More than three-quarters of exposed HCWs reported at least 1 unprotected encounter with a patient who had monkeypox. One asymptomatic HCW showed laboratory evidence of recent orthopoxvirus infection, which was possibly attributable to either recent infection or smallpox vaccination. Transmission of monkeypox likely is a rare event in the health care setting.

No abstract

The properdin or alternate complement pathway may function as a heat-labile opsonin for pneumococci, and evidence has been sought for its activation in pneumococcal infections. Twenty-two patients had determinations of Clq, C4, properdin factor B, C3, and hemolytic complement during hospitalization for pneumococcal infection. Measurements were made during the first 36 h after admission on 16 patients and later during recovery on 16. The admission and recovery values were compared statistically with each other and with the levels of 15 normal individuals. The admission and recovery mean values were normal and nearly identical for Clq and C4, which are two early components of the classical pathway. The mean level of factor B, a properdin pathway component, was significantly depressed on admission, but the mean recovery value was normal. Admission levels for C3, a component ofthe late common pathway, were depressed, and recovery values were normal. Total hemolytic complement was decreased on admission, although the decrease was not significant for the patients with both admission and recovery determinations. The findings are consistent with the hypothesis that factor B is turned over rapidly, or consumed, early in pneumococcal infections; alternatively, persons with low baseline factor B levels may be particularly susceptible to pneumococcal infection.

We compared the safety of monthly and bimonthly solution transfer set tubing changes by following 40 patients for one year. In 20 the solutiontransfer-set tubing was changed monthly and in 20 the tubing was changed every two months. In the monthly group, there were 10 episodes of peritonitis per 192 patient months and, in the bi-monthly group, 10 episodes of peritonitis per 207 patient months. Spike durability was assessed in both groups over a six-month period. Of the tubings that were changed monthly, 23% had spikes with curled edges or chips, compared to 25% in the bi-monthly group. The tubing material proved durable over a two month period when the two groups were compared. There was no statistically significant difference in peritonitis rates or spike failure rates. Changing the solution transfer set every two months offers a practical and safe alternative to the customary monthly change.