Epidemiology and Control of a Head Louse Outbreak in Ames, Iowa, 1976

At the onset of school in 1976, head lice were recognized by teachers and school nurses in the public and parochial schools in Ames, Iowa. One or more cases were identified from the 9 elementary schools and 3 secondary schools in the community. The greatest prevalence of louse infestations occurred in 2 elementary schools (1 parochial) where 16% and 14%, respectively, of the students were infested. A program was established to screen children and exclude infested individuals from class until they were effectively treated. The community was surveyed to determine the extent of infestation in each household from which at least 1 member was attending school and had a confirmed louse infestation. Data were tabulated on the incidence of louse infestations by school, grade, sex, hair color, hair length, number of persons living in homes where louse infestations were recognized and incomes of families that had infested members. Factors that contributed to louse transmission and an evaluation of an intensive community-wide control program are discussed

Results and harmonization guidelines from two large-scale international Elispot proficiency panels conducted by the Cancer Vaccine Consortium (CVC/SVI)

The Cancer Vaccine Consortium of the Sabin Vaccine Institute (CVC/SVI) is conducting an ongoing large-scale immune monitoring harmonization program through its members and affiliated associations. This effort was brought to life as an external validation program by conducting an international Elispot proficiency panel with 36 laboratories in 2005, and was followed by a second panel with 29 participating laboratories in 2006 allowing for application of learnings from the first panel. Critical protocol choices, as well as standardization and validation practices among laboratories were assessed through detailed surveys. Although panel participants had to follow general guidelines in order to allow comparison of results, each laboratory was able to use its own protocols, materials and reagents. The second panel recorded an overall significantly improved performance, as measured by the ability to detect all predefined responses correctly. Protocol choices and laboratory practices, which can have a dramatic effect on the overall assay outcome, were identified and lead to the following recommendations: (A) Establish a laboratory SOP for Elispot testing procedures including (A1) a counting method for apoptotic cells for determining adequate cell dilution for plating, and (A2) overnight rest of cells prior to plating and incubation, (B) Use only pre-tested serum optimized for low background: high signal ratio, (C) Establish a laboratory SOP for plate reading including (C1) human auditing during the reading process and (C2) adequate adjustments for technical artifacts, and (D) Only allow trained personnel, which is certified per laboratory SOPs to conduct assays. Recommendations described under (A) were found to make a statistically significant difference in assay performance, while the remaining recommendations are based on practical experiences confirmed by the panel results, which could not be statistically tested. These results provide initial harmonization guidelines to optimize Elispot assay performance to the immunotherapy community. Further optimization is in process with ongoing panels

ASYMMETRY IN RAW MILK SAFETY PERCEPTIONS AND INFORMATION: IMPLICATIONS FOR RISK IN FRESH PRODUCE MARKETING AND POLICY

Scientific evidence clearly indicates that consumption of raw milk carries substantial disease-inducing health risks. While federal U.S. policy mandates that milk moving in interstate commerce be pasteurized; within 41 of 50 states, raw milk can be obtained for consumption. Warning labels notwithstanding, a segment of U.S. consumers pays higher prices for higher-risk raw milk than for either organic or conventional milk. The behavioral factors leading to raw milk consumption are explored. The paternalistic regulatory options for reducing the risk associated with drinking raw milk are identified. Implications for fresh produce sold directly from farms to consumers or through farmers markets are drawn

ASYMMETRY IN RAW MILK SAFETY PERCEPTIONS AND INFORMATION: IMPLICATIONS FOR RISK IN FRESH PRODUCE MARKETING AND POLICY

Scientific evidence clearly indicates that consumption of raw milk carries substantial disease-inducing health risks. While federal U.S. policy mandates that milk moving in interstate commerce be pasteurized; within 41 of 50 states, raw milk can be obtained for consumption. Warning labels notwithstanding, a segment of U.S. consumers pays higher prices for higher-risk raw milk than for either organic or conventional milk. The behavioral factors leading to raw milk consumption are explored. The paternalistic regulatory options for reducing the risk associated with drinking raw milk are identified. Implications for fresh produce sold directly from farms to consumers or through farmers markets are drawn.raw milk, pasteurization, health risks, behavioral economics, bounded rationality, paternalistic regulations, public health, HACCP, GLOBALG.A.P., Agricultural and Food Policy, Consumer/Household Economics, Demand and Price Analysis, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, Health Economics and Policy, A12, A13, A14, D11, D18, D46, D71, D78, D82, I18, K23, K32, Q11, Q18,

Hydroxychloroquine for pre-exposure prophylaxis of COVID-19 in health care workers: a randomized, multicenter, placebo-controlled trial Healthcare Worker Exposure Response and Outcomes of Hydroxychloroquine (HERO-HCQ)

ABSTRACT: Objectives: To determine whether hydroxychloroquine (HCQ) is safe and effective at preventing COVID-19 infections among health care workers (HCWs). Methods: In a 1: 1 randomized, placebo-controlled, double-blind, parallel-group, superiority trial at 34 US clinical centers, 1360 HCWs at risk for COVID-19 infection were enrolled between April and November 2020. Participants were randomized to HCQ or matched placebo. The HCQ dosing included a loading dose of HCQ 600 mg twice on day 1, followed by 400 mg daily for 29 days. The primary outcome was a composite of confirmed or suspected COVID-19 clinical infection by day 30, defined as new-onset fever, cough, or dyspnea and either a positive SARS-CoV-2 polymerase chain reaction test (confirmed) or a lack of confirmatory testing due to local restrictions (suspected). Results: Study enrollment closed before full accrual due to recruitment challenges. The primary end point occurred in 41 (6.0%) participants receiving HCQ and 53 (7.8%) participants receiving placebo. No difference in the proportion of participants experiencing clinical infection (estimated difference of -1.8%, 95% confidence interval -4.6-0.9%, P = 0.20) was identified nor any significant safety issues. Conclusion: Oral HCQ taken as prescribed appeared safe among HCWs. No significant clinical benefits were observed. The study was not powered to detect a small but potentially important reduction in infection. Trial registration: NCT04334148

Divergent gene expression responses to Complicated Grief and Non-complicated Grief

The “widowhood effect” (i.e., morbidity/mortality in recently bereaved spouses) may be related to changes in immune function, but little is known about the impact of bereavement on gene transcription in immune cells. This study examined how Complicated Grief and Non-complicated Grief responses to bereavement differentially affect leukocyte gene expression. Genome-wide transcriptional profiling and bioinformatic analyses were completed on 63 older adults. Thirty-six of them had lost their spouse/partner on average 2 years ago, and 27 were nonbereaved, married controls. Twelve of the bereaved participants met criteria for Complicated Grief. Compared to nonbereaved controls, bereavement (both Complicated Grief and Non-complicated Grief) was associated with upregulated expression of genes involved in general immunologic activation and a selective downregulation of genes involved in B lymphocyte responses. However, Complicated Grief and Non-complicated Grief differed markedly in their expression of Type I interferon-related transcripts, with Non-complicated Grief subjects showing substantial upregulation relative to nonbereaved controls and Complicated Grief subjects showing substantial downregulation. Bereavement significantly modulates immune function gene expression. The magnitude of bereavement-related distress (i.e., Complicated Grief vs. Non-complicated Grief) is linked to differential patterns of transcription factor activation and gene expression involved in innate antiviral responses. These findings provide a molecular framework for understanding the health effects of bereavement, as well as new insights into the particular gene modules that are most sensitive to the individual's psychological response to loss