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In 1979 the infant mortality rate (IMR) dropped nearly 50% in a rural health district in southeast Georgia, and this lower rate continued during the next two years. For infants born during 1979 to 1981, the IMR was 12.4 as compared with 21.6 for those born from 1974 to 1978. Using linked birth and infant death records to identify shifts in the components of infant mortality in this district, we found that the change in IMR primarily reflected a decrease in neonatal and postneonatal deaths among infants with birth weight greater than or equal to 2,500 gm, rather than a change in the distribution of birth weights. Although the IMR was approximately twofold higher in white than in black infants, a similar relative decline in mortality was observed in both racial groups. For infants weighing greater than or equal to 2,500 gm, approximately half of the lower death rate was due to fewer deaths caused by infections. The decline in mortality in this district was greater than declines in neighboring districts and accompanied efforts to improve services for medically indigent mothers and infants. The findings suggest that in areas with high infant mortality, initial efforts to lower mortality should focus on primary care programs rather than more specialized interventions.

In the period 1960 to 1979, 177 cases of tularemia occurred in residents of Georgia. A tick bite was the implicated source of exposure in eight cases (4.5%), whereas 91 cases (51.4%) were associated with direct contact with infected rabbits. In Georgia and other southeastern states, the epidemiology of human tularemia infection primarily involves rabbits. However, a diagnosis of tularemia should still be considered in this region in a febrile patient with or without a primary lesion or reported exposure to rabbits. A history of having been bitten by a tick may be the major clue in determining the diagnosis. A primary ulcerative lesion on the legs or in concealed body areas such as the axillary or intergluteal regions, is commonly the presenting sign in the patient with tick-borne tularemia.

In 1980-1981, 158 motorcycle-associated fatalities occurred in Georgia, accounting for an estimated 6,113 lost years of productive life. Death ratios were highest for men 20 to 29 years of age, and motorcycle-associated fatalities occurred most frequently during summer months, on weekends, and during afternoon and evening hours. Forty-six percent of motorcycle-associated fatalities did not involve another vehicle, and head injuries alone or in combination with other injuries were responsible for death in approximately half. Helmet use, an effective measure for preventing motorcycle-associated fatalities, is required in Georgia; additional injury prevention strategies are discussed.

Eight cases of central nervous system infection due to La Crosse (California serogroup) virus were detected in Georgia children in 1982. The patients were residents of the state, without histories of travel away from the vicinities of their homes during the 30 days before the onset of their illnesses. All were hospitalized with a diagnosis of aseptic meningitis or encephalitis; none had sequelae. Onset dates were from May 1 to Aug 30. Distribution of cases within the state suggested that active transmission of La Crosse virus occurred at least in the southeast quadrant of the state. The epidemiology and natural cycle of La Crosse in the southeastern United States are briefly discussed.

In late summer 1981, a widespread outbreak of acute bacterial conjunctivitis occurred in southeast Georgia, affecting primarily grade-school children. This outbreak was similar to previously described seasonal conjunctivitis in the South. As suggested in previous studies, the eye gnat, Hippelates pusio, may serve as a mechanical vehicle in the transmission of the suspected causative agent, a possible Haemophilus species. The 1981 Georgia outbreak illustrates that "gnat sore eyes" is not obsolete and apparently can occur unpredictably during warm months in the southern states. Physicians and other health-care workers should be aware of the unique clinical and epidemiologic features of acute seasonal conjunctivitis.