We studied the DNA sequence of the entire coding region of ERCC1 gene, in five cell lines established from human Ž . ovarian cancer A2780, A2780rCP70, MCAS, OVCAR-3, SK-OV-3 , 29 human ovarian cancer tumor tissue specimens, Ž . Ž . one human T-lymphocyte cell line H9 , and non-malignant human ovary tissue NHO . Samples were assayed by Ž . PCR-SSCP and DNA sequence analyses. A silent mutation at codon 118 site for restriction endonuclease MaeII in exon 4 of the gene was detected in MCAS, OVCAR-3 and SK-OV-3 cells, and NHO. This mutation was a C ™ T transition, that Ž . codes for the same amino acid: asparagine. This transition converts a common codon usage AAC to an infrequent codon Ž . usage AAT , whereas frequency of use is reduced two-fold. This base change was associated with a detectable band shift on SSCP analysis. For the 29 ovarian cancer specimens, the same base change was observed in 15 tumor samples and was associated with the same band shift in exon 4. Cells and tumor tissue specimens that did not contain the C ™ T transition, did not show the band shift in exon 4. Our data suggest that this alteration at codon 118 within the ERCC1 gene, may exist in platinum-sensitive and platinum-resistant ovarian cancer tissues. q 1997 Elsevier Science B.V.

Future interventions to promote WNV prevention among older adults should seek to enhance perceptions of vulnerability to WNV through risk communication, including media outreach and written messaging, emphasizing the benefits of personal protective behaviors. Community partnerships may aid in outreach to this population.

Summary Current guidelines in the setting of exposures to potentially rabid bats established by the Advisory Committee on Immunization Practices (ACIP) address post-exposure prophylaxis (PEP) administration in situations where a person may not be aware that a bite or direct contact has occurred and the bat is not available for diagnostic testing. These include instances when a bat is discovered in a room where a person awakens from sleep, is a child without an adult witness, has a mental disability or is intoxicated. The current ACIP guidelines, however, do not address PEP in the setting of multiple persons exposed to a bat or a bat colony, otherwise known as mass bat exposure (MBE) events. Due to a dearth of recommendations for response to these events, the reported reactions by public health agencies have varied widely. To address this perceived limitation, a survey of 45 state public health agencies was conducted to characterize prior experiences with MBE and practices to mitigate the public health risks. In general, most states (69% of the respondents) felt current ACIP guidelines were unclear in MBE scenarios. Thirty-three of the 45 states reported prior experience with MBE, receiving an average of 16.9 MBE calls per year and an investment of 106.7 person-hours annually on MBE investigations. PEP criteria, investigation methods and the experts recruited in MBE investigations varied between states. These dissimilarities could reflect differences in experience, scenario and resources. The lack of consistency in state responses to potential mass exposures to a highly fatal disease along with the large contingent of states dissatisfied with current ACIP guidance warrants the development of national guidelines in MBE settings.

This article describes and contrasts the public health response to two human rabies cases: one organ recipient diagnosed within days of symptom onset and the transplant donor who was diagnosed 18 months post-symptom onset. In response to an organ-transplant-related rabies case diagnosed in 2013, organ donor and recipient investigations were conducted by multiple public health agencies. Persons with potential exposure to infectious patient materials were assessed for rabies virus exposure. An exposure investigation was conducted to determine the source of the organ donor's infection. Over 100 persons from more than 20 agencies spent over 2700 h conducting contact investigations in healthcare, military and community settings. The 564 persons assessed include 417 healthcare workers [5.8% recommended for post-exposure prophylaxis (PEP)], 96 community contacts (15.6% recommended for PEP), 30 autopsy personnel (50% recommended for PEP), and 21 other persons (4.8% recommended for PEP). Donor contacts represented 188 assessed with 20.2% recommended for PEP, compared with 5.6% of 306 recipient contacts recommended for PEP. Human rabies cases result in substantial use of public health and medical resources, especially when diagnosis is delayed. Although rare, clinicians should consider rabies in cases of encephalitis of unexplained aetiology, particularly for cases that may result in organ donation.

This article is the first to describe the clinical picture and potential human health impact of laboratory-confirmed rabies infection in a pet Vietnamese pot-bellied pig in Maryland. Although cases of confirmed rabies infection have been infrequently reported in pet or agricultural during the past 10 years in the United States, exposure to rabies-positive animals remains a public health concern particularly for veterinarians, pet owners and other animal caretakers. It is important that individuals who are in a high-risk rabies exposure group remain vigilant to this potential public health threat in all mammal species.