injections. A new enhanced-potency Dutch inactivated vaccine could circumvent these difficulties. We compared antibody concentrations measured as neutralization or ELISA titers, and avidity of serum and salivary antibodies in children vaccinated with three doses of the earlier Swedish vaccine given over nine months or the new antigen-rich vaccine. After three doses, but not after two, serum neutralization titers for type 1 and type 3 poliovirus were higher using the new vaccine but secretory IgA levels in saliva were similar. The avidity of the serum IgG antibodies was significantly higher after two doses of the new vaccine than after three doses of the old. Thus the new vaccine gives excellent antibody responses of high titers and avidities, but should preferably be given in three doses.