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Sample records for successful outbreak control

  1. Nosocomial Outbreak of Carbapenem-Resistant Acinetobacter baumannii in Intensive Care Units and Successful Outbreak Control Program

    PubMed Central

    Choi, Won Suk; Kim, Su Hyun; Jeon, Eun Gyong; Son, Myeung Hee; Yoon, Young Kyung; Kim, Jung-Yeon; Kim, Mi Jeong; Sohn, Jang Wook; Kim, Min Ja

    2010-01-01

    Acinetobacter baumannii has been increasingly reported as a significant causative organism of various nosocomial infections. Here we describe an outbreak of carbapenem-resistant A. baumannii (CRAB) in the ICUs of a Korean university hospital, along with a successful outbreak control program. From October 2007 through July 2008, CRAB was isolated from 57 ICU patients. Nineteen patients were diagnosed as being truly infected with CRAB, four of whom were presumed to have died due to CRAB infection, producing a case-fatality rate of 21.1%. In surveillance of the environment and the healthcare workers (HCWs), CRAB was isolated from 24 (17.9%) of 135 environmental samples and seven (10.9%) of 65 HCWs. The pulsed field gel electrophoresis patterns showed that the isolates from patients, HCWs, and the environment were genetically related. Control of the outbreak was achieved by enforcing contact precautions, reducing environmental contamination through massive cleaning, and use of a closed-suctioning system. By August 2008 there were no new cases of CRAB in the ICUs. This study shows that the extensive spread of CRAB can happen through HCWs and the environmental contamination, and that proper strategies including strict contact precautions, massive environmental decontamination, and a closed-suctioning system can be effective for controlling CRAB outbreaks. PMID:20592889

  2. Infection prevention and control of the Ebola outbreak in Liberia, 2014-2015: key challenges and successes.

    PubMed

    Cooper, Catherine; Fisher, Dale; Gupta, Neil; MaCauley, Rose; Pessoa-Silva, Carmem L

    2016-01-01

    Prior to the 2014-2015 Ebola outbreak, infection prevention and control (IPC) activities in Liberian healthcare facilities were basic. There was no national IPC guidance, nor dedicated staff at any level of government or healthcare facility (HCF) to ensure the implementation of best practices. Efforts to improve IPC early in the outbreak were ad hoc and messaging was inconsistent. In September 2014, at the height of the outbreak, the national IPC Task Force was established with a Ministry of Health (MoH) mandate to coordinate IPC response activities. A steering group of the Task Force, including representatives of the World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC), supported MoH leadership in implementing standardized messaging and IPC training for the health workforce. This structure, and the activities implemented under this structure, played a crucial role in the implementation of IPC practices and successful containment of the outbreak. Moving forward, a nationwide culture of IPC needs to be maintained through this governance structure in Liberia's health system to prevent and respond to future outbreaks. PMID:26732586

  3. Forest dynamics after successive spruce budworm outbreaks in mixedwood forests.

    PubMed

    Bouchard, Mathieu; Kneeshaw, Daniel; Bergeron, Yves

    2006-09-01

    In order to assess the long-term spatiotemporal influence of the spruce budworm in sub-boreal mixedwood forests, we studied the effect of three successive outbreaks in a region of western Quebec, Canada. We used dendrochronology to detect past outbreaks in three areas (111-185 ha), based on the recruitment age of balsam fir (Abies balsamea) and on growth patterns of white spruce (Picea glauca), the two main host species of this defoliating insect. We also used a series of aerial photographs taken between 1935 and 2003 to evaluate overstory mortality and post-outbreak succession patterns in these same areas. Individual outbreaks had a spatially homogenous impact on host species throughout the region, but successive outbreaks differed in intensity: the two outbreaks around 1910 and 1980 caused widespread mortality in the overstory, but an outbreak around 1945 had little impact, probably because the forest mosaic had not yet recuperated from the 1910 outbreak. No clear outbreak was detected in the later part of the 19th century. In portions of the study areas where the 1910 outbreak had a major impact, between 36% and 50% of the stands were reoccupied by balsam fir stands in the period up to the 1980 outbreak (cyclic succession), the rest being at least partly replaced by nonhost species such as Betula spp. Changes in forest composition after the 1910 outbreak were mostly associated with upper-slope positions in all study areas. The 1980 outbreak also had a higher impact than earlier outbreaks in lower-slope positions dominated by black spruce (Picea mariana)-balsam fir mixtures. These results suggest that, at the regional scale, the abundance of mature or over-mature balsam fir stands does not determine the outbreak cycle. When an outbreak occurs, however, its impact will be strongly constrained by forest characteristics such as stand composition and structure, which are themselves influenced by previous disturbances and slope position. PMID:16995632

  4. Communicable Diseases and Outbreak Control.

    PubMed

    Ameli, Jonathan

    2015-10-01

    Infectious disease during an emergency condition can raise the death rate 60 times in comparison to other causes including trauma. An epidemic, or outbreak, can occur when several aspects of the agent (pathogen), population (hosts), and the environment create an ideal situation for spread. Overcrowding, poor regional design and hygiene due to poverty, dirty drinking water, rapid climate changes, and natural disasters, can lead to conditions that allow easier transmission of disease. Once it has been established that an emergency condition exists, there must be a prompt and thorough response for communicable disease control. A camp should be created, and the disease managed rapidly. The overall goals are rapid assessment, prevention, surveillance, outbreak control, and disease management. PMID:27437528

  5. Successful control of a Methicillin-resistant Staphylococcus aureus outbreak in a neonatal intensive care unit: a retrospective, before-after study

    PubMed Central

    2013-01-01

    The implementation of multiple, simultaneous, evidence-based management strategies is effective for controlling nosocomial infections. Outbreak management strategies may benefit from tools improving the communication between the institutional and scientific leadership and the ground-level staff. These measures can help to identify individualized solutions addressing specific unit needs. PMID:24053628

  6. Infection Control During Filoviral Hemorrhagic Fever Outbreaks

    PubMed Central

    Vanessa, N Raabe; Matthias, Borchert

    2012-01-01

    Breaking the human-to-human transmission cycle remains the cornerstone of infection control during filoviral (Ebola and Marburg) hemorrhagic fever outbreaks. This requires effective identification and isolation of cases, timely contact tracing and monitoring, proper usage of barrier personal protection gear by health workers, and safely conducted burials. Solely implementing these measures is insufficient for infection control; control efforts must be culturally sensitive and conducted in a transparent manner to promote the necessary trust between the community and infection control team in order to succeed. This article provides a review of the literature on infection control during filoviral hemorrhagic fever outbreaks focusing on outbreaks in a developing setting and lessons learned from previous outbreaks. The primary search database used to review the literature was PUBMED, the National Library of Medicine website. PMID:22529631

  7. Outbreaks of virulent diarrheagenic Escherichia coli - are we in control?

    PubMed Central

    2012-01-01

    Shiga toxin-producing Escherichia coli (STEC) are the most virulent diarrheagenic E. coli known to date. They can be spread with alarming ease via food as exemplified by a large sprout-borne outbreak of STEC O104:H4 in 2011 that was centered in northern Germany and affected several countries. Effective control of such outbreaks is an important public health task and necessitates early outbreak detection, fast identification of the outbreak vehicle and immediate removal of the suspected food from the market, flanked by consumer advice and measures to prevent secondary spread. In our view, opportunities to improve control of STEC outbreaks lie in early clinical suspicion for STEC infection, timely diagnosis of all STEC at the serotype-level and integrating molecular subtyping information into surveillance systems. Furthermore, conducting analytical studies that supplement patients' imperfect food history recall and performing, as an investigative element, product tracebacks, are pivotal but underutilized tools for successful epidemiologic identification of the suspected vehicle in foodborne outbreaks. As a corollary, these tools are amenable to tailor microbiological testing of suspected food. Please see related article: http://www.biomedcentral.com/1741-7015/10/12 PMID:22300479

  8. Meningococcal meningitis outbreak control strategies.

    PubMed

    Ahlawat, S; Kumar, R; Roy, P; Varma, S; Sharma, B K

    2000-12-01

    Meningococcal meningitis has been occurring worldwide in both endemic and epidemic forms. Serogroup A accounts for majority of cases of epidemic as well as endemic Meningococcal meningitis in developing nations, whereas group C and group B causes epidemic and endemic meningococcal meningitis in developed countries. Person to person spread of N. meningitides generally occurs through inhalation of droplets of infected nasopharyngeal secretions by direct or indirect oral contact. Incubation period varies from 2 to 10 days. N. meningitides typically causes acute infective illness characterized by sequential development of upper respiratory tract infection, meningococcemia, meningitis and focal neurological deficit. Over 90 per cent cases of adult meningococcal infections have cerebrospinal meningitis, whereas in children prevalence of meningitis is much lower (50 per cent). Acute meningitis manifests with fever, severe headache, vomiting and neck stiffness. Presentations may be non-specific in infants, elderly and in patients with fulminant meningococcemia. Diagnosis is confirmed with cerebrospinal fluid analysis. Overall mortality due to meningitis is usually around 10 per cent. In meningococcal septicemia, the case fatality rate may exceed 50 per cent. Preventive strategies include vaccination, chemoprophylaxis and early detection and treatment. Mass vaccination campaign, if appropriately carried out, has been documented to halt an epidemic of meningococcal disease due to serogroup A or C. In the present review we have discussed the available evidence with regards to prevention at primary, secondary and tertiary level. Public health approach to an outbreak of meningococcal meningitis in a community or an organization is also outlined. PMID:11668937

  9. Surveillance and Outbreak Response Management System (SORMAS) to support the control of the Ebola virus disease outbreak in West Africa.

    PubMed

    Fähnrich, C; Denecke, K; Adeoye, O O; Benzler, J; Claus, H; Kirchner, G; Mall, S; Richter, R; Schapranow, M P; Schwarz, N; Tom-Aba, D; Uflacker, M; Poggensee, G; Krause, G

    2015-01-01

    In the context of controlling the current outbreak of Ebola virus disease (EVD), the World Health Organization claimed that 'critical determinant of epidemic size appears to be the speed of implementation of rigorous control measures', i.e. immediate follow-up of contact persons during 21 days after exposure, isolation and treatment of cases, decontamination, and safe burials. We developed the Surveillance and Outbreak Response Management System (SORMAS) to improve efficiency and timeliness of these measures. We used the Design Thinking methodology to systematically analyse experiences from field workers and the Ebola Emergency Operations Centre (EOC) after successful control of the EVD outbreak in Nigeria. We developed a process model with seven personas representing the procedures of EVD outbreak control. The SORMAS system architecture combines latest In-Memory Database (IMDB) technology via SAP HANA (in-memory, relational database management system), enabling interactive data analyses, and established SAP cloud tools, such as SAP Afaria (a mobile device management software). The user interface consists of specific front-ends for smartphones and tablet devices, which are independent from physical configurations. SORMAS allows real-time, bidirectional information exchange between field workers and the EOC, ensures supervision of contact follow-up, automated status reports, and GPS tracking. SORMAS may become a platform for outbreak management and improved routine surveillance of any infectious disease. Furthermore, the SORMAS process model may serve as framework for EVD outbreak modeling. PMID:25846493

  10. A Hospital-wide Outbreak of Serratia marcescens, and Ishikawa's "Fishbone" Analysis to Support Outbreak Control.

    PubMed

    Vetter, Luzia; Schuepfer, Guido; Kuster, Stefan P; Rossi, Marco

    2016-01-01

    A nosocomial outbreak of Serratia marcescens in respiratory samples predominantly from patients in a surgical intensive care unit is reported. Most of these patients were cardiac surgical patients. Initially, a vigorous but inconclusive investigation was implemented on the basis of standardized (according the US Centers for Disease Control and Prevention) steps of outbreak investigation. Then, a systemic quality management approach with "fishbone" analysis was added. As a consequence, plausible causes for the outbreak were identified: (i) S marcescens was found on the transesophageal echocardiography probe used during cardiac surgery; and (ii) the quality of the surface disinfection was insufficient due to multiple reasons and was completely reengineered. In conclusion, in addition to the standardized steps of outbreak investigation, the complementary use of quality management tools such as the Ishikawa "fishbone" analysis is helpful for outbreak control. The complete reengineering of the disinfectant procurement and logistics is assumed to have been the most effective measure to control the described outbreak. PMID:26783861

  11. Tuberculosis control: lessons for outbreak preparedness in correctional facilities.

    PubMed

    Parvez, Farah M; Lobato, Mark N; Greifinger, Robert B

    2010-07-01

    Correctional facilities typically house large numbers of persons in close and crowded conditions for long periods. Clusters of communicable diseases ranging from simple viral upper respiratory infections to more serious threats, such as tuberculosis (TB), infections with methicillin-resistant Staphylococcus aureus, and influenza, often emerge in these surroundings. The recent H1N1 influenza pandemic highlights the importance of outbreak prevention and containment preparedness, particularly in congregate settings. In this commentary, the authors propose that the TB control model can provide valuable lessons for infection control practitioners to prepare for, identify, investigate, and control outbreaks of communicable diseases to prevent transmission in correctional facilities and to the surrounding community. PMID:20466700

  12. 75 FR 34146 - Draft Guideline for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-16

    ... of Norovirus Gastroenteritis Outbreaks in Healthcare Settings AGENCY: Centers for Disease Control and... for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in Healthcare Settings... control programs for healthcare settings across the continuum of care. This guideline provides...

  13. Short communication: Strengthening sub-national communicable disease surveillance in a remote Pacific Island country by adapting a successful African outbreak surveillance model.

    PubMed

    Nelesone, Tekaai; Durrheim, David N; Speare, Richard; Kiedrzynski, Tom; Melrose, Wayne D

    2006-01-01

    Successful communicable disease surveillance depends on effective bidirectional information flow between clinicians at the periphery and communicable disease control units at regional, national and global levels. Resource-poor countries often struggle to establish and maintain the crucial link with the periphery. A simple syndrome-based outbreak surveillance system initially developed and evaluated in Mpumalanga Province, South Africa was adapted for the Pacific island nation of Tuvalu. Eight syndromes were identified for surveillance: acute flaccid paralysis (poliomyelitis), profuse watery diarrhoea (cholera), diarrhoea outbreak, dysentery outbreak, febrile disease with abdominal symptoms and headache (typhoid), febrile disease with generalized non-blistering rash (measles), febrile disease with intense headache and/or neck stiffness with or without haemorrhagic rash (meningococcal meningitis), and outbreaks of other febrile diseases of unknown origin. A user-oriented manual, the Tuvalu Outbreak Manual (http://www.wepi.org/books/tom/), was developed to support introduction of the surveillance system. Nurses working in seven outer island clinics and the hospital outpatient department on the main island rapidly report suspected outbreaks and submit weekly zero-reports to the central communicable disease control unit. An evaluation of the system after 12 months indicated that the Outbreak Manual was regarded as very useful by clinic nurses, and there was early evidence of improved surveillance and response to the disease syndromes under surveillance. PMID:16398751

  14. A Hospital-wide Outbreak of Serratia marcescens, and Ishikawa's “Fishbone” Analysis to Support Outbreak Control

    PubMed Central

    Vetter, Luzia; Schuepfer, Guido; Kuster, Stefan P.

    2016-01-01

    A nosocomial outbreak of Serratia marcescens in respiratory samples predominantly from patients in a surgical intensive care unit is reported. Most of these patients were cardiac surgical patients. Initially, a vigorous but inconclusive investigation was implemented on the basis of standardized (according the US Centers for Disease Control and Prevention) steps of outbreak investigation. Then, a systemic quality management approach with “fishbone” analysis was added. As a consequence, plausible causes for the outbreak were identified: (i) S marcescens was found on the transesophageal echocardiography probe used during cardiac surgery; and (ii) the quality of the surface disinfection was insufficient due to multiple reasons and was completely reengineered. In conclusion, in addition to the standardized steps of outbreak investigation, the complementary use of quality management tools such as the Ishikawa “fishbone” analysis is helpful for outbreak control. The complete reengineering of the disinfectant procurement and logistics is assumed to have been the most effective measure to control the described outbreak. PMID:26783861

  15. Control selection methods in recent case-control studies conducted as part of infectious disease outbreaks.

    PubMed

    Waldram, Alison; McKerr, Caoimhe; Gobin, Maya; Adak, Goutam; Stuart, James M; Cleary, Paul

    2015-06-01

    Successful investigation of national outbreaks of communicable disease relies on rapid identification of the source. Case-control methodologies are commonly used to achieve this. We assessed control selection methods used in recently published case-control studies for methodological and resource issues to determine if a standard approach could be identified. Neighbourhood controls were the most frequently used method in 53 studies of a range of different sizes, infections and settings. The most commonly used method of data collection was face to face interview. Control selection issues were identified in four areas: method of identification of controls, appropriateness of controls, ease of recruitment of controls, and resource requirements. Potential biases arising from the method of control selection were identified in half of the studies assessed. There is a need to develop new ways of selecting controls in a rapid, random and representative manner to improve the accuracy and timeliness of epidemiological investigations and maximise the effectiveness of public health interventions. Innovative methods such as prior recruitment of controls could improve timeliness and representativeness of control selection. PMID:25762171

  16. Detection and control of a nosocomial outbreak caused by Salmonella Newport at a large animal hospital

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objective – To describe active surveillance, early recognition, and aggressive mitigation efforts that allowed control of an outbreak of nosocomial S. Newport infections in a large referral hospital without closure. Design – Longitudinal outbreak investigation Procedures – An outbreak of S. Newpor...

  17. Prevention and control of meningococcal outbreaks: The emerging role of serogroup B meningococcal vaccines.

    PubMed

    Oviedo-Orta, Ernesto; Ahmed, Sohail; Rappuoli, Rino; Black, Steven

    2015-07-17

    Recently an investigational meningococcal B vaccine has been used in two college outbreaks in the US. This is the first time that a meningococcal B vaccine has been used for outbreak control in the US. However, strain specific vaccines for meningococcal B outbreaks have been developed in Norway, Cuba and to control a large prolonged outbreak in New Zealand. Although meningococcal disease is mostly endemic and baseline rates in the US have fallen over the past decade, outbreaks are not uncommon in the US and globally. In an outbreak, disease risk can rise 1000 fold or more and such outbreaks can last a decade or longer causing significant morbidity and mortality. Here we review the evolution of several serogroup B outbreaks, and, when applicable, the development and impact of meningococcal B vaccines to control these outbreaks. Prior to the availability of "broad spectrum" meningococcal B vaccines, vaccines developed to control meningococcal B outbreaks were strain specific. With the development of two newly licensed meningococcal B vaccines - a four component meningococcal B vaccine (Bexsero, Novartis) and the two component fHBP vaccine (Trumenba, Pfizer) that target a broad array of meningococcal B strains, there is now the potential to prevent outbreaks and as well as to shorten the delay between identification of an outbreak and availability of a vaccine. PMID:26093201

  18. Ebola virus disease outbreak in Nigeria: Transmission dynamics and rapid control.

    PubMed

    Althaus, C L; Low, N; Musa, E O; Shuaib, F; Gsteiger, S

    2015-06-01

    International air travel has already spread Ebola virus disease (EVD) to major cities as part of the unprecedented epidemic that started in Guinea in December 2013. An infected airline passenger arrived in Nigeria on July 20, 2014 and caused an outbreak in Lagos and then Port Harcourt. After a total of 20 reported cases, including 8 deaths, Nigeria was declared EVD free on October 20, 2014. We quantified the impact of early control measures in preventing further spread of EVD in Nigeria and calculated the risk that a single undetected case will cause a new outbreak. We fitted an EVD transmission model to data from the outbreak in Nigeria and estimated the reproduction number of the index case at 9.0 (95% confidence interval [CI]: 5.2-15.6). We also found that the net reproduction number fell below unity 15 days (95% CI: 11-21 days) after the arrival of the index case. Hence, our study illustrates the time window for successful containment of EVD outbreaks caused by infected air travelers. PMID:25979285

  19. Tularemia Outbreak Investigation in Kosovo: Case Control and Environmental Studies

    PubMed Central

    Dedushaj, Isuf; Gjini, Ardiana; Jorgensen, Tine Rikke; Cotter, Benvon; Lieftucht, Alfons; D’Ancona, Fortunato; Dennis, David T.; Kosoy, Michael A.; Mulliqi-Osmani, Gjyle; Grunow, Roland; Kalaveshi, Ariana; Gashi, Luljeta; Humolli, Isme

    2002-01-01

    A large outbreak of tularemia occurred in Kosovo in the early postwar period, 1999-2000. Epidemiologic and environmental investigations were conducted to identify sources of infection, modes of transmission, and household risk factors. Case and control status was verified by enzyme-linked immunosorbent assay, Western blot, and microagglutination assay. A total of 327 serologically confirmed cases of tularemia pharyngitis and cervical lymphadenitis were identified in 21 of 29 Kosovo municipalities. Matched analysis of 46 case households and 76 control households suggested that infection was transmitted through contaminated food or water and that the source of infection was rodents. Environmental circumstances in war-torn Kosovo led to epizootic rodent tularemia and its spread to resettled rural populations living under circumstances of substandard housing, hygiene, and sanitation. PMID:11749751

  20. Tuberculosis outbreak in a housing unit for human immunodeficiency virus-infected patients in a correctional facility: transmission risk factors and effective outbreak control.

    PubMed

    Mohle-Boetani, Janet C; Miguelino, Vanessa; Dewsnup, Daniel H; Desmond, Edward; Horowitz, Evalyn; Waterman, Stephen H; Bick, Joseph

    2002-03-01

    In 1995, an outbreak of tuberculosis (TB) occurred among residents of a correctional-facility housing unit for inmates infected with human immunodeficiency virus (HIV). We isolated and treated patients who were suspected to have TB. To determine risk factors for in-prison transmission of TB, we conducted a case-control study to compare inmate case patients infected with a distinct outbreak strain of TB with control subjects who resided in the HIV unit. We identified 15 case patients during a 4-month period. Among inmates with a CD4 count of <100 cells/mm(3), case patients were more likely than control subjects to spend >/=20 hours per week in a communal day room (odds ratio, 42; P=.002) and were less likely to have a television in their single-person room (odds ratio, 0.10; P=.003). The communal day room was a likely site of transmission. Successful collaboration between the correctional system and public health departments halted the outbreak. PMID:11803502

  1. Large Outbreak Caused by Methicillin Resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital – From Outbreak Control to Outbreak Prevention

    PubMed Central

    Grönthal, Thomas; Moodley, Arshnee; Nykäsenoja, Suvi; Junnila, Jouni; Guardabassi, Luca; Thomson, Katariina; Rantala, Merja

    2014-01-01

    Introduction The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP) ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 – January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. Methods Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. Results Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR = 6.2; CI95% 2.3–17.0, P = 0.0003), antimicrobial treatment (OR = 3.8, CI95% 1.0–13.9, P = 0.0442), cumulative number of days in the intensive care unit (OR = 1.3, CI95% 1.1–1.6, P = 0.0007) or in the surgery ward (OR = 1.1, CI95% 1.0–1.3, P = 0.0401). Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. Conclusion Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring

  2. Pathogen filtration to control plant disease outbreak in greenhouse production

    NASA Astrophysics Data System (ADS)

    Jeon, Sangho; Krasnow, Charles; Bhalsod, Gemini; Granke, Leah; Harlan, Blair; Hausbeck, Mary; Zhang, Wei

    2016-04-01

    Previous research has been extensively focused on understanding the fate and transport of human microbial pathogens in soil and water environments. However, little is known about the transport of plant pathogens, although these pathogens are often found in irrigation waters and could cause severe crop damage and economical loss. Water mold pathogens including Phytophthora spp. and Pythium spp. are infective to a wide range of vegetable and floriculture crops, and they are primarily harbored in soils and disseminated through water flow. It is challenging to control these pathogens because they often quickly develop resistance to many fungicides. Therefore, this multi-scale study aimed to investigate physical removal of plant pathogens from water by filtration, thus reducing the pathogen exposure risks to crops. In column-scale experiments, we studied controlling factors on the transport and retention of Phytophthora capsici zoospores in saturated columns packed with iron oxide coated-sand and uncoated-sand under varying solution chemistry. Biflagellate zoospores were less retained than encysted zoospores, and lower solution pH and greater iron oxide content increased the retention of encysted zoospores. These results provided insights on environmental dispersal of Phytophthora zoospores in natural soils as well as on developing cost-effective engineered filtration systems for pathogen removal. Using small-scale greenhouse filtration systems, we further investigated the performance of varying filter media (i.e., granular sand, iron oxide coated ceramic porous media, and activated carbon) in mitigating disease outbreaks of Phytophthora and Pythium for greenhouse-grown squash and poinsettia, respectively, in comparison with fungicide treatment. For squash, filtration by iron oxide coated media was more effective in reducing the Phytophthora infection, comparing to sand filtration and fungicide application. For poinsettia, sand filtration performed better in controlling

  3. Control of norovirus outbreak on a pediatric oncology unit

    PubMed Central

    Sheahan, Anna; Copeland, Gretchen; Richardson, Lauren; McKay, Shelley; Chou, Alexander; Babady, N. Esther; Tang, Yi-Wei; Boulad, Farid; Eagan, Janet; Sepkowitz, Kent; Kamboj, Mini

    2016-01-01

    Background Patients undergoing treatment for cancer with chemotherapy and hematopoietic stem cell recipients are at risk for severe morbidity caused by norovirus (NV). Methods We describe a NV outbreak on the Memorial Sloan Kettering Cancer Center's pediatric oncology unit. Stool testing for diagnosis of NV was performed by real-time polymerase chain reaction (PCR). Results Twelve NV cases occurred; 7 were hospital acquired. Twenty-five health care workers reported NV compatible illness. Patient-to-patient transmission occurred once. The practices of the Centers for Disease Control and Prevention were supplemented with electronic surveillance, surrogate screening for NV, and heightened cleaning. Two additional cases occurred after implementation of interventions. Long-term shedding was detected in 2 patients. Conclusion We describe interventions for controlling NV on a pediatric oncology unit. High-risk chronic shedders pose ongoing transmission risks. PCR is a valuable diagnostic tool but may be overly sensitive. Surrogate markers to assess NV burden in stool and studies on NV screening are needed to develop guidelines for high-risk chronic shedders. PMID:26164767

  4. Recent worldwide outbreaks of avian influenza and methods for control

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Twenty-five epizootics of high pathogenicity avian influenza (HPAI) have occurred in the world since 1959. The largest of these outbreaks has been the H5N1 HPAI which has caused problems in poultry and other birds in 55 countries of Asia, Europe and Africa since 1996. These viruses have also cause...

  5. Measles: Current Status and Outbreak Control on Campus.

    ERIC Educational Resources Information Center

    Amler, Robert W.; Orenstein, Walter A.

    1984-01-01

    The current effort to eliminate measles in the United States has caused record low levels of the disease. This strategy must continue to be applied in order to break the transmission of measles on college campuses through high immunization levels, promotion of rapid reporting of cases, and quick responses to outbreaks. (Author/DF)

  6. Modeling control of rabies outbreaks in red fox populations to evaluate culling, vaccination, and vaccination combined with fertility control.

    PubMed

    Smith, G C; Wilkinson, D

    2003-04-01

    A predictive model of spread and control of rabies in red fox (Vulpes vulpes) populations was used to evaluate efficacy of culling, oral vaccination, and oral vaccination and fertility control (V + FC) as rabies control strategies. In addition, effects of season, fox population density, and a delay in starting control were modeled. At fox densities of 0.5 fox families/km2 or greater, a single oral vaccination campaign with bait uptake rates of less than 50% resulted in ineffective rabies control. An uptake rate of at least 80% was required to give a better than 80% chance of eliminating rabies. Vaccination was least effective at controlling rabies if applied 1 or 2 mo before the foxes gave birth. Seasonal timing of poison or V + FC had little effect on efficacy, which was always more successful than the oral vaccination alone. The longer the delay between the simulated start of the rabies infection and the application of a single vaccination campaign, the less successful was the control, particularly at the higher fox densities tested. At a fox density of 0.25 families/km2, all the strategies were equally successful at eliminating rabies. At higher fox densities V + FC was slightly less successful than culling, whereas vaccination-only was considerably less successful. The sole use of vaccination is not considered a viable control method for areas with high fox densities. The model suggests that an area of culling centered on the disease focus, plus an outer ring of vaccine or V + FC, could be the best strategy to control a point-source wildlife rabies outbreak. PMID:12910754

  7. Modelling Aedes aegypti mosquito control via transgenic and sterile insect techniques: endemics and emerging outbreaks.

    PubMed

    Seirin Lee, S; Baker, R E; Gaffney, E A; White, S M

    2013-08-21

    The invasion of pest insects often changes or destroys a native ecosystem, and can result in food shortages and disease endemics. Issues such as the environmental effects of chemical control methods, the economic burden of maintaining control strategies and the risk of pest resistance still remain, and mosquito-borne diseases such as malaria and dengue fever prevail in many countries, infecting over 100 million worldwide in 2010. One environmentally friendly method for mosquito control is the Sterile Insect Technique (SIT). This species-specific method of insect control relies on the mass rearing, sterilization and release of large numbers of sterile insects. An alternative transgenic method is the Release of Insects carrying a Dominant Lethal (RIDL). Our objective is to consider contrasting control strategies for two invasive scenarios via SIT and RIDL: an endemic case and an emerging outbreak. We investigate how the release rate and size of release region influence both the potential for control success and the resources needed to achieve it, under a range of conditions and control strategies, and we discuss advantageous strategies with respect to reducing the release resources and strategy costs (in terms of control mosquito numbers) required to achieve complete eradication of wild-type mosquitoes. PMID:23608633

  8. The Spread and Control of Norovirus Outbreaks Among Hospitals in a Region: A Simulation Model

    PubMed Central

    Bartsch, Sarah M.; Huang, Susan S.; Wong, Kim F.; Avery, Taliser R.; Lee, Bruce Y.

    2014-01-01

    Background  Because hospitals in a region are connected via patient sharing, a norovirus outbreak in one hospital may spread to others. Methods.  We utilized our Regional Healthcare Ecosystem Analyst software to generate an agent-based model of all the acute care facilities in Orange County (OC), California and simulated various norovirus outbreaks in different locations, both with and without contact precautions. Results.  At the lower end of norovirus reproductive rate (R0) estimates (1.64), an outbreak tended to remain confined to the originating hospital (≤6.1% probability of spread). However, at the higher end of R0 (3.74), an outbreak spread 4.1%–17.5% of the time to almost all other OC hospitals within 30 days, regardless of the originating hospital. Implementing contact precautions for all symptomatic cases reduced the probability of spread to other hospitals within 30 days and the total number of cases countywide, but not the number of other hospitals seeing norovirus cases. Conclusions.  A single norovirus outbreak can continue to percolate throughout a system of different hospitals for several months and appear as a series of unrelated outbreaks, highlighting the need for hospitals within a region to more aggressively and cooperatively track and control an initial outbreak. PMID:25734110

  9. Program control for mission success

    NASA Technical Reports Server (NTRS)

    Longanecker, G. W.

    1994-01-01

    This article suggests that in order to be able to exercise control over a particular program, the program itself must be controllable. A controllable program therefore, according to the author, is one that has been properly scoped technically, realistically scheduled, and adequately budgeted. The article delves indepth into each of the above aspects of a controllable program and discusses both the pros and cons of each.

  10. Ebola hemorrhagic fever outbreaks: strategies for effective epidemic management, containment and control.

    PubMed

    Matua, Gerald Amandu; Van der Wal, Dirk Mostert; Locsin, Rozzano C

    2015-01-01

    Ebola hemorrhagic fever, caused by the highly virulent RNA virus of the filoviridae family, has become one of the world's most feared pathogens. The virus induces acute fever and death, often associated with hemorrhagic symptoms in up to 90% of infected patients. The known sub-types of the virus are Zaire, Sudan, Taï Forest, Bundibugyo and Reston Ebola viruses. In the past, outbreaks were limited to the East and Central African tropical belt with the exception of Ebola Reston outbreaks that occurred in animal facilities in the Philippines, USA and Italy. The on-going outbreak in West Africa that is causing numerous deaths and severe socio-economic challenges has resulted in widespread anxiety globally. This panic may be attributed to the intense media interest, the rapid spread of the virus to other countries like United States and Spain, and moreover, to the absence of an approved treatment or vaccine. Informed by this widespread fear and anxiety, we analyzed the commonly used strategies to manage and control Ebola outbreaks and proposed new approaches that could improve epidemic management and control during future outbreaks. We based our recommendations on epidemic management practices employed during recent outbreaks in East, Central and West Africa, and synthesis of peer-reviewed publications as well as published "field" information from individuals and organizations recently involved in the management of Ebola epidemics. The current epidemic management approaches are largely "reactive", with containment efforts aimed at halting spread of existing outbreaks. We recommend that for better outcomes, in addition to "reactive" interventions, "pre-emptive" strategies also need to be instituted. We conclude that emphasizing both "reactive" and "pre-emptive" strategies is more likely to lead to better epidemic preparedness and response at individual, community, institutional, and government levels, resulting in timely containment of future Ebola outbreaks. PMID

  11. A cholera outbreak in Alborz Province, Iran: a matched case-control study

    PubMed Central

    2016-01-01

    OBJECTIVES: A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks. METHODS: An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs) using the logistic regression method. RESULTS: In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41), consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89), and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72). CONCLUSIONS: Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks. PMID:27188308

  12. Control of a Non-foodborne Outbreak of Salmonellosis: Day Care in Isolation.

    ERIC Educational Resources Information Center

    Chorba, Terence, L.; And Others

    1987-01-01

    In this study of a salmonellosis outbreak at a day care center an analysis of five variables revealed that the disease was transferred person to person or by a continuing common source. Successful preventive measures included instruction in proper handwashing and diaper changing procedures and isolation of the infected children. (VM)

  13. Control of a non-foodborne outbreak of salmonellosis: day care in isolation.

    PubMed Central

    Chorba, T L; Meriwether, R A; Jenkins, B R; Gunn, R A; MacCormack, J N

    1987-01-01

    We report an outbreak of Salmonella typhimurium in the infant room of a day care center. Time between onset dates, clustering of cases in the room, lack of a common food exposure, lack of illness among other children and staff, and lack of community-wide infection suggested person-to-person or continuing-common-source transmission. Successful preventive measures included instruction of personnel in proper handwashing and diaper-changing procedures and cohorting of infected and non-infected children. This is the second description of a non-foodborne outbreak of salmonellosis in a day care center, and the first involving S. typhimurium. PMID:3300382

  14. Importance of Multifaceted Approaches in Infection Control: A Practical Experience from an Outbreak Investigation

    PubMed Central

    Petráš, Petr; Melter, Oto; Kapounová, Gabriela; Vopalková, Petra; Kubele, Jan; Vaniš, Václav; Tkadlec, Jan; Bukáčková, Eva; Machová, Ivana; Jindrák, Vlastimil

    2016-01-01

    Background This study presents the results of a multidisciplinary, nosocomial MRSA outbreak investigation in an 8-bed medical intensive care unit (ICU). The identification of seven MRSA positive patients in the beginning of 2014 led to the closure of the ward for several weeks. A multidisciplinary, retrospective investigation was initiated in order to identify the reason and the source for the outbreak, describe MRSA transmission in the department and identify limitations in infection control. Methods The investigation comprised an epidemiological description of MRSA cases from 2012 to 2014 and a characterization of MRSA isolates, including phage-, spa- and PFGE-typing. Additionally, MRSA screening was performed from the hospital staff and the environment. To identify the reason for the outbreak, work-related, psychological and behavioral factors were investigated by impartial audits and staff interviews. Results Thirty-one MRSA cases were registered during the study period, and 36 isolates were investigated. Molecular typing determined the outbreak strain (phage type 54/812, PFGE type A4, spa type t003) and identified the probable index case. Nasal carriage in one employee and a high environmental contamination with the outbreak strain was documented. Important gaps in nursing procedures and general management were identified. Elevated stress levels and communication problems preceded the outbreak. Compliance with hand hygiene and isolation procedures was evaluated as appropriate. Conclusion This study demonstrates the complexity of controlling hospital-associated infections. The combined use of different typing methods is beneficial for outbreak investigations. Psychological, behavioral and other work-related factors have an important impact on the spread of nosocomial pathogens. These factors should be addressed and integrated in routine infection control practice. PMID:27322433

  15. On the role of successive downstream development in East Asian polar air outbreaks

    NASA Technical Reports Server (NTRS)

    Jung, C. H.; Hitchman, M. H.

    1982-01-01

    Common features were drawn from 16 events of wintertime migration of cold Siberian air moving southeastward across the east Asia coast, accompanied by strong northerly winds. Criteria for including an event as an instance of a typical synoptic scale occurrence comprised a surface pressure gradient over Korea exceeding 2.5 mb/100 km, and a drop in the daily mean temperature of over 5 C in one day. The events were required to have at least a 10 day separation. A sequence of events was discerned, including the formation of troughs and ridges over the western north Atlantic 6-7 days before an event, their development and decay downstream from one another across the Eurasian continent, and then an outbreak of polar weather. The troughs and ridges displayed maximum amplitude in the same places in the majority of cases studied, with the center moving along a curved trajectory of the 300 mb flow at nearly 30 deg longitudinally every day.

  16. Successful combat of an outbreak due to Clostridium difficile PCR ribotype 027 and recognition of specific risk factors.

    PubMed

    Debast, S B; Vaessen, N; Choudry, A; Wiegers-Ligtvoet, E A J; van den Berg, R J; Kuijper, E J

    2009-05-01

    In the period April-September 2005, an outbreak of Clostridium difficile infection (CDI) due to PCR ribotype 027 occurred among 50 patients in a 341-bed community hospital in Harderwijk, The Netherlands. A retrospective case-control study was performed to identify risk factors specific for CDI, using a group of patients with CDI (n = 45), a group of randomly selected control patients without diarrhoea (n = 90), and a group of patients with non-infectious diarrhoea (n = 109). Risk factors for CDI and for non-CDI diarrhoea were identified using multiple logistic regression analysis. Independent risk factors for CDI were: age above 65 years (OR 2.6; 95% CI 1.0-5.7), duration of hospitalization (OR 1.04 per additional day; 95% CI 1.0-1.1), and antibiotic use (OR 12.5; 95% CI 3.2-48.1). Of the antibiotics used, cephalosporins and fluoroquinolones were identified as the major risk factors for development of CDI. The risk of developing CDI was particularly high in people receiving a combination of a cephalosporin and a fluoroquinolone (OR 57.5; 95% CI 6.8-483.6). The main factors affecting the risk of non-CDI diarrhoea were proton-pump inhibitors, immunosuppressive drugs, underlying digestive system disease, previous surgery, and gastric tube feeding. The outbreak ended only after implementation of restricted use of cephalosporins and a complete ban on fluoroquinolones, in addition to general hygienic measures, cohorting of patients in a separate ward, education of staff, and intensified environmental cleaning. The results of this study support the importance of appropriate antimicrobial stewardship in the control of hospital outbreaks with C. difficile PCR ribotype 027. PMID:19416295

  17. Community Involvement in Dengue Outbreak Control: An Integrated Rigorous Intervention Strategy

    PubMed Central

    Lin, Hualiang; Liu, Tao; Song, Tie; Lin, Lifeng; Xiao, Jianpeng; Lin, Jinyan; He, Jianfeng; Zhong, Haojie; Hu, Wenbiao; Deng, Aiping; Peng, Zhiqiang; Ma, Wenjun; Zhang, Yonghui

    2016-01-01

    Background An explosive outbreak of dengue fever occurred in Guangdong Province, China in 2014. A community-based integrated intervention was applied to control this outbreak in the capital city Guangzhou, where dengue epidemic was mainly caused by imported cases. Methodology/Principal Findings We used a time series generalized additive model based on meteorological factors to assess the effectiveness of this intervention. The results showed that there was significant reduction in mosquito density following the intervention, and there was a 70.47% (95% confidence interval: 66.07%, 74.88%) reduction in the reported dengue cases compared with the predicted cases after 12 days since the beginning of the intervention, we estimated that a total of 23,302 dengue cases were prevented. Conclusions This study suggests that an integrated dengue intervention program has significant effects to control a dengue outbreak in areas where dengue epidemic was mainly caused by imported dengue cases. PMID:27548481

  18. The role of movement restrictions and pre-emptive destruction in the emergency control strategy against CSF outbreaks in domestic pigs.

    PubMed

    Thulke, Hans-Hermann; Eisinger, Dirk; Beer, Martin

    2011-04-01

    Classical swine fever (CSF) outbreaks in domestic pig herds lead to the implementation of standard control measures according to legislative regulations. Ideal outbreak control entails the swift and efficient culling of all pigs on premises detected positive for CSF virus. Often all pig holdings around the detected cases are pre-emptively destroyed to exclude transmission into the neighbourhood. In addition to these measures, zones are defined in which surveillance and protection measures are intensified to prevent further distant disease spread. In particular, all movements are prohibited within standstill areas. Standstill also excludes the transport of fattened pigs to slaughter. Historical outbreaks provide evidence of the success of this control strategy. However, the extent to which the individual strategy elements contribute to this success is unknown. Therefore, we applied a spatially and temporally explicit epidemic model to the problem. Its rule-based formulation is tailored to a one-by-one model implementation of existing control concepts. Using a comparative model analysis the individual contributions of single measures to overall control success were revealed. From the results of the model we concluded that movement restrictions had the dominant impact on strategy performance suggesting a reversal of the current conceptual thinking. Additional measures such as pre-emptive culling only became relevant under imperfect compliance with movement restrictions. The importance of movement restrictions for the overall control success illustrates the need for explicit consideration of this measure when contingency strategies are being amended (e.g. emergency vaccination) and associated risks assessed. PMID:21300412

  19. Epidemiological and clinical analysis of hepatitis virus A infections during three successive outbreaks in Sfax (Tunisia) between 2007 and 2010.

    PubMed

    Gargouri, S; Fki Berrajah, L; Ayadi, I; Messedi, E; Jallouli, H; Hammami, A; Karray-Hakim, H

    2016-05-01

    to describe the epidemiological and clinical characteristics of HAV infection during three successive outbreaks occurring between 2007 and 2010 in the governorate of Sfax. epidemiological and clinical characteristics were retrospectively analyzed from the outbreak investigations. The diagnosis of acute hepatitis A was confirmed by ELISA detection of immunoglobulin M serum antibodies to HAV. 443 patients were identified and 159 of them investigated. Their mean age was 12.2 years and the M/F ratio was 0.9. The most affected age groups were 6-10 years (35%) and 11-15 years (33%). The most likely sources of contamination were drinking water from wells or tanks and direct transmission. The most frequent symptoms included asthenia, digestive disorders, and jaundice. Two cases of fulminant hepatitis were reported, one lethal. our results show that HAV endemicity in the governorate of Sfax has dropped from high to intermediate as demonstrated by the increasing age at primary HAV infection. Strengthening health education and improving access to drinking water would reduce the transmission risk of HAV in our regions. PMID:27412977

  20. Outbreaks of H5N1 in poultry in Thailand: the relative role of poultry production types in sustaining transmission and the impact of active surveillance in control

    PubMed Central

    Walker, Patrick; Cauchemez, Simon; Hartemink, Nienke; Tiensin, Thanawat; Ghani, Azra C.

    2012-01-01

    H5N1, highly pathogenic avian influenza, continues to pose a public health risk in the countries of southeast Asia where it has become endemic. However, in Thailand, which experienced two of the largest recorded epidemics in 2004–2005, the disease has been successfully reduced to very low levels. We fitted a spatio-temporal model of the spread of infection to outbreak data collected during the second wave of outbreaks to assess the extent to which different poultry types were responsible for propagating infection. Our estimates suggest that the wave of outbreaks would not have been possible without the contribution of backyard flocks to the susceptibility of a sub-district. However, we also estimated that outbreaks involving commercial poultry, a much larger sector in Thailand than in neighbouring countries, were disproportionately infectious, a factor which was also crucial in sustaining the wave. As a result, implemented measures that aim to reduce the role of commercial farms in the spread of infection, such as the drive to bring aspects of the supply chain ‘in house’, may help to explain the subsequent success in controlling H5N1 in Thailand. We also found that periods of active surveillance substantially improved the rate of outbreak detection. PMID:22356818

  1. Outbreaks of H5N1 in poultry in Thailand: the relative role of poultry production types in sustaining transmission and the impact of active surveillance in control.

    PubMed

    Walker, Patrick; Cauchemez, Simon; Hartemink, Nienke; Tiensin, Thanawat; Ghani, Azra C

    2012-08-01

    H5N1, highly pathogenic avian influenza, continues to pose a public health risk in the countries of southeast Asia where it has become endemic. However, in Thailand, which experienced two of the largest recorded epidemics in 2004-2005, the disease has been successfully reduced to very low levels. We fitted a spatio-temporal model of the spread of infection to outbreak data collected during the second wave of outbreaks to assess the extent to which different poultry types were responsible for propagating infection. Our estimates suggest that the wave of outbreaks would not have been possible without the contribution of backyard flocks to the susceptibility of a sub-district. However, we also estimated that outbreaks involving commercial poultry, a much larger sector in Thailand than in neighbouring countries, were disproportionately infectious, a factor which was also crucial in sustaining the wave. As a result, implemented measures that aim to reduce the role of commercial farms in the spread of infection, such as the drive to bring aspects of the supply chain 'in house', may help to explain the subsequent success in controlling H5N1 in Thailand. We also found that periods of active surveillance substantially improved the rate of outbreak detection. PMID:22356818

  2. Genetic Similarity of Island Populations of Tent Caterpillars during Successive Outbreaks

    PubMed Central

    Franklin, Michelle T.; Myers, Judith H.; Cory, Jenny S.

    2014-01-01

    Cyclic or fluctuating populations experience regular periods of low population density. Genetic bottlenecks during these periods could give rise to temporal or spatial genetic differentiation of populations. High levels of movement among increasing populations, however, could ameliorate any differences and could also synchronize the dynamics of geographically separated populations. We use microsatellite markers to investigate the genetic differentiation of four island and one mainland population of western tent caterpillars, Malacosoma californicum pluviale, in two periods of peak or pre-peak density separated by 8 years. Populations showed high levels of genetic variation and little genetic differentiation either temporally between peaks or spatially among sites. Mitochondrial haplotypes were also shared between one island population and one mainland population in the two years studied. An isolation-by-distance analysis showed the FST values of the two geographically closest populations to have the highest level of differentiation in both years. We conclude that high levels of dispersal among populations maintain both synchrony of population dynamics and override potential genetic differentiation that might occur during population troughs. As far we are aware, this is the first time that genetic similarity between temporally separated population outbreaks in insects has been investigated. A review of genetic data for both vertebrate and invertebrate species of cyclic animals shows that a lack of spatial genetic differentiation is typical, and may result from high levels of dispersal associated with fluctuating dynamics. PMID:24858905

  3. Estimates of Outbreak Risk from New Introductions of Ebola with Immediate and Delayed Transmission Control

    PubMed Central

    Gundlapalli, Adi V.; Khader, Karim; Pettey, Warren B.P.; Rubin, Michael A.; Adler, Frederick R.; Samore, Matthew H.

    2015-01-01

    While the ongoing Ebola outbreak continues in the West Africa countries of Guinea, Sierra Leone, and Liberia, health officials elsewhere prepare for new introductions of Ebola from infected evacuees or travelers. We analyzed transmission data from patients (i.e., evacuees, international travelers, and those with locally acquired illness) in countries other than the 3 with continuing Ebola epidemics and quantitatively assessed the outbreak risk from new introductions by using different assumptions for transmission control (i.e., immediate and delayed). Results showed that, even in countries that can quickly limit expected number of transmissions per case to <1, the probability that a single introduction will lead to a substantial number of transmissions is not negligible, particularly if transmission variability is high. Identifying incoming infected travelers before symptom onset can decrease worst-case outbreak sizes more than reducing transmissions from patients with locally acquired cases, but performing both actions can have a synergistic effect. PMID:26196264

  4. A Review of Gastrointestinal Outbreaks in Schools: Effective Infection Control Interventions

    ERIC Educational Resources Information Center

    Lee, Marilyn B.; Greig, Judy D.

    2010-01-01

    Background: The purpose of this study was to review documented outbreaks of gastrointestinal illness in schools, published in the last 10 years, to identify etiology, mode of transmission, the number of children affected, morbidity and mortality patterns, and interventions for control and prevention. Methods: Searches of electronic databases,…

  5. Outbreak of Salmonella Enteritidis phage type 13a: case-control investigation in Hertsmere, United Kingdom.

    PubMed

    Morgan, O; Milne, L; Kumar, S; Murray, D; Man, W; Georgiou, M; Verlander, N Q; de Pinna, E; McEvoy, M

    2007-07-01

    Cases of illness were reported to Hertsmere Borough Council among attendees of a children's charity event in June 2006. Initial laboratory investigation identified Salmonella Enteritidis PT13a as a possible cause of the outbreak. We carried out an unmatched case-control investigation. The population at risk included all individuals who attended the event. Self-completion questionnaires were sent to 53 presumptive cases and 212 randomly selected potential controls. Information was available for 49 cases and 128 controls (overall response rate=75%). We calculated odds ratios from single and multivariable analysis and tested for all two-way interactions. Risk factors for diarrhoea were eating egg mayonnaise bagels (OR=34.1, 95%CI 10.5 - 111.3) and drinking apple juice (OR=16.1, 95% CI 3.5 - 74.2). There was weak statistical evidence to suggest that the risk of diarrhoea after eating egg mayonnaise bagels was greater in the afternoon. No food samples were available to confirm which food item might have caused this outbreak. Eggs from Spain were used by the caterer. The ecology of salmonella, experience from previous outbreaks and epidemiological findings from this case-control investigation suggest that the most likely cause of the outbreak was contaminated eggs. PMID:17991411

  6. Factors associated with larval control practices in a dengue outbreak prone area.

    PubMed

    Mohamad, Mariam; Selamat, Mohamad Ikhsan; Ismail, Zaliha

    2014-01-01

    In order to reduce the risk of dengue outbreak recurrence in a dengue outbreak prone area, the members of the community need to sustain certain behavior to prevent mosquito from breeding. Our study aims to identify the factors associated with larval control practices in this particular community. A cross-sectional study involves 322 respondents living in a dengue outbreak prone area who were interviewed using a pretested questionnaire. The level of knowledge about Aedes mosquitoes, dengue transmission, its symptoms, and personal preventive measures ranges from fair to good. The level of attitude towards preventive measures was high. However, reported level of personal larval control practices was low (33.2%). Our multiple logistic regression analysis showed that only those with a good level of attitude towards personal preventive measure and frequent attendance to health campaigns were significantly associated with the good larval control practices. We conclude that, in a dengue outbreak prone area, having a good attitude towards preventive measures and frequent participation in health campaigns are important factors to sustain practices on larval control. PMID:25309602

  7. Measles outbreak in Greater Manchester, England, October 2012 to September 2013: epidemiology and control.

    PubMed

    Pegorie, M; Shankar, K; Welfare, W S; Wilson, R W; Khiroya, C; Munslow, G; Fiefield, D; Bothra, V; McCann, R

    2014-01-01

    This paper describes the epidemiology and management of a prolonged outbreak of measles across the 2.7 million conurbation of Greater Manchester in the United Kingdom. Over a period of one year (from October 2012 to September 2013), over a thousand suspected measles cases (n = 1,073) were notified across Greater Manchester; of these, 395 (37%) were laboratory-confirmed, 91 (8%) were classed as probable, 312 (29%) were classed as possible and 275 (26%) excluded. Most confirmed and probable cases occurred in children within two age groups—infants (too young to be eligible for measles-mumps-rubella (MMR) vaccination according to the national immunisation programme) and children aged 10-19 years (low vaccine uptake in this cohort because of unfounded alleged links between the MMR vaccine and autism). During this one year period, there were a series of local outbreaks and many of these occurred within the secondary school setting. A series of public health measures were taken to control this prolonged outbreak: setting up incident management teams to control local outbreaks, a concerted immunisation catch-up campaign (initially local then national) to reduce the pool of children partially or totally unprotected against measles, and the exclusion of close contacts from nurseries and school settings for a period of 10 days following the last exposure to a case of measles. PMID:25523970

  8. Fire Severity Controlled Susceptibility to a 1940s Spruce Beetle Outbreak in Colorado, USA

    PubMed Central

    Kulakowski, Dominik; Veblen, Thomas T.; Bebi, Peter

    2016-01-01

    killed in the 1940s outbreak. No young post-fire trees (< ca. 128 years) were susceptible to the 1940s outbreak, implying that under the relatively cool and wet conditions of the mid-20th century, susceptibility to and spatial patterns of spruce beetle outbreak were most likely controlled by variations in severity of prior disturbance by fire. This study provides a baseline for comparing linked disturbances under the relatively warmer and drier conditions of recent (e.g. post-1990) outbreaks in order to assess how climate mitigates the degree to which pre-disturbance history and structure affect susceptibility to disturbances. PMID:27438289

  9. Fire Severity Controlled Susceptibility to a 1940s Spruce Beetle Outbreak in Colorado, USA.

    PubMed

    Kulakowski, Dominik; Veblen, Thomas T; Bebi, Peter

    2016-01-01

    killed in the 1940s outbreak. No young post-fire trees (< ca. 128 years) were susceptible to the 1940s outbreak, implying that under the relatively cool and wet conditions of the mid-20th century, susceptibility to and spatial patterns of spruce beetle outbreak were most likely controlled by variations in severity of prior disturbance by fire. This study provides a baseline for comparing linked disturbances under the relatively warmer and drier conditions of recent (e.g. post-1990) outbreaks in order to assess how climate mitigates the degree to which pre-disturbance history and structure affect susceptibility to disturbances. PMID:27438289

  10. Evaluation of outbreak response immunization in the control of pertussis using agent-based modeling

    PubMed Central

    Qian, Weicheng; Osgood, Nathaniel D.

    2016-01-01

    Background Pertussis control remains a challenge due to recently observed effects of waning immunity to acellular vaccine and suboptimal vaccine coverage. Multiple outbreaks have been reported in different ages worldwide. For certain outbreaks, public health authorities can launch an outbreak response immunization (ORI) campaign to control pertussis spread. We investigated effects of an outbreak response immunization targeting young adolescents in averting pertussis cases. Methods We developed an agent-based model for pertussis transmission representing disease mechanism, waning immunity, vaccination schedule and pathogen transmission in a spatially-explicit 500,000-person contact network representing a typical Canadian Public Health district. Parameters were derived from literature and calibration. We used published cumulative incidence and dose-specific vaccine coverage to calibrate the model’s epidemiological curves. We endogenized outbreak response by defining thresholds to trigger simulated immunization campaigns in the 10–14 age group offering 80% coverage. We ran paired simulations with and without outbreak response immunization and included those resulting in a single ORI within a 10-year span. We calculated the number of cases averted attributable to outbreak immunization campaign in all ages, in the 10–14 age group and in infants. The count of cases averted were tested using Mann–Whitney U test to determine statistical significance. Numbers needed to vaccinate during immunization campaign to prevent a single case in respective age groups were derived from the model. We varied adult vaccine coverage, waning immunity parameters, immunization campaign eligibility and tested stronger vaccination boosting effect in sensitivity analyses. Results 189 qualified paired-runs were analyzed. On average, ORI was triggered every 26 years. On a per-run basis, there were an average of 124, 243 and 429 pertussis cases averted across all age groups within 1, 3 and

  11. Outbreak of sarcoptic mange in alpacas (Vicugna pacos) and control with repeated subcutaneous ivermectin injections.

    PubMed

    Twomey, D F; Birch, E S; Schock, A

    2009-02-01

    An outbreak of sarcoptic mange was investigated in an alpaca herd. Clinical disease occurred 2 months after the introduction of four alpacas with dry seborrhoeic skin lesions, the cause of which was not investigated. Initially a group of females was affected, despite repeated topical treatment with ivermectin at a dose of 0.5mg/kg bodyweight. One female died and post-mortem examination indicated sarcoptic mange as the cause of death. Infection with Sarcoptes scabiei was also demonstrated on microscopic examination of skin scrapes taken from clinically affected cohorts. Later in the outbreak, a separate group of male alpacas was also affected. Treatment using subcutaneous ivermectin injections at a dose of 0.2mg/kg, administered at 14-day intervals, was evaluated. During this course of treatment, another female died. A successful response in the other alpacas was eventually reached following 12 treatments of the female group and 8 treatments of the male group. PMID:19019545

  12. One Health approach to controlling a Q fever outbreak on an Australian goat farm.

    PubMed

    Bond, K A; Vincent, G; Wilks, C R; Franklin, L; Sutton, B; Stenos, J; Cowan, R; Lim, K; Athan, E; Harris, O; Macfarlane-Berry, L; Segal, Y; Firestone, S M

    2016-04-01

    A recent outbreak of Q fever was linked to an intensive goat and sheep dairy farm in Victoria, Australia, 2012-2014. Seventeen employees and one family member were confirmed with Q fever over a 28-month period, including two culture-positive cases. The outbreak investigation and management involved a One Health approach with representation from human, animal, environmental and public health. Seroprevalence in non-pregnant milking goats was 15% [95% confidence interval (CI) 7-27]; active infection was confirmed by positive quantitative PCR on several animal specimens. Genotyping of Coxiella burnetii DNA obtained from goat and human specimens was identical by two typing methods. A number of farming practices probably contributed to the outbreak, with similar precipitating factors to the Netherlands outbreak, 2007-2012. Compared to workers in a high-efficiency particulate arrestance (HEPA) filtered factory, administrative staff in an unfiltered adjoining office and those regularly handling goats and kids had 5·49 (95% CI 1·29-23·4) and 5·65 (95% CI 1·09-29·3) times the risk of infection, respectively; suggesting factory workers were protected from windborne spread of organisms. Reduction in the incidence of human cases was achieved through an intensive human vaccination programme plus environmental and biosecurity interventions. Subsequent non-occupational acquisition of Q fever in the spouse of an employee, indicates that infection remains endemic in the goat herd, and remains a challenge to manage without source control. PMID:26493615

  13. Successfully controlling malaria in South Africa.

    PubMed

    Blumberg, L; Frean, J; Moonasar, D

    2014-03-01

    Following major successes in malaria control over the past 75 years, South Africa is now embarking on a malaria elimination campaign with the goal of zero local transmission by the year 2018. The key control elements have been intensive vector control, primarily through indoor residual spraying, case management based on parasitological diagnosis using evidence-based drug policies with artemisinin-based combination therapy since 2001, active health promotion in partnership with communities living in the malaria transmission areas, and cross-border collaborations. Political commitment and long-term funding for the malaria control programme have been a critical component of the programme's success. Breaking the cycle of transmission through strengthening of active surveillance using sensitive molecular tests and field treatment of asymptomatic persons, monitoring for antimalarial drug resistance and insecticide resistance, strengthening cross-border initiatives, and ongoing programme advocacy in the face of a significant decrease in disease burden are key priorities for achieving the elimination goal. PMID:24893497

  14. Health care-associated infection outbreak investigations by the Centers for Disease Control and Prevention, 1946-2005.

    PubMed

    Archibald, Lennox K; Jarvis, William R

    2011-12-01

    Since 1946, Centers for Disease Control and Prevention (CDC) personnel have investigated outbreaks of infections and adverse events associated with delivery of health care. CDC Epidemic Intelligence Service officers have led onsite investigations of these outbreaks by systematically applying epidemiology, statistics, and laboratory science. During 1946-2005, CDC Epidemic Intelligence Service officers conducted 531 outbreak investigations in facilities across the United States and abroad. Initially, the majority of outbreaks involved gastrointestinal tract infections; however, in later years, bloodstream, respiratory tract, and surgical wound infections predominated. Among pathogens implicated in CDC outbreak investigations, Staphylococcus aureus, Enterococcus species, Enterobacteriaceae, nonfermentative Gram-negative bacteria, or yeasts predominated, but unusual organisms (e.g., the atypical mycobacteria) were often included. Outbreak types varied and often were linked to transfer of colonized patients or health care personnel between facilities (multihospital outbreaks), national distribution of contaminated products, use of invasive medical devices, or variances in practices and procedures in health care environments (e.g., intensive care units, water reservoirs, or hemodialysis units). Through partnerships with health care facilities and local and state health departments, outbreaks were terminated and lives saved. Data from investigations invariably contributed to CDC-generated guidelines for prevention and control of health care-associated infections. PMID:22135394

  15. Diagnosis and Control of a LPAI H5N8 Outbreak in a Japanese Quail (Coturnix coturnix japonica) Commercial Flock in the Central Valley of California.

    PubMed

    Carnaccini, Silvia; Crossley, Beate; Breitmeyer, Richard; Charlton, Bruce R; Bland, Mark; Fowler, Kent; De La Torre, Felicia; Torchetti, Mia Kim; Wong, Sook-San; Wilson, Dennis; Jones, Annette; Sentíes-Cué, C Gabriel

    2015-06-01

    In April 2014 an outbreak of low pathogenic avian influenza H5N8 North American genetic lineage was diagnosed in a commercial quail operation in Stanislaus County, California. Sudden increase in mortality prompted the submission of 20 Japanese quail hens (Coturnix c. japonica) to the California Animal Health and Food Safety Laboratory, Turlock Branch. Oropharyngeal and cloacal swabs tested positive for influenza A virus H5N8 by real-time reverse transcription-polymerase chain reaction. The virus was subsequently isolated. In vivo assay and sequencing of the hemagglutinin protein cleavage site classified the virus as a North American genetic lineage of low pathogenicity for chickens. Following the diagnosis, a rapid and coordinated response took place to contain the outbreak. The affected premise was depopulated, cleaned, and disinfected. Three areas from the affected premises-a 3 kilometer (km) radius (High Risk Zone), a 3-10 km area (Buffer Zone), and a 10-20 km (Surveillance Zone)-were established for avian influenza testing of commercial and noncommercial poultry operations. Surveillance testing and rapid control measures were successful in the control and eradication of the outbreak and revealed no area of spread of the virus from the index flock. This report describes the history, diagnosis, surveillance, and control measures applied to manage this outbreak. PMID:26473689

  16. Successes and Challenges for Flow Control Simulations

    NASA Technical Reports Server (NTRS)

    Rumsey, Christopher L.

    2008-01-01

    A survey is made of recent computations published for synthetic jet flow control cases from a CFD workshop held in 2004. The three workshop cases were originally chosen to represent different aspects of flow control physics: nominally 2-D synthetic jet into quiescent air, 3-D circular synthetic jet into turbulent boundary-layer crossflow, and nominally 2-D flow-control (both steady suction and oscillatory zero-net-mass-flow) for separation control on a simple wall-mounted aerodynamic hump shape. The purpose of this survey is to summarize the progress as related to these workshop cases, particularly noting successes and remaining challenges for computational methods. It is hoped that this summary will also by extension serve as an overview of the state-of-the-art of CFD for these types of flow-controlled flow fields in general.

  17. Successes and Challenges for Flow Control Simulations

    NASA Technical Reports Server (NTRS)

    Rumsey, Christopher L.

    2008-01-01

    A survey is made of recent computations published for synthetic jet flow control cases from a CFD workshop held in 2004. The three workshop cases were originally chosen to represent different aspects of flow control physics: nominally 2-D synthetic jet into quiescent air, 3-D circular synthetic jet into turbulent boundarylayer crossflow, and nominally 2-D flow-control (both steady suction and oscillatory zero-net-mass-flow) for separation control on a simple wall-mounted aerodynamic hump shape. The purpose of this survey is to summarize the progress as related to these workshop cases, particularly noting successes and remaining challenges for computational methods. It is hoped that this summary will also by extension serve as an overview of the state-of-the-art of CFD for these types of flow-controlled flow fields in general.

  18. Hospital outbreak control requires joint efforts from hospital management, microbiology and infection control.

    PubMed

    Ransjö, U; Lytsy, B; Melhus, A; Aspevall, O; Artinger, C; Eriksson, B-M; Günther, G; Hambraeus, A

    2010-09-01

    An outbreak of multidrug-resistant Klebsiella pneumoniae producing the extended-spectrum beta-lactamase CTX-M15 affected 247 mainly elderly patients in more than 30 wards in a 1000-bedded swedish teaching hospital between May 2005 and August 2007. A manual search of the hospital administrative records for possible contacts between cases in wards and outpatient settings revealed a complex chain of transmission. Faecal screening identified twice as many cases as cultures from clinical samples. Transmission occurred by direct and indirect patient-to-patient contact, facilitated by patient overcrowding. Interventions included formation of a steering group with economic power, increased bed numbers, better compliance with alcohol hand disinfection and hospital dress code, better hand hygiene for patients and improved cleaning. The cost of the interventions was estimated to be euro3 million. Special infection control policies were not necessary, but resources were needed to make existing policies possible to follow, and for educational efforts to improve compliance. PMID:20359768

  19. Strategies for Controlling Non-Transmissible Infection Outbreaks Using a Large Human Movement Data Set

    PubMed Central

    Hancock, Penelope A.; Rehman, Yasmin; Hall, Ian M.; Edeghere, Obaghe; Danon, Leon; House, Thomas A.; Keeling, Matthew J.

    2014-01-01

    Prediction and control of the spread of infectious disease in human populations benefits greatly from our growing capacity to quantify human movement behavior. Here we develop a mathematical model for non-transmissible infections contracted from a localized environmental source, informed by a detailed description of movement patterns of the population of Great Britain. The model is applied to outbreaks of Legionnaires' disease, a potentially life-threatening form of pneumonia caused by the bacteria Legionella pneumophilia. We use case-report data from three recent outbreaks that have occurred in Great Britain where the source has already been identified by public health agencies. We first demonstrate that the amount of individual-level heterogeneity incorporated in the movement data greatly influences our ability to predict the source location. The most accurate predictions were obtained using reported travel histories to describe movements of infected individuals, but using detailed simulation models to estimate movement patterns offers an effective fast alternative. Secondly, once the source is identified, we show that our model can be used to accurately determine the population likely to have been exposed to the pathogen, and hence predict the residential locations of infected individuals. The results give rise to an effective control strategy that can be implemented rapidly in response to an outbreak. PMID:25211122

  20. Strategies for controlling non-transmissible infection outbreaks using a large human movement data set.

    PubMed

    Hancock, Penelope A; Rehman, Yasmin; Hall, Ian M; Edeghere, Obaghe; Danon, Leon; House, Thomas A; Keeling, Matthew J

    2014-09-01

    Prediction and control of the spread of infectious disease in human populations benefits greatly from our growing capacity to quantify human movement behavior. Here we develop a mathematical model for non-transmissible infections contracted from a localized environmental source, informed by a detailed description of movement patterns of the population of Great Britain. The model is applied to outbreaks of Legionnaires' disease, a potentially life-threatening form of pneumonia caused by the bacteria Legionella pneumophilia. We use case-report data from three recent outbreaks that have occurred in Great Britain where the source has already been identified by public health agencies. We first demonstrate that the amount of individual-level heterogeneity incorporated in the movement data greatly influences our ability to predict the source location. The most accurate predictions were obtained using reported travel histories to describe movements of infected individuals, but using detailed simulation models to estimate movement patterns offers an effective fast alternative. Secondly, once the source is identified, we show that our model can be used to accurately determine the population likely to have been exposed to the pathogen, and hence predict the residential locations of infected individuals. The results give rise to an effective control strategy that can be implemented rapidly in response to an outbreak. PMID:25211122

  1. First Outbreak with MRSA in a Danish Neonatal Intensive Care Unit: Risk Factors and Control Procedures

    PubMed Central

    Ramsing, Benedicte Grenness Utke; Arpi, Magnus; Andersen, Erik Arthur; Knabe, Niels; Mogensen, Dorthe; Buhl, Dorte; Westh, Henrik; Østergaard, Christian

    2013-01-01

    Introduction The purpose of the study was to describe demographic and clinical characteristics and outbreak handling of a large methicillin-resistant Staphylococcus aureus (MRSA) outbreak in a neonatal intensive care unit (NICU) in Denmark June 25th–August 8th 2008, and to identify risk factors for MRSA transmission. Methods Data were collected retrospectively from medical records and the Danish Neobase database. All MRSA isolates obtained from neonates, relatives and NICU health care workers (HCW) as well as environmental cultures were typed. Results During the 46 day outbreak period, 102 neonates were admitted to the two neonatal wards. Ninety-nine neonates were subsequently sampled, and 32 neonates (32%) from 25 families were colonized with MRSA (spa-type t127, SCCmec V, PVL negative). Thirteen family members from 11 of those families (44%) and two of 161 HCWs (1%) were colonized with the same MRSA. No one was infected. Five environmental cultures were MRSA positive. In a multiple logistic regression analysis, nasal Continuous Positive Airway Pressure (nCPAP) treatment (p = 0.006) and Caesarean section (p = 0.016) were independent risk factors for MRSA acquisition, whereas days of exposure to MRSA was a risk factors in the unadjusted analysis (p = 0.04). Conclusions MRSA transmission occurs with high frequency in the NICU during hospitalization with unidentified MRSA neonates. Caesarean section and nCPAP treatment were identified as risk factors for MRSA colonization. The MRSA outbreak was controlled through infection control procedures. PMID:23825581

  2. A large Legionnaires' disease outbreak in Pamplona, Spain: early detection, rapid control and no case fatality

    PubMed Central

    CASTILLA, J.; BARRICARTE, A.; ALDAZ, J.; GARCÍA CENOZ, M.; FERRER, T.; PELAZ, C.; PINEDA, S.; BALADRÓN, B.; MARTÍN, I.; GOÑI, B.; ARATAJO, P.; CHAMORRO, J.; LAMEIRO, F.; TORROBA, L.; DORRONSORO, I.; MARTÍNEZ-ARTOLA, V.; ESPARZA, M. J.; GASTAMINZA, M. A.; FRAILE, P.; ALDAZ, P.

    2008-01-01

    SUMMARY An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality. PMID:17662166

  3. Ebola Virus Disease: Rapid Diagnosis and Timely Case Reporting are Critical to the Early Response for Outbreak Control.

    PubMed

    Stamm, Lola V

    2015-09-01

    Ebola virus disease (EVD) is a life-threatening zoonosis caused by infection with the Ebola virus. Since the first reported EVD outbreak in the Democratic Republic of the Congo, several small outbreaks have been reported in central Africa with about 2,400 cases occurring between 1976 and 2013. The 2013-2015 EVD outbreak in west Africa is the first documented outbreak in this region and the largest ever with over 27,000 cases and more than 11,000 deaths. Although EVD transmission rates have recently decreased in west Africa, this crisis continues to threaten global health and security, particularly since infected travelers could spread EVD to other resource-limited areas of the world. Because vaccines and drugs are not yet licensed for EVD, outbreak control is dependent on the use of non-pharmaceutical interventions (e.g., infection control practices, isolation of EVD cases, contact tracing with follow-up and quarantine, sanitary burial, health education). However, delays in diagnosing and reporting EVD cases in less accessible rural areas continue to hamper control efforts. New advances in rapid diagnostics for identifying presumptive EVD cases and in mobile-based technologies for communicating critical health-related information should facilitate deployment of an early response to prevent the amplification of sporadic EVD cases into large-scale outbreaks. PMID:26175026

  4. Environmental Control of Phase Transition and Polyp Survival of a Massive-Outbreaker Jellyfish

    PubMed Central

    Prieto, Laura; Astorga, Diana; Navarro, Gabriel; Ruiz, Javier

    2010-01-01

    A number of causes have been proposed to account for the occurrence of gelatinous zooplankton (both jellyfish and ctenophore) blooms. Jellyfish species have a complex life history involving a benthic asexual phase (polyp) and a pelagic sexual phase (medusa). Strong environmental control of jellyfish life cycles is suspected, but not fully understood. This study presents a comprehensive analysis on the physicochemical conditions that control the survival and phase transition of Cotylorhiza tuberculata; a scyphozoan that generates large outbreaks in the Mediterranean Sea. Laboratory experiments indicated that the influence of temperature on strobilation and polyp survival was the critical factor controlling the capacity of this species to proliferate. Early life stages were less sensitive to other factors such as salinity variations or the competitive advantage provided by zooxanthellae in a context of coastal eutrophication. Coherently with laboratory results, the presence/absence of outbreaks of this jellyfish in a particular year seems to be driven by temperature. This is the first time the environmental forcing of the mechanism driving the life cycle of a jellyfish has been disentangled via laboratory experimentation. Projecting this understanding to a field population under climatological variability results in a pattern coherent with in situ records. PMID:21072185

  5. A novel experience in the use of control charts for the detection of nosocomial infection outbreaks

    PubMed Central

    Gomes, Isabel Cristina; Mingoti, Sueli Aparecida; Di Lorenzo Oliveira, Cláudia

    2011-01-01

    OBJECTIVE: This study aims to compare different control charts to monitor the nosocomial infection rate per 1,000 patient-days. METHODS: The control charts considered in this study were the traditional Shewhart chart and a variation of this, the Cumulative Sum and Exponentially Weighted Moving Average charts. RESULTS: We evaluated 238 nosocomial infections that were registered in the intensive care unit and were detected by the Committee for Nosocomial Infection Control in a university hospital in Belo Horizonte, Brazil, in 2004 and 2005. The results showed that the traditional Shewhart chart was the most appropriate method for monitoring periods with large deviations, while the Exponentially Weighted Moving Average and Cumulative Sum charts were better for monitoring periods with smaller deviations of the mean infection rate. CONCLUSION: The ability to detect nosocomial outbreaks was improved by using the information provided by all three different control charts. PMID:22012038

  6. Undesirable Consequences of Insecticide Resistance following Aedes aegypti Control Activities Due to a Dengue Outbreak

    PubMed Central

    Maciel-de-Freitas, Rafael; Avendanho, Fernando Campos; Santos, Rosangela; Sylvestre, Gabriel; Araújo, Simone Costa; Lima, José Bento Pereira; Martins, Ademir Jesus; Coelho, Giovanini Evelim; Valle, Denise

    2014-01-01

    Background During a dengue outbreak with co-circulation of DENV-1 and -2 in the city of Boa Vista, one patient was diagnosed with DENV-4, a serotype supposed absent from Brazil for almost 30 years. The re-emergence of DENV-4 triggered the intensification of mechanical and chemical Aedes aegypti control activities in order to reduce vector density and avoid DENV-4 dissemination throughout the country. Methods/Principal Findings Vector control activities consisted of (a) source reduction, (b) application of diflubenzuron against larvae and (c) vehicle-mounted space spraying of 2% deltamethrin to eliminate adults. Control activity efficacy was monitored by comparing the infestation levels and the number of eggs collected in ovitraps before and after interventions, performed in 22 Boa Vista districts, covering an area of ∼80% of the city and encompassing 56,837 dwellings. A total of 94,325 containers were eliminated or treated with diflubenzuron. The most frequently positive containers were small miscellaneous receptacles, which corresponded to 59% of all positive breeding sites. Insecticide resistance to deltamethrin was assessed before, during and after interventions by dose-response bioassays adopting WHO-based protocols. The intense use of the pyrethroid increased fourfold the resistance ratio of the local Ae. aegypti population only six months after the beginning of vector control. Curiously, this trend was also observed in the districts in which no deltamethrin was applied by the public health services. On the other hand, changes in the resistance ratio to the organophosphate temephos seemed less influenced by insecticide in Boa Vista. Conclusions Despite the intense effort, mosquito infestation levels were only slightly reduced. Besides, the median number of eggs in ovitraps remained unaltered after control activity intensification. The great and rapid increase in pyrethroid resistance levels of natural Ae. aegypti populations is discussed in the context of

  7. How do resources influence control measures during a simulated outbreak of foot and mouth disease in Australia?

    PubMed

    Roche, S E; Garner, M G; Wicks, R M; East, I J; de Witte, K

    2014-03-01

    An outbreak of foot and mouth disease (FMD) could seriously impact Australia's livestock sector and economy. As an FMD-free country, an outbreak would trigger a major disease control and eradication program that would include the culling of infected and at risk animals ('stamping out'), movement restrictions and zoo-sanitary measures. Additional control measures may also include pre-emptive culling or vaccination. However, it is unclear what disease strategy would be most effective under Australian conditions and different resource levels. Using a stochastic simulation model that describes FMD transmission between farms in a livestock dense region of Australia, our results suggest that using current estimates of human resource capacity for surveillance, infected premises operations and vaccination, outbreaks were effectively controlled under a stamping out strategy. However, under more constrained resource allocations, ring vaccination was more likely to achieve eradication faster than stamping out or pre-emptive culling strategies. PMID:24412502

  8. Investigation and control of an outbreak of Enterobacter aerogenes bloodstream infection in a neonatal intensive care unit in Fiji.

    PubMed

    Narayan, Swastika A; Kool, Jacob L; Vakololoma, Miriama; Steer, Andrew C; Mejia, Amelita; Drake, Anne; Jenney, Adam; Turton, Jane F; Kado, Joseph; Tikoduadua, Lisi

    2009-08-01

    Ten neonates developed blood stream infection with extended-spectrum beta-lactamase-producing Enterobacter aerogenes in a neonatal intensive care unit in Fiji. The source of the outbreak was traced to a bag of contaminated normal saline in the ward, which was used for multiple patients. All isolates recovered from patients were indistinguishable from the bacteria recovered from the normal saline by pulsed-field gel electrophoresis. The outbreak was controlled using simple infection control practices such as reinforcement of strict hand hygiene policy, provision of single use vials of normal saline, and strict aseptic technique for injections. PMID:19552517

  9. Investigation of outbreaks: epidemiology.

    PubMed

    Joseph, Carol

    2013-01-01

    Outbreaks of Legionnaires' disease create high levels of public anxiety and media interest and inevitably consume a great deal of public health resources. Investigations should begin as early as possible in order to rapidly identify suspected sources of infection, control the outbreak and prevent further cases occurring. The investigations should be coordinated by an outbreak control team who work collaboratively within local/national/international public health guidelines and with clear terms of reference. The actions carried out by epidemiologists when investigating community-, hospital-, or travel-associated outbreaks are comprehensively outlined in this chapter. The microbiological and environmental actions that complement this work are discussed in the accompanying chapters. PMID:23150390

  10. Emergency vector control in a DENV-2 outbreak in 2002 in Pingtung City, Pingtung County, Taiwan.

    PubMed

    Teng, Hwa-Jen; Chen, Tzay-Jinn; Tsai, Shu-Fen; Lin, Chiung-Pin; Chiou, Horng-Ying; Lin, Min-Cheng; Yang, Shih-Yan; Lee, Yi-Wun; Kang, Chi-Chieh; Hsu, Ho-Cheng; Chang, Niann-Tai

    2007-09-01

    This paper reports the strategy and effectiveness of an emergency control program conducted in Pingtung City, Taiwan in response to dengue outbreaks. In our control strategy, we carried out 3 insecticide space sprays with an interval of 6-7 days and 2 source reductions to cover the entire duration of dengue virus exposure in humans and mosquito vectors. The control effect was demonstrated by a significant reduction in the Breteau (51.1%) and larval (80.0%) indices, but no such effect was demonstrated by alterations in the adult index (54.9%), house index (45.0%), container index (33.8%), or by indoor (15.8%), outdoor (31.2%), or total water-filled containers (22.7%) per 100 premises examined. The contribution made by the reduction in the number of positive containers was primarily in the outdoor (77.2%), and not the indoor containers (-6.0%). This reduction attributed to an overall reduction of 96.0% Aedes albopictus larvae and 71.0% Aedes aegypti. Therefore, 4 weeks after this extensive emergency control measure, the number of dengue cases dropped to one. Finally, due to both the decrease in temperature resulting from the upcoming winter, and to the sustained effort toward source reduction, the transmission cycle of DENV-2 in Pingtung City was interrupted at the beginning of 2003, and no additional cases were identified in late 2003. PMID:17881866

  11. Measles (Rubeola): The Control of an Outbreak at a Large University.

    ERIC Educational Resources Information Center

    Bridgewater, Sharon C.; Lotz, Doris I.

    1984-01-01

    This article discusses the immunization program that followed an outbreak of measles (rubeloa) at Indiana University. Factors that may have contributed to the outbreak were less natural immunity in this age group, absence of school legislation requiring immunization, and use of killed vaccine which did not provide immunity. (Author/DF)

  12. Ensuring safety of home-produced eggs to control salmonellosis in Poland: lessons from an outbreak in September 2011.

    PubMed

    Zielicka-Hardy, A; Zarowna, D; Szych, J; Madajczak, G; Sadkowska-Todys, M

    2012-01-01

    Implementation of control measures in line with European Commission regulations has led to a decrease in salmonellosis in the European Union since 2004. However, control programmes do not address laying hens whose eggs are produced for personal consumption or local sale. This article reports an investigatxion of a salmonellosis outbreak linked to home-produced eggs following a family event held in a farm in September 2011 near Warsaw, Poland. In the outbreak, 34 people developed gastroenteritis symptoms. Results from a cohort study indicated a cake, prepared from raw home-produced eggs, as the vehicle of the outbreak. Laboratory analysis identified Salmonella enterica serotype Enteritidis (S. Enteritidis) in stool samples or rectal swabs from 18 of 24 people and in two egg samples. As no food items remained, we used phage typing to link the source of the outbreak with the isolated strains. Seven S. Enteritidis strains analysed (five from attendees and two from eggs) were phage type 21c. Our findings resulted in culling of the infected laying hens and symptomatic pigeons housed next to the hens. Salmonella poses as a public health problem in Poland: control measures should not forget home-produced eggs, as there is a risk of infection from their consumption. PMID:23231857

  13. Modeling the impact of vaccination control strategies on a foot and mouth disease outbreak in the Central United States.

    PubMed

    McReynolds, Sara W; Sanderson, Michael W; Reeves, Aaron; Hill, Ashley E

    2014-12-01

    The central United States (U.S.) has a large livestock population including cattle, swine, sheep and goats. Simulation models were developed to assess the impact of livestock herd types and vaccination on foot and mouth disease (FMD) outbreaks using the North American Animal Disease Spread Model. In this study, potential FMD virus outbreaks in the central region of the U.S. were simulated to compare different vaccination strategies to a depopulation only scenario. Based on data from the U.S. Department of Agriculture National Agricultural Statistics Service, a simulated population of 151,620 livestock operations characterized by latitude and longitude, production type, and herd size was generated. For the simulations, a single 17,000 head feedlot was selected as the initial latently infected herd in an otherwise susceptible population. Direct and indirect contact rates between herds were based on survey data of livestock producers in Kansas and Colorado. Control methods included ring vaccination around infected herds. Feedlots ≥3000 head were either the only production type that was vaccinated or were assigned the highest vaccination priority. Simulated vaccination scenarios included low and high vaccine capacity, vaccination zones of 10 km or 50 km around detected infected premises, and vaccination trigger of 10 or 100 detected infected herds. Probability of transmission following indirect contact, movement controls and contact rate parameters were considered uncertain and so were the subjects of sensitivity analysis. All vaccination scenarios decreased number of herds depopulated but not all decreased outbreak duration. Increased size of the vaccination zone during an outbreak decreased the length of the outbreak and number of herds destroyed. Increased size of the vaccination zone primarily resulted in vaccinating feedlots ≥3000 head across a larger area. Increasing the vaccination capacity had a smaller impact on the outbreak and may not be feasible if

  14. How can health systems be strengthened to control and prevent an Ebola outbreak? A narrative review

    PubMed Central

    Regmi, Krishna; Gilbert, Ruth; Thunhurst, Colin

    2015-01-01

    The emergence and re-emergence of infectious diseases are now more than ever considered threats to public health systems. There have been over 20 outbreaks of Ebola in the past 40 years. Only recently, the World Health Organization has declared a public health emergency of international concern (PHEIC) in West Africa, with a projected estimate of 1.2 million deaths expected in the next 6 months. Ebola virus is a highly virulent pathogen, often fatal in humans and non-human primates. Ebola is now a great priority for global health security and often becomes fatal if left untreated. This study employed a narrative review. Three major databases – MEDLINE, EMBASE, and Global Health – were searched using both ‘text-words’ and ‘thesaurus terms’. Evidence shows that low- and middle-income countries (LMICs) are not coping well with the current challenges of Ebola, not only because they have poor and fragile systems but also because there are poor infectious disease surveillance and response systems in place. The identification of potential cases is problematic, particularly in the aspects of contact tracing, infection control, and prevention, prior to the diagnosis of the case. This review therefore aims to examine whether LMICs’ health systems would be able to control and manage Ebola in future and identifies two key elements of health systems strengthening that are needed to ensure the robustness of the health system to respond effectively. PMID:26609690

  15. Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction

    PubMed Central

    Fast, Shannon M.; González, Marta C.; Markuzon, Natasha

    2015-01-01

    Background Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence. Methodology The spread of disease and social response are simulated under several different intervention strategies. The modeled social response depends upon the perceived risk of the disease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response. Conclusions The model-based simulations suggest that the least-cost disease control strategy depends upon the perceived risk of the disease, as well as media intervention. The most cost-effective solution for diseases with low perceived risk was to implement moderate control measures. For diseases with higher perceived severity, such as SARS or Ebola, the most cost-effective strategy shifted toward intervening earlier in the outbreak, with greater resources. When intervention elicited increased media involvement, it remained important to control high severity diseases quickly. For moderate severity diseases, however, it became most cost-effective to implement no intervention and allow the disease to run its course. Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy. PMID:26288274

  16. Nosocomial outbreak of staphylococcal scalded skin syndrome in neonates: epidemiological investigation and control.

    PubMed

    El Helali, N; Carbonne, A; Naas, T; Kerneis, S; Fresco, O; Giovangrandi, Y; Fortineau, N; Nordmann, P; Astagneau, P

    2005-10-01

    Over a three-month period, 13 neonates developed staphylococcal scalded skin syndrome (SSSS) in a maternity unit, between four and 18 days after their birth. An epidemiological and descriptive study followed by a case-control study was performed. A case was defined as a neonate with blistering or peeling skin, and exfoliative toxin A Staphylococcus aureus positive cultures. Controls were selected at random from the asymptomatic, non-colonized neonates born on the same day as the cases. All staff members and all neonates born during the outbreak period were screened for carriage by nasal swabs and umbilical swabs, respectively. S. aureus isolates were polymerase chain reaction (PCR) screened for etA gene and genotyped by pulsed-field gel electrophoresis (PFGE). Two clusters of eight and five cases were identified. Receiving more than one early umbilical care procedure by the same ancillary nurse was the only risk factor identified in the case-control study (odds ratio=15, 95% confidence intervals 2-328). The ancillary nurse suffered from chronic dermatitis on her hands that favoured S. aureus carriage. Exfoliative-toxin-A-producing strains, as evidenced by PCR and indistinguishable by PFGE, were isolated from all but one of the SSSS cases, from four asymptomatic neonates, from two staff members and from the ancillary nurse's hands. Removal of the ancillary nurse from duty, infection control measures (isolation precautions, chlorhexidine handwashing and barrier protections), and treatment of the carriers (nasal mupirocin and chlorhexidine showers) led to control of the epidemic. In conclusion, this study emphasizes the need for tight surveillance of chronic dermatitis in healthcare workers. PMID:16009455

  17. Controlling highly pathogenic avian influenza outbreaks: An epidemiological and economic model analysis.

    PubMed

    Backer, J A; van Roermund, H J W; Fischer, E A J; van Asseldonk, M A P M; Bergevoet, R H M

    2015-09-01

    Outbreaks of highly pathogenic avian influenza (HPAI) can cause large losses for the poultry sector and for animal disease controlling authorities, as well as risks for animal and human welfare. In the current simulation approach epidemiological and economic models are combined to compare different strategies to control highly pathogenic avian influenza in Dutch poultry flocks. Evaluated control strategies are the minimum EU strategy (i.e., culling of infected flocks, transport regulations, tracing and screening of contact flocks, establishment of protection and surveillance zones), and additional control strategies comprising pre-emptive culling of all susceptible poultry flocks in an area around infected flocks (1 km, 3 km and 10 km) and emergency vaccination of all flocks except broilers around infected flocks (3 km). Simulation results indicate that the EU strategy is not sufficient to eradicate an epidemic in high density poultry areas. From an epidemiological point of view, this strategy is the least effective, while pre-emptive culling in 10 km radius is the most effective of the studied strategies. But these two strategies incur the highest costs due to long duration (EU strategy) and large-scale culling (pre-emptive culling in 10 km radius). Other analysed pre-emptive culling strategies (i.e., in 1 km and 3 km radius) are more effective than the analysed emergency vaccination strategy (in 3 km radius) in terms of duration and size of the epidemics, despite the assumed optimistic vaccination capacity of 20 farms per day. However, the total costs of these strategies differ only marginally. Extending the capacity for culling substantially reduces the duration, size and costs of the epidemic. This study demonstrates the strength of combining epidemiological and economic model analysis to gain insight in a range of consequences and thus to serve as a decision support tool in the control of HPAI epidemics. PMID:26087887

  18. Margaret Sanger: birth control's successful revolutionary.

    PubMed Central

    Wardell, D

    1980-01-01

    The year 1979 marked the centennial of Margaret Sanger, birth control pioneer. Sanger worked to secure two new human rights: the right to decide whether to have a child and the right of a child to be wanted. Beginning in 1873, antipornography crusader Anthony Comstock lobbied through Congress and the state legislatures laws forbidding the distribution of contraceptive devices and even information. He equated these with erotic postcards as "obscene, lewd, lascivious, filthy, indecent and disgusting." Sanger's strategy was to challenge the Comstock laws in the courts. She studied birth control methods abroad and published a pamphlet, Family Limitation, in 1914. It was the first modern marriage manual; it was also illegal. The publicity her trial generated was immense and highly sympathetic. The government dropped its case when it saw it could only make her a martyr. An obstetrical nurse, Sanger had seen the plight of factory women in the poorest sections of New York City. In order to provide the medical advice and supplies women clamored for, Sanger opened the first U.S. birth control clinic, in Brooklyn in 1916. The New York City Vice Squad raided and closed it, and jailed Sanger. Margaret Sanger underwent other trials, raids, and harassments, but each time won additional public support for her organization--Planned Parenthood--and her cause. Images p737-a p740-a p741-a PMID:6992603

  19. Controlling outbreaks of the coral-eating crown-of-thorns starfish using a single injection of common household vinegar

    NASA Astrophysics Data System (ADS)

    Boström-Einarsson, Lisa; Rivera-Posada, Jairo

    2016-03-01

    Outbreaks of the destructive coral-eating crown-of-thorns starfish, Acanthaster planci, present a considerable threat to coral reefs worldwide, and mitigating their impact has proven challenging. The most effective methods to control A. planci require injecting individual starfish with lethal chemicals. While some of these are highly effective, their administration often requires permits, training and access to specialised equipment. We aimed to identify a widely available and highly efficient alternative. We discovered that common household vinegar is lethal to A. planci individuals when injected at the base of one their arms. A single injection of 25 ml vinegar induced functional mortality in <24 h and 100 % mortality in <48 h. These results demonstrate that vinegar is an effective alternative to currently used chemicals. Vinegar is a viable alternative in the toolkit of methods that can control and eradicate local outbreaks of COTS on coral reefs.

  20. Outbreak investigation and control case report of brucellosis: experience from livestock research centre, Mpwapwa, Tanzania.

    PubMed

    Shirima, Gabriel M; Masola, Seleman N; Malangu, Obeid N; Schumaker, Brant A

    2014-01-01

    Brucellosis screening was conducted between 2005 and 2010 at the National Livestock Research Institute headquarters, Mpwapwa, Tanzania, following an abortion storm in cattle. The initial screening targeted breeding herds; 483 cattle were screened using the Rose Bengal Plate Test (RBPT) followed by the Competitive Enzyme-linked Immunosorbent Assay (c-ELISA) as a confirmatory test. The seropositivity on c-ELISA was 28.95% in 2005; it subsequently declined to 6.72%, 1.17%, 0.16% and 0.00% in 2006, 2007, 2009 and 2010, respectively. Brucella seropositivity was not detected in goats. Seropositivity declined following institution of stringent control measures that included: gradual culling of seropositive animals through slaughter; isolation and confinement of pregnant cows close to calving; proper disposal of placentas and aborted foetuses; the use of the S19 vaccine; and restricted introduction of new animals. It was thought that the source of this outbreak was likely to have been from the introduction of infected animals from another farm. Furthermore, humans were found with brucellosis antibodies. Out of 120 people screened, 12 (10%) were confirmed seropositive to brucella antigen exposure by c-ELISA analysis. The majority of the seropositive individuals (80%) were milkers and animal handlers from the farm. Nine individuals had clinical signs suggestive of brucellosis. All cases received medical attention from the district hospital. This achievement in livestock and human health showed that it is possible to control brucellosis in dairy farms, compared to pastoral and agro-pastoral farms, thus providing evidence to adopt these strategies in dairy farms thought to be at risk. PMID:25685904

  1. Lime Juice and Vinegar Injections as a Cheap and Natural Alternative to Control COTS Outbreaks.

    PubMed

    Moutardier, Grégoire; Gereva, Sompert; Mills, Suzanne C; Adjeroud, Mehdi; Beldade, Ricardo; Ham, Jayven; Kaku, Rocky; Dumas, Pascal

    2015-01-01

    Outbreaks of the corallivorous crown-of-thorns seastar Acanthaster planci (COTS) represent one of the greatest disturbances to coral reef ecosystems in the Indo-Pacific, affecting not only coral reefs but also the coastal communities which rely on their resources. While injection approaches are increasingly used in an attempt to control COTS densities, most of them display severe drawbacks including logistical challenges, high residual environmental impacts or low cost-effectiveness. We tested a new alternative control method based upon acidic injections of cheap, 100% natural products. We investigated the lethal doses, intra- and inter-specific disease transmission and immune responses of COTS when injected with fresh lime juice (extracted from local Citrus arantifolia) and white spirit vinegar. High COTS mortality was achieved with small volumes: 10-20 ml per seastar induced death in 89%/97% of injected specimens after an average 34.3 h/29.8 h for lime juice and vinegar respectively. Highest efficiency was reached for both solutions with double shots of (2 × 10 ml) in two different areas on the body: 100% mortality occurred within 12-24 h, which is similar or faster compared with other current injection methods. Multiple immune measures suggested that death was very likely caused by pH stress from the acidic solutions rather than a bacterial infection. Contagion to either conspecifics or a variety of other reef species was not observed, even at COTS densities 15 times higher than the highest naturally reported. 10 to 20 l lime juice/vinegar could kill up to a thousand COTS at a cost of less than 0.05 USD per specimen; no permits or special handling procedures are required. We conclude that injections of lime juice and vinegar offer great advantages when compared to current best practises and constitute a cheap and natural option for all reefs affected by COTS. PMID:26356840

  2. Lime Juice and Vinegar Injections as a Cheap and Natural Alternative to Control COTS Outbreaks

    PubMed Central

    Moutardier, Grégoire; Gereva, Sompert; Mills, Suzanne C.; Adjeroud, Mehdi; Beldade, Ricardo; Ham, Jayven; Kaku, Rocky; Dumas, Pascal

    2015-01-01

    Outbreaks of the corallivorous crown-of-thorns seastar Acanthaster planci (COTS) represent one of the greatest disturbances to coral reef ecosystems in the Indo-Pacific, affecting not only coral reefs but also the coastal communities which rely on their resources. While injection approaches are increasingly used in an attempt to control COTS densities, most of them display severe drawbacks including logistical challenges, high residual environmental impacts or low cost-effectiveness. We tested a new alternative control method based upon acidic injections of cheap, 100% natural products. We investigated the lethal doses, intra- and inter-specific disease transmission and immune responses of COTS when injected with fresh lime juice (extracted from local Citrus arantifolia) and white spirit vinegar. High COTS mortality was achieved with small volumes: 10–20 ml per seastar induced death in 89%/97% of injected specimens after an average 34.3 h/29.8 h for lime juice and vinegar respectively. Highest efficiency was reached for both solutions with double shots of (2 × 10 ml) in two different areas on the body: 100% mortality occurred within 12–24 h, which is similar or faster compared with other current injection methods. Multiple immune measures suggested that death was very likely caused by pH stress from the acidic solutions rather than a bacterial infection. Contagion to either conspecifics or a variety of other reef species was not observed, even at COTS densities 15 times higher than the highest naturally reported. 10 to 20 l lime juice/vinegar could kill up to a thousand COTS at a cost of less than 0.05 USD per specimen; no permits or special handling procedures are required. We conclude that injections of lime juice and vinegar offer great advantages when compared to current best practises and constitute a cheap and natural option for all reefs affected by COTS. PMID:26356840

  3. Modelling of control options for an outbreak of Mycoplasma gallisepticum in egg production: a decision support tool.

    PubMed

    Bennett, R M; McClement, I; McFarlane, I D; Parker, C D

    2013-12-01

    Mycoplasma gallisepticum (MG) is a bacterium that causes respiratory disease in chickens, leading to reduced egg production. A dynamic simulation model was developed that can be used to assess the costs and benefits of control using antimicrobials or vaccination in caged or free range systems. The intended users are veterinarians and egg producers. A user interface is provided for input of flock specific parameters. The economic consequence of an MG outbreak is expressed as a reduction in expected egg output. The model predicts that either vaccination or microbial treatment can approximately halve potential losses from MG in some circumstances. Sensitivity analysis is used to test assumptions about infection rate and timing of an outbreak. Feedback from veterinarians points to the value of the model as a discussion tool with producers. PMID:24206630

  4. Dengue vector control and surveillance during a major outbreak in a coastal Red Sea area in Sudan.

    PubMed

    Seidahmed, O M E; Siam, H A M; Soghaier, M A; Abubakr, M; Osman, H A; Abd Elrhman, L S; Elmagbol, B; Velayudhan, R

    2012-12-01

    An unprecedented dengue outbreak occurred in 2010 in Port Sudan city, Sudan. Dengue incidence was 94 cases per 10 000 observed over 17 epidemiological weeks (total cases = 3 765). We report here the impact of the vector control response plan to the outbreak, which mainly entailed house inspection and insecticide space spraying. In total 3 048 houses were inspected during vector surveillance and 19 794 larvae and 3 240 pupae of Aedes aegypti were collected. Entomological indices decreased during the period: house index declined from 100% to 16% (F= 57.8, P < 0.001) and pupal/person (P/P) index from 0.77 to 0.10 (F= 3.06, P < 0.01) in weeks 9 and 21 respectively. This decline was accompanied by a decrease in cases from a peak of 341 cases in week 13 to zero in week 29 and the end of the outbreak. There was a significant correlation between the entomological parameters and dengue incidence (R2 = 0.83, F= 23.9, P < 0.001). Integrated epidemiological and vector surveillance is essential to an effective dengue control programme PMID:23301396

  5. Rubella: Current Status, Diagnosis, Outbreak Control, and Use of Rubella Vaccine in Females of Childbearing Age.

    ERIC Educational Resources Information Center

    Preblud, Stephen R.

    1984-01-01

    Widespread rubella vaccination of young children with a secondary emphasis on vaccinating susceptible adolescents and young adults has prevented epidemics of rubella and congenital rubella syndrome. Benefits of ensuring high immunity levels in college students, quick response to disease outbreak, and safety and efficacy of rubella vaccine in this…

  6. Lack of evidence for the efficacy of enhanced surveillance compared to other specific interventions to control neonatal healthcare-associated infection outbreaks

    PubMed Central

    Birt, J.; Le Doare, K.; Kortsalioudaki, C.; Lawn, J.; Heath, P. T.; Sharland, M.

    2016-01-01

    Background Despite current prevention efforts, outbreaks of healthcare-associated infections in neonatal units remain high globally, with a considerable burden of mortality and morbidity. Methods We searched Medline, Cochrane Library and Outbreak database to identify studies of neonatal healthcare-associated outbreaks between 2005 and 2015 that described interventions to control outbreaks. All studies were evaluated using the ORION guidance. Results Thirty studies were identified including 17 102 infants of whom 664 (3.9%) became infected. No single intervention was identified that reduced duration or mortality. Studies that introduced multiple interventions had significantly reduced case fatality ratio and outbreak duration compared to those that used basic surveillance only. Low and low-middle income countries reported the fewest interventions to control outbreaks and these studies were also associated with higher mortality than that found in middle and high income countries. Conclusions Systematic reporting and formal evaluation of interventions used to reduce healthcare-associated neonatal infection outbreaks is key to identifying containment strategies worldwide. PMID:26822602

  7. Outbreaks in Health Care Settings.

    PubMed

    Sood, Geeta; Perl, Trish M

    2016-09-01

    Outbreaks and pseudo-outbreaks in health care settings can be complex and should be evaluated systematically using epidemiologic tools. Laboratory testing is an important part of an outbreak evaluation. Health care personnel, equipment, supplies, water, ventilation systems, and the hospital environment have been associated with health care outbreaks. Settings including the neonatal intensive care unit, endoscopy, oncology, and transplant units are areas that have specific issues which impact the approach to outbreak investigation and control. Certain organisms have a predilection for health care settings because of the illnesses of patients, the procedures performed, and the care provided. PMID:27515142

  8. [Nosocomial scabies outbreak].

    PubMed

    Robles García, M; de la Lama López-Areal, J; Avellaneda Martínez, C; Giménez García, R; Cortejoso Gonzalo, B; Vaquero Puerta, J L

    2000-10-01

    A scabies outbreak is reported which appeared in the Inpatient Pneumology Department in a 500-bed hospital. The outbreak began after the admission of a 90-year old woman referred from a nursing home. A total of 27 secondary cases occurred among health care personnel (14) and patients (13); other 7 cases of likely scabies occurred among 198 contacts. Patients were treated with 5% permetrine cream, in three applications one week apart from each other. It was also applied as prophylaxis in non involved patients in a single application. A discussion follows on the medical and preventive recommendations to control the spreading of these outbreak. PMID:11153236

  9. Seasonal Succession of Fungi Associated with Ips typographus Beetles and Their Phoretic Mites in an Outbreak Region of Finland

    PubMed Central

    Mahilainen, Saila; Harrington, Alison; Vanhanen, Henri; Eriksson, Miikka; Mehtätalo, Lauri; Pappinen, Ari; Wingfield, Michael J.

    2016-01-01

    The ophiostomatoid fungi (Microascales and Ophiostomatales, Ascomycota) are common associates of Ips typographus, and include tree pathogens and species responsible for blue-stain of timber. Fungal assemblages associated with I. typographus have varied considerably between studies but few investigations have attempted to explain this variation. For this reason, we assessed the overall cultivable fungal diversity associated with I. typographus in a storm-felled spruce forest in south-eastern Finland. Fungi were isolated from the individually collected beetles as well as their phoretic mites in spring, summer and autumn, including different life stages of the beetle (hibernation, dispersal flight and first generation). The internal transcribed spacer (ITS) gene region was used to identify the fungi. A total of 32 operational taxonomic units (OTUs) were found and these resided in four fungal phyla/subphyla (24 Ascomycota, 2 Basidiomycota, 5 Mucoromycotina, 1 Mortierellomycotina) in association with adult bark beetles. Ophiostomatoid species were the most commonly detected fungal associates. A generalized linear model analysis showed a clear association between fungal communities and season, indicating seasonal succession among I. typographus-associated fungi. The season of sampling appears to be an important factor that has resulted in inconsistencies between results in previous studies. Many of these fungi were also found on phoretic mites and their presence or absence could have influenced variation in patterns of association. PMID:27187192

  10. Seasonal Succession of Fungi Associated with Ips typographus Beetles and Their Phoretic Mites in an Outbreak Region of Finland.

    PubMed

    Linnakoski, Riikka; Mahilainen, Saila; Harrington, Alison; Vanhanen, Henri; Eriksson, Miikka; Mehtätalo, Lauri; Pappinen, Ari; Wingfield, Michael J

    2016-01-01

    The ophiostomatoid fungi (Microascales and Ophiostomatales, Ascomycota) are common associates of Ips typographus, and include tree pathogens and species responsible for blue-stain of timber. Fungal assemblages associated with I. typographus have varied considerably between studies but few investigations have attempted to explain this variation. For this reason, we assessed the overall cultivable fungal diversity associated with I. typographus in a storm-felled spruce forest in south-eastern Finland. Fungi were isolated from the individually collected beetles as well as their phoretic mites in spring, summer and autumn, including different life stages of the beetle (hibernation, dispersal flight and first generation). The internal transcribed spacer (ITS) gene region was used to identify the fungi. A total of 32 operational taxonomic units (OTUs) were found and these resided in four fungal phyla/subphyla (24 Ascomycota, 2 Basidiomycota, 5 Mucoromycotina, 1 Mortierellomycotina) in association with adult bark beetles. Ophiostomatoid species were the most commonly detected fungal associates. A generalized linear model analysis showed a clear association between fungal communities and season, indicating seasonal succession among I. typographus-associated fungi. The season of sampling appears to be an important factor that has resulted in inconsistencies between results in previous studies. Many of these fungi were also found on phoretic mites and their presence or absence could have influenced variation in patterns of association. PMID:27187192

  11. Success Stories in Control: Nonlinear Dynamic Inversion Control

    NASA Technical Reports Server (NTRS)

    Bosworth, John T.

    2010-01-01

    NASA plays an important role in advancing the state of the art in flight control systems. In the case of Nonlinear Dynamic Inversion (NDI) NASA supported initial implementation of the theory in an aircraft and demonstration in a space vehicle. Dr. Dale Enns of Honeywell Aerospace Advanced Technology performed this work in cooperation with NASA and under NASA contract. Honeywell and Lockheed Martin were subsequently contracted by AFRL to create "Design Guidelines for Multivariable Control Theory". This foundational work directly contributed to the advancement of the technology and the credibility of the control law as a design option. As a result Honeywell collaborated with Lockheed Martin to produce a Nonlinear Dynamic Inversion controller for the X-35 and subsequently Lockheed Martin did the same for the production Lockheed Martin F-35 vehicle. The theory behind NDI is to use a systematic generalized approach to controlling a vehicle. Using general aircraft nonlinear equations of motion and onboard aerodynamic, mass properties, and engine models specific to the vehicle, a relationship between control effectors and desired aircraft motion can be formulated. Using this formulation a control combination is used that provides a predictable response to commanded motion. Control loops around this formulation shape the response as desired and provide robustness to modeling errors. Once the control law is designed it can be used on a similar class of vehicle with only an update to the vehicle specific onboard models.

  12. Controlling equine influenza: policy networks and decision-making during the 2007 Australian equine influenza outbreak.

    PubMed

    Schemann, K; Gillespie, J A; Toribio, J-A L M L; Ward, M P; Dhand, N K

    2014-10-01

    Rapid, evidence-based decision-making is critical during a disease outbreak response; however, compliance by stakeholders is necessary to ensure that such decisions are effective - especially if the response depends on voluntary action. This mixed method study evaluated technical policy decision-making processes during the 2007 outbreak of equine influenza in Australia by identifying and analysing the stakeholder network involved and the factors driving policy decision-making. The study started with a review of the outbreak literature and published policy documents. This identified six policy issues regarding policy modifications or differing interpretations by different state agencies. Data on factors influencing the decision-making process for these six issues and on stakeholder interaction were collected using a pre-tested, semi-structured questionnaire. Face-to-face interviews were conducted with 24 individuals representing 12 industry and government organizations. Quantitative data were analysed using social network analysis. Qualitative data were coded and patterns matched to test a pre-determined general theory using a method called theory-oriented process-tracing. Results revealed that technical policy decisions were framed by social, political, financial, strategic and operational considerations. Industry stakeholders had influence through formal pre-existing channels, yet specific gaps in stakeholder interaction were overcome by reactive alliances formed during the outbreak response but outside the established system. Overall, the crisis management system and response were seen as positive, and 75-100% of individuals interviewed were supportive of, had interest in and considered the outcome as good for the majority of policy decisions, yet only 46-75% of those interviewed considered that they had influence on these decisions. Training to increase awareness and knowledge of emergency animal diseases (EADs) and response systems will improve stakeholder

  13. Fear of Success and Locus of Control in Young Women

    ERIC Educational Resources Information Center

    Midgley, Nina; Abrams, Marsha Stein

    1974-01-01

    This study examines the relationship, in women, between the motive to avoid success and feelings of being controlled externally. The results suggest that achievement motivation is blocked or lowered by feelings of external control in the situation of arousal of achievement anxieties in young women. (Author/PC)

  14. Challenges in controlling the Ebola outbreak in two prefectures in Guinea: why did communities continue to resist?

    PubMed Central

    Thiam, Sylla; Delamou, Alexandre; Camara, Soriba; Carter, Jane; Lama, Eugene Kaman; Ndiaye, Bara; Nyagero, Josephat; Nduba, John; Ngom, Mor

    2015-01-01

    Introduction The Ebola outbreak emerged in a remote corner of Guinea in December 2013, and spread into Liberia and Sierra Leone in the context of weak health systems. In this paper, we report on the main challenges faced by frontline health services and by communities including their perceptions and views on the current Ebola response in the Prefectures of Coyah and Forecariah in Guinea. Methods A cross-sectional study was conducted in December 2014 using mixed approaches: (i) Desk review; (ii) Interviews; and (iii) Direct observation. Results Almost one year after the beginning of the Ebola virus disease outbreak in West Africa, the perceptions of stakeholders and the observed reality were that the level of preparedness in the two health districts was low. The study identified poor coordination mechanisms, inadequate training of human resources and lack of equipment and supplies to field teams and health facilities as key elements that affected the response. The situation was worsened by the inadequate communication strategy, misconceptions around the disease, ignorance of local culture and customs and lack of involvement of local communities in the control strategies, within the context of poor socioeconomic development. As a result distrust developed between communities and those seeking to control the epidemic and largely contributed to the reluctance of the communities to participate and contribute to the effort. Conclusion There is a need to rethink the way disease control interventions in the context of an emergency such as Ebola virus disease are designed, planned and implemented in low income countries. PMID:26740850

  15. Assessment of antemortem tests used in the control of an outbreak of tuberculosis in llamas (Lama glama).

    PubMed

    Twomey, D F; Crawshaw, T R; Anscombe, J E; Barnett, J E F; Farrant, L; Evans, L J; McElligott, W S; Higgins, R J; Dean, G S; Vordermeier, H M; de la Rua-Domenech, R

    2010-09-25

    An outbreak of tuberculosis (TB) caused by Mycobacterium bovis in a llama herd is described. Over a 25-month period, a total of 70 llamas were selected for postmortem examination using four distinct criteria: clinical suspicion of disease (15 animals), positive tuberculin skin test result (three animals), antibody positive using a novel serological test (Rapid Test, 54 animals) and elective cull (five animals). Some animals qualified on more than one criterion. Gross lesions of TB were detected in 15 animals, with lung and lymph node lesions consistently observed. Samples were collected from 14 of 15 animals with visible lesions as well as those with no visible lesions, for histopathology and mycobacterial culture. All 14 llamas with visible lesions had caseonecrotic granulomatous lesions associated with acid-fast bacteria and variable mineralisation, and M bovis was isolated from 13. There were no histopathological lesions of TB in llamas with no grossly visible lesions, and M bovis was not isolated from any of these. The predictive value of suspicious gross lesions at postmortem examination was therefore high in the herd. Molecular typing results indicated that the outbreak was caused by a single strain likely to have originated from a local reservoir, probably cattle or wildlife. Antemortem indicators of infection assisted control of the outbreak, but no single test accurately identified all TB cases. Visible lesions were detected in nine of 15 llamas with clinical suspicion of disease, in two of three that had positive tuberculin skin test results and in 10 of 54 that were antibody positive; there was none (zero out of five) in llamas that were electively culled. PMID:20871080

  16. Prediction of the spatial evolution and effects of control measures for the unfolding Haiti cholera outbreak

    NASA Astrophysics Data System (ADS)

    Bertuzzo, E.; Mari, L.; Righetto, L.; Gatto, M.; Casagrandi, R.; Blokesch, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2011-03-01

    Here we propose spatially explicit predictions of the residual progression of the current Haiti cholera outbreak accounting for the dynamics of susceptible and infected individuals within different local human communities, and for the redistribution among them of Vibrio cholerae, the causative agent of the disease. Spreading mechanisms include the diffusion of pathogens in the aquatic environment and their dissemination due to the movement of human carriers. The model reproduces the spatiotemporal features of the outbreak to date, thus suggesting the robustness of predicted future developments of the epidemic. We estimate that, under unchanged conditions, the number of new cases in the whole country should start to decrease in January. During this month the epidemic should mainly involve the Ouest department (Port-au-Prince) while fading out in northern regions. Our spatially explicit model allows also the analysis of the effectiveness of alternative intervention strategies. To that end our results show that mass vaccinations would have a negligible impact at this stage of the epidemic. We also show that targeted sanitation strategies, providing clean drinking water supply and/or staging educational campaigns aimed at reducing exposure, may weaken the strength of the residual evolution of the infection.

  17. Who Controls Succession in the Superintendency? A Minority Perspective.

    ERIC Educational Resources Information Center

    Ortiz, Flora Ida

    2000-01-01

    Studied a sample of 12 Hispanic American women seeking and being appointed to the superintendency. Demonstrated that the succession to the superintendency was controlled by school board members and former superintendents who held search committee membership. Hispanic women are hired when it is perceived that Hispanics were the source of school…

  18. Prevention and management of avian influenza outbreaks: experiences from the United States of America.

    PubMed

    Halvorson, D A

    2009-04-01

    The epidemiology and control of avian influenza (AI) are complex. The virus is transported in nature by the activities of wild birds and in commercial poultry by the activities of people. In general, all the outbreaks of AI in the United States of America (U.S.A.) have involved AI virus spread by the movement of poultry and manure and objects contaminated by poultry and manure, butthe specific cause of spread has been different for most outbreaks. The 1924 highly pathogenic AI (HPAI) outbreak was spread halfway across the U.S.A. by contaminated rail cars and poultry crates; the 1983 HPAI outbreak was spread by the movement of people between farms and transport of live and dead poultry, including depopulation efforts; whereas low pathogenicity AI (LPAI) outbreaks in different states were spread by people and equipment, partial flock removal, transport of spent hens and/or manure, and transport of dead birds for rendering. There is a dichotomy surrounding AI control methods in the USA. Large LPAI outbreaks have mainly affected turkeys in the western part of the country and have been controlled by vaccination and controlled marketing-strategies developed prior to the 1983 HPAI outbreak. By contrast, in the eastern part of the country, the AI control strategy has been modelled on the successful stamping-out programme that was used during the HPAI outbreak in 1983. The author presents a summary of the costs and control strategies in table form. PMID:19618639

  19. Outbreak of hepatitis C virus infections at an outpatient hemodialysis facility: the importance of infection control competencies.

    PubMed

    Rao, Agam K; Luckman, Emily; Wise, Matthew E; MacCannell, Taranisia; Blythe, David; Lin, Yulin; Xia, Guoliang; Drobeniuc, Jan; Noble-Wang, Judith; Arduino, Matthew J; Thompson, Nicola D; Patel, Priti R; Wilson, Lucy E

    2013-01-01

    In the United States, the prevalence of hepatitis C virus infection among patients treated in hemodialysis facilities is five times higher than among the general population. This study investigated eight new hepatitis C virus infections among patients treated at an outpatient hemodialysis facility. Epidemiologic investigation and viral sequencing demonstrated that transmission likely occurred between patients typically treated during the same or consecutive shifts at the same or a nearby station. Several infection control breaches were observed including lapses involving the preparation, handling, and administration of parenteral medications. Improved infection control education and training for all hemodialysis facility staff is an important component of assuring adherence to appropriate procedures and preventing future outbreaks. PMID:23785746

  20. Epidemiological investigation and case-control study: a Legionnaires' disease outbreak associated with cooling towers in Warstein, Germany, August-September 2013.

    PubMed

    Maisa, Anna; Brockmann, Ansgar; Renken, Frank; Lück, Christian; Pleischl, Stefan; Exner, Martin; Daniels-Haardt, Inka; Jurke, Annette

    2015-01-01

    Between 1 August and 6 September 2013, an outbreak of Legionnaires' disease (LD) with 159 suspected cases occurred in Warstein, North Rhine-Westphalia, Germany. The outbreak consisted of 78 laboratory-confirmed cases of LD, including one fatality, with a case fatality rate of 1%. Legionella pneumophila, serogroup 1, subtype Knoxville, sequence type 345, was identified as the epidemic strain. A case-control study was conducted to identify possible sources of infection. In univariable analysis, cases were almost five times more likely to smoke than controls (odds ratio (OR): 4.81; 95% confidence interval (CI): 2.33-9.93; p < 0.0001). Furthermore, cases were twice as likely to live within a 3 km distance from one identified infection source as controls (OR: 2.14; 95% CI: 1.09-4.20; p < 0.027). This is the largest outbreak of LD in Germany to date. Due to a series of uncommon events, this outbreak was most likely caused by multiple sources involving industrial cooling towers. Quick epidemiological assessment, source tracing and shutting down of potential sources as well as rapid laboratory testing and early treatment are necessary to reduce morbidity and mortality. Maintenance of cooling towers must be carried out according to specification to prevent similar LD outbreaks in the future. PMID:26607018

  1. The neurobiology of cognitive control in successful cocaine abstinence

    PubMed Central

    Connolly, Colm G.; Foxe, John J.; Nierenberg, Jay; Shpaner, Marina; Garavan, Hugh

    2011-01-01

    Introduction Extensive evidence demonstrates that current cocaine abusers show hypoactivity in anterior cingulate and dorsolateral prefrontal cortex and respond poorly relative to drug-naïve controls on tests of executive function. Relatively little is known about the cognitive sequalae of long-term abstinence in cocaine addicts. Methods Here, we use a GO-NOGO task in which successful performance necessitated withholding a prepotent response to assay cognitive control in short-and long-term abstinent cocaine users (1-5 weeks and 40-102 weeks, respectively). Results We report significantly greater activity in prefrontal, cingulate, cerebellar and inferior frontal gyrii in abstinent cocaine users for both successful response inhibitions and errors of commission. Moreover, this relative hyperactivity was present in both abstinent groups, which, in the presence of comparable behavioral performance, suggests a functional compensation. Conclusions Differences between the short- and long-abstinence groups in the patterns of functional recruitment suggest different cognitive control demands at different stages in abstinence. Short-term abstinence showed increased inhibition-related dorsolateral and inferior frontal activity indicative of the need for increased inhibitory control while long-term abstinence showed increased error-related ACC activity indicative of heightened behavioral monitoring. The results suggest that the integrity of prefrontal systems that underlie cognitive control functions may be an important characteristic of successful long-term abstinence. PMID:21885214

  2. The potential for sexual transmission to compromise control of Ebola virus outbreaks.

    PubMed

    Vinson, John E; Drake, John M; Rohani, Pejman; Park, Andrew W

    2016-06-01

    Recent evidence suggests that sexual contact may give rise to transmission of Ebola virus long after infection has been cleared from blood. We develop a simple mathematical model that incorporates contact transmission and sexual transmission parametrized from data relating to the 2013-2015 West African Ebola epidemic. The model explores scenarios where contact transmission is reduced following infection events, capturing behaviour change, and quantifies how these actions reducing transmission may be compromised by sexual transmission in terms of increasing likelihood, size and duration of outbreaks. We characterize the extent to which sexual transmission operates in terms of the probability of initial infection resolving to sexual infectiousness and the sexual transmission rate, and relate these parameters to the overall case burden. We find that sexual transmission can have large effects on epidemic dynamics (increasing attack ratios from 25% in scenarios without sexual transmission but with contact-transmission-reducing behaviour, up to 80% in equivalent scenarios with sexual transmission). PMID:27277951

  3. Outbreak Control and Clinical, Pathological, and Epidemiological Aspects and Molecular Characterization of a Bovine Herpesvirus Type 5 on a Feedlot Farm in São Paulo State

    PubMed Central

    Ferreira Vicente, Acácia; Appolinario, Camila Michele; Allendorf, Susan Dora; Gasparini Baraldi, Thaís; Cortez, Adriana; Bryan Heinemann, Marcos; Reinaldo Silva Fonseca, Clovis; Cristina Pelícia, Vanessa; Devidé Ribeiro, Bruna Leticia; Hiromi Okuda, Liria; Pituco, Edviges Maristela

    2015-01-01

    This paper describes the control, epidemiological, pathological, and molecular aspects of an outbreak of meningoencephalitis in calves due to bovine herpesvirus 5 at a feedlot with 540 animals in São Paulo State, Brazil. The introduction of new animals and contact between the resident animals and the introduced ones were most likely responsible for virus transmission. Bovine herpesvirus 1 vaccine was used, resulting in the efficacy of the outbreak control, although two bovine herpesvirus 1 positive animals, vaccinated and revaccinated, presented meningoencephalitis, thereby characterizing vaccinal failure. PMID:26090469

  4. Evaluation of the use of oseltamivir prophylaxis in the control of influenza outbreaks in long-term care facilities in Alberta, Canada: a retrospective provincial database analysis

    PubMed Central

    Ye, Ming; Jacobs, Angela; Khan, Muhammad Naeem; Jaipaul, Joy; Oda, Joanna; Johnson, Marcia; Doroshenko, Alexander

    2016-01-01

    Objectives To evaluate the impact of oseltamivir prophylaxis in the management and control of influenza outbreaks in long-term care facilities in Alberta, Canada. Setting and participants Long-term care facilities where 127 influenza outbreaks were reported to public health authorities in Alberta, Canada, during two influenza seasons from 2013 to 2015. Design and outcome measures Using routinely collected surveillance and administrative data, we examined the association between decision-making time for oseltamivir recommendation as prophylaxis strategy for influenza outbreaks in long-term care facilities (explanatory variable) and the duration of an influenza outbreak, the postprophylaxis risk of influenza-like illness and hospitalisation among residents of long-term care facilities in Alberta (outcome variables) using multivariable linear and Poisson regression models. Results Oseltamivir prophylaxis decision-making time was positively associated with the postintervention duration of an outbreak, with a 1-day delay in making decision on oseltamivir prophylaxis associated with 2.22 (95% CI 1.37 to 3.06) more days of the duration of an outbreak after controlling for potential confounding effect of the number of residents at risk at intervention, outbreak progression time, prevalence of influenza-like illness during outbreak progression, facility location, presence of mixed strain and based on optimal timing of oseltamivir prophylaxis. Although not statistically significant, a 1-day delay in making decision on oseltamivir prophylaxis was associated with a 5% (95% CI −1% to 11%) increase in the postintervention risk of influenza-like illness, and a 6% (95% CI −8% to 22%) increase in the postintervention risk of hospitalisation after controlling for the same potential confounders. Conclusions Our study demonstrated benefits of using oseltamivir prophylaxis to shorten the duration of influenza outbreaks; however, there were no significant differences in the

  5. Successful Control of Ebola Virus Disease: Analysis of Service Based Data from Rural Sierra Leone

    PubMed Central

    Lokuge, Kamalini; Caleo, Grazia; Greig, Jane; Duncombe, Jennifer; McWilliam, Nicholas; Squire, James; Lamin, Manjo; Veltus, Emily; Wolz, Anja; Kobinger, Gary; de la Vega, Marc-Antoine; Gbabai, Osman; Nabieu, Sao; Lamin, Mohammed; Kremer, Ronald; Danis, Kostas; Banks, Emily; Glass, Kathryn

    2016-01-01

    Introduction The scale and geographical distribution of the current outbreak in West Africa raised doubts as to the effectiveness of established methods of control. Ebola Virus Disease (EVD) was first detected in Sierra Leone in May 2014 in Kailahun district. Despite high case numbers elsewhere in the country, transmission was eliminated in the district by December 2014. We describe interventions underpinning successful EVD control in Kailahun and implications for EVD control in other areas. Methods Internal service data and published reports from response agencies were analysed to describe the structure and type of response activities, EVD case numbers and epidemic characteristics. This included daily national situation reports and District-level data and reports of the Sierra Leone Ministry of Health and Sanitation, and Médecins Sans Frontières (MSF) patient data and internal epidemiological reports. We used EVD case definitions provided by the World Health Organisation over the course of the outbreak. Characteristics assessed included level of response activities and epidemiological features such as reported exposure (funeral-related or not), time interval between onset of illness and admission to the EVD Management Centre (EMC), work-related exposures (health worker or not) and mortality. We compared these characteristics between two time periods—June to July (the early period of response), and August to December (when coverage and quality of response had improved). A stochastic model was used to predict case numbers per generation with different numbers of beds and a varying percentage of community cases detected. Results There were 652 probable/confirmed EVD cases from June-December 2014 in Kailahun. An EMC providing patient care opened in June. By August 2014 an integrated detection, treatment, and prevention strategy was in place across the district catchment zone. From June-July to August-December 2014 surveillance and contact tracing staff increased

  6. Fleshflies in the flesh: epidemiology, population genetics and control of outbreaks of traumatic myiasis in the Mediterranean Basin.

    PubMed

    Sotiraki, S; Farkas, R; Hall, M J R

    2010-11-24

    Although the damaging effects on healthy tissues of its developing larvae were first described in 1770, the fleshfly Wohlfahrtia magnifica remains a serious pest for the livestock industry. Wohlfahrtiosis, the severe myiasis caused by this fly, is a grave problem in terms of both the animal welfare and economic loss. This review highlights important aspects of the biology, pest status, epidemiology, population genetic structure, economics and control of W. magnifica and wohlfahrtiosis, with an emphasis on recent outbreaks in Greece and Morocco and fly population dynamics in the Mediterranean Basin. Potential areas for future studies on genetics, host tolerance, in vitro rearing, field behaviour and range expansion of the species are also discussed. PMID:20850931

  7. Avian influenza worldwide: current status and successful control tools

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The H5N1 high pathogenicity avian influenza (HPAI) virus emerged in China during 1996 and has spread to infect poultry and/or wild birds in 62 countries during the past 15 years. For 2010-2011, 20 countries reported outbreaks of H5N1 in domestic poultry (n = 11), wild birds (n = 4) or both (n=5). Th...

  8. Using Positive Deviance for Determining Successful Weight-Control Practices

    PubMed Central

    Stuckey, Heather L.; Boan, Jarol; Kraschnewski, Jennifer L.; Miller-Day, Michelle; Lehman, Erik B.; Sciamanna, Christopher N.

    2013-01-01

    Based on positive deviance (examining the practices of successful individuals), we identified five primary themes from 36 strategies that help to maintain long-term weight loss (weight control) in 61 people. We conducted in-depth interviews to determine what successful individuals did and/or thought about regularly to control their weight. The themes included weight-control practices related to (a) nutrition: increase water, fruit, and vegetable intake, and consistent meal timing and content; (b) physical activity: follow and track an exercise routine at least 3×/week; (c) restraint: practice restraint by limiting and/or avoiding unhealthy foods; (d) self-monitor: plan meals, and track calories/weight progress; and (e) motivation: participate in motivational programs and cognitive processes that affect weight-control behavior. Using the extensive data involving both the practices and practice implementation, we used positive deviance to create a comprehensive list of practices to develop interventions for individuals to control their weight. PMID:20956609

  9. The new ACAM2000 vaccine and other therapies to control orthopoxvirus outbreaks and bioterror attacks.

    PubMed

    Handley, Lauren; Buller, Robert Mark; Frey, Sharon E; Bellone, Clifford; Parker, Scott

    2009-07-01

    Quarantine, case tracing and population vaccination facilitated the global eradication, in 1980, of variola virus, the causative agent of smallpox. The vaccines used during the eradication period, including Dryvax, the smallpox vaccine used in the USA, were live vaccinia and cowpoxvirus-based vaccines, which induced long-lasting and cross-protective immunity against variola and other related poxviruses. These vaccine viruses were produced by serial propagation in domesticated animals. The drawbacks to such serially propagated live viral vaccines include the level of postvaccination local and systemic reactions and contraindications to their use in immunocompromised individuals, individuals with certain skin and cardiac diseases, and pregnant women. In the latter stages of the population-based smallpox vaccination campaign, research began with ways to improve safety and modernizing the manufacture of vaccinia vaccines; however, with the eradication of variola this work stopped. Outbreaks of monkeypoxvirus in humans and the bioterrorist threat of monkeypox and variola virus renewed the need for improved vaccinia vaccines. ACAM2000 is one of the new generation of smallpox vaccines. It is produced in cell culture from a clonally purified master seed stock of vaccinia derived from the New York City Board of Health strain of vaccinia. The clonally purified master seed assures a more homogeneous vaccine without the inherent mutations associated with serial propagation and the cell culture limits adventitious and bacterial contamination in vaccine production. In preclinical and clinical trials, ACAM2000 demonstrated an immunogenicity and safety profile similar to that of Dryvax. PMID:19538111

  10. Molecular characterization of SAT 2 foot-and-mouth disease virus from post-outbreak slaughtered animals: implications for disease control in Uganda.

    PubMed

    Balinda, S N; Belsham, G J; Masembe, C; Sangula, A K; Siegismund, H R; Muwanika, V B

    2010-08-01

    In Uganda, limiting the extent of foot-and-mouth disease (FMD) spread during outbreaks involves short-term measures such as ring vaccination and restrictions of the movement of livestock and their products to and from the affected areas. In this study, the presence of FMD virus RNA was investigated in cattle samples 3 months after FMD quarantine measures had been lifted following an outbreak in 2004. Oropharyngeal tissue samples were obtained from 12 cattle slaughtered in a small town abattoir in Kiboga. FMD virus RNA was detected by diagnostic RT-PCR in nine of the 12 tissue samples. Part of the coding region for the capsid protein VP1 was amplified and sequenced. All samples were identified as belonging to the SAT 2 serotype. The implications for FMD control of both virus introduction into Uganda and the presence of carrier animals following outbreaks are discussed. PMID:20003615

  11. An Infection Control Program for a 2009 Influenza A H1N1 Outbreak in a University-Based Summer Camp

    ERIC Educational Resources Information Center

    Tsalik, Ephraim L.; Cunningham, Coleen K.; Cunningham, Hannah M.; Lopez-Marti, Maria G.; Sangvai, Devdutta G.; Purdy, William K.; Anderson, Deverick J.; Thompson, Jessica R.; Brown, Monte; Woods, Christopher W.; Jaggers, L. Brett; Hendershot, Edward F.

    2011-01-01

    Objectives: Describe two 2009-H1N1 influenza outbreaks in university-based summer camps and the implementation of an infection control program. Participants: 7,906 campers across 73 residential camps from May 21-August 2, 2009. Methods: Influenza-like-illness (ILI) was defined as fever with cough and/or sore throat. Influenza A was identified…

  12. Planning for smallpox outbreaks

    NASA Astrophysics Data System (ADS)

    Ferguson, Neil M.; Keeling, Matt J.; John Edmunds, W.; Gani, Raymond; Grenfell, Bryan T.; Anderson, Roy M.; Leach, Steve

    2003-10-01

    Mathematical models of viral transmission and control are important tools for assessing the threat posed by deliberate release of the smallpox virus and the best means of containing an outbreak. Models must balance biological realism against limitations of knowledge, and uncertainties need to be accurately communicated to policy-makers. Smallpox poses the particular challenge that key biological, social and spatial factors affecting disease spread in contemporary populations must be elucidated largely from historical studies undertaken before disease eradication in 1979. We review the use of models in smallpox planning within the broader epidemiological context set by recent outbreaks of both novel and re-emerging pathogens.

  13. DISEASE OUTBREAKS CAUSED BY DRINKING WATER

    EPA Science Inventory

    Thirty-two waterborne disease outbreaks were reported to the Centers for Disease Control (CDC) and the Environmental Protection Agency in 1981. The outbreaks occurred in 17 states and involved 4430 cases. This was only 64% of the number of outbreaks that were reported in 1980 and...

  14. EPICS: A control system software co-development success story

    SciTech Connect

    Knott, M.; Gurd, D.; Lewis, S.; Thuot, M.

    1993-11-01

    The Experimental Physics and Industrial Control Systems (EPICS) is the result of a software sharing and co-development effort of major importance now underway. The initial two participants, LANL and ANL, have now been joined by three other labs, and an earlier version of the software has been transferred to three commercial firms and is currently undergoing separate development. The reasons for EPICS`s success may be useful to enumerate and explain and the desire and prospects for its continued development are certainly worth examining.

  15. Emergence and outbreak of carbapenemase-producing KPC-3 Klebsiella pneumoniae in Spain, September 2009 to February 2010: control measures.

    PubMed

    Robustillo Rodela, A; Díaz-Agero Pérez, C; Sanchez Sagrado, T; Ruiz-Garbajosa, P; Pita López, M J; Monge, V

    2012-01-01

    This report describes the epidemiological features of the first outbreak caused by KPC3 carbapenemase-producing Klebsiella pneumoniae (KPC-3-KP) in Spain and how it was effectively controlled. From 16 September 2009 to the end of February 2010, seven patients infected or colonised with KPC-3-KP were detected. Stool surveillance cultures were recovered from patients, doctors, nurses, nursing assistants, cleaners and hospital porters working in the affected units. Hand swabs were taken from workers and patients’ relatives for culturing. Environmental samples were also taken. Patients infected or colonised with KPC-3-KP were placed in single rooms under contact precautions and 4% chlorhexidine soap was used for their daily hygiene. Staff attended educational seminars and workshops on hand hygiene and isolation of patients. An alcohol-based disinfectant was used for surface cleaning and disinfecting. The floor was cleaned with a disinfectant containing benzalkonium chloride and didecyldimethylammonium. All samples collected were negative for KPC-3-KP. After implementing the control measures, no further cases were reported in the affected units. All cases had comorbidities, long hospital stay and aggressive/intensive antimicrobial treatment. This study emphasises the importance of early intensification of infection control to interrupt the transmission of KPC-producing organisms. PMID:22370016

  16. Surveillance for Pasteurella multocida in Ring-Necked Pheasants (Phasianus colchicus) After an Outbreak of Avian Cholera and Apparently Successful Antibiotic Treatment.

    PubMed

    Brown, Justin D; Dunn, Patricia; Wallner-Pendleton, Eva; Kariyawasam, Subhashinie; Schriner, Timothy; Hofacre, Charles; Johnson, Joshua; Boyd, Robert

    2016-03-01

    Avian cholera is a significant disease of domestic and wild birds caused by the bacterium Pasteurella multocida (PM). In poultry, a major source of PM infection is chronic carriers, domestic birds that have become infected and recovered or had subclinical infections. Although outbreaks of avian cholera in ring-necked pheasants (Phasianus colchicus) have been reported, the potential for chronic carriers is unknown. To address this, we conducted surveillance for PM in a flock of captive ring-necked pheasants after an outbreak of avian cholera that responded positively to antibiotic treatment based on resolution of morbidity and mortality. At approximately 1 mo after antibiotic treatment, oropharyngeal swabs were collected from 300 pheasants (out of a total population of ~2300) in a single winter holding pen. All samples were tested for PM through routine aerobic bacterial culture, but none of the samples were positive. In addition, there were no additional outbreaks within this infected pen over the subsequent months. These data provide preliminary evidence to suggest that pheasants that respond to antibiotic therapy may be less likely to become chronic carriers of PM than other poultry species, such as chickens (Gallus domesticus). However, due to marked phenotypic and biologic differences between PM strains, additional studies are needed to further support or refute these findings and better understand avian cholera in this species. PMID:26953951

  17. Successful control of lymphatic filariasis in the Republic of Korea.

    PubMed

    Cheun, Hyeng-Il; Kong, Yoon; Cho, Shin-Hyeong; Lee, Jong-Soo; Chai, Jong-Yil; Lee, Joo-Shil; Lee, Jong-Koo; Kim, Tong-Soo

    2009-12-01

    A successful experience of lymphatic filariasis control in the Republic of Korea is briefly reviewed. Filariasis in the Republic of Korea was exclusively caused by infection with Brugia malayi. Over the past several decades from the 1950s to 2006, many investigators exerted their efforts to detection, treatment, and follow-up of filariasis patients in endemic areas, and to control filariasis. Mass, combined with selective, treatments with diethylcarbamazine to microfilaria positive persons had been made them free from microfilaremia and contributed to significant decrease of the microfilarial density in previously endemic areas. Significant decrease of microfilaria positive cases in an area influenced eventually to the endemicity of filariasis in the relevant locality. Together with remarkable economic growth followed by improvement of environmental and personal hygiene and living standards, the factors stated above have contributed to blocking the transmission cycle of B. malayi and led to disappearance of this mosquito-borne ancient disease in the Republic of Korea. PMID:19967079

  18. Effects of a Five-Year Citywide Intervention Program To Control Aedes aegypti and Prevent Dengue Outbreaks in Northern Argentina

    PubMed Central

    Gürtler, Ricardo E.; Garelli, Fernando M.; Coto, Héctor D.

    2009-01-01

    Background Dengue has propagated widely through the Americas. Most countries have not been able to maintain permanent larval mosquito control programs, and the long-term effects of control actions have rarely been documented. Methodology The study design was based on a before-and-after citywide assessment of Aedes aegypti larval indices and the reported incidence of dengue in Clorinda, northeastern Argentina, over 2003–2007. Interventions were mainly based on focal treatment with larvicides of every mosquito developmental site every four months (14 cycles), combined with limited source reduction efforts and ultra-low-volume insecticide spraying during emergency operations. The program conducted 120,000 house searches for mosquito developmental sites and 37,000 larvicide applications. Principal Findings Random-effects regression models showed that Breteau indices declined significantly in nearly all focal cycles compared to pre-intervention indices clustered by neighborhood, after allowing for lagged effects of temperature and rainfall, baseline Breteau index, and surveillance coverage. Significant heterogeneity between neighborhoods was revealed. Larval indices seldom fell to 0 shortly after interventions at the same blocks. Large water-storage containers were the most abundant and likely to be infested. The reported incidence of dengue cases declined from 10.4 per 10,000 in 2000 (by DEN-1) to 0 from 2001 to 2006, and then rose to 4.5 cases per 10,000 in 2007 (by DEN-3). In neighboring Paraguay, the reported incidence of dengue in 2007 was 30.6 times higher than that in Clorinda. Conclusions Control interventions exerted significant impacts on larval indices but failed to keep them below target levels during every summer, achieved sustained community acceptance, most likely prevented new dengue outbreaks over 2003–2006, and limited to a large degree the 2007 outbreak. For further improvement, a shift is needed towards a multifaceted program with intensified

  19. Social and cultural factors in the successful control of tuberculosis.

    PubMed Central

    Rubel, A J; Garro, L C

    1992-01-01

    The burden of tuberculosis on the public health is staggering. Worldwide, annual incidence of new cases is estimated to be about 8 million. Almost 3 million deaths occur yearly. Early case identification and adherence to treatment regimens are the remaining barriers to successful control. In many nations, however, fewer than half those with active disease receive a diagnosis, and fewer than half those beginning treatment complete it. The twin problems of delay in seeking treatment and abandonment of a prescribed regimen derive from complex factors. People's confusion as to the implications of the tuberculosis symptoms, costs of transportation to clinic services, the social stigma that attaches to tuberculosis, the high cost of medication, organizational problems in providing adequate followup services, and patients' perception of clinic facilities as inhospitable all contribute to the complexity. Sociocultural factors are emphasized in this report because hitherto they have not been adequately explored. Salient among those sociocultural factors is the health culture of the patients. That is, the understanding and information people have from family, friends, and neighbors as to the nature of a health problem, its cause, and its implications. A knowledge of the health culture of their patients has become a critical tool if tuberculosis control programs are to be successful. Several anthropological procedures are recommended to help uncover the health culture of people served by tuberculosis clinics. PMID:1454974

  20. Conditioned food aversion to control outbreaks of intoxication by Ipomoea carnea and Turbina cordata in goats

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Conditioned food aversion is used to train livestock to avoid the ingestion of toxic plants. This technique was used to control Turbina cordata poisoning in goats in one farm, and to control Ipomoea carnea subsp. istulosa poisoning in another farm. The goats were penned at night and the next mornin...

  1. CURRENT STATUS OF RECOMBINANT MAREK'S DISEASE VACCINES FOR CONTROL OF FUTURE OUTBREAKS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    More than 4 decades of vaccination has resulted in good control of Marek’s disease (MD). Although vaccination has dramatically reduced the incidence of the disease, more virulent viruses are emerging and the development of new control strategies is needed. Recently, the student of MD virus (MDV) g...

  2. Evidence for Emergency Vaccination Having Played a Crucial Role to Control the 1965/66 Foot-and-Mouth Disease Outbreak in Switzerland

    PubMed Central

    Zingg, Dana; Häsler, Stephan; Schuepbach-Regula, Gertraud; Schwermer, Heinzpeter; Dürr, Salome

    2015-01-01

    Foot-and-mouth disease (FMD) is a highly contagious disease that caused several large outbreaks in Europe in the last century. The last important outbreak in Switzerland took place in 1965/66 and affected more than 900 premises and more than 50,000 animals were slaughtered. Large-scale emergency vaccination of the cattle and pig population has been applied to control the epidemic. In recent years, many studies have used infectious disease models to assess the impact of different disease control measures, including models developed for diseases exotic for the specific region of interest. Often, the absence of real outbreak data makes a validation of such models impossible. This study aimed to evaluate whether a spatial, stochastic simulation model (the Davis Animal Disease Simulation model) can predict the course of a Swiss FMD epidemic based on the available historic input data on population structure, contact rates, epidemiology of the virus, and quality of the vaccine. In addition, the potential outcome of the 1965/66 FMD epidemic without application of vaccination was investigated. Comparing the model outcomes to reality, only the largest 10% of the simulated outbreaks approximated the number of animals being culled. However, the simulation model highly overestimated the number of culled premises. While the outbreak duration could not be well reproduced by the model compared to the 1965/66 epidemic, it was able to accurately estimate the size of the area infected. Without application of vaccination, the model predicted a much higher mean number of culled animals than with vaccination, demonstrating that vaccination was likely crucial in disease control for the Swiss FMD outbreak in 1965/66. The study demonstrated the feasibility to analyze historical outbreak data with modern analytical tools. However, it also confirmed that predicted epidemics from a most carefully parameterized model cannot integrate all eventualities of a real epidemic. Therefore, decision

  3. Use of the CDC Autocidal Gravid Ovitrap to Control and Prevent Outbreaks of Aedes aegypti (Diptera: Culicidae)

    PubMed Central

    Barrera, Roberto; Amador, Manuel; Acevedo, Veronica; Caban, Belkis; Felix, Gilberto; Mackay, Andrew J.

    2015-01-01

    Populations of Aedes aegypti (L.) can be managed through reductions in adult mosquito survival, number of offspring produced, or both. Direct adult mortality can be caused by the use of space sprays or residual insecticides to mosquito resting sites, and with a variety of residual insecticide-impregnated surfaces that are being tested, such as curtains, covers for water-storage vessels, bednets, and ovitraps. The fertility of Ae. aegypti populations can be reduced by the use of autocidal oviposition cups that prevent the development of mosquitoes inside the trap by mechanical means or larvicides, as well as by releasing sterile, transgenic, and para-transgenic mosquitoes. Survival and fertility can be simultaneously reduced by capturing gravid female Ae. aegypti with sticky gravid traps. We tested the effectiveness of the novel Centers for Disease Control and Prevention autocidal gravid ovitrap (CDC-AGO trap) to control natural populations of Ae. aegypti under field conditions in two isolated urban areas (reference vs. intervention areas) in southern Puerto Rico for 1 yr. There were significant reductions in the captures of female Ae. aegypti (53–70%) in the intervention area. The presence of three to four AGO control traps per home in 81% of the houses prevented outbreaks of Ae. aegypti, which would be expected after rains. Mosquito captures in BG-Sentinel and AGO traps were significantly and positively correlated, showing that AGO traps are useful and inexpensive mosquito surveillance devices. The use of AGO traps to manage Ae. aegypti populations is compatible with other control means such as source reduction, larviciding, adulticiding, sterile insect techniques, induced cytoplasmic incompatibility, and dominant lethal gene systems. PMID:24605464

  4. Use of the CDC autocidal gravid ovitrap to control and prevent outbreaks of Aedes aegypti (Diptera: Culicidae).

    PubMed

    Barrera, Roberto; Amador, Manuel; Acevedo, Veronica; Caban, Belkis; Felix, Gilberto; Mackay, Andrew J

    2014-01-01

    Populations ofAedes aegypti (L.) can be managed through reductions in adult mosquito survival, number of offspring produced, or both. Direct adult mortality can be caused by the use of space sprays or residual insecticides to mosquito resting sites, and with a variety of residual insecticide-impregnated surfaces that are being tested, such as curtains, covers for water-storage vessels, bednets, and ovitraps. The fertility ofAe. aegypti populations can be reduced by the use of autocidal oviposition cups that prevent the development of mosquitoes inside the trap by mechanical means or larvicides, as well as by releasing sterile, transgenic, and para-transgenic mosquitoes. Survival and fertility can be simultaneously reduced by capturing gravid female Ae. aegypti with sticky gravid traps. We tested the effectiveness of the novel Centers for Disease Control and Prevention autocidal gravid ovitrap (CDC-AGO trap) to control natural populations ofAe. aegypti under field conditions in two isolated urban areas (reference vs. intervention areas) in southern Puerto Rico for 1 yr. There were significant reductions in the captures of female Ae. aegypti (53-70%) in the intervention area The presence of three to four AGO control traps per home in 81% of the houses prevented outbreaks of Ae. aegypti, which would be expected after rains. Mosquito captures in BG-Sentinel and AGO traps were significantly and positively correlated, showing that AGO traps are useful and inexpensive mosquito surveillance devices. The use of AGO traps to manage Ae. aegypti populations is compatible with other control means such as source reduction, larviciding, adulticiding, sterile insect techniques, induced cytoplasmic incompatibility, and dominant lethal gene systems. PMID:24605464

  5. Epidemic outbreaks, diagnostics, and control measures of the H5N1 highly pathogenic avian influenza in the Kingdom of Saudi Arabia, 2007-08.

    PubMed

    Lu, Huaguang; Ismail, Mahmoud Moussa; Khan, Owais Ahmed; Al Hammad, Yousef; Abdel Rhman, Salah Shaban; Al-Blowi, Mohamed Hamad

    2010-03-01

    The first outbreak of H5N1 highly pathogenic avian influenza (HPAI) in the Kingdom of Saudi Arabia (KSA) occurred in two "backyard" flocks of Houbara bustards and falcons in February 2007. Subsequent outbreaks were seen through the end of 2007 in "backyard" birds including native chickens, ostriches, turkeys, ducks, and peacocks. From November 2007 through January 2008, H5N1 HPAI outbreaks occurred in 19 commercial poultry premises, including two broiler breeder farms, one layer breeder farm, one ostrich farm, and 15 commercial layer farms, with approximately 4.75 million birds affected. Laboratory diagnosis of all H5N1-positive cases was conducted at the Central Veterinary Diagnostic Laboratory (CVDL) in Riyadh, Saudi Arabia. A combination of diagnostic tests was used to confirm the laboratory diagnosis. A rapid antigen-capture test and real-time reverse transcriptase-PCR (rtRT-PCR) assay on clinical and field specimens were conducted initially. Meanwhile, virus isolation in specific-pathogen-free embryonating chicken eggs was performed and was followed by hemagglutinin (HA) and hemagglutination inhibition tests, then rapid antigen-capture and rtRT-PCR tests on HA-positive allantoic fluid samples. In most HPAI cases, a complete laboratory diagnosis was made within 24-48 hr at the CVDL. Saudi Arabian government officials made immediate decisions to depopulate all H5N1-affected and nonaffected flocks within a 5-km radius area and applied quarantine zones to prevent the virus from spreading to other areas. Other control measures, such as closure of live bird markets and intensive surveillance tests on all poultry species within quarantine zones, were in place during the outbreaks. As a result, the HPAI outbreaks were quickly controlled, and no positive cases were detected after January 29, 2008. The KSA was declared free of HPAI on April 30, 2008, by the World Animal Health Organization. PMID:20521658

  6. Perifolliculitis capitis abscedens et suffodiens successfully controlled with topical isotretinoin.

    PubMed

    Karpouzis, Anthony; Giatromanolaki, Alexandra; Sivridis, Efthymios; Kouskoukis, Constantin

    2003-01-01

    Perifolliculitis capitis abscedens et suffodiens (or dissecting folliculitis of the scalp or dissecting cellulitis of the scalp or dissecting perifolliculitis of the scalp) is a rare entity and constitutes the equivalent over the scalp, of hidradenitis suppurativa and acne conglobata. Etiologic factors are unknown. Diagnosis is proven histologically. Management is very difficult and consists in systemic administration or intralesional injection of several drugs or in surgical manipulations. An 18 year-old white patient with cystic infiltrations, alopecia plaques, pustules and other inflammatory elements (clinicohistological features consistent with dissecting folliculitis of the scalp), is presented. Isotretinoin topical application assured successful control of the disease and averted the evolution of the clinical aspect to scarring alopecia and nodule formation. Topical isotretinoin exercises a curative, inhibitory and antiproliferative action, in perifolliculitis capitis abscedens et suffodiens. PMID:12695138

  7. Improved husbandry to control an outbreak of rainbow trout fry syndrome caused by infection with Flavobacterium psychrophilum

    USGS Publications Warehouse

    Bebak, J.A.; Welch, T.J.; Starliper, C.E.; Baya, A.M.; Garner, M.M.

    2007-01-01

    Case Description - A cohort of 35,200, 13-week-old, female rainbow trout at a fish farm was evaluated because of a 2-week history of anorexia and lethargy and a mortality rate of approximately 100 fish/d. Clinical Findings - Affected fish were lethargic and thin and had disequilibrium, bilateral exophthalmia, pale red gills and kidneys, red-tinged coelomic fluid, and pale brown livers. Some fish were differentially pigmented bilaterally. The presumptive diagnosis was bacterial or viral septicemia. The definitive diagnosis was rainbow trout fry syndrome caused by infection with Flavobacterium psychrophilum. Treatment and Outcome - A strategy for controlling the outbreak based on reducing pathogen numbers in affected tanks and reducing pathogen spread among tanks was developed. The option of treating with antimicrobial-medicated feed was discussed with the farmer, but was declined. After changes were made, mortality rate declined quickly, with no more deaths within 10 days after the initial farm visit. Clinical Relevance - Bacterial coldwater disease is the most common manifestation of infection with F psychrophilum in fingerling and adult rainbow trout. However, the organism can also cause rainbow trout fry syndrome. This condition should be included on a list of differential diagnoses for septicemia in hatchery-reared rainbow trout fry.

  8. Integration of Genomic and Other Epidemiologic Data to Investigate and Control a Cross-Institutional Outbreak of Streptococcus pyogenes

    PubMed Central

    Chalker, Victoria J.; Smith, Alyson; Al-Shahib, Ali; Botchway, Stella; Macdonald, Emily; Daniel, Roger; Phillips, Sarah; Platt, Steven; Doumith, Michel; Tewolde, Rediat; Coelho, Juliana; Jolley, Keith A.; Underwood, Anthony

    2016-01-01

    Single-strain outbreaks of Streptococcus pyogenes infections are common and often go undetected. In 2013, two clusters of invasive group A Streptococcus (iGAS) infection were identified in independent but closely located care homes in Oxfordshire, United Kingdom. Investigation included visits to each home, chart review, staff survey, microbiologic sampling, and genome sequencing. S. pyogenes emm type 1.0, the most common circulating type nationally, was identified from all cases yielding GAS isolates. A tailored whole-genome reference population comprising epidemiologically relevant contemporaneous isolates and published isolates was assembled. Data were analyzed independently using whole-genome multilocus sequencing and single-nucleotide polymorphism analyses. Six isolates from staff and residents of the homes formed a single cluster that was separated from the reference population by both analytical approaches. No further cases occurred after mass chemoprophylaxis and enhanced infection control. Our findings demonstrate the ability of 2 independent analytical approaches to enable robust conclusions from nonstandardized whole-genome analysis to support public health practice. PMID:27192043

  9. Integration of Genomic and Other Epidemiologic Data to Investigate and Control a Cross-Institutional Outbreak of Streptococcus pyogenes.

    PubMed

    Chalker, Victoria J; Smith, Alyson; Al-Shahib, Ali; Botchway, Stella; Macdonald, Emily; Daniel, Roger; Phillips, Sarah; Platt, Steven; Doumith, Michel; Tewolde, Rediat; Coelho, Juliana; Jolley, Keith A; Underwood, Anthony; McCarthy, Noel D

    2016-06-01

    Single-strain outbreaks of Streptococcus pyogenes infections are common and often go undetected. In 2013, two clusters of invasive group A Streptococcus (iGAS) infection were identified in independent but closely located care homes in Oxfordshire, United Kingdom. Investigation included visits to each home, chart review, staff survey, microbiologic sampling, and genome sequencing. S. pyogenes emm type 1.0, the most common circulating type nationally, was identified from all cases yielding GAS isolates. A tailored whole-genome reference population comprising epidemiologically relevant contemporaneous isolates and published isolates was assembled. Data were analyzed independently using whole-genome multilocus sequencing and single-nucleotide polymorphism analyses. Six isolates from staff and residents of the homes formed a single cluster that was separated from the reference population by both analytical approaches. No further cases occurred after mass chemoprophylaxis and enhanced infection control. Our findings demonstrate the ability of 2 independent analytical approaches to enable robust conclusions from nonstandardized whole-genome analysis to support public health practice. PMID:27192043

  10. There's No Place Like Home: Crown-of-Thorns Outbreaks in the Central Pacific Are Regionally Derived and Independent Events

    PubMed Central

    Timmers, Molly A.; Bird, Christopher E.; Skillings, Derek J.; Smouse, Peter E.; Toonen, Robert J.

    2012-01-01

    One of the most significant biological disturbances on a tropical coral reef is a population outbreak of the fecund, corallivorous crown-of-thorns sea star, Acanthaster planci. Although the factors that trigger an initial outbreak may vary, successive outbreaks within and across regions are assumed to spread via the planktonic larvae released from a primary outbreak. This secondary outbreak hypothesis is predominantly based on the high dispersal potential of A. planci and the assertion that outbreak populations (a rogue subset of the larger population) are genetically more similar to each other than they are to low-density non-outbreak populations. Here we use molecular techniques to evaluate the spatial scale at which A. planci outbreaks can propagate via larval dispersal in the central Pacific Ocean by inferring the location and severity of gene flow restrictions from the analysis of mtDNA control region sequence (656 specimens, 17 non-outbreak and six outbreak locations, six archipelagos, and three regions). Substantial regional, archipelagic, and subarchipelagic-scale genetic structuring of A. planci populations indicate that larvae rarely realize their dispersal potential and outbreaks in the central Pacific do not spread across the expanses of open ocean. On a finer scale, genetic partitioning was detected within two of three islands with multiple sampling sites. The finest spatial structure was detected at Pearl & Hermes Atoll, between the lagoon and forereef habitats (<10 km). Despite using a genetic marker capable of revealing subtle partitioning, we found no evidence that outbreaks were a rogue genetic subset of a greater population. Overall, outbreaks that occur at similar times across population partitions are genetically independent and likely due to nutrient inputs and similar climatic and ecological conditions that conspire to fuel plankton blooms. PMID:22363570

  11. Pertussis (Whooping Cough) Outbreaks

    MedlinePlus

    ... questions about pertussis outbreaks... Resources and Publications Find articles about pertussis outbreaks and resources for outbreak response... Postexposure Antimicrobial Prophylaxis The primary objective of PEP should be to prevent death ...

  12. A review of the vector management methods to prevent and control outbreaks of West Nile virus infection and the challenge for Europe

    PubMed Central

    2014-01-01

    West Nile virus infection is a growing concern in Europe. Vector management is often the primary option to prevent and control outbreaks of the disease. Its implementation is, however, complex and needs to be supported by integrated multidisciplinary surveillance systems and to be organized within the framework of predefined response plans. The impact of the vector control measures depends on multiple factors and the identification of the best combination of vector control methods is therefore not always straightforward. Therefore, this contribution aims at critically reviewing the existing vector control methods to prevent and control outbreaks of West Nile virus infection and to present the challenges for Europe. Most West Nile virus vector control experiences have been recently developed in the US, where ecological conditions are different from the EU and vector control is organized under a different regulatory frame. The extrapolation of information produced in North America to Europe might be limited because of the seemingly different epidemiology in the European region. Therefore, there is an urgent need to analyse the European experiences of the prevention and control of outbreaks of West Nile virus infection and to perform robust cost-benefit analysis that can guide the implementation of the appropriate control measures. Furthermore, to be effective, vector control programs require a strong organisational backbone relying on a previously defined plan, skilled technicians and operators, appropriate equipment, and sufficient financial resources. A decision making guide scheme is proposed which may assist in the process of implementation of vector control measures tailored on specific areas and considering the available information and possible scenarios. PMID:25015004

  13. Malaria in Turkey: successful control and strategies for achieving elimination.

    PubMed

    Özbilgina, Ahmet; Topluoglu, Seher; Es, Saffet; Islek, Elif; Mollahaliloglu, Salih; Erkoc, Yasin

    2011-01-01

    Turkey is located in the middle of Asia, Africa and Europe, close to Caucasia, Balkans and Middle East in subtropical climate zone. Malaria has been known since the early ages of human history and it was one of the leading diseases in Anatolian history, as well. Today, chloroquine-sensitive Plasmodium vivax is the only agent of autochthonous malaria cases in Turkey. The other Plasmodium species identified are isolated from imported cases of malaria. The most common vector of malaria in Turkey is Anopheles sacharovi followed by An. superpictus, An. maculipennis and An. subalpinus. In 2009, pre-elimination stage of Malaria Program was started due to dramatic decline in the number of malaria cases in Turkey (Total, 84; 38 autochthonous cases only in 26 foci in south-eastern Anatolia, and 46 imported cases; incidence: 0.1/100,000). As there were no detected cases of new autochthonous malaria in the first 8 months of 2010, elimination stage was started. The role of the persistent policies and successful applications of the Ministry of Health, such as the strict control of the patients using anti-malarial drugs especially chloroquine, avoidance of resistant insecticides, facilitation of access to patients via Health Transformation Program (HTP), establishment of close contact with the patients' families, and improvement of reporting and surveillance system, was essential. In addition, improvement maintained in the motivations and professional rights of malaria workers, as well in the coordination of field studies and maintenance of a decline or termination in vector-to-person transmission were all achieved with the insistent policies of the Ministry of Health. Other factors that probably contributed to elimination studies include lessening of military operations in south-eastern Anatolia and the lowering of malaria cases in neighbouring countries in recent years. Free access to health services concerning malaria is still successfully conducted throughout the country

  14. Risk factors for winter outbreak of acute diarrhoea in France: case-control study.

    PubMed Central

    Letrilliart, L.; Desenclos, J. C.; Flahault, A.

    1997-01-01

    OBJECTIVES: To assess the potential role of consumption of shellfish (particularly raw oysters) and tap water in the winter epidemic of acute diarrhoea in France. DESIGN: Population based, case-control study during the 1995-6 winter epidemic of acute diarrhoea in France. SETTING: A national network comprising 1% of general practitioners in France. SUBJECTS: 568 pairs of cases and controls consulting in general practice and interviewed by 209 doctors from 26 December 1995 to 31 January 1996. Cases and controls were matched for age, doctor, and time of consultation. MAIN OUTCOME MEASURES: Adjusted relative risk of diarrhoea estimated from conditional logistic regression. RESULTS: The risk of acute diarrhoea was not increased in people who had recently eaten raw oysters (odds ratio 1.1; 95% confidence interval 0.9% to 1.4%) or other shellfish such as clams, cockles, and mussels, or in those people who usually consumed tap water rather than bottled water (0.8; 0.6% to 1.1%). The risk was, however, increased in people who had had recent contact wit ha person with diarrhoea either within the household (adjusted odds ratio 5.0) or in the workplace (3.1), and in people who lived with a child < or = 2 years of age (1.6). Recent treatment with either oral penicillin or cephalosporin was also independently associated with acute diarrhoea in winter. CONCLUSIONS: The winter epidemic of acute diarrhoea in France is probably not caused by consumption of either shellfish or tap water. A viral aetiology, however, is suggested by the speed with which the acute diarrhoea is transmitted. PMID:9448526

  15. Control of malaria: a successful experience from Viet Nam.

    PubMed Central

    Hung, Le Q.; Vries, Peter J. de; Giao, Phan T.; Nam, Nguyen V.; Binh, Tran Q.; Chong, M. T.; Quoc, N. T. T. A.; Thanh, T. N.; Hung, L. N.; Kager, P. A.

    2002-01-01

    OBJECTIVE: To follow malaria prospectively in an ethnic minority commune in the south of Viet Nam with high malaria transmission and seasonal fluctuation, during malaria control interventions using insecticide-treated bednets (ITBNs) and early diagnosis and treatment (EDT) of symptomatic patients. METHODS: From 1994 onwards the following interventions were used: distribution of ITBNs to all households with biannual reimpregnation; construction of a health post and appointment of staff trained in microscopic diagnosis and treatment of malaria; regular supply of materials and drugs; annual cross-sectional malaria surveys with treatment of all parasitaemic subjects, and a programme of community involvement and health education. Surveys were held yearly at the end of the rainy season. During the surveys, demographic data were updated. Diagnosis and treatment of malaria were free of charge. Plasmodium falciparum infection was treated with artesunate and P. vivax infection with chloroquine plus primaquine. FINDINGS: The baseline survey in 1994 recorded 716 inhabitants. Of the children under 2 years of age, 37% were parasitaemic; 56% of children aged 2-10 years, and 35% of the remaining population were parasitaemic. P. falciparum accounted for 73-79% of these infections. The respective splenomegaly rates for the above-mentioned age groups were 20%, 56%, and 32%. In 1999, the proportion of parasitaemic subjects was 4%, 7% and 1%, respectively, of which P.falciparum contributed 56%. The splenomegaly rate was 0%, 5% and 2%, respectively. CONCLUSIONS: A combination of ITBNs and EDT, provided free of charge, complemented by annual diagnosis and treatment during malaria surveys and community involvement with health education successfully brought malaria under control. This approach could be applied to other regions in the south of Viet Nam and provides a sound basis for further studies in other areas with different epidemiological patterns of malaria. PMID:12219158

  16. Middle East respiratory syndrome coronavirus: transmission, virology and therapeutic targeting to aid in outbreak control

    PubMed Central

    Durai, Prasannavenkatesh; Batool, Maria; Shah, Masaud; Choi, Sangdun

    2015-01-01

    Middle East respiratory syndrome coronavirus (MERS-CoV) causes high fever, cough, acute respiratory tract infection and multiorgan dysfunction that may eventually lead to the death of the infected individuals. MERS-CoV is thought to be transmitted to humans through dromedary camels. The occurrence of the virus was first reported in the Middle East and it subsequently spread to several parts of the world. Since 2012, about 1368 infections, including ~487 deaths, have been reported worldwide. Notably, the recent human-to-human ‘superspreading' of MERS-CoV in hospitals in South Korea has raised a major global health concern. The fatality rate in MERS-CoV infection is four times higher compared with that of the closely related severe acute respiratory syndrome coronavirus infection. Currently, no drug has been clinically approved to control MERS-CoV infection. In this study, we highlight the potential drug targets that can be used to develop anti-MERS-CoV therapeutics. PMID:26315600

  17. EV71 vaccine, a new tool to control outbreaks of hand, foot and mouth disease (HFMD).

    PubMed

    Mao, Qun-Ying; Wang, Yiping; Bian, Lianlian; Xu, Miao; Liang, Zhenglun

    2016-05-01

    On December 3rd 2015, the China Food and Drug Administration (CFDA) approved the first inactivated Enterovirus 71 (EV71) whole virus vaccine for preventing severe hand, foot and mouth disease (HFMD). As one of the few preventive vaccines for children's infectious diseases generated by the developing countries in recent years, EV71 vaccine is a blessing to children's health in China and worldwide. However, there are still a few challenges facing the worldwide use of EV71 vaccine, including the applicability against various EV71 pandemic strains in other countries, international requirements on vaccine production and quality control, standardization and harmonization on different pathogen monitoring and detecting methods, etc. In addition, the affordability of EV71 vaccine in other countries is a factor to be considered in HFMD prevention. Therefore, with EV71 vaccine commercially available, there is still a long way to go before reaching effective protection against severe HFMD after EV71 vaccines enter the market. In this paper, the bottlenecks and prospects for the wide use of EV71 vaccine after its approval are evaluated. PMID:26732723

  18. Importance of Internet Surveillance in Public Health Emergency Control and Prevention: Evidence From a Digital Epidemiologic Study During Avian Influenza A H7N9 Outbreaks

    PubMed Central

    Zhu, Honghong; Jiang, Tao; Wang, Xinyi; Chen, Lei; Jiang, Zhenggang; Zheng, Dawei

    2014-01-01

    Background Outbreaks of human infection with a new avian influenza A H7N9 virus occurred in China in the spring of 2013. Control and prevention of a new human infectious disease outbreak can be strongly affected by public reaction and social impact through the Internet and social media. Objective This study aimed to investigate the potential roles of Internet surveillance in control and prevention of the human H7N9 outbreaks. Methods Official data for the human H7N9 outbreaks were collected via the China National Health and Family Planning Committee website from March 31 to April 24, 2013. We obtained daily posted and forwarded number of blogs for the keyword “H7N9” from Sina microblog website and a daily Baidu Attention Index (BAI) from Baidu website, which reflected public attention to the outbreak. Rumors identified and confirmed by the authorities were collected from Baidu search engine. Results Both daily posted and forwarded number and BAI for keyword H7N9 increased quickly during the first 3 days of the outbreaks and remained at a high level for 5 days. The total daily posted and forwarded number for H7N9 on Sina microblog peaked at 850,000 on April 3, from zero blogs before March 31, increasing to 97,726 on April 1 and to 370,607 on April 2, and remaining above 500,000 from April 5-8 before declining to 208,524 on April 12. The total daily BAI showed a similar pattern of change to the total daily posted and forwarded number over time from March 31 to April 12. When the outbreak locations spread, especially into other areas of the same province/city and the capital, Beijing, daily posted and forwarded number and BAI increased again to a peak at 368,500 and 116,911, respectively. The median daily BAI during the studied 25 days was significantly higher among the 7 provinces/cities with reported human H7N9 cases than the 2 provinces without any cases (P<.001). So were the median daily posted and forwarded number and daily BAI in each province/city except

  19. Lessons for Control of Heroin-Associated Anthrax in Europe from 2009–2010 Outbreak Case Studies, London, UK

    PubMed Central

    Abbara, Aula; Brooks, Tim; Taylor, Graham P.; Nolan, Marianne; Donaldson, Hugo; Manikon, Maribel

    2014-01-01

    Outbreaks of serious infections associated with heroin use in persons who inject drugs (PWIDs) occur intermittently and require vigilance and rapid reporting of individual cases. Here, we give a firsthand account of the cases in London during an outbreak of heroin-associated anthrax during 2009–2010 in the United Kingdom. This new manifestation of anthrax has resulted in a clinical manifestation distinct from already recognized forms. During 2012–13, additional cases of heroin-associated anthrax among PWIDs in England and other European countries were reported, suggesting that anthrax-contaminated heroin remains in circulation. Antibacterial drugs used for serious soft tissue infection are effective against anthrax, which may lead to substantial underrecognition of this novel illness. The outbreak in London provides a strong case for ongoing vigilance and the use of serologic testing in diagnosis and serologic surveillance schemes to determine and monitor the prevalence of anthrax exposure in the PWID community. PMID:24959910

  20. Control of a Reassortant Pandemic 2009 H1N1 Influenza Virus Outbreak in an Intensive Swine Breeding Farm: Effect of Vaccination and Enhanced Farm Management Practices

    PubMed Central

    Mughini-Gras, Lapo; Beato, Maria Serena; Angeloni, Giorgia; Monne, Isabella; Buniolo, Filippo; Zuliani, Federica; Morini, Matteo; Castellan, Alberto; Bonfanti, Lebana; Marangon, Stefano

    2015-01-01

    Influenza A viruses in swine cause considerable economic losses and raise concerns about their zoonotic potential. The current paucity of thorough empirical assessments of influenza A virus infection levels in swine herds under different control interventions hinders our understanding of their effectiveness. Between 2012 and 2013, recurrent outbreaks of respiratory disease caused by a reassortant pandemic 2009 H1N1 (H1N1pdm) virus were registered in a swine breeding farm in North-East Italy, providing the opportunity to assess an outbreak response plan based on vaccination and enhanced farm management. All sows/gilts were vaccinated with a H1N1pdm-specific vaccine, biosecurity was enhanced, weaning cycles were lengthened, and cross-fostering of piglets was banned. All tested piglets had maternally-derived antibodies at 30 days of age and were detectable in 5.3% of ~90 day-old piglets. There was a significant reduction in H1N1pdm RT-PCR detections after the intervention. Although our study could not fully determine the extent to which the observed trends in seropositivity or RT-PCR positivity among piglets were due to the intervention or to the natural course of the disease in the herd, we provided suggestive evidence that the applied measures were useful in controlling the outbreak, even without an all-in/all-out system, while keeping farm productivity at full. PMID:25932349

  1. Control of a Reassortant Pandemic 2009 H1N1 Influenza Virus Outbreak in an Intensive Swine Breeding Farm: Effect of Vaccination and Enhanced Farm Management Practices.

    PubMed

    Mughini-Gras, Lapo; Beato, Maria Serena; Angeloni, Giorgia; Monne, Isabella; Buniolo, Filippo; Zuliani, Federica; Morini, Matteo; Castellan, Alberto; Bonfanti, Lebana; Marangon, Stefano

    2015-01-01

    Influenza A viruses in swine cause considerable economic losses and raise concerns about their zoonotic potential. The current paucity of thorough empirical assessments of influenza A virus infection levels in swine herds under different control interventions hinders our understanding of their effectiveness. Between 2012 and 2013, recurrent outbreaks of respiratory disease caused by a reassortant pandemic 2009 H1N1 (H1N1pdm) virus were registered in a swine breeding farm in North-East Italy, providing the opportunity to assess an outbreak response plan based on vaccination and enhanced farm management. All sows/gilts were vaccinated with a H1N1pdm-specific vaccine, biosecurity was enhanced, weaning cycles were lengthened, and cross-fostering of piglets was banned. All tested piglets had maternally-derived antibodies at 30 days of age and were detectable in 5.3% of ~90 day-old piglets. There was a significant reduction in H1N1pdm RT-PCR detections after the intervention. Although our study could not fully determine the extent to which the observed trends in seropositivity or RT-PCR positivity among piglets were due to the intervention or to the natural course of the disease in the herd, we provided suggestive evidence that the applied measures were useful in controlling the outbreak, even without an all-in/all-out system, while keeping farm productivity at full. PMID:25932349

  2. A Mixed Outbreak of Epidemic Typhus Fever and Trench Fever in a Youth Rehabilitation Center: Risk Factors for Illness from a Case-Control Study, Rwanda, 2012.

    PubMed

    Umulisa, Irenee; Omolo, Jared; Muldoon, Katherine A; Condo, Jeanine; Habiyaremye, Francois; Uwimana, Jean Marie; Muhimpundu, Marie Aimee; Galgalo, Tura; Rwunganira, Samuel; Dahourou, Anicet G; Tongren, Eric; Koama, Jean Baptiste; McQuiston, Jennifer; Raghunathan, Pratima L; Massung, Robert; Gatei, Wangeci; Boer, Kimberly; Nyatanyi, Thierry; Mills, Edward J; Binagwaho, Agnes

    2016-08-01

    In August 2012, laboratory tests confirmed a mixed outbreak of epidemic typhus fever and trench fever in a male youth rehabilitation center in western Rwanda. Seventy-six suspected cases and 118 controls were enrolled into an unmatched case-control study to identify risk factors for symptomatic illness during the outbreak. A suspected case was fever or history of fever, from April 2012, in a resident of the rehabilitation center. In total, 199 suspected cases from a population of 1,910 male youth (attack rate = 10.4%) with seven deaths (case fatality rate = 3.5%) were reported. After multivariate analysis, history of seeing lice in clothing (adjusted odds ratio [aOR] = 2.6, 95% confidence interval [CI] = 1.1-5.8), delayed (≥ 2 days) washing of clothing (aOR = 4.0, 95% CI = 1.6-9.6), and delayed (≥ 1 month) washing of beddings (aOR = 4.6, 95% CI = 2.0-11) were associated with illness, whereas having stayed in the rehabilitation camp for ≥ 6 months was protective (aOR = 0.20, 95% CI = 0.10-0.40). Stronger surveillance and improvements in hygiene could prevent future outbreaks. PMID:27352876

  3. Investigation of a staphylococcal food poisoning outbreak combining case-control, traditional typing and whole genome sequencing methods, Luxembourg, June 2014.

    PubMed

    Mossong, Joël; Decruyenaere, Frédéric; Moris, Gilbert; Ragimbeau, Catherine; Olinger, Christophe M; Johler, Sophia; Perrin, Monique; Hau, Patrick; Weicherding, Pierre

    2015-01-01

    In June 2014, a staphylococcal food poisoning outbreak occurred at an international equine sports event in Luxembourg requiring the hospitalisation of 31 persons. We conducted a microbiological investigation of patients and buffet items, a case-control study and a carriage study of catering staff. Isolates of Staphylococcus aureus from patients, food and catering staff were characterised and compared using traditional typing methods and whole genome sequencing. Genotypically identical strains (sequence type ST8, spa-type t024, MLVA-type 4698, enterotoxin A FRI100) were isolated in 10 patients, shiitake mushrooms, cured ham, and in three members of staff. The case-control study strongly suggested pasta salad with pesto as the vehicle of infection (p<0.001), but this food item could not be tested, because there were no leftovers. Additional enterotoxigenic strains genetically unrelated to the outbreak strain were found in four members of staff. Non-enterotoxigenic strains with livestock-associated sequence type ST398 were isolated from three food items and two members of staff. The main cause of the outbreak is likely to have been not maintaining the cold chain after food preparation. Whole genome sequencing resulted in phylogenetic clustering which concurred with traditional typing while simultaneously characterising virulence and resistance traits. PMID:26608881

  4. Forecasting Infectious Disease Outbreaks

    NASA Astrophysics Data System (ADS)

    Shaman, J. L.

    2015-12-01

    Dynamic models of infectious disease systems abound and are used to study the epidemiological characteristics of disease outbreaks, the ecological mechanisms affecting transmission, and the suitability of various control and intervention strategies. The dynamics of disease transmission are non-linear and consequently difficult to forecast. Here, we describe combined model-inference frameworks developed for the prediction of infectious diseases. We show that accurate and reliable predictions of seasonal influenza outbreaks can be made using a mathematical model representing population-level influenza transmission dynamics that has been recursively optimized using ensemble data assimilation techniques and real-time estimates of influenza incidence. Operational real-time forecasts of influenza and other infectious diseases have been and are currently being generated.

  5. Correlates of Successful Response to a Behavioral Weight Control Clinic.

    ERIC Educational Resources Information Center

    And Others; Gormally, Jim

    1980-01-01

    Initial weight-loss success was correlated with two severity variables. Persons reporting frequent binge eating and histories of previous dieting weight loss lost the most weight. Persons who were successful at maintenance used frequent exercise. Those who relapsed reported high levels of stress during follow-up. (Author)

  6. Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden

    PubMed Central

    2012-01-01

    Background The first outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in horses in Sweden occurred in 2008 at the University Animal Hospital and highlighted the need for improved infection prevention and control. The present study describes interventions and infection prevention control in an equine hospital setting July 2008 - April 2010. Method This descriptive study of interventions is based on examination of policy documents, medical records, notes from meetings and cost estimates. MRSA cases were identified through clinical sampling and telephone enquiries about horses post-surgery. Prospective sampling in the hospital environment with culture for MRSA and genotyping of isolates by spa-typing and pulsed-field gel electrophoresis (PFGE) were performed. Results Interventions focused on interruption of indirect contact spread of MRSA between horses via staff and equipment and included: Temporary suspension of elective surgery; and identification and isolation of MRSA-infected horses; collaboration was initiated between authorities in animal and human public health, human medicine infection control and the veterinary hospital; extensive cleaning and disinfection was performed; basic hygiene and cleaning policies, staff training, equipment modification and interior renovation were implemented over seven months. Ten (11%) of 92 surfaces sampled between July 2008 and April 2010 tested positive for MRSA spa-type 011, seven of which were from the first of nine sampling occasions. PFGE typing showed the isolates to be the outbreak strain (9 of 10) or a closely related strain. Two new cases of MRSA infection occurred 14 and 19 months later, but had no proven connections to the outbreak cases. Conclusions Collaboration between relevant authorities and the veterinary hospital and formation of an infection control committee with an executive working group were required to move the intervention process forward. Support from hospital management and the

  7. A prospective matched nested case-control study of bacterial gill disease outbreaks in Ontario, Canada government salmonid hatcheries

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Early-rearing salmonids in Ontario, Canada government fish hatcheries have been persistently affected by bacterial gill disease (BGD), and outbreaks at these locations have often been associated with high morbidity and mortality. The causative agent of BGD, Flavobacterium branchiophilum, is consider...

  8. Large Nosocomial Outbreak Associated with a Norwegian Scabies Index Case Undergoing TNF-α Inhibitor Treatment: Management and Control.

    PubMed

    Belvisi, Valeria; Orsi, Giovanni Battista; Del Borgo, Cosmo; Fabietti, Paolo; Ianari, Adriana; Albertoni, Francesco; Porcelli, Patricia; Potenza, Concetta; Mastroianni, Claudio Maria

    2015-11-01

    We describe a large outbreak associated with a crusted (Norwegian) scabies case in an immunocompromised patient following treatment with TNF-α inhibitor (adalimumab) for psoriasis arthritis. The increasing use of TNF-α inhibitors should induce clinicians to consider this serious parasitic infection when evaluating skin rashes in patients receiving biologic therapies. PMID:26288185

  9. Nanopore Sequencing as a Rapidly Deployable Ebola Outbreak Tool.

    PubMed

    Hoenen, Thomas; Groseth, Allison; Rosenke, Kyle; Fischer, Robert J; Hoenen, Andreas; Judson, Seth D; Martellaro, Cynthia; Falzarano, Darryl; Marzi, Andrea; Squires, R Burke; Wollenberg, Kurt R; de Wit, Emmie; Prescott, Joseph; Safronetz, David; van Doremalen, Neeltje; Bushmaker, Trenton; Feldmann, Friederike; McNally, Kristin; Bolay, Fatorma K; Fields, Barry; Sealy, Tara; Rayfield, Mark; Nichol, Stuart T; Zoon, Kathryn C; Massaquoi, Moses; Munster, Vincent J; Feldmann, Heinz

    2016-02-01

    Rapid sequencing of RNA/DNA from pathogen samples obtained during disease outbreaks provides critical scientific and public health information. However, challenges exist for exporting samples to laboratories or establishing conventional sequencers in remote outbreak regions. We successfully used a novel, pocket-sized nanopore sequencer at a field diagnostic laboratory in Liberia during the current Ebola virus outbreak. PMID:26812583

  10. Nanopore Sequencing as a Rapidly Deployable Ebola Outbreak Tool

    PubMed Central

    Groseth, Allison; Rosenke, Kyle; Fischer, Robert J.; Hoenen, Andreas; Judson, Seth D.; Martellaro, Cynthia; Falzarano, Darryl; Marzi, Andrea; Squires, R. Burke; Wollenberg, Kurt R.; de Wit, Emmie; Prescott, Joseph; Safronetz, David; van Doremalen, Neeltje; Bushmaker, Trenton; Feldmann, Friederike; McNally, Kristin; Bolay, Fatorma K.; Fields, Barry; Sealy, Tara; Rayfield, Mark; Nichol, Stuart T.; Zoon, Kathryn C.; Massaquoi, Moses; Munster, Vincent J.; Feldmann, Heinz

    2016-01-01

    Rapid sequencing of RNA/DNA from pathogen samples obtained during disease outbreaks provides critical scientific and public health information. However, challenges exist for exporting samples to laboratories or establishing conventional sequencers in remote outbreak regions. We successfully used a novel, pocket-sized nanopore sequencer at a field diagnostic laboratory in Liberia during the current Ebola virus outbreak. PMID:26812583

  11. Community Attitudes Toward Mass Drug Administration for Control and Elimination of Neglected Tropical Diseases After the 2014 Outbreak of Ebola Virus Disease in Lofa County, Liberia.

    PubMed

    Bogus, Joshua; Gankpala, Lincoln; Fischer, Kerstin; Krentel, Alison; Weil, Gary J; Fischer, Peter U; Kollie, Karsor; Bolay, Fatorma K

    2016-03-01

    The recent outbreak of Ebola virus disease (EVD) interrupted mass drug administration (MDA) programs to control and eliminate neglected tropical diseases in Liberia. MDA programs treat entire communities with medication regardless of infection status to interrupt transmission and eliminate lymphatic filariasis and onchocerciasis. Following reports of hostilities toward health workers and fear that they might be spreading EVD, it was important to determine whether attitudes toward MDA might have changed after the outbreak. We surveyed 140 community leaders from 32 villages in Lofa County, Liberia, that had previously participated in MDA and are located in an area that was an early epicenter of the EVD outbreak. Survey respondents reported a high degree of community trust in the MDA program, and 97% thought their communities were ready to resume MDA. However, respondents predicted that fewer people would comply with MDA after the EVD epidemic than before. The survey also uncovered fears in the community that EVD and MDA might be linked. Respondents suggested that MDA programs emphasize to people that the medications are identical to those previously distributed and that MDA programs have nothing to do with EVD. PMID:26666700

  12. Community Attitudes toward Mass Drug Administration for Control and Elimination of Neglected Tropical Diseases after the 2014 Outbreak of Ebola Virus Disease in Lofa County, Liberia

    PubMed Central

    Bogus, Joshua; Gankpala, Lincoln; Fischer, Kerstin; Krentel, Alison; Weil, Gary J.; Fischer, Peter U.; Kollie, Karsor; Bolay, Fatorma K.

    2016-01-01

    The recent outbreak of Ebola virus disease (EVD) interrupted mass drug administration (MDA) programs to control and eliminate neglected tropical diseases in Liberia. MDA programs treat entire communities with medication regardless of infection status to interrupt transmission and eliminate lymphatic filariasis and onchocerciasis. Following reports of hostilities toward health workers and fear that they might be spreading EVD, it was important to determine whether attitudes toward MDA might have changed after the outbreak. We surveyed 140 community leaders from 32 villages in Lofa County, Liberia, that had previously participated in MDA and are located in an area that was an early epicenter of the EVD outbreak. Survey respondents reported a high degree of community trust in the MDA program, and 97% thought their communities were ready to resume MDA. However, respondents predicted that fewer people would comply with MDA after the EVD epidemic than before. The survey also uncovered fears in the community that EVD and MDA might be linked. Respondents suggested that MDA programs emphasize to people that the medications are identical to those previously distributed and that MDA programs have nothing to do with EVD. PMID:26666700

  13. Groundwater, biogeomorphic succession and controls on river channel pattern

    NASA Astrophysics Data System (ADS)

    Bätz, N.; Colombini, P.; Cherubini, P.; Lane, S. N.

    2015-12-01

    Strong feedbacks between river braiding and vegetation processes are now well-recognised. Recently, this has been illustrated in the notion of biogeomorphic succession, the transition from pioneer vegetation establishment to a fully-developed floodplain forest ecosystem. This succession also results in important vegetation-mediated feedbacks, through bank stabilisation and the capture of organic matter and fine sediments, stimulating soil formation and further enhancing the succession process itself. However, there are few studies that have addressed what this succession might mean for the evolution of channel planform, and almost no studies that have considered how this succession rates might be mediated by groundwater. The latter is a key concern for gravel-bed rivers with low water retention capacity. Here, we present results from a 2 km length of braiding-wandering river system in Switzerland (Allondon River). We show that the spatio-temporal dynamics of the groundwater table drives the biogeomorphic succession process at different rates, leading to very different river channel pattern responses. In the upper braiding-anastomosing part of the reach, the groundwater table is deeper. Here, dendrochronological data show that rates of pioneer vegetation growth are strongly dependent upon groundwater table fluctuations. Bank resistance modelling shows that vegetation-reinforcement of bank resistance is below its maximum. In the meandering lower part of the reach, with a mature floodplain forest, tree growth rates are independent of groundwater fluctuations, because trees can almost always access the higher groundwater table. Bank resistance is at its maximum. Through time, in response to disturbance frequency, the meandering tendency has migrated upstream. Thus, our results suggest that groundwater access modulates biogeomorphic succession processes in ways that determine the resultant river channel pattern.

  14. Dengue disease outbreak definitions are implicitly variable

    PubMed Central

    Brady, Oliver J.; Smith, David L.; Scott, Thomas W.; Hay, Simon I.

    2015-01-01

    Infectious diseases rarely exhibit simple dynamics. Outbreaks (defined as excess cases beyond response capabilities) have the potential to cause a disproportionately high burden due to overwhelming health care systems. The recommendations of international policy guidelines and research agendas are based on a perceived standardised definition of an outbreak characterised by a prolonged, high-caseload, extra-seasonal surge. In this analysis we apply multiple candidate outbreak definitions to reported dengue case data from Brazil to test this assumption. The methods identify highly heterogeneous outbreak characteristics in terms of frequency, duration and case burden. All definitions identify outbreaks with characteristics that vary over time and space. Further, definitions differ in their timeliness of outbreak onset, and thus may be more or less suitable for early intervention. This raises concerns about the application of current outbreak guidelines for early warning/identification systems. It is clear that quantitatively defining the characteristics of an outbreak is an essential prerequisite for effective reactive response. More work is needed so that definitions of disease outbreaks can take into account the baseline capacities of treatment, surveillance and control. This is essential if outbreak guidelines are to be effective and generalisable across a range of epidemiologically different settings. PMID:25979287

  15. 7 CFR 4288.25 - Succession and control of facilities and production.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Succession and control of facilities and production... Repowering Assistance Payments to Eligible Biorefineries § 4288.25 Succession and control of facilities and... that, the party is eligible, and permitting such succession would serve the purposes of the program....

  16. 7 CFR 4288.137 - Succession and loss of control of advanced biofuel facilities and production.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Succession and loss of control of advanced biofuel... PROGRAMS Advanced Biofuel Payment Program General Provisions Payment Provisions § 4288.137 Succession and loss of control of advanced biofuel facilities and production. (a) Contract succession. An entity...

  17. 7 CFR 1424.10 - Succession and control of facilities and production.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Succession and control of facilities and production... § 1424.10 Succession and control of facilities and production. A person who obtains a facility that is... grant such request if it is determined that permitting such succession would serve the purposes of...

  18. 7 CFR 4288.25 - Succession and control of facilities and production.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Succession and control of facilities and production... Repowering Assistance Payments to Eligible Biorefineries § 4288.25 Succession and control of facilities and... that, the party is eligible, and permitting such succession would serve the purposes of the program....

  19. 7 CFR 1424.10 - Succession and control of facilities and production.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Succession and control of facilities and production... § 1424.10 Succession and control of facilities and production. A person who obtains a facility that is... grant such request if it is determined that permitting such succession would serve the purposes of...

  20. 7 CFR 4288.25 - Succession and control of facilities and production.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Succession and control of facilities and production... Repowering Assistance Payments to Eligible Biorefineries § 4288.25 Succession and control of facilities and... that, the party is eligible, and permitting such succession would serve the purposes of the program....

  1. 76 FR 45600 - Order of Succession for the Office of Healthy Homes and Lead Hazard Control

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-29

    ... URBAN DEVELOPMENT Order of Succession for the Office of Healthy Homes and Lead Hazard Control AGENCY: Office of Healthy Homes and Lead Hazard Control, HUD. ACTION: Notice of Order of Succession. SUMMARY: In... Housing and Urban Development designates the Order of Succession for the Office of Healthy Homes and...

  2. 7 CFR 4288.137 - Succession and loss of control of advanced biofuel facilities and production.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Succession and loss of control of advanced biofuel... PROGRAMS Advanced Biofuel Payment Program General Provisions § 4288.137 Succession and loss of control of advanced biofuel facilities and production. (a) Contract succession. An entity who becomes the...

  3. 7 CFR 1424.10 - Succession and control of facilities and production.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Succession and control of facilities and production... § 1424.10 Succession and control of facilities and production. A person who obtains a facility that is... grant such request if it is determined that permitting such succession would serve the purposes of...

  4. 7 CFR 1424.10 - Succession and control of facilities and production.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Succession and control of facilities and production... § 1424.10 Succession and control of facilities and production. A person who obtains a facility that is... grant such request if it is determined that permitting such succession would serve the purposes of...

  5. 7 CFR 4288.137 - Succession and loss of control of advanced biofuel facilities and production.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Succession and loss of control of advanced biofuel... PROGRAMS Advanced Biofuel Payment Program General Provisions § 4288.137 Succession and loss of control of advanced biofuel facilities and production. (a) Contract succession. An entity who becomes the...

  6. Controlling Your Environment and Yourself: Implications for Career Success

    ERIC Educational Resources Information Center

    Converse, Patrick D.; Pathak, Jaya; DePaul-Haddock, Anne Marie; Gotlib, Tomer; Merbedone, Matthew

    2012-01-01

    Given the complex and rapidly changing nature of the current work environment, individuals' capabilities to effectively influence their environment and regulate their behavior may be critical to career success. Drawing from the model of emergent interactive agency (Bandura, 1989), the current research examines this perspective, focusing on…

  7. Can Contextual Cues Control Consummatory Successive Negative Contrast?

    ERIC Educational Resources Information Center

    Daniel, Alan M.; Wood, Michael; Pellegrini, Santiago; Norris, Jacob N.; Papini, Mauricio R.

    2008-01-01

    Rats exposed to incentive downshift show behavioral deterioration. This phenomenon, called successive negative contrast (SNC), occurs in instrumental and consummatory responses (iSNC, cSNC). Whereas iSNC is related to the violation of reward expectancies retrieved in anticipation of the goal (cued-recall), cSNC involves reward rejection and may…

  8. Results of a Randomized Controlled Trial of Student Success Skills

    ERIC Educational Resources Information Center

    Webb, Linda; Carey, John; Villares, Elizabeth; Wells, Craig; Sayer, Aline

    2014-01-01

    Numerous authors have reviewed research to determine which skills are considered fundamental to successful academic and social outcomes for students (Hattie, Briggs, & Purdie, 1996; Masten & Coatworth, 1998; Wang, Haertel, & Walberg, 1994; Zins, Weissberg, Wang, & Walberg, 2004). These skills include: (1) cognitive and…

  9. Refractory dissecting Cellulitis of the Scalp Successfully controlled with Adalimumab.

    PubMed

    Martin-García, Rafael F; Rullán, Jennifer M

    2015-06-01

    Dissecting cellulitis of the scalp (DCS) is an uncommon inflammatory disease that often results in scarring alopecia. Numerous therapies have either proved ineffective or only temporarily effective in the management of this condition. Recent reports show adequate responses to tumor necrosis factor (TNF) inhibitors in cases of DCS. We report a case of severe recalcitrant DCS successfully treated with adalimumab. PMID:26061062

  10. African horse sickness: The potential for an outbreak in disease-free regions and current disease control and elimination techniques.

    PubMed

    Robin, M; Page, P; Archer, D; Baylis, M

    2016-09-01

    African horse sickness (AHS) is an arboviral disease of equids transmitted by Culicoides biting midges. The virus is endemic in parts of sub-Saharan Africa and official AHS disease-free status can be obtained from the World Organization for Animal Health on fulfilment of a number of criteria. AHS is associated with case fatality rates of up to 95%, making an outbreak among naïve horses both a welfare and economic disaster. The worldwide distributions of similar vector-borne diseases (particularly bluetongue disease of ruminants) are changing rapidly, probably due to a combination of globalisation and climate change. There is extensive evidence that the requisite conditions for an AHS epizootic currently exist in disease-free countries. In particular, although the stringent regulations enforced upon competition horses make them extremely unlikely to redistribute the virus, there are great concerns over the effects of illegal equid movement. An outbreak of AHS in a disease free region would have catastrophic effects on equine welfare and industry, particularly for international events such as the Olympic Games. While many regions have contingency plans in place to manage an outbreak of AHS, further research is urgently required if the equine industry is to avoid or effectively contain an AHS epizootic in disease-free regions. This review describes the key aspects of AHS as a global issue and discusses the evidence supporting concerns that an epizootic may occur in AHS free countries, the planned government responses, and the roles and responsibilities of equine veterinarians. PMID:27292229

  11. Case-control study of risk factors for human infection with a new zoonotic paramyxovirus, Nipah virus, during a 1998-1999 outbreak of severe encephalitis in Malaysia.

    PubMed

    Parashar, U D; Sunn, L M; Ong, F; Mounts, A W; Arif, M T; Ksiazek, T G; Kamaluddin, M A; Mustafa, A N; Kaur, H; Ding, L M; Othman, G; Radzi, H M; Kitsutani, P T; Stockton, P C; Arokiasamy, J; Gary, H E; Anderson, L J

    2000-05-01

    An outbreak of encephalitis affecting 265 patients (105 fatally) occurred during 1998-1999 in Malaysia and was linked to a new paramyxovirus, Nipah, that infected pigs, humans, dogs, and cats. Most patients were pig farmers. Clinically undetected Nipah infection was noted in 10 (6%) of 166 community-farm controls (persons from farms without reported encephalitis patients) and 20 (11%) of 178 case-farm controls (persons from farms with encephalitis patients). Case patients (persons with Nipah infection) were more likely than community-farm controls to report increased numbers of sick/dying pigs on the farm (59% vs. 24%, P=.001) and were more likely than case-farm controls to perform activities requiring direct contact with pigs (86% vs. 50%, P=.005). Only 8% of case patients reported no contact with pigs. The outbreak stopped after pigs in the affected areas were slaughtered and buried. Direct, close contact with pigs was the primary source of human Nipah infection, but other sources, such as infected dogs and cats, cannot be excluded. PMID:10823779

  12. EPIDEMIOLOGY AND CONTROL OF THE FIRST REPORTED VANCOMYCIN-RESISTANT ENTEROCOCCUS OUTBREAK AT A TERTIARY-CARE HOSPITAL IN BANGKOK, THAILAND.

    PubMed

    Chotiprasitsakul, Darunee; Santanirand, Pitak; Thitichai, Phantanee; Rotjanapan, Porpon; Watcharananan, Siriorn; Siriarayapon, Potjaman; Chaihongsa, Narong; Sirichot, Suntariya; Chitasombat, Maria; Chantharit, Prawat; Malathum, Kumthorn

    2016-05-01

    This retrospective study described the first reported vancomycin-resistant enterococci (VRE) outbreak from June 2013 through January 2014 at a tertiary-care hospital in Bangkok, Thailand. After the index case was detected in an 18-bed medical intermediate care unit, a number of interventions was implemented, including targeted active surveillance for VRE, strict contact precautions, enhanced standard precautions, dedicated units for VRE cases, extensive cleaning of the environment and the restricted use of antibiotics. VRE isolates were evaluated by polymerase chain reaction and random amplified polymorphic DNA (RAPD) testing. A prevalence case-control study was conducted. Among 3,699 culture samples from 2,671 patients screened, 74 patients (2.8%) had VRE. The positivity rate declined from 15.1% during week 1 to 8.2% during week 2 and then 1.4% during week 3. By weeks 4-9, the prevalences were 0-2.7%. However, the prevalence rose to 9.4% during week 10 and then subsequently declined. All VRE isolates were Enterococcus faecium and had the vanA gene. RAPD analysis revealed a single predominant clone. Multivariate analysis showed mechanical ventilation for ≥ 7 days was a predictive factor for VRE colonization [odds ratio (OR) 11.47; 95% confidence interval (CI): 1.75-75.35; p = 0.011]. This experience demonstrates VRE can easily spread and result in an outbreak in multiple-bed units. Active surveillance, early infection control interventions and rapid patient cohorting were important tools for control of this outbreak. Patients requiring mechanical ventilator for ≥ 7 days were at higher risk for VRE acquisition. PMID:27405133

  13. Developmental Transitions as Successive Reorganizations of a Control Hierarchy.

    ERIC Educational Resources Information Center

    Plooij, Frans X.; And Others

    1990-01-01

    Describes two studies involving chimpanzee mother-infant pairs in Tanzania between 1980 and 1987 that implemented control theory concepts. The first identified behavioral development in infant chimps; the second observed the growth of independence and parenting patterns. Concludes that the hierarchy of controlled variables develops consecutively…

  14. Biological control of postharvest diseases: hurdles, successes, and prospects

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Research has accelerated recently on biological control of postharvest diseases (BCPD) and has resulted in the development of several commercial products for controlling decays of temperate and subtropical fruits. The demand for alternatives to synthetic fungicides is much greater than the supply p...

  15. Cryptosporidiosis outbreak in visitors of a UK industry-compliant petting farm caused by a rare Cryptosporidium parvum subtype: a case-control study.

    PubMed

    Utsi, L; Smith, S J; Chalmers, R M; Padfield, S

    2016-04-01

    A case-control study was conducted to investigate an outbreak of 46 cases of cryptosporidiosis in visitors to a petting farm in England. Details of exposures on the farm were collected for 38 cases and 39 controls, recruited through snowball sampling. Multivariable logistic regression identified that cases were 5·5 times more likely than controls to have eaten without washing their hands [95% confidence interval (CI) 1·51-19·9, P = 0·01] and 10 times less likely to report being informed of risk of infection on arrival (odds ratio 0·10, 95% CI 0·01-0·71, P = 0·02). An uncommon Cryptosporidium parvum gp60 subtype (IIaA19G1R1) was identified in a lamb faecal sample and all subtyped cases (n = 22). We conclude that lack of verbal advice and non-compliance with hand washing are significantly associated with a risk of cryptosporidiosis on open farms. These findings highlight the public health importance of effectively communicating risk to petting farm visitors in order to prevent future outbreaks of zoonotic infections. PMID:26424385

  16. Epidemiology, production losses, and control measures associated with an outbreak of avian influenza subtype H7N2 in Pennsylvania (1996-98).

    PubMed

    Henzler, D J; Kradel, D C; Davison, S; Ziegler, A F; Singletary, D; DeBok, P; Castro, A E; Lu, H; Eckroade, R; Swayne, D; Lagoda, W; Schmucker, B; Nesselrodt, A

    2003-01-01

    An outbreak of H7N2 low-pathogenicity (LP) avian influenza (AI) occurred in a two-county area in Pennsylvania from December of 1996 through April of 1998. The outbreak resulted in infection of 2,623,116 commercial birds on 25 premises encompassing 47 flocks. Twenty-one (one premise with infection twice) of the twenty-five infected premises housed egg-laying chickens and one premise each had turkeys, layer pullets, quail, and a mixed backyard dealer flock. Despite dose proximity of infected flocks to commercial broiler flocks, no infected broilers were identified. Experimentally, when market age broilers were placed on an influenza-infected premise they seroconverted and developed oviduct lesions. The outbreak was believed to have originated from two separate introductions into commercial layer flocks from premises and by individuals dealing in sales of live fowl in the metropolitan New York and New Jersey live-bird markets. Source flocks for these markets are primarily in the northeast and mid-Atlantic areas, including Pennsylvania. Mixed fowl sold include ducks, geese, guinea hens, quail, chukar partridges, and a variety of chickens grown on perhaps hundreds of small farms. Infections with the H7N2 AI virus were associated with variable morbidity and temporary decreases in egg production ranging from 1.6% to 29.1% in commercial egg-laying chickens. Egg production losses averaged 4.0 weeks duration. Mortality ranged from 1.5 to 18.3 times normal (mean of 4.3 times normal). Duration of mortality ranged from 2 to 13 weeks (average of 3.9 weeks) in flocks not depopulated. Lesions observed were primarily oviducts filled with a mucous and white gelatinous exudates and atypical egg yolk peritonitis. Quarantine of premises and complete depopulation were the early measures employed in control of this outbreak. Epidemiological studies suggested that depopulation furthered the spread of influenza to nearby flocks. Thereafter, later control measures included quarantine

  17. Lack of Comprehensive Outbreak Detection in Hospitals.

    PubMed

    Baker, Meghan A; Huang, Susan S; Letourneau, Alyssa R; Kaganov, Rebecca E; Peeples, Jennifer R; Drees, Marci; Platt, Richard; Yokoe, Deborah S

    2016-04-01

    Timely identification of outbreaks of hospital-associated infections is needed to implement control measures and minimize impact. Survey results from 33 hospitals indicated that most hospitals lacked a formal cluster definition and all targeted a very limited group of prespecified pathogens. Standardized, statistically based outbreak detection could greatly improve current practice. PMID:26996060

  18. Modeling cholera outbreaks

    PubMed Central

    Longini, Ira M.; Morris, J. Glenn

    2014-01-01

    Mathematical modeling can be a valuable tool for studying infectious disease outbreak dynamics and simulating the effects of possible interventions. Here, we describe approaches to modeling cholera outbreaks and how models have been applied to explore intervention strategies, particularly in Haiti. Mathematical models can play an important role in formulating and evaluating complex cholera outbreak response options. Major challenges to cholera modeling are insufficient data for calibrating models and the need to tailor models for different outbreak scenarios. PMID:23412687

  19. Tuberculosis outbreak associated with a homeless shelter - Kane County, Illinois, 2007-2011.

    PubMed

    2012-03-23

    Despite the overall decline in tuberculosis (TB) incidence in the United States to a record low, outbreaks of TB among homeless persons continue to challenge TB control efforts. In January 2010, public health officials recognized an outbreak of TB after three overnight guests at a homeless shelter in Illinois received diagnoses of TB disease caused by Mycobacterium tuberculosis isolates with matching genotype patterns. As of September 2011, a total of 28 outbreak-associated cases involving shelter guests, dating back to 2007, had been recognized, indicating ongoing M. tuberculosis transmission. The subsequent investigation found that all patients were homeless and had been overnight shelter guests. Excess alcohol use was common (82%), and two bars emerged as additional sites of potential transmission. Patients with outbreak-associated TB were treated successfully for TB disease. To prevent future cases of TB, public health officials are implementing a program to offer 12 once-weekly doses of isoniazid and rifapentine under direct observation for treatment of latent tuberculosis infection (LTBI) in this high-risk population. Although the United States has made progress toward TB elimination, this outbreak demonstrates the vulnerability of homeless persons to outbreaks of TB, highlighting the need for aggressive and sustained TB control efforts. PMID:22437912

  20. Tobacco industry successfully prevented tobacco control legislation in Argentina

    PubMed Central

    Sebrie, E; Barnoya, J; Perez-Stable, E; Glantz, S

    2005-01-01

    Objective: To evaluate how transnational tobacco companies, working through their local affiliates, influenced tobacco control policymaking in Argentina between 1966 and 2005. Methods: Analysis of internal tobacco industry documents, local newspapers and magazines, internet resources, bills from the Argentinean National Congress Library, and interviews with key individuals in Argentina. Results: Transnational tobacco companies (Philip Morris International, British American Tobacco, Lorillard, and RJ Reynolds International) have been actively influencing public health policymaking in Argentina since the early 1970s. As in other countries, in 1977 the tobacco industry created a weak voluntary self regulating code to avoid strong legislated restrictions on advertising. In addition to direct lobbying by the tobacco companies, these efforts involved use of third party allies, public relations campaigns, and scientific and medical consultants. During the 1980s and 1990s efforts to pass comprehensive tobacco control legislation intensified, but the organised tobacco industry prevented its enactment. There has been no national activity to decrease exposure to secondhand smoke. Conclusions: The tobacco industry, working through its local subsidiaries, has subverted meaningful tobacco control legislation in Argentina using the same strategies as in the USA and other countries. As a result, tobacco control in Argentina remains governed by a national law that is weak and restricted in its scope. PMID:16183967

  1. Successful biological control of tropical soda apple in Florida

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Tropical soda apple, Solanum viarum, is a small shrub native to tropical regions of Brazil, Paraguay, and Argentina. This weed was first found in Florida in 1988. In May 2003, a leaf feeding beetle, Gratiana boliviana, from South America was released in Florida as a biological control agent of tro...

  2. Controlling automotive exhaust emissions: successes and underlying science.

    PubMed

    Twigg, Martyn V

    2005-04-15

    Photochemical reactions of vehicle exhaust pollutants were responsible for photochemical smog in many cities during the 1960s and 1970s. Engine improvements helped, but additional measures were needed to achieve legislated emissions levels. First oxidation catalysts lowered hydrocarbon and carbon monoxide, and later nitrogen oxides were reduced to nitrogen in a two-stage process. By the 1980s, exhaust gas could be kept stoichiometric and hydrocarbons, carbon monoxide and nitrogen oxides were simultaneously converted over a single 'three-way catalyst'. Today, advanced three-way catalyst systems emissions are exceptionally low. NOx control from lean-burn engines demands an additional approach because NO cannot be dissociated under lean conditions. Current lean-burn gasoline engine NOx control involves forming a nitrate phase and periodically enriching the exhaust to reduce it to nitrogen, and this is being modified for use on diesel engines. Selective catalytic reduction with ammonia is an alternative that can be very efficient, but it requires ammonia or a compound from which it can be obtained. Diesel engines produce particulate matter, and, because of health concerns, filtration processes are being introduced to control these emissions. On heavy duty diesel engines the exhaust gas temperature is high enough for NO in the exhaust to be oxidised over a catalyst to NO2 that smoothly oxidises particulate material (PM) in the filter. Passenger cars operate at lower temperatures, and it is necessary to periodically burn the PM in air at high temperatures. PMID:15901550

  3. Fatal respiratory infections associated with rhinovirus outbreak, Vietnam.

    PubMed

    Hai, Le Thanh; Bich, Vu Thi Ngoc; Ngai, Le Kien; Diep, Nguyen Thi Ngoc; Phuc, Phan Huu; Hung, Viet Pham; Taylor, Walter R; Horby, Peter; Liem, Nguyen Thanh; Wertheim, Heiman F L

    2012-11-01

    During an outbreak of severe acute respiratory infections in 2 orphanages, Vietnam, 7/12 hospitalized children died. All hospitalized children and 26/43 children from outbreak orphanages tested positive for rhinovirus versus 9/40 control children (p = 0.0005). Outbreak rhinoviruses formed a distinct genetic cluster. Human rhinovirus is an underappreciated cause of severe pneumonia in vulnerable groups. PMID:23092635

  4. Mass vaccination as a complementary tool in the control of a severe outbreak of bovine brucellosis due to Brucella abortus in Extremadura, Spain.

    PubMed

    Sanz, Cristina; Sáez, José Luis; Alvarez, Julio; Cortés, María; Pereira, Gema; Reyes, Aurelia; Rubio, Félix; Martín, Javier; García, Nerea; Domínguez, Lucas; Hermoso-de-Mendoza, María; Hermoso-de-Mendoza, Javier

    2010-11-01

    We report the evolution of an outbreak of bovine brucellosis (Brucella abortus) in the region of Extremadura (Spain) involving more than 1000 herds and nearly 40,000 animals. S19 vaccination of young cattle combined with a test and slaughter strategy did not result in a rapid decrease in herd prevalence and animal incidence; these parameters showed a constant decreasing trend only when a combination of restriction of cattle movements, increased test frequency, S19 vaccination and mass RB51 vaccination (with yearly revaccinations) were applied to all susceptible populations. These measures were applied for 5 years; abortions following RB51 vaccination of pregnant cows were limited to the first inoculation and the involvement of the vaccine strain could only be demonstrated in 78 out of 897 abortions. Our results demonstrate the usefulness - and lack of significant side effects - of RB51 mass vaccination as a complementary tool to control bovine brucellosis outbreaks in areas where the disease cannot be contained using more conservative approaches. PMID:20833439

  5. The ring vaccination trial: a novel cluster randomised controlled trial design to evaluate vaccine efficacy and effectiveness during outbreaks, with special reference to Ebola

    PubMed Central

    2015-01-01

    A World Health Organization expert meeting on Ebola vaccines proposed urgent safety and efficacy studies in response to the outbreak in West Africa. One approach to communicable disease control is ring vaccination of individuals at high risk of infection due to their social or geographical connection to a known case. This paper describes the protocol for a novel cluster randomised controlled trial design which uses ring vaccination. In the Ebola ça suffit ring vaccination trial, rings are randomised 1:1 to (a) immediate vaccination of eligible adults with single dose vaccination or (b) vaccination delayed by 21 days. Vaccine efficacy against disease is assessed in participants over equivalent periods from the day of randomisation. Secondary objectives include vaccine effectiveness at the level of the ring, and incidence of serious adverse events. Ring vaccination trials are adaptive, can be run until disease elimination, allow interim analysis, and can go dormant during inter-epidemic periods. PMID:26215666

  6. The ring vaccination trial: a novel cluster randomised controlled trial design to evaluate vaccine efficacy and effectiveness during outbreaks, with special reference to Ebola.

    PubMed

    2015-01-01

    A World Health Organization expert meeting on Ebola vaccines proposed urgent safety and efficacy studies in response to the outbreak in West Africa. One approach to communicable disease control is ring vaccination of individuals at high risk of infection due to their social or geographical connection to a known case. This paper describes the protocol for a novel cluster randomised controlled trial design which uses ring vaccination.In the Ebola ça suffit ring vaccination trial, rings are randomised 1:1 to (a) immediate vaccination of eligible adults with single dose vaccination or (b) vaccination delayed by 21 days. Vaccine efficacy against disease is assessed in participants over equivalent periods from the day of randomisation. Secondary objectives include vaccine effectiveness at the level of the ring, and incidence of serious adverse events. Ring vaccination trials are adaptive, can be run until disease elimination, allow interim analysis, and can go dormant during inter-epidemic periods. PMID:26215666

  7. An interdisciplinary approach to controlling chikungunya outbreaks on French islands in the south-west Indian ocean.

    PubMed

    Flahault, A; Aumont, G; Boisson, V; de Lamballerie, X; Favier, F; Fontenille, D; Journeaux, S; Lotteau, V; Paupy, C; Sanquer, M A; Setbon, M; Gaüzere, B A

    2012-03-01

    The outbreak of chikungunya that occurred on French Island territories in the southwest Indian Ocean in 2005 and 2006 caused severe morbidity and mortality. In the aftermath, French authorities set up a scientific task force including experts in epidemiology, public health, entomology, virology, immunology, sociology, animal health, community and hospital medicine. The mission of the task force was to conceive and propose research programs needed to increase understanding of the disease and epidemic and to help public health officials in improving epidemic response measures. The purpose of this article is to describe the findings of the task force at the end of its two-year existence and initial outcomes in the the areas studied. Discussion emphasizes topics requiring further study. PMID:22693932

  8. Successive bilateral frontal controlled cortical impact injuries show behavioral savings.

    PubMed

    Vonder Haar, Cole; Friend, Danielle M; Mudd, David B; Smith, Jeffrey S

    2013-03-01

    Traumatic brain injuries (TBIs) affect millions of people each year. Research investigating repeated or serial damage in the form of lesions indicates that behavioral deficits are reduced in animals given sequential lesions separated by a sufficient period of recovery. In the lesion literature, this phenomenon is known as the serial lesion effect (SLE). Although the SLE phenomenon is established in the lesion literature, it has not been thoroughly investigated under current models of brain injury. In the current study, a controlled cortical impact of the bilateral frontal cortex was performed in either a single procedure or a serial procedure separated by two weeks. Rats were tested on the Morris water maze, bilateral tactile adhesive removal task, rotarod and Barnes maze task to determine behavioral deficits. Histology was performed to determine lesion size and astrocyte and microglial response. A serial lesion effect was demonstrated across a majority of the behavioral tasks. However, histological analyses did not suggest a clear mechanistic link to the behavioral phenomena. This is the first study to demonstrate the SLE in a model of TBI, suggesting that behavioral deficits may actually be reduced in repeated head injuries, given an adequate time window between injuries. PMID:23201357

  9. Staff perception and institutional reporting: two views of infection control compliance in British Columbia and Ontario three years after an outbreak of severe acute respiratory syndrome.

    PubMed

    Bryce, E; Copes, R; Gamage, B; Lockhart, K; Yassi, A

    2008-06-01

    Few studies have audited the resources available to infection control (IC) and occupational health (OH) to promote safe work behaviour, whilst comparing audited findings with perceptions by healthcare workers (HCWs). We aimed to determine the IC and OH resources available and compare this with HCWs' perception of resources, following an outbreak of severe acute respiratory syndrome (SARS). A survey of IC and OH resources and a questionnaire completed by HCWs were compared with on-site observational audits. HCWs believed that plans were available to protect against future SARS-like events but audits revealed that these did not exist in many facilities. Both OH and IC were under-resourced post-SARS, with OH professionals particularly lacking in British Columbia. There is a discrepancy between HCWs' perception of what is available and what is actually accessible in facilities. Experts in IC and OH need to focus on communication. PMID:18485532

  10. Interventions to control virus transmission during an outbreak of Ebola hemorrhagic fever: experience from Kikwit, Democratic Republic of the Congo, 1995.

    PubMed

    Kerstiëns, B; Matthys, F

    1999-02-01

    On 6 May 1995, the Médecins sans Frontières (MSF) coordinator in Kinshasa, Democratic Republic of the Congo (DRC), received a request for assistance for what was believed to be a concurrent outbreak of bacillary dysentery and viral hemorrhagic fever (suspected Ebola hemorrhagic fever [EHF]) in the town of Kikwit, DRC. On 11 May, the MSF intervention team assessed Kikwit General Hospital. This initial assessment revealed a nonfunctional isolation ward for suspected EHF cases; a lack of water and electricity; no waste disposal system; and no protective gear for medical staff. The priorities set by MSF were to establish a functional isolation ward to deal with EHF and to distribute protective supplies to individuals who were involved with patient care. Before the intervention, 67 health workers contracted EHF; after the initiation of control measures, just 3 cases were reported among health staff and none among Red Cross volunteers involved in body burial. PMID:9988193

  11. Dengue disease outbreak detection.

    PubMed

    Dayama, Pankaj; Sampath, Kameshwaran

    2014-01-01

    Early detection of outbreak of a disease may help in timely and effective public health interventions. Our motivation for this work is to assist EHD planning officer to analyze the incidence data and based on it declare whether there is an outbreak or not. In this paper, we develop ensemble of multiple techniques for detecting dengue disease outbreak. These techniques are applied to dengue incidence data from Singapore and results are summarized. PMID:25160360

  12. The First Outbreak Caused by Acinetobacter baumannii ST208 and ST195 in China

    PubMed Central

    Qu, Junyan; Du, Yu

    2016-01-01

    This study aimed to analyze the clinical characteristics of patients and molecular mechanisms of the first outbreak mainly caused by sequence types (STs) 208 multidrug resistant (MDR) Acinetobacter baumannii in China. A total of 10 clinical samples were collected from 5 patients who were involved in the outbreak. Bacterial identification and antibiotic sensitivity tests were performed by the VITEK-2 COMPACT automated system. MICs of tigecycline for clinical isolates were determined using broth microdilution. The clonal relatedness of A. baumannii clinical isolates in our local settings was determinated by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). A total of 7 A. baumannii strains were isolated and all were MDR strains; two of them were carbapenem-nonsusceptible strains. blaOXA-23 was the only acquired carbapenemase gene in the isolates. The isolates belonged to a single clonal pulsotype determined by PFGE and two sequences types (STs) determined by MLST. The isolates belonged to the globally disseminated clonal complex 92, among which ST195 and ST208 were the most common sequence types (71.43% and 28.57%). The outbreak was successfully controlled by stringent infection control measures, especially improving the hand hygiene compliance and enhancing antimicrobial stewardship. In conclusion, this is the first description of an outbreak caused mainly by A. baumannii of ST208 in China. Infection control measures should be strengthened when infection outbreaks in hospital. PMID:27144176

  13. Economic Costs of Measles Outbreak in the Netherlands, 2013-2014.

    PubMed

    Suijkerbuijk, Anita W M; Woudenberg, Tom; Hahné, Susan J M; Nic Lochlainn, Laura; de Melker, Hester E; Ruijs, Wilhelmina L M; Lugnér, Anna K

    2015-11-01

    In 2013 and 2014, the Netherlands experienced a measles outbreak in orthodox Protestant communities with low measles-mumps-rubella vaccination coverage. Assessing total outbreak costs is needed for public health outbreak preparedness and control. Total costs of this outbreak were an estimated $4.7 million. PMID:26488199

  14. Economic Costs of Measles Outbreak in the Netherlands, 2013–2014

    PubMed Central

    Woudenberg, Tom; Hahné, Susan J.M.; Lochlainn, Laura Nic; de Melker, Hester E.; Ruijs, Wilhelmina L.M.; Lugnér, Anna K.

    2015-01-01

    In 2013 and 2014, the Netherlands experienced a measles outbreak in orthodox Protestant communities with low measles–mumps–rubella vaccination coverage. Assessing total outbreak costs is needed for public health outbreak preparedness and control. Total costs of this outbreak were an estimated $4.7 million. PMID:26488199

  15. Social media in Ebola outbreak.

    PubMed

    Hossain, L; Kam, D; Kong, F; Wigand, R T; Bossomaier, T

    2016-07-01

    The West African 2014 Ebola outbreak has highlighted the need for a better information network. Hybrid information networks, an integration of both hierarchical and formalized command control-driven and community-based, or ad hoc emerging networks, could assist in improving public health responses. By filling the missing gaps with social media use, the public health response could be more proactive rather than reactive in responding to such an outbreak of global concern. This article provides a review of the current social media use specifically in this outbreak by systematically collecting data from ProQuest Newsstand, Dow Jones Factiva, Program for Monitoring Emerging Diseases (ProMED) as well as Google Trends. The period studied is from 19 March 2014 (first request for information on ProMED) to 15 October 2014, a total of 31 weeks. The term 'Ebola' was used in the search for media reports. The outcome of the review shows positive results for social media use in effective surveillance response mechanisms - for improving the detection, preparedness and response of the outbreak - as a complement to traditional, filed, work-based surveillance approach. PMID:26939535

  16. Two Linked Enteroinvasive Escherichia coli Outbreaks, Nottingham, UK, June 2014.

    PubMed

    Newitt, Sophie; MacGregor, Vanessa; Robbins, Vivienne; Bayliss, Laura; Chattaway, Marie Anne; Dallman, Tim; Ready, Derren; Aird, Heather; Puleston, Richard; Hawker, Jeremy

    2016-07-01

    Enteroinvasive Escherichia coli (EIEC) outbreaks are uncommon in Europe. In June 2014, two EIEC outbreaks occurred in Nottingham, UK, within 2 days; outbreak A was linked to a takeaway restaurant and outbreak B to a wedding party. We conducted 2 analytical studies: a case-control study for outbreak A and a cohort study for outbreak B. We tested microbiological and environmental samples, including by using whole-genome sequencing. For both outbreaks combined, we identified 157 probable case-patients; 27 were laboratory-confirmed as EIEC O96:H19-positive. Combined epidemiologic, microbiological, and environmental findings implicated lettuce as the vehicle of infection in outbreak A, but the source of the organism remained unknown. Whole-genome sequencing identified the same organism in cases from both outbreaks, but no epidemiologic link was confirmed. These outbreaks highlight that EIEC has the capacity to cause large and severe gastrointestinal disease outbreaks and should be considered as a potential pathogen in foodborne outbreaks in Europe. PMID:27314432

  17. Two Linked Enteroinvasive Escherichia coli Outbreaks, Nottingham, UK, June 2014

    PubMed Central

    MacGregor, Vanessa; Robbins, Vivienne; Bayliss, Laura; Chattaway, Marie Anne; Dallman, Tim; Ready, Derren; Aird, Heather; Puleston, Richard; Hawker, Jeremy

    2016-01-01

    Enteroinvasive Escherichia coli (EIEC) outbreaks are uncommon in Europe. In June 2014, two EIEC outbreaks occurred in Nottingham, UK, within 2 days; outbreak A was linked to a takeaway restaurant and outbreak B to a wedding party. We conducted 2 analytical studies: a case–control study for outbreak A and a cohort study for outbreak B. We tested microbiological and environmental samples, including by using whole-genome sequencing. For both outbreaks combined, we identified 157 probable case-patients; 27 were laboratory-confirmed as EIEC O96:H19–positive. Combined epidemiologic, microbiological, and environmental findings implicated lettuce as the vehicle of infection in outbreak A, but the source of the organism remained unknown. Whole-genome sequencing identified the same organism in cases from both outbreaks, but no epidemiologic link was confirmed. These outbreaks highlight that EIEC has the capacity to cause large and severe gastrointestinal disease outbreaks and should be considered as a potential pathogen in foodborne outbreaks in Europe. PMID:27314432

  18. Biological control of Melaleuca quinquenervia: goal-based assessment of success

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Success means different things to different people. Unfortunately, successes in weed biological control projects are often determined after the fact by non-participants lacking knowledge of the original goals set out by project architects. The Australian tree Melaleuca quinquenervia, which is an agg...

  19. Career Locus of Control and Career Success among Chinese Employees: A Multidimensional Approach

    ERIC Educational Resources Information Center

    Guan, Yanjun; Wang, Zhen; Dong, Zhilin; Liu, Yukun; Yue, Yumeng; Liu, Haiyang; Zhang, Yuqing; Zhou, Wenxia; Liu, Haihua

    2013-01-01

    The current research aimed to develop a multidimensional measure of career locus of control (LOC) and examine its predictive validity on objective and subjective career success among Chinese employees. Items of career LOC were generated based on literature review of the significant predictors of career success, as well as the open-ended responses…

  20. Biological Control of Melaleuca quinquenervia: Goal-based Assessment of Success.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Success means different things to different people. Unfortunately, the success or failure of weed biological control projects is often evaluated by non-participants lacking knowledge of the original goals set by project architects. The Australian tree Melaleuca quinquenervia, which is an aggressive ...

  1. Cholera outbreaks in Africa.

    PubMed

    Mengel, Martin A; Delrieu, Isabelle; Heyerdahl, Leonard; Gessner, Bradford D

    2014-01-01

    an infectious dose of Vibrio cholerae and on the virulence of the implicated strain. Cholera transmission can then be amplified by several factors including contamination of human water- or food sources; climate and extreme weather events; political and economic crises; high population density combined with poor quality informal housing and poor hygiene practices; spread beyond a local community through human travel and animals, e.g., water birds. At an individual level, cholera risk may increase with decreasing immunity and hypochlorhydria, such as that induced by Helicobacter pylori infection, which is endemic in much of Africa, and may increase individual susceptibility and cholera incidence. Since contaminated water is the main vehicle for the spread of cholera, the obvious long-term solution to eradicate the disease is the provision of safe water to all African populations. This requires considerable human and financial resources and time. In the short and medium term, vaccination may help to prevent and control the spread of cholera outbreaks. Regardless of the intervention, further understanding of cholera biology and epidemiology is essential to identify populations and areas at increased risk and thus ensure the most efficient use of scarce resources for the prevention and control of cholera. PMID:24827501

  2. Individual differences in self-reported self-control predict successful emotion regulation.

    PubMed

    Paschke, Lena M; Dörfel, Denise; Steimke, Rosa; Trempler, Ima; Magrabi, Amadeus; Ludwig, Vera U; Schubert, Torsten; Stelzel, Christine; Walter, Henrik

    2016-08-01

    Both self-control and emotion regulation enable individuals to adapt to external circumstances and social contexts, and both are assumed to rely on the overlapping neural resources. Here, we tested whether high self-reported self-control is related to successful emotion regulation on the behavioral and neural level. One hundred eight participants completed three self-control questionnaires and regulated their negative emotions during functional magnetic resonance imaging using reappraisal (distancing). Trait self-control correlated positively with successful emotion regulation both subjectively and neurally, as indicated by online ratings of negative emotions and functional connectivity strength between the amygdala and prefrontal areas, respectively. This stronger overall connectivity of the left amygdala was related to more successful subjective emotion regulation. Comparing amygdala activity over time showed that high self-controllers successfully maintained down-regulation of the left amygdala over time, while low self-controllers failed to down-regulate towards the end of the experiment. This indicates that high self-controllers are better at maintaining a motivated state supporting emotion regulation over time. Our results support assumptions concerning a close relation of self-control and emotion regulation as two domains of behavioral control. They further indicate that individual differences in functional connectivity between task-related brain areas directly relate to differences in trait self-control. PMID:27013102

  3. Using an integrated infection control strategy during outbreak control to minimize nosocomial infection of severe acute respiratory syndrome among healthcare workers.

    PubMed

    Yen, M-Y; Lin, Y E; Su, I-J; Huang, F-Y; Huang, F-Y; Ho, M-S; Chang, S-C; Tan, K-H; Chen, K-T; Chang, H; Liu, Y-C; Loh, C-H; Wang, L-S; Lee, C-H

    2006-02-01

    Healthcare workers (HCWs) are at risk of acquiring severe acute respiratory syndrome (SARS) while caring for SARS patients. Personal protective equipment and negative pressure isolation rooms (NPIRs) have not been completely successful in protecting HCWs. We introduced an innovative, integrated infection control strategy involving triaging patients using barriers, zones of risk, and extensive installation of alcohol dispensers for glove-on hand rubbing. This integrated infection control approach was implemented at a SARS designated hospital ('study hospital') where NPIRs were not available. The number of HCWs who contracted SARS in the study hospital was compared with the number of HCWs who contracted SARS in 86 Taiwan hospitals that did not use the integrated infection control strategy. Two HCWs contracted SARS in the study hospital (0.03 cases/bed) compared with 93 HCWs in the other hospitals (0.13 cases/bed) during the same three-week period. Our strategy appeared to be effective in reducing the incidence of HCWs contracting SARS. The advantages included rapid implementation without NPIRs, flexibility to transfer patients, and re-inforcement for HCWs to comply with infection control procedures, especially handwashing. The efficacy and low cost are major advantages, especially in countries with large populations at risk and fewer economic resources. PMID:16153744

  4. An Outbreak of Clostridium difficile Ribotype 027 Associated with Length of Stay in the Intensive Care Unit and Use of Selective Decontamination of the Digestive Tract: A Case Control Study

    PubMed Central

    van Beurden, Yvette H.; Dekkers, Olaf M.; Bomers, Marije K.; Kaiser, Annie M.; van Houdt, Robin; Knetsch, Cornelis W.; Girbes, Armand R. J.; Mulder, Chris J. J.; Vandenbroucke-Grauls, Christina M. J. E.

    2016-01-01

    Background An outbreak of Clostridium difficile ribotype 027 infection (CDI) occurred at an university hospital, involving 19 departments. To determine what hospital-associated factors drove the outbreak of this particular strain we performed a case-control study. Methods Cases (n = 79), diagnosed with CDI due to C. difficile ribotype 027 were matched for age and treating medical specialty to four control patients (n = 316). Patients diagnosed with CDI due to other ribotypes were included as a second control group. A random selection of C. difficile ribotype 027 strains (n = 10) was genotyped by Whole Genome Sequencing (WGS). Findings WGS showed the outbreak was likely caused by a single strain of C. difficile (two or less single-nucleotide variants between isolates). Ninety-five percent of cases had used antibiotics, compared to 56% of controls. Previous admission to the intensive care unit (ICU) (OR: 2.4, 95% CI 1.0–5.6), longer length of stay (LOS), and recent hospital admission were associated with CDI ribotype 027. Cases were less likely to have been admitted to a ward with a known isolated CDI patient (OR: 0.2, 95% CI 0.1–0.6). Analysis of patients who stayed at the ICU (35 cases; 51 controls), indicated that the use of selective decontamination of the digestive tract (SDD) and a longer LOS in the ICU were associated with CDI risk. Interpretation In this large outbreak, any antibiotic use, including SDD use, appeared as a prerequisite for acquisition of the outbreak strain. The role of use of SDD and prolonged stay on the ICU could not be disentangled, but both factors can play a biologically plausible role in C. difficile acquisition and infection. PMID:27533048

  5. Linking Successive Entries Based upon the OCLC Control Number, ISSN, or LCCN.

    ERIC Educational Resources Information Center

    Alan, Robert

    1993-01-01

    Describes a study that examined the feasibility of using machine links in an online catalog based on the presence of an OCLC control number, International Standard Serial Number (ISSN), or Library of Congress control number (LCCN) to link successive-entry serial bibliographic records that result from serial title changes. (Contains nine…

  6. Determining SARS sub-clinical infection: a longitudinal seroepidemiological study in recovered SARS patients and controls after an outbreak in a general hospital.

    PubMed

    Yang, Zhen; Wang, Shixin; Li, Qian; Li, Yuming; Wei, Maoti; Gao, Hongsheng; Donovan, Catherine; Wang, Peizhong Peter

    2009-01-01

    A cohort of 67 confirmed SARS patients were prospectively followed for 16 months and were compared with a control population. Serum samples taken at various times were tested for IgG and IgM; dynamic serological changes in these antibodies were described. The positive responses of IgM and IgG antibodies in sera against SARS virus from the first week to the sixth week after onset of the illness in patients with SARS were measured. The ELISA test of IgG antibody was negative in 200 community controls. The positive rate in the SARS high-risk population was 0.61% tested by ELISA and 0.21% by IFA. The high-risk population in this study was defined as those who provided health care and other services to SARS patients during the outbreak. IgG antibody in convalescent serum of patients with SARS revealed an increasing trend, peaking at the 22nd week after onset of illness followed by a slow decline. IgM appeared earlier than IgG and can be better used for early detection. IgG remained at a high level for a much longer period, serving as a good indicator for follow-up and for assessing past exposure. Our results also suggest that sub-clinical infection, if it exists, is very rare. PMID:19396666

  7. Why achievement motivation predicts success in business but failure in politics: the importance of personal control.

    PubMed

    Winter, David G

    2010-12-01

    Several decades of research have established that implicit achievement motivation (n Achievement) is associated with success in business, particularly in entrepreneurial or sales roles. However, several political psychology studies have shown that achievement motivation is not associated with success in politics; rather, implicit power motivation often predicts political success. Having versus lacking control may be a key difference between business and politics. Case studies suggest that achievement-motivated U.S. presidents and other world leaders often become frustrated and thereby fail because of lack of control, whereas power-motivated presidents develop ways to work with this inherent feature of politics. A reevaluation of previous research suggests that, in fact, relationships between achievement motivation and business success only occur when control is high. The theme of control is also prominent in the development of achievement motivation. Cross-national data are also consistent with this analysis: In democratic industrialized countries, national levels of achievement motivation are associated with strong executive control. In countries with low opportunity for education (thus fewer opportunities to develop a sense of personal control), achievement motivation is associated with internal violence. Many of these manifestations of frustrated achievement motivation in politics resemble authoritarianism. This conclusion is tested by data from a longitudinal study of 113 male college students, showing that high initial achievement motivation combined with frustrated desires for control is related to increases in authoritarianism (F-scale scores) during the college years. Implications for the psychology of leadership and practical politics are discussed. PMID:21039527

  8. Environmentally controlled succession in a late Pleistocene coral reef (Sinai, Egypt)

    NASA Astrophysics Data System (ADS)

    Mewis, H.; Kiessling, W.

    2013-03-01

    The concept of ecological succession has been frequently applied in the study of ancient reefs. Whereas Paleozoic and Mesozoic reefs are commonly thought to reveal an autogenic primary—climax zonation, patterns in Neogene and Quaternary reefs are much more diverse. Here, we describe a well-preserved late Pleistocene coral reef from Dahab on Sinai Peninsula (Egypt), which shows a distinct zonation that resembles an ecological succession. In contrast to classical examples of ecological successions, species composition, paleoenvironmental conditions, and coral biodiversity of the Dahab reef indicate an allogenic, sea-level controlled community change, from marginal marine to reef slope and back reef. A review of the literature confirms that autogenic, short-term successions are virtually absent in Quaternary reefs. We predict that long generation times of corals make it unlikely that classical autogenic successions develop in reefs at all, unless environmental conditions are unusually stable.

  9. Relationship between Control Grade, Stereoacuity and Surgical Success in Basic Intermittent Exotropia

    PubMed Central

    Kang, Kyung Tae

    2015-01-01

    Purpose This study was conducted to identify the relationship between control grade, stereoacuity and surgical success in basic intermittent exotropia. Methods This retrospective study involved 44 basic intermittent exotropia patients who underwent strabismus surgery and completed at least 6 months of follow-up. The 44 patients were divided into three subgroups according to their control grade: group 1 (good control group, n = 12), group 2 (fair control group, n = 18), and group 3 (poor control group, n = 14). Evaluation was done to identify the relationships between near and distance stereoacuity and control grade, and between surgical success and control grade. Surgical success was defined as ocular alignment between 5 prism diopters esodeviation and 10 prism diopters exodeviation in the primary position at the final visit. Results Mean near stereoacuity measured by the graded circle test was 57.50 seconds of arc (seconds) in group 1, 77.77 seconds in group 2, and 131.43 seconds in group 3 (p < 0.01). Mean distance steroacuity measured by Mentor B-VAT II BVS contour circle was 108.33 seconds in group 1, 148.33 seconds in group 2, and 262.82 seconds in group 3 (p < 0.01). Ten patients (83.33%) in group 1, 12 (66.67%) in group 2, and 9 (64.29%) in group 3 obtained surgical success (p = 0.28). Conclusions In basic intermittent exotropia, better control grade was significantly accompanied by better stereoacuity. Better control grade was accompanied by higher surgical success rate but with no statistical significance. PMID:26028945

  10. Whole-Genome Sequencing for the Investigation of a Hospital Outbreak of MRSA in China

    PubMed Central

    Kong, Zhenzhen; Zhao, Peipei; Liu, Haibing; Yu, Xiang; Qin, Yanyan; Su, Zhaoliang; Wang, Shengjun; Xu, Huaxi; Chen, Jianguo

    2016-01-01

    Staphylococcus aureus is a globally disseminated drug-resistant bacterial species. It remains a leading cause of hospital-acquired infection, primarily among immunocompromised patients. In 2012, the Affiliated People’s Hospital of Jiangsu University experienced a putative outbreak of methicillin-resistant S. aureus (MRSA) that affected 12 patients in the Neurosurgery Department. In this study, whole-genome sequencing (WGS) was used to gain insight into the epidemiology of the outbreak caused by MRSA, and traditional bacterial genotyping approaches were also applied to provide supportive evidence for WGS. We sequenced the DNA from 6 isolates associated with the outbreak. Phylogenetic analysis was constructed by comparing single-nucleotide polymorphisms (SNPs) in the core genome of 6 isolates in the present study and another 3 referenced isolates from GenBank. Of the 6 MRSA sequences in the current study, 5 belonged to the same group, clustering with T0131, while the other one clustered closely with TW20. All of the isolates were identified as ST239-SCCmecIII clones. Whole-genome analysis revealed that four of the outbreak isolates were more tightly clustered into a group and SA13002 together with SA13009 were distinct from the outbreak strains, which were considered non-outbreak strains. Based on the sequencing results, the antibiotic-resistance gene status (present or absent) was almost perfectly concordant with the results of phenotypic susceptibility testing. Various toxin genes were also analyzed successfully. Our analysis demonstrates that using traditional molecular methods and WGS can facilitate the identification of outbreaks and help to control nosocomial transmission. PMID:26950298

  11. Whole-Genome Sequencing for the Investigation of a Hospital Outbreak of MRSA in China.

    PubMed

    Kong, Zhenzhen; Zhao, Peipei; Liu, Haibing; Yu, Xiang; Qin, Yanyan; Su, Zhaoliang; Wang, Shengjun; Xu, Huaxi; Chen, Jianguo

    2016-01-01

    Staphylococcus aureus is a globally disseminated drug-resistant bacterial species. It remains a leading cause of hospital-acquired infection, primarily among immunocompromised patients. In 2012, the Affiliated People's Hospital of Jiangsu University experienced a putative outbreak of methicillin-resistant S. aureus (MRSA) that affected 12 patients in the Neurosurgery Department. In this study, whole-genome sequencing (WGS) was used to gain insight into the epidemiology of the outbreak caused by MRSA, and traditional bacterial genotyping approaches were also applied to provide supportive evidence for WGS. We sequenced the DNA from 6 isolates associated with the outbreak. Phylogenetic analysis was constructed by comparing single-nucleotide polymorphisms (SNPs) in the core genome of 6 isolates in the present study and another 3 referenced isolates from GenBank. Of the 6 MRSA sequences in the current study, 5 belonged to the same group, clustering with T0131, while the other one clustered closely with TW20. All of the isolates were identified as ST239-SCCmecIII clones. Whole-genome analysis revealed that four of the outbreak isolates were more tightly clustered into a group and SA13002 together with SA13009 were distinct from the outbreak strains, which were considered non-outbreak strains. Based on the sequencing results, the antibiotic-resistance gene status (present or absent) was almost perfectly concordant with the results of phenotypic susceptibility testing. Various toxin genes were also analyzed successfully. Our analysis demonstrates that using traditional molecular methods and WGS can facilitate the identification of outbreaks and help to control nosocomial transmission. PMID:26950298

  12. Nitrogen availability as a control mechanism of secondary succession within a semiarid shrubland ecosystem

    SciTech Connect

    Redente, E.F.; McLendon, T.

    1992-09-25

    Three experiments were conducted within a semiarid shrubland to test the role of nitrogen availability as a control mechanism in secondary succession. Secondary succession patterns were documented for seven years and effects of increased and decreased N availability levels, fumigation, and competition by early-seral species were tested. Differential responses by seral species were determined and related to successional patterns. Nitrogen availability was found to be a primary mechanism controlling the rate of succession. Relative growth rate was an important factor determining which species initially dominated and N availability became the primary control factor by the third year. As N availability increased, the rate of succession decreased. Conversely, as N availability was decreased, the rate of succession increased. The abundance of annuals was increased and abundance of perennials decreased by increased N availability. Tissue N concentration was related to lifeform and seral position, and these relationships were important in the transition from early- to mid-seral stages. Decomposer subsystem dynamics were correlated with seral community dynamics. The effect of fumigation was minimized by initially planting with late-seral species. A conceptual model of secondary succession is presented based on N availability, relative growth rate, lifeform, and decomposition dynamics.

  13. Varicella outbreaks in Army recruits from Puerto Rico. Varicella susceptibility in a population from the tropics.

    PubMed

    Longfield, J N; Winn, R E; Gibson, R L; Juchau, S V; Hoffman, P V

    1990-05-01

    Two outbreaks of varicella consisting of a total of 105 cases occurred in a highly varicella-susceptible population of young adult Army recruits from Puerto Rico enrolled in the Defense Language Institute in San Antonio, Tex, between October 1986 and November 1987. Epidemiologic investigation found a significantly higher risk for enlisted recruits housed in open barracks than for officers housed in private rooms. The attack rate in the first outbreak was 30%, with an estimated attack rate of 71% among susceptible persons. Serologic testing of 810 adult recruits from Puerto Rico for varicella-zoster antibody by means of an enzyme-linked immunosorbent assay procedure found 42% to be seronegative, with no significant difference by sex. The enzyme-linked immunosorbent assay test had a positive predictive value for absence of disease development of 95% in the second outbreak. Serologic test results were successfully used as part of the outbreak control strategy, with a resultant decrease in attack rates to 19% overall and 30% among susceptible persons in the second outbreak. Uniquely susceptible adult populations placed in conditions with high likelihood of infection on exposure are potential candidates for the varicella vaccine after its licensure. PMID:2158774

  14. Self-Control and Grit: Related but Separable Determinants of Success

    PubMed Central

    Duckworth, Angela; Gross, James J.

    2015-01-01

    Other than talent and opportunity, what makes some people more successful than others? One important determinant of success is self-control – the capacity to regulate attention, emotion, and behavior in the presence of temptation. A second important determinant of success is grit – the tenacious pursuit of a dominant superordinate goal despite setbacks. Self-control and grit are strongly correlated, but not perfectly so. This means that some people with high levels of self-control capably handle temptations but do not consistently pursue a dominant goal. Likewise, some exceptional achievers are prodigiously gritty but succumb to temptations in domains other than their chosen life passion. Understanding how goals are hierarchically organized clarifies how self-control and grit are related but distinct: Self-control entails aligning actions with any valued goal despite momentarily more-alluring alternatives; grit, in contrast, entails having and working assiduously toward a single challenging superordinate goal through thick and thin, on a timescale of years or even decades. Although both self-control and grit entail aligning actions with intentions, they operate in different ways and at different time scales. This hierarchical goal framework suggests novel directions for basic and applied research on success. PMID:26855479

  15. Mediational Effects of Self-Efficacy Dimensions in the Relationship between Knowledge of Dengue and Dengue Preventive Behaviour with Respect to Control of Dengue Outbreaks: A Structural Equation Model of a Cross-Sectional Survey

    PubMed Central

    Isa, Affendi; Loke, Yoon K.; Smith, Jane R.; Papageorgiou, Alexia; Hunter, Paul R.

    2013-01-01

    Background Dengue fever is endemic in Malaysia, with frequent major outbreaks in urban areas. The major control strategy relies on health promotional campaigns aimed at encouraging people to reduce mosquito breeding sites close to people's homes. However, such campaigns have not always been 100% effective. The concept of self-efficacy is an area of increasing research interest in understanding how health promotion can be most effective. This paper reports on a study of the impact of self-efficacy on dengue knowledge and dengue preventive behaviour. Methods and Findings We recruited 280 adults from 27 post-outbreak villages in the state of Terengganu, east coast of Malaysia. Measures of health promotion and educational intervention activities and types of communication during outbreak, level of dengue knowledge, level and strength of self-efficacy and dengue preventive behaviour were obtained via face-to-face interviews and questionnaires. A structural equation model was tested and fitted the data well (χ2 = 71.659, df = 40, p = 0.002, RMSEA = 0.053, CFI = 0.973, TLI = 0.963). Mass media, local contact and direct information-giving sessions significantly predicted level of knowledge of dengue. Level and strength of self-efficacy fully mediated the relationship between knowledge of dengue and dengue preventive behaviours. Strength of self-efficacy acted as partial mediator in the relationship between knowledge of dengue and dengue preventive behaviours. Conclusions To control and prevent dengue outbreaks by behavioural measures, health promotion and educational interventions during outbreaks should now focus on those approaches that are most likely to increase the level and strength of self-efficacy. PMID:24086777

  16. Mumps Cases and Outbreaks

    MedlinePlus

    ... or cigarettes, might increase spread of the virus. MMR vaccine prevents most, but not all, cases of mumps ... is 78% (range: 49% to 92%) effective. The MMR vaccine protects against currently circulating mumps strains. Outbreaks can ...

  17. Outbreaks and Investigations

    MedlinePlus

    ... Rhizopus Investigation web page. Histoplasmosis in an Illinois Prison Histoplasmosis outbreak at a state prison in Illinois, ... Department of Corrections Coccidioidomycosis (Valley fever) in California Prisons High rates of coccidioidomycosis (Valley fever) at two ...

  18. Working practices and success of infection prevention and control teams: a scoping study.

    PubMed

    Hale, R; Powell, T; Drey, N S; Gould, D J

    2015-02-01

    Little research has been undertaken on how infection prevention and control (IPC) teams operate and how their effectiveness is assessed. This review aimed to explore how IPC teams embed IPC throughout hospitals, balance outbreak management with strategic aspects of IPC work (e.g. education), and how IPC team performance is measured. A scoping exercise was performed combining literature searches, evidence synthesis, and intelligence from expert advisers. Eleven publications were identified. One paper quantified how IPC nurses spend their time, two described daily activities of IPC teams, five described initiatives to embed IPC across organizations following legislation since 1999 in the UK or changes in the delivery of healthcare, and three explored the contribution of IPC intermediaries (link nurses and champions). Eight publications reported research findings. The others reported how IPC teams are embedding IPC practice in UK hospitals. In conclusion, there is scope for research to explore different models of IPC team-working and effectiveness, and cost-effectiveness. Other topics that need addressing are the willingness and ability of ward staff to assume increased responsibility for IPC and the effectiveness of intermediaries. PMID:25549828

  19. Investigation of multistate foodborne disease outbreaks.

    PubMed

    Sobel, Jeremy; Griffin, Patricia M; Slutsker, Laurence; Swerdlow, David L; Tauxe, Robert V

    2002-01-01

    The U.S. food supply is characterized increasingly by centralized production and wide distribution of products, and more foodborne disease outbreaks are dispersed over broad geographic areas. Such outbreaks may present as a gradual, diffuse, and initially unapparent increase in sporadic cases. Recognition and reporting by clinicians and local public health officials and the ordering of laboratory tests by clinicians continue to be cornerstones of detecting all outbreaks. New methods--such as active laboratory-based surveillance, automated algorithms for detecting increases in infection rates, and molecular subtyping--facilitate detection of diffuse outbreaks. Routines have evolved for the investigation of multistate outbreaks; they are characterized by rapid communication between local, state, and federal public health officials; timely review of epidemiologic data by expert panels; collaboration on tracebacks with food safety regulatory agencies; and communication with the public and media. Rapid, efficient investigation of multistate outbreaks may result in control of acute public health emergencies, identification and correction of hazardous food production and processing practices, and consequent improvement in food safety. PMID:12297677

  20. Data modeling for detection of epidemic outbreak

    NASA Astrophysics Data System (ADS)

    Jaenisch, Holger M.; Handley, James W.; Jaenisch, Kristina L.; Conn, Michael S.; Faucheux, Jeffrey P.

    2005-05-01

    Data Modeling is successfully applied to outbreak detection using epidemicological time series data. With proper selection of features, same day detection was demonstrated. Predictive Data Models are derived from the features in the form of integro-differential equations or their solution. These models are used as real-time change detectors. Data Modeling enables change detection using only nominal (no-outbreak) examples for training. Modeling naturally occurring dynamics due to assignable causes such as flu season enables distinction to be made of chemical and biological (chem-bio) causes.

  1. 7 CFR 1424.10 - Succession and control of facilities and production.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Succession and control of facilities and production. 1424.10 Section 1424.10 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOENERGY...

  2. Controlling disease outbreaks in wildlife using limited culling: modelling classical swine fever incursions in wild pigs in Australia

    PubMed Central

    2012-01-01

    Disease modelling is one approach for providing new insights into wildlife disease epidemiology. This paper describes a spatio-temporal, stochastic, susceptible- exposed-infected-recovered process model that simulates the potential spread of classical swine fever through a documented, large and free living wild pig population following a simulated incursion. The study area (300 000 km2) was in northern Australia. Published data on wild pig ecology from Australia, and international Classical Swine Fever data was used to parameterise the model. Sensitivity analyses revealed that herd density (best estimate 1-3 pigs km-2), daily herd movement distances (best estimate approximately 1 km), probability of infection transmission between herds (best estimate 0.75) and disease related herd mortality (best estimate 42%) were highly influential on epidemic size but that extraordinary movements of pigs and the yearly home range size of a pig herd were not. CSF generally established (98% of simulations) following a single point introduction. CSF spread at approximately 9 km2 per day with low incidence rates (< 2 herds per day) in an epidemic wave along contiguous habitat for several years, before dying out (when the epidemic arrived at the end of a contiguous sub-population or at a low density wild pig area). The low incidence rate indicates that surveillance for wildlife disease epidemics caused by short lived infections will be most efficient when surveillance is based on detection and investigation of clinical events, although this may not always be practical. Epidemics could be contained and eradicated with culling (aerial shooting) or vaccination when these were adequately implemented. It was apparent that the spatial structure, ecology and behaviour of wild populations must be accounted for during disease management in wildlife. An important finding was that it may only be necessary to cull or vaccinate relatively small proportions of a population to successfully contain

  3. Detecting and Responding to a Dengue Outbreak: Evaluation of Existing Strategies in Country Outbreak Response Planning

    PubMed Central

    Kroeger, Axel; Runge-Ranzinger, Silvia; O'Dempsey, Tim

    2013-01-01

    Background. Dengue outbreaks are occurring with increasing frequency and intensity. Evidence-based epidemic preparedness and effective response are now a matter of urgency. Therefore, we have analysed national and municipal dengue outbreak response plans. Methods. Thirteen country plans from Asia, Latin America and Australia, and one international plan were obtained from the World Health Organization. The information was transferred to a data analysis matrix where information was extracted according to predefined and emerging themes and analysed for scope, inconsistencies, omissions, and usefulness. Findings. Outbreak response planning currently has a considerable number of flaws. Outbreak governance was weak with a lack of clarity of stakeholder roles. Late timing of responses due to poor surveillance, a lack of combining routine data with additional alerts, and lack of triggers for initiating the response weakened the functionality of plans. Frequently an outbreak was not defined, and early response mechanisms based on alert signals were neglected. There was a distinct lack of consideration of contextual influences which can affect how an outbreak detection and response is managed. Conclusion. A model contingency plan for dengue outbreak prediction, detection, and response may help national disease control authorities to develop their own more detailed and functional context specific plans. PMID:24222774

  4. Detecting and responding to a dengue outbreak: evaluation of existing strategies in country outbreak response planning.

    PubMed

    Harrington, Julia; Kroeger, Axel; Runge-Ranzinger, Silvia; O'Dempsey, Tim

    2013-01-01

    Background. Dengue outbreaks are occurring with increasing frequency and intensity. Evidence-based epidemic preparedness and effective response are now a matter of urgency. Therefore, we have analysed national and municipal dengue outbreak response plans. Methods. Thirteen country plans from Asia, Latin America and Australia, and one international plan were obtained from the World Health Organization. The information was transferred to a data analysis matrix where information was extracted according to predefined and emerging themes and analysed for scope, inconsistencies, omissions, and usefulness. Findings. Outbreak response planning currently has a considerable number of flaws. Outbreak governance was weak with a lack of clarity of stakeholder roles. Late timing of responses due to poor surveillance, a lack of combining routine data with additional alerts, and lack of triggers for initiating the response weakened the functionality of plans. Frequently an outbreak was not defined, and early response mechanisms based on alert signals were neglected. There was a distinct lack of consideration of contextual influences which can affect how an outbreak detection and response is managed. Conclusion. A model contingency plan for dengue outbreak prediction, detection, and response may help national disease control authorities to develop their own more detailed and functional context specific plans. PMID:24222774

  5. Historical inability to control Aedes aegypti as a main contributor of fast dispersal of chikungunya outbreaks in Latin America.

    PubMed

    Fernández-Salas, Ildefonso; Danis-Lozano, Rogelio; Casas-Martínez, Mauricio; Ulloa, Armando; Bond, J Guillermo; Marina, Carlos F; Lopez-Ordóñez, Teresa; Elizondo-Quiroga, Armando; Torres-Monzón, Jorge A; Díaz-González, Esteban E

    2015-12-01

    The arrival of chikungunya fever (CHIKF) in Latin American countries has been expected to trigger epidemics and challenge health systems. Historically considered as dengue-endemic countries, abundant Aedes aegypti populations make this region highly vulnerable to chikungunya virus (CHIKV) circulation. This review describes the current dengue and CHIKF epidemiological situations, as well as the role of uncontrolled Ae. aegypti and Aedes albopictus vectors in spreading the emerging CHIKV. Comments are included relating to the vector competence of both species and failures of surveillance and vector control measures. Dengue endemicity is a reflection of these abundant and persistent Aedes populations that are now spreading CHIKV in the Americas. This article forms part of a symposium in Antiviral Research on "Chikungunya discovers the New World." PMID:26518229

  6. Executive Control Circuitry Differentiates Degree of Success in Weight Loss Following Gastric-Bypass Surgery

    PubMed Central

    Borckardt, Jeffrey J.; Madan, Alok; Byrne, T. Karl; George, Mark S.; O'Neil, Patrick M.; Hanlon, Colleen A.

    2014-01-01

    Objective While overall success rates of bariatric surgery are high, approximately 20% of patients either regain or never lose the expected amount of weight. The purpose of this study was to determine whether, after gastric-bypass surgery, the degree of weight loss can be differentiated based on the neural response to food cues. Design and Methods In this functional MRI study, 31 post-surgical patients viewed food and neutral images in two counterbalanced runs during which they were either instructed to “crave” or to “resist” craving. The neural response to food cues was assessed within and between runs for all participants, and further analyzed between more successful (n = 24) and less successful (n = 7) groups. More successful was defined by meeting 50% excess weight loss. Results Overall, instructions to “crave” elicited significant activity in the dorsomedial prefrontal cortex (PFC) whereas “resist” elicited significant activity in the dorsolateral PFC (DLPFC). Between groups there was no brain difference when instructed to “crave.” The more successful participants however had significantly more activity in the DLPFC when instructed to “resist.” Conclusions These findings suggest that the ability to mobilize neural circuits involved in executive control post-gastric-bypass surgery may be a unique component of successful outcome post-surgery. PMID:24136926

  7. Challenges in Investigating a Salmonellosis Outbreak in a Correctional Facility.

    PubMed

    Eshofonie, Anthony Olufemi; Lin, Huai; Valcin, Randy Paul; Irvin, Darrel; Goss, Kathleen; Piper, Jeremy

    2016-07-01

    Timely reporting of disease outbreak and access to the outbreak site are necessary for prompt investigation and control. Local health departments (LHDs) establish the reporting time frames, methods, and communication channels within their jurisdictions in advance. This report describes a salmonellosis outbreak investigation in a federal correctional center (FCC) that was delayed due to issues with jurisdictional ownership and with separate reporting protocols for the FCC. The setting of the outbreak within an FCC posed additional unique challenges to the outbreak investigation. These challenges resulted in the outbreak response being delayed by 6 days and inconclusive investigation. It is recommended that LHDs and FCCs work together to create an advance protocol for improved public health coordination, oversight, and response. PMID:27302705

  8. Modeling Classical Swine Fever Outbreak-Related Outcomes.

    PubMed

    Yadav, Shankar; Olynk Widmar, Nicole J; Weng, Hsin-Yi

    2016-01-01

    The study was carried out to estimate classical swine fever (CSF) outbreak-related outcomes, such as epidemic duration and number of infected, vaccinated, and depopulated premises, using defined most likely CSF outbreak scenarios. Risk metrics were established using empirical data to select the most likely CSF outbreak scenarios in Indiana. These scenarios were simulated using a stochastic between-premises disease spread model to estimate outbreak-related outcomes. A total of 19 single-site (i.e., with one index premises at the onset of an outbreak) and 15 multiple-site (i.e., with more than one index premises at the onset of an outbreak) outbreak scenarios of CSF were selected using the risk metrics. The number of index premises in the multiple-site outbreak scenarios ranged from 4 to 32. The multiple-site outbreak scenarios were further classified into clustered (N = 6) and non-clustered (N = 9) groups. The estimated median (5th, 95th percentiles) epidemic duration (days) was 224 (24, 343) in the single-site and was 190 (157, 251) and 210 (167, 302) in the clustered and non-clustered multiple-site outbreak scenarios, respectively. The median (5th, 95th percentiles) number of infected premises was 323 (0, 488) in the single-site outbreak scenarios and was 529 (395, 662) and 465 (295, 640) in the clustered and non-clustered multiple-site outbreak scenarios, respectively. Both the number and spatial distributions of the index premises affected the outcome estimates. The results also showed the importance of implementing vaccinations to accommodate depopulation in the CSF outbreak controls. The use of routinely collected surveillance data in the risk metrics and disease spread model allows end users to generate timely outbreak-related information based on the initial outbreak's characteristics. Swine producers can use this information to make an informed decision on the management of swine operations and continuity of business, so that potential losses could

  9. Deltamethrin flea-control preserves genetic variability of black-tailed prairie dogs during a plague outbreak

    USGS Publications Warehouse

    Jones, P.H.; Biggins, D.E.; Eads, D.A.; Eads, S.L.; Britten, H.B.

    2012-01-01

    Genetic variability and structure of nine black-tailed prairie dog (BTPD, Cynomys ludovicianus) colonies were estimated with 15 unlinked microsatellite markers. A plague epizootic occurred between the first and second years of sampling and our study colonies were nearly extirpated with the exception of three colonies in which prairie dog burrows were previously dusted with an insecticide, deltamethrin, used to control fleas (vectors of the causative agent of plague, Yersinia pestis). This situation provided context to compare genetic variability and structure among dusted and non-dusted colonies pre-epizootic, and among the three dusted colonies pre- and post-epizootic. We found no statistical difference in population genetic structures between dusted and non-dusted colonies pre-epizootic. On dusted colonies, gene flow and recent migration rates increased from the first (pre-epizootic) year to the second (post-epizootic) year which suggested dusted colonies were acting as refugia for prairie dogs from surrounding colonies impacted by plague. Indeed, in the dusted colonies, estimated densities of adult prairie dogs (including dispersers), but not juveniles (non-dispersers), increased from the first year to the second year. In addition to preserving BTPDs and many species that depend on them, protecting colonies with deltamethrin or a plague vaccine could be an effective method to preserve genetic variability of prairie dogs. ?? 2011 Springer Science+Business Media B.V.

  10. Outbreaks Attributed to Cheese: Differences Between Outbreaks Caused by Unpasteurized and Pasteurized Dairy Products, United States, 1998–2011

    PubMed Central

    Gould, L. Hannah; Mungai, Elisabeth; Behravesh, Casey Barton

    2015-01-01

    Introduction The interstate commerce of unpasteurized fluid milk, also known as raw milk, is illegal in the United States, and intrastate sales are regulated independently by each state. However, U.S. Food and Drug Administration regulations allow the interstate sale of certain types of cheeses made from unpasteurized milk if specific aging requirements are met. We describe characteristics of these outbreaks, including differences between outbreaks linked to cheese made from pasteurized or unpasteurized milk. Methods We reviewed reports of outbreaks submitted to the Foodborne Disease Outbreak Surveillance System during 1998–2011 in which cheese was implicated as the vehicle. We describe characteristics of these outbreaks, including differences between outbreaks linked to cheese made from pasteurized versus unpasteurized milk. Results During 1998–2011, 90 outbreaks attributed to cheese were reported; 38 (42%) were due to cheese made with unpasteurized milk, 44 (49%) to cheese made with pasteurized milk, and the pasteurization status was not reported for the other eight (9%). The most common cheese–pathogen pairs were unpasteurized queso fresco or other Mexican-style cheese and Salmonella (10 outbreaks), and pasteurized queso fresco or other Mexican-style cheese and Listeria (6 outbreaks). The cheese was imported from Mexico in 38% of outbreaks caused by cheese made with unpasteurized milk. In at least five outbreaks, all due to cheese made from unpasteurized milk, the outbreak report noted that the cheese was produced or sold illegally. Outbreaks caused by cheese made from pasteurized milk occurred most commonly (64%) in restaurant, delis, or banquet settings where cross-contamination was the most common contributing factor. Conclusions In addition to using pasteurized milk to make cheese, interventions to improve the safety of cheese include limiting illegal importation of cheese, strict sanitation and microbiologic monitoring in cheese-making facilities, and

  11. Nosocomial Outbreak of New Delhi Metallo-β-Lactamase-1-Producing Gram-Negative Bacteria in South Africa: A Case-Control Study

    PubMed Central

    de Jager, Pieter; Chirwa, Tobias; Naidoo, Shan; Perovic, Olga; Thomas, Juno

    2015-01-01

    Objective New Delhi metallo-β-lactamase (NDM)-producing Gram-negative bacteria have spread globally and pose a significant public health threat. There is a need to better define risk factors and outcomes of NDM-1 clinical infection. We assessed risk factors for nosocomial infection with NDM-1-producers and associated in-hospital mortality. Methods A matched case-control study was conducted during a nosocomial outbreak of NDM-1-producers in an adult intensive care unit (ICU) in South Africa. All patients from whom NDM-1-producers were identified were considered (n=105). Cases included patients admitted during the study period in whom NDM-1 producing Gram-negative bacteria were isolated from clinical specimens collected ≥48 hours after admission, and where surveillance definitions for healthcare-associated infections were met. Controls were matched for age, sex, date of hospital admission and intensive-care admission. Conditional logistic regression was used to identify risk factors for NDM-1 clinical infection and associated in-hospital mortality. Findings 38 cases and 68 controls were included. Klebsiella pneumoniae was the most common NDM-1-producer (28/38, 74%). Cases had longer mean hospital stays (44.0 vs. 13.3 days; P < 0.001) and ICU stays (32.5 vs. 8.3 days; P < 0.001). Adjusting for co-morbid disease, the in-hospital mortality of cases was significantly higher than controls (55.3% vs. 14.7%; AOR, 11.29; P < 0.001). Higher Charlson co-morbidity index score (5.2 vs. 4.1; AOR, 1.59; P = 0.005), mechanical ventilation days (7.47 vs. 0.94 days; AOR, 1.32; P = 0.003) and piperacillin/tazobactam exposure (11.03 vs. 1.05 doses; AOR, 1.08; P = 0.013) were identified as risk factors on multivariate analysis. Cases had a significantly higher likelihood of in-hospital mortality when the NDM-1-producer was Klebsiella pneumoniae (AOR, 16.57; P = 0.007), or when they had a bloodstream infection (AOR, 8.84; P = 0.041). Conclusion NDM-1 infection is associated with

  12. Rapidly controlled outbreak of Serratia marcescens infection/colonisations in a neonatal intensive care unit, Pescara General Hospital, Pescara, Italy, April 2011.

    PubMed

    Polilli, E; Parruti, G; Fazii, P; D'Antonio, D; Palmieri, D; D'Incecco, C; Mangifesta, A; Garofalo, G; Del Duca, L; D'Amario, C; Scimia, M; Cortesi, V; Fortunato, V

    2011-01-01

    In April 2011, an outbreak of Serratia marcescens infection/ colonisations occurred in the neonatal intensive care unit of Pescara General Hospital. Rapid microbiological investigations lead to identification of five cases of likely cross-transmission from a neonate hospitalised for S. marcescens sepsis: four infections and one neonate colonised post-mortem. Two low birth weight neonates died. The environmental investigation detected S. marcescens from two soap dispensers. Strict hygiene measures lead to early interruption of the outbreak, without recurrences to date. PMID:21699768

  13. Assessment of African Swine Fever Diagnostic Techniques as a Response to the Epidemic Outbreaks in Eastern European Union Countries: How To Improve Surveillance and Control Programs

    PubMed Central

    Nieto, R.; Soler, A.; Pelayo, V.; Fernández-Pinero, J.; Markowska-Daniel, I.; Pridotkas, G.; Nurmoja, I.; Granta, R.; Simón, A.; Pérez, C.; Martín, E.; Fernández-Pacheco, P.; Arias, M.

    2015-01-01

    This study represents a complete comparative analysis of the most widely used African swine fever (ASF) diagnostic techniques in the European Union (EU) using field and experimental samples from animals infected with genotype II ASF virus (ASFV) isolates circulating in Europe. To detect ASFV, three different PCRs were evaluated in parallel using 785 field and experimental samples. The results showed almost perfect agreement between the Universal ProbeLibrary (UPL-PCR) and the real-time (κ = 0.94 [95% confidence interval {CI}, 0.91 to 0.97]) and conventional (κ = 0.88 [95% CI, 0.83 to 0.92]) World Organisation for Animal Health (OIE)-prescribed PCRs. The UPL-PCR had greater diagnostic sensitivity for detecting survivors and allows earlier detection of the disease. Compared to the commercial antigen enzyme-linked immunosorbent assay (ELISA), good-to-moderate agreement (κ = 0.67 [95% CI, 0.58 to 0.76]) was obtained, with a sensitivity of 77.2% in the commercial test. For ASF antibody detection, five serological methods were tested, including three commercial ELISAs, the OIE-ELISA, and the confirmatory immunoperoxidase test (IPT). Greater sensitivity was obtained with the IPT than with the ELISAs, since the IPT was able to detect ASF antibodies at an earlier point in the serological response, when few antibodies are present. The analysis of the exudate tissues from dead wild boars showed that IPT might be a useful serological tool for determining whether or not animals had been exposed to virus infection, regardless of whether antibodies were present. In conclusion, the UPL-PCR in combination with the IPT was the most trustworthy method for detecting ASF during the epidemic outbreaks affecting EU countries in 2014. The use of the most appropriate diagnostic tools is critical when implementing effective control programs. PMID:26041901

  14. Fresh Produce-Associated Listeriosis Outbreaks, Sources of Concern, Teachable Moments, and Insights.

    PubMed

    Garner, Danisha; Kathariou, Sophia

    2016-02-01

    Foodborne transmission of Listeria monocytogenes was first demonstrated through the investigation of the 1981 Maritime Provinces outbreak involving coleslaw. In the following two decades, most listeriosis outbreaks involved foods of animal origin, e.g., deli meats, hot dogs, and soft cheeses. L. monocytogenes serotype 4b, especially epidemic clones I, II, and Ia, were frequently implicated in these outbreaks. However, since 2008 several outbreaks have been linked to diverse types of fresh produce: sprouts, celery, cantaloupe, stone fruit, and apples. The 2011 cantaloupe-associated outbreak was one of the deadliest foodborne outbreaks in recent U.S. history. This review discusses produce-related outbreaks of listeriosis with a focus on special trends, unusual findings, and potential paradigm shifts. With the exception of sprouts, implicated produce types were novel, and outbreaks were one-time events. Several involved serotype 1/2a, and in the 2011 cantaloupe-associated outbreak, serotype 1/2b was for the first time conclusively linked to a common-source outbreak of invasive listeriosis. Also in this outbreak, for the first time multiple strains were implicated in a common-source outbreak. In 2014, deployment of whole genome sequencing as part of outbreak investigation validated this technique as a pivotal tool for outbreak detection and speedy resolution. In spite of the unusual attributes of produce-related outbreaks, in all but one of the investigated cases (the possible exception being the coleslaw outbreak) contamination was traced to the same sources as those for outbreaks associated with other vehicles (e.g., deli meats), i.e., the processing environment and equipment. The public health impact of farm-level contamination remains uncharacterized. This review highlights knowledge gaps regarding virulence and other potentially unique attributes of produce outbreak strains, the potential for novel fresh produce items to become unexpectedly implicated in outbreaks

  15. Keyboard before Head Tracking Depresses User Success in Remote Camera Control

    NASA Astrophysics Data System (ADS)

    Zhu, Dingyun; Gedeon, Tom; Taylor, Ken

    In remote mining, operators of complex machinery have more tasks or devices to control than they have hands. For example, operating a rock breaker requires two handed joystick control to position and fire the jackhammer, leaving the camera control to either automatic control or require the operator to switch between controls. We modelled such a teleoperated setting by performing experiments using a simple physical game analogue, being a half size table soccer game with two handles. The complex camera angles of the mining application were modelled by obscuring the direct view of the play area and the use of a Pan-Tilt-Zoom (PTZ) camera. The camera control was via either a keyboard or via head tracking using two different sets of head gestures called “head motion” and “head flicking” for turning camera motion on/off. Our results show that the head motion control was able to provide a comparable performance to using a keyboard, while head flicking was significantly worse. In addition, the sequence of use of the three control methods is highly significant. It appears that use of the keyboard first depresses successful use of the head tracking methods, with significantly better results when one of the head tracking methods was used first. Analysis of the qualitative survey data collected supports that the worst (by performance) method was disliked by participants. Surprisingly, use of that worst method as the first control method significantly enhanced performance using the other two control methods.

  16. Cross-Border Cholera Outbreaks in Sub-Saharan Africa, the Mystery behind the Silent Illness: What Needs to Be Done?

    PubMed Central

    Mwesawina, Maurice; Baluku, Yosia; Kanyanda, Setiala S. E.; Orach, Christopher Garimoi

    2016-01-01

    school going children were the most affected age groups. To successfully prevent and control these outbreaks, guidelines and strategies should be reviewed to assign clear roles and responsibilities to cholera actors on collaboration, prevention, detection, monitoring and control of these epidemics. PMID:27258124

  17. Outbreak of severe acute respiratory syndrome--worldwide, 2003.

    PubMed

    2003-03-21

    Since late February 2003, CDC has been supporting the World Health Organization (WHO) in the investigation of a multicountry outbreak of atypical pneumonia of unknown etiology. The illness is being referred to as severe acute respiratory syndrome (SARS). This report describes the scope of the outbreak, preliminary case definition, and interim infection control guidance for the United States. PMID:12665115

  18. Lessons Learned from an Elementary School Norovirus Outbreak

    ERIC Educational Resources Information Center

    Gomez, Eileen Button

    2008-01-01

    Outbreaks of norovirus have been on the increase. The virus often spreads quickly through schools and similar institutions. The school nurse may be able to minimize the impact of a school norovirus outbreak by providing accurate information about the disease, the scope of the local situation, and instruction on infection control measures. This…

  19. Teachers' Risk Perception and Needs in Addressing Infectious Disease Outbreak

    ERIC Educational Resources Information Center

    Wong, Emmy M. Y.; Cheng, May M. H.; Lo, S.K.

    2010-01-01

    The outbreak of the Influenza A (H1N1) virus has led to numerous precautionary school closures in several countries. No research is available on the school teachers' perceptions as a health protective resource in controlling communicable disease outbreaks. The purposes of this study were to examine the risk perception, the perceived understanding…

  20. Measles (Rubeola) Cases and Outbreaks

    MedlinePlus

    ... that caused the large measles outbreak in the Philippines in 2014. 2014: The U.S. experienced 23 measles ... were associated with cases brought in from the Philippines, which experienced a large measles outbreak. For more ...

  1. Successfully maintaining program funding during trying times: lessons from tobacco control programs in five states.

    PubMed

    Nelson, David E; Reynolds, Jennifer H; Luke, Douglas A; Mueller, Nancy B; Eischen, Monica H; Jordan, Jerelyn; Lancaster, R Brick; Marcus, Stephen E; Vallone, Donna

    2007-01-01

    Despite negative financial conditions in recent years, several states were able to successfully maintain funding for tobacco prevention and control, which provided an opportunity to understand the factors associated with success. One explanation may be the level of long-term program sustainability in some states. According to a model developed by Saint Louis University researchers, the five elements critical to tobacco control sustainability are state political and financial climate; community awareness and capacity; program structure and administration; funding stability and planning; and surveillance and evaluation. Five states (Nebraska, New York, Indiana, Virginia, and Colorado) maintained funding for their tobacco control programs. Four of these states gained additional legislative appropriations or prevented a massive reduction; Colorado used a statewide ballot initiative to increase funding. On the basis of the sustainability framework, case studies, and prior research, the major lessons learned for maintaining funding were the importance of (1) strong and experienced leadership, (2) broad and deep organizational and community ties, (3) coordinated efforts, (4) strategic use of surveillance and evaluation data, (5) active dissemination of information about program successes, and (6) policy maker champions. The sustainability framework and lessons learned may provide valuable insights for other public health programs facing funding threats. PMID:17984716

  2. Modeling Classical Swine Fever Outbreak-Related Outcomes

    PubMed Central

    Yadav, Shankar; Olynk Widmar, Nicole J.; Weng, Hsin-Yi

    2016-01-01

    The study was carried out to estimate classical swine fever (CSF) outbreak-related outcomes, such as epidemic duration and number of infected, vaccinated, and depopulated premises, using defined most likely CSF outbreak scenarios. Risk metrics were established using empirical data to select the most likely CSF outbreak scenarios in Indiana. These scenarios were simulated using a stochastic between-premises disease spread model to estimate outbreak-related outcomes. A total of 19 single-site (i.e., with one index premises at the onset of an outbreak) and 15 multiple-site (i.e., with more than one index premises at the onset of an outbreak) outbreak scenarios of CSF were selected using the risk metrics. The number of index premises in the multiple-site outbreak scenarios ranged from 4 to 32. The multiple-site outbreak scenarios were further classified into clustered (N = 6) and non-clustered (N = 9) groups. The estimated median (5th, 95th percentiles) epidemic duration (days) was 224 (24, 343) in the single-site and was 190 (157, 251) and 210 (167, 302) in the clustered and non-clustered multiple-site outbreak scenarios, respectively. The median (5th, 95th percentiles) number of infected premises was 323 (0, 488) in the single-site outbreak scenarios and was 529 (395, 662) and 465 (295, 640) in the clustered and non-clustered multiple-site outbreak scenarios, respectively. Both the number and spatial distributions of the index premises affected the outcome estimates. The results also showed the importance of implementing vaccinations to accommodate depopulation in the CSF outbreak controls. The use of routinely collected surveillance data in the risk metrics and disease spread model allows end users to generate timely outbreak-related information based on the initial outbreak’s characteristics. Swine producers can use this information to make an informed decision on the management of swine operations and continuity of business, so that potential losses

  3. An overview of disease surveillance and notification system in Nigeria and the roles of clinicians in disease outbreak prevention and control.

    PubMed

    Isere, Elvis E; Fatiregun, Akinola A; Ajayi, Ikeoluwapo O

    2015-01-01

    While outbreaks of infectious diseases have long presented a public health challenge, especially in developing countries like Nigeria; within recent years, the frequency of such outbreaks has risen tremendously. Furthermore, with the recent outbreaks of emerging and re-emerging infectious diseases such as Ebola virus disease and other epidemic prone diseases in Nigeria demanding immediate public health action, there is a need to strengthen the existing notifiable disease surveillance and notification system with increased clinicians' involvement in timely reporting of notifiable diseases to designated public health authorities for prompt public health action. Hence, this paper provides the opportunity to increase awareness among clinicians on the importance of immediate reporting of notifiable diseases and intensify engagement of clinicians in disease notification activities by describing various notifiable diseases in Nigeria using their surveillance case definition, outlines the reporting channel for notifying these diseases and highlights the roles of clinicians in the current disease surveillance and notification network for early disease outbreak detection and public health response in Nigeria. PMID:26229222

  4. An overview of disease surveillance and notification system in Nigeria and the roles of clinicians in disease outbreak prevention and control

    PubMed Central

    Isere, Elvis E.; Fatiregun, Akinola A.; Ajayi, Ikeoluwapo O.

    2015-01-01

    While outbreaks of infectious diseases have long presented a public health challenge, especially in developing countries like Nigeria; within recent years, the frequency of such outbreaks has risen tremendously. Furthermore, with the recent outbreaks of emerging and re-emerging infectious diseases such as Ebola virus disease and other epidemic prone diseases in Nigeria demanding immediate public health action, there is a need to strengthen the existing notifiable disease surveillance and notification system with increased clinicians’ involvement in timely reporting of notifiable diseases to designated public health authorities for prompt public health action. Hence, this paper provides the opportunity to increase awareness among clinicians on the importance of immediate reporting of notifiable diseases and intensify engagement of clinicians in disease notification activities by describing various notifiable diseases in Nigeria using their surveillance case definition, outlines the reporting channel for notifying these diseases and highlights the roles of clinicians in the current disease surveillance and notification network for early disease outbreak detection and public health response in Nigeria. PMID:26229222

  5. An outbreak of hepatitis A virus associated with a multi-national inner-city nursery in Glasgow, Scotland.

    PubMed

    Li, Kathy K; Penrice, Glillian M; Gunson, Rory N

    2015-08-01

    This report describes an outbreak of hepatitis A virus linked to a nursery which affected a total of 10 individuals. Active case finding, using oral fluid testing, helped identify asymptomatic cases. Nucleotide sequencing showed that all cases were caused by the same virus, which was most similar to HAV strains circulating Zimbabwe. Interestingly, an asymptomatic child had recently returned from visiting family in that country. Standard infection control procedures and vaccination of contacts successfully contained the outbreak. Only one patient developed hepatitis A despite having been vaccinated a week before symptoms began. This hepatitis A outbreak scenario may become more common as the numbers of international travellers and immigrants increase in the UK. It highlights the importance of recommending HAV vaccination to foreign nationals and their families who are travelling to countries endemic for hepatitis A. PMID:26209369

  6. School Systems' Practices of Controlling Socialization during Principal Succession: Looking through the Lens of an Organizational Socialization Theory

    ERIC Educational Resources Information Center

    Bengtson, Ed; Zepeda, Sally J.; Parylo, Oksana

    2013-01-01

    The importance of effective school leadership is well known. The inevitable changing of school leaders raises concerns over the successfulness of the succession process. Directly linked to leader succession is socialization; therefore, the purpose of this study was to examine the processes and practices of school systems that control the…

  7. 81 FR 21550 - Emergency Funding for Puerto Rico Department of Health, Zika Virus Outbreak

    Federal Register 2010, 2011, 2012, 2013, 2014

    2016-04-12

    ... of Health, Zika Virus Outbreak AGENCY: Centers for Disease Control and Prevention (CDC), Department... Puerto Rico Department of Health, Zika virus Outbreak for Infectious Diseases (ELC)--financed solely by... Department of Health (PRDOH) to combat the current outbreak of Zika virus. Project Description Puerto Rico...

  8. Concurrent assessment of schedule and intensity control across successive discriminations1

    PubMed Central

    Raslear, Thomas G.; Pierrel-Sorrentino, Rosemary; Brissey, Catherine

    1975-01-01

    Two chinchillas were trained on a series of two-valued auditory intensity discriminations. Lever presses were reinforced when no tone was present and not reinforced in the presence of a four-kiloHertz tone. The intensity of the nonreinforced tone was successively decreased, increasing the difficulty of the discrimination, until differential responding resembled that on a mixed schedule (no-tone–no-tone). Response data were partitioned in such a way as to provide a continuing assessment of the relative amounts of control exerted by the reinforcement schedule and the sound intensity, respectively. Control by reinforcement density was a direct function of discrimination difficulty, whereas the control exerted by intensity was inversely related to difficulty. For these chinchillas, the absolute threshold value obtained at four kiloHertz was about two decibels referenced to 20 microNewtons per meter squared. PMID:16811846

  9. Optimal feedback control successfully explains changes in neural modulations during experiments with brain-machine interfaces

    PubMed Central

    Benyamini, Miri; Zacksenhouse, Miriam

    2015-01-01

    Recent experiments with brain-machine-interfaces (BMIs) indicate that the extent of neural modulations increased abruptly upon starting to operate the interface, and especially after the monkey stopped moving its hand. In contrast, neural modulations that are correlated with the kinematics of the movement remained relatively unchanged. Here we demonstrate that similar changes are produced by simulated neurons that encode the relevant signals generated by an optimal feedback controller during simulated BMI experiments. The optimal feedback controller relies on state estimation that integrates both visual and proprioceptive feedback with prior estimations from an internal model. The processing required for optimal state estimation and control were conducted in the state-space, and neural recording was simulated by modeling two populations of neurons that encode either only the estimated state or also the control signal. Spike counts were generated as realizations of doubly stochastic Poisson processes with linear tuning curves. The model successfully reconstructs the main features of the kinematics and neural activity during regular reaching movements. Most importantly, the activity of the simulated neurons successfully reproduces the observed changes in neural modulations upon switching to brain control. Further theoretical analysis and simulations indicate that increasing the process noise during normal reaching movement results in similar changes in neural modulations. Thus, we conclude that the observed changes in neural modulations during BMI experiments can be attributed to increasing process noise associated with the imperfect BMI filter, and, more directly, to the resulting increase in the variance of the encoded signals associated with state estimation and the required control signal. PMID:26042002

  10. Cost of dengue outbreaks: literature review and country case studies

    PubMed Central

    2013-01-01

    Background Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save – through early response activities – resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. Methods Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. Results Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems. The country case studies – conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the

  11. Detection and isolation of infectious laryngotracheitis virus on a broiler farm after a disease outbreak.

    PubMed

    Dormitorio, Teresa V; Giambrone, Joseph J; Macklin, Kenneth S

    2013-12-01

    A broiler farm in North Alabama suffered a mild infectious laryngotracheitis (ILT) outbreak, as determined by clinical disease and PCR. The poultry integrator sought help to control further outbreaks in subsequent flocks. Samples were collected from various areas of the poultry houses on the farm over an 8-wk period. The first sampling was conducted 8 days after the infected farm was depopulated; the second was conducted 2 days prior to subsequent flock placement; and the third was conducted when the new flock was 5 wk of age. Samples were examined for ILT virus (ILTV) DNA by real-time PCR and virus isolation in embryos. The infected houses were cleaned, disinfected, heated, litter composted, and curtains replaced after the first sampling and prior to placement of the next flock. Samples from all periods were positive for ILTV DNA. However, the number of positive samples and crossing point values indicated a decrease in the amount of viral DNA, while virus isolation in embryos was successful only on the first sampling. The subsequent flock was vaccinated against ILTV by in ovo route using a commercial recombinant vaccine. Cleaning and sanitation after the disease outbreak reduced the amount of ILTV on the farm and together with in ovo vaccination of the new flock may have prevented a recurrence of another ILT outbreak. PMID:24597126

  12. Residency Training at the Front of the West African Ebola Outbreak: Adapting for a Rare Opportunity

    PubMed Central

    Mo, Yin; Archuleta, Sophia; Salmon, Sharon; Fisher, Dale

    2016-01-01

    Medical trainees face multiple barriers to participation in major outbreak responses such as that required for Ebola Virus Disease through 2014-2015 in West Africa. Hurdles include fear of contracting and importing the disease, residency requirements, scheduling conflicts, family obligations and lack of experience and maturity. We describe the successful four-week deployment to Liberia of a first year infectious diseases trainee through the mechanism of the Global Outbreak Alert and Response Network of the World Health Organization. The posting received prospective approval from the residency supervisory committees and employing hospital management and was designed with components fulfilling the Accreditation Council for Graduate Medical Education (ACGME) core competencies. It mirrored conventional training with regards to learning objectives, supervisory framework and assessment methods. Together with Centers for Disease Control and Prevention and many other partners, the team joined the infection prevention and control efforts in Monrovia. Contributions were made to a 'ring fencing' infection control approach that was being introduced, including enhancement of triage, training and providing supplies in high priority health-care facilities in the capital and border zones. In addition the fellow produced an electronic database that enabled monitoring infection control standards in health facilities. This successful elective posting illustrates that quality training can be achieved, even in the most challenging environments, with support from the pedagogic and sponsoring institutions. Such experiential learning opportunities benefit both the outbreak response and the trainee, and if scaled up would contribute towards building a global health emergency workforce. More should be done from residency accreditation bodies in facilitating postings in outbreak settings. PMID:27330848

  13. Residency Training at the Front of the West African Ebola Outbreak: Adapting for a Rare Opportunity.

    PubMed

    Mo, Yin; Archuleta, Sophia; Salmon, Sharon; Fisher, Dale

    2016-01-01

    Medical trainees face multiple barriers to participation in major outbreak responses such as that required for Ebola Virus Disease through 2014-2015 in West Africa. Hurdles include fear of contracting and importing the disease, residency requirements, scheduling conflicts, family obligations and lack of experience and maturity. We describe the successful four-week deployment to Liberia of a first year infectious diseases trainee through the mechanism of the Global Outbreak Alert and Response Network of the World Health Organization. The posting received prospective approval from the residency supervisory committees and employing hospital management and was designed with components fulfilling the Accreditation Council for Graduate Medical Education (ACGME) core competencies. It mirrored conventional training with regards to learning objectives, supervisory framework and assessment methods. Together with Centers for Disease Control and Prevention and many other partners, the team joined the infection prevention and control efforts in Monrovia. Contributions were made to a 'ring fencing' infection control approach that was being introduced, including enhancement of triage, training and providing supplies in high priority health-care facilities in the capital and border zones. In addition the fellow produced an electronic database that enabled monitoring infection control standards in health facilities. This successful elective posting illustrates that quality training can be achieved, even in the most challenging environments, with support from the pedagogic and sponsoring institutions. Such experiential learning opportunities benefit both the outbreak response and the trainee, and if scaled up would contribute towards building a global health emergency workforce. More should be done from residency accreditation bodies in facilitating postings in outbreak settings. PMID:27330848

  14. Bacterial Community Succession During in situ Uranium Bioremediation: Spatial Similarities Along Controlled Flow Paths

    SciTech Connect

    Hwang, Chiachi; Wu, Weimin; Gentry, Terry J.; Carley, Jack; Corbin, Gail A.; Carroll, Sue L.; Watson, David B.; Jardine, Phil M.; Zhou, Jizhong; Criddle, Craig S.; Fields, Matthew W.

    2009-05-22

    Bacterial community succession was investigated in a field-scale subsurface reactor formed by a series of wells that received weekly ethanol additions to re-circulating groundwater. Ethanol additions stimulated denitrification, metal reduction, sulfate reduction, and U(VI) reduction to sparingly soluble U(IV). Clone libraries of SSU rRNA gene sequences from groundwater samples enabled tracking of spatial and temporal changes over a 1.5 y period. Analyses showed that the communities changed in a manner consistent with geochemical variations that occurred along temporal and spatial scales. Canonical correspondence analysis revealed that the levels of nitrate, uranium, sulfide, sulfate, and ethanol strongly correlated with particular bacterial populations. As sulfate and U(VI) levels declined, sequences representative of sulfate-reducers and metal-reducers were detected at high levels. Ultimately, sequences associated with sulfate-reducing populations predominated, and sulfate levels declined as U(VI) remained at low levels. When engineering controls were compared to the population variation via canonical ordination, changes could be related to dissolved oxygen control and ethanol addition. The data also indicated that the indigenous populations responded differently to stimulation for bio-reduction; however, the two bio-stimulated communities became more similar after different transitions in an idiosyncratic manner. The strong associations between particular environmental variables and certain populations provide insight into the establishment of practical and successful remediation strategies in radionuclide-contaminated environments with respect to engineering controls and microbial ecology.

  15. An adenovirus 4 outbreak amongst staff in a pediatric ward manifesting as keratoconjunctivitis-a possible failure of contact and aerosol infection control.

    PubMed

    Hoyle, Elizabeth; Erez, Joanne C; Kirk-Granger, Helen R; Collins, Elizabeth; Tang, Julian W

    2016-05-01

    An adenovirus serotype 4 outbreak was identified on a pediatric ward involving 4 members of the health care staff. Two inpatients on the ward at the time (1 immunocompromised) were shedding this virus from their respiratory tracts and could have acted as independent index cases for the staff infections. Significantly, upon investigation, it was found that staff members were unaware that adenoviruses are not completely eliminated by alcohol gel handrubs and that soap and water handwashing is also required. PMID:26804304

  16. A waterborne tularemia outbreak.

    PubMed

    Greco, D; Allegrini, G; Tizzi, T; Ninu, E; Lamanna, A; Luzi, S

    1987-03-01

    A waterborne tularemia outbreak is described. Forty nine cases were identified in Sansepolcro, a small Medioeval town in the province of Arezzo, Tuscany, Italy. All cases had laterocervical or sub-mandibular adenitis, and occurred within a period of three weeks during March and April 1982. The study showed association between cases and the consumption of water from an unchlorinated water system. Francisella tularensis type 1 was isolated from wild hares captured in the area. PMID:3582597

  17. Mitigating Infectious Disease Outbreaks

    NASA Astrophysics Data System (ADS)

    Davey, Victoria

    The emergence of new, transmissible infections poses a significant threat to human populations. As the 2009 novel influenza A/H1N1 pandemic and the 2014-2015 Ebola epidemic demonstrate, we have observed the effects of rapid spread of illness in non-immune populations and experienced disturbing uncertainty about future potential for human suffering and societal disruption. Clinical and epidemiologic characteristics of a newly emerged infectious organism are usually gathered in retrospect as the outbreak evolves and affects populations. Knowledge of potential effects of outbreaks and epidemics and most importantly, mitigation at community, regional, national and global levels is needed to inform policy that will prepare and protect people. Study of possible outcomes of evolving epidemics and application of mitigation strategies is not possible in observational or experimental research designs, but computational modeling allows conduct of `virtual' experiments. Results of well-designed computer simulations can aid in the selection and implementation of strategies that limit illness and death, and maintain systems of healthcare and other critical resources that are vital to public protection. Mitigating Infectious Disease Outbreaks.

  18. Managing for Successful Control of Naturally Occurring Asbestos During Large Scale Grading

    NASA Astrophysics Data System (ADS)

    Saur, R.; Harnish, D.; Cavanaugh, J.; Kendall, K.; Virdee, A.; Ludlam, D.

    2012-12-01

    caused trigger level exceedences in perimeter monitors, including from off-site vehicles, nearby construction, and mechanical vegetation management (e.g. weed whacking). Regulatory and Owner Oversight. Monitoring results were reported daily to agencies, agencies made frequent inspections, and owner's independent compliance representatives observed the NOA mitigation and provided real-time feedback to the construction team. NOA Controls. NOA emissions were controlled site-wide and for each work activity. Site systems included misting, water trucks on roads, temporary covers and soil sealants. Work activity controls for excavation/grading included both source and perimeter controls. Water application technologies specially designed for NOA fiber mitigation, and not just dust mitigation, were effective without adding excessive water to work areas. These activities collectively created a management structure that facilitated successful implementation of NOA control technologies.

  19. Outbreak of cyclosporiasis in British Columbia associated with imported Thai basil.

    PubMed Central

    Hoang, L. M. N.; Fyfe, M.; Ong, C.; Harb, J.; Champagne, S.; Dixon, B.; Isaac-Renton, J.

    2005-01-01

    Sporadic outbreaks of cyclosporiasis, a common cause of protracted diarrhoea in underdeveloped countries, are often undetected and undiagnosed in industrial countries. In May 2001, an outbreak of Cyclospora cayetanensis gastroenteritis was identified in British Columbia, Canada, with 17 reported cases. We conducted a case-control study involving 12 out of the 17 reported and confirmed case patients. Eleven (92%) of the patients had consumed Thai basil, an essential ingredient in Vietnamese cuisine, compared to 3 out of 16 (19%) of the control patients (P = 0.003). Trace-back investigations implicated Thai basil imported via the United States as the vehicle for this outbreak. This is the first documented sporadic outbreak of cyclosporiasis linked to Thai basil in Canada, and the first outbreak of cyclosporiasis identified in an ethnic immigrant population. This outbreak provides the opportunity to increase our understanding of this emerging pathogen and improve on our prevention and control for future outbreaks. PMID:15724706

  20. lin-28 Controls the Succession of Cell Fate Choices via Two Distinct Activities

    PubMed Central

    Vadla, Bhaskar; Kemper, Kevin; Alaimo, Jennifer; Heine, Christian; Moss, Eric G.

    2012-01-01

    lin-28 is a conserved regulator of cell fate succession in animals. In Caenorhabditis elegans, it is a component of the heterochronic gene pathway that governs larval developmental timing, while its vertebrate homologs promote pluripotency and control differentiation in diverse tissues. The RNA binding protein encoded by lin-28 can directly inhibit let-7 microRNA processing by a novel mechanism that is conserved from worms to humans. We found that C. elegans LIN-28 protein can interact with four distinct let-7 family pre-microRNAs, but in vivo inhibits the premature accumulation of only let-7. Surprisingly, however, lin-28 does not require let-7 or its relatives for its characteristic promotion of second larval stage cell fates. In other words, we find that the premature accumulation of mature let-7 does not account for lin-28's precocious phenotype. To explain let-7's role in lin-28 activity, we provide evidence that lin-28 acts in two steps: first, the let-7–independent positive regulation of hbl-1 through its 3′UTR to control L2 stage-specific cell fates; and second, a let-7–dependent step that controls subsequent fates via repression of lin-41. Our evidence also indicates that let-7 functions one stage earlier in C. elegans development than previously thought. Importantly, lin-28's two-step mechanism resembles that of the heterochronic gene lin-14, and the overlap of their activities suggests a clockwork mechanism for developmental timing. Furthermore, this model explains the previous observation that mammalian Lin28 has two genetically separable activities. Thus, lin-28's two-step mechanism may be an essential feature of its evolutionarily conserved role in cell fate succession. PMID:22457637

  1. Outbreak Caused by Enterobacteriaceae Harboring NDM-1 Metallo-β-Lactamase Carried in an IncFII Plasmid in a Tertiary Care Hospital in Mexico City

    PubMed Central

    Torres-González, Pedro; Bobadilla-del Valle, Miriam; Tovar-Calderón, Estrella; Leal-Vega, Francisco; Hernández-Cruz, Araceli; Martínez-Gamboa, Areli; Niembro-Ortega, María Dolores; Sifuentes-Osornio, José

    2015-01-01

    Carbapenem-resistant Enterobacteriaceae carrying New Delhi metallo-β-lactamase 1 (NDM-1) have rarely been reported in Latin America. We report of an outbreak caused by a blaNDM-1-harboring plasmid spread through different bacterial species, including Escherichia coli (ST617) and Enterobacter cloacae (ST182) isolates from the same patient and three Klebsiella pneumoniae isolates (ST22) derived from three epidemiologically related patients. IncFII plasmids were found in all strains. Measures to control the outbreak were applied successfully. PMID:26282410

  2. Role of healthcare workers in early epidemic spread of Ebola: policy implications of prophylactic compared to reactive vaccination policy in outbreak prevention and control.

    PubMed

    Coltart, Cordelia E M; Johnson, Anne M; Whitty, Christopher J M

    2015-01-01

    Ebola causes severe illness in humans and has epidemic potential. How to deploy vaccines most effectively is a central policy question since different strategies have implications for ideal vaccine profile. More than one vaccine may be needed. A vaccine optimised for prophylactic vaccination in high-risk areas but when the virus is not actively circulating should be safe, well tolerated, and provide long-lasting protection; a two- or three-dose strategy would be realistic. Conversely, a reactive vaccine deployed in an outbreak context for ring-vaccination strategies should have rapid onset of protection with one dose, but longevity of protection is less important. In initial cases, before an outbreak is recognised, healthcare workers (HCWs) are at particular risk of acquiring and transmitting infection, thus potentially augmenting early epidemics. We hypothesise that many early outbreak cases could be averted, or epidemics aborted, by prophylactic vaccination of HCWs. This paper explores the potential impact of prophylactic versus reactive vaccination strategies of HCWs in preventing early epidemic transmissions. To do this, we use the limited data available from Ebola epidemics (current and historic) to reconstruct transmission trees and illustrate the theoretical impact of these vaccination strategies. Our data suggest a substantial potential benefit of prophylactic versus reactive vaccination of HCWs in preventing early transmissions. We estimate that prophylactic vaccination with a coverage >99% and theoretical 100% efficacy could avert nearly two-thirds of cases studied; 75% coverage would still confer clear benefit (40% cases averted), but reactive vaccination would be of less value in the early epidemic. A prophylactic vaccination campaign for front-line HCWs is not a trivial undertaking; whether to prioritise long-lasting vaccines and provide prophylaxis to HCWs is a live policy question. Prophylactic vaccination is likely to have a greater impact on the

  3. A polymicrobial outbreak of surgical site infections following cardiac surgery at a community hospital in Florida, 2011–2012

    PubMed Central

    Nguyen, Duc B.; Gupta, Neil; Abou-Daoud, Alison; KleKamp, Benjamin G.; Rhone, Chaz; Winston, Tiffany; Hedberg, Trevor; Scuteri, Ana; Evans, Charlotte; Jensen, Bette; Moulton-Meissner, Heather; Török, Thomas; Berríos-Torres, Sandra I.; Noble-Wang, Judith; Kallen, Alexander

    2015-01-01

    We describe an outbreak of 22 sternal surgical site infections following cardiac surgery, including 4 Gordonia infections. Possible operation room environmental contamination and suboptimal infection control practices regarding scrub attire may have contributed to the outbreak. PMID:24679572

  4. Blood, sweat, tears and success of technology transfer long-term controlled-release of herbicides

    SciTech Connect

    Van Voris, P.; Cataldo, D.A.; Burton, F.G.; Skeins, W.E.

    1988-01-01

    The problems encountered, the technical difficulties that had to be overcome, and the successful transfer of technology related to controlled-release of pesticides is reviewed. Research on control-release of pesticides to date has resulted in products designed to extend bioactivity for periods of several days, months, or at most, several years. However, research supported by the U.S. Department of Energy directed toward solving problems associated with plant-root penetration through caps and liners engineered to minimize leaching or movement of buried nuclear and chemical wastes has resulted in development of a long-term controlled-release herbicide delivery system designed to stop root growth for periods of up to 100 years. Through the unique combination of polymers with a herbicidally active dinitroaniline, a cylindrical pellet was developed that continuously releases a herbicide for a period of up to 100 years. Equilibrium concentration of the herbicide in soil adjacent to the pellet and the bioactive lifetime of the device can be adjusted by changing the size of the pellet; the type of polymer; the type, quality, and quantity of carrier; and/or the concentration and type of dinitroaniline was used.

  5. Surveillance for foodborne disease outbreaks in Iran, 2006-2011

    PubMed Central

    Masoumi Asl, Hossein; Gouya, Mohammad Mehdi; Soltan-dallal, Mohammad Mehdi; Aghili, Nooshin

    2015-01-01

    Background: The outbreaks of foodborne diseases is a major health problem and occur daily in all countries, from the most to the least developed. This study is the first report of foodborne outbreaks in Iran that carried out from 2006 to 2011. Methods: A retrospective, longitudinal study carried out using foodborne disease national surveillance system data from 2006-2011, which have been reported by all provincial health centers to the Center for Communicable Disease Control. Collected data were analyzed using SPSS version 18 software. Results: Since 2006 to 2011, a total of 2250 outbreaks were reported in Iran. Analyzed data showed that the outbreak rate has increased from 0.07/100000 in 2006 to 1.38/100000 population in 2011. Khuzestan, Kermanshah and Qazvin were three provinces that reported more outbreaks than nationally expected outbreak incidence rate during 2011. Analysis of epidemiological characteristics of foodborne outbreaks during 2011 indicated that the numbers of outbreaks were highest in warm months, e.g. 17.8% of total outbreaks was just reported in August. Females and age group of 16-30 years old were more affected and 55% of cases occurred in rural area. Among 684 human samples which have been tested, E. coli, Shigella, Hepatitis A and Vibrio cholera were predominant etiologic agents respectively. Conclusion: Increasing the detection rate of foodborne outbreaks imply the expansion of surveillance activities and improved primary health care in Iran in recent years. Foodborne disease surveillance system is a new program in Iran that should be continued and strengthened including diagnostic laboratory capacities. PMID:26913248

  6. Impact of climate change on larch budmoth cyclic outbreaks

    NASA Astrophysics Data System (ADS)

    Iyengar, Sudharsana V.; Balakrishnan, Janaki; Kurths, Jürgen

    2016-06-01

    Periodic outbreaks of the larch budmoth Zeiraphera diniana population (and the massive forest defoliation they engender) have been recorded in the Alps over the centuries and are known for their remarkable regularity. But these have been conspicuously absent since 1981. On the other hand, budmoth outbreaks have been historically unknown in the larches of the Carpathian Tatra mountains. To resolve this puzzle, we propose here a model which includes the influence of climate and explains both the 8–9 year periodicity in the budmoth cycle and the variations from this, as well as the absence of cycles. We successfully capture the observed trend of relative frequencies of outbreaks, reproducing the dominant periodicities seen. We contend that the apparent collapse of the cycle in 1981 is due to changing climatic conditions following a tipping point and propose the recurrence of the cycle with a changed periodicity of 40 years – the next outbreak could occur in 2021. Our model also predicts longer cycles.

  7. The History of Dengue Outbreaks in the Americas

    PubMed Central

    Brathwaite Dick, Olivia; San Martín, José L.; Montoya, Romeo H.; del Diego, Jorge; Zambrano, Betzana; Dayan, Gustavo H.

    2012-01-01

    Dengue is a viral disease usually transmitted by Aedes aegypti mosquitoes. Dengue outbreaks in the Americas reported in medical literature and to the Pan American Health Organization are described. The outbreak history from 1600 to 2010 was categorized into four phases: Introduction of dengue in the Americas (1600–1946); Continental plan for the eradication of the Ae. aegypti (1947–1970) marked by a successful eradication of the mosquito in 18 continental countries by 1962; Ae. aegypti reinfestation (1971–1999) caused by the failure of the mosquito eradication program; Increased dispersion of Ae. aegypti and dengue virus circulation (2000–2010) characterized by a marked increase in the number of outbreaks. During 2010 > 1.7 million dengue cases were reported, with 50,235 severe cases and 1,185 deaths. A dramatic increase in the number of outbreaks has been reported in recent years. Urgent global action is needed to avoid further disease spread. PMID:23042846

  8. Outbreak of norovirus gastroenteritis infection, Thailand.

    PubMed

    McCarthy, Katie S; Guntapong, Ratigorn; Thattiyaphong, Aree; Wangroongsarb, Piyada; Hall, Aron J; Olsen, Sonja J; Holtz, Timothy H

    2013-05-01

    Norovirus is a leading cause of gastrointestinal illness worldwide. We investigated an outbreak of gastrointestinal illness in Pattaya, Thailand, among participants of a course. We asked participants and family members to complete a questionnaire asking about symptoms, meals eaten, and foods consumed during the course. We collected stool samples from persons reporting illness and analyzed specimens for several viruses and enteropathogenic bacteria. We defined a case as a person having one or more episodes of diarrhea, with onset between 30 August and 1 September 2010, in a participant or family member who attended the course. Of 56 people who attended, 95% completed the questionnaire: nine met the case definition (attack rate, 17%). Common symptoms included abdominal cramps, nausea, fatigue, headache, and vomiting. Food items with elevated risk ratios included: crispy fish maw, dried squid, and cashew nut salad [risk ratio (RR) 5.1; 95% confidence interval (CI) 0.7-37]; assorted salad bar with dressing (RR 3.0; 95% CI 0.9-11); and seafood kebab (RR 5.8; 95% CI 0.8-43). Among ill persons, four (44%) provided stool samples and two (50%) were positive for norovirus. Our data suggest a foodborne outbreak of norovirus. Increased use of norovirus diagnostics as well as measures to prevent transmission may help identify additional outbreaks and improve control measures to limit the spread of outbreaks. PMID:24050072

  9. Predicting outbreak detection in public health surveillance: quantitative analysis to enable evidence-based method selection.

    PubMed

    Buckeridge, David L; Okhmatovskaia, Anna; Tu, Samson; O'Connor, Martin; Nyulas, Csongor; Musen, Mark A

    2008-01-01

    Public health surveillance is critical for accurate and timely outbreak detection and effective epidemic control. A wide range of statistical algorithms is used for surveillance, and important differences have been noted in the ability of these algorithms to detect outbreaks. The evidence about the relative performance of these algorithms, however, remains limited and mainly qualitative. Using simulated outbreak data, we developed and validated quantitative models for predicting the ability of commonly used surveillance algorithms to detect different types of outbreaks. The developed models accurately predict the ability of different algorithms to detect different types of outbreaks. These models enable evidence-based algorithm selection and can guide research into algorithm development. PMID:18999264

  10. Predicting Outbreak Detection in Public Health Surveillance: Quantitative Analysis to Enable Evidence-Based Method Selection

    PubMed Central

    Buckeridge, David L.; Okhmatovskaia, Anna; Tu, Samson; O’Connor, Martin; Nyulas, Csongor; Musen, Mark A.

    2008-01-01

    Public health surveillance is critical for accurate and timely outbreak detection and effective epidemic control. A wide range of statistical algorithms is used for surveillance, and important differences have been noted in the ability of these algorithms to detect outbreaks. The evidence about the relative performance of these algorithms, however, remains limited and mainly qualitative. Using simulated outbreak data, we developed and validated quantitative models for predicting the ability of commonly used surveillance algorithms to detect different types of outbreaks. The developed models accurately predict the ability of different algorithms to detect different types of outbreaks. These models enable evidence-based algorithm selection and can guide research into algorithm development. PMID:18999264

  11. Project SUCCESS' Effects on Substance Use-Related Attitudes and Behaviors: A Randomized Controlled Trial in Alternative High Schools

    ERIC Educational Resources Information Center

    Clark, Heddy Kovach; Ringwalt, Chris L.; Shamblen, Stephen R.; Hanley, Sean M.

    2011-01-01

    Using a randomized controlled effectiveness trial, we examined the effects of Project SUCCESS on a range of secondary outcomes, including the program's mediating variables. Project SUCCESS, which is based both on the Theory of Reasoned Action and on Cognitive Behavior Theory, is a school-based substance use prevention program that targets…

  12. Zika virus outbreak in Brazil.

    PubMed

    Heukelbach, Jorg; Alencar, Carlos Henrique; Kelvin, Alyson Ann; de Oliveira, Wanderson Kleber; Pamplona de Góes Cavalcanti, Luciano

    2016-02-01

    Zika virus (ZIKV) infection is spreading rapidly within the Americas after originating from an outbreak in Brazil. We describe the current ZIKV infection epidemic in Brazil and the neurological symptoms arising. First cases of an acute exanthematic disease were reported in Brazil's Northeast region at the end of 2014. In March 2015, autochthonous ZIKV was determined to be the causative agent of the exanthematic disease. As cases of neurological syndromes in regions where ZIKV, dengue and/or Chikungunya viruses co-circulate were reported, ZIKV was also identified in the cerebrospinal fluid of patients with acute neurological syndromes and previous exanthematic disease. By the end of September 2015, an increasing number of infants with small head circumference or microcephaly were noted in Brazil's Northeast which was estimated to be 29 cases between August and October. ZIKV was identified in blood and tissue samples of a newborn and in mothers who had given birth to infants with microcephaly and ophthalmological anomalies. In 2015, there were an estimated 440,000 - 1,300,000 Zika cases in Brazil. There have been 4,783 suspected cases of microcephaly, most of them in the Northeast of Brazil associated with 76 deaths. The Ministry of Health is intensifying control measures against the mosquito Aedes aegypti and implemented intensive surveillance actions. Further studies are needed to confirm the suspected association between ZIKV infection and microcephaly; to identify antiviral, immunotherapy, or prophylactic vaccine; to introduce diagnostic ELISA testing. Clinical and epidemiological studies must be performed to describe viral dynamics and expansion of the outbreak. PMID:26927450

  13. A review of outbreaks of foodborne disease associated with passenger ships: evidence for risk management.

    PubMed Central

    Rooney, Roisin M.; Cramer, Elaine H.; Mantha, Stacey; Nichols, Gordon; Bartram, Jamie K.; Farber, Jeffrey M.; Benembarek, Peter K.

    2004-01-01

    OBJECTIVE: Foodborne disease outbreaks on ships are of concern because of their potentially serious health consequences for passengers and crew and high costs to the industry. The authors conducted a review of outbreaks of foodborne diseases associated with passenger ships in the framework of a World Health Organization project on setting guidelines for ship sanitation. METHODS: The authors reviewed data on 50 outbreaks of foodborne disease associated with passenger ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and food vehicles were collected. RESULTS: The findings of this review show that the majority of reported outbreaks were associated with cruise ships and that almost 10,000 people were affected. Salmonella spp were most frequently associated with outbreaks. Foodborne outbreaks due to enterotoxigenic E. coli spp, Shigella spp, noroviruses (formally called Norwalk-like viruses), Vibrio spp, Staphylococcus aureus, Clostridium perfringens, Cyclospora sp, and Trichinella sp also occurred on ships. Factors associated with the outbreaks reviewed include inadequate temperature control, infected food handlers, contaminated raw ingredients, cross-contamination, inadequate heat treatment, and onshore excursions. Seafood was the most common food vehicle implicated in outbreaks. CONCLUSIONS: Many ship-associated outbreaks could have been prevented if measures had been taken to ensure adequate temperature control, avoidance of cross-contamination, reliable food sources, adequate heat treatment, and exclusion of infected food handlers from work. PMID:15219800

  14. INVESTIGATIONS OF WATERBORNE DISEASE OUTBREAKS

    EPA Science Inventory

    From 1971-2000, there were about 751 waterborne disease outbreaks recognized and reported, with over 500,000 associated cases of illness. From 1989-1994, of 90 total outbreaks, 2% were associated with untreated surface water, 30% with untreated ground water, 42% with treatment de...

  15. Disease Outbreaks Caused by Water.

    ERIC Educational Resources Information Center

    Craun, Gunther F.

    1978-01-01

    Presents a literature review of the disease outbreaks caused by drinking polluted water, covering publications of 1976-77. Some of the waterborn outbreaks included are: (1) cholera; (2) gastroenteritis; (3) giardiasis; and (4) typhoid fever and salmonellosis. A list of 66 references is also presented. (HM)

  16. Bluetongue in small ruminants: An opinionated review, with a brief appraisal of the 2014 outbreak of the disease in Greece and the south-east Europe.

    PubMed

    Kyriakis, C S; Billinis, C; Papadopoulos, E; Vasileiou, N G C; Athanasiou, L V; Fthenakis, G C

    2015-12-14

    Bluetongue is an arthropod-borne viral disease of ruminants, especially of sheep, caused by Bluetongue virus, which belongs to the genus Orbivirus of the family Reoviridae and is classified into 26 antigenically distinct serotypes. Once thought to be restricted in Africa and parts of the Middle East, bluetongue has now become a concern in sheep-rearing countries around the world. In the past 10 years, severe outbreaks have occurred in Europe with important economic consequences; of these, the 2006-20008 outbreak in Europe was caused by a serotype 8 strain and the 2014 outbreak in Greece and the other countries of south-east Europe was caused by a serotype 4 strain, suggested to be a reassortant strain with genome segments from lineages of serotype 1, 2 and 4. Immunisation campaigns can be implemented for successful control and limiting of the disease. Nevertheless, in both of the above outbreaks, late application of vaccinations led to a wide spread of the disease, which subsequently resulted in significant losses in livestock in the affected regions. In view of that, standardisation of control measures in the future will be beneficial for efficiently limiting outbreaks of the disease. PMID:26304745

  17. Patterns of Success: Online Self-Monitoring in a Web-Based Behavioral Weight Control Program

    PubMed Central

    Krukowski, Rebecca A.; Harvey-Berino, Jean; Bursac, Zoran; Ashikaga, Taka; West, Delia Smith

    2016-01-01

    Objectives Online weight control technologies could reduce barriers to treatment, including increased ease and convenience of self-monitoring. Self-monitoring consistently predicts outcomes in behavioral weight loss programs; however, little is known about patterns of self-monitoring associated with success. Methods The current study examines 161 participants (93% female; 31% African-American; mean BMI=35.7±5.7) randomized to a 6-month online behavioral weight control program which offered weekly group “chat” sessions and online self-monitoring. Self-monitoring log-ins were continuously monitored electronically during treatment and examined in association with weight change and demographics. Weekend and weekday log-ins were examined separately and length of periods of continuous self-monitoring were examined. Results We found that 91% of participants logged in to the self-monitoring webpage at least once. Over 6 months, these participants monitored on an average of 28% of weekdays and 17% of weekend days, with most log-ins earlier in the program. Women were less likely to log-in, and there were trends for greater self-monitoring by older participants. Race, education and marital status were not significant predictors of self-monitoring. Both weekday and weekend log-ins were significant independent predictors of weight loss. Patterns of consistent self-monitoring emerged early for participants who went on to achieve greater than a five percent weight loss. Conclusions Patterns of online self-monitoring were strongly associated with weight loss outcomes. These results suggest a specific focus on consistent self-monitoring early in a behavioral weight control program might be beneficial for achieving clinically significant weight losses. PMID:22545978

  18. The global health network on alcohol control: successes and limits of evidence-based advocacy.

    PubMed

    Schmitz, Hans Peter

    2016-04-01

    Global efforts to address alcohol harm have significantly increased since the mid-1990 s. By 2010, the World Health Organization (WHO) had adopted the non-binding Global Strategy to Reduce the Harmful Use of Alcohol. This study investigates the role of a global health network, anchored by the Global Alcohol Policy Alliance (GAPA), which has used scientific evidence on harm and effective interventions to advocate for greater global public health efforts to reduce alcohol harm. The study uses process-tracing methodology and expert interviews to evaluate the accomplishments and limitations of this network. The study documents how network members have not only contributed to greater global awareness about alcohol harm, but also advanced a public health approach to addressing this issue at the global level. Although the current network represents an expanding global coalition of like-minded individuals, it faces considerable challenges in advancing its cause towards successful implementation of effective alcohol control policies across many low- and middle-income countries (LMICs). The analysis reveals a need to transform the network into a formal coalition of regional and national organizations that represent a broader variety of constituents, including the medical community, consumer groups and development-focused non-governmental organizations. Considering the growing harm of alcohol abuse in LMICs and the availability of proven and cost-effective public health interventions, alcohol control represents an excellent 'buy' for donors interested in addressing non-communicable diseases. Alcohol control has broad beneficial effects for human development, including promoting road safety and reducing domestic violence and health care costs across a wide variety of illnesses caused by alcohol consumption. PMID:26276763

  19. Successes and Challenges in Implementation of Radon Control Activities in Iowa, 2010–2015

    PubMed Central

    Abbott, Anne L.; Miller, Laura L.

    2016-01-01

    Background Radon gas has recently become more prominent in discussions of lung cancer prevention nationally and in Iowa. A review in 2013 of cancer plans in the National Comprehensive Cancer Control Program found that 42% of cancer plans, including Iowa’s, had terminology on radon. Plans included awareness activities, home testing, remediation, policy, and policy evaluation. Community Context Iowa has the highest average radon concentrations in the United States; 70% of homes have radon concentrations above the Environmental Protection Agency’s action levels. Radon control activities in Iowa are led by the Iowa Cancer Consortium, the Iowa Department of Public Health, and the Iowa Radon Coalition. Methods A collaborative approach was used to increase levels of awareness, testing, and (if necessary) mitigation, and to introduce a comprehensive radon control policy in Iowa by engaging partners and stakeholders across the state. Outcome The multipronged approach and collaborative work in Iowa appears to have been successful in increasing awareness: the number of radon tests completed in Iowa increased by 20% from 19,600 in 2009 to 23,500 in 2014, and the number of mitigations completed by certified mitigators increased by 108% from 2,600 to more than 5,400. Interpretation Through collaboration, Iowa communities are engaged in activities that led to increases in awareness, testing, mitigation, and policy. States interested in establishing a similar program should consider a multipronged approach involving multiple entities and stakeholders with different interests and abilities. Improvements in data collection and analysis are necessary to assess impact. PMID:27079648

  20. Biotic and abiotic controls of argentine ant invasion success at local and landscape scales

    USGS Publications Warehouse

    Menke, S.B.; Fisher, R.N.; Jetz, W.; Holway, D.A.

    2007-01-01

    Although the ecological success of introduced species hinges on biotic interactions and physical conditions, few experimental studies - especially on animals - have simultaneously investigated the relative importance of both types of factors. The lack of such research may stem from the common assumption that native and introduced species exhibit similar environmental tolerances. Here we combine experimental and spatial modeling approaches (1) to determine the relative importance of biotic and abiotic controls of Argentine ant (Linepithema humile) invasion success, (2) to examine how the importance of these factors changes with spatial scale in southern California (USA), and (3) to assess how Argentine ants differ from native ants in their environmental tolerances. A factorial field experiment that combined native ant removal with irrigation revealed that Argentine ants failed to invade any dry plots (even those lacking native ants) but readily invaded all moist plots. Native ants slowed the spread of Argentine ants into irrigated plots but did not prevent invasion. In areas without Argentine ants, native ant species showed variable responses to irrigation. At the landscape scale, Argentine ant occurrence was positively correlated with minimum winter temperature (but not precipitation), whereas native ant diversity increased with precipitation and was negatively correlated with minimum winter temperature. These results are of interest for several reasons. First, they demonstrate that fine-scale differences in the physical environment can eclipse biotic resistance from native competitors in determining community susceptibility to invasion. Second, our results illustrate surprising complexities with respect to how the abiotic factors limiting invasion can change with spatial scale, and third, how native and invasive species can differ in their responses to the physical environment. Idiosyncratic and scale-dependent processes complicate attempts to forecast where

  1. Ebola virus disease outbreak; the role of field epidemiology training programme in the fight against the epidemic, Liberia, 2014

    PubMed Central

    Lubogo, Mutaawe; Donewell, Bangure; Godbless, Lucas; Shabani, Sasita; Maeda, Justin; Temba, Herilinda; Malibiche, Theophil C; Berhanu, Naod

    2015-01-01

    The African Field Epidemiology Network (AFENET) is a public health network established in 2005 as a non-profit networking alliance of Field Epidemiology and Laboratory Training Programs (FELTPs) and Field Epidemiology Training Programs (FETPs) in Africa. AFENET is dedicated to supporting Ministries of Health in Africa build strong, effective and sustainable programs and capacity to improve public health systems by partnering with global public health experts. The Network's goal is to strengthen field epidemiology and public health laboratory capacity to contribute effectively to addressing epidemics and other major public health problems in Africa. The goal for the establishment of FETP and FELTP was and still is to produce highly competent multi-disciplinary public health professionals who would assume influential posts in the public health structures and tackle emerging and re-emerging communicable and non-communicable diseases. AFENET currently networks 12 FELTPs and FETPs in sub-Saharan Africa with operations in 20 countries. During the Ebola Virus Disease (EVD) outbreak in West Africa, African Union Support for the Ebola Outbreak in West Africa (ASEOWA) supported FETP graduates from Uganda, Zimbabwe, Ethiopia and Tanzania for the investigation and control of the EVD outbreak in Liberia. The graduates were posted in different counties in Liberia where they lead teams of other experts conduct EVD outbreak investigations, Infection Control and Prevention trainings among health workers and communities, Strengthening integrated disease surveillance, developing Standard Operating Procedures for infection control and case notification in the Liberian setting as well as building capacity of local surveillance officers’ conduct outbreak investigation and contact tracing. The team was also responsible for EVD data management at the different Counties in Liberia. The FETP graduates have been instrumental in the earlier successes registered in various counties in

  2. Too tempting to resist? Past success at weight control rather than dietary restraint determines exposure-induced disinhibited eating.

    PubMed

    Houben, Katrijn; Nederkoorn, Chantal; Jansen, Anita

    2012-10-01

    As the prevalence of obesity is increasing, many people resort to dieting to achieve a healthy body weight. Such dietary restraint has been suggested to cause counterproductive effects leading to disinhibited eating. However, it is more likely that dietary restraint is a by-product of previous difficulties in weight control and disinhibited eating. If so, disinhibition should be related more strongly to unsuccessful weight control than dietary restraint. This possibility was examined in the present study. Participants were exposed to palatable food or to neutral objects. Before and after exposure, we measured craving, general inhibitory control and inhibition of food-related responses with the Stop-Signal Task (SST), and food consumption during a taste test. Results showed that exposure increased craving in both successful and unsuccessful weight regulators. People who were successful at controlling their weight, however, were better able to regulate this temptation compared to unsuccessful weight regulators: while exposure to palatable food reduced inhibitory control over food-related responses and increased food consumption in unsuccessful weight regulators, successful weight regulators did not show such disinhibition. Dietary restraint did not influence any of these findings. Further, the exposure-induced difference in inhibition between successful and unsuccessful weight regulators was specific for food-related responses, as regulatory success did not influence general inhibitory control. Thus, while successful and unsuccessful weight regulators seem equally tempted by palatable food, those who are successful in controlling their weight seem better able to resist these temptations by exerting inhibitory control over appetitive responses toward palatable food. PMID:22796949

  3. Multiclonal outbreak of methicillin-resistant Staphylococcus aureus infections on a collegiate football team.

    PubMed

    Hall, A J; Bixler, D; Haddy, L E

    2009-01-01

    An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) occurred in a college football team in August 2006. Of 109 players on the team roster, 88 (81%) were interviewed during a cohort investigation. Twenty-five cases were identified, six of which were culture-confirmed. Available culture isolates were typed by pulsed-field gel electrophoresis (PFGE), which identified two different MRSA strains associated with the outbreak. Playing positions with the most physical contact (offensive linemen, defensive linemen, and tight ends) had the greatest risk of infection [risk ratio (RR) 5.1, 95% confidence interval (CI) 2.3-11.5. Other risk factors included recent skin trauma (RR 1.9, 95% CI 0.95-3.7), use of therapeutic hydrocollator packs (RR 2.5, 95% CI 1.1-5.7), and miscellaneous training equipment use (RR 2.1, 95% CI 1.1-4.1). The outbreak was successfully controlled through team education and implementation of improved infection-control practices and hygiene policies. PMID:18419855

  4. Outbreak of paralytic poliomyelitis in Oman: evidence for widespread transmission among fully vaccinated children.

    PubMed

    Sutter, R W; Patriarca, P A; Brogan, S; Malankar, P G; Pallansch, M A; Kew, O M; Bass, A G; Cochi, S L; Alexander, J P; Hall, D B

    1991-09-21

    From January, 1988, to March, 1989, a widespread outbreak (118 cases) of poliomyelitis type 1 occurred in Oman. Incidence of paralytic disease was highest in children younger than 2 years (87/100,000) despite an immunisation programme that recently had raised coverage with 3 doses of oral poliovirus vaccine (OPV) among 12-month-old children from 67% to 87%. We did a case-control study (70 case-patients, 692 age-matched controls) to estimate the clinical efficacy of OPV, assessed the immunogenicity of OPV and extent of poliovirus spread by serology, retrospectively evaluated the cold chain and vaccine potency, and sought the origin of the outbreak strain by genomic sequencing. 3 doses of OPV reduced the risk of paralysis by 91%; vaccine failures could not be explained by failures in the cold chain nor on suboptimum vaccine potency. Cases and controls had virtually identical type 1 neutralising antibody profiles, suggesting that poliovirus type 1 circulation was widespread. Genomic sequencing indicated that the outbreak strain had been recently imported from South Asia and was distinguishable from isolates indigenous to the Middle East. Accumulation of enough children to sustain the outbreak seems to have been due to previous success of the immunisation programme in reducing spread of endemic strains, suboptimum efficacy of OPV, and delay in completing the primary immunisation series until 7 months of age. Additionally, the estimated attack rate of infection among children aged 9-23 months exceeded 25% in some regions, suggesting that a substantial proportion of fully vaccinated children had been involved in the chain of transmission. PMID:1679866

  5. Epidemiology of Foodborne Disease Outbreaks Caused by Clostridium perfringens, United States, 1998–2010

    PubMed Central

    Grass, Julian E.; Gould, L. Hannah; Mahon, Barbara E.

    2015-01-01

    Clostridium perfringens is estimated to be the second most common bacterial cause of foodborne illness in the United States, causing one million illnesses each year. Local, state, and territorial health departments voluntarily report C. perfringens outbreaks to the U.S. Centers for Disease Control and Prevention through the Foodborne Disease Outbreak Surveillance System. Our analysis included outbreaks confirmed by laboratory evidence during 1998–2010. A food item was implicated if C. perfringens was isolated from food or based on epidemiologic evidence. Implicated foods were classified into one of 17 standard food commodities when possible. From 1998 to 2010, 289 confirmed outbreaks of C. perfringens illness were reported with 15,208 illnesses, 83 hospitalizations, and eight deaths. The number of outbreaks reported each year ranged from 16 to 31 with no apparent trend over time. The annual number of outbreak-associated illnesses ranged from 359 to 2,173, and the median outbreak size was 24 illnesses. Outbreaks occurred year round, with the largest number in November and December. Restaurants (43%) were the most common setting of food preparation. Other settings included catering facility (19%), private home (16%), prison or jail (11%), and other (10%). Among the 144 (50%) outbreaks attributed to a single food commodity, beef was the most common commodity (66 outbreaks, 46%), followed by poultry (43 outbreaks, 30%), and pork (23 outbreaks, 16%). Meat and poultry outbreaks accounted for 92% of outbreaks with an identified single food commodity. Outbreaks caused by C. perfringens occur regularly, are often large, and can cause substantial morbidity yet are preventable if contamination of raw meat and poultry products is prevented at the farm or slaughterhouse or, after contamination, if these products are properly handled and prepared, particularly in restaurants and catering facilities. PMID:23379281

  6. Scabies outbreaks in residential care homes: factors associated with late recognition, burden and impact. A mixed methods study in England.

    PubMed

    Hewitt, K A; Nalabanda, A; Cassell, J A

    2015-05-01

    Scabies is an important public health problem in residential care homes. Delayed diagnosis contributes to outbreaks, which may be prolonged and difficult to control. We investigated factors influencing outbreak recognition, diagnosis and treatment, and staff experiences of outbreak control, identifying areas for intervention. We carried out a semi-structured survey of managers, affected residents and staff of seven care homes reporting suspected scabies outbreaks in southern England over a 6-month period. Attack rates ranged from 2% to 50%, and most cases had dementia (37/39, 95%). Cases were diagnosed clinically by GPs (59%) or home staff (41%), none by dermatologists. Most outbreaks were attributable to avoidably late diagnosis of the index case. Participants reported considerable challenges in managing scabies outbreaks, including late diagnosis and recognition of outbreaks; logistically difficult mass treatment; distressing treatment processes and high costs. This study demonstrates the need for improved support for care homes in detecting and managing these outbreaks. PMID:25195595

  7. Arterial microanatomy determines the success of energy-based renal denervation in controlling hypertension

    PubMed Central

    Tzafriri, Abraham R.; Keating, John H.; Markham, Peter M.; Spognardi, Anna-Maria; Stanley, James R. L.; Wong, Gee; Zani, Brett G.; Grunewald, Debby; O’Fallon, Patrick; Fuimaono, Kristine; Mahfoud, Felix; Edelman, Elazer R.

    2015-01-01

    Renal Denervation (RDN) is a treatment option for patients with hypertension resistant to conventional therapy. Clinical trials have demonstrated variable benefit. To understand the determinants of successful clinical response to this treatment, we integrated porcine and computational models of intravascular radiofrequency RDN. Controlled single-electrode denervation resulted in ablation zone geometries that varied in arc, area and depth, depending on the composition of the adjacent tissue substructure. Computational simulations predicted that delivered power density was influenced by tissue substructure, and peaked at the conductivity discontinuities between soft fatty adventitia and water rich tissues (media, lymph nodes etc.), not at the electrode-tissue interface). Electrode irrigation protected arterial wall tissue adjacent to the electrode by clearing heat that diffuses from within the tissue, without altering peri-arterial ablation. Seven days after multi-electrode treatments, renal norepinephrine and blood pressure were reduced. Blood pressure reductions were correlated with the size-weighted number of degenerative nerves, implying that the effectiveness of the treatment in decreasing hypertension depends on the extent of nerve injury and ablation, which in turn are determined by the tissue microanatomy at the electrode site. These results may explain the variable patient response to RDN and suggest a path to more robust outcomes. PMID:25925684

  8. Role of auditory feedback in the control of successive keystrokes during piano playing

    PubMed Central

    Soechting, John F.

    2011-01-01

    The purpose of this study was to elucidate the role of auditory feedback derived from one keystroke in the control of the rhythmicity and velocity of successive keystrokes during piano playing. We examined the effects of transient auditory perturbations with respect to the pitch, loudness, and timing of one tone on subsequent keystrokes while six pianists played short excerpts from three simple musical pieces having different tempi (“event rates”). Immediately after a delay in tone production, the inter-keystroke interval became shorter. This compensatory action depended on the tempo, being most prominent at the medium tempo. This indicates that temporal information provided by auditory feedback is utilized to regulate the timing of movement elements produced in a sequence. We also found that the keystroke velocity changed after the timing, pitch, or loudness of a tone was altered, although the response differed depending on the type of perturbation. While delaying the timing or altering the pitch led to an increase in the velocity, altering the loudness changed the velocity in an inconsistent manner. Furthermore, perturbing a tone elicited by the right hand also affected the rhythmicity and velocity of keystrokes with the left hand, indicating that bimanual coordination of tone production was maintained. Finally, altering the pitch sometimes resulted in striking an incorrect key, mostly in the slow piece, emphasizing the importance of pitch information for accurate planning and execution of sequential piano keystrokes. PMID:20521031

  9. Role of auditory feedback in the control of successive keystrokes during piano playing.

    PubMed

    Furuya, Shinichi; Soechting, John F

    2010-07-01

    The purpose of this study was to elucidate the role of auditory feedback derived from one keystroke in the control of the rhythmicity and velocity of successive keystrokes during piano playing. We examined the effects of transient auditory perturbations with respect to the pitch, loudness, and timing of one tone on subsequent keystrokes while six pianists played short excerpts from three simple musical pieces having different tempi ("event rates"). Immediately after a delay in tone production, the inter-keystroke interval became shorter. This compensatory action depended on the tempo, being most prominent at the medium tempo. This indicates that temporal information provided by auditory feedback is utilized to regulate the timing of movement elements produced in a sequence. We also found that the keystroke velocity changed after the timing, pitch, or loudness of a tone was altered, although the response differed depending on the type of perturbation. While delaying the timing or altering the pitch led to an increase in the velocity, altering the loudness changed the velocity in an inconsistent manner. Furthermore, perturbing a tone elicited by the right hand also affected the rhythmicity and velocity of keystrokes with the left hand, indicating that bimanual coordination of tone production was maintained. Finally, altering the pitch sometimes resulted in striking an incorrect key, mostly in the slow piece, emphasizing the importance of pitch information for accurate planning and execution of sequential piano keystrokes. PMID:20521031

  10. [Success in maintaining weight loss in Portugal: the Portuguese Weight Control Registry].

    PubMed

    Vieira, Paulo Nuno; Teixeira, Pedro; Sardinha, Luís Bettencourt; Santos, Teresa; Coutinho, Sílvia; Mata, Jutta; Silva, Marlene Nunes

    2014-01-01

    The scope of this article is to describe the Portuguese Weight Control Registry (PWCR) methodology and the participants currently enrolled specifically with respect to their individual and family weight history, previous weight loss attempts, and psychosocial characteristics. One hundred and ninety-eight adults (age: 39.7±11.1 years; BMI: 26.0±3.9 kg/m2), 59% women, filled out a questionnaire about demographics, health-related behaviors and motivation, and methods and strategies used to lose and/or maintain weight loss. Participants reported an average weight loss of 17.4 kg for an average of 29 months. Concerning the number of weight loss attempts, 73% of participants reported a maximum of three attempts of going on a diet, and 34% indicated only one attempt to lose weight in the past. The PWCR now features a considerable number of successful long-term weight loss maintainers in Portugal. Participants will be followed over the next years to learn about their characteristics and weight loss strategies in further detail, as well as to identify predictors of continued weight loss maintenance. PMID:24473606

  11. Slithering on sand: kinematics and controls for success on granular media

    NASA Astrophysics Data System (ADS)

    Schiebel, Perrin E.; Zhang, Tingnan; Dai, Jin; Gong, Chaohui; Yu, Miao; Astley, Henry C.; Travers, Matthew; Choset, Howie; Goldman, Daniel I.

    Previously, we studied the subsurfacelocomotion of undulatory sand-swimming snakes and lizards; using empirical drag response of GM to subsurface intrusion of simple objects allowed us to develop a granular resistive force theory (RFT) to model the locomotion and predict optimal movement patterns. However, our knowledge of the physics of GM at the surface is limited; this makes it impossible to determine how the desert-dwelling snake C. occipitalis moves effectively (0.45 +/-0.04 bodylengths/sec) on the surface of sand .We combine organism biomechanics studies, GM drag experiments, RFT calculations and tests of a physical model (a snake-like robot), to reveal how multiple factors acting together contribute to slithering on sandy surfaces. These include the kinematics--targeting an ideal waveform which maximizes speed while minimizing joint-level torque, the ability to modulate ground interactions by lifting body segments, and the properties of the GM. Based on the sensitive nature of the relationship between these factors, we hypothesize that having an element of force-based control, where the waveform is modulated in response to the forces acting between the body and the environment, is necessary for successful locomotion on yielding substrates.

  12. Effect of β radiation on success of glaucoma drainage surgery in South Africa: randomised controlled trial

    PubMed Central

    Kirwan, James F; Cousens, Simon; Venter, Lynette; Cook, Colin; Stulting, Andries; Roux, Paul; Murdoch, Ian

    2006-01-01

    Objective To evaluate whether β radiation may offer a practical method of improving surgical success for glaucoma drainage surgery in South Africa. Design Double blind, randomised controlled trial. Setting Three public hospitals in South Africa. Participants 450 black Africans with primary glaucoma. Interventions Trabeculectomy with 1000 cGy β radiation or standard trabeculectomy without β radiation (placebo). Main outcome measures Primary outcome measure was surgical failure within 12 months (intraocular pressure > 21 mm Hg while receiving no treatment for ocular hypotension). Secondary outcomes were visual acuity, surgical reintervention for cataract, and intraoperative and postoperative complications. Results 320 people were recruited. β radiation was given to 164; 20 (6%) were not seen again after surgery. One year after surgery the estimated risk of surgical failure was 30% (95% confidence interval 22% to 38%) in the placebo arm compared with 5% (2% to 10%) in the radiation arm. The radiation group experienced a higher incidence of operable cataract (18 participants) than the placebo group (five participants; P = 0.01). At two years the estimated risks with placebo and β radiation were, respectively, 2.8% (0.9% to 8.3%) and 16.7% (10.0% to 27.3%). Conclusion β radiation substantially reduced the risk of surgical failure after glaucoma surgery. Some evidence was, however, found of an increased risk for cataract surgery (a known complication of trabeculectomy) in the β radiation arm during the two years after surgery. Trial registration ISRCTN62430622. PMID:17023435

  13. Optimal Power Distribution Control for Multicode MC-CDMA with Zero-Forcing Successive Interference Cancellation

    NASA Astrophysics Data System (ADS)

    Tan, Mizhou; Ibars, Christian; Bar-Ness, Yeheskel

    2005-12-01

    Multicarrier CDMA (MC-CDMA) has become a promising candidate for future wireless multimedia communications for its robustness to frequency-selective fading and its flexibility for handling multiple data rates. Among different multirate access schemes, multicode MC-CDMA is attractive for its high performance, good flexibility in rate matching, and low complexity. However, its performance is limited by self-interference (SI) and multiuser interference (MUI). In this paper a zero-forcing successive interference cancellation (ZF-SIC) receiver is used to mitigate this problem for multicode MC-CDMA. Furthermore, optimal power distribution control (PDC), which minimizes each user's bit error rate (BER), is considered. Our results show that, in correlated Rayleigh fading channels, the ZF-SIC receiver integrated with the optimal PDC dramatically improves the performance of the multicode MC-CDMA system in comparison to other receivers proposed in the literature. Moreover, the optimal PDC significantly outperforms the PDC based on equal BER criterion, particularly under a short-term transmit power constraint.

  14. Outbreaks associated with cantaloupe, watermelon, and honeydew in the United States, 1973-2011.

    PubMed

    Walsh, Kelly A; Bennett, Sarah D; Mahovic, Michael; Gould, L Hannah

    2014-12-01

    Fresh fruits and vegetables are an important part of a healthy diet. Melons have been associated with enteric infections. We reviewed outbreaks reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System during 1973-2011 in which the implicated food was a single melon type. We also reviewed published literature and records obtained from investigating agencies. During 1973-2011, 34 outbreaks caused by a single melon type were reported, resulting in 3602 illnesses, 322 hospitalizations, 46 deaths, and 3 fetal losses. Cantaloupes accounted for 19 outbreaks (56%), followed by watermelons (13, 38%) and honeydew (2, 6%). Melon-associated outbreaks increased from 0.5 outbreaks per year during 1973-1991 to 1.3 during 1992-2011. Salmonella was the most common etiology reported (19, 56%), followed by norovirus (5, 15%). Among 13 outbreaks with information available, melons imported from Mexico and Central America were implicated in 9 outbreaks (69%) and domestically grown melons were implicated in 4 outbreaks (31%). The point of contamination was known for 20 outbreaks; contamination occurred most commonly during growth, harvesting, processing, or packaging (13, 65%). Preventive measures focused on reducing bacterial contamination of melons both domestically and internationally could decrease the number and severity of melon-associated outbreaks. PMID:25407556

  15. Outbreaks Associated with Cantaloupe, Watermelon, and Honeydew in the United States, 1973–2011

    PubMed Central

    Walsh, Kelly A.; Bennett, Sarah D.; Mahovic, Michael; Gould, L. Hannah

    2015-01-01

    Fresh fruits and vegetables are an important part of a healthy diet. Melons have been associated with enteric infections. We reviewed outbreaks reported to the Centers for Disease Control and Prevention’s Foodborne Disease Outbreak Surveillance System during 1973–2011 in which the implicated food was a single melon type. We also reviewed published literature and records obtained from investigating agencies. During 1973–2011, 34 outbreaks caused by a single melon type were reported, resulting in 3602 illnesses, 322 hospitalizations, 46 deaths, and 3 fetal losses. Cantaloupes accounted for 19 outbreaks (56%), followed by watermelons (13, 38%) and honeydew (2, 6%). Melon-associated outbreaks increased from 0.5 outbreaks per year during 1973–1991 to 1.3 during 1992–2011. Salmonella was the most common etiology reported (19, 56%), followed by norovirus (5, 15%). Among 13 outbreaks with information available, melons imported from Mexico and Central America were implicated in 9 outbreaks (69%) and domestically grown melons were implicated in 4 outbreaks (31%). The point of contamination was known for 20 outbreaks; contamination occurred most commonly during growth, harvesting, processing, or packaging (13, 65%). Preventive measures focused on reducing bacterial contamination of melons both domestically and internationally could decrease the number and severity of melon-associated outbreaks. PMID:25407556

  16. Whole-Genome Sequencing to Determine Origin of Multinational Outbreak of Sarocladium kiliense Bloodstream Infections

    PubMed Central

    Roe, Chandler C.; Smith, Rachel M.; Vallabhaneni, Snigdha; Duarte, Carolina; Escandón, Patricia; Castañeda, Elizabeth; Gómez, Beatriz L.; de Bedout, Catalina; López, Luisa F.; Salas, Valentina; Hederra, Luz Maria; Fernández, Jorge; Pidal, Paola; Hormazabel, Juan Carlos; Otaíza-O’Ryan, Fernando; Vannberg, Fredrik O.; Gillece, John; Lemmer, Darrin; Driebe, Elizabeth M.; Engelthaler, David M.; Litvintseva, Anastasia P.

    2016-01-01

    We used whole-genome sequence typing (WGST) to investigate an outbreak of Sarocladium kiliense bloodstream infections (BSI) associated with receipt of contaminated antinausea medication among oncology patients in Colombia and Chile during 2013–2014. Twenty-five outbreak isolates (18 from patients and 7 from medication vials) and 11 control isolates unrelated to this outbreak were subjected to WGST to elucidate a source of infection. All outbreak isolates were nearly indistinguishable (<5 single-nucleotide polymorphisms), and >21,000 single-nucleotide polymorphisms were identified from unrelated control isolates, suggesting a point source for this outbreak. S. kiliense has been previously implicated in healthcare-related infections; however, the lack of available typing methods has precluded the ability to substantiate point sources. WGST for outbreak investigation caused by eukaryotic pathogens without reference genomes or existing genotyping methods enables accurate source identification to guide implementation of appropriate control and prevention measures. PMID:26891230

  17. Individualised controlled ovarian stimulation (iCOS): maximising success rates for assisted reproductive technology patients

    PubMed Central

    2011-01-01

    Background In the last two decades, pregnancy rates for patients undergoing in-vitro fertilisation (IVF) have significantly increased. Some of the major advances responsible for this improvement were the introduction of controlled ovarian stimulation (COS) for the induction of multiple follicle development, and the utilisation of mid-luteal gonadotropin-releasing hormone agonists to achieve pituitary down-regulation and full control of the cycle. As a result, a combination of a gonadotropin-releasing hormone agonist with high doses (150-450 IU/day) of recombinant follicle-stimulating hormone has become the current standard approach for ovarian stimulation. However, given the heterogeneity of patients embarking on IVF, and the fact that many different drugs can be used alone or in different combinations (generating multiple potential protocols of controlled ovarian stimulation), we consider the need to identify special populations of patients and adapt treatment protocols accordingly, and to implement a more individualised approach to COS. Discussion Studies on mild, minimal and natural IVF cycles have yielded promising results, but have focused on fresh embryo transfers and included relatively young patient populations who generally have the potential for more favourable outcomes. The efficacy of these protocols in patients with a poorer prognosis remains to be tested. When comparing protocols for COS, it is important to think beyond current primary endpoints, and to consider the ideal quality and quantity of oocytes and embryos being produced per stimulated patient, in order to achieve a pregnancy. We should also focus on the cumulative pregnancy rate, which is based on outcomes from fresh and frozen embryos from the same cycle of stimulation. Individualised COS (iCOS) determined by the use of biomarkers to test ovarian reserve has the potential to optimise outcomes and reduce safety issues by adapting treatment protocols according to each patient's specific

  18. The effectiveness of mass vaccination on Marek's disease virus (MDV) outbreaks and detection within a broiler barn: A modeling study☆

    PubMed Central

    Atkins, Katherine E.; Read, Andrew F.; Walkden-Brown, Stephen W.; Savill, Nicholas J.; Woolhouse, Mark E.J.

    2013-01-01

    Marek's disease virus (MDV), a poultry pathogen, has been increasing in virulence since the mid twentieth century. Since multiple vaccines have been developed and widely implemented, losses due to MDV have decreased. However, vaccine failure has occurred in the past and vaccine breakthroughs remain a problem. Failure of disease control with current vaccines would have significant economic and welfare consequences. Nevertheless, the epidemiology of the disease during a farm outbreak is not well understood. Here we present a mathematical model to predict the effectiveness of vaccines to reduce the outbreak probability and disease burden within a barn. We find that the chance of an outbreak within a barn increases with the virulence of an MDV strain, and is significantly reduced when the flock is vaccinated, especially when there the contaminant strain is of low virulence. With low quantities of contaminated dust, there is nearly a 100% effectiveness of vaccines to reduce MDV outbreaks. However, the vaccine effectiveness drops to zero with an increased amount of contamination with a middle virulence MDV strain. We predict that the larger the barn, and the more virulent the MDV strain is, the more virus is produced by the time the flock is slaughtered. With the low-to-moderate virulence of the strains studied here, the number of deaths due to MDV is very low compared to all-cause mortality regardless of the vaccination status of the birds. However, the cumulative MD incidence can reach 100% for unvaccinated cohorts, and 35% for vaccinated cohorts. These results suggest that death due to MDV is an insufficient metric to assess the prevalence of MDV broiler barns regardless of vaccine status, such that active surveillance is required to successfully assess the probability of MDV outbreaks, and to limit transmission of MDV between successive cohorts of broiler chickens. PMID:24267877

  19. Yellow Fever Outbreak, Imatong, Southern Sudan

    PubMed Central

    Ofula, Victor O.; Sang, Rosemary C.; Konongoi, Samson L.; Sow, Abdourahmane; De Cock, Kevin M.; Tukei, Peter M.; Okoth, Fredrick A.; Swanepoel, Robert; Burt, Felicity J.; Waters, Norman C.; Coldren, Rodney L.

    2004-01-01

    In May 2003, the World Health Organization received reports about a possible outbreak of a hemorrhagic disease of unknown cause in the Imatong Mountains of southern Sudan. Laboratory investigations were conducted on 28 serum samples collected from patients in the Imatong region. Serum samples from 13 patients were positive for immunoglobulin M antibody to flavivirus, and serum samples from 5 patients were positive by reverse transcription–polymerase chain reaction with both the genus Flavivirus–reactive primers and yellow fever virus–specific primers. Nucleotide sequencing of the amplicons obtained with the genus Flavivirus oligonucleotide primers confirmed yellow fever virus as the etiologic agent. Isolation attempts in newborn mice and Vero cells from the samples yielded virus isolates from five patients. Rapid and accurate laboratory diagnosis enabled an interagency emergency task force to initiate a targeted vaccination campaign to control the outbreak. PMID:15207058

  20. Potential for large outbreaks of Ebola virus disease.

    PubMed

    Camacho, A; Kucharski, A J; Funk, S; Breman, J; Piot, P; Edmunds, W J

    2014-12-01

    Outbreaks of Ebola virus can cause substantial morbidity and mortality in affected regions. The largest outbreak of Ebola to date is currently underway in West Africa, with 3944 cases reported as of 5th September 2014. To develop a better understanding of Ebola transmission dynamics, we revisited data from the first known Ebola outbreak, which occurred in 1976 in Zaire (now Democratic Republic of Congo). By fitting a mathematical model to time series stratified by disease onset, outcome and source of infection, we were able to estimate several epidemiological quantities that have previously proved challenging to measure, including the contribution of hospital and community infection to transmission. We found evidence that transmission decreased considerably before the closure of the hospital, suggesting that the decline of the outbreak was most likely the result of changes in host behaviour. Our analysis suggests that the person-to-person reproduction number was 1.34 (95% CI: 0.92-2.11) in the early part of the outbreak. Using stochastic simulations we demonstrate that the same epidemiological conditions that were present in 1976 could have generated a large outbreak purely by chance. At the same time, the relatively high person-to-person basic reproduction number suggests that Ebola would have been difficult to control through hospital-based infection control measures alone. PMID:25480136

  1. Entomologic investigations during an outbreak of West Nile virus disease in Maricopa County, Arizona, 2010.

    PubMed

    Godsey, Marvin S; Burkhalter, Kristen; Young, Ginger; Delorey, Mark; Smith, Kirk; Townsend, John; Levy, Craig; Mutebi, John-Paul

    2012-12-01

    Entomologic investigations were conducted during an intense outbreak of West Nile virus (WNV) disease in Maricopa County, Arizona during July 31-August 9, 2010. The investigations compared the East Valley outbreak area, and a demographically similar control area in northwestern metropolitan Phoenix where no human cases were reported. Five mosquito species were identified in each area, and species composition was similar in both areas. Significantly more Culex quinquefasciatus females were collected by gravid traps at Outbreak sites (22.2 per trap night) than at control sites (8.9 per trap night), indicating higher Cx. quinquefasciatus abundance in the outbreak area. Twenty-eight WNV TaqMan reverse transcription-polymerase chain reaction-positive mosquito pools were identified, including 24 of Cx. quinquefasciatus, 3 of Psorophora columbiae, and 1 of Culex sp. However, Cx. quinquefasciatus WNV infection rates did not differ between outbreak and control sites. At outbreak sites, 30 of 39 engorged Cx. quinquefasciatus had fed on birds, 8 of 39 on humans, and 1 of 39 on a lizard. At control sites, 20 of 20 identified blood meals were from birds. Data suggest that Cx. quinquefasciatus was the primary enzootic and epidemic vector of this outbreak. The most important parameters in the outbreak were vector abundance and blood meal analysis, which suggested more frequent contact between Cx. quinquefasciatus and human hosts in the outbreak area compared with the control area. PMID:23109372

  2. Entomologic Investigations during an Outbreak of West Nile Virus Disease in Maricopa County, Arizona, 2010

    PubMed Central

    Godsey, Marvin S.; Burkhalter, Kristen; Young, Ginger; Delorey, Mark; Smith, Kirk; Townsend, John; Levy, Craig; Mutebi, John-Paul

    2012-01-01

    Entomologic investigations were conducted during an intense outbreak of West Nile virus (WNV) disease in Maricopa County, Arizona during July 31–August 9, 2010. The investigations compared the East Valley outbreak area, and a demographically similar control area in northwestern metropolitan Phoenix where no human cases were reported. Five mosquito species were identified in each area, and species composition was similar in both areas. Significantly more Culex quinquefasciatus females were collected by gravid traps at Outbreak sites (22.2 per trap night) than at control sites (8.9 per trap night), indicating higher Cx. quinquefasciatus abundance in the outbreak area. Twenty-eight WNV TaqMan reverse transcription-polymerase chain reaction–positive mosquito pools were identified, including 24 of Cx. quinquefasciatus, 3 of Psorophora columbiae, and 1 of Culex sp. However, Cx. quinquefasciatus WNV infection rates did not differ between outbreak and control sites. At outbreak sites, 30 of 39 engorged Cx. quinquefasciatus had fed on birds, 8 of 39 on humans, and 1 of 39 on a lizard. At control sites, 20 of 20 identified blood meals were from birds. Data suggest that Cx. quinquefasciatus was the primary enzootic and epidemic vector of this outbreak. The most important parameters in the outbreak were vector abundance and blood meal analysis, which suggested more frequent contact between Cx. quinquefasciatus and human hosts in the outbreak area compared with the control area. PMID:23109372

  3. Modeling and Prediction of Oyster Norovirus Outbreaks along Gulf of Mexico Coast

    PubMed Central

    Wang, Jiao; Deng, Zhiqiang

    2015-01-01

    Background: Oyster norovirus outbreaks often pose high risks to human health. However, little is known about environmental factors controlling the outbreaks, and little can be done to prevent the outbreaks because they are generally considered to be unpredictable. Objective: We sought to develop a mathematical model for predicting risks of oyster norovirus outbreaks using environmental predictors. Methods: We developed a novel probability-based Artificial Neural Network model, called NORF model, using 21 years of environmental and norovirus outbreak data collected from Louisiana oyster harvesting areas along the Gulf of Mexico coast, USA. The NORF model involves six input variables that were selected through stepwise regression analysis and sensitivity analysis. Results: We found that the model-based probability of norovirus outbreaks was most sensitive to gage height (the depth of water in an oyster bed) and water temperature, followed by wind, rainfall, and salinity, respectively. The NORF model predicted all historical oyster norovirus outbreaks from 1994 through 2014. Specifically, norovirus outbreaks occurred when the NORF model probability estimate was > 0.6, whereas no outbreaks occurred when the estimated probability was < 0.5. Outbreaks may also occur when the estimated probability is 0.5–0.6. Conclusions: Our findings require further confirmation, but they suggest that oyster norovirus outbreaks may be predictable using the NORF model. The ability to predict oyster norovirus outbreaks at their onset may make it possible to prevent or at least reduce the risk of norovirus outbreaks by closing potentially affected oyster beds. Citation: Wang J, Deng Z. 2016. Modeling and prediction of oyster norovirus outbreaks along Gulf of Mexico coast. Environ Health Perspect 124:627–633; http://dx.doi.org/10.1289/ehp.1509764 PMID:26528621

  4. Control and eventual eradication of Trypanosoma evansi infection in dromedary camels after an episodic outbreak in mainland Spain: an example in a non-endemic area.

    PubMed

    Gutiérrez, C; Tamarit, A; González-Martín, M; Tejedor-Junco, M T

    2014-08-29

    In 2008, Trypanosoma evansi was detected on a camel farm in mainland Spain. The animals were isolated, confined in a closed stable, and treated twice with melarsamine (Cymelarsan(®), Merial, Lyon, France) with an interval of 1 month. Clinical and laboratory examinations by means of parasitological, serological, and molecular procedures (polymerase chain reaction (PCR)) were carried out regularly for 6 years. After the treatment, all parasitemic camels were cleared of parasites, and in the seropositive camels a progressive decrease in antibody levels was observed, with complete disappearance of antibodies between 15 and 21 months, except in one animal which showed doubtful Ag-Ab reaction at 21 months post treatment. In the next assessment, 6 months later, the diagnostic tests conducted on all animals had a negative result. The diagnostic and therapeutic tools recently developed against T. evansi will evidence new and alternative approaches after the parasite is detected, particularly if outbreak occurs in geographically localized areas in territories free of the disease. PMID:24933467

  5. Innovative Technological Approach to Ebola Virus Disease Outbreak Response in Nigeria Using the Open Data Kit and Form Hub Technology

    PubMed Central

    Nguku, Patrick; Waziri, Ndadilnasiya; Adewuyi, Peter; Adeoye, Olawunmi; Adeseye, Aderonke; Oguntimehin, Olukayode; Shuaib, Faisal

    2015-01-01

    The recent outbreak of Ebola Virus Disease (EVD) in West Africa has ravaged many lives. Effective containment of this outbreak relies on prompt and effective coordination and communication across various interventions; early detection and response being critical to successful control. The use of information and communications technology (ICT) in active surveillance has proved to be effective but its use in Ebola outbreak response has been limited. Due to the need for timeliness in reporting and communication for early discovery of new EVD cases and promptness in response; it became imperative to empower the response team members with technologies and solutions which would enable smooth and rapid data flow. The Open Data Kit and Form Hub technology were used in combination with the Dashboard technology and ArcGIS mapping for follow up of contacts, identification of cases, case investigation and management and also for strategic planning during the response. A remarkable improvement was recorded in the reporting of daily follow-up of contacts after the deployment of the integrated real time technology. The turnaround time between identification of symptomatic contacts and evacuation to the isolation facility and also for receipt of laboratory results was reduced and informed decisions could be taken by all concerned. Accountability in contact tracing was ensured by the use of a GPS enabled device. The use of innovative technologies in the response of the EVD outbreak in Nigeria contributed significantly to the prompt control of the outbreak and containment of the disease by providing a valuable platform for early warning and guiding early actions. PMID:26115402

  6. Innovative Technological Approach to Ebola Virus Disease Outbreak Response in Nigeria Using the Open Data Kit and Form Hub Technology.

    PubMed

    Tom-Aba, Daniel; Olaleye, Adeniyi; Olayinka, Adebola Tolulope; Nguku, Patrick; Waziri, Ndadilnasiya; Adewuyi, Peter; Adeoye, Olawunmi; Oladele, Saliu; Adeseye, Aderonke; Oguntimehin, Olukayode; Shuaib, Faisal

    2015-01-01

    The recent outbreak of Ebola Virus Disease (EVD) in West Africa has ravaged many lives. Effective containment of this outbreak relies on prompt and effective coordination and communication across various interventions; early detection and response being critical to successful control. The use of information and communications technology (ICT) in active surveillance has proved to be effective but its use in Ebola outbreak response has been limited. Due to the need for timeliness in reporting and communication for early discovery of new EVD cases and promptness in response; it became imperative to empower the response team members with technologies and solutions which would enable smooth and rapid data flow. The Open Data Kit and Form Hub technology were used in combination with the Dashboard technology and ArcGIS mapping for follow up of contacts, identification of cases, case investigation and management and also for strategic planning during the response. A remarkable improvement was recorded in the reporting of daily follow-up of contacts after the deployment of the integrated real time technology. The turnaround time between identification of symptomatic contacts and evacuation to the isolation facility and also for receipt of laboratory results was reduced and informed decisions could be taken by all concerned. Accountability in contact tracing was ensured by the use of a GPS enabled device. The use of innovative technologies in the response of the EVD outbreak in Nigeria contributed significantly to the prompt control of the outbreak and containment of the disease by providing a valuable platform for early warning and guiding early actions. PMID:26115402

  7. Environmental role in influenza virus outbreaks.

    PubMed

    Sooryanarain, Harini; Elankumaran, Subbiah

    2015-01-01

    The environmental drivers of influenza outbreaks are largely unknown. Despite more than 50 years of research, there are conflicting lines of evidence on the role of the environment in influenza A virus (IAV) survival, stability, and transmissibility. With the increasing and looming threat of pandemic influenza, it is important to understand these factors for early intervention and long-term control strategies. The factors that dictate the severity and spread of influenza would include the virus, natural and acquired hosts, virus-host interactions, environmental persistence, virus stability and transmissibility, and anthropogenic interventions. Virus persistence in different environments is subject to minor variations in temperature, humidity, pH, salinity, air pollution, and solar radiations. Seasonality of influenza is largely dictated by temperature and humidity, with cool-dry conditions enhancing IAV survival and transmissibility in temperate climates in high latitudes, whereas humid-rainy conditions favor outbreaks in low latitudes, as seen in tropical and subtropical zones. In mid-latitudes, semiannual outbreaks result from alternating cool-dry and humid-rainy conditions. The mechanism of virus survival in the cool-dry or humid-rainy conditions is largely determined by the presence of salts and proteins in the respiratory droplets. Social determinants of heath, including health equity, vaccine acceptance, and age-related illness, may play a role in influenza occurrence and spread. PMID:25422855

  8. Discrimination of tornadic and non-tornadic severe weather outbreaks

    NASA Astrophysics Data System (ADS)

    Mercer, Andrew Edward

    best discriminating statistical technique (SVM) at 24-hours lead time. Results degrade only slightly by 72-hours lead time (maximum POD of 0.833 and minimum FAR of 0.276). Synoptic composites of the outbreak types are the second analysis considered. Composites are used to reveal synoptic features of outbreak types, which can be utilized to diagnose the differences between classes (in this case, TOs and NTOs). The composites are created using PCA. Five raw variables, height, temperature, relative humidity, and u and v wind components, are extracted from the NCEP/NCAR reanalysis data for North America. Converging longitude lines with increasing latitude on the reanalysis grid introduce bias into correlation calculations in higher latitudes; hence, the data are mapped onto both a latitudinal density grid and a Fibonacci grid. The resulting PCA produces two significant principal components (PCs), and a cluster analysis on these PCs for each outbreak type results in two types of TOs and NTOs. TO composites are characterized by a trough of low pressure over the central United States and major quasigeostrophic forcing features such as an upper level jet streak, cyclonic vorticity advection increasing with height, and warm air advection. These dynamics result in a strong surface cyclone in most tornado outbreaks. These features are considerably less pronounced in NTOs. The statistical analyses presented herein were successful in classifying outbreak types at various lead times, using synoptic scale data as input.

  9. Epidemic simulation of a foot and mouth disease outbreak in Minnesota.

    PubMed

    Gale, S B; Miller, G Y; Eshelman, C E; Wells, S J

    2015-12-01

    Foot and mouth disease (FMD) is a primary transboundary livestock disease of international concern. Outbreaks of the disease have recently occurred in several countries that were previously FMD-free. For countries with limited direct experience of this disease, modelling is a useful tool for the study of a potential outbreak. The objectives of this study were to determine specific FMD risk parameters for Minnesota and the United States (USA) and to use these parameters to create a baseline FMD outbreak model for Minnesota. Of specific interest was to assess whether the type of herd in which the outbreak began (a dairy herd or a large-scale swine herd) influenced the basic model outcomes of outbreak size and duration, and to examine the effects of depopulation and movement controls. The mean values for disease duration, outbreak duration and number of farms and animals infected were larger in the scenario with a dairy index herd. The results of these two outbreak models demonstrated the entire spectrum of FMD outbreak types; that is, from limited, focal outbreaks to widespread, uncontrolled outbreaks. The findings from this study provide details of a baseline model that emergency preparedness planners can use to evaluate response strategies for a potential incursion of FMD into the USA. These findings are also of value for all countries as veterinary authorities develop or adjust their FMD emergency response plans. PMID:27044160

  10. Retrospective analysis of institutional scabies outbreaks from 1984 to 2013: lessons learned and moving forward.

    PubMed

    Mounsey, K E; Murray, H C; King, M; Oprescu, F

    2016-08-01

    Scabies outbreaks can be disruptive in institutional settings, and are associated with considerable but under-researched morbidity, especially in vulnerable populations. In this paper, we describe key findings from a retrospective review of scabies outbreaks reported in the literature over the past 30 years. We undertook this review to gain insights into the impact of institutional outbreaks, the burden in terms of attack rates, economic costs, treatment trends, the types of index cases and outbreak progression. We found 84 reports over 30 years, with outbreaks most frequently reported in aged care facilities (n = 40) and hospitals (n = 33). On average, scabies outbreaks persisted for 3 months, and the median attack rate was 38%. While 1% lindane was once the most commonly employed acaricide, 5% permethrin and oral ivermectin are increasingly used. Crusted scabies represented the index case for 83% of outbreaks, and scabies was misdiagnosed in 43% outbreaks. The frequency of reported scabies outbreaks has not declined consistently over time suggesting the disease is still highly problematic. We contend that more research and practice emphasis must be paid to improve diagnostic methods, surveillance and control, health staff education and management of crusted scabies to prevent the development of scabies outbreaks in institutional settings. PMID:27019288

  11. Listeriosis outbreaks and associated food vehicles, United States, 1998-2008.

    PubMed

    Cartwright, Emily J; Jackson, Kelly A; Johnson, Shacara D; Graves, Lewis M; Silk, Benjamin J; Mahon, Barbara E

    2013-01-01

    Listeria monocytogenes, a bacterial foodborne pathogen, can cause meningitis, bacteremia, and complications during pregnancy. This report summarizes listeriosis outbreaks reported to the Foodborne Disease Outbreak Surveillance System of the Centers for Disease Control and Prevention during 1998-2008. The study period includes the advent of PulseNet (a national molecular subtyping network for outbreak detection) in 1998 and the Listeria Initiative (enhanced surveillance for outbreak investigation) in 2004. Twenty-four confirmed listeriosis outbreaks were reported during 1998-2008, resulting in 359 illnesses, 215 hospitalizations, and 38 deaths. Outbreaks earlier in the study period were generally larger and longer. Serotype 4b caused the largest number of outbreaks and outbreak-associated cases. Ready-to-eat meats caused more early outbreaks, and novel vehicles (i.e., sprouts, taco/nacho salad) were associated with outbreaks later in the study period. These changes may reflect the effect of PulseNet and the Listeria Initiative and regulatory initiatives designed to prevent contamination in ready-to-eat meat and poultry products. PMID:23260661

  12. Epidemiology and characteristics of the dengue outbreak in Guangdong, Southern China, in 2014.

    PubMed

    Huang, L; Luo, X; Shao, J; Yan, H; Qiu, Y; Ke, P; Zheng, W; Xu, B; Li, W; Sun, D; Cao, D; Chen, C; Zhuo, F; Lin, X; Tang, F; Bao, B; Zhou, Y; Zhang, X; Li, H; Li, J; Wan, D; Yang, L; Chen, Y; Zhong, Q; Gu, X; Liu, J; Huang, L; Xie, R; Li, X; Xu, Y; Luo, Z; Liao, M; Wang, H; Sun, L; Li, H; Lau, G W; Duan, C

    2016-02-01

    Dengue is a rapidly spreading mosquito-borne disease caused by the dengue virus (DENV) and has emerged as a severe public health problem around the world. Guangdong, one of the southern Chinese provinces, experienced a serious outbreak of dengue in 2014, which was believed to be the worst dengue epidemic in China over the last 20 years. To better understand the epidemic, we collected the epidemiological data of the outbreak and analyzed 14,594 clinically suspected dengue patients from 25 hospitals in Guangdong. Dengue cases were then laboratory-confirmed by the detection of DENV non-structural protein 1 (NS1) antigen and/or DENV RNA. Afterwards, clinical manifestations of dengue patients were analyzed and 93 laboratory-positive serum specimens were chosen for the DENV serotyping and molecular analysis. Our data showed that the 2014 dengue outbreak in Guangdong had spread to 20 cities and more than 45 thousand people suffered from dengue fever. Of 14,594 participants, 11,387 were definitively diagnosed. Most manifested with a typical non-severe clinical course, and 1.96 % developed to severe dengue. The strains isolated successfully from the serum samples were identified as DENV-1. Genetic analyses revealed that the strains were classified into genotypes I and V of DENV-1, and the dengue epidemic of Guangdong in 2014 was caused by indigenous cases and imported cases from the neighboring Southeast Asian countries of Malaysia and Singapore. Overall, our study is informative and significant to the 2014 dengue outbreak in Guangdong and will provide crucial implications for dengue prevention and control in China and elsewhere. PMID:26700953

  13. High trait self-control predicts positive health behaviors and success in weight loss

    PubMed Central

    Crescioni, A. Will; Ehrlinger, Joyce; Alquist, Jessica L.; Conlon, Kyle E.; Baumeister, Roy F.; Schatschneider, Christopher; Dutton, Gareth R.

    2015-01-01

    Surprisingly few studies have explored the intuitive connection between self-control and weight loss. We tracked participants’ diet, exercise and weight loss during a 12-week weight loss program. Participants higher in self-control weighed less and reported exercising more than their lower self-control counterparts at baseline. Independent of baseline differences, individuals high in dispositional self-control ate fewer calories overall and fewer calories from fat, burned marginally more calories through exercise, and lost more weight during the program than did those lower in self-control. These data suggest that trait self-control is, indeed, an important predictor of health behaviors. PMID:21421645

  14. Public health approach to detection of non-O157 Shiga toxin-producing Escherichia coli: summary of two outbreaks and laboratory procedures.

    PubMed

    Schaffzin, J K; Coronado, F; Dumas, N B; Root, T P; Halse, T A; Schoonmaker-Bopp, D J; Lurie, M M; Nicholas, D; Gerzonich, B; Johnson, G S; Wallace, B J; Musser, K A

    2012-02-01

    Routine laboratory testing may not detect non-O157 Shiga toxin-producing Escherichia coli (STEC) reliably. Active clinical, epidemiological, environmental health, and laboratory collaboration probably influence successful detection and study of non-O157 STEC infection. We summarized two outbreak investigations in which such coordinated efforts identified non-O157 STEC disease and led to effective control measures. Outbreak 1 involved illness associated with consuming unpasteurized apple cider from a local orchard. Public health personnel were notified by a local hospital; stool specimens from ill persons contained O111 STEC. Outbreak 2 involved bloody diarrhoea at a correctional facility. Public health personnel were notified by the facility infection control officer; O45 STEC was the implicated agent. These reports highlight the ability of non-O157 STEC to cause outbreaks and demonstrate that a coordinated effort by clinicians, infection-control practitioners, clinical diagnostic laboratorians, and public health personnel can lead to effective identification, investigation, and prevention of non-O157 STEC disease. PMID:21554779

  15. The space-time clustering of highly pathogenic avian influenza (HPAI) H5N1 outbreaks in Bangladesh.

    PubMed

    Ahmed, S S U; Ersbøll, A K; Biswas, P K; Christensen, J P

    2010-06-01

    Bangladesh faced two epidemic waves of highly pathogenic avian influenza (HPAI) H5N1 in two consecutive years. The peaks of the waves were observed in February-July 2007 and January-April 2008, respectively. We examined the spatial and temporal patterns of the 293 outbreaks in 143 subdistricts in 2007 and 2008. Global clustering assessed by K-function was seen at distances 150-300 km between subdistricts. Significant local clusters were detected by space-time scan statistics. In both waves, significant primary clusters of HPAI outbreaks were identified in the central part of the country dominated by commercial production systems and in the northwestern part primarily in backyard production systems. Secondary clusters varied from the northwestern part in 2007 and the southern part in 2008. The findings are highly relevant for the successful planning and implementation of control, prevention and surveillance strategies by highlighting areas where detailed investigations should be initiated. PMID:20109257

  16. Estimating Costs Associated with a Community Outbreak of Meningococcal Disease in a Colombian Caribbean City

    PubMed Central

    Pinzón-Redondo, Hernando; Coronell-Rodriguez, Wilfrido; Díaz-Martinez, Inés; Guzmán-Corena, Ángel; Constenla, Dagna

    2014-01-01

    ABSTRACT Meningococcal disease is a serious and potentially life-threatening infection that is caused by the bacterium Neisseria meningitidis (N. meningitidis), and it can cause meningitis, meningococcaemia outbreaks and epidemics. The disease is fatal in 9-12% of cases and with a death rate of up to 40% among patients with meningococcaemia. The objective of this study was to estimate the costs of a meningococcal outbreak that occurred in a Caribbean city of Colombia. We contacted experts involved in the outbreak and asked them specific questions about the diagnosis and treatment for meningococcal cases during the outbreak. Estimates of costs of the outbreak were also based on extensive review of medical records available during the outbreak. The costs associated with the outbreak were divided into the cost of the disease response phase and the cost of the disease surveillance phase. The costs associated with the outbreak control and surveillance were expressed in US$ (2011) as cost per 1,000 inhabitants. The average age of patients was 4.6 years (SD 3.5); 50% of the cases died; 50% of the cases were reported to have meningitis (3/6); 33% were diagnosed with meningococcaemia and myocarditis (2/6); 50% of the cases had bacteraemia (3/6); 66% of the cases had a culture specimen positive for Neisseria meningitidis; 5 of the 6 cases had RT-PCR positive for N. meningitidis. All N. meningitidis were serogroup B; 50 doses of ceftriaxone were administered as prophylaxis. Vaccine was not available at the time. The costs associated with control of the outbreak were estimated at US$ 0.8 per 1,000 inhabitants, disease surveillance at US$ 4.1 per 1,000 inhabitants, and healthcare costs at US$ 5.1 per 1,000 inhabitants. The costs associated with meningococcal outbreaks are substantial, and the outbreaks should be prevented. The mass chemoprophylaxis implemented helped control the outbreak. PMID:25395916

  17. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 2. Description of outbreaks by size, severity, and settings.

    PubMed

    Todd, Ewen C D; Greig, Judy D; Bartleson, Charles A; Michaels, Barry S

    2007-08-01

    This article is the second in a series of several by members of the Committee on the Control of Foodborne Illness of the International Association of Food Protection, and it continues the analysis of 816 outbreaks where food workers were implicated in the spread of foodborne disease. In this article, we discuss case morbidity and mortality and the settings where the 816 outbreaks occurred. Some of the outbreaks were very large; 11 involved more than 1,000 persons, 4 with more than 3,000 ill. The larger outbreaks tended to be extended over several days with a continuing source of infections, such as at festivals, resorts, and community events, or the contaminated product had been shipped to a large number of customers, e.g., icing on cakes or exported raspberries. There were five outbreaks with more than 100 persons hospitalized, with rates ranging from 9.9 to 100%. However, overall, the hospitalization rate was low (1.4%), and deaths were rare (0.11% of the 80,682 cases). Many of the deaths were associated with high-risk persons (i.e., those who had underlying diseases, malnutrition, or both, as in a refugee camp, or young children), but a few occurred with apparently healthy adults. An analysis of the settings for the food worker-related events showed that most of the outbreaks came from food service facilities (376 outbreaks [46.1%]), followed by catered events (126 outbreaks [15.4%]), the home (83 outbreaks [10.2%]), schools and day care centers (49 [6.0%]), and health care institutions (43 outbreaks [5.3%]). However, many cases resulted from relatively few outbreaks (< 30 each) associated with community events (9,726), processing plants (8,580), mobile/temporary service (5,367), and camps/ armed forces (5,117). The single most frequently reported setting was restaurants, with 324 outbreaks and 16,938 cases. Improper hygienic practices in homes, on picnics, or at community events accounted for 89 of the 816 outbreaks. There were 18 outbreaks associated with

  18. Flatness-based embedded control in successive loops for spark-ignited engines

    NASA Astrophysics Data System (ADS)

    Rigatos, Gerasimos

    2015-11-01

    Embedded control units for transportation systems make use of advanced nonlinear control methods. In this research article a new nonlinear control method is applied to spark ignited (SI) engines. The proposed SI engine's control scheme is based on differential flatness theory The considered method succeeds the efficient control of the SI engine parameters such as intake pressure and turn speed. The method makes use of a state-space model of the SI-engine in the so-called triangular form. The controller design proceeds by showing that each row of the state-space model of the SI engine stands for a differentially flat system, where the flat output is chosen to be the associated state variable. Next, for each subsystem which is linked with a row of the state-space model, a virtual control input is computed, that can invert the subsystem's dynamics and can eliminate the subsystem's tracking error. From the last row of the state-space description, the control input that is actually applied to the SI engine is found. This control input contains recursively all virtual control inputs which were computed for the individual subsystems associated with the previous rows of the state-space equation. Thus, by tracing the rows of the state-space model backwards, at each iteration of the control algorithm, one can finally obtain the control input that should be applied to the SI-engine so as to assure that all its state vector elements will converge to the desirable setpoints.

  19. Investigation and management of multidrug-resistant Acinetobacter baumannii spread in a French medical intensive care unit: one outbreak may hide another.

    PubMed

    Bourigault, Céline; Corvec, Stéphane; Bretonnière, Cédric; Guillouzouic, Aurélie; Crémet, Lise; Marraillac, Julie; Juvin, Marie-Emmanuelle; Bemer, Pascale; Le Gallou, Florence; Reynaud, Alain; Boutoille, David; Villers, Daniel; Lepelletier, Didier

    2013-07-01

    An outbreak in a medical intensive care unit was due to an OXA-23-producing Acinetobacter baumannii strain imported from a repatriate hospitalized in Singapore. This outbreak revealed another multidrug resistant epidemic strain that had been present in the hospital for 2 years. Both outbreaks were controlled after 9 months of an extensive infection control program. PMID:23266385

  20. Beliefs underlying blood donors' intentions to donate during two phases of an avian influenza outbreak.

    PubMed

    Masser, Barbara M; White, Katherine M; Hamilton, Kyra; McKimmie, Blake M

    2012-02-01

    Using a Theory of Planned Behavior (TPB) framework the current study explored the beliefs of current blood donors (N=172) about donating during a low and high-risk phase of a potential avian influenza outbreak. While the majority of behavioral, normative, and control beliefs identified in preliminary research differed as a function of donors' intentions to donate during both phases of an avian influenza outbreak, regression analyses suggested that the targeting of different specific beliefs during each phase of an outbreak would yield most benefit in bolstering donors' intentions to remain donating. The findings provide insight in how to best motivate donors in different phases of an avian influenza outbreak. PMID:22142514

  1. Early outbreaks of 'epidemic neuromyasthenia'.

    PubMed Central

    Parish, J. G.

    1978-01-01

    The literature of the outbreaks of 'epidemic neuromyasthenia' (ENM) from 1934 to 1955 has been selected to show that the disease affects other people besides young adult females in hospitals and nursing homes. There have been district epidemics, in which the male: female ratio was almost even and several male outbreaks affecting soldiers in barracks. Some outbreaks appear to have been triggered off by an epidemic of poliomyelitis, and the epidemiology of outbreaks in Iceland in 1948 and 1955 suggests that the normal cytopathological effects of poliomyelitis infection have been suppressed by the new disease. In the Durban epidemic (1955) a toxic metabolite was discovered in the urine of many patients and a markedly increased urinary excretion of creatine was noted in two New York State outbreaks. The results of the transmission of an agent from patients with ENM to monkeys suggest that the neurological disorder might be in the form of mild disseminated lesions scattered throughout the nervous system from the brain to peripheral nerves and associated with perivascular round cell infiltration without significant cellular damage. ENM infection was widespread in the North of England in 1955 and associated with lymphocyte abnormalities, which have persisted in some cases for several years. This suggests a continuous organic process. PMID:370810

  2. Vaccine breaks: Outbreaks of myxomatosis on Spanish commercial rabbit farms.

    PubMed

    Dalton, K P; Nicieza, I; de Llano, D; Gullón, J; Inza, M; Petralanda, M; Arroita, Z; Parra, F

    2015-08-01

    Despite the success of vaccination against myxoma virus, myxomatosis remains a problem on rabbit farms throughout Spain and Europe. In this study we set out to evaluate possible causes of myxoma virus (MYXV) vaccine failures addressing key issues with regard to pathogen, vaccine and vaccination strategies. This was done by genetically characterising MYXV field isolates from farm outbreaks, selecting a representative strain for which to assay its virulence and measuring the protective capability of a commercial vaccine against this strain. Finally, we compare methods (route) of vaccine administration under farm conditions and evaluate immune response in vaccinated rabbits. The data presented here show that the vaccine tested is capable of eliciting protection in rabbits that show high levels of seroconversion. However, the number of animals failing to seroconvert following subcutaneous vaccination may leave a large number of rabbits unprotected following vaccine administration. Successful vaccination requires the strict implication of workable, planned, on farm programs. Following this, analysis to confirm seroconversion rates may be advisable. Factors such as the wild rabbit reservoir, control of biting insects and good hygienic practices must be taken into consideration to prevent vaccine failures from occurring. PMID:26009303

  3. Community matters - why outbreak responses need to integrate health promotion.

    PubMed

    Kickbusch, Ilona; Reddy, K Srikanth

    2016-03-01

    Communities are characterized by common interests, common ecology, and common social system or structure. These characteristics, qualities, and processes involved in the community affect both health behaviors and health outcomes during disease outbreaks. Hence, health promotion theorists and practitioners emphasize working 'with' rather than 'on' communities. They believe health promotion, with all its experiences in community mobilization, empowerment, and health literacy programs, should be part of disease prevention and control efforts from the very beginning. Health promotion knowledge needs to be fully integrated into infectious disease control, especially in the context of outbreaks. PMID:26518038

  4. Outbreaks attributed to fresh leafy vegetables, United States, 1973-2012.

    PubMed

    Herman, K M; Hall, A J; Gould, L H

    2015-10-01

    Leafy vegetables are an essential component of a healthy diet; however, they have been associated with high-profile outbreaks causing severe illnesses. We reviewed leafy vegetable-associated outbreaks reported to the Centers for Disease Control and Prevention between 1973 and 2012. During the study period, 606 leafy vegetable-associated outbreaks, with 20 003 associated illnesses, 1030 hospitalizations, and 19 deaths were reported. On average, leafy vegetable-associated outbreaks were larger than those attributed to other food types. The pathogens that most often caused leafy vegetable-associated outbreaks were norovirus (55% of outbreaks with confirmed aetiology), Shiga toxin-producing Escherichia coli (STEC) (18%), and Salmonella (11%). Most outbreaks were attributed to food prepared in a restaurant or catering facility (85%). An ill food worker was implicated as the source of contamination in 31% of outbreaks. Efforts by local, state, and federal agencies to control leafy vegetable contamination and outbreaks should span from the point of harvest to the point of preparation. PMID:25697407

  5. NASA flight controllers - Meeting cultural and leadership challenges on the critical path to mission success

    NASA Technical Reports Server (NTRS)

    Clement, James L., Jr.; Ritsher, Jennifer Boyd

    2006-01-01

    As part of its preparation for missions to the Moon and Mars, NASA has identified high priority critical path roadmap (CPR) questions, two of which focus on the performance of mission control personnel. NASA flight controllers have always worked in an incredibly demanding setting, but the International Space Station poses even more challenges than prior missions. We surveyed 14 senior ISS flight controllers and a contrasting sample of 12 more junior controllers about the management and cultural challenges they face and the most effective strategies for addressing them. There was substantial consensus among participants on some issues, such as the importance of building a personal relationship with Russian colleagues. Responses from junior and senior controllers differed in some areas, such as training. We frame the results in terms of two CPR questions. We aim to use our results to improve flight controller training.

  6. Scabies and bedbugs in hospital outbreaks.

    PubMed

    Sfeir, Maroun; Munoz-Price, L Silvia

    2014-08-01

    Scabies and bedbugs are two emerging ectoparasitic infections reported in crowded areas, including hospitals. Skin involvement is the main presenting initial manifestation for both infections, and the diagnosis is yet challenging for both. Topical permethrin is considered the first-line therapy for scabies except for crusted scabies which is mainly treated with oral ivermectin. To the contrary, treatment of bedbugs is mainly symptomatic. Avoiding close contact, early diagnosis and treatment of infected persons as well as decontamination of the involved environment play an essential role in controlling outbreaks in healthcare settings. PMID:24897948

  7. Matrix acidizing design and quality-control techniques prove successful in Main Pass area sandstone

    SciTech Connect

    Brannon, D.H.; Netters, C.K.; Grimmer, P.J.

    1987-08-01

    Successful acidizing techniques have been developed and implemented in the Main Pass area, offshore Louisiana. Since mid-1984, 37 oil wells have been acidized, resulting in a success rate of 95% and a total increase in production of almost 12,700 BOPD (2019 m/sup 3//d oil). One of the primary reasons these treatments were so successful was the continuous injection of a finely ground oil-soluble resin diverting agent throughout all acid stages, which decreased acid injection into the more permeable zones and helped distribute the treating fluids more uniformly. Other factors that may not be the industry norm that influenced the effectiveness of these treatments included (1) reduced-strength HCl/HF and preflush acids, (2) xylene solvents pumped ahead of injected acid for possible paraffin and/or asphaltene removal, (3) xylene pumped after the overflush stage as a diverter breaker, (4) filtration of all fluids, (5) low-rate, high-pressure pump for continuous injection of diverter downstream of filters, (6) use of ''pickled'' coiled tubing, (7) coil/production tubing annulus pressure recorder, (8) testing production tubing before pumping, (9) use of boats exclusively, rather than offloaded skids, from which to mix and pump, (10) on-site acid mixing with titration checks of concentration before pumping, and (11) postjob laboratory analysis of concentrations and solids content of selected spot samples.

  8. Controls of biological soil crust cover and composition shift with succession in sagebrush shrub-steppe

    USGS Publications Warehouse

    Dettweiler-Robinson, E.; Bakker, J.D.; Grace, J.B.

    2013-01-01

    Successional stage may determine strength and causal direction of interactions among abiotic and biotic factors; e.g., species that facilitate the establishment of other species may later compete with them. We evaluated multivariate hypotheses about abiotic and biotic factors shaping biological soil crusts (BSCs) in early and late successional stages. We surveyed vegetation and BSC in the shrub-steppe ecosystem of the Columbia Basin. We analyzed the relationships with bryophyte and lichen covers using structural equation models, and analyzed the relationships with BSC composition using Indicator Species Analysis and distance-based linear models. Cover, indicator species, and composition varied with successional stage. Increasing elevation and bryophyte cover had higher lichen cover early in succession; these relationships were negative in the later successional stage. Lichen cover did not appear to impede B. tectorum cover, but B. tectorum appeared to strongly negatively affect lichen cover in both stages. Biological soil crust composition varied with bunchgrass cover in the early successional stage, but with elevation and B. tectorum cover later in succession. Our findings support the hypotheses that as succession progresses, the strength and direction of certain community interactions shift, and B. tectorum leads to reductions in biological soil crust cover regardless of successional stage.

  9. Enhanced Hygiene Measures and Norovirus Transmission during an Outbreak

    PubMed Central

    Teunis, Peter; Morroy, Gabriella; Wijkmans, Clementine; Oostveen, Sandy; Duizer, Erwin; Kretzschmar, Mirjam; Wallinga, Jacco

    2009-01-01

    Control of norovirus outbreaks relies on enhanced hygiene measures, such as handwashing, surface cleaning, using disposable paper towels, and using separate toilets for sick and well persons. However, little is known about their effectiveness in limiting further spread of norovirus infections. We analyzed norovirus outbreaks in 7 camps at an international scouting jamboree in the Netherlands during 2004. Implementation of hygiene measures coincided with an 84.8% (95% predictive interval 81.2%–86.6%) reduction in reproduction number. This reduction was unexpectedly large but still below the reduction needed to contain a norovirus outbreak. Even more stringent control measures are required to break the chain of transmission of norovirus. PMID:19116045

  10. Full-Scaled Advanced Systems Testbed: Ensuring Success of Adaptive Control Research Through Project Lifecycle Risk Mitigation

    NASA Technical Reports Server (NTRS)

    Pavlock, Kate M.

    2011-01-01

    The National Aeronautics and Space Administration's Dryden Flight Research Center completed flight testing of adaptive controls research on the Full-Scale Advance Systems Testbed (FAST) in January of 2011. The research addressed technical challenges involved with reducing risk in an increasingly complex and dynamic national airspace. Specific challenges lie with the development of validated, multidisciplinary, integrated aircraft control design tools and techniques to enable safe flight in the presence of adverse conditions such as structural damage, control surface failures, or aerodynamic upsets. The testbed is an F-18 aircraft serving as a full-scale vehicle to test and validate adaptive flight control research and lends a significant confidence to the development, maturation, and acceptance process of incorporating adaptive control laws into follow-on research and the operational environment. The experimental systems integrated into FAST were designed to allow for flexible yet safe flight test evaluation and validation of modern adaptive control technologies and revolve around two major hardware upgrades: the modification of Production Support Flight Control Computers (PSFCC) and integration of two, fourth-generation Airborne Research Test Systems (ARTS). Post-hardware integration verification and validation provided the foundation for safe flight test of Nonlinear Dynamic Inversion and Model Reference Aircraft Control adaptive control law experiments. To ensure success of flight in terms of cost, schedule, and test results, emphasis on risk management was incorporated into early stages of design and flight test planning and continued through the execution of each flight test mission. Specific consideration was made to incorporate safety features within the hardware and software to alleviate user demands as well as into test processes and training to reduce human factor impacts to safe and successful flight test. This paper describes the research configuration

  11. Outbreak of mortality in Russian (Acipenser gueldenstaedtii) and Siberian (Acipenser baerii) sturgeons associated with sturgeon nucleo-cytoplasmatic large DNA virus.

    PubMed

    Ciulli, S; Volpe, E; Sirri, R; Passalacqua, P L; Cesa Bianchi, F; Serratore, P; Mandrioli, L

    2016-08-15

    Diseased outbreaks with high mortality in farmed sturgeon are a limiting factor to the success of this emerging aquaculture sector in Europe. Thorough investigations of outbreaks can determine the aetiological agents, identify important pathological and epidemiological pathways of infections and pave the way for effective control strategies. A thorough investigation of a mortality outbreak in Russian (Acipenser gueldenstaedtii) and Siberian (Acipenser baerii) sturgeons in Italy, demonstrated the primary involvement of a sturgeon nucleo-cytoplasmic large DNA virus (NCLDV). While, the taxonomy classification of this new virus is still uncertain, its involvement in sturgeon mortality outbreaks in Europe is, for the first time, fully investigated and described. Furthermore, the coinfection of bacteria such as motile Aeromonas spp. and Acinetobacter spp. was reported. Genetic characterisation showed the close relationship between the European sturgeon NCLDV with North American sturgeon NCLDVs. Similarly to the latter, the European sturgeon NCLDV persists in survivors. Furthermore, a systemic distribution of the European sturgeon NCLDV was evident in diseased A. baerii and A. gueldenstaedtii and in recovered A. gueldenstaedtii. These epidemiological and pathological findings will help in the identification of effective control strategies for sturgeon NCLDV infection, which afflicts an important and emerging European aquaculture sector. PMID:27374904

  12. Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study

    PubMed Central

    Eriksen, Hanne M; Guerin, Philippe J; Nygård, Karin; Hjertqvist, Marika; de Jong, Birgitta; Rose, Angela MC; Kuusi, Markku; Durr, Ulrike; Rojas, AG; Mør, Cato; Aavitsland, Preben

    2004-01-01

    Background Between November 2 and 10, 2002 several patients with psoriasis and personnel staying in the health centre in Gran Canaria, Spain fell ill with diarrhoea, vomiting or both. Patient original came from Norway, Sweden and Finland. The patient group was scheduled to stay until 8 November. A new group of patients were due to arrive from 7 November. Methods A retrospective cohort study was conducted to assess the extent of the outbreak, to identify the source and mode of transmission and to prevent similar problems in the following group. Results Altogether 41% (48/116) of persons staying at the centre fell ill. Norovirus infection was suspected based on clinical presentations and the fact that no bacteria were identified. Kaplan criteria were met. Five persons in this outbreak were hospitalised and the mean duration of diarrhoea was 3 days. The consequences of the illness were more severe compared to many other norovirus outbreaks, possibly because many of the cases suffered from chronic diseases and were treated with drugs reported to affect the immunity (methotrexate or steroids). During the two first days of the outbreak, the attack rate was higher in residents who had consumed dried fruit (adjusted RR = 3.1; 95% CI: 1.4–7.1) and strawberry jam (adjusted RR = 1.9; 95% CI: 0.9–4.1) than those who did not. In the following days, no association was found. The investigation suggests two modes of transmission: a common source for those who fell ill during the two first days of the outbreak and thereafter mainly person to person transmission. This is supported by a lower risk associated with the two food items at the end of the outbreak. Conclusions We believe that the food items were contaminated by foodhandlers who reported sick before the outbreak started. Control measures were successfully implemented; food buffets were banned, strict hygiene measures were implemented and sick personnel stayed at home >48 hours after last symptoms. PMID:15511300

  13. Outbreak of Ciprofloxacin-Resistant Shigella sonnei Associated with Travel to Vietnam, Republic of Korea.

    PubMed

    Kim, Jin Seok; Kim, Jae Joon; Kim, Soo Jin; Jeon, Se-Eun; Seo, Ki Yeon; Choi, Jun-Kil; Kim, Nan-Ok; Hong, Sahyun; Chung, Gyung Tae; Yoo, Cheon-Kwon; Kim, Young-Taek; Cheun, Hyeng Il; Bae, Geun-Ryang; Yeo, Yeong-Hee; Ha, Gang-Ja; Choi, Mi-Suk; Kang, Shin-Jung; Kim, Junyoung

    2015-07-01

    We investigated an October 2014 outbreak of illness caused by Shigella sonnei in a daycare center in the Republic of Korea (South Korea). The outbreak strain was resistant to extended-spectrum cephalosporins and fluoroquinolones and was traced to a child who had traveled to Vietnam. Improved hygiene and infection control practices are needed for prevention of shigellosis. PMID:26079171

  14. Factors controlling accumulation of soil organic carbon along vegetation succession in a typical karst region in Southwest China.

    PubMed

    Liu, Shujuan; Zhang, Wei; Wang, Kelin; Pan, Fujing; Yang, Shan; Shu, Shiyan

    2015-07-15

    Vegetation succession enhances the accumulation of carbon in the soil. However, little is known about the mechanisms underlying soil organic carbon (SOC) accumulation in different vegetation types in the karst region of Southwest China. The goal of this study was to identify and prioritize the effects of environmental parameters, including soil physico-chemical properties, microbial biomass, enzyme activities, and litter characteristics, on SOC accumulation along a vegetation succession sere (grassland, shrubland, secondary forest, and primary forest) in the karst landscape of Southwest China. Relationships between these parameters and SOC were evaluated by redundancy analysis. The results showed that SOC accumulation was significantly different among vegetation types (P<0.01) and increased with vegetation succession (from 29.10g·kg(-1) in grassland to 73.92g·kg(-1) in primary forest). Soil biochemistry and physical characteristics significantly affected the accumulation of SOC. Soil microbial biomass showed a predominant effect on SOC in each of the four vegetation types. In addition, the soil physical property (especially the silt content) was another controlling factor in the early stages (grassland), and urease activity and saccharase activity were important controlling factors in the early-middle and middle-late stages, respectively. Litter characteristics only showed mild effects on SOC accumulation. Variation partitioning analysis showed that the contribution of sole main factors to SOC variation decreased, while the interaction effect among parameters increased along the succession gradient. PMID:25828412

  15. Tuberculosis outbreak in a Texas prison, 1994.

    PubMed

    Bergmire-Sweat, D; Barnett, B J; Harris, S L; Taylor, J P; Mazurek, G H; Reddy, V

    1996-12-01

    In 1994 a Texas prison containing a population of mentally retarded inmates experienced a large tuberculosis outbreak. Fifteen cases of tuberculosis were identified (8 confirmed by positive cultures for Mycobacterium tuberculosis) and more than 100 inmates became infected. The culture-confirmed patients were infected with an identical strain of tuberculosis as demonstrated by polymerase chain reaction (PCR) based DNA fingerprinting technique. The prison followed standard tuberculosis infection control policies, but these controls were inadequate to prevent tuberculosis transmission in this special population. Two hundred and thirty inmates (119 inmates showing evidence of new tuberculosis infection or active disease and 111 healthy controls) were enrolled in the investigation. Inmate cell assignments, job duties, and educational classes were identified and medical chart reviews were conducted on all inmates. Tuberculosis transmission was associated with residing on the D Wing of the prison (OR = 25.84, P < 0.01), attending school in Classroom A (OR = 8.34, P = 0.01) and working on the prison utility work crew (OR = 2.52, P < 0.01). The index case in the outbreak had been prescribed 6 months of isoniazid (INH) chemoprophylaxis in 1988. PMID:8972673

  16. Recruiting and retaining low-income, multi-ethnic women into randomized controlled trials: Successful strategies and staffing

    PubMed Central

    Barnett, Josephine; Aguilar, Stephanie; Brittner, Mindy; Bonuck, Karen

    2012-01-01

    Developing effective recruitment and retention strategies in populations with traditionally high attrition rates is critical to the success of Randomized Controlled Trials (RCTs). Data on successful participation of women from low-income, minority populations in RCTs of behavioral interventions are limited. This is problematic given the multiplicity of Healthy People 2020 goals that target health disparities in these populations. This paper reports successful recruitment and retention methods from two separately funded NIH clinical trials of primary care-based prenatal interventions to increase breastfeeding among ethnically diverse, low-income women in urban medical centers in the Bronx, NY. It also presents the required staff effort necessary to conduct such a successful RCT, in terms of full-time equivalents (FTEs). Results include timely recruitment of 941 participants over 29 months, with 98.1% completing 1̄ follow-up interview. A recruitment and retention plan that maximized study staff access and availability to the participant, as well as strong study staff rapport with participants, addressed previously reported barriers in this population, optimizing follow-up rates. A qualitative assessment of the participants' study experience suggesting that high retention was due to strong rapport with participants, short interviews requiring little time commitment, and participants' perception of the study as informative, provides further evidence of our approach's effectiveness. Logistical protocol procedures and staff management strategies relating to successful recruitment/retention are provided to propose a practical, cost-effective and translational recruitment–retention plan for other researchers to adopt. PMID:22732312

  17. Environmental Variation Generates Environmental Opportunist Pathogen Outbreaks.

    PubMed

    Anttila, Jani; Kaitala, Veijo; Laakso, Jouni; Ruokolainen, Lasse

    2015-01-01

    Many socio-economically important pathogens persist and grow in the outside host environment and opportunistically invade host individuals. The environmental growth and opportunistic nature of these pathogens has received only little attention in epidemiology. Environmental reservoirs are, however, an important source of novel diseases. Thus, attempts to control these diseases require different approaches than in traditional epidemiology focusing on obligatory parasites. Conditions in the outside-host environment are prone to fluctuate over time. This variation is a potentially important driver of epidemiological dynamics and affect the evolution of novel diseases. Using a modelling approach combining the traditional SIRS models to environmental opportunist pathogens and environmental variability, we show that epidemiological dynamics of opportunist diseases are profoundly driven by the quality of environmental variability, such as the long-term predictability and magnitude of fluctuations. When comparing periodic and stochastic environmental factors, for a given variance, stochastic variation is more likely to cause outbreaks than periodic variation. This is due to the extreme values being further away from the mean. Moreover, the effects of variability depend on the underlying biology of the epidemiological system, and which part of the system is being affected. Variation in host susceptibility leads to more severe pathogen outbreaks than variation in pathogen growth rate in the environment. Positive correlation in variation on both targets can cancel the effect of variation altogether. Moreover, the severity of outbreaks is significantly reduced by increase in the duration of immunity. Uncovering these issues helps in understanding and controlling diseases caused by environmental pathogens. PMID:26710238

  18. Environmental Variation Generates Environmental Opportunist Pathogen Outbreaks

    PubMed Central

    Anttila, Jani; Kaitala, Veijo; Laakso, Jouni; Ruokolainen, Lasse

    2015-01-01

    Many socio-economically important pathogens persist and grow in the outside host environment and opportunistically invade host individuals. The environmental growth and opportunistic nature of these pathogens has received only little attention in epidemiology. Environmental reservoirs are, however, an important source of novel diseases. Thus, attempts to control these diseases require different approaches than in traditional epidemiology focusing on obligatory parasites. Conditions in the outside-host environment are prone to fluctuate over time. This variation is a potentially important driver of epidemiological dynamics and affect the evolution of novel diseases. Using a modelling approach combining the traditional SIRS models to environmental opportunist pathogens and environmental variability, we show that epidemiological dynamics of opportunist diseases are profoundly driven by the quality of environmental variability, such as the long-term predictability and magnitude of fluctuations. When comparing periodic and stochastic environmental factors, for a given variance, stochastic variation is more likely to cause outbreaks than periodic variation. This is due to the extreme values being further away from the mean. Moreover, the effects of variability depend on the underlying biology of the epidemiological system, and which part of the system is being affected. Variation in host susceptibility leads to more severe pathogen outbreaks than variation in pathogen growth rate in the environment. Positive correlation in variation on both targets can cancel the effect of variation altogether. Moreover, the severity of outbreaks is significantly reduced by increase in the duration of immunity. Uncovering these issues helps in understanding and controlling diseases caused by environmental pathogens. PMID:26710238

  19. Genetic Clues to the 2014 Ebola Outbreak

    MedlinePlus

    ... External link, please review our exit disclaimer . Subscribe Genetic Clues to the 2014 Ebola Outbreak Scientists sequenced ... of Ebola as the outbreak continues. Understanding the genetics of the virus will also help scientists develop ...

  20. Opioids by Injection May Drive HIV Outbreaks

    MedlinePlus

    ... fullstory_159978.html Opioids by Injection May Drive HIV Outbreaks Indiana case offers a lesson for other ... drug abuse epidemic has increased the risk of HIV outbreaks in rural and suburban communities, where up ...

  1. Coping with Stress during Infectious Disease Outbreaks

    MedlinePlus

    · Coping With Stress During Infectious Disease Outbreaks What You Should Know When you hear, read, or watch news about an outbreak ... you may feel anxious and show signs of stress. These signs of stress are normal, and may ...

  2. Outbreak Caused by an Ertapenem-Resistant, CTX-M-15-Producing Klebsiella pneumoniae Sequence Type 101 Clone Carrying an OmpK36 Porin Variant

    PubMed Central

    Poulou, Aggeliki; Voulgari, Evangelia; Vrioni, Georgia; Koumaki, Vasiliki; Xidopoulos, Grigorios; Chatzipantazi, Vasiliki; Markou, Fani

    2013-01-01

    Although numerous studies have documented outbreaks of carbapenem-resistant Klebsiella pneumoniae (CRKP) possessing various carbapenemases, reports on outbreaks due to CRKP possessing extended-spectrum β-lactamases (ESBLs) and/or AmpCs with porin lesions have been limited. Here, we describe an outbreak caused by an ertapenem-resistant, CTX-M-15-producing clonal K. pneumoniae strain expressing an OmpK36 porin variant. From May 2012 to November 2012, 37 ertapenem-resistant K. pneumoniae isolates phenotypically negative for carbapenemase production were recovered from 19 patients hospitalized in the intensive care unit of a Greek hospital. The isolates were either susceptible or intermediate to other carbapenems and resistant to all remaining β-lactams but cefotetan. Phenotypic and molecular analysis revealed the presence in all isolates of the blaCTX-M-15 gene on a conjugative 100-kb plasmid, disruption in the expression of the ompK35 gene, and the production of an Ompk36 porin variant. The index case was a patient admitted from another hospital. Active surveillance upon admission and on a weekly basis was immediately initiated; environmental samples were also periodically tested. Molecular typing showed that all clinical isolates as well as two ertapenem-resistant environmental K. pneumoniae isolates belonged to the same clonal type and were assigned to multilocus sequence typing (MLST) sequence type 101 (ST101). As all colonized/infected patients were hospitalized during overlapping periods, cross-infection was considered the main route for the dissemination of the outbreak strain. Despite reinforcement of infection control measures and active surveillance, the outbreak lasted approximately 7 months. Identification of hidden carriers upon admission and by screening on a weekly basis was found valuable for early recognition and subsequent successful management of the outbreak. PMID:23850951

  3. From global agenda-setting to domestic implementation: successes and challenges of the global health network on tobacco control.

    PubMed

    Gneiting, Uwe

    2016-04-01

    Global policy attention to tobacco control has increased significantly since the 1990 s and culminated in the first international treaty negotiated under the auspices of the World Health Organization--the Framework Convention on Tobacco Control (FCTC). Although the political process that led to the creation of the FCTC has been extensively researched, the FCTC's progression from an aspirational treaty towards a global health governance framework with tangible policy effects within FCTC member countries has not been well-understood to date. This article analyses the role of the global health network of tobacco control advocates and scientists, which formed during the FCTC negotiations during the late 1990 s, in translating countries' commitment to the FCTC into domestic policy change. By comparing the network's influence around two central tobacco control interventions (smoke-free environments and taxation), the study identifies several scope conditions, which have shaped the network's effectiveness around the FCTC's implementation: the complexity of the policy issue and the relative importance of non-health expertise, the required scope of domestic political buy-in, the role of the general public as network allies, and the strength of policy opposition. These political factors had a greater influence on the network's success than the evidence base for the effectiveness of tobacco control interventions. The network's variable success points to a trade-off faced by global health networks between their need to maintain internal cohesion and their ability to form alliances with actors in their social environment. PMID:26253698

  4. Emergency vaccination use in a modelled foot and mouth disease outbreak in Minnesota.

    PubMed

    Miller, G; Gale, S B; Eshelman, C E; Wells, S J

    2015-12-01

    Epidemiological modelling is an important approach used by the Veterinary Services of the United States Department of Agriculture Animal and Plant Health Inspection Service to evaluate the potential effectiveness of different strategies for handling foot and mouth disease (FMD). Identifying the potential spread of FMD by modelling an outbreak, and then considering the impacts of FMD vaccination, is important in helping to inform decision-makers about the potential outcomes of vaccination programmes. The objective of this study was to evaluate emergency vaccination control strategies used in a simulated FMD outbreak in Minnesota. The North American Animal Disease Spread Model (NAADSM, Version 3.2.18) was used to simulate the outbreak. Large-scale (1,500 herds per day) emergency vaccination reduced the size of the modelled outbreak in both swine and dairy production types, but the effect was larger when the outbreak began in a dairy herd. Large-scale vaccination also overcame limitations caused by delays in vaccine delivery. Thus, even if vaccination did not begin until 21 days into the outbreak, large-scale vaccination still reduced the size and duration of the outbreak. The quantity of vaccine used was markedly larger when large-scale vaccination was used, compared with small-scale (50 herds per day) vaccine administration. In addition, the number of animals and herds vaccinated in an outbreak originating in a herd of swine was substantially lower than in an outbreak beginning in a herd of dairy cattle. PMID:27044148

  5. A review of epidemiological parameters from Ebola outbreaks to inform early public health decision-making.

    PubMed

    Van Kerkhove, Maria D; Bento, Ana I; Mills, Harriet L; Ferguson, Neil M; Donnelly, Christl A

    2015-01-01

    The unprecedented scale of the Ebola outbreak in West Africa has, as of 29 April 2015, resulted in more than 10,884 deaths among 26,277 cases. Prior to the ongoing outbreak, Ebola virus disease (EVD) caused relatively small outbreaks (maximum outbreak size 425 in Gulu, Uganda) in isolated populations in central Africa. Here, we have compiled a comprehensive database of estimates of epidemiological parameters based on data from past outbreaks, including the incubation period distribution, case fatality rate, basic reproduction number (R 0 ), effective reproduction number (R t ) and delay distributions. We have compared these to parameter estimates from the ongoing outbreak in West Africa. The ongoing outbreak, because of its size, provides a unique opportunity to better understand transmission patterns of EVD. We have not performed a meta-analysis of the data, but rather summarize the estimates by virus from comprehensive investigations of EVD and Marburg outbreaks over the past 40 years. These estimates can be used to parameterize transmission models to improve understanding of initial spread of EVD outbreaks and to inform surveillance and control guidelines. PMID:26029377

  6. A review of epidemiological parameters from Ebola outbreaks to inform early public health decision-making

    PubMed Central

    Van Kerkhove, Maria D.; Bento, Ana I.; Mills, Harriet L.; Ferguson, Neil M.; Donnelly, Christl A.

    2015-01-01

    The unprecedented scale of the Ebola outbreak in West Africa has, as of 29 April 2015, resulted in more than 10,884 deaths among 26,277 cases. Prior to the ongoing outbreak, Ebola virus disease (EVD) caused relatively small outbreaks (maximum outbreak size 425 in Gulu, Uganda) in isolated populations in central Africa. Here, we have compiled a comprehensive database of estimates of epidemiological parameters based on data from past outbreaks, including the incubation period distribution, case fatality rate, basic reproduction number (R0), effective reproduction number (Rt) and delay distributions. We have compared these to parameter estimates from the ongoing outbreak in West Africa. The ongoing outbreak, because of its size, provides a unique opportunity to better understand transmission patterns of EVD. We have not performed a meta-analysis of the data, but rather summarize the estimates by virus from comprehensive investigations of EVD and Marburg outbreaks over the past 40 years. These estimates can be used to parameterize transmission models to improve understanding of initial spread of EVD outbreaks and to inform surveillance and control guidelines. PMID:26029377

  7. Epidemic keratoconjunctivitis outbreak at a tertiary referral eye care clinic.

    PubMed

    Montessori, V; Scharf, S; Holland, S; Werker, D H; Roberts, F J; Bryce, E

    1998-08-01

    An outbreak of epidemic keratoconjunctivitis (EKC) occurred at a tertiary referral eye care clinic between late September and mid-November 1995. Before the outbreak, instruments were cleaned with 70% isopropyl alcohol and handwashing between patients was not routine. Infection control measures were implemented when the outbreak was recognized in mid-October. Control measures included triaging suspected cases to a separate waiting area, cohorting cases to a specific examining room, endorsing the use of gloves and handwashing during examinations of patients, and cleaning instruments with a buffered bleach solution. Thirty-six cases were diagnosed before the infection control measures were taken, and 3 cases were seen after the control measures were taken. Also, numerous secondary cases occurred in the community. No additional cases were diagnosed from DEcember to February 25, 1996. Acquisition of the infection was linked to visits to 4 of 20 physicians in the eye clinic with 61% of cases associated with visits to 1 of those 4 physicians. The use of diagnostic lenses applied directly to the eye was associated with infection (odds ratio = 2.83, 95% confidence interval = 0.79 to 10.4), although this did not reach statistical significance. The use of tonometers, ophthalmic solutions, or laser therapy was not associated with infection, and all environmental cultures were negative. This outbreak emphasizes the need for implementation of routine infection control guidelines to prevent nosocomial transmission of epidemic keratoconjunctivitis and stresses the need for appropriate disinfection of instruments. PMID:9721392

  8. IMPROVING WATERBORNE DISEASE OUTBREAK INVESTIGATIONS

    EPA Science Inventory

    This article summarizes the discussions and conclusions of a workshop held December 7-8, 1998, to consider the inherent limitations and weaknesses of waterborne outbreak investigations and make recommendations for their improvement. In recent years, an increased number of suspec...

  9. Outbreaks of foot-and-mouth disease in Peninsular Malaysia from 2001 to 2007.

    PubMed

    Ramanoon, Siti Zubaidah; Robertson, Ian Duncan; Edwards, John; Hassan, Latiffah; Isa, Kamaruddin Md

    2013-02-01

    This is a retrospective study of the outbreaks of foot-and-mouth disease (FMD) in Peninsular Malaysia between 2001 and May 2007. In total, 270 outbreaks of FMD were recorded. Serotype O virus (89.95 %) and serotype A (7.7 %) had caused the outbreaks. Significant differences on the occurrence of FMD were found between the years (t = 5.73, P = 0.000, df = 11), months (t = 4.7, P = 0.000, df = 11), monsoon season (t = 2.63, P = 0.025, df = 10) and states (t = 4.84, P = 0.001, df = 10). A peak of outbreaks observed in 2003 could be due to increased animal movement and the other peak in 2006 could be due to a compromised FMD control activities due to activities on the eradication of highly pathogenic avian influenza. Cattle (86 % of outbreaks) suffered the most. However, no difference in disease occurrence between species was observed. The populations of cattle (r = 0.672, P = 0.023) and sheep (r = 0.678, P = 0.022) were significantly correlated with occurrence of FMD. Movement of animals (66 % of outbreaks) was the main source for outbreaks. A combination of control measures were implemented during outbreaks. In conclusion, the findings of this study show that FMD is endemic in Peninsular Malaysia, and information gained could be used to improve the existing control strategy. PMID:22826115

  10. Successful Control of Liver Metastases From Pancreatic Solid-Pseudopapillary Neoplasm (SPN) Using Hepatic Arterial Embolization

    SciTech Connect

    Violari, Elena G. Brody, Lynn A.; Covey, Anne M.; Erinjeri, Joseph P.; Getrajdman, George I.; Sofocleous, Constantinos T.; Reidy, Diane L.; Jarnagin, William R.; Brown, Karen T.

    2015-04-15

    No systemic agents that are known to be effective for the treatment of solid-pseudopapillary neoplasm (SPN) are available. We report the prolonged and sustained control of metastatic pancreatic SPN to the liver using hepatic arterial embolization (HAE), where a total of 13 HAE sessions were performed over a 6-year period.

  11. Successful establishment of epiphytotics of Puccinia punctiformis for biological control of Cirsium arvense

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Canada thistle (Cirsium arvense, CT) is one of the worst weeds in temperate areas of the world. The rust fungus Puccinia punctiformis was first proposed as a biological control agent for CT in 1893. The rust causes systemic disease, is specific to CT, and is in all countries where CT is found. Despi...

  12. A Humidity-Driven Prediction System for Influenza Outbreaks

    NASA Astrophysics Data System (ADS)

    Thrastarson, H. T.; Teixeira, J.

    2015-12-01

    Recent studies have highlighted the role of absolute (or specific) humidity conditions as a leading explanation for the seasonal behavior of influenza outbreaks in temperate regions. If the timing and intensity of seasonal influenza outbreaks can be forecast, this would be of great value for public health response efforts. We have developed and implemented a SIRS (Susceptible-Infectious-Recovered-Susceptible) type numerical prediction system that is driven by specific humidity to predict influenza outbreaks. For the humidity, we have explored using both satellite data from the AIRS (Atmospheric Infrared Sounder) instrument as well as ERA-Interim re-analysis data. We discuss the development, testing, sensitivities and limitations of the prediction system and show results for influenza outbreaks in the United States during the years 2010-2014 (modeled in retrospect). Comparisons are made with other existing prediction systems and available data for influenza outbreaks from Google Flu Trends and the CDC (Center for Disease Control), and the incorporation of these datasets into the forecasting system is discussed.

  13. Innovation in observation: a vision for early outbreak detection

    PubMed Central

    Fefferman, NH; Naumova, EN

    2010-01-01

    The emergence of new infections and resurgence of old ones—health threats stemming from environmental contamination or purposeful acts of bioterrorism—call for a worldwide effort in improving early outbreak detection, with the goal of ameliorating current and future risks. In some cases, the problem of outbreak detection is logistically straightforward and mathematically easy: a single case of a disease of great concern can constitute an outbreak. However, for the vast majority of maladies, a simple analytical solution does not exist. Furthermore, each step in developing reliable, sensitive, effective surveillance systems demonstrates enormous complexities in the transmission, manifestation, detection, and control of emerging health threats. In this communication, we explore potential future innovations in early outbreak detection systems that can overcome the pitfalls of current surveillance. We believe that modern advances in assembling data, techniques for collating and processing information, and technology that enables integrated analysis will facilitate a new paradigm in outbreak definition and detection. We anticipate that moving forward in this direction will provide the highly desired sensitivity and specificity in early detection required to meet the emerging challenges of global disease surveillance. PMID:22460396

  14. Outbreaks of food-borne and waterborne viral gastroenteritis.

    PubMed Central

    Hedberg, C W; Osterholm, M T

    1993-01-01

    Norwalk virus infection is the epidemiologic prototype for outbreaks of food-borne and waterborne gastroenteritis. Around the world, Norwalk virus and Norwalk-like viruses appear to be major causes of food-borne and waterborne illness. Assessment of the overall significance of viral agents to the epidemiology of food-borne and waterborne illness is hampered by the lack of surveillance throughout much of the world. In areas where food-borne and waterborne illness surveillance is conducted, outbreaks of viral gastroenteritis are underreported because of the lack of availability of routine laboratory services to confirm the viral etiology. Routine use of epidemiologic criteria as an alternative to laboratory confirmation will allow better assessments of the importance of viral gastroenteritis until effective laboratory methods can be widely implemented. Outbreaks of viral gastroenteritis have been propagated by contamination of water supplies, raw foods, and ill food handlers. Controlling an outbreak depends on identifying and removing the source of contamination. The demonstrated occurrence of person-to-person transmission and the likely occurrence of transmission of Norwalk-like viruses by aerosol make it necessary to evaluate the potential for transmission by food handlers and servers in every outbreak, regardless of primary source. PMID:8395330

  15. A trichinosis outbreak among Southeast Asian refugees.

    PubMed

    McAuley, J B; Michelson, M K; Hightower, A W; Engeran, S; Wintermeyer, L A; Schantz, P M

    1992-06-15

    The number of cases of trichinosis reported to Centers for Disease Control has declined steadily, with an average of only 44 cases per year from 1984 through 1988. This decline was almost entirely due to a reduction in cases acquired from ingestion of fresh commercial pork. However, from July 21 through September 3, 1990, 90 (72%) of 125 Southeast Asian refugees from six states and Canada developed trichinosis after attending or eating pork sausage taken from a wedding held in Des Moines, Iowa, on July 14, 1990. Eating uncooked sausage prepared at home from commercially obtained pork was associated with the development of this illness (odds ratio = 34.0, p less than 0.001). Analysis by amount of pork consumed was significant (Mann-Whitney U rank sum test, p less than 0.001). This outbreak of trichinosis in Iowa is the fourth reported within the last 15 years among the 900,000 Southeast Asian refugees resident in the United States and one of the largest reported outbreaks in US history. The continued presence of Trichinella spiralis in commercial pork emphasizes the need for further education and control measures for persons whose dietary habits place them at risk for developing trichinosis. PMID:1510086

  16. Outbreak of Hepatitis A on an Offshore Petroleum Platform, Alaska

    PubMed Central

    Kosatsky, Tom; Middaugh, John P.; Hall, David

    1988-01-01

    An outbreak of 8 cases of hepatitis A among the 36-member crew of an offshore Alaska petroleum production platform was linked to a previous outbreak in an urban day-care center. Transmission of hepatitis A on the platform related most plausibly to refrigerated food items contaminated by a cook with mild disease. Control efforts included identifying and treating contacts of case patients who had traveled far from the platform before becoming ill. Early serologic confirmation of diagnosed cases and rapid reporting to public health authorities are essential to prevent disease transmission. Timely investigation can limit the administration of immune globulin to persons at high risk of contracting the disease. PMID:3348024

  17. [Shigella sonnei outbreak in a school in Northern Spain].

    PubMed

    Artieda, Juncal; Manterola, Jose Maria; Tolosa, Elena; Moreno, Belen; Alustiza, Jesus; Astigarraga, Uxue; Botello, Rene; Arostegui, Nerea; Basterrechea, Mikel

    2015-03-01

    In October 2012, an outbreak of acute gastroenteritis caused by Shigella sonnei was detected in a nursery and primary school in the north of Spain affecting 112 people: 63.7% were pupils and teachers and 35.7% their co-habitants. The source was a sick child who had travelled to an endemic country, and the key trigger factor was inadequate hygiene in one of the toilets of the school. The enforcement of strict hygiene measures was essential for controlling the outbreak. PMID:24801526

  18. Detecting the start of an influenza outbreak using exponentially weighted moving average charts

    PubMed Central

    2010-01-01

    Background Influenza viruses cause seasonal outbreaks in temperate climates, usually during winter and early spring, and are endemic in tropical climates. The severity and length of influenza outbreaks vary from year to year. Quick and reliable detection of the start of an outbreak is needed to promote public health measures. Methods We propose the use of an exponentially weighted moving average (EWMA) control chart of laboratory confirmed influenza counts to detect the start and end of influenza outbreaks. Results The chart is shown to provide timely signals in an example application with seven years of data from Victoria, Australia. Conclusions The EWMA control chart could be applied in other applications to quickly detect influenza outbreaks. PMID:20587013

  19. Community Survey after Rabies Outbreaks, Flagstaff, Arizona, USA

    PubMed Central

    Blanton, Jesse D.; Holman, Robert C.; Callinan, Laura S.; Baty, Steven; Phillips, Randy; Callahan, Michael; Levy, Craig; Komatsu, Ken; Sunenshine, Rebecca; Bergman, David L.; Rupprecht, Charles E.

    2012-01-01

    Flagstaff, Arizona, USA, experienced notable outbreaks of rabies caused by a bat rabies virus variant in carnivore species in 2001, 2004, 2005, 2008, and 2009. The most recent epizootic involved transmission among skunk and fox populations and human exposures. Multiple, wide-ranging control efforts and health communications outreach were instituted in 2009, including a household survey given to community members. Although the Flagstaff community is knowledgeable about rabies and the ongoing outbreaks in general, gaps in knowledge about routes of exposure and potential hosts remain. Future educational efforts should include messages on the dangers of animal translocation and a focus on veterinarians and physicians as valuable sources for outreach. These results will be useful to communities experiencing rabies outbreaks as well as those at current risk. PMID:22607999

  20. Community survey after rabies outbreaks, Flagstaff, Arizona, USA.

    PubMed

    McCollum, Andrea M; Blanton, Jesse D; Holman, Robert C; Callinan, Laura S; Baty, Steven; Phillips, Randy; Callahan, Michael; Levy, Craig; Komatsu, Ken; Sunenshine, Rebecca; Bergman, David L; Rupprecht, Charles E

    2012-06-01

    Flagstaff, Arizona, USA, experienced notable outbreaks of rabies caused by a bat rabies virus variant in carnivore species in 2001, 2004, 2005, 2008, and 2009. The most recent epizootic involved transmission among skunk and fox populations and human exposures. Multiple, wide-ranging control efforts and health communications outreach were instituted in 2009, including a household survey given to community members. Although the Flagstaff community is knowledgeable about rabies and the ongoing outbreaks in general, gaps in knowledge about routes of exposure and potential hosts remain. Future educational efforts should include messages on the dangers of animal translocation and a focus on veterinarians and physicians as valuable sources for outreach. These results will be useful to communities experiencing rabies outbreaks as well as those at current risk. PMID:22607999

  1. [Interdisciplinary management of a large Legionella outbreak in Germany].

    PubMed

    Freudenmann, M; Kurz, S; von Baum, H; Reick, D; Schreff, A M; Essig, A; Lück, C; Gonser, T; Brockmann, S O; Härter, G; Eberhardt, B; Embacher, A; Höller, C

    2011-11-01

    Between December 2009 and the end of January 2010, the largest hitherto known outbreak of Legionella in Germany took place in the cities of Ulm and Neu-Ulm. Of a total of 64 patients involved, 60 patients had to be hospitalized, and 5 patients died from the infection. This event was caused by a wet cooling tower of a large air conditioning system in the city center of Ulm. The search for the source of the Legionella emission was extremely difficult, since these plants are neither notifiable nor subject to authorization in Germany. We report about the search for the source and the measures to control the outbreak. We also discuss communication and coordination during these investigations. Regulatory measures as proposed by the World Health Organization (WHO) and the European Network for Legionellosis (EWGLI) and already implemented in numerous other European countries would be desirable to prevent such outbreaks in the future. PMID:22015788

  2. Nosocomial outbreak of Clostridium difficile diarrhea in a pediatric service.

    PubMed

    Ferroni, A; Merckx, J; Ancelle, T; Pron, B; Abachin, E; Barbut, F; Larzul, J; Rigault, P; Berche, P; Gaillard, J L

    1997-12-01

    An outbreak of nosocomial diarrhea that occurred in a pediatric orthopedic service between 1 December 1993 and 15 April 1994 is reported. A total of 37 patients (mean age, 9.6 years; range, 2 months-19.3 years) were involved in the outbreak, including six patients with bacteriologically documented Clostridium difficile infection. A multivariate analysis identified lincomycin treatment for at least three days as the only significant risk factor. Stool samples from four asymptomatic patients were also positive for Clostridium difficile and its cytotoxins. Isolates from all patients belonged to serogroup C, were highly resistant to lincomycin, and exhibited the same restriction pattern by pulsed-field gel electrophoresis. The outbreak ended after treatment with lincomycin was discontinued and hygiene control measures were implemented. PMID:9495676

  3. Wetland environmental conditions associated with the risk of avian cholera outbreaks and the abundance of Pasteurella multocida

    USGS Publications Warehouse

    Blanchong, Julie A.; Samuel, Michael D.; Goldberg, Diana R.; Shadduck, Daniel J.; Creekmore, L.H.

    2006-01-01

    Avian cholera is a significant infectious disease affecting waterfowl across North America and occurs worldwide among various avian species. Despite the importance of this disease, little is known about the factors that cause avian cholera outbreaks and what management strategies might be used to reduce disease mortality. Previous studies indicated that wetland water conditions may affect survival and transmission of Pasteurella multocida, the agent that causes avian cholera. These studies hypothesized that water conditions affect the likelihood that avian cholera outbreaks will occur in specific wetlands. To test these predictions, we collected data from avian cholera outbreak and non-outbreak (control) wetlands throughout North America (wintera??spring 1995a??1996 to 1998a??1999) to evaluate whether water conditions were associated with outbreaks. Conditional logistic regression analysis on paired outbreak and non-outbreak wetlands indicated no significant association between water conditions and the risk of avian cholera outbreaks. For wetlands where avian cholera outbreaks occurred, linear regression showed that increased eutrophic nutrient concentrations (Potassium [K], nitrate [NO3], phosphorus [P], and phosphate [PO3]) were positively related to the abundance of P. multocida recovered from water and sediment samples. Wetland protein concentration and an El Ni??o event were also associated with P. multocida abundance. Our results indicate that wetland water conditions are not strongly associated with the risk of avian cholera outbreaks; however, some variables may play a role in the abundance of P. multocida bacteria and might be important in reducing the severity of avian cholera outbreaks.

  4. Evaluating rehabilitation efforts following the Milford Flat Fire: successes, failures, and controlling factors

    USGS Publications Warehouse

    Duniway, Michael C.; Palmquist, Emily C.; Miller, Mark E.

    2015-01-01

    response to moister conditions, seeded forage species. These results suggest the post-fire rehabilitation efforts conducted in the lower elevation regions affected by the Milford Flat Fire were not generally successful. Though dry conditions are likely to blame for the lack of success, the low and variable precipitation characteristic of these regions suggest future post-fire rehabilitation decisions must assume that precipitation is going to be insufficient and plan rehabilitation efforts that are resilient to dry conditions.

  5. Surface Water Nutrient Budget Controlled by Vegetation Succession in the Deglaciating Copper River Basin, Southcentral Alaska

    NASA Astrophysics Data System (ADS)

    Tomco, P. L.; Zulueta, R. C.; Welker, J. M.

    2011-12-01

    In southcentral Alaska, rapid climate change is manifested by extensive recession of glaciers. This is accompanied by an acceleration of plant succession, as recently deglaciated landscapes evolve to form mature forests and wetlands over time. As ice melt exposes ancient labile nutrients, and as vegetation succession generates high ecosystem productivity, changes in the patterns of dissolved C and N transport from terrestrial to aquatic systems are hypothesized, with cascading impacts on in-river, estuarine and possibly ocean nutrient processing. The Copper River watershed, at 63,000 km2, is the largest drainage basin in the Gulf of Alaska, and derives the major portion of discharge from glacier melt. The commercial fishery based on returning salmon is valued at 25 million dollars, and with salmon return directly linked to phytoplankton blooms in the Gulf of Alaska, understanding nutrient delivery to the marine environment is vital in determining population dynamics of marine and freshwater organisms at all trophic levels. To make predictions about the evolution of terrestrial nutrient contributions to the Copper River, we employ a space-for-time substitution at two endmembers representative of glacial successional stages in the watershed: 1) Lakina River, a recently deglaciated ecosystem dominated by rocky glacial debris containing early successional vegetation species (Dryas, spp., Shepherdia spp., and Salix spp.), and 2) May Creek, a mature spruce-dominated forested ecosystem with surface water contributions from permafrost, snow melt, and precipitation. In addition, we attempted to determine the relative contribution of source water to May Creek via sampling of two nearby springs throughout the season. To determine the seasonality of each site's nutrient budget, we measured dissolved organic carbon (DOC), dissolved organic nitrogen (DON), soluble reactive phosphorus (SRP), δ18O, δD, conductivity, NH4-N, NO3-N, Fe (soluble and colloidal), and Si flux from grab

  6. High-Frequency Chest Wall Oscillation Successful in Controlling Refractory Asthma

    PubMed Central

    BOSE, SONALI; JUN, JONATHAN; DIETTE, GREGORY B.

    2016-01-01

    Introduction High-frequency chest wall oscillation (HFCWO) has been traditionally implemented for airway secretion clearance in conditions such as cystic fibrosis (CF) and bronchiectasis. There have been few reports of its use in refractory asthma. Case report A 36-year-old, non-smoker male presented with a lifelong history of poorly controlled asthma. Despite multiple controller medications, he reported daily chest congestion, copious phlegm, and frequent exacerbations. Imaging, blood work, and bronchoscopy ruled out atypical infections, immunodeficiency, CF, and other chronic conditions. Pulmonary function tests supported a diagnosis of asthma. Results We initiated HFCWO therapy twice daily in addition to standard inhaled pharmacological therapy. After 2 months, the patient noted resolution of respiratory symptoms as well as improvement in lung function. He remained symptom-free at his 2-year follow-up. Conclusion High-frequency chest oscillation may be useful in phenotypes of asthma characterized by prominent mucus hypersecretion. PMID:23394251

  7. Modeling effective transmission pathways and control of the world's most successful parasite.

    PubMed

    Turner, Matthew; Lenhart, Suzanne; Rosenthal, Benjamin; Zhao, Xiaopeng

    2013-06-01

    Toxoplasma gondii(T. gondii) is a single-celled, intracellular protozoan responsible for the disease toxoplasmosis. The parasite is prevalent worldwide, and it infects all warm-blooded vertebrates. Consumption of meats in which this parasite has encysted confers risk of infection to people and other animals, as does ingestion of water or foods contaminated with environmentally resistant oocysts excreted by cats. Vertical transmission (from mother to offspring) is also possible, leading to disease risk and contributing additional means of ensuring perpetuation of transmission. In this work, we adopt a differential equation model to investigate the effective transmission pathways of T. gondii, as well as potential control mechanisms. Detailed analyses are carried out to examine the significance of transmission routes, virulence, vertical transmission, parasite-induced changes in host behavior, and controls based on vaccination and harvesting. Modeling and analysis efforts may shed insights into understanding the complex life cycle of T. gondii. PMID:23624067

  8. Guidance for Schools on the Recent Flu Outbreak

    ERIC Educational Resources Information Center

    US Department of Education, 2009

    2009-01-01

    The document provides a transcript of a conference call moderated by Bill Modzeleski, Director of the Office of Safe and Drug-Free Schools. The focus of the call was the recent outbreak of swine flu in Mexico and the United States. Centers for Disease Control (CDC) actions and recommendations to the education community were discussed. A comparison…

  9. Sharing Data for Global Infectious Disease Surveillance and Outbreak Detection.

    PubMed

    Aarestrup, Frank M; Koopmans, Marion G

    2016-04-01

    Rapid global sharing and comparison of epidemiological and genomic data on infectious diseases would enable more rapid and efficient global outbreak control and tracking of diseases. Several barriers for global sharing exist but, in our opinion, the presumed magnitude of the problems appears larger than they are, and solutions can be found. PMID:26875619

  10. Ensuring Success of Adaptive Control Research Through Project Lifecycle Risk Mitigation

    NASA Technical Reports Server (NTRS)

    Pavlock, Kate M.

    2011-01-01

    Lessons Learne: 1. Design-out unnecessary risk to prevent excessive mitigation management during flight. 2. Consider iterative checkouts to confirm or improve human factor characteristics. 3. Consider the total flight test profile to uncover unanticipated human-algorithm interactions. 4. Consider test card cadence as a metric to assess test readiness. 5. Full-scale flight test is critical to development, maturation, and acceptance of adaptive control laws for operational use.

  11. Intervention Costs and Cost-Effectiveness of a Successful Telephonic Intervention to Promote Diabetes Control

    PubMed Central

    Schechter, Clyde B.; Cohen, Hillel W.; Shmukler, Celia; Walker, Elizabeth A.

    2012-01-01

    OBJECTIVE To characterize the costs and cost-effectiveness of a telephonic behavioral intervention to promote glycemic control in the Improving Diabetes Outcomes study. RESEARCH DESIGN AND METHODS Using the provider perspective and a time horizon to the end of the 1-year intervention, we calculate the costs of a telephonic intervention by health educators compared with an active control (print) intervention to improve glycemic control in adults with type 2 diabetes. We calculate the cost-effectiveness ratios for a reduction of one percentage point in hemoglobin A1c (A1C), as well as for one participant to achieve an A1C <7%. Base-case and sensitivity analysis results are presented. RESULTS The intervention cost $176.61 per person randomized to the telephone group to achieve a mean 0.36 percentage point of A1C improvement. The incremental cost-effectiveness ratio was $490.58 per incremental percentage point of A1C improvement and $2,617.35 per person over a 1-year intervention in achieving the A1C goal. In probabilistic sensitivity analysis, the median (interquartile range) of per capita cost, cost per percentage point reduction in A1C, and cost per person achieving the A1C goal of <7% are $175.82 (147.32–203.56), $487.75 (356.50–718.32), and $2,312.88 (1,785.58–3,220.78), respectively. CONCLUSIONS The costs of a telephonic intervention for diabetes self-management support are moderate and commensurate to the modest associated improvement in glycemic control. PMID:22851599

  12. Successful GP intervention with frequent attenders in primary care: randomised controlled trial

    PubMed Central

    Bellón, Juan Ángel; Rodríguez-Bayón, Antonina; de Dios Luna, Juan; Torres-González, Francisco

    2008-01-01

    Background Frequent attenders to GP clinics can place an unnecessary burden on primary care. Interventions to reduce frequent attendance have had mixed results. Aim To assess the effectiveness of a GP intervention to reduce frequent-attender consultations. Design of study Randomised controlled trial with frequent attenders divided into an intervention group and two control groups (one control group was seen by GPs also providing care to patients undergoing the intervention). Setting A health centre in southern Spain. Method Six GPs and 209 randomly-selected frequent attenders participated. Three GPs were randomly allocated to perform the new intervention: of the 137 frequent attenders registered with these three GPs, 66 were randomly allocated to receive the intervention (IG) and 71 to a usual care control group (CG2). The other three GPs offered usual care to the other 72 frequent attenders (CG1). The main outcome measure was the total number of consultations 1 year post-intervention. Baseline measurements were recorded of sociodemographic characteristics, provider–user interface, chronic illnesses, and psychosocial variables. GPs allocated to the new intervention received 15 hours' training which incorporated biopsychosocial, organisational, and relational approaches. After 1 year of follow-up frequent attenders were contacted. An intention-to-treat analysis was used. Results A multilevel model was built with three factors: time, patient, and doctor. After adjusting for covariates, the mean number of visits at 1 year in IG was 13.10 (95% confidence interval [CI] = 11.39 to 14.94); in the CG1 group was 19.37 (95% CI = 17.31 to 21.55); and in the CG2 group this was 16.72 (95% CI =14.84 to 18.72). Conclusion The new intervention with GPs resulted in a significant and relevant reduction in frequent-attender consultations. Although further trials are needed, this intervention is recommended to GPs interested in reducing consultations by their frequent attenders

  13. School Meal Programs: Few Outbreaks of Foodborne Illness Reported. Report to the Ranking Minority Member, Committee on Agriculture, Nutrition, and Forestry, U.S. Senate.

    ERIC Educational Resources Information Center

    Robertson, Robert E.

    Twenty outbreaks of foodborne illness in schools were reported to the Centers for Disease Control and Prevention (CDC) during 1997; however, only 8 cases were associated with food served in the school meal programs. Preliminary findings identified nine outbreaks in 1998, affecting an estimated 1,609 individuals. CDC notes that such outbreaks are…

  14. EFIS lecture. Immune response to tuberculosis: How to control the most successful pathogen on earth.

    PubMed

    Kaufmann, Stefan H E

    2016-07-01

    Tuberculosis (TB) remains a major health threat and general agreement exists that better control measures are needed. These include better diagnostics, drugs and vaccines. In particular, vaccines will be critical for better TB control. Based on knowledge about protective immunity against TB, a vaccine was created, VPM1002, which shows high protective efficacy and safety in experimental animal models. The vaccine has proven safe and immunogenic in human adults and neonates and is currently assessed in clinical trials in the context of HIV exposure. As a next step, a phase III efficacy trial in adults and a phase IIb efficacy trial in neonates are being planned. Biosignatures that differentially diagnose TB disease versus latent infection with high sensitivity and specificity have been designed. Most recently, a prognostic biosignature which predicts progression from latent infection to active TB has been identified. Biosignatures are not only of great value for improved diagnosis and prognosis of TB, they can also provide guidelines for better understanding of molecular mechanisms underlying disease. Accordingly, distinct biomarkers of diagnostic and prognostic value but of unknown biological function are being characterized functionally. In this way, deeper insights have been obtained on the role of type I interferon and of neutrophils in TB in experimental animal models of TB. In conclusion, clinical and basic research further supported by computational biology can complement each other in the pursuit of knowledge-based development of improved intervention measures for TB control. PMID:27181094

  15. Controlling water pollution in developing and transition countries--lessons from three successful cases.

    PubMed

    Kathuria, Vinish

    2006-03-01

    The policy prescription for solving environmental problems of developing countries and countries-in-transition (CIT) is slowly getting polarized into two viewpoints. One group of researchers and policy advocates including multilateral organizations upholds extensive use of market based instruments (MBIs) in these countries. The other group argues that institutions need to be built first or the policy makers should select the incremental or tiered approach taking into account the existing capabilities. The group also insists that the financial, institutional and political constraints make environmental regulation in these countries more problematic than in industrialized countries. In the short-run, the immediate needs of the developing countries can be addressed effectively by learning lessons from the difficulties encountered by a few successful cases and accordingly evolving an appropriate policy instrument. In this paper an attempt has been made to highlight three such cases from three different parts of the world--Malaysia (Asia-pacific), Poland (Eastern Europe) and Colombia (Latin America). The paper looks into what policy instruments led to a fall in water pollution levels in these countries and what role did MBIs play in this pollution mitigation? The case studies suggest that it is a combination of instruments--license fee, standards, charge and subsidies--reinforced by active enforcement that led to an overall improvement in environment compliance. PMID:16171929

  16. Collaboration between infection control and occupational health in three continents: a success story with international impact.

    PubMed

    Yassi, Annalee; Bryce, Elizabeth A; Breilh, Jaime; Lavoie, Marie-Claude; Ndelu, Lindiwe; Lockhart, Karen; Spiegel, Jerry

    2011-01-01

    Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work.The products developed have been widely heralded as innovative and interactive, leading to their inclusion into "toolkits" used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between occupational

  17. Collaboration between infection control and occupational health in three continents: a success story with international impact

    PubMed Central

    2011-01-01

    Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work. The products developed have been widely heralded as innovative and interactive, leading to their inclusion into “toolkits” used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between

  18. Outbreak of Mycoplasma pneumoniae–Associated Stevens-Johnson Syndrome

    PubMed Central

    Watkins, Louise K. Francois; Demirjian, Alicia; Lin, Xia; Robinson, Christine C.; Pretty, Kristin; Benitez, Alvaro J.; Winchell, Jonas M.; Diaz, Maureen H.; Miller, Lisa A.; Foo, Teresa A.; Mason, Melanie D.; Lauper, Ursula L.; Kupfer, Oren; Kennedy, Jeffrey; Glodé, Mary P.; Kutty, Preeta K.; Dominguez, Samuel R.

    2015-01-01

    BACKGROUND: Stevens-Johnson syndrome (SJS) is an uncommon, sporadic disease and outbreaks are rare. In November 2013, an outbreak of SJS was identified at Children’s Hospital Colorado. METHODS: Outbreak cases were children aged 5–21 with a discharge diagnosis of SJS admitted from September 1 to November 30, 2013. Medical charts were reviewed using standardized data collection forms. Respiratory specimens were tested for viruses and Mycoplasma pneumoniae (Mp) by polymerase chain reaction (PCR). We conducted a separate 4-year retrospective case-control study comparing hospitalized SJS cases with and without evidence of Mp infection. RESULTS: During the outbreak, 8 children met SJS criteria. Median age was 11.5 years (range 8–16 years); 5 (63%) were boys and 5 (63%) were Mp-PCR–positive. Of the 5 PCR-positive children, none had preceding medication exposure, and all had radiographic pneumonia. All outbreak Mp isolates were macrolide susceptible. The retrospective case-control analysis showed that Mp-associated SJS episodes (n = 17) were more likely to have pneumonia (odds ratio [OR] 10.0, confidence interval [CI] 1.3–5.1), preceding respiratory symptoms (OR 30.0, CI 1.6–72.6), an erythrocyte sedimentation rate ≥35 mg/dL (OR 22.8, CI 2.1–244.9), and ≤3 affected skin sites (OR 4.5, CI 1.2–17.4) than non–Mp-associated SJS episodes (n = 23). CONCLUSIONS: We report the largest outbreak of SJS in children, which was also predominately associated with Mp infection. Mp-associated SJS was associated with a distinct clinical presentation that included less extensive skin disease, an elevated erythrocyte sedimentation rate, and evidence of a preceding respiratory infection. PMID:26216320

  19. Ebola virus outbreak, updates on current therapeutic strategies.

    PubMed

    Elshabrawy, Hatem A; Erickson, Timothy B; Prabhakar, Bellur S

    2015-07-01

    Filoviruses are enveloped negative-sense single-stranded RNA viruses, which include Ebola and Marburg viruses, known to cause hemorrhagic fever in humans with a case fatality of up to 90%. There have been several Ebola virus outbreaks since the first outbreak in the Democratic Republic of Congo in 1976 of which, the recent 2013-2015 epidemic in Guinea, Liberia, and Sierra Leone is the largest in recorded history. Within a few months of the start of the outbreak in December 2013, thousands of infected cases were reported with a significant number of deaths. As of March 2015, according to the Centers for Disease Control and Prevention, there have been nearly 25,000 suspected cases, with 15,000 confirmed by laboratory testing, and over 10,000 deaths. The large number of cases and the high mortality rate, combined with the lack of effective Food and Drug Administration-approved treatments, necessitate the development of potent and safe therapeutic measures to combat the current and future outbreaks. Since the beginning of the outbreak, there have been considerable efforts to develop and characterize protective measures including vaccines and antiviral small molecules, and some have proven effective in vitro and in animal models. Most recently, a cocktail of monoclonal antibodies has been shown to be highly effective in protecting non-human primates from Ebola virus infection. In this review, we will discuss what is known about the nature of the virus, phylogenetic classification, genomic organization and replication, disease transmission, and viral entry and highlight the current approaches and efforts, in the development of therapeutics, to control the outbreak. PMID:25962887

  20. Strategies to Mitigate a Mycobacterium marinum Outbreak in a Zebrafish Research Facility

    PubMed Central

    Snell, Kathy; Mittge, Erika; Melancon, Ellie; Montgomery, Rebecca; McFadden, Marcie; Camoriano, Javier; Kent, Michael L.; Whipps, Christopher M.; Peirce, Judy

    2016-01-01

    Abstract In 2011, the zebrafish research facility at the University of Oregon experienced an outbreak of Mycobacterium marinum that affected both research fish and facility staff. A thorough review of risks to personnel, the zebrafish veterinary care program, and zebrafish husbandry procedures at the research facility followed. In the years since 2011, changes have been implemented throughout the research facility to protect the personnel, the fish colony, and ultimately the continued success of the zebrafish model research program. In this study, we present the history of the outbreak, the changes we implemented, and recommendations to mitigate pathogen outbreaks in zebrafish research facilities. PMID:27351618

  1. Control of secondary instability of the crossflow and Görtler-like vortices (Success and problems)

    NASA Astrophysics Data System (ADS)

    Kozlov, Viktor V.; Grek, Genrich R.

    The secondary instability on a group of crossflow vortices developing in a swept wing boundary layer is described. It is shown that, for travelling waves, there is a region of linear development, and the growth rate of disturbances appreciably depends on the separation between the vortices. Methods of controlling the secondary instability of the vortices by a controlled wave and local suction are proposed and substantiated. The stability of a flat plate boundary layer modulated by G&ou ml;rtler-like stationary vortices is described. Vortices were generated inside the boundary layer by means of roughness elements arranged in a regular array along the spanwise (z) direction. Transition is not caused directly by these structures, but by the growth of small amplitude travelling waves riding on top of the steady vortices. This situation is analogous to the transition process in Görtler and cross-flows. The waves were found to amplify up to a stage where higher harmonics are gener ated, leading to turbulent breakdown and disintegration of the spanwise boundary layer structure. For strong modulations, the observed instability is quite powerful, and can be excited "naturally" by small uncontrollable background disturbances. Controlled oscillations were then introduced by means of a vibrating ribbon, allowing a detailed investigation of the wave characteristics. The instability seems to be associated with the spanwise gradients of the mean flow, , and at all z-positions, the maximum wave amplitude was found at a wall-normal position where the mean velocity is equal to the phase velocity of the wave, U(y)=c, i.e., at the local critical layer. Unstable waves were observed at frequency well above those for which Tollmien-Schlichting (TS) waves amplify in the Blasius boundary layer. Excitation at lower frequencies and milder basic flow modulation showed that TS-type waves may a lso develop. Study of the transition control in that flow by means of riblets shows that the effect

  2. Investigation of vancomycin resistant Enterococcus faecium outbreak in neonatal intensive care unit

    PubMed Central

    Cilo, Burcu Dalyan; Ağca, Harun; Efe, Kadir; Sınırtaş, Melda; Çelebi, Solmaz; Özkan, Hilal; Köksal, Nilgün; Hacımustafaoğlu, Mustafa; Özakın, Cüneyt

    2014-01-01

    Enterococci are one of the major agents of community-acquired and nosocomial infections. In this study we aimed to analyze the clonal relation of the vancomycin-resistant Enterococci outbreak seen at the Neonate Intensive Care Unit (NICU) of Uludag University Hospital. Vancomycin resistance gene was investigated in the Enterococcus faecium strains and pulsed field gel electrophoresis (PFGE) was used to investigate the genetic relation between outbreak strains. Enterococci grown in all patient samples were identified as Enterococcus faecium by BD Phoenix 100 (Becton Dickinson, USA). We found vanA resistance gene in all of the swab samples by Xpert VanA/B test on Cepheid (Cepheid, USA). PFGE band patterns revealed two different strains, of which the majority of them (22/24) had the same clonal origin. The common clonal origin was also isolated from rectal probes. Perianal swab culture positivity was evaluated as colonization but culture growth in two blood cultures, two urine cultures and one wound culture was evaluated as infection and treated with linezolid. All of the patients survived the outbreak. Besides the infection control precautions determining the genetic relation between outbreak strains which can be done in the microbiology laboratory is necessary to control an outbreak. PFGE is a reliable method in the microbiologic analysis of outbreaks. Molecular microbiologic analysis of outbreak strains will contribute to prove the epidemiologic and evolution of outbreaks. PMID:25664041

  3. Foodborne disease outbreaks of chemical etiology in the United States, 1970-1974.

    PubMed

    Hughes, J M; Horwitz, M A; Merson, M H; Barker, W H; Gangarosa, E J

    1977-03-01

    In the United States between 1970 and 1974 there was an increase each year both in the absolute number of foodborne diseases outbreaks of chemical etiology reported to the Center for Disease Control and in the proportion of these outbreaks in the total reported foodborne disease outbreaks. Nearly half (48.9%) of these foodborne disease outbreaks of chemical origin were caused by toxic fish or shellfish. Of the rest, 16.5% were caused by poisonous mushrooms, 10.9% by heavy metal poisoning, 7.2% by excessive use in food of monosodium glutamate (the etiologic agent of Chinese Restaurant Syndrome) and 16.5% by miscellaneous chemicals. Practices that contributed to the occurrence of these outbreaks included the inadvertent selection for consumption of toxic fish, shellfish, or mushrooms, storage of fish at improper temperatures, storage of acidic liquids in metal containers, and addition of excessive amounts of monosodium glutamate to foods. Commercially-processed foods were responsible for outbreaks of scombroid fish poisoning, shellfish poisoning, and heavy metal poisoning. Because outbreaks of chemical etiology due to contaminated commercial products do occur, prompt recognition and reporting of outbreaks to public health personnel are essential so that epidemiologic investigations can be conducted and effective control measures promptly initiated. PMID:557897

  4. Modulating prefrontal control in humans reveals distinct pathways to competitive success and collective waste.

    PubMed

    De Dreu, Carsten K W; Kret, Mariska E; Sligte, Ilja G

    2016-08-01

    Competitive decision making may require controlling and calculative mind-sets. We examined this possibility in repeated predator-prey contests by up- or down-regulating the individual's right inferior frontal gyrus (rIFG), a brain region involved in impulse inhibition and mentalizing. Following brain stimulation, subjects invested as predator or prey against a non-treated antagonist. Relative to sham-treatment (i) prey-defense was relatively frequent, strong and unaffected by stimulation, (ii) down-regulating predator rIFG produced a high-firing strategy-predators earned more because they attacked more frequently, while (iii) up-regulating predator rIFG produced a track-and-attack strategy-predators earned more because they attacked especially when their (non-stimulated) antagonist lowered its prey-defense. Results suggest that calculative mindsets are not needed to compete effectively, especially not when the goal is to survive. Enhanced prefrontal control enables individuals to appear less aggressive without sacrificing competitive effectiveness-it provides human predators with an iron fist in a velvet glove. PMID:27036875

  5. Remotely Controlled Mandibular Protrusion during Sleep Predicts Therapeutic Success with Oral Appliances in Patients with Obstructive Sleep Apnea

    PubMed Central

    Remmers, John; Charkhandeh, Shouresh; Grosse, Joshua; Topor, Zbigniew; Brant, Rollin; Santosham, Peter; Bruehlmann, Sabina

    2013-01-01

    Study Objectives: The present study addresses the need for a validated tool that prospectively identifies favorable candidates for oral appliance therapy in treatment of obstructive sleep apnea. The objective of the study was to evaluate the ability of a mandibular titration study, performed with a remotely controlled mandibular positioner (RCMP), to predict treatment outcome with a mandibular repositioning appliance (MRA) and to predict an effective target protrusive position (ETPP). Design: A prospective, blinded, outcome study. Setting: Standard clinical care with tests performed in the polysomnographic laboratory. Participants: Consecutive patients (n = 67) recruited from a sleep center or a dental practice using broad inclusion criteria (age 21-80 years; AHI > 10/h; BMI < 40 kg/m2). Interventions: Therapeutic outcome with a mandibular protruding oral appliance was predicted following a mandibular protrusive titration study in the polysomnographic laboratory using a remotely controlled positioner and prospectively established predictive rules. An ETPP was also prospectively determined for participants predicted to be therapeutically successful with MRA therapy. All participants were blindly treated with a MRA, at either the predicted ETPP or a sham position, and therapeutic outcome was compared against prediction. Measurements and Results: At the final protrusive position, standard predictive parameters (sensitivity, specificity, positive and negative predictive values) showed statistically significant predictive accuracy (P < 0.05) in the range of 83% to 94%. The predicted ETPP provided an efficacious protrusive position in 87% of participants predicted to be therapeutically successful with MRA therapy (P < 0.05). Conclusions: Using prospectively established rules for interpreting the polysomnographic data, the mandibular titration study predicted mandibular repositioning appliance therapeutic outcome with significant accuracy, particularly with regard to

  6. The biopharmaceutics of successful controlled release drug product: Segmental-dependent permeability of glipizide vs. metoprolol throughout the intestinal tract.

    PubMed

    Zur, Moran; Cohen, Noa; Agbaria, Riad; Dahan, Arik

    2015-07-15

    The purpose of this work was to study the challenges and prospects of regional-dependent absorption in a controlled-release scenario, through the oral biopharmaceutics of the sulfonylurea antidiabetic drug glipizide. The BCS solubility class of glipizide was determined, and its physicochemical properties and intestinal permeability were thoroughly investigated, both in-vitro (PAMPA and Caco-2) and in-vivo in rats. Metoprolol was used as the low/high permeability class boundary marker. Glipizide was found to be a low-solubility compound. All intestinal permeability experimental methods revealed similar trend; a mirror image small intestinal permeability with opposite regional/pH-dependency was obtained, a downward trend for glipizide, and an upward trend for metoprolol. Yet the lowest permeability of glipizide (terminal Ileum) was comparable to the lowest permeability of metoprolol (proximal jejunum). At the colon, similar permeability was evident for glipizide and metoprolol, that was higher than metoprolol's jejunal permeability. We present an analysis that identifies metoprolol's jejunal permeability as the low/high permeability class benchmark anywhere throughout the intestinal tract; we show that the permeability of both glipizide and metoprolol matches/exceeds this threshold throughout the entire intestinal tract, accounting for their success as controlled-release dosage form. This represents a key biopharmaceutical characteristic for a successful controlled-release dosage form. PMID:25957705

  7. “Save Antibiotics, Save lives”: an Indian success story of infection control through persuasive diplomacy

    PubMed Central

    2012-01-01

    Background Carbapenem resistant Enterobacteriaceae is a worldwide threat, with increasing prevalence in many countries. Restricted usage of higher end antibiotics, especially carbapenem is of great importance in tackling these super bugs. Purpose of this retrospective study was to analyse the impact of antibiotic stewardship activities on the prevalence of carbapenem resistant Enterobacteriaceae in our hospital. Findings In the first Quarter of 2009, average usage of carbapenem group of antibiotics was 955 vials a month while in 2010, the usage dropped to 745 vials per month. Carbapenem resistant E.coli rate dropped from 3.7% in 2009 to 1.6% in 2010 and Klebsiella rate reduced from 6% in 2009 to 3.6% in 2010. Conclusions Strict antibiotic stewardship strategies in conjunction with good infection control practices are useful in restricting higher end antibiotic usage and reducing the prevalence of carbapenem resistant Enterobacteriaceae. PMID:22958711

  8. Air quality control in the ART laboratory is a major determinant of IVF success

    PubMed Central

    Esteves, Sandro C; Bento, Fabiola C

    2016-01-01

    A recently published article described how a fertility center in the United States implemented air quality control to newly designed in vitro fertilization (IVF) laboratory.1 A highly-efficient air filtration was achieved by installing a centered system supplying filtered air to the IVF laboratory and related critical areas, combining air particulate and volatile organic compound (VOC) filtration. As a consequence, live birth rates were increased by improvements in air quality. This article highlights the key aspects of air contamination in the IVF context. The topic is important not only to IVF specialists but also to Andrologists due to the great number of male infertility patients referred to assisted reproductive technology (ART) treatments. The evidence is growing that laboratory air quality is paramount importance for improved IVF outcome. PMID:26585700

  9. Malaria Control and Elimination in Sri Lanka: Documenting Progress and Success Factors in a Conflict Setting

    PubMed Central

    Abeyasinghe, Rabindra R.; Galappaththy, Gawrie N. L.; Smith Gueye, Cara; Kahn, James G.; Feachem, Richard G. A.

    2012-01-01

    Background Sri Lanka has a long history of malaria control, and over the past decade has had dramatic declines in cases amid a national conflict. A case study of Sri Lanka's malaria programme was conducted to characterize the programme and explain recent progress. Methods The case study employed qualitative and quantitative methods. Data were collected from published and grey literature, district-level and national records, and thirty-three key informant interviews. Expenditures in two districts for two years – 2004 and 2009 – were compiled. Findings Malaria incidence in Sri Lanka has declined by 99.9% since 1999. During this time, there were increases in the proportion of malaria infections due to Plasmodium vivax, and the proportion of infections occurring in adult males. Indoor residual spraying and distribution of long-lasting insecticide-treated nets have likely contributed to the low transmission. Entomological surveillance was maintained. A strong passive case detection system captures infections and active case detection was introduced. When comparing conflict and non-conflict districts, vector control and surveillance measures were maintained in conflict areas, often with higher coverage reported in conflict districts. One of two districts in the study reported a 48% decline in malaria programme expenditure per person at risk from 2004 to 2009. The other district had stable malaria spending. Conclusions/Significance Malaria is now at low levels in Sri Lanka – 124 indigenous cases were found in 2011. The majority of infections occur in adult males and are due to P. vivax. Evidence-driven policy and an ability to adapt to new circumstances contributed to this decline. Malaria interventions were maintained in the conflict districts despite an ongoing war. Sri Lanka has set a goal of eliminating malaria by the end of 2014. Early identification and treatment of infections, especially imported ones, together with effective surveillance and response, will

  10. An outbreak of scarlet fever in a primary school.

    PubMed

    Lamden, K H

    2011-04-01

    Scarlet fever, due to infection with an erythrogenic toxin-producing Group A streptococcus, is an uncommon and generally mild illness, although serious sequelae do occur. In March 2009, 57 of the 126 (45%) pupils in a primary school in Lancashire, UK developed scarlet fever over a 4-week period. Infection was transmitted via direct contact between pupils, particularly among the youngest pupils. A significant degree of transmission also occurred between siblings. The median number of days absent from school was 3 (range 1-10 days). No children were hospitalised. Control measures, including hygiene advice to the school and exclusion of pupils for 24h while initiating penicillin treatment, were ineffective. The outbreak occurred against a background of an unusually high incidence of invasive Group A streptococcal infection. While there are national guidelines for the control of invasive disease, none exist for the control of scarlet fever outbreaks. This prolonged outbreak of scarlet fever highlights the need for an evidence based approach to outbreak management. PMID:21068078

  11. Impact of climate change on larch budmoth cyclic outbreaks.

    PubMed

    Iyengar, Sudharsana V; Balakrishnan, Janaki; Kurths, Jürgen

    2016-01-01

    Periodic outbreaks of the larch budmoth Zeiraphera diniana population (and the massive forest defoliation they engender) have been recorded in the Alps over the centuries and are known for their remarkable regularity. But these have been conspicuously absent since 1981. On the other hand, budmoth outbreaks have been historically unknown in the larches of the Carpathian Tatra mountains. To resolve this puzzle, we propose here a model which includes the influence of climate and explains both the 8-9 year periodicity in the budmoth cycle and the variations from this, as well as the absence of cycles. We successfully capture the observed trend of relative frequencies of outbreaks, reproducing the dominant periodicities seen. We contend that the apparent collapse of the cycle in 1981 is due to changing climatic conditions following a tipping point and propose the recurrence of the cycle with a changed periodicity of 40 years - the next outbreak could occur in 2021. Our model also predicts longer cycles. PMID:27293118

  12. Impact of climate change on larch budmoth cyclic outbreaks

    PubMed Central

    Iyengar, Sudharsana V.; Balakrishnan, Janaki; Kurths, Jürgen

    2016-01-01

    Periodic outbreaks of the larch budmoth Zeiraphera diniana population (and the massive forest defoliation they engender) have been recorded in the Alps over the centuries and are known for their remarkable regularity. But these have been conspicuously absent since 1981. On the other hand, budmoth outbreaks have been historically unknown in the larches of the Carpathian Tatra mountains. To resolve this puzzle, we propose here a model which includes the influence of climate and explains both the 8–9 year periodicity in the budmoth cycle and the variations from this, as well as the absence of cycles. We successfully capture the observed trend of relative frequencies of outbreaks, reproducing the dominant periodicities seen. We contend that the apparent collapse of the cycle in 1981 is due to changing climatic conditions following a tipping point and propose the recurrence of the cycle with a changed periodicity of 40 years – the next outbreak could occur in 2021. Our model also predicts longer cycles. PMID:27293118

  13. Genomics and outbreaks: foot and mouth disease.

    PubMed

    Freimanis, G L; Di Nardo, A; Bankowska, K; King, D J; Wadsworth, J; Knowles, N J; King, D P

    2016-04-01

    Foot and mouth disease virus (FMDV) is an animal pathogen of global economic significance. Identifying the sources of outbreaks plays an important role in disease control; however, this can be confounded by the ease with which FMDV can spread via movement of infected livestock and animal products, aerosols or fomites, e.g. contaminated persons and objects. As sequencing technologies have advanced, this review highlights the uses of viral genomic data in helping to understand the global distribution and transboundary movements of FMDV, and the role that these approaches have played in control and surveillance programmes. The recent application of next-generation sequencing platforms to address important epidemiological and evolutionary challenges is discussed with particular reference to the advent of 'omics' technologies. PMID:27217177

  14. OutbreakTools: A new platform for disease outbreak analysis using the R software

    PubMed Central

    Jombart, Thibaut; Aanensen, David M.; Baguelin, Marc; Birrell, Paul; Cauchemez, Simon; Camacho, Anton; Colijn, Caroline; Collins, Caitlin; Cori, Anne; Didelot, Xavier; Fraser, Christophe; Frost, Simon; Hens, Niel; Hugues, Joseph; Höhle, Michael; Opatowski, Lulla; Rambaut, Andrew; Ratmann, Oliver; Soubeyrand, Samuel; Suchard, Marc A.; Wallinga, Jacco; Ypma, Rolf; Ferguson, Neil

    2014-01-01

    The investigation of infectious disease outbreaks relies on the analysis of increasingly complex and diverse data, which offer new prospects for gaining insights into disease transmission processes and informing public health policies. However, the potential of such data can only be harnessed using a number of different, complementary approaches and tools, and a unified platform for the analysis of disease outbreaks is still lacking. In this paper, we present the new R package OutbreakTools, which aims to provide a basis for outbreak data management and analysis in R. OutbreakTools is developed by a community of epidemiologists, statisticians, modellers and bioinformaticians, and implements classes and methods for storing, handling and visualizing outbreak data. It includes real and simulated outbreak datasets. Together with a number of tools for infectious disease epidemiology recently made available in R, OutbreakTools contributes to the emergence of a new, free and open-source platform for the analysis of disease outbreaks. PMID:24928667

  15. A large outbreak of salmonellosis associated with sandwiches contaminated with multiple bacterial pathogens purchased via an online shopping service.

    PubMed

    Wei, Sung-Hsi; Huang, Angela S; Liao, Ying-Shu; Liu, Yu-Lun; Chiou, Chien-Shun

    2014-03-01

    Food sold over the internet is an emerging business that also presents a concern with regard to food safety. A nationwide foodborne disease outbreak associated with sandwiches purchased from an online shop in July 2010 is reported. Consumers were telephone interviewed with a structured questionnaire and specimens were collected for etiological examination. A total of 886 consumers were successfully contacted and completed the questionnaires; 36.6% had become ill, with a median incubation period of 18 h (range, 6-66 h). The major symptoms included diarrhea (89.2%), abdominal pain (69.8%), fever (47.5%), headache (32.7%), and vomiting (17.3%). Microbiological laboratories isolated Salmonella enterica serovar Enteritidis, Salmonella Virchow, Staphylococcus aureus, Bacillus cereus, and enterotoxigenic Escherichia coli from the contaminated sandwiches, Salmonella Enteritidis and Salmonella Virchow from the patients, and Salmonella Enteritidis and Staphylococcus aureus from food handlers. Pulsed-field gel electrophoresis genotyping suggested a common origin of Salmonella bacteria recovered from the patients, food, and a food handler. Among the pathogens detected, the symptoms and incubation period indicated that Salmonella, likely of egg origin, was the probable causative agent of the outbreak. This outbreak illustrates the importance of meticulous hygiene practices during food preparation and temperature control during food shipment and the food safety challenges posed by online food-shopping services. PMID:24313786

  16. A Large Outbreak of Salmonellosis Associated with Sandwiches Contaminated with Multiple Bacterial Pathogens Purchased via an Online Shopping Service

    PubMed Central

    Wei, Sung-Hsi; Huang, Angela S.; Liao, Ying-Shu; Liu, Yu-Lun

    2014-01-01

    Abstract Food sold over the internet is an emerging business that also presents a concern with regard to food safety. A nationwide foodborne disease outbreak associated with sandwiches purchased from an online shop in July 2010 is reported. Consumers were telephone interviewed with a structured questionnaire and specimens were collected for etiological examination. A total of 886 consumers were successfully contacted and completed the questionnaires; 36.6% had become ill, with a median incubation period of 18 h (range, 6–66 h). The major symptoms included diarrhea (89.2%), abdominal pain (69.8%), fever (47.5%), headache (32.7%), and vomiting (17.3%). Microbiological laboratories isolated Salmonella enterica serovar Enteritidis, Salmonella Virchow, Staphylococcus aureus, Bacillus cereus, and enterotoxigenic Escherichia coli from the contaminated sandwiches, Salmonella Enteritidis and Salmonella Virchow from the patients, and Salmonella Enteritidis and Staphylococcus aureus from food handlers. Pulsed-field gel electrophoresis genotyping suggested a common origin of Salmonella bacteria recovered from the patients, food, and a food handler. Among the pathogens detected, the symptoms and incubation period indicated that Salmonella, likely of egg origin, was the probable causative agent of the outbreak. This outbreak illustrates the importance of meticulous hygiene practices during food preparation and temperature control during food shipment and the food safety challenges posed by online food–shopping services. PMID:24313786

  17. The most successful method in teaching nursing students infection control - E-learning or lecture?

    PubMed

    Reime, Marit Hegg; Harris, Anette; Aksnes, June; Mikkelsen, Jane

    2008-10-01

    Approximately 33% of all health care-associated infections are preventable. It is therefore important to provide training for nursing students about this topic. In collaboration with the local hospital, the Department of Nursing evaluated a newly developed e-learning program on infection control normally used among employees in the hospital but now tried in the setting of bachelor students. The students received learning goals for the course and were divided into two groups: one group used the e-learning program, and the other group had 3-h-long lectures. After the course they took a multiple-choice test. In addition, three focus groups were established. The students were satisfied with both teaching approaches. The lectures provided a good introduction to the recommended reading. The e-learning program was rated as good on design, academic content, and the integrated tests were motivating for their learning. Specific learning goals were found to be useful. Gender and age, depending on the teaching approach used, were significant in determining the results of the test, the same were the number of sources used in preparing for the test. E-learning has to be viewed as a resource in the same way as a lecture. It is important that the students are competent in ICT, because they will need to use this tool in their clinical practice. In addition, a degree level course needs to use many different teaching methods to achieve goals related to in-depth and superficial learning. PMID:18442872

  18. Influence of visual feedback on successive control mechanisms in upright quiet stance in humans assessed by fractional Brownian motion modelling.

    PubMed

    Rougier, P

    1999-05-14

    An up-to-date way to model the centre of pressure (CP) trajectories may consist in using fractional Brownian motion (fBm). By doing so, one may note that standing still is in fact controlled by two separate and successive mechanisms. The point raised in this study concerns the nature of these control mechanisms and their level of interaction. Following this idea, visual feedback (VFB), which is known to affect postural control by significantly decreasing sway magnitudes, was used. Twelve healthy adults, instructed to stand as still as possible, were tested under this VFB protocol (via a PC screen). In order to model the CP trajectories as fBm, variograms (mean square distances, MSD, expressed as a function of increasing time intervals deltat) were bi-logarithmically plotted. The main visual effect of VFB on these variograms concerns longest latency scaling regimes which reveal less stochastic and consequently more accurate control (P < 0.05 and P < 0.01 for X and Y components, respectively). An increase in the MSD of the transition point, which corresponds to the switch between the two control mechanisms, is also noted (P < 0.05). Overall, evidence is provided from this data that long latency scaling regimes do operate through a feedback process. Interestingly, this improved determinism in feedback control in turn induces a similar effect on the control operating over the shortest deltat. Thus, by privileging a control strategy based on feedback mechanisms, VFB in turn would make the subjects quicker in their initial displacement in order to reach a position capable of initiating a feedback mechanism. PMID:10465697

  19. Detection and response to a meningococcal disease outbreak following a youth football tournament with teams from four European countries.

    PubMed

    Reintjes, Ralf; Kistemann, Thomas; MacLehose, Laura; McKee, Martin; Gill, Noel; Weinberg, Julius; Schaefer, Oliver; Camaroni, Ivonne; Fulop, Naomi; Brand, Helmut

    2002-05-01

    An outbreak of meningococcal disease, caused by Neisseria meningitidis, occurred following an international youth football tournament in the summer of 1997, affecting individuals from four European countries. This paper describes the outbreak, focusing on international co-operation in detection, investigation, control and follow-up, identifying weaknesses and exploring opportunities for improved co-operation. Data came from interviews, reports and related documents. The detection and management of the outbreak in each country is analysed. Eleven cases were linked to this outbreak and serotyped as C:2a:P1.5. Control measures varied in each country, reflecting different national guidelines. The outbreak illustrated deficiencies in management of international outbreaks but also demonstrated benefits of international co-operation. PMID:12068748

  20. Rubella outbreak in the union territory of Chandigarh, North India.

    PubMed

    Singh, Mini P; Kumar, Archit; Gautam, Neha; Khurana, Jasmine; Gupta, Madhu; Ratho, Radha Kanta

    2015-02-01

    Rubella virus outbreaks usually occur when a large numbers of susceptible individuals accumulate. The disease presents clinically with fever and maculopapular rash. The present study reports the investigation of rubella outbreak in a modern and well-planned village near Chandigarh, North India. The blood samples were collected from 39 cases with febrile rash and from 15 age and sex matched healthy controls residing in the same locality and subjected for the detection of Rubella IgM and IgG antibodies by Enzyme linked immunosorbent assay. The throat swabs, urine and blood samples from acute cases were also collected and subjected to RT-PCR using the primers targeting the E1 region. The genetic characterization of the rubella virus was carried out to identify the circulating genotypes. In the present outbreak, 13 laboratory confirmed cases were reported. Rubella IgM antibodies were detected in 12/39 (30.7%) patients. Rubella RNA could be detected in 83.3% (5/6) of urine, 22.2% (2/9) of throat swabs, and 8.3% (1/12) of blood samples. The rubella genotype responsible for the present outbreak was identified as genotype 1a. This outbreak highlights the need for the introduction of rubella vaccine in the National Immunization Programme of India to prevent outbreaks and to aim towards the eradication of this disease. This study reports the presence of genotype 1a in North India for the first time and stresses the need for further molecular work to identify the circulating strains of the virus. PMID:25156964

  1. An acute gastroenteritis outbreak caused by GII.17 norovirus in Jiangsu Province, China.

    PubMed

    Shi, Chao; Feng, Wei-Hong; Shi, Ping; Ai, Jing; Guan, Hong-Xia; Sha, Dan; Geng, Qian; Mei, Jun; Chen, Shan-Hui; Xiao, Yong; Qian, Yan-Hua

    2016-08-01

    Noroviruses are a common cause of acute gastroenteritis around the world; however, reports of outbreaks caused by GII.17 norovirus are rare. An outbreak caused by GII.17 norovirus in a senior high school in Wuxi, Jiangsu Province, China is reported here. An epidemiological investigation, pathogen detection, and case-control study were performed. Epidemiological data combined with the epidemic curve indicated that this outbreak was a point source type initially, followed by secondary transmission. The first case was identified as most likely the source of the outbreak. Risk analysis showed exposure to patients and sharing a communal water cooler to be associated with the spread of infection. Sequence analysis of GII-positive samples confirmed that the norovirus GII.17 variant was the etiological agent of this outbreak. PMID:27224012

  2. A Call to Action to Enhance Filovirus Disease Outbreak Preparedness and Response

    PubMed Central

    Roddy, Paul

    2014-01-01

    The frequency and magnitude of recognized and declared filovirus-disease outbreaks have increased in recent years, while pathogenic filoviruses are potentially ubiquitous throughout sub-Saharan Africa. Meanwhile, the efficiency and effectiveness of filovirus-disease outbreak preparedness and response efforts are currently limited by inherent challenges and persistent shortcomings. This paper delineates some of these challenges and shortcomings and provides a proposal for enhancing future filovirus-disease outbreak preparedness and response. The proposal serves as a call for prompt action by the organizations that comprise filovirus-disease outbreak response teams, namely, Ministries of Health of outbreak-prone countries, the World Health Organization, Médecins Sans Frontières, the Centers for Disease Control and Prevention—Atlanta, and others. PMID:25271875

  3. Nigerian response to the 2014 Ebola viral disease outbreak: lessons and cautions

    PubMed Central

    Oleribe, Obinna Ositadimma; Crossey, Mary Margaret Elizabeth; Taylor-Robinson, Simon David

    2015-01-01

    The Ebola virus disease outbreak that initially hit Guinea, Liberia and Senegal in 2014 was projected to affect Nigeria very badly when the first case was reported in July 2014. However, the outbreak was effectively and swiftly contained with only eight deaths out of 20 cases, confounding even the most optimistic predictions of the disease modelers. A combination of health worker and public education, a coordinated field epidemiology and laboratory training program (with prior experience in disease outbreak control in other diseases) and effective set-up of emergency operations centers were some of the measures that helped to confound the critics and contain what would have been an otherwise deadly outbreak in a densely populated country with a highly mobile population. This article highlights the measures taken in Nigeria and looks to the translatable lessons learnt for future disease outbreaks, whether that be from the Ebola virus or other infectious agents. PMID:26740841

  4. Large outbreak of Legionnaires' disease and Pontiac fever at a military base.

    PubMed

    Ambrose, J; Hampton, L M; Fleming-Dutra, K E; Marten, C; McClusky, C; Perry, C; Clemmons, N A; McCormic, Z; Peik, S; Mancuso, J; Brown, E; Kozak, N; Travis, T; Lucas, C; Fields, B; Hicks, L; Cersovsky, S B

    2014-11-01

    We investigated a mixed outbreak of Legionnaires' disease (LD) and Pontiac fever (PF) at a military base to identify the outbreak's environmental source as well as known legionellosis risk factors. Base workers with possible legionellosis were interviewed and, if consenting, underwent testing for legionellosis. A retrospective cohort study collected information on occupants of the buildings closest to the outbreak source. We identified 29 confirmed and probable LD and 38 PF cases. All cases were exposed to airborne pathogens from a cooling tower. Occupants of the building closest to the cooling tower were 6·9 [95% confidence interval (CI) 2·2-22·0] and 5·5 (95% CI 2·1-14·5) times more likely to develop LD and PF, respectively, than occupants of the next closest building. Thorough preventive measures and aggressive responses to outbreaks, including searching for PF cases in mixed legionellosis outbreaks, are essential for legionellosis control. PMID:25267405

  5. Epidemiology of Escherichia coli O157:H7 Outbreaks, United States, 1982–2002

    PubMed Central

    Sparling, Phyllis H.; Crowe, Collen; Griffin, Patricia M.; Swerdlow, David L.

    2005-01-01

    Escherichia coli O157:H7 causes 73,000 illnesses in the United States annually. We reviewed E. coli O157 outbreaks reported to Centers for Disease Control and Prevention (CDC) to better understand the epidemiology of E. coli O157. E. coli O157 outbreaks (≥2 cases of E. coli O157 infection with a common epidemiologic exposure) reported to CDC from 1982 to 2002 were reviewed. In that period, 49 states reported 350 outbreaks, representing 8,598 cases, 1,493 (17%) hospitalizations, 354 (4%) hemolytic uremic syndrome cases, and 40 (0.5%) deaths. Transmission route for 183 (52%) was foodborne, 74 (21%) unknown, 50 (14%) person-to-person, 31 (9%) waterborne, 11 (3%) animal contact, and 1 (0.3%) laboratory-related. The food vehicle for 75 (41%) foodborne outbreaks was ground beef, and for 38 (21%) outbreaks, produce. PMID:15829201

  6. Characteristics of Rural Leptospirosis Patients Admitted to Referral Hospitals during the 2008 Leptospirosis Outbreak in Sri Lanka: Implications for Developing Public Health Control Measures

    PubMed Central

    Agampodi, Suneth B.; Nugegoda, Dhanaseela B.; Thevanesam, Vasanthi; Vinetz, Joseph M.

    2015-01-01

    To determine the exposure risk factors of highly endemic rural leptospirosis in tropical setting, we conducted a prospective, hospital-based case control study in Sri Lanka. A conceptual hierarchy of variables was used to analyze the data. Case patients included 38 (34%) females and 73 (66%) males with a mean age of 36 yr (SD 12.7 yr). Using piped, chlorinated water for drinking/general purposes (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.16–0.67), paddy fields in the vicinity of home (OR 1.77, 95% CI 1.06–2.97), sighting dogs at home yard/dog ownership (OR 1.79, 95% CI 1.11–2.91), sighting cattle at home yard/cattle ownership (OR 1.69, 95% CI 1.00–2.84), and work in a paddy field (OR 3.02, 95% CI 1.68, 5.41) were the main predictors of leptospirosis among febrile patients. In high endemic tropical settings with rural leptospirosis, risk factors in residential environments, rather than individual exposures, seemed to play a major role in leptospirosis disease transmission. PMID:25331809

  7. Characteristics of rural leptospirosis patients admitted to referral hospitals during the 2008 leptospirosis outbreak in Sri Lanka: implications for developing public health control measures.

    PubMed

    Agampodi, Suneth B; Nugegoda, Dhanaseela B; Thevanesam, Vasanthi; Vinetz, Joseph M

    2015-01-01

    To determine the exposure risk factors of highly endemic rural leptospirosis in tropical setting, we conducted a prospective, hospital-based case control study in Sri Lanka. A conceptual hierarchy of variables was used to analyze the data. Case patients included 38 (34%) females and 73 (66%) males with a mean age of 36 yr (SD 12.7 yr). Using piped, chlorinated water for drinking/general purposes (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.16-0.67), paddy fields in the vicinity of home (OR 1.77, 95% CI 1.06-2.97), sighting dogs at home yard/dog ownership (OR 1.79, 95% CI 1.11-2.91), sighting cattle at home yard/cattle ownership (OR 1.69, 95% CI 1.00-2.84), and work in a paddy field (OR 3.02, 95% CI 1.68, 5.41) were the main predictors of leptospirosis among febrile patients. In high endemic tropical settings with rural leptospirosis, risk factors in residential environments, rather than individual exposures, seemed to play a major role in leptospirosis disease transmission. PMID:25331809

  8. Epizootiology of infectious laryngotracheitis and presentation of an industry control program.

    PubMed

    Dufour-Zavala, Louise

    2008-03-01

    Despite improved biosecurity and vaccination programs in recent years, infectious laryngotracheitis continues to emerge in the field on a regular basis in poultry producing states. Evidence is mounting that most field outbreaks are caused by viruses indistinguishable from chicken-embryo-origin vaccine strains and, for that reason, broiler outbreaks are often referred to in the field as "vaccinal laryngotracheitis" (VLT). Cooperative industry programs are described, in which the poultry industry, along with government, laboratories, and other sectors involved with poultry live production work together to control and contain VLT outbreaks. These programs take into account many epizootiologic aspects of the disease and, when diligently followed, are successful in most instances at keeping the numbers of cases low and the outbreaks under control. The programs include the rapid diagnosis of the disease, the use of geographic information system technology, biosecurity, vaccination, and communications between all stakeholders. PMID:18459288

  9. The design of an observational study of hypertension management, adherence and pressure control in Blood Pressure Success Zone Program participants

    PubMed Central

    Payne, K A; Caro, J J; Daley, W L; Khan, Z M; Ishak, K J; Stark, K; Purkayastha, D; Flack, J; Velázquez, E; Nesbitt, S; Morisky, D; Califf, R

    2008-01-01

    Aims The Blood Pressure Success Zone (BPSZ) Program, a nationwide initiative, provides education in addition to a complimentary trial of one of three antihypertensive medications. The BPSZ Longitudinal Observational Study of Success (BPSZ-BLISS) aims to evaluate blood pressure (BP) control, adherence, persistence and patient satisfaction in a representative subset of BPSZ Program participants. The BPSZ-BLISS study design is described here. Methods A total of 20,000 physicians were invited to participate in the study. Using a call centre supported Interactive Voice Response System (IVRS), physicians report BP and other data at enrolment and every usual care visit up to 12 ± 2 months; subjects self-report BPs, persistence, adherence and treatment satisfaction at 3, 6 and 12 months post-BPSZ Program enrolment. In addition to BPSZ Program enrolment medications, physicians prescribe antihypertensive medications and schedule visits as per usual care. The General Electric Healthcare database will be used as an external reference. Results After 18 months, over 700 IRB approved physicians consented and enrolled 10,067 eligible subjects (48% male; mean age 56 years; 27% newly diagnosed); 97% of physicians and 78% of subjects successfully entered IVRS enrolment data. Automated IVRS validations have maintained data quality (< 5% error on key variables). Enrolment was closed 30 April 2007; study completion is scheduled for June 2008. Conclusions The evaluation of large-scale health education programmes requires innovative methodologies and data management and quality control processes. The BPSZ-BLISS design can provide insights into the conceptualisation and planning of similar studies. PMID:18647193

  10. Media impact switching surface during an infectious disease outbreak.

    PubMed

    Xiao, Yanni; Tang, Sanyi; Wu, Jianhong

    2015-01-01

    There are many challenges to quantifying and evaluating the media impact on the control of emerging infectious diseases. We modeled such media impacts using a piecewise smooth function depending on both the case number and its rate of change. The proposed model was then converted into a switching system, with the switching surface determined by a functional relationship between susceptible populations and different subgroups of infectives. By parameterizing the proposed model with the 2009 A/H1N1 influenza outbreak data in the Shaanxi province of China, we observed that media impact switched off almost as the epidemic peaked. Our analysis implies that media coverage significantly delayed the epidemic's peak and decreased the severity of the outbreak. Moreover, media impacts are not always effective in lowering the disease transmission during the entire outbreak, but switch on and off in a highly nonlinear fashion with the greatest effect during the early stage of the outbreak. The finding draws the attention to the important role of informing the public about 'the rate of change of case numbers' rather than 'the absolute number of cases' to alter behavioral changes, through a self-adaptive media impact switching on and off, for better control of disease transmission. PMID:25592757

  11. Outbreaks of Pneumocystis carinii pneumonia in colonies of immunodeficient mice.

    PubMed

    Walzer, P D; Kim, C K; Linke, M J; Pogue, C L; Huerkamp, M J; Chrisp, C E; Lerro, A V; Wixson, S K; Hall, E; Shultz, L D

    1989-01-01

    Outbreaks of Pneumocystis carinii pneumonia occurred in colonies of nu/nu and scid/scid mice at four different institutions. The disease, which was characterized by chronic wasting and respiratory insufficiency, was more severe in older mice and in animals housed in cages with special protective tops. Histopathologic features included alveolar filling with the typical foamy honeycomb material and a mild, nonspecific host inflammatory response. Immunofluorescence and immunoblotting studies suggested the P. carinii isolate was of mouse rather than of rat or human origin, and the outbreaks could be related to each other by common vendor or source of breeding animals. Once P. carinii became established in a mouse colony, the organism tended to persist for long periods of time. The principal control measure was depopulation of the colony, although limited experience with the administration of trimethoprim-sulfamethoxazole was encouraging. Thus, outbreaks of pneumocystosis are a serious problem among colonies of immunodeficient mice, with important implications for the use of these animals in biomedical research. Data obtained by studying these outbreaks should enhance understanding of the pathogenesis of P. carinii pneumonia and be helpful in formulating improved methods of detection and control. PMID:2642471

  12. Media impact switching surface during an infectious disease outbreak

    NASA Astrophysics Data System (ADS)

    Xiao, Yanni; Tang, Sanyi; Wu, Jianhong

    2015-01-01

    There are many challenges to quantifying and evaluating the media impact on the control of emerging infectious diseases. We modeled such media impacts using a piecewise smooth function depending on both the case number and its rate of change. The proposed model was then converted into a switching system, with the switching surface determined by a functional relationship between susceptible populations and different subgroups of infectives. By parameterizing the proposed model with the 2009 A/H1N1 influenza outbreak data in the Shaanxi province of China, we observed that media impact switched off almost as the epidemic peaked. Our analysis implies that media coverage significantly delayed the epidemic's peak and decreased the severity of the outbreak. Moreover, media impacts are not always effective in lowering the disease transmission during the entire outbreak, but switch on and off in a highly nonlinear fashion with the greatest effect during the early stage of the outbreak. The finding draws the attention to the important role of informing the public about `the rate of change of case numbers' rather than `the absolute number of cases' to alter behavioral changes, through a self-adaptive media impact switching on and off, for better control of disease transmission.

  13. Cryptosporidium plus Campylobacter: an outbreak in a semi-rural population.

    PubMed Central

    Casemore, D. P.; Jessop, E. G.; Douce, D.; Jackson, F. B.

    1986-01-01

    An outbreak of cryptosporidiosis in a circumscribed semi-rural population is described; some cases were infected concurrently with campylobacter. The results of a detailed case-control study and environmental surveillance are discussed. PMID:3950400

  14. Surveillance for Waterborne Disease Outbreaks Associated with Drinking Water United States, 2007-2008

    EPA Science Inventory

    Problem/Condition: Since 1971, the Centers for Disease Control and Prevention (CDC), the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists have maintained a collaborative Waterborne Disease and Outbreak Surveillance System (WBDOS...

  15. Contagious Comments: What Was the Online Buzz About the 2011 Quebec Measles Outbreak?

    PubMed Central

    Pereira, Jennifer A.; Quach, Susan; Dao, Huy Hao; Kwong, Jeffrey C.; Deeks, Shelley L.; Crowcroft, Natasha S.; Quan, Sherman D.; Guay, Maryse

    2013-01-01

    Background Although interruption of endemic measles was achieved in the Americas in 2002, Quebec experienced an outbreak in 2011 of 776 reported cases; 80% of these individuals had not been fully vaccinated. We analyzed readers’ online responses to Canadian news articles regarding the outbreak to better understand public perceptions of measles and vaccination. Methods We searched Canadian online English and French news sites for articles posted between April 2011 and March 2012 containing the words “measles” and “Quebec”. We included articles that i) concerned the outbreak or related vaccination strategies; and ii) generated at least ten comments. Two English and two bilingual researchers coded the unedited comments, categorizing codes to allow themes to emerge. Results We analyzed 448 comments from 188 individuals, in response to three French articles and six English articles; 112 individuals expressed positive perceptions of measles vaccination (2.2 comments/person), 38 were negative (4.2 comments/person), 11 had mixed feelings (1.5 comments/person), and 27 expressed no opinion (1.1 comments/person). Vaccine-supportive themes involved the success of vaccination in preventing disease spread, societal responsibility to vaccinate for herd immunity, and refutation of the autism link. Those against measles vaccination felt it was a personal rather than societal choice, and conveyed a distrust of vaccine manufacturers, believing that measles infection is not only safe but safer than vaccination. Commenters with mixed feelings expressed uncertainty of the infection’s severity, and varied in support of all vaccines based on perceived risk/benefit ratios. Conclusion The anti-vaccine minority’s volume of comments translates to a disproportionately high representation on online boards. Public health messages should address concerns by emphasizing that immunization is always a personal choice in Canada, and that the pharmaceutical industry is strictly

  16. Automatic determination of the transition between successive control mechanisms in upright stance assessed by modelling of the centre of pressure.

    PubMed

    Rougier, P

    1999-02-01

    A recently introduced concept models the trajectory of the centre of pressure as a fractional Brownian motion and reveals that two successive scaling regimes, acting hypothetically as open and closed loop mechanisms, are implicated in posture control. Objectivity is obviously required in the determination of the transition point, i.e. the point at which an open-loop control mechanism would switch to a closed-loop one, in order to provide reproducibility and automatism in the processing of data. In the method proposed herein, the transition point corresponds to the maximal distance separating a diffusion curve in a double logarithmic plot (mean square distances MSD calculated on each axis versus increasing time intervals Deltat) from a straight line characterising a pure stochastic behaviour. In closed eye conditions, the switch appears medio-laterally in a 0. 26-0.52 s range for Deltat, the corresponding MSD being in the range of 1.86-10.50 mm(2). In the forward-backward direction, the transition is in a 0.28-0.42 s range and the corresponding MSD is between 3.60 and 15.17 mm(2). Finally, these co-ordinates induce scaling exponents over 0.50 for the shortest Deltat, thus suggesting open-loop control, whereas those of longest Deltat, ranged between 0 and 0.20, give evidence of close-loop control. This data is compared to previous data based upon empirical methods. PMID:10455557

  17. Successful control of epidemic diphtheria in the states of the Former Union of Soviet Socialist Republics: lessons learned.

    PubMed

    Dittmann, S; Wharton, M; Vitek, C; Ciotti, M; Galazka, A; Guichard, S; Hardy, I; Kartoglu, U; Koyama, S; Kreysler, J; Martin, B; Mercer, D; Rønne, T; Roure, C; Steinglass, R; Strebel, P; Sutter, R; Trostle, M

    2000-02-01

    Epidemic diphtheria reemerged in the Russian Federation in 1990 and spread to all Newly Independent States (NIS) and Baltic States by the end of 1994. Factors contributing to the epidemic included increased susceptibility of both children and adults, socioeconomic instability, population movement, deteriorating health infrastructure, initial shortages of vaccine, and delays in implementing control measures. In 1995, aggressive control strategies were implemented, and since then, all affected countries have reported decreases of diphtheria; however, continued efforts by national health authorities and international assistance are still needed. The legacy of this epidemic includes a reexamination of the global diphtheria control strategy, new laboratory techniques for diphtheria diagnosis and analysis, and a model for future public health emergencies in the successful collaboration of multiple international partners. The reemergence of diphtheria warns of an immediate threat of other epidemics in the NIS and Baltic States and a longer-term potential for the reemergence of vaccine-preventable diseases elsewhere. Continued investment in improved vaccines, control strategies, training, and laboratory techniques is needed. PMID:10657185

  18. Shigellosis Outbreak in Al Batinah South Governorate, Oman

    PubMed Central

    Abaidani, Idris; Raju, Prasanna A.; Al-Shualli, Issa; Al-Sa’di, Khalid; Al-Shaqsi, Nasser; Al-Khatri, Amer

    2015-01-01

    Objectives: An outbreak of acute gastroenteritis due to Shigella flexneri occurred in August 2012 in the catchment area of the Wadi Sahtan Health Center in Rustaq, Al Batinah South Governorate, Oman. The aim of this study was to discover possible causes of this outbreak in the villages of Fassa, Rogh and Amk and to measure the risk of exposure among cases and controls. Methods: A case-control study was conducted in September 2012 in Fassa, Rogh and Amk. All households in the three villages were interviewed. Case and control households were compared to determine possible exposure avenues, including place of residence, source of drinking water, hand hygiene levels and practices related to drinking water, food preparation and environmental sanitation. Results: Residing in Fassa (P <0.0001; odds ratio [OR] = 4.86, 95% confidence interval [CI] = 2.22–10.63) and average hand hygiene practices (P = 0.008; OR = 13.97, 95% CI = 1.58–123.36) were associated with an increased risk of contracting shigellosis. No significant differences were found with regards to the other exposure avenues. Conclusion: This was the first study conducted in Oman regarding an outbreak of shigellosis in a community setting. The only variables that significantly impacted the risk of acute gastroenteritis were residing in Fassa and average hand hygiene practices. The source of the outbreak could not be identified. However, septic tank sanitation and water and food consumption practices were not satisfactory in the studied villages. These need to be addressed to prevent similar outbreaks of acute gastroenteritis in this region in the future. PMID:26357558

  19. Rapid response to Ebola outbreaks in remote areas - Liberia, July-November 2014.

    PubMed

    Kateh, Francis; Nagbe, Thomas; Kieta, Abraham; Barskey, Albert; Gasasira, Alex Ntale; Driscoll, Anne; Tucker, Anthony; Christie, Athalia; Karmo, Ben; Scott, Colleen; Bowah, Collin; Barradas, Danielle; Blackley, David; Dweh, Emmanuel; Warren, Felicia; Mahoney, Frank; Kassay, Gabriel; Calvert, Geoffrey M; Castro, Georgina; Logan, Gorbee; Appiah, Grace; Kirking, Hannah; Koon, Hawa; Papowitz, Heather; Walke, Henry; Cole, Isaac B; Montgomery, Joel; Neatherlin, John; Tappero, Jordan W; Hagan, Jose E; Forrester, Joseph; Woodring, Joseph; Mott, Joshua; Attfield, Kathleen; DeCock, Kevin; Lindblade, Kim A; Powell, Krista; Yeoman, Kristin; Adams, Laura; Broyles, Laura N; Slutsker, Laurence; Larway, Lawrence; Belcher, Lisa; Cooper, Lorraine; Santos, Marjorie; Westercamp, Matthew; Weinberg, Meghan Pearce; Massoudi, Mehran; Dea, Monica; Patel, Monita; Hennessey, Morgan; Fomba, Moses; Lubogo, Mutaawe; Maxwell, Nikki; Moonan, Patrick; Arzoaquoi, Sampson; Gee, Samuel; Zayzay, Samuel; Pillai, Satish; Williams, Seymour; Zarecki, Shauna Mettee; Yett, Sheldon; James, Stephen; Grube, Steven; Gupta, Sundeep; Nelson, Thelma; Malibiche, Theophil; Frank, Wilmont; Smith, Wilmot; Nyenswah, Tolbert

    2015-02-27

    West Africa is experiencing its first epidemic of Ebola virus disease (Ebola). As of February 9, Liberia has reported 8,864 Ebola cases, of which 3,147 were laboratory-confirmed. Beginning in August 2014, the Liberia Ministry of Health and Social Welfare (MOHSW), supported by CDC, the World Health Organization (WHO), and others, began systematically investigating and responding to Ebola outbreaks in remote areas. Because many of these areas lacked mobile telephone service, easy road access, and basic infrastructure, flexible and targeted interventions often were required. Development of a national strategy for the Rapid Isolation and Treatment of Ebola (RITE) began in early October. The strategy focuses on enhancing capacity of county health teams (CHT) to investigate outbreaks in remote areas and lead tailored responses through effective and efficient coordination of technical and operational assistance from the MOHSW central level and international partners. To measure improvements in response indicators and outcomes over time, data from investigations of 12 of 15 outbreaks in remote areas with illness onset dates of index cases during July 16-November 20, 2014, were analyzed. The times to initial outbreak alerts and durations of the outbreaks declined over that period while the proportions of patients who were isolated and treated increased. At the same time, the case-fatality rate in each outbreak declined. Implementation of strategies, such as RITE, to rapidly respond to rural outbreaks of Ebola through coordinated and tailored responses can successfully reduce transmission and improve outcomes. PMID:25719682

  20. Twin outbreak of cholera in rural North Karnataka, India

    PubMed Central

    Dey, Shuchismita; Parande, Mahantesh V.; Parande, Aisha M.; Lakkannavar, S.L.; Rathore, Poonam K.; Mantur, B.G.; Kholkute, Sanjiva D.; Roy, Subarna

    2014-01-01

    Background & objectives: Successive outbreaks of acute watery diarrhoea occurred in Talikoti and Harnal, located in Bijapur District of the southern Indian State of Karnataka, in July and August 2012, respectively. These outbreaks were investigated to identify the aetiology and epidemiology. Methods: Information was collected from the local population and health centres. Stool and water samples were collected from the admitted patients and their drinking water sources. Standard microbiological and PCR techniques were employed for isolation and characterization of the pathogen. Results: While 101 people (0.38%) were affected in Talikoti, 200 (20.94%) were affected in Harnal which is a small remote village. All age groups were affected but no death occurred. While the outbreak was smaller, longer and apparently spread by person to person contact in Talikoti, it occurred as a single source flash outbreak at Harnal. A single clone of toxigenic Vibrio cholerae O1 Ogawa biotype El Tor was isolated from the two stool samples obtained from Talikoti and subsequently from three of five stool samples obtained from Harnal indicating village to village spread of the aetiological agent. Striking similarity in antibiotic resistance profiles of these isolates with a particular strain isolated from the city of Belgaum, 250 km away, in 2010, prompted tracking the lineage of the V. cholerae isolates by DNA fingerprinting. Random amplified polymorphic DNA (RAPD) fingerprinting assay helped confirm the origin of the incriminating strain to Belgaum. Interpretation & conclusions: Our study reported the first twin outbreak of cholera in two remote areas of Bijapur district, Karnataka, south India. It also indicated the need for immediate preparedness to deal with such emergencies. PMID:25366211

  1. Dissecting Japan's Dengue Outbreak in 2014

    PubMed Central

    Quam, Mikkel B.; Sessions, October; Kamaraj, Uma Sangumathi; Rocklöv, Joacim; Wilder-Smith, Annelies

    2016-01-01

    Despite Japan's temperate climate, a dengue outbreak occurred in Tokyo for the first time in over 70 years in 2014. We dissected this dengue outbreak based on phylogenetic analysis, travel interconnectivity, and environmental drivers for dengue epidemics. Comparing the available dengue virus 1 (DENV1) E gene sequence from this outbreak with 3,282 unique DENV1 sequences in National Center for Biotechnology Information suggested that the DENV might have been imported from China, Indonesia, Singapore, or Vietnam. With travelers arriving into Japan, Guangzhou (China) may have been the source of DENV introduction, given that Guangzhou also reported a large-scale dengue outbreak in 2014. Coinciding with the 2014 outbreak, Tokyo's climate conditions permitted the amplification of Aedes vectors and the annual peak of vectorial capacity. Given suitable vectors and climate conditions in addition to increasing interconnectivity with endemic areas of Asia, Tokyo's 2014 outbreak did not come as a surprise and may foretell more to come. PMID:26711518

  2. Dissecting Japan's Dengue Outbreak in 2014.

    PubMed

    Quam, Mikkel B; Sessions, October; Kamaraj, Uma Sangumathi; Rocklöv, Joacim; Wilder-Smith, Annelies

    2016-02-01

    Despite Japan's temperate climate, a dengue outbreak occurred in Tokyo for the first time in over 70 years in 2014. We dissected this dengue outbreak based on phylogenetic analysis, travel interconnectivity, and environmental drivers for dengue epidemics. Comparing the available dengue virus 1 (DENV1) E gene sequence from this outbreak with 3,282 unique DENV1 sequences in National Center for Biotechnology Information suggested that the DENV might have been imported from China, Indonesia, Singapore, or Vietnam. With travelers arriving into Japan, Guangzhou (China) may have been the source of DENV introduction, given that Guangzhou also reported a large-scale dengue outbreak in 2014. Coinciding with the 2014 outbreak, Tokyo's climate conditions permitted the amplification of Aedes vectors and the annual peak of vectorial capacity. Given suitable vectors and climate conditions in addition to increasing interconnectivity with endemic areas of Asia, Tokyo's 2014 outbreak did not come as a surprise and may foretell more to come. PMID:26711518

  3. A Geographic Perspective on Factors Controlling Post-Fire Succession in Boreal Black Spruce Forests in Western North America

    NASA Astrophysics Data System (ADS)

    Kasischke, E. S.; Kane, E. S.; Genet, H.; Turetsky, M. R.; ODonnell, J. A.; Hoy, E.; Barrett, K.; Baltzer, J. L.

    2014-12-01

    Recent changes to climate and the fire regime have resulted in a number of distinct changes to patterns of post-fire succession in the boreal forest region of western North America. In interior Alaska and Yukon, these responses include a shift from spruce to deciduous dominated forests in black spruce forests that experienced exposure of mineral soils from deep burning of surface organic soils, as well as low seedling recruitment in white spruce forests as a result of moisture stress. In this presentation, we will use a physical geography framework to analyze factors controlling low seedling recruitment in recently burned black spruce forests in Alaska. This approach allows for understanding how changes in the biologic components of black spruce forest ecosystems (e.g., biogeography) are controlled by factors related to geomorphology and climate over multiple spatial and temporal scales. In particular, this framework will be used to examine how the interactions between fire, climate, topography and soil texture influence pre-fire and post-fire permafrost conditions, which interact to have a strong influence on variations in soil moisture. In turn, recent changes to climate combined with variations in soil moisture controlled by differences in permafrost conditions (ground ice content, active layer thickness) can be used to explain variations in post-fire seedling recruitment in black spruce forests, where low recruitment is occurring on the sites with the driest soils. In addition, we will examine the need for further research in other boreal forest regions of western North America where the presence of pine species (jack and lodgepole) that are absent in Alaska, as well as differences in soils and permafrost conditions, are likely resulting in additional patterns of post-fire succession as a result of recent changes to climate and the fire regime.

  4. Controlled continuous systemic heparinization increases success rate of artery-only anastomosis replantation in single distal digit amputation

    PubMed Central

    Lee, Jun Yong; Kim, Hak Soo; Heo, Sang Taek; Kwon, Ho; Jung, Sung-No

    2016-01-01

    Abstract Replantation is a prime indication for distal digital amputation, as it helps restore hand aesthetics and functions; however, venous anastomosis is often not feasible. Previous studies used systemic anticoagulation in distal digital artery only anastomosis replantation surgery to improve replantation success rate, however, which yielded limited level of clinical evidence. This study aimed to compare controlled continuous heparinization (CCH) and intermittent bolus heparinization (IBH) for surgical outcome and clinical variables after single distal digital artery only anastomosis replantation surgery. A single-institution, retrospective cohort study was performed. Out of 324 patients who underwent digital replantation surgery, we focused the study for the Zone I and II single distal digital amputation patients excluding confounding factors. Sixty-one patients were included in this study and underwent artery-only anastomosis replantation surgery with postoperative CCH (34 patients) or IBH (27 patients) protocols. The CCH group targeted activated partial thromboplastin time (aPTT) at 51 to 70 seconds, monitoring aPTT levels every eight hours and administering 100 mg of aspirin per day. The IBH group received 300 mg of aspirin per day and underwent IBH (12,500 U). Both groups received intravenous prostaglandin E1 drips (10 μg). To verify the factors affecting the success rate of the heparin protocol, patient factors, clinical factors, and operative factors were extracted from the medical records. Statistical analysis with inverse probability of treatment weights propensity score methods compared treatment outcomes and clinical variables. The CCH group's replantation success rate was higher (91.17% vs 59.25%), and the transfusion rate was increased (P = 0.032). However, the significant decrease in hemoglobin levels (>15%) did not differ between the groups (P = 0.108). Multivariable logistic regression analysis with potent univariate variables (P

  5. Outbreak of boils in an Alaskan village

    PubMed Central

    Landen, Michael G; McCumber, Barbara J; Asay, Elvin D; Egeland, Grace M

    2000-01-01

    Objective To determine whether taking steam baths was associated with furunculosis and to evaluate possible risk factors for the occurrence of boils during a large outbreak in Alaska. Design A cohort study of village residents, a case-control study, and assessment of environmental cultures taken from steam baths. Setting Village in southwestern Alaska. Participants 1 adult member from 77 of the 92 house-holds in the village was interviewed; 115 residents with at least one boil occurring between January 1 and December 12, 1996 were considered to be cases; 209 residents without a boil acted as the control group. All 459 village residents were included in the cohort study. Main outcome measure Rate of infection among all residents and residents who regularly took steam baths, risk factors for infection, and relative risk of infection. Results 115 people (25%) had had at least one boil. Men were more likely to have had a boil than women (relative risk 1.5; 95% confidence interval 1.1 to 2.2). The highest rate of infection was among people ages 25-34 years (32/76; 42%). No children younger than 2 years had had boils. Boils were associated with using a steam bath (odds ratio 8.1; 3.3 to 20.1). Among those who used a steam bath, the likelihood of developing boils was reduced by routinely sitting on a towel while bathing, which women were more likely to do, and bathing with fewer than 8 people. Of the 93 samples taken from steam baths, one Staphylococcus aureus isolate was obtained from a bench in an outer dressing room. Conclusion Using a steam bath was associated with developing boils in this outbreak in a village in Alaska. People should be advised to sit on towels while using steam baths. PMID:10778372

  6. Genomic Stability over 9 Years of an Isoniazid Resistant Mycobacterium tuberculosis Outbreak Strain in Sweden

    PubMed Central

    Sandegren, Linus; Groenheit, Ramona; Koivula, Tuija; Ghebremichael, Solomon; Advani, Abdolreza; Castro, Elsie; Pennhag, Alexandra; Hoffner, Sven; Mazurek, Jolanta; Pawlowski, Andrzej; Kan, Boris; Bruchfeld, Judith; Melefors, Öjar; Källenius, Gunilla

    2011-01-01

    In molecular epidemiological studies of drug resistant Mycobacterium tuberculosis (TB) in Sweden a large outbreak of an isoniazid resistant strain was identified, involving 115 patients, mainly from the Horn of Africa. During the outbreak period, the genomic pattern of the outbreak strain has stayed virtually unchanged with regard to drug resistance, IS6110 restriction fragment length polymorphism and spoligotyping patterns. Here we present the complete genome sequence analyses of the index isolate and two isolates sampled nine years after the index case as well as experimental data on the virulence of this outbreak strain. Even though the strain has been present in the community for nine years and passaged between patients at least five times in-between the isolates, we only found four single nucleotide polymorphisms in one of the later isolates and a small (4 amino acids) deletion in the other compared to the index isolate. In contrast to many other evolutionarily successful outbreak lineages (e.g. the Beijing lineage) this outbreak strain appears to be genetically very stable yet evolutionarily successful in a low endemic country such as Sweden. These findings further illustrate that the rate of genomic variation in TB can be highly strain dependent, something that can have important implications for epidemiological studies as well as development of resistance. PMID:21304944

  7. Alarm Variables for Dengue Outbreaks: A Multi-Centre Study in Asia and Latin America

    PubMed Central

    Bowman, Leigh R.; Tejeda, Gustavo S.; Coelho, Giovanini E.; Sulaiman, Lokman H.; Gill, Balvinder S.; McCall, Philip J.; Olliaro, Piero L.; Ranzinger, Silvia R.; Quang, Luong C.; Ramm, Ronald S.; Kroeger, Axel; Petzold, Max G.

    2016-01-01

    Background Worldwide, dengue is an unrelenting economic and health burden. Dengue outbreaks have become increasingly common, which place great strain on health infrastructure and services. Early warning models could allow health systems and vector control programmes to respond more cost-effectively and efficiently. Methodology/Principal Findings The Shewhart method and Endemic Channel were used to identify alarm variables that may predict dengue outbreaks. Five country datasets were compiled by epidemiological week over the years 2007–2013. These data were split between the years 2007–2011 (historic period) and 2012–2013 (evaluation period). Associations between alarm/ outbreak variables were analysed using logistic regression during the historic period while alarm and outbreak signals were captured during the evaluation period. These signals were combined to form alarm/ outbreak periods, where 2 signals were equal to 1 period. Alarm periods were quantified and used to predict subsequent outbreak periods. Across Mexico and Dominican Republic, an increase in probable cases predicted outbreaks of hospitalised cases with sensitivities and positive predictive values (PPV) of 93%/ 83% and 97%/ 86% respectively, at a lag of 1–12 weeks. An increase in mean temperature ably predicted outbreaks of hospitalised cases in Mexico and Brazil, with sensitivities and PPVs of 79%/ 73% and 81%/ 46% respectively, also at a lag of 1–12 weeks. Mean age was predictive of hospitalised cases at sensitivities and PPVs of 72%/ 74% and 96%/ 45% in Mexico and Malaysia respectively, at a lag of 4–16 weeks. Conclusions/Significance An increase in probable cases was predictive of outbreaks, while meteorological variables, particularly mean temperature, demonstrated predictive potential in some countries, but not all. While it is difficult to define uniform variables applicable in every country context, the use of probable cases and meteorological variables in tailored early warning

  8. Repetitive dengue outbreaks in East Africa: A proposed phased mitigation approach may reduce its impact.

    PubMed

    Baba, Marycelin; Villinger, Jandouwe; Masiga, Daniel K

    2016-05-01

    Dengue outbreaks have persistently occurred in eastern African countries for several decades. We assessed each outbreak to identify risk factors and propose a framework for prevention and impact mitigation. Seven out of ten countries in eastern Africa and three islands in the Indian Ocean have experienced dengue outbreaks between 1823 and 2014. Major risk factors associated with past dengue outbreaks include climate, virus and vector genetics and human practices. Appropriate use of dengue diagnostic tools and their interpretation are necessary for both outbreak investigations and sero-epidemiological studies. Serosurvey findings during inter-epidemic periods have not been adequately utilised to prevent re-occurrence of dengue outbreaks. Local weather variables may be used to predict dengue outbreaks, while entomological surveillance can complement other disease-mitigation efforts during outbreaks and identify risk-prone areas during inter-epidemic periods. The limitations of past dengue outbreak responses and the enormous socio-economic impacts of the disease on human health are highlighted. Its repeated occurrence in East Africa refutes previous observations that susceptibility may depend on race. Alternate hypotheses on heterotypic protection among flaviviruses may not be applied to all ecologies. Prevention and mitigation of severe dengue outbreaks should necessarily consider the diverse factors associated with their occurrence. Implementation of phased dengue mitigation activities can enforce timely and judicious use of scarce resources, promote environmental sanitation, and drive behavioural change, hygienic practices and community-based vector control. Understanding dengue epidemiology and clinical symptoms, as determined by its evolution, are significant to preventing future dengue epidemics. PMID:26922851

  9. Food-initiated outbreak of methicillin-resistant Staphylococcus aureus analyzed by pheno- and genotyping.

    PubMed Central

    Kluytmans, J; van Leeuwen, W; Goessens, W; Hollis, R; Messer, S; Herwaldt, L; Bruining, H; Heck, M; Rost, J; van Leeuwen, N

    1995-01-01

    An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) involving 27 patients and 14 health-care workers (HCW) was studied. The outbreak started in the hematology unit of the University Hospital Rotterdam, Dijkzigt, The Netherlands, and spread to the surgical unit. Twenty-one patients (77.8%) developed clinical disease, and five died. Subsequently, MRSA was detected in food and in the throat of one of the HCW who prepared food for hematology patients. Food contaminated by an HCW most likely caused the first case of MRSA septicemia. This route of transmission has not been described before. The outbreak strain was probably transmitted to the surgical unit by a colonized nurse, where it caused an explosive outbreak. Airborne probably transmitted to the surgical unit by a colonized nurse, where it caused an explosive outbreak. Airborne MRSA transmission played an important role in disseminating the organism. The outbreak was controlled within 6 months by intensifying surveillance, temporarily closing the affected wards, treating carriers, and instituting an MRSA ward outside the hospital. Phage typing, insertion sequence probing, protein A gene typing, and DNA fingerprinting by PCR revealed that all outbreak-related isolates were identical. By pulsed-field gel electrophoresis, all but one of the outbreak-related isolates were determined to be identical. Protein A gene typing identified numerous (11) repeat units in all outbreak-related isolates, which supports the suggestion that the outbreak strain may have been more virulent and more transmissible than other MRSA strains. Pheno- and genotyping studies underlined the value of DNA fingerprinting methods for investigation of MRSA epidemiology. Optimal discriminatory power was achieved by combining the results of four genotyping methods. PMID:7615715

  10. Coherence-controlled holographic microscopy principle embodiment into Q-PHASE microscope: story of a successful technology transfer

    NASA Astrophysics Data System (ADS)

    Lostak, M.; Chmelik, R.

    2016-03-01

    Curiously, the coherence-controlled holographic microscopy (CCHM) was brought into the world owing to the endeavor of Chmelik's team at Brno University of Technology (BUT) to avoid scanning in confocal microscopy. As coherence gating seemed to be the way, the Leith & Upatnieks proposal of incoherent holography had been considered attractive. Their method made interference system free from strict dependence on both spatial and temporal coherence. Off axis holographic system proposed on such basis has been proved capable of coherence based depth discrimination in single wide-field shot in reflected-light arrangement. Consequently, extremely low-coherence holographic imaging had been found highly contributive also to the image quality depriving it from coherence artefacts and improving its transversal resolution. This is why CCHM promised high precision of quantitative phase imaging (QPI) in transmitted light set up that was realized for cell biology. However the cost of necessarily complicated optical design and need of very precise mechanics forced the team of prof Chmelik at BUT to search for a company capable of mastering the instrument. It was TESCAN ORSAY the highly successful scanning electron microscopes producer that finally took charge of the commercial design. Long-term collaboration of the company with BUT made possible both the CCHM technology successful transfer up to Q-PHASE microscope production as well as the company Light microscopy division reinforcement. This contribution merges views of CCHM technology author and the TESCAN development team.

  11. A pragmatic randomised controlled trial on routine iron prophylaxis during pregnancy in Maputo, Mozambique (PROFEG): rationale, design, and success.

    PubMed

    Nwaru, Bright I; Parkkali, Saara; Abacassamo, Fatima; Salomé, Graca; Chilundo, Baltazar; Augusto, Orvalho; Cliff, Julie; Dgedge, Martinho; Regushevskaya, Elena; Nikula, Minna; Hemminki, Elina

    2015-04-01

    The effects of prophylactic iron during pregnancy on maternal and child health in developing settings with endemic malaria and high prevalence of HIV remain unclear. This paper describes the rationale, implementation and success of a pragmatic randomised controlled trial comparing routine iron supplementation vs. screening and treatment for anaemia during pregnancy. The setting was two health centres in Maputo, Mozambique. Pregnant women (≥ 12-week gestation; ≥ 18 years old; and not with a high-risk pregnancy, n=4326) were recruited. The main outcomes are preterm delivery and low birthweight. The women were randomly assigned to one of two iron administration policies: a routine iron group (n=2184) received 60 mg of ferrous sulphate plus 400 μg of folic acid daily while a selective iron group (n=2142) had screening and treatment for anaemia and a daily intake of 1 mg of folic acid. The recruitment, follow-up, and collection of follow-up data were successful; both groups were similar to each other in all the trial stages. Collection of delivery data was challenging and data on about 40% of births is missing. These are currently being traced through different hospitals and health centres. The compliance of the study personnel and the women with regard to regular measurement of haemoglobin and intake of the iron and folic acid tablets was high and similar in both trial arms. Taking into account the various constraints encountered, the stages of the present trial prior to delivery were carried out well. PMID:23020829

  12. Host-Parasitoid Dynamics and the Success of Biological Control When Parasitoids Are Prone to Allee Effects

    PubMed Central

    Bompard, Anaïs; Amat, Isabelle; Fauvergue, Xavier; Spataro, Thierry

    2013-01-01

    In sexual organisms, low population density can result in mating failures and subsequently yields a low population growth rate and high chance of extinction. For species that are in tight interaction, as in host-parasitoid systems, population dynamics are primarily constrained by demographic interdependences, so that mating failures may have much more intricate consequences. Our main objective is to study the demographic consequences of parasitoid mating failures at low density and its consequences on the success of biological control. For this, we developed a deterministic host-parasitoid model with a mate-finding Allee effect, allowing to tackle interactions between the Allee effect and key determinants of host-parasitoid demography such as the distribution of parasitoid attacks and host competition. Our study shows that parasitoid mating failures at low density result in an extinction threshold and increase the domain of parasitoid deterministic extinction. When proned to mate finding difficulties, parasitoids with cyclic dynamics or low searching efficiency go extinct; parasitoids with high searching efficiency may either persist or go extinct, depending on host intraspecific competition. We show that parasitoids suitable as biocontrol agents for their ability to reduce host populations are particularly likely to suffer from mate-finding Allee effects. This study highlights novel perspectives for understanding of the dynamics observed in natural host-parasitoid systems and improving the success of parasitoid introductions. PMID:24116153

  13. First documented outbreak of hepatitis E virus transmission in Java, Indonesia.

    PubMed

    Sedyaningsih-Mamahit, E R; Larasati, R P; Laras, K; Sidemen, A; Sukri, N; Sabaruddin, N; Didi, S; Saragih, J M; Myint, K S A; Endy, T P; Sulaiman, A; Campbell, J R; Corwin, A L

    2002-01-01

    A suspected hepatitis outbreak occurred in Bondowoso District, East Java Province, Indonesia, in March-May 1998. An investigation was initiated in April 1998, involving a retrospective review of hospital records, a community-based cross-sectional study, and a health service-based case detection and household follow-up. Sera and epidemiological information were collected from 962 individuals: 235 from 3 outbreak-affected communities along the same rural stretch of river, 101 from community controls living distant from the river, 151 cases detected in health centres, 141 family members of the cases, and 334 subjects from neighbouring families. The prevalence of acute hepatitis E virus (HEV), based on anti-HEV IgM, total antibody (Ig) to HEV and polymerase chain reaction (PCR), was significantly (P < 0.00001) higher (52.4%) among the outbreak communities than among the community controls (3%). The background prevalence of HEV, based on anti-HEV IgG, was also significantly (P < 0.00001) higher (47%) among the outbreak communities than among the community controls (3%). None of the 476 sera screened for anti-HAV (hepatitis A virus) IgM was positive. These results indicate that HEV was the aetiological agent responsible for the outbreak. The overall attack rate (AR) for the 3 outbreak-affected communities surveyed was 19%, with AR determined on the basis of clinically recognized, acute jaundice illness. The usage of river water as primary source for bathing, human-waste disposal, and drinking purposes differed significantly (P < 0.00001) between the communities in outbreak areas and those in non-outbreak areas. There is no significant influence attributed to 'boiling water' on acute HEV. No climatic influences (flooding or drought) predisposed this instance of epidemic HEV transmission. This outbreak represents the first documented evidence of epidemic HEV transmission in Java, Indonesia. PMID:12497976

  14. Managing and preventing outbreaks of Gram-negative infections in UK neonatal units.

    PubMed

    Anthony, Mark; Bedford-Russell, Alison; Cooper, Tracey; Fry, Carole; Heath, Paul T; Kennea, Nigel; McCartney, Maureen; Patel, Bharat; Pollard, Tina; Sharland, Mike; Wilson, Peter

    2013-11-01

    De novo guidance on the management of Gram-negative bacteria outbreaks in UK neonatal units was developed in 2012 by a Department of Health, England Antimicrobial Resistance and Healthcare Associated Infection working group. The recommendations included activation of an organisational response and establishing a control team when an outbreak is suspected; screening for the specific organism only during an outbreak; undertaking multidisciplinary reviews of cleaning routines, hand hygiene and Gram-negative bacteria transmission risks; considering deep-cleaning; cohorting colonised and infected babies preferably but not necessarily in isolation cubicles; and considering reducing beds or closing a unit to new admissions as a way of improving spacing and staff:patient ratios until the outbreak is under control. The group advised establishing mechanisms to communicate effectively across the network; informing parents of the outbreak as early as possible, and providing prewritten 'infection outbreak' information sheets. For prevention of outbreaks, the group advised meeting national staffing and cot-spacing requirements; following a Water Action Plan; using infection reduction care bundles and benchmarking; and introducing breast milk early and limiting antibiotic use. PMID:23792354

  15. Outbreaks of infectious intestinal disease in schools and nurseries in England and Wales 1992 to 1994.

    PubMed

    Evans, H S; Maguire, H

    1996-06-21

    We present data on outbreaks of infectious intestinal disease in schools and nurseries obtained from the surveillance scheme of all general outbreaks of infectious intestinal disease in England and Wales reported to the PHLS Communicable Disease Surveillance Centre between 1992 and 1994. A minimum set of data was received for 1280 outbreaks, 95 of which (7%) arose in schools and nurseries. The commonest pathogens were salmonellas, Shigella sonnei, and small round structured viruses. The mode of transmission was described as mainly from person to person in 55 outbreaks and mainly foodborne in 30. The mean attack rate was 30% and median duration was 10 days. The attack rate and duration varied with the pathogen involved. Forty-five of the 3118 people reported to have been ill were admitted to hospital. Outbreaks in schools and nurseries are common. Attack rates are high and such outbreaks are often prolonged. Effective infection control policies and appropriate training of staff are needed. Good local systems for surveillance can help identify outbreaks quickly and allow control measures to be applied early. PMID:8680501

  16. Persistent Multiyear Control of Relapsed T-Cell Acute Lymphoblastic Leukemia With Successive Donor Lymphocyte Infusions: A Case Report.

    PubMed

    Huo, Jeffrey S; Symons, Heather J; Robey, Nancy; Borowitz, Michael J; Schafer, Eric S; Chen, Allen R

    2016-07-01

    There are few therapeutic options for patients with T-cell acute lymphoblastic leukemia (T-ALL) who have recurrent disease after initial matched sibling hematopoietic stem cell transplantation. While a second hematopoietic stem cell transplant (HSCT) from a haploidentical donor offers the conceptual possibility of greater graft versus leukemia effect, there is minimal literature to describe the efficacy of this approach in recurrent pediatric T-ALL. We present the case of a now 9-year-old female in whom second haploidentical HSCT, followed by successive donor lymphocyte infusions in response to minimal residual disease reemergence, has led to 3+ years of ongoing disease control without graft versus host disease and excellent quality of life. PMID:26990138

  17. Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma

    PubMed Central

    Martinez, Elizabeth A.; Chavez-Valdez, Raul; Holt, Natalie F.; Grogan, Kelly L.; Khalifeh, Katherine W.; Slater, Tammy; Winner, Laura E.; Moyer, Jennifer; Lehmann, Christoph U.

    2011-01-01

    Although the evidence strongly supports perioperative glycemic control among cardiac surgical patients, there is scant literature to describe the practical application of such a protocol in the complex ICU environment. This paper describes the use of the Lean Six Sigma methodology to implement a perioperative insulin protocol in a cardiac surgical intensive care unit (CSICU) in a large academic hospital. A preintervention chart audit revealed that fewer than 10% of patients were admitted to the CSICU with glucose <200 mg/dL, prompting the initiation of the quality improvement project. Following protocol implementation, more than 90% of patients were admitted with a glucose <200 mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period. PMID:22091218

  18. A waterborne norovirus gastroenteritis outbreak in a school, eastern China.

    PubMed

    Zhou, N; Zhang, H; Lin, X; Hou, P; Wang, S; Tao, Z; Bi, Z; Xu, A

    2016-04-01

    In late 2014, a gastroenteritis outbreak occurred in a school in Shandong Province, eastern China. Hundreds of individuals developed the symptoms of diarrhoea and vomiting. Epidemiological investigation showed that food consumption was not linked to this outbreak, and unboiled direct drinking water was identified as the independent risk factor with a relative risk of 1·37 (95% confidence interval 1·03-1·83). Furthermore, examination of common bacterial and viral gastroenteritis pathogens was conducted on different specimens. Norovirus GI.1, GI.2, GI.6, GII.4, GII.6 and GII.13 were detected in clinical specimens and a water sample. GII.4 sequences between clinical specimens and the water sample displayed a close relationship and belonged to GII.4 variant Sydney 2012. These results indicate that direct drinking water contaminated by norovirus was responsible for this gastroenteritis outbreak. This study enriches our knowledge of waterborne norovirus outbreaks in China, and presents valuable prevention and control practices for policy-makers. In future, strengthened surveillance and supervision of direct drinking-water systems is needed. PMID:26482884

  19. Measles Outbreak among Previously Immunized Adult Healthcare Workers, China, 2015

    PubMed Central

    Zhang, Zhengyi; Zhao, Yuan; Yang, Lili; Lu, Changhong; Meng, Ying; Guan, Xiaoli; An, Hongjin; Zhang, Meizhong; Guo, Wenqin; Shang, Bo; Yu, Jing

    2016-01-01

    Measles is caused by measles virus belonging to genus Morbillivirus of the family Paramyxoviridae. Vaccination has played a critical role in controlling measles infection worldwide. However, in the recent years, outbreaks of measles infection still occur in many developing countries. Here, we report an outbreak of measles among healthcare workers and among the 60 measles infected patients 50 were healthcare workers including doctors, nurses, staff, and medics. Fifty-one patients (85%) tested positive for IgM antibodies against the measles virus and 50 patients (83.3%) tested positive for measles virus RNA. Surprisingly, 73.3% of the infected individuals had been previously immunized against measles. Since there is no infection division in our hospital, the fever clinics are located in the Emergency Division. In addition, the fever and rash were not recognized as measles symptoms at the beginning of the outbreak. These factors result in delay in isolation and early confirmation of the suspected patients and eventually a measles outbreak in the hospital. Our report highlights the importance of following a two-dose measles vaccine program in people including the healthcare workers. In addition, vigilant attention should be paid to medical staff with clinical fever and rash symptoms to avoid a possible nosocomial transmission of measles infection. PMID:27366157

  20. Molecular Investigation into a Malaria Outbreak in Cusco, Peru: Plasmodium falciparum BV1 Lineage is Linked to a Second Outbreak in Recent Times.

    PubMed

    Okoth, Sheila Akinyi; Chenet, Stella M; Arrospide, Nancy; Gutierrez, Sonia; Cabezas, Cesar; Matta, Jose Antonio; Udhayakumar, Venkatachalam

    2016-01-01

    In November 2013, a Plasmodium falciparum malaria outbreak of 11 cases occurred in Cusco, southern Peru, where falciparum malaria had not been reported since 1946. Although initial microscopic diagnosis reported only Plasmodium vivax infection in each of the specimens, subsequent examination by the national reference laboratory confirmed P. falciparum infection in all samples. Molecular typing of four available isolates revealed identity as the B-variant (BV1) strain that was responsible for a malaria outbreak in Tumbes, northern Peru, between 2010 and 2012. The P. falciparum BV1 strain is multidrug resistant, can escape detection by PfHRP2-based rapid diagnostic tests, and has contributed to two malaria outbreaks in Peru. This investigation highlights the importance of accurate species diagnosis given the potential for P. falciparum to be reintroduced to regions where it may have been absent. Similar molecular epidemiological investigations can track the probable source(s) of outbreak parasite strains for malaria surveillance and control purposes. PMID:26483121

  1. Triflic acid controlled successive annelation of aromatic sulfonamides: An efficient one-pot synthesis of N-sulfonyl pyrroles, indoles and carbazoles

    PubMed Central

    Abid, Mohammed; Teixeira, Liliana; Török, Béla

    2009-01-01

    A novel one-pot synthesis of N-substituted heterocycles via successive cyclization/annelation starting from primary sulfonamides is described. This process leads directly to N-sulfonyl pyrroles, indoles and carbazoles. The selection of appropriate reactant/triflic acid ratio successfully controls the formation of the desired product. PMID:19629194

  2. War diseases revealed by the social media: massive leishmaniasis outbreak in the Syrian Spring.

    PubMed

    Alasaad, Samer

    2013-01-01

    Social media introduce pivotal changes to communication between individuals, organizations and communities. A clear example of the power of social media is the spread of the revolutionary outbreaks in the Arabic countries during 2011, where people used Facebook, YouTube and Skype to communicate, organise meetings and protest actions. Here I report how Doctor-Activists use these social media as an alarm system for 'war disease' outbreaks in the Syrian Spring. Social media are used as an alarm system to attract the attention of international organizations, which should assume their responsibilities and play their part in controlling the outbreak of such war diseases. PMID:23587258

  3. A review of outbreaks of infectious disease in schools in England and Wales 1979-88.

    PubMed Central

    Joseph, C.; Noah, N.; White, J.; Hoskins, T.

    1990-01-01

    In this review of 66 outbreaks of infectious disease in schools in England and Wales between 1979-88, 27 were reported from independent and 39 from maintained schools. Altogether, over 8000 children and nearly 500 adults were affected. Most of the outbreaks investigated were due to gastrointestinal infections which affected about 5000 children: respiratory infections affected a further 2000 children. Fifty-two children and seven adults were admitted to hospital and one child with measles died. Vaccination policies and use of immunoglobulin for control and prevention of outbreaks in schools have been discussed. PMID:2209745

  4. Tuberculosis Beijing strain outbreak in an Israeli Arab rural community linked to an incarcerated immigrant.

    PubMed

    Bishara, H; Rorman, E; Mor, Z; Shechter-Amram, D; Weiler-Ravell, D

    2014-12-01

    A tuberculosis (TB) outbreak with six definite and four probable cases, caused by a Beijing strain isolate, occurred in an Arab rural community in north Israel. Using epidemiological investigation and strain genotyping, we identified the source case as an incarcerated immigrant. This outbreak illustrates how a systematic breakdown in TB prevention and control measures at multiple levels, within prisons and upon exiting prison, can result in rapid, cross-ethnic transmission of TB to a low-risk population. The close social bonds in this rural community and downsizing of the regional TB clinic staff may also have contributed to the magnitude of this outbreak. PMID:25517819

  5. Large ongoing measles outbreak in a religious community in the Netherlands since May 2013.

    PubMed

    Knol, Mj; Urbanus, At; Swart, Em; Mollema, L; Ruijs, Wl; van Binnendijk, Rs; Te Wierik, Mj; de Melker, He; Timen, A; Hahne, Sj

    2013-01-01

    Despite vaccination coverage over 95%, a measles outbreak started in May 2013 in the Netherlands. As of 28 August, there were 1,226 reported cases, including 82 hospitalisations. It is anticipated that the outbreak will continue. Most cases were orthodox Protestants (n=1,087/1,186; 91.7%) and unvaccinated (n=1,174/1,217; 96.5%). A unique outbreak control intervention was implemented: a personal invitation for measles-mumps-rubella (MMR) vaccination was sent for all children aged 6–14 months living in municipalities with MMR vaccination coverage below 90%. PMID:24079377

  6. Tailored Print Communication and Telephone Motivational Interviewing Are Equally Successful in Improving Multiple Lifestyle Behaviors in a Randomized Controlled Trial

    PubMed Central

    Mesters, Ilse; Ausems, Marlein; van Breukelen, Gerard; Campbell, Marci; Resnicow, Ken; Brug, Johannes; de Vries, Hein

    2010-01-01

    Background Computer tailoring and motivational interviewing show promise in promoting lifestyle change, despite few head-to-head comparative studies. Purpose Vitalum is a randomized controlled trial in which the efficacy of these methods was compared in changing physical activity and fruit and vegetable consumption in middle-aged Dutch adults. Methods Participants (n = 1,629) were recruited via 23 general practices and randomly received either four tailored print letters, four motivational telephone calls, two of each type of intervention, or no information. The primary outcomes were absolute change in self-reported physical activity and fruit and vegetable consumption. Results All three intervention groups (i.e., the tailored letters, the motivational calls, and the combined version) were equally and significantly more effective than the control group in increasing physical activity (hours/day), intake of fruit (servings/day), and consumption of vegetables (grams/day) from baseline to the intermediate measurement (week 25), follow-up 1 (week 47) and 2 (week 73). Effect sizes (Cohen’s d) ranged from 0.15 to 0.18. Participants rated the interventions positively; interviews were more positively evaluated than letters. Conclusions Tailored print communication and telephone motivational interviewing or their combination are equally successful in changing multiple behaviors. Electronic supplementary material The online version of this article (doi:10.1007/s12160-010-9231-3) contains supplementary material, which is available to authorized users. PMID:20878293

  7. Successful implementation of infection control strategies prevents P. aeruginosa transmission among cystic fibrosis patients inside the hospital

    PubMed Central

    Matt, Benedikt; Mitteregger, Dieter; Renner, Sabine; Presterl, Elisabeth; Assadian, Ojan; Diab-Elschahawi, Magda

    2014-01-01

    Background: The aim of this study was to characterise the epidemiology of P. aeruginosa isolated from cystic fibrosis (CF) patients at the Vienna General Hospital (VGH) by molecular genetic fingerprinting in order to understand transmission ways and to evaluate the established infection control protocols. Methods: The outpatient clinic for CF patients at the VGH cares for children and adolescents up to the age of 18 years. Among an average of 139 patients cared for at the clinic, 41 were tested positive for P. aeruginosa during the study period. Fifty P. aeruginosa isolates, obtained between August 2010 and March 2012 from routine examinations of CF patients, were subject to molecular characterization using the DiversiLab® method. Results: 42 distinguishable molecular-biological patterns were identified, 7 of which were found multiple times. 40 out of 42 genotypes were retrieved from single patients only, while two patterns were present in two patients each. Nine patients presented with two or more phenotypically diverse P. aeruginosa isolates. In five of these cases the retrieved isolates belonged to the same genotype. Conclusion: The broad genetic heterogeneity of P. aeruginosa in the studied patient population suggests that the majority of CF patients cared for at the VGH acquire P. aeruginosa from environmental sources. It may be concluded that implemented infection control guidelines have been successful in preventing nosocomial transmission of P. aeruginosa among CF patients within the VGH and patient-to-patient transmission outside the hospital. Chronic polyclonal infection/colonization was rare in the study population. PMID:25285264

  8. Management of a Trichophyton tonsurans outbreak in a day-care center.

    PubMed

    Gray, Robert M; Champagne, Caroline; Waghorn, David; Ong, Eugene; Grabczynska, Sophie A; Morris, Jill

    2015-01-01

    Trichophyton tonsurans is the leading cause of tinea capitis in the United Kingdom (UK) as well as causing tinea corporis. This organism has been linked to several outbreaks in the UK and abroad, and such outbreaks may be prolonged since T. tonsurans can be difficult to control. There remains an incomplete consensus in the literature on the optimal management of such outbreaks of this infection. Following notification that a child with T. tonsurans was identified at a day-care center in the UK, initial investigations identified nine cases of fungal infection involving children and staff over the previous 7 months. We report on the management of an outbreak of T. tonsurans tinea capitis and tinea corporis among children and staff in a day-care center. An outbreak control team with representatives from dermatology, microbiology, day-care center management, and the Health Protection Agency initiated case ascertainment by scalp inspection and brushing of all children and staff at the nursery. Two complete rounds of screening were required before the outbreak was declared over. Infection control measures included antifungal shampoo use, exclusion of identified cases for a short period, removal of shared items from the center, and enhanced decontamination of fomites. The outbreak, which lasted longer than 12 months, involved 12 children and 7 staff members. Of these, 12 cases were confirmed by positive fungal culture. T. tonsurans is difficult to manage, especially in childcare settings, but case ascertainment, appropriate treatment with oral agents, and sustained infection control measures can be effective in controlling such outbreaks. PMID:25257708

  9. Cost-Analysis of Seven Nosocomial Outbreaks in an Academic Hospital

    PubMed Central

    Dik, Jan-Willem H.; Dinkelacker, Ariane G.; Vemer, Pepijn; Lo-Ten-Foe, Jerome R.; Lokate, Mariëtte; Sinha, Bhanu; Friedrich, Alex W.; Postma, Maarten J.

    2016-01-01

    Objectives Nosocomial outbreaks, especially with (multi-)resistant microorganisms, are a major problem for health care institutions. They can cause morbidity and mortality for patients and controlling these costs substantial amounts of funds and resources. However, how much is unclear. This study sets out to provide a comparable overview of the costs of multiple outbreaks in a single academic hospital in the Netherlands. Methods Based on interviews with the involved staff, multiple databases and stored records from the Infection Prevention Division all actions undertaken, extra staff employment, use of resources, bed-occupancy rates, and other miscellaneous cost drivers during different outbreaks were scored and quantified into Euros. This led to total costs per outbreak and an estimated average cost per positive patient per outbreak day. Results Seven outbreaks that occurred between 2012 and 2014 in the hospital were evaluated. Total costs for the hospital ranged between €10,778 and €356,754. Costs per positive patient per outbreak day, ranged between €10 and €1,369 (95% CI: €49-€1,042), with a mean of €546 and a median of €519. Majority of the costs (50%) were made because of closed beds. Conclusions This analysis is the first to give a comparable overview of various outbreaks, caused by different microorganisms, in the same hospital and all analyzed with the same method. It shows a large variation within the average costs due to different factors (e.g. closure of wards, type of ward). All outbreaks however cost considerable amounts of efforts and money (up to €356,754), including missed revenue and control measures. PMID:26863145

  10. Molecular Diagnostic Analysis of Outbreak Scenarios

    ERIC Educational Resources Information Center

    Morsink, M. C.; Dekter, H. E.; Dirks-Mulder, A.; van Leeuwen, W. B.

    2012-01-01

    In the current laboratory assignment, technical aspects of the polymerase chain reaction (PCR) are integrated in the context of six different bacterial outbreak scenarios. The "Enterobacterial Repetitive Intergenic Consensus Sequence" (ERIC) PCR was used to analyze different outbreak scenarios. First, groups of 2-4 students determined optimal…

  11. Yellow Fever Outbreak, Southern Sudan, 2003

    PubMed Central

    Onyango, Clayton O.; Grobbelaar, Antoinette A.; Gibson, Georgina V.F.; Sang, Rosemary C.; Sow, Abdourahmane; Swanepoel, Robert

    2004-01-01

    In May 2003, an outbreak of fatal hemorrhagic fever, caused by yellow fever virus, occurred in southern Sudan. Phylogenetic analysis showed that the virus belonged to the East African genotype, which supports the contention that yellow fever is endemic in East Africa with the potential to cause large outbreaks in humans. PMID:15498174

  12. Selection tool for foodborne norovirus outbreaks.

    PubMed

    Verhoef, Linda P B; Kroneman, Annelies; van Duynhoven, Yvonne; Boshuizen, Hendriek; van Pelt, Wilfrid; Koopmans, Marion

    2009-01-01

    Detection of pathogens in the food chain is limited mainly to bacteria, and the globalization of the food industry enables international viral foodborne outbreaks to occur. Outbreaks from 2002 through 2006 recorded in a European norovirus surveillance database were investigated for virologic and epidemiologic indicators of food relatedness. The resulting validated multivariate logistic regression model comparing foodborne (n = 224) and person-to-person (n = 654) outbreaks was used to create a practical web-based tool that can be limited to epidemiologic parameters for nongenotyping countries. Non-genogroup-II.4 outbreaks, higher numbers of cases, and outbreaks in restaurants or households characterized (sensitivity = 0.80, specificity = 0.86) foodborne outbreaks and reduced the percentage of outbreaks requiring source-tracing to 31%. The selection tool enabled prospectively focused follow-up. Use of this tool is likely to improve data quality and strain typing in current surveillance systems, which is necessary for identification of potential international foodborne outbreaks. PMID:19116046

  13. Incentives for Reporting Infectious Disease Outbreaks

    ERIC Educational Resources Information Center

    Malani, Anup; Laxminarayan, Ramanan

    2011-01-01

    The global spread of diseases such as swine flu and SARS highlights the difficult decision governments face when presented with evidence of a local outbreak. Reporting the outbreak may bring medical assistance but is also likely to trigger trade sanctions by countries hoping to contain the disease. Suppressing the information may avoid trade…

  14. WATERBORNE DISEASE OUTBREAKS, 1986-1988

    EPA Science Inventory

    From 1986 to 1988, 24 states and Puerto Rico reported 50 outbreaks of illness due to water that people intended to drink, affecting 25,846 persons. he protozoal parasite Giardia lamblia was the agent most commonly implicated in outbreaks, as it has been for the last 10 years; man...

  15. Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014.

    PubMed

    Haviari, Skerdi; Cassier, Pierre; Dananché, Cédric; Hulin, Monique; Dauwalder, Olivier; Rouvière, Olivier; Bertrand, Xavier; Perraud, Michel; Bénet, Thomas; Vanhems, Philippe

    2016-08-01

    We report an outbreak of healthcare-associated prostatitis involving rare environmental pathogens in immunocompetent patients undergoing transrectal prostate biopsies at Hôpital Édouard Herriot (Lyon, France) during August 13-October 10, 2014. Despite a fluoroquinolone-based prophylaxis, 5 patients were infected with Achromobacter xylosoxidans and 3 with Ochrobactrum anthropi, which has not been reported as pathogenic in nonimmunocompromised persons. All patients recovered fully. Analysis of the outbreak included case investigation, case-control study, biopsy procedure review, microbiologic testing of environmental and clinical samples, and retrospective review of hospital records for 4 years before the outbreak. The cases resulted from asepsis errors during preparation of materials for the biopsies. A low-level outbreak involving environmental bacteria was likely present for years, masked by antimicrobial drug prophylaxis and a low number of cases. Healthcare personnel should promptly report unusual pathogens in immunocompetent patients to infection control units, and guidelines should explicitly mention asepsis during materials preparation. PMID:27434277

  16. Lessons Learned during Dengue Outbreaks in the United States, 2001–2011

    PubMed Central

    Sell, Tara Kirk; Bouri, Nidhi; Franco, Crystal

    2012-01-01

    Since 2001, three autochthonous dengue fever outbreaks have occurred in the United States: in Hawaii (2001); Brownsville, Texas (2005); and southern Florida (2009–2011). We sought to characterize and describe the response to these outbreaks from the perspectives of public health and vector control officials. By conducting a medical literature review through PubMed and news media searches through Google, we identified persons involved in managing each outbreak; 26 persons then participated in qualitative, semistructured interviews. After analyzing the 3 outbreaks, we found the following prominent themes in the response efforts: timely detection of illness; communication of up-to-date, correct information; and development of a rapid response that engages the community. We therefore recommend that public health authorities involve the clinical and laboratory community promptly, provide accurate information, and engage the local community in vector control and case identification and reporting. PMID:22469195

  17. Norovirus outbreak associated with a hotel in the west of Ireland, 2006.

    PubMed

    Michel, A; Fitzgerald, R; Whyte, D; Fitzgerald, A; Beggan, E; O'Connell, N; Greally, T

    2007-07-01

    An outbreak of gastrointestinal disease (nausea, vomiting or diarrhoea) occurred among a party of wedding guests, staff and other guests in a hotel in the west of Ireland, in October 2006. Upon notification, a multi-disciplinary outbreak control team was convened to investigate and control the outbreak. In all, 98 people were ascertained ill. The median duration of illness was 48 hours. The attack rate ranged between 48 and 85%. The hotel voluntarily notified health authorities and co-operated fully with investigation and control measures. Strict prevention and control measures were instituted promptly, including air ventilation, enhanced hand hygiene, isolation of cases, temporary "cooked food only", temporary alternative accommodation and specialised cleaning. Three cases of norovirus infection were laboratory-confirmed. There was no evidence of food- or water-borne transmission. Clinical and epidemiological findings indicated person-to-person transmission of norovirus. This report highlights the potential for large social gatherings to facilitate the spread of viral gastroenteritis by person-to-person transmission and via contaminated environment. Effective community management of this outbreak appears to have prevented its having an impact on local acute hospital services. The authors conclude that in addition to the existing national guidelines on the management of outbreaks of norovirus in healthcare settings, agreed guidelines for the management of norovirus outbreaks in the hotel and tourism industry are needed in Ireland. PMID:17991406

  18. [Outbreaks of Measles in Andalusia, Spain, during the Period 2010-2015].

    PubMed

    Montaño Remacha, Carmen; Gallardo García, Virtudes; Mochón Ochoa, M Mar; García Fernández, Marcelino; Mayoral Cortés, José María; Ruiz Fernández, Josefa

    2015-01-01

    The Andalusian Surveillance Epidemiological System (SVEA) controls and investigates any notification of measles or any other communicable disease. The aim of this article is to describe the epidemiological characteristics of measles outbreaks occurred in Andalusia in the last five years (2010-2015) and their control measures. In this period three outbreaks were reported: the first one started in Granada in 2010 in a community of objectors to vaccination. Control measures of measles protocol of SVEA were adopted (case isolation, identification and contacts immunization), including judicial measures among the group who refused the vaccination. The second outbreak started in Seville in 2011 in an "area in need of social transformation" and it spread throughout the region. The routine vaccination coverage review was introduced within the surveillance system after those outbreaks, identifying the most vulnerable people. During the first six months of 2015, a small outbreak, of 15 cases, occurred in Granada. The outbreak was controlled mainly due to the early intervention, the health measures adopted in the schools and health centres involved and the high vaccination coverage achieved in the population. PMID:26580796

  19. Real-time automatic hospital-wide surveillance of nosocomial infections and outbreaks in a large Chinese tertiary hospital

    PubMed Central

    2014-01-01

    Background We aimed to develop a real-time nosocomial infection surveillance system (RT-NISS) to monitor all nosocomial infections (NIs) and outbreaks in a Chinese comprehensive hospital to better prevent and control NIs. Methods The screening algorithm used in RT-NISS included microbiological reports, antibiotic usage, serological and molecular testing, imaging reports, and fever history. The system could, in real-time, identify new NIs, record data, and produce time-series reports to align NI cases. Results Compared with a manual survey of NIs (the gold standard), the sensitivity and specificity of RT-NISS was 98.8% (84/85) and 93.0% (827/889), with time-saving efficiencies of about 200 times. RT-NISS obtained the highest hospital-wide monthly NI rate of 2.62%, while physician and medical record reviews reported rates of 1.52% and 2.35% respectively. It took about two hours for one infection control practitioner (ICP) to deal with 70 new suspicious NI cases; there were 3,500 inpatients each day in the study hospital. The system could also provide various updated data (i.e. the daily NI rate, surgical site infection (SSI) rate) for each ward, or the entire hospital. Within 3 years of implementing RT-NISS, the ICPs monitored and successfully controlled about 30 NI clusters and 4 outbreaks at the study hospital. Conclusions Just like the “ICPs’ eyes”, RT-NISS was an essential and efficient tool for the day-to-day monitoring of all NIs and outbreak within the hospital; a task that would not have been accomplished through manual process. PMID:24475790

  20. A one-year intensified study of outbreaks of gastroenteritis in The Netherlands.

    PubMed Central

    van Duynhoven, Y. T. H. P.; de Jager, C. M.; Kortbeek, L. M.; Vennema, H.; Koopmans, M. P. G.; van Leusden, F.; van der Poel, W. H. M.; van den Broek, M. J. M.

    2005-01-01

    In 2002, in The Netherlands a national study of gastroenteritis outbreaks was performed. Epidemiological information was collected by the Public Health Services (PHS) and the Food Inspection Services (FIS) using standardized questionnaires. Stool samples were collected for diagnostic testing. For foodborne outbreaks, food samples were taken. In total, 281 gastroenteritis outbreaks were included, mainly from nursing homes and homes for the elderly (57%), restaurants (11%), hospitals (9%) and day-care centres (7%). Direct person-to-person spread was the predominant transmission route in all settings (overall 78%), except for restaurant outbreaks where food was suspected in almost 90% (overall in 21% of outbreaks). The most common pathogen was norovirus (54%), followed by Salmonella spp. (4%), rotavirus group A (2%), Campylobacter spp. (1%) and only incidentally others. In conclusion, most outbreaks were reported from health and residential institutions, with norovirus as the dominant agent. Control should aim at reducing person-to-person spread. In foodborne outbreaks norovirus was common, due to contamination of food by food handlers. Salmonella, as the second foodborne pathogen, was mainly associated with raw shell eggs. These results stress the continuous need for food safety education, complementary to governmental regulation. PMID:15724705

  1. Gastroenteritis outbreaks associated with Norwalk-like viruses and their investigation by nested RT-PCR

    PubMed Central

    O'Neill, Hugh J; McCaughey, Conall; Wyatt, Dorothy E; Mitchell, Frederick; Coyle, Peter V

    2001-01-01

    Background Norwalk-like viruses are the most common cause of gastroenteritis outbreaks and sporadic cases of vomiting and diarrhoea. In healthy individuals infection is often mild and short-lived but in debilitated patients infection can be severe. It is essential that the virus laboratory can offer a sensitive and specific test, delivered in a timely manner. Methods We have developed a nested reverse transcriptase PCR based on published primers against the RNA polymerase gene and after comparison with electronmicroscopy used the assay to investigate 31 outbreaks of gastroenteritis. These were in diverse situations including nursing homes, small district hospitals, large general hospitals, a ferry ship, hotels, restaurants and staff canteens. Results A positive diagnosis was made in 30/31 outbreaks investigated giving an overall outbreak positive detection rate of 97%. At an individual patient level there was a positive diagnostic rate of 11.5% in a large hospital environment to 100% in smaller outbreak situations. The average patient positive rate was 34%. In addition we investigated 532 control faecal specimens from adults. Of these 530 were negative and 2 were repeatedly positive. Conclusions It is essential that insensitive electronmicroscopy is replaced with the more sensitive reverse transcription PCR assays. These tests should be made available "on call" at weekends and public holidays. It is also important that outbreaks of NLV infection are monitored using sensitive RT-PCR assays so that the laboratory information can be used in ascertaining the spread and duration of the outbreak PMID:11511325

  2. Multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak and its control after use of the Veterans Affairs (VA) MRSA bundle in a VA long-term care facility, 2004-2014.

    PubMed

    Webb, Risa M; Denton, Carmelita; Spruill, Emily; Henson, Gay; Bruce, Lisa; Woods, Gail L; Swiatlo, Andrea; Walker, Erica D; Peel, Chere; Sullivan, Donna

    2016-06-01

    A multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak with 91 infections occurred in our Veterans Affairs (VA) community living center over 46 months. Both similar and unique strains were shown by repetitive polymerase chain reaction to contribute to the outbreak, including 1 strain causing infections over a 33-month period. Most infections were soft tissue infections (67%). For 21 months after the initiation of the VA MRSA bundle, no infections were identified, and low rates of infection have been sustained an additional 4 years. The average annual rate of MRSA infection decreased by 62% (P < .001) from 0.6 per 1,000 resident days for 4 years prior to the bundle implementation to 0.09 per 1,000 resident days for 4 years after the bundle implementation. PMID:26922103

  3. Outbreak of hepatitis A infection associated with the consumption of frozen berries, Ireland, 2013--linked to an international outbreak.

    PubMed

    Fitzgerald, M; Thornton, L; O'Gorman, J; O'Connor, L; Garvey, P; Boland, M; Part, A M; Rogalska, J; Coughlan, H; MacDiarmada, J; Heslin, J; Canny, M; Finnegan, P; Moran, J; O'Flanagan, D

    2014-01-01

    In May 2013, a European alert was issued regarding a hepatitis A virus (HAV) outbreak in Italy. In June 2013, HAV subgenotype IA with an identical sequence was identified in Ireland in three cases who had not travelled to Italy. The investigation consisted of descriptive epidemiology, a case-control study, microbiological testing of human and food specimens, molecular typing of positive specimens and food traceback. We identified 21 outbreak cases (14 confirmed primary cases) with symptom onset between 31 January and 11 October 2013. For the case-control study, we recruited 11 confirmed primary cases and 42 matched controls. Cases were more likely than controls to have eaten berry cheesecake (matched odds ratio (mOR): 12; 95% confidence interval (CI): 1.3-114), whole frozen berries (mOR: 9.5; 95% CI: 1.0-89), yoghurt containing frozen berries (mOR: 6.6, 95% CI: 1.2-37) or raw celery (mOR: 4; 95% CI: 1.2-16). Among cases, 91% had consumed at least one of four products containing frozen berries (mOR: 12; 95% CI: 1.5-94). Sixteen food samples tested were all negative for HAV. As products containing frozen berries were implicated in the outbreak, the public were advised to heat-treat frozen berries before consumption. PMID:25375902

  4. Influence of recent bark beetle outbreak on fire severity and postfire tree regeneration in montane Douglas-fir forests.

    PubMed

    Harvey, Brian J; Donato, Daniel C; Romme, William H; Turner, Monica G

    2013-11-01

    Understanding how disturbances interact to shape ecosystems is a key challenge in ecology. In forests of western North America, the degree to which recent bark beetle outbreaks and subsequent fires may be linked (e.g., outbreak severity affects fire severity) and/ or whether these two disturbances produce compound effects on postfire succession is of widespread interest. These interactions remain unresolved, largely because field data from actual wildfires following beetle outbreaks are lacking. We studied the 2008 Gunbarrel Fire, which burned 27 200 ha in Douglas-fir (Pseudotsuga menziesii) forests that experienced a bark beetle outbreak 4-13 years prefire ("gray stage," after trees have died and needles have dropped), to determine whether outbreak severity influenced subsequent fire severity and postfire tree regeneration. In 85 sample plots we recorded prefire stand structure and outbreak severity; multiple measures of canopy and forest-floor fire severity; and postfire tree seedling density. Prefire outbreak severity was not related to any measure of fire severity except for mean bole scorch, which declined slightly with increasing outbreak severity. Instead, fire severity varied with topography and burning conditions (proxy for weather at time of fire). Postfire Douglas-fir regeneration was low, with tree seedlings absent in 65% of plots. Tree seedlings were abundant in plots of low fire severity that also had experienced low outbreak severity (mean = 1690 seedlings/ha), suggesting a dual filter on tree regeneration. Although bark beetles and fire collectively reduced live basal area to < 5% and increased snag density to > 2000% of pre-outbreak levels, the lack of relationship between beetle outbreak and fire severity suggests that these disturbances were not linked. Nonetheless, effects on postfire tree regeneration suggest compound disturbance interactions that contribute to the structural heterogeneity characteristic of mid/lower montane forests. PMID

  5. Pertussis Outbreak, Southeastern Minnesota, 2012

    PubMed Central

    Theofiles, Alexander G.; Cunningham, Scott A.; Chia, Nicholas; Jeraldo, Patricio R.; Quest, Daniel J.; Mandrekar, Jayawant N.; Patel, Robin

    2015-01-01

    Objective To describe clinical and laboratory findings from the 2012 southeastern Minnesota pertussis outbreak. Patients and Methods Patients were selected for 2 parts of the study. In the first part, nasopharyngeal swabs from a convenience sample of 265 unique patients were used for both the clinician-requested polymerase chain reaction (PCR) test and culture. B pertussis isolates were tested for macrolide susceptibility and typed using whole genome sequencing and pulsed-field gel electrophoresis. Pertactin gene sequences were analyzed to identify pertactin-deficient B pertussis. In the second part, all patients seen at Mayo Clinic in Rochester, Minnesota, who had PCR results positive for Bordetella pertussis or Bordetella parapertussis between January 1, 2012, and December 31, 2012, were analyzed for patient demographic features and vaccination records. Results One hundred sixty patients had results positive for B pertussis, and 21 patients had results positive for B parapertussis. Among the 265 swabs cultured, B pertussis was detected by both culture and PCR in 11. One swab was positive for B pertussis by culture alone, and 13 were positive by PCR alone. Polymerase chain reaction detected B pertussis more frequently than did culture (P=.001). No macrolide resistance was detected. All 12 isolates tested had an altered pertactin gene, including 9 with a signal sequence deletion, 2 with insertion sequence disruptions, and 1 with a premature stop codon. Nine and 3 isolates were pertactin types prn1 and prn2, respectively. Whole genome sequencing and pulsed-field gel electrophoresis detected the presence of multiple B pertussis strains. The mean age of patients with pertussis was younger than that of those without pertussis (15.6 and 25.5 years, respectively; P=.002). Compared with those whose test results were negative for B pertussis, fewer patients with positive results had received whole-cell pertussis vaccine (P=.02). In the subgroup who had received acellular

  6. An outbreak of Ebola in Uganda.

    PubMed

    Okware, S I; Omaswa, F G; Zaramba, S; Opio, A; Lutwama, J J; Kamugisha, J; Rwaguma, E B; Kagwa, P; Lamunu, M

    2002-12-01

    An outbreak of Ebola disease was reported from Gulu district, Uganda, on 8 October 2000. The outbreak was characterized by fever and haemorrhagic manifestations, and affected health workers and the general population of Rwot-Obillo, a village 14 km north of Gulu town. Later, the outbreak spread to other parts of the country including Mbarara and Masindi districts. Response measures included surveillance, community mobilization, case and logistics management. Three coordination committees were formed: National Task Force (NTF), a District Task Force (DTF) and an Interministerial Task Force (IMTF). The NTF and DTF were responsible for coordination and follow-up of implementation of activities at the national and district levels, respectively, while the IMTF provided political direction and handled sensitive issues related to stigma, trade, tourism and international relations. The international response was coordinated by the World Health Organization (WHO) under the umbrella organization of the Global Outbreak and Alert Response Network. A WHO/CDC case definition for Ebola was adapted and used to capture four categories of cases, namely, the 'alert', 'suspected', 'probable' and 'confirmed cases'. Guidelines for identification and management of cases were developed and disseminated to all persons responsible for surveillance, case management, contact tracing and Information Education Communication (IEC). For the duration of the epidemic that lasted up to 16 January 2001, a total of 425 cases with 224 deaths were reported countrywide. The case fatality rate was 53%. The attack rate (AR) was highest in women. The average AR for Gulu district was 12.6 cases/10 000 inhabitants when the contacts of all cases were considered and was 4.5 cases/10 000 if limited only to contacts of laboratory confirmed cases. The secondary AR was 2.5% when nearly 5000 contacts were followed up for 21 days. Uganda was finally declared Ebola free on 27 February 2001, 42 days after the last case

  7. Factory outbreak of Escherichia coli O157:H7 infection in Japan.

    PubMed Central

    Watanabe, Y.; Ozasa, K.; Mermin, J. H.; Griffin, P. M.; Masuda, K.; Imashuku, S.; Sawada, T.

    1999-01-01

    To determine the cause of a July 1996 outbreak of Escherichia coli O157:H7 among factory workers in Kyoto, Japan, we conducted cohort and case-control studies. Eating radish sprout salad during lunch at the factory cafeteria had been linked to illness. The sprouts were traced to four growers in Japan; one had been associated with an outbreak of E. coli O157:H7 among 6,000 schoolchildren in Sakai earlier in July. PMID:10341179

  8. An ongoing measles outbreak linked to a suspected imported case, Ireland, April to June 2016.

    PubMed

    Barrett, Peter; Chaintarli, Katerina; Ryan, Fiona; Cotter, Suzanne; Cronin, Anthony; Carlton, Louise; MacSweeney, Mary; McDonnell, Mairead; Connell, Jeff; Fitzgerald, Rose; Hamilton, Douglas; Ward, Mary; Glynn, Ronan; Migone, Chantal

    2016-07-01

    We report an outbreak of measles which started in April 2016 and which, by 13 June, has resulted in 22 confirmed and five probable measles cases occurring in four regions of Ireland. Genotype B3 was identified. We describe the identification, ongoing investigation and control measures being implemented. This outbreak occurs during a period of very low measles transmission in Ireland, with only one confirmed case (imported) notified in 2016 before this event. PMID:27416848

  9. Spinach-associated Escherichia coli O157:H7 Outbreak, Utah and New Mexico, 2006

    PubMed Central

    Wendelboe, Aaron M.; Wendel, Arthur; Jepson, Barbara; Torres, Paul; Smelser, Chad; Rolfs, Robert T.

    2008-01-01

    In 2006, Utah and New Mexico health departments investigated a multistate cluster of Escherichia coli O157:H7. A case–control study of 22 case-patients found that consuming bagged spinach was significantly associated with illness (p<0.01). The outbreak strain was isolated from 3 bags of 1 brand of spinach. Nationally, 205 persons were ill with the outbreak strain. PMID:18826833

  10. Dynamics of a Tularemia Outbreak in a Closely Monitored Free-Roaming Population of Wild House Mice

    PubMed Central

    Dobay, Akos; Pilo, Paola; Lindholm, Anna K.; Origgi, Francesco; Bagheri, Homayoun C.; König, Barbara

    2015-01-01

    Infectious disease outbreaks can be devastating because of their sudden occurrence, as well as the complexity of monitoring and controlling them. Outbreaks in wildlife are even more challenging to observe and describe, especially when small animals or secretive species are involved. Modeling such infectious disease events is relevant to investigating their dynamics and is critical for decision makers to accomplish outbreak management. Tularemia, caused by the bacterium Francisella tularensis, is a potentially lethal zoonosis. Of the few animal outbreaks that have been reported in the literature, only those affecting zoo animals have been closely monitored. Here, we report the first estimation of the basic reproduction number R0 of an outbreak in wildlife caused by F. tularensis using quantitative modeling based on a susceptible-infected-recovered framework. We applied that model to data collected during an extensive investigation of an outbreak of tularemia caused by F. tularensis subsp. holarctica (also designated as type B) in a closely monitored, free-roaming house mouse (Mus musculus domesticus) population in Switzerland. Based on our model and assumptions, the best estimated basic reproduction number R0 of the current outbreak is 1.33. Our results suggest that tularemia can cause severe outbreaks in small rodents. We also concluded that the outbreak self-exhausted in approximately three months without administrating antibiotics. PMID:26536232

  11. Analysis of foodborne disease outbreaks for improvement of food safety programs in Seoul, Republic of Korea, from 2002 to 2006.

    PubMed

    Lee, Jib Ho; Lee, Joon-Hak; Kim, Moo Sang; Park, Seog Gee

    2009-03-01

    Foodborne disease (FBD) is a common food safety problem in Seoul, Republic of Korea. To identify target areas for improvement of the food safety programs, FBD outbreaks from 2002 to 2006 were analyzed with regard to facility, monthly occurrences, and causative agents. A total of 147 FBD outbreaks were reported, with an average of 29.4 FBD outbreaks per year and 49 cases per outbreak. Restaurants and school lunches were two main facilities associated with 76.2% of the outbreaks. A majority of FBD cases (73.1%) were from school lunches. The highest number of outbreaks and cases occurred in June, followed by March. Among the seven identified causative agents, norovirus was the most significant in the number of outbreaks and cases. Among the outbreaks and cases with causative agents identified, norovirus and Staphylococcus aureus were responsible for 61.7% of outbreaks and 81.5% of cases. The analysis indicates that the efficiency of current food safety programs could be enhanced if critical control points in school lunch programs are identified and incorporated in the training and inspection. Identifying risk factors for contamination of norovirus and Staphylococcus aureus would also be beneficial. PMID:19326670

  12. Population response to the risk of vector-borne diseases: lessons learned from socio-behavioural research during large-scale outbreaks

    PubMed Central

    Setbon, M; Raude, J

    2009-01-01

    Vector-borne infectious diseases, such as malaria, dengue, chikungunya, and West Nile fevers are increasingly identified as major global human health threats in developing and developed countries. The success or failure of vector control rests mainly on the nature and scale of the behavioural response of exposed populations. Large-scale adoption of recommended protective behaviour represents a critical challenge that cannot be addressed without a better understanding of how individuals perceive and react to the risk of infection. Recently, French overseas territories faced large-scale outbreaks: an epidemic of chikungunya fever in La Re′ union and Mayotte (2005–2006) and four successive outbreaks of dengue fever in one Caribbean island, Martinique (1995–2007). To assess how these populations perceived and responded to the risk, and how the nature and scale of protection affected their clinical status, socio-epidemiological surveys were conducted on each island during the outbreaks. These surveys address three crucial and interconnected questions relevant to the period after persons infected by the virus were identified: which factors shape the risk of acquiring disease? Which socio- demographic characteristics and living conditions induce a higher likelihood of infection? What is the impact of risk perception on protective behaviours adopted against mosquito bites? Grounded on the results of these surveys, a general framework is proposed to help draw out the knowledge needed to reveal the factors associated with higher probability of infection as an outbreak emerges. The lessons learnt can inform health authorities’ efforts to improve risk communication programmes, both in terms of the target and content of messages, so as to explore new strategies for ensuring sustainable protective behaviour. The authors compare three epidemics of vector-borne diseases to elucidate psychosocial factors that determine how populations perceive and respond to the risk of

  13. An outbreak of Trichinella spiralis infection in southern Lebanon.

    PubMed

    Haim, M; Efrat, M; Wilson, M; Schantz, P M; Cohen, D; Shemer, J

    1997-12-01

    An outbreak of trichinosis occurred during January 1995 in a south Lebanese village with a population of 800-1000 persons. The estimated number of persons treated for a Trichinella-like illness was 200. Sixty-three persons sought medical attention at a local infirmary: 44 of them were diagnosed as having trichinosis or suspected trichinosis according to their clinical symptoms, signs and laboratory tests. An environmental investigation indicated that the source of infection was pork obtained from a single butcher in the village and consumed uncooked, as an ingredient of 'kubeniye' (a local dish), during Christmas and New Year's meals. Sera of patients, suspected patients, and asymptomatic controls were tested for the presence of anti-Trichinella antibodies. Eight (89%) of the 9 tested patients were positive, 1 (11%) was negative. Among the 7 suspected patients, 2 (28.5%) were positive, 3 (42.9%) had equivocal results, and 2 (28.5%) were negative. Among the 20 asymptomatic persons, 3 (15%) were positive, 12 (60%) negative and 5 (25%) had equivocal results. Specimens from the implicated pork meat were examined by microscopy and were found to contain encysted larvae of Trichinella spiralis. This outbreak of trichinosis is one of the largest reported. Previous outbreaks in Lebanon occurred under very similar circumstances, indicating a need to control and prevent the trading of pork meat that is not under veterinary control, and to increase the awareness of the population for this problem. PMID:9440440

  14. Successful Promotion of Hepatitis B Vaccinations Among Vietnamese-American Children Ages 3 to 18: Results of a Controlled Trial

    PubMed Central

    McPhee, Stephen J.; Nguyen, Thoa; Euler, Gary L.; Mock, Jeremiah; Wong, Ching; Lam, Tram; Nguyen, Walter; Nguyen, Sang; Ha, Martin Quach Huynh; Do, Son T.; Buu, Chau

    2006-01-01

    Objective Chronic infection with the hepatitis B virus is endemic in Southeast Asian populations, including Vietnamese. Previous research has documented low rates of hepatitis B vaccine coverage among Vietnamese-American children and adolescents ages 3 to 18. To address this problem, we designed and tested in a controlled trial 2 public health outreach “catch-up” campaigns for this population. Design In the Houston, Texas metropolitan area, we mounted a media-led information and education campaign, and in the Dallas metropolitan area, we organized a community mobilization strategy. We evaluated the success of these interventions in a controlled trial, using the Washington, DC metropolitan area as a control site. To do so, we conducted computer-assisted telephone interviews with random samples of ~500 Vietnamese-American households in each of the 3 study sites both before and after the interventions. We assessed respondents’ awareness and knowledge of hepatitis B and asked for hepatitis B vaccination dates for a randomly selected child in each household. When possible, we validated vaccination dates through direct contact with each child’s providers. Results Awareness of hepatitis B increased significantly between the pre- and postintervention surveys in all 3 areas, and the increase in the media education area (+21.5 percentage points) was significantly larger than in the control area (+9.0 percentage points). At postintervention, significantly more parents knew that free vaccines were available for children in the media education (+31.9 percentage points) and community mobilization (+16.7 percentage points) areas than in the control area (+4.7 percentage points). An increase in knowledge of sexual transmission of hepatitis B virus was significant in the media education area (+14.0 percentage points) and community mobilization (+13.6 percentage points) areas compared with the control area (+5.2 percentage points). Parent- or provider-reported data (n = 783

  15. Bacillus cereus infection outbreak in captive psittacines.

    PubMed

    Godoy, S N; Matushima, E R; Chaves, J Q; Cavados, C F G; Rabinovitch, L; Teixeira, R H F; Nunes, A L V; Melville, P; Gattamorta, M A; Vivoni, A M

    2012-12-28

    This study reports an uncommon epizootic outbreak of Bacillus cereus that caused the sudden death of 12 psittacines belonging to the species Anodorhynchus hyacinthinus (1 individual), Diopsittaca nobilis (1 individual), Ara severa (1 individual) and Ara ararauna (9 individuals) in a Brazilian zoo. Post-mortem examination of the animals reveled extensive areas of lung hemorrhage, hepatic congestion, hemorrhagic enteritis and cardiac congestion. Histopathological examination of the organs showed the presence of multiple foci of vegetative cells of Gram-positive bacilli associated with discrete and moderate mononuclear inflammatory cell infiltrate. Seventeen B. cereus strains isolated from blood and sterile organs of nine A. ararauna were analyzed in order to investigate the genetic diversity (assessed by Rep-PCR) and toxigenic profiles (presence of hblA, hblC and hblD; nheA, nheB and nheC as well as cytK, ces and entFM genes) of such strains. Amplification of genomic DNA by Rep-PCR of B. cereus strains generated two closely related profiles (Rep-PCR types A and B) with three bands of difference. All strains were classified as belonging to the toxigenic profile I which contained HBL and NHE gene complexes, entFM and cytK genes. Altogether, microbiological and histopathological findings and the evidence provided by the success of the antibiotic prophylaxis, corroborate that B. cereus was the causative agent of the infection that killed the birds. PMID:22902190

  16. An outbreak of Brucella abortus biovar 2 in Canadian cattle.

    PubMed

    Forbes, L B; Steele, T B

    1989-11-01

    An outbreak of brucellosis caused by Brucella abortus biovar 2 was identified in cattle in Alberta in December 1986. This was the only clinical infection discovered since the national cattle herd was declared brucellosisfree in 1985. It was the first report of B. abortus biovar 2 in Canadian cattle. The outbreak, involving three herds containing purebred Hereford cattle, was spread by the private treaty sale of untested cattle, and was identified following investigation of an abortion. The source of infection for the outbreak was not established, but several possibilities were identified including infected herds present in the area during the mid-1970's, latent infection originating in a Saskatchewan herd during the early 1960's, American cattle imported during the early 1970's, and brucellosis-infected bison in Wood Buffalo National Park. The containment and elimination of this nidus of infection appears to have been successful, and the national cattle herd at the time of writing is free of the disease. PMID:17423457

  17. Molecular epidemiology of Mycoplasma hyopneumoniae from outbreaks of enzootic pneumonia in domestic pig and the role of wild boar.

    PubMed

    Kuhnert, Peter; Overesch, Gudrun

    2014-11-01

    Mycoplasma hyopneumoniae is the major cause of enzootic pneumonia (EP) in domestic pigs, a disease with low mortality but high morbidity, having a great economic impact for producers. In Switzerland EP has been successfully eradicated, however, sporadic outbreaks are observed with no obvious source. Besides the possibility of recurrent outbreaks due to persisting M. hyopneumoniae strains within the pig population, there is suspicion that wild boars might introduce M. hyopneumoniae into swine herds. To elucidate possible links between domestic pig and wild boar, epidemiological investigations of recent EP outbreaks were initiated and lung samples of pig and wild boar were tested for the presence of specific genotypes by multilocus sequence typing (MLST). Despite generally different genotypes in wild boar, outbreak strains could be found in geographically linked wild boar lungs after, but so far not before the outbreak. Recurrent outbreaks in a farm were due to the same strain, indicating unsuccessful sanitation rather than reintroduction by wild boar. In another case outbreaks in six different farms were caused by the same strain never found in wild boar, confirming spread between farms due to hypothesized animal transport. Results indicate the presence of identical lineages of wild boar and domestic pig strains, and possible transmission of M. hyopneumoniae between wild boar and pig. However, the role of wild boar might be rather one as a recipient than a transmitter. More important than contact to wild boar for sporadic outbreaks in Switzerland is apparently persistence of M. hyopneumoniae within a farm as well as transmission between farms. PMID:25236987

  18. The need of a weight management control program in judo: a proposal based on the successful case of wrestling

    PubMed Central

    2010-01-01

    Judo competitions are divided into weight classes. However, most athletes reduce their body weight in a few days before competition in order to obtain a competitive advantage over lighter opponents. To achieve fast weight reduction, athletes use a number of aggressive nutritional strategies so many of them place themselves at a high health-injury risk. In collegiate wrestling, a similar problem has been observed and three wrestlers died in 1997 due to rapid weight loss regimes. After these deaths, the National Collegiate Athletic Association had implemented a successful weight management program which was proven to improve weight management behavior. No similar program has ever been discussed by judo federations even though judo competitors present a comparable inappropriate pattern of weight control. In view of this, the basis for a weight control program is provided in this manuscript, as follows: competition should begin within 1 hour after weigh-in, at the latest; each athlete is allowed to be weighed-in only once; rapid weight loss as well as artificial rehydration (i.e., saline infusion) methods are prohibited during the entire competition day; athletes should pass the hydration test to get their weigh-in validated; an individual minimum competitive weight (male athletes competing at no less than 7% and females at no less than 12% of body fat) should be determined at the beginning of each season; athletes are not allowed to compete in any weight class that requires weight reductions greater than 1.5% of body weight per week. In parallel, educational programs should aim at increasing the athletes', coaches' and parents' awareness about the risks of aggressive nutritional strategies as well as healthier ways to properly manage body weight. PMID:20441594

  19. An outbreak of invasive fusariosis in a children's cancer hospital.

    PubMed

    Litvinov, Nadia; da Silva, Mariama Tomaz N; van der Heijden, Inneke M; Graça, Mariana G; Marques de Oliveira, Larissa; Fu, Liang; Giudice, Mauro; Zilda de Aquino, Maria; Odone-Filho, Vicente; Marques, Heloisa Helena; Costa, Silvia F; Levin, Anna S

    2015-03-01

    Fusarium is considered an emerging pathogen, and there are few reports of fusariosis in children. The objective of this study was to describe an outbreak of invasive fusariosis in a children's cancer hospital. A neutropenic 17-year-old male patient hospitalized for 10 days for a relapse of acute myeloid leukaemia, under chemotherapy, presented fever without any other symptoms; a thoracic computerized tomography showed bilateral pulmonary nodules. During voriconazole treatment, 1-cm reddened and painful subcutaneous nodules appeared on arms and legs and the culture of a skin biopsy revealed F. solani. Another case occurred 11 days later and started an outbreak investigation. Water samples for cultures were collected from taps, showers and water reservoirs. Air from all patient rooms was sampled. Faucets and the drains of sinks and showers were swabbed and cultured. Environmental and clinical isolates were typed. There were 10 confirmed cases of infection caused by Fusarium spp. F. oxysporum and F. solani were isolated from water, swabs and air in patient rooms. Many control measures were instituted, but the outbreak was only controlled 1 year after the first case, when water filters filtering 0.2 μm were installed at the exit of all faucets and showers in all patient rooms (points-of-use). Typing demonstrated that clinical isolates of F. oxysporum were similar to those of the environment. In conclusion, to our knowledge this is the first reported outbreak of invasive fusariosis in children with oncohaematologic disease. It was controlled using 0.2-μm filters in all tap faucets and showers. PMID:25658562

  20. Enhanced performance of PbS-sensitized solar cells via controlled successive ionic-layer adsorption and reaction.

    PubMed

    Abbas, Muhammad A; Basit, Muhammad A; Park, Tae Joo; Bang, Jin Ho

    2015-04-21

    Despite the potential of PbS quantum dots (QDs) as sensitizers for quantum-dot-sensitized solar cells (QDSSCs), achieving a high photocurrent density over 30 mA cm(-2) remains a challenging task in PbS-sensitized solar cells. In contrast to previous attempts, where Hg(2+)-doping or multi-step post-treatment is necessary, we are capable of achieving a high photocurrent exceeding 30 mA cm(-2) simply by manipulating the successive ionic layer adsorption and reaction (SILAR) method. We show that controlling temperature at which SILAR is performed is critical to obtain a higher and more uniform coverage of PbS QDs over a mesoporous TiO2 film. The deposition of a CdS inter-layer between TiO2 and PbS is found to be an effective means of ensuring high photocurrent and stability. Not only does this modification improve the light absorption capability of the photoanode, but it also has a significant effect on charge recombination and electron injection efficiency at the PbS/TiO2 interface according to our in-depth study using electrochemical impedance spectroscopy (EIS). The implication of subtle changes in the interfacial events via modified SILAR conditions for PbS-sensitized solar cells is discussed. PMID:25773573

  1. Lessons from the Nipah virus outbreak in Malaysia.

    PubMed

    Looi, Lai-Meng; Chua, Kaw-Bing

    2007-12-01

    The Nipah virus outbreak in Malaysia (September 1998 to May 1999) resulted in 265 cases of acute encephalitis with 105 deaths, and near collapse of the billion-dollar pig-farming industry. Because it was initially attributed to Japanese encephalitis, early control measures were ineffective, and the outbreak spread to other parts of Malaysia and nearby Singapore. The isolation of the novel aetiological agent, the Nipah virus (NiV), from the cerebrospinal fluid of an outbreak victim was the turning point which led to outbreak control 2 months later. Together with the Hendra virus, NiV is now recognised as a new genus, Henipavirus (Hendra + Nipah), in the Paramyxoviridae family. Efforts of the local and international scientific community have since elucidated the epidemiology, clinico-pathophysiology and pathogenesis of this new disease. Humans contracted the infection from close contact with infected pigs, and formed the basis for pig-culling that eventually stopped the outbreak. NiV targeted medium-sized and small blood vessels resulting in endothelial multinucleated syncytia and fibrinoid necrosis. Autopsies revealed disseminated cerebral microinfarctions resulting from vasculitis-induced thrombosis and direct neuronal involvement. The discovery of NiV in the urine and saliva of Malaysian Island flying foxes (Pteropus hypomelanus and Petropus vampyrus) implicated these as natural reservoir hosts of NiV. It is probable that initial transmission of NiV from bats to pigs occurred in late 1997/early 1998 through contamination of pig swill by bat excretions, as a result of migration of these forest fruitbats to cultivated orchards and pig-farms, driven by fruiting failure of forest trees during the El Nino-related drought and anthropogenic fires in Indonesia in 1997-1998. This outbreak emphasizes the need for sharing information of any unusual illnesses in animals and humans, an open-minded approach and close collaboration and co-ordination between the medical

  2. Complicated infectious coryza outbreaks in Argentina.

    PubMed

    Sandoval, V E; Terzolo, H R; Blackall, P J

    1994-01-01

    Seventeen complicated outbreaks of infectious coryza in layer, broiler-breeder, and broiler flocks were studied. In the layer flock outbreaks, drops in egg production of up to 35% were seen. In the broiler flocks and several of the layer flocks, losses due to persistent mortality and/or culling varied between 2 and 5%. Signs of infectious coryza in both layers and broiler-breeders were typical; in broilers, however, swollen head-like syndrome was seen. Except in one flock, no viral diseases were clinically or serologically detected. Excluding broiler-breeders, birds from most other flocks were serologically positive for Mycoplasma gallisepticum, and some were also positive for M. synoviae. Haemophilus paragallinarum was isolated from all of the outbreaks, but only as a pure culture in three outbreaks. Isolation of H. paragallinarum from sites such as liver, kidney, and particularly tarsal arthritis and ocular globes appears to be reported for the first time. Serovar A was isolated in eight outbreaks, serovar B in six, serovar C in one, and untypable serovars in two. The severity of these infectious coryza outbreaks may have been increased by concurrent salmonellosis, pasteurellosis, and mycoplasmosis, although under certain conditions H. paragallinarum is able to cause septicemia. Ten of the outbreaks occurred in birds vaccinated against infectious coryza; this may be due to the use of vaccines that do not provide protection against the types of H. paragallinarum that affect poultry in the region. PMID:7832727

  3. The May 2003 Extended Tornado Outbreak.

    NASA Astrophysics Data System (ADS)

    Hamill, Thomas M.; Schneider, Russell S.; Brooks, Harold E.; Forbes, Gregory S.; Bluestein, Howard B.; Steinberg, Michael; Meléndez, Daniel; Dole, Randall M.

    2005-04-01

    In May 2003 there was a very destructive extended outbreak of tornadoes across the central and eastern United States. More than a dozen tornadoes struck each day from 3 May to 11 May 2003. This outbreak caused 41 fatalities, 642 injuries, and approximately $829 million dollars of property damage. The outbreak set a record for most tornadoes ever reported in a week (334 between 4 10 May), and strong tornadoes (F2 or greater) occurred in an unbroken sequence of nine straight days. Fortunately, despite this being one of the largest extended outbreaks of tornadoes on record, it did not cause as many fatalities as in the few comparable past outbreaks, due in large measure to the warning efforts of National Weather Service, television, and private-company forecasters and the smaller number of violent (F4 F5) tornadoes. This event was also relatively predictable; the onset of the outbreak was forecast skillfully many days in advance.An unusually persistent upper-level trough in the intermountain west and sustained low-level southerly winds through the southern Great Plains produced the extended period of tornado-favorable conditions. Three other extended outbreaks in the past 88 years were statistically comparable to this outbreak, and two short-duration events (Palm Sunday 1965 and the 1974 Superoutbreak) were comparable in the overall number of strong tornadoes. An analysis of tornado statistics and environmental conditions indicates that extended outbreaks of this character occur roughly every 10 to 100 years.


  4. Effects of Mumps Outbreak in Hospital, Chicago, Illinois, USA, 2006

    PubMed Central

    Bonebrake, Amanda L.; Silkaitis, Christina; Monga, Gaurav; Galat, Amy; Anderson, Jay; Trad, JoEllyn Tiesi; Hedley, Kenneth; Burgess, Nanette

    2010-01-01

    In 2006, nearly 6,000 mumps cases were reported in the United States, 795 of which occurred in Illinois. In Chicago, 1 healthcare institution experienced ongoing transmission for 4 weeks. This study examines the outbreak epidemiology and quantifies the financial affect on this organization. This retrospective cohort study was conducted through case and exposure identification, interviews, medical record reviews, and immunologic testing of blood specimens. Nine mumps cases resulted in 339 exposures, 325 (98%) among employees. During initial investigation, 186 (57%) of the exposed employees had evidence of mumps immunity. Physicians made up the largest group of noncompliers (55%) with mumps immunity testing. The cost to the institution was $262,788 or $29,199 per mumps case. The outbreak resulted in substantial staffing and financial challenges for the institution that may have been minimized with readily accessible electronic employee vaccination records and adherence to infection control recommendations. PMID:20202417

  5. An Outbreak of Bartonella bacilliformis in an Endemic Andean Community

    PubMed Central

    Sanchez Clemente, Nuria; Ugarte-Gil, Cesar; Solorzano, Nelson; Maguiña, Ciro; Moore, David

    2016-01-01

    Background Bartonellosis affects small Andean communities in Peru, Colombia and Ecuador. Research in this area has been limited. Methods Retrospective review of 191 cases of bartonellosis managed in Caraz District Hospital, Peru, during the last outbreak (2003). Results The majority of cases (65%) were 14 years old and younger. There was a peak in acute cases after the rainy season; chronic cases presented more constantly throughout the year. The sensitivity of blood smear against blood culture in acute disease was 25%. The most commonly used treatment for chronic disease was rifampicin; chloramphenicol was used to treat most acute cases. Complications arose in 6.8% and there were no deaths. Conclusions Diagnostic and treatment algorithms for acute and chronic bartonellosis have been developed without a strong evidence base. Preparation of ready-to-go operational research protocols for future outbreaks would strengthen the evidence base for diagnostic and treatment strategies and enhance opportunities for control. PMID:26991495

  6. [No best treatment for severe outbreaks: Maintenance, the key in colitis].

    PubMed

    Sicilia, Beatriz

    2011-12-01

    Several drugs are currently available to maintain remission in patients who have responded after one or other type of induction therapy, depending on the initial severity of the outbreak. Salicylates are the drugs of choice to maintain remission after a mild-to-moderate outbreak controlled by salicylates or oral corticosteroids. To maintain remission after a severe outbreak or in patients with corticosteroid dependence or resistance, thiopurines are the drugs of choice. In patients who have failed to respond to thiopurines and in those with thiopurine intolerance, biological agents, mainly infliximab, can be used to maintain remission in patients after induction therapy with infliximab for a severe outbreak. However, these scenarios may not reflect reality of gastroenterologists' daily clinical practice. Treatment will therefore be based on the patient's individual characteristics (age, clinical course, previous treatment, adverse effects and personal preferences) as well as the physician's medical art. PMID:25443222

  7. Outbreaks of monophasic Salmonella enterica serovar 4,[5],12:i:- in Luxembourg, 2006.

    PubMed

    Mossong, J; Marques, P; Ragimbeau, C; Huberty-Krau, P; Losch, S; Meyer, G; Moris, G; Strottner, C; Rabsch, W; Schneider, F

    2007-06-01

    A monophasic Salmonella enterica serovar 4,[5],12:i:- phage type DT193 emerged as the dominant serovar in Luxembourg in 2006, when it caused two major outbreaks involving 133 laboratory-confirmed human cases, 24 hospitalisations, and one death. The outbreak strain had an uncommon pulsed-field gel electrophoresis pattern STYMXB.0031 and antibiotic resistance profile ASSuT. A high proportion of cases were clustered in institutions for the elderly and in day-care centers. Strains identical to the outbreak strain were recovered from two control meals, a nappy changing table, retail sausages and caecal porcine samples at an abattoir. Locally produced pork meat is strongly suspected to have been the vehicle for the outbreaks, although the precise mechanisms remain unclear. PMID:17991400

  8. Perspectives on West Africa Ebola Virus Disease Outbreak, 2013-2016

    DOE PAGESBeta

    Spengler, Jessica R.; Ervin, Elizabeth D.; Towner, Jonathan S.; Rollin, Pierre E.; Nichol, Stuart T.

    2016-06-01

    The variety of factors that contributed to the initial undetected spread of Ebola virus disease in West Africa during 2013-2016 and the difficulty controlling the outbreak once the etiology was identified highlight priorities for disease prevention, detection, and response. These factors include occurrence in a region recovering from civil instability and lacking experience with Ebola response; inadequate surveillance, recognition of suspected cases, and Ebola diagnosis; mobile populations and extensive urban transmission; and the community's insufficient general understanding about the disease. The magnitude of the outbreak was not attributable to a substantial change of the virus. Finally, continued efforts during themore » outbreak and in preparation for future outbreak response should involve identifying the reservoir, improving in-country detection and response capacity, conducting survivor studies and supporting survivors, engaging in culturally appropriate public education and risk communication, building productive interagency relationships, and continuing support for basic research.« less

  9. Guidance for improving the federal response to foodborne illness outbreaks associated with fresh produce.

    PubMed

    Benson, Sara M

    2010-01-01

    Today, our nation's food supply flows through a complicated chain of farmers, processors, and distributors before reaching consumers. At some point during this process, food can become contaminated with pathogens and it can make people sick. The Food and Drug Administration, along with the Centers for Disease Control, are in charge of fighting an outbreak once it occurs. The CDC first identifies a specific food that is making people ill, and then the FDA steps in to find the source of that contaminated food. This process, however, does not always run smoothly. Historically, these federal agencies have been underfunded and have had few staff dedicated to fighting foodborne illness outbreaks. This means that an outbreak is not always handled effectively or efficiently, which can have devastating effects on innocent industry actors. This Note gives practical guidance to the FDA and CDC for improving its responses to foodborne illness outbreaks so that consumers, as well as innocent industry actors, are protected. PMID:24479238

  10. Tactics and Strategies for Managing Ebola Outbreaks and the Salience of Immunization

    PubMed Central

    Getz, Wayne M.; Gonzalez, Jean-Paul; Salter, Richard; Bangura, James; Carlson, Colin; Coomber, Moinya; Dougherty, Eric; Kargbo, David; Wolfe, Nathan D.; Wauquier, Nadia

    2015-01-01

    We present a stochastic transmission chain simulation model for Ebola viral disease (EVD) in West Africa, with the salutary result that the virus may be more controllable than previously suspected. The ongoing tactics to detect cases as rapidly as possible and isolate individuals as safely as practicable is essential to saving lives in the current outbreaks in Guinea, Liberia, and Sierra Leone. Equally important are educational campaigns that reduce contact rates between susceptible and infectious individuals in the community once an outbreak occurs. However, due to the relatively low R0 of Ebola (around 1.5 to 2.5 next generation cases are produced per current generation case in naïve populations), rapid isolation of infectious individuals proves to be highly efficacious in containing outbreaks in new areas, while vaccination programs, even with low efficacy vaccines, can be decisive in curbing future outbreaks in areas where the Ebola virus is maintained in reservoir populations. PMID:25755674

  11. Perspectives on West Africa Ebola Virus Disease Outbreak, 2013–2016

    PubMed Central

    Spengler, Jessica R.; Ervin, Elizabeth D.; Towner, Jonathan S.; Rollin, Pierre E.

    2016-01-01

    The variety of factors that contributed to the initial undetected spread of Ebola virus disease in West Africa during 2013–2016 and the difficulty controlling the outbreak once the etiology was identified highlight priorities for disease prevention, detection, and response. These factors include occurrence in a region recovering from civil instability and lacking experience with Ebola response; inadequate surveillance, recognition of suspected cases, and Ebola diagnosis; mobile populations and extensive urban transmission; and the community’s insufficient general understanding about the disease. The magnitude of the outbreak was not attributable to a substantial change of the virus. Continued efforts during the outbreak and in preparation for future outbreak response should involve identifying the reservoir, improving in-country detection and response capacity, conducting survivor studies and supporting survivors, engaging in culturally appropriate public education and risk communication, building productive interagency relationships, and continuing support for basic research. PMID:27070842

  12. Perspectives on West Africa Ebola Virus Disease Outbreak, 2013-2016.

    PubMed

    Spengler, Jessica R; Ervin, Elizabeth D; Towner, Jonathan S; Rollin, Pierre E; Nichol, Stuart T

    2016-06-01

    The variety of factors that contributed to the initial undetected spread of Ebola virus disease in West Africa during 2013-2016 and the difficulty controlling the outbreak once the etiology was identified highlight priorities for disease prevention, detection, and response. These factors include occurrence in a region recovering from civil instability and lacking experience with Ebola response; inadequate surveillance, recognition of suspected cases, and Ebola diagnosis; mobile populations and extensive urban transmission; and the community's insufficient general understanding about the disease. The magnitude of the outbreak was not attributable to a substantial change of the virus. Continued efforts during the outbreak and in preparation for future outbreak response should involve identifying the reservoir, improving in-country detection and response capacity, conducting survivor studies and supporting survivors, engaging in culturally appropriate public education and risk communication, building productive interagency relationships, and continuing support for basic research. PMID:27070842

  13. Outbreak of Shigella sonnei infection traced to imported iceberg lettuce.

    PubMed Central

    Kapperud, G; Rørvik, L M; Hasseltvedt, V; Høiby, E A; Iversen, B G; Staveland, K; Johnsen, G; Leitao, J; Herikstad, H; Andersson, Y

    1995-01-01

    In the period from May through June 1994, an increase in the number of domestic cases of Shigella sonnei infection was detected in several European countries, including Norway, Sweden, and the United Kingdom. In all three countries epidemiological evidence incriminated imported iceberg lettuce of Spanish origin as the vehicle of transmission. The outbreaks shared a number of common features: a predominance of adults among the case patients, the presence of double infections with other enteropathogens, and the finding of two dominant phage types among the bacterial isolates. In Norway 110 culture-confirmed cases of infection were recorded; more than two-thirds (73%) were adults aged 30 to 60 years. A nationwide case-control study comprising 47 case patients and 155 matched control individuals showed that the consumption of imported iceberg lettuce was independently associated with an increased risk of shigellosis. Epidemiological investigation of a local outbreak incriminated iceberg lettuce from Spain, consumed from a salad bar, as the source. The presence of shigellae in the suspected food source could not be documented retrospectively. However, high numbers of fecal coliforms were detected in iceberg lettuce from patients' homes. Three lettuce specimens yielded salmonellae. The imported iceberg lettuce harbored Escherichia coli strains showing resistance to several antimicrobial agents, including ampicillin, ciprofloxacin, gentamicin, and trimethoprim-sulfamethoxazole. During the outbreak it is likely that thousands of Norwegians and an unknown number of consumers in other countries were exposed to coliforms containing antibiotic resistance genes. PMID:7751364

  14. Temporal variations in the effective reproduction number of the 2014 west Africa ebola outbreak.

    PubMed

    Towers, Sherry; Patterson-Lomba, Oscar; Castillo-Chavez, Carlos

    2014-01-01

    Background The rapidly evolving 2014 Ebola virus disease (EVD) outbreak in West Africa is the largest documented in history, both in terms of the number of people infected and in the geographic spread. The high morbidity and mortality have inspired response strategies to the outbreak at the individual, regional, and national levels. Methods to provide real-time assessment of changing transmission dynamics are critical to the understanding of how these adaptive intervention measures have affected the spread of the outbreak. Methods In this analysis, we use the time series of EVD cases in Guinea, Sierra Leone, and Liberia up to September 8, 2014, and employ novel methodology to estimate how the rate of exponential rise of new cases has changed over the outbreak using piecewise fits of exponential curves to the outbreak data. Results We find that for Liberia and Guinea, the effective reproduction number rose, rather than fell, around the time that the outbreak spread to densely populated cities, and enforced quarantine was imposed on several regions in the countries; this may indicate that enforced quarantine may not be an effective control measure. Conclusions If effective control measures are not put in place, and the current rate of exponential rise of new cases continues, we predict 4400 new Ebola cases in West Africa during the last half of the month of September, with an upper 95% confidence level of 6800 new cases. PMID:25642357

  15. Mass Gatherings and Respiratory Disease Outbreaks in the United States – Should We Be Worried? Results from a Systematic Literature Review and Analysis of the National Outbreak Reporting System

    PubMed Central

    Rainey, Jeanette J.; Phelps, Tiffani; Shi, Jianrong

    2016-01-01

    Background Because mass gatherings create environments conducive for infectious disease transmission, public health officials may recommend postponing or canceling large gatherings during a moderate or severe pandemic. Despite these recommendations, limited empirical information exists on the frequency and characteristics of mass gathering-related respiratory disease outbreaks occurring in the United States. Methods We conducted a systematic literature review to identify articles about mass gathering-related respiratory disease outbreaks occurring in the United States from 2005 to 2014. A standard form was used to abstract information from relevant articles identified from six medical, behavioral and social science literature databases. We also analyzed data from the National Outbreaks Reporting System (NORS), maintained by the Centers for Disease Control and Prevention since 2009, to estimate the frequency of mass gathering-related respiratory disease outbreaks reported to the system. Results We identified 21 published articles describing 72 mass gathering-related respiratory disease outbreaks. Of these 72, 40 (56%) were associated with agriculture fairs and Influenza A H3N2v following probable swine exposure, and 25 (35%) with youth summer camps and pandemic Influenza A H1N1. Outbreaks of measles (n = 1) and mumps (n = 2) were linked to the international importation of disease. Between 2009 and 2013, 1,114 outbreaks were reported to NORS, including 96 respiratory disease outbreaks due to Legionella. None of these legionellosis outbreaks was linked to a mass gathering according to available data. Conclusion Mass gathering-related respiratory disease outbreaks may be uncommon in the United States, but have been reported from fairs (zoonotic transmission) as well as at camps where participants have close social contact in communal housing. International importation can also be a contributing factor. NORS collects information on certain respiratory diseases and could

  16. A coccidioidomycosis outbreak following the Northridge, Calif, earthquake

    USGS Publications Warehouse

    Schneider, E.; Hajjeh, R.A.; Spiegel, R.A.; Jibson, R.W.; Harp, E.L.; Marshall, G.A.; Gunn, R.A.; McNeil, M.M.; Pinner, R.W.; Baron, R.C.; Burger, R.C.; Hutwagner, L.C.; Crump, C.; Kaufman, L.; Reef, S.E.; Feldman, G.M.; Pappagianis, D.; Werner, S.B.

    1997-01-01

    Objective. - To describe a coccidioidomycosis outbreak in Ventura County following the January 1994 earthquake, centered in Northridge, Calif, and to identify factors that increased the risk for acquiring acute coccidioidomycosis infection. Design. - Epidemic investigation, population- based skin test survey, and case-control study. Setting. - Ventura County, California. Results. - In Ventura County, between January 24 and March 15, 1994, 203 outbreak-associated coccidioidomycosis cases, including 3 fatalities, were identified (attack rate [AR], 30 cases per 100 000 population). The majority of cases (56%) and the highest AR (114 per 100 000 population) occurred in the town of Simi Valley, a community located at the base of a mountain range that experienced numerous landslides associated with the earthquake. Disease onset for cases peaked 2 weeks after the earthquake. The AR was 2.8 times greater for persons 40 years of age and older than for younger persons (relative risk, 2.8; 95% confidence interval [CI], 2.1-3.7; P<.001). Environmental data indicated that large dust clouds, generated by landslides following the earthquake and strong aftershocks in the Santa Susana Mountains north of Simi Valley, were dispersed into nearby valleys by northeast winds. Simi Valley case-control study data indicated that physically being in a dust cloud (odds ratio, 3.0; 95% CI, 1.6-5.4; P<.001) and time spent in a dust cloud (P<.001) significantly increased the risk for being diagnosed with acute coccidioidomycosis. Conclusions. - Both the location and timing of cases strongly suggest that the coccidioidomycosis outbreak in Ventura County was caused when arthrospores were spread in dust clouds generated by the earthquake. This is the first report of a coccidioidomycosis outbreak following an earthquake. Public and physician awareness, especially in endemic areas following similar dust cloud- generating events, may result in prevention and early recognition of acute

  17. Outbreak of mumps in a school setting, United Kingdom, 2013

    PubMed Central

    Aasheim, Erlend T; Inns, Thomas; Trindall, Amy; Emmett, Lynsey; Brown, Kevin E; Williams, Chris J; Reacher, Mark

    2014-01-01

    Effective protection against mumps can be achieved through 2 doses of the measles-mumps-rubella (MMR) vaccine. However, outbreaks of mumps have recently been described among populations with high vaccination coverage, including 2 doses of MMR. Here we describe an outbreak at a school in the East of England, UK. The school was attended by 540 pupils aged 10–19 years and had 170 staff. In total, 28 cases of mumps (24 pupils and 4 staff) were identified during 10 January to 16 March 2013. Vaccination status was known in 25 of the cases, and among these 21 (84.0%) had a documented history of 2 doses of MMR while the remaining had a history of one dose (2/25 cases, 8.0%) or no doses (2/25, 8.0%) of MMR. An outbreak control team recommended that MMR vaccine should be offered to all pupils whose parents consented to it, regardless of previous vaccination status. Additional MMR vaccines were administered to 103 pupils, including 76 (73.8%) third doses of MMR. Offering an additional dose of MMR appeared to be acceptable to parents, and we found it feasible to administer the intervention in a timely manner with resources from the local Public Health Centre (Primary Care Trust). An additional dose of MMR to all individuals at risk can be considered as an acceptable control measure for mumps outbreaks in schools even if the vaccination coverage is high. However, further evidence on the effectiveness, acceptability, and safety of this intervention is needed. PMID:25424953

  18. Nitrogen availability as a control mechanism of secondary succession within a semiarid shrubland ecosystem. Final report, October 1, 1990--June 27, 1992

    SciTech Connect

    Redente, E.F.; McLendon, T.

    1992-09-25

    Three experiments were conducted within a semiarid shrubland to test the role of nitrogen availability as a control mechanism in secondary succession. Secondary succession patterns were documented for seven years and effects of increased and decreased N availability levels, fumigation, and competition by early-seral species were tested. Differential responses by seral species were determined and related to successional patterns. Nitrogen availability was found to be a primary mechanism controlling the rate of succession. Relative growth rate was an important factor determining which species initially dominated and N availability became the primary control factor by the third year. As N availability increased, the rate of succession decreased. Conversely, as N availability was decreased, the rate of succession increased. The abundance of annuals was increased and abundance of perennials decreased by increased N availability. Tissue N concentration was related to lifeform and seral position, and these relationships were important in the transition from early- to mid-seral stages. Decomposer subsystem dynamics were correlated with seral community dynamics. The effect of fumigation was minimized by initially planting with late-seral species. A conceptual model of secondary succession i