In Reply.—In response to Drs Teixeira and Quinn's letter describing their findings of a case-control study of children with KS, I have the following comments.
I have conducted four case-control studies of children with KS, including the two outbreaks described in my article,1 the Denver study,2 and a study in Milwaukee (unpublished data). We found an association with rug shampooing in only one outbreak (Denver). We did not inquire about maternal smoking.
The biologic hypothesis linking exposure to cigarette smoking and acquisition of KS is not clear to me, however.