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Epidemiologic Aspects

David R. Perera, MD; Karl A. Western, MD; H. Durell Johnson, MD; Warren W. Johnson, MD; Myron G. Schultz, DVM, MD, DCMT; Philip V. Akers, MA

JAMA. 1970;214(6):1074-1078.

Abstract
The first large outbreak of Pneumocystis carinii pneumonia reported in the United States occurred at St. Jude Children's Research Hospital in Memphis. Seventeen cases were documented during 1968 through 1969; only two cases had been identified in the preceding six years. All 19 affected children were being given immunosuppressive drugs for malignant disease; 14 had acute leukemia. A review of 301 consecutive autopsies at St. Jude demonstrated clinically inapparent P carinii infection in 40 additional patients. Epidemiologic analysis suggested that more intensive chemotherapy caused the outbreak of Pneumocystis pneumonia by activating the inapparent Pneumocystis infection commonly associated with neoplastic disease.

Author Affiliations
From the Parasitic Diseases Branch, Epidemiology Program, National Communicable Disease Center, Health Services and Mental Health Administration, Atlanta, (Drs. Perera, Western, and Schultz); and St. Jude Children's Research Hospital, Memphis (Drs. H. D. Johnson, W. W. Johnson, and Akers).

Footnotes
Reprint requests to National Communicable Disease Center, Atlanta 30333 (Dr. Schultz).

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