Michael H Merson
Michael Howard Merson
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Clinical Professor of Global and Environmental Health
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Professional overview
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Michael Merson is a Clinical Professor of Global and Environmental Health at NYU and 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.
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Education
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B.A., 1966, cum laude, Amherst College, Amherst, MassachusettsM.D., 1970, summa cum laude, SUNY, Health Sciences Center at Brooklyn, New York
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Honors and awards
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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)
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Publications
Publications
Glucose vs sucrose in oral rehydration solutions for infants and young children with rotavirus-associated diarrhea
AbstractBlack, R. E., Merson, M. H., Taylor, P. R., Yolken, R. H., & Sack, D. A. (n.d.).Publication year
1981Journal title
PediatricsVolume
67Issue
1Page(s)
79-83AbstractThe use of oral dehydration solutions containing essential electrolytes and either glucose or sucrose of equal osmolality was compared in a double-blind sequential trial of 784 children with rotavirus-associated diarrhea treated at a center in rural Bangladesh. The oral fluid failure rate was 11.5% for the sucrose-containing group (P = NS). Vomiting was a significantly more common cause of failure for the group treated with sucrose-containing oral rehydration solution and was associated with an increased rate of intake of the sweeter sucrose-containing solution. The purging rate was not different for the two groups. The oral fluid failure rates for children in the most underweight category (<60% of expected weight for age) were not different from those for other groups, although as assessed by purging rate and initial dehydration, the stool losses of members of this group constituted a greater proportion of their body weight. Glucose is the preferred carbohydrate for oral electrolyte solutions, although sucrose can be substituted with only minimum loss of efficacy.INCIDENCE AND SEVERITY OF ROTAVIRUS AND ESCHERICHIA COLI DIARRHOEA IN RURAL BANGLADESH. Implications for Vaccine Development
AbstractBlack, R. E., Huq, I., Merson, M. H., Alim, A. R., & Yunus, M. (n.d.).Publication year
1981Journal title
The LancetVolume
317Issue
8212Page(s)
141-143AbstractIn a 1 year study of diarrhoea in a village in rural Bangladesh, enterotoxigenic Escherichia coli (ETEC) were the most frequently detected enteropathogens; shigellae were the second most commonly detected enteropathogens and rotaviruses the third. ETEC and rotavirus were found in 31% of diarrhoea episodes experienced by children aged less than 2 years and in 70% of episodes associated with dehydration. Furthermore these two pathogens were identified in the stools of 77% of young children with life-threatening dehydration seen at a diarrhoea treatment centre. The association of ETEC and rotavirus with such a substantial proportion of cases of dehydrating diarrhoea suggests that immunoprophylaxis to reduce the high incidence of deaths from diarrhoea in developing countries may be feasible and that vaccine development should concentrate on these two enteropathogens.Oral rehydration therapy: Recent advances
Mahalanabis, D., Merson, M. H., & Barua, D. (n.d.).Publication year
1981Journal title
World Health ForumVolume
2Issue
2Page(s)
245-249A two-year study of bacterial, viral, and parasitic agents associated with diarrhea in rural Bangladesh
AbstractBlack, R. E., Merson, M. H., Rahman, A. S., Yunus, M., Alim, A. R., Huq, I., Yolken, R. H., & Curlin, G. T. (n.d.).Publication year
1980Journal title
Unknown JournalVolume
142Issue
5Page(s)
660-664AbstractEnteric pathogens associated with diarrhea were studied for two years at a diarrhea treatment center in rural Bangladesh. Enterotoxigenic Escherichia coli (ETEC) was the most frequently identified pathogen for patients of all ages. Rotavirus and ETEC were isolated from ~50% and ~25%, respectively, of patients less than two years of age. A bacterial or viral pathogen was identified for 70% of these young children and for 56% of all patients with diarrhea. Most ETEC isolates were obtained in the hot dry months of March and April and the hot wet months of August and September. Rotavirus identification peaked in the cool dry months of December and January, but infected patients were found year-round. The low case-fatality rates for patients with watery diarrhea and substantial dehydration further document the usefulness of treating patients with diarrhea with either a glucose- or sucrose-base electrolyte solution such as those used in this treatment center.Detection of Escherichia coli enterotoxins in stools
AbstractMerson, M. H., Yolken, R. H., Bradley Sack, R., Froehlich, J. L., Greenberg, H. B., Huq, I., & Black, R. W. (n.d.).Publication year
1980Journal title
Infection and ImmunityVolume
29Issue
1Page(s)
108-113AbstractWe 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.Diarrhoeal disease in Bangladesh epidemiology, mortality averted and costs at a rural treatment centre
AbstractOberle, M. W., Merson, M. H., Islam, M. S., Rahman, A. S., Huber, D. H., & Curlin, G. (n.d.).Publication year
1980Journal title
International Journal of EpidemiologyVolume
9Issue
4Page(s)
341-348AbstractOberle 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.Disease due to enterotoxigenic Escherichia coli in Bangladeshi adults: Clinical aspects and a controlled trial of tetracycline
AbstractMerson, 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
1980Journal title
Journal of Infectious DiseasesVolume
141Issue
6Page(s)
702-711AbstractThe 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.Foodborne outbreak of shigellosis caused by an unusual Shigella strain
AbstractHuq, I., Alam, A. K., Morris, G. K., Wathen, G., & Merson, M. (n.d.).Publication year
1980Journal title
Journal of Clinical MicrobiologyVolume
11Issue
4Page(s)
337-339AbstractA family outbreak of foodborne shigellosis caused by an unusual strain of Shigella is described. The strain was a mannitol-positive variant of Shigella dysenteriae and agglutinated in antiserum prepared against provisional serotype 3341-55.Increase in antibiotic resistance among isolates of salmonella in the united states, 1967-1975
AbstractRyder, R. W., Blake, P. A., Murlin, A. C., Carter, G. P., Pollard, R. A., Merson, M. H., Allen, S. D., & Brenner, D. J. (n.d.).Publication year
1980Journal title
Journal of Infectious DiseasesVolume
142Issue
4Page(s)
485-491AbstractTo study temporal changes in the antibiotic resistance of Salmonella in the United States, a study design similar to that of a 1967 study was used to determine the antibiotic sensitivity of 754 human nontyphoid Salmonella isolates sent to the Center for Disease Control, Atlanta, Georgia, in 1975. The frequency of resistance to one or more of the same nine antibiotics used in both studies increased significantly during the eight years in Salmonella typhimurium (40%-59%; P = 0.004), other serotypes (14%-23%; P = 0.001), and all serotypes combined (21%-31%; P` 0.001). The increase in frequency of resistance was significant for streptomycin (P = 0.022), sulfonamides (P` 0.001), am- picillin (P ` 0.001), and kanamycin (P ` 0.001). No chloramphenicol-resistant isolates were found in the 1967 study, whereas six isolates (0.8%) were resistant in 1975. The frequency of strains resistant to six or more antibiotics increased greatly (0.8%-5.0%; P` 0.001). These data document a continuing increase in antimicrobial resistance among Salmonella isolates.MATERNAL CHOLERA IMMUNISATION AND SECRETORY IgA IN BREAST MILK
Merson, M. H., Black, R. E., Sack, D. A., Svennerholm, A. M., & Holmgren, J. (n.d.). In The Lancet (1–).Publication year
1980Volume
315Issue
8174Page(s)
931-932Oral rehydration therapy for treatment of rotavirus diarrhea in a rural treatment center in Bangladesh
AbstractTaylor, P. R., Merson, M. H., Black, R. E., Mizanur Rahman, A. S., Yunus, M. D., Alim, A. R., & Yolken, R. H. (n.d.).Publication year
1980Journal title
Archives of Disease in ChildhoodVolume
55Issue
5Page(s)
376-379AbstractIn November 1977, an enzyme-linked immunosorbent assay for detecting rotavirus antigen was introduced in the laboratory of a rural treatment center in Bangladesh. During the next 40 days rotavirus without other pathogens was found in the stools of 216 (45%) of 480 children under age 5 yr who visited the center with a gastrointestinal illness. One hundred and eighty-eight (87%) of these children were treated with oral rehydration alone, using the solution currently recommended by the World Health Organization, while 28 (13%) also required some intravenous rehydration; there were no deaths. Oral rehydration treatment was judged successful in 205 (95%) of the rotavirus patients and was not associated with any serious side effects. Oral rehydration treatment, with this solution, has been used extensively and successfully in the treatment of enterotoxin-mediated diarrhea and can also safely be used for treating rotavirus diarrhea in infants and young children.USE OF ANTISERA FOR IDENTIFICATION OF ENTEROTOXIGENIC ESCHERICHIA COLI
AbstractMerson, M. H., Black, R. E., Gross, R. J., Rowe, B., Huq, I., & Eusof, A. (n.d.).Publication year
1980Journal title
The LancetVolume
316Issue
8188Page(s)
222-224AbstractThe usual methods for identifying enterotoxigenic Escherichia coli (ETEC) strains involve testing for production of heat-labile and heat-stable enterotoxins. To simplify the identification of ETEC, antisera against common ETEC O serogroups were used to identify ETEC in the stools from 618 patients with acute diarrhœa and dehydration (≽5% loss of body-weight) receiving treatment at a hospital in Dacca, Bangladesh. Compared with enterotoxin testing the antisera had a sensitivity of 64%, a specificity of 96%, and a predictive accuracy of 89%. These antisera may be useful in the identification ETEC in clinical laboratories which are unable to perform toxin testing and should be evaluated in other geographical areas.Village-based distribution of oral rehydration therapy packets in Bangladesh
AbstractChen, L. C., Black, R. E., Sarder, A. M., Merson, M. H., Bhatia, S., Yunus, M., & Chakraborty, J. (n.d.).Publication year
1980Journal title
American Journal of Tropical Medicine and HygieneVolume
29Issue
2Page(s)
285-290AbstractThe distribution of sucrose-electrolyte oral therapy packets (1 liter)by community-based workers in a rural Bangladesh population of 157,000 was evaluated. A similar population of 134,000 served as comparison group. The locally-produced packets showed satisfactory chemical composition with a shelf-life of up to 3 months and a cost of U.S. $0.05. After 4 months the workers were distributing an average of 70 packets/1,000 population per month. Most patients used one packet for each episode of diarrhea; 13% of children used two packets, and 15% and 8% of adults used, respectively, two and three packets. The electrolyte composition of the oral fluids prepared by field workers and mothers showed substantial variation, but no hyperconcentrated solutions were noted. A comparison of the hospitalization rate from the two study areas suggested a 29% reduction in hospitalization for diarrhea during the 4 months of distribution.Comparison of four plating media for isolating Vibrio cholerae
AbstractMorris, G. K., Merson, M. H., Huq, I., Kibrya, A. K., & Black, R. (n.d.).Publication year
1979Journal title
Journal of Clinical MicrobiologyVolume
9Issue
1Page(s)
79-83AbstractTwo brands of thiosulfate citrate bile salts sucrose agar and Monsur taurocholate tellurite gelatin (TTG) agar were compared with two newly developed media, sucrose tellurite teepol agar and Vibrio parahaemolyticus agar for isolation and identification of Vibrio cholerae. The thiosulfate citrate bile salts sucrose and TTG agars were the best selective media, whereas sucrose tellurite teepol agar was the poorest. Both TTG and sucrose tellurite teepol agars were good for use in follow-up serological tests, whereas only TTG agar could be used for follow-up oxidase tests. In our opinion, TTG agar has more advantages for cholera research laboratories routinely culturing large numbers of patients for cholera on a daily basis and where media needs can be accurately predicted. In contrast, in smaller clinical laboratories or in laboratories investigating epidemics, thiosulfate citrate bile salts sucrose agar is best because it is commercially available and easy to prepare and can be used to distinguish colonies of suspect V. cholerae from V. parahaemolyticus.Disease Caused by a Marine Vibrio: Clinical Characteristics and Epidemiology
AbstractBlake, P. A., Merson, M. H., Weaver, R. E., Hollis, D. G., & Heublein, P. C. (n.d.).Publication year
1979Journal title
New England Journal of MedicineVolume
300Issue
1Page(s)
1-5AbstractWe 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.Doxycycline and the traveller
Merson, M. H. (n.d.).Publication year
1979Journal title
GastroenterologyVolume
76Issue
6Page(s)
1485-1488Relationship between enterotoxin production and serotype in enterotoxigenic Escherichia coli
AbstractMerson, M. H., Ørskov, F., Ørskov, I., Sack, R. B., Huq, I., & Koster, F. T. (n.d.).Publication year
1979Journal title
Unknown JournalVolume
23Issue
2Page(s)
325-329AbstractThe authors examined the relationship between serotype and enterotoxin production in 109 enterotoxigenic E. coli strains isolated from 109 patients with severe cholera-like diarrhea in Dacca, Bangladesh. Of 69 strains producing both heat-labile and heat-stable toxins, 59 (86%) belonged to the one of four O serogroups, and 56 (81%) of these strains belonged to one of six O:K:H serotypes. In contrast, 34 strains producing only heat-stable toxin were distributed among 15 O serogroups, and six strains producing only heat-labile toxin were distributed among six O serogroups. Twelve strains producing heat-labile and heat-stable toxins and five strains producing heat-stable toxin were found which had the same serotype (O78:K-:H12) and biotype. It appears that at least in one geographic setting E. coli strains producing both heat-labile and heat-stable toxins are more restricted in their O groups and O:K:H serotypes than E. coli that produce only heat-stable toxin and that certain serobiotypes may commonly include strains which produce both toxin types.Solid-phase microtiter radioimmunoassay blocking test for detection of antibodies to Escherichia coli heat-labile enterotoxin
AbstractGreenberg, H. B., Levine, M. M., Merson, M. H., Sack, R. B., Sack, D. A., Valdesuso, J. R., Nalin, D., Hoover, D., Chanock, R. M., & Kapikian, A. Z. (n.d.).Publication year
1979Journal title
Journal of Clinical MicrobiologyVolume
9Issue
1Page(s)
60-64AbstractThe development of a solid-phase microtiter radioimmunoassay blocking test to detect serum antibody to Escherichia coli heat-labile enterotoxin is described. The assay is easy to perform and quantitate, and it is sensitive and specific.Use of colony pools for diagnosis of enterotoxigenic Escherichia coli diarrhea
Merson, M. H., Sack, R. B., Kibriya, A. K., Al-Mahmood, A., Adamed, Q. S., & Huq, I. (n.d.).Publication year
1979Journal title
Journal of Clinical MicrobiologyVolume
9Issue
4Page(s)
493-497Fecal steroids in diarrhea. II. Travellers' diarrhea
AbstractHuang, C. T., Udall, J. N., Merson, M., & Nichols, B. L. (n.d.).Publication year
1978Journal title
American Journal of Clinical NutritionVolume
31Issue
4Page(s)
626-632AbstractFecal bile acid and neutral sterol patterns of five healthy adult volunteers from the United States who contracted travellers' diarrhea in Mexico City in 1974 were studied. The only pathogen in four of these patients was the heat-stable-only enterotoxin producing strain of Escherichia coli. Stool culture for pathogens was negative in the fifth subject. Bacterial 7α-dehydroxylation of cholic and chenodeoxycholic acids was not altered in diarrhea associated with toxigenic E. coli heat-stable, although total concentrations of bile acids in the feces in mg/g of feces (wet weight) were decreased during the diarrheal episode (1.3 ± 0.2 versus 3.3 ± 0.4 in controls, P < 0.02). Consistent with findings on bile acids, no significant changes in the production of coprostanol from cholesterol were observed. Although total concentrations of cholesterol metabolites, in milligrams per grams of feces (wet weight), were reduced in diarrhea, the difference was not significant statistically (2.2 ± 0.9 versus 5.4 ± 0.8 in controls, P > 0.05). There was an apparent increase in bacterial alteration of fecal steroids in the subject who showed no pathogens in stool culture, despite a decrease in total steroid concentrations of a magnitude similar to those observed in diarrhea associated with E. coli heat-stable. The production of coprostanol was correlated with 7α-dehydroxylation of cholic acid (r = 0.829, P < 0.001) and chenodeoxycholic acid (r = 0.749, P < 0.001). The results from this study are in striking contrast to the changes in gastrointestinal steroid metabolism previously observed in acute shigellosis.ORAL HYDRATION IN ROTAVIRUS DIARRHŒA: A DOUBLE BLIND COMPARISON OF SUCROSE WITH GLUCOSE ELECTROLYTE SOLUTION
AbstractSack, D. A., Eusof, A., Merson, M. H., Black, R. E., Chowdhury, A. M., Akbar Ali, M., Islam, S., & Brown, K. H. (n.d.).Publication year
1978Journal title
The LancetVolume
312Issue
8084Page(s)
280-283AbstractOf 57 male children, aged 5 months to 21/2 years with rotavirus diarrhœa, 28 were given oral therapy with sucrose electrolyte solution and 29 were given glucose electrolyte solution in a randomised double-blind trial. All were rehydrated and remained so on oral therapy alone. These patients were compared with 44 children, also with rotavirus, who were treated only with intravenous hydration. The oral therapy and intravenous therapy groups did not differ clinically in the rate of rehydration or the rate of purging. Vomiting did not prevent the giving of oral therapy during hospital admission. Bangladeshi children with rotavirus diarrhœa have a defect of carbohydrate digestion but this defect does not prevent the use of a sugar electrolyte solution for oral hydration.A large outbreak of foodborne salmonellosis on the Navajo Nation Indian Reservation, epidemiology and secondary transmission
AbstractHorwitz, M. A., Pollard, R. A., Merson, M. H., & Martin, S. M. (n.d.).Publication year
1977Journal title
American journal of public healthVolume
67Issue
11Page(s)
1071-1076AbstractIn September 1974, the largest outbreak of foodborne salmonellosis ever reported to the Center for Disease Control - affecting an estimated 3,400 persons - occurred on the Navajo Nation Indian Reservation. The responsible agent was Salmonella newport and the vehicle of transmission was potato salad served to an estimated 11,000 persons at a free barbecue. The cooked ingredients of the potato salad had been stored for up to 16 hours at improper holding temperatures. The magnitude of the outbreak allowed the authors to study secondary transmission by calculating the rates of diarrheal illness during the 2 weeks following the outbreak in persons who did not attend the barbecue and by examining the results of stool cultures obtained after the outbreak. They found no secondary transmission. The authors conclude that a health official should monitor food preparation and service at large social gatherings and that person-to-person transmission of salmonellosis probably does not normally occur even in settings considered highly conductive to cross-infection.An evaluation of penicillin prophylaxis during an outbreak of foodborne streptococcal pharyngitis
AbstractRyder, R. W., Lawrence, D. N., Nitzkin, J. L., Feeley, J. C., & Merson, M. H. (n.d.).Publication year
1977Journal title
American Journal of EpidemiologyVolume
106Issue
2Page(s)
139-144AbstractRyder, R. W. (CDC, Atlanta, GA 30333), D. N. Lawrence, J. L. Nitzkin, J. C. Feeley and M. H. Merson. An evaluation of penicillin prophylaxis during an outbreak of foodborne ttreptococcal pharyngitis. Am J Epidemiol 106:139-144, 1977.Between August 16 and 21, 1974, an outbreak of β-hemolytic group A M-9 T-9 streptococcal pharyngitis affected 49% of a randomly selected group of inmates at a jail in southern Florida. Food-specific attack rates incriminated improperly stored egg salad served at lunch on August 16 as the vehicle of transmission. By August 20, 290 symptomatic inmates had been placed on penicillin or erythromycin; on that day fewer than 5% of throat cultures from 400 allegedly non-penicillin-allergic largely asymptomatic inmates, cultured just before penicillin prophylaxis, were positive for the epidemic strain. At the time prophylaxis was given, secondary transmission had accounted for only 3% of cases. No non-suppurative sequelae were observed but 5% of inmates who received penicillin prophylaxis experienced an adverse reaction to the drug. Although widespread penicillin prophylaxis during outbreaks of group A β-hemolytic streptococcal pharyngitis will likely prevent transmission of these organisms, prompt treatment of all symptomatic cases may be equally as effective in controlling adult institutional foodborne outbreaks of streptococcal pharyngitis and will likely minimize the number of adverse reactions to penicillin which may be seen.An Infected Wound as a Cause of Botulism in a 12-Year-Old Boy: Debridement, Medical Management, and Intensive Respiratory Support Resulted in Complete Recovery
Kennedy, T. L., & Merson, M. H. (n.d.).Publication year
1977Journal title
Clinical PediatricsVolume
16Issue
2Page(s)
151-153Cholera on Guam, 1974: Epidemiologic findings and isolation of non-toxinogenic strains
AbstractMerson, M. H., Martin, W. T., Craig, J. P., Morris, G. K., Blake, P. A., Craun, G. F., Feeley, J. C., Camacho, J. C., & Gangarosa, E. J. (n.d.).Publication year
1977Journal title
American Journal of EpidemiologyVolume
105Issue
4Page(s)
349-361AbstractIn August 1974, six cases of cholera occurred on Guam. The index case had severe diarrhea and metabolic acidosis and died from pneumonia on the ninth day of illness; the other five cases had only mild to moderate diarrhea. Fish caught in Agana Bay and home-preserved was found to be the vehicle most likely responsible for the cases. Vibrio cholerae, El Tor Ogawa, was isolated from two patients, the Guam sewerage system, and a river emptying into Agana Bay. V. cholerae, El Tor Inaba, was isolated from the sewerage system, three storm drains emptying into Agana Bay, and Agana Bay. The Ogawa and Inaba isolates differed in their sucrose fermentation and hemolysis reactions, phage type and ability to produce toxin. Although this was the first reported cholera outbreak on Guam, the isolation of different V. cholerae strains suggested that multiple introductions of V. cholerae had occurred on the island.