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This updated unit describes four assays for detection of HIV proteins including: (1) a quantitative ELISA, (2) a quantitative immunoblotting assay, (3) a qualitative immunofluorescence assay, and (4) a functional assay to measure virus-associated reverse transcriptase activity as an indicator of viral production.

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Both exposures reported to poison centers and the treatments used involved potential teratogens. This investigation describes the patterns of exposures and treatments among women of childbearing age and pregnant women reported to Texas poison centers during 2000-2002. Of 476,365 total reported human exposures, 65,074 (13.7%) involved women of childbearing age and 1,406 (0.3%) involved pregnant women. The most frequently reported exposures among women of childbearing age were analgesics (sedatives, hypnotics, antipsychotics) and antidepressants. The teratogens alcohol and anticonvulsants were the 5th and 13th most frequently reported exposures, respectively. The substances used most often to treat women of childbearing age were oral N-acetylcysteine, antihistamines and naloxone; anticonvulsants were the 7th most frequently reported substance used in treatment, and ethanol the 28th most commonly reported substance. Although only a small fraction of pregnant women of childbearing age reported to Texas poison centers, a portion of women reported to be not pregnant may have been pregnant and unaware of the fact, and thus may have been exposed to a teratogen at a time when susceptibility to teratogens is greatest. Poison centers need to be aware of this when providing information to patients and recommending treatment.

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About 90 scorpion species occur in the US, and scorpion stings accounted for over 15,600 calls to poison centers in the US in 2002. However, epidemiologic information on scorpion envenomations in the US, and Texas in particular, is limited. This study investigated the relationship between epidemiological factors and the scorpion stings reported to the Texas poison centers. Cases consisted of all human exposure calls of scorpion stings to Texas poison centers during 1998-2003; there were 11,545 total cases. The reported scorpion envenomation penetrance increased during 1998-2002. Among cases with a known patient age, 10.9% were < 6 y of age, 21.7% were age 6-19 y and 67.3% were > 19 y of age. Females accounted for 55.8% of the cases and males for 44.2% of the cases. Scorpion stings were most frequently reported in May and June with envenomation penetrance lowest in northeast Texas and highest in west Texas. The exposure site was the patient's own residence for 93.9% of the cases. The management site was not a health care facility for 95.8% of cases, and there were minor effects in 88.4% of cases with a known clinical outcome.

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A portion of calls handled by poison centers involve poisonings of animals; however, information on such calls is limited. This study used data from poison centers in Texas collected during 1998-2002 to document the epidemiology of animal poisoning calls. There were a total of 24,467 animal poisoning calls, representing 2.0% of all calls. Dogs were affected in 87% of the calls and cats in 11%. The exposures were unintentional in 99% of the cases, occurred via ingestion in 95% and involved dermal exposure in 5% of the cases. Exposures occurred at the owner's own residence 91% of the time and were handled outside of health care facilities 61% of the time. The outcome involved no clinical effect for 60% of the cases involving dogs and 39% of the cases involving cats. Reported exposures occurred more often during the summer, and the most frequently reported exposures involved pesticides and plants. These findings were consistent with the limited reports from on poison center regarding animal poisonings.

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BACKGROUND: Lindane (gamma-benzene hexachloride), commonly used as a treatment for pediculosis, has been associated with adverse reactions and has recently undergone increased regulation. OBJECTIVE: We sought to describe the patterns of a large number of lindane exposures reported to poison centers in Texas during 1998-2002. METHODS: Data on all lindane exposures for pediculosis reported to the Texas Poison Center Network were analyzed. RESULTS: There were 528 reported human exposures to lindane for pediculosis. The incidence of lindane exposures has decreased by 52% from 1998 to 2002. Misuse or abuse of lindane was reported in at least 87% of the cases. Of those cases with a known patient age, 45% were less than age 6 yrs, 23% age 6-19 yrs, and 32% over age 19 yrs. Female patients accounted for 55% of reported cases. Of those cases with a known medical outcome, 61% reported no effects. The most frequently reported symptoms were vomiting, nausea, and ocular irritation or ocular pain. CONCLUSION: The number of reported lindane exposures in Texas is decreasing. The majority of reported exposures involve misuse or abuse of the product. The pattern of symptoms reported in Texas was consistent with the literature.

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Pepper spray is used as an incapacitant agent. Although now available for general use in the US, the health consequences of pepper spray exposures are poorly understood. This study used data from human exposure calls to poison centers in Texas to investigate the epidemiology of pepper spray exposures. During 1998-2002 there were 1,531 human exposures to pepper spray identified by the Texas poison centers. Pepper spray reports declined during the 5-y period of the study. The majority of exposures were unintentional (84%), occurred at home (68%), involved males (56%), and comprised children and adolescents (64%). Risk factors for pepper spray exposure varied by patient age. Although 85% of the pepper spray exposures were managed outside of health care facilities, 97% of exposures involved at least minimal notable clinical effects. Given the level of detectable clinical effects of this intervention and the widespread availability of these agents, there is a need for better education of the public regarding the proper use of pepper spray and the effects of its use.

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Between October 4, 2001 and November 20, 2001, 22 cases of anthrax were identified in a bioterrorism attack on the US. This study examined the patterns of anthrax calls before and after the bioterrorist attack based on calls received by poison centers in Texas, a state that reported no anthrax cases as a result of the attack. During 1998-2002, 553 calls about anthrax were received. The majority of the anthrax calls occurred in 2001 (n = 489, 88.4%) and 2002 (n = 52, 9.4%). The number of calls increased greatly in the days after October 4, 2001, reaching a peak of 31 anthrax calls in 1 d and then declining sharply in succeeding months. However, by December 2002 the number of calls about anthrax still had not returned to pre-attack levels. This study demonstrated the value of poison centers in documenting public need for information on biological agents used in a terrorist attack, even if the attack did not occur in the area serviced by the poison center. Poison centers may expect to receive calls regarding a bioterrorist attack shortly after the public became aware of the attack and will continue to receive related calls for months afterward. Poison centers need to be prepared with appropriate information prior to such attacks to provide to the public upon request.

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Black widow spiders and brown recluse spiders are of medical importance to humans in the US. However, these spiders differ in their habits, habitat, and the clinical effects and treatment of their bite. This study used data from human exposure calls to poison centers in Texas to compare the epidemioloy of bites from these 2 spiders. During 1998-2002, 760 black widow spider bites and 1,369 brown recluse spider bites were reported. Black widow spider bite penetrance demonstrated no secular trend during this time period while the penetrance of brown recluse spider bites increased. A higher percentage of black widow spider bites occurred among males, while a higher proportion of brown recluse spider bites were reported for females. Black widow spider bites most frequently had mild outcomes while brown recluse spider bites most often had moderate outcomes. The majority of reported bites for both types of spider occurred at the patient's own residence, although the percentage was lower for black widow spiders. Seasonal trends were noted for both black widow and brown recluse spiders. The highest penetrance of black widow spider bites was observed in western Texas while the highest penetrance of brown recluse spider bites was observed in central Texas. This information is useful for identifying those populations at greatest risk for the respective spider bites.

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This study evaluates the prenatal human immunodeficiency virus (HIV) testing behaviors of private obstetrics and gynecology practitioners in Texas. A statewide telephone survey of 614 providers of prenatal care determined the level of HIV testing, how testing is offered, and patient acceptance of the test. Ninety-nine percent of the practices offered HIV testing to all their pregnant patients, and 96% of the practices included HIV testing in the routine panel of tests for pregnant patients. More than 95% of the practices reported that 10% or less of the women refused the test when offered it; 73% of the practices reported no refusals. Less than half of the practices, however, discussed HIV prevention topics, and only 29% of the practices referred high-risk pregnant patients for prevention counseling. Although private practices of obstetrics and gynecology report testing almost all their prenatal patients, survey results suggest that providers could improve their prevention and patient education practices.

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