Routine screening for group B streptococcus during pregnancy prevents more cases of early-onset disease than the risk-based approach. Recommendations that endorse both strategies as equivalent warrant reconsideration.

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Despite concerns that IAP guidelines would result in excessive neonatal evaluations, infants sampled whose mothers received IAP were not more likely to undergo invasive procedures or to receive antibiotics. Consistent with the guidelines, collection of complete blood counts was more common among such infants.

When a plasmid containing the wild-type polyomavirus intergenic regulatory region fused to the bacterial cat gene was introduced into mouse NIH 3T3 cells along with a plasmid coding for the early viral proteins (T antigens), chloramphenicol transacetylase enzyme activity and mRNA levels were increased about 10-fold over levels observed in the absence of early proteins. To investigate this transactivation phenomenon further, 11 specific deletion mutant derivatives of the wild-type parent plasmid were constructed and studied. One mutant (NAL) with a minimal level of chloramphenicol transacetylase expression in the absence of T antigens was capable of being transactivated more than 40-fold. A number of other mutants, however, had little capacity for transactivation. Each of these mutants had in common a defect in large T-antigen-mediated DNA replication. Interestingly, one of the transactivation-defective mutants showed a basal late promoter activity fivefold higher than that of wild type and replicated in mouse cells in the absence of large T antigen. Subsequently, a small deletion abolishing viral DNA replication was introduced into those mutants capable of transactivation. The effect of the second deletion was to eliminate both replication and transactivation. Finally, wild-type and mutant constructs were transfected into Fisher rat F-111 cells in the presence or absence of early proteins. No transactivation or replication was ever observed in these cells. We concluded from these studies that the observed transactivation of the polyomavirus late promoter by one or more of the viral early proteins was due to either higher template concentration resulting from DNA replication or replication-associated changes in template conformation.

OBJECTIVES. This study was undertaken to determine an accurate vaccination rate and identify factors influencing nonvaccination in a meningococcal vaccination campaign on a Connecticut university campus in May 1993. METHODS. Vaccination and student data were merged to determine demographic factors associated with nonvaccination. A case-control study examined reasons for nonvaccination. RESULTS. The estimated vaccination rate for students returning to the campus was 93%. Lower rates occurred among older students, students living off campus, graduate and nondegree students, and married students. Perceived poor access to the vaccination center was the strongest predictor of nonvaccination. CONCLUSIONS. Higher vaccination rates may be achieved by specifically targeting students who live off campus and by providing multiple vaccination sites with extended hours.

Widespread varicella transmission occurred at the camp. A case of zoster was the most likely source. The risk for such outbreaks can be minimized through vaccinating susceptible staff members, considering vaccination for asymptomatic or mildly symptomatic HIV-infected children according to Advisory Committee on Immunization Practices and American Academy of Pediatrics guidelines, rigorously collecting recent varicella and zoster exposure information, excluding anyone with active varicella or zoster or with recent varicella or zoster exposure, and considering varicella and zoster exposures at camp to be potentially camp-wide.varicella, human immunodeficiency virus infections, disease outbreaks, intravenous immunoglobulin.

Although chronic hepatitis B and chronic hepatitis C are diseases of public health importance, only a few health departments nationally have chronic viral hepatitis under surveillance; these programs rely primarily on direct reporting by medical laboratories. We conducted an evaluation to determine if lessons from these programs can guide other health departments. Between December 2002 and February 2003, we visited the Connecticut Department of Public Health, the Multnomah County Health Department in Portland, Oregon, and the Minnesota Department of Health to determine the capacity of their chronic hepatitis registries to monitor trends and provide case management. We found that the registries facilitated investigations of potentially acute cases by identifying previously known infections, and aided prevention planning by pinpointing areas where viral hepatitis was being diagnosed. For chronic cases, case management (defined as the process of ensuring that infected individuals and their partners receive medical evaluation, counseling, vaccination, and referral to specialists for treatment when indicated) was provided for hepatitis B in Multnomah County, but was limited in other programs; barriers included resource constraints, difficulties confirming chronic infection, and privacy concerns. Finding innovative ways to overcome these barriers and improve case management is important if chronic hepatitis surveillance is to realize its full potential.