RESUMO
Of 48,712 acquired immunodeficiency syndrome (AIDS) cases reported to the Centers for Disease Control from October 1987 through March 1989, 1239 (2.5%) were diagnosed with extrapulmonary tuberculosis. Extrapulmonary tuberculosis was diagnosed in 1013 (2.3%) of the US-born persons with AIDS, compared with 26 (8%) of the Mexican-born, 82 (13%) of the Haitian-born, and 4 (1%) of the Cuban-born. Patients with AIDS with and without extrapulmonary tuberculosis were similar in age, except that extrapulmonary tuberculosis was relatively rare in patients with AIDS under the age 10. Compared with white homosexual/bisexual men, black race (odds ratio, 2.7), intravenous drug use (odds ratio, 2.0), heterosexual AIDS transmission category (odds ratio, 1.9), and Hispanic ethnicity (odds ratio, 1.6) were independently associated with extrapulmonary tuberculosis. In 1988, extrapulmonary tuberculosis in persons known to be human immunodeficiency virus seropositive represented 21% of national extrapulmonary tuberculosis morbidity.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Tuberculose/complicações , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/transmissão , Cuba/etnologia , Feminino , Haiti/etnologia , Hispânico ou Latino , Humanos , Masculino , México/etnologia , Análise Multivariada , Razão de Chances , Fatores de Risco , Tuberculose/epidemiologia , Estados Unidos/epidemiologiaRESUMO
In 1976 and 1981, two outbreaks of gastrointestinal illness aboard cruise ships occurred within 24 hours following onshore visits to Haiti and Mexico, respectively. Three hundred eighty-six of 600 (64 per cent) and 98 of 260 (38 per cent) passengers became ill following luncheons in Port-au-Prince, Haiti, and Cozumel, Mexico. No increase in illness was observed among those passengers who did not attend the onshore luncheons. In both outbreaks, unrefrigerated seafood dishes served at outdoor buffets were epidemiologically incriminated as the vehicles of transmission. Several species of Vibrion, Salmonella, and toxigenic Escherichia coli were recovered from stool specimens of ill passengers in both outbreaks. In addition, invasive Escherichia coli and Shigella were isolated from stool specimens of ill passengers who ate at the Haitian buffet. Previous investigations of outbreaks of gastrointestinal illness aboard cruise ships have implicated exposures on board as the source and have involved only a single pathogen.