Campylobacter is a common cause of gastroenteritis in the United States. We conducted a population-based case-control study to determine risk factors for sporadic Campylobacter infection. During a 12-month study, we enrolled 1316 patients with culture-confirmed Campylobacter infections from 7 states, collecting demographic, clinical, and exposure data using a standardized questionnaire. We interviewed 1 matched control subject for each case patient. Thirteen percent of patients had traveled abroad. In multivariate analysis of persons who had not traveled, the largest population attributable fraction (PAF) of 24% was related to consumption of chicken prepared at a restaurant. The PAF for consumption of nonpoultry meat that was prepared at a restaurant was also large (21%); smaller proportions of illness were associated with other food and nonfood exposures. Efforts to reduce contamination of poultry with Campylobacter should benefit public health. Restaurants should improve food-handling practices, ensure adequate cooking of meat and poultry, and consider purchasing poultry that has been treated to reduce Campylobacter contamination.

Hydrogen sulfide (H(2)S) is emerging as a physiological neuromodulator as well as a smooth muscle relaxant. We submit the first evidence that blood H(2)S levels are significantly lower in fasting blood obtained from type 2 diabetes patients compared with age-matched healthy subjects, and in streptozotocin-treated diabetic rats compared with control Sprague-Dawley rats. We further observed that supplementation with H(2)S or an endogenous precursor of H(2)S (l-cysteine) in culture medium prevents IL-8 and MCP-1 secretion in high-glucose-treated human U937 monocytes. These first observations led to the hypothesis that lower blood H(2)S levels may contribute to the vascular inflammation seen in diabetes.

In March 1998, an outbreak of acute gastroenteritis occurred among students at a Texas university. Overall, 125 ill students sought medical care. Case-control studies revealed that illness was significantly associated with eating foods from the university's main cafeteria deli bar on 9 and 10 March. Stool specimens from 9 (50%) of 18 ill students and samples of deli ham showed evidence of Norwalk-like viruses (NLVs) by reverse-transcriptase (RT) polymerase chain reaction (PCR) assay. A food handler who prepared sandwiches for lunch on 9 March reported that her infant had been sick with watery diarrhea since just before the outbreak. A stool sample from the infant was positive for NLV by RT-PCR, and the sequence of the amplified product was identical to that of amplified product from deli ham and students' stool specimens. This is the first time RT-PCR and sequence analysis have successfully confirmed viral contamination of a food item likely to have been contaminated by a food handler.

The purpose of this study was to explore the relationship of obesity and physical limitations with food insecurity among Georgians participating in the Older Americans Act (OAA) congregate meal-site program (N = 621, median age = 76 years, 83% female, 36% Black, and 64% White, convenience sample). Food insecurity was assessed using the modified 6-item US Household Food Security Survey Module; obesity was defined as Body Mass Index (BMI) or waist circumference (WC) class I or II obesity; and physical limitations (arthritis, joint pain, poor physical function, weight-related disability) were based on the Disablement Process. A series of multivariate logistic regression models found weight-related disability and obesity (WC class II) may be potential risk factors for food insecurity. Thus, obesity and weight-related disability may be risk factors to consider when assessing the risk of food insecurity and the need for food assistance in this vulnerable subgroup of older adults.

To understand physician practices regarding the diagnosis of acute diarrheal diseases, we conducted a survey, in 1996, of 2839 physicians in Connecticut, Georgia, Minnesota, Oregon, and California. Bacterial stool culture was requested for samples from the last patient seen for acute diarrhea by 784 (44%; 95% confidence interval, 42%-46%) of 1783 physicians. Physicians were more likely to request a culture for persons with acquired immune deficiency syndrome, bloody stools, travel to a developing country, diarrhea for >3 days, intravenous rehydration, or fever. Substantial geographic and specialty differences in culture-request practices were observed. Twenty-eight percent of physicians did not know whether stool culture included testing for Escherichia coli O157:H7; 40% did not know whether Yersinia or Vibrio species were included. These variabilities suggest a need for clinical diagnostic guidelines for diarrhea. Many physicians could benefit from education to improve their knowledge about tests included in routine stool examinations.