HICN243 News Part 1/3 
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 HICN243 News Part 1/3

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Volume  2, Number 43                                      November 20, 1989

              !                                                !
              !              Health Info-Com Network           !
              !                    Newsletter                  !
                         Editor: David Dodell, D.M.D.
                   St. Joseph's Hospital and Medical Center
    10250 North 92nd Street, Suite 210, Scottsdale, Arizona 85258-4599 USA
                           Telephone (602) 860-1121
         FAX Available - Call/Write/Email for Additional Information

   Copyright 1989 - Distribution on Commercial/Pay Systems Prohibited without
                              Prior Authorization

             International Distribution Coordinator: Robert Klotz
                            Nova Research Institute
            217 South Flood Street, Norman, Oklahoma 73069-5462 USA
                           Telephone (405) 366-3898

The Health Info-Com Network Newsletter is distributed weekly.  Articles  on  a
medical  nature  are  welcomed.  If  you  have an article,  please contact the
editor for information on how to submit it.  If you are intrested  in  joining
the distribution system please contact the distribution coordinator.

E-Mail Address:
                              FidoNet = 1:114/15

                         anonymous ftp = vm1.nodak.edu


North America                               Australia/Far East    Europe
FidoNet = 1:19/9                            David More         George Cordner


                       T A B L E   O F   C O N T E N T S

1.  Comments & News from the Editor
     Next Week's Issue Schedule ............................................  1

2.  Medical News
     Medical News for Week ending November 19, 1989 ........................  2

3.  Center for Disease Control Reports
     [MMWR 11-16-89] Eosinophilia-Myalgia Syndrome .........................  7
     Earthquake-Associated Deaths .......................................... 10
     Elemental Mercury Vapor Poisoning ..................................... 12
     Pap Smear Screening - Behavi{*filter*}Risk Factor System ................... 15
     Urine Testing for Drug Use Among Male Arrestees ....................... 18

4.  Dental News
     {*filter*}Secondary Syphilis in AIDS Patient. A Case Report ................ 21

5.  Food & Drug Administration News
     News from the FDA - Articles about L-tryptophan recall, and more ...... 24

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Volume  2, Number 43                                      November 20, 1989

                        Comments & News from the Editor

                          Next Week's Issue Schedule

Due to the Thanksgiving Holiday,  I probably will only publish an  abbreviated
edition next week, if at all.

As usual, articles, comments are welcomed at all times.


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Volume  2, Number 43                                      November 20, 1989

                                 Medical News

                Medical News for Week ending November 19, 1989
        Copyright 1989: USA TODAY/Gannett National Information Network
                          Reproduced with Permission

                                 Nov. 13, 1989

                            TECHNIQUE TO MAP GENES:

   Johns Hopkins geneticists expect to complete a genetic copy  of  chromosome
21  by  1993  with a new cloning technique.  How:  By using a technique called
Yeast Artificial Chromosome cloning.  A form of yeast is  used  to  create  an
artificial chromosome that allows huge fragments of DNA to reproduce at a rate
10 times faster than present cloning methods.

                        DRUG TREATS CANCER, ARTHRITIS:

   Methotrexate,  a drug developed for the treatment of cancer,  is being used
in low doses to treat rheumatoid arthritis. Results: Successful. Possible side
effects: Nausea, vomiting, diarrhea and anorexia. Doctors are debating when to
use the drug in the treatment of rheumatoid arthritis.

                             DRUG STOPS BLEEDING:

   Recent studies have shown that the drug Alphanon  is  beneficial  to  those
suffering  from  bleeding  hemorrhoids,  reports Rene Lambert,  M.D.  of Lyon,
France School of Medicine at a symposium Thursday in Florida.  How:  The drug,
administered through the navel,  stops bleeding in 60 percent to 72 percent of
patients during a 14-day treatment period. Research is continuing.

                         TRANSDERMAL TREATMENT WORKS:

   {*filter*} can be  successfully  administered  through  skin  sites,  said  Rene
Lambert,  M.D.  Of Lyon,  France School of Medicine at a symposium Thursday in
Florida.  Findings:  Hemorrhoidal drug treatment administered nightly into the
navel for transderma absorption has been successful.  Future: Research to test
other transdermal points - forearm and chest wall.

                        RHEUMATIC FEVER CASES GROWING:

   Scattered cases of rheumatic fever have been  reported  among  U.S.  school
children  and  military  personal,  reports  Journal  of  the American Medical
Association's Nov.  10 issue.  Findings: The disease will again become a major
health problem in North American.Recommendations:  Routine penicillin shots be
given to military recruits and children.

                          ELDERLY DIABETICS EXAMINED:

   Experts are urging physicians who treat patients with {*filter*}medications  for
non-insulin  dependent  diabetes  to  pay  more  attention to a patient's age,

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Volume  2, Number 43                                      November 20, 1989

dietary habits and medical condition before selecting a drug therapy,  reports
the  New  England  Journal  of  Medicine.   Why:  Unwanted  side  effects  and
complications in some patients.

                            BLAME MALE BIRTH RATES:

   A new study says one in four black women and about one in  10  white  women
now  in their mid to late 30s will never marry,  reports a sociologist at Yale
University.  Reasons:  Shortage of marriage-aged  men.  Contributing  factors:
Higher rates of early death among black men,  imprisonment of young black men,
higher rates of single-motherhood for black women.  (From the USA  TODAY  Life

                                 Nov. 14, 1989

                         FOOD HABITS UNDERMINE GOALS:

   How  people are taught to think about fatty foods undermines national goals
to cut back on fatty items,  said  psychologist  Leann  Birch,  University  of
Illinois, Urbana.  Why: Fatty foods like desserts are used as a reward and put
in a positive social context,  which encourages people to eat  more  of  these
items. (From the USA TODAY Life section.)

                         GENE FOR WILM'S TUMOR FOUND:

   Geneticists  at  MIT  and  the  University of Colorado have isolated a gene
involved in a childhood cancer called Wilm's tumor. Where: On human chromosome
11. The finding was reported in November at the annual meeting of the American
Society of Human Genetics in Baltimore. Future: More research needed.

                        DECAF COFFEE, CHOLESTEROL TIED:

   Cholesterol levels among drinkers  of  caffeinated  coffee  and  non-coffee
drinkers are the same,  but levels of "bad" cholesterol are higher in drinkers
of decaffeinated coffee, says a study of 180 healthy middle-aged men who drank
three to six cups of black coffee a day for two  months.  The  robusta  coffee
bean,  used  in most brands of decaffeinated coffee,  appears to be the cause,
the study says.

                           BRAIN CRAVES FAT, SUGAR:

   Once the brain gets used to the "calorie rush," it has a  physical  craving
for  fat and sugar mixtures similar to opiate drug {*filter*}ion,  a University of
Michigan researcher says.  Other blocks to cutting fat:  Parents  using  fatty
foods  as a reward for kids;  confusing cooking.net">food labels.  (From the USA TODAY Life

                          ALMONDS REDUCE CHOLESTEROL:

   New research shows that monounsaturated fat in almonds can help control  or
lower {*filter*} cholesterol when used as a replacement for saturated fats, reports
a clinical study funded by the Almond Board of California.  Facts:  After nine
weeks on a diet with 100 grams or 3.5 ounces of raw,  unblanched almonds as  a

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fat  source,  a  group  showed  an  average  drop  of  10.1  percent  in {*filter*}
cholesterol levels.

                        LASER HELPS REDUCE EYE DISEASE:

   A clinical trial supported by the National Eye Institute  provided  further
evidence  that  laser  treatment is highly effective in preventing visual loss
from diabetic eye disease.  Facts:  Focal treatment in which the  laser  seals
leaky  retinal  {*filter*}  vessels  proved  effective  in  reducing  visual  loss.
Scattered laser treatment also proved effective.

                        {*filter*} PROGRAM BEING LAUNCHED:

   "Talking About {*filter*}" is a public service program that will be introduced
nationwide by Education Development Center and Joseph E.  Seagram & Sons. Why:
To help parents discuss {*filter*} with their  pre{*filter*}  children.  The  25-minute
audiocassette and 24-page parents handbook are being distributed free. To find
out where call toll free 1-800-SEAGRAM.

                             DIETARY DRUG TROUBLE:

   There are three more reasons  to  steer  clear  of  dietary  supplement  L-
Tryptophan.  Three  more  states have reported cases of a rare {*filter*} disorder,
after a cooking.net">food and Drug Administration's  consumer  warning  against  the  drug.
Total:  50 cases in nine states.  The drug is often sold in health-food stores
and is a non-prescription amino acid. (From the USA TODAY Life section.)

                                 Nov. 15, 1989

                            HELP FOR HEART DISEASE:

   Three studies presented Tuesday at an American  Heart  Association  meeting
show  blockages  in  heart  arteries  can  be  reversed  with {*filter*},  diet and
lifestyle changes.  Facts: Thirty percent to 50 percent of people with serious
blockages in the heart arteries may avoid bypass surgery and angioplasty. How:
By eating a strict low-fat vegetarian diet and managing stress.

                           {*filter*} DAMAGING TO MEN:

   The National Heart,  Lung and {*filter*} Institute says middle-aged men who have
one or two {*filter*}ic drinks a day  are  putting  themselves  at  risk  for  an
enlarged  heart.  Why:  An  oversized  heart  is  linked to the development of
abnormal heartbeats and forces the main pumping chamber to work harder.  (From
the USA TODAY News section.)

                        NEW TREATMENT FOR PARKINSON'S:

   Researchers at the University of California, San Diego, School of Medicine,
found  that  grafting  altered  cells into the brains of rats with Parkinson's
symptoms helped their condition.  The grafted cells were genetically  modified
to  produce  a  substance  called L-dopa,  which is deficient in the brains of
Parkinson's patients.

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                            DRUG WARNING FROM FDA:

   The number of cases of a rare {*filter*} disorder linked to the diet  supplement
L-tryptophan has risen to over 80.  New Mexico banned the drug Monday, and the
cooking.net">food and Drug Administration has warned consumers  against  it.  At  least  12
different  brands  of  the non-prescription amino acid have been identified as
having been used by the individuals who became ill.


   The drug Pentamidine is gaining acceptance as the treatment of  choice  for
fighting  pneumonia  in  AIDS  patients.  Why:  It  has  proven  to reduce the
fatalities from pneumonia and  produces  fewer  side  effects  than  the  drug
combination Septra - the drug now commonly used.  Future: Research still needs
to find other {*filter*} to combine with Pentamidine for treatment.

                         DRUG IS MARGINALLY EFFECTIVE:

   The drug combination Septra - composed of Trimethoprim and Sulfamethoxazole
- used as a standard treatment for  Pneumocystis  carinii  pneumonia  in  AIDS
patients  is  marginally  effective,  said  researchers  at  UC San Francisco.
Findings:  Trimethoprim is the weaker of the two {*filter*} in Septra  and  lessens
the effectiveness of the drug combination.

                        EXAMINE GUMS BEFORE TREATMENT:

   In  order  to  prevent  gum  loss or recession after undergoing orthodontic
treatment,  patients should have  their  gums  examined  prior  to  treatment,
reports  the  American Academy of Periodontology.  Why:  To make sure there is
sufficient gum tissue to support the teeth after orthodontic treatment.

                        GENETICS LINKED TO GUM DISEASE:

   Recent research show that up to 75 percent of all forms of gum disease  are
inherited, said Dr.  Jon Suzuki, professor of periodontics and microbiology at
the University of Maryland.  Research,  so far,  involves {*filter*}  samples  from
patients with gum disease and interviewing family members with gum disease.

                         STUDY LINKS DRUG TO DEFECTS:

   Researchers  from Duke University Medical Center and Johns Hopkins Hospital
have presented a study to the American Society of Human Genetics in  Baltimore
that  they  believe is the first to link maternal drug use with birth defects.
Findings:  A woman who uses {*filter*} at any time during pregnancy  runs  nearly
three times the risk of having a child with birth defects.

                                 Nov. 16, 1989

                        PROTEINS REDUCE TISSUE DAMAGE:

   T  Cell  Sciences  said  Wednesday  that complement proteins reduced tissue
damage of the heart by 40 percent in animal studies.  How: The natural protein
blocks  complement  protein  activation,  which results in less tissue damage.

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Possible use:  To be administered to individuals who've suffered heart attacks
to reduce further tissue damage.

                          ANGIOPLASTY MORE EFFECTIVE:

   According  to  American  Heart Association researchers,  angioplasty may be
more effective at treating heart attacks than clotbuster {*filter*}.  Study: Of 600
patients in a 10-year study, clotbuster {*filter*} worked about 70 percent of time;
angioplasty  worked  in  93  percent  of  the cases.  (From the USA TODAY Life

                         STRESS WORSENS SKIN DISEASE:

   A new study at the University of Pennsylvania has  shown  that  stress  can
worsen  skin  diseases.  Findings:  Nerve fibers in the skin release a protein
that triggers inflammation, such as in psoriasis or acne.  Conclusion:  In the
skin,  the  immune  response is controlled to some degree by state of mind and
emotional status.  (From the USA TODAY Life section.)

                           ANOREXIA CAN BE OVERCOME:

   Recent long-term studies shows that when treated most young women suffering
from anorexia nervosa return to normal weight and resume and  maintain  normal
menstrual  periods,  according  to a University of Rochester study.  Facts:  A
seven-year follow-up of 49 females  who  were  hospitalized  for  anorexia  as
adolescents found fewer than 15 percent had severe, ongoing eating problems.

                           BOOKLET HELPS CONSUMERS:

   Keebler Co.  has developed a free  booklet  to  help  consumers  understand
cholesterol and its effects on health. The booklet, "Controlling Cholesterol,"
offers  tips for {*filter*}s and children about how to choose snacks that help keep
cholesterol levels in check.  For a copy  write:  Uncommonly  Smart  Snacking,
Suite 200, 500 N. Michigan Ave., Chicago, Ill. 60611

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Volume  2, Number 43                                      November 20, 1989

                      Center for Disease Control Reports

                     Morbidity and Mortality Weekly Report
                          Thursday  November 16, 1989

                        Epidemiologic Notes and Reports
                  Eosinophilia-Myalgia Syndrome -- New Mexico

    On October 30,  1989,  the New Mexico Department of Health and Environment
(NMDHE)  was  notified  of three patients with eosinophilia and severe myalgia
who had been taking {*filter*}preparations of the  amino  acid  L-tryptophan  (LT).
Even  though  the  patients  had  undergone  extensive clinical evaluation and
testing, their illnesses were not consistent with any known diagnostic entity.
Public announcement of the cluster led rapidly to reports  of  similar  cases.
Using  a  provisional  case  definition of eosinophil count of greater than or
equal to 2000 cells per mm3 and  absence  of  documentation  in  the  clinical
record  of  any  known  cause  of  eosinophilia  (e.g.,  parasitic  or  fungal
infection,  end-stage renal disease,  leukemia,  allergic disorder,  and  drug
reactions),  NMDHE  initiated  an  active  search for additional cases through
review of laboratory records of eosinophil counts.
    As of November 13,  1989,  30 potential cases had  been  identified.  Most
cases were reported in Albuquerque and Santa Fe,  but cases were also reported
in other parts of the state.  The 17 female patients ranged in age from 20  to
80  years (mean:  42 years),  and the 13 males,  from 4 to 78 years (mean:  48
years).  Reported eosinophil counts ranged from 2064 to 12,100 cells  per  mm3
(mean: 2300 cells per mm3) (normal: 50-350 cells per mm3 (1)).
    Fif{*filter*} of the 30 patients were hospitalized.  Detailed clinical histories
were available for 14 patients,  each of whom reported myalgia;  for 11  (79%)
the myalgias were incapacitating.  Other clinical findings included subjective
weakness (11 (79%) of patients),  fever 99.7-105 F (11 (79%)),  arthralgia (11
(79%)),  shortness  of breath (nine (64%)),  rash (eight (57%)),  edema in the
extremities (eight (57%)), and clinical pneumonia (five (36%)).
    Eleven of these 14 patients are known to have been users of  LT.  Multiple
brands  and  dosages  were involved.  To further assess a possible association
between use of LT and this syndrome, a case-control study is under way.

Reported by: WL Blevins, MD, Taos;  P Hertzman, MD, Los Alamos;  M Ting, MD, K
Keith,  MD,  J Mayer,  MD,  BM Greenfield,  MD,  Santa Fe;  M Eidson,  DVM,  R
Voorhees, MD, M Tanuz, CM Sewell, DrPH, State Epidemiologist,  New Mexico Dept
of Health and Environment. GJ Gleich, MD, Rochester, Minnesota. Health Studies
Br  and Surveillance and Programs Br,  Div of Environmental Hazards and Health
Effects, Center for Environmental Health and Injury Control, CDC.

Editorial Note:  Although the syndrome described in patients from  New  Mexico
shares  some  features  with  previous  case  reports  (2-4),  it has not been
described in epidemic form.  In addition,  the illness in New  Mexico  closely
parallels  the  intermediate  and  chronic phases of toxic-oil syndrome (TOS),
which occurred in epidemic form in Spain in 1981.  In that epidemic,  patients
also   had  severe  myalgia  and  intense  eosinophilia,   as  well  as  other
manifestations (5,6).  However,  the full range of clinical findings  and  the
severity of illness described for TOS are not apparent in this outbreak.
    By November 15,  following media publicity and contact by NMDHE with other
state health departments concerning the New Mexico  cases,  CDC  had  received

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Volume  2, Number 43                                      November 20, 1989

reports  of  a  total  of 154 potential cases of a similar illness from public
health agencies,  physicians,  and the general public in  17  states  and  the
District  of  Columbia.  The  extent of this epidemic is unknown.  Most of the
patients in New Mexico had onset after July 1989.  However, reports from other
states suggest that illness in some patients occurred before that time.
    LT is an essential amino acid that is normally ingested as  a  constituent
of dietary protein. LT supplements are used by some persons for disorders such
as insomnia,  depression,  and premenstrual syndrome (7).  On November 11, the
cooking.net">food and Drug Administration (FDA) advised consumers to discontinue use of LT-
containing tablets, capsules,  and caplets pending further evaluation of their
potential  adverse  effects.  FDA is investigating the composition and sources
of these products.  To date, at least four states (California, Minnesota,  New
Mexico,  and  Oregon) have made recommendations or taken action to suspend the
sale of LT products within their states.
    Because this  syndrome  represents  an  apparently  new  clinical  entity,
diagnostic criteria have not yet been established. Many of the potential cases
reported  to  CDC  had  initially  been diagnosed as other illnesses,  such as
eosinophilic  myositis,  eosinophilic  fasciitis,  polyarteritis  nodosa,  and
suspected  trichinosis.  For surveillance purposes,  CDC recommends defining a
case of eosinophilia-myalgia syndrome (EMS) as an illness characterized by all
of the following:  1) eosinophil count greater than or equal to 1000 cells per
mm3;  2)  generalized  myalgia (at some point during the course of illness) of
severity sufficient to affect a patient's ability to pursue his or  her  usual
daily activities; 3) one or both of the following: a) exclusion of trichinosis
by  serologic  tests  performed  at  an  appropriate  interval  after onset of
symptoms and/or b) muscle biopsy that does not  show  trichinella  larvae  but
does show an inflammatory infiltrate including eosinophils;  and 4) absence of
any infection or neoplasm that could account for 1 or 2  above.  However,  the
physician's  clinical judgment will continue to be important in diagnosing the
syndrome in specific patients, and a variety of different case definitions may
be appropriate for specific epidemiologic investigations and research studies.
    The surveillance case definition  should  be  considered  provisional  and
subject  to  change as knowledge of EMS evolves.  Since the potentially causal
relationship  between  LT  use  and  EMS  remains  the   subject   of   active
investigation,  a  patient's  use  or  nonuse  of LT should not influence case
    CDC is working  with  state  health  departments  to  develop  state-based
surveillance  of  EMS  using  a  uniform  case  report  form with standardized
instructions.  CDC requests,  therefore,  that possible cases be  reported  to
state health departments.


1.  Elin RJ. Reference intervals and laboratory values of clinical importance.
In:  Wyngaarden JB,  Smith LH Jr,  eds.  Cecil textbook of medicine.  18th ed.
Philadelphia: WB Saunders, 1988:2394-404.

2.  Yonker  RA,  Panush RS.  Idiopathic eosinophilic myositis with preexisting
fibromyalgia. J Rheumatol 1985;12:165-7.

3. Symmans WA, Beresford CH, Bruton D, et al. Cyclic eosinophilic myositis and
hyper immunoglobulin-E. Ann Intern Med 1986;104:26-32.

4.  Lakhanpal S, Duffy J, Engel AG.  Eosinophilia associated with perimyositis
and pneumonitis. Mayo Clin Proc 1988;63:37-41.

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Volume  2, Number 43                                      November 20, 1989

5.  Kilbourne EM, Rigau-Perez JG, Heath CW Jr, et al. Clinical epidemiology of
toxic-oil  syndrome:   manifestations  of  a  new  illness.   N  Engl  J   Med

6.  Toxic Epidemic Syndrome Study Group. Toxic epidemic syndrome, Spain, 1981.
Lancet 1982;2:697-702.

7.  Boman B.  L-tryptophan: a rational anti-depressant and a natural hypnotic?
Aust NZ J Psychiatry 1988;22:83-97.

Health InfoCom Network News                                             Page  9
Volume  2, Number 43                                      November 20, 1989

                  Earthquake-Associated Deaths -- California

    On October 17,  1989,  at 5:04 p.m.  Pacific daylight time,  an earthquake
registering 7.1 on the Richter scale,  with an epicenter in  the  Loma  Prieta
section of the San Andreas fault,  occurred in northern California (Figure 1).
The earthquake released seismic  energy  equivalent  to  a  7-megaton  nuclear
explosion,  generated lateral acceleration forces exceeding 60% of the earth's
gravitational pull,  and caused an estimated $5.6 billion in  property  damage
(excluding  damage  to highways,  bridges,  and state office buildings) in the
seven disaster counties (Alameda,  Monterey,  San Benito,  San Francisco,  San
Mateo,  Santa  Clara,  and  Santa  Cruz  (combined January 1,  1989,  resident
population approximately 4,672,300) (1)).
    Using contact information in Medical Examiner and Coroner Jurisdictions in
the United States (2),  public health officials asked county medical examiners
and  coroners  (ME/Cs)  in  the  disaster  counties to report 1) the number of
earthquake-related deaths investigated in their jurisdictions from October  17
through  October  31 and 2) information about the demographic characteristics,
cause,  and circumstance of each  death.  There  is  no  universally  accepted
definition   of   an   "earthquake-related  death";   for  this  report,   the
determination was made by each county ME/C.
    County ME/Cs in the disaster area reported  63  earthquake-related  deaths
(60 directly related and three indirectly related). Of the 60 directly related
deaths,  57  (95%)  resulted  from  injuries sustained within 2 minutes of the
earthquake;  three resulted from injuries sustained  within  8  hours  of  the
earthquake (Table 1). Three deaths occurring within 24 hours of the earthquake
were indirectly related (Table 1).  The highest county-specific mortality rate
for all earthquake-related deaths occurred in Alameda County (3.4 per  100,000
population) (Figure 1, Table 2).

Reported by:  DP Cain, CC Plummer, Sheriff-Coroners Office, Alameda County; DB
Cook, Sheriff-Coroners Office,  Monterey County;  HS Nyland,  Sheriff-Coroners
Office,  San Benito County;  JE Surdyka,  BG Stephens,  MD,  Medical Examiner-
Coroners Office, San Francisco County;  PB Jensen, Coroners Office,  San Mateo
County;  NL Gossett,  JE Hauser,  MD,  Medical Examiner-Coroners Office, Santa
Clara County; AF Noren, Sheriff-Coroners Office, Santa Cruz County; SJ Martel,
PhD,  Earth Sciences Div,  Lawrence Berkeley Laboratory,  Univ of  California,
Berkeley;  TR  Toppozada,  PhD,  Div of Mines and Geology,  California Dept of
Conservation;  RB  Trent,  PhD,  Emergency  Preparedness  and  Injury  Control
Program,  JW  Stratton,  MD,  Hazard  Evaluation  Section,  DC  Mortenson,  RA
Kreutzer,  MD,  LR Goldman,  MD,  Environmental  Epidemiology  and  Toxicology
Section,  KH Acree,  MD,  DO Lyman, MD, Preventive Medical Svcs Div, KW Kizer,
MD, Director, California Dept of Health Svcs.  Div of Field Svcs, Epidemiology
Program  Office;  Div of Environmental Hazards and Health Effects,  Center for
Environmental Health and Injury Control, CDC.

Editorial Note:  An earthquake's  magnitude  (measured  with  the  logarithmic
Richter scale (3)) is one of the most important factors influencing the extent
of  earthquake-related  destruction and mortality.  Other contributing factors
include  population  density,  proximity  to  the  epicenter,  local  geology,
building codes and compliance with them, building materials, number of stories
and  age  of structures,  and capabilities of local emergency medical services
    As with Hurricane Hugo (5,6), ME/Cs, who are responsible for investigating
deaths related to trauma  and  {*filter*},  rapidly  determined  the  extent  of
earthquake-related    mortality   and   provided   detailed   information   on

Health InfoCom Network News                                             Page 10
Volume  2, Number 43                                      November 20, 1989

circumstances of death,  as well  as  demographic  information  on  decedents.
Mortality  associated with the California earthquake was lower than for recent
earthquakes of similar  magnitude.  Potentially  responsible  factors  include
local  geology  and building patterns;  incorporation of aseismic (earthquake-
resistant) engineering features in buildings in the densely populated downtown
sections of Oakland,  San Francisco,  and San  Jose;  and  absence  of  major,
widespread  fires following the earthquake.  The lower mortality in the recent
earthquake also contrasts with the mortality in the  1906  earthquake  in  San
Francisco (approximately 667 deaths per 100,000 population) (7).
    The  California  Emergency  Medical  Service  Authority and the California
Department of Health Services, in cooperation with the Region IX Office of the
--- end part 1 of 3 cut here ---

Mon, 19 Apr 1993 06:03:00 GMT
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