Risk Factors for Mortality among 2009 A/H1N1 Influenza Hospitalizations in Maricopa County, Arizona, April 2009 to March 2010

We analyzed individual-level data on pandemic influenza A/H1N1pdm hospitalizations from the enhanced surveillance system of the Maricopa County Department of Public Health, AZ, USA from April 1st, 2009 to March 31st, 2010. We also assessed the the risk of death among A/H1N1 hospitalizations using multivariate logistic regression. Hospitalization rates were significantly higher among Native Americans (risk ratio (RR) = 6.2; 95% CI: 6.15, 6.21), non-Hispanic Black (RR = 3.84; 95% CI: 3.8, 3.9), and Hispanics (RR = 2.0; 95% CI: 2.0, 2.01) compared to non-HispanicWhites. Throughout the spring, 59.2% of hospitalized patients received antiviral treatment; the proportion of patients treated increased significantly during the fall to 74.4% (Chi-square test, P \u3c 0.0001). In our best-fit logisticmodel, the adjusted risk of death among A/H1N1 inpatients was significantly higher during the fall wave (August 16, 2009 toMarch 31, 2010, OR = 3.94; 95% CI: 1.72, 9.03) compared to the spring wave (April 1, 2009 to August 15, 2009). Moreover, chronic lung disease (OR = 3.5; 95% CI: 1.7, 7.4), cancer within the last 12 months (OR = 4.3; 95%CI: 1.3, 14.8), immuno-suppression (OR = 4.0; 95% CI: 1.84, 8.9), and admission delays (OR = 4.6; 95% CI: 2.2, 9.5) were significantly associated with an increased the risk of death among A/H1N1 inpatients

An Outbreak of Dengue Fever in St. Croix (US Virgin Islands), 2005

BACKGROUND: Periodic outbreaks of dengue fever occur in the United States Virgin Islands. In June 2005, an outbreak of dengue virus (DENV) serotype-2 with cases of dengue hemorrhagic fever (DHF) was detected in St. Croix, US Virgin Islands. The objective of this report is to describe this outbreak of DENV-2 and the findings of a case-control study examining risk factors for DHF. METHODOLOGY/PRINCIPAL FINDINGS: This is the largest dengue outbreak ever recorded in St. Croix, with 331 suspected dengue cases reported island-wide during 2005 (62.2 cases/10,000 population); 54% were hospitalized, 21% had at least one hemorrhagic manifestation, 28% had thrombocytopenia, 5% had DHF and 1 patient died. Eighty-nine laboratory-positive hospitalized patients were identified. Of these, there were 15 (17%) who met the WHO criteria for DHF (cases) and 74 (83%) who did not (controls). The only variable significantly associated with DHF on bivariate or multivariable analysis was age, with an adjusted odds ratio (95% confidence interval) of 1.033 (1.003,1.064). CONCLUSIONS/SIGNIFICANCE: During this outbreak of DENV-2, a high proportion of cases developed DHF and increasing age was significantly associated with DHF

Surveillance for Mass Gatherings: Super Bowl XLIX in Maricopa County, Arizona, 2015

Super Bowl XLIX took place on February 1st, 2015 in Glendale, Arizona. In preparation for this large scale public event and related activities, the Maricopa County Department of Public Health developed methods for enhanced surveillance, situational awareness and early detection of public health emergencies. This presentation describes enhanced epidemiologic surveillance efforts in place during Super Bowl XLIX and associated events. A summary of surveillance result highlights will be presented. Lessons learned from surveillance strategies implemented during mass gatherings will be reviewed and novel approaches for near real-time surveillance for situational awareness and early event detection will be examined

Number of suspected, laboratory-positive, and fatal dengue cases.

<p>Number of suspected, laboratory-positive, and fatal dengue cases.</p

Frequency of cases and controls by age-group.

<p>Frequency of cases and controls by age-group.</p

Proportion of DF and DHF cases in the case-control study by age-group.

<p>Proportion of DF and DHF cases in the case-control study by age-group.</p