To determine the risk of transmission of human T-cell lymphotropic virus Type III/lymphadenopathy-associated virus (HTLV-III/LAV) to close but nonsexual contacts of patients with the acquired immunodeficiency syndrome (AIDS), we studied the nonsexual household contacts of patients with AIDS or the AIDS-related complex with oral candidiasis. Detailed interviews, physical examinations, and tests for serum antibody to HTLV-III/LAV were performed on 101 household contacts of 39 AIDS patients (68 children and 33 adults), all of whom had lived in the same household with an index patient for at least three months. These contacts had shared household items and facilities and had close personal interaction with the patient for a median of 22 months (range, 3 to 48) during the period of presumed infectivity. Only 1 of 101 household contacts--a five-year-old child--had evidence of infection with the virus, which had probably been acquired perinatally rather than through horizontal transmission. This study indicates that household contacts who are not sexual partners of, or born to, patients with AIDS are at minimal or no risk of infection with HTLV-III/LAV.

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Objective Humoral and cell-mediated immune responses to monovalent H1N1/2009 and seasonal trivalent influenza (TIV) vaccines were evaluated in healthy children and those with asthma, sickle cell disease (SCD), systemic lupus erythematosus (SLE), and solid organ transplantation (SOT). Study design Blood was collected from 112 subjects at the time of H1N1/2009 vaccination and 46±15 days later for hemagglutination inhibition (HI) titers and IFNγ ELISPOT responses to H1N1/2009 vaccine and TIV; unvaccinated children also received TIV at enrollment. Results A significant increase in the percentage of subjects with seroprotective HI titers to both vaccines was observed in all high risk groups. Children with asthma and SCD were most likely to achieve seroprotective titers to H1N1/2009, whereas fewer than 50% of subjects with SOT and SLE mounted a seroprotective response. The latter also had lower rates of seroprotection following TIV, and subjects with SLE had the lowest ELISPOT responses to both vaccines. Overall, 73% of healthy children exhibited protective responses to TIV; only 35% achieved seroprotection for H1N1/2009. Conclusions This evaluation of immune responses to H1N1/2009 in high risk children suggests suboptimal responses for SOT and SLE, but not subjects with SCD or asthma. Higher antigen dose and/or additional dose regimens for immunocompromised children warrant further investigation.

While intracranial tuberculomas have become uncommon in industrial nations, 12 patients with signs and symptoms of an intracranial mass lesion were recently found to have tuberculomas. Clinical findings suggestive of tuberculosis were frequently subtle or absent. Five patients did not have extracranial tuberculosis. Two patients had intracranial tuberculomas that became superinfected with bacteria and appeared initially as pyogenic brain abscesses. Intracranial tuberculomas in this country almost always occur in adults and represent reactivation of dormant infection. Medical therapy alone is indicated as the initial therapy except in the presence of intolerably increased intracranial pressure. A chemotherapeutic regimen is suggested.