The prevalence of infection with the genital herpes simplex virus type 2 (HSV-2) has been difficult to ascertain, primarily because of the large percentage of subclinical cases and the limitations in specificity of serologic assays for antibody to HSV-2. To obtain an improved estimate of the distribution of HSV-2 infection in the United States, we used an HSV type-specific antibody assay to test serum samples from 4201 participants in the second National Health and Nutrition Examination Survey. The results in our sample indicate that in the period from 1976 to 1980, 16.4 percent of the U.S. population 15 to 74 years of age (approximately 25 million persons) was infected with HSV-2 (95 percent confidence interval, 14.2 to 18.6 percent). Age and race were the demographic factors associated most strongly with the presence of HSV-2 antibody. The prevalence of the antibody increased from less than 1 percent in the group under 15 years old to 20.2 percent in the group 30 to 44 years old; it increased only slightly thereafter. In the oldest group, 60 to 74 years of age, the prevalence was 19.7 percent in whites and 64.7 percent in blacks. Among blacks of all age groups, but not whites, higher rates were observed in women than in men. The associations were weaker with respect to marital status, income, education, urban residence, and region of the country. After control for age, sex, and race, only the association with marital status remained significant; the rate was increased in persons previously married--i.e., divorced, separated, or widowed. We conclude that the prevalence of HSV-2 infection in the United States is higher than has previously been recognized and that many infections with this sexually transmitted virus may be subclinical.

As part of a Federal consortium, the National Institute of Dental Research's (NIDR) Division of Epidemiology and Oral Disease Prevention (DEODP) staff and consultants collaborated with the National Center for Health Statistics (NCHS) to conduct a national oral health examination as a component of the 1988-94 National Health and Nutrition Examination Survey (NHANES III). The Phase 1 took place between October 18, 1988, and October 24, 1991, at 44 survey locations; Phase 2, between September 20, 1991, and October 15, 1994, at 45 sites. This article provides general background information on the NHANES III and its oral health examination component which pertains to all six years of the full survey. It also focuses on particular aspects of the first three years of the survey (NHANES III-Phase 1)--the database for the articles in this peer-reviewed Special Issue--and provides the essential context for the substantively oriented analyses of the Phase 1 database which are presented in the articles which follow this overview.

The incidence of clinically recognized coronary heart disease and its relation to risk factors have been studied for 596 sibships in the Framingham Heart Study cohort. Only the 186 pairs of brothers were considered in the multivariate analysis, since the rate of coronary heart disease in women is low. Multiple logistic regression was performed by using endpoints of coronary heart disease as the dependent variable for the younger brother of the pair. Age, Metropolitan relative weight, systolic blood pressure, total cholesterol, cigarette smoking and endpoints of coronary heart disease for the older brother represent the independent variables. The incidence of myocardial infarction in the older brother is significantly related to myocardial infarction experience of the younger brother, even after the strong effects of total cholesterol, systolic blood pressure and cigarette smoking were controlled. These findings suggest that family history of myocardial infarction may be an important independent predictor of myocardial infarction, and suggest that familial aggregation for coronary heart disease may result from predisposition to disease, possibly genetic, that is not reflected in the measured levels of total cholesterol, systolic blood pressure or cigarette smoking.

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