Spatial targeting of infectious disease control: identifying multiple, unknown sources

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Efficacious, effective, and embedded interventions: Implementation research in infectious disease control

Background: Research in infectious disease control is heavily skewed towards high end technology; development of new drugs, vaccines and clinical interventions. Oft ignored, is the evidence to inform the best strategies that ensure the embedding of interventions into health systems and amongst populations. In this paper we undertake an analysis of the challenge in the development of research for the sustainable implementation of disease control interventions. Results: We highlight the fundamental differences between the research paradigms associated with the development of technologies and interventions for disease control on the one hand and the research paradigms required for enhancing the sustainable uptake of those very same interventions within the communities on the other. We provide a definition for implementation research in an attempt to underscore its critical role and explore the multidisciplinary science needed to address the challenges in disease control. Conclusion: The greatest value for money in health research lies in the sustainable and effective implementation of already proven, efficacious solutions. The development of implementation research that can help provide some solutions on how this can be achieved is sorely needed

Infectious Disease Control by Vaccines Giving Full or Partial Immunity

We use a simple Lotka-Volterra model of the disease transmission process to analyse the dynamic population structure in two scenarios. Firstly a vaccine is available\ on the market at a constant price through time. Secondly, the vaccine is publicly provided. The vaccine works either by giving partial or full immunity to the disease. We analyse market provision for vaccines providing partial immunity and public provision of both types of vaccine. In the case of market provision we find that there may be multiple stationary states and instability. This is in contrast with earlier results under full immunity. In the publicly provided scenario we find that in the partial immunity case a procyclical policy is desirable but for the full immunity case a countercyclical policy is preferable. This is robust to alternative specifications of the basic Lotka-Volterra system.

Emerging Trends in International Law Concerning Global Infectious Disease Control1

International cooperation has become critical in controlling infectious diseases. In this article, I examine emerging trends in international law concerning global infectious disease control. The role of international law in horizontal and vertical governance responses to infectious disease control is conceptualized; the historical development of international law regarding infectious diseases is described; and important shifts in how states, international institutions, and nonstate organizations use international law in the context of infectious disease control today are analyzed. The growing importance of international trade law and the development of global governance mechanisms, most prominently in connection with increasing access to drugs and other medicines in unindustrialized countries, are emphasized. Traditional international legal approaches to infectious disease control—embodied in the International Health Regulations—may be moribund

Towards bioinformatics assisted infectious disease control

BACKGROUND: This paper proposes a novel framework for bioinformatics assisted biosurveillance and early warning to address the inefficiencies in traditional surveillance as well as the need for more timely and comprehensive infection monitoring and control. It leverages on breakthroughs in rapid, high-throughput molecular profiling of microorganisms and text mining. RESULTS: This framework combines the genetic and geographic data of a pathogen to reconstruct its history and to identify the migration routes through which the strains spread regionally and internationally. A pilot study of Salmonella typhimurium genotype clustering and temporospatial outbreak analysis demonstrated better discrimination power than traditional phage typing. Half of the outbreaks were detected in the first half of their duration. CONCLUSION: The microbial profiling and biosurveillance focused text mining tools can enable integrated infectious disease outbreak detection and response environments based upon bioinformatics knowledge models and measured by outcomes including the accuracy and timeliness of outbreak detection.9 page(s

Justifications for Non-­Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation

A central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to the intervention. However, in some circumstances it is tempting to say that the moral reason to obtain informed consent prior to administering a medical intervention is outweighed. For example, if an individual’s refusal to undergo a medical intervention would lead to the transmission of a dangerous infectious disease to other members of the community, one might claim that it would be morally permissible to administer the intervention even in the absence of consent. Indeed, as we shall discuss below, there are a number of examples of public health authorities implementing compulsory or coercive measures for the purposes of infectious disease control (IDC). The plausibility of the thought that non-consensual medical interventions might be justified when performed for the purpose of IDC raises the question of whether such interventions might permissibly be used to realize other public goods. In this article we focus on one possibility: whether it could be permissible to non-consensually impose certain interventions that alter brain states or processes through chemical or physical means on serious criminal offenders. We shall suggest that some such interventions might be permissible if they safely and effectively serve to facilitate the offender’s rehabilitation and thereby prevent criminal recidivism

Infectious disease control and occupational health : Report for 2012

Sinds 2006 heeft het Centrum Infectieziektebestrijding (CIb) van het RIVM structureel aandacht voor de gezondheid van werknemers. Dit komt voort uit het project 'Infectieziektebestrijding en Werknemersgezondheid', dat het CIb in opdracht van het ministerie van Sociale Zaken en Werkgelegenheid (SZW) uitvoert. Het doel van dit project is de gezondheid van werknemers die blootstaan aan ziekteverwekkers te bevorderen. Dat gebeurt door hier aandacht aan te besteden binnen het CIb en kennis te verspreiden naar arboprofessionals en werkgevers. Daarnaast krijgt SZW meer zicht op de mate waarin werknemers op hun werk met infectieziekten te maken krijgen. Werknemersgezondheid onderdeel binnen CIb De gezondheid van werknemers wordt onder andere bevorderd door bij uitbraken van infectieziekten expliciet rekening te houden met de gezondheid van werknemers. Dit komt sinds 2011 tot uiting doordat een arboprofessional een vast onderdeel is van het Outbreak Management Team (OMT) en Deskundigenberaad. Daarnaast is onder andere een surveillancerapport ontwikkeld, waarin staat weergegeven welk type infectieziekten bij bepaalde werknemers optreden en welke trend daarin valt waar te nemen. Kennis vergroten en verspreiden Om de doelen te bereiken is het van belang de kennis over arbeidsgerelateerde infectieziekten bij arboprofessionals en werkgevers te vergroten.Werkgevers dienen namelijk op de hoogte te zijn van (infectie)risico's die samenhangen met het werk en mogelijke beheersmaatregelen waarmee werknemers hun werk veilig en gezond kunnen uitvoeren. Kennis hierover wordt op diverse manieren verspreid, bijvoorbeeld door de digitale berichtenservice voor arboprofessionals (Arbo-inf@ct) en artikelen in vaktijdschriften. Bovendien is er structureel aandacht voor werknemers in voorlichtingsmateriaal van het RIVM (toolkits) en in de LCI-richtlijnenbundel. Maatregelen en produkten uit 2012 Net als in voorgaande jaren zijn in 2012 maatregelen getroffen. Werknemersgezondheid staat bijvoorbeeld sindsdien standaard op de agenda bij een OMT en Deskundigenberaad. Daarnaast is de groep meelezers en medeauteurs van arboparagrafen in de LCI-richtlijnen uitgebreid met arbeidshygiënisten en bedrijfsartsen. De bijdrage van arbeidshygiënisten geldt formeel als bijscholingsactiviteit. Verder is het jaarthema van het Landelijk Overleg Infectieziektebestrijding (LOI) gewijd aan de samenwerking tussen GGD en bedrijfsarts bij de bestrijding van infectieziekten.The Centre for Infectious Disease Control (CIb) at the National Institute for Public Health and the Environment (RIVM) has paid sustained attention to the health of employees since 2006. This is the result of the 'Infectious Disease Control and Employee Health' project that is being carried out by the CIb at the request of the Netherlands Ministry of Social Affairs and Employment (SWZ). The aim of this project is to promote the health of employees who are exposed to pathogens in the workplace. This takes place by focusing on the subject at the CIb and by spreading knowledge and information to occupational health and safety professionals and to employers. In addition, SZW will gain more insight into the degree to which employees come into contact with infectious diseases in the workplace. Employee health, part of the CIb's task One way to promote employee health is to pay special attention to the well-being of employees when an outbreak of an infectious disease occurs. This is reflected in the addition of permanent occupational health consultants to the Outbreak Management Team (OMT) and the Commission of Experts that took place in 2011. Another contributory factor is the development of yearly surveillance reports which document which type of infectious disease is contracted by which type of employee as well as associated trends. The increase and spread of knowledge In order to achieve objectives, it is important to increase the knowledge base of occupational health and safety professionals and employers on work-related infectious diseases. Employers should be kept up-to-date on the risks of infection associated with their workplace and with which preventive measures can be taken to ensure that employees can carry out their work in a safe and healthy environment. Information on how to do this is spread in various ways, for example, via the Arbo-inf@ct electronic message service for occupational health and safety professionals and via articles in journals. There is also specific information for employees provided by the RIVM contained in toolkits and in the LCI guidelines. Measures and products developed in 2012 As in previous years, measures for employee health have been taken in 2012. For example, since the beginning of the year, employee health has been on the agendas of the OMT and Commission of Experts meetings. In addition, the group of people directly involved in the LCI guideline sections on occupational health and safety now includes occupational hygienists and occupational physicians. The contribution of occupational hygienists is formally seen as additional training for professionals. Furthermore, the yearly theme of the national meeting for infectious disease control (LOI) was dedicated to the collaboration between the public health services and occupational physicians with regard to the control of infectious diseases.Ministerie van Sociale Zaken en Werkgelegenhei

Operational research in low-income countries: what, why, and how?

Operational research is increasingly being discussed at institutional meetings, donor forums, and scientific conferences, but limited published information exists on its role from a disease-control and programme perspective. We suggest a definition of operational research, clarify its relevance to infectious-disease control programmes, and describe some of the enabling factors and challenges for its integration into programme settings. Particularly in areas where the disease burden is high and resources and time are limited, investment in operational research and promotion of a culture of inquiry are needed so that health care can become more efficient. Thus, research capacity needs to be developed, specific resources allocated, and different stakeholders (academic institutions, national programme managers, and non-governmental organisations) brought together in promoting operational research