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TPDN 1986 Vol. 46, No. 27
The 1985 incidence rate, 2.35 cases per 100,000 population, is the highest experienced in Texas
since 1971, when the rate was 2.47 per 100,000 population (Figure 1). Only one death was
officially associated with pertussis during 1985. This figure is probably understated, as several
cases were complicated with severe sequelae.
Fifty-one cases occurred among infants one month of age or younger, too young ,to be
vaccinated. Of the remaining 328 cases, 94 (28.7%) had no history of pertussis vaccination, and
106 (32.3%) had a history of vaccination that was appropriate for their age.
TUBERCULOSIS
The number of cases of tuberculosis reported in Texas increased in 1985. There were 1,891
cases (11.7 cases per 100,000 population) reported in 1985 compared to 1,762 cases (11.2) in 1984.
Of the 1,891 cases, 943 (49.9%) occurred in the seven major metropolitan areas of the state. The
city of Houston reported 497 tuberculosis cases, 26.3% of the total state morbidity; Dallas
reported 230 cases (12.2%). The next five major population areas contributed 216 cases (11.4%).
During 1985, 85 cases of tuberculosis were reported in children under 5 years of age. This
increase of 22 cases from the 63 cases reported in 1984 occurred despite the tuberculosis
program's efforts to interrupt the transmission of infection. Houston reported 36.5% of the
cases in children under 5 years of age.
CONGENITAL SYPHILIS
During 1985, 96 congenital syphilis infections were reported among newborns. Ninety-four were
single deliveries; one was a twin delivery. Of the 96 cases reported, 43 were stillbirths, and 53
were live births, three of whom subsequently died.
Harris County led the state with the reporting of 28 cases. Dallas County reported 14 cases,
whereas Bexar, El Paso, and Jefferson Counties reported four cases each. Several areas, notably
Public Health Region 11 (excluding Harris County) and Public Health Region 8, reported
increased numbers of cases; both reported nine cases each.
The typical mother who delivered an infant with congenital syphilis was young (80% were
under 25 years of age), unmarried (68%), and Hispanic (50%) or black (35%). Two percent of
the total reported were native Americans, and. the remainder (13%) were non-Hispanic whites.
. KForty-five percent of the mothers received no prenatal care during their pregnancies. However,
the remaining 65% who received prenatal care did not seek care until after the beginning of the
second trimester. Of those who did have a first trimester visit with a negative serologic test for
syphilis, few had a repeat test in the third trimester.
ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)
Four hundred eighty-three cases of AIDS with onset in 1985 were reported in 1985, a 52%
increase over the 317 cases with onset in 1984. The majority of Texas cases (90%) were
homosexual or bisexual males. An additional 3% were intravenous (IV) drug users, 1% were
hemophiliacs, 2% were associated with transfusion, and 4% had inapparent or unknown risk
factors. Twenty-seven (3%) female cases were reported, and the majority of these (44%) were IV
drug users. Nationally, only 73% of the cases were homosexual/bisexual males, and 17% were IV
drug users. The very large number of IV drug user cases from the New York and New Jersey
metropolitan areas skew the national data.
The proportion of AIDS cases associated with blood transfusions has increased both in Texas
and nationally from 1% to 2%. This is due to the long period between infection with human T-
lymphotropic virus type III (HTLV-III) and development of AIDS. The benefit of serologic
screening of blood .donations, begun in the spring of 1985, and self-deferral by those at
increased risk will, therefore, not be fully realized in AIDS reporting for a period of years.
Blood banks throughout Texas now use antibody detection kits to screen the state's blood supply
for HTLV-III and have reported that 0.25% of the donated units were repeatedly reactive by
EIA.
One percent (7) of the cases reported in Texas have been reported in children under 13 years of
age. Nationally, three fourths of pediatric AIDS cases result from perinatal transmission of
HTLV-III, therefore, the race/ethnicity and geographic distribution of pediatric AIDS patients
would be similar to that of reported AIDS cases among adult females. In Texas, females
account for a small number of cases, which is reflected in the small number of pediatric cases.
Of the seven pediatric cases in Texas, three are related to a parent at risk, and four are
transfusion-associated.
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