Infectious disease risks among refugees from North Korea.

OBJECTIVES: The characteristics of disease in North Korea, including severe malnutrition and infectious disease risks, have not been openly and widely analyzed. This study was performed to estimate the risks of infectious diseases among refugees from North Korea. METHODS: A literature review of clinical studies among North Korean defectors was conducted to statistically estimate the risks of infectious diseases among North Korean subjects. RESULTS: A total of six groups of data from five publications covering the years 2004 to 2014 were identified. Tuberculosis and viral hepatitis appeared to be the two most common infectious diseases, especially among adult refugees. When comparing the risks of infectious diseases between North Korean and Syrian refugees, it is critical to remember that Plasmodium vivax malaria has been endemic in North Korea, while cutaneous leishmaniasis has frequently been seen among Syrian migrants. CONCLUSIONS: Valuable datasets from health surveys of defectors were reviewed. In addition to tuberculosis and viral hepatitis, which were found to be the two most common infectious diseases, a special characteristic of North Korean defectors was Plasmodium vivax malaria. This needs to be added to the list of differential diagnoses for pyretic patients

Legislative Documents

Also, variously referred to as: House bills; House documents; House legislative documents; legislative documents; General Court documents

Transmission dynamics of cholera in Yemen, 2017 : a real time forecasting

Background: A large epidemic of cholera, caused by Vibrio cholerae, serotype Ogawa, has been ongoing in Yemen, 2017. To improve the situation awareness, the present study aimed to forecast the cholera epidemic, explicitly addressing the reporting delay and ascertainment bias. Methods: Using weekly incidence of suspected cases, updated as a revised epidemic curve every week, the reporting delay was explicitly incorporated into the estimation model. Using the weekly case fatality risk as calculated by the World Health Organization, ascertainment bias was adjusted, enabling us to parameterize the family of logistic curves (i.e., logistic and generalized logistic models) for describing the unbiased incidence in 2017. Results: The cumulative incidence at the end of the epidemic, was estimated at 790,778 (95% CI: 700,495, 914,442) cases and 767,029 (95% CI: 690,877, 871,671) cases, respectively, by using logistic and generalized logistic models. It was also estimated that we have just passed through the epidemic peak by week 26, 2017. From week 27 onwards, the weekly incidence was predicted to decrease. Conclusions: Cholera epidemic in Yemen, 2017 was predicted to soon start to decrease. If the weekly incidence is reported in the up-to-the-minute manner and updated in later weeks, not a single data point but the entire epidemic curve must be precisely updated

Assessing the transmissibility of epidemics involving epidemic zoning

Abstract Background Epidemic zoning is an important option in a series of measures for the prevention and control of infectious diseases. We aim to accurately assess the disease transmission process by considering the epidemic zoning, and we take two epidemics with distinct outbreak sizes as an example, i.e., the Xi’an epidemic in late 2021 and the Shanghai epidemic in early 2022. Methods For the two epidemics, the total cases were clearly distinguished by their reporting zone and the Bernoulli counting process was used to describe whether one infected case in society would be reported in control zones or not. Assuming the imperfect or perfect isolation policy in control zones, the transmission processes are respectively simulated by the adjusted renewal equation with case importation, which can be derived on the basis of the Bellman-Harris branching theory. The likelihood function containing unknown parameters is then constructed by assuming the daily number of new cases reported in control zones follows a Poisson distribution. All the unknown parameters were obtained by the maximum likelihood estimation. Results For both epidemics, the internal infections characterized by subcritical transmission within the control zones were verified, and the median control reproduction numbers were estimated as 0.403 (95% confidence interval (CI): 0.352, 0.459) in Xi’an epidemic and 0.727 (95% CI: 0.724, 0.730) in Shanghai epidemic, respectively. In addition, although the detection rate of social cases quickly increased to 100% during the decline period of daily new cases until the end of the epidemic, the detection rate in Xi’an was significantly higher than that in Shanghai in the previous period. Conclusions The comparative analysis of the two epidemics with different consequences highlights the role of the higher detection rate of social cases since the beginning of the epidemic and the reduced transmission risk in control zones throughout the outbreak. Strengthening the detection of social infection and strictly implementing the isolation policy are of great significance to avoid a larger-scale epidemic

Duality in phase space and complex dynamics of an integrated pest management network model

Fragmented habitat patches between which plants and animals can disperse can be modeled as networks with varying degrees of connectivity. A predator–prey model with network structures is proposed for integrated pest management (IPM) with impulsive control actions. The model was analyzed using numerical methods to investigate how factors such as the impulsive period, the releasing constant of natural enemies and the mode of connections between the patches affect pest outbreak patterns and the success or failure of pest control. The concept of the cluster as defined by Holland and Hastings is used to describe variations in results ranging from global synchrony when all patches have identical fluctuations to n-cluster solutions with all patches having different dynamics. Heterogeneity in the initial densities of either pest or natural enemy generally resulted in a variety of cluster oscillations. Surprisingly, if n > 1, the clusters fall into two groups one with low amplitude fluctuations and the other with high amplitude fluctuations (i.e. duality in phase space), implying that control actions radically alter the system's characteristics by inducing duality and more complex dynamics. When the impulsive period is small enough, i.e. the control strategy is undertaken frequently, the pest can be eradicated. As the period increases, the pest's dynamics shift from a steady state to become chaotic with periodic windows and more multicluster oscillations arise for heterogenous initial density distributions. Period-doubling bifurcation and periodic halving cascades occur as the releasing constant of the natural enemy increases. For the same ecological system with five differently connected networks, as the randomness of the connectedness increases, the transient duration becomes smaller and the probability of multicluster oscillations appearing becomes higher

Holocene environmental change according to lake core in Fildes Peninsula of King George Island, Antarctica

Lake core sampled from Xihu in Fildes Peninsula of King George Island, Antarctica could reveal the environmental change of the district. The lake core (GA7), 9.28 meters long, was sectioned at an interval of 2 cm. Through measuring the organic carbon, magnetic susceptibility, granularity and organic carbon isotope of GA7, by use of (14)C age it was estimated that there were four periods of high temperature in Fildes Peninsula: 4800 - 4400 aB. P., 3600 - 3350 aB. P., 2100- 1800 aB. P. and 900 aB. P. - present. Meanwhile, results showed that there was a strikingly positive correlation between the content of organic carbon and that of organic carbon isotope (δC(13)org) which could be the substitute indicators of environmental temperature

Assessing dengue control in Tokyo, 2014

Background In summer 2014, an autochthonous outbreak of dengue occurred in Tokyo, Japan, in which Yoyogi Park acted as the focal area of transmission. Recognizing the outbreak, concerted efforts were made to control viral spread, which included mosquito control, public announcement of the outbreak, and a total ban on entering the park. We sought to assess the effectiveness of these control measures. Methodology/Principal findings We used a mathematical model to describe the transmission dynamics. Using dates of exposure and illness onset, we categorized cases into three groups according to the availability of these datasets. The infection process was parametrically modeled by generation, and convolution of the infection process and the incubation period was fitted to the data. By estimating the effective reproduction number, we determined that the effect of dengue risk communication together with mosquito control from 28 August 2014 was insufficiently large to lower the reproduction number to below 1. However, once Yoyogi Park was closed on 4 September, the value of the effective reproduction number began to fall below 1, and the associated relative reduction in the effective reproduction number was estimated to be 20%-60%. The mean incubation period was an estimated 5.8 days. Conclusions/Significance Regardless of the assumed number of generations of cases, the combined effect of mosquito control, risk communication, and park closure appeared to be successful in interrupting the chain of dengue transmission in Tokyo. Author summary Evaluating the interventions implemented during an outbreak of mosquito-borne disease is of utmost importance, offering lessons for future control strategies. By retrospectively analyzing data of the first autochthonous dengue epidemic of the 21st century in Tokyo, Japan, we assessed the effectiveness of the interventions. Once a dengue outbreak was confirmed in late August 2014, the government of Japan took drastic mosquito control measures, targeting both adults and larvae. News of the outbreak was also widely disseminated via mass media along with experts' recommendations as to how people could avoid the risks of dengue infection. As the outbreak was not immediately controlled, the focal area of transmission, Yoyogi Park, was closed on 4 September. Using a mathematical model, we assessed how well dengue virus transmission was intervened in relation to the start times of interventions. As we incorporated precise timing into the model, we directly modeled the time of infection and accounted for the time delay from infection to illness onset. Thus, we revealed that mosquito control and risk communication measures alone could not interrupt the chain of transmission; however, adding park closure to these interventions was substantially effective in reducing the number of transmissions