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Background In September 1994, the Minnesota Department of Health detected an increase in the number of reports of Salmonella enteritidis infections. After a case–control study implicated a nationally distributed brand of ice cream (Schwan's) in the outbreak, the product was recalled and further epidemiologic and microbiologic investigations were conducted. Methods We defined an outbreak-associated case of S. enteritidis infection as one in which S. enteritidis was cultured from a person who became ill in September or October 1994. We established national surveillance and surveyed customers of the implicated manufacturer. The steps involved in the manufacture of ice cream associated with cases of S. enteritidis infection were compared with those of products not known to be associated with infection matched for the date of manufacture. Cultures for bacteria were obtained from ice cream samples, the ice cream plant, and tanker trailers that had transported the ice cream base (premix) to the plant. Results We...

Transmission of the human immunodeficiency virus (HIV) to five patients receiving care from an HIV-infected dentist in Florida has recently been reported. Current data indicate that the risk of HIV transmission from health care workers to patients is low. Despite this low risk, programs to notify patients of past exposure to an HIV-infected health care worker are being conducted with increasing frequency.We recently conducted an investigation of all the patients cared for by an HIV-infected family physician during a period when he had severe dermatitis caused by Mycobacterium marinum on his hands and forearms. After reviewing the patients' records, we notified 336 patients who had undergone one or more procedures (digital examination of a body cavity or vaginal delivery) placing them at potentially increased risk of HIV infection. The patients were offered tests for HIV infection and counseling.Of the 336 patients, 325 (97 percent) had negative tests for HIV antibody, 3 (1 percent) refused testing, 1 (less than 1 percent) died of a cause unrelated to HIV infection before notification, and the HIV-antibody status of 7 (2 percent) remained unknown. The direct and indirect public health costs of this investigation were approximately $130,000.The results of this investigation raise important questions about the risk of HIV transmission from health care workers to patients and the usefulness of HIV look-back programs, particularly in the light of recently published recommendations from the Centers for Disease Control. We propose that before a look-back investigation is undertaken, there should be a clearly identifiable risk of transmission of the infection, substantially higher than the risk requiring limitation of an HIV-infected health care worker's practice prospectively.

Adolescent smoking rates remain high and the use of smokeless tobacco is increasing, especially among males. Despite this continuing public health problem and the recent development of more effective prevention programs, few adolescents now participate in such programs at school. Recent legislation in Minnesota established guidelines for tobacco-use prevention programming and provides financial incentives to school districts to use more effective methods. The Minnesota-Wisconsin Adolescent Tobacco-Use Research Project has implemented an evaluation design that will provide data on the efficacy of this statewide approach to the prevention of tobacco use among adolescents. This article describes the current state of tobacco-use prevention programming in Minnesota schools, current efforts to improve on that record, and the research design set up to evaluate these strategies.

The Minnesota Department of Health has successfully introduced nonsmoking legislation which was enacted by the Minnesota Legislature in June, 1985. The legislation raises the excise tax on tobacco products and appropriates a percentage of the excise tax revenues to fund multiple programs comprising a coordinated nonsmoking initiative. Specific appropriations fund statewide tobacco-use prevention curricula targeted for adolescents; a continuum of nonsmoking education from kindergarten through grade 12; a multi-media public education and communications campaign; competitive special project grants to community health service agencies and nonprofit organizations for community-level and statewide smoking prevention programs; and peer-reviewed program evaluation.