Michael H Merson

Interim Chair of the Department of Social and Behavioral Sciences

Clinical Professor of Global and Environmental Health

Professional overview

Michael Merson is Interim Chair of the Department of Social and Behavioral Sciences and a Clinical Professor of Global and Environmental Health at NYU. He also the William Joklik Emeritus Professor of Medicine and Global Health at Duke University, where he served as the founding director of the Duke Global Health Institute and as Vice President and Vice Provost for Global Affairs. His current research is focused on policy issues related to the response to pandemics, evaluating the rollout of Paxlovid in low-income countries and on ways to regain trust in public health.

Prior to NYU, he joined the faculty at Yale University as its first Dean of Public Health. Before entering academia, between 1980 and 1995, Dr. Merson served as director of the World Health Organization (WHO) programs on Diarrheal Diseases and Acute Respiratory Infections, and subsequently the WHO Global Program on AIDS. He has authored over 150 articles, is the senior editor of a leading global health textbook “Global Health: Disease, Programs, Systems, and Policies” and lead author of The AIDS Pandemic: Searching for a Global Response on the history of the global response to AIDS. He has served in advisory capacities for UNAIDS, WHO, the Global Fund to Fight AIDS, TB and Malaria, World Bank, World Economic Forum, Bill & Melinda Gates Foundation, and was an advisor to various private sector entities on the COVID-19 pandemic. He has two honorary degrees and is a member of the National Academy of Medicine.

Education

B.A., 1966, cum laude, Amherst College, Amherst, Massachusetts

M.D., 1970, summa cum laude, SUNY, Health Sciences Center at Brooklyn, New York

Honors and awards

Consortium of Universities for Global Health (CUGH) Distinguished Leadership Award (2018)

Duke Medical Alumni Association Distinguished Faculty Award (2017)

Master Teacher Award in Preventive Medicine, Downstate Medical Center (2010)

Outstanding Contribution to the Campaign Against HIV/AIDS, Russian Association Against AIDS (2000)

Connecticut Health Commissioner’s AIDS Leadership Award (1998)

Connecticut Health Commissioner’s AIDS Leadership Award (1997)

Frank Babbott Alumni Award (1995)

Surgeon General's Exemplary Service Medal (1993)

Commendation Medal, US Public Health Service; (1986)

Arthur S. Flemming Award for Outstanding Federal Service (1983)

Commendation Medal, US Public Health Service (1975)

Publications

Publications

Corporate citizenship, aids and Africa : Lessons from bristol-myers squibb company’s secure the future™

Hartwig, K. A., Rosenberg, A., & Merson, M. H. (n.d.).

Publication year

2017

Page(s)

132-143

10.4324/9781351281768

Abstract

Abstract

The title of Alan Paton’s South African novel, Ah, But Your Land is Beautiful, reflects the common impression of most visitors and residents as they travel across the widely differing terrains of sub-Saharan Africa. As the story tells, however, the beauty is often eclipsed by the evidence of human suffering, social injustices, environmental degradation and exploitation of resources exerted by ever-changing political elites. Today’s South Africa and its neighbouring states are living on the foundations of this history, some with constitutions barely ten years old. Infrastructure and economic development were fostered within the urban and suburban centres allowing the rural areas with the majority of the population to remain in living conditions of decades past. The economic and human resources in southern Africa remain strong, but generating future economic development that will correct some of the current human and ecological imbalances will require new social contracts with businesses and corporations. Historically in this region, governments and corporations have often worked against the civil, social and political rights of the majority of its citizens, and worker-corporate relations have been tense, leaving the majority of the population suspicious of corporations and their motives (Bauer and Taylor 2005).

Current Trends in Botulism in the United States

Merson, M. H., Hughes, J. M., Dowell, V. R., Taylor, A., Barker, W. H., & Gangarosa, E. J. (n.d.).

Publication year

1974

Journal title

JAMA: The Journal of the American Medical Association

Volume

229

Issue

10

Page(s)

1305-1308

10.1001/jama.1974.03230480021022

Abstract

Abstract

Between 1970 and 1973, thirty outbreaks of food-borne botulism involving 91 cases and 21 deaths (23%) were reported to the Center for Disease Control (CDC). Three of the 30 outbreaks were attributed to commercial foods. Six cases of wound botulism were also reported. Electromyography and a recently developed test for detection of botulinal toxin in human feces have facilitated the laboratory diagnosis of botulism. Intensive respiratory care and elimination of toxin from the gastrointestinal tract remain the most important aspects of therapy. The efficacy of botulinal antitoxin is unclear, and the rate of untoward reactions to its administration appears to be about 20%. Education of the home canner and enforcement of federal regulations established for the canning of low-acid foods by the food industry are vital to the prevention and control of botulism.

Detection of Escherichia coli enterotoxins in stools

Merson, M. H., Yolken, R. H., Bradley Sack, R., Froehlich, J. L., Greenberg, H. B., Huq, I., & Black, R. W. (n.d.).

Publication year

1980

Journal title

Infection and Immunity

Volume

29

Issue

1

Page(s)

108-113

10.1128/iai.29.1.108-113.1980

Abstract

Abstract

We determined whether enterotoxigenic Escherichia coli diarrhea could be diagnosed by direct examination of stools for heat-labile (LT) and heat-stable (ST) enterotoxins. The Y-1 adrenal cell and an enzyme-linked immunosorbent assay (ELISA) detected LT in 85 and 93%, respectively, of stool specimens obtained from adults with acute diarrhea from whom an LT- and ST-producing organism had been isolated. Furthermore, the ELISA assay detected LT in 8 of 35 stool specimens from which no LT-producing E. coli had been isolated. The infant mouse assay was utilized to detect ST in these stool specimens and was found to be an insensitive method, showing positive results in only 36% of the specimens from which an ST-producing organism was isolated. Further studies are warranted to determine the diagnostic value of direct detection of LT in stools, especially by the ELISA method.

Diagnosis of Acute HIV infection in Connecticut

Dubrow, R., Sikkema, K. J., Mayer, K. H., Bruce, R. D., Julian, P., Rodriguez, I., Beckwith, C., Roome, A., Dunne, D., Boeving, A., Kidder, T. J., Jenkins, H., Dobson, M., Becker, J., & Merson, M. H. (n.d.).

Publication year

2009

Journal title

Connecticut medicine

Volume

73

Issue

6

Page(s)

325-331

Abstract

Abstract

Acute HIV infection (AHI) is the earliest stage of HIV disease, when plasma HIV viremia, but not HIV antibodies, can be detected. Acute HIV infection often presents as a nonspecific viral syndrome. However, its diagnosis, which enables linkage to early medical care and limits further HIV transmission, is seldom made. We describe the experience of Yale's Center for Interdisciplinary Research on AIDS with AHI diagnosis in Connecticut, as a participating center in the National Institute of Mental Health Multisite AHI Study. We sought to identify AHI cases by clinical referrals and by screening for AHI at two substance abuse care facilities and an STD clinic. We identified one case by referral and one through screening of 590 persons. Screening for AHI is feasible and probably cost effective. Primary care providers should include AHI in the differential diagnosis when patients present with a nonspecific viral syndrome.

Diagnostic value of indirect hemagglutination in the seroepidemiology of Shigella infections

Merson, M. H., Patton, C. M., Gangarosa, E. J., Weissman, J. B., Merson, M. H., & Morris, G. K. (n.d.).

Publication year

1976

Journal title

Journal of Clinical Microbiology

Volume

3

Issue

2

Page(s)

143-148

Abstract

Abstract

To evaluate the usefulness of the indirect hemagglutination (HA) test in the epidemiological investigation of shigellosis, single serum specimens were tested from 50 patients with Shigella dysenteriae 1 (Shiga bacillus) infections, 103 asymptomatic contacts of these cases, 267 adult and 100 student control, and serum specimens collected during two outbreaks caused by S. sonnei and one outbreak due to S. flexneri 6. In patients with S. dysenteriae 1, 74% demonstrated titers of ≥ 1:40, with 50% showing titers of ≥ 1:60, whereas in the controls 10.4% had titers of ≥ 1:40 and only 0.3% had titers of ≥ 1:60. IHA titers in serum specimens collected from patients with S. sonnei and S. flexneri 6 were too low to be considered diagnostic for individual patients, but were useful in analysis of group results. Groups of ill individuals yielded titers significantly higher than non ill groups; however, titers from ill groups were usually less than 1:40. The IHA test for S. dysenteriae 1 antibodies serves as a valuable adjunct to the diagnosis of Shiga bacillus dysentery. In the laboratory, an IHA titer of 1:40 or 1:80 is a 'borderline positive.' Shiga bacillus dysentery is strongly indicated when IHA titers are ≥ 1:60.

Diarrhoeal disease control : Reviews of potential interventions

Merson, M. H., Feachem, R. G., Hogan, R. C., & Merson, M. H. (n.d.).

Publication year

1983

Journal title

Bulletin of the World Health Organization

Volume

61

Issue

4

Page(s)

637-640

Abstract

Abstract

Diarrhoeal diseases are a major cause of sickness and death among young children in most developing countries. Since effective interventions to control these diseases are available, they are a priority target for the primary health care programmes being planned or implemented in many countries. Governments and international agencies, including the World Health Organization, have emphasized oral rehydration as an effective intervention for reducing diarrhoeal disease mortality. Other interventions are, however, needed to reduce morbidity, to reduce mortality not averted by oral rehydration, and to develop a multifaceted approach in which oral rehydration is one of several anti-diarrhoea measures being implemented simultaneously with mutally reinforcing and complementary impacts. This paper presents a classification of potential interventions for the control of diarrhoeal disease morbidity and/or mortality among children under 5 years of age and introduces a series of reviews of these interventions. The first of these reviews, on measles immunization, also appears in this issue of the Bulletin of the World Health Organization.

Diarrhoeal disease in Bangladesh epidemiology, mortality averted and costs at a rural treatment centre

Oberle, M. W., Merson, M. H., Islam, M. S., Rahman, A. S., Huber, D. H., & Curlin, G. (n.d.).

Publication year

1980

Journal title

International Journal of Epidemiology

Volume

9

Issue

4

Page(s)

341-348

10.1093/ije/9.4.341

Abstract

Abstract

Oberle M W (Bureau of Epidemiology, Center for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia 30333, USA), Merson M H, Islam M S, Rahman A S M M, Huber D H and Curlin G. Diarrhoeal disease in Bangladesh: Epidemiology, mortality averted and costs at a rural treatment centre. International Journal of Epidemiology 1980, 9: 341-348.The basic epidemiology of acute diarrhoeal disease seen at a rural Bangladesh hospital in 1975 is reviewed. V.cholerae 01 was isolated from 28% of 1 964 patients. Significant differences in hospltalisation rates were observed between males and females in several age groups. Overall hospital case fatality was 9/1000 cases. We estimate that approximately a quarter to half of the hospitalised patients would have died had no rehydration therapy been available. The region's total mortality was reduced by approximately 7%-15%, at a cost of United States $0.14 per capita. Mortality from acute diarrhoeal diseases was greatly reduced for all age groups, and total mortality and mortality from all diarrhoeal diseases were particularly reduced for young children and young adults. Rehydration therapy used in a field hospital was apparently highly effective in reducing general mortality and mortality from acute diarrhoeal diseases.

DIARRHŒA ASSOCIATED WITH HEAT-STABLE ENTEROTOXIN-PRODUCING STRAINS OF ESCHERICHIA COLI

Sack, D. A., Wells, J. G., Merson, M. H., Sack, R. B., & Morris, G. K. (n.d.).

Publication year

1975

Journal title

The Lancet

Volume

306

Issue

7928

Page(s)

239-241

10.1016/S0140-6736(75)90958-7

Abstract

Abstract

Five patients who developed acute watery diarrhœa while travelling in Mexico in October, 1974, were found to have enterotoxigenic Escherichia coli in their stool which produced heat-stable enterotoxin (S.T.) without producing heat-labile enterotoxin (L.T.). These S.T.-only E. coli,which have previously been described as causing diseases in animals, must now be regarded as pathogenic for humans as well.

Disease Caused by a Marine Vibrio : Clinical Characteristics and Epidemiology

Blake, P. A., Merson, M. H., Weaver, R. E., Hollis, D. G., & Heublein, P. C. (n.d.).

Publication year

1979

Journal title

New England Journal of Medicine

Volume

300

Issue

1

Page(s)

1-5

10.1056/NEJM197901043000101

Abstract

Abstract

We studied the clinical characteristics and epidemiology of disease associated with a rare, unnamed halophilic lactose-fermenting Vibrio species in 39 persons from whom the organism had been isolated. Two distinct clinical presentations were seen. In the first, the illness began with septicemia, often within 24 hours after raw oysters had been eaten; 18 of 24 such patients had pre-existing hepatic disease, and 11 of the 24 died. In the second, there was a wound infection after exposure to seawater or an injury incurred during the handling of crabs; none of these persons had pre-existing hepatic disease, and one of 15 died. Most cases (85 per cent) occurred during relatively warm months (May to October) in men (90 per cent) 40 or more years of age (95 per cent). This Vibrio species is a pathogen and should be considered in the differential diagnosis of septicemia with secondary skin lesions and of wound infections after exposure to seawater. (N Engl J Med 300:1–5, 1979) RECENTLY, Hollis et al. described the laboratory characteristics of an as yet unnamed halophilic Vibrio species.1 This Vibrio has been shown by deoxyribonucleic acid reassociation experiments to be a single species distinct from two other halophilic species, Vibrio parahaemolyticus and V. alginolyticus2; it can be distinguished from them biochemically by several reactions, including the fermentation of lactose (Table 1). This lactose-positive (L+) Vibrio is remarkable in that isolates from human beings have been from blood and infected tissue rather than from stool. In this report, we describe the clinical and epidemiologic characteristics of 39 illnesses associated with isolation of.

Disease due to enterotoxigenic Escherichia coli in Bangladeshi adults : Clinical aspects and a controlled trial of tetracycline

Merson, M. H., Merson, M. H., Sack, R. B., Islam, S., Saklayen, G., Huda, N., Huq, I., Zulich, A. W., Yolken, R. H., & Kapikian, A. Z. (n.d.).

Publication year

1980

Journal title

Journal of Infectious Diseases

Volume

141

Issue

6

Page(s)

702-711

10.1093/infdis/141.6.702

Abstract

Abstract

The clinical characteristics of disease due to enterotoxigenic Escherichia coli (ETEC) were determined in 88 adult males admitted to a hospital in Dacca, Bangladesh, with moderate to severe dehydration. Persons infected with ETEC strains producing both heat-labile toxin (LT) and heat-stable (ST) toxin had more dehydration and acidosis, longer duration of illness, and greater stool volume than persons infected with strains producing only ST. Tetracycline therapy, evaluated in 63 cases, resulted in slightly earlier termination of illness in the patients with LT-ST strains but had no effect on illness in the patients with ST strains. In both groups of patients tetracycline shortened the duration of excretion of organisms. Because of its limited effectiveness and the generally excellent response of ETEC diarrhea to rehydration therapy alone, tetracycline is not warranted for use in treatment of ETEC diarrhea in adults in this population.

Doxycycline and the traveller

Merson, M. H. (n.d.).

Publication year

1979

Journal title

Gastroenterology

Volume

76

Issue

6

Page(s)

1485-1488

10.1016/0016-5085(79)90420-7

Abstract

Abstract

~

Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030

Black, R., Fontaine, O., Lamberti, L., Bhan, M., Huicho, L., El Arifeen, S., Masanja, H., Walker, C. F., Mengestu, T. K., Pearson, L., Young, M., Orobaton, N., Chu, Y., Jackson, B., Bateman, M., Walker, N., & Merson, M. H. (n.d.).

Publication year

2019

Journal title

Journal of Global Health

Volume

9

Issue

2

10.7189/jogh.09.020801

Abstract

Abstract

Background Childhood diarrhea deaths have declined more than 80% from 1980 to 2015, in spite of an increase in the number of children in low-and middle-income countries (LMIC). Possible drivers of this remarkable accomplishment can guide the further reduction of the half million annual child deaths from diarrhea that still occur. Methods We used the Lives Saved Tool, which models effects on mortality due to changes in coverage of preventive or therapeutic interventions or risk factors, for 50 LMIC to determine the proximal drivers of the diarrhea mortality reduction. Results Diarrhea treatment (oral rehydration solution [ORS], zinc, antibiotics for dysentery and management of persistent diarrhea) and use of rotavirus vaccine accounted for 49.7% of the diarrhea mortality reduction from 1980 to 2015. Improvements in nutrition (stunting, wasting, breastfeeding practices, vitamin A) accounted for 38.8% and improvements in water, sanitation and handwashing for 11.5%. The contribution of ORS was greater from 1980 to 2000 (58.0% of the reduction) than from 2000 to 2015 (30.7%); coverage of ORS increased from zero in 1980 to 29.5% in 2000 and more slowly to 44.1% by 2015. To eliminate the remaining childhood diarrhea deaths globally, all these interventions will be needed. Scaling up diarrhea treatment and rotavirus vaccine, to 90% coverage could reduce global child diarrhea mortality by 74.1% from 2015 levels by 2030. Adding improved nutrition could increase that to 89.1%. Finally, adding increased use of improved water sources, sanitation and handwashing could result in a 92.8% reduction from the 2015 level. Conclusions Employing the interventions that have resulted in such a large reduction in diarrhea mortality in the last 35 years can virtually eliminate remaining childhood diarrhea deaths by 2030.

Early detection : The next steps

Merson, M. H., & Merson, M. H. (n.d.).

Publication year

2000

Journal title

Journal of Acquired Immune Deficiency Syndromes

Volume

25

Issue

SUPPL. 2

Page(s)

S157-S159

10.1097/00126334-200012152-00011

Abstract

Abstract

~

Effectiveness of HIV prevention interventions in developing countries

Merson, M. H., Merson, M. H., Dayton, J. M., & O'Reilly, K. (n.d.).

Publication year

2000

Journal title

AIDS, Supplement

Volume

14

Issue

2

Page(s)

S68-S84

Abstract

Abstract

Objective: To review the effectiveness of projects and programs in developing countries that aim to reduce sexual transmission of HIV infection or transmission related to injection drug use. Design: We identified 34 published studies undertaken in 18 developing countries that met rigorous inclusion criteria. These criteria included the length of follow-up, use of statistical analysis, the inclusion of a comparison group, and type of outcomes measured. Results: We found that behavioral change interventions are effective when targeted to populations at high risk, particularly female sex workers and their clients. Few studies have evaluated harm reduction interventions in injecting drug users (IDUs). Evidence on the effectiveness of voluntary counseling and testing programs was promising, and VCT was most effective when directed at discordant couples. Treatment of sexually transmitted diseases (STD) appears highly effective in reducing HIV/STD transmission, particularly in the earlier stages of the epidemic. Conclusions: This review demonstrates that HIV prevention interventions can be effective in changing risk behaviors and preventing transmission in low and middle-income countries. When the appropriate mix of interventions is applied, they can lead to significant reductions in the prevalence of HIV at the national level. Additional research is needed to identify effective interventions, particularly in men who have sex with men, youth, IDUs and HIV-infected persons. Structural and environmental interventions show great promise, although more evaluation is needed. (C) 2000 Lippincott Williams and Wilkins.

Endemic cholera in rural Bangladesh, 1966-1980

Glass, R. I., Becker, S., Huq, M. I., Stoll, B. J., Khan, M. U., Merson, M. H., Lee, J. V., & Black, R. E. (n.d.).

Publication year

1982

Journal title

American Journal of Epidemiology

Volume

116

Issue

6

Page(s)

959-970

10.1093/oxfordjournals.aje.a113498

Abstract

Abstract

Since 1963, the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR.B), formerly the Cholera Research Laboratory, has maintained a field station in Matlab to treat patients from a surveillance population of 240,000 who have cholera and other diarrheal diseases. Since 1966, the authors have analyzed hospital records of 7141 surveillance-area patients culture-positive for V. cholerae 01 to relate the seasonally, age and sex distribution, and geographic trends with hypotheses concerning transmission, immunity, and risk groups. From this review, they have found that: 1) children 2-9 years old and adult women are most commonly hospitalized for cholera; 2) V. cholerae 01 emerges simultaneously throughout the area of surveillance, with the early cases being of different phage types; 3) three patients were hospitalized twice for cholera compared with 29 expected on the basis of life-table analysis (p < 0.01), suggesting that Immunity to severe disease conferred by previous Illness may be stable and long-lasting; 4) no constant relationship was found between the times of onset or peaks of the yearly cholera epidemic and the times of onset or peaks of the monsoon rains or river water levels; and 5) an outbreak of multiply antibiotic-resistant V. cholerae 01 infection documented in 1979 raises questions about the dissemination of resistance plasmids, antibiotic-use patterns, and the need for other drugs in addition to tetracycline. While little progress has been made in understanding the mode of transmission of V. cholerae 01, and in Identifying practices for prevention, fluid therapy in this area has decreased the case fatality rate significantly and provides guidance for similar programs elsewhere.

Enfrentar a diarreia à escala mundial.

Merson, M. H., & Merson, M. H. (n.d.).

Publication year

1986

Journal title

Servir (Lisbon, Portugal)

Volume

34

Issue

4

Page(s)

198-199

Abstract

Abstract

~

Enhancing Awareness of Hospice Through Physician Assisted Living : Public Health Perspectives

Merson, M. H., & Bradley, E. H. (n.d.).

Publication year

1997

Journal title

Connecticut medicine

Volume

61

Issue

12

Page(s)

789-791

Abstract

Abstract

The provision, management, and financing of care for patients with irreversible diseases has become increasingly complex in this era of advanced medical technology. With enhanced capabilities of medicine to prolong life, clinical practice has taken on legal and ethical dimensions that reach beyond the traditional scope of medicine. This paper demonstrates that hospice represents a major area of public health practice and research. It argues for enhanced involvement of public health practitioners and academics in the design and evaluation of efforts to encourage appropriate use of hospice for patients with irreversible diseases. The physician assisted living intervention in Connecticut represents one such effort. However, ongoing educational efforts targeted at both the public and health care providers are needed to ensure that all those with irreversible diseases fully understand and have access to hospice care at the end of life.

Enriching the mix : Incorporating structural factors into HIV prevention

Merson, M. H., Sumartojo, E., Doll, L., Holtgrave, D., Gayle, H., & Merson, M. (n.d.).

Publication year

2000

Journal title

AIDS

Volume

14

Issue

11 SUPPL.

Page(s)

S1-S2

10.1097/00002030-200006001-00001

Abstract

Abstract

~

ENTEROTOXIGENIC ESCHERICHIA COLI AND REOVIRUS-LIKE AGENT IN RURAL BANGLADESH

Ryder, R. W., Sack, D. A., Kapikian, A. Z., Mclaughlin, J. C., Chakraborty, J., Mizanur Rahman, A. S., Merson, M. H., & Wells, J. G. (n.d.).

Publication year

1976

Journal title

The Lancet

Volume

307

Issue

7961

Page(s)

659-663

10.1016/S0140-6736(76)92776-8

Abstract

Abstract

48 patients admitted to a rural Bangladesh hospital with dehydration secondary to diarrhœa were examined for infection caused by reovirus-like agent (R.L.A.) or enterotoxigenic Escherichia coli (E.T.E.C.). The diagnosis of R.L.A. infection was established by electron microscopy of stool filtrates and by a fourfold or greater rise in serum complement-fixing antibodies to the Nebraska calf diarrhœa virus. Evidence of infection by heat-labile-toxin (L.T.)-producing E.T.E.C. was sought by stool culture and serological testing using the adrenal-cell tissue-culture system. Infection by heat-stable-toxin (S.T.)-producing E.T.E.C. was sought by stool culture using the infant mouse test. 12 patients, all less than two years old, had evidence of R.L.A. infection, accounting for illness in 55% of the 22 patients who were less than two years old. None of these 22 children had evidence of E.T.E.C. infection. R.L.A. diarrhœa lasted five to six days, often led to serious dehydration, and was associated with vomiting and fever. 11 cases of E.T.E.C. diarrhœa were detected, accounting for 56% of the cases of diarrhœa in the 18 patients who were more than ten years old. Diarrhœa caused by E.T.E.C. was sudden in onset, shorter in duration, and caused pronounced dehydration. In a community survey E.T.E.C. was isolated with equal frequency in the stools of control and case family members. The data suggest that E.T.E.C. is a common cause of adult diarrhœa in Bangladesh, while R.L.A. is a common cause of diarrhœa in children.

Enterotoxigenic Escherichia coli diarrhoea : Acquired immunity and transmission in an endemic area

Merson, M. H., Black, R. E., Merson, M. H., Rowe, B., Taylor, P. R., Abdul Alim, A. R., Gross, R. J., & Sack, D. A. (n.d.).

Publication year

1981

Journal title

Bulletin of the World Health Organization

Volume

59

Issue

2

Page(s)

263-268

Abstract

Abstract

Enterotoxigenic Escherichia coli (ETEC) are an important cause of diarrhoea in developing countries. Studies were made, in an endemic area of Bangladesh, of household contacts of patients with diarrhoea associated with E. coli producing heat-stable and heat-labile toxins (ST/LT) or heat-stable toxin (ST) only. It was found that 11% of contacts were infected in the 10-day study period, and that both the rate of infection and the proportion of infected persons with diarrhoea decreased with increasing age, suggesting the development of immunity. ETEC of the same serotype as that of the index patient were found in 9% of water sources used by index households, in a small number of food and drinking water specimens from the index homes, and in faeces from 3 healthy calves. The rate of infection of household members was highest in houses where there was contaminated food or water which suggests that infection may take place in the home when contaminated water is brought in.

Enzyme-linked immunosorbent assay for detection of Escherichia coli heat-labile enterotoxin

Merson, M. H., Yolken, R. H., Greenberg, H. B., Merson, M. H., Sack, R. B., & Kapikian, A. Z. (n.d.).

Publication year

1977

Journal title

Journal of Clinical Microbiology

Volume

6

Issue

5

Page(s)

439-444

Abstract

Abstract

The development of an enzyme-linked immunosorbent assay (ELISA) for the detection of heat-labile Escherichia coli enterotoxin is described. The assay, which is based on the immunological similarity between Vibrio cholerae toxin and heat-labile E. coli enterotoxin, is similar in design to a radioimmunoassay but utilizes enzyme-labeled rather than radioactive isotope-labeled reagents. The ELISA system is as sensitive as both radioimmunoassay and the y-1 adrenal cell assay for the detection of heat-labile E. coli enterotoxin but requires neither radioactive reagents nor tissue culture techniques. The ELISA is easy to perform and is adaptable for use in small laboratories.

Epidemiologic Assessment of the Relevance of the So-Called Enteropathogenic Serogroups of Escherichia coli in Diarrhea

Gangarosa, E. J., & Merson, M. H. (n.d.).

Publication year

1977

Journal title

New England Journal of Medicine

Volume

296

Issue

21

Page(s)

1210-1213

10.1056/NEJM197705262962106

Abstract

Abstract

Since the early 1950's the concept has evolved that certain serogroups of Escherichia coli, commonly designated enteropathogenic, are like shigellae and salmonellae, inherent enteric pathogens. This view is so widely held that many clinicians regard diarrhea associated with these serogroups as a distinct clinical entity, and many large hospitals include, as diagnostic laboratory routine, a search for these serogroups in stools from patients, particularly infants, with diarrhea. In the light of knowledge obtained in the last 10 years about virulence plasmids and about mechanisms by which Esch. coli causes diarrhea, we attempt to evaluate this concept through a historical.

Epidemiologic, Clinical and Laboratory Aspects of Wound Botulism

Merson, M. H., & Dowell, V. R. (n.d.).

Publication year

1973

Journal title

New England Journal of Medicine

Volume

289

Issue

19

Page(s)

1005-1010

10.1056/NEJM197311082891904

Abstract

Abstract

An analysis of the clinical, epidemiologic and laboratory aspects of nine patients with wound botulism showed that all had characteristic clinical findings, including respiratory paralysis. Five cases were reported between April, 1971, and November, 1972. Laboratory confirmation was obtained in six cases by demonstration of botulinal toxin in serum or isolation of Clostridium botulinum from a wound or both; all were Type A. Although four of the nine patients died, only one of the six most recent cases was fatal. Electromyography was helpful in confirming the diagnosis in three cases. A diagnosis of wound botulism should be considered when characteristic neurologic abnormalities are present and no food item can be implicated epidemiologically. Use of proper laboratory methods for detection of botulinal toxin and identification of clostridial isolates is imperative. (N Engl J Med 289:1005–1010, 1973).

EPIDEMIOLOGY OF WATERBORNE DISEASE IN THE UNITED STATES, 1971-1973.

Hughes, J. M., Merson, M. H., & Craun, G. F. (n.d.).

Publication year

1975

Page(s)

38-55

Abstract

Abstract

Reported outbreaks of waterborne disease most frequently involve semi-public systems which are frequently inadequately maintained and monitored. The most common system deficiencies associated with these outbreaks are lack of treatment of ground water and treatment deficiencies such as malfunctioning chlorinators. The most common factors associated with these outbreaks are treatment deficiencies and deficiencies in the distribution system. Data are tabulated and presented graphically.

Escherichia coli Serotypes and Diarrhea

Gurwith, M., Hinde, D., Gangarosa, E. J., & Merson, M. H. (n.d.).

Publication year

1977

Journal title

New England Journal of Medicine

Volume

297

Issue

9

Page(s)

510-511

10.1056/NEJM197709012970917

Abstract

Abstract

To the Editor: Gangarosa and Merson (N Engl J Med 296:1210, 1977) conclude that “routine serogrouping of Esch. coli in sporadic cases of diarrhea using commercial antiserums#x2026;is#x2026;useless.” They review studies relating Esch. coli of the traditional enteropathogenic serotypes (EPEC) to diarrhea. Seven of these reports, published from 1950 to 1961, form the entire epidemiologic evidence “refuting” the virulence of EPEC.1 2 3 4 5 6 7 We wonder whether the results of these studies, especially when their methods are scrutinized, support the conclusions drawn, and we question their relevance to serogrouping in 1977. In one study, transient and sometimes asymptomatic infection with EPEC was found in.