We report an outbreak of 235 community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections among military recruits. In this unique environment, the close contact between recruits and the physical demands of training may have contributed to the spread of MRSA. Control measures included improved hygiene and aggressive clinical treatment.

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A Marine deployed aboard a U.S. Navy amphibious ship had smear-positive, cavitary pulmonary tuberculosis (TB). Contact investigation ultimately found 21 active cases of TB among sailors and Marines who were aboard the affected ship. Approximately 3 months lapsed between onset of the source patient's illness and appropriate diagnosis and treatment. During the contact investigation, 3,338 persons received tuberculin skin tests and 712 were identified as new latent tuberculosis infection cases. Four persons diagnosed with latent tuberculosis infection developed active TB because of poor compliance with treatment. After personnel disembarked from the ship, persistent efforts to identify persons with active disease and latent infections were successful in controlling further spread of tuberculosis in military units and local communities. The Mycobacterium tuberculosis bacteria isolated from the source patient and 16 of the other active cases were susceptible to all drugs commonly used to treat TB.

This paper describes the epidemiology of a probable Shigella dysenteriae type 1 dysentery epidemic in western Kenya. A retrospective record review over 2 years of all cases of dysentery, amoebiasis and diarrhoea was carried out in 13 healthcare facilities in the Rarieda Division of Nyanza province. Of the 3301 cases recorded, 2191 were dysentery, giving a cumulative 2 years incidence rate for dysentery of 4%. The epidemic began in December 1994 and peaked in February 1995, coinciding with the very dry season. One location in the area had an overall attack rate of 9.3%, double that of other locations. Highest rates were in children aged < 5 years and in persons > 15 years old. S. dysenteriae type 1, with its increasing multiantibiotic resistance, is a continuing threat to the health of people in this region; this area may be suitable for intensive, prospective surveillance as a prelude to a Shigella vaccine trial.