Positive Rates of 2009 Novel Influenza A (H1N1) was High in School-Aged Individuals: Significance in Pandemic Control

In this study, data from a pandemic H1N1 outbreak in Korea were analyzed according to time, geography (districts), and age. A total of 252,271 samples collected nationwide were referred to the Greencross Reference Laboratory from June 2009 to February 2010 for H1N1 confirmation testing. Of these samples, 105,300 (41.7%) were H1N1-positive. With time, positivity was highest (57.0%) from October 26 - November 1 (4 weeks after Chuseok). The positive rates among districts show the highest value in Ulsan City (63.1%) and the lowest in Gyeongnam Province (32.8%). The positive rates for ages 0-2, 3-5, 6-11, 12-17, 18-20, 21-30, 31-40, 41-50, 51-60, and > 60 yr were 17.0%, 33.1%, 56.2%, 55.5%, 55.3%, 41.5%, 28.2%, 30.5%, 31.1%, and 16.8%, respectively, indirectly indicating propagation of H1N1 through schools. Pandemic control should involve school-targeted strategies

Drug-resistant Neisseria gonorrhoeae in Michigan

The increasing prevalence of quinolone-resistant Neisseria gonorrhoeae (QRNG) in the United States is a cause for concern. Detecting resistance is complicated by the widespread use of molecular tests that do not provide isolates for susceptibility testing. The Michigan Department of Community Health developed a sentinel surveillance program to detect antimicrobial drug resistance in N. gonorrhoeae. Sentinel surveillance from 11 laboratories submitted 1,122 isolates for antimicrobial drug susceptibility testing and detected 2 clusters of QRNG from January 2003 to September 2004. These clusters were epidemiologically distinct: one involved young, heterosexual youth, and the other involved older men who have sex with men. This finding led to changes in local treatment recommendations that limited spread of resistant strains. Development of the sentinel program, collection of data, and epidemiologic analysis of the clusters are discussed

A survey of core and support activities of communicable disease surveillance systems at operating-level CDCs in China

<p>Abstract</p> <p>Background</p> <p>In recent years, problems like insufficient coordination, low efficiency, and heavy working load in national communicable disease surveillance systems in China have been pointed out by many researchers. To strengthen the national communicable disease surveillance systems becomes an immediate concern. Since the World Health Organization has recommended that a structured approach to strengthen national communicable disease surveillance must include an evaluation to existing systems which usually begins with a systematic description, we conducted the first survey for communicable disease surveillance systems in China, in order to understand the situation of core and support surveillance activities at province-level and county-level centers for disease control and prevention (CDCs).</p> <p>Methods</p> <p>A nationwide survey was conducted by mail between May and October 2006 to investigate the implementation of core and support activities of the Notifiable Disease Reporting System (NDRS) and disease-specific surveillance systems in all of the 31 province-level and selected 14 county-level CDCs in Mainland China The comments on the performance of communicable disease surveillance systems were also collected from the directors of CDCs in this survey.</p> <p>Results</p> <p>The core activities of NDRS such as confirmation, reporting and analysis and some support activities such as supervision and staff training were found sufficient in both province-level and county-level surveyed CDCs, but other support activities including information feedback, equipment and financial support need to be strengthened in most of the investigated CDCs. A total of 47 communicable diseases or syndromes were under surveillance at province level, and 20 diseases or syndromes at county level. The activities among different disease-specific surveillance systems varied widely. Acute flaccid paralysis (AFP), measles and tuberculosis (TB) surveillance systems got relatively high recognition both at province level and county level.</p> <p>Conclusions</p> <p>China has already established a national communicable disease surveillance framework that combines NDRS and disease-specific surveillance systems. The core and support activities of NDRS were found sufficient, while the implementation of those activities varied among different disease-specific surveillance systems.</p

Outbreak of Type 2 Vaccine-Derived Poliovirus in Nigeria: Emergence and Widespread Circulation in an Underimmunized Population

Wild poliovirus has remained endemic in northern Nigeria because of low coverage achieved in the routine immunization program and in supplementary immunization activities (SIAs). An outbreak of infection involving 315 cases of type 2 circulating vaccine-derived poliovirus (cVDPV2; >1% divergent from Sabin 2) occurred during July 2005–June 2010, a period when 23 of 34 SIAs used monovalent or bivalent oral poliovirus vaccine (OPV) lacking Sabin 2. In addition, 21 “pre-VDPV2” (0.5%–1.0% divergent) cases occurred during this period. Both cVDPV and pre-VDPV cases were clinically indistinguishable from cases due to wild poliovirus. The monthly incidence of cases increased sharply in early 2009, as more children aged without trivalent OPV SIAs. Cumulative state incidence of pre-VDPV2/cVDPV2 was correlated with low childhood immunization against poliovirus type 2 assessed by various means. Strengthened routine immunization programs in countries with suboptimal coverage and balanced use of OPV formulations in SIAs are necessary to minimize risks of VDPV emergence and circulation

Knowledge and risk perceptions of the Ebola virus in the United States

Objectives: The Ebola epidemic has received extensive media coverage since the first diagnosed cases of the virus in the US. We investigated risk perceptions of Ebola among individuals living in the US and measured their knowledge of the virus. Method: US residents completed an online survey (conducted 14-18 November 2014) that assessed their Ebola knowledge and risk perceptions. Results: Respondents who were more knowledgeable of Ebola perceived less risk of contracting the virus and were less worried about the virus, but also regarded Ebola as more serious than less knowledgeable respondents. The internet served as a major source of additional information among knowledgeable respondents. Conclusion: The findings suggest that the provision of health information about Ebola may be effective in informing the public about Ebola risks and of preventive measures without curtailing the seriousness of the virus. Policymakers may seek to further exploit the internet as a means of delivering information about Ebola in the US and worldwide

Optimising time-limited non-pharmaceutical interventions for COVID-19 outbreak control

Retrospective analyses of the non-pharmaceutical interventions (NPIs) used to combat the ongoing COVID-19 outbreak have highlighted the potential of optimizing interventions. These optimal interventions allow policymakers to manage NPIs to minimize the epidemiological and human health impacts of both COVID-19 and the intervention itself. Here, we use a susceptible-infectious-recovered (SIR) mathematical model to explore the feasibility of optimizing the duration, magnitude and trigger point of five different NPI scenarios to minimize the peak prevalence or the attack rate of a simulated UK COVID-19 outbreak. An optimal parameter space to minimize the peak prevalence or the attack rate was identified for each intervention scenario, with each scenario differing with regard to how reductions to transmission were modelled. However, we show that these optimal interventions are fragile, sensitive to epidemiological uncertainty and prone to implementation error. We highlight the use of robust, but suboptimal interventions as an alternative, with these interventions capable of mitigating the peak prevalence or the attack rate over a broader, more achievable parameter space, but being less efficacious than theoretically optimal interventions. This work provides an illustrative example of the concept of intervention optimization across a range of different NPI strategies. This article is part of the theme issue 'Modelling that shaped the early COVID-19 pandemic response in the UK'

Predictors of Resilience Among Infants at Risk for Rapid Weight Gain

Objective: The study objective was to investigate factors associated with resilience to rapid weight gain (RWG) among predominantly bottle-fed infants. Methods: Data came from 1,353 mothers who participated in the Infant Feeding Practices Study 2. Mothers completed a prenatal questionnaire and monthly surveys of infant feeding and growth between birth and 12 months. Infants were classified as resilient if they were predominantly bottle fed but did not exhibit RWG between birth and the latter half of infancy (≥ +0.67 change in weight-for-age z score). Results: Thirty-five percent of the sample (n = 467) was predominantly bottle fed but did not exhibit RWG (“Resilient”), 17% (n = 228) was predominantly bottle fed and exhibited RWG (“Not Resilient”), and 49% (n = 658) was not predominantly bottle fed (“Low Risk”). Significant predictors of resilience to RWG were greater gestational age (P = 0.042) and weight (P \u3c 0.001) at birth, lower frequency of adding cereal to the bottle (P = 0.022), lower frequency of infant-led bottle-emptying (P = 0.047), and greater frequency of maternal encouragement of bottle-emptying (P = 0.002). Conclusions: Associations between bottle-feeding and RWG may be moderated by infant characteristics and maternal feeding practices. The present study highlighted several characteristics of predominantly bottle-fed infants who were resilient to RWG, but further research is needed to identify a broader array of key targets for future intervention efforts

Methods for the 2019 New Zealand family violence study- a study on the association between violence exposure, health and well-being

Family violence, which includes child abuse, intimate partner violence and elder abuse, is a problem of national and global significance. Robust evidence about the scale and consequences of the problem is needed to inform policy and practice, including information on high-risk groups, and risk and protective factors. In this article, the methods utilised for collecting data for NZ’s 2019 Family Violence Survey are described, along with a summary of the characteristics of the population-based sample obtained. The 2019 NZ Family Violence Survey will provide prevalence estimates of violence exposure for women and men across a wide range of types of violence across the lifespan. This article provides a basis for understanding who was included in the study sample, and for enabling understanding and interpretation of future study findings