28 research outputs found

    Contribution of Company Affiliation and Social Contacts to Risk Estimates of Between-Farm Transmission of Avian Influenza

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    BACKGROUND: Models of between-farm transmission of pathogens have identified service vehicles and social groups as risk factors mediating the spread of infection. Because of high levels of economic organization in much of the poultry industry, we examined the importance of company affiliation, as distinct from social contacts, in a model of the potential spread of avian influenza among broiler poultry farms in a poultry-dense region in the United States. The contribution of company affiliation to risk of between-farm disease transmission has not been previously studied. METHODOLOGY/PRINCIPAL FINDINGS: We obtained data on the nature and frequency of business and social contacts through a national survey of broiler poultry growers in the United States. Daily rates of contact were estimated using Monte Carlo analysis. Stochastic modeling techniques were used to estimate the exposure risk posed by a single infectious farm to other farms in the region and relative risk of exposure for farms under different scenarios. The mean daily rate of vehicular contact was 0.82 vehicles/day. The magnitude of exposure risk ranged from <1% to 25% under varying parameters. Risk of between-farm transmission was largely driven by company affiliation, with farms in the same company group as the index farm facing as much as a 5-fold increase in risk compared to farms contracted with different companies. Employment of part-time workers contributed to significant increases in risk in most scenarios, notably for farms who hired day-laborers. Social visits were significantly less important in determining risk. CONCLUSIONS/SIGNIFICANCE: Biosecurity interventions should be based on information on industry structure and company affiliation, and include part-time workers as potentially unrecognized sources of viral transmission. Modeling efforts to understand pathogen transmission in the context of industrial food animal production should consider company affiliation in addition to geospatial factors and pathogen characteristics. Restriction of social contacts among farmers may be less useful in reducing between-farm transmission

    COVID-19 and CKD: Employment, Food Security and Healthcare in El Salvador

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    Background: In Central America, the COVID-19 pandemic coexists with a devastating epidemic of chronic kidney disease of unknown origin. The consequences of these overlapping health crises remain largely unknown. Methods: We assessed vulnerability to and impact of the first wave of COVID-19 on participants in a cohort study of chronic kidney disease (CKD) in El Salvador (n = 229). Participants were contacted by phone during August and September 2020. We queried changes to employment, healthcare access, household income and food security due to the pandemic (from March 2020 until the time of the interview) and COVID-19-associated symptoms during that time. Findings: We reached 94% of the cohort (n = 215). Nearly 40% of participants reported an unexpected change in employment or work activities and 8.8% reported new unemployment due to the pandemic. Participants with CKD (n = 27) had higher odds of reporting new income insecurity, food insecurity, and reductions in medical care access due to the pandemic. COVID-19-associated symptoms (an approximation of disease) were reported in 7.0% (n = 15). Participants with CKD were more likely to report COVID-19-associated symptoms compared to those without CKD, although these differences were not statistically significant. Conclusions: Overall, participants with CKD suffered greater economic consequences as a result of the pandemic and may have experienced higher incidence of COVID-19 disease, although laboratory diagnostics would be required to draw this conclusion. Longitudinal analyses are required to comprehensively evaluate the implications of the pandemic for individuals with CKD in Central America

    Long-Term Aircraft Noise Exposure and Risk of Hypertension in Postmenopausal Women [2022]

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    13-C-AJFE-BU-002This is an open access article under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) license https://creativecommons.org/licenses/by/4.0/. Please cite this article as: Daniel D. Nguyen, Eric A. Whitsel, Gregory A. Wellenius, Jonathan I. Levy, Jessica H. Leibler, Stephanie T. Grady, James D. Stewart, Matthew P. Fox, Jason M. Collins, Melissa N. Eliot, Andrew Malwitz, JoAnn E. Manson, Junenette L. Peters, Long-term aircraft noise exposure and risk of hypertension in postmenopausal women, Environmental Research, Volume 218, 2023, 115037, ISSN 0013-9351, https://doi.org/10.1016/j.envres.2022.115037.Background: Studies of the association between aircraft noise and hypertension are complicated by inadequate control for potential confounders and a lack of longitudinal assessments, and existing evidence is inconclusive. Objectives: We evaluated the association between long-term aircraft noise exposure and risk of hypertension among post-menopausal women in the Women\u2019s Health Initiative Clinical Trials, an ongoing prospective U.S. cohort

    Characterizing the contribution of industrial food animal production to the transmission and emergence of influenza A viruses

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    The goal of my dissertation is to characterize the contribution of industrial food animal production to between-farm transmission of zoonotic influenza A viruses and transmission of these viruses from industrial food animals to humans. The intention of this research is to improve the capacity of public health policies in the United States to prevent the emergence of pandemic influenza viruses. Preventing and controlling outbreaks within animal populations and avoiding human infection with zoonotic influenza A viruses can reduce the risk of emergence of pandemic influenza viruses in human populations. Industrial food animal production, which dominates the market in the United States and much of the developed world – and increasingly, the developing world as well – has long been considered biosecure. However, emerging research indicates that these industrial systems are vulnerable to disease incursions and suggests that they may play a central role in driving the emergence of zoonotic diseases. The implications of these industrial systems for human influenza risk, particularly the emergence of novel zoonotic influenza A viruses, remains largely unaddressed in the current literature and in health policy strategies in the United States. Chapter 1 of this dissertation outlines my research goals and provides background on my central research themes and topics. Chapter 2 documents the limits of biosecurity within industrial systems, highlighting risks to food animal workers. Chapter 3 details a cross-sectional serology study of a cohort of industrial poultry workers and community members (n=99) in the Delmarva Peninsula, a tri-state area of intense poultry production in the Mid-Atlantic region of the United States. No evidence of infection with avian influenza viruses is observed in this population. Chapter 4 contains a quantitative modeling study to estimates risk of between-farm transmission of avian influenza viruses among industrial poultry farms. This study concluded that company affiliation was a significant source of exposure risk from vehicular transmission. Chapter 5 is a policy analysis of the limitations of current pandemic preparedness policy in the United States to adequately incorporate primary prevention. The central results of this dissertation, their significance to public health and opportunities for further research are highlighted in Chapter 6

    Animal Husbandry Practices and Perceptions of Zoonotic Infectious Disease Risks Among Livestock Keepers in a Rural Parish of Quito, Ecuador.

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    Small-scale livestock production plays an essential role as a source of income and nutrition for households in low- and middle-income countries, yet these practices can also increase risk of zoonotic infectious diseases, especially among young children. To mitigate this risk, there is a need to better understand how livestock producers perceive and manage risks of disease transmission. Twenty semistructured, in-depth interviews were conducted with small-scale livestock producers in a semirural parish of Quito, Ecuador. Interviews explored livestock-raising practices, including animal health-care practices and use of antimicrobials, family members' interactions with livestock and other animals, and perceptions of health risk associated with these practices and activities. Interviews were analyzed for common themes. Awareness of zoonotic disease transmission was widespread, yet few study participants considered raising livestock a significant health risk for themselves or their families. Several study households reported handling and consuming meat or poultry from sick or dead animals and using animal waste as a fertilizer on their crops. Households typically diagnosed and treated their sick animals, occasionally seeking treatment advice from employees of local animal feed stores where medications, including antimicrobials, are available over the counter. Despite a basic understanding of zoonotic disease risk, this study identified several factors, such as the handling and consumption of sick and dead animals and purchasing medications for sick animals over the counter, that potentially increase the risk of zoonotic disease transmission as well as the development and spread of antimicrobial resistance

    Personal Hygiene Practices among Urban Homeless Persons in Boston, MA

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    Persons experiencing homelessness in the United States experience significant barriers to self-care and personal hygiene, including limited access to clean showers, laundry and hand washing facilities. While the obstacles to personal hygiene associated with homelessness may increase risk of infectious disease, hygiene-related behaviors among people experiencing homelessness has received limited attention. We conducted a cross-sectional study of individuals experiencing homelessness in Boston, MA (n = 194) to identify hygiene-related self-care practices and risk factors for reduced hygiene in this population. Most participants (72%) reported taking a daily shower. More than 60% reported hand washing with soap five or more times each day, and use of hand sanitizer was widespread (89% reported using sanitizer in the last week). A majority (86%) used a laundromat or laundry machine to wash clothing, while 14% reported washing clothing in the sink. Heavy drinking, injection drug use, and sleeping outdoors were identified as significant risk factors for reduced hygiene practices. People experiencing homelessness who also engage in these activities may be among the most difficult to reach for intervention, yet targeted efforts may decrease illness risk associated with reduced hygiene. Housed friends and family play a critical role in assisting homeless individuals maintain hygiene by providing showers and laundry facilities
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