ACUTE DIARRHEA ON AN APACHE INDIAN RESERVATION
A comprehensive study of the causes and treatment of acute “summer diarrhea” on the Fort Apache Reservation found that the peak incidence was in children under age two of whom two-fifths were affected at least once, and one-quarter of all children required hospitalization. Thirty-five per cent of re...
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| Veröffentlicht in: | American journal of epidemiology 1974-04, Vol.99 (4), p.281-290 |
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| container_title | American journal of epidemiology |
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| creator | WOODWARD, WILLIAM E. HIRSCHHORN, NORBERT SACK, R. BRADLEY CASH, RICHARD A. BROWNLEE, INEZ CHICKADONZ, GRACE H. EVANS, LOIS K. SHEPARD, RICHARD H. WOODWARD, R. CRAIG |
| description | A comprehensive study of the causes and treatment of acute “summer diarrhea” on the Fort Apache Reservation found that the peak incidence was in children under age two of whom two-fifths were affected at least once, and one-quarter of all children required hospitalization. Thirty-five per cent of rectal swab cultures yielded a recognized pathogen, primarily Shigella species. In spite of liberal antimicrobial usage on the reservation no Shigella isolate showed multiple drug resistance. Conversely, one-third of the isolates of enteropathogenic Escherichia coli serotypes were multiply resistant. S. flexneri predominated over S. sonnei by 4: 1. A significant correlation between poor home sanitation and the isolation of S. flexneri was found. The diarrheal attack rate rose simultaneously with rainfall, temperature and bacterial contamination of water sources. Diarrhea continues to be a serious burden to Apache people. |
| doi_str_mv | 10.1093/oxfordjournals.aje.a121613 |
| format | Article |
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BRADLEY ; CASH, RICHARD A. ; BROWNLEE, INEZ ; CHICKADONZ, GRACE H. ; EVANS, LOIS K. ; SHEPARD, RICHARD H. ; WOODWARD, R. CRAIG</creator><creatorcontrib>WOODWARD, WILLIAM E. ; HIRSCHHORN, NORBERT ; SACK, R. BRADLEY ; CASH, RICHARD A. ; BROWNLEE, INEZ ; CHICKADONZ, GRACE H. ; EVANS, LOIS K. ; SHEPARD, RICHARD H. ; WOODWARD, R. CRAIG</creatorcontrib><description>A comprehensive study of the causes and treatment of acute “summer diarrhea” on the Fort Apache Reservation found that the peak incidence was in children under age two of whom two-fifths were affected at least once, and one-quarter of all children required hospitalization. Thirty-five per cent of rectal swab cultures yielded a recognized pathogen, primarily Shigella species. In spite of liberal antimicrobial usage on the reservation no Shigella isolate showed multiple drug resistance. Conversely, one-third of the isolates of enteropathogenic Escherichia coli serotypes were multiply resistant. S. flexneri predominated over S. sonnei by 4: 1. A significant correlation between poor home sanitation and the isolation of S. flexneri was found. The diarrheal attack rate rose simultaneously with rainfall, temperature and bacterial contamination of water sources. Diarrhea continues to be a serious burden to Apache people.</description><identifier>ISSN: 0002-9262</identifier><identifier>EISSN: 1476-6256</identifier><identifier>DOI: 10.1093/oxfordjournals.aje.a121613</identifier><identifier>PMID: 4594476</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Adolescent ; Adult ; Arizona ; Child ; Child, Preschool ; diarrhea ; Diarrhea - epidemiology ; Diarrhea - microbiology ; Diarrhea, Infantile - epidemiology ; Diarrhea, Infantile - microbiology ; Drug Resistance, Microbial ; Dysentery, Bacillary - epidemiology ; Escherichia coli - isolation & purification ; Escherichia coli infections ; Female ; Hospitalization ; Humans ; Indian ; Indians, North American ; Male ; Microbial Sensitivity Tests ; North American ; Parasites - isolation & purification ; Rectum - microbiology ; Sanitation ; Seasons ; Shigella ; Shigella - isolation & purification ; Shigella flexneri - isolation & purification ; Temperature ; United States ; United States Public Health Service ; Water Microbiology ; Water Supply ; Weather</subject><ispartof>American journal of epidemiology, 1974-04, Vol.99 (4), p.281-290</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27846,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/4594476$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>WOODWARD, WILLIAM E.</creatorcontrib><creatorcontrib>HIRSCHHORN, NORBERT</creatorcontrib><creatorcontrib>SACK, R. BRADLEY</creatorcontrib><creatorcontrib>CASH, RICHARD A.</creatorcontrib><creatorcontrib>BROWNLEE, INEZ</creatorcontrib><creatorcontrib>CHICKADONZ, GRACE H.</creatorcontrib><creatorcontrib>EVANS, LOIS K.</creatorcontrib><creatorcontrib>SHEPARD, RICHARD H.</creatorcontrib><creatorcontrib>WOODWARD, R. CRAIG</creatorcontrib><title>ACUTE DIARRHEA ON AN APACHE INDIAN RESERVATION</title><title>American journal of epidemiology</title><addtitle>Am J Epidemiol</addtitle><description>A comprehensive study of the causes and treatment of acute “summer diarrhea” on the Fort Apache Reservation found that the peak incidence was in children under age two of whom two-fifths were affected at least once, and one-quarter of all children required hospitalization. Thirty-five per cent of rectal swab cultures yielded a recognized pathogen, primarily Shigella species. In spite of liberal antimicrobial usage on the reservation no Shigella isolate showed multiple drug resistance. Conversely, one-third of the isolates of enteropathogenic Escherichia coli serotypes were multiply resistant. S. flexneri predominated over S. sonnei by 4: 1. A significant correlation between poor home sanitation and the isolation of S. flexneri was found. The diarrheal attack rate rose simultaneously with rainfall, temperature and bacterial contamination of water sources. Diarrhea continues to be a serious burden to Apache people.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Arizona</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>diarrhea</subject><subject>Diarrhea - epidemiology</subject><subject>Diarrhea - microbiology</subject><subject>Diarrhea, Infantile - epidemiology</subject><subject>Diarrhea, Infantile - microbiology</subject><subject>Drug Resistance, Microbial</subject><subject>Dysentery, Bacillary - epidemiology</subject><subject>Escherichia coli - isolation & purification</subject><subject>Escherichia coli infections</subject><subject>Female</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Indian</subject><subject>Indians, North American</subject><subject>Male</subject><subject>Microbial Sensitivity Tests</subject><subject>North American</subject><subject>Parasites - isolation & purification</subject><subject>Rectum - microbiology</subject><subject>Sanitation</subject><subject>Seasons</subject><subject>Shigella</subject><subject>Shigella - isolation & purification</subject><subject>Shigella flexneri - isolation & purification</subject><subject>Temperature</subject><subject>United States</subject><subject>United States Public Health Service</subject><subject>Water Microbiology</subject><subject>Water Supply</subject><subject>Weather</subject><issn>0002-9262</issn><issn>1476-6256</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1974</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>K30</sourceid><recordid>eNpdkNFKwzAUhoMoc04fQSgK3rUmOWmSXtZa18ropG4yvAlpm0Lntm7tCvPtLWx6IRz44Xwf58CP0B3BDsEePNaHsm6KZd01G71qHb00jiaUcAJnaEiY4DanLj9HQ4wxtT3K6SW6atslxoR4Lh6gAXM91ntD5PjBfBZaz7GfplHoW9PE8vt584MotOKk3ydWGr6H6Yc_i6fJNboo-5fm5pQjNH8JZ0FkT6bjOPAndkUF3dtGsJzgTObEBWEYFUxmYMADbTJJGJe5kaQ0WVlokRkJrigoZbQAyCmwXMAIPRzvbpt615l2r9ZVm5vVSm9M3bVKUgCKPdqL9__E31oUAcw585hkvXV7srpsbQq1baq1br7VqYae20detXtz-MO6-VJcgHBVtPhUi3H6GiVPXC3gB6yGbOo</recordid><startdate>197404</startdate><enddate>197404</enddate><creator>WOODWARD, WILLIAM E.</creator><creator>HIRSCHHORN, NORBERT</creator><creator>SACK, R. 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CRAIG</creator><general>Oxford University Press</general><general>School of Hygiene and Public Health of the Johns Hopkins University</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>HVZBN</scope><scope>K30</scope><scope>PAAUG</scope><scope>PAWHS</scope><scope>PAWZZ</scope><scope>PAXOH</scope><scope>PBHAV</scope><scope>PBQSW</scope><scope>PBYQZ</scope><scope>PCIWU</scope><scope>PCMID</scope><scope>PCZJX</scope><scope>PDGRG</scope><scope>PDWWI</scope><scope>PETMR</scope><scope>PFVGT</scope><scope>PGXDX</scope><scope>PIHIL</scope><scope>PISVA</scope><scope>PJCTQ</scope><scope>PJTMS</scope><scope>PLCHJ</scope><scope>PMHAD</scope><scope>PNQDJ</scope><scope>POUND</scope><scope>PPLAD</scope><scope>PQAPC</scope><scope>PQCAN</scope><scope>PQCMW</scope><scope>PQEME</scope><scope>PQHKH</scope><scope>PQMID</scope><scope>PQNCT</scope><scope>PQNET</scope><scope>PQSCT</scope><scope>PQSET</scope><scope>PSVJG</scope><scope>PVMQY</scope><scope>PZGFC</scope><scope>7X8</scope></search><sort><creationdate>197404</creationdate><title>ACUTE DIARRHEA ON AN APACHE INDIAN RESERVATION</title><author>WOODWARD, WILLIAM E. ; HIRSCHHORN, NORBERT ; SACK, R. BRADLEY ; CASH, RICHARD A. ; BROWNLEE, INEZ ; CHICKADONZ, GRACE H. ; EVANS, LOIS K. ; SHEPARD, RICHARD H. ; WOODWARD, R. 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BRADLEY</au><au>CASH, RICHARD A.</au><au>BROWNLEE, INEZ</au><au>CHICKADONZ, GRACE H.</au><au>EVANS, LOIS K.</au><au>SHEPARD, RICHARD H.</au><au>WOODWARD, R. CRAIG</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>ACUTE DIARRHEA ON AN APACHE INDIAN RESERVATION</atitle><jtitle>American journal of epidemiology</jtitle><addtitle>Am J Epidemiol</addtitle><date>1974-04</date><risdate>1974</risdate><volume>99</volume><issue>4</issue><spage>281</spage><epage>290</epage><pages>281-290</pages><issn>0002-9262</issn><eissn>1476-6256</eissn><abstract>A comprehensive study of the causes and treatment of acute “summer diarrhea” on the Fort Apache Reservation found that the peak incidence was in children under age two of whom two-fifths were affected at least once, and one-quarter of all children required hospitalization. Thirty-five per cent of rectal swab cultures yielded a recognized pathogen, primarily Shigella species. In spite of liberal antimicrobial usage on the reservation no Shigella isolate showed multiple drug resistance. Conversely, one-third of the isolates of enteropathogenic Escherichia coli serotypes were multiply resistant. S. flexneri predominated over S. sonnei by 4: 1. A significant correlation between poor home sanitation and the isolation of S. flexneri was found. The diarrheal attack rate rose simultaneously with rainfall, temperature and bacterial contamination of water sources. Diarrhea continues to be a serious burden to Apache people.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>4594476</pmid><doi>10.1093/oxfordjournals.aje.a121613</doi><tpages>10</tpages></addata></record> |
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| ispartof | American journal of epidemiology, 1974-04, Vol.99 (4), p.281-290 |
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| language | eng |
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| source | MEDLINE; Oxford University Press Journals Digital Archive Legacy; Periodicals Index Online |
| subjects | Adolescent Adult Arizona Child Child, Preschool diarrhea Diarrhea - epidemiology Diarrhea - microbiology Diarrhea, Infantile - epidemiology Diarrhea, Infantile - microbiology Drug Resistance, Microbial Dysentery, Bacillary - epidemiology Escherichia coli - isolation & purification Escherichia coli infections Female Hospitalization Humans Indian Indians, North American Male Microbial Sensitivity Tests North American Parasites - isolation & purification Rectum - microbiology Sanitation Seasons Shigella Shigella - isolation & purification Shigella flexneri - isolation & purification Temperature United States United States Public Health Service Water Microbiology Water Supply Weather |
| title | ACUTE DIARRHEA ON AN APACHE INDIAN RESERVATION |
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