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To help college health services in all parts of the country improve their approach to latent tuberculosis, two Listservs were provided for them to post their questions on dealing with TB infection. In this article, the authors present some of the questions posted in the Listservs and their corresponding answers. In their answers, the authors have tried to highlight areas of agreement, continuing controversy, and discrepancies between the Massachusetts recommendations and those of the Centers for Disease Control and Prevention and the American College Health Association. The authors conclude that a successful program of risk assessment, targeted tuberculin skin testing, and treatment of latent TB infection benefits both the individual student and the college community. Such an approach prevents cases of active TB and also uses college health service financial resources and personnel time efficiently.

Abstract. A double-blind, placebo-controlled comparison of single component and combination measles, mumps, and rubella (HPV-77:DE-5 and RA 27/3) virus vaccines involving 502 young children was conducted. The rubella antibody response was similar with RA 27/3 rubella and measles-mumps-rubella (RA 27/3) vaccines, but was diminished with the combination vaccine that incorporated HPV-77:DE-5 rubella. There was no evidence of enhanced clinical reactivity with either of the measles-mumps-rubella vaccines. Pediatrics 68:18-22, 1981; measles-mumps-rubella vaccine, measles vaccine, mumps vaccine, rubella vaccine, viral interference, viral vaccines. [ABSTRACT FROM AUTHOR]

Abstract. We selected 16 schools representing a broad socioeconomic cross-section of metropolitan Omaha and obtained nasopharyngeal cultures for Haemophilus influenzae from 1,084 healthy 4- to 7-year-old children. We found that 34.2% of the children carried nontypable strains and 2.0% carried type b strains. Carriage rates were not influenced by recent illness, family size, or number of people sharing a bedroom. The prevalence of ampicillin-resistant H influenzae in the sample population was 0.9% for nontypable strains and 0.4% for type b strains; it was not significantly different in the group of children who had recently used betalactam antibiotics. One child carried a nontypable strain which was resistant to both chloramphenicol and tetracycline, the first chloramphenicol-resistant H influenzae detected in Omaha. A survey of healthy children may be a useful method for projecting a community's risk of disease caused by ampicillin-resistant H influenzae. Among the nasopharyngeal isolates from healthy children, 2.7% of nontypable strains and 18.2% of type b strains were resistant to ampicillin (P < .01). During the same five-month period in Omaha; clinical failure in the treatment of otitis media with ampicillin was uncommon and four (20.0%) of 20 cases of H influenzae type b bacteremia and meningitis were caused by ampicillin-resistant organisms. Pediatrics 64:287-291, 1979; Haemophilus influenzae, ampicillin, antibiotic resistance, chloramphenicol, carrier state, tetracycline. [ABSTRACT FROM AUTHOR]

Giardia lamblia has emerged as the most common intestinal parasite in the United States. This article presents a brief review of the clinically important aspects of giardiasis and evaluates the currently used therapeutic agents. Three drugs have been advocated for the treatment of giardiasis: furazolidone (Furoxone®), metronidazole (Flagyl®), and quinacrine (Atabrine®). None of them, however, is ideal. Metronidazole and quinacrine are more effective than furazolidone, but furazolidone has the advantage of a liquid formulation that makes administration to children easier. Quinacrine is much less expensive than the other two agents but has a somewhat higher rate of side effects and a bitter taste. There is concern about the carcinogenic potential of furazolidone and metronidazole, but this has not been evaluated for quinacrine. In the balance, we conclude that quinacrine is probably the preferable drug to use in the pediatric age group because of proven effectiveness and lower cost. [ABSTRACT FROM AUTHOR]

In Omaha, from 1974 to 79,30(12.5%) of 240 patients with Haemophilus influenzae bacteremia or meningitis had a wide variety of conditions known to be associated with increased susceptibility to bacterial infection. Neonates and adults accounted for 47 per cent of the infections. Non-type b and non-typable strains caused 41 per cent of the episodes. Forty-one per cent of patients had bacteremia with no detectable focus of infection. The incidence of meningitis was low. Mortality was 28 per cent, considerably higher than in patients who were previously healthy. A review of the medical literature indicated that low-birth weight infants and patients with leukemia and other malignancies undergoing chemotherapy, splenectomy, congenital asplenia, sickle cell anemia, immunoglobulin deficiency diseases, cerebrospinal fluid shunts, and skull defects are at greater risk for systemic H. influenzae disease than the general population. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article about the MMR vaccine by H. Peltola and O.P. Heinonen.