The geographic spread and temporal increase of the Lyme disease epidemic
Lyme disease is caused by the spirochete Borrelia burgdorferi, and is passed from one person or animal to another by the bite of the pinhead-sized tick Ixodes dammini. Although it was first described in 1977 in Lyme, Connecticut, the disease is not new nor is it limited to Lyme: New York State accounted for over half the reported cases in 1988. This article describes the spread of Lyme disease in New York State from 1977 to 1989. Between 1977 and 1981, 150 cases were reported; between 1986 and 1989, the number grew to 8,357 (of which 4,174 met the case definition, presented in a table). The number of confirmed cases of Lyme disease reported in 1989 was 1,942. As these figures increased, so, too, did the number of hospital discharges related to Lyme disease. The range of Ixodes dammini during the years studied is plotted. Before 1986, Lyme disease transmission in New York State took place in only four counties (Suffolk, Nassau, Westchester, Putnam): later, four adjacent counties were known sites of transmission (Rockland, Orange, Dutchess, Ulster). The considerable increase in the incidence of Lyme disease results in part from increased awareness, better diagnostic techniques, overdiagnosis and better reporting, as well as a true increase in the number of cases. As the range of infected and uninfected Ixodes dammini has expanded beyond its original range in Connecticut and Long Island, the Lyme disease rate has climbed. It is likely that reported rates underestimate the incidence of the disease. Physicians and patients alike should be aware of the symptoms, diagnosis and treatment of Lyme disease. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Abbreviated regimens of zidovudine prophylaxis and perinatal transmission of the human immunodeficiency virus
The prophylactic use of zidovudine (AZT) to reduce the incidence of maternal-fetal transmission of HIV virus seems to be highly effective, even when used in an abbreviated course of treatment. The initial three-part regimen which provides treatment before and during labor, and after birth, to the newborn reduced the rate of transmission from 25.5% to 8.3%. Even a shortened course of treatment starting during labor or in the first two days of life were effective in reducing the rate of infection.
Publication Name: The New England Journal of Medicine
Consented testing of newborns and childbearing women for human immunodeficiency virus through a newborn metabolic screening program
Testing pregnant women prenatally and then testing their newborn babies can increase the number of HIV-infected women and babies who are diagnosed and offered early treatment. Combined testing identified 94% of women and babies infected with the virus in the New York State Newborn Screening Program.
Publication Name: American Journal of Obstetrics and Gynecology
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