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Sample records for vaccination complications taiwan

  1. Neurologic complications of vaccinations.

    PubMed

    Miravalle, Augusto A; Schreiner, Teri

    2014-01-01

    This chapter reviews the most common neurologic disorders associated with common vaccines, evaluates the data linking the disorder with the vaccine, and discusses the potential mechanism of disease. A literature search was conducted in PubMed using a combination of the following terms: vaccines, vaccination, immunization, and neurologic complications. Data were also gathered from publications of the American Academy of Pediatrics Committee on Infectious Diseases, the World Health Organization, the US Centers for Disease Control and Prevention, and the Vaccine Adverse Event Reporting System. Neurologic complications of vaccination are rare. Many associations have been asserted without objective data to support a causal relationship. Rarely, patients with a neurologic complication will have a poor outcome. However, most patients recover fully from the neurologic complication. Vaccinations have altered the landscape of infectious disease. However, perception of risk associated with vaccinations has limited the success of disease eradication measures. Neurologic complications can be severe, and can provoke fear in potential vaccines. Evaluating whether there is causal link between neurologic disorders and vaccinations, not just temporal association, is critical to addressing public misperception of risk of vaccination. Among the vaccines available today, the cost-benefit analysis of vaccinations and complications strongly argues in favor of vaccination. © 2014 Elsevier B.V. All rights reserved.

  2. Cost-effectiveness of childhood rotavirus vaccination in Taiwan.

    PubMed

    Wu, Chia-Ling; Yang, Yi-Ching; Huang, Li-Min; Chen, Kow-Tong

    2009-03-04

    Rotavirus is the most common cause of severe diarrhea in children. Two rotavirus vaccines (RotaTeq and Rotarix) have been licensed in Taiwan. We have investigated whether routine infant immunization with either vaccine could be cost-effective in Taiwan. We modeled specific disease outcomes including hospitalization, emergency department visits, hospital outpatient visits, physician office visits, and death. Cost-effectiveness was analyzed from the perspectives of the health care system and society. A decision tree was used to estimate the disease burden and costs based on data from published and unpublished sources. A routine rotavirus immunization program would prevent 146,470 (Rotarix) or 149,937 (RotaTeq) cases of rotavirus diarrhea per year, and would prevent 21,106 (Rotarix) and 23,057 (RotaTeq) serious cases (hospitalizations, emergency department visits, and death). At US$80 per dose for the Rotarix vaccine, the program would cost US$32.7 million, provided an increasing cost offset of US$19.8 million to the health care system with $135 per case averted. Threshold analysis identified a break-even price per dose of US$27 from the health care system perspective and US$41 from a societal perspective. At US$60.0 per dose of RotaTeq vaccine, the program would cost US$35.4 million and provide an increasing cost offset of US$22.5 million to the health care system, or US$150 per case averted. Threshold analysis identified a break-even price per dose of US$20.0 from the health care system perspective and $29 from the societal perspective. Greater costs of hospitalization and lower vaccine price could increase cost-effectiveness. Despite a higher burden of serious rotavirus disease than estimated previously, routine rotavirus vaccination would unlikely be cost-saving in Taiwan at present unless the price fell to US$41 (Rotarix) or US$29 (RotaTeq) per dose from societal perspective, respectively. Nonetheless, rotavirus immunization could reduce the substantial burden of

  3. Oral poliovirus vaccination and pregnancy complications.

    PubMed

    Harjulehto-Mervaala, T; Hovi, T; Aro, T; Saxén, H; Hiilesmaa, V K

    1995-04-01

    To determine whether the effect of live attenuated oral polio virus vaccine given to pregnant women increases pregnancy complications. A study of women who had been vaccinated against poliovirus during a national vaccination campaign and who had delivered by cesarean section in three obstetrical hospitals in southern Finland. One thousand seven hundred and forty-seven vaccinated women (in three study cohorts), and their 2293 nonvaccinated controls (in two reference cohorts) were analyzed. Subjects are out of 22,000 deliveries evaluated earlier. Vaccinated sectioned women did not show an excess of pregnancy complications. The mean rate of cesarean sections was 18.4% in the study cohorts and 18.9% in the reference cohorts counted from the 22,000 deliveries. Oral live attenuated polio virus vaccine does not increase pregnancy complications and is considered a safe alternative for vaccinating pregnant women.

  4. Cost-Effectiveness Analysis of Universal Influenza Vaccination: Application of Susceptible-Infectious-Complication-Recovery Model.

    PubMed

    Yang, Kuen-Cheh; Hung, Hui-Fang; Chen, Meng-Kan; Chen, Li-Sheng; Fann, Jean Ching-Yuan; Chiu, Sherry Yueh-Hsia; Yen, Amy-Ming Fang; Huang, Kuo-Chin; Chen, Hsiu-Hsi; Wang, Sen-Te

    2018-06-12

    Despite the fact that vaccination is an effective primary prevention strategy for containing influenza outbreak, health policymakers show great concern over enormous costs involved in universal immunization particularly when resources are limited. We conducted a two-arm cost-effectiveness analysis (CEA) that takes into account the aspect of herd immunity, using a study cohort that was composed of 100,000 residents with the make-up of demographic characteristics identical to those of the underlying population in Taipei County, Taiwan, during the epidemic influenza season of 2001-2002. The parameters embedded in the dynamic process of infection were estimated by the application of the newly proposed susceptible-infection-complication-recovery model to the empirical data in order to compute the number of deaths and complications averted due to universal vaccination compared to non-vaccination. Incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curve (CEAC) given maximum amount of willingness-to-pay (WTP) were calculated to delineate the results of the two-arm CEA. Incremental costs involved in the vaccinated group as opposed to the unvaccinated group was $1,195 for reducing one additional complication and $805 for averting one additional death, allowing for herd immunity. The corresponding figures were higher for the results without considering herd immunity. Given the ceiling ratio of willingness-to-pay (WTP) equal to $10,000 (approximately two-thirds of the GDP), the probability of being cost-effective for vaccination was 100% and 96.7% for averting death and complications, respectively. Universal vaccination against seasonal influenza was very cost-effective particularly when herd immunity is considered. The probability of being cost-effective was almost certain given the maximum amount of WTP within two-thirds of the GDP. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. BCG vaccination in patients with severe combined immunodeficiency: complications, risks, and vaccination policies.

    PubMed

    Marciano, Beatriz E; Huang, Chiung-Yu; Joshi, Gyan; Rezaei, Nima; Carvalho, Beatriz Costa; Allwood, Zoe; Ikinciogullari, Aydan; Reda, Shereen M; Gennery, Andrew; Thon, Vojtech; Espinosa-Rosales, Francisco; Al-Herz, Waleed; Porras, Oscar; Shcherbina, Anna; Szaflarska, Anna; Kiliç, Şebnem; Franco, Jose L; Gómez Raccio, Andrea C; Roxo, Persio; Esteves, Isabel; Galal, Nermeen; Grumach, Anete Sevciovic; Al-Tamemi, Salem; Yildiran, Alisan; Orellana, Julio C; Yamada, Masafumi; Morio, Tomohiro; Liberatore, Diana; Ohtsuka, Yoshitoshi; Lau, Yu-Lung; Nishikomori, Ryuta; Torres-Lozano, Carlos; Mazzucchelli, Juliana T L; Vilela, Maria M S; Tavares, Fabiola S; Cunha, Luciana; Pinto, Jorge A; Espinosa-Padilla, Sara E; Hernandez-Nieto, Leticia; Elfeky, Reem A; Ariga, Tadashi; Toshio, Heike; Dogu, Figen; Cipe, Funda; Formankova, Renata; Nuñez-Nuñez, M Enriqueta; Bezrodnik, Liliana; Marques, Jose Gonçalo; Pereira, María I; Listello, Viviana; Slatter, Mary A; Nademi, Zohreh; Kowalczyk, Danuta; Fleisher, Thomas A; Davies, Graham; Neven, Bénédicte; Rosenzweig, Sergio D

    2014-04-01

    Severe combined immunodeficiency (SCID) is a syndrome characterized by profound T-cell deficiency. BCG vaccine is contraindicated in patients with SCID. Because most countries encourage BCG vaccination at birth, a high percentage of patients with SCID are vaccinated before their immune defect is detected. We sought to describe the complications and risks associated with BCG vaccination in patients with SCID. An extensive standardized questionnaire evaluating complications, therapeutics, and outcomes regarding BCG vaccination in patients given a diagnosis of SCID was widely distributed. Summary statistics and association analysis was performed. Data on 349 BCG-vaccinated patients with SCID from 28 centers in 17 countries were analyzed. Fifty-one percent of the patients had BCG-associated complications, 34% disseminated and 17% localized (a 33,000- and 400-fold increase, respectively, over the general population). Patients receiving early vaccination (≤1 month) showed an increased prevalence of complications (P = .006) and death caused by BCG-associated complications (P < .0001). The odds of experiencing complications among patients with T-cell numbers of 250/μL or less at diagnosis was 2.1 times higher (95% CI, 1.4-3.4 times higher; P = .001) than among those with T-cell numbers of greater than 250/μL. BCG-associated complications were reported in 2 of 78 patients who received antimycobacterial therapy while asymptomatic, and no deaths caused by BCG-associated complications occurred in this group. In contrast, 46 BCG-associated deaths were reported among 160 patients treated with antimycobacterial therapy for a symptomatic BCG infection (P < .0001). BCG vaccine has a very high rate of complications in patients with SCID, which increase morbidity and mortality rates. Until safer and more efficient antituberculosis vaccines become available, delay in BCG vaccination should be considered to protect highly vulnerable populations from preventable complications

  6. Threat-responsiveness and the decision to obtain free influenza vaccinations among the older adults in Taiwan.

    PubMed

    Li, Ying-Chun; Liu, Chi-Mei

    2009-07-31

    Although older adults are encouraged by government agencies to receive influenza vaccinations, many do not obtain them. In Taiwan, where universal health care coverage has significantly reduced the barriers of access to care, the health care system has provided free influenza vaccinations for people 65 years or older since 2001. Nevertheless, the numbers of people who use this service are much fewer than expected. The aim of this study was to explore major factors that might affect the decision to receive influenza vaccinations among older adults in Taiwan. Using national representative health insurance medical claims from the National Health Insurance Research Database between 2002 and 2004, we investigated the role of threat-responsiveness, represented by prior vaccinations and prior physician visits for flu-like respiratory conditions, in the decisions of older adults to obtain vaccinations in Taiwan. Among the sample of 23,023 older adults, the overall yearly vaccination rates in this study were 38.6%, 44.3% and 39.3% for 2002, 2003, and 2004, respectively. Adjusting for covariates of individual and health care facility characteristics, the multivariate logistic regression revealed that older adults who had had prior vaccinations were ten times more likely to be vaccinated during the following influenza season than those who had not (OR=10.22, 95%CI: 9.82-10.64). The greater the frequency of prior physician visits for flu-like respiratory conditions, the greater the likelihood that one would decide to be vaccinated. Visits during prior interim (non-epidemic) season exerted a stronger positive influence than prior influenza season on this likelihood (OR=1.59, 95% CI: 1.46-1.73 vs. OR=1.11 95% CI: 1.01-1.22, respectively). Threat-responsiveness, or perceived risk, greatly influences influenza vaccination rates among the older adults in Taiwan. These findings can be used to help design public health campaigns to increase the influenza vaccination rate in this

  7. Change in hepatitis A epidemiology after vaccinating high risk children in Taiwan, 1995-2008.

    PubMed

    Tsou, Tsung-Pei; Liu, Cheng-Chung; Huang, Ji-Jia; Tsai, Kun-Ju; Chang, Hsiu-Fang

    2011-04-05

    Taiwan started to immunize children in 30 indigenous townships against hepatitis A since June 1995. The program was further expanded to 19 non-indigenous townships with higher incidence or increased risk of epidemic in 1997-2002, covering 2% of total population. Annual incidence of hepatitis A decreased from 2.96 in 1995 (baseline period) to 0.90/100,000 in 2003-2008 (vaccination period). The incidence in vaccinated townships and unvaccinated townships declined 98.3% (49.66-0.86/100,000) and 52.6% (1.90-0.90/100,000). In 2003-2008, incidence doubled in people aged >=30 years, mostly in unvaccinated townships (0.42-0.92). During 2003-2008, travel to endemic countries was the most commonly reported risk factor (13.5%). First dose vaccine coverage was 78.8% in 1994-2005 birth cohort. Taiwan's experience demonstrates the great, long-term efficacy of hepatitis A vaccine in disease control in vaccinated townships, and out-of-cohort effect in unvaccinated townships. Further reduction can be achieved by improving vaccination coverage of adults at risk. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Childhood tuberculosis in southern Taiwan, with emphasis on central nervous system complications.

    PubMed

    Cho, Yu-Hao; Ho, Tzong-Shiann; Wang, Shih-Min; Shen, Ching-Fen; Chuang, Po-Kai; Liu, Ching-Chuan

    2014-12-01

    Childhood tuberculosis (TB) continues to be a major public health problem in Taiwan. Taiwan remains a highly endemic area despite neonatal Bacillus Calmette-Guérin (BCG) vaccination and the availability of anti-TB therapy. The presentation is highly variable and it is often difficult to make an accurate diagnosis. This study was designed to evaluate the demographic, clinical, and laboratory findings and outcomes of TB in children with emphasis on central nervous system (CNS) complications. The medical records of 80 children diagnosed with TB at a medical center in southern Taiwan over the past 24 years (1988-2012) were reviewed. Among them, 48.8% (39/80) had pulmonary TB, 27.5% (22/80) had isolated extrapulmonary TB, and 23.7% (19/80) had disseminated TB. Most infected cases were aged either < 4 years or > 12 years. TB contact history was found in 42.5% (34/80) cases. Fourteen (17.5%) of the cases had CNS involvement. The most common presentations were fever (85.7%), signs of increased intracranial pressure (71.4%), drowsiness (64.3%), and focal neurological signs (57.1%). The major radiological findings were tuberculoma (50%), basilar enhancement (41.6%), infarction (41.6%), hydrocephalus (16.6%), and transverse myelitis (16.6%). The case fatality of CNS TB was 14.3% and 21.4% had neurologic sequelae. Findings suggest that positive exposure history and suspicious clinical presentations are important clues for further confirmatory laboratory and image studies in childhood TB. CNS TB usually presented as part of disseminated TB in children. Early diagnosis and treatment may lead to favorable outcomes in CNS TB. Copyright © 2013. Published by Elsevier B.V.

  9. Protective effect of vaccination against mumps complications, Czech Republic, 2007-2012.

    PubMed

    Orlíková, Hana; Malý, Marek; Lexová, Pavla; Šebestová, Helena; Limberková, Radomíra; Jurzykowská, Lucie; Kynčl, Jan

    2016-04-01

    In the Czech Republic, two-dose immunization against mumps achieves 98% coverage. The routine reporting detects mumps cases, clinical complications, and hospital admissions in unvaccinated but also in vaccinated individuals. Using surveillance data of patients with mumps we assessed the effectiveness of mumps vaccination on mumps clinical complications and hospitalization need. We also investigated the effect of the time since immunization. We analysed data on incident mumps cases reported to the Czech national surveillance system in 2007-2012. Using a logistic regression model with adjustment for age, sex, year of onset, and the administrative region, the association between vaccination and the most frequent mumps complications and hospitalization was evaluated. The adjusted odds ratios (ORa) for mumps complications were compared between the vaccinated and non-vaccinated groups, reflecting the vaccine effectiveness (VEa) computed as VEa = (1-ORa) × 100. We estimated the risk of mumps complications by the time from vaccination. From total of 9663 mumps analysed cases 5600 (58%) occurred in males. The mean age at the disease onset was 17.3, median 16 years. Ninety percent of the study patients had no complications, while 1.6% developed meningitis, 0.2% encephalitis, and 0.6% pancreatitis. Mumps orchitis occurred in 659 (11.8%) male cases. In total, 1192 (12.3%) patients required hospitalization. Two doses of vaccine received by 81.8% cases significantly reduced the risk of hospitalization: ORa 0.29 (95% CI: 0.24, 0.35). Two doses showed statistically significant VEa 64% (95% CI: 46, 79) for meningitis, 93% (95% CI: 66, 98) for encephalitis in all cases, and 72% (95% CI: 64, 78) for orchitis in males. Vaccine effectiveness for orchitis declined from 81 to 74% and 56% in the most affected age groups 10-14, 15-19, and 20-24 years, respectively. Among 7850 two-dose recipients, the rate of complications rose from below 1 to 16% in categories up to 6 years and 24 and

  10. Anticipating smallpox and monkeypox outbreaks: complications of the smallpox vaccine.

    PubMed

    Abrahams, Brian C; Kaufman, David M

    2004-09-01

    The recent outbreak in the Midwest of monkeypox, as well as the continued fears of a terrorist-induced epidemic of smallpox, prompted the authors' review of the literature regarding past and current experiences with smallpox vaccination. The smallpox vaccine, which is highly effective in preventing the spread of both these orthopoxvirus infectious illnesses, might be administered to numerous health care workers and, in the event of a smallpox attack, millions of other citizens. However, vaccinees would be at risk for several vaccine-related neurologic complications. According to prior reports, neurologic complications have occurred in 2.5 per million US individuals, with the most common being postvaccinal encephalomyelitis (PVEM). In older children and adults, PVEM causes stupor and coma, seizures, paraparesis, and other neurologic and mental abnormalities, and, in 16% of cases, permanent neurologic sequelae. The overall mortality rate of neurologic complications is approximately 1.5 per million vaccinees. Risk factors for PVEM were age younger than 1 year and no previous smallpox vaccination, but not a prior episode of PVEM or other preexisting neurologic illnesses. Neither the current smallpox vaccination campaigns in Israel nor the one in the United States has had comparable complications, but the US campaign has been associated with myocarditis and myopericarditis. Although the potential neurologic complications of the smallpox vaccine must be weighed against the threat of monkeypox and smallpox, current experience with vaccination suggests it carries a very low risk of neurologic complications and does not lead to exacerbations of chronic neurologic illnesses.

  11. Factors associated with future commitment and past history of human papilloma virus vaccination among female college students in northern Taiwan.

    PubMed

    Kuo, Ping-Fen; Yeh, Ying-Tse; Sheu, Shuh-Jen; Wang, Tze-Fang

    2014-07-01

    To investigate factors influencing commitment to human papilloma virus (HPV) vaccination and prior vaccination among female college students in northern Taiwan. A quota sample of 400 female college students was recruited from nine colleges in northern Taiwan during March 2013. Of these, 398 completed the self administered questionnaire which was designed based on the health promotion model. The results showed that factors associated with prior vaccination behavior were family history of gynecologic malignancy, ever being advised to get HPV vaccination, perceived barriers of action and perceived self-efficacy. Predictors for commitment to HPV vaccination in the next 6 months were the cost of vaccination, ever being advised to get HPV vaccination, perceived self-efficacy and situational influences. Perceived self-efficacy was significantly influenced by relationship status, past receipt of a recommendation for HPV vaccination and level of knowledge about HPV. When formulating vaccination policies, governmental or medical institutions should include these factors to promote vaccination.

  12. Absence of endemic measles transmission in a highly vaccinated population from 1999 to 2008: implications of sustained measles elimination in Taiwan.

    PubMed

    Chang, Yu-Kang; Chen, Jacky Y H; Chang, Hsiao-Ling; Yu, Mei-Ching; Hsiao, Hsu-Feng; Hou, Ching-Cheng; Liu, Shyun-Yeu; Chen, Kow-Tong

    2010-07-19

    Measles remains a leading vaccine-preventable cause of child mortality worldwide. The impact of vaccination programs can be seen in the increasingly low incidence of measles. However, cases of measles continue to occur in low numbers every year in Taiwan. We assessed the epidemiology of measles in Taiwan from 1999 to 2008 with a focus on domestic versus imported cases. We analyzed the data reported to surveillance systems at the Taiwan Center for Disease Control, where viral isolation was performed. A total of 84 measles cases were reported from 1999 to 2008 in Taiwan with the incidence of measles varying from 0 to 1.5 per 1,000,000 people per year, peaking in 2002 and again in 2008. The incidence decreased with increasing age in both males and females. Among the 84 reported measles cases, 39 (46%) originated internationally, 8 (10%) were epidemiologically linked to imported cases and the source was unknown in 37 (44%) of the cases. The unknown-source cases were analyzed for potential evidence of endemic measles transmission. Most of the measles cases that occurred in Taiwan from 1999 to 2008 were associated with imported cases. No endemic transmission of measles in Taiwan was identified. This study suggests that maintaining the high rate of vaccination coverage is needed to prevent future outbreak and sustain the elimination of measles in Taiwan. (c) 2010 Elsevier Ltd. All rights reserved.

  13. Cost-effectiveness analysis of the bivalent compared with the quadrivalent human papillomavirus vaccines in Taiwan.

    PubMed

    Demarteau, Nadia; Tang, Chao-Hsiun; Chen, Hui-Chi; Chen, Chien-Jen; Van Kriekinge, Georges

    2012-01-01

    To compare the epidemiological and economic impact of additional cross-protection against oncogenic human papillomavirus (HPV) types beyond 16/18 of the bivalent vaccine (BV) versus protection against nononcogenic HPV types 6/11 of the quadrivalent vaccine (QV) in Taiwan. A lifetime Markov model calibrated to the Taiwanese setting simulated the natural history of low-risk (engendering cervical intraepithelial neoplasia [CIN] 1 and genital warts) and high-risk HPV (engendering CIN1, CIN2/3, and cervical cancer [CC]) infections, screening, and vaccination (100% coverage) for a cohort of 12-year-old girls (N = 153,000). Transition probabilities, costs, and utilities were estimated from published data and expert opinion. Vaccine efficacy was obtained from each vaccine's respective clinical trials. Price-parity and lifelong protection was assumed for both vaccines. The number of CIN lesions, CC cases, CC deaths and genital wart (GW) cases, and quality-adjusted life-years were estimated. Costs and outcomes (discounted at 3% and 1.5%, respectively) were compared from a payer's perspective. The model estimated that the BV led to an additional, undiscounted, 11,484 CIN1, 1,779 (+34.3% vs. QV) CIN2/3, 188 (+29.0% vs. QV) CC, and 69 (+29.0% vs. QV) CC deaths prevented compared with the QV, while the QV prevented 4,150 GW (+71%). This resulted in an additional 768 quality-adjusted life-years (QALY) and 11.6 million new Taiwan dollars costs saved for the BV versus the QV after discounting. Both vaccines have a different epidemiological impact with an increased number of CC-related lesions potentially prevented for the BV because of additional cross-protection. In the Taiwanese setting, HPV mass vaccination using the BV was estimated to dominate vaccination using the QV. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. Association between complicated liver cirrhosis and the risk of hepatocellular carcinoma in Taiwan.

    PubMed

    Hung, Tsung-Hsing; Liang, Chih-Ming; Hsu, Chien-Ning; Tai, Wei-Chen; Tsai, Kai-Lung; Ku, Ming-Kun; Wang, Jiunn-Wei; Tseng, Kuo-Lun; Yuan, Lan-Ting; Nguang, Seng-Howe; Yang, Shih-Cheng; Wu, Cheng-Kun; Hsu, Pin-I; Wu, Deng-Chyang; Chuah, Seng-Kee

    2017-01-01

    Hepatic encephalopathy, ascites, and variceal bleeding are the three major complications of cirrhosis. It is well known that cirrhosis is the most important risk factor of hepatocellular carcinoma (HCC). However, little is known about whether the severity of liver cirrhosis has an effect on the incidence of HCC. This population-based cohort study aimed to explore the association between complicated cirrhosis and HCC, and identify the risk factors of HCC in patients with complicated cirrhosis. Data of the years 1997-2011 were extracted from the National Health Insurance Research Database of Taiwan. A total of 2568 patients with complicated cirrhosis without HCC at baseline were enrolled. After propensity score matching, another 2568 patients with non-complicated cirrhosis were included. Hazards Cox regression analysis by using a competing risk regression model to control for possible confounding factors was utilized to estimate the association of the complications of liver cirrhosis with the risk of HCC. We observed by using competing risk analysis that the adjusted hazard ratio (HR) for developing HCC during the follow-up period after the initial hospitalization was higher among the patients with baseline complicated cirrhosis than in those with uncomplicated cirrhosis (HR, 1.23; 95% confidence interval, CI, 1.10-1.37, p<0.001). Additionally, older patients (HR, 1.01; 95% CI, 1.01-1.02, p<0.001), males (HR, 0.84; 95% CI, 0.74-0.96, p = 0.009), and patients with alcohol-related cirrhosis (HR, 1.93; 95% CI, 1.65-2.26, p<0.001) had a statistically significant difference in the incidence of HCC. In conclusion, complicated liver cirrhosis is associated with a higher risk of HCC in Taiwan compared with cirrhosis without complications.

  15. Use of Seasonal Influenza Vaccination and Its Associated Factors among Elderly People with Disabilities in Taiwan: A Population-Based Study.

    PubMed

    Chang, Yu-Chia; Tung, Ho-Jui; Hsu, Shang-Wei; Chen, Lei-Shin; Kung, Pei-Tseng; Huang, Kuang-Hua; Chiou, Shang-Jyh; Tsai, Wen-Chen

    2016-01-01

    Influenza immunization among elderly people with disabilities is a critical public health concern; however, few studies have examined the factors associated with vaccination rates in non-Western societies. By linking the National Disability Registration System and health service claims dataset from the National Health Insurance program, this population-based study investigated the seasonal influenza vaccination rate among elderly people with disabilities in Taiwan (N = 283,172) in 2008. A multivariate logistic regression analysis was conducted to adjust for covariates. Nationally, only 32.7% of Taiwanese elderly people with disabilities received influenza vaccination. The strongest predictor for getting vaccinated among older Taiwanese people with disabilities was their experience of receiving an influenza vaccination in the previous year (adjusted odds ratio [AOR] = 6.80, 95% confidence interval [CI]: 6.67-6.93). Frequent OPD use (AOR = 1.85, 95% CI: 1.81-1.89) and undergoing health examinations in the previous year (AOR = 1.66, 95% CI: 1.62-1.69) also showed a moderate and significant association with receiving an influenza vaccination. Although free influenza vaccination has been provided in Taiwan since 2001, influenza immunization rates among elderly people with disabilities remain low. Policy initiatives are required to address the identified factors for improving influenza immunization rates among elderly people with disabilities.

  16. Patient preferences for diabetes-related complications in Taiwan.

    PubMed

    Lin, Yi-Ju; Wang, Chin-Yuan; Cheng, Ssu-Wei; Ko, Yu

    2018-05-25

    As the prevalence of diabetes mellitus (DM) continues to increase rapidly, there has been a rising need not only to assess the clinical outcomes but also the impact of DM on the health-related quality of life (HRQoL) of affected individuals. Most previous studies have found that having complications is strongly associated with decreased HRQoL in DM patients. As such, it is crucial to measure individuals' preferences for DM-related complications in order to assess the magnitude of complications' effect on overall HRQoL. In addition, preference scores are an essential component of cost-utility analyses (CUAs), which studies can incorporate healthcare costs, HRQoL and clinical outcomes of DM into one analysis. The aims of this study were to assess the preference scores of DM-related complications using both the standard gamble (SG), a choice-based method, and visual analogue scale (VAS), a scaling method. We also aimed to assess several possible factors that might be associated with the preference scores of the complications. This is a cross-sectional interview-administered survey, and 213 patients with type 2 DM were interviewed. The respondents' preference scores of eleven DM-related complications were obtained using VAS and SG techniques. Demographic information, clinical characteristics and risk attitudes were also collected to explore factors that may affect patients' preference scores. Nearly one quarter of participants in Taiwan ranked at least one of the complications worse than death. The mean VAS scores ranged from 0.004 (amputation) to 0.47 (nocturnal hypoglycemia) while the mean adjusted SG scores ranged from 0.30 (blindness) to 0.66 (nocturnal hypoglycemia). There were significant differences in all of the complications' preference scores depending on risk attitudes. Both the VAS and SG methods were used to elicit the preference scores of DM-related complications, and the preference scores derived could be useful for future cost utility analyses.

  17. [Neurologic Complications in HPV Vaccination].

    PubMed

    Ikeda, Shu-ichi

    2015-07-01

    A relatively high incidence of chronic limb pain, frequently complicated by violent, tremulous involuntary movements, has been noted in Japanese girls following human papillomavirus vaccination. The average incubation period after the first dose of the vaccine was 5.47 ± 5.00 months. Frequent manifestations included headaches, general fatigue, coldness of the feet, limb pain, and weakness. The skin temperature of the girls with limb symptoms was slightly lower in the fingers and moderately lower in the toes. Digital plethysmograms revealed a reduced peak of the waves, especially in the toes. Limb symptoms of the affected girls were compatible with the diagnostic criteria for complex regional pain syndrome. The Schellong test identified a significant number of patients with orthostatic hypotension and a few with postural orthostatic tachycardia syndrome. Electron-microscopic examinations of the intradermal nerves showed an abnormal pathology in the unmyelinated fibers in two of the three girls examined. The symptoms observed in this study can be explained by abnormal peripheral sympathetic responses. The most common previous diagnosis in the patients was psychosomatic disease. Recently, delayed manifestation of cognitive dysfunction in the post-vaccinated girls has attracted attention. The symptoms include memory loss and difficulty in reading textbooks and/or calculation.

  18. Disease burden and epidemiology of herpes zoster in pre-vaccine Taiwan.

    PubMed

    Lin, Yung-Hsiu; Huang, Li-Min; Chang, I-Shou; Tsai, Fang-Yu; Lu, Chun-Yi; Shao, Pei-Lan; Chang, Luan-Yin

    2010-02-03

    Herpes zoster, a common disease, has an important impact on the health of adults, particularly the elderly, and the health system. This study evaluated the disease burden and epidemiological characteristics of herpes zoster in Taiwan. Using herpes zoster-related ICD-9-CM codes used on Taiwan's National Health Insurance claims, we analyzed overall and age group differences in incidence, complications, utilization of healthcare facilities, lengths of stay, and cost of their medical care in Taiwan's population from 2000 to 2005. The overall annual incidence of zoster was 4.97 cases per 1000 people, with women having a significantly higher incidence than men (5.20 per 1000 vs. 4.72 per 1000, p<0.001). The incidence increased stepwise with age, with 5.18 cases per 1000 in people 40-50 years old, 8.36 in those 50-60, 11.09 in those 60-70, and 11.77 in those above 70 years old. The estimated lifetime risk of developing herpes zoster was 32.2%. Zoster-related hospitalizations and medical cost per patient increased with age. In conclusion, about two-thirds of Taiwan's zoster cases occur in adults older than 40 years old and about one-third of the population would develop zoster within their lifetime. (c) 2009 Elsevier Ltd. All rights reserved.

  19. Epidemiological Features of Japanese Encephalitis in Taiwan from 2000 to 2014

    PubMed Central

    Chang, Yu-Kang; Chang, Hsiao-Ling; Wu, Ho-Sheng; Chen, Kow-Tong

    2017-01-01

    The incidence of Japanese encephalitis (JE) decreased sharply after the national vaccination program was implemented in Taiwan in 1968. However, cases of JE still occur. The purpose of this study was to assess the epidemiology and vaccination policy for JE in Taiwan. We analyzed the data on JE cases reported to the Taiwan Centers for Disease Control (Taiwan CDC) between 2000 and 2014. During the 15-year study period, a total of 4,474 cases were reported to the Taiwan CDC. Of these, 379 (8.5%) were classified as confirmed cases, and 4,095 (91.5%) were classified as suspected cases. The incidence of JE ranged from 0.59 to 1.61 per 1,000,000 people and peaked in 2007. Men had a higher incidence of JE than women (1.37 versus 0.84 per 1,000,000; P = 0.03). Patients who were 40–59 years of age had a higher incidence than did patients younger than 20 years (1.82 versus 0.23; P < 0.001). Patients who lived in the eastern region of Taiwan had the highest incidence rate of JE (P < 0.001). Compared with those who were not vaccinated with the JE vaccine, patients who received four doses of JE vaccine had a lower risk of suffering from death and/or hospitalization (adjusted odds ratio: 0.26; 95% confidence interval: 0.08–0.90; P = 0.04). JE is still a public health problem in Taiwan, and monitoring JE via diagnostic testing to determine the best vaccination program along with enforcing JE vaccine boosters for adults is necessary to eliminate JE in Taiwan. PMID:27821699

  20. Epidemiological Features of Japanese Encephalitis in Taiwan from 2000 to 2014.

    PubMed

    Chang, Yu-Kang; Chang, Hsiao-Ling; Wu, Ho-Sheng; Chen, Kow-Tong

    2017-02-08

    The incidence of Japanese encephalitis (JE) decreased sharply after the national vaccination program was implemented in Taiwan in 1968. However, cases of JE still occur. The purpose of this study was to assess the epidemiology and vaccination policy for JE in Taiwan. We analyzed the data on JE cases reported to the Taiwan Centers for Disease Control (Taiwan CDC) between 2000 and 2014. During the 15-year study period, a total of 4,474 cases were reported to the Taiwan CDC. Of these, 379 (8.5%) were classified as confirmed cases, and 4,095 (91.5%) were classified as suspected cases. The incidence of JE ranged from 0.59 to 1.61 per 1,000,000 people and peaked in 2007. Men had a higher incidence of JE than women (1.37 versus 0.84 per 1,000,000; P = 0.03). Patients who were 40-59 years of age had a higher incidence than did patients younger than 20 years (1.82 versus 0.23; P < 0.001). Patients who lived in the eastern region of Taiwan had the highest incidence rate of JE ( P < 0.001). Compared with those who were not vaccinated with the JE vaccine, patients who received four doses of JE vaccine had a lower risk of suffering from death and/or hospitalization (adjusted odds ratio: 0.26; 95% confidence interval: 0.08-0.90; P = 0.04). JE is still a public health problem in Taiwan, and monitoring JE via diagnostic testing to determine the best vaccination program along with enforcing JE vaccine boosters for adults is necessary to eliminate JE in Taiwan. © The American Society of Tropical Medicine and Hygiene.

  1. Epidemic of complicated mumps in previously vaccinated young adults in the South-West of France.

    PubMed

    Vareil, M-O; Rouibi, G; Kassab, S; Soula, V; Duffau, P; Lafon, M-E; Neau, D; Cazanave, C

    2014-12-01

    We report the features and diagnosis of complicated mumps in previously vaccinated young adults. We retrospectively studied 7 cases of complicated mumps managed during 1 year at the Bordeaux University Hospital. The diagnosis was suggested by the clinical presentation and confirmed using specific RT-PCR. Five cases of meningitis, 1 of orchitis, and 1 of unilateral hearing impairment were identified. Each of the 7 patients had been previously vaccinated with MMR, 4 had received 2 doses of this vaccine. Blood tests revealed high rates of IgG antibodies, usually considered as sufficient for immunological protection, and every patient had at least 1 positive RT-PCR test for mumps. Outbreaks of complicated mumps may still occur despite a broad coverage of MMR vaccination. The clinical presentation suggested mumps but the final diagnosis could only be confirmed by genomic detection of the virus. Unusual viral strains with increased neurovirulence, insufficient population coverage associated with immunity decrease over time may explain outbreaks of complicated mumps. A full vaccine scheme of contact people or a third injection of vaccine for previously vaccinated people who are at risk of developing mumps are required to prevent further spreading of the disease during the outbreak. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  2. Emergency medicine tools to manage smallpox (vaccinia) vaccination complications: clinical practice guideline and policies and procedures.

    PubMed

    Thorne, Craig D; Hirshon, Jon Mark; Himes, Carrie D; McDiarmid, Melissa A

    2003-11-01

    In December 2002, the federal government began a program to immunize approximately 500000 civilian public health and health care workers with smallpox (vaccinia) vaccine as a part of our pre-event defense against bioterrorism. First responders will likely follow, and the general US population might be offered vaccination in the next 1 to 2 years. Recent reports that suggest the possible association of the vaccine to adverse cardiac events (including deaths), liability concerns for hospitals, and the availability of compensation for workers with vaccine complications have significantly reduced voluntary participation. Vaccinees might experience robust primary takes or serious adverse events, including viral or even bacterial cellulitides, encephalitis, progressive skin destruction, and other life-threatening complications. With the increasing prevalence of immune suppression from both diseases and immunosuppressive medications, complications might be seen in higher frequency than previously reported. Emergency medicine providers and staff must become familiar with clinical presentations and management of vaccine complications. In addition, policies and procedures must be developed to prevent unimmunized providers from inadvertently contacting the active vaccination sites of their patients and, if the providers themselves have active vaccination sites, to protect their patients and their own families.

  3. Redistribution of Streptococcus pneumoniae Serotypes After Nationwide 13-valent Pneumococcal Conjugate Vaccine Program in Children in Northern Taiwan.

    PubMed

    Cho, Ying-Chun; Chiu, Nan-Chang; Lu, Chun-Yi; Huang, Daniel Tsung-Ning; Huang, Fu-Yuan; Chang, Luan-Yin; Huang, Li-Min; Chi, Hsin

    2017-12-01

    After the introduction of 13-valent pneumococcal conjugate vaccine (PCV13) against Streptococcus pneumoniae, public health officials in Taiwan monitored a decline in circulating vaccine serotypes and the emergence of nonvaccine serotypes in children with invasive pneumococcal disease. A gradually expanded PCV13 national immunization program was launched in 2013 in Taiwan. Here, we evaluate the changes in the distribution of pneumococcal serotypes and antimicrobial nonsusceptibility in children during the evolution of vaccination policy. S. pneumoniae isolates from children with pneumococcal disease were collected and serotyped from 2010 to 2015 in northern Taiwan. PCVs were administered at the recipients' expense between 2010 and 2012, and then PCV13 was partially reimbursed by the government beginning in 2013. The distribution and diversity of serotypes were analyzed along with their antimicrobial susceptibilities. Among a total of 498 isolates, the proportion of invasive pneumococcal disease isolates declined (47.1%-10.6%) during the study period, and serotype diversity increased after 2011. Between 2010 and 2012, the dominant serotypes were 19A, 19F, 3, 6B and 14, and serotype 19A rose from 44.1% to 57.5%. Serotypes 19A, 15A, 19F and 15B were more prevalent from 2013 to 2015, and serotype 19A decreased from 42.1% to 4.5%. Serotypes 19F and 15A became the most commonly detected serotypes in 2015. Overall, PCV13 additional serotypes were reduced by 80% (P < 0.0001) but nonvaccine serotypes increased from 8.8% to 51.5% (P < 0.0001). The step-by-step PCV13 national immunization program is effective against pneumococcal disease in Taiwanese children, mainly by reducing PCV13 additional serotypes.

  4. Characteristics of a large mumps outbreak: Clinical severity, complications and association with vaccination status of mumps outbreak cases.

    PubMed

    Zamir, C Stein; Schroeder, H; Shoob, H; Abramson, N; Zentner, G

    2015-01-01

    In recent years, large mumps outbreaks, involving mainly adolescents and young adults, have re-emerged in several countries. We investigated a large mumps outbreak, evaluated the association between mumps clinical severity (complications, hospitalization) and vaccination status (number of previous measles, mumps and rubella - MMR vaccine doses), and assessed vaccine effectiveness. The first mumps cases emerged in an ultra-orthodox boys' school in Jerusalem and were epidemiologically linked to the mumps outbreak in New York. Overall, 3130 mumps cases were notified in the Jerusalem district during September 2009-August 2011 (median age 13y, 64% males). Most cases were reported from community clinics. Patients with systemic symptoms and/or complications (419, 13.4%) were either hospitalized (n = 79) or treated in an emergency medical center (n = 340). The main complications included orchitis (3.8% males> age 12y) and meningoencephalitis (0.5%). The mumps virus genotype was G5. The distribution of previous MMR vaccine doses (n = 0,1,2) was: 24.8%, 28.3% and 46.9%, respectively. The number of previous vaccine doses was inversely associated with clinical severity. Adjusted values for MMR vaccine effectiveness against complications were estimated as 52.1% (95% CI -4 -78%) for one vaccine dose and 62.7% (95% CI 25.7-81.3%) for 2 doses. The outbreak was characterized by predominance of male students; the majority of whom had been previously vaccinated. The reported complication rate was relatively low. Vaccination status was associated with age and disease severity. The combination of limited mumps vaccine effectiveness and the specific school setting (dense learning and living conditions) probably contributed to the disease spread.

  5. Characteristics of a large mumps outbreak: Clinical severity, complications and association with vaccination status of mumps outbreak cases

    PubMed Central

    Zamir, C Stein; Schroeder, H; Shoob, H; Abramson, N; Zentner, G

    2015-01-01

    In recent years, large mumps outbreaks, involving mainly adolescents and young adults, have re-emerged in several countries. We investigated a large mumps outbreak, evaluated the association between mumps clinical severity (complications, hospitalization) and vaccination status (number of previous measles, mumps and rubella - MMR vaccine doses), and assessed vaccine effectiveness. The first mumps cases emerged in an ultra-orthodox boys' school in Jerusalem and were epidemiologically linked to the mumps outbreak in New York. Overall, 3130 mumps cases were notified in the Jerusalem district during September 2009-August 2011 (median age 13y, 64% males). Most cases were reported from community clinics. Patients with systemic symptoms and/or complications (419, 13.4%) were either hospitalized (n = 79) or treated in an emergency medical center (n = 340). The main complications included orchitis (3.8% males> age 12y) and meningoencephalitis (0.5%). The mumps virus genotype was G5. The distribution of previous MMR vaccine doses (n = 0,1,2) was: 24.8%, 28.3% and 46.9%, respectively. The number of previous vaccine doses was inversely associated with clinical severity. Adjusted values for MMR vaccine effectiveness against complications were estimated as 52.1% (95% CI −4 −78%) for one vaccine dose and 62.7% (95% CI 25.7–81.3%) for 2 doses. The outbreak was characterized by predominance of male students; the majority of whom had been previously vaccinated. The reported complication rate was relatively low. Vaccination status was associated with age and disease severity. The combination of limited mumps vaccine effectiveness and the specific school setting (dense learning and living conditions) probably contributed to the disease spread. PMID:25874726

  6. Does parents' socio-economic status matter in intentions of vaccinating against human papillomavirus for adolescent daughters?

    PubMed

    Pan, Frank; Shu, Hui-Gan

    2015-03-01

    The Human Papilloma Virus (HPV) vaccination provides substantial protection, and it is best to be taken before the age of twelve. Taiwan approved HPV vaccines since 2006. However, very few female adolescent have been vaccinated until now. To examine whether the parents' socio-economic status matters in deciding to purchase HPV vaccination for their daughters based on the theory of planned behavior. A structured questionnaire to collect 394 responses from parents of adolescent girls in Taiwan. Data was coded to categorize relevant socio-economic classes, and was analyzed with SPSS. The behavior intentions of parents with low (mean= 5.28) and high (5.01) socio-economic status are significantly stronger than the moderate (4.56) in deciding to purchase the HPV vaccination. Socio-economic factor has a slightly negative impact (B= -0.08), and attitude (0.68), subjective norms (0.16), and behavior control (0.32) have positive impacts on the parents' intention. Major impacts on the decision to purchase an HPV vaccination for their adolescent was not due to the parents' socio-economic status but the parent's attitude. As the major predictor of a less complicated decision, attitudes toward the HPV vaccination should be reinforced through continuous communications between service providers and patient-advocate groups.

  7. Bell's Palsy as a Possible Complication of Hepatitis B Vaccination in A Child

    PubMed Central

    Tan, Hüseyin; Orbak, Zerrin

    2009-01-01

    Bell's Palsy is the sudden onset of unilateral temporary paralysis of facial muscles resulting from seventh cranial nerve dysfunction. Presented here is a two-year old female patient with right peripheral facial palsy following hepatitis B vaccination. Readers’ attention is drawn to an uncommon cause of Bell's Palsy, as a rare complication of hepatitis B vaccination. PMID:19902808

  8. Japanese encephalitis vaccines: current vaccines and future prospects.

    PubMed

    Monath, T P

    2002-01-01

    Vaccination against JE ideally should be practiced in all areas of Asia where the virus is responsible for human disease. The WHO has placed a high priority on the development of a new vaccine for prevention of JE. Some countries in Asia (Japan, South Korea, North Korea, Taiwan, Vietnam, Thailand, and the PRC) manufacture JE vaccines and practice childhood immunization, while other countries suffering endemic or epidemic disease (India, Nepal, Laos, Cambodia, Bangladesh, Myanmar, Malaysia, Indonesia and the Philippines) have no JE vaccine manufacturing or policy for use. With the exception of the PRC, all countries practicing JE vaccination use formalin inactivated mouse brain vaccines, which are relatively expensive and are associated with rare but clinically significant allergic and neurological adverse events. New inactivated JE vaccines manufactured in Vero cells are in advanced preclinical or early clinical development in Japan, South Korea, Taiwan, and the PRC. An empirically derived, live attenuated vaccine (SA14-14-2) is widely used in the PRC. Trials in the PRC have shown SA14-14-2 to be safe and effective when administered in a two-dose regimen, but regulatory concerns over manufacturing and control have restricted international distribution. The genetic basis of attenuation of SA14-14-2 has been partially defined. A new live attenuated vaccine (ChimeriVax-JE) that uses a reliable flavivirus vaccine--yellow fever 17D--as a live vector for the envelope genes of SA14-14-2 virus is in early clinical trials and appears to be well tolerated and immunogenic after a single dose. Vaccinia and avipox vectored vaccines have also been tested clinically, but are no longer being pursued due to restricted effectiveness mediated by anti-vector immunity. Other approaches to JE vaccines--including naked DNA, oral vaccination, and recombinant subunit vaccines--have been reviewed.

  9. High prevalence of SV40 infection in patients with nodal non-Hodgkin's lymphoma but not acute leukemia independent of contaminated polio vaccines in Taiwan.

    PubMed

    Chen, Po-Min; Yen, Chueh-Chuan; Yang, Muh-Hwa; Poh, Say-Bee; Hsiao, Liang-Tsai; Wang, Wei-Shu; Lin, Peng-Chan; Lee, Ming-Yang; Teng, Hao-Wei; Bai, Li-Yuan; Chu, Chiau-Jun; Chao, Shu-Chauo; Yang, An-Hang; Chiou, Tzeon-Jye; Liu, Jin-Hwang; Chao, Ta-Chung

    2006-01-01

    Recent studies have linked simian virus 40 (SV40) to non-Hodgkin's lymphoma (NHL), especially in countries in which people were exposed to contaminated polio vaccines prior to 1963. In Taiwan, nearly all children were not exposed to contaminated polio vaccine during this period; the relationship between SV40 infection and hematological malignancies is unclear and deserves to be studied. Using PCR amplification of SV40 large T antigen DNA, confirmed by Southern blot hybridization and sequence analysis, 91 frozen lymph nodes from NHL patients were examined. Thirteen (14.3 percent) showed positive for SV40. All other test samples, including diagnostic bone marrow from patients with acute leukemia, peripheral blood from 10 relatives of SV40 positive-patients and 91 age-matched normal volunteers, and 5 reactive hyperplastic lymphoid tissues, showed negative. These results may reflect that human-to-human transmission of SV40 is independent of contaminated polio vaccines; and SV40 is possibly associated with the development of NHL in Taiwan (p = 0.0001). Prospective studies are needed to determine the prevalence of SV40 infections in our and other human populations and to explore the means of transmission of the virus.

  10. Additive benefits of pneumococcal and influenza vaccines among elderly persons aged 75 years or older in Taiwan--a representative population-based comparative study.

    PubMed

    Chang, Yu-Chia; Chou, Yiing-Jenq; Liu, Jen-Yin; Yeh, Te-Feng; Huang, Nicole

    2012-09-01

    It remains unclear whether pneumococcal vaccine provides additional protection to the elderly who have already vaccinated with influenza vaccine. This retrospective cohort study aimed to assess the additive effect of pneumococcal and influenza vaccines on the risk of mortality, hospitalization, and inpatient expenditure in the elderly aged 75 years or older in Taiwan. Data were extracted from the National Health Insurance claims data of a nationally representative elderly sample. To reduce potential selection bias, we employed a propensity score matching method to classify the vaccination status into 3 groups. Multivariable logistic and linear regression models were used to compare the outcomes among different groups. Each group contained 8142 subjects. The results indicated that an additive effect of receiving both vaccines was associated with a significantly lower all-cause mortality (relative risk [RR]: 0.74; 95% confidence interval [CI]: 0.57-0.96), hospitalization of all diseases including pneumonia, influenza, chronic obstructive pulmonary disease, respiratory diseases, and congestive heart disease (RR: 0.77; 95% CI: 0.67-0.90), and a 13% reduction (95% CI: 0.81-0.94) in inpatient expenditures of all diseases when compared with receiving influenza vaccine alone. This study confirmed that vaccination of elderly individuals with pneumococcal vaccine and influenza vaccine concomitantly has substantial beneficial effects. Copyright © 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  11. Shift within age-groups of mumps incidence, hospitalizations and severe complications in a highly vaccinated population. Spain, 1998-2014.

    PubMed

    López-Perea, Noemí; Masa-Calles, Josefa; Torres de Mier, María de Viarce; Fernández-García, Aurora; Echevarría, Juan E; De Ory, Fernando; Martínez de Aragón, María Victoria

    2017-08-03

    The mumps vaccine (Jeryl-Lynn-strain) was introduced in Spain in 1981, and a vaccination policy which included a second dose was added in 1995. From 1992-1999, a Rubini-strain based vaccine was administered in many regions but later withdrawn due to lack of effectiveness. Despite high levels of vaccination coverage, epidemics have continued to appear. We characterized the three epidemic waves of mumps between 1998 and 2014, identifying major changes in susceptible populations using Poisson regression. For the period 1998-2003 (P1), the most affected group was from 1 to 4years old (y) [Incidence Rate (IR)=71.7 cases/100,000 population]; in the periods 2004-2009 (P2) and 2010-2014 (P3) IR ratio (IRR) increased among 15-24y (P2=1.46; P3=2.68) and 25-34y (P2=2.17; P3=4.05). Hospitalization rate (HR), complication rate (CR) and neurological complication rate (NR) among hospitalized subjects decreased across the epidemics, except for 25-34y which increased: HR ratio (HRR) (P2=2.18; P3=2.16), CRR (P3=2.48), NRR (P3=2.41). In Spain mumps incidence increased, while an overall decrease of hospitalizations and severe complications occurred across the epidemics. Cohorts born during periods of low vaccination coverage and those vaccinated with Rubini-strain were the most affected populations, leading to a shift in mumps cases from children to adolescents and young adults; this also reveals the waning immunity provided by the mumps vaccine. Despite not preventing all mumps cases, the vaccine appears to prevent serious forms of the disease. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Prevention of herpes zoster and its complications: from the clinic to the real-life experience with the vaccine.

    PubMed

    Giovanni, Gabutti; Nicoletta, Valente; Parvanè, Kuhdari; Silvia, Lupi; Armando, Stefanati

    2016-12-01

    The erpes zoster is an acute viral illness characterized by a vesicular rash of unilateral distribution, which can eventually cause severe complications, such as post-herpetic neuralgia, ophthalmic zoster, stroke or other neurological complications. In Europe, an incidence of between 2.0 and 4.6 cases per 1000 person-years is estimated, with an increase after 50 years of age. Currently, the therapeutic options for are only partially effective in limiting the acute phase, while the management of complications is frequently complex and not satisfactory. The overall burden of the disease and the elevated costs associated with diagnosis and clinical and therapeutic management led to the development of a new preventive approach through a live attenuated virus vaccine. The vaccine now available decreases the incidence of the disease, post-herpetic neuralgia and the burden of illness. Moreover, the vaccine is safe and well tolerated and it seems to confer long-term protection. Based on the clinical results and evidence provided by the Health Technology Assessment, several countries introduced immunization although with different recommendations and methods of funding.

  13. Effectiveness of 2 rotavirus vaccines against rotavirus disease in Taiwanese infants.

    PubMed

    Chang, Wan-Chi; Yen, Catherine; Wu, Fang-Tzy; Huang, Yhu-Chering; Lin, Jen-Shiou; Huang, Fu-Chen; Yu, Hui-Tzu; Chi, Cheng-Liang; Lin, Han-Ying; Tate, Jacqueline E; Parashar, Umesh D; Wu, Ho-Sheng; Hsiung, Chao A

    2014-03-01

    Two rotavirus (RV) vaccines (Rotarix and RotaTeq) are available on the private market in Taiwan, but are not recommended for routine use. We examined RV vaccine effectiveness (VE) against severe RV acute gastroenteritis (AGE) among Taiwanese infants to inform policymakers on the potential benefits of national RV vaccine introduction. From May 2009 to April 2011, a case-control assessment of VE against severe RV AGE was conducted at 3 hospital-based surveillance sites in Taiwan. Case-patients included children aged 8-35 months, hospitalized with laboratory-confirmed RV AGE. Controls included children age-matched within 1 month of age of the case-patient, hospitalized with RV-negative AGE or seen for non-AGE illnesses at the same hospitals. Vaccination history was confirmed through vaccination card or hospital record review. VE was calculated as (1--odds ratio of vaccination) × 100%. We enrolled 184 case-patients with RV AGE, 904 RV-negative AGE and 909 non-AGE controls. Two-dose Rotarix series VE against RV gastroenteritis hospitalization was 90.4% [95% confidence interval (CI): 70.3%, 98.1%) and 92.5% (95% CI: 77.1%, 98.5%) with RV-negative AGE and non-AGE controls, respectively. Three-dose RotaTeq series VE was 96.8% (95% CI: 82.3%, 100%) and 97.1% (95% CI: 84%, 100%) with RV-negative AGE and non-AGE controls, respectively. Both vaccines provided excellent protection against severe RV AGE hospitalization. Addition of RV vaccination into Taiwan's National Immunization Program could substantially decrease AGE hospitalizations among children <3 years. Our findings should help inform policymakers in Taiwan and other similar Asian countries when deciding whether to include RV vaccination into their national immunization programs.

  14. Effectiveness of influenza vaccination for preventing influenza-related complications in people with asthma: a systematic review protocol

    PubMed Central

    Vasileiou, Eleftheria; Sheikh, Aziz; Butler, Chris; von Wissmann, Beatrix; McMenamin, Jim; Ritchie, Lewis; Tian, Lilly; Simpson, Colin

    2016-01-01

    Introduction Influenza vaccination is administered annually as a preventive measure against influenza infection and influenza-related complications in high-risk individuals, such as those with asthma. However, the effectiveness of influenza vaccination in people with asthma against influenza-related complications is still not well established. Methods and analysis We will search the following databases: MEDLINE (Ovid), EMBASE (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Cochrane Database of Systematic Reviews (CDSR), Web of Science Core Collection, Science direct, WHO Library Information System (WHOLIS), Global Health Library and Chinese databases (CNKI, Wanfang and ChongQing VIP) from Jan 1970 to Jan 2016 for observational and experimental studies on effectiveness of influenza vaccine in people with asthma. The identification of studies will be complemented with the searching of the reference lists and citations, and contacting influenza vaccine manufacturers to identify unpublished or ongoing studies. Two reviewers will extract data and appraise the quality of each study independently. Separate meta-analyses will be undertaken for observational and experimental evidence using fixed-effect or random-effects models, as appropriate. Ethics and dissemination Formal ethical approval is not required, as primary data will not be collected. The review will be disseminated in peer-reviewed publications and conference presentations. PMID:27026658

  15. Emergence and evolution of avian H5N2 influenza viruses in chickens in Taiwan.

    PubMed

    Lee, Chang-Chun David; Zhu, Huachen; Huang, Pei-Yu; Peng, Liuxia; Chang, Yun-Cheng; Yip, Chun-Hung; Li, Yao-Tsun; Cheung, Chung-Lam; Compans, Richard; Yang, Chinglai; Smith, David K; Lam, Tommy Tsan-Yuk; King, Chwan-Chuen; Guan, Yi

    2014-05-01

    Sporadic activity by H5N2 influenza viruses has been observed in chickens in Taiwan from 2003 to 2012. The available information suggests that these viruses were generated by reassortment between a Mexican-like H5N2 virus and a local enzootic H6N1 virus. Yet the origin, prevalence, and pathogenicity of these H5N2 viruses have not been fully defined. Following the 2012 highly pathogenic avian influenza (HPAI) outbreaks, surveillance was conducted from December 2012 to July 2013 at a live-poultry wholesale market in Taipei. Our findings showed that H5N2 and H6N1 viruses cocirculated at low levels in chickens in Taiwan. Phylogenetic analyses revealed that all H5N2 viruses had hemagglutinin (HA) and neuraminidase (NA) genes derived from a 1994 Mexican-like virus, while their internal gene complexes were incorporated from the enzootic H6N1 virus lineage by multiple reassortment events. Pathogenicity studies demonstrated heterogeneous results even though all tested viruses had motifs (R-X-K/R-R) supportive of high pathogenicity. Serological surveys for common subtypes of avian viruses confirmed the prevalence of the H5N2 and H6N1 viruses in chickens and revealed an extraordinarily high seroconversion rate to an H9N2 virus, a subtype that is not found in Taiwan but is prevalent in mainland China. These findings suggest that reassortant H5N2 viruses, together with H6N1 viruses, have become established and enzootic in chickens throughout Taiwan and that a large-scale vaccination program might have been conducted locally that likely led to the introduction of the 1994 Mexican-like virus to Taiwan in 2003. H5N2 avian influenza viruses first appeared in chickens in Taiwan in 2003 and caused a series of outbreaks afterwards. Phylogenetic analyses show that the chicken H5N2 viruses have H5 and N2 genes that are closely related to those of a vaccine strain originating from Mexico in 1994, while the contemporary duck H5N2 viruses in Taiwan belong to the Eurasian gene pool. The

  16. Emergence and Evolution of Avian H5N2 Influenza Viruses in Chickens in Taiwan

    PubMed Central

    Lee, Chang-Chun David; Zhu, Huachen; Huang, Pei-Yu; Peng, Liuxia; Chang, Yun-Cheng; Yip, Chun-Hung; Li, Yao-Tsun; Cheung, Chung-Lam; Compans, Richard; Yang, Chinglai; Smith, David K.; Lam, Tommy Tsan-Yuk

    2014-01-01

    ABSTRACT Sporadic activity by H5N2 influenza viruses has been observed in chickens in Taiwan from 2003 to 2012. The available information suggests that these viruses were generated by reassortment between a Mexican-like H5N2 virus and a local enzootic H6N1 virus. Yet the origin, prevalence, and pathogenicity of these H5N2 viruses have not been fully defined. Following the 2012 highly pathogenic avian influenza (HPAI) outbreaks, surveillance was conducted from December 2012 to July 2013 at a live-poultry wholesale market in Taipei. Our findings showed that H5N2 and H6N1 viruses cocirculated at low levels in chickens in Taiwan. Phylogenetic analyses revealed that all H5N2 viruses had hemagglutinin (HA) and neuraminidase (NA) genes derived from a 1994 Mexican-like virus, while their internal gene complexes were incorporated from the enzootic H6N1 virus lineage by multiple reassortment events. Pathogenicity studies demonstrated heterogeneous results even though all tested viruses had motifs (R-X-K/R-R) supportive of high pathogenicity. Serological surveys for common subtypes of avian viruses confirmed the prevalence of the H5N2 and H6N1 viruses in chickens and revealed an extraordinarily high seroconversion rate to an H9N2 virus, a subtype that is not found in Taiwan but is prevalent in mainland China. These findings suggest that reassortant H5N2 viruses, together with H6N1 viruses, have become established and enzootic in chickens throughout Taiwan and that a large-scale vaccination program might have been conducted locally that likely led to the introduction of the 1994 Mexican-like virus to Taiwan in 2003. IMPORTANCE H5N2 avian influenza viruses first appeared in chickens in Taiwan in 2003 and caused a series of outbreaks afterwards. Phylogenetic analyses show that the chicken H5N2 viruses have H5 and N2 genes that are closely related to those of a vaccine strain originating from Mexico in 1994, while the contemporary duck H5N2 viruses in Taiwan belong to the

  17. Seroepidemiology of varicella among elementary school children in northern Taiwan.

    PubMed

    Lin, Ming-Ru; Kuo, Ching-Chia; Hsieh, Yu-Chia; Huang, Ya-Ling; Huang, Yu-Chiau; Hung, Yung-Tai; Huang, Yhu-Chering

    2017-06-01

    In Taiwan, varicella vaccine was included in the expanded program of immunization since 2004. A seroepidemiologic study in the postvaccine era is helpful to evaluate the efficiency of current varicella vaccination strategies. We used a multistage stratified systematic sampling design to classify 29 administrative districts of New Taipei City into five strata. In 2013, a total of 936 students from 14 primary schools were recruited and had blood drawn for serology tests for varicella-zoster virus-immunoglobulin-G via indirect chemiluminescence immunoassays. A history of clinical varicella and information on varicella vaccination status were obtained. Overall, the seroprevalence was 64.1%. For the five strata, the seropositive rate ranged from 54.2% (Stratum 5) to 71.7% (Stratum 2) with no significant difference. For each participating school, the seropositive rate ranged from 44.4% to 72.9% with a statistically significant difference (p < 0.005). For school children in each grade, seropositive rate increased significantly from 53.2% for Grade 1 to 71.8% for Grade 3 (p = 0.005) and increased steadily from 61.2% for Grade 4 to 71.2% for Grade 6 (p = 0.17). A positive correlation was observed between the seropositive rate and geometric mean titers (p = 0.035). Geometric mean titers and the rate of a history of clinical varicella were positively correlated with increasing class grades. Nine years after the introduction of the varicella vaccine into the expanded program of immunization in Taiwan, around two-thirds of elementary schoolchildren were seropositive for varicella-zoster virus. Further surveillance studies on clinical varicella cases are worthwhile to determine whether a second dose of varicella vaccine is needed in Taiwan. Copyright © 2015. Published by Elsevier B.V.

  18. Robotic surgery in complicated gynecologic diseases: experience of Tri-Service General Hospital in Taiwan.

    PubMed

    Tan, Shun-Jen; Lin, Chi-Kung; Fu, Pei-Te; Liu, Yung-Liang; Sun, Cheng-Chian; Chang, Cheng-Chang; Yu, Mu-Hsien; Lai, Hung-Cheng

    2012-03-01

    Minimally invasive surgery has been the trend in various specialties and continues to evolve as new technology develops. The development of robotic surgery in gynecology remains in its infancy. The present study reports the first descriptive series of robotic surgery in complicated gynecologic diseases in Taiwan. From March 2009 to February 2011, the records of patients undergoing robotic surgery using the da Vinci Surgical System were reviewed for patient demographics, indications, operative time, hospital stay, conversion to laparotomy, and complications. Sixty cases were reviewed in the present study. Forty-nine patients had benign gynecologic diseases, and 11 patients had malignancies. These robot-assisted laparoscopic procedures include nine hysterectomy, 15 subtotal hysterectomy, 13 myomectomy, eight staging operation, two radical hysterectomy, five ovarian cystectomy, one bilateral salpingo-oophorectomy and myomectomy, two resections of deep pelvic endometriosis, one pelvic adhesiolysis, three sacrocolpopexy and one tuboplasty. Thirty-three patients had prior pelvic surgery, and one had a history of pelvic radiotherapy. Adhesiolysis was necessary in 38 patients to complete the whole operation. Robotic myomectomy was easily accomplished in patients with huge uterus or multiple myomas. The suturing of myometrium or cervical stump after ligation of the uterine arteries minimized the blood loss. In addition, it was much easier to dissect severe pelvic adhesions. The dissection of para-aortic lymph nodes can be easily accomplished. All these surgeries were performed smoothly without ureteral, bladder or bowel injury. The present analyses include various complicated gynecologic conditions, which make the estimation of the effectiveness of robotic surgery in each situation individually not appropriate. However, our experiences do show that robotic surgery is feasible and safe for patients with complicated gynecologic diseases. Copyright © 2012. Published by

  19. Cost-effectiveness of vaccination against cervical cancer: a multi-regional analysis assessing the impact of vaccine characteristics and alternative vaccination scenarios.

    PubMed

    Suárez, Eugenio; Smith, Jennifer S; Bosch, F Xavier; Nieminen, Pekka; Chen, Chien-Jen; Torvinen, Saku; Demarteau, Nadia; Standaert, Baudouin

    2008-09-15

    Mathematical models provide valuable insights into the public health and economic impact of cervical cancer vaccination programmes. An in-depth economic analysis should explore the effects of different vaccine-related factors and vaccination scenarios (independent of screening practices) on health benefits and costs. In this analysis, a Markov cohort model was used to explore the impact of vaccine characteristics (e.g. cross-type protection and waning of immunity) and different vaccination scenarios (e.g. age at vaccination and multiple cohort strategies) on the cost-effectiveness results of cervical cancer vaccination programmes. The analysis was applied across different regions in the world (Chile, Finland, Ireland, Poland and Taiwan) to describe the influence of location-specific conditions. The results indicate that in all the different settings cervical cancer vaccination becomes more cost-effective with broader and sustained vaccine protection, with vaccination at younger ages, and with the inclusion of several cohorts. When other factors were varied, the cost-effectiveness of vaccination was most negatively impacted by increasing the discount rate applied to costs and health effects.

  20. Hospitalization rates for complicated and uncomplicated chickenpox in a poorly vaccined pediatric population.

    PubMed

    Bonsignori, F; Chiappini, E; Frenos, S; Peraldo, M; Galli, L; de Martino, M

    2007-12-01

    A retrospective study was conducted to provide epidemiological data on hospitalization for complicated and uncomplicated chickenpox in a pediatric population. The study analyzed hospitalization cases for chickenpox, among all the 31 Tuscan hospitals, during the period 1997-2003. Globally, 650 cases were recorded (306 = 47.07% for uncomplicated and 344 = 52.92% for complicated chickenpox). Total hospitalization rate was 22.66 per 100,000 living Tuscan children and 11.52 per 1,000 notified chickenpox cases. Hospitalization rates for complicated chickenpox were 12.00 per 100,000 living children and 6.09 per 1,000 notified cases. Notably, significantly increased hospitalization rates for complicated chickenpox were evidenced over years (p = 0.011 per 100,000 living children and p = 0.001 per 1,000 notified cases), due to the increased proportion of neurological (p = 0.043 per 100,000 living children and p = 0.025 per 1,000 notified cases) and respiratory (p = 0.021 per 100,000 living children and p = 0.008 per 1,000 notified cases) complications, whereas hospitalization rates for other complications as well as for uncomplicated chickenpox remained constant (p = 0.25 per 100,000 living children and p = 0.09 per 1,000 notified cases). Chickenpox complications, requiring hospitalization, occurred at a substantial rate in our pediatric population. In particular, increasing hospitalization rates for neurological and respiratory complications were evidenced over the study period. Our epidemiological data may provide additional information while planning a vaccination strategy for Italy.

  1. Effectiveness of influenza vaccination for preventing influenza-related complications in people with asthma: a systematic review protocol.

    PubMed

    Vasileiou, Eleftheria; Sheikh, Aziz; Butler, Chris; von Wissmann, Beatrix; McMenamin, Jim; Ritchie, Lewis; Tian, Lilly; Simpson, Colin

    2016-03-29

    Influenza vaccination is administered annually as a preventive measure against influenza infection and influenza-related complications in high-risk individuals, such as those with asthma. However, the effectiveness of influenza vaccination in people with asthma against influenza-related complications is still not well established. We will search the following databases: MEDLINE (Ovid), EMBASE (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Cochrane Database of Systematic Reviews (CDSR), Web of Science Core Collection, Science direct, WHO Library Information System (WHOLIS), Global Health Library and Chinese databases (CNKI, Wanfang and ChongQing VIP) from Jan 1970 to Jan 2016 for observational and experimental studies on effectiveness of influenza vaccine in people with asthma. The identification of studies will be complemented with the searching of the reference lists and citations, and contacting influenza vaccine manufacturers to identify unpublished or ongoing studies. Two reviewers will extract data and appraise the quality of each study independently. Separate meta-analyses will be undertaken for observational and experimental evidence using fixed-effect or random-effects models, as appropriate. Formal ethical approval is not required, as primary data will not be collected. The review will be disseminated in peer-reviewed publications and conference presentations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Mumps Complications and Effects of Mumps Vaccination, England and Wales, 2002–2006

    PubMed Central

    Andrews, Nick; Bukasa, Antoaneta; Brown, Kevin E.; Ramsay, Mary

    2011-01-01

    We analyzed data from hospital admissions and enhanced mumps surveillance to assess mumps complications during the largest mumps outbreak in England and Wales, 2004–2005, and their association with mumps vaccination. When compared with nonoutbreak periods, the outbreak was associated with a clear increase in hospitalized patients with orchitis, meningitis, and pancreatitis. Routine mumps surveillance and hospital data showed that 6.1% of estimated mumps patients were hospitalized, 4.4% had orchitis, 0.35% meningitis, and 0.33% pancreatitis. Enhanced surveillance data showed 2.9% of mumps patients were hospitalized, 6.1% had orchitis, 0.3% had meningitis, and 0.25% had pancreatitis. Risk was reduced for hospitalization (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.43–0.68), mumps orchitis (OR 0.72, 95% CI 0.56–0.93) and mumps meningitis (OR 0.28, 95% CI 0.14–0.56) when patient had received 1 dose of measles, mumps, and rubella vaccine. The protective effect of vaccination on disease severity is critical in assessing the total effects of current and future mumps control strategies. PMID:21470456

  3. Disease burden and related medical costs of rotavirus infections in Taiwan

    PubMed Central

    Lu, Chun-Yi; Lauderdale, Tsai-Ling; Fang, Yin-Hua; Wang, Chung-Yi; Ho, Yu-Huai; Hung, Che-Lun; Chang, Luan-Yin; Lee, Chin-Yun; Huang, Li-Min

    2006-01-01

    Background The disease burden and associated medical costs of rotavirus infections in inpatient and outpatient sectors in Taiwan were examined in anticipation of the availability of new rotavirus vaccines. Methods The yearly national case number and medical costs for all for inpatients and outpatients with acute gastroenteritis (AGE) were extracted from the Bureau of National Health Insurance database in Taiwan according to ICD-9-CM codes. A retrospective study was also performed using records of children with AGE seen at three hospitals in Taiwan in 2001 to identify laboratory confirmed rotavirus infection cases. The annual incidence and related medical costs of AGE due to rotavirus infection were then estimated. Results Children <5 years old comprised 83.6% of inpatient and 62.0% of outpatient pediatric AGE cases in Taiwan in 2001. Rotavirus was the most common agent detected among AGE patients in this age group in the three hospitals, and was detected in 32.9% (221/672) of inpatient and 24% (23/96) of outpatient stool specimens tested for microbial etiologies. An estimated 277,400 to 624,892 cases of rotavirus infections sought medical care in Taiwan in 2001, equaling one in 2 to 5 children <5 years old required medical care due to rotavirus infection. The incidence of hospitalization due to rotavirus infections was 1,528–1,997/100,000 for children <5 years old. The total associated medical costs due to rotavirus infection were estimated at US $10–16 millions in Taiwan in 2001. Although the per-capita medical cost of rotavirus infection was lower in Taiwan than in the United States or Hong Kong, the personal economic burden was similar among the three places when normalized for gross national incomes per capita. Conclusion Infections caused by rotavirus constitute an important human and economic burden among young children in Taiwan. A safe and effective vaccine is urgently needed. PMID:17173677

  4. Neurological adverse events associated with vaccination.

    PubMed

    Piyasirisilp, Sucheep; Hemachudha, Thiravat

    2002-06-01

    Public tolerance to adverse reactions is minimal. Several reporting systems have been established to monitor adverse events following immunization. The present review summarizes data on neurologic complications following vaccination, and provides evidence that indicates whether they were directly associated with the vaccines. These complications include autism (measles vaccine), multiple sclerosis (hepatitis B vaccine), meningoencephalitis (Japanese encephalitis vaccine), Guillain-Barré syndrome and giant cell arteritis (influenza vaccine), and reactions after exposure to animal rabies vaccine. Seizures and hypotonic/hyporesponsive episodes following pertussis vaccination and potential risks associated with varicella vaccination, as well as vaccine-associated paralytic poliomyelitis following oral poliovirus vaccination, are also described. In addition, claims that complications are caused by adjuvants, preservatives and contaminants [i.e. macrophagic myofasciitis (aluminium), neurotoxicity (thimerosal), and new variant Creutzfeldt-Jakob disease (bovine-derived materials)] are discussed.

  5. Economic benefits of sharing and redistributing influenza vaccines when shortages occurred.

    PubMed

    Chen, Sheng-I

    2017-01-01

    Recurrent influenza outbreak has been a concern for government health institutions in Taiwan. Over 10% of the population is infected by influenza viruses every year, and the infection has caused losses to both health and the economy. Approximately three million free vaccine doses are ordered and administered to high-risk populations at the beginning of flu season to control the disease. The government recommends sharing and redistributing vaccine inventories when shortages occur. While this policy intends to increase inventory flexibility, and has been proven as widely valuable, its impact on vaccine availability has not been previously reported. This study developed an inventory model adapted to vaccination protocols to evaluate government recommended polices under different levels of vaccine production. Demands were uncertain and stratified by ages and locations according to the demographic data in Taiwan. When vaccine supply is sufficient, sharing pediatric vaccine reduced vaccine unavailability by 43% and overstock by 54%, and sharing adult vaccine reduced vaccine unavailability by 9% and overstock by 15%. Redistributing vaccines obtained greater gains for both pediatrics and adults (by 75%). When the vaccine supply is in short, only sharing pediatric vaccine yielded a 48% reduction of unused inventory, while other polices do not improve performances. When implementing vaccination activities for seasonal influenza intervention, it is important to consider mismatches of demand and vaccine inventory. Our model confirmed that sharing and redistributing vaccines can substantially increase availability and reduce unused vaccines.

  6. Economic benefits of sharing and redistributing influenza vaccines when shortages occurred

    PubMed Central

    2017-01-01

    Background Recurrent influenza outbreak has been a concern for government health institutions in Taiwan. Over 10% of the population is infected by influenza viruses every year, and the infection has caused losses to both health and the economy. Approximately three million free vaccine doses are ordered and administered to high-risk populations at the beginning of flu season to control the disease. The government recommends sharing and redistributing vaccine inventories when shortages occur. While this policy intends to increase inventory flexibility, and has been proven as widely valuable, its impact on vaccine availability has not been previously reported. Material and methods This study developed an inventory model adapted to vaccination protocols to evaluate government recommended polices under different levels of vaccine production. Demands were uncertain and stratified by ages and locations according to the demographic data in Taiwan. Results When vaccine supply is sufficient, sharing pediatric vaccine reduced vaccine unavailability by 43% and overstock by 54%, and sharing adult vaccine reduced vaccine unavailability by 9% and overstock by 15%. Redistributing vaccines obtained greater gains for both pediatrics and adults (by 75%). When the vaccine supply is in short, only sharing pediatric vaccine yielded a 48% reduction of unused inventory, while other polices do not improve performances. Conclusions When implementing vaccination activities for seasonal influenza intervention, it is important to consider mismatches of demand and vaccine inventory. Our model confirmed that sharing and redistributing vaccines can substantially increase availability and reduce unused vaccines. PMID:29040317

  7. Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

    PubMed Central

    Wei, Shu-Chen; Chang, Ting-An; Chao, Te-Hsin; Chen, Jinn-Shiun; Chou, Jen-Wei; Chou, Yenn-Hwei; Chuang, Chiao-Hsiung; Hsu, Wen-Hung; Huang, Tien-Yu; Hsu, Tzu-Chi; Lin, Chun-Chi; Lin, Hung-Hsin; Lin, Jen-Kou; Lin, Wei-Chen; Ni, Yen-Hsuan; Shieh, Ming-Jium; Shih, I-Lun; Shun, Chia-Tung; Tsang, Yuk-Ming; Wang, Cheng-Yi; Wang, Horng-Yuan; Weng, Meng-Tzu; Wu, Deng-Chyang; Wu, Wen-Chieh; Yen, Hsu-Heng

    2017-01-01

    Crohn's disease (CD) is a chronic relapsing and remitting inflammatory disease of the gastrointestinal tract. CD is rare in Taiwan and other Asian countries, but its prevalence and incidence have been steadily increasing. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of CD taking into account currently available evidence and the expert opinion of the committee. Thorough clinical, endoscopic, and histological assessments are required for accurate diagnosis of CD. Computed tomography and magnetic resonance imaging are complementary to endoscopic evaluation for disease staging and detecting complications. The goals of CD management are to induce and maintain remission, reduce the risk of complications, and improve quality of life. Corticosteroids are the mainstay for inducing re-mission. Immunomodulating and biologic therapies should be used to maintain remission. Patients should be evaluated for hepatitis B virus and tuberculosis infection prior to treatment and receive regular surveillance for cancer. These consensus statements are based on current local evidence with consideration of factors, and could be serve as concise and practical guidelines for supporting clinicians in the management of patients with CD in Taiwan. PMID:28670226

  8. [Use of highly purified subvirion trivalent flue vaccine ("Grippovak") in groups with a high risk of complications].

    PubMed

    Chumakov, M P; Beregovskiĭ, N A; Linev, M B; Reĭzin, F N; Malyshkina, L P; Matrosovich, M N; Mart'ianova, L I; Piatnitskaia, A F; Solov'eva, M V

    1992-03-01

    During the epidemic season of 1989-1990 the subunit vaccine Grippovac was used in 20 asylums for old people and psychoneurological invalids in Moscow for the protection of the inhabitants and the personnel from influenza. Follow-up of the vaccinees during the period from November 1989 to March 1990 revealed that the use of this vaccine decreased the incidence of influenza-like diseases (ILD) 3.4-4.1 times among the vaccinees in comparison with that in the nonvaccinated control groups and significantly decreased the severity of the course of ILD, as well as the mortality because of ILD, among those vaccinees who had contacted ILD. This is indicative of good prospects of regular vaccinal prophylaxis of influenza at asylums for old people and other persons at a high risk of influenza complications.

  9. Public Health Responses to Reemergence of Animal Rabies, Taiwan, July 16–December 28, 2013

    PubMed Central

    Huang, Angela Song-En; Chen, Wan-Chin; Huang, Wan-Ting; Huang, Shih-Tse; Lo, Yi-Chun; Wei, Sung-Hsi; Kuo, Hung-Wei; Chan, Pei-Chun; Hung, Min-Nan; Liu, Yu-Lun; Mu, Jung-Jung; Yang, Jyh-Yuan; Liu, Ding-Ping; Chou, Jih-Haw; Chuang, Jen-Hsiang; Chang, Feng-Yee

    2015-01-01

    Taiwan had been free of indigenous human and animal rabies case since canine rabies was eliminated in 1961. In July 2013, rabies was confirmed among three wild ferret-badgers, prompting public health response to prevent human rabies cases. This descriptive study reports the immediate response to the reemergence of rabies in Taiwan. Response included enhanced surveillance for human rabies cases by testing stored cerebrospinal fluids (CSF) from patients with encephalitides of unknown cause by RT-PCR, prioritizing vaccine use for postexposure prophylaxis (PEP) during periods of vaccine shortage and subsequent expansion of PEP, surveillance of animal bites using information obtained from vaccine application, roll out of preexposure prophylaxis (PrEP) with vaccine stock restoration, surveillance for adverse events following immunization (AEFI), and ensuring surge capacity to respond to general public inquiries by phone and training for healthcare professionals. Enhanced surveillance for human rabies found no cases after testing 205 stored CSF specimens collected during January 2010–July 2013. During July 16 to December 28, 2013, we received 8,241 rabies PEP application; 6,634 (80.5%) were consistent with recommendations. Among the 6,501persons who received at least one dose of rabies vaccine postexposure, 4,953 (76.2%) persons who were bitten by dogs; only 59 (0.9%) persons were bitten by ferret-badgers. During the study period, 6,247 persons received preexposure prophylaxis. There were 23 reports of AEFI; but no anaphylaxis, Guillain-Barré syndrome, or acute disseminated encephalomyelitis were found. During the study period, there were 40,312 calls to the Taiwan Centers for Disease Control hotline, of which, 8,692 (22%) were related to rabies. Recent identification of rabies among ferret-badgers in a previously rabies-free country prompted rapid response. To date, no human rabies has been identified. Continued multifaceted surveillance and interministerial

  10. Phylogenetic Analysis of the Spike (S) Gene of the New Variants of Porcine Epidemic Diarrhoea Virus in Taiwan.

    PubMed

    Chiou, H-Y; Huang, Y-L; Deng, M-C; Chang, C-Y; Jeng, C-R; Tsai, P-S; Yang, C; Pang, V F; Chang, H-W

    2017-02-01

    New variants of porcine epidemic diarrhoea virus (PEDV), which emerged in Taiwan in late 2013, have caused a high morbidity and mortality in neonatal piglets. To investigate the molecular characteristics of the spike (S) gene of the emerging Taiwan PEDV strains for a better understanding of the genetic diversity and relationship among the Taiwan new variants and the global PEDVs, full-length S genes of PEDVs from nine 1-7 day-old piglets from three pig farms in the central and southern Taiwan were sequenced and analysed. The result of phylogenetic analysis of the S gene showed that all the Taiwan PEDV strains were closely related to the non-S INDEL strains from US, Canada and China, suggesting a common ancestor for these strains. As compared with the historic PEDVs and CV777-based vaccine strains, the nine Taiwan PEDV variants shared almost the same genetic signatures as the global non-S INDEL strains, including a series of insertions, deletions and mutations in the amino terminal as well as identical mutations in the neutralizing epitopes of the S gene. The high similarity of the S protein among the Taiwan and the globally emerged non-S INDEL PEDV strains suggests that the Taiwan new variants may share similar pathogenesis and immunogenicity as the global outbreak variants. The development of a novel vaccine based on the Taiwan or the global non-S INDEL strains may be contributive to the control of the current global porcine epidemic diarrhoea outbreaks. © 2015 Blackwell Verlag GmbH.

  11. Dengue Fever: Causes, Complications, and Vaccine Strategies

    PubMed Central

    Khanna, Ira

    2016-01-01

    Dengue is a highly endemic infectious disease of the tropical countries and is rapidly becoming a global burden. It is caused by any of the 4 serotypes of dengue virus and is transmitted within humans through female Aedes mosquitoes. Dengue disease varies from mild fever to severe conditions of dengue hemorrhagic fever and shock syndrome. Globalization, increased air travel, and unplanned urbanization have led to increase in the rate of infection and helped dengue to expand its geographic and demographic distribution. Dengue vaccine development has been a challenging task due to the existence of four antigenically distinct dengue virus serotypes, each capable of eliciting cross-reactive and disease-enhancing antibody response against the remaining three serotypes. Recently, Sanofi Pasteur's chimeric live-attenuated dengue vaccine candidate has been approved in Mexico, Brazil, and Philippines for usage in adults between 9 and 45 years of age. The impact of its limited application to the public health system needs to be evaluated. Simultaneously, the restricted application of this vaccine candidate warrants continued efforts in developing a dengue vaccine candidate which is additionally efficacious for infants and naïve individuals. In this context, alternative strategies of developing a designed vaccine candidate which does not allow production of enhancing antibodies should be explored, as it may expand the umbrella of efficacy to include infants and naïve individuals. PMID:27525287

  12. Long-term complications and risk of other serious infections following invasive Haemophilus influenzae serotype b disease in vaccinated children.

    PubMed

    Ladhani, Shamez; Heath, Paul T; Aibara, Rashna J; Ramsay, Mary E; Slack, Mary P E; Hibberd, Martin L; Pollard, Andrew J; Moxon, E Richard; Booy, Robert

    2010-03-02

    This study describes the long-term complications in children with Haemophilus influenzae serotype b (Hib) vaccine failure and to determine their risk of other serious infections. The families of 323 children with invasive Hib disease after appropriate vaccination (i.e. vaccine failure) were contacted to complete a questionnaire relating to their health and 260 (80.5%) completed the questionnaire. Of the 124 children with meningitis, 18.5% reported serious long-term sequelae and a further 12.1% of parents attributed other problems to Hib meningitis. Overall, 14% (32/231 cases) of otherwise healthy children and 59% (17/29 cases) of children with an underlying condition developed at least one other serious infection requiring hospital admission. In a Poisson regression model, the risk of another serious infection was independently associated with the presence of an underlying medical condition (incidence risk ratio (IRR) 7.6, 95% CI 4.8-12.1; p<0.0001), both parents having had a serious infection (IRR 4.1, 95% CI 1.6-10.3; p=0.003), requirement of more than two antibiotic courses per year (IRR 2.3, 95% CI 1.4-3.6; p=0.001) and the presence of a long-term complication after Hib infection (IRR 1.8, 95% CI 1.1-3.1; p=0.03). Thus, rates of long-term sequelae in children with vaccine failure who developed Hib meningitis are similar to those in unvaccinated children in the pre-vaccine era. One in seven otherwise healthy children (14%) with Hib vaccine failure will go on to suffer another serious infection requiring hospital admission in childhood, which is higher than would be expected for the UK paediatric population. Copyright 2009 Elsevier Ltd. All rights reserved.

  13. Analyzing titers of antibodies against bacterial and viral antigens, and bacterial toxoids in the intravenous immunoglobulins utilized in Taiwan.

    PubMed

    Wu, Chi-Yu; Wang, Hsiu-Chi; Wang, Kun-Teng; Yang-Chih Shih, Daniel; Lo, Chi-Fang; Wang, Der-Yuan

    2013-03-01

    Intravenous immunoglobulin (IVIG) manufactured from human plasma contains IgG as the primary ingredient, and is used for indications such as immunodeficiency syndrome. Available IVIGs in Taiwan are either manufactured from Taiwanese or North American plasma. The effectiveness of the national immunization program of Taiwan can be evaluated by analyzing and comparing IVIG antibody titers that are induced through the corresponding vaccines (tetanus, diphtheria, and pertussis, measles, rubella, hepatitis A, hepatitis B and varicella). Both enzyme-linked immunosorbent assay (ELISA) and the in vitro neutralization test demonstrated that all IVIGs provide adequate clinical protection against diphtheria and tetanus toxins. ELISA results further revealed that plasma of Taiwanese subjects contains higher levels of pertussis toxin and filamentous hemagglutinin antibodies, when compared to foreign IVIGs. This may be related to the later adoption of acellular pertussis vaccine in Taiwan. Antibodies titers against measles, rubella, hepatitis A, and varicella-zoster virus were otherwise low. Low titers of hepatitis B surface antigen antibodies are present in Taiwanese plasma IVIG, indicating immune memory decline or loss. In conclusion, our results show that Taiwanese IVIG contains varying titers of vaccine-induced antibodies, and serves as a guide for future amendments to Taiwan's immunization program. Copyright © 2013 The International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

  14. Decline of Neurologic Varicella Complications in Children During the First Seven Years After Introduction of Universal Varicella Vaccination in Germany, 2005-2011.

    PubMed

    Streng, Andrea; Grote, Veit; Rack-Hoch, Anita; Liese, Johannes G

    2017-01-01

    Universal varicella vaccination for 1-year-old children was introduced in Germany in 2004. We investigated changes in the incidence and type of varicella-associated neurologic complications in children during the first 7 years after universal vaccination recommendation. A surveillance study was conducted based on patients <17 years of age with an International Classification of Diseases (10th Revision) discharge diagnosis of varicella, annually reported by 22-29 pediatric hospitals in Bavaria, Germany, 2005 to 2011. Annual incidences were estimated and linear trend across years was assessed by Poisson regression models. Of a total of 1263 varicella-associated pediatric hospitalizations, 228 children (18.1%) had neurologic complications (median age 4 years, interquartile range 2-7; 56% male). The most frequent neurologic complications were febrile convulsion (32.0% of 228 children, median age 3.0 years), varicella encephalitis or meningitis (28.9%; median age 4.5 years), syncope (13.2%; median age 7.0 years) and cerebral convulsion (11.0%; median age 4.0 years). Other complications included ataxia (3.1%), facial nerve palsy (2.6%) and cerebral vasculitis/infarction (1.8%). Neurologic complications showed a continuous decrease between 2005 and 2011, from an incidence of 2.8 (95% confidence interval: 2.1-3.6) per 100,000 children <17 years of age to 1.2 (95% confidence interval: 0.7-2.1; P < 0.001). In particular, a marked decline was observed among children up to 7 years of age, mainly because of a decrease in the number of febrile convulsions and encephalitis or meningitis. The incidence of varicella-associated neurologic complications in children decreased approximately by 60% during the first 7 years following the recommendation for universal vaccination.

  15. Comparing the rubella seronegativity in pregnant women who received one dose of rubella vaccine at different ages in Taiwan.

    PubMed

    Shih, Ching-Tang; Chang, Yuan-Chun; Wang, Huey-Lan; Lin, Ching-Chiang

    2016-09-14

    Vaccination is the best strategy to prevent rubella and congenital rubella. The aim of our study was to assess the immunity to rubella and determine rubella virus antibody titers in pregnant women who were offered a single dose of rubella vaccine at different ages of their lives. A total 15,067 rubella IgG antibody test results for Taiwanese pregnant women who received routine prenatal checkup at Fooyin University Hospital from 1999 to 2014 were analyzed in this study. The women were divided into five birth cohorts in order to compare their rubella seronegativities and antibody titers according to the different period of rubella vaccination policy in Taiwan. The total rubella seronegativity rate was 11.2% (95% CI: 10.7-11.7%) and the mean rubella antibody titers was 51.0IU/mL (SD=54.7IU/mL). The junior school cohort has the lowest rubella seronegativity of 7.6% (95% CI: 6.9-8.2%). The seronegativities were significantly high in the preschool cohort and in the 15-month-old cohort, 14.9% (95% CI: 13.2-16.6%) and 14.8% (95% CI: 11.5-18.1%), respectively. The OR values were 2.1 (95% CI: 1.8-2.5, p<0.001) in the preschool cohort and 2.2 (95% CI: 1.6-2.8, p<0.001) in the 15-month-old cohort, respectively, against the junior school cohort. Women in the 15-month-old cohort have lowest average rubella IgG titer, 25.4IU/mL. The total rubella seronegativity rate was 11.2% in all native pregnant women. Women who received one dose rubella vaccine at preschool and 15-month-old have highest seronegativities. The 15-month-old cohort has the lowest average rubella IgG titer. We recommend a revised catch-up immunization policy to women who received one dose rubella vaccine at a younger age. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Incidence of diabetes-related complications in Chinese patients with type 1 diabetes: a population-based longitudinal cohort study in Taiwan.

    PubMed

    Ou, Huang-Tz; Lee, Tsung-Ying; Li, Chung-Yi; Wu, Jin-Shang; Sun, Zih-Jie

    2017-06-21

    To estimate the incidence densities and cumulative incidence of diabetes-related complications in patients with type 1 diabetes for a maximum of 15-year follow-up. The estimations were further stratified by gender and age at diagnosis (ie, early onset: 0-12 years, late onset:≥13 years). A population-based retrospective longitudinal cohort study. Taiwan's National Health Insurance medical claims. 4007 patients newly diagnosed with type 1 diabetes were identified during 1999-2012. Acute complications included diabetic ketoacidosis (DKA) and hypoglycaemia. Chronic complications were cardiovascular diseases (CVD), retinopathy, neuropathy and nephropathy. The incidence density of retinopathy was greatest (97.74 per 1000 person-years), followed by those of nephropathy (31.36), neuropathy (23.93) and CVD (4.39). Among acute complications, the incidence density of DKA was greatest (121.11 per 1000 person-years). The cumulative incidences of acute complications after 12 years following diagnosis were estimated to be 52.1%, 36.1% and 4.1% for DKA, outpatient hypoglycaemia and hospitalised hypoglycaemia, respectively. For chronic complications, the cumulative incidence of retinopathy after 12 years following diagnosis was greatest (65.2%), followed by those of nephropathy (30.2%), neuropathy (23.7%) and CVD (4.1%). Females with late-onset diabetes were greatly affected by advanced retinopathy (ie, sight-threatening diabetic retinopathy) and hospitalised hypoglycaemia, whereas those with early-onset diabetes were more vulnerable to DKA. Chronic complications were more commonly seen in late-onset diabetes, whereas early-onset diabetes were most affected by acute complications. Ethnic Chinese patients with type 1 diabetes were greatly affected by DKA and retinopathy. The incidence of diabetes-related complications differed by age at diagnosis and sex. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  17. Epidemiology of pandemic influenza A/H1N1 virus during 2009-2010 in Taiwan.

    PubMed

    Lan, Yu-Ching; Su, Mei-Chi; Chen, Chao-Hsien; Huang, Su-Hua; Chen, Wan-Li; Tien, Ni; Lin, Cheng-Wen

    2013-10-01

    Outbreak of swine-origin influenza A/H1N1 virus (pdmH1N1) occurred in 2009. Taiwanese authorities implemented nationwide vaccinations with pdmH1N1-specific inactivated vaccine as of November 2009. This study evaluates prevalence, HA phylogenetic relationship, and transmission dynamic of influenza A and B viruses in Taiwan in 2009-2010. Respiratory tract specimens were analyzed for influenza A and B viruses. The pdmH1N1 peaked in November 2009, was predominant from August 2009 to January 2010, then sharply dropped in February 2010. Significant prevalence peaks of influenza B in April-June of 2010 and H3N2 virus in July and August were observed. Highest percentage of pdmH1N1- and H3N2-positive cases appeared among 11-15-year-olds; influenza B-positive cases were dominant among those 6-10 years old. Maximum likelihood phylogenetic trees showed 11 unique clusters of pdmH1N1, seasonal H3N2 influenza A and B viruses, as well as transmission clusters and mixed infections of influenza strains in Taiwan. The 2009 pdmH1N1 virus was predominant in Taiwan from August 2009 to January 2010; seasonal H3N2 influenza A and B viruses exhibited small prevalence peaks after nationwide vaccinations. Phylogenetic evidence indicated transmission clusters and multiple independent clades of co-circulating influenza A and B strains in Taiwan. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  18. Chickenpox complications, incidence and financial burden in previously healthy children and those with an underlying disease in Ankara in the pre-vaccination period.

    PubMed

    Ozdemir, Halil; Candir, Mehmet Onur; Karbuz, Adem; Belet, Nurşen; Tapisiz, Anil; Ciftçi, Ergin; Ince, Erdal

    2011-01-01

    The aim of this study was to determine the complications, financial burden and mortality caused by chickenpox using the data of Ankara, Turkey in the pre-vaccination period. The study was conducted as a retrospective sectional study. Of the 65 patients admitted to our hospital, 34 (52.3%) had been previously healthy, 10 (15.4%) had previous chronic disease and 21 (32.3%) were immunocompromised. The most common complications of chickenpox in those patient groups were skin and soft tissue infections (41.2%), hematological complications (50%) and gastrointestinal complications (38.1%), respectively. We found 10.6/100,000 and 8.7/100,000 rates of hospitalization due to chickenpox in Ankara for all children and for previously healthy children, respectively. The chickenpox-related mortality rate for the 0-17 age group was 3.03/1,000,000 in Ankara. In conclusion, we feel that a national vaccination program for chickenpox will lead to a significant decrease in the overall cost to our country.

  19. Acute demyelinating encephalomyelitis due to neural antirabies vaccine.

    PubMed

    Shah, Ira

    2008-01-01

    Rabies is highly endemic in India and seen with dog bites from rabid dogs. In India, nervous tissue vaccine is commonly used as it is inexpensive and freely available despite frequent neurological complications. Neurological complications seen with traditional vaccine are morbid and the medical community should switch over to the cell culture rabies vaccine in spite of the expense to prevent these complications with rabies vaccine.

  20. Molecular Epidemiology of Japanese Encephalitis Virus in Mosquitoes in Taiwan during 2005–2012

    PubMed Central

    Su, Chien-Ling; Yang, Cheng-Fen; Teng, Hwa-Jen; Lu, Liang-Chen; Lin, Cheo; Tsai, Kun-Hsien; Chen, Yu-Yu; Chen, Li-Yu; Chang, Shu-Fen; Shu, Pei-Yun

    2014-01-01

    Japanese encephalitis (JE) is a mosquito-borne zoonotic disease caused by the Japanese encephalitis virus (JEV). Pigs and water birds are the main amplifying and maintenance hosts of the virus. In this study, we conducted a JEV survey in mosquitoes captured in pig farms and water bird wetland habitats in Taiwan during 2005 to 2012. A total of 102,633 mosquitoes were collected. Culex tritaeniorhynchus was the most common mosquito species found in the pig farms and wetlands. Among the 26 mosquito species collected, 11 tested positive for JEV by RT-PCR, including Cx. tritaeniorhynchus, Cx. annulus, Anopheles sinensis, Armigeres subalbatus, and Cx. fuscocephala. Among those testing positive, Cx. tritaeniorhynchus was the predominant vector species for the transmission of JEV genotypes I and III in Taiwan. The JEV infection rate was significantly higher in the mosquitoes from the pig farms than those from the wetlands. A phylogenetic analysis of the JEV envelope gene sequences isolated from the captured mosquitoes demonstrated that the predominant JEV genotype has shifted from genotype III to genotype I (GI), providing evidence for transmission cycle maintenance and multiple introductions of the GI strains in Taiwan during 2008 to 2012. This study demonstrates the intense JEV transmission activity in Taiwan, highlights the importance of JE vaccination for controlling the epidemic, and provides valuable information for the assessment of the vaccine's efficacy. PMID:25275652

  1. Safety, efficacy and immunogenicity evaluation of the SAG2 oral rabies vaccine in Formosan ferret badgers.

    PubMed

    Hsu, Ai-Ping; Tseng, Chun-Hsien; Barrat, Jacques; Lee, Shu-Hwae; Shih, Yu-Hua; Wasniewski, Marine; Mähl, Philippe; Chang, Chia-Chia; Lin, Chun-Ta; Chen, Re-Shang; Tu, Wen-Jane; Cliquet, Florence; Tsai, Hsiang-Jung

    2017-01-01

    Since 2013, rabies cases have been reported among Formosan ferret badgers in Taiwan, and they have been shown to be the major reservoirs for Taiwanese enzootics. To control and eradicate rabies, the authorities plan to implement a vaccination programme. Before distributing live vaccines in the field, this study assessed the safety, efficacy, and immunogenicity of SAG2 vaccine on ferret badgers by direct oral instillation. After application of 109 TCID50/dose, no virus was excreted into the oral cavity 1-7 days post-application, and safety was also satisfactorily verified over a 266-day period. Moreover, despite the low level of rabies virus neutralising antibodies induced after vaccination of a 108 TCID50/dose, the efficacy assessment revealed a 100% survival rate (15/15) of vaccinees and an 87.5% fatality rate (7/8) in control animals after a challenge on the 198th day post-vaccination. The immunisation and protection rates obtained more than 6 months after a single vaccination dose demonstrated that SAG2 is an ideal vaccine candidate to protect Formosan ferret badgers against rabies in Taiwan.

  2. Human papillomavirus vaccines and vaccine implementation.

    PubMed

    de Sanjosé, Silvia; Alemany, Laia; Castellsagué, Xavier; Bosch, F Xavier

    2008-11-01

    Countries are now challenged by the rapid development of vaccines aimed at the primary prevention of infections. In the years to come, several vaccines will need to be considered as potential candidates in routine immunization programs. Recently, two new vaccines against two/four types of human papillomavirus (HPV) have been commercialized. Bivalent HPV 16 and 18 (Cervarix) and quadrivalent HPV 6, 11, 16 and 18 (Gardasil) vaccines are now extensively used in some countries. These vaccines will prevent infection and long-running complications, such as cervical cancer, other HPV-related cancers and genital warts (for the quadrivalent vaccine). The beneficial effect of these vaccines will be largely observed in women. This article summarizes the burden of HPV preventable disease worldwide and briefly describes the impact of secondary prevention and the most relevant aspects of the current available vaccines, their efficacy and safety. Finally, some major aspects that are likely to impact the introduction of these vaccines around the world are outlined, with particular emphasis on developing countries.

  3. Universal Hepatitis B Vaccination Coverage in Children and Adolescents with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Lin, Pei-Ying; Lin, Lan-Ping

    2010-01-01

    There is little information of hepatitis B vaccination coverage for people with intellectual disabilities (ID). The present paper aims to examine the completed hepatitis B vaccination coverage rate and its determinants of children and adolescents with ID in Taiwan. A cross-sectional questionnaire survey, with the entire response participants was…

  4. Do Vaccines Cause Autism? Is it OK to Skip Certain Vaccines? Get the facts

    MedlinePlus

    ... Lifestyle Infant and toddler health Do vaccines cause autism? Is it OK to skip certain vaccines? Get ... their potentially serious complications. Vaccines do not cause autism. Despite much controversy on the topic, researchers haven' ...

  5. Hepatitis A virus seroepidemiology of elementary school children in New Taipei City in Taiwan.

    PubMed

    Tseng, Shih-Lun; Hsieh, Yu-Chia; Huang, Ya-Ling; Huang, Yu-Chiau; Hung, Yung-Tai; Huang, Yhu-Chering

    2016-10-01

    To establish the seroepidemiologic data of hepatitis A virus (HAV) vaccine-preventable HAV diseases among school children (7-12 years old) attending elementary schools in New Taipei City, Taiwan. This is a pilot study of an ongoing nationwide study, and will be the reference for a national immunization program. The school children were selected for samplings, based on a multistage stratified sampling method that included 14 variables (4 socioeducational variables, 4 socioeducational variables, and 6 medical facilities' variables). The 29 administrative districts of New Taipei City were categorized into five strata. In total, 936 school children from 14 schools were recruited and bled for the serologic tests of HAV by enzyme-linked immunosorbent assay method. The seropositive rate for HAV was 8.33% among the 936 children. From each school, the difference in the seropositive rate for HAV ranged 0-18.75%. There was no significant difference between each stratum (p = 0.059) or grade (p = 0.570); however, there was a difference between schools in the first stratum (p = 0.033) that was associated with different vaccination rates. This study also revealed a significantly greater seropositive rate in the vaccination group (p < 0.001) and in females (p = 0.02). The seropositive rate for the HAV was <10% and was mostly associated with the vaccination status. Because of the low HAV vaccination rate and low seropositive rate for the HAV, an effective hepatitis A vaccine is a useful tool to prevent HAV infection. It is worthy to discuss whether to include the HAV vaccine as part of a routine vaccination program in Taiwan. Copyright © 2014. Published by Elsevier B.V.

  6. Initial pen and field assessment of baits to use in oral rabies vaccination of Formosan ferret-badgers in response to the re-emergence of rabies in Taiwan

    PubMed Central

    Wallace, Ryan M.; Lai, Yuching; Doty, Jeffrey B.; Chen, Chen-Chih; Vora, Neil M.; Blanton, Jesse D.; Chang, Susan S.; Pei, Kurtis J. C.

    2018-01-01

    Background Taiwan had been considered rabies free since 1961, until a newly established wildlife disease surveillance program identified rabies virus transmission within the Formosan ferret-badger (Melogale moschata subaurantiaca) in 2013. Ferret-badgers occur throughout southern China and Southeast Asia, but their ecological niche is not well described. Methodology/Principle findings As an initial feasibility assessment for potential rabies control measures, field camera trapping and pen assessment of 6 oral rabies vaccine (ORV) baits were conducted in Taiwan in 2013. 46 camera nights were recorded; 6 Formosan ferret-badgers and 14 non-target mammals were sighted. No baits were consumed by ferret-badgers and 8 were consumed by non-target mammals. Penned ferret-badgers ingested 5 of the 18 offered baits. When pen and field trials were combined, and analyzed for palatability, ferret-badgers consumed 1 of 9 marshmallow baits (11.1%), 1 of 21 fishmeal baits (4.8%), 0 of 3 liver baits, and 3 of 3 fruit-flavored baits. It took an average of 261 minutes before ferret-badgers made oral contact with the non-fruit flavored baits, and 34 minutes for first contact with the fruit-based bait. Overall, ferret-badgers sought out the fruit baits 8 times faster, spent a greater proportion of time eating fruit baits, and were 7.5 times more likely to have ruptured the vaccine container of the fruit-based bait. Conclusions/Significance Ferret-badgers are now recognized as rabies reservoir species in China and Taiwan, through two independent ‘dog to ferret-badger’ host-shift events. Species of ferret-badgers can be found throughout Indochina, where they may be an unrecognized rabies reservoir. Findings from this initial study underscore the need for further captive and field investigations of fruit-based attractants or baits developed for small meso-carnivores. Non-target mammals’ competition for baits, ants, bait design, and dense tropical landscape represent potential

  7. Initial pen and field assessment of baits to use in oral rabies vaccination of Formosan ferret-badgers in response to the re-emergence of rabies in Taiwan.

    PubMed

    Wallace, Ryan M; Lai, Yuching; Doty, Jeffrey B; Chen, Chen-Chih; Vora, Neil M; Blanton, Jesse D; Chang, Susan S; Cleaton, Julie M; Pei, Kurtis J C

    2018-01-01

    Taiwan had been considered rabies free since 1961, until a newly established wildlife disease surveillance program identified rabies virus transmission within the Formosan ferret-badger (Melogale moschata subaurantiaca) in 2013. Ferret-badgers occur throughout southern China and Southeast Asia, but their ecological niche is not well described. As an initial feasibility assessment for potential rabies control measures, field camera trapping and pen assessment of 6 oral rabies vaccine (ORV) baits were conducted in Taiwan in 2013. 46 camera nights were recorded; 6 Formosan ferret-badgers and 14 non-target mammals were sighted. No baits were consumed by ferret-badgers and 8 were consumed by non-target mammals. Penned ferret-badgers ingested 5 of the 18 offered baits. When pen and field trials were combined, and analyzed for palatability, ferret-badgers consumed 1 of 9 marshmallow baits (11.1%), 1 of 21 fishmeal baits (4.8%), 0 of 3 liver baits, and 3 of 3 fruit-flavored baits. It took an average of 261 minutes before ferret-badgers made oral contact with the non-fruit flavored baits, and 34 minutes for first contact with the fruit-based bait. Overall, ferret-badgers sought out the fruit baits 8 times faster, spent a greater proportion of time eating fruit baits, and were 7.5 times more likely to have ruptured the vaccine container of the fruit-based bait. Ferret-badgers are now recognized as rabies reservoir species in China and Taiwan, through two independent 'dog to ferret-badger' host-shift events. Species of ferret-badgers can be found throughout Indochina, where they may be an unrecognized rabies reservoir. Findings from this initial study underscore the need for further captive and field investigations of fruit-based attractants or baits developed for small meso-carnivores. Non-target mammals' competition for baits, ants, bait design, and dense tropical landscape represent potential challenges to effective ORV programs that will need to be considered in future

  8. Safety, efficacy and immunogenicity evaluation of the SAG2 oral rabies vaccine in Formosan ferret badgers

    PubMed Central

    Hsu, Ai-Ping; Tseng, Chun-Hsien; Barrat, Jacques; Lee, Shu-Hwae; Shih, Yu-Hua; Wasniewski, Marine; Mähl, Philippe; Chang, Chia-Chia; Lin, Chun-Ta; Chen, Re-Shang; Tu, Wen-Jane; Cliquet, Florence

    2017-01-01

    Since 2013, rabies cases have been reported among Formosan ferret badgers in Taiwan, and they have been shown to be the major reservoirs for Taiwanese enzootics. To control and eradicate rabies, the authorities plan to implement a vaccination programme. Before distributing live vaccines in the field, this study assessed the safety, efficacy, and immunogenicity of SAG2 vaccine on ferret badgers by direct oral instillation. After application of 109 TCID50/dose, no virus was excreted into the oral cavity 1–7 days post-application, and safety was also satisfactorily verified over a 266-day period. Moreover, despite the low level of rabies virus neutralising antibodies induced after vaccination of a 108 TCID50/dose, the efficacy assessment revealed a 100% survival rate (15/15) of vaccinees and an 87.5% fatality rate (7/8) in control animals after a challenge on the 198th day post-vaccination. The immunisation and protection rates obtained more than 6 months after a single vaccination dose demonstrated that SAG2 is an ideal vaccine candidate to protect Formosan ferret badgers against rabies in Taiwan. PMID:28977009

  9. Influenza Vaccine, Inactivated or Recombinant

    MedlinePlus

    ... flu vaccine. This risk has been estimated at 1 or 2 additional cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine. Young children who get the flu shot along with pneumococcal vaccine (PCV13) and/or DTaP ...

  10. The economic burden of childhood invasive pneumococcal diseases and pneumonia in Taiwan: Implications for a pneumococcal vaccination program

    PubMed Central

    Ho, Yi-Chien; Lee, Pei-Lun; Wang, Yu-Chiao; Chen, Shiou-Chien; Chen, Kow-Tong

    2015-01-01

    Invasive pneumococcal disease (IPD) and pneumonia are the major causes of morbidity and deaths in children in the world. The management of IPD and pneumonia is an important economic burden on healthcare systems and families. The aim of this study was to assess the economic burden of IPD and pneumonia among younger children in Taiwan. We used a cost-illness approach to identify the cost categories for analysis in this study according to various perspectives. We obtained data of admission, outpatient, and emergency department visit data from the National Health Insurance Research (NHIR) database for children <5 y of age between January 2008 and December 2008. A prospective survey was administered to the families of patients to obtain detailed personal costs. All costs are presented in US dollars and were estimated by extrapolating 2008 cost data to 2013 price levels. We estimated the number of pneumococcal disease cases that were averted if the PCV-13 vaccine had been available in 2008. The total annual social and hospital costs for IPD were US $4.3 million and US $926,000, respectively. The total annual social and hospital costs for pneumonia were US $150 million and US $17 million, respectively. On average, families spent US $653 or US $218 when their child was diagnosed with IPD or pneumonia, respectively. This cost is approximately 27%–81% of the monthly salary of an unskilled worker. In conclusion, a safe and effective pediatric pneumococcal vaccine is needed to reduce the economic burden caused by pneumococcal infection. PMID:25874476

  11. Imperfect Vaccine Aggravates the Long-Standing Dilemma of Voluntary Vaccination

    PubMed Central

    Wu, Bin; Fu, Feng; Wang, Long

    2011-01-01

    Achieving widespread population immunity by voluntary vaccination poses a major challenge for public health administration and practice. The situation is complicated even more by imperfect vaccines. How the vaccine efficacy affects individuals' vaccination behavior has yet to be fully answered. To address this issue, we combine a simple yet effective game theoretic model of vaccination behavior with an epidemiological process. Our analysis shows that, in a population of self-interested individuals, there exists an overshooting of vaccine uptake levels as the effectiveness of vaccination increases. Moreover, when the basic reproductive number, , exceeds a certain threshold, all individuals opt for vaccination for an intermediate region of vaccine efficacy. We further show that increasing effectiveness of vaccination always increases the number of effectively vaccinated individuals and therefore attenuates the epidemic strain. The results suggest that ‘number is traded for efficiency’: although increases in vaccination effectiveness lead to uptake drops due to free-riding effects, the impact of the epidemic can be better mitigated. PMID:21687680

  12. Perforated peptic ulcer in southeastern Taiwan.

    PubMed

    Li, Chin-Hsien; Chang, Wen-Hsiung; Shih, Shou-Chuan; Lin, Shee-Chan; Bair, Ming-Jong

    2010-09-01

    No studies focus on the population with perforated peptic ulcer in southeastern Taiwan. The present study aimed to assess the differences between the different races and the risk factors related to mortality and morbidity in postoperative patients in southeastern Taiwan. The medical records of 237 patients were reviewed retrospectively. The following factors were analyzed: patient profiles, coexisting illnesses, diagnostic method, fever, preoperative shock, clinical data at emergency room, delay operation, site of perforation, operative method, positive ascites culture, species of microbes in ascites culture, postoperative complications, death and the length of hospital stay. Aborigines were significantly different from non-aborigines in the ratio of female cases and in the habits of alcohol drinking and betel nut chewing. There were also four significantly different variables between them: fever, hemoglobin value, site of perforation and operative method. Total postoperative complication rate was 41.3% and 39 patients (16.6%) died. In multivariate analysis, age > or = 65 years, lipase > upper normal limit and preoperative shock were independent predictors of mortality. Significant risk factors associated with morbidity were NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock. Aborigines were different from non-aborigines in several categories. In southeastern Taiwan, NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock were independent risk factors of morbidity, and age > or = 65 years, lipase > upper normal limit and preoperative shock were independent risk factors of mortality in postoperative perforated peptic ulcer. Lipase > upper normal limit is needed for further research on the influence on mortality.

  13. Routine vaccination against chickenpox?

    PubMed

    2012-04-01

    Varicella-zoster virus (VZV) causes both varicella and herpes zoster. In 1995 a varicella vaccine was licensed in the USA and was incorporated into the routine vaccination programme for children; a decline of varicella among children and adults, and a reduction in associated hospitalisation, complications and mortality, has resulted. In the UK, a policy of targeted vaccination of at-risk groups has been in place since the vaccine was introduced. Here we review the evidence for the different approaches to VZV vaccination policy.

  14. Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

    PubMed Central

    Wei, Shu-Chen; Chang, Ting-An; Chao, Te-Hsin; Chen, Jinn-Shiun; Chou, Jen-Wei; Chou, Yenn-Hwei; Chuang, Chiao-Hsiung; Hsu, Wen-Hung; Huang, Tien-Yu; Hsu, Tzu-Chi; Lin, Chun-Chi; Lin, Hung-Hsin; Lin, Jen-Kou; Lin, Wei-Chen; Ni, Yen-Hsuan; Shieh, Ming-Jium; Shih, I-Lun; Shun, Chia-Tung; Tsang, Yuk-Ming; Wang, Cheng-Yi; Wang, Horng-Yuan; Weng, Meng-Tzu; Wu, Deng-Chyang; Wu, Wen-Chieh; Yen, Hsu-Heng

    2017-01-01

    Ulcerative colitis (UC) is an inflammatory bowel disease characterized by chronic mucosal inflammation of the colon, and the prevalence and incidence of UC have been steadily increasing in Taiwan. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of UC taking into account currently available evidence and the expert opinion of the committee. Accurate diagnosis of UC requires thorough clinical, endoscopic, and histological assessment and careful exclusion of differential diagnoses, particularly infectious colitis. The goals of UC therapy are to induce and maintain remission, reduce the risk of complications, and improve quality of life. As outlined in the recommended treatment algorithm, choice of treatment is dictated by severity, extent, and course of disease. Patients should be evaluated for hepatitis B virus and tuberculosis infection prior to immunosuppressive treatment, especially with steroids and biologic agents, and should be regularly monitored for reactivation of latent infection. These consensus statements are also based on current local evidence with consideration of factors, and could be serve as concise and practical guidelines for supporting clinicians in the management of UC in Taiwan. PMID:28670225

  15. The Effectiveness of Influenza Vaccination in Different Groups.

    PubMed

    Domínguez, Angela; Godoy, Pere; Torner, Nuria

    2016-06-01

    Annual administration of the seasonal influenza vaccine, especially to persons known to be at elevated risk for developing serious complications, is the focus of current efforts to reduce the impact of influenza. The main factors influencing estimated inactivated influenza vaccine efficacy and effectiveness, the results obtained in different population groups, current vaccination strategies and the possible advantages of new vaccines are discussed. The available evidence suggests that influenza vaccines are less effective in the elderly than in young adults, but vaccination is encouraged by public health institutions due to higher mortality and complications. There is no consensus on universal vaccination of children yet economic studies suggest that yearly paediatric vaccination is cost saving. The benefits of herd immunity generated by paediatric vaccination require further study. Newer vaccines should be more and more-broadly protective, stable, easy to manufacture and administer and highly immunogenic across all population groups.

  16. An investigation of snakebite antivenom usage in Taiwan.

    PubMed

    Lin, Chih-Chuan; Chaou, Chung-Hsien; Tseng, Chiung-Yao

    2016-08-01

    Four types of antivenom are used to treat snakebites by the six species of venomous snakes native to Taiwan. Research into antivenom use in Taiwan and its outcomes, as well as the utility of current Taiwan Poison Control Center guidelines for antivenom use, has been limited. We aimed to provide increased understanding by investigating the treatment and outcomes of patients treated for snakebite in Taiwan. On the basis of data collected from the 2009 Taiwan National Health Insurance database, patients with snakebites were identified and categorized into two sets of groups according to types of antivenom administered. The relationships between antivenom types, dosage and the variables of antibiotic use, surgical intervention, acute respiratory failure acute, renal failure, antivenom-related allergic reaction, mortality, need for hospital admission, and length of hospitalization were analyzed by multivariate logistic regression and the Kruskal-Wallis test. The majority of patients were successfully treated by administration of 1 vial of antivenom and discharged without complications. However, patients treated for neurotoxic-type venom snakebite required administration of larger doses of antivenom and > 30% required surgical intervention, particularly those treated for Chinese cobra snakebite. Approximately 10% of patients were administered two types of antivenom. The results partially support Taiwan Poison Control Center guidelines for treating the hemorrhagic-type venom snakebite. However, deficit in the guidelines for treatment of neurotoxic-type venom snakebite is obvious and new guidelines for treatment of neurotoxic-type venom snakebite and diagnosis should be developed. Copyright © 2015. Published by Elsevier B.V.

  17. Varicella zoster virus vaccines: potential complications and possible improvements.

    PubMed

    Silver, Benjamin; Zhu, Hua

    2014-10-01

    Varicella zoster virus (VZV) is the causative agent of varicella (chicken pox) and herpes zoster (shingles). After primary infection, the virus remains latent in sensory ganglia, and reactivates upon weakening of the cellular immune system due to various conditions, erupting from sensory neurons and infecting the corresponding skin tissue. The current varicella vaccine (v-Oka) is highly attenuated in the skin, yet retains its neurovirulence and may reactivate and damage sensory neurons. The reactivation is sometimes associated with postherpetic neuralgia (PHN), a severe pain along the affected sensory nerves that can linger for years, even after the herpetic rash resolves. In addition to the older population that develops a secondary infection resulting in herpes zoster, childhood breakthrough herpes zoster affects a small population of vaccinated children. There is a great need for a neuro-attenuated vaccine that would prevent not only the varicella manifestation, but, more importantly, any establishment of latency, and therefore herpes zoster. The development of a genetically-defined live-attenuated VZV vaccine that prevents neuronal and latent infection, in addition to primary varicella, is imperative for eventual eradication of VZV, and, if fully understood, has vast implications for many related herpesviruses and other viruses with similar pathogenic mechanisms.

  18. Mumps vaccine associated orchitis: Evidence supporting a potential immune-mediated mechanism.

    PubMed

    Clifford, Vanessa; Wadsley, Jane; Jenner, Bernard; Buttery, Jim P

    2010-03-19

    We report 3 cases of orchitis following vaccination with mumps-measles-rubella (MMR) vaccine, two with an onset within 3 days following vaccination. Orchitis is a common complication of mumps infection, particularly in post-pubertal males, and is also recognized as a very rare complication of mumps vaccination. These cases, discussed together with a comprehensive review of the existing literature regarding post-vaccine orchitis, highlight uncertainty regarding the pathogenesis of post-vaccine orchitis. Copyright 2010 Elsevier Ltd. All rights reserved.

  19. Epidemiology and molecular characterization of chicken anaemia virus from commercial and native chickens in Taiwan.

    PubMed

    Ou, S-C; Lin, H-L; Liu, P-C; Huang, H-J; Lee, M-S; Lien, Y-Y; Tsai, Y-L

    2018-04-25

    Chicken infectious anaemia (CIA) is a disease with a highly economic impact in the poultry industry. The infected chickens are characterized by aplastic anaemia and extreme immunosuppression, followed by the increased susceptibility to secondary infectious pathogens and suboptimal immune responses for vaccination. Commercially available CIA vaccines are routinely used in the breeders in Taiwan to protect their progeny with maternal-derived antibodies. However, CIA cases still occur in the field and little is known about the genetic characteristics of Taiwanese chicken anaemia viruses (CAVs). In this study, CAV DNA was detected in 72 of 137 flocks collected during 2010-2015. Among the PCR-positive samples, the coding regions of 51 CAVs were sequenced. Phylogenetic analysis of the VP1 gene revealed that, although most of Taiwanese CAVs belonged to genotypes II and III, some isolates were clustered into a novel genotype (genotype IV). Moreover, a Taiwanese isolate in this novel genotype IV appeared to be derived from a recombination event between genotypes II and III viruses. Five Taiwanese CAV isolates were highly similar to the vaccine strains, 26P4 or Del-Ros. Taken together, these results indicate that the sequences of CAVs in Taiwan are variable, and inter-genotypic recombination had occurred between viruses of different genotypes. Moreover, vaccine-like strains might induce clinical signs of CIA in chickens. Our findings could be useful for understanding the evolution of CAVs and development of a better control strategy for CIA. © 2018 Blackwell Verlag GmbH.

  20. [A comparative study on Koii (public doctor) system and its effect on public health in colonial Taiwan and Korea].

    PubMed

    Moon, Myungki

    2014-08-01

    manpower shortage, thus shifting their duties like vaccination onto police officers who was inevitably inferior to doctors in medical terms, whereas vaccination was led by Koiis in Taiwan, with the help of police officers and traditional doctors. The difference between Korea and Taiwan in terms of Koii system and its effect implies that public health network in colonial Taiwan was better organized and more stable than that in colonial Korea, and therefore we should be careful about applying the concept of disciplinary power or modernization theory to colonial medical history of Korea.

  1. The Moho discontinuity beneath Taiwan orogenic zone inferred from receiver function analysis

    NASA Astrophysics Data System (ADS)

    Chang, H.; Chen, C.; Liang, W.

    2013-12-01

    We determine the depth variations of the Moho discontinuity beneath Taiwan from receiver function analysis. Taiwan is a young (~6.5 Ma) orogenic zone as a consequence of oblique collision between the Philippine Sea Plate and the Eurasian Plate. In northeastern Taiwan, the Philippine Sea Plate subducts northwestward under the Eurasian Plate along the Ryukyu Trench; in southern Taiwan, the Eurasian Plate subducts eastward beneath the Philippine Sea Plate along the Manila Trench. Recent tomographic models of Taiwan reveal P-wave velocity variations of the lithospheric structure that provide important constraints on the orogenic processes in this region. However, the depth variations of the Moho discontinuity, a key observation for better understanding crustal deformation, remain elusive. In this study, we aim to delineate the Moho depth variations by analyzing seismic converted phases indicative of the presence of discontinuity structure. We analyze waveform data from teleseismic events recorded at the Broadband Array in Taiwan for Seismology (BATS). Preliminary results of receiver functions beneath BATS stations in eastern Taiwan show that more than one converted phase (P-to-S) are likely present in crustal depths, suggesting possible multiple crustal layering, which may complicate the detection of the Moho. We further carry out synthetic experiments to explore possible crustal structures that reconcile our observations.

  2. Team care of type 2 diabetes mellitus in Taiwan.

    PubMed

    Wang, Chih-Yuan; Yu, Neng-Chun; Sheu, Wayne Huey-Herng; Tsai, Shih-Tzer; Tai, Tong-Yuan

    2014-12-01

    Type 2 diabetes mellitus (T2DM) is a global health-care and national policy issue. As fluctuating glycemic control in diabetes often results in serious complications, we must encourage the diabetes educators' efforts at long-term follow-up among patients with T2DM. Therefore, certified diabetes educators (CDEs) play the most pivotal roles as life-long protectors for patients with T2DM. In the past 15 years, more than 4,000 CDEs have been trained and qualified, including health professionals such as physicians, nurses, dieticians, and pharmacists. The most important initiation of diabetes share care in Taiwan was originated in I-Lan County. Initiated to provide regional diabetes care, the name of this program is the Lan-Yang Diabetes Shared Care System. In 2006, the Taiwanese Association of Diabetes Educators (TADE) carried out a nationwide survey to evaluate the status of diabetes control in Taiwan, focusing on the "ABC" goal (A: HbA1c <7.0%, B: blood pressure <130/80 mmHg, C: LDL-cholesterol <100 mg/dl/total cholesterol <160 mg/dl). The results revealed that the percentage of patients with diabetes who fulfilled all ABC goals was only 4.1%. Five years later, in 2011, TADE compared two nationwide surveys and found total ABC attainment rates of 4.1% and 8.6%, respectively. The team-care approach to T2DM has been underway for over 20 years in Taiwan. Future interventions and treatment algorithms with team-based education should aim at preventing acute and chronic complications, which remains a long-term challenge in Taiwan. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. New Genotypes of Orientia tsutsugamushi Isolated from Humans in Eastern Taiwan

    PubMed Central

    Lin, Chin-Hui; Chen, Tren-Yi; Chen, Li-Kuang

    2012-01-01

    Scrub typhus, an acute febrile illness, is caused by the obligate intracellular bacterium Orientia tsutsugamushi. In our study, O. tsutsugamushi was rapidly detected and typed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis of the 56-kDa type-specific antigen (TSA) gene. To investigate the genotypes of clinical variants of O. tsutsugamushi, we collected 3223 blood samples from eastern Taiwanese patients with suspected scrub typhus from 2002 to 2008. In total, 505 samples were found to be positive for scrub typhus infection by PCR, and bacteria were isolated from 282 of them. Four prototype genotype strains (Karp, Kato, Kawasaki and Gilliam) and eleven different Taiwanese genotype isolates (Taiwan-A, -B, -C, -D, -E, -G, -H, -J, -N, -O and -P) were identified by RPLF analysis. Taiwan-H, the major genotype in eastern Taiwan, exhibited prevalence and isolation rates of 47.3% (239/505) and 42.6% (120/282), respectively. We also assessed the genetic relatedness of the 56-kDa TSA gene among eight Taiwan-H isolates, thirteen other Taiwanese isolates and 104 DNA sequences deposited in the GenBank database using MEGA version 5.0 and PHYLIP version 3.66. We found that the Taiwan-H isolates formed into a new cluster, which was designated the Taiwan Gilliam-variant (TG-v) cluster to distinguish it from the Japanese Gilliam-variant (JG-v) cluster. According to Simplot analysis, TG-v is a new recombinant strain among Gilliam, Ikeda and Kato. Moreover, the Gilliam-Kawasaki cluster had the highest percentage of RFLP cases and was the most frequently isolated type in eastern Taiwan (50.1%, 253/505; 44.0%, 124/282). These findings shed light on the genetic evolution of O. tsutsugamushi into different strains and may be useful in vaccine development and epidemic disease control in the future. PMID:23071693

  4. Factors Influencing Administration of Hepatitis B Vaccine to Community-Dwelling Teenagers Aged 12-18 with an Intellectual Disability

    ERIC Educational Resources Information Center

    Yen, Chia-Feng; Lin, Jin-Ding

    2011-01-01

    The study aims to determine hepatitis B vaccination coverage rates among community-dwelling teenagers with an intellectual disability in Taiwan and to identify the possible influencing factors of their vaccination. The present paper was part of the results of the "2007 National Survey on Healthy Behaviors and Preventive Health Utilizations of…

  5. Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for influenza vaccination in children

    PubMed Central

    2010-01-01

    Background Influenza vaccination in infants and children with existing health complications is current practice in many countries, but healthy children are also susceptible to influenza, sometimes with complications. The under-recognised burden of disease in young children is greater than in elderly populations and the number of paediatric influenza cases reported does not reflect the actual frequency of influenza. Discussion Vaccination of healthy children is not widespread in Europe despite clear demonstration of the benefits of vaccination in reducing the large health and economic burden of influenza. Universal vaccination of infants and children also provides indirect protection in other high-risk groups in the community. This paper contains the Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for the vaccination of infants and children against influenza. The aim of CEVAG is to encourage the efficient and safe use of vaccines to prevent and control infectious diseases. Summary CEVAG recommends the introduction of universal influenza vaccination for all children from the age of 6 months. Special attention is needed for children up to 60 months of age as they are at greatest risk. Individual countries should decide on how best to implement this recommendation based on their circumstances. PMID:20546586

  6. Vaccine herd effect

    PubMed Central

    Kim, Tae Hyong; Johnstone, Jennie; Loeb, Mark

    2011-01-01

    Vaccination ideally protects susceptible populations at high risk for complications of the infection. However, vaccines for these subgroups do not always provide sufficient effectiveness. The herd effect or herd immunity is an attractive way to extend vaccine benefits beyond the directly targeted population. It refers to the indirect protection of unvaccinated persons, whereby an increase in the prevalence of immunity by the vaccine prevents circulation of infectious agents in susceptible populations. The herd effect has had a major impact in the eradication of smallpox, has reduced transmission of pertussis, and protects against influenza and pneumococcal disease. A high uptake of vaccines is generally needed for success. In this paper we aim to provide an update review on the herd effect, focusing on the clinical benefit, by reviewing data for specific vaccines. PMID:21604922

  7. Seroepidemiology of pertussis among elementary school children in northern Taiwan.

    PubMed

    Kuo, Ching-Chia; Huang, Yhu-Chering; Hsieh, Yu-Chia; Huang, Ya-Ling; Huang, Yu-Chiau; Hung, Yung-Tai

    2017-06-01

    Pertussis has been considered a vaccine-preventable "childhood disease", but a shift in age distribution has been reported worldwide. We conducted a seroepidemiological study in 2013 in Taiwan to elucidate the seroprevalence of pertussis among elementary school children. With a multilevel randomized method, which included 14 variables (4 population variables, 4 socio-educational variables, and 6 medical facilities' variables), the 29 executive districts of New Taipei City, Taiwan, were categorized into five strata. From each stratum, the number of school children as well as the number of elementary schools were proportionally selected. Enzyme immunoassay was applied for pertussis immunoglobulin-G measurement. A total of 936 children from 14 schools were recruited. Most participants (98.89%) received at least three doses of acellular diphtheria-tetanus-pertussis vaccine. The overall seropositive rate for pertussis was 33.97%. The seropositive rate was highest for students in Grade 1 (49.36%) and then declined with time, except for Grade 6 students. Students from Grade 1 to Grade 4 had a significant higher seropositive rate (37.18% vs. 27.56%, p = 0.002) than those from Grade 5 to Grade 6, but a lower geometric mean titer (18.71 NovaTec Unit/mL vs. 20.04 NovaTec Unit/mL, p = 0.20). For the class grades, geometric mean titers were positively correlated with seroprevalence (p < 0.005). Currently, almost one-third of elementary school children in Taiwan were seropositive for pertussis, a rate lower than expected. Seroprevalence declined with increasing class grades except for Grade 6. The current national immunization program may not provide adequate protection for children against pertussis. Copyright © 2015. Published by Elsevier B.V.

  8. [STUDY OF SAFETY OF PAROTITIS VACCINE].

    PubMed

    Ignatiev, G M; Kulak, M V; Otrashevskaya, E V; Bukin, E K; Nesterov, A A E; Gorbunov, M A; Mikheev, V N

    2015-01-01

    Monitoring of post-vaccinal complications in children immunized with a parotitis vaccine. Observation of 198 945 children, immunized with 16 lots of parotitis vaccine with Leningrad-3 strain (L-3), was carried out for 3 years. Paired samples of sera and saliva were obtained from children, in whom adverse events were registered for 42 days after vaccination. Titers of specific IgM and IgG were determined in blood sera. Analysis of nucleotide sequences of genes F, SH and NH of RNA of parotitis virus was carried out from samples of blood and saliva. Intensive parameter of vaccine-associated aseptic meningitis under the conditions of the experiments was 0 for 100 000 immunized. Frequency of occurrence of post-vaccinal parotitis was 0.06% from the number of vaccinated--18 cases of vaccine-associated parotitis were registered and laboratory confirmed. A significant difference in specific activity was detected for 3 lots of the vaccine, that were associated with cases of development of parotitis, relative to that of 13 lots of vaccine, development of parotitis was not registered after administration of those. The study carried out confirmed low neurovirulence of the parotitis vaccine with the L-3 strain of parotitis virus, as well as a low degree of its reactogenicity. A relatively high immunization dose of the used vaccine could be one of the reasons of development of post-vaccinal complications in part of the immunized children.

  9. Is influenza vaccination in asthma helpful?

    PubMed

    Bueving, Herman J; Thomas, Siep; Wouden, Johannes C van der

    2005-02-01

    Influenza infections are frequently involved in asthma exacerbations. During influenza epidemics substantial excess morbidity due to respiratory tract complications is reported in all age categories as well as excess mortality among the elderly. Vaccines are available for protection against influenza. Worldwide, vaccination is advised and considered a quality point for asthma care. However, the protective effect of influenza vaccination in patients with asthma is still disputed. In order to establish the current state of affairs we reviewed the recent literature on the protective effect of influenza vaccination and its usefulness in patients with asthma. Several studies were found addressing influenza and the protective aspects of vaccination. They discussed the incidence, the adverse effects of vaccination, the coverage of influenza vaccination among patients with asthma and the effectiveness of the vaccine. Influenza vaccination can safely be used in patients with asthma. Allegations that vaccination could provoke asthma exacerbations are convincingly invalidated by previous and recent research. Although patients with asthma are one of the major target groups for immunization, vaccine coverage in all age categories remains low. So far, no unequivocal beneficial effect of influenza vaccination in patients with asthma was found in observational and experimental studies in the sense of reduction of asthma exacerbations and other complications. Recent studies confirm these negative findings. More long-term randomized, placebo-controlled studies, focusing on influenza- proven illness in patients with asthma, are needed to address the question of how helpful influenza vaccination is in these patients.

  10. The effect of pneumococcal conjugate vaccines on incidence and microbiology associated with complicated acute otitis media.

    PubMed

    Laursen, B B; Danstrup, C S; Hoffmann, S; Nørskov-Lauritsen, N; Christensen, A L B; Ovesen, T

    2017-10-01

    The objectives of this study were to investigate the incidence of complicated acute otitis media (cAOM) as well as the associated microbiology before and after introduction of the 7- and 13-valent pneumococcal conjugate vaccines (PCV-7 and -13), respectively. CAOM comprises "heavy" AOM (AOM demanding hospitalization), mastodismus (M) and acute mastoiditis (AM). A retrospective cohort study of the incidence and microbiology associated with cAOM during the non-PCV era, the PCV-7 and 13 eras, respectively. Clinical and microbiological data were prospectively registered in a local database. The incidences of cAOM as well as the distribution of various bacterial strains in the three eras were compared. A total of 246 cases of cAOM (125 in the pre-vaccine period (2001-2006), 50 in the PCV-7 period (2007-2010) and 71 in the PCV-13 period (2011-2015)) were identified. The incidence of hAOM decreased by 62% in the PCV7-era but increased to almost pre-vaccine levels in the PCV-13 era. In the M + AM group, a decrease by almost 21% in the PCV7-era was found compared to the pre vaccine era, whereas the decrease was only 12% in the PCV13-era. The three most common findings in both hAOM and M + AM were Streptococcus pneumonia (SP), group A streptococcus (GAS) and "no growth". In the hAOM group, SP decreased from 38% in the pre-vaccine era to 31% in the PCV7-era and further to 16% in the PCV13-era. GAS decreased from 17% in the pre-vaccine era to 0% in the PCV7-era and 16% in the PCV13-era. The percentage of "no growth" increased from 12% to 38% and 44%, respectively. In the M + AM group, SP decreased to 10% in the PCV13-era compared with 44% in the pre-vaccine era and 41% in the PCV7-era. An increase in GAS from 15% in the pre-vaccine era and PCV7-era to 30% in the PCV13-era was observed. The "no growth" percentage increased from 13% in the pre-vaccine era to 26% in the PCV7-era and 33% in the PCV13-era. Introduction of PCV7 and PCV13 has been associated with an overall

  11. Influvac, a trivalent inactivated subunit influenza vaccine.

    PubMed

    Zuccotti, Gian Vincenzo; Fabiano, Valentina

    2011-01-01

    Influenza represents a major sanitary and socio-economic burden and vaccination is universally considered the most effective strategy for preventing the disease and its complications. Traditional influenza vaccines have been on the market since the late 1940s, with million of doses administered annually worldwide, and demonstrated a substantial efficacy and safety. The trivalent inactivated subunit vaccine has been available for more than 25 years and has been studied in healthy children, adults and the elderly and in people affected by underlying chronic medical conditions. We describe vaccine technology focusing on subunit vaccine production procedures and mode of action and provide updated information on efficacy and safety available data. A review of efficacy and safety data in healthy subjects and in high risk populations from major sponsor- and investigator-driven studies. The vaccine showed a good immunogenicity and a favorable safety profile in all target groups. In the panorama of actually available influenza vaccines, trivalent inactivated subunit vaccine represents a well-established tool for preventing flu and the associated complications.

  12. Extrusional Tectonics over Plate Corner: an Example in Northern Taiwan

    NASA Astrophysics Data System (ADS)

    Lu, Chia-Yu; Lee, Jian-Cheng; Li, Zhinuo; Lee, Ching-An; Yeh, Chia-Hung

    2016-04-01

    In northern Taiwan, contraction, transcurrent shearing, block rotation and extension are four essential tectonic deformation mechanisms involved in the progressive deformation of this arcuate collision mountain belt. The neotectonic evolution of the Taiwan mountain belt is mainly controlled not only by the oblique convergence between the Eurasian plate and the Philippine Sea plate but also the corner shape of the plate boundary. Based on field observations and analyses, and taking geophysical data (mostly GPS) and experimental modelling into account, we interpret the curved belt of northern Taiwan as a result of of contractional deformation (with compression, thrust-sheet stacking & folding, back thrust duplex & back folding) that induced vertical extrusion, combined with increasing transcurrent & rotational deformation (with transcurrent faulting, bookshelf-type strike-slip faulting and block rotation) that induced transcurrent/rotational extrusion and extension deformation which in turn induced extensional extrusion. As a consequence, a special type of extrusional folds was formed in association with contractional, transcurrent & rotational and extensional extrusions subsequently. The extrusional tectonics in northern Taiwan reflect a single, albeit complicated, regional pattern of deformation. The crescent-shaped mountain belt of Northeastern Taiwan develops in response to oblique indentation by an asymmetric wedge indenter, retreat of Ryukyu trench and opening of the Okinawa trough.

  13. Extrusional Tectonics at Plate Corner: an Example in Northern Taiwan

    NASA Astrophysics Data System (ADS)

    Lu, C. Y.; Lee, J. C.; Li, Z.; Yeh, C. H.; Lee, C. A.

    2015-12-01

    In northern Taiwan, contraction, transcurrent shearing, block rotation and extension are four essential tectonic deformation mechanisms involved in the progressive deformation of this arcuate collision mountain belt. The neotectonic evolution of the Taiwan mountain belt is mainly controlled not only by the oblique convergence between the Eurasian plate and the Philippine Sea plate but also the corner shape of the plate boundary. Based on field observations and analyses, and taking geophysical data (mostly GPS) and experimental modelling into account, we interpret the curved belt of northern Taiwan as a result of of contractional deformation (with compression, thrust-sheet stacking & folding, back thrust duplex & back folding) that induced vertical extrusion, combined with increasing transcurrent & rotational deformation (with transcurrent faulting, bookshelf-type strike-slip faulting and block rotation) that induced transcurrent/rotational extrusion and extension deformation which in turn induced extensional extrusion. As a consequence, a special type of extrusional folds was formed in association with contractional, transcurrent & rotational and extensional extrusions subsequently. The extrusional tectonics in northern Taiwan reflect a single, albeit complicated, regional pattern of deformation. The crescent-shaped mountain belt of Northeastern Taiwan develops in response to oblique indentation by an asymmetric wedge indenter and opening of the Okinawa trough at plate corner.

  14. Seismic Migration Imaging of the Crust and Upper Mantle Discontinuity Structure beneath Southern Taiwan

    NASA Astrophysics Data System (ADS)

    Liu, Y.-S.; Kuo, B.-Y.

    2009-04-01

    Taiwan is located in the convergent plate boundary zone where the Philippine Sea plate has obliquely collided on the Asian continental margin, initiating the arc-continent collision and subsequent mountain-building in Taiwan. Receiver function has been a powerful tool to image seismic velocity discontinuity structure in the crust and upper mantle which can help illuminate the deep dynamic process of active Taiwan orogeny. In this study, we adopt backprojection migration processing of teleseismic receiver functions to investigate the crust and upper mantle discontinuities beneath southern Taiwan, using the data from Southern Taiwan Transect Seismic Array (STTA), broadband stations of Central Weather Bureau (CWB), Broadband Array in Taiwan for Seismology (BATS), and Taiwan Integrated Geodynamics Research (TAIGER). This composite east-west trending linear array has the aperture of about 150 km with the station spacing of ~5-10 km. Superior to the common midpoint (CMP) stack approach, the migration can properly image the dipping, curved, or laterally-varying topography of discontinuous interfaces which very likely exist under the complicated tectonic setting of Taiwan. We first conduct synthetic experiments to test the depth and lateral resolution of migration images based on the WKBJ synthetic waveforms calculated from available source and receiver distributions. We will next construct the 2-D migration image under the array to reveal the topographic variation of the Moho and lithosphere discontinuities beneath southern Taiwan.

  15. Measles related complications and the role of vitamin A supplementation.

    PubMed

    Mishra, Ashok; Mishra, Subodh; Jain, Pankaj; Bhadoriya, Rahul Singh; Mishra, Rakesh; Lahariya, Chandrakant

    2008-09-01

    Measles is associated with high rate of complications and contributes to a major proportion of childhood morbidity and mortality. The role of vit A supplementation (VAS) in the case management of measles and prevention of complications is partially understood and not sufficiently supported by epidemiological data. This paper analyses the possible role of vit A supplementation in prevention of measles related complications and associated fatality. A cross sectional study was carried out during an outbreak of measles in Shivpuri, India. A total population of 193,000 was covered by house to house visit and, the caregivers of total 1204 measles cases, including 214 cases with complications, were interviewed using a semi structured interview schedule. The analysis of data was done using Epi Info. The attack rate of 6.7% and rate of complications at 17.8% were found in this investigation. The coverage with routine measles vaccine and the vit A supplementation was 18.3% and 28.9% respectively. The management of measles cases was poor with only 15.8% cases receiving therapeutic doses of vit A. Both complications and case fatality rate was higher amongst children who had not received vit A supplementation in previous 6 months (p<0.05). Measles vaccine also found to have preventive effect on development of complications (p<0.05). Routine vit A supplementation and measles vaccination reduce the chances of complications amongst cases of measles. The role of VAS becomes more important when the case management is poor. While, measles is frequently associated with complications in the Indian setting, there is a need of enhancing the efforts to improve the delivery of vit A supplementation and measles vaccine to the children in rural areas.

  16. Influenza Vaccination Strategies: Comparing Inactivated and Live Attenuated Influenza Vaccines

    PubMed Central

    Sridhar, Saranya; Brokstad, Karl A.; Cox, Rebecca J.

    2015-01-01

    Influenza is a major respiratory pathogen causing annual outbreaks and occasional pandemics. Influenza vaccination is the major method of prophylaxis. Currently annual influenza vaccination is recommended for groups at high risk of complications from influenza infection such as pregnant women, young children, people with underlying disease and the elderly, along with occupational groups such a healthcare workers and farm workers. There are two main types of vaccines available: the parenteral inactivated influenza vaccine and the intranasal live attenuated influenza vaccine. The inactivated vaccines are licensed from 6 months of age and have been used for more than 50 years with a good safety profile. Inactivated vaccines are standardized according to the presence of the viral major surface glycoprotein hemagglutinin and protection is mediated by the induction of vaccine strain specific antibody responses. In contrast, the live attenuated vaccines are licensed in Europe for children from 2–17 years of age and provide a multifaceted immune response with local and systemic antibody and T cell responses but with no clear correlate of protection. Here we discuss the immunological immune responses elicited by the two vaccines and discuss future work to better define correlates of protection. PMID:26343192

  17. Government Response to the Discovery of a Rabies Virus Reservoir Species on a Previously Designated Rabies-Free Island, Taiwan, 1999-2014.

    PubMed

    Chang, S-S; Tsai, H-J; Chang, F-Y; Lee, T-S; Huang, K-C; Fang, K-Y; Wallace, R M; Inoue, S; Fei, C-Y

    2016-08-01

    Taiwan had been considered rabies free since 1961. In 2013, Taiwan confirmed the detection of rabies virus in wild Taiwan ferret-badgers. Up to December 2014, there have been 423 rabies-confirmed ferret-badgers and three cases of spillover infection into non-reservoir hosts. Genetic analysis indicates that TFBV is distinct from all other known rabies virus variants. To date, ferret-badger rabies is known to occur only in China and Taiwan. The temporal dynamics of rabid ferret-badgers in Taiwan suggests that the epizootic appears to have subsided to enzootic levels as of December 2014. According to the current epidemiologic data, there is only one TFBV strain in Taiwan. TFBV is still sequestered to the mountainous regions. Humans are at risk mainly through exposure to the virus from infected domestic meso-carnivores, mainly dogs and cats. Dogs and cats should be vaccinated to establish an immunological barrier to stop the spread of the disease from mountainous regions to domestic meso-carnivores. © 2015 The Authors. Zoonoses and Public Health Published by Blackwell Verlag GmbH.

  18. An observational study of complications in chickenpox with special reference to unusual complications in an apex infectious disease hospital, Kolkata, India.

    PubMed

    Kole, A K; Roy, R; Kole, D C

    2013-01-01

    Chickenpox can cause serious complications and even death in persons without any risk factors. To observe the different complications with special reference to unusual complications of chickenpox and their outcomes. The present study was a prospective observational study where 300 patients suffering from chickenpox were evaluated with special reference to unusual complications and outcomes. The usual complications of chickenpox commonly observed were acute hepatitis in 30 (10%) and cerebellar ataxia in 22 patients (7.3%), whereas common unusual complications were acute pancreatitis in 45 (15%), hemorrhagic rash in 10 (3.3%), Guillain-Barrι syndrome in 4 (1.3%), disseminated intravascular coagulation in 4 (1.3%), necrotizing fasciitis in 4 (1.3%), and acute renal failure in 3 patients (1%). It had been observed that most of these unusual complications occurred in patients without any risk factor. A total of 18 patients (6%) died in this study and of them 12 patients (4%) died due to unusual complications. Compulsory childhood varicella vaccination including vaccination of risk groups and susceptible individuals are all essential to reduce the incidence of chickenpox, associated complications, and subsequent death.

  19. BVDV vaccination in North America: risks versus benefits.

    PubMed

    Griebel, Philip J

    2015-06-01

    The control and prevention of bovine viral diarrhea virus (BVDV) infections has provided substantial challenges. Viral genetic variation, persistent infections, and viral tropism for immune cells have complicated disease control strategies. Vaccination has, however, provided an effective tool to prevent acute systemic infections and increase reproductive efficiency through fetal protection. There has been substantial controversy about the safety and efficacy of BVDV vaccines, especially when comparing killed versus modified-live viral (MLV) vaccines. Furthermore, numerous vaccination protocols have been proposed to protect the fetus and ensure maternal antibody transfer to the calf. These issues have been further complicated by reports of immune suppression during natural infections and following vaccination. While killed BVDV vaccines provide the greatest safety, their limited immunogenicity makes multiple vaccinations necessary. In contrast, MLV BVDV vaccines induce a broader range of immune responses with a longer duration of immunity, but require strategic vaccination to minimize potential risks. Vaccination strategies for breeding females and young calves, in the face of maternal antibody, are discussed. With intranasal vaccination of young calves it is possible to avoid maternal antibody interference and induce immune memory that persists for 6-8 months. Thus, with an integrated vaccination protocol for both breeding cows and calves it is possible to maximize disease protection while minimizing vaccine risks.

  20. The Value Profile of Physical Education Teachers in Taiwan, ROC

    ERIC Educational Resources Information Center

    Liu, Hsien-Yung; Silverman, Stephen

    2006-01-01

    The purpose of this study was to ascertain the educational value orientations of physical education teachers in Taiwan, and the relationships of gender, teaching experience, grade level, and the locations in which they work. Value orientations were measured with the Value Orientation Inventory-2, which was translated into complicated Chinese for…

  1. Introducing dengue vaccine: Implications for diagnosis in dengue vaccinated subjects.

    PubMed

    Alagarasu, Kalichamy

    2016-05-27

    Diagnosis of dengue virus infections is complicated by preference for different diagnostic tests in different post onset days of illness and the presence of multiple serotypes leading to secondary and tertiary infections. The sensitivity of the most commonly employed diagnostic assays such as anti dengue IgM capture (MAC) ELISA and non structural protein (NS) 1 capture ELISA are lower in secondary and subsequent infections. Introduction of dengue vaccine in endemic regions will affect the way how dengue is diagnosed in vaccinated subjects. This viewpoint article discusses implications of introduction of dengue vaccine on the diagnosis of dengue infections in vaccinated subjects and the strategies that are needed to tackle the issue. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Progress with new malaria vaccines.

    PubMed Central

    Webster, Daniel; Hill, Adrian V. S.

    2003-01-01

    Malaria is a parasitic disease of major global health significance that causes an estimated 2.7 million deaths each year. In this review we describe the burden of malaria and discuss the complicated life cycle of Plasmodium falciparum, the parasite responsible for most of the deaths from the disease, before reviewing the evidence that suggests that a malaria vaccine is an attainable goal. Significant advances have recently been made in vaccine science, and we review new vaccine technologies and the evaluation of candidate malaria vaccines in human and animal studies worldwide. Finally, we discuss the prospects for a malaria vaccine and the need for iterative vaccine development as well as potential hurdles to be overcome. PMID:14997243

  3. Constructing a Teleseismic Tomographic Image of Taiwan using BATS Recordings

    NASA Astrophysics Data System (ADS)

    Krajewski, J.; Roecker, S.

    2005-12-01

    Taiwan is an evolving arc-continent collision located at a complicated part of the plate boundary between the Eurasian and Philippine Sea plates. To better understand the role of the upper mantle in the dynamics of this collision, we reviewed 4 years of data from the Broadband Array in Taiwan for Seismology (BATS) in Taiwan to construct a teleseismic dataset for tomographic imaging of the subsurface of the island. From an initial selection of approximately 300 events, we used waveform correlation to generate a dataset of 4500 relative arrival times. To calculate accurate travel times in three dimensional wavespeed models over the large lateral distances in our model (~800 km), we solve the eikonal equation directly in a spherical coordinate system. We reduce the influence of smearing of crustal heterogeneity into the deeper mantle, we fix the upper 30 km to a previously determined P wavespeed model for the region. Initial resolution tests suggest a spatial limit on the order of 40 km.

  4. Essential components in developing public policy to control viral hepatitis: lessons from Taiwan.

    PubMed

    Wallace, Jack; Pitts, Marian; Locarnini, Stephen; Ellard, Jeanne; Carman, Marina; Chen, Ding-Shinn

    2016-03-01

    Over 500 million people are estimated to be infected with chronic viral hepatitis with an increasing burden resulting from the infections. In 2010, the World Health Organization recommended national governments develop effective strategies to reduce the global impact of viral hepatitis. Taiwan, to support the implementation of the world's first national vaccination program, developed the first of a series of 5-year national strategies in 1982. Our study sought to identify the essential constituents of the strategic response to chronic viral hepatitis in Taiwan, which could then be used by other governments to inform best practice in strategy development. Semistructured qualitative interviews were conducted with key participants involved in the national response to viral hepatitis in Taiwan (n = 26) and a review of the literature. The development of a national strategic response is one of several factors in reducing the burden of viral hepatitis in Taiwan. Other critical factors are effective health services, a prioritization of disease prevention, government funding of science and technology, and sustained advocacy informed by a rigorous evidence base. While there has been significant policy, structural and financial commitment to reduce the burden of related to viral hepatitis, essential challenges remain. Taiwan's viral hepatitis policy response focuses on clinical interventions and would be strengthened by a broader involvement of interdisciplinary stakeholders, including people with viral hepatitis, and stronger coordination between the policy and government agencies responsible for their implementation.

  5. Analysis of the causes of surgery-related medical disputes in Taiwan: Need for acute care surgeons to improve quality of care.

    PubMed

    Hu, Yi-Hsuan; Wang, Chien-Ying; Huang, Mu-Shun; Lee, Chen-Hsen; Wen, Yi-Szu

    2016-11-01

    This study investigated surgery-related medical disputes and analyzed disease etiologies and the main causes of disputes in order to identify key points for the purpose of improving the quality of surgical patient care in Taiwan. Reports on all surgery-related cases appraised by the Taiwan Witness Examiner Committee of the Department of Health between 2004 and 2008 were reviewed retrospectively by three senior physicians from the emergency department who specialize in both trauma and emergency general surgery. The causes of the various medical disputes were categorized under the following descriptions: operation- or procedure-related complication, anesthesia complication, inappropriate management or decision, delayed diagnosis or misdiagnosis, and unsatisfactory result. A total of 154 cases were reviewed, of which 39 were trauma-related and 115 were disease-related. The two leading causes of disputes in this review were found to be operation- or procedure-related complications (35.7%) and unsatisfactory results (31.8%), followed by delayed diagnoses or misdiagnoses, inappropriate management, and anesthesia complications. Among these, 74 cases (48.1%) required the care of an acute care surgeon and 40 cases (26.0%) required emergency general surgery intervention. Surgery- or procedure-related complications and unsatisfactory treatment results constituted the major causes of medical disputes in Taiwan. The majority of these cases involved acute care surgery; thus, the establishment of an acute care surgery system should be considered to improve patient care. The management of hemorrhagic shock and incarcerated hernia should be reinforced in future medical training. Copyright © 2016. Published by Elsevier Taiwan LLC.

  6. The Acceptability of Human Papillomavirus (HPV) Vaccination among Women with Physical Disabilities

    ERIC Educational Resources Information Center

    Yen, Chia-Feng; Chen, Si-Fan; Lin, Lan-Ping; Hsu, Shang-Wei; Chang, Mao-Jung; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    The present paper aims to explore awareness and acceptability of human papillomavirus (HPV) vaccination and to identify factors influencing HPV acceptability among women with physical disabilities in Taiwan. The study participants were 438 adult women with physical disabilities, aged 18-69 years. The participants were all officially registered as…

  7. Vaccine-associated enhanced respiratory disease is influenced by hemagglutinin and neuraminidase in whole inactivated influenza virus vaccines

    USDA-ARS?s Scientific Manuscript database

    Multiple subtypes and many antigenic variants of influenza A virus (IAV) co-circulate in swine in the USA, complicating effective use of commercial vaccines to control disease and transmission. Whole inactivated virus (WIV) vaccines may provide partial protection against IAV with substantial antigen...

  8. Zika virus, vaccines, and antiviral strategies.

    PubMed

    Masmejan, Sophie; Baud, David; Musso, Didier; Panchaud, Alice

    2018-06-28

    Zika virus (ZIKV) recently emerged as a global public health emergency of international concern. ZIKV is responsible for severe neurological complications in adults and infection during pregnancy and can lead to congenital Zika syndrome. There is no licensed vaccine or drug to prevent or treat ZIKV infection. Areas covered: The aim of this article is to provide an overview and update of the progress of research on anti-ZIKV vaccine and medications until the end of 2017, with a special emphasis on drugs that can be used during pregnancy. Expert commentary: Development of new vaccines and drugs is challenging and several points particular to ZIKV infections augment this difficulty: (1) Cross-reactions between ZIKV and other flaviviruses, the impact of ZIKV vaccination on subsequent flavivirus infections, and vice-versa, is unknown, (2) Drugs against ZIKV should be safe in pregnant women, and (3) Evaluation of the efficacy of vaccine and drugs against ZIKV in clinical trials phase II-IV will be complicated due to the decline of ZIKV circulation.

  9. Challenges in adult vaccination.

    PubMed

    de Gomensoro, Eduardo; Del Giudice, Giuseppe; Doherty, T Mark

    2018-05-01

    Life-long primary prevention interventions beginning and continuing throughout an individual's lifetime are increasingly seen as key to meeting the global healthcare challenges that accompany demographic changes - a concept referred to as "Healthy aging". In this perspective, vaccination is seen as part of a triad, together with healthy diet and exercise. Current adult vaccine coverage is lower than target vaccination rates in most developed countries, and so vaccine preventable diseases continue to present a substantial burden on health and healthcare resources, especially in older individuals. In part, this is due to lack of knowledge and understanding of the benefits of vaccination, inconsistent recommendations by providers and uncertainties about cost benefits. However, lower vaccine effectiveness in older adults plays a part, and new vaccines with novel characteristics to improve effectiveness in older adults are required. A life-course immunization approach to ensure optimal vaccine uptake across adults of all ages can be expected to reduce morbidity and mortality in later life. To achieve this, greater emphasis on public and healthcare provider education is necessary, based on appropriate economic analyses that demonstrate the overall value of vaccination. This article introduces the technical, economic, political and demographic issues that make establishing effective adult vaccination programs such a difficult, but pressing issue, and outlines some of the steps that are now being taken to address them. Key messages Life-long preventive activities that start and continue throughout life are essential, especially as the world's population is "getting older". This "Healthy aging" approach includes not only healthy diet and physical exercise; vaccination is critical in reducing some infectious diseases and their complications. Many adults, especially older adults (who have lower immunity than younger people) develop infections such as influenza and shingles

  10. Vaccinations for Adults with Hepatitis C Infection

    MedlinePlus

    ... up to date. Vaccine Do you need it? Hepatitis A (HepA) Yes! Your chronic liver disease puts you ... serious complications if you get infected with the hepatitis A virus. If you’ve never been vaccinated against ...

  11. Complications of serogroup B meningococcal disease in survivors: a review.

    PubMed

    Dastouri, Fereshteh; Hosseini, Ahmad Mirmohammad; Haworth, Elizabeth; Khandaker, Gulam; Rashid, Harunor; Booy, Robert

    2014-01-01

    This systematic review evaluates the prevalence of long-term complications of serogroup B meningococcal disease (MD) in light of the recent licensure of a vaccine against meningococcal B disease. Twelve appropriate studies were identified by searching available databases from 1946 to July 2014. The average prevalence of hearing impairment was 4.2% among serogroup B MD survivors; 2.3% suffered amputation and 2.3% developed seizures. When compared with complications due to non-meningococcal B bacterial meningitis, physical impairment and seizures were more common in survivors of meningococcal B disease but hearing impairment had similar prevalence. Few studies quantified less frequent complications such as visual impairment and cognitive dysfunction. Better comprehensive reporting of the complications and costs of serogroup B MD in survivors and their families is needed to inform vaccination policy.

  12. Pricing of new vaccines

    PubMed Central

    McGlone, Sarah M

    2010-01-01

    New vaccine pricing is a complicated process that could have substantial long-standing scientific, medical and public health ramifications. Pricing can have a considerable impact on new vaccine adoption and, thereby, either culminate or thwart years of research and development and public health efforts. Typically, pricing strategy consists of the following eleven components: (1) Conduct a target population analysis; (2) Map potential competitors and alternatives; (3) Construct a vaccine target product profile (TPP) and compare it to projected or actual TPPs of competing vaccines; (4) Quantify the incremental value of the new vaccine's characteristics; (5) Determine vaccine positioning in the marketplace; (6) Estimate the vaccine price-demand curve; (7) Calculate vaccine costs (including those of manufacturing, distribution, and research and development); (8) Account for various legal, regulatory, third party payer and competitor factors; (9) Consider the overall product portfolio; (10) Set pricing objectives; (11) Select pricing and pricing structure. While the biomedical literature contains some studies that have addressed these components, there is still considerable room for more extensive evaluation of this important area. PMID:20861678

  13. Pricing of new vaccines.

    PubMed

    Lee, Bruce Y; McGlone, Sarah M

    2010-08-01

    New vaccine pricing is a complicated process that could have substantial long-standing scientific, medical, and public health ramifications. Pricing can have a considerable impact on new vaccine adoption and, thereby, either culminate or thwart years of research and development and public health efforts. Typically, pricing strategy consists of the following ten components: 1. Conduct a target population analysis; 2. Map potential competitors and alternatives; 3. Construct a vaccine target product profile (TPP) and compare it to projected or actual TPPs of competing vaccines; 4. Quantify the incremental value of the new vaccine's characteristics; 5. Determine vaccine positioning in the marketplace; 6. Estimate the vaccine price-demand curve; 7. Calculate vaccine costs (including those of manufacturing, distribution, and research and development); 8. Account for various legal, regulatory, third party payer, and competitor factors; 9. Consider the overall product portfolio; 10. Set pricing objectives; 11. Select pricing and pricing structure. While the biomedical literature contains some studies that have addressed these components, there is still considerable room for more extensive evaluation of this important area.

  14. Molecular epidemiological studies on foot-and-mouth disease type O Taiwan viruses from the 1997 epidemic.

    PubMed

    Tsai, C P; Pan, C H; Liu, M Y; Lin, Y L; Chen, C M; Huang, T S; Cheng, I C; Jong, M H; Yang, P C

    2000-06-01

    Sequence diversity was assessed of the complete VP1 gene directly amplified from 49 clinical specimens during an explosive foot-and-mouth disease (FMD) outbreak in Taiwan. Type O Taiwan FMD viruses are genetically highly homogenous, as seen by the minute divergence of 0.2-0.9% revealed in 20 variants. The O/HCP-0314/TW/97 and O/TCP-022/TW/97 viral variants dominated FMD outbreaks and were prevalent in most affected pig-raising areas. Comparison of deduced amino acid sequences around the main neutralizable antigenic sites on the VP1 polypeptide showed no significant antigenic variation. However, the O/CHP-158/TW/97 variant had an alternative critical residue at position 43 in antigenic site 3, which may be due to selective pressure in the field. Two vaccine production strains (O1/Manisa/Turkey/69 and O1/Campos/Brazil/71) probably provide partial heterologous protection of swine against O Taiwan viruses. The type O Taiwan variants clustered in sublineage A1 of four main lineages in the phylogenetic tree. The O/Hong Kong/9/94 and O/1685/Moscow/Russia/95 viruses in sublineage A2 are closely related to the O Taiwan variants. The causative agent for the 1997 epidemic presumably originated from a single common source of type O FMD viruses prevalent in neighboring areas.

  15. Progress in Brucella vaccine development

    PubMed Central

    YANG, Xinghong; SKYBERG, Jerod A.; CAO, Ling; CLAPP, Beata; THORNBURG, Theresa; PASCUAL, David W.

    2012-01-01

    Brucella spp. are zoonotic, facultative intracellular pathogens, which cause animal and human disease. Animal disease results in abortion of fetuses; in humans, it manifests flu-like symptoms with an undulant fever, with osteoarthritis as a common complication of infection. Antibiotic regimens for human brucellosis patients may last several months and are not always completely effective. While there are no vaccines for humans, several licensed live Brucella vaccines are available for use in livestock. The performance of these animal vaccines is dependent upon the host species, dose, and route of immunization. Newly engineered live vaccines, lacking well-defined virulence factors, retain low residual virulence, are highly protective, and may someday replace currently used animal vaccines. These also have possible human applications. Moreover, due to their enhanced safety and efficacy in animal models, subunit vaccines for brucellosis show great promise for their application in livestock and humans. This review summarizes the progress of brucellosis vaccine development and presents an overview of candidate vaccines. PMID:23730309

  16. Which Dengue Vaccine Approach Is the Most Promising, and Should We Be Concerned about Enhanced Disease after Vaccination? The Path to a Dengue Vaccine: Learning from Human Natural Dengue Infection Studies and Vaccine Trials.

    PubMed

    de Silva, Aravinda M; Harris, Eva

    2018-06-01

    Dengue virus (DENV) is the most common arthropod-borne viral disease of humans. Although effective vaccines exist against other flaviviral diseases like yellow fever and Japanese encephalitis, dengue vaccine development is complicated by the presence of four virus serotypes and the possibility of partial immunity enhancing dengue disease severity. Several live attenuated dengue vaccines are being tested in human clinical trials. Initial results are mixed, with variable efficacy depending on DENV serotype and previous DENV exposure. Here, we highlight recent discoveries about the human antibody response to DENV and propose guidelines for advancing development of safe and effective dengue vaccines. Copyright © 2018 Cold Spring Harbor Laboratory Press; all rights reserved.

  17. Suspected YF-AND after yellow fever vaccination in Finland.

    PubMed

    Jääskeläinen, Anne J; Huhtamo, Eili; Kivioja, Reetta; Domingo, Cristina; Vene, Sirkka; Kallio-Kokko, Hannimari; Niedrig, Matthias; Tienari, Pentti J; Vapalahti, Olli

    2014-11-01

    Yellow fever (YF) vaccine is considered safe but vaccine-associated complications have also been encountered. We report neurological symptoms after YF-vaccination in a previously healthy Finnish male. Other concomitant infections or causes for the symptoms could not be identified. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Herpes zoster and vaccination: a clinical review.

    PubMed

    Adams, Erin N; Parnapy, Sarah; Bautista, Philip

    2010-05-01

    Herpes zoster, herpes zoster vaccine, and the cost-effectiveness of the vaccine are reviewed. Herpes zoster infection is estimated to affect one in three people during their lifetime. Two thirds of people who develop this disease are over age 60 years. Postherpetic neuralgia (PHN) is the most common complication of herpes zoster, occurring in 10-18% of patients. The associated chronic pain can be very debilitating, affecting patients' quality of life. The pain may last for months or years and is difficult to treat, leading to increased health care costs and morbidity. To prevent herpes zoster, a live attenuated vaccine was developed and approved for marketing in 2006 for individuals age > or = 60 years. The safety and efficacy of the vaccine were evaluated in the Shingles Prevention Study in 38,546 adults age > or = 60 years. Compared with placebo, administration of the vaccine resulted in a 51.3% reduction in the incidence of herpes zoster and a 66.5% reduction in the incidence of PHN (p < 0.001 for both comparisons). A single dose of the vaccine is approximately $162 and is not covered by all insurance plans. Several studies evaluated the cost-effectiveness of the vaccine, which was found to be most beneficial in individuals age 70 years or older. The use of the vaccine appears to reduce health care costs and protect the public health. The herpes zoster vaccine is effective in preventing herpes zoster and decreasing the incidence of complications. However, insurance coverage may hinder eligible patients from receiving the vaccination.

  19. [Vaccines against Herpes zoster: Effectiveness, safety, and cost/benefit ratio].

    PubMed

    Ferahta, Nabila; Achek, Imene; Dubourg, Julie; Lang, Pierre-Olivier

    2016-02-01

    A vaccination against herpes zoster and its complication is available in France since June 2015. Its exact benefit for public health is still controversial and its level of protection is not optimal. All those reasons seem to suggest a low acceptation rate from general practitioners. To evaluate the effectiveness, the safety, and the cost/benefit ratio of the vaccination against herpes zoster in people aged 50 year or over. Systematic review in Medline and PubMed with research by key words: "herpes zoster vaccine", "zoster vaccine" and "post herpetic neuralgia vaccine". Randomized and observational studies published in English and French language have been selected by two readers. On 1886 articles identified, 62 studies were included in this systematic review of which 21 randomized trials, 21 observational studies, and 17 medico-economic studies concerned the unadjuvanted vaccine. Considered studies showed an effectiveness of 50% against herpes zoster and 60% on post-herpetic neuralgia incidence of the unadjuvanted vaccine. Five randomized controlled studies were identified for the adjuvanted vaccine. The overall effectiveness of this vaccine was > 90% whatever the age of subjects including those over age 70 and 80. The medico-economic studies conducted in many countries have shown that vaccine policies were beneficial in individuals aged 60 years or over. Most of data of effectiveness, and tolerance result from 2 large controlled studies only (SPS and ZEST) for the unadjuvanted vaccine and only one for the adjuvanted vaccine. Despite controversy and few uncertainties, the vaccine significantly reduces herpes zoster and its complication incidence. In terms of public health objectives, it reduces the burden of the disease and has a positive medico-economic impact. Preliminary data concerning the adjuvanted vaccine, whilst very promising, are still too limited. Up to now, no group of people with particularly high risk of herpes zoster-related complication who will

  20. Using prediction markets of market scoring rule to forecast infectious diseases: a case study in Taiwan.

    PubMed

    Tung, Chen-yuan; Chou, Tzu-chuan; Lin, Jih-wen

    2015-08-11

    The Taiwan CDC relied on the historical average number of disease cases or rate (AVG) to depict the trend of epidemic diseases in Taiwan. By comparing the historical average data with prediction markets, we show that the latter have a better prediction capability than the former. Given the volatility of the infectious diseases in Taiwan, historical average is unlikely to be an effective prediction mechanism. We designed and built the Epidemic Prediction Markets (EPM) system based upon the trading mechanism of market scoring rule. By using this system, we aggregated dispersed information from various medical professionals to predict influenza, enterovirus, and dengue fever in Taiwan. EPM was more accurate in 701 out of 1,085 prediction events than the traditional baseline of historical average and the winning ratio of EPM versus AVG was 64.6 % for the target week. For the absolute prediction error of five diseases indicators of three infectious diseases, EPM was more accurate for the target week than AVG except for dengue fever confirmed cases. The winning ratios of EPM versus AVG for the confirmed cases of severe complicated influenza case, the rate of enterovirus infection, and the rate of influenza-like illness in the target week were 69.6 %, 83.9 and 76.0 %, respectively; instead, for the prediction of the confirmed cases of dengue fever and the confirmed cases of severe complicated enterovirus infection, the winning ratios of EPM were all below 50 %. Except confirmed cases of dengue fever, EPM provided accurate, continuous and real-time predictions of four indicators of three infectious diseases for the target week in Taiwan and outperformed the historical average data of infectious diseases.

  1. Prevention of Herpes Zoster and its complications: From clinical evidence to real life experience.

    PubMed

    Gabutti, Giovanni; Bonanni, Paolo; Conversano, Michele; Fanelli, Guido; Franco, Elisabetta; Greco, Donato; Icardi, Giancarlo; Lazzari, Marzia; Rossi, Alessandro; Scotti, Silvestro; Volpi, Antonio

    2017-02-01

    Herpes zoster (HZ) is an acute viral illness characterized by a vesicular rash with unilateral distribution, which can also result in severe complications such as post-herpetic neuralgia (PHN), ophthalmic zoster, stroke or other neurological complications. The estimate incidence in Europe ranges between 2.0 and 4.6 cases per 1,000 person-years, with a sharp increase in >50 year-old subjects. Currently, treatment options for HZ are only partially effective in limiting the acute phase, while the management of complications is complex and often unsatisfactory. The total burden of the disease and the high costs related to its diagnostic and therapeutic management led researchers to develop a new preventive approach through a live attenuated virus vaccine. The currently available vaccine, with a high antigen content, is safe, well tolerated and reduces the incidence of HZ, PHN and the burden of illness. Several countries have introduced this vaccination, albeit with different recommendations and methods of financing. Taking into account the barriers to this immunization registered in some areas (difficulty of vaccine distribution, lack of physician recommendations, the cost of vaccine for patients, etc.), this group of Italian experts advocate that a common strategy able to guarantee a good compliance with this vaccination should be implemented. The same group addresses some practical questions concerning the use of zoster vaccine.

  2. Prevention of Herpes Zoster and its complications: From clinical evidence to real life experience

    PubMed Central

    Gabutti, Giovanni; Bonanni, Paolo; Conversano, Michele; Fanelli, Guido; Greco, Donato; Lazzari, Marzia; Rossi, Alessandro; Scotti, Silvestro; Volpi, Antonio

    2017-01-01

    ABSTRACT Herpes zoster (HZ) is an acute viral illness characterized by a vesicular rash with unilateral distribution, which can also result in severe complications such as post-herpetic neuralgia (PHN), ophthalmic zoster, stroke or other neurological complications. The estimate incidence in Europe ranges between 2.0 and 4.6 cases per 1,000 person-years, with a sharp increase in >50 year-old subjects. Currently, treatment options for HZ are only partially effective in limiting the acute phase, while the management of complications is complex and often unsatisfactory. The total burden of the disease and the high costs related to its diagnostic and therapeutic management led researchers to develop a new preventive approach through a live attenuated virus vaccine. The currently available vaccine, with a high antigen content, is safe, well tolerated and reduces the incidence of HZ, PHN and the burden of illness. Several countries have introduced this vaccination, albeit with different recommendations and methods of financing. Taking into account the barriers to this immunization registered in some areas (difficulty of vaccine distribution, lack of physician recommendations, the cost of vaccine for patients, etc.), this group of Italian experts advocate that a common strategy able to guarantee a good compliance with this vaccination should be implemented. The same group addresses some practical questions concerning the use of zoster vaccine. PMID:27925894

  3. Which Dengue Vaccine Approach Is the Most Promising, and Should We Be Concerned about Enhanced Disease after Vaccination? The Challenges of a Dengue Vaccine.

    PubMed

    Screaton, Gavin; Mongkolsapaya, Juthathip

    2017-07-17

    A dengue vaccine has been pursued for more than 50 years and, unlike other flaviviral vaccines such as that against yellow fever, progress has been slow. In this review, we describe progress toward the first licensed dengue vaccine Dengvaxia, which does not give complete protection against disease. The antibody response to the dengue virion is reviewed, highlighting immunodominant yet poorly neutralizing responses in the context of a highly dynamic structurally flexible dengue virus particle. Finally, we review recent evidence for cross-reactivity between antibody responses to Zika and dengue viruses, which may further complicate the development of broadly protective dengue virus vaccines. Copyright © 2017 Cold Spring Harbor Laboratory Press; all rights reserved.

  4. Bone erosion and subacromial bursitis caused by diphtheria-tetanus-poliomyelitis vaccine.

    PubMed

    Salmon, J H; Geoffroy, M; Eschard, J P; Ohl, X

    2015-11-17

    Revaxis(®) is a vaccine against diphtheria, tetanus and poliomyelitis (dT-IPV). This vaccine should not be administered by the intradermal or intravenous route. Poor injection techniques and related consequences are rare. We report a case of bursitis associated with reactive glenohumeral effusion complicated by bone erosion occurring after injection of the dT-IPV vaccine. A 26 year old patient was admitted for painful left shoulder causing functional impairment. Control magnetic resonance imaging showed bone oedema on the upper outer part of the humeral head, with a slight cortical irregularity, indicating that the vaccine was injected in contact with the bone at this location, causing erosion. Outcome was favourable after intra-articular corticosteroids. Reports of articular or periarticular injury after vaccination are extremely rare, in view of the substantial number of vaccines administered every year. The potential complications of vaccination are well known to general practitioners but under-reported in the literature. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Status of vaccine research and development of vaccines for herpes simplex virus.

    PubMed

    Johnston, Christine; Gottlieb, Sami L; Wald, Anna

    2016-06-03

    Herpes simplex virus type-1 (HSV-1) and -2 (HSV-2) are highly prevalent global pathogens which commonly cause recurrent oral and genital ulcerations. Less common but more serious complications include meningitis, encephalitis, neonatal infection, and keratitis. HSV-2 infection is a significant driver of the HIV epidemic, increasing the risk of HIV acquisition 3 fold. As current control strategies for genital HSV-2 infection, including antiviral therapy and condom use, are only partially effective, vaccines will be required to reduce infection. Both preventive and therapeutic vaccines for HSV-2 are being pursued and are in various stages of development. We will provide an overview of efforts to develop HSV-2 vaccines, including a discussion of the clinical need for an HSV vaccine, and status of research and development with an emphasis on recent insights from trials of vaccine candidates in clinical testing. In addition, we will touch upon aspects of HSV vaccine development relevant to low and middle income countries. Copyright © 2016 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

  6. Development and trial of vaccines against Brucella.

    PubMed

    Lalsiamthara, Jonathan; Lee, John Hwa

    2017-08-31

    The search for ideal brucellosis vaccines remains active today. Currently, no licensed human or canine anti-brucellosis vaccines are available. In bovines, the most successful vaccine (S19) is only used in calves, as adult vaccination results in orchitis in male, prolonged infection, and possible abortion complications in pregnant female cattle. Another widely deployed vaccine (RB51) has a low protective efficacy. An ideal vaccine should exhibit a safe profile as well as enhance protective efficacy. However, currently available vaccines exhibit one or more major drawbacks. Smooth live attenuated vaccines suffer shortcomings such as residual virulence and serodiagnostic interference. Inactivated vaccines, in general, confer relatively low levels of protection. Recent developments to improve brucellosis vaccines include generation of knockout mutants by targeting genes involved in metabolism, virulence, and the lipopolysaccharide synthesis pathway, as well as generation of DNA vaccines, mucosal vaccines, and live vectored vaccines, have all produced varying degrees of success. Herein, we briefly review the bacteriology, pathogenesis, immunological implications, candidate vaccines, vaccinations, and models related to Brucella .

  7. Development and trial of vaccines against Brucella

    PubMed Central

    Lalsiamthara, Jonathan

    2017-01-01

    The search for ideal brucellosis vaccines remains active today. Currently, no licensed human or canine anti-brucellosis vaccines are available. In bovines, the most successful vaccine (S19) is only used in calves, as adult vaccination results in orchitis in male, prolonged infection, and possible abortion complications in pregnant female cattle. Another widely deployed vaccine (RB51) has a low protective efficacy. An ideal vaccine should exhibit a safe profile as well as enhance protective efficacy. However, currently available vaccines exhibit one or more major drawbacks. Smooth live attenuated vaccines suffer shortcomings such as residual virulence and serodiagnostic interference. Inactivated vaccines, in general, confer relatively low levels of protection. Recent developments to improve brucellosis vaccines include generation of knockout mutants by targeting genes involved in metabolism, virulence, and the lipopolysaccharide synthesis pathway, as well as generation of DNA vaccines, mucosal vaccines, and live vectored vaccines, have all produced varying degrees of success. Herein, we briefly review the bacteriology, pathogenesis, immunological implications, candidate vaccines, vaccinations, and models related to Brucella. PMID:28859268

  8. Herpes zoster vaccine in Korea.

    PubMed

    Choi, Won Suk

    2013-07-01

    Herpes zoster and post-herpetic neuralgia deteriorate the quality of life because of severe pain and complications, and cause considerable social and economic burden of disease. In 2012, herpes zoster vaccine was released in Korea. The efficacy of herpes zoster vaccine is known to be 51.3-66.5% among the aged over 60 and 69.8-72.4% among adults between 50 and 59. It is also known that preventive efficacy is maintained for at least 5 years. Although there can be local reactions such as redness, pain and swelling at the site of injection and systemic reaction such as headache and eruption after herpes zoster vaccination, most of the adverse reactions are minor and disappear within days by themselves. As it is a live vaccine, persons with severe immune-suppression and pregnant women should not be vaccinated with the vaccine. Currently, Korean Society of Infectious Diseases recommended for the aged over 60 to be vaccinated with herpes zoster vaccine by subcutaneous route. In this article, clinical aspects and burden of disease of herpes zoster, efficacy and effects of herpes zoster vaccine, and herpes zoster vaccine recommendation by Korean Society of Infectious Diseases are discussed.

  9. Herpes zoster vaccine in Korea

    PubMed Central

    2013-01-01

    Herpes zoster and post-herpetic neuralgia deteriorate the quality of life because of severe pain and complications, and cause considerable social and economic burden of disease. In 2012, herpes zoster vaccine was released in Korea. The efficacy of herpes zoster vaccine is known to be 51.3-66.5% among the aged over 60 and 69.8-72.4% among adults between 50 and 59. It is also known that preventive efficacy is maintained for at least 5 years. Although there can be local reactions such as redness, pain and swelling at the site of injection and systemic reaction such as headache and eruption after herpes zoster vaccination, most of the adverse reactions are minor and disappear within days by themselves. As it is a live vaccine, persons with severe immune-suppression and pregnant women should not be vaccinated with the vaccine. Currently, Korean Society of Infectious Diseases recommended for the aged over 60 to be vaccinated with herpes zoster vaccine by subcutaneous route. In this article, clinical aspects and burden of disease of herpes zoster, efficacy and effects of herpes zoster vaccine, and herpes zoster vaccine recommendation by Korean Society of Infectious Diseases are discussed. PMID:23858399

  10. Sediment characteristics and provenance of the Taiwan Shoal in the southern Taiwan Strait

    NASA Astrophysics Data System (ADS)

    Koo, W. S.; Lin, A. T.; Kuo, L. W.; Lee, Y. H.

    2016-12-01

    The Taiwan Shoal in the southern Taiwan Strait exhibits a lobe-shaped shallow water area, with a depth less than around 40 m and an area approximately of 13,000 km2. The Shoal consists of relict sediments remnant from deltaic deposits during the last glacial period and associated with the paleo-Min River. We collected seafloor sediments in and around the Taiwan Shoal to study the sediment characteristics and provenance of the Shoal as well as Taiwanese river sediments to characterize sediment sourced from southern Taiwan. Our results help to understand possible sediment delivery pathways in a source-to-sink context from the southern Taiwan Strait to the northern South China Sea. The method of X-ray diffraction is used to identify mineral compositions for muds and mineral compositions are examined under polarized microscope for sands. Zircon grains are separated from heavy minerals for U-Pb dating in order to understand the sediment source terranes. Sediments of the Taiwan Shoal are mostly tawny-colored, medium to coarse-grained sands with abundant shell fragments and shallow-water benthic foraminifera. Sediments to the south of the Taiwan Shoal and in the outer shelf consist of dark brown-colored and fine-grained sands with rare shell fragments. Siliciclastic compositions of the Taiwan Shoal sediments are mostly quartz. The second abundant composition is rock fragments with more occurrences near the Chinese coastline and the Penghu archipelago. Slate fragments are found to occur near Taiwan, especially in the Penghu Channel area. Clay minerals from the Penghu Channels and south of the Taiwan Shoal are dominated by illite and chlorite with minor smectite and kaolinite. The sediment colors and mineral species are very different for the sediments of the Taiwan Shoal and outer shelf, revealing that these two areas featuring different oceanographic processes and sediment provenance.

  11. Taiwan`s experience with municipal waste recycling

    SciTech Connect

    Lee, C.H.

    1998-12-31

    Currently, each person on the average produces 1.15 kg of the municipal waste per day and a total of 9 million metric tons were generated annually in Taiwan. The disposal of such a huge amount of waste presents tremendous challenge for the island due to the scarcity of landfills and incineration facilities available locally. EPA of Taiwan, R.O.C. thus takes an active role in promoting waste recycling to reduce the garbage produced in municipalities. In order to efficiently utilize the government`s human and financial resources used in recycling, started from January 31, 1989, EPA has mandated the producer responsibility recyclingmore » program for several designated post-consumer products such as PET, PVC bottles, scrap tires, scrap motor vehicles, etc. Producer responsibility recycling program specifies that the manufacturers, importers and sellers of these designated products have the responsibility to retrieve their products and recycle them properly. Several negative effects have been encountered while the implementation of this producer responsibility recycling program in Taiwan which resulted in a modification of this recycling program recently. This paper presents the encountered experiences on the implementation of municipal waste recycling program in Taiwan.« less

  12. Influenza (Flu) Vaccine (Inactivated or Recombinant): What You Need to Know

    MedlinePlus

    ... flu vaccine. This risk has been estimated at 1 or 2 additional cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine. • Young children who get the flu shot along with pneumococcal vaccine (PCV13) and/or DTaP ...

  13. Asymptomatic ratio for seasonal H1N1 influenza infection among schoolchildren in Taiwan.

    PubMed

    Hsieh, Ying-Hen; Tsai, Chen-An; Lin, Chien-Yu; Chen, Jin-Hua; King, Chwan-Chuen; Chao, Day-Yu; Cheng, Kuang-Fu

    2014-02-12

    Studies indicate that asymptomatic infections do indeed occur frequently for both seasonal and pandemic influenza, accounting for about one-third of influenza infections. Studies carried out during the 2009 pH1N1 pandemic have found significant antibody response against seasonal H1N1 and H3N2 vaccine strains in schoolchildren receiving only pandemic H1N1 monovalent vaccine, yet reported either no symptoms or only mild symptoms. Serum samples of 255 schoolchildren, who had not received vaccination and had pre-season HI Ab serotiters <40, were collected from urban, rural areas and an isolated island in Taiwan during the 2005-2006 influenza season. Their hemagglutination inhibition antibody (HI Ab) serotiters against the 2005 A/New Caledonia/20/99 (H1N1) vaccine strain at pre-season and post-season were measured to determine the symptoms with the highest correlation with infection, as defined by 4-fold rise in HI titer. We estimate the asymptomatic ratio, or the proportion of asymptomatic infections, for schoolchildren during the 2005-6 influenza season when this vaccine strain was found to be antigenically related to the circulating H1N1 strain. Fever has the highest correlation with the 2005-06 seasonal influenza A(H1N1) infection, followed by headache, cough, vomiting, and sore throat. Asymptomatic ratio for the schoolchildren is found to range between 55.6% (95% CI: 44.7-66.4)-77.9% (68.8-87.0) using different sets of predictive symptoms. Moreover, the asymptomatic ratio was 66.9% (56.6-77.2) when using US-CDC criterion of fever + (cough/sore throat), and 73.0 (63.3-82.8) when under Taiwan CDC definition of Fever + (cough or sore throat or nose) + ( headache or pain or fatigue). Asymptomatic ratio for children is found to be substantially higher than that of the general population in literature. In providing reasonable quantification of the asymptomatic infected children spreading pathogens to others in a seasonal epidemic or a pandemic, our estimates

  14. Vaccinating high-risk children with the intranasal live-attenuated influenza vaccine: the Quebec experience.

    PubMed

    Quach, Caroline

    2014-12-01

    Given the burden of illness associated with influenza, vaccination is recommended for individuals at high risk of complications. The live-attenuated influenza vaccine (LAIV) is administered by intranasal spray, thus directly stimulating mucosal immunity. In this review, we aimed to provide evidence for its efficacy and safety in different paediatric populations. We also share the Quebec experience of LAIV use through a publicly funded vaccination program for children with chronic, high-risk conditions. from randomized controlled trials in healthy children and in asthmatics have demonstrated superior efficacy of LAIV over the injectable vaccine (IIV). LAIV is well tolerated: its administration is associated with runny nose and nasal congestion, but not with asthma exacerbations and is well tolerated in children with cystic fibrosis, when compared to IIV. The vaccine is well accepted by children and parents and can easily be part of vaccination clinics in paediatric tertiary care centres targeting children with chronic, high-risk conditions, not leading to immunosuppression. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Pharmacy management of vaccines.

    PubMed

    Cannon, H Eric

    2007-09-01

    Although standard vaccines have traditionally been granted full coverage in managed care, the recent introduction of several novel vaccine products has necessitated the revision of pharmacy management strategies throughout the nation. To review pharmacy management strategies for a number of emerging vaccines, with unique plan perspectives from SelectHealth, an Intermountain Healthcare company serving approximately 500,000 members in Utah. Because several recently introduced vaccines target previously unaddressed diseases and carry higher costs than traditional vaccines, several plans have adapted a novel approach to manage vaccine coverage on an individual product basis. At SelectHealth, recently introduced vaccines for rotavirus, respiratory syncytial virus (RSV), herpes zoster, and human papillomavirus (HPV) have required special attention in terms of pharmacy management. After carefully weighing acquisition and administration costs, anticipated uptake and use, direct and indirect health care costs averted, and quality of life issues, plan leadership decided to cover many of the new vaccines (i.e., rotavirus, RSV, and herpes zoster) under a nonstandard vaccination benefit. However, because substantial cost savings and high use of the quadrivalent HPV vaccine was anticipated within SelectHealth, the plan decided to fully cover the product. Although they complicate traditional pharmacy management, novel vaccines provide clinical benefit that managed care organizations cannot ignore. One universal strategy will not suffice in managing all the different vaccines entering the market, and a tailored approach should be employed based on the individual characteristics and use of each product.

  16. Herpes zoster caused by vaccine-strain varicella zoster virus in an immunocompetent recipient of zoster vaccine.

    PubMed

    Tseng, Hung Fu; Schmid, D Scott; Harpaz, Rafael; LaRussa, Philip; Jensen, Nancy J; Rivailler, Pierre; Radford, Kay; Folster, Jennifer; Jacobsen, Steven J

    2014-04-01

    We report the first laboratory-documented case of herpes zoster caused by the attenuated varicella zoster virus (VZV) contained in Zostavax in a 68-year-old immunocompetent adult with strong evidence of prior wild-type VZV infection. The complete genome sequence of the isolate revealed that the strain carried 15 of 42 (36%) recognized varicella vaccine-associated single-nucleotide polymorphisms, including all 5 of the fixed vaccine markers present in nearly all of the strains in the vaccine. The case of herpes zoster was relatively mild and resolved without complications.

  17. Using Dynamic Transmission Modeling to Determine Vaccination Coverage Rate Based on 5-Year Economic Burden of Infectious Disease: An Example of Pneumococcal Vaccine.

    PubMed

    Wen, Yu-Wen; Wu, Hsin; Chang, Chee-Jen

    2015-05-01

    Vaccination can reduce the incidence and mortality of an infectious disease and thus increase the years of life and productivity for the entire society. But when determining the vaccination coverage rate, its economic burden is usually not taken into account. This article aimed to use a dynamic transmission modeling (DTM), which is based on a susceptible-infectious-recovered model and is a system of differential equations, to find the optimal vaccination coverage rate based on the economic burden of an infectious disease. Vaccination for pneumococcal diseases was used as an example to demonstrate the main purpose. 23-Valent pneumococcal polysaccharide vaccines (PPV23) and 13-valent pneumococcal conjugate vaccines (PCV13) have shown their cost-effectiveness in elderly and children, respectively. Scenarios analysis of PPV23 to elderly aged 65+ years and of PCV13 to children aged 0 to 4 years was applied to assess the optimal vaccination coverage rate based on the 5-year economic burden. Model parameters were derived from Taiwan's National Health Insurance Research Database, government data, and published literature. Various vaccination coverage rates, the vaccine efficacy, and all epidemiologic parameters were substituted into DTM, and all differential equations were solved in R Statistical Software. If the coverage rate of PPV23 for the elderly and of PCV13 for the children both reach 50%, the economic burden due to pneumococcal disease will be acceptable. This article provided an alternative perspective from the economic burden of diseases to obtain a vaccination coverage rate using the DTM. This will provide valuable information for vaccination policy decision makers. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  18. Use of Lot Quality Assurance Sampling (LQAS) to estimate vaccination coverage helps guide future vaccination efforts.

    PubMed

    Alberti, K P; Guthmann, J P; Fermon, F; Nargaye, K D; Grais, R F

    2008-03-01

    Inadequate evaluation of vaccine coverage after mass vaccination campaigns, such as used in national measles control programmes, can lead to inappropriate public health responses. Overestimation of vaccination coverage may leave populations at risk, whilst underestimation can lead to unnecessary catch-up campaigns. The problem is more complex in large urban areas where vaccination coverage may be heterogeneous and the programme may have to be fine-tuned at the level of geographic subunits. Lack of accurate population figures in many contexts further complicates accurate vaccination coverage estimates. During the evaluation of a mass vaccination campaign carried out in N'Djamena, the capital of Chad, Lot Quality Assurance Sampling was used to estimate vaccination coverage. Using this method, vaccination coverage could be evaluated within smaller geographic areas of the city as well as for the entire city. Despite the lack of accurate population data by neighbourhood, the results of the survey showed heterogeneity of vaccination coverage within the city. These differences would not have been identified using a more traditional method. The results can be used to target areas of low vaccination coverage during follow-up vaccination activities.

  19. Update on recommendations for use of herpes zoster vaccine.

    PubMed

    Hales, Craig M; Harpaz, Rafael; Ortega-Sanchez, Ismael; Bialek, Stephanie R

    2014-08-22

    Herpes zoster vaccine (Zostavax [Merck & Co., Inc.]) was licensed in 2006 and recommended by the Advisory Committee on Immunization Practices (ACIP) in 2008 for prevention of herpes zoster (shingles) and its complications among adults aged ≥60 years. The Food and Drug Administration (FDA) approved the use of Zostavax in 2011 for adults aged 50 through 59 years based on a large study of safety and efficacy in this age group. ACIP initially considered the use of herpes zoster vaccine among adults aged 50 through 59 years in June 2011, but declined to recommend the vaccine in this age group, citing shortages of Zostavax and limited data on long-term protection afforded by herpes zoster vaccine. In October 2013, ACIP reviewed the epidemiology of herpes zoster and its complications, herpes zoster vaccine supply, short-term vaccine efficacy in adults aged 50 through 59 years, short- and long- term vaccine efficacy and effectiveness in adults aged ≥60 years, an updated cost-effectiveness analysis, and deliberations of the ACIP herpes zoster work group, all of which are summarized in this report. No vote was taken, and ACIP maintained its current recommendation that herpes zoster vaccine be routinely recommended for adults aged ≥60 years. Meeting minutes are available at http://www.cdc.gov/vaccines/acip/meetings/meetings-info.html.

  20. Vaccines for Malaria: How Close Are We?

    PubMed Central

    Thera, Mahamadou A.; Plowe, Christopher V.

    2012-01-01

    Vaccines are the most powerful public health tools mankind has created, but malaria parasites are bigger, more complicated, and wilier than the viruses and bacteria that have been conquered or controlled with vaccines. Despite decades of research toward a vaccine for malaria, this goal has remained elusive. Nevertheless, recent advances justify optimism that a licensed malaria vaccine is within reach. A subunit recombinant protein vaccine that affords in the neighborhood of 50% protective efficacy against clinical malaria is in the late stages of clinical evaluation in Africa. Incremental improvements on this successful vaccine are possible and worth pursuing, but the best hope for a highly efficacious malaria vaccine that would improve prospects for malaria eradication may lie with the use of attenuated whole parasites and powerful immune-boosting adjuvants. PMID:22077719

  1. Vaccines for malaria: how close are we?

    PubMed

    Thera, Mahamadou A; Plowe, Christopher V

    2012-01-01

    Vaccines are the most powerful public health tools mankind has created, but malaria parasites are bigger, more complicated, and wilier than the viruses and bacteria that have been conquered or controlled with vaccines. Despite decades of research toward a vaccine for malaria, this goal has remained elusive. Nevertheless, recent advances justify optimism that a licensed malaria vaccine is within reach. A subunit recombinant protein vaccine that affords in the neighborhood of 50% protective efficacy against clinical malaria is in the late stages of clinical evaluation in Africa. Incremental improvements on this successful vaccine are possible and worth pursuing, but the best hope for a highly efficacious malaria vaccine that would improve prospects for malaria eradication may lie with the use of attenuated whole parasites and powerful immune-boosting adjuvants.

  2. Overview of measles and mumps vaccine: origin, present, and future of vaccine production.

    PubMed

    Betáková, T; Svetlíková, D; Gocník, M

    2013-01-01

    Measles and mumps are common viral childhood diseases that can cause serious complications. Vaccination remains the most efficient way to control the spread of these viruses. The manufacturing capability for viral vaccines produced in embryonated hen eggs and conventional/classical cell substrates, such as chicken embryo fibroblast or primary dog kidney cell substrates, is no longer sufficient. This limitation can be overcome by utilizing other recognized cell substrates such as Madin Darby Canine Kidney (MDCK), Chinese Hamster Ovary (CHO), Vero (monkey origin) cells, MRC-5 (human diploid) or as an alternative, introducing new cell substrates of human or avian origin. A very important factor in vaccine production is the safety and immunogenicity of the final vaccine, where the proper choice of cell substrate used for virus propagation is made. All substrates used in vaccine production must be fully characterized to avoid the contamination of hidden unknown pathogens which is difficult to achieve in primary cell substrates.

  3. Taiwan Regulation of Biobanks.

    PubMed

    Fan, Chien-Te; Hung, Tzu-Hsun; Yeh, Chan-Kun

    2015-01-01

    This paper introduces legal framework and governance structure in relation to the management and development of biobanks in Taiwan. At first, we briefly describe Taiwan's population, political system and health care system. Secondly, this research introduces biobanking framework of Taiwan including 25 biobanks established with the approval of the Ministry of Health and Welfare. In those biobanks, "Taiwan Biobank" is the first and the largest government-supported biobank which comprises population-based cohort study and disease- oriented study. Since the collection of information, data, and biological specimen of biobanks often involve highly sensitive personal information, in the legal framework of Taiwan, there is a specific regulation, "Human Biobank Management Act" (HBMA), which plays an important role in regulating biobanks in Taiwan. HBMA, the Personal Information Act and other regulations constitute a comprehensive legal and regulatory privacy framework of biobanks. Through the introduction and analysis of the current legal framework applicable to biobanks, we found that there are several challenges that need to be solved appropriately that involve duplicate review systems, the obstacles in the international collaboration, and data sharing between biobanks in Taiwan. © 2015 American Society of Law, Medicine & Ethics, Inc.

  4. Taiwan: Background Notes Series.

    ERIC Educational Resources Information Center

    Reams, Joanne Reppert

    Concise background information on Taiwan is provided. The publication begins with a profile of Taiwan, discussing the people, geography, political establishment, and economy. A map of the country is provided. The bulk of the publication then provides more detailed information on Taiwan's people, geography, history, administration, political…

  5. Safety and tolerability of cell culture-derived and egg-derived trivalent influenza vaccines in 3 to <18-year-old children and adolescents at risk of influenza-related complications.

    PubMed

    Diez-Domingo, Javier; de Martino, Maurizio; Lopez, Jose Garcia-Sicilia; Zuccotti, Gian Vincenzo; Icardi, Giancarlo; Villani, Alberto; Moreno-Perez, David; Hernández, María Méndez; Aldeán, Javier Álvarez; Mateen, Ahmed Abdul; Enweonye, Igwebuike; de Rooij, Richard; Chandra, Richa

    2016-08-01

    This descriptive, non-comparative, phase III study evaluated the safety and tolerability of cell culture-derived (TIVc) and egg-derived (TIV) seasonal influenza vaccines in children at risk of influenza-related complications. Four hundred and thirty subjects were randomized 2:1 to TIVc or TIV. Subjects aged 3 to <9 years received one dose (if previously vaccinated, n=89) or two doses (if not previously vaccinated, n=124) of the study vaccines; the 9 to <18-year-olds (n=213) received one dose. Reactogenicity was assessed for 7 days after vaccination; safety was monitored for 6 months. After any vaccination, the most frequently reported solicited local adverse event (AE) was tenderness/pain (TIVc 44%, 66%, 53% and TIV 56%, 51%, 65% in the age groups 3 to <6 years, 6 to <9 years, and 9 to <18 years, respectively) and the systemic AE was irritability (22% TIVc, 24% TIV) in 3 to <6-year-olds and headache in 6 to <9-year-olds (20% TIVc, 13% TIV) and 9 to <18-year-olds (21% TIVc, 26% TIV). There were no cases of severe fever (≥40°C). No vaccine-related serious AEs were noted. New onset of chronic disease was reported in ≤1% of subjects. TIVc and TIV had acceptable tolerability and similar safety profiles in at-risk children (NCT01998477). Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  6. Countermeasures and vaccination against terrorism using smallpox: pre-event and post-event smallpox vaccination and its contraindications.

    PubMed

    Sato, Hajime

    2011-09-01

    Smallpox, when used as a biological weapon, presents a serious threat to civilian populations. Core components of the public health management of a terrorism attack using smallpox are: vaccination (ring vaccination and mass vaccination), adverse event monitoring, confirmed and suspected smallpox case management, contact management, identifying, tracing, monitoring contacts, and quarantine. Above all, pre-event and post-event vaccination is an indispensable part of the strategies. Since smallpox patients are most infectious from onset of the rash through the first 7-10 days of the rash, vaccination should be administered promptly within a limited time frame. However, vaccination can accompany complications, such as postvaccinial encephalitis, progressive vaccinia, eczema vaccinatum, and generalized vaccinia. Therefore, vaccination is not recommended for certain groups. Public health professionals, as well as physicians and government officials, should also be well equipped with all information necessary for appropriate and effective smallpox management in the face of such a bioterrorism attack.

  7. Smallpox and smallpox vaccine: ocular and systemic risks and ethical uncertainties.

    PubMed

    Chous, A Paul; Hom, Gregory G

    2003-09-01

    The threat of bioterrorism and use of biological weapons has drawn renewed attention to smallpox, and smallpox vaccinations have been resumed in the United States. Both smallpox and smallpox vaccine carry risk of potentially debilitating or fatal adverse effects. The optometrist must be familiar with the signs and symptoms of smallpox disease and complications of smallpox vaccine for proper management and preservation of vision. The literature on the ocular and systemic effects of smallpox and smallpox vaccination is reviewed to provide the practicing optometrist with an overview of the issues involved in case management. Recent guidelines have placed additional ocular-related contraindications to receiving the smallpox vaccine. Risk factors for complications arising from smallpox vaccination are discussed. A discussion of the ethical implications is also presented. Knowledge of the signs and symptoms of smallpox infection, and of adverse effects caused by smallpox vaccination, can provide the necessary background to help eye care providers make appropriate diagnoses and referrals. Understanding ethical and legal/Constitutional questions surrounding the risk of outbreak and various vaccination containment strategies will help optometrists make informed decisions as health care professionals, patient advocates, and concerned citizens, as well as weigh the risks and benefits of vaccination, if it is offered to them.

  8. Clinical characteristics and economic consequence of Klebsiella pneumoniae liver abscess in Taiwan.

    PubMed

    Wu, Ping-Feng; Chang, Yea-Yuan; Lin, Yi-Tsung; Wang, Fu-Der; Chan, Yu-Jiun; Fung, Chang-Phone

    2015-04-01

    Klebsiella pneumoniae liver abscess (KPLA) has emerged as an endemic disease in Taiwan, and its prevalence has been increasing in east Asian countries in the past three decades. The utilization of healthcare resources associated with KPLA is assumed to be substantial, and may be of future concern. This study investigated the clinical characteristics and economic burden of KPLA in Taiwan in 2011 and 2012. Adult patients with KPLA were identified retrospectively in a tertiary medical center in Taiwan from January 2011 to December 2012. The clinical characteristics, total and daily hospitalization expenditure, and the risk factors for the costs of KPLA were analyzed. Among patients with KPLA, the median cost was $5290.80 in US dollars, and the mean cost was $6337.50 ± $4363.40. Length of hospital stay was the only independent risk factor for the high total hospitalization expenditure. The duration of antibiotic use was nearly the same as the length of hospital stay. The prolonged stay in the general ward (≥21 days) also contributed to the high total cost of hospitalization. The independent risk factors for the high average daily cost of hospitalization were a higher Charlson Comorbidity Index and the requirement of intensive care on admission. The current study is the first to demonstrate the high economic burden resulting from KPLA in a medical center in Taiwan. Standardizing the treatment protocol for KPLA inpatients and introducing an outpatient parenteral antimicrobial therapy center to reduce the length of stay may reduce costs, whereas development of a vaccine may be necessary to tackle endemic KPLA in the future. Copyright © 2013. Published by Elsevier B.V.

  9. Viral hepatitis vaccination during pregnancy

    PubMed Central

    Zhao, Yueyuan; Jin, Hui; Zhang, Xuefeng; Wang, Bei; Liu, Pei

    2016-01-01

    Abstract Viral hepatitis is a serious global public health problem. It is also a common cause of jaundice and gestational complications in pregnant women. Moreover, infected mothers can transmit the virus to their fetus or neonate, which may increase disease burden and decrease quality of life. To date, commercial vaccines have been developed for hepatitis A, B, and E and are available to the general population. The Advisory Committee on Immunization Practices currently accepts emergency vaccination against hepatitis A and B during pregnancy due to benefits that overweight the potential risks. While there are limited data from trials with limited numbers of samples that suggest the efficacy or safety of hepatitis B and E vaccines in pregnant women, additional data are necessary to provide evidence of vaccination during pregnancy. PMID:26833263

  10. Viral hepatitis vaccination during pregnancy.

    PubMed

    Zhao, Yueyuan; Jin, Hui; Zhang, Xuefeng; Wang, Bei; Liu, Pei

    2016-04-02

    Viral hepatitis is a serious global public health problem. It is also a common cause of jaundice and gestational complications in pregnant women. Moreover, infected mothers can transmit the virus to their fetus or neonate, which may increase disease burden and decrease quality of life. To date, commercial vaccines have been developed for hepatitis A, B, and E and are available to the general population. The Advisory Committee on Immunization Practices currently accepts emergency vaccination against hepatitis A and B during pregnancy due to benefits that overweight the potential risks. While there are limited data from trials with limited numbers of samples that suggest the efficacy or safety of hepatitis B and E vaccines in pregnant women, additional data are necessary to provide evidence of vaccination during pregnancy.

  11. Molecular analysis of varicella vaccines and varicella-zoster virus from vaccine-related skin lesions.

    PubMed

    Thiele, Sonja; Borschewski, Aljona; Küchler, Judit; Bieberbach, Marc; Voigt, Sebastian; Ehlers, Bernhard

    2011-07-01

    To prevent complications that might follow an infection with varicella-zoster virus (VZV), the live attenuated Oka strain (V-Oka) is administered to children in many developed countries. Three vaccine brands (Varivax from Sanofi Pasteur MSD; Varilrix and Priorix-Tetra, both from Glaxo-Smith-Kline) are licensed in Germany and have been associated with both different degrees of vaccine effectiveness and adverse effects. To identify genetic variants in the vaccines that might contribute to rash-associated syndromes, single nucleotide polymorphism (SNP) profiles of variants from the three vaccines and rash-associated vaccine-type VZV from German vaccinees were quantitatively compared by PCR-based pyrosequencing (PSQ). The Varivax vaccine contained an estimated 3-fold higher diversity of VZV variants, with 20% more wild-type (wt) SNPs than Varilrix and Priorix-Tetra. These minor VZV variants in the vaccines were identified by analyzing cloned full-length open reading frame (ORF) orf62 sequences by chain termination sequencing and PSQ. Some of these sequences amplified from vaccine VZV were very similar or identical to those of the rash-associated vaccine-type VZV from vaccinees and were almost exclusively detected in Varivax. Therefore, minorities of rash-associated VZV variants are present in varicella vaccine formulations, and it can be concluded that the analysis of a core set of four SNPs is required as a minimum for a firm diagnostic differentiation of vaccine-type VZV from wt VZV.

  12. Travel-related mosquito-transmitted disease questionnaire survey among health professionals in Taiwan.

    PubMed

    Huang, Hsien-Liang; Chiu, Tai-Yuan; Huang, Kuo-Chin; Cheng, Shao-Yi; Yao, Chien-An; Lee, Long-Teng

    2011-01-01

    Health-care professionals can help travelers by providing accurate pre-travel counseling for mosquito-transmitted diseases such as malaria, yellow fever, and dengue fever. Governments and international organizations will benefit from knowledge survey among health professionals in this field to promote the development of travel health profession. This study investigates physicians' and nurses' knowledge regarding malaria, yellow fever, and dengue fever. A cross-sectional questionnaire survey was distributed to physicians and nurses in Taiwan interested in travel medicine between April and September of 2008. The self-administered, single-choice questionnaire evaluated knowledge regarding epidemiology, prophylactic medication for malaria, yellow fever, and dengue fever, and vaccinations for yellow fever as well as background information of participants. Complete information was collected from 82 physicians and 203 nurses. (Out of 289, effective response rate = 99.9%). The mean percentage of accurate responses was similar for all three diseases: malaria 67.3% (range, 16.8%-90.5%); yellow fever 65.4% (39.6%-79.3%); and dengue fever 74.4% (14.4%-96.5%). The items with the lowest accuracy were (1) behavior of the dengue fever vector Aedes aegypti mosquito (14.4%) and (2) incubation period of malaria (16.8%). There were 60.4% participants who did not know the current revaccination interval for the yellow fever vaccine. The average knowledge scores for all three diseases were statistically significantly higher in the physician group. Analysis of the results revealed significant deficits in travel medicine knowledge among health-care providers. Emphasis on continuing medical education for disease vector behavior, prophylactic drug prescription, and preventative vaccination is important to travel safety. Health professionals in Taiwan should actively participate in the International Society of Travel Medicine to follow the international standard of travel medicine

  13. Spatial distribution of non volcanic tremors offshore eastern Taiwan

    NASA Astrophysics Data System (ADS)

    Xie, X. S.; Lin, J. Y.; Hsu, S. K.; Lee, C. H.; Liang, C. W.

    2012-04-01

    Non-volcanic tremor (NVT), originally identified in the subduction zone of the southwest Japan, have been well studied in the circum-Pacific subduction zones and the transform plate boundary in California. Most studies related NVT to the release of fluids, while some others associated them with slow-slip events, and can be triggered instantaneously by the surface waves of teleseismic events. Taiwan is located at a complex intersection of the Philippines Sea Plate and the Eurasian Plate. East of Taiwan, the Philippine Sea plate subducts northward beneath the Ryukyu arc. The major part of the island results from the strong convergence between the two plates and the convergent boundary is along the Longitudinal Valley. Moreover, an active strike-slip fault along the Taitung Canyon was reported in the offshore eastern Taiwan. In such complicate tectonic environments, NVT behavior could probably bring us more information about the interaction of all the geological components in the area. In this study, we analyze the seismic signals recorded by the Ocean bottom Seismometer (OBS) deployed offshore eastern Taiwan in September 2009. TAMS (Tremor Active Monitor System) software was used to detect the presence of NVT. 200 tremor-like signals were obtained from the 3 weeks recording period. We use the SSA (Source-Scanning Algorithm) to map the possible distribution of the tremor. In total, 180 tremors were located around the eastern offshore Taiwan. The tremors are mainly distributed in two source areas: one is along the Taitung Canyon, and the other is sub-parallel to the Ryukyu Trench, probably along the plate interface. Many tremors are located at depth shallower than 5 km, which suggests a possible existence of a weak basal detachment along the sea bottom. Other tremors with larger depth may be related to the dehydration of the subducting sea plate as suggested by the former studies. Limited by the short recording period of the OBS experiment, we could not obtain any

  14. Taiwan Biobank: a project aiming to aid Taiwan's transition into a biomedical island.

    PubMed

    Fan, Chien-Te; Lin, Jui-Chu; Lee, Chung-His

    2008-02-01

    Essentially, the term 'biobank' can be defined in different ways. Taking the UK Biobank's experience as the main example, the Taiwan Biobank aims to collect the DNA of a large group of people on the population base and track their health and lifestyle for at least 10 years. It is hoped that the information collected, regarding the mechanisms underlying how genes and environmental factors interact with each other to make us ill, will benefit the society in various ways, including the exploration of a new generation of treatments, support to preventive medicine discovery and also the possible benefits for the promotion of evolving public health-related industries in Taiwan. However, the involvement of large-scale population base gene data collection also triggered serious ethical, legal and social issues. In Taiwan, the challenge is even more serious than for any other biobanking experiences that have occurred previously. Among all the ethical, legal and social issues, the convergence of aboriginal people protection provided under Taiwan's Constitution imposes on the research team an obligation to create an innovative Ethical & Legal Governance Framework adaptable to the unique social background of Taiwan, including a workable public consultation/communication mechanism. In early 2005, the creation of the 'Taiwan Biobank' has been included as a part of Taiwan's strategic development in promoting the country as an island of biomedicine. In this report, the ideology, the goals and special features, government strategy, visions and, in particular, the ethical, legal and social issue planning of the Taiwan Biobank will be briefly introduced and reviewed.

  15. [A short history of infectious diseases since the fifties of the last century and the importance of vaccination].

    PubMed

    Marešová, Vilma

    2015-01-01

    Vaccination in the Czech lands has a long history; it begun during the Austro-Hungarian Empire in 1803 by vaccination against smallpox, and in the late 19th century by vaccination against rabies. In the second half of the 20th century, the basic vaccination included also other vaccines. Thanks to paediatricians, vaccination coverage of children was so high that in addition to the immunity of individuals the collective immunity was also significant. The incidence of infectious diseases has dropped significantly. Today the population, both medical and lay, almost does not know the classic childrens infectious diseases or their risk of complications. This creates a feeling in recent years that vaccination is unnecessary and that it is a source of complication and, therefore, better not to vaccinate. However, diseases, except for smallpox, have not disappeared, and for the susceptible unvaccinated individuals they represent a great risk. There are now occurring at atypical age groups where their diagnosis is even not considered. Therefore, it is important to return to the course of disease as well as to the potentially serious complications in unvaccinated people.

  16. Herpes Zoster Vaccine in the Long-Term Care Setting: A Clinical and Logistical Conundrum.

    PubMed

    Schafer, Katherine Montag; Reidt, Shannon

    2016-01-01

    Advancing age is associated with an increased risk of herpes zoster (shingles) infection and latent effects such as postherpetic neuralgia. The herpes zoster vaccine is recommended in those 60 years of age and older and has been shown to prevent both the primary disease and associated complications. While this recommendation applies to those living in long-term care facilities, there is little clinical evidence to support use in this population. Additionally, there are logistical barriers that may complicate the use of the vaccine. The article examines the evidence for vaccinating residents in long-term care facilities and discusses logistical barriers to vaccination. Pharmacists and providers may consider life expectancy and other factors when evaluating which patients should receive the vaccination.

  17. Therapeutic Vaccines for Chronic Infections

    NASA Astrophysics Data System (ADS)

    Autran, Brigitte; Carcelain, Guislaine; Combadiere, Béhazine; Debre, Patrice

    2004-07-01

    Therapeutic vaccines aim to prevent severe complications of a chronic infection by reinforcing host defenses when some immune control, albeit insufficient, can already be demonstrated and when a conventional antimicrobial therapy either is not available or has limited efficacy. We focus on the rationale and challenges behind this still controversial strategy and provide examples from three major chronic infectious diseases-human immunodeficiency virus, hepatitis B virus, and human papillomavirus-for which the efficacy of therapeutic vaccines is currently being evaluated.

  18. In elderly persons live attenuated influenza A virus vaccines do not offer an advantage over inactivated virus vaccine in inducing serum or secretory antibodies or local immunologic memory.

    PubMed Central

    Powers, D C; Fries, L F; Murphy, B R; Thumar, B; Clements, M L

    1991-01-01

    In a double-blind, randomized trial, 102 healthy elderly subjects were inoculated with one of four preparations: (i) intranasal bivalent live attenuated influenza vaccine containing cold-adapted A/Kawasaki/86 (H1N1) and cold-adapted A/Bethesda/85 (H3N2) viruses; (ii) parenteral trivalent inactivated subvirion vaccine containing A/Taiwan/86 (H1N1), A/Leningrad/86 (H3N2), and B/Ann Arbor/86 antigens; (iii) both vaccines; or (iv) placebo. To determine whether local or systemic immunization augmented mucosal immunologic memory, all volunteers were challenged intranasally 12 weeks later with the inactivated virus vaccine. We used a hemagglutination inhibition assay to measure antibodies in sera and a kinetic enzyme-linked immunosorbent assay to measure immunoglobulin G (IgG) and IgA antibodies in sera and nasal washes, respectively. In comparison with the live virus vaccine, the inactivated virus vaccine elicited higher and more frequent rises of serum antibodies, while nasal wash antibody responses were similar. The vaccine combination induced serum and local antibodies slightly more often than the inactivated vaccine alone did. Coadministration of live influenza A virus vaccine did not alter the serum antibody response to the influenza B virus component of the inactivated vaccine. The anamnestic nasal antibody response elicited by intranasal inactivated virus challenge did not differ in the live, inactivated, or combined vaccine groups from that observed in the placebo group not previously immunized. These results suggest that in elderly persons cold-adapted influenza A virus vaccines offer little advantage over inactivated virus vaccines in terms of inducing serum or secretory antibody or local immunological memory. Studies are needed to determine whether both vaccines in combination are more efficacious than inactivated vaccine alone in people in this age group. PMID:2037667

  19. Differences in Influenza Vaccination Coverage between Adult Immigrants and Italian Citizens at Risk for Influenza-Related Complications: A Cross-Sectional Study

    PubMed Central

    Fabiani, Massimo; Riccardo, Flavia; Di Napoli, Anteo; Gargiulo, Lidia; Declich, Silvia; Petrelli, Alessio

    2016-01-01

    Background Due to their increased vulnerability, immigrants are considered a priority group for communicable disease prevention and control in Europe. This study aims to compare influenza vaccination coverage (IVC) between regular immigrants and Italian citizens at risk for its complications and evaluate factors affecting differences. Methods Based on data collected by the National Institute of Statistics during a population-based cross-sectional survey conducted in Italy in 2012–2013, we analysed information on 42,048 adult residents (≥ 18 years) at risk for influenza-related complications and with free access to vaccination (elderly residents ≥ 65 years and residents with specific chronic diseases). We compared IVC between 885 regular immigrants and 41,163 Italian citizens using log-binomial models and stratifying immigrants by area of origin and length of stay in Italy (recent: < 10 years; long-term: ≥ 10 years). Results IVC among all immigrants was 16.9% compared to 40.2% among Italian citizens (vaccination coverage ratio (VCR) = 0.42, 95% confidence interval (CI): 0.36–0.49). Adjusting for sex, age and area of residence, this difference was greatly reduced but remained statistically significant (VCR = 0.71, 95 CI: 0.61–0.81). Further adjustment for socio-economic factors (education, occupation, family composition and economic status) and a composite indicator of health-services utilization did not affect the difference (VCR = 0.78, 95% CI: 0.68–0.90). However, after adjustments, only long-term immigrants from Africa (VCR = 0.49, 95% CI: 0.28–0.85) and recent immigrants (VCR = 0.58, 95% CI: 0.43–0.78) showed a significantly different IVC compared to Italian citizens. Conclusions Differences in demographic characteristics, socio-economic conditions and health-services utilization explained the reduced IVC in most long-term immigrants compared to Italian citizens. By contrast, these differences did not explain the reduced IVC in long

  20. A case study on the influences of long-range transport to Taiwan`s acid deposition using Taiwan air quality model

    SciTech Connect

    Ken-Hui Chang; Fu-Tien Jeng

    1996-12-31

    The long-range and transboundary transport of precursors of add deposition in East Asia became important due to the industrial development around this area. We started to develop Taiwan Air Quality Model (TAQM) system since 1992, which is based on regional Acid Deposition Model (RADM) system. A typical episode in Mei-Yu season has been selected to study. A case considering all emissions within simulated domain has been run as a reference case, and another perturbed case, not including Taiwan`s emission, has been also run for analyzing quantitatively the influence of long-range transport to Taiwan`s wet deposition during the episode are 31%more » and 24% for total sulfur compounds and total nitrogen compounds respectively; but for dry deposition, only 6% is contributed by long range transport for sulfur compounds and 29% for total nitrogen compounds. Therefore, the percentages of total acid deposition contributed by long-range transport are 27% and 25% for total sulfur compounds and total nitrogen compounds, respectively.« less

  1. Multiple Vaccinations: Friend or Foe

    PubMed Central

    Church, Sarah E.; Jensen, Shawn M.; Twitty, Chris; Bahjat, Keith; Hu, Hong-Ming; Urba, Walter J.; Fox, Bernard A.

    2013-01-01

    Few immunotherapists would accept the concept of a single vaccination inducing a therapeutic anti-cancer immune response in a patient with advanced cancer. But what is the evidence to support the “more-is-better” approach of multiple vaccinations? Since we are unaware of trials comparing the effect of a single vaccine versus multiple vaccinations on patient outcome, we considered that an anti-cancer immune response might provide a surrogate measure of the effectiveness of vaccination strategies. Since few large trials include immunological monitoring, the majority of information is gleaned from smaller trials in which an evaluation of immune responses to vaccine or tumor, before and at one or more times following the first vaccine was performed. In some studies there is convincing evidence that repeated administration of a specific vaccine can augment the immune response to antigens contained in the vaccine. In other settings multiple vaccinations can significantly reduce the immune response to one or more targets. Results from three large adjuvant vaccine studies support the potential detrimental effect of multiple vaccinations as clinical outcomes in the control arms were significantly better than that for treatment groups. Recent research has provided insights into mechanisms that are likely responsible for the reduced responses in the studies noted above, but supporting evidence from clinical specimens is generally lacking. Interpretation of these results is further complicated by the possibility that the dominant immune response may evolve to recognize epitopes not present in the vaccine. Nonetheless, the FDA-approval of the first therapeutic cancer vaccine and recent developments from preclinical models and clinical trials provide a substantial basis for optimism and a critical evaluation of cancer vaccine strategies. PMID:21952289

  2. Tuberculosis vaccine development at a divide.

    PubMed

    Kaufmann, Stefan H E

    2014-05-01

    Tuberculosis (TB) remains a major health threat that will only be defeated by a combination of better drugs, diagnostics and vaccines. The only licensed TB vaccine, bacille Calmette-Guérin (BCG), protects against extrapulmonary TB in infants. Novel vaccine candidates that could protect against pulmonary TB either in TB naïve or in latent TB-infected healthy individuals have been developed and are currently being assessed in clinical trials. Subunit booster vaccines are either based on viral vectors expressing TB-specific antigens or on TB-protein antigens in adjuvants. Subunit vaccines are administered on top of BCG. Replacement vaccines for BCG are recombinant viable BCG or Mycobacterium tuberculosis. Several candidates are undergoing, or will soon start, phase IIb assessment for efficacy. The first vaccine candidate, MVA85A, to complete a phase IIb trial, unfortunately failed to show protection against TB in infants. Therapeutic vaccines composed of killed mycobacterial preparations target patients with complicated TB in adjunct to drug treatment. With increasing numbers of TB vaccine candidates in clinical trials, financial, regulatory and infrastructural issues arise, which would be best tackled by a global strategy. In addition, selection of the most promising vaccine candidates for further clinical development gains increasing importance.

  3. A new reportable disease is born: Taiwan Centers for Disease Control's response to emerging Zika virus infection.

    PubMed

    Huang, Angela Song-En; Shu, Pei-Yun; Yang, Chin-Hui

    2016-04-01

    Zika virus infection, usually a mild disease transmitted through the bite of Aedes mosquitos, has been reported to be possibly associated with microcephaly and neurologic complications. Taiwan's first imported case of Zika virus infection was found through fever screening at airport entry in January 2016. No virus was isolated from patient's blood taken during acute illness; however, PCR products showed that the virus was of Asian lineage closely related to virus from Cambodia. To prevent Zika virus from spreading in Taiwan, the Taiwan Centers for Disease Control has strengthened efforts in quarantine and surveillance, increased Zika virus infection diagnostic capacity, implemented healthcare system preparedness plans, and enhanced vector control program through community mobilization and education. Besides the first imported case, no additional cases of Zika virus infection have been identified. Furthermore, no significant increase in the number of microcephaly or Guillain- Barré Syndrome has been observed in Taiwan. To date, there have been no autochthonous transmissions of Zika virus infection. Copyright © 2016. Published by Elsevier B.V.

  4. [Evaluating efficiency of influenza vaccinal prevention among oil and gas industry workers].

    PubMed

    Bulanov, V E; Ivanov, A V; Shostak, G R

    2013-01-01

    Explore information about the incidence of employees of enterprises of the oil and gas industry with the influenza (SARS). The degree of influence of vaccination on the incidence of influenza, the number and structure of complications as a result of vaccination and their impact on efficiency. Evaluation of the cost-effectiveness of vaccination.

  5. Transcutaneous yellow fever vaccination of subjects with or without atopic dermatitis

    PubMed Central

    Slifka, Mark K.; Leung, Donald Y. M.; Hammarlund, Erika; Raué, Hans-Peter; Simpson, Eric L.; Tofte, Susan; Baig-Lewis, Shahana; David, Gloria; Lynn, Henry; Woolson, Rob; Hata, Tissa; Milgrom, Henry; Hanifin, Jon

    2013-01-01

    Background Atopic dermatitis (AD) is a common inflammatory skin disease with global prevalence ranging from 3% to 20%. AD patients have an increased risk for complications following viral infection (e.g., herpes simplex virus), and vaccination of AD patients with live vaccinia virus is contraindicated due to a heightened risk of eczema vaccinatum, a rare but potentially lethal complication associated with smallpox vaccination. Objective To develop a better understanding of immunity to cutaneous viral infection in AD patients. Methods In a double-blind, randomized study, we investigated the safety and immunogenicity of live attenuated yellow fever virus (YFV) vaccination of non-atopic (NA) subjects and AD patients following standard subcutaneous (SC) inoculation or transcutaneous (TC) vaccination administered with a bifurcated needle. Viremia, neutralizing antibody, and antiviral T cell responses were analyzed for up to 30 days post-vaccination. Results YFV vaccination by either route was well tolerated. SC vaccination resulted in higher seroconversion rates than TC vaccination but elicited similar antiviral antibody levels and T cell responses in both NA and AD groups. Following TC vaccination, both groups mounted similar neutralizing antibody responses, but AD patients demonstrated lower antiviral T cell responses by 30 days after vaccination. Among TC-vaccinated subjects, a significant inverse correlation between baseline IgE levels and the magnitude of antiviral antibody and CD4+ T cell responses was observed. Conclusions YFV vaccination of AD patients by the TC route revealed that high baseline IgE levels provides a potential biomarker for predicting reduced virus-specific immune memory following TC infection with a live virus. PMID:24331381

  6. Differences between native and immigrant women in Taiwan in factors associated with caesarean section: A prospective observational study.

    PubMed

    Weng, Shiue-Shan; Lin, Chen-Li; Tai, Chen-Jei; Chien, Li-Yin

    2017-01-01

    This study aimed to examine the association of social support, social factors, and maternal complications with caesarean deliveries in native and immigrant women, and to explore the association between acculturation and caesarean deliveries in immigrant women in Taiwan. This prospective panel study was conducted from August 2012 through April 2014 and included 222 native and 147 immigrant pregnant women in Taiwan. Caesarean rates did not differ significantly between native and immigrant women, including the overall caesarean rate (28.8%, 32.0%), medically indicated caesarean (22.5%, 24.5%), and caesarean without medical indications (6.3%, 7.5%). Results of multiple logistic regression models revealed that maternal complications and household activity support were positively associated with caesarean deliveries. Both native and immigrant women with high levels of informational support were less likely to receive caesareans. Immigrant women who were older than 35 years, had a middle level socioeconomic status, and perceived a high level of acceptance of caesarean in Taiwan were more likely to have caesarean deliveries. Informational support was a protective factor for caesarean delivery, whereas household activity support offered by the family was positively associated with caesarean delivery. Perceived acceptance level in mainstream society could affect immigrant women's use of caesarean delivery.

  7. Dengue vaccines: recent developments, ongoing challenges and current candidates

    PubMed Central

    McArthur, Monica A.; Sztein, Marcelo B.; Edelman, Robert

    2013-01-01

    Summary Dengue is among the most prevalent and important arbovirus diseases of humans. In order to effectively control this rapidly spreading disease, control of the vector mosquito and a safe and efficacious vaccine are critical. Despite considerable efforts, the development of a successful vaccine has remained elusive. Multiple factors have complicated the creation of a successful vaccine, not the least of which are the complex, immune-mediated responses against four antigenically distinct serotypes necessitating a tetravalent vaccine providing long lasting protective immunity. Despite the multiple impediments, there are currently many promising vaccine candidates in pre-clinical and clinical development. Here we review the recent advances in dengue virus vaccine development and briefly discuss the challenges associated with the use of these vaccines as a public health tool. PMID:23984962

  8. [Differences in influenza vaccination coverage among subgroups of adult immigrants residing in Italy at risk for complications (2012-2013)].

    PubMed

    Fabiani, Massimo; Di Napoli, Anteo; Riccardo, Flavia; Gargiulo, Lidia; Declich, Silvia; Petrelli, Alessio

    2017-01-01

    to evaluate differences in influenza vaccination coverage (IVC) in immigrants at risk for influenza-related complications, according to their area of origin and length of stay in Italy. cross-sectional survey conducted on the sample of foreign citizens included in the survey on health conditions and use of health services of the Italian resident population (Italian national institute of statistics, 2012-2013). analysis conducted on 885 foreign adult citizens (≥18 years) at risk for influenza-related complications (elderly residents ≥65 years and residents with specific chronic diseases). vaccination coverage ratios (VCR) comparison between long-term immigrants (≥10 years) and recent immigrants (<10 years), and between non-African and African immigrants, adjusted by demographic and socioeconomic characteristics and level of health services utilization. IVC among immigrants was 15.6%, significantly higher in long-term immigrants (18.3%) compared to recent immigrants (10.2%) (VCR: 1.79; 95%CI 1.21-2.66), and in non-African immigrants (17.1%) compared to African immigrants (9.4%) (VCR: 1.82; 95%CI 1.04-3.17). After adjusting on the basis of demographic and socioeconomic characteristics and for level of health services utilization between the compared subgroups, the difference in IVC according to the length of stay was greatly reduced (VCR: 1.41; 95%CI 0.94- 2.10), while IVC difference reduction according to area of origin was less relevant (VCR: 1.66; 95%CI 0.95-2.91). demographic and socioeconomic characteristics and level of health services utilization explained part of the difference in IVC between the compared subgroups, particularly between long-term and recent immigrants. The difference in IVC between African immigrants and immigrants from other areas remained quite pronounced even after adjusting on the basis of these factors. This suggests that IVC, especially in African immigrants, is affected by other informal barriers, such as cultural and linguistic

  9. Influenza vaccination in adult patients with solid tumours treated with chemotherapy.

    PubMed

    Vollaard, Albert; Schreuder, Imke; Slok-Raijmakers, Lizzy; Opstelten, Wim; Rimmelzwaan, Guus; Gelderblom, Hans

    2017-05-01

    Patients with solid tumours receiving chemotherapy are at risk for influenza complications. Yearly influenza vaccination is recommended to patients treated with chemotherapy. However, adherence to vaccination is low, most likely due to lack of data on efficacy, optimal timing and safety of vaccination. There is scarce evidence for the effectiveness of the influenza vaccine in adult patients with solid tumours and chemotherapy on reduction of pneumonia, decreased mortality and fewer interruptions of oncological treatment. A review of 20 non-randomised serological studies in adult patients with different cancer types and chemotherapy provides insight in general trends of response to vaccination. Overall, the magnitude of the antibody response after influenza vaccination (i.e. seroconversion) can be lower than in healthy controls, but the majority of patients with solid tumours is able to mount a timely, protective immunological response (i.e. seroprotection) regardless of chemotherapy schedule, similar to healthy controls. Small sample sizes, patient heterogeneity and lack of comparable study designs limit more specific recommendations related to cancer type and optimal timing of vaccination. The inactivated influenza vaccine is safe to administer to immunosuppressed patients; side-effects are similar to those in healthy individuals. Although vaccination before start of chemotherapy is preferred to ensure optimal protection in adults with solid tumours, also vaccination during chemotherapy can reduce influenza-related complications considering the overall trends in serological response. Given the increased morbidity and mortality of influenza, influenza vaccination should be advocated as an inexpensive and safe preventive measure in patients with solid tumours receiving chemotherapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Vaccine platform recombinant measles virus.

    PubMed

    Mühlebach, Michael D

    2017-10-01

    The classic development of vaccines is lengthy, tedious, and may not necessarily be successful as demonstrated by the case of HIV. This is especially a problem for emerging pathogens that are newly introduced into the human population and carry the inherent risk of pandemic spread in a naïve population. For such situations, a considerable number of different platform technologies are under development. These are also under development for pathogens, where directly derived vaccines are regarded as too complicated or even dangerous due to the induction of inefficient or unwanted immune responses causing considerable side-effects as for dengue virus. Among platform technologies are plasmid-based DNA vaccines, RNA replicons, single-round infectious vector particles, or replicating vaccine-based vectors encoding (a) critical antigen(s) of the target pathogens. Among the latter, recombinant measles viruses derived from vaccine strains have been tested. Measles vaccines are among the most effective and safest life-attenuated vaccines known. Therefore, the development of Schwarz-, Moraten-, or AIK-C-strain derived recombinant vaccines against a wide range of mostly viral, but also bacterial pathogens was quite straightforward. These vaccines generally induce powerful humoral and cellular immune responses in appropriate animal models, i.e., transgenic mice or non-human primates. Also in the recent first clinical phase I trial, the results have been quite encouraging. The trial indicated the expected safety and efficacy also in human patients, interestingly independent from the level of prevalent anti-measles immunity before the trial. Thereby, recombinant measles vaccines expressing additional antigens are a promising platform for future vaccines.

  11. Vaccine profile of herpes zoster (HZ/su) subunit vaccine.

    PubMed

    Cunningham, Anthony L; Heineman, Thomas

    2017-07-01

    Herpes zoster (HZ) causes an often severe and painful rash in older people and may be complicated by prolonged pain (postherpetic neuralgia; PHN) and by dissemination in immune-compromised patients. HZ results from reactivation of latent varicella-zoster virus (VZV) infection, often associated with age-related or other causes of decreased T cell immunity. A live attenuated vaccine boosts this immunity and provides partial protection against HZ, but this decreases with age and declines over 8 years. Areas covered: A new HZ subunit (HZ/su) vaccine combines a key surface VZV glycoprotein (E) with a T cell-boosting adjuvant system (AS01 B ) and is administered by two intramuscular injections two months apart. Expert commentary: HZ/su showed excellent efficacy of ~90% in immunocompetent adults ≥50 and ≥70 years of age, respectively, in the ZOE-50 and ZOE-70 phase III controlled trials. Efficacy was unaffected by advancing age and persisted for >3 years. Approximately 9.5% of subjects had severe, but transient (1-2 days) injection site pain, swelling or redness. Compliance with both vaccine doses was high (95%). The vaccine will have a major impact on HZ management. Phase I-II trials showed safety and immunogenicity in severely immunocompromised patients. Phase III trial results are expected soon.

  12. Long-term mortality of patients with septic ocular or central nervous system complications from pyogenic liver abscess: a population-based study.

    PubMed

    Lin, Yi-Tsung; Liu, Chia-Jen; Chen, Tzeng-Ji; Fung, Chang-Phone

    2012-01-01

    Taiwan is endemic for pyogenic liver abscess (PLA). Septic ocular or central nervous system (CNS) complications derived from PLA can result in catastrophic disability. We investigated the epidemiology and long-term prognosis of PLA patients with septic ocular or CNS complications over an 8-year period. We extracted 21,307 patients with newly diagnosed PLA from a nationwide health registry in Taiwan between 2000 and 2007. The frequency of and risk factors for PLA with septic ocular or CNS complications were determined. The 2-year survival of these patients was compared between those with and without septic ocular or CNS complications. Septic ocular or CNS complications accounted for 2.1% of all PLA patients. Age and the Charlson comorbidity index were significantly lower in PLA patients with ocular or CNS complications than those without. Diabetes and age <65 years were independent predictors of septic ocular or CNS complications. The 2-year mortality of patients with septic ocular or CNS complications was similar to those without complications (24.8% vs. 27.5%, p = 0.502). However, among patients <65 years old and a Charlson index ≤ 1, the 2-year mortality was significantly higher in those with than without complications (18.6% vs. 11.8%, p = 0.001). Physicians should recognize that catastrophic disability due to ocular or neurological complications from PLA could lead to a poor long-term prognosis, and should follow-up these patients more closely.

  13. Predicting influenza vaccination intent among at-risk chinese older adults in Hong Kong.

    PubMed

    Yu, Doris S F; Low, Lisa P L; Lee, Iris F K; Lee, Diana T F; Ng, Wai Man

    2014-01-01

    Older adults with major chronic illnesses are very susceptible to influenza and its serious complications, but many do not obtain vaccinations. Little is known about factors associated with intention to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong. The aim of this study was to identify factors associated with intent to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong. This multicenter descriptive correlational study recruited a convenience sample of 306 Chinese older adults with medical risk factors for influenza and its serious complications from the general outpatient clinics in Hong Kong. Interviews were conducted to assess intent to obtain influenza vaccination for the coming year, health beliefs about influenza, and discomfort following past vaccinations. The current influenza vaccination rate was 58.5%; only 36.3% intended to get vaccinated the following year. After controlling for clinical and demographic factors in a logistic regression model, perceived susceptibility predicted intention to obtain future vaccination (OR = 1.42, 95% CI [1.14, 1.78]), whereas postvaccination discomfort was negatively associated with intention (OR = 0.063, 95% CI [0.006, 0.63]). Intention to obtain influenza vaccination was low among at-risk Chinese older adults. Strengthening health beliefs and creating strategies to provide positive influenza vaccination experiences are possible approaches to interventions to improve uptake of influenza vaccination rates.

  14. Evaluation of a streptococcal pharyngitis score in southern Taiwan.

    PubMed

    Shih, Ching-Tang; Lin, Ching-Chiang; Lu, Chung-Ching

    2012-02-01

    Group A streptococcus (GAS) pharyngitis can cause serious complications such as rheumatic heart disease. The McIsaac sore throat score is a clinical prediction score used to improve the detection rate of GAS pharyngitis. We evaluated the validity of the McIsaac sore throat score in Southern Taiwan and compared our findings to those of other studies. We retrospectively analyzed chart records from children aged 3 to 15 years old who complained of fever and sore throat. They had throat cultures collected at the outpatient pediatric clinic of Fooyin University Hospital, located in Pingtung County, Taiwan during the period between January 2007 and January 2010. Clinical characteristics were reviewed, and sore throat score was analyzed. A total of 342 throat cultures met the inclusion criteria of sore throat and fever. The positive rate of GAS was 4.1%. Culture-positive cases were associated with higher odds for a skin rash [adjusted odds ratio (AOR): 14.66, 95% confidence interval (CI): 4.63-46.40, p < 0.001), lower odds for cough (AOR: 0.19, 95% CI: 0.04-0.85, p = 0.030) and having a runny nose (AOR: 0.22, 95% CI: 0.05-0.99, p = 0.048). The most common physical sign was scarlet fever rash (AOR: 57.35, 95% CI: 15.45-212.98, p < 0.001). A McIsaac score of 5 had a sensitivity of 71%, specificity of 70%, and a positive predictive value of only 9.3%. Pediatric streptococcal pharyngitis in Southern Taiwan is uncommon. Diagnosis of GAS pharyngitis based on the McIsaac sore throat score is unreliable among pediatric patients with febrile pharyngitis in Southern Taiwan. Copyright © 2012. Published by Elsevier B.V.

  15. Viral vector-based influenza vaccines.

    PubMed

    de Vries, Rory D; Rimmelzwaan, Guus F

    2016-11-01

    Antigenic drift of seasonal influenza viruses and the occasional introduction of influenza viruses of novel subtypes into the human population complicate the timely production of effective vaccines that antigenically match the virus strains that cause epidemic or pandemic outbreaks. The development of game-changing vaccines that induce broadly protective immunity against a wide variety of influenza viruses is an unmet need, in which recombinant viral vectors may provide. Use of viral vectors allows the delivery of any influenza virus antigen, or derivative thereof, to the immune system, resulting in the optimal induction of virus-specific B- and T-cell responses against this antigen of choice. This systematic review discusses results obtained with vectored influenza virus vaccines and advantages and disadvantages of the currently available viral vectors.

  16. [Seasonal flu vaccination for older people: Evaluation of the adjuvanted vaccine. Positioning report].

    PubMed

    López Mongil, Rosa; López Trigo, José Antonio; Mariano Lázaro, Alberto; Mato Chaín, Gloria; Ramos Cordero, Primitivo; Salleras Sanmartí, Luis

    2017-11-01

    Flu is a major public health problem, particularly for older people, and creates an important clinical and economic burden. A high mortality rate was reported in Spain during the period 2015 to 2016; 3,101 serious cases were hospitalised with a confirmed diagnosis of flu, of which 11% died (352 cases). Furthermore, financial and health costs are greatly increased by the complications of flu; people aged over 65 years represent approximately 64% of the total costs. Seasonal flu vaccination is the fundamental strategy, as demonstrated by cost-benefit and cost-effectiveness studies. A priority objective is to improve the vaccine's immune response and the search for and inclusion of adjuvants and immunostimulants in vaccines is a major line of research. This positioning report evaluates vaccination for older people and the importance of the adjuvanted vaccine in the elderly in strengthening immunogenicity, by means of a critical review of the literature based on the best evidence available on its immunogenicity and effectiveness, and an economic assessment. Copyright © 2017 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Herpes zoster vaccine effectiveness and manifestations of herpes zoster and associated pain by vaccination status.

    PubMed

    Marin, Mona; Yawn, Barbara P; Hales, Craig M; Wollan, Peter C; Bialek, Stephanie R; Zhang, John; Kurland, Marge J; Harpaz, Rafael

    2015-01-01

    Options for managing herpes zoster (HZ)-related pain and complications have limited effectiveness, making HZ prevention through vaccination an important strategy. Limited data are available on HZ vaccine effectiveness against confirmed HZ and manifestations of HZ among vaccinated persons. We conducted a matched case-control study to assess HZ vaccine effectiveness for prevention of HZ and other HZ-related outcomes and a cohort study of persons with HZ to compare HZ-related outcomes by vaccination status. Cases were identified through active surveillance among persons age ≥ 60 years with HZ onset and health-care encounters during 2010-2011 in Southeastern Minnesota. Controls were age- and sex-matched to cases. Data were collected by medical record review and from participants via interviews and daily pain diaries. 266 HZ case-patients and 362 matched controls were enrolled in the vaccine effectiveness studies and 303 case-patients in the cohort study of HZ characteristics by vaccination status. Vaccination was associated with 54% (95% CI:32%-69%) reduction in HZ incidence, 58% (95% CI:31%-75%) reduction in HZ prodromal symptoms, and 70% (95% CI:33%-87%) reduction in medically-attended prodrome. HZ vaccine was statistically significant effective at preventing postherpetic neuralgia (PHN) measured at 30 d after rash onset, 61% (95% CI: 22%-80%). Among persons who developed HZ, no differences were found by vaccination status in severity or duration of HZ pain after rash onset. In this population-based study, HZ vaccination was associated with >50% reduction in HZ, HZ prodrome, and medically-attended prodrome.

  18. Herpes zoster vaccine effectiveness and manifestations of herpes zoster and associated pain by vaccination status

    PubMed Central

    Marin, Mona; Yawn, Barbara P; Hales, Craig M; Wollan, Peter C; Bialek, Stephanie R; Zhang, John; Kurland, Marge J; Harpaz, Rafael

    2015-01-01

    Options for managing herpes zoster (HZ)-related pain and complications have limited effectiveness, making HZ prevention through vaccination an important strategy. Limited data are available on HZ vaccine effectiveness against confirmed HZ and manifestations of HZ among vaccinated persons. We conducted a matched case-control study to assess HZ vaccine effectiveness for prevention of HZ and other HZ-related outcomes and a cohort study of persons with HZ to compare HZ-related outcomes by vaccination status. Cases were identified through active surveillance among persons age ≥60 years with HZ onset and health-care encounters during 2010-2011 in Southeastern Minnesota. Controls were age- and sex-matched to cases. Data were collected by medical record review and from participants via interviews and daily pain diaries. 266 HZ case-patients and 362 matched controls were enrolled in the vaccine effectiveness studies and 303 case-patients in the cohort study of HZ characteristics by vaccination status. Vaccination was associated with 54% (95% CI:32%-69%) reduction in HZ incidence, 58% (95% CI:31%-75%) reduction in HZ prodromal symptoms, and 70% (95% CI:33%-87%) reduction in medically-attended prodrome. HZ vaccine was statistically significant effective at preventing postherpetic neuralgia (PHN) measured at 30 d after rash onset, 61% (95% CI: 22%-80%). Among persons who developed HZ, no differences were found by vaccination status in severity or duration of HZ pain after rash onset. In this population-based study, HZ vaccination was associated with >50% reduction in HZ, HZ prodrome, and medically-attended prodrome. PMID:25806911

  19. Transcutaneous yellow fever vaccination of subjects with or without atopic dermatitis.

    PubMed

    Slifka, Mark K; Leung, Donald Y M; Hammarlund, Erika; Raué, Hans-Peter; Simpson, Eric L; Tofte, Susan; Baig-Lewis, Shahana; David, Gloria; Lynn, Henry; Woolson, Rob; Hata, Tissa; Milgrom, Henry; Hanifin, Jon

    2014-02-01

    Atopic dermatitis (AD) is a common inflammatory skin disease with a global prevalence ranging from 3% to 20%. Patients with AD have an increased risk for complications after viral infection (eg, herpes simplex virus), and vaccination of patients with AD with live vaccinia virus is contraindicated because of a heightened risk of eczema vaccinatum, a rare but potentially lethal complication associated with smallpox vaccination. We sought to develop a better understanding of immunity to cutaneous viral infection in patients with AD. In a double-blind randomized study we investigated the safety and immunogenicity of live attenuated yellow fever virus (YFV) vaccination of nonatopic subjects and patients with AD after standard subcutaneous inoculation or transcutaneous vaccination administered with a bifurcated needle. Viremia, neutralizing antibody, and antiviral T-cell responses were analyzed for up to 30 days after vaccination. YFV vaccination administered through either route was well tolerated. Subcutaneous vaccination resulted in higher seroconversion rates than transcutaneous vaccination but elicited similar antiviral antibody levels and T-cell responses in both the nonatopic and AD groups. After transcutaneous vaccination, both groups mounted similar neutralizing antibody responses, but patients with AD demonstrated lower antiviral T-cell responses by 30 days after vaccination. Among transcutaneously vaccinated subjects, a significant inverse correlation between baseline IgE levels and the magnitude of antiviral antibody and CD4(+) T-cell responses was observed. YFV vaccination of patients with AD through the transcutaneous route revealed that high baseline IgE levels provide a potential biomarker for predicting reduced virus-specific immune memory after transcutaneous infection with a live virus. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  20. [BCG vaccination in low risk tuberculosis; first experiences after the suspension of BCG vaccination of newborns in Czechoslovakia].

    PubMed

    Trnka, L; Danková, D

    1989-01-01

    With the steadily declining risk of tuberculosis infection in CSR the question arose whether vaccination of infants remains worthwhile considering not only resources spent but also complications to vaccination vis-a-vis benefits derived. A prospective study has been designed in which BCG vaccination of newborns is discontinued in an area with 30,000 newborns yearly. In the period from April 1, 1986 to January 31, 1988 there were not vaccinated 43,428 children (84.8% of the newborns). The collaboration of mothers was good. The one year old non-vaccinated children were tested with 2 TU PPD RT 23 with Tween 80. The distribution of positive tuberculin reactions appears unimodal, relatively large reactions being absent. 8 children had reactions with 6 or more mm induration. That corresponds to a risk of infection of 0.04%. The project continues in the research area and might be extended to another area.

  1. Vaccines and Disease-Modifying Antirheumatic Drugs: Practical Implications for the Rheumatologist.

    PubMed

    Friedman, Marcia A; Winthrop, Kevin L

    2017-02-01

    Patients with rheumatoid arthritis are highly vulnerable to infections because of abnormalities in their immune system, and because of immunosuppressive effects of their medications. Vaccinations in this population are complicated by disease-modifying antirheumatic drugs, which also modulate or suppress the immune system and potentially decrease the immunogenicity and efficacy of the vaccines. We review the available data regarding the impact of rheumatoid arthritis therapy on the immunogenicity of various common vaccines. We also review rheumatoid arthritis-specific vaccination recommendations, live vaccine safety concerns, and current gaps in our understanding of these issues." Published by Elsevier Inc.

  2. Childlessness patterns in Taiwan.

    PubMed

    Poston Dl

    1988-06-01

    Taiwan is a newly developed and industrialized area, and along with Korea, Brazil, Argentina, and a few other countries, belongs in a special class of recently industrialized areas. Taiwan has been undergoing large-scale modernization since the 1950s when the Nationalist government 1st began to implement land reform programs and today is 1 of the showcase of newly developed areas of the world. Demographic transition theory shows that fertility is negatively associated with modernization. During the past 3 decades, fertility in Taiwan has followed this pattern in a dramatic manner. Studies of childlessness conducted in Western countries have shown also that as the modernizing influences continue, fertility declines, and childlessness increases as it becomes more and more voluntary. Subregions with the highest levels of modernization and the lowest fertility rates should therefore be characterized by the highest levels of childlessness, particularly among younger women, and vice versa. Given the levels of socioeconomic and demographic development in Taiwan and its subregions circa 1980, as well as its variability among the hsiens and major cities, the author would expect to find higher levels of childlessness in the more developed localities, and lower levels in the less developed subregions. This hypothesis is tested with data from the 1980 Census of Population and Housing: General Report, Taiwan--Fukien Area (Republic of China, 1982) and the 1980 Taiwan--Fukien Demographic Fact Book (Republic of China, 1980).

  3. Epidemic of Mumps among Vaccinated Persons, the Netherlands, 2009–2012

    PubMed Central

    Gouma, Sigrid; Koopmans, Marion; de Melker, Hester; Swaan, Corien; van Binnendijk, Rob; Hahné, Susan

    2014-01-01

    To analyze the epidemiology of a nationwide mumps epidemic in the Netherlands, we reviewed 1,557 notified mumps cases in persons who had disease onset during September 1, 2009–August 31, 2012. Seasonality peaked in spring and autumn. Most case-patients were males (59%), 18–25 years of age (67.9%), and vaccinated twice with measles-mumps-rubella vaccine (67.7%). Nearly half (46.6%) of cases occurred in university students or in persons with student contacts. Receipt of 2 doses of vaccine reduced the risk for orchitis, the most frequently reported complication (vaccine effectiveness [VE] 74%, 95% CI 57%–85%); complications overall (VE 76%, 95% CI 61%–86%); and hospitalization (VE 82%, 95% CI 53%–93%). Over time, the age distribution of case-patients changed, and proportionally more cases were reported from nonuniversity cities (p<0.001). Changes in age and geographic distribution over time may reflect increased immunity among students resulting from intense exposure to circulating mumps virus. PMID:24655811

  4. HIV/HCV Coinfection in Taiwan.

    PubMed

    Hsu, Ching-Sheng; Kao, Jia-Horng

    2016-01-01

    Both human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection are important global public health problems with shared transmission routes. Although HIV/HCV coinfection is not uncommon, the prevalence rates vary significantly across different studies and regions. In Taiwan, injection drug users have become the major contributors to the HIV/AIDS epidemic since 2005. Because the prevalence of HCV infection is high in injection drug users, this HIV epidemic is also associated with a significant increase of HIV/HCV coinfection in Taiwan. To control Taiwan's HIV epidemic, Taiwan Centers for Disease Control (CDC) launched a harm-reduction program in 2006. The HIV epidemic, the percentage attributed to injection drug users, and the prevalence of HIV/HCV coinfection gradually declined thereafter. In this article, we aimed to thoroughly examine the current literatures of HIV/HCV coinfection in Taiwan and hope to provide a better understanding of the needs for the management of this coinfection. We conducted a narrative review and searched for literature from PubMed, Ovid MEDLINE, and the Cochrane Library database untill August 2015. Studies relevant to the epidemiology and associated risk factors of HIV/HCV coinfection in Taiwan were examined and discussed.

  5. Integrated structural model for active arc-continental collision from southern Taiwan to central Taiwan inferred from seismogenic views

    NASA Astrophysics Data System (ADS)

    Nagai, S.; Wang, Y.; Ma, K.; Wu, Y.; Huang, H.

    2010-12-01

    The Taiwan Island is located in ongoing arc-continent collision zone between the Philippine Sea Plate and the Eurasian Plate. Numerous geophysical and geological studies have explained the tectonic processes and developed various models. There are two end-member models for Taiwan collision; Thin-skinned model [e.g. Suppe, 1987] and Lithospheric collision model [Wu et al., 1997]. One of most important issue is that collision in Taiwan involves and contributes deformation to what depth. We have presented on this point in central Taiwan through seismological views, including both observed facts and results of tomographic inversion [Nagai et al., 2010 in WPGM 2010]. We have concluded that orogenic process should involve and contribute to depth of 30 km at least in central Taiwan, and suggested ’Upper Crustal Stacking Model’. We have indicated that existence of low-velocity blocks under Central Mountain Range (CMR) is one of the most important factors to understand Taiwan arc-continental collision process. We extend this idea to southern and northern Taiwan and to connect with balanced cross-sections proposed in Ustaszewski et al. [2010]. In this talk, we focused on the structural variation from southern Taiwan to central Taiwan. We have been performing the local double-difference tomography [Zhang and Thurber, 2003] in southern and northern Taiwan using the Central Weather Bureau Seismic Network with temporary array observations. These results in seismic tomography show variation of seismic velocity under the CMR like in central Taiwan. Low-velocity anomalies are also detected. Although it should be checked carefully, velocity blocks segmented some parts and seismic activities seem to be located on their boundaries. The Jiaxian earthquake on 4th Mar, 2010 occurred on one of these segmentation boundaries. The tectonic process in Taiwan arc-continental collision consists of different-scale structures, which means finer resolution structures may be nested with the

  6. Emergency physicians' perspectives on smallpox vaccination.

    PubMed

    Kwon, Nancy; Raven, Maria C; Chiang, William K; Moran, Gregory J; Jui, Jon; Carter, Richard A; Goldfrank, Lewis

    2003-06-01

    To evaluate emergency physician (EP) attitudes toward smallpox vaccination, the treatment of patients with suspected smallpox, and the threat of a bioterrorist attack. This was a prospective study utilizing a standardized survey instrument that was distributed on November 16, 2002, and collected by February 1, 2003. EPs from a sample of 50 accredited emergency medicine programs were surveyed regarding their perspectives on smallpox vaccination. A total of 989 surveys were collected from 42 emergency medicine programs. Of the respondents, 43.4% would currently volunteer for smallpox vaccination. EPs previously vaccinated against smallpox were 1.46 times more likely to volunteer for vaccination (95% CI = 1.14 to 1.93). EPs who believed they were at risk for complications were less than half as likely to volunteer for vaccination. EPs who perceived a significant risk of a bioterrorist attack were 2.7 times more likely to volunteer for the vaccine compared with those who thought the risk was minimal (95% CI = 2.06 to 3.47). Of the respondents, 34.4% believed the risks of the vaccination outweighed the benefits, 33% did not, and 32.6% were unsure. Currently, fewer than half of EPs surveyed would volunteer for smallpox vaccination. Factors associated with a willingness to be vaccinated include previous smallpox vaccination and the perceived threat of a bioterrorist attack. The variation in EP attitudes toward smallpox vaccination may be due to uncertain risk-to-benefit ratio. The opinions and actions of EPs may be influential on current and future government policy and public opinion.

  7. Viral vector-based influenza vaccines

    PubMed Central

    de Vries, Rory D.; Rimmelzwaan, Guus F.

    2016-01-01

    ABSTRACT Antigenic drift of seasonal influenza viruses and the occasional introduction of influenza viruses of novel subtypes into the human population complicate the timely production of effective vaccines that antigenically match the virus strains that cause epidemic or pandemic outbreaks. The development of game-changing vaccines that induce broadly protective immunity against a wide variety of influenza viruses is an unmet need, in which recombinant viral vectors may provide. Use of viral vectors allows the delivery of any influenza virus antigen, or derivative thereof, to the immune system, resulting in the optimal induction of virus-specific B- and T-cell responses against this antigen of choice. This systematic review discusses results obtained with vectored influenza virus vaccines and advantages and disadvantages of the currently available viral vectors. PMID:27455345

  8. Herpes Zoster Caused by Vaccine-Strain Varicella Zoster Virus in an Immunocompetent Recipient of Zoster Vaccine

    PubMed Central

    Tseng, Hung Fu; Schmid, D. Scott; Harpaz, Rafael; LaRussa, Philip; Jensen, Nancy J.; Rivailler, Pierre; Radford, Kay; Folster, Jennifer; Jacobsen, Steven J.

    2014-01-01

    We report the first laboratory-documented case of herpes zoster caused by the attenuated varicella zoster virus (VZV) contained in Zostavax in a 68-year-old immunocompetent adult with strong evidence of prior wild-type VZV infection. The complete genome sequence of the isolate revealed that the strain carried 15 of 42 (36%) recognized varicella vaccine–associated single-nucleotide polymorphisms, including all 5 of the fixed vaccine markers present in nearly all of the strains in the vaccine. The case of herpes zoster was relatively mild and resolved without complications. PMID:24470276

  9. Update on herpes zoster vaccination

    PubMed Central

    Shapiro, Marla; Kvern, Brent; Watson, Peter; Guenther, Lyn; McElhaney, Janet; McGeer, Allison

    2011-01-01

    Abstract Objective To answer frequently asked questions surrounding the use of the new herpes zoster (HZ) vaccine. Sources of information Published results of clinical trials and other studies, recommendations from the Canadian National Advisory Committee on Immunization, and the US Advisory Committee on Immunization Practices; data were also obtained from the vaccine’s Health Canada–approved product monograph. Main message Herpes zoster results from reactivation of the varicella-zoster virus; postherpetic neuralgia (PHN) is its most common and serious complication. The incidence of PHN after HZ is directly related to age, with 50% of affected individuals older than 60 years experiencing persistent and unrelieved pain. The live virus HZ vaccine reduces the incidence of HZ by about 50% and the occurrence of PHN by two-thirds, with vaccinated individuals experiencing attenuated or shortened symptoms. The vaccine is contraindicated in many immunocompromised patients and might not be effective in patients taking antiviral medications active against the HZ virus. Physicians should be aware of the different recommendations for these groups. Conclusion The HZ vaccine is a safe and effective preventive measure for reducing the overall burden and severity of HZ in older adults. The vaccine appears to be cost-effective when administered to adults aged 60 years and older. PMID:21998225

  10. Taiwan: growing, growing, gone.

    PubMed

    Hanson, R

    1979-10-01

    Accommodation between Taiwan and the People's Republic of China may not be inconceivable as trade contacts (though officially disallowed) grow. Because of Taiwan's well-established success and the pressing need in China to industrialize, it appears, however, that such an accommodation will occur only after China becomes more like Taiwan. Taiwan owes its success, first, to land reform and then, in the 1960s, to steady industrialization. Besides broad controls over money supply and capital designed to ward off inflationary pressures when needed, and the grand outlines for development, another factor in the island's economic success is that the government has interfered little with private enterprise. The economy has an underpinning of small to medium size businesses. There are more than 10,000 trading companies. This diverse foundation has given the economy as a whole a flexible buffer on which more sophisticated industires can be formed.

  11. Severe Dengue Fever Outbreak in Taiwan

    PubMed Central

    Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur

    2016-01-01

    Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005–2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission. PMID:26572871

  12. Severe Dengue Fever Outbreak in Taiwan.

    PubMed

    Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur

    2016-01-01

    Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005-2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission. © The American Society of Tropical Medicine and Hygiene.

  13. Neurologic illness following post-exposure prophylaxis with purifiled chick embryo cell antirabies vaccine.

    PubMed

    Chakravarty, A

    2001-09-01

    Clinical details of a neurologic illness simultating Guillain Barre syndrome developing in a patient after post-exposure prophylaxis with purified chick embryo cell (PCEC) anti-rabies vaccine is reported. Neurologic complication following PCEC vaccination has not been reported earlier.

  14. Molecular surveillance of rubella viruses in Taiwan from 2005 to 2011.

    PubMed

    Cheng, Wen-Yueh; Wang, Hsiao-Chi; Liu, Ming-Tsan; Wu, Ho-Sheng

    2013-04-01

    Rubella has been listed as a mandatory notifiable disease in Taiwan since 1988. Because of high coverage rates with an effective vaccine, rubella cases have decreased dramatically in Taiwan since 1994. However, rubella outbreaks still occur due to imported transmission. Five large clusters were detected in Taiwan from 2007 to 2011. In 2007, one cluster was caused by rubella genotype 1E viruses that were imported from Vietnam, whereas another cluster was caused by genotype 2B viruses and was untraceable. In 2008, two clusters were caused by different lineages of genotype 1E viruses that were imported from Malaysia. In 2009, a cluster that was caused by genotype 2B viruses was associated with imported cases from Vietnam. The rubella viruses from 124 confirmed cases from 2005 to 2011 were characterized, and the data revealed that these viruses were distributed in the following four genotypes: 1E (n = 56), 1h (n = 1), 1j (n = 4), and 2B (n = 63). Of these viruses, 93 (75%) were associated with imported cases, and 43 of 56 genotype 1E viruses were associated with imported cases from China, Vietnam, Malaysia, and Indonesia. One genotype 1h virus was imported from Belarus, and three of four genotype 1j viruses were imported from the Philippines. Of 63 rubella genotype 2B viruses, 46 were imported from Vietnam, Thailand, Malaysia, China, Germany, and South Africa. Molecular surveillance allows for the differentiation of circulating rubella viruses and can be used to investigate transmission pathways, which are important to identify the interruption of endemic virus transmission. Copyright © 2013 Wiley Periodicals, Inc.

  15. Herpes Zoster Vaccination: Controversies and Common Clinical Questions.

    PubMed

    Van Epps, Puja; Schmader, Kenneth E; Canaday, David H

    2016-01-01

    Herpes zoster, clinically referred to as shingles, is an acute, cutaneous viral infection caused by reactivation of the varicella zoster virus, the same virus that causes chickenpox. The incidence of herpes zoster and its complications increase with decline in cell-mediated immunity, including age-associated decline. The most effective management strategy for herpes zoster is prevention of the disease through vaccination in those who are most vulnerable. Despite the demonstrated efficacy in reducing the incidence and severity of herpes zoster, the uptake of vaccine remains low. Here, we will discuss the controversies that surround the live herpes zoster vaccine and address the common clinical questions that arise. We will also discuss the new adjuvanted herpes zoster vaccine currently under investigation. © 2015 S. Karger AG, Basel.

  16. Structural Features of the Western Taiwan Foreland Basin in the Eastern Taiwan Strait since Late Miocene

    NASA Astrophysics Data System (ADS)

    WANG, J. H.; Liu, C. S.; Chang, J. H.; Yang, E. Y.

    2017-12-01

    The western Taiwan Foreland Basin lies on the eastern part of Taiwan Strait. The structures in this region are dominated by crustal stretch and a series of flexural normal faults have been developed since Late Miocene owing to the flexural of Eurasia Plate. Through deciphering multi-channel seismic data and drilling data, these flexural features are observed in the offshore Changhua coastal area. The flexure normal faults are important features to realize structural activity in the western Taiwan Foreland Basin. Yang et al. (2016) mention that the reactivated normal faults are found north of the Zhushuixi estuary. It should be a significant issue to decipher whether these faults are still active. In this study, we have analyzed all the available seismic reflections profiles in the central part of the Taiwan Strait, and have observed many pre-Pliocene normal faults that are mainly distributed in the middle of the Taiwan Strait to Changyun Rise, and we tentatively suggest that the formation of these faults may be associated with the formation of the foreland basal unconformity. Furthermore, we will map the distribution of these normal faults and examine whether the reactivated normal faults have extended to south of the Zhushuixi estuary. Finally, we discuss the relation between the reactivated normal faults in the Taiwan Strait and those faults onshore. Key words: Multichannel seismic reflection profile, Taiwan Strait, Foreland basin, normal fault.

  17. Middle East respiratory syndrome: obstacles and prospects for vaccine development

    PubMed Central

    Papaneri, Amy B.; Johnson, Reed F.; Wada, Jiro; Bollinger, Laura; Jahrling, Peter B.; Kuhn, Jens H.

    2016-01-01

    Summary The recent emergence of Middle East respiratory syndrome (MERS) highlights the need to engineer new methods for expediting vaccine development against emerging diseases. However, several obstacles prevent pursuit of a licensable MERS vaccine. First, the lack of a suitable animal model for MERS complicates in vivo testing of candidate vaccines. Second, due to the low number of MERS cases, pharmaceutical companies have little incentive to pursue MERS vaccine production as the costs of clinical trials are high. In addition, the timeline from bench research to approved vaccine use is 10 years or longer. Using novel methods and cost-saving strategies, genetically engineered vaccines can be produced quickly and cost-effectively. Along with progress in MERS animal model development, these obstacles can be circumvented or at least mitigated. PMID:25864502

  18. Ophthalmic plastic and orbital surgery in Taiwan.

    PubMed

    Hsu, Chi-Hsin; Lin, I-Chan; Shen, Yun-Dun; Hsu, Wen-Ming

    2014-06-01

    We describe in this paper the current status of ophthalmic plastic and orbital surgery in Taiwan. Data were collected from the Bureau of National Health Insurance of Taiwan, the Bulletin of the Taiwan Ophthalmic Plastic and Reconstructive Society, and the Statistics Yearbook of Practicing Physicians and Health Care Organizations in Taiwan by the Taiwan Medical Association. We ascertained that 94 ophthalmologists were oculoplastic surgeons and accounted for 5.8% of 1621 ophthalmologists in Taiwan. They had their fellowship training abroad (most ophthalmologists trained in the United States of America) or in Taiwan. All ophthalmologists were well trained and capable of performing major oculoplastic surgeries. The payment rates by our National Health Insurance for oculoplastic and orbital surgeries are relatively low, compared to Medicare payments in the United States. Ophthalmologists should promote the concept that oculoplastic surgeons specialize in periorbital plastic and aesthetic surgeries. However, general ophthalmologists should receive more educational courses on oculoplastic and cosmetic surgery. Copyright © 2014. Published by Elsevier B.V.

  19. Seasonal influenza vaccines.

    PubMed

    Fiore, Anthony E; Bridges, Carolyn B; Cox, Nancy J

    2009-01-01

    safety of LAIV among young children suggest an increased risk of wheezing in some young children, and the vaccine is not recommended for children younger than 2 years old, ages 2-4 old with a history of recurrent wheezing or reactive airways disease, or older persons who have any medical condition that confers an increased risk of influenza-related complications.The effectiveness of influenza vaccines is related predominantly to the age and immune competence of the vaccinee and the antigenic relatedness of vaccine strains to circulating strains. Vaccine effectiveness in preventing laboratory-confirmed influenza illness when the vaccine strains are well matched to circulating strains is 70-90% in randomized, placebo-controlled trials conducted among children and young healthy adults, but is lower among elderly or immunocompromised persons. In years with a suboptimal match, vaccine benefit is likely to be lower, although the vaccine can still provide substantial benefit, especially against more severe outcomes. Live, attenuated influenza vaccines have been most extensively studied among children, and have been shown to be more effective than inactivated vaccines in several randomized controlled trials among young children.Influenza vaccination is recommended in the United States for all children six months or older, all adults 50 years or older, all persons with chronic medical conditions, and pregnant women, and contacts of these persons, including healthcare workers. The global disease burden of influenza is substantial, and the World Health Organization has indicated that member states should evaluate the cost-effectiveness of introducing influenza vaccination into national immunization programs. More research is needed to develop more effective seasonal influenza vaccines that provide long-lasting immunity and broad protection against strains that differ antigenically from vaccine viruses.

  20. Mucosal Vaccine Development Based on Liposome Technology

    PubMed Central

    Norling, Karin; Bally, Marta; Höök, Fredrik

    2016-01-01

    Immune protection against infectious diseases is most effective if located at the portal of entry of the pathogen. Hence, there is an increasing demand for vaccine formulations that can induce strong protective immunity following oral, respiratory, or genital tract administration. At present, only few mucosal vaccines are found on the market, but recent technological advancements and a better understanding of the principles that govern priming of mucosal immune responses have contributed to a more optimistic view on the future of mucosal vaccines. Compared to live attenuated vaccines, subcomponent vaccines, most often protein-based, are considered safer, more stable, and less complicated to manufacture, but they require the addition of nontoxic and clinically safe adjuvants to be effective. In addition, another limiting factor is the large antigen dose that usually is required for mucosal vaccines. Therefore, the combination of mucosal adjuvants with the recent progress in nanoparticle technology provides an attractive solution to these problems. In particular, the liposome technology is ideal for combining protein antigen and adjuvant into an effective mucosal vaccine. Here, we describe and discuss recent progress in nanoparticle formulations using various types of liposomes that convey strong promise for the successful development of the next generation of mucosal vaccines. PMID:28127567

  1. Vaccines for preventing influenza in healthy adults.

    PubMed

    Jefferson, T O; Rivetti, D; Di Pietrantonj, C; Rivetti, A; Demicheli, V

    2007-04-18

    influenza when the vaccine matched the circulating strain and circulation was high, but decreased to 50% (95% CI 27% to 65%) when it did not. Excluding the studies of the 1968 to 1969 pandemic, effectiveness was 15% (95% CI 9% to 22%) and efficacy was 73% (95% CI 53% to 84%). Vaccination had a modest effect on time off work, but there was insufficient evidence to draw conclusions on hospital admissions or complication rates. Inactivated vaccines caused local tenderness and soreness and erythema. Spray vaccines had more modest performance. Monovalent whole-virion vaccines matching circulating viruses had high efficacy (VE 93%, 95% CI 69% to 98%) and effectiveness (VE 66%, 95% CI 51% to 77%) against the 1968 to 1969 pandemic. Influenza vaccines are effective in reducing cases of influenza, especially when the content predicts accurately circulating types and circulation is high. However, they are less effective in reducing cases of influenza-like illness and have a modest impact on working days lost. There is insufficient evidence to assess their impact on complications. Whole-virion monovalent vaccines may perform best in a pandemic.

  2. Women scientists in Taiwan: an update.

    PubMed

    Wang, Hsiu-Yun; Stocker, Joel Floyd

    2010-06-01

    This paper reflects upon issues of gender and science in Taiwan. Its starting point is the first academic paper on the subject published in Taiwan in 1996 by Fu and Wang, and then it draws upon the biographical accounts of 20 women scientists. We emphasize the importance of focusing on the specific contexts of the history of science and women in Taiwan. Partly as a result of Taiwan's colonial past and women's limited access to education, women scientists did not emerge in Taiwan until the second half of the 20(th) century when higher education became available to women. The gender issues with which women scientists in Taiwan have had to cope include the ways in which women have been excluded or included, their marital and career status, the local and global politics of scientific knowledge, and negotiating social networks. These issues have remained largely the same since the Fu and Wang study, but they have certainly gained wider attention and understanding, and greater articulation, both within academia and society. 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

  3. [Chickenpox and shingles: one virus, two diseases and current vaccination recommendations in Switzerland].

    PubMed

    Eckert, Nadine; Masserey Spicher, Virginie

    2016-01-01

    Adults, pregnant women, premature babies and immunocompromised persons are at increased risk for varicella complications. Therefore the current Swiss vaccination recommendations against varicella include a general recommendation for 11 to 15 year old adolescents with a negative varicella history, as well as a specific recommendation for risk groups. The goal of both recommendations is to reduce varicella complications in persons most at risk. The vaccine is not universally recommended for all toddlers in Switzerland, while this is the case in some countries such as the United States. Pros and cons of different vaccination strategies, as well as possible short- and long-term effects on herpes zoster incidence are taken into account. In the United States, there was a marked decline in incidence and hospitalisations, but an increased herpes zoster incidence in the short term. Finally, public health aspects of herpes zoster, post-herpetic neuralgia and possible vaccination strategies are outlined.

  4. The Final (Oral Ebola) Vaccine Trial on Captive Chimpanzees?

    PubMed Central

    Walsh, Peter D.; Kurup, Drishya; Hasselschwert, Dana L.; Wirblich, Christoph; Goetzmann, Jason E.; Schnell, Matthias J.

    2017-01-01

    Could new oral vaccine technologies protect endangered wildlife against a rising tide of infectious disease? We used captive chimpanzees to test oral delivery of a rabies virus (RABV) vectored vaccine against Ebola virus (EBOV), a major threat to wild chimpanzees and gorillas. EBOV GP and RABV GP-specific antibody titers increased exponentially during the trial, with rates of increase for six orally vaccinated chimpanzees very similar to four intramuscularly vaccinated controls. Chimpanzee sera also showed robust neutralizing activity against RABV and pseudo-typed EBOV. Vaccination did not induce serious health complications. Blood chemistry, hematologic, and body mass correlates of psychological stress suggested that, although sedation induced acute stress, experimental housing conditions did not induce traumatic levels of chronic stress. Acute behavioral and physiological responses to sedation were strongly correlated with immune responses to vaccination. These results suggest that oral vaccination holds great promise as a tool for the conservation of apes and other endangered tropical wildlife. They also imply that vaccine and drug trials on other captive species need to better account for the effects of stress on immune response. PMID:28277549

  5. COST-EFFECTIVENESS ANALYSIS OF HERPES ZOSTER VACCINATION IN ITALIAN ELDERLY PERSONS.

    PubMed

    Coretti, Silvia; Codella, Paola; Romano, Federica; Ruggeri, Matteo; Cicchetti, Americo

    2016-01-01

    Herpes zoster (HZ) is characterized by a painful skin rash. Its main complication is postherpetic neuralgia (PHN), pain persisting or occurring after the rash onset. HZ treatment aims to reduce acute pain, impede the onset complications, and disease progression. The aim of this study was to assess the cost-effectiveness of HZ vaccination compared with no vaccination strategy, within the Italian context. The natural history of HZ and PHN was mapped through a Markov model with lifetime horizon. A population of patients aged between 60 and 79 years was hypothesized. Third party payer (Italian National Health Service, I-NHS) and societal perspectives were adopted. Data were derived from literature. The incremental cost-effectiveness ratio of the vaccination equaled EUR 11,943 per quality-adjusted life-year (QALY) under the I-NHS perspective and EUR 11,248 per QALY under the societal perspective. Considering a cost-effectiveness threshold of EUR 30,000/QALY, the multi-way sensitivity analysis showed that vaccination is cost-effective regardless of the perspective adopted, in 99 percent of simulations.

  6. Herpes Zoster: the rationale for the introduction of vaccination in Italy.

    PubMed

    Paganino, C; Alicino, C; Trucchi, C; Albanese, E; Sticchi, L; Icardi, G

    2015-06-10

    Herpes Zoster (HZ) and its main complication, post-herpetic neuralgia (PHN), represent an important public health issue because of their relevant burden within older adult population and the actual suboptimal therapeutic management of the diseases. Incidences of HZ and PHN are comparable all over the world and are closely related with the population age. Epidemiological data collected in Italy about HZ and its complications confirmed the trend registered in North America and Europe. Moreover HZ related burden is exacerbated by a significant economic impact related to both direct and indirect costs. Since 2006 a live, attenuated varicella zoster virus vaccine, that contains VZV Oka strain [Zostavax, Merck & Co., Inc.], was licensed for the prevention of HZ and PHN in adults aged ≥ 60 years. Since 2011, the licensure has been extended to adults between 50 and 59 years. The vaccine has demonstrated a good immunogenicity, efficacy and safety profiles in two pivotal phase III clinical trials and the effectiveness was further confirmed after vaccine licensure. Pharmaco-economic studies concluded that HZ vaccine is cost-effective in most European countries and generally supported the economic value of this vaccination. The vaccine is actually recommended in USA, Canada and several European countries. The opportunity to reduce the burden of these diseases by the recommendation of HZ vaccination have been evaluated and suggested also in our Country and some Regions have been recently introduced the vaccine in their immunization plan. If the good results, already obtained with HZ vaccine in other countries, will be confirmed by these Italian pilot experiences, vaccination programs should be made uniform in all Country in order to ensure an equitable offer of this important preventive tool. © Copyright by Pacini Editore SpA, Pisa, Italy.

  7. Vaccination, herd behavior, and herd immunity.

    PubMed

    Cohen, Matan J; Brezis, Mayer; Block, Colin; Diederich, Adele; Chinitz, David

    2013-11-01

    During the 2009 outbreak of novel influenza AH1N1, insufficient data were available to adequately inform decision makers about benefits and risks of vaccination and disease. We hypothesized that individuals would opt to mimic their peers, having no better decision anchor. We used Game Theory, decision analysis, and transmission models to simulate the impact of subjective risks and preference estimates on vaccination behavior. We asked 95 students to provide estimates of risk and health state valuations with regard to AH1N1 infection, complications, and expectations of vaccine benefits and risks. These estimates were included in a sequential chain of models: a dynamic epidemic model, a decision tree, and a population-level model. Additionally, participants' intentions to vaccinate or not at varying vaccination rates were documented. The model showed that at low vaccination rates, vaccination dominated. When vaccination rates increased above 78%, nonvaccination was the dominant strategy. We found that vaccination intentions did not correspond to the shift in strategy dominance and segregated to 3 types of intentions: regardless of what others do 29/95 (31%) intended to vaccinate while 27/95 (28%) did not; among 39 of 95 (41%) intention was positively associated with putative vaccination rates. Some people conform to the majority's choice, either shifting epidemic dynamics toward herd immunity or, conversely, limiting societal goals. Policy leaders should use models carefully, noting their limitations and theoretical assumptions. Behavior drivers were not explicitly explored in this study, and the discrepant results beg further investigation. Models including real subjective perceptions with empiric or subjective probabilities can provide insight into deviations from expected rational behavior and suggest interventions in order to provide better population outcomes.

  8. Vaccination adherence: Review and proposed model.

    PubMed

    Abahussin, Asma A; Albarrak, Ahmed I

    The prevalence of childhood vaccine-preventable diseases can be significantly reduced through adherence to confirmed vaccination schedules. However, many barriers to vaccination compliance exist, including a lack of awareness regarding the importance of vaccines, missing due dates, and fear of complications from vaccinations. The aim of this study is to review the existing tools and publications regarding vaccination adherence, and to propose a design for a vaccination adherence application (app) for smartphones. Android and iOS apps designed for vaccination reminders have been reviewed to examine six elements: educational factor; customizing features; reminder tools; peer education facilitations; feedback, and the language of apps' interface and content. The literature from PubMed has been reviewed for studies addressing reminder systems or tools including apps. The study has revealed insufficient (n=6) technology-based interventions for increasing childhood vaccination rates by reminding parents in comparison to the fast growth in technology, out of which are two publications discussed mobile apps. Ten apps have been found in apps stores; only one out of them was designed for the Saudi vaccination schedule in Arabic language with some weaknesses. The study proposed a design for a vaccination reminder app that includes a number of features in order to overcome the limitations discussed in the studied reminders, apps, and systems. The design supports the Arabic language and the Saudi vaccination schedule; parental education including peer education; a variety of reminder methods, and the capability to track vaccinations and refer to the app as a personal health record. The study discussed a design for a vaccination reminder app that satisfies the specific requirements for better compliance to children's immunization schedules based on reviewing the existing apps and publications. The proposed design includes element to educate parents and answer their concerns

  9. Repeated Vaccination Does Not Appear to Impact Upon Influenza Vaccine Effectiveness Against Hospitalization With Confirmed Influenza.

    PubMed

    Cheng, Allen C; Macartney, Kristine K; Waterer, Grant W; Kotsimbos, Tom; Kelly, Paul M; Blyth, Christopher C

    2017-06-01

    Annual influenza vaccine is recommended for those at greatest risk of severe influenza infection. Recent reports of a negative impact of serial influenza vaccination on vaccine effectiveness (VE) raises concerns about the recommendation for annual influenza vaccines, particularly in persons at greatest risk. The Influenza Complications Alert Network (FluCAN) is an Australian hospital-based sentinel surveillance program. In this observational study, cases were defined as subjects aged >9 years admitted with influenza confirmed by polymerase chain reaction. Controls were subjects with acute respiratory illness testing negative for influenza. Propensity scores were used to adjust for the likelihood of being vaccinated. VE was calculated as 1 - adjusted odds ratio of vaccination in cases compared with test-negative controls. Over 2010-2015, 6223 cases and 6505 controls were hospitalized with confirmed influenza and influenza test-negative acute respiratory illness, respectively. Following stratification by quintile of propensity score, site, and year, VE was estimated to be 43% (95% confidence interval [CI], 37%-49%) overall. VE was estimated to be 51% (95% CI, 45%-57%) in those vaccinated in both the current and previous season, compared with 33% (95% CI, 17%-47%) vaccinated in the current season only and 35% (95% CI, 21%-46%) in the previous season only. Similar results were observed for influenza A/H1N1, influenza A/H3N2, and influenza B strains. Vaccination in both the current and previous seasons was associated with a higher VE against hospitalization with influenza than vaccination in either single season. These findings reinforce current recommendations for annual influenza vaccination, particularly those at greatest risk of influenza disease. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com

  10. Effectiveness of influenza vaccination for children in Japan: Four-year observational study using a large-scale claims database.

    PubMed

    Shibata, Natsumi; Kimura, Shinya; Hoshino, Takahiro; Takeuchi, Masato; Urushihara, Hisashi

    2018-05-11

    To date, few large-scale comparative effectiveness studies of influenza vaccination have been conducted in Japan, since marketing authorization for influenza vaccines in Japan has been granted based only on the results of seroconversion and safety in small-sized populations in clinical trial phases not on the vaccine effectiveness. We evaluated the clinical effectiveness of influenza vaccination for children aged 1-15 years in Japan throughout four influenza seasons from 2010 to 2014 in the real world setting. We conducted a cohort study using a large-scale claims database for employee health care insurance plans covering more than 3 million people, including enrollees and their dependents. Vaccination status was identified using plan records for the influenza vaccination subsidies. The effectiveness of influenza vaccination in preventing influenza and its complications was evaluated. To control confounding related to influenza vaccination, odds ratios (OR) were calculated by applying a doubly robust method using the propensity score for vaccination. Total study population throughout the four consecutive influenza seasons was over 116,000. Vaccination rate was higher in younger children and in the recent influenza seasons. Throughout the four seasons, the estimated ORs for influenza onset were statistically significant and ranged from 0.797 to 0.894 after doubly robust adjustment. On age stratification, significant ORs were observed in younger children. Additionally, ORs for influenza complication outcomes, such as pneumonia, hospitalization with influenza and respiratory tract diseases, were significantly reduced, except for hospitalization with influenza in the 2010/2011 and 2012/2013 seasons. We confirmed the clinical effectiveness of influenza vaccination in children aged 1-15 years from the 2010/2011 to 2013/2014 influenza seasons. Influenza vaccine significantly prevented the onset of influenza and was effective in reducing its secondary complications

  11. Summary of the NACI Statement on Seasonal Influenza Vaccine for 2017-2018.

    PubMed

    Vaudry, W; Stirling, R

    2017-05-04

    Influenza is a respiratory infection caused primarily by influenza A and B viruses. Vaccination is the most effective way to prevent influenza and its complications. The National Advisory Committee on Immunization (NACI) provides recommendations regarding seasonal influenza vaccines annually to the Public Health Agency of Canada (PHAC). To summarize the NACI recommendations regarding the use of seasonal influenza vaccines for the 2017-2018 influenza season. Annual influenza vaccine recommendations are developed by NACI's Influenza Working Group for consideration and approval by NACI, based on NACI's evidence-based process for developing recommendations. The recommendations include a consideration of the burden of influenza illness and the target populations for vaccination; efficacy and effectiveness, immunogenicity and safety of influenza vaccines; vaccine schedules; and other aspects of influenza immunization. These recommendations are published annually on the Agency's website in the NACI Advisory Committee Statement: Canadian Immunization Guide Chapter on Influenza and Statement on Seasonal Influenza Vaccine (the Statement). The annual statement has been updated for the 2017-2018 influenza season to incorporate recommendations for the use of live attenuated influenza vaccine (LAIV) that were contained in two addenda published after the 2016-2017 statement. These recommendations were 1) that egg-allergic individuals may be vaccinated against influenza using the low ovalbumin-containing LAIV licensed for use in Canada and 2) to continue to recommend the use of LAIV in children and adolescents 2-17 years of age, but to remove the preferential recommendation for its use. NACI continues to recommend annual influenza vaccination for all individuals aged six months and older, with particular focus on people at high risk of influenza-related complications or hospitalization, people capable of transmitting influenza to those at high risk, and others as indicated.

  12. Seismic Strain Field in Taiwan

    NASA Astrophysics Data System (ADS)

    Kao, H.; Liang, W.; Chang, T.; Liu, Y.; Lee, E.

    2001-12-01

    Centroid-moment-tensor (CMT) solutions determined by inverting waveform data of Broadband Array in Taiwan for Seismology (BATS) are collected for earthquakes that occurred in the Taiwan region. In total, the dataset contains more than 300 events that scattered across an area of 400 km by 400 km, including the devastating 1999 Chi-Chi earthquake sequence. The entire region is divided into 3 layers (0-40 km, 40-70 km, and greater than 70 km) with blocks of 0.2 degree by 0.2 degree in lateral dimension. Seismic moment tensors of all earthquakes that occurred inside each block are summed to give the strain tensor characterizing the corresponding seismic deformation. We calculate the eigenvalues and eigenvectors of the resulted strain tensor for each block and project the normalized maximum compressional (P) and extensional (T) axes on horizontal plane to resolve the strain field in Taiwan associated with regional seismic activities. For the majority of events with depths less than 40 km (i.e., at crustal scale), the strain field is characterized by nearly E-W compression along the eastern coastline and immediately offshore east of Taiwan. Once inland, clear fan-shaped trajectories of P-axes are observed, ranging from NW-SE in the northwest to NE-SW in the southwest. The Ryukyu and Luzon subduction systems show compression in the forearc region and extension in the backarc and outerrise regions. For depths greater than 40 km, a clear pattern of lateral compression is observed within the subducted Philippine Sea plate to the northeast of Taiwan. It is doubtless that the "slab-continent" collision is predominant at deeper depths near the junction between the Ryukyu arc and Taiwan Collision Zone, whereas the "arc-continent" collision is predominant in the central and southern Taiwan.

  13. [Typhoid fever in school children: by what measures is the modification of the clinical course due to oral vaccination?].

    PubMed

    Contreras, R; Ferreccio, C; Sotomayor, V; Astroza, L; Berríos, G; Ortiz, E; Palomino, C; Prenzel, I; Pinto, M E; Levine, M

    1992-02-01

    The clinical course of infection by Salmonellae was compared between patients who had been vaccinated against typhoid fever using the Ty21a vaccine and those who had not. Of 2566 bacteriological confirmed cases 84% were infected with S typhi, 14% with S paratyphi B and 2% with S paratyphi A. Among patients with typhoid fever, 34% were treated in hospital, 3.5% had relapses, 5.4% developed complications and 1 patient died (0.05%). Among patients with paratyphoid fever, 18% were treated in hospital, 0.6% had relapses, 1.4% developed complications and there were no deaths. These figures were similar among vaccinated and non-vaccinated cases. A slightly greater proportion of vaccinated cases were treated in hospital (38 vs 30%). Thus, use of oral vaccination against typhoid fever does not alter the clinical course of infection with Salmonellae.

  14. Varicella prevention in Costa Rica: impact of a one-dose schedule universal vaccination.

    PubMed

    Avila-Aguero, María L; Ulloa-Gutierrez, Rolando; Camacho-Badilla, Kattia; Soriano-Fallas, Alejandra; Arroba-Tijerino, Roberto; Morice-Trejos, Ana

    2017-03-01

    To describe the impact following a 1-dose Varicella vaccination schedule introduced in Costa Rica in September 2007. Areas covered: This is a retrospective review using epidemiologic surveillance national databases of varicella cases and hospitalizations, period 2000-2015. We analyzed age-related varicella incidence cases and hospitalization trends before and after the vaccine introduction. Expert commentary: Varicella vaccine coverage among children 16 months age increased from 76% in 2008 to 95% in 2015. During this period Costa Rica reached a 73.8% reduction of Varicella reported cases and 85.9% reduction of hospitalizations in the general population. Among children under 5 years of age, that reduction was 79.1% and 87%, respectively. Varicella complications in hospitalized patients decreased 98%, from n = 53 in 2008 to n = 1 in 2014. After 8-years post implementation of a 1-dose schedule of universal varicella vaccination, a dramatic overall disease reduction in incidence, hospitalizations and complicated cases has been observed in all age groups.

  15. History and development of ophthalmology in Taiwan.

    PubMed

    Hou, Yu-Chih; Oren, Gale A; Chen, Muh-Shy; Hu, Fung-Rong

    2016-12-01

    Western medicine was first introduced to Taiwan by medical missionaries in the mid-19 th century. Modernization of medicine was systematically transplanted to Taiwan in the Japanese colonial period, and ophthalmology was established third among hospital departments, following internal medicine and surgery. Dr Hidetaka Yamaguchi, an ophthalmologist, was the first head of the Taihoku Hospital, later known as National Taiwan University Hospital (NTUH; Taipei, Taiwan). Ophthalmologists during the colonial period conducted studies on tropical and infectious eye diseases. After World War II, ophthalmologists at NTUH played an important role in medical education, residency training, studies, and teaching. Dr Yan-Fei Yang established the Taiwan Ophthalmological Society in 1960 and instituted its official journal in 1962. Dr Ho-Ming Lin established the Department of Ophthalmology at the Tri-Service General Hospital in the 1950s and the Veterans General Hospital in the 1960s. Taiwan ophthalmologists eradicated trachoma by 1971. Cataract surgery and penetrating keratoplasty were initially performed in the 1960s. Currently, there are about 1600 ophthalmologists in Taiwan conducting an estimated 120,000 cataract surgeries and 600 corneal transplantations annually. Many subspecialty societies have been established recently that serve to educate Taiwanese ophthalmologists and to connect with international ophthalmic societies. Taiwan ophthalmologists continue to contribute to the advancement of ophthalmic knowledge globally. Copyright © 2016. Published by Elsevier B.V.

  16. Impact of the introduction of rotavirus vaccination on paediatric hospital admissions, Lothian, Scotland: a retrospective observational study.

    PubMed

    Forrest, Ruth; Jones, Laura; Willocks, Lorna; Hardie, Alison; Templeton, Kate

    2017-04-01

    Rotavirus (RV) vaccination was introduced into the UK vaccination schedule in July 2013. This retrospective observational study assessed, in a UK setting, the impact of the vaccination programme on the number of RV gastroenteritis (RVGE) admissions, the complications of RVGE in hospitalised children, and the impact on hospital-acquired RVGE. Over a 3 year period, 1-year before and 2 years after the introduction of the vaccine, children under 13 years of age in Lothian region with RV+ve stool sample by PCR were identified, retrospectively, and admission data (length of stay, complications) and vaccination status analysed. Viral strain (vaccine/wild type) was typed using PCR-based methods in vaccinated children. Vaccination uptake in the first 2 years of the programme was 93-94%. In the 2 years following vaccine introduction, the annual number of confirmed RVGE admissions fell by 84.7% (95% CI 75.4 to 91.0), from 131 to 20, bed days reduced by 91.1% (86.9 to 94.1), from 325 to 29, and suspected hospital-acquired infections reduced by 95.7% (73.5-99.5), from 23 to 1. The reduction in admissions was seen across all age groups despite the vaccination only being administered to infants. Despite the reduction in incidence, complication rates in children admitted with RVGE remained unchanged across the three study years. A frequent incidental finding was RV vaccine strain in the stools of vaccinated children, up to 43 days after last immunisation. There has been no concurrent increase in rate of intussusception in the region. These results provide encouraging initial evidence of the public health benefit, including to the unimmunised population, of the RV vaccination programme in the UK. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. Evaluating the effectiveness, impact and safety of live attenuated and seasonal inactivated influenza vaccination: protocol for the Seasonal Influenza Vaccination Effectiveness II (SIVE II) study

    PubMed Central

    Lone, Nazir I; Kavanagh, Kimberley; Robertson, Chris; McMenamin, Jim; von Wissmann, Beatrix; Vasileiou, Eleftheria; Butler, Chris; Ritchie, Lewis D; Gunson, Rory; Schwarze, Jürgen; Sheikh, Aziz

    2017-01-01

    Introduction Seasonal (inactivated) influenza vaccination is recommended for all individuals aged 65+ and in individuals under 65 who are at an increased risk of complications of influenza infection, for example, people with asthma. Live attenuated influenza vaccine (LAIV) was recommended for children as they are thought to be responsible for much of the transmission of influenza to the populations at risk of serious complications from influenza. A phased roll-out of the LAIV pilot programme began in 2013/2014. There is limited evidence for vaccine effectiveness (VE) in the populations targeted for influenza vaccination. The aim of this study is to examine the safety and effectiveness of the live attenuated seasonal influenza vaccine programme in children and the inactivated seasonal influenza vaccination programme among different age and at-risk groups of people. Methods and analysis Test negative and cohort study designs will be used to estimate VE. A primary care database covering 1.25 million people in Scotland for the period 2000/2001 to 2015/2016 will be linked to the Scottish Immunisation Recall Service (SIRS), Health Protection Scotland virology database, admissions to Scottish hospitals and the Scottish death register. Vaccination status (including LAIV uptake) will be determined from the primary care and SIRS database. The primary outcome will be influenza-positive real-time PCR tests carried out in sentinel general practices and other healthcare settings. Secondary outcomes include influenza-like illness and asthma-related general practice consultations, hospitalisations and death. An instrumental variable analysis will be carried out to account for confounding. Self-controlled study designs will be used to estimate the risk of adverse events associated with influenza vaccination. Ethics and dissemination We obtained approval from the National Research Ethics Service Committee, West Midlands—Edgbaston. The study findings will be presented at

  18. Effect of vaccines on bacterial meningitis worldwide.

    PubMed

    McIntyre, Peter B; O'Brien, Katherine L; Greenwood, Brian; van de Beek, Diederik

    2012-11-10

    Three bacteria--Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis--account for most acute bacterial meningitis. Measurement of the effect of protein-polysaccharide conjugate vaccines is most reliable for H influenzae meningitis because one serotype and one age group account for more than 90% of cases and the incidence has been best measured in high-income countries where these vaccines have been used longest. Pneumococcal and meningococcal meningitis are caused by diverse serotypes and have a wide age distribution; measurement of their incidence is complicated by epidemics and scarcity of surveillance, especially in low-income countries. Near elimination of H influenzae meningitis has been documented after vaccine introduction. Despite greater than 90% reductions in disease attributable to vaccine serotypes, all-age pneumococcal meningitis has decreased by around 25%, with little data from low-income settings. Near elimination of serogroup C meningococcal meningitis has been documented in several high-income countries, boding well for the effect of a new serogroup A meningococcal conjugate vaccine in the African meningitis belt. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Maternity Leave in Taiwan

    ERIC Educational Resources Information Center

    Feng, Joyce Yen; Han, Wen-Jui

    2010-01-01

    Using the first nationally representative birth cohort study in Taiwan, this paper examines the role that maternity leave policy in Taiwan plays in the timing of mothers returning to work after giving birth, as well as the extent to which this timing is linked to the amount of time mothers spend with their children and their use of breast milk…

  20. Professional Counseling in Taiwan: Past to Future

    ERIC Educational Resources Information Center

    Guo, Yuh-Jen; Wang, Shu-Ching; Combs, Don C.; Lin, Yi-Chun; Johnson, Veronica

    2013-01-01

    Because of the recent introduction of a licensure law, professional counseling has grown rapidly in Taiwan after decades of slow development. The authors provide a historical review of the development of professional counseling in Taiwan and discuss the current status and future trajectory of professional counseling in Taiwan.

  1. Association of influenza vaccination and reduced risk of stroke hospitalization among the elderly: a population-based case-control study.

    PubMed

    Lin, Hui-Chen; Chiu, Hui-Fen; Ho, Shu-Chen; Yang, Chun-Yuh

    2014-04-02

    The aim of this study was to investigate the effect of influenza vaccination (and annual revaccination) on the risk of stroke admissions. We conducted a population-based case-control study in Taiwan. Cases consisted of patients >65 years of age who had a first-time diagnosis of stroke during the influenza seasons from 2006 to 2009. Controls were selected by matching age, sex, and index date to cases. Multiple logistic regression analysis was used to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Ever vaccinated individuals in the current vaccination season were associated with a reduced risk of ischemic stroke admissions (OR = 0.76, 95% CI = 0.60-0.97). Compared with individuals never vaccinated against influenza during the past 5 years, the adjusted ORs were 0.92 (95% CI = 0.68-1.23) for the group with 1 or 2 vaccinations, 0.73 (95% CI = 0.54-1.00) for the group with 3 or 4 vaccinations, and 0.56 (95% CI = 0.38-0.83) for the group with 5 vaccinations. There was a significant trend of decreasing risk of ischemic stroke admissions with an increasing number of vaccinations. This study provides evidence that vaccination against influenza may reduce the risk of hospitalization for ischemic stroke and that annual revaccination provides greater protection.

  2. Estimating true hospital morbidity of complications associated with mumps outbreak, England, 2004/05.

    PubMed

    Yung, C F; Ramsay, M

    2016-08-18

    Mumps outbreaks in highly vaccinated populations continue to be reported globally. Therefore, quantifying the burden of mumps morbidity accurately will be necessary to better assess the impact of mumps vaccination programmes. We aim to estimate the true morbidity resulting from mumps complications in terms of hospitalised orchitis, meningitis, oophoritis and pancreatitis in England during the outbreak in 2004/05. This outbreak in England led to a clear increase in hospitalisations coded to mumps for complications of orchitis in those born in the 1970s and 1980s and possibly for meningitis in those born in the 1980s. A simple statistical model, based on analysing time trends for diagnosed complications in hospital databases with routine laboratory surveillance data, found that the actual morbidity was much higher. There were 2.5 times (166 cases) more mumps orchitis cases in the 1970s cohort and 2.0 times (708 cases) more mumps orchitis cases in the 1980s cohort than complications coded to mumps in hospital databases. Our study demonstrated that the mumps outbreak in England 2004/05 resulted in a substantial increase in hospitalised mumps complications, and the model we used can improve the ascertainment of morbidity from a mumps outbreak. This article is copyright of The Authors, 2016.

  3. Estimating true hospital morbidity of complications associated with mumps outbreak, England, 2004/05

    PubMed Central

    Yung, CF; Ramsay, M

    2016-01-01

    Mumps outbreaks in highly vaccinated populations continue to be reported globally. Therefore, quantifying the burden of mumps morbidity accurately will be necessary to better assess the impact of mumps vaccination programmes. We aim to estimate the true morbidity resulting from mumps complications in terms of hospitalised orchitis, meningitis, oophoritis and pancreatitis in England during the outbreak in 2004/05. This outbreak in England led to a clear increase in hospitalisations coded to mumps for complications of orchitis in those born in the 1970s and 1980s and possibly for meningitis in those born in the 1980s. A simple statistical model, based on analysing time trends for diagnosed complications in hospital databases with routine laboratory surveillance data, found that the actual morbidity was much higher. There were 2.5 times (166 cases) more mumps orchitis cases in the 1970s cohort and 2.0 times (708 cases) more mumps orchitis cases in the 1980s cohort than complications coded to mumps in hospital databases. Our study demonstrated that the mumps outbreak in England 2004/05 resulted in a substantial increase in hospitalised mumps complications, and the model we used can improve the ascertainment of morbidity from a mumps outbreak. PMID:27562958

  4. Medical education in Taiwan.

    PubMed

    Chou, Jen-Yu; Chiu, Chiung-Hsuan; Lai, Enoch; Tsai, Duujian; Tzeng, Chii-Ruey

    2012-01-01

    Taiwan's medical education system bears a close relationship with its colonial and post-colonial history. Since the late nineteenth century, Western medicine, Chinese medicine, and the practice of the other forms of traditional healing have encountered complex transactions with the state and one another, eventually evolving into the present medical system. Nowadays, the mainstream form of medical education in Taiwan is a 7-year Western program; other forms of medical education include a 5-year graduate program and traditional medicine programs. Challenged by the National Health Insurance that emphasizes cost management since 1995 and criticized by the US National Committee on Foreign Medical Education and Accreditation in 1998, medical education reform was implemented by the Taiwan Medical Accreditation Council established in 2000. The reform tries to bring humanities into various aspects of medical education, including student recruitment, curriculum, licensing, and continuing education. Similar to other modernization projects, the reform transplants the American and British standards to Taiwan. These changes hope to insure the reflective capabilities in physicians on the welfare of patients. However, frustration of current and future physicians may be deepened if the reform is insensitive to local issues or incapable of addressing new global tendencies.

  5. Lithospheric Structure Beneath Taiwan From Sp Converted Waves

    NASA Astrophysics Data System (ADS)

    Glasgow, D.; McGlashan, N.; Brown, L.

    2006-12-01

    Taiwan is the product of three dimensionally complex interaction between the Eurasian Plate (EP) and the Philippine Sea plate (PSP), with the EP subducting eastward beneath the PSP in southern Taiwan while the PSP subducts northward beneath the EP in northern Taiwan. The structural emplacement of Philippine Arc lithosphere onto Chinese passive margin lithosphere is an exemplar of continental amalgamation, yet there are relatively few contraints on the geometry of lithosphere involved at depth. We have used teleseismic data recorded by the Broadband Array for Taiwan Seismology (BATS) to compute S-to-p wave receiver functions for the Taiwan region to provide new constraints on deep geometries. Moho conversions provide independent new estimates of crustal thickness, which vary from 35 to 55 km across the island in agreement with previous P to S conversion studies and local tomography. More significantly, our results suggest that the lithosphere- asthenosphere boundary (LAB) varies in depth from ca 140 km beneath northeastern Taiwan to ca 120 km beneath central Taiwan to perhaps less than 80 km beneath southern Taiwan. We attribute this along strike variation to the depression and decapitation of the Eurasian plate in the transition to northward subduction of the PSP.

  6. Current situation and industrialization of Taiwan nanotechnology

    NASA Astrophysics Data System (ADS)

    Su, Hsin-Ning; Lee, Pei-Chun; Tsai, Min-Hua; Chien, Kuo-Ming

    2007-12-01

    Nanotechnology is projected to be a very promising field, and the impact of nanotechnology on society is increasingly significant as the research funding and manufactured goods increase exponentially. A clearer picture of Taiwan's current and future nanotechnology industry is an essential component for future planning. Therefore, this investigation studies the progress of industrializing nanotechnology in Taiwan by surveying 150 companies. Along with understanding Taiwan's current nanotechnology industrialization, this paper also suggests ways to promote Taiwan's nanotechnology. The survey results are summarized and serve as the basis for planning a nanotechnology industrialization strategy.

  7. Quantifying the seismicity on Taiwan

    NASA Astrophysics Data System (ADS)

    Wu, Yi-Hsuan; Chen, Chien-Chih; Turcotte, Donald L.; Rundle, John B.

    2013-07-01

    We quantify the seismicity on the island of Taiwan using the frequency-magnitude statistics of earthquakes since 1900. A break in Gutenberg-Richter scaling for large earthquakes in global seismicity has been observed, this break is also observed in our Taiwan study. The seismic data from the Central Weather Bureau Seismic Network are in good agreement with the Gutenberg-Richter relation taking b ≈ 1 when M < 7. For large earthquakes, M ≥ 7, the seismic data fit Gutenberg-Richter scaling with b ≈ 1.5. If the Gutenberg-Richter scaling for M < 7 earthquakes is extrapolated to larger earthquakes, we would expect a M > 8 earthquake in the study region about every 25 yr. However, our analysis shows a lower frequency of occurrence of large earthquakes so that the expected frequency of M > 8 earthquakes is about 200 yr. The level of seismicity for smaller earthquakes on Taiwan is about 12 times greater than in Southern California and the possibility of a M ≈ 9 earthquake north or south of Taiwan cannot be ruled out. In light of the Fukushima, Japan nuclear disaster, we also discuss the implications of our study for the three operating nuclear power plants on the coast of Taiwan.

  8. Diabetes-related avoidable hospitalizations in Taiwan.

    PubMed

    Kornelius, Edy; Huang, Chien-Ning; Yang, Yi-Sun; Lu, Ying-Li; Peng, Chiung-Huei; Chiou, Jeng-Yuan

    2014-12-01

    An avoidable hospitalization (AH) is a condition that could have been prevented through effective treatment in outpatient care. Diabetes is often referred to as an ambulatory care-sensitive condition, and its associated hospitalizations are often referred to as avoidable hospitalizations. There are limited data on avoidable hospitalizations for individuals with diabetes in Taiwan. We used the National Health Interview Survey (NHIS) dataset to obtain diabetes-related avoidable hospitalizations for subjects aged above 12 years. We included data from 20,826 subjects who had completed the interview between 2004 and 2005. Data were collected from a total of 15,574 people, who had agreed to link their health information to the Taiwan National Health Insurance Research Database, including basic demographic variables, inpatient or outpatient medical events, admission date, discharge date, and diagnosis. The 1005 individuals who self-reported having diabetes or had at least 1 hospitalization or 2 physician service claims for diabetes mellitus with an ICD-9 diagnosis of 250 were included in the analysis. We divided those with diagnosis of diabetes into two groups: never hospitalized and hospitalized. The never hospitalized group served as the control group. We further identified hospitalized subjects with long-term complications due to diabetes (PQI-3) that included ICD-CM codes 250.4-250.9. The mean ages of patients with diabetes-related long-term complications in the hospitalized and never hospitalized groups were 65 years and 58 years, respectively (p-value<0.01). More than half (52%) of the patients with diabetes-related long-term complications had a body mass index (BMI) lower than 24. The hospitalized group also had lower educational status compared with that of patients in the never hospitalized group (equal to or lower than elementary school, 63% vs. 50%; junior high school, 23% vs. 14%; equal or higher than senior high school, 14% vs. 36%). Furthermore, hospitalized

  9. Origins of Semisulcospira libertina (gastropoda: semisulcospiridae) in Taiwan.

    PubMed

    Chiu, Yuh-Wen; Bor, Hor; Kuo, Po-Hsun; Hsu, Kui-Ching; Tan, Mian-Shin; Wang, Wei-Kuang; Lin, Hung-Du

    2017-07-01

    The most accepted hypothesis has suggested that the fauna in Taiwan Island originated from South China, but some studies supported the Japan, Ryukyu Archipelago, and Taiwan Islands as a unique biogeographical district. This study examines whether the populations of freshwater snail Semisulcospira libertina in Taiwan are closer to those in Japan based on the mitochondrial cytochrome c oxidase subunit I (COI) gene sequences. Our study shows the populations in North Taiwan originated from Japan and the cyclic glacial caused the migrations among islands and continent repeatedly; the populations in South Taiwan might originate from South China or South Asia. Our results will not only affect the conclusions in phylogeography of freshwater species in Taiwan but also change the sampling plans in the future studies about evolutionary of freshwater species in East Asia.

  10. Myocardial complications of immunisations.

    PubMed

    Helle, E P; Koskenvuo, K; Heikkilä, J; Pikkarainen, J; Weckström, P

    1978-10-01

    Immunisation may induce myocardial complications. In this pilot study clinical, electrocardiographic, chemical and immunological findings have been studied during a six weeks' follow-up after routine immunisation (mumps, polio, tetanus, smallpox, diphtheria and type A meningococcal disease) among 234 Finnish conscripts at the beginning of their military service. Serial pattern of ECG changes suggestive of myocarditis was recorded in eight of the 234 conscripts one to two weeks after vaccination against smallpox and diphtheria. Changes were mainly minor ST segment elevations and T wave inversions and usually they disappeared in a few weeks. The ECG positives more often had a history of atopy, and their mean body temperatures and heart rates after the vaccinations were higher than among the other subjects (p less than 0.01). However, clinical myocarditis was never noted, nor were immunological or enzymological changes different among the ECG positives. Thus in 3% of the study population, evidence of postvaccinal myocarditis was noted, based on serial ECG patterns, but without any other evidence of cardiac disease.

  11. Scrap car recycling in Taiwan

    SciTech Connect

    Lee, C.H.; Tai, H.S.; Fan, R.K.S.

    1997-12-31

    The official figure of registered automobiles released by the Ministry of Transportation of Taiwan, R.O.C. as of the end of April 1996, is approximately 4.8 millions. Among them, 18% of the cars are between seven and ten years old and 15% of the cars are old than ten years. The result of this large number of old cars is the problem of abandoned cars on the street of Taiwan. This phenomena not only hinders traffic flow but also undermines the living quality in the cities. To minimize these negative effects, EPA has promulgated a Scrap Motor Vehicles Management Regulation tomore » enforce the scrap car recycling in Taiwan. Under this regulation, a buyer of a new vehicle has to pay the Scrap Motor Vehicle Disposal fee (NT$ 3000, or US$ 110 for a car; and NT$ 700, or US$ 25 for a motorcycle). This paper presents the current status of scrap car recycling in Taiwan.« less

  12. BCG vaccination-induced suppurative lymphadenitis: four signs to pay attention to.

    PubMed

    Baek, Sang Oon; Ko, Hyo Sun; Han, Hyun Ho

    2017-12-01

    Suppurative lymphadenitis is one of the severe complication after BCG vaccination, but its diagnostic criteria and treatment guidelines have not yet been established. In this article, we describe a case of suppurative lymphadenitis caused by BCG vaccination and propose diagnostic criteria and treatment guidelines of the disease. The lymphadenitis was presented as skin involving mass and was completely extirpated. Pathological evaluation revealed a necrotising lymphadenitis, consistent with the diagnosis of BCG lymphadenitis. The patient was administered adjuvant medical treatment with anti-TB medications (Isoniazid and Rifampicin) for 3 months. At 6 months follow-up, the disease was in complete remission without complications. We recommend focus on the following four signs when diagnosing BCG lymphadenitis: (i) previous history of vaccination on the ipsilateral side of the lesion, (ii) absence of any other infection signs, (iii) absence of fever and (iv) isolated axillary or supraclavicular/cervical lymph node enlargement proven by ultrasonography or computed tomography scan. BCG vaccination-induced suppurative lymphadenitis can easily be overlooked, but prompt, accurate diagnosis followed by appropriate surgical resection should result in complete healing as in this case. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  13. Discrepancy of cytogenetic analysis in Western and eastern Taiwan.

    PubMed

    Chang, Yu-Hsun; Chen, Pui-Yi; Li, Tzu-Ying; Yeh, Chung-Nan; Li, Yi-Shian; Chu, Shao-Yin; Lee, Ming-Liang

    2013-06-01

    This study aimed at investigating the results of second-trimester amniocyte karyotyping in western and eastern Taiwan, and identifying any regional differences in the prevalence of fetal chromosomal anomalies. From 2004 to 2009, pregnant women who underwent amniocentesis in their second trimester at three hospitals in western Taiwan and at four hospitals in eastern Taiwan were included. All the cytogenetic analyses of cultured amniocytes were performed in the cytogenetics laboratory of the Genetic Counseling Center of Hualien Buddhist Tzu Chi General Hospital. We used the chi-square test, Student t test, and Mann-Whitney U test to evaluate the variants of clinical indications, amniocyte karyotyping results, and prevalence and types of chromosomal anomalies in western and eastern Taiwan. During the study period, 3573 samples, 1990 (55.7%) from western Taiwan and 1583 (44.3%) from eastern Taiwan, were collected and analyzed. The main indication for amniocyte karyotyping was advanced maternal age (69.0% in western Taiwan, 67.1% in eastern Taiwan). The detection rates of chromosomal anomalies by amniocyte karyotyping in eastern Taiwan (45/1582, 2.8%) did not differ significantly from that in western Taiwan (42/1989, 2.1%) (p = 1.58). Mothers who had abnormal ultrasound findings and histories of familial hereditary diseases or chromosomal anomalies had higher detection rates of chromosomal anomalies (9.3% and 7.2%, respectively). The detection rate of autosomal anomalies was higher in eastern Taiwan (93.3% vs. 78.6%, p = 0.046), but the detection rate of sex-linked chromosomal anomalies was higher in western Taiwan (21.4% vs. 6.7%, p = 0.046). We demonstrated regional differences in second-trimester amniocyte karyotyping results and established a database of common chromosomal anomalies that could be useful for genetic counseling, especially in eastern Taiwan. Copyright © 2012. Published by Elsevier B.V.

  14. Cost-effectiveness of routine varicella vaccination using the measles, mumps, rubella and varicella vaccine in France: an economic analysis based on a dynamic transmission model for varicella and herpes zoster.

    PubMed

    Littlewood, Kavi J; Ouwens, Mario J N M; Sauboin, Christophe; Tehard, Bertrand; Alain, Sophie; Denis, François

    2015-04-01

    Each year in France, varicella and zoster affect large numbers of children and adults, resulting in medical visits, hospitalizations for varicella- and zoster-related complications, and societal costs. Disease prevention by varicella vaccination is feasible, wherein a plausible option involves replacing the combined measles, mumps, and rubella (MMR) vaccine with the combined MMR and varicella (MMRV) vaccine. This study aimed to: (1) assess the cost-effectiveness of adding routine varicella vaccination through MMRV, using different vaccination strategies in France; and (2) address key uncertainties, such as the economic consequences of breakthrough varicella cases, the waning of vaccine-conferred protection, vaccination coverage, and indirect costs. Based on the outputs of a dynamic transmission model that used data on epidemiology and costs from France, a cost-effectiveness model was built. A conservative approach was taken regarding the impact of varicella vaccination on zoster incidence by assuming the validity of the hypothesis of an age-specific boosting of immunity against varicella. The model determined that routine MMRV vaccination is expected to be a cost-effective option, considering a cost-effectiveness threshold of €20,000 per quality-adjusted life-year saved; routine vaccination was cost-saving from the societal perspective. Results were driven by a large decrease in varicella incidence despite a temporary initial increase in the number of zoster cases due to the assumption of exogenous boosting. In the scenario analyses, despite moderate changes in assumptions about incidence and costs, varicella vaccination remained a cost-effective option for France. Routine vaccination with MMRV was associated with high gains in quality-adjusted life-years, substantial reduction in the occurrences of varicella- and zoster-related complications, and few deaths due to varicella. Routine MMRV vaccination is also expected to provide reductions in costs related to

  15. Epidemiology and economic burden of rotavirus gastroenteritis in hospitals and paediatric clinics in Taiwan, 2005-2006.

    PubMed

    Mast, T Christopher; Chen, Po-Yen; Lu, Kun-Chia; Hsu, Chun-Ming; Lin, Hsiao Chuan; Liao, Wen-Chen; Lin, Da-Pi; Chen, Hung-Chih; Lac, Christina

    2010-04-09

    Baseline estimates of rotavirus disease burden and epidemiology are useful for the evaluation of newly introduced rotavirus vaccination programs. Prospective, cross-sectional surveillance for acute gastroenteritis (AGE) was conducted in hospitals and outpatient paediatric clinics in Taiwan to assess the prevalence of rotavirus gastroenteritis and associated medical costs prior to rotavirus vaccine introduction. Faecal specimens were collected from 1130 children <5 years of age from December 2004 to June 2006. The year-round rate of rotavirus detection in faecal specimens was 46% for children seen in hospitals and 14% for children seen in paediatric clinics. In the winter season, the burden was higher, reaching a peak of 60% and 21% in hospitals and paediatric clinics, respectively. The rotavirus genotype distributions were 39% (G1), 34% (G9), 12% (G2), 15% (G3), and 0.3% (G5). Total medical and nonmedical costs were US $754 for a rotavirus hospitalisation and US $60 for an outpatient clinic visit. Parental work loss averaged 4.0 days per hospital visit and 1.3 days per paediatric clinic visit. These data show that rotavirus was associated with a substantial proportion of AGE medical visits and had considerable medical costs prior to rotavirus vaccine introduction. Copyright 2010 Elsevier Ltd. All rights reserved.

  16. Influenza vaccine-mediated protection in older adults: Impact of influenza infection, cytomegalovirus serostatus and vaccine dosage.

    PubMed

    Merani, Shahzma; Kuchel, George A; Kleppinger, Alison; McElhaney, Janet E

    2018-07-01

    Age-related changes in T-cell function are associated with a loss of influenza vaccine efficacy in older adults. Both antibody and cell-mediated immunity plays a prominent role in protecting older adults, particularly against the serious complications of influenza. High dose (HD) influenza vaccines induce higher antibody titers in older adults compared to standard dose (SD) vaccines, yet its impact on T-cell memory is not clear. The aim of this study was to compare the antibody and T-cell responses in older adults randomized to receive HD or SD influenza vaccine as well as determine whether cytomegalovirus (CMV) serostatus affects the response to vaccination, and identify differences in the response to vaccination in those older adults who subsequently have an influenza infection. Older adults (≥65years) were enrolled (n=106) and randomized to receive SD or HD influenza vaccine. Blood was collected pre-vaccination, followed by 4, 10 and 20weeks post-vaccination. Serum antibody titers, as well as levels of inducible granzyme B (iGrB) and cytokines were measured in PBMCs challenged ex vivo with live influenza virus. Surveillance conducted during the influenza season identified those with laboratory confirmed influenza illness or infection. HD influenza vaccination induced a high antibody titer and IL-10 response, and a short-lived increase in Th1 responses (IFN-γ and iGrB) compared to SD vaccination in PBMCs challenged ex vivo with live influenza virus. Of the older adults who became infected with influenza, a high IL-10 and iGrB response in virus-challenged cells was observed post-infection (week 10 to 20), as well as IFN-γ and TNF-α at week 20. Additionally, CMV seropositive older adults had an impaired iGrB response to influenza virus-challenge, regardless of vaccine dose. This study illustrates that HD influenza vaccines have little impact on the development of functional T-cell memory in older adults. Furthermore, poor outcomes of influenza infection in

  17. Zoster vaccine live for the prevention of shingles in the elderly patient

    PubMed Central

    Zussman, Jamie; Young, Lorraine

    2008-01-01

    Shingles, also known as herpes zoster, is a common disease in the elderly population that is caused by reactivation of latent varicella zoster virus. Its manifestations and complications can lead to significant short- and long-term morbidity. In 2006, the United States Food and Drug Administration approved Zoster Vaccine Live (Zostavax®) for the prevention of herpes zoster in immunocompetent adults age 60 and over. The approval was based on the results of a large, multi-center clinical trial, the Shingles Prevention Study. This study showed that vaccination significantly decreased shingles incidence, burden of illness due to disease, and the development of, and severity of postherpetic neuralgia. This review offers an overview of varicella zoster virus infection and complications, a summary of the Shingles Prevention Study, and a critical analysis designed to aid the practicing physician who has questions about vaccine administration. PMID:18686747

  18. The Geothermal Potential, Current and Opportunity in Taiwan

    NASA Astrophysics Data System (ADS)

    Song, Sheng-Rong

    2016-04-01

    Located in the west Pacific Rim of Fire, Taiwan possesses rich geothermal resources due to volcanic activities and rapid uplifting of plate collision. Based on available data prior to 1980, Taiwan may have about 1 GWe of potential shallow geothermal energy, which is less than 3% of the national gross power generation. A 3-Mw pilot power plant, therefore, was constructed in 1981 and terminated in 1993 in the Chingshui geothermal field of Ilan, northeastern Taiwan. Recently, one of the National Science & Technology Program (NSTP) projects has been conducting research and reevaluating the island-wide deep geothermal energy. Four hot potential sites have been recognized. They are: (1) Tatun Volcano Group of northern Taiwan; (2) I-Lan Plain of NE Taiwan; (3) Lu-Shan area of Central Taiwan; and (4) Hua-Tung area of eastern Taiwan. We found that the geothermal resource in Taiwan may be as high as 160 GWe, with 33.6 GWe of exploitable geothermal energy. There are no any commercial geothermal power plants until now in Taiwan, although the potential is great. However, geothermal energy has been listed as one of major tasks of National Energy Program, Phase II (NEP-II) in Taiwan. We will conduct more detailed geothermal energy surveys on some proposed hot sites and to construct an EGS pilot geothermal plant with 1 MWe capability in a few years. Currently, there are three nuclear power plants, named No. 1, 2 & 3, in operations, which produce 16.5% gross generation of electricity and one (No. 4) is under construction, but is stopped and sealed now in Taiwan. Furthermore, the life-span of 40-year operation for those three power plants will be close-at hand and retire in 2018-2019, 2021-2023 and 2024-2025, respectively. Therefore, to find alternative energy sources, especially on the clean, renewable and sustainable ones for generating electricity are emergent and important for Taiwan's government in next few years. Among various energy sources, geothermal energy can be as base

  19. Varicella and herpes zoster vaccine development: lessons learned.

    PubMed

    Warren-Gash, Charlotte; Forbes, Harriet; Breuer, Judith

    2017-12-01

    Before vaccination, varicella zoster virus (VZV), which is endemic worldwide, led to almost universal infection. This neurotropic virus persists lifelong by establishing latency in sensory ganglia, where its reactivation is controlled by VZV-specific T-cell immunity. Lifetime risk of VZV reactivation (zoster) is around 30%. Vaccine development was galvanised by the economic and societal burden of VZV, including debilitating zoster complications that largely affect older individuals. Areas covered: We describe the story of development, licensing and implementation of live attenuated vaccines against varicella and zoster. We consider the complex backdrop of VZV virology, pathogenesis and immune responses in the absence of suitable animal models and examine the changing epidemiology of VZV disease. We review the vaccines' efficacy, safety, effectiveness and coverage using evidence from trials, observational studies from large routine health datasets and clinical post-marketing surveillance studies and outline newer developments in subunit and inactivated vaccines. Expert commentary: Safe and effective, varicella and zoster vaccines have already made major inroads into reducing the burden of VZV disease globally. As these live vaccines have the potential to reactivate and cause clinical disease, developing alternatives that do not establish latency is an attractive prospect but will require better understanding of latency mechanisms.

  20. The Potential Public Health Impact of Herpes Zoster Vaccination of People Aged ≥ 50 Years in Japan: Results of a Markov Model Analysis.

    PubMed

    Watanabe, Daisuke; Mizukami, Akiko; Holl, Katsiaryna; Curran, Desmond; Van Oorschot, Desirée; Varghese, Lijoy; Shiragami, Makoto

    2018-06-01

    The aim of this study was to compare the public health impact of introducing two herpes zoster (HZ) vaccines into the vaccination programs for the Japanese population aged ≥ 50 years: a single-dose Varicella Vaccine Live (VVL) or a two-dose adjuvanted Recombinant Zoster Vaccine (RZV). A multi-cohort static Markov model was developed to follow age cohorts (50-59, 60-69, 70-79 and ≥ 80 years) over their remaining lifetime. Japan-specific data inputs for the model were obtained from Japanese data sources. Age-stratified vaccine efficacy and waning rates were based on published clinical trial data. In the base-case analysis, vaccine coverage was assumed to be 40% for both vaccines, and compliance with second-dose of the RZV vaccine was set to 95%. Vaccination with RZV was projected to prevent approximately 3.3 million HZ cases, 692,000 cases of postherpetic neuralgia (PHN), and 281,000 cases of other complications, compared with the prevention of 0.8 million HZ cases, 216,000 PHN cases, and 57,000 other complications with vaccination with VVL. The number of individuals needed to vaccinate in order to prevent one HZ case ranged from 6 to 14 using RZV (depending on age and assumed second-dose compliance) and from 21 to 138 depending on age using VVL. By preventing a higher number of HZ cases and its complications, RZV vaccination led to fewer outpatient visits and hospitalizations than vaccination with VVL. Both vaccines had a positive public health impact compared to no vaccination, but due to its higher vaccine efficacy, RZV demonstrated a superior public health impact compared with VVL. GlaxoSmithKline Biologicals SA.

  1. Evolution of hepatitis A virus seroprevalence among HIV-positive adults in Taiwan.

    PubMed

    Lee, Yu-Lin; Lin, Kuan-Yin; Cheng, Chien-Yu; Li, Chia-Wen; Yang, Chia-Jui; Tsai, Mao-Song; Tang, Hung-Jen; Lin, Te-Yu; Wang, Ning-Chi; Lee, Yi-Chien; Lin, Shih-Ping; Huang, Yu-Shan; Sun, Hsin-Yun; Zhang, Jun-Yu; Ko, Wen-Chien; Cheng, Shu-Hsing; Lee, Yuan-Ti; Liu, Chun-Eng; Hung, Chien-Ching

    2017-01-01

    The study aimed to describe the seroprevalence of hepatitis A virus (HAV) in HIV-positive adult patients in Taiwan between 2012 and 2016 and to examine the evolution of HAV seroprevalence between 2004-2007 and 2012-2016. Clinical information and data of anti-HAV antibody results were collected from 2,860 antiretroviral-naïve HIV-positive Taiwanese aged 18 years or older who initiated combination antiretroviral therapy at 11 hospitals around Taiwan between 2012 and 2016 (2012-2016 cohort). A multivariate logistic regression model was applied to identify independent variables associated with HAV seropositivity. Comparisons of HAV seroprevalences and associated clinical characteristics were made between this 2012-2016 cohort and a previous cohort of 1580 HIV-positive patients in 2004-2007 (2004-2007 cohort). Of the 2,860 HIV-positive patients between 2012 and 2016, the overall HAV seropositivity rate was 21.2% (605/2860), which was independently associated with an older age (adjusted odds ratio [AOR], per 1-year increase, 1.13; 95% confidence interval [95% CI], 1.11-1.15) and co-infection with hepatitis B virus (AOR 1.44; 95% CI, 1.08-1.93). Residence in southern Taiwan (AOR 0.49; 95% CI, 0.34-0.72) was inversely associated with HAV seropositivity. The overall HAV seroprevalence in the 2012-2016 cohort was significantly lower than that in the 2004-2007 cohort (21.2% vs 60.9%, p<0.01). The decreases of HAV seropositivity rate were observed in nearly every age-matched group, which suggested the cohort effect on HAV seroepidemiology. However, among individuals aged 25 years or younger, the HAV seropositivity rate increased from 3.8% (2/52) in the 2004-2007 cohort to 8.5% (50/587) in the 2012-2016 cohort, with 95.4% (560/587) being MSM in this age group of the latter cohort. HAV seroprevalence has decreased with time among HIV-positive adults in Taiwan. The cohort effect has increased the number of young HIV-positive patients that are susceptible to HAV infection in a

  2. Evolution of hepatitis A virus seroprevalence among HIV-positive adults in Taiwan

    PubMed Central

    Lin, Kuan-Yin; Cheng, Chien-Yu; Li, Chia-Wen; Yang, Chia-Jui; Tsai, Mao-Song; Tang, Hung-Jen; Lin, Te-Yu; Wang, Ning-Chi; Lee, Yi-Chien; Lin, Shih-Ping; Huang, Yu-Shan; Sun, Hsin-Yun; Zhang, Jun-Yu; Ko, Wen-Chien; Cheng, Shu-Hsing; Lee, Yuan-Ti; Hung, Chien-Ching

    2017-01-01

    Objectives The study aimed to describe the seroprevalence of hepatitis A virus (HAV) in HIV-positive adult patients in Taiwan between 2012 and 2016 and to examine the evolution of HAV seroprevalence between 2004–2007 and 2012–2016. Methods Clinical information and data of anti-HAV antibody results were collected from 2,860 antiretroviral-naïve HIV-positive Taiwanese aged 18 years or older who initiated combination antiretroviral therapy at 11 hospitals around Taiwan between 2012 and 2016 (2012–2016 cohort). A multivariate logistic regression model was applied to identify independent variables associated with HAV seropositivity. Comparisons of HAV seroprevalences and associated clinical characteristics were made between this 2012–2016 cohort and a previous cohort of 1580 HIV-positive patients in 2004–2007 (2004–2007 cohort). Results Of the 2,860 HIV-positive patients between 2012 and 2016, the overall HAV seropositivity rate was 21.2% (605/2860), which was independently associated with an older age (adjusted odds ratio [AOR], per 1-year increase, 1.13; 95% confidence interval [95% CI], 1.11–1.15) and co-infection with hepatitis B virus (AOR 1.44; 95% CI, 1.08–1.93). Residence in southern Taiwan (AOR 0.49; 95% CI, 0.34–0.72) was inversely associated with HAV seropositivity. The overall HAV seroprevalence in the 2012–2016 cohort was significantly lower than that in the 2004–2007 cohort (21.2% vs 60.9%, p<0.01). The decreases of HAV seropositivity rate were observed in nearly every age-matched group, which suggested the cohort effect on HAV seroepidemiology. However, among individuals aged 25 years or younger, the HAV seropositivity rate increased from 3.8% (2/52) in the 2004–2007 cohort to 8.5% (50/587) in the 2012–2016 cohort, with 95.4% (560/587) being MSM in this age group of the latter cohort. Conclusions HAV seroprevalence has decreased with time among HIV-positive adults in Taiwan. The cohort effect has increased the number of young

  3. An adult case of mumps brainstem meningoencephalitis with a past measles-mumps-rubella (MMR) vaccination.

    PubMed

    Hong, Ji Man; Jung, Ki Young

    2006-06-01

    Severe complications such as meningoencephalitis are quite rare in the setting of mumps infection. We report here on a 24-year-old soldier with a past history of MMR vaccination who was admitted because of aseptic meningitis. His mental status rapidly deteriorated and swelling of both parotid glands was observed. The MR findings revealed discrete lesions in the brainstem and thalamus. He barely recovered within 2 months. Among the adults with failure to acquire immunity despite MMR vaccination, institutional crowding can lead to cases of potentially fatal CNS complication such as mumps meningoencephalitis.

  4. Effective case/infection ratio of poliomyelitis in vaccinated populations.

    PubMed

    Bencskó, G; Ferenci, T

    2016-07-01

    Recent polio outbreaks in Syria and Ukraine, and isolation of poliovirus from asymptomatic carriers in Israel have raised concerns that polio might endanger Europe. We devised a model to calculate the time needed to detect the first case should the disease be imported into Europe, taking the effect of vaccine coverage - both from inactivated and oral polio vaccines, also considering their differences - on the length of silent transmission into account by deriving an 'effective' case/infection ratio that is applicable for vaccinated populations. Using vaccine coverage data and the newly developed model, the relationship between this ratio and vaccine coverage is derived theoretically and is also numerically determined for European countries. This shows that unnoticed transmission is longer for countries with higher vaccine coverage and a higher proportion of IPV-vaccinated individuals among those vaccinated. Assuming borderline transmission (R = 1·1), the expected time to detect the first case is between 326 days and 512 days in different countries, with the number of infected individuals between 235 and 1439. Imperfect surveillance further increases these numbers, especially the number of infected until detection. While longer silent transmission does not increase the number of clinical diseases, it can make the application of traditional outbreak response methods more complicated, among others.

  5. Herbal Medicine Research in Taiwan*

    PubMed Central

    Kaphle, Krishna; Wu, Leang-Shin; Yang, Nai-Yen Jack; Lin, Jen-Hsou

    2006-01-01

    Of all the countries in the world, why did you choose Taiwan to pursue your study? It is a question that I (comments of the first author) have answered a thousand times. My first visit to a laboratory at National Taiwan University opened my eyes to the possibilities of herbal medicine research, especially in the area of veterinary medicine. It became my ambition to link the knowledge of Traditional Chinese Medicine (TCM) and Ayurveda from the Indian subcontinent and their integration with other systems of medicine, including Western medicine (WM), to achieve the concept of Sustainable Medicine, firstly for animals and then for humans. The Ministry of Economic Affairs (MOEA) has implemented a technology development program to quickly establish the key technologies, and this is a moment of opportunity for Taiwan's traditional herbal medicine industry to upgrade and transform itself. This paper, initially intended to be a student's narration, has evolved into a multi-author treatise on the present state and likely future scenario of herbal medicine research in Taiwan. PMID:16550238

  6. [BCG vaccines for the prevention of tuberculosis in the world].

    PubMed

    Hashimoto, T

    1997-11-01

    effect against pulmonary TB could not be calculated, but protective effect against meningeal and miliary TB was calculated as 86%, 75% respectively, in RCT and CCS, being higher than against pulmonary TB. 3. The duration of BCG efficacy against tuberculosis was confirmed to continue for 15 years after vaccination. The incidence of every form of tuberculosis decreased steeply during the 15 years following vaccination. 4. BCG revaccination. A WHO statement was issued in 1995 mentioning that there is no definitive evidence that repeated BCG vaccination confers additional protection against tuberculosis. Therefore WHO has not recommended to repeat BCG vaccination because of no scientific evidence to support this practice. Multiple BCG revaccinations are not indicated in any persons. 5. Complications with BCG Second IUATLD study (1988) on complications induced by BCG was reviewed, especially following two points: 1-2) Regional suppurative lymphadenitis 3) Generalized lesions: fatal cases 1-2 Several African regions had experienced that the risk of outbreak of suppurative BCG lymphadenitis was low for vaccines with Glaxo and Japanese strains, but much higher for vaccines with Pasteur. This experience in nineteen eighties has led EPI to replace the Pasteur BCG vaccine with less reactogenic BCG, Japanese or Glaxo BCG to solve the outbreak of suppurative adenitis complication. 3 At moment, the only contra-indication of EPI BCG vaccination is symptomatic HIV infection (AIDS), but in the future asymptomatic HIV infection should be placed on alert, because fatal BCG generalized disseminations have already been experienced by HIV positive vaccinees although in a few cases in USA. 6. BCG seed lots for use of vaccination in the world. Nearly 10 seed lots (BCG) are being used in the world at present. However, they are more or less different each other in various characteristics: morphological, biochemical, biophysical, immunological, vaccinological and so on. None of them is the same

  7. [Nursing manpower and solutions in Taiwan].

    PubMed

    Teng, Su-Wen

    2014-04-01

    The shortage of nursing manpower is a long-term problem worldwide that affects Taiwan despite this country's internationally admired achievements in terms of its healthcare and national health insurance systems. This article reviews discussions related to the nursing shortage issue published by the World Health Organization, International Council of Nurses, and Taiwan Ministry of Health and Welfare. Next, an overview is given of the nursing workforce profile, causal factors behind the nursing shortage, and demand for and supply of nursing manpower. Finally, problems, resolutions, and expected outcomes for the nursing shortage in Taiwan are analyzed.

  8. 76 FR 13982 - Antidumping Duty Order: Polyvinyl Alcohol From Taiwan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-15

    ...: Polyvinyl Alcohol From Taiwan AGENCY: Import Administration, International Trade Administration, Department... on polyvinyl alcohol (PVA) from Taiwan. DATES: Effective Date: March 15, 2011. FOR FURTHER... from Taiwan. See Polyvinyl Alcohol From Taiwan: Final Determination of Sales at Less Than Fair Value...

  9. Comparative cost effectiveness of varicella, hepatitis A, and pneumococcal conjugate vaccines.

    PubMed

    Jacobs, R J; Meyerhoff, A S

    2001-12-01

    Several state and local U.S. governments are considering making varicella, hepatitis A, and/or pneumococcal conjugate vaccination conditions of day care or school entry. These requirements will likely be issued sequentially, because simultaneous mandates exacerbate budget constraints and complicate communication with parents and providers. Cost-effectiveness assessments should aid the establishment of vaccination priorities, but comparing results of published studies is confounded by their dissimilar methods. We reviewed U.S. cost-effectiveness studies of childhood varicella, hepatitis A, and pneumococcal conjugate vaccines and identified four providing data required to standardize methods. Vaccination, disease treatment, and work-loss costs were estimated from original study results and current prices. Estimated life-years saved were derived from original study results, epidemiological evidence, and alternative procedures for discounting to present values. Hepatitis A vaccine would have the lowest health system costs per life-year saved. Varicella vaccine would provide the greatest reduction in societal costs, mainly through reduced parent work loss. Pneumococcal conjugate vaccine would cost twice the amount of varicella and hepatitis A vaccines combined and be less cost effective than the other vaccines. Hepatitis A and varicella vaccines, but not pneumococcal conjugate vaccine, meet or exceed conventional standards of cost effectiveness. Copyright 2001 American Health Foundation and Elsevier Science.

  10. Evaluating the effectiveness, impact and safety of live attenuated and seasonal inactivated influenza vaccination: protocol for the Seasonal Influenza Vaccination Effectiveness II (SIVE II) study.

    PubMed

    Simpson, Colin R; Lone, Nazir I; Kavanagh, Kimberley; Robertson, Chris; McMenamin, Jim; von Wissmann, Beatrix; Vasileiou, Eleftheria; Butler, Chris; Ritchie, Lewis D; Gunson, Rory; Schwarze, Jürgen; Sheikh, Aziz

    2017-02-28

    Seasonal (inactivated) influenza vaccination is recommended for all individuals aged 65+ and in individuals under 65 who are at an increased risk of complications of influenza infection, for example, people with asthma . Live attenuated influenza vaccine (LAIV) was recommended for children as they are thought to be responsible for much of the transmission of influenza to the populations at risk of serious complications from influenza. A phased roll-out of the LAIV pilot programme began in 2013/2014. There is limited evidence for vaccine effectiveness (VE) in the populations targeted for influenza vaccination. The aim of this study is to examine the safety and effectiveness of the live attenuated seasonal influenza vaccine programme in children and the inactivated seasonal influenza vaccination programme among different age and at-risk groups of people. Test negative and cohort study designs will be used to estimate VE. A primary care database covering 1.25 million people in Scotland for the period 2000/2001 to 2015/2016 will be linked to the Scottish Immunisation Recall Service (SIRS), Health Protection Scotland virology database, admissions to Scottish hospitals and the Scottish death register. Vaccination status (including LAIV uptake) will be determined from the primary care and SIRS database. The primary outcome will be influenza-positive real-time PCR tests carried out in sentinel general practices and other healthcare settings. Secondary outcomes include influenza-like illness and asthma-related general practice consultations, hospitalisations and death. An instrumental variable analysis will be carried out to account for confounding. Self-controlled study designs will be used to estimate the risk of adverse events associated with influenza vaccination. We obtained approval from the National Research Ethics Service Committee, West Midlands-Edgbaston. The study findings will be presented at international conferences and published in peer-reviewed journals

  11. Molecular epidemiology of porcine reproductive and respiratory syndrome viruses isolated from 1991 to 2013 in Taiwan.

    PubMed

    Deng, Ming-Chung; Chang, Chia-Yi; Huang, Tien-Shine; Tsai, Hsiang-Jung; Chang, Chieh; Wang, Fun-In; Huang, Yu-Liang

    2015-11-01

    Porcine reproductive and respiratory syndrome virus (PRRSV) was first identified in Taiwan in 1991, but the genetic diversity and evolution of PRRSV has not been thoroughly investigated over the past 20 years. The aim of this study was to bridge the gap in understanding of its molecular epidemiology. A total of 31 PRRSV strains were collected and sequenced. The sequences were aligned using the MUSCLE program, and phylogenetic analysis were performed by the maximum-likelihood method and the neighbor-joining method using MEGA 5.2 software. In the early 1990s, two prototype strains, WSV and MD001 of the North American genotype, were first identified. Over the years, both viruses evolved separately. The population dynamics of PRRSV revealed that the strains of the MD001 group were predominant in Taiwan. Evolution was manifested in changes in the nsp2 and ORF5 genes. In addition, a suspected newly invading exotic strain was recovered in 2013, suggesting that international spread is still taking place and that it is affecting the population dynamics. Overall, the results provide an important basis for vaccine development for the control and prevention of PRRS.

  12. Measles lessons in an anti-vaccination era: public health is a social duty, not a political option.

    PubMed

    Lancella, L; Di Camillo, C; Vittucci, A C; Boccuzzi, E; Bozzola, E; Villani, A

    2017-11-15

    Measles virus, member of the genus Morbillivirus in the family Paramyxoviridae, is a highly contagious human pathogen. An effective live-attenuated vaccine is available and its use has the potential to eradicate the disease from the human population. Although the vaccine was introduced in national vaccination schedules, several measles outbreaks have occurred because of insufficient vaccination coverage. Since early January 2017, a new outbreak of measles in Italy has been observed. We analyzed all the patients admitted to the Emergency Department of Bambino Gesù Children Hospital of Rome from the 1st of January 2017 to the end of May 2017 and discharged with diagnosis of suspected or confirmed measles or admitted to the Pediatric and Infectious Disease Unit. For each confirmed case, demographic data, vaccination history, exposure to source case, clinical presentation, date of onset of symptoms, hospitalization, laboratory test results, complications and therapy were collected. From the 1st of January 2017 to the 31st of May 2017, we enrolled 139 patients who were conducted to the Emergency Department of Bambino Gesù Children's Hospital because of measles: 33 patients were discharged with the diagnosis of suspected measles by clinical manifestations; 33 discharged with the diagnosis of confirmed measles by laboratory tests and 73 were admitted to the Pediatric and Infectious Disease Unit. Seven patients, who were exposed to mothers with measles, were admitted to receive treatment with Measles Immune Globulin intravenously. Among the 66 patients admitted to the hospital with measles, 31 cases (47%) occurred in unvaccinated individuals who were age-eligible for measles vaccination; 29 (44%) were infants too young to be vaccinated; only five patients (8%) received one dose of measles-containing vaccine. Out of the 66 patients, 35 (53%) developed complications. Acute respiratory failure was the most reported complications (20%). Death, due to multiorgan failure by

  13. Influenza vaccine effectiveness assessment through sentinel virological data in three post-pandemic seasons

    PubMed Central

    Torner, Núria; Martínez, Ana; Basile, Luca; Marcos, M Angeles; Antón, Andrés; Mar Mosquera, M; Isanta, Ricard; Cabezas, Carmen; Jané, Mireia; Domínguez, Angela; Program of Catalonia, the PIDIRAC Sentinel Surveillance

    2014-01-01

    Influenza vaccination aims at reducing the incidence of serious disease, complications and death among those with the most risk of severe influenza disease. Influenza vaccine effectiveness (VE) through sentinel surveillance data from the PIDIRAC program (Daily Acute Respiratory Infection Surveillance of Catalonia) during 2010–2011, 2011–2012, and 2012–2013 influenza seasons, with three different predominant circulating influenza virus (IV) types [A(H1N1)pdm09, A(H3N2) and B, respectively] was assessed. The total number of sentinel samples with known vaccination background collected during the study period was 3173, 14.7% of which had received the corresponding seasonal influenza vaccine. 1117 samples (35.2%) were positive for IV. A retrospective negative case control design was used to assess vaccine effectiveness (VE) for the entire period and for each epidemic influenza season. An overall VE of 58.1% (95% CI:46.8–67) was obtained. Differences in VE according to epidemic season were observed, being highest for the 2012–2013 season with predominance of IV type B (69.7% ;95% CI:51.5–81) and for the 2010–2011 season, with predominance of the A(H1N1)pdm09 influenza virus strain (67.2% ;95%CI:49.5–78.8) and lowest for the 2011–2012 season with A(H3N2) subtype predominance (34.2% ;95%CI:4.5–54.6). Influenza vaccination prevents a substantial number of influenza-associated illnesses. Although vaccines with increased effectiveness are needed and the search for a universal vaccine that is not subject to genetic modifications might increase VE, nowadays only the efforts to increase vaccination rates of high-risk population and healthcare personnel let reduce the burden of influenza and its complications. PMID:25483540

  14. Physics teaching in the medical schools of Taiwan.

    PubMed

    Hsu, Jiann-wien; Hsu, Roy

    2012-02-01

    We describe and analyze the statistics of general physics and laboratory courses in the medical schools of Taiwan. We explore the development of the general physics curriculum for medical students of Taiwan. Also, an approach to designing a general physics course in combination with its application to medical sciences is proposed. We hope this preliminary study can provide a useful reference for physics colleagues in the medical schools of Taiwan to revolutionize the dynamics of teaching physics to the medical students of Taiwan. Copyright © 2011. Published by Elsevier B.V.

  15. Land, carbon and water footprints in Taiwan

    SciTech Connect

    Lee, Yung-Jaan, E-mail: yungjaanlee@gmail.com

    The consumer responsibility approach uses footprints as indicators of the total direct and indirect effects of a product or consumption activity. This study used a time-series analysis of three environmental pressures to quantify the total environmental pressures caused by consumption in Taiwan: land footprint, carbon footprint, and water footprint. Land footprint is the pressure from appropriation of biologically productive land and water area. Carbon footprint is the pressure from greenhouse gas emissions. Water footprint is the pressure from freshwater consumption. Conventional carbon footprint is the total CO{sub 2} emitted by a certain activity or the CO{sub 2} accumulation during amore » product life cycle. This definition cannot be used to convert CO{sub 2} emissions into land units. This study responds to the needs of “CO{sub 2} land” in the footprint family by applying the carbon footprint concept used by GFN. The analytical results showed that consumption by the average Taiwan citizen in 2000 required appropriation of 5.39 gha (hectares of land with global-average biological productivity) and 3.63 gha in 2011 in terms of land footprint. The average Taiwan citizen had a carbon footprint of 3.95 gha in 2000 and 5.94 gha in 2011. These results indicate that separately analyzing the land and carbon footprints enables their trends to be compared and appropriate policies and strategies for different sectors to be proposed accordingly. The average Taiwan citizen had a blue water footprint of 801 m{sup 3} in 2000 and 784 m{sup 3} in 2011. By comparison, their respective global averages were 1.23 gha, 2.36 gha and 163 m{sup 3} blue water in 2011, respectively. Overall, Taiwan revealed higher environmental pressures compared to the rest of the world, demonstrating that Taiwan has become a high footprint state and has appropriated environmental resources from other countries. That is, through its imports of products with embodied pressures and its exports

  16. Cost-effectiveness of a herpes zoster vaccination program among the French elderly people.

    PubMed

    Belchior, Emmanuel; Lévy-Bruhl, Daniel; Le Strat, Yann; Herida, Magid

    2016-09-01

    A vaccine against herpes zoster (HZ) and its complications has already proven safe and effective against infection and pain and against the related deterioration of quality of life in the elderly. In order to inform the vaccination decision-making process regarding inclusion of this vaccine in the French immunization schedule, we assessed the cost-effectiveness of several vaccination scenarios, compared to no vaccination. We chose to use a previously published Markov model. Starting vaccination in elderly individuals aged 65, 70 and 75 y old appears more cost-effective than vaccination for those aged 60 y old, with a cost-effectiveness ratio between 30,000 and 35,000 euros per quality-adjusted-life year (QALY) gained for the first 3 age groups versus 54,500 €; for the latter group. These results largely contributed to the recommendation to include the HZ vaccination in the French immunization schedule for people aged between 65 and 74 y old in France.

  17. Vaccines for emerging infectious diseases: Lessons from MERS coronavirus and Zika virus.

    PubMed

    Maslow, Joel N

    2017-12-02

    The past decade and a half has been characterized by numerous emerging infectious diseases. With each new threat, there has been a call for rapid vaccine development. Pathogens such as the Middle East Respiratory Syndrome coronavirus (MERS-CoV) and the Zika virus represent either new viral entities or viruses emergent in new geographic locales and characterized by novel complications. Both serve as paradigms for the global spread that can accompany new pathogens. In this paper, we review the epidemiology and pathogenesis of MERS-CoV and Zika virus with respect to vaccine development. The challenges in vaccine development and the approach to clinical trial design to test vaccine candidates for disease entities with a changing epidemiology are discussed.

  18. Vaccines for preventing influenza in healthy adults.

    PubMed

    Demicheli, V; Rivetti, D; Deeks, J J; Jefferson, T O

    2001-01-01

    Three different types of influenza vaccines are currently produced world wide. None is traditionally targeted to healthy adults. Despite the publication of a large number of clinical trials, there is still substantial uncertainty about the clinical effectiveness of influenza vaccines and this has negative impact on the vaccines acceptance and uptake. To identify, retrieve and assess all studies evaluating the effects of vaccines on influenza in healthy adults. To assess the effectiveness of vaccines in preventing cases of influenza in healthy adults. To estimate the frequency of adverse effects associated with influenza vaccination in healthy adults. MEDLINE was searched using the strategy of the Cochrane Acute Respiratory Infections Group. The bibliography of retrieved articles, the Cochrane Controlled Trials Register (CCTR), and EMBASE (1990 to 1997) were also searched. Handsearch of the journal Vaccine from its first issue to the end of 1997 (Jefferson and Jefferson, 1996; Jefferson, 1998). We wrote to vaccine manufacturers and first or corresponding authors of studies in the review. Any randomised or quasi-randomised studies comparing influenza vaccines in humans with placebo, control vaccines or no intervention, or comparing types, doses or schedules of influenza vaccine. Live, attenuated or killed vaccines or fractions thereof administered by any route, irrespective of antigenic configuration were considered. Only studies assessing protection from exposure to naturally occurring influenza in healthy individuals aged 14 to 60 (irrespective of influenza immune status) were considered. Both clinically defined cases and serologically confirmed cases of influenza were considered as outcomes according to the authors' definitions. Time off work, complication and hospitalisation rates were considered, together with adverse effects. Vaccine schedules were analysed including one component matching the recommended vaccine (WHO or government recommendations) for the year

  19. Smallpox: a review of clinical disease and vaccination.

    PubMed

    Lofquist, Jennifer M; Weimert, Nicole A; Hayney, Mary S

    2003-04-15

    The clinical course of smallpox infection and the current and future roles of vaccination and strategies for controlling smallpox outbreaks are reviewed. Close personal contact is required for transmission of variola, the DNA virus that causes smallpox. Following an incubation period, infected persons have prodromal symptoms that include high fever, back pain, malaise, and prostration. The eruptive stage is characterized by maculopapular rash that progresses to papules, then vesicles, and then pustules and scab lesions. The mortality rate for smallpox is approximately 30%. Patients having a fever and rash may be confused with having chickenpox. The most effective method for preventing smallpox epidemic progression is vaccination. Until recently, only 15 million doses of smallpox vaccine--manufactured 20 years ago--were available in the United States. The vaccine is a live vaccinia virus preparation administered by scarification with a bifurcated needle. The immune response is protective against orthopoxviruses, including variola. Vaccination is associated with moderate to severe complications, such as generalized vaccinia, eczema vaccinatum, progressive vaccinia, and postvaccinial encephalitis. Efforts for vaccine production are now focused on a live cell-culture-derived vaccinia virus vaccine. Although smallpox was eradicated in 1980, it remains a potential agent for bioterrorism. As a category A biological weapon, its potential to devastate populations causes concern among those in the public health community who have been actively developing plants to deal with smallpox and other potential agents of biological warfare. The only proven effective strategy against smallpox is vaccination.

  20. From waste minimization to ISO 14000: Taiwan`s experience and prospects

    SciTech Connect

    Wen-Huei Chen; Wain-Sun Hou

    Taiwan has completed a very successful five-year industrial waste minimization (IWM) demonstration and promotion project sponsored by the government. From 1990 to 1995, the project successfully disseminated the IWM concept of pollution prevention (P2) to industries. It effectively reduced industrial waste while significantly benefitting the economy by assisting industries in implementing in-plant IWM programs. In July 1995, the second stage of the five-year IWM and ISO 14000 promotion project was initiated for further promoting the IWM, P2, and cleaner production and, in particular, coping with the upcoming international environmental management standards (ISO 14000). To assist industries in establishing an environmentalmore » management system (EMS) and accumulating related experience, an EMS pilot demonstration project of five model industries and an ISO 14001 EMS demonstration and promotion project for 22 factories in 13 industries were initiated in October 1995 and August 1996, respectively. These projects can assist Taiwan`s industries in changing the constitution of their enterprises, enhancing competition in the international market, and helping our nation achieve the forerunner`s profits in sustainable development. 9 refs., 3 figs.« less

  1. THE EFFECT OF IONIZING RADIATION ON THE COURSE OF VACCINAL TULAREMIA AND THE STATE OF THE IMMUNITY IN EXPERIMENT (in Russian)

    SciTech Connect

    Savel'eva, R.A.

    1960-08-01

    Active vaccinal tularemia seriously complicates the course of radiation sickness and results in 100% fatality. The survival of mice proved possible only in the event the acute stages of radiation sickness do not coincide with vaccinal processes. Immunity to 1000 DCLM virus in survived vaccinated irradiated animals was similar to that of nonirradiated vaccinated animals. (R.V.J.) Oak Ridge National Lab., Tenn.

  2. [Measles vaccination campaign for vulnerable populations: lessons learned].

    PubMed

    Laurence, Sophie; Chappuis, Marielle; Lucas, Dorinela; Duteurtre, Martin; Corty, Jean-François

    2013-01-01

    Between 2008 and 2011, a measles epidemic raged in France. Immunization coverage in France, already insufficient in the general population, is even more worrying for deprived populations in whom exposure to the disease and the risk of complications are much higher. In this context, Medecins du Monde (MdM), the General Council of the Seine-Saint-Denis (CG93) and the Territorial Directorate of the Regional Health Agency (DTARS) implemented a measles vaccination campaign among the Rom population of the department. The objective was to improve coverage of this population by providing ambulatory services in collaboration between various field partners in a single public health project. Twenty-two of the known Rom settlements were selected to receive vaccination. MdM was in charge of logistics, mediation and vaccinations at 13 sites and the DTARS and CG93 were in charge of vaccination at another 9 sites with support from MdM for mediation and logistics. Between January and June 2012, 250 persons were vaccinated, 34.7% of the target population. Coverage of the population after the vaccination campaign was still very low. The partnership between MdM, DTARS and CG93 helped to create a positive mobile action experience and extended prevention actions towards the most vulnerable populations excluded from conventional health care structures.

  3. Varicella and herpes zoster vaccine development: lessons learned

    PubMed Central

    Warren-Gash, Charlotte; Forbes, Harriet; Breuer, Judith

    2017-01-01

    ABSTRACT Introduction: Before vaccination, varicella zoster virus (VZV), which is endemic worldwide, led to almost universal infection. This neurotropic virus persists lifelong by establishing latency in sensory ganglia, where its reactivation is controlled by VZV-specific T-cell immunity. Lifetime risk of VZV reactivation (zoster) is around 30%. Vaccine development was galvanised by the economic and societal burden of VZV, including debilitating zoster complications that largely affect older individuals. Areas covered: We describe the story of development, licensing and implementation of live attenuated vaccines against varicella and zoster. We consider the complex backdrop of VZV virology, pathogenesis and immune responses in the absence of suitable animal models and examine the changing epidemiology of VZV disease. We review the vaccines’ efficacy, safety, effectiveness and coverage using evidence from trials, observational studies from large routine health datasets and clinical post-marketing surveillance studies and outline newer developments in subunit and inactivated vaccines. Expert commentary: Safe and effective, varicella and zoster vaccines have already made major inroads into reducing the burden of VZV disease globally. As these live vaccines have the potential to reactivate and cause clinical disease, developing alternatives that do not establish latency is an attractive prospect but will require better understanding of latency mechanisms. PMID:29047317

  4. Taiwan's second remote sensing satellite

    NASA Astrophysics Data System (ADS)

    Chern, Jeng-Shing; Ling, Jer; Weng, Shui-Lin

    2008-12-01

    FORMOSAT-2 is Taiwan's first remote sensing satellite (RSS). It was launched on 20 May 2004 with five-year mission life and a very unique mission orbit at 891 km altitude. This orbit gives FORMOSAT-2 the daily revisit feature and the capability of imaging the Arctic and Antarctic regions due to the high enough altitude. For more than three years, FORMOSAT-2 has performed outstanding jobs and its global effectiveness is evidenced in many fields such as public education in Taiwan, Earth science and ecological niche research, preservation of the world heritages, contribution to the International Charter: space and major disasters, observation of suspected North Korea and Iranian nuclear facilities, and scientific observation of the atmospheric transient luminous events (TLEs). In order to continue the provision of earth observation images from space, the National Space Organization (NSPO) of Taiwan started to work on the second RSS from 2005. This second RSS will also be Taiwan's first indigenous satellite. Both the bus platform and remote sensing instrument (RSI) shall be designed and manufactured by NSPO and the Instrument Technology Research Center (ITRC) under the supervision of the National Applied Research Laboratories (NARL). Its onboard computer (OBC) shall use Taiwan's indigenous LEON-3 central processing unit (CPU). In order to achieve cost effective design, the commercial off the shelf (COTS) components shall be widely used. NSPO shall impose the up-screening/qualification and validation/verification processes to ensure their normal functions for proper operations in the severe space environments.

  5. Cost-effectiveness of HPV vaccination regime: comparing twice versus thrice vaccinations dose regime among adolescent girls in Malaysia.

    PubMed

    Aljunid, Syed; Maimaiti, Namaitijiang; Nur, Amrizal M; Noor, Mohd Rushdan Md; Wan Puteh, Sharifa Ezat

    2016-01-23

    The HPV vaccine was introduced to Malaysian national immunization programme in 2010. The current implementation age of HPV vaccination in Malaysian is at the age of 13 years school girls, given according to a 3 doses protocol which may complicate implementation and compliance. Aim of the study is to determine the cost-effectiveness of HPV vaccination regime comparing twice versus thrice HPV vaccinations dose regime among adolescent girls in Malaysia. A Markov cohort model reflecting the natural history of HPV infection accounting for oncogenic and low-risk HPV was adapted for 13 year old Malaysian girls cohort (n = 274,050). Transition probabilities, utilities values, epidemiological and cost data were sourced from published literature and local data. Vaccine effectiveness was based on overall efficacy reported from 3-doses clinical trials, with the assumption that the 2-doses is non-inferior to the 3-doses allowing overall efficacy to be inferred from the 3-doses immunogenicity data. Price parity and life-long protection were assumed. The payer perspective was adopted, with appropriate discounting for costs (3 %) and outcomes (3 %). One way sensitivity analysis was conducted. The sensitivity analysis on cost of vaccine, vaccine coverage and discount rate with a 2-doses protocol was performed. The 3-doses and 2-doses regimes showed same number of Cervical Cancers averted (361 cases); QALYs saved at 7,732,266. However, the lifetime protection under the 2-doses regime, showed a significant cost-savings of RM 36, 722,700 compared to the 3-doses scheme. The MOH Malaysia could vaccinate 137,025 more girls in this country using saving 2-doses regime vaccination programme. The model predicted that 2-doses HPV vaccination schemes can avoid additional 180 Cervical Cancers and 63 deaths compare to 3-doses. A 2-doses HPV vaccination scheme may enable Malaysian women to be protected at a lower cost than that achievable under a 3-doses scheme, while avoiding the same number of

  6. Benefits of flu vaccination for persons with diabetes mellitus: A review.

    PubMed

    Goeijenbier, M; van Sloten, T T; Slobbe, L; Mathieu, C; van Genderen, P; Beyer, Walter E P; Osterhaus, Albert D M E

    2017-09-12

    Diabetes mellitus imposes a significant and increasing burden on society, with major consequences for human health, welfare and the economy worldwide. Persons with diabetes mellitus are at increased risk of developing severe complications after influenza virus infection and guidelines advise vaccination. The present evidence for influenza vaccine effectiveness in persons with diabetes mellitus is mainly based on observational studies with clinical endpoints like hospitalization and death, indicating a beneficial reduction of morbidity and mortality. Further supportive evidence comes from serological studies, in which persons with diabetes mellitus usually develop similar antibody levels after vaccination as healthy people. Observational studies may be prone to selection bias, and serological studies may not completely mirror vaccine effectiveness in the field. Although more controlled trials in persons with diabetes mellitus with laboratory-confirmed, influenza-specific outcomes would be desirable to better estimate the effect of vaccination, the currently available data justify routine influenza vaccination in persons with diabetes mellitus. As in this risk group, the use of influenza vaccine is far below target worldwide, efforts should be made to increase vaccination coverage. Copyright © 2017. Published by Elsevier Ltd.

  7. Evaluation of efficacy and effectiveness of live attenuated zoster vaccine.

    PubMed

    Gabutti, G; Valente, N; Sulcaj, N; Stefanati, A

    2014-12-01

    Herpes zoster (HZ) is a viral disease characterized by a dermatologic and neurologic involvement caused by the reactivation of the latent varicella zoster virus (VZV) acquired during primary infection (varicella). HZ incidence increases with age and is related to waning specific cell-mediated immunity (CMI). The most frequent complication of HZ is post-herpetic neuralgia (PHN) characterized by chronic pain lasting at least 30 days, with impact on patients' quality of life. Available treatments are quite unsatisfactory in reducing pain and length of the disease. The evaluation of the epidemiology, the debilitating complications (PHN), the suboptimal available treatments and the costs related to the diagnosis and clinical/therapeutic management of HZ patients have been the rationale for the search of an adequate preventive measure against this disease. The target of this intervention is to reduce the frequency and severity of HZ and related complications by stimulating CMI. Prevention has recently become possible with the live attenuated vaccine Oka/Merck, with an antigen content at least 10-fold higher than the antigen content of pediatric varicella vaccines. Clinical studies show a good level of efficacy and effectiveness, particularly against the burden of illness and PHN in all age classes. Accordingly to the summary of the characteristics of the product the zoster vaccine is indicated for the prevention of HZ and PHN in individuals 50 years of age or older and is effective and safe in subjects with a positive history of HZ.

  8. Investigation of Tectonic Boundaries in Taiwan Obtained with a Hierarchical Clustering of Dense GNSS Data

    NASA Astrophysics Data System (ADS)

    Takahashi, A.; Hashimoto, M.; Hu, J. C.; Fukahata, Y.

    2017-12-01

    Taiwan Island is composed of many geological structures. The main tectonic feature is the collision of the Luzon volcanic arc with the Eurasian continent, which propagates westward and generates complicated crustal deformation. One way to model crustal deformation is to divide Taiwan island into man rigid blocks that moves relatively each other along the boundaries (deformation zones) of the blocks. Since earthquakes tend to occur in the deformation zones, identification of such tectonic boundaries is important. So far, many tectonic boundaries have been proposed on the basis of geology, geomorphology, seismology and geodesy. However, which is the most significant boundary depends on disciplines and there is no way to objectively classify them. Here, we introduce an objective method to identify significant tectonic boundaries with a hierarchical representation proposed by Simpson et al. [2012].We apply a hierarchical agglomerative clustering algorithm to dense GNSS horizontal velocity data in Taiwan. One of the significant merits of the hierarchical representation of the clustering results is that we can consistently explore crustal structures from larger to smaller scales. This is because a higher hierarchy corresponds to a larger crustal structure, and a lower hierarchy corresponds to a smaller crustal structure. Relative motion between clusters can be obtained from this analysis.The first major boundary is identified along the eastern margin of the Longitudinal Valley, which corresponds to the separation of the Philippine Sea plate and the Eurasian continental margin. The second major boundary appears along the Chaochou fault and the Chishan fault in southwestern Taiwan. The third major boundary appears along the eastern margin of the coastal plane. The identified major clusters can be divided into several smaller blocks without losing consistency with geological boundaries. For example, the Fengshun fault, concealed beneath thick sediment layers, is identified

  9. Do People Taking Flu Vaccines Need Them the Most?

    PubMed Central

    Gu, Qian; Sood, Neeraj

    2011-01-01

    Background A well targeted flu vaccine strategy can ensure that vaccines go to those who are at the highest risk of getting infected if unvaccinated. However, prior research has not explicitly examined the association between the risk of flu infection and vaccination rates. Purpose This study examines the relationship between the risk of flu infection and the probability of getting vaccinated. Methods Nationally representative data from the US and multivariate regression models were used to estimate what individual characteristics are associated with (1) the risk of flu infection when unvaccinated and (2) flu vaccination rates. These results were used to estimate the correlation between the probability of infection and the probability of getting vaccinated. Separate analyses were performed for the general population and the high priority population that is at increased risk of flu related complications. Results We find that the high priority population was more likely to get vaccinated compared to the general population. However, within both the high priority and general populations the risk of flu infection when unvaccinated was negatively correlated with vaccination rates (r = −0.067, p<0.01). This negative association between the risk of infection when unvaccinated and the probability of vaccination was stronger for the high priority population (r = −0.361, p<0.01). Conclusions There is a poor match between those who get flu vaccines and those who have a high risk of flu infection within both the high priority and general populations. Targeting vaccination to people with low socioeconomic status, people who are engaged in unhealthy behaviors, working people, and families with kids will likely improve effectiveness of flu vaccine policy. PMID:22164202

  10. Influenza vaccination among pregnant women--Massachusetts, 2009-2010.

    PubMed

    2013-11-01

    The emergence of the novel influenza A (H1N1) pdm09 (pH1N1) strain in 2009 required a coordinated public health response, especially among high-risk populations. Because pregnant women were at increased risk for influenza-related complications and hospitalization compared with the general population, the American College of Obstetricians and Gynecologists and the Advisory Committee on Immunization Practices recommended pregnant women receive both the pH1N1 vaccine and the annual seasonal vaccine during the 2009-10 influenza season as a safe and effective way of protecting both mother and infant. To describe acceptance, predictors, and barriers to influenza vaccination among pregnant women in Massachusetts during the 2009-10 influenza season, the Massachusetts Department of Public Health (MDPH) analyzed data from supplemental influenza questions on the Massachusetts Pregnancy Risk Assessment Monitoring System (PRAMS) survey. The results indicated that 67.5% of residents who had live births in Massachusetts during September 2009-May 2010 received the seasonal vaccine, and 57.6% received the pH1N1 vaccine. Women who were non-Hispanic blacks, aged <25 years, Medicaid beneficiaries, or lived in a household with an income at or below the federal poverty level were significantly less likely to receive the seasonal vaccine. For the pH1N1 vaccine, only being non-Hispanic black was associated with being less likely to have been vaccinated. Vaccination rates were significantly higher among women whose provider offered or recommended the seasonal (75.8%) and pH1N1 (68.1%) vaccines compared with those who did not receive a recommendation (32.4% and 8.6%, respectively). Coverage in Massachusetts was among the highest of 29 PRAMS sites and might have reflected strategic efforts by MDPH to support vaccine education and equity across the state.

  11. Vaccine recommendations for children and youth for the 2014/2015 influenza season.

    PubMed

    Moore, Dorothy L

    2014-10-01

    The Canadian Paediatric Society continues to encourage annual influenza vaccination for ALL children and youth ≥6 months of age. Recommendations from the National Advisory Committee on Immunization for the 2014/2015 influenza season include some important changes: Influenza vaccination is recommended for ALL individuals ≥6 months of age, with particular focus on those at high risk of influenza-related complications and their close contacts. Definitions of high-risk conditions and close contacts have not changed from those of 2013/2014.The preference for intranasal, live attenuated influenza vaccine (LAIV) over trivalent inactivated influenza vaccines for healthy children is restricted to individuals two to six years of age. There is insufficient evidence to recommend LAIV over trivalent inactivated influenza vaccines in older children or in children with chronic health conditions; either vaccine may be used unless there are specific contraindications.Quadrivalent influenza vaccines are expected to be available for the 2014/2015 season and may be used interchangeably with trivalent vaccines. They may offer improved protection.Trivalent or quadrivalent inactivated vaccines may be used in individuals with egg allergy; LAIV has not yet been evaluated in this population and is not recommended at this time.

  12. Opportunity, Choice, and Burglary Victimization in Taiwan.

    PubMed

    Kuo, Shih-Ya

    2015-07-01

    This study examined burglary victimization in Taiwan with an application of the structure-choice model that included four theoretical dimensions: proximity to crime, exposure to crime, target attractiveness, and guardianship. Drawing on the 2000 Taiwan Areas Criminal Victimization Survey, the results of the current study showed a moderate effect of the opportunity model on Taiwan's burglary victimization. Also, this study found both consistent and conflicting findings in the current data. The null effect of motorcycles (including scooters) that represented the concept of target attractiveness in relation to burglary risk reflected a difference in population density and transportation needs between Taiwan and the West. Clearly, the role of social context needs to be understood when studies apply a Western model to a non-Western context. © The Author(s) 2014.

  13. Utilization of and Direct Expenditure for Emergency Medical 
Care in Taiwan: A Population-based Descriptive Study

    PubMed Central

    Yang, Nan-Ping; Lee, Yi-Hui; Lin, Ching-Heng; Chung, Yuan-Chang; Chen, Wen-Jone; Chou, Pesus

    2009-01-01

    Background We surveyed the emergency medical system (EMS) in Taiwan to provide information to policymakers responsible for decisions regarding the redistribution of national medical resources. Methods A systematic sampling method was used to randomly sample a representative database from the National Health Insurance (NHI) database in Taiwan, during the period from 2000 to 2004. Results We identified 10,124, 10,408, 11,209, 10,686, and 11,914 emergency room visits in 2000, 2001, 2002, 2003, and 2004, respectively. There were more males than females, and the majority of adults were younger than 50 years. Diagnose of injury/poisoning was the most frequently noted diagnostic category in emergency departments (EDs) in Taiwan. There were 13,196 (24.3%) and 2,952 (5.4%) patients with 2 and 3 concomitant diagnoses, respectively. There was a significant association between advanced age and the existence of multiple diagnoses (P < 0.001). With the exception of the ill-defined symptoms/signs/conditions, the two most frequent diagnoses were diseases of the circulatory system and diseases of the respiratory system in patients aged 65 years or older. On average, treatment-associated expenditure and drug-associated expenditure in Taiwan EDs averaged NT$1,155 ($35.0) and NT$190 ($5.8), respectively, which was equal to 64.5% and 10.6% of the total ED-associated cost. General ED medical expenditure increased with patient age; the increased cost ratio due to age was estimated at 8% per year (P < 0.001). Conclusions The frequency of major health problems diagnosed at ED visits varied by age: more complicated complaints and multiple diagnoses were more frequent in older patients. In Taiwan, the ED system remains overloaded, possibly because of the low cost of an ED visit. PMID:19164870

  14. The Complexity of a Dengue Vaccine: A Review of the Human Antibody Response

    PubMed Central

    Flipse, Jacky; Smit, Jolanda M.

    2015-01-01

    Dengue is the most prevalent mosquito-borne viral disease worldwide. Yet, there are no vaccines or specific antivirals available to prevent or treat the disease. Several dengue vaccines are currently in clinical or preclinical stages. The most advanced vaccine is the chimeric tetravalent CYD-TDV vaccine of Sanofi Pasteur. This vaccine has recently cleared Phase III, and efficacy results have been published. Excellent tetravalent seroconversion was seen, yet the protective efficacy against infection was surprisingly low. Here, we will describe the complicating factors involved in the generation of a safe and efficacious dengue vaccine. Furthermore, we will discuss the human antibody responses during infection, including the epitopes targeted in humans. Also, we will discuss the current understanding of the assays used to evaluate antibody response. We hope this review will aid future dengue vaccine development as well as fundamental research related to the phenomenon of antibody-dependent enhancement of dengue virus infection. PMID:26065421

  15. Parental weighting of seizure risks vs. fever risks in vaccination tradeoff decisions.

    PubMed

    Zikmund-Fisher, Brian J; Wittenberg, Eve; Lieu, Tracy A

    2016-12-07

    As part of a survey of about vaccination beliefs, a nationally representative sample of parents of young children answered a series of tradeoff questions that asked them to choose between two vaccination approaches that differed in terms of risks of vaccine complications, number of injections, and/or vaccine effectiveness. Most parents were willing to have their children endure more injections, and many were willing to forgo disease protection, in order to reduce the rare chance of febrile seizures. Yet, most parents were unwilling to trade disease protection to reduce the risk of fever alone, even though this is correlated with the risk of febrile seizures. Vaccine risk communications need to address the heightened emotional weight that parents give to febrile seizure risk, even when the rarity of such events is explicit. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Application of INCSEA principles to the Taiwan Strait.

    SciTech Connect

    Wen-Chung, Chai

    2003-06-01

    The waters surrounding Taiwan are important international waterways. In addition to merchant ships of every nation, the warships of the United States, Japan, Russia, and China may appear in these waters. No hostility is expected between Taiwan and the United States, Japan, or Russia; however, Taiwan and China have a tense relationship, and both sides face a potential for naval incidents. As Taiwan and China expand their naval capability, the International Maritime Organization Convention for the lnternational Regulations for Preventing Collisions at Sea may not be sufficient to prevent naval incidents, any of which might develop into conflict or war.more » Therefore, China and Taiwan need to develop maritime confidence building measures (CBMs) that could reduce the chance of naval incidents and strengthen mutual trust and confidence. Among the variety of maritime CBM concepts for military purposes, the most successful and effective measure has been the 1972 U.S.-Soviet Union Agreement on the Prevention of Incidents On and Over the High Seas (INCSEA). The success of the agreement demonstrates that CBMs represent a workable alternative to traditional arms controls. The purpose of this paper is to suggest a concrete approach to the constraint of naval activities between China and Taiwan to reduce accidents and misunderstandings. This paper outlines the categories and characteristics of incidents at sea. Next, the author identifies the successful factors of the U.S.-Soviet INCSEA and applies the INCSEA concept to the Taiwan Strait. Finally, the author develops a framework of options and a step-by-step approach for establishing an INCSEA between Taiwan and China.« less

  17. Should the chickenpox vaccine be included in the National Immunization Schedule in India?

    PubMed

    Verma, Ramesh; Bairwa, Mohan; Chawla, Suraj; Prinja, Shankar; Rajput, Meena

    2011-08-01

    Varicella (chickenpox) is an acute, highly contagious viral disease with worldwide distribution. The highest prevalence occurs in the 4-10 year age group but tends to be more severe in adults. It may be fatal in neonates, immunocompromised persons, and normal adults, especially smokers. Varicella is usually a benign childhood disease, and rarely rated as an important public health problem, but this can be severe and even fatal in otherwise healthy children (< 1 out of every 10,000 cases). Chickenpox can cause pneumonia (23 out of every 10,000 cases), and is an important risk factor for developing severe invasive "strep" (group A streptococcal disease). Complications of varicella include bacterial infections (up to 5% of cases), decreased platelets, arthritis, hepatitis, pneumonia (more commonly in adults) or encephalitis (1 in 10,000 cases), which may cause a failure of muscular coordination, sometimes resulting in persistent sequelae or death. Varicella is the leading cause of vaccine-preventable death in children. Universal vaccination can cause a dramatic reduction in the incidence of varicella, associated complications, hospitalizations and fatality rates. In India, due to the high cost of the vaccine, it would be difficult to vaccinate a large percentage of the children. The government of India should consider the inclusion of varicella vaccine in the National Immunization Schedule with the help of International agencies.

  18. Herpes zoster vaccine: A health economic evaluation for Switzerland.

    PubMed

    Blank, Patricia R; Ademi, Zanfina; Lu, Xiaoyan; Szucs, Thomas D; Schwenkglenks, Matthias

    2017-07-03

    Herpes zoster (HZ) or "shingles" results from a reactivation of the varicella zoster virus (VZV) acquired during primary infection (chickenpox) and surviving in the dorsal root ganglia. In about 20% of cases, a complication occurs, known as post-herpetic neuralgia (PHN). A live attenuated vaccine against VZV is available for the prevention of HZ and subsequent PHN. The present study aims to update an earlier evaluation estimating the cost-effectiveness of the HZ vaccine from a Swiss third party payer perspective. It takes into account updated vaccine prices, a different age cohort, latest clinical data and burden of illness data. A Markov model was developed to simulate the lifetime consequences of vaccinating 15% of the Swiss population aged 65-79 y. Information from sentinel data, official statistics and published literature were used. Endpoints assessed were number of HZ and PHN cases, quality-adjusted life years (QALYs), costs of hospitalizations, consultations and prescriptions. Based on a vaccine price of CHF 162, the vaccination strategy accrued additional costs of CHF 17,720,087 and gained 594 QALYs. The incremental cost-effectiveness ratio (ICER) was CHF 29,814 per QALY gained. Sensitivity analyses showed that the results were most sensitive to epidemiological inputs, utility values, discount rates, duration of vaccine efficacy, and vaccine price. Probabilistic sensitivity analyses indicated a more than 99% chance that the ICER was below 40,000 CHF per QALY. Findings were in line with existing cost-effectiveness analyses of HZ vaccination. This updated study supports the value of an HZ vaccination strategy targeting the Swiss population aged 65-79 y.

  19. Effectiveness of a vaccination program against mumps in Ukraine.

    PubMed

    Hrynash, Y; Nadraga, A; Dasho, M

    2008-12-01

    Medical records and incidence data were analyzed retrospectively to document the epidemiology, clinical features, and outcomes of mumps in relation to vaccination status in the Lviv province of Ukraine over a 7.5-year period, beginning in 2000, when a second dose of mumps vaccine was introduced. Lviv, 1 of 27 provinces in western Ukraine, with a land area of 21,833 km(2), had a total population of about 2,555,834 in 2006. The initial success of the second dose introduction in 2000 in Ukraine was limited by a local outbreak of mumps in Lviv province in 2000-2002 due to a vaccine shortage; most cases were over the age of 7 years. The vaccine with the Leningrad-3 virus strain used before 2001 was then replaced by the triple vaccine "Priorix", with the RIT 4385 derivate of the Jeryl Lynn strain, Belgium. Orchitis and aseptic meningitis were associated with the Russian vaccine. Of the 10,894 reported cases, the most severe (367 cases, 3.4%) were hospitalized in the Lviv Hospital for Infectious Diseases. Admitted patients were predominantly male and over 14 years old. Of the 367 patients admitted to the Lviv Hospital for Infectious Diseases, 45.8% had been vaccinated (mostly by a first dose of Russian vaccine), 15.9% had not been vaccinated, and 38.1% had an unknown vaccination status. More mumps cases occurred in winter and spring than in summer and autumn. The clinical picture and complications (orchitis, pancreatitis, meningitis, and encephalitis) were typical of this disease. The vaccine shortage and an increase in the susceptible population among those who received the Russian vaccine contributed to the outbreak. The use of vaccine with a derivate of the Jeryl Lynn strain has resulted in a dramatic drop in mumps cases since 2002.

  20. Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol: A 16-year tertiary single-institution experience.

    PubMed

    Li, Meng-Ju; Chang, Hsiu-Hao; Yang, Yung-Li; Lu, Meng-Yao; Shao, Pei-Lan; Fu, Chun-Min; Chou, An-Kuo; Liu, Yen-Lin; Lin, Kai-Hsin; Huang, Li-Min; Lin, Dong-Tsamn; Jou, Shiann-Tarng

    2017-10-01

    Infection is a major complication in pediatric patients with acute lymphoblastic leukemia during chemotherapy. In this study, the infection characteristics were determined and risk factors analyzed based on the Taiwan Pediatric Oncology Group (TPOG) acute lymphoblastic leukemia (ALL) protocol. We retrospectively reviewed fever events during chemotherapy in 252 patients treated during two consecutive clinical trials at a single institution between 1997 and 2012. Patients were classified as standard, high, and very high risk by treatment regimen according to the TPOG definitions. We analyzed the characteristics and risk factors for infection. Fever occurred in 219 patients (86.9%) with a mean of 2.74 episodes per person. The fever events comprised 64% febrile neutropenia, 39% clinically documented infections, and 44% microbiologically documented infections. The microbiologically documented infections were mostly noted during the induction phase and increased in very high risk patients (89 vs. 24% and 46% in standard-risk and high-risk patients, respectively). Younger age and higher risk (high-risk and very high risk groups) were risk factors for fever and microbiologic and bloodstream infections. Female gender and obesity were additive risk factors for urinary tract infection (odds ratios = 3.52 and 3.24, P < 0.001 and P = 0.004, respectively). Infections developed primarily during the induction phase, for which younger age and higher risk by treatment regimen were risk factors. Female gender and obesity were additive risk factors for urinary tract infection. © 2017 Wiley Periodicals, Inc.

  1. Vaccines for emerging infectious diseases: Lessons from MERS coronavirus and Zika virus

    PubMed Central

    Maslow, Joel N.

    2017-01-01

    ABSTRACT The past decade and a half has been characterized by numerous emerging infectious diseases. With each new threat, there has been a call for rapid vaccine development. Pathogens such as the Middle East Respiratory Syndrome coronavirus (MERS-CoV) and the Zika virus represent either new viral entities or viruses emergent in new geographic locales and characterized by novel complications. Both serve as paradigms for the global spread that can accompany new pathogens. In this paper, we review the epidemiology and pathogenesis of MERS-CoV and Zika virus with respect to vaccine development. The challenges in vaccine development and the approach to clinical trial design to test vaccine candidates for disease entities with a changing epidemiology are discussed. PMID:28846484

  2. Summary of the National Advisory Committee on Immunization (NACI) Statement on Seasonal Influenza Vaccine for 2016-2017.

    PubMed

    Gemmill, I; Zhao, L; Cochrane, L

    2016-09-01

    Influenza is a respiratory infection caused primarily by influenza A and B viruses. Vaccination is the most effective way to prevent influenza and its complications. The National Advisory Committee on Immunization (NACI) provides recommendations regarding seasonal influenza vaccines annually to the Public Health Agency of Canada (the Agency). To summarize the NACI recommendations regarding the use of seasonal influenza vaccines for the 2016-2017 influenza season. Annual influenza vaccine recommendations are developed by NACI's Influenza Working Group for consideration and approval by NACI, based on NACI's evidence-based process for developing recommendations, and include a consideration of the burden of influenza illness and the target populations for vaccination; efficacy and effectiveness, immunogenicity and safety of influenza vaccines; vaccine schedules; and other aspects of influenza immunization. These recommendations are published annually on the Agency's website in the NACI Advisory Committee Statement: Canadian Immunization Guide Chapter on Influenza and Statement on Seasonal Influenza Vaccine (the Statement). The annual NACI seasonal influenza vaccine recommendations have been updated for the 2016-2017 influenza season to include adults with neurologic or neurodevelopment conditions among the groups for whom influenza vaccination is particularly recommended; to include the new high-dose, trivalent inactivated influenza vaccine for use in adults 65 years of age and over; to recommend that egg-allergic individuals may also be vaccinated against influenza using the low ovalbumin-containing live attenuated influenza vaccine (LAIV) licensed for use in Canada (NACI has previously recommended that egg-allergic individuals may be vaccinated using inactivated influenza vaccines); and to remove the preferential recommendation for the use of LAIV in children 2-17 years of age. Two addenda to the 2016-2017 Statement address these new LAIV recommendations. NACI

  3. H1N1 vaccination in pediatric renal transplant patients.

    PubMed

    Kelen, K; Ferenczi, D; Jankovics, I; Varga, M; Molnar, M Z; Sallay, P; Reusz, G; Langer, R M; Pasti, K; Gerlei, Z; Szabo, A J

    2011-05-01

    Solid organ transplant recipients undergoing immunosuppressive therapy are considered to be at high risk of serious infectious complications. In 2009, a new influenza pandemic caused serious infections and deaths, especially among children and immunocompromised patients. Herein we have reported the safety and efficacy of a single-shot monovalent whole-virus vaccine against H1N1 infection in the pediatric renal transplant population. In November and December 2009, we vaccinated 37 renal transplant children and adolescents and measured their antibody responses. Seroprotection, seroconversion, and seroconversion factors were analyzed at 21 days after vaccination. None of the vaccinated patients experienced vaccine-related side effects. None of the patients had an H1N1 influenza infection after vaccination. All of the patients showed elevations in antibody titer at 21 days after vaccination. In contrast, only 29.72% of the patients achieved a safe seroprotection level and only 18.75% a safe seroconversion rate. More intense immunosuppressive treatment displayed negative effect on seroprotection and seroconversion, and antibody production significantly increased with age. No other factor was observed to influence seroprotection. We recommend vaccination of children and adolescent renal transplant recipients against H1N1 virus. However, a single shot of vaccine may not be sufficient; to achieve seroprotection, a booster vaccination and measurement of the antibody response are needed to assure protection of our patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Detecting Moho Boundary under Taiwan with Wide-angle Data by Ray-tracing Method - The TAIGER Project

    NASA Astrophysics Data System (ADS)

    Kuo, Y. N.; Wang, C.; Okaya, D. A.

    2009-12-01

    Taiwan is located at the converging boundary of the Eurasian plate and the Philippine Sea plate, and is one of the most rapidly uplifting orogeny in the world. The geological structure is relatively complicated. There exist several models of tectonic collisions from the thin-skinned thrust, the lithospheric collision, to uplifting by buoyancy. The shape of Moho should be a key factor to evaluate these models. In this study, we try to detect the Moho beneath Taiwan using the newly collected wide-angle data from the Taiwan Integrated Geodynamic Research (TAIGER) project. The results could be of help to set up some constrains for the Taiwan tectonics. The TAIGER project is a collaboration between America and Taiwan. The land stations collected two parts of data (land and marine) generated by active sources. The land part was carried out in 2008/2~3, which created 6 kinds of data from explosion sources including: 1) 3 E-W wide-angle reflections of Texans arrays; 2) 2 N-S seismometer arrays; 3) the seismic networks of Central Weather Bureau(CWB) and Institute of Earth Science(IES) over the island; 4) a short array of RT130; 5) 2 short period OBS arrays in the Taiwan Strait; 6) 2 temporary seismic arrays in Fujan, mainland China. The marine part was carried out in 2009/4~6, which provided 4 kinds of data from air-gun sources including: 1) 4 wide-angle refractions of E-W RT130 arrays; 2) 2 N-S seismometer arrays; 3) the CWB network; 4) the broad band array in Taiwan for Seismology(BATS). In this study, we focus on analyzing the wide-angle data, which contain land explosion data, onshore-offshore data, OBS data and mainland data, especially concentrate on the line in the southern Taiwan (Transect T4). We make a summary of the TAIGER project and show several plots of real data and arrivals. A 2D E-W velocity model was constructed from the mainland side to the ocean side about 600 km long using the ray-tracing method with layer-striping technique. The preliminary results are

  5. Quarantine for SARS, Taiwan

    PubMed Central

    King, Chwan-Chuan; Chen, Cathy W. S.; Ho, Mei-Shang; Lee, Jen-Yu; Liu, Feng-Chi; Wu, Yi-Chun

    2005-01-01

    During the 2003 outbreak of severe acute respiratory syndrome (SARS) in Taiwan, >150,000 persons were quarantined, 24 of whom were later found to have laboratory-confirmed SARS-coronavirus (SARS-CoV) infection. Since no evidence exists that SARS-CoV is infective before the onset of symptoms and the quarantined persons were exposed but not symptomatic, we thought the quarantine's effectiveness should be investigated. Using the Taiwan quarantine data, we found that the onset-to-diagnosis time of previously quarantined confirmed case-patients was significantly shortened compared to that for those who had not been quarantined. Thus, quarantine for SARS in Taiwan screened potentially infective persons for swift diagnosis and hospitalization after onset, thereby indirectly reducing infections. Full-scale quarantine measures implemented on April 28 led to a significant improvement in onset-to-diagnosis time of all SARS patients, regardless of previous quarantine status. We discuss the temporal effects of quarantine measures and other interventions on detection and isolation as well as the potential usefulness of quarantine in faster identification of persons with SARS and in improving isolation measures. PMID:15752447

  6. Factors associated with mumps meningitis and the possible impact of vaccination

    PubMed Central

    Rhie, Kyuyol; Park, Heung-Keun; Kim, Young-Soo; Park, Ji Sook; Seo, Ji-Hyun; Park, Eun Sil; Lim, Jae-Young; Park, Chan-Hoo; Woo, Hyang-Ok; Youn, Hee-Shang

    2016-01-01

    Purpose Mumps meningitis is a common complication of mumps infection; however, information on mumps meningitis in the postvaccine era is limited. The purpose of the present study was to determine factors associated with mumps meningitis and to discuss the effect of vaccination on this disease. Methods We retrospectively reviewed patients younger than 19 years with mumps, diagnosed at a university hospital in Korea between 2003 and 2013. Patients were divided into groups with and without meningitis, and the clinical features of the 2 groups were compared. Results The study enrolled 119 patients: 19 patients with meningitis and 100 patients without. Univariate analysis showed that older age (median: 15 years vs. 9.5 years, respectively), a longer interval from last vaccination (median: 10.2 years vs. 4.8 years, respectively), and febrile presentation (94.7% vs. 31.0%, respectively) were significantly associated with mumps meningitis. Sex, number of vaccination doses, bilateral parotitis, and the presence of complications other than meningitis did not differ between the 2 groups. In multivariate logistic regression analysis, age (odds ratio, 1.38; 95% confidence interval, 1.01–1.89; P=0.04) and fever (odds ratio, 30.46; 95% confidence interval, 3.27–283.61; P<0.01) remained independent factors for mumps meningitis. Conclusion Clinicians in the postvaccine era should be aware of the possibility of mumps meningitis in febrile cases of mumps in adolescents, regardless of the number of vaccination doses. To establish the role of vaccination in mumps meningitis, further studies will be necessary. PMID:26893600

  7. Efficacy, Immunogenicity, and Safety of a 9-Valent Human Papillomavirus Vaccine: Subgroup Analysis of Participants From Asian Countries

    PubMed Central

    Garland, S M; Pitisuttithum, P; Ngan, H Y S; Cho, C -H; Lee, C -Y; Chen, C -A; Yang, Y C; Chu, T -Y; Twu, N -F; Samakoses, R; Takeuchi, Y; Cheung, T H; Kim, S C; Huang, L -M; Kim, B -G; Kim, Y -T; Kim, K -H; Song, Y -S; Lalwani, S; Kang, J -H; Sakamoto, M; Ryu, H -S; Bhatla, N; Yoshikawa, H; Ellison, M C; Han, S R; Moeller, E; Murata, S; Ritter, M; Sawata, M; Shields, C; Walia, A; Perez, G; Luxembourg, A

    2018-01-01

    Abstract Background A 9-valent human papillomavirus-6/11/16/18/31/33/45/52/58 (9vHPV) vaccine extends coverage to 5 next most common oncogenic types (31/33/45/52/58) in cervical cancer versus quadrivalent HPV (qHPV) vaccine. We describe efficacy, immunogenicity, and safety in Asian participants (India, Hong Kong, South Korea, Japan, Taiwan, and Thailand) from 2 international studies: a randomized, double-blinded, qHPV vaccine-controlled efficacy study (young women aged 16–26 years; NCT00543543; Study 001); and an immunogenicity study (girls and boys aged 9–15 years; NCT00943722; Study 002). Methods Participants (N = 2519) were vaccinated at day 1 and months 2 and 6. Gynecological samples (Study 001 only) and serum were collected for HPV DNA and antibody assessments, respectively. Injection-site and systemic adverse events (AEs) were monitored. Data were analyzed by country and vaccination group. Results 9vHPV vaccine prevented HPV-31/33/45/52/58–related persistent infection with 90.4%–100% efficacy across included countries. At month 7, ≥97.9% of participants seroconverted for each HPV type. Injection-site AEs occurred in 77.7%–83.1% and 81.9%–87.5% of qHPV and 9vHPV vaccine recipients in Study 001, respectively, and 62.4%–85.7% of girls/boys in Study 002; most were mild to moderate. Conclusions The 9vHPV vaccine is efficacious, immunogenic, and well tolerated in Asian participants. Data support 9vHPV vaccination programs in Asia. Clinical Trials Registration NCT00543543; NCT00943722. PMID:29767739

  8. Taiwan's underwater cultural heritage documentation management

    NASA Astrophysics Data System (ADS)

    Tung, Y.-Y.

    2015-09-01

    Taiwan is an important trading and maritime channels for many countries since ancient time. Numerous relics lie underwater due to weather, wars, and other factors. In the year of 2006, Bureau of Cultural Heritage (BOCH) entrusted the Underwater Archaeological Team of Academia Sinica to execute the underwater archaeological investigation projects. Currently, we verified 78 underwater targets, with 78 site of those had been recognized as shipwrecks sites. Up to date, there is a collection of 638 underwater objects from different underwater archaeological sites. Those artefacts are distributed to different institutions and museums. As very diverse management methods/systems are applied for every individual institution, underwater cultural heritage data such as survey, excavation report, research, etc. are poorly organized and disseminated for use. For better communication regarding to Taiwan's underwater cultural heritage in every level, a universal format of documentation should be established. By comparing the existing checklist used in Taiwan with guidelines that are followed in other countries, a more intact and appropriate underwater cultural heritage condition documentation system can be established and adapted in Taiwan.

  9. Vaccines for preventing influenza in healthy children.

    PubMed

    Jefferson, Tom; Rivetti, Alessandro; Di Pietrantonj, Carlo; Demicheli, Vittorio

    2018-02-01

    The consequences of influenza in children and adults are mainly absenteeism from school and work. However, the risk of complications is greatest in children and people over 65 years of age. This is an update of a review published in 2011. Future updates of this review will be made only when new trials or vaccines become available. Observational data included in previous versions of the review have been retained for historical reasons but have not been updated because of their lack of influence on the review conclusions. To assess the effects (efficacy, effectiveness, and harm) of vaccines against influenza in healthy children. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 12), which includes the Cochrane Acute Respiratory Infections Group Specialised Register, MEDLINE (1966 to 31 December 2016), Embase (1974 to 31 December 2016), WHO International Clinical Trials Registry Platform (ICTRP; 1 July 2017), and ClinicalTrials.gov (1 July 2017). Randomised controlled trials comparing influenza vaccines with placebo or no intervention in naturally occurring influenza in healthy children under 16 years. Previous versions of this review included 19 cohort and 11 case-control studies. We are no longer updating the searches for these study designs but have retained the observational studies for historical purposes. Review authors independently assessed risk of bias and extracted data. We used GRADE to rate the certainty of evidence for the key outcomes of influenza, influenza-like illness (ILI), complications (hospitalisation, ear infection), and adverse events. Due to variation in control group risks for influenza and ILI, absolute effects are reported as the median control group risk, and numbers needed to vaccinate (NNVs) are reported accordingly. For other outcomes aggregate control group risks are used. We included 41 clinical trials (> 200,000 children). Most of the studies were conducted in children over the

  10. [Dengue, zika, chikungunya and the development of vaccines].

    PubMed

    Kantor, Isabel N

    2018-01-01

    Dengue (DENV), zika (ZIKV) and chikungunya (CHIKV), three arbovirosis transmitted by Aedes mosquitoes, have spread in recent decades in humid tropical and subtropical zones. Dengue is epidemic in subtropical areas of Argentina. DENV infection confers lasting immunity against the infecting serotype but increases the risk of serious disease upon reinfection by any of the other three. The recombinant tetravalent vaccine Dengvaxia® prevents severe dengue and hospitalization in seropositive subjects. In 2017, Dengvaxia was approved in Argentina, for ages 9 to 45, but is not included in the national vaccination calendar. Two other vaccines are in Phase III evaluation: one developed by NIAID / Instituto Butantan and the other by Takeda. ZIKV, a virus associated with microcephaly in newborns in Brazil, circulates since 2016 in Argentina. There is still not effective treatment nor vaccine with proven activity against ZIKV. There has been no active circulation of CHIKV in Argentina in 2017. Outbreaks of CHIKV fever have a complication: the development of chronic post-disease rheumatism. There are not approved vaccines for humans nor effective antiviral therapies. The seriousness of these virosis has contributed to a rapid progress in the knowledge of the infection processes and the immune response. For now, Aedes aegypti and A. albopictus vectors continue to expand, suggesting that the vaccine will be the most effective means of controlling these viruses. Here we summarize information about these arbovirosis in Argentina and Brazil and describe advances in the development and evaluation of vaccines.

  11. Pre-clinical and clinical development of the first placental malaria vaccine.

    PubMed

    Pehrson, Caroline; Salanti, Ali; Theander, Thor G; Nielsen, Morten A

    2017-06-01

    Malaria during pregnancy is a massive health problem in endemic areas. Placental malaria infections caused by Plasmodium falciparum are responsible for up to one million babies being born with a low birth weight every year. Significant efforts have been invested into preventing the condition. Areas covered: Pub Med was searched using the broad terms 'malaria parasite placenta' to identify studies of interactions between parasite and host, 'prevention of placental malaria' to identify current strategies to prevent placental malaria, and 'placental malaria vaccine' to identify pre-clinical vaccine development. However, all papers from these searches were not systematically included. Expert commentary: The first phase I clinical trials of vaccines are well underway. Trials testing efficacy are more complicated to carry out as only women that are exposed to parasites during pregnancy will contribute to endpoint measurements, further it may require extensive follow-up to establish protection. Future second generation vaccines may overcome the inherent challenges in making an effective placental malaria vaccine.

  12. Thiomersal-containing vaccines - a review of the current state of knowledge.

    PubMed

    Gołoś, Aleksandra; Lutyńska, Anna

    2015-01-01

    Thiomersal is an organomercury compound known for its antiseptic and antifungal properties and used as an antibacterial agent in pharmaceutical products, including vaccines and other injectable biological products. In recent years, concerns about the possible link between immunization with thiomersal-containing vaccines and autism development have grown. Many case-control and cohort studies have been conducted on a number of populations, and none of them have confirmed the hypothetical relation between thiomersal and increased risk of autism spectrum disorders (ASDs) development. It is also confirmed by the fact, that since 1999, number of thiomersal-containing vaccines used worldwide is decreasing year by year, while the prevalence of ASDs cases is rising. There are no contraindications to the use of vaccines with thiomersal in infants, children and non-pregnant women. The risk of serious complications associated with the development of diseases in unvaccinated individuals far outweighs the potential risk of adverse consequences associated with immunization with thiomersal-containing vaccines.

  13. Development and Application of a Taiwan Domestic Generalized Water Supply Model

    NASA Astrophysics Data System (ADS)

    Ho, C. C.; Chang, L. C.

    2016-12-01

    Water allocation in Taiwan is more complicated than other countries because high river turbidity caused by rainstorm, reservoir management governed by different organization and conjunctive use of inter-basin reservoirs and dams. Those properties cause water resource planners need make extra effort on developing customized model to simulate the impact of water supply strategies on water resources. Hence, the study develops a Generalized Water Supply Model (GWSM) to analysis Multi-reservoirs water allocation in Taiwan for advancing the planning process. The model has following functions: (1) considering reservoirs operating rule curve. (2) considering the rule of multi-reservoir operation. Such as setting supply priority of different reservoirs or using "index balance" rule. (3) considering optimal hydroelectric power operation. (4) estimating the impact of high river turbidity on water supply. (5) considering the supply priority of different water use. (6) considering irrigation supply under special constraint. Such as the maximum irrigation supply is subject to natural inflow without reservoir storage. (7) considering two-way conduit transport. (8) considering environmental flow reservation. Conjunctive use Taan and Dajia Rivers was selected to demonstrate the ability of GWSM. The results also can be provided to different authorities to realize the impact of different strategies and that is good for negotiation and reaching a consensus.

  14. Influenza Vaccination Among US Children With Asthma, 2005–2013

    PubMed Central

    Simon, Alan E.; Ahrens, Katherine A.; Akinbami, Lara J.

    2016-01-01

    Background Children with asthma face higher risk of complications from influenza. Trends in influenza vaccination among children with asthma are unknown. Methods We used 2005–2013 National Health Interview Survey data for children 2 to 17 years of age. We assessed, separately for children with and without asthma, any vaccination (received August through May) during each of the 2005–2006 through 2012–2013 influenza seasons and, for the 2010–2011 through 2012–2013 seasons only, early vaccination (received August through October). We used April–July interviews each year (n = 31,668) to assess vaccination during the previous influenza season. Predictive margins from logistic regression with time as the independent and vaccination status as the dependent variable were used to assess time trends. We also estimated the association between several sociodemographic variables and the likelihood of influenza vaccination. Results From 2005 to 2013, among children with asthma, influenza vaccination receipt increased about 3 percentage points per year (P < .001), reaching 55% in 2012–2013. The percentage of all children with asthma vaccinated by October (early vaccination) was slightly above 30% in 2012–2013. In 2010–2013, adolescents, the uninsured, children of parents with some college education, and those living in the Midwest, South, and West were less likely to be vaccinated. Conclusions The percentage of children 2 to 17 years of age with asthma receiving influenza vaccination has increased since 2004–2005, reaching approximately 55% in 2012–2013. PMID:26518382

  15. Hepatitis A and B vaccination--the rate of uptake and course completion in patients with hepatitis C.

    PubMed

    Fredericks, Trinity; Kwan, Kellie; Mak, Donna

    2010-10-01

    Western Australian general practitioners may order Department of Health funded hepatitis A and B vaccines for patients newly notified with hepatitis C to prevent complications associated with co-infections. The aim of this study was to determine vaccination uptake of hepatitis C patients through this program. We reviewed hepatitis C notifications and hepatitis A and B vaccine orders received in 2007 and 2008 to determine the rate of vaccine uptake and course completion. Vaccination orders for initial doses were received for 37% (448/1209) of patients. Vaccination uptake was positively associated with age and non- Aboriginality. Final vaccination doses were ordered for 30% of patients for whom an initial order had been received. Uptake of hepatitis A and B vaccination was higher than that of similar populations. However, vaccination course completion was low. General practitioners need to emphasise to their patients the importance of completing a vaccine course.

  16. Paradoxical increase in cigarette smuggling after the market opening in Taiwan.

    PubMed

    Wen, C P; Peterson, R A; Cheng, T Y D; Tsai, S P; Eriksen, M P; Chen, T

    2006-06-01

    To assess the magnitude of cigarette smuggling after the market opened in Taiwan. Review of tobacco industry documents for references to smuggling activities related to Taiwan and government statistics on seizure of smuggled cigarettes. The market opening in 1987 led to an increase in smuggling. Contraband cigarettes became as available as legal ones, with only a small fraction (8%) being seized. Being specifically excluded from the market-opening, Japan entered the Taiwan market by setting up a Swiss plant as a legal cover for smuggling 10-20 times its legal quota of exports to Taiwan. Smuggling in Taiwan contributed to increased consumption of foreign brands, particularly by the young. Taiwan, not a member of the World Health Organization, was excluded from the East Asian 16-member "Project Crocodile", a regional anti-smuggling collaborative effort to implement the Framework Convention on Tobacco Control. Taiwan showed a sharp increase in smuggling after market liberalisation. Being excluded from the international community, Taiwan faces an uphill battle to fight smuggling alone. If Taiwan remained as its weakest link, global efforts to reduce tobacco use will be undermined, particularly for countries in the East Asian region.

  17. Factors that influence influenza vaccination rates among the elderly: nurses' perspectives.

    PubMed

    Ellen, Moriah

    2018-03-01

    To explore which factors nurses perceive to help and hinder influenza vaccination rates among the elderly. Influenza-related illnesses and deaths have disproportionately high prevalence among the elderly. Vaccination is an effective tool to prevent complications. Semistructured interviews were conducted with nurses focusing on barriers, facilitators and health care providers' roles in influencing patients to be vaccinated. Interviews were recorded, transcribed and thematically analysed. Nurses identified that the prevalent barriers were fear of the vaccine's side effects, feelings of good health and technical considerations. Facilitators included ease of access and encouragement from health providers, media and social networks. The health care team was influential in raising vaccination rates through direct recommendation, providing concrete information or leading by example. The health care team can influence patients to vaccinate. Investments in training nurses in the knowledge and skills needed to educate patients, and providing nurses with the necessary resources to engage patients in these discussions may be beneficial. Nurse managers can be instrumental in enhancing nurses' roles and actions to increase influenza vaccination rates among the elderly. It is essential to reinforce the nurses' role in promoting vaccination among seniors. Given that nurses are the largest number of health professionals, their potential outreach to large numbers of people is strong. © 2017 John Wiley & Sons Ltd.

  18. Use of Licensed Vaccines for Active Immunization of the Immunocompromised Host

    PubMed Central

    Pirofski, Liise-anne; Casadevall, Arturo

    1998-01-01

    The latter part of the 20th century has witnessed an unprecedented rise in the number of individuals with impaired immunity. This is primarily attributable to the increased development and use of antineoplastic therapy for malignancies, organ and bone marrow transplantation, and the AIDS epidemic. Individuals with impaired immunity are often at increased risk for infections, and they can experience more severe and complicated courses of infection. The lack of therapy for a variety of viruses and the rise in antimicrobial resistance of many pathogens have focused attention on vaccination to prevent infectious diseases. The efficacy of most licensed vaccines has been established in immunocompetent hosts. However, there is also considerable experience with most vaccines in those with impaired immunity. We reviewed the use of licensed live, inactivated, and polysaccharide vaccines in this group, and several themes emerged: (i) most vaccines are less immunogenic in those with impaired immunity than in normal individuals; (ii) live vaccines are generally contraindicated in this group; and (iii) the efficacy of many commonly used vaccines has not been established in people with impaired immunity. This review suggests that for most vaccines there are little or no efficacy data in those with impaired immunity but their use in this patient group is generally safe. PMID:9457426

  19. Species of Nepalomyia Hollis from Taiwan (Diptera: Dolichopodidae: Peloropeodinae).

    PubMed

    Wang, Mengoing; Chen, Hongyin; Yang, Ding

    2013-01-01

    An overview is presented for the species of the genus Nepalomyia Hollis, 1964 trom Taiwan. Nepalonyia xtaoyanae sp. nov. is described and N. brevifurcata (Yang & Saigusa, 2001) and N. orientalis (Yang & Li, 1998) are recorded from Taiwan for the first time. A key is provided for all seven named species of this genus from Taiwan.

  20. Real-Time Surveillance of Infectious Diseases: Taiwan's Experience.

    PubMed

    Jian, Shu-Wan; Chen, Chiu-Mei; Lee, Cheng-Yi; Liu, Ding-Ping

    Integration of multiple surveillance systems advances early warning and supports better decision making during infectious disease events. Taiwan has a comprehensive network of laboratory, epidemiologic, and early warning surveillance systems with nationwide representation. Hospitals and clinical laboratories have deployed automatic reporting mechanisms since 2014 and have effectively improved timeliness of infectious disease and laboratory data reporting. In June 2016, the capacity of real-time surveillance in Taiwan was externally assessed and was found to have a demonstrated and sustainable capability. We describe Taiwan's disease surveillance system and use surveillance efforts for influenza and Zika virus as examples of surveillance capability. Timely and integrated influenza information showed a higher level and extended pattern of influenza activity during the 2015-16 season, which ensured prompt information dissemination and the coordination of response operations. Taiwan also has well-developed disease detection systems and was the first country to report imported cases of Zika virus from Miami Beach and Singapore. This illustrates a high level of awareness and willingness among health workers to report emerging infectious diseases, and highlights the robust and sensitive nature of Taiwan's surveillance system. These 2 examples demonstrate the flexibility of the surveillance systems in Taiwan to adapt to emerging infectious diseases and major communicable diseases. Through participation in the GHSA, Taiwan can more actively collaborate with national counterparts and use its expertise to strengthen global and regional surveillance capacity in the Asia Pacific and in Southeast Asia, in order to advance a world safe and secure from infectious disease.

  1. Real-Time Surveillance of Infectious Diseases: Taiwan's Experience

    PubMed Central

    Jian, Shu-Wan; Chen, Chiu-Mei; Lee, Cheng-Yi

    2017-01-01

    Integration of multiple surveillance systems advances early warning and supports better decision making during infectious disease events. Taiwan has a comprehensive network of laboratory, epidemiologic, and early warning surveillance systems with nationwide representation. Hospitals and clinical laboratories have deployed automatic reporting mechanisms since 2014 and have effectively improved timeliness of infectious disease and laboratory data reporting. In June 2016, the capacity of real-time surveillance in Taiwan was externally assessed and was found to have a demonstrated and sustainable capability. We describe Taiwan's disease surveillance system and use surveillance efforts for influenza and Zika virus as examples of surveillance capability. Timely and integrated influenza information showed a higher level and extended pattern of influenza activity during the 2015-16 season, which ensured prompt information dissemination and the coordination of response operations. Taiwan also has well-developed disease detection systems and was the first country to report imported cases of Zika virus from Miami Beach and Singapore. This illustrates a high level of awareness and willingness among health workers to report emerging infectious diseases, and highlights the robust and sensitive nature of Taiwan's surveillance system. These 2 examples demonstrate the flexibility of the surveillance systems in Taiwan to adapt to emerging infectious diseases and major communicable diseases. Through participation in the GHSA, Taiwan can more actively collaborate with national counterparts and use its expertise to strengthen global and regional surveillance capacity in the Asia Pacific and in Southeast Asia, in order to advance a world safe and secure from infectious disease. PMID:28418738

  2. Influenza Vaccination Rate and Reasons for Nonvaccination in Children With Cardiac Disease.

    PubMed

    Livni, Gilat; Wainstein, Alina; Birk, Einat; Chodick, Gabriel; Levy, Itzhak

    2017-11-01

    Influenza is a major cause of respiratory morbidity worldwide. It poses a risk of complications in children with cardiac disease. Influenza vaccine is considered the most effective and safe means of preventing the disease. The aims of this study were to determine the rate of influenza vaccination in children with cardiac disease and to identify the reasons for failure to vaccinate in this patient population. The study group included 186 children and their parents who attended the cardiology institute of a tertiary pediatric medical center between September and October 2012. Parents were asked to complete a questionnaire covering demographics, clinical features, influenza vaccination, receipt of advice from medical professionals regarding vaccination and personal knowledge about and attitude toward the influenza vaccine. Median age of the children was 7.6 years. Thirty-six percent had been vaccinated in the previous influenza season. Vaccination was unrelated to the child's age or sex or the parents' education. Factors significantly affecting the decision of the parents to have their child vaccinated were their knowledge, beliefs and conceptions about the vaccine and their receipt of a recommendation to do so from the pediatrician or cardiologist (P < 0.001). The rate of vaccination against influenza is low in children with heart disease. Major factors encouraging vaccination are proper parental knowledge and the recommendation of the primary physician or cardiologist. Medical professionals caring for this patient population should be alerted to the need to routinely counsel parents on the importance of influenza vaccination.

  3. Is a multivalent hand, foot, and mouth disease vaccine feasible?

    PubMed Central

    Klein, Michel; Chong, Pele

    2015-01-01

    Enterovirus A infections are the primary cause of hand, foot and mouth disease (HFMD) in infants and young children. Although enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16) are the predominant causes of HFMD epidemics worldwide, EV-A71 has emerged as a major neurovirulent virus responsible for severe neurological complications and fatal outcomes. HFMD is a serious health threat and economic burden across the Asia-Pacific region. Inactivated EV-A71 vaccines have elicited protection against EV-A71 but not against CV-A16 infections in large efficacy trials. The current development of a bivalent inactivated EV-A71/CV-A16 vaccine is the next step toward that of multivalent HFMD vaccines. These vaccines should ultimately include other prevalent pathogenic coxsackieviruses A (CV-A6 and CV-A10), coxsackieviruses B (B3 and B5) and echovirus 30 that often co-circulate during HFMD epidemics and can cause severe HFMD, aseptic meningitis and acute viral myocarditis. The prospect and challenges for the development of such multivalent vaccines are discussed. PMID:26009802

  4. [Glocalization: the outlook for Taiwan evidence based health care].

    PubMed

    Chen, Chiehfeng

    2014-12-01

    Public attention to evidence-based health care (EBHC) has increased significantly in recent years. Key problems related to applying EBHC in current healthcare practice include the timely update of up-to-date knowledge and skills and the methodology used to implement EBHC in clinical settings. EBHC has been introduced to the Taiwan healthcare system for the past two decades. The annual EBM (Evidence based medicine) National Competition is a unique and important EBHC activity in Taiwan. EBHC has been promoted widely in medicine, nursing, pharmacy, public health and other professions, and EBHC-related organizations such as the Taiwan Evidence Based Medicine Association (TEBMA), and Taiwan Evidence Based Nursing Association (TEBNA), have increased in number and grown in membership. In addition to domestic developments, Taiwan is also actively involved in global organizations, such as the Cochrane Collaboration, East Asian Cochrane Alliance (EACA), and the International Society for Evidence Based Health Care (ISEHC). In Taiwan, most medical professionals work cooperatively to promote EBHC, which facilitates the gradual improvement of healthcare quality.

  5. Development of a multiplex amplification refractory mutation system reverse transcription polymerase chain reaction assay for the differential diagnosis of Feline leukemia virus vaccine and wild strains.

    PubMed

    Ho, Chia-Fang; Chan, Kun-Wei; Yang, Wei-Cheng; Chiang, Yu-Chung; Chung, Yang-Tsung; Kuo, James; Wang, Chi-Young

    2014-07-01

    A multiplex amplification refractory mutation system reverse transcription polymerase chain reaction (ARMS RT-PCR) was developed for the differential diagnosis of Feline leukemia virus (FeLV) vaccine and wild-type strains based on a point mutation between the vaccine strain (S) and the wild-type strain (T) located in the p27 gene. This system was further upgraded to obtain a real-time ARMS RT-PCR (ARMS qRT-PCR) with a high-resolution melt analysis (HRMA) platform. The genotyping of various strains of FeLV was determined by comparing the HRMA curves with the defined wild-type FeLV (strain TW1), and the results were expressed as a percentage confidence. The detection limits of ARMS RT-PCR and ARMS qRT-PCR combined with HRMA were 100 and 1 copies of transcribed FeLV RNA per 0.5 ml of sample, respectively. No false-positive results were obtained with 6 unrelated pathogens and 1 feline cell line. Twelve FeLV Taiwan strains were correctly identified using ARMS qRT-PCR combined with HRMA. The genotypes of the strains matched the defined FeLV wild-type strain genotype with at least 91.17% confidence. A higher degree of sequence polymorphism was found throughout the p27 gene compared with the long terminal repeat region. In conclusion, the current study describes the phylogenetic relationship of the FeLV Taiwan strains and demonstrates that the developed ARMS RT-PCR assay is able to be used to detect the replication of a vaccine strain that has not been properly inactivated, thus acting as a safety check for the quality of FeLV vaccines.

  6. Antiradiation Vaccine: Technology Development Of Prophylaxis, Prevention And Treatment Of Biological Consequences And Complications After Neutron Irradiation.

    NASA Astrophysics Data System (ADS)

    Popov, Dmitri; Maliev, Slava; Jones, Jeffrey

    Introduction: Neutrons irradiation produce a unique biological effectiveness compare to different types of radiation because their ability to create a denser trail of ionized atoms in biological living tissues[Straume 1982; Latif et al.2010; Katz 1978; Bogatyrev 1982]. The efficacy of an Anti-Radiation Vaccine for the prophylaxis, prevention and therapy of acute radiation pathology was studied in a neutron exposure facility. The biological effects of fast neutrons include damage of central nervous system and cardiovascular system with development of Acute Cerebrovascular and Cardiovascular forms of acute radiation pathology. After irradiation by high doses of fast neutron, formation of neurotoxins, hematotoxins,cytotoxins forming from cell's or tissue structures. High doses of Neutron Irradiation generate general and specific toxicity, inflammation reactions. Current Acute Medical Management and Methods of Radiation Protection are not effective against moderate and high doses of neutron irradiation. Our experiments demonstrate that Antiradiation Vaccine is the most effective radioprotectant against high doses of neutron-radiation. Radiation Toxins(biological substances with radio-mimetic properties) isolated from central lymph of gamma-irradiated animals could be working substance with specific antigenic properties for vaccination against neutron irradiation. Methods: Antiradiation Vaccine preparation standard - mixture of a toxoid form of Radiation Toxins - include Cerebrovascular RT Neurotoxin, Cardiovascular RT Neurotoxin, Gastrointestinal RT Neurotoxin, Hematopoietic RT Hematotoxin. Radiation Toxins were isolated from the central lymph of gamma-irradiated animals with different forms of Acute Radiation Syndromes - Cerebrovascular, Cardiovascular, Gastrointestinal, Hematopoietic forms. Devices for Y-radiation were "Panorama","Puma". Neutron exposure was accomplished at the Department of Research Institute of Nuclear Physics, Dubna, Russia. The neutrons

  7. Herpes zoster vaccine: A health economic evaluation for Switzerland

    PubMed Central

    Blank, Patricia R.; Ademi, Zanfina; Lu, Xiaoyan; Szucs, Thomas D.; Schwenkglenks, Matthias

    2017-01-01

    ABSTRACT Herpes zoster (HZ) or “shingles” results from a reactivation of the varicella zoster virus (VZV) acquired during primary infection (chickenpox) and surviving in the dorsal root ganglia. In about 20% of cases, a complication occurs, known as post-herpetic neuralgia (PHN). A live attenuated vaccine against VZV is available for the prevention of HZ and subsequent PHN. The present study aims to update an earlier evaluation estimating the cost-effectiveness of the HZ vaccine from a Swiss third party payer perspective. It takes into account updated vaccine prices, a different age cohort, latest clinical data and burden of illness data. A Markov model was developed to simulate the lifetime consequences of vaccinating 15% of the Swiss population aged 65–79 y. Information from sentinel data, official statistics and published literature were used. Endpoints assessed were number of HZ and PHN cases, quality-adjusted life years (QALYs), costs of hospitalizations, consultations and prescriptions. Based on a vaccine price of CHF 162, the vaccination strategy accrued additional costs of CHF 17,720,087 and gained 594 QALYs. The incremental cost-effectiveness ratio (ICER) was CHF 29,814 per QALY gained. Sensitivity analyses showed that the results were most sensitive to epidemiological inputs, utility values, discount rates, duration of vaccine efficacy, and vaccine price. Probabilistic sensitivity analyses indicated a more than 99% chance that the ICER was below 40,000 CHF per QALY. Findings were in line with existing cost-effectiveness analyses of HZ vaccination. This updated study supports the value of an HZ vaccination strategy targeting the Swiss population aged 65–79 y. PMID:28481678

  8. Oseltamivir use and outcomes during the 2009 influenza A H1N1 pandemic in Taiwan

    PubMed Central

    2013-01-01

    Background The Taiwan CDC provided free oseltamivir to all patients with influenza infections confirmed by rapid testing or who had clinical warning symptoms during the 2009 H1N1 influenza pandemic in Taiwan. However, oseltamivir utilization patterns, cost, and outcomes among oseltamivir-treated patients remained unclear. Method A population-level, observational cohort study was conducted using the Taiwan National Health Insurance Database from January to December 2009 to describe the use of oseltamivir. Result Prescription trend over weeks increased after a change in government policy and responded to the influenza virus activity. The overall prescription rate was 22.33 per 1000 persons, with the highest prescription rate of 116.5 for those aged 7–12 years, followed by 69.0 for those aged 13–18 years, while the lowest rate was 1.7 for those aged ≥ 65 years. As influenza virus activity increased, the number of prescriptions for those aged ≤18 years rose significantly, whereas no substantial change was observed for those aged ≥65 years. There were also regional variations in terms of oseltamivir utilization and influenza complication rates. Conclusions Oseltamivir was widely used in the 2009 H1N1 influenza pandemic in Taiwan, particularly in those aged 7–18 years. The number of prescriptions for oseltamivir increased with a change in government policy and with increasing cases of pandemic influenza. Further study is needed to examine whether there is an over- or under-use of anti-influenza drugs in different age groups or regions and to examine the current policy of public use of anti-influenza drugs to reduce influenza-associated morbidity and mortality. PMID:23849163

  9. Leptin-based adjuvants: an innovative approach to improve vaccine response.

    PubMed

    White, Sarah J; Taylor, Matthew J; Hurt, Ryan T; Jensen, Michael D; Poland, Gregory A

    2013-03-25

    Leptin is a pleiotropic hormone with multiple direct and regulatory immune functions. Leptin deficiency or resistance hinders the immunologic, metabolic, and neuroendocrinologic processes necessary to thwart infections and their associated complications, and to possibly protect against infectious diseases following vaccination. Circulating leptin levels are proportional to body fat mass. High circulating leptin concentrations, as observed in obesity, are indicative of the development of leptin transport saturation/signaling desensitization. Leptin bridges nutritional status and immunity. Although its role in vaccine response is currently unknown, over-nutrition has been shown to suppress vaccine-induced immune responses. For instance, obesity (BMI ≥30 kg/m(2)) is associated with lower antigen-specific antibody titers following influenza, hepatitis B, and tetanus vaccinations. This suggests that obesity, and possibly saturable leptin levels, are contributing factors to poor vaccine immunogenicity. While leptin-based therapies have not been investigated as vaccine adjuvants thus far, leptin's role in immunity suggests that application of these therapies is promising and worth investigation to enhance vaccine response in people with leptin signaling impairments. This review will examine the possibility of using leptin as a vaccine adjuvant by: briefly reviewing the distribution and signal transduction of leptin and its receptors; discussing the physiology of leptin with emphasis on its immune functions; reviewing the causes of attenuation of leptin signaling; and finally, providing plausible inferences for the innovative use of leptin-based pharmacotherapies as vaccine adjuvants. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Leptin-based Adjuvants: An Innovative Approach to Improve Vaccine Response

    PubMed Central

    White, Sarah J.; Taylor, Matthew J.; Hurt, Ryan; Jensen, Michael D.; Poland, Gregory A.

    2013-01-01

    Leptin is a pleiotropic hormone with multiple direct and regulatory immune functions. Leptin deficiency or resistance hinders the immunologic, metabolic, and neuroendocrinologic processes necessary to thwart infections and their associated complications, and to possibly protect against infectious diseases following vaccination. Circulating leptin levels are proportional to body fat mass. High circulating leptin concentrations, as observed in obesity, are indicative of the development of leptin transport saturation/signaling desensitization. Leptin bridges nutritional status and immunity. Although its role in vaccine response is currently unknown, over-nutrition has been shown to suppress vaccine-induced immune responses. For instance, obesity (BMI ≥ 30 kg/m2) is associated with lower antigen-specific antibody titers following influenza, hepatitis B, and tetanus vaccinations. This suggests that obesity, and possibly saturable leptin levels, are contributing factors to poor vaccine immunogenicity. While leptin-based therapies have not been investigated as vaccine adjuvants thus far, leptin’s role in immunity suggests that application of these therapies is promising and worth investigation to enhance vaccine response in people with leptin signaling impairments. This review will examine the possibility of using leptin as a vaccine adjuvant by: briefly reviewing the distribution and signal transduction of leptin and its receptors; discussing the physiology of leptin with emphasis on its immune functions; reviewing the causes of attenuation of leptin signaling; and finally, providing plausible inferences for the innovative use of leptin-based pharmacotherapies as vaccine adjuvants. PMID:23370154

  11. Influenza vaccination reduces hemorrhagic stroke risk in patients with atrial fibrillation: A population-based cohort study.

    PubMed

    Liu, Ju-Chi; Wang, Ta-Jung; Sung, Li-Chin; Kao, Pai-Feng; Yang, Tsung-Yeh; Hao, Wen-Rui; Chen, Chun-Chao; Hsu, Yi-Ping; Wu, Szu-Yuan

    2017-04-01

    The risk of hemorrhagic stroke in patients with atrial fibrillation (AF) is low but the consequences of its occurrence are extremely severe. In this study, we investigated the association of influenza vaccination with the risk of hemorrhagic stroke to develop an efficient strategy for reducing this risk in patients with AF. In this study, data were retrieved from the Taiwan National Health Insurance Research Database. The study cohort comprised all patients who received a diagnosis of AF (n=14,454) before January 1, 2005 (index date) and were followed until December 31, 2012. Propensity scores were calculated using a logistic regression model to determine the effects of vaccination by accounting for covariates that predict receiving the intervention (vaccine). A time-dependent Cox proportional hazard model was used to calculate the hazard ratios (HRs) for hemorrhagic stroke in vaccinated and unvaccinated patients with AF. The study population comprised 6570 patients who did (2547 [38.77%]) and did not receive (4023 [61.23%]) influenza vaccination. The adjusted HRs (aHRs) for hemorrhagic stroke were lower in the vaccinated patients than in the unvaccinated patients (influenza season, noninfluenza season, and all seasons: aHRs=0.97 [0.59-1.60], 0.51 [0.30-0.87], and 0.72 [0.50-1.03], respectively). Influenza vaccination exerts dose-response and synergistic protective effects against hemorrhagic stroke in patients with AF who have a high risk of hemorrhagic stroke (i.e., male sex, age≥75years, Charlson comorbidity index ≥3, and hypertension) and reduces the incidence of hemorrhagic stroke. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. 76 FR 13660 - Polyvinyl Alcohol From Taiwan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-14

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-1088 (Final)] Polyvinyl Alcohol From Taiwan Determination On the basis of the record \\1\\ developed in the subject investigation, the United... (March 2011), entitled Polyvinyl Alcohol from Taiwan: Investigation No. 731-TA-1088 (Final). By order of...

  13. Elucidation of the full genetic information of Japanese rubella vaccines and the genetic changes associated with in vitro and in vivo vaccine virus phenotypes.

    PubMed

    Otsuki, Noriyuki; Abo, Hitoshi; Kubota, Toru; Mori, Yoshio; Umino, Yukiko; Okamoto, Kiyoko; Takeda, Makoto; Komase, Katsuhiro

    2011-02-24

    Rubella is a mild disease characterized by low-grade fever, and a morbilliform rash, but causes congenital defects in neonates born from mothers who suffered from rubella during the pregnancy. After many passages of wild-type rubella virus strains in various types of cultured cells, five live attenuated rubella vaccines were developed in Japan. An inability to elicit anti-rubella virus antibodies in experimentally infected animals was used as an in vivo marker phenotype of Japanese rubella vaccines. All Japanese rubella vaccine viruses exhibit a temperature-sensitive (ts) phenotype, and replicate very poorly at a high temperature. We determined the entire genome sequences of three Japanese rubella vaccines (Matsuba, TCRB19, and Matsuura), thereby completing the sequencing of all five Japanese rubella vaccines. In addition, the entire genome sequences of three vaccine progenitors were determined. Comparative nucleotide sequence analyses revealed mutations that were introduced into the genomes of the TO-336 and Matsuura vaccines during their production by laboratory passaging. Analyses involving cellular expression of viral P150 nonstructural protein-derived peptides revealed that the N1159S mutation conferred the ts phenotype on the TO-336 vaccine, and that reduced thermal stability of the P150 protease domain was a cause of the ts phenotype of some rubella vaccine viruses. The ts phenotype of vaccine viruses was not necessarily correlated with their inability to elicit humoral immune responses in animals. Therefore, the molecular mechanisms underlying the inability of these vaccines to elicit humoral responses in animals are more complicated than the previously considered mechanism involving the ts phenotype as the major cause. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Siderophore vaccine conjugates protect against uropathogenic Escherichia coli urinary tract infection

    PubMed Central

    Mike, Laura A.; Smith, Sara N.; Sumner, Christopher A.; Eaton, Kathryn A.; Mobley, Harry L. T.

    2016-01-01

    Uropathogenic Escherichia coli (UPEC) is the primary cause of uncomplicated urinary tract infections (UTIs). Whereas most infections are isolated cases, 1 in 40 women experience recurrent UTIs. The rise in antibiotic resistance has complicated the management of chronic UTIs and necessitates new preventative strategies. Currently, no UTI vaccines are approved for use in the United States, and the development of a highly effective vaccine remains elusive. Here, we have pursued a strategy for eliciting protective immunity by vaccinating with small molecules required for pathogenesis, rather than proteins or peptides. Small iron-chelating molecules called siderophores were selected as antigens to vaccinate against UTI for this vaccine strategy. These pathogen-associated stealth siderophores evade host immune defenses and enhance bacterial virulence. Previous animal studies revealed that vaccination with siderophore receptor proteins protects against UTI. The poor solubility of these integral outer-membrane proteins in aqueous solutions limits their practical utility. Because their cognate siderophores are water soluble, we hypothesized that these bacterial-derived small molecules are prime vaccine candidates. To test this hypothesis, we immunized mice with siderophores conjugated to an immunogenic carrier protein. The siderophore–protein conjugates elicited an adaptive immune response that targeted bacterial stealth siderophores and protected against UTI. Our study has identified additional antigens suitable for a multicomponent UTI vaccine and highlights the potential use of bacterial-derived small molecules as antigens in vaccine therapies. PMID:27821778

  15. Siderophore vaccine conjugates protect against uropathogenic Escherichia coli urinary tract infection.

    PubMed

    Mike, Laura A; Smith, Sara N; Sumner, Christopher A; Eaton, Kathryn A; Mobley, Harry L T

    2016-11-22

    Uropathogenic Escherichia coli (UPEC) is the primary cause of uncomplicated urinary tract infections (UTIs). Whereas most infections are isolated cases, 1 in 40 women experience recurrent UTIs. The rise in antibiotic resistance has complicated the management of chronic UTIs and necessitates new preventative strategies. Currently, no UTI vaccines are approved for use in the United States, and the development of a highly effective vaccine remains elusive. Here, we have pursued a strategy for eliciting protective immunity by vaccinating with small molecules required for pathogenesis, rather than proteins or peptides. Small iron-chelating molecules called siderophores were selected as antigens to vaccinate against UTI for this vaccine strategy. These pathogen-associated stealth siderophores evade host immune defenses and enhance bacterial virulence. Previous animal studies revealed that vaccination with siderophore receptor proteins protects against UTI. The poor solubility of these integral outer-membrane proteins in aqueous solutions limits their practical utility. Because their cognate siderophores are water soluble, we hypothesized that these bacterial-derived small molecules are prime vaccine candidates. To test this hypothesis, we immunized mice with siderophores conjugated to an immunogenic carrier protein. The siderophore-protein conjugates elicited an adaptive immune response that targeted bacterial stealth siderophores and protected against UTI. Our study has identified additional antigens suitable for a multicomponent UTI vaccine and highlights the potential use of bacterial-derived small molecules as antigens in vaccine therapies.

  16. Simultaneous subtyping and pathotyping of avian influenza viruses in chickens in Taiwan using reverse transcription loop-mediated isothermal amplification and microarray

    PubMed Central

    WANG, Lih-Chiann; HUANG, Dean; CHEN, Hui-Wen

    2016-01-01

    The H6N1 avian influenza virus has circulated in Taiwan for more than 40 years. The sporadic activity of low pathogenic H5N2 virus has been noted since 2003, and highly pathogenic H5N2 avian influenza virus has been detected since 2008. Ressortant viruses between H6N1 and H5N2 viruses have become established and enzootic in chickens throughout Taiwan. Outbreaks caused by Novel highly pathogenic H5 avian influenza viruses whose HA genes were closely related to that of the H5N8 virus isolated from ducks in Korea in 2014 were isolated from outbreaks in Taiwan since early 2015. The avian influenza virus infection status is becoming much more complicated in chickens in Taiwan. This necessitates a rapid and simple approach to detect and differentiate the viruses that prevail. H6N1, H5N2 and novel H5 viruses were simultaneously subtyped and pathotyped in this study using reverse transcription loop-mediated isothermal amplification and microarray, with detection limits of 10°, 101 and 10° viral copy numbers, respectively. The microarray signals were read by the naked eye with no expensive equipment needed. The method developed in this study could greatly improve avian influenza virus surveillance efficiency. PMID:27086860

  17. Vaccine-strain herpes zoster found in the trigeminal nerve area in a healthy child: A case report.

    PubMed

    Iwasaki, Sayaka; Motokura, Kouji; Honda, Yoshitaka; Mikami, Masamitsu; Hata, Daisuke; Hata, Atsuko

    2016-12-01

    A previously healthy 2-year-old girl, vaccinated for varicella at 17 months, was admitted because of left-sided facial herpes zoster caused by vaccine-strain varicella-zoster virus (VZV). She recovered fully with no complication after intravenous treatment using acyclovir. Earlier reports have described that herpes zoster (HZ) rashes caused by vaccine-strain VZV tend to occur on the dermis corresponding to the skin area where the varicella vaccine was received. However, rashes appeared on this girl only in the trigeminal nerve area, which is unrelated to the vaccinated site. Results underscore the importance of distinguishing vaccine-strain VZV from wild-type VZV whenever encountering HZ cases after vaccination, even in immunocompetent children, irrespective of the skin lesion site. Monitoring vaccine-strain HZ incidence rates is expected to elucidate many aspects of varicella vaccine safety. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Paradoxical increase in cigarette smuggling after the market opening in Taiwan

    PubMed Central

    Wen, C P; Peterson, R A; Cheng, T Y D; Tsai, S P; Eriksen, M P; Chen, T

    2006-01-01

    Objectives To assess the magnitude of cigarette smuggling after the market opened in Taiwan. Methods Review of tobacco industry documents for references to smuggling activities related to Taiwan and government statistics on seizure of smuggled cigarettes. Results The market opening in 1987 led to an increase in smuggling. Contraband cigarettes became as available as legal ones, with only a small fraction (8%) being seized. Being specifically excluded from the market‐opening, Japan entered the Taiwan market by setting up a Swiss plant as a legal cover for smuggling 10–20 times its legal quota of exports to Taiwan. Smuggling in Taiwan contributed to increased consumption of foreign brands, particularly by the young. Taiwan, not a member of the World Health Organization, was excluded from the East Asian 16‐member “Project Crocodile”, a regional anti‐smuggling collaborative effort to implement the Framework Convention on Tobacco Control. Conclusions Taiwan showed a sharp increase in smuggling after market liberalisation. Being excluded from the international community, Taiwan faces an uphill battle to fight smuggling alone. If Taiwan remained as its weakest link, global efforts to reduce tobacco use will be undermined, particularly for countries in the East Asian region. PMID:16728745

  19. The Characteristics of Seismogenic Zones in SW Taiwan: Implications from Studying Mechanisms of Microearthquakes

    NASA Astrophysics Data System (ADS)

    Wen, Strong; Chang, Yi-Zen; Yeh, Yu-Lien; Wen, Yi-Ying

    2017-04-01

    Due to the complicated geomorphology and geological conditions, the southwest (SW) Taiwan suffers the invasion of various natural disasters, such as landslide, mud flow and especially the threat of strong earthquakes as result of convergence between the Eurasian and the Philippine Sea plate. Several disastrous earthquakes had occurred in this area and often caused serious hazards. Therefore, it is fundamentally important to understand the correlation between seismic activity and seismogenic structures in SW Taiwan. Previous studies have indicated that before the failure of rock strength, the behaviors of micro-earthquakes can provide essential clues to help investigating the process of rock deformation. Thus, monitoring the activity of micro-earthquakes plays an important role in studying fault rupture or crustal deformation before the occurrence of a large earthquake. Because the time duration of micro-earthquakes activity can last for years, this phenomenon can be used to indicate the change of physical properties in the crust, such as crustal stress changes or fluid migration. The main purpose of this research is to perform a nonlinear waveform inversion to investigate source parameters of micro-earthquakes which include the non-double couple components owing to the shear rupture usually associated with complex morphology as well as tectonic fault systems. We applied a nonlinear waveform procedure to investigate local stress status and source parameters of micro-earthquakes that occurred in SW Taiwan. Previous studies has shown that microseismic fracture behaviors were controlled by the non-double components, which could lead to cracks generating and fluid migration, which can result in changing rock volume and produce partial compensation. Our results not only giving better understanding the seismogenic structures in the SW Taiwan, but also allowing us to detect variations of physical parameters caused by crack propagating in stratum. Thus, the derived source

  20. Impacts of a mass vaccination campaign against pandemic H1N1 2009 influenza in Taiwan: a time-series regression analysis.

    PubMed

    Wu, Un-In; Wang, Jann-Tay; Chang, Shan-Chwen; Chuang, Yu-Chung; Lin, Wei-Ru; Lu, Min-Chi; Lu, Po-Liang; Hu, Fu-Chang; Chuang, Jen-Hsiang; Chen, Yee-Chun

    2014-06-01

    A multicenter, hospital-wide, clinical and epidemiological study was conducted to assess the effectiveness of the mass influenza vaccination program during the 2009 H1N1 influenza pandemic, and the impact of the prioritization strategy among people at different levels of risk. Among the 34 359 medically attended patients who displayed an influenza-like illness and had a rapid influenza diagnostic test (RIDT) at one of the three participating hospitals, 21.0% tested positive for influenza A. The highest daily number of RIDT-positive cases in each hospital ranged from 33 to 56. A well-fitted multiple linear regression time-series model (R(2)=0.89) showed that the establishment of special community flu clinics averted an average of nine cases daily (p=0.005), and an increment of 10% in daily mean level of population immunity against pH1N1 through vaccination prevented five cases daily (p<0.001). Moreover, the regression model predicted five-fold or more RIDT-positive cases if the mass influenza vaccination program had not been implemented, and 39.1% more RIDT-positive cases if older adults had been prioritized for vaccination above school-aged children. Mass influenza vaccination was an effective control measure, and school-aged children should be assigned a higher priority for vaccination than older adults during an influenza pandemic. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Pneumococcal Conjugate Vaccines and Otitis Media: An Appraisal of the Clinical Trials

    PubMed Central

    Fletcher, Mark A.; Fritzell, Bernard

    2012-01-01

    Streptococcus pneumoniae is the predominant otitis media pathogen and its prevention through effective vaccination could diminish childhood illness and antibiotic use. This paper reviews 5 pneumococcal conjugate vaccine (PCV) trials that used otitis media as an endpoint: Northern California Kaiser Permanente (NCKP; vaccine, 7-valent PCV [PCV7]-CRM); Finnish Otitis Media (FinOM; vaccines, PCV7-CRM or PCV7-OMPC); Native American Trial (vaccine, PCV7-CRM); Pneumococcal Otitis Efficacy Trial (POET; vaccine, 11-valent PCV [PCV11]-PD). For the microbiological endpoint, vaccine efficacy against vaccine-serotype pneumococcal otitis media was about 60% across trials. Against the clinical endpoint of all episodes, vaccine efficacy was 7% (PCV7-CRM/NCKP), 6% (PCV7-CRM/FinOM), −1% (PCV7-OMPC/FinOM), and −0.4% (PCV7-CRM/Native American Trial); 34% against first episodes of ear, nose, and throat specialist-referral cases (PCV11-PD/POET). Both follow-up through 2 years of age, for the 5 trials, and long-term follow-up, for PCV7-CRM/NCKP and PCV7-CRM/FinOM, demonstrated greater vaccine efficacy against recurrent AOM and tympanostomy-tube placement, suggesting that vaccination against early episodes of AOM may prevent subsequent episodes of complicated otitis media. Although study designs varied by primary endpoint measured, age at follow-up, source of middle-ear fluid for culture, case ascertainment, and type of randomization, each clinical trial demonstrated vaccine efficacy against microbiological and/or clinical otitis media. PMID:22701486

  2. Taiwan Space Programs

    NASA Astrophysics Data System (ADS)

    Liu, Jann-Yenq

    Taiwan space programs consist of FORMOSAT-1, -2, and -3, sounding rockets, and international cooperation. FORMOSAT-1, a low-earth-orbit (LEO) scientific experimental satellite, was launched on January 26, 1999. It circulates with an altitude of 600 km and 35 degree inclination around the Earth every 97 minutes, transmitting collected data to Taiwan's receiving stations approximately six times a day. The major mission of FORMOSAT-1 includes three scientific experiments for measuring the effects of ionospheric plasma and electrodynamics, taking the ocean color image and conducting Ka-band communication experiment. The FORMOSAT- 1 mission was ended by June 15, 2004. FORMOSAT-2, launched on May 21, 2004 onto the Sun-synchronous orbit located at 891 km above ground. The main mission of FORMOSAT-2 is to conduct remote sensing imaging over Taiwan and on terrestrial and oceanic regions of the entire earth. The images captured by FORMOSAT-2 during daytime can be used for land distribution, natural resources research, environmental protection, disaster prevention and rescue work etc. When the satellite travels to the eclipsed zone, it observes natural phenomena of lighting in the upper atmosphere. FORMOSAT-3 is an international collaboration project between Taiwan and the US to develop advanced technology for the real-time monitoring of the global climate. This project is also named Constellation Observing System for Meteorology, Ionosphere and Climate, or FORMOSAT-3/COSMIC for short. Six micro-satellites were launched on 15 April 2007 and eventually placed into six different orbits at 700 800 kilometer above the earth ground. These satellites orbit around the earth to form a LEO constellation that receives signals transmitted by the 24 US GPS satellites. The satellite observation covers the entire global atmosphere and ionosphere, providing over 2,500 global sounding data per day. These data distribute uniformly over the earth's atmosphere. The global climate information

  3. [The medical autonomy of elderly in Taiwan].

    PubMed

    Chen, Kai-Li; Chen, Ching-Huey

    2014-10-01

    The elderly population is increasing rapidly in Taiwan. With the average life expectancy on the rise, the elderly have become major consumers of healthcare products and services. Factors that influence respect for autonomy, a core value of medical ethics, may be related to family, society, and the medical culture. Especially in patients who are already elderly, aging causes declines in physical, mental and societal capacities. Practicing a respect for patient autonomy is particularly challenging for healthcare professionals in Taiwan due the unique culture background of elderly Taiwanese patients. This article reviews and integrates the literature related to the issue of patient autonomy and elaborates on medical decision-making among elderly patients in Taiwan in the contexts of: the disadvantages faced by the elderly, the background of Chinese culture, and the current medical decision-making environment. A few suggestions are proposed to help preserve the medical-decision-making autonomy of elderly patients in Taiwan.

  4. Evaluation of pneumococcal vaccination rates after vaccine protocol changes and nurse education in a tertiary care teaching hospital.

    PubMed

    Smith, Jennifer G; Metzger, Nicole L

    2011-11-01

    Pneumococcal vaccination in eligible patients is recommended by the Infectious Disease Society of America and the Centers for Disease Control (CDC) Advisory Committee on Immunization Practices. Because hospitalization provides an opportunity to vaccinate patients at high risk for developing serious pneumonia complications, eligibility screening and administration of the pneumococcal vaccine prior to discharge in qualified patients are evaluated by the Joint Commission and the Centers for Medicare Medicaid Services (CMS) as part of pneumococcal vaccination core quality measures. Among patients with an inpatient diagnosis of pneumonia in 2008, 56% in our 580-bed tertiary care teaching hospital, compared with 84% nationwide, received pneumococcal vaccination. To improve pneumococcal vaccination rates for all patients in the study facility and not just those with pneumonia, a multifaceted intervention including a revised nurse screening tool, rescheduling of the vaccine order, storage of the vaccine in automated dispensing cabinets on the nursing unit, and creation of a vaccine tracking system was developed and implemented between August 2009 and October 2009. To determine the impact of a multifaceted intervention on pneumococcal vaccine screening and administration rates in eligible patients according to the CDC recommendations who were admitted to an internal medicine unit of a tertiary care teaching hospital. All patients aged 18 years or older from 2 internal medicine units were identified during 4-month time intervals before (pre-intervention, April through July 2009) and after (post-intervention, November 2009 through February 2010) implementation of the multifaceted pneumococcal vaccine protocol. Of these, 150 patients from each 4-month period were randomly selected for electronic medical record review. Eligibility for pneumococcal vaccination was derived from the CDC recommendations and consensus of the vaccine steering committee at the study institution; the

  5. Evaluation of the cost-effectiveness in the United States of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.

    PubMed

    Pellissier, James M; Brisson, Marc; Levin, Myron J

    2007-11-28

    A live-attenuated varicella-zoster virus vaccine, demonstrated to reduce the incidence of herpes zoster (HZ) and postherpetic neuralgia (PHN) and the morbidity associated with incident HZ and its sequelae, has recently been approved for use in the United States (U.S.). To examine the potential value of zoster vaccine for society and payers. DESIGN, SETTING AND POPULATION: An age-specific decision analytic model was designed to estimate the lifetime costs and outcomes associated with HZ, PHN and other HZ-related complications for vaccinated and non-vaccinated cohorts aged >or=60 years. Clinical trial data, published literature and other primary studies were used to inform the model. Robustness of results to key model parameters was explored through a series of one-way, multivariate and probabilistic sensitivity analyses. Both societal and payer perspectives were considered. Incremental cost per quality-adjusted life year (QALY) gained. For a representative cohort of 1,000,000 U.S. vaccine recipients aged >or=60 years, use of the zoster vaccine was projected to eliminate 75,548-88,928HZ cases and over 20,000 PHN cases. Over 300,000 outpatient visits, 375,000 prescriptions, 9,700 ER visits and 10,000 hospitalizations were projected to be eliminated with the vaccine translating into savings of US$ 82 million to US$ 103 million in healthcare costs associated with the diagnosis and treatment of HZ, PHN and other HZ-related complications. Cost-effectiveness ratios range from US$ 16,229 to US$ 27,609 per QALY gained, depending on the input data source and analytic perspective. Results were most sensitive to PHN costs, duration of vaccine efficacy, vaccine efficacy against PHN and HZ, QALY loss associated with pain states and complication costs. The zoster vaccine at a price of US$ 150 is likely to be cost-effective for a cohort of immunocompetent U.S. vaccine recipients aged >or=60 years using commonly cited thresholds for judging cost-effectiveness. Conclusions are robust

  6. Maternity Leave in Taiwan

    PubMed Central

    Feng, Joyce Yen; Han, Wen-Jui

    2011-01-01

    Using the first nationally representative birth cohort study in Taiwan, this paper examines the role that maternity leave policy in Taiwan plays in the timing of mothers returning to work after giving birth, as well as the extent to which this timing is linked to the amount of time mothers spend with their children and their use of breast milk versus formula. We found that the time when mothers returned to work coincided with the duration of guaranteed leave. In particular, mothers with a labor pension plan resumed work significantly earlier than mothers with no pension plan, and mothers with no pension plan returned to work significantly later than those with pension plans. The short leave of absence guaranteed under existing policies translated into mothers spending less time with their children and being more likely to exclusively use formula by 6 months after birth. In contrast, mothers who resumed work later than 6 months after birth were more likely to have not worked before birth or to have quit their jobs during pregnancy. Implications and recommendations for parental leave policy in Taiwan are discussed. PMID:21603074

  7. Maternity Leave in Taiwan.

    PubMed

    Feng, Joyce Yen; Han, Wen-Jui

    2010-07-01

    Using the first nationally representative birth cohort study in Taiwan, this paper examines the role that maternity leave policy in Taiwan plays in the timing of mothers returning to work after giving birth, as well as the extent to which this timing is linked to the amount of time mothers spend with their children and their use of breast milk versus formula. We found that the time when mothers returned to work coincided with the duration of guaranteed leave. In particular, mothers with a labor pension plan resumed work significantly earlier than mothers with no pension plan, and mothers with no pension plan returned to work significantly later than those with pension plans. The short leave of absence guaranteed under existing policies translated into mothers spending less time with their children and being more likely to exclusively use formula by 6 months after birth. In contrast, mothers who resumed work later than 6 months after birth were more likely to have not worked before birth or to have quit their jobs during pregnancy. Implications and recommendations for parental leave policy in Taiwan are discussed.

  8. Bioterrorism preparedness--Part II. Smallpox vaccination in a hospital setting.

    PubMed

    Jacobs, Lenworth M; Emanuelsen, Kathy; McKay, Charles; Burns, Karyl

    2004-01-01

    The threat of using smallpox as an agent for bioterrorism resulted in a directive for the creation of smallpox response teams. In Connecticut, The Commissioner of the Department of Public Health convened public health and hospital leadership to plan for the vaccination of these teams. The purpose of this paper is to provide a description of the vaccination program at Hartford Hospital, a Center of Excellence for Bioterrorism Preparedness, and to report the results of a survey of the vaccinees regarding the vaccination experience. Ninety persons were vaccinated. Six individuals experienced low-grade fever and 10 had axillary node swelling. One individual experienced significant fatigue. A total of six persons lost time from work. Four lost one day and two persons lost between four to five days of work. There was no autoinoculation, transfer inoculation, vaccinia or any other significant complication. Survey results indicate that most vaccinees felt positive about the experience.

  9. Taiwan-U.S. Relations: Developments and Policy Implications

    DTIC Science & Technology

    2009-05-01

    ally, China’s situation changed dramatically after the civil war victory of Mao Tse-tung in 1949. The reigning Chinese government, led by Chiang Kai ...Congressional Research Service 5 Changing Political Dynamics in Taiwan Until the mid-1980s, Taiwan had a one-party system in which Chiang Kai -shek’s...Taipei Times, January 23, 2009, p. 1. 21 Xie Yu , “Taiwan put under WHO health rules,” China Daily, February 12, 2009. 22 Chen, Jian, “WHA arrangements

  10. Hand, foot and mouth disease (HFMD): emerging epidemiology and the need for a vaccine strategy.

    PubMed

    Aswathyraj, S; Arunkumar, G; Alidjinou, E K; Hober, D

    2016-10-01

    Hand, foot, and mouth disease (HFMD) is a contagious viral disease and mainly affects infants and young children. The main manifestations are fever, vesicular rashes on hand, feet and buttocks and ulcers in the oral mucosa. Usually, HFMD is self-limiting, but a small proportion of children may experience severe complications such as meningitis, encephalitis, acute flaccid paralysis and neurorespiratory syndrome. Historically, outbreaks of HFMD were mainly caused by two enteroviruses: the coxsackievirus A16 (CV-A16) and the enterovirus 71 (EV-A71). In the recent years, coxsackievirus A6 and coxsackievirus A10 have been widely associated with both sporadic cases and outbreaks of HFMD worldwide, particularly in India, South East Asia and Europe with an increased frequency of neurological complications as well as mortality. Currently, there is no pharmacological intervention or vaccine available for HFMD. A formalin-inactivated EV-A71 vaccine has completed clinical trial in several Asian countries. However, this vaccine cannot protect against other major emerging etiologies of HFMD such as CV-A16, CV-A6 and CV-A10. Therefore, the development of a globally representative multivalent HFMD vaccine could be the best strategy.

  11. Accountability, utilization and providers for diabetes management in Taiwan, 2000-2009: an analysis of the National Health Insurance database.

    PubMed

    Chang, Tien-Jyun; Jiang, Yi-Der; Chang, Chia-Hsiun; Chung, Ching-Hu; Yu, Neng-Chun; Chuang, Lee-Ming

    2012-11-01

    The prevalence of diabetes has increased worldwide. To obtain nationwide data on accountability and utilization of health resources among diabetes patients in Taiwan, an analysis of the claims data for the National Health Insurance (NHI) from 2000 to 2009 was conducted. One-third of the NHI claims database was randomly sampled from 2000 to 2009. Diabetes was defined by three or more outpatient visits with diagnostic codes [International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM): 250 or A code: A181] within 1 year, or one inpatient discharge diagnosis. Accountability items and NHI codes of various metabolic parameters and examinations were identified. Medical utilization was measured by the frequency and cost of care associated with ambulatory visits, hospitalizations, and emergency care within each year. The annual check-up frequency for various examinations significantly increased from 2000 to 2009. Both the average outpatient department (OPD) cost per diabetes patient/year and the average inpatient department (IPD) cost per time increased 1.34-fold in the past decade. The average OPD cost per diabetes patient and average IPD cost of each admission for diabetes patients was four times and 1.4 times compare with the general population, respectively. The annual average medical cost of each diabetes patient affected with both micro- and macrovascular complications was four times compared with those without vascular complications. There was an increasing trend for diabetes patients to visit regional hospital for OPD and IPD, whereas visits to the local hospital decreased in the past decade. Due to the increased frequency of annual check-ups after various examinations, the quality of diabetes management has improved in the past decade in Taiwan. As diabetes patients affected with both micro- and macrovascular complications incurred costs four times compared with those without complications, it is worth screening high-risk individuals to

  12. Pneumococcal vaccine failure: can it be a primary immunodeficiency?

    PubMed

    Moinho, Rita; Brett, Ana; Ferreira, Gisela; Lemos, Sónia

    2014-06-12

    Vaccine failure is a rare condition and the need to investigate a primary immunodeficiency is controversial. We present the case of a 4-year-old boy, with complete antipneumococcal vaccination, who had necrotising pneumonia with pleural effusion and severe pancytopaenia with need for transfusion. A vaccine-serotype Streptococcus pneumoniae was isolated in the blood culture. On follow-up, detailed medical history, laboratory and genetic investigation led to the diagnosis of X linked dyskeratosis congenita. Dyskeratosis congenita is an inherited disorder that causes shortening or dysfunction of telomeres, affecting mainly rapidly dividing cells (particularly in the skin and haematopoietic system). It leads to bone marrow failure, combined immunodeficiency and predisposition to cancer. The confirmation of this diagnosis allows genetic counselling and medical monitoring of these patients, in order to detect early complications such as bone marrow aplasia or malignancies. 2014 BMJ Publishing Group Ltd.

  13. Regulatory control of low level radioactive waste in Taiwan

    SciTech Connect

    Liu, T.D.S.; Chiou, Syh-Tsong

    1996-12-31

    The commercial operation of Chinshan Nuclear Power Plant (NPP) Unit One marked the beginning of Taiwan`s nuclear power program. There are now three NPPs, each consisting of two units, in operation. This represents a generating capacity of 5,144 MWe. Nuclear power plants are sharing some 30 percent of electricity supplies in Taiwan. As far as low level radwaste (LLRW) is concerned, Taiwan Power Company (TPC) is the principal producer, contributing more than 90 percent of total volume of waste arising in Taiwan. Small producers, other than nuclear industries, medicine, research institutes, and universities, are responsible for the remaining 10 percent.more » In the paper, the LLRW management policy, organizational scheme, regulatory control over waste treatment, storage, transportation and disposal are addressed. Added to the paper in the last is how this country is managing its Naturally Occurring Radioactive Materials (NORM) waste.« less

  14. What shapes vaccine policy? The case of hepatitis B in the UK.

    PubMed

    Stanton, J

    1994-12-01

    Comparison of hepatitis B vaccine policy with other cases in the past is complicated by the restricted modes of transmission of this disease, which affects relatively few people in the UK. Still, considerations of cost, fear of contamination, divisions of opinion within the medical profession, and regional dispersal of authority are all factors--analysed for other vaccines--which help to explain the limited UK central policy on hepatitis B immunization observed through the 1980s. An important issue, in previous debates on vaccine policies, has been the conflict between public health interests and the rights of individuals to eschew health interventions imposed by the state. It is argued here that this question fed into hepatitis B vaccine policy in an oblique manner, via policy on screening for hepatitis B in the 1970s; minimal screening mainly of selected groups of health workers was favoured, maximizing individual rights. Changes to hepatitis B vaccine policy can be traced, linked with international policy, pharmaceutical company pressure, advances in vaccine technology, and questions of legal liability. The most accurate predictor for vaccine policy appears to have been screening policy. Will this apply to AIDS, which is epidemiologically similar to hepatitis B?

  15. Subsurface imaging, TAIGER experiments and tectonic models of Taiwan

    NASA Astrophysics Data System (ADS)

    Wu, Francis T.; Kuo-Chen, H.; McIntosh, K. D.

    2014-08-01

    The seismicity, deformation rates and associated erosion in the Taiwan region clearly demonstrate that plate tectonic and orogenic activities are at a high level. Major geologic units can be neatly placed in the plate tectonic context, albeit critical mapping in specific areas is still needed, but the key processes involved in the building of the island remain under discussion. Of the two plates in the vicinity of Taiwan, the Philippine Sea Plate (PSP) is oceanic in its origin while the Eurasian Plate (EUP) is comprised partly of the Asian continental lithosphere and partly of the transitional lithosphere of the South China Sea basin. It is unanimously agreed that the collision of PSP and EU is the cause of the Taiwan orogeny, but several models of the underlying geological processes have been proposed, each with its own evolutionary history and implied subsurface tectonics. TAIGER (TAiwan Integrated GEodynamics Research) crustal- and mantle-imaging experiments recently made possible a new round of testing and elucidation. The new seismic tomography resolved structures under and offshore of Taiwan to a depth of about 200 km. In the upper mantle, the steeply east-dipping high velocity anomalies from southern to central Taiwan are clear, but only the extreme southern part is associated with seismicity; toward the north the seismicity disappears. The crustal root under the Central Range is strongly asymmetrical; using 7.5 km/s as a guide, the steep west-dipping face on the east stands in sharp contrast to a gradual east-dipping face on the west. A smaller root exists under the Coastal Range or slightly to the east of it. Between these two roots lies a well delineated high velocity rise spanning the length from Hualien to Taitung. The 3-D variations in crustal and mantle structures parallel to the trend of the island are closely correlated with the plate tectonic framework of Taiwan. The crust is thickest in the central Taiwan collision zone, and although it thins

  16. [Caregivers and residents, raising awareness of the influenza vaccine].

    PubMed

    Plantet, Claire; Sanchez, Stéphane; Cohen, Nadia; Denormandie, Philippe; Dinh, Aurélien

    Influenza epidemics in nursing homes can lead to serious complications with a high level of lethality. It has been shown that an active policy of awareness campaigns with obligatory information materials and easy access to influenza immunisation increases the rate of vaccination coverage. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. What University Governance Can Taiwan Learn from the United States?

    ERIC Educational Resources Information Center

    Lee, Lung-Sheng; Land, Ming H.

    2010-01-01

    Due to changes from centralization to marketization, Taiwan's university governance must increase its effectiveness. The purpose of this paper was to introduce trends in and issues of Taiwan's university governance, describe university governance in the United States, and draw implications that Taiwan's university governance needs to learn from…

  18. Seroprevalence of influenza A H1N1 and seroconversion of mothers and infants induced by a single dose of monovalent vaccine.

    PubMed

    Chao, Anne; Huang, Yhu-Chering; Chang, Yao-Lung; Wang, Tzu-Hao; Chang, Shuenn-Dyh; Wu, Ting-Shu; Wu, Tsu-Lan; Chao, An-Shine

    2013-09-01

    To determine the prevalence of preexisting antibodies against the pandemic 2009 Influenza A (H1N1) virus in pregnant women and to evaluate the seroprotection of the mothers and infants by a single injection of monovalent vaccine during the pandemic. Seropositivity rate of H1N1 among the nonvaccinated were compared with the vaccinated women. A single dose of vaccine, either nonadjuvanted AdimFlu-S or MF59-adjuvanted vaccine, was injected to the voluntarily vaccinated group. Maternal and cord blood sera were collected to evaluate the antibody response of the H1N1 virus. Seropositivity was defined as a hemagglutination inhibition titer to H1N1 (A/Taiwan/126/09) ≥ 1:40. A total of 210 healthy, singleton, pregnant women were enrolled between January 2010 and May 2010. Seropositivity (≥ 1:40) of maternal hemagglutination inhibition was significantly higher in the vaccinated group (78%) than the nonvaccinated group (9.5%); 41.6% (20/48) of seropositive titers were >1:80. In nine vaccinated cases resulting in negative serum titers (<1:40), the prevalence of negative titer in the women received AdimFlu-S (14.8%, 4/31) was lower (p = 0.025) than those received MF59-adjuvanted vaccine (50%, 5/10). Subclinical infection against H1N1 was low in Taiwanese pregnant women in the pandemic 2009. Seropositivity >75% could be achieved in the paired maternal and cord serum samples by a single injection of monovalent H1N1 vaccine. Copyright © 2013. Published by Elsevier B.V.

  19. Influenza vaccination among cancer survivors: disparities in prevalence between blacks and whites.

    PubMed

    Stafford, Kristen A; Sorkin, John D; Steinberger, Eileen K

    2013-06-01

    Cancer survivors are at increased risk for influenza-related complications. Racial disparities in preventive health services have not been extensively studied among cancer survivors. Our objective is to compare influenza vaccination prevalence among black and white cancer survivors We performed a secondary data analysis of 41,346 white and black cancer survivors (excluding non-melanoma skin cancer) from the 2009 Behavioral Risk Factor Surveillance System survey. Respondents were asked whether they had received an influenza vaccination in the previous year. Multivariable logistic regression was used to estimate the odds of having influenza vaccine by race. Sixty-five percent of whites reported receiving the vaccine in the last year compared to 50 % of blacks. Blacks had significantly lower odds of vaccination after controlling for covariates significantly associated with the odds of influenza vaccination. Higher education, having health insurance, having a primary care provider, and having a routine check-up in the last year increased the odds of receiving an influenza vaccine. Our analysis supports that racial disparities in vaccine coverage persist among cancer survivors, a group strongly recommended to receive annual influenza vaccine, even when predictors significantly associated with increased vaccination are controlled for. As a nationally representative survey with a large sample size, our study provides a picture of self-reported vaccine coverage among cancer survivors in the USA and the disparity that exists between blacks and whites in this population. Care teams can use these findings to better target follow-up care for cancer survivors.

  20. The control of H5 or H7 mildly pathogenic avian influenza: a role for inactivated vaccine.

    PubMed

    Halvorson, David A

    2002-02-01

    Biosecurity is the first line of defence in the prevention and control of mildly pathogenic avian influenza (MPAI). Its use has been highly successful in keeping avian influenza (AI) out of commercial poultry worldwide. However, sometimes AI becomes introduced into poultry populations and, when that occurs, biosecurity again is the primary means of controlling the disease. There is agreement that routine serological monitoring, disease reporting, isolation or quarantine of affected flocks, application of strict measures to prevent the contamination of and movement of people and equipment, and changing flock schedules are necessities for controlling AI. There is disagreement as to the disposition of MPAI-infected flocks: some advocate their destruction and others advocate controlled marketing. Sometimes biosecurity is not enough to stop the spread of MPAI. In general, influenza virus requires a dense population of susceptible hosts to maintain itself. When there is a large population of susceptible poultry in an area, use of an inactivated AI vaccine can contribute to AI control by reducing the susceptibility of the population. Does use of inactivated vaccine assist, complicate or interfere with AI control and eradication? Yes, it assists MPAI control (which may reduce the risk of highly pathogenic AI (HPAI)) but, unless steps are taken to prevent it, vaccination may interfere with sero-epidemiology in the case of an HPAI outbreak. Does lack of vaccine assist, complicate or interfere with AI control and eradication? Yes, it assists in identification of sero-positive (convalescent) flocks in a HPAI eradication program, but it interferes with MPAI control (which in turn may increase the risk of emergence of HPAI).A number of hypothetical concerns have been raised about the use of inactivated AI vaccines. Infection of vaccinated flocks, serology complications and spreading of virus by vaccine crews are some of the hypothetical concerns. The discussion of these concerns

  1. Influenza Vaccination Coverage Rates, Knowledge, Attitudes, and Beliefs in Jordan: A Comprehensive Study.

    PubMed

    Assaf, Areej M; Hammad, Eman A; Haddadin, Randa N

    2016-11-01

    Influenza vaccination is the most effective method in preventing influenza and its complications. This study's objectives were to investigate the vaccination coverage and frequency and to assess knowledge, attitudes, and practices toward influenza vaccination in Jordan during the year 2012 and the 5 years preceding it. Additionally, it aimed at identifying the barriers and motivations to receive the vaccine and the factors contributing to its uptake. In May 2012, a self-administered cross-sectional survey was distributed to 3,200 adults conveniently selected across Jordan to explore influenza vaccination status, knowledge, attitudes, and practices toward the influenza vaccine. The survey response rate was 98.3%. The overall coverage rate of seasonal influenza vaccination ranged from 9.9% to 27.5%. Results of the univariate analysis revealed that males, participants older than 45 years, business owners, and university students or graduates were more likely to take the vaccine. Healthcare workers (HCW) showed higher rates than non-HCW and those with concomitant chronic diseases were more committed to receive the vaccine. Knowledge about the influenza vaccine is considered high in the Jordanian population. Fear from side effects was the major barrier, while the fear of the virus spread and outbreak was the major reason to receive the vaccine. The coverage rates were low in Jordan compared to other countries. The need for influenza vaccine campaigns and on-going education in Jordan health schools is crucial to increase the rate and remove misconceptions and negative attitudes toward vaccination.

  2. [EFFECTIVENESS OF PREVENTIVE VACCINE PROPHYLAXIS OF CHICKEN POX IN MILITARY COLLECTIVES].

    PubMed

    Dubodelov, D V; Rybin, V V; Rikhter, V V; Yaroslavtsev, V V; Gritsik, A A; Kazanova, A S; Lavrov, V F; Semenenko, T A; Kuzin, S N

    2015-01-01

    Study the effectiveness of preventive vaccine prophylaxis of chicken pox in military collectives. In the focus of chicken pox, 200 servicemen of the new addition by conscription were immunized once against chicken pox; 97 servicemen by conscription of the new addition (comparison group) were not vaccinated. Epidemiologic and immunologic effectiveness of conduction of preventive vaccine prophylaxis in chicken pox focus were studied. In the group of 200 soldiers, that were present in the focus of infection and were immunized once against chicken pox, only 2 cases of this disease were registered (10 per thousand). In the comparison group, that consisted of 97 unvaccinated servicemen, chicken pox disease was registered in 7 individuals (72 per thousand). Epidemiologic effectiveness of preventive vaccine prophylaxis of chicken pox amounted to 86%. Immunologic effectiveness of vaccination 2-3 weeks after the immunization was 42%, and 2 months after--44%. Local reactions in the form of hyperemia (up to 1.5 cm) and edema were noted in 10% of the vaccinated at the location of preparation administration; in 1.7%--general reaction in the form of temperature increase to 37.8°C was observed. Post-vaccinal complications in the immunized group were not detected. Preventive vaccination of servicemen allows to minimize the spread of chicken pox, however can not serve as means of complete elimination of the infection from military collectives.

  3. Vaccinating parents experience vaccine anxiety too.

    PubMed

    Luthy, Karlen E; Beckstrand, Renea L; Asay, Whitney; Hewett, Carly

    2013-12-01

    To identify common causes of parental anxiety regarding childhood vaccinations among parents who vaccinate. Another purpose was to seek recommendations for healthcare providers to help parents overcome their anxiety when their children are immunized. Four 1-h focus groups were conducted, each consisting of 8-10 parents. Each focus group discussion was conducted by a moderator and an assistant moderator. The moderator facilitated discussion while the assistant moderator took notes. Each session was recorded on video. The data were transcribed and analyzed for themes. Parents identifying themselves as being compliant with childhood vaccination requirements reported anxiety that can be divided into five major themes: parental anxiety prior to vaccination, parental anxiety during the vaccination, parental anxiety after the vaccination, parental suggestions for healthcare providers, and informational issues. Making minor changes in office policies may help alleviate some parental anxiety regarding vaccinations. Providers should also create lists of credible sources about vaccination information. Because the cause of vaccine-related parental anxiety varies, targeted education is necessary to relieve common causes of vaccine anxiety, even among parents who vaccinate. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  4. Vaccine decision-making begins in pregnancy: Correlation between vaccine concerns, intentions and maternal vaccination with subsequent childhood vaccine uptake.

    PubMed

    Danchin, M H; Costa-Pinto, J; Attwell, K; Willaby, H; Wiley, K; Hoq, M; Leask, J; Perrett, K P; O'Keefe, Jacinta; Giles, M L; Marshall, H

    2017-08-12

    Maternal and childhood vaccine decision-making begins prenatally. Amongst pregnant Australian women we aimed to ascertain vaccine information received, maternal immunisation uptake and attitudes and concerns regarding childhood vaccination. We also aimed to determine any correlation between a) intentions and concerns regarding childhood vaccination, (b) concerns about pregnancy vaccination, (c) socioeconomic status (SES) and (d) uptake of influenza and pertussis vaccines during pregnancy and routine vaccines during childhood. Women attending public antenatal clinics were recruited in three Australian states. Surveys were completed on iPads. Follow-up phone surveys were done three to six months post delivery, and infant vaccination status obtained via the Australian Childhood Immunisation Register (ACIR). Between October 2015 and March 2016, 975 (82%) of 1184 mothers consented and 406 (42%) agreed to a follow up survey, post delivery. First-time mothers (445; 49%) had significantly more vaccine concerns in pregnancy and only 73% had made a decision about childhood vaccination compared to 89% of mothers with existing children (p-value<0.001). 66% of mothers reported receiving enough information during pregnancy on childhood vaccination. In the post delivery survey, 46% and 82% of mothers reported receiving pregnancy influenza and pertussis vaccines respectively. The mother's degree of vaccine hesitancy and two attitudinal factors were correlated with vaccine uptake post delivery. There was no association between reported maternal vaccine uptake or SES and childhood vaccine uptake. First time mothers are more vaccine hesitant and undecided about childhood vaccination, and only two thirds of all mothers believed they received enough information during pregnancy. New interventions to improve both education and communication on childhood and maternal vaccines, delivered by midwives and obstetricians in the Australian public hospital system, may reduce vaccine hesitancy

  5. Knowledge and attitude of pregnant women toward flu vaccination: a cross-sectional survey.

    PubMed

    Maurici, Massimo; Dugo, Valentina; Zaratti, Laura; Paulon, Luca; Pellegrini, Maria Grazia; Baiocco, Elisa; Rizzo, Giuseppe; Franco, Elisabetta

    2016-10-01

    The study was conducted to explore the knowledge of pregnant women about influenza, influenza vaccine during pregnancy and the attitudes regarding immunization. A questionnaire based on the model proposed by Yudin in 2009 was translated, adapted and administered to 309 pregnant women in the third trimester of pregnancy between October 1 and December 1, 2013 at San Giovanni Calibita Fatebenefratelli hospital of Rome (Italy). Most of the interviewed women (68.9%) answered that influenza is highly contagious, 34.6% of them believed that pregnant women have the same risk of complications as non-pregnant women. Only 5.8% were aware that the vaccine is recommended for women in the second and third trimester of pregnancy and only 14.2% of women answered that the vaccine is safe during pregnancy. Only 3/309 women reported recommendation and offer of vaccination during current pregnancy, but none of them was vaccinated. Overall, knowledge regarding influenza, implications during pregnancy and influenza vaccine was poor among pregnant women. In Italy, the National Vaccine Prevention Plan 2012-2014 recommends influenza vaccine during pregnancy, but only 18/309 were aware of this recommendation. These results suggest that in order to increase influenza vaccine acceptance it is necessary to improve pregnant women knowledge about influenza and to offer education to healthcare providers.

  6. Active opioid use does not attenuate the humoral responses to inactivated influenza vaccine

    PubMed Central

    Moroz, Ekaterina; Albrecht, Randy A.; Aden, Brandon; Beeder, Ann Bordwine; Yuan, Jianda; García-Sastre, Adolfo; Edlin, Brian R.; Salvatore, Mirella

    2016-01-01

    Background Influenza vaccination is recommended for vulnerable individuals, including active drug users, to prevent influenza complications and decrease influenza spread. Recent studies suggest that opioids negatively regulate immune responses in experimental models, but the extent to which opioid use will affect the humoral responses to influenza vaccine in humans is unknown. This information is critical in maximizing vaccination efforts. Objective To determine whether there is a difference in antibody response after influenza vaccination in heroin or methadone users compared to control subjects. Methods We studied active heroin users, subjects on methadone maintenance treatment (MMT) and subjects that did not use any drugs before and 1 and 4 weeks after vaccination with trivalent influenza vaccine (TIV). We measured hemagglutination inhibition and microneutralization titers, and we compared geometric mean titers (GMT), and rates of seroprotection and seroconversion for each of the vaccine strains among the 3 groups of subjects. Results Heroin users, subjects on MMT and non-user controls mount a similarly robust serologic response to TIV. GMT and rates of seroprotection and seroconversion were not significantly different among groups. Conclusion Our results suggest that opioid use do not significantly alter antibody responses to influenza vaccine supporting the vaccination effort in these populations. PMID:26859239

  7. Dendritic cell-targeting DNA-based mucosal adjuvants for the development of mucosal vaccines

    PubMed Central

    Kataoka, Kosuke; Fujihashi, Kohtaro

    2009-01-01

    In order to establish effective mucosal immunity against various mucosal pathogens, vaccines must be delivered via the mucosal route and contain effective adjuvant(s). Since mucosal adjuvants can simply mix with the antigen, it is relatively easy to adapt them for different types of vaccine development. Even in simple admixture vaccines, the adjuvant itself must be prepared without any complications. Thus, CpG oligodeoxynucleotides or plasmids encoding certain cDNA(s) would be potent mucosal adjuvant candidates when compared with other substances that can be used as mucosal adjuvants. The strategy of a DNA-based mucosal adjuvant facilitates the targeting of mucosal dendritic cells, and thus is an effective and safe approach. It would also provide great flexibility for the development of effective vaccines for various mucosal pathogens. PMID:19722892

  8. Vaccine preventable meningitis in Malaysia: epidemiology and management.

    PubMed

    McNeil, Hannah C; Jefferies, Johanna M C; Clarke, Stuart C

    2015-06-01

    Worldwide bacterial meningitis accounts for more than one million cases and 135,000 deaths annually. Profound, lasting neurological complications occur in 9-25% of cases. This review confirms the greatest risk from bacterial meningitis is in early life in Malaysia. Much of the disease burden can be avoided by immunization, particularly against Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae. Despite inclusion of the Hib vaccine in the National Immunisation Programme and the licensure of pneumococcal vaccines, these two species are the main contributors to bacterial meningitis in Malaysia, with Neisseria meningitidis and Mycobacterium tuberculosis, causing a smaller proportion of disease. The high Hib prevalence may partly be due to dated, small-scale studies limiting the understanding of the current epidemiological situation. This highlights the need for larger, better quality surveillance from Malaysia to evaluate the success of Hib immunization and to help guide immunization policy for vaccines against S. pneumoniae and N. meningitidis.

  9. 2016 guideline strategies for the use of antifungal agents in patients with hematological malignancies or hematopoietic stem cell transplantation recipients in Taiwan.

    PubMed

    Ko, Bor-Sheng; Chen, Wei-Ting; Kung, Hsiang-Chi; Wu, Un-In; Tang, Jih-Luh; Yao, Ming; Chen, Yee-Chun; Tien, Hwei-Fang; Chang, Shan-Chwen; Chuang, Yin-Ching; Lin, Dong-Tsamn

    2017-07-25

    The Infectious Diseases Society of Taiwan (IDST), the Hematology Society of Taiwan, the Taiwan Society of Blood and Marrow Transplantation, Medical Foundation in Memory of Dr. Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, and CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines cooperatively published this guideline for the use of antifungal agents in hematological patients with invasive fungal diseases (IFDs) in Taiwan. The guideline is the first one endorsed by IDST focusing on selection of antifungal strategies, including prophylaxis, empirical (or symptom-driven) and pre-emptive (or diagnostic-driven) strategy. We suggest a risk-adapted dynamic strategy and provide an algorithm to facilitate decision making in population level as well as for individual patient. Risk assessment and management accordingly is explicitly emphasized. In addition, we highlight the importance of diagnosis in each antifungal strategy among five elements of the antimicrobial stewardship (diagnosis, drug, dose, de-escalation and duration). The rationale, purpose, and key recommendations for the choice of antifungal strategy are summarized, with concise review of international guidelines or recommendation, key original articles and local epidemiology reports. We point out the interaction and influence between elements of recommendations and limitation of and gap between evidences and daily practice. The guideline balances the quality of evidence and feasibility of recommendation in clinical practice. Finally, this version introduces the concept of health economics and provides data translated from local disease burdens. All these contents hopefully facilitate transparency and accountability in medical decision-making, improvements in clinical care and health outcomes, and appropriateness of medical resource allocation. Copyright © 2017. Published by Elsevier B.V.

  10. Clinical Characteristics and In-Hospital Prognosis of Infective Endocarditis in Two Eastern Counties of Taiwan

    PubMed Central

    Hsieh, Jen-Che; Wang, Ling-Yi; Chang, Huai-Ren; Chao, Shen-Feng; Wang, Ji-Hung

    2014-01-01

    Background Infective endocarditis (IE) is a common and potentially serious disease. Although it is an illness that affects populations around the world, narrower descriptions of this disease as it impacts specific regions are uncommon. We analyzed the clinical characteristics of IE patients from two eastern counties in Taiwan and studied the relationship between the isolated pathogens and clinical outcomes in these patients. Methods This is a retrospective chart review study which enrolled patients who received services between January 2007 and December 2010. Subsequent to chart review, IE was confirmed in a total of 55 patients by the modified Duke criteria. Results Of these patients, 17 (31%) had previous traumatic open skin wounds. Pre-existing cardiac abnormalities were found in 47 (85%) patients, 28 of whom had valvular abnormalities. Staphylococcus aureus was isolated from the blood as the leading pathogen in 25 (45%) patients (including 23 methicillin-sensitive and 2 methicillin-resistant). Septic emboli and shock occurred in 27 (49%) of 55 patients; surgery was performed on 11 (20%) of those patients, and 4 (36%) of them died post-operatively. The total in-hospital mortality rate was 40% (n = 22). Staphylococcus aureus infection was associated with significantly higher complication and mortality rate than non-Staphylococcus aureus infection (59% vs. 41% and 64% vs. 36%, respectively; p < 0.05). In addition, patients with complications had a very high mortality rate (81.5%). Conclusions We found that Staphylococcus aureus was the most common pathogen of IE in Eastern Taiwan, and was associated with higher rates of morbidities and mortality. PMID:27122782

  11. Development of a Freeze-Dried, Heat-Stable Influenza Subunit Vaccine Formulation

    PubMed Central

    Flood, Alexander; Chen, Dexiang

    2016-01-01

    An influenza pandemic remains a major public health concern. A key strategy to prevent a pandemic is to stockpile and pre-position stable influenza vaccine to allow rapid deployment in response to an outbreak. However, most influenza vaccines today are formulated as liquids that are stable only within a temperature range of 2°C to 8°C and require use of a cold chain, making vaccine transportation, distribution, and storage complicated and expensive, particularly for developing countries. To support the National Strategy for Pandemic Influenza preparedness in the United States and internationally, we developed two lead dry formulations of stable H1N1 influenza subunit vaccines using freeze-drying technology. The stable formulations contain an excipient combination of a disaccharide, such as sucrose or trehalose, and glycine, in addition to a surfactant and phosphate buffer. The freeze-dried vaccines were shown to be safe and remained immunogenic in an in vivo study in mice. Moreover, the lead formulations demonstrated no significant loss of activity after 40 months at storage temperatures of 25°C and 37°C. This stability can be particularly attractive as it could eliminate the need to use a cold chain for vaccine deployment and facilitate integration of vaccine distribution with general drug distribution where appropriate. These freeze-dried thermostable influenza subunit vaccines could also reduce the frequency of vaccine stockpile turnover, offering a cost-effective option for pandemic preparedness. PMID:27851765

  12. Development of a Freeze-Dried, Heat-Stable Influenza Subunit Vaccine Formulation.

    PubMed

    Flood, Alexander; Estrada, Marcus; McAdams, David; Ji, Yuhua; Chen, Dexiang

    2016-01-01

    An influenza pandemic remains a major public health concern. A key strategy to prevent a pandemic is to stockpile and pre-position stable influenza vaccine to allow rapid deployment in response to an outbreak. However, most influenza vaccines today are formulated as liquids that are stable only within a temperature range of 2°C to 8°C and require use of a cold chain, making vaccine transportation, distribution, and storage complicated and expensive, particularly for developing countries. To support the National Strategy for Pandemic Influenza preparedness in the United States and internationally, we developed two lead dry formulations of stable H1N1 influenza subunit vaccines using freeze-drying technology. The stable formulations contain an excipient combination of a disaccharide, such as sucrose or trehalose, and glycine, in addition to a surfactant and phosphate buffer. The freeze-dried vaccines were shown to be safe and remained immunogenic in an in vivo study in mice. Moreover, the lead formulations demonstrated no significant loss of activity after 40 months at storage temperatures of 25°C and 37°C. This stability can be particularly attractive as it could eliminate the need to use a cold chain for vaccine deployment and facilitate integration of vaccine distribution with general drug distribution where appropriate. These freeze-dried thermostable influenza subunit vaccines could also reduce the frequency of vaccine stockpile turnover, offering a cost-effective option for pandemic preparedness.

  13. For t 2 DNA vaccine prevents Forcipomyia taiwana (biting midge) allergy in a mouse model.

    PubMed

    Lee, M-F; Song, P-P; Lin, T-M; Chiu, Y-T; Chen, Y-H

    2016-04-01

    Forcipomyia taiwana (biting midge) is the most prevalent allergenic biting insect in Taiwan, and 60% of the exposed subjects develop allergic reactions. Subjects with insect allergy frequently limit their outdoor activities to avoid the annoyingly intense itchy allergic reactions, leading to significant worsening of their quality of life. Allergen-specific immunotherapy is the only known therapy that provides long-term host immune tolerance to the allergen, but is time-consuming and cumbersome. This study tested whether the For t 2 DNA vaccine can prevent allergic symptoms in For t 2-sensitized mice. Two consecutive shots of For t 2 DNA vaccine were given to mice with a 7-day interval before sensitization with recombinant For t 2 proteins, using the two-step sensitization protocol reported previously. The For t 2 DNA vaccine at 50 μg prevented the production of For t 2-specific IgE (P < 0.05), as well as midge allergen-challenge-induced scratch bouts, midge allergen-induced IL-13 and IL-4 production from splenocytes, and inflammatory cell infiltrations in the lesions 48 h after intradermal challenge. This study is the first to demonstrate that DNA vaccine encoding midge allergen is effective in preventing allergic skin inflammation induced by biting midge. Immunotherapy using For t 2 DNA vaccine can protect mice from being sensitized by midge allergen and may be a promising treatment for biting midge allergy in the future. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. The Study of Aeromagnetic Surveys in Taiwan

    NASA Astrophysics Data System (ADS)

    Li, P. T.; Tong, L. T.; Lin, W.; Chang, S. F.

    2016-12-01

    The airborne magnetic survey is a cost-effective method for regional geological investigation. Most of developed countries use aeromagnetic data as important fundamental information for resources development. The first aeromagnetic survey was conducted in the offshore areas of west and southern Taiwan in 1968 by U.S. Naval Oceanographic Office to help Taiwan finding oil. Later, in 2007, a helicopter-borne magnetic survey was proceed in east Taiwan for underground granite bodies. In order to improve better understanding of deep geological structures associated with the Holocene volcanism in Taiwan, we applied helicopter-borne magnetic technique in northern Taiwan include Tatun Volcano Group (TVG) and Kueishan island in 2013 and 2014 to obtain the distribution information of potential magma chamber as well as hydrothermal pathways along regional geological structures. The most important findings of the high-resolution aeromagnetic dataset since 1960's to 2014 acquired include: (1) the distribution of subsurface igneous rocks and the Curie point depth in Tatun Volcano Group, Keelung Volcano Group, and Kueishantao Volcano; (2) the widely distributed NE high-magnetic belts in northern Taiwan may be associated with NE fractures created by long-term subsidence in this area; (3) the high-magnetic belts in south of Lanyang River which is very different from the magnetic characteristics of the Central Range may imply paleo oceanic plate; (4) the NE high-magnetic belts in Penghu area formed by magma intrusion along NE fractures and the dense and high-magnetic anomalies may be associated with the Miocene basaltic lava overlying on the pre-Tertiary igneous dykes and are widely spread in northern Penghu area. The new aeromagnetic survey techniques help us to investigate the areas with steep terrain or covered by dense vegetation which was difficult to obtain reasonable geological understanding, and also provide an opportunity for us to apply the geothermal energy prospecting.

  15. Travel and biologic therapy: travel-related infection risk, vaccine response and recommendations.

    PubMed

    Hall, Victoria; Johnson, Douglas; Torresi, Joseph

    2018-01-01

    Biologic therapy has revolutionized the management of refractory chronic autoimmune and auto-inflammatory disease, as well as several malignancies, providing rapid symptomatic relief and/or disease remission. Patients receiving biologic therapies have an improved quality of life, facilitating travel to exotic destinations and potentially placing them at risk of a range of infections. For each biologic agent, we review associated travel-related infection risk and expected travel vaccine response and effectiveness. A PUBMED search [vaccination OR vaccine] AND/OR ['specific vaccine'] AND/OR [immunology OR immune response OR response] AND [biologic OR biological OR biologic agent] was performed. A review of the literature was performed in order to develop recommendations on vaccination for patients in receipt of biologic therapy travelling to high-risk travel destinations. There is a paucity of literature in this area, however, it is apparent that travel-related infection risk is increased in patients on biologic therapy and when illness occurs they are at a higher risk of complication and hospitalization. Patients in receipt of biologic agents are deemed as having a high level of immunosuppression-live vaccines, including the yellow fever vaccine, are contraindicated. Inactivated vaccines are considered safe; however, vaccine response can be attenuated by the patient's biologic therapy, thereby resulting in reduced vaccine effectiveness and protection. Best practice requires a collaborative approach between the patient's primary healthcare physician, relevant specialist and travel medicine expert, who should all be familiar with the immunosuppressive and immunomodulatory effects resulting from the biologic therapies. Timing of vaccines should be carefully planned, and if possible, vaccination provided well before established immunosuppression.

  16. [Prevention of elderly pneumonia by pneumococcal, influenza and BCG vaccinations].

    PubMed

    Ohrui, Takashi; Nakayama, Katsutoshi; Fukushima, Takeyasu; Chiba, Hiroshi; Sasaki, Hidetada

    2005-01-01

    Pneumonia is a major cause of morbidity and mortality in elderly people, especially in those with chronic medical conditions such as chronic heart and lung diseases. We prospectively examined the effect of influenza and pneumococcal vaccinations on the rate of hospitalization for and complications of pneumonia, all respiratory tract conditions and mortality in elderly bedridden patients and found that both febrile days and pneumonia cases decreased. Thus, these results show that it is valuable to vaccinate for influenza elderly people even if they are confined to bed. Furthermore, the tuberculin skin test is an easy method to check the cell-mediated immunity in the elderly people. In the tuberculin skin test, all Japanese over 65 years old should have positive status. A negative result indicates depressed cell-mediated immunity. We undertook a trial to vaccinate tuberculin negative elderly people with BCG vaccine and found that the risk of pneumonia is decreased to a similar degree to that in subjects with positive tuberculin test results. We conclude that vaccination might be an effective strategy for the prevention of pneumonia in elderly people with limited activities of daily living.

  17. Risk of cancer in patients with genital warts: A nationwide, population-based cohort study in Taiwan

    PubMed Central

    Cho, Ching-Yi; Lo, Yu-Cheng; Hung, Miao-Chiu; Lai, Chou-Cheng; Chen, Chun-Jen

    2017-01-01

    Background Condyloma acuminata currently affects around 1% of sexually active adults, and its incidence is increasing. The coexistence of genital warts (GW) and certain cancers and an association between human papillomavirus (HPV) and various malignancies have been reported. Therefore, we conducted this large national study to analyze the risk of malignancies among men and women with GW in Taiwan. Methods and findings Between January 2000 and December 2013, approximately 3 million patients were reported to the National Health Insurance Research Database of Taiwan. Of these patients, 21,763 were diagnosed with GW. In the same time period, a total of 213,541 cancer cases were reported to the registry, of which 1002 were recorded among patients with GW. The age-specific incidence rates of GW and standardized incidence ratios (SIRs) of malignancies compared to the general population were calculated. Women acquired GW earlier than men, with a mean age at diagnosis of 32.63±12.78 years. The highest incidence rate for both genders peaked at 20–29 years. Of the 1002 patients with GW and malignancies, the SIR was 1.95 (95%CI 1.83–2.07). The most markedly increased risk was found for HPV-related cancers, with a SIR of 9.74 (95%CI 3.70–15.77). Significantly elevated risks were also noted for smoking-related cancers, anogenital cancers, cervix in situ, colon, rectum, lung, kidney, and prostate cancers. Most cancers developed within 10 years after the diagnosis of GW. Conclusions Patients with GW have an increased risk of HPV-related cancers, especially anogenital malignancies in Taiwan. The elevated risk of other cancers highlights differences in exposure and risk factors among patients with GW compared to the general population. Cancer screening and HPV vaccination programs should be emphasized for at-risk patients. PMID:28806741

  18. Educating Students with Learning Disabilities in Taiwan

    ERIC Educational Resources Information Center

    Hsiao, Yun-Ju

    2011-01-01

    In East Asia, Taiwan is one of only a few countries that has a clear definition of learning disabilities (LD) as well as operational criteria for the identification of LD. In Taiwan, special education services for students with LD are mandated in the Special Education Act of 1984. According to the official statistics from the Taiwanese Special…

  19. Impact of Aging and Cytomegalovirus on Immunological Response to Influenza Vaccination and Infection.

    PubMed

    Merani, Shahzma; Pawelec, Graham; Kuchel, George A; McElhaney, Janet E

    2017-01-01

    The number of people over the age of 60 is expected to double by 2050 according to the WHO. This emphasizes the need to ensure optimized resilience to health stressors in late life. In older adults, influenza is one of the leading causes of catastrophic disability (defined as the loss of independence in daily living and self-care activities). Influenza vaccination is generally perceived to be less protective in older adults, with some studies suggesting that the humoral immune response to the vaccine is further impaired in cytomegalovirus (CMV)-seropositive older people. CMV is a β-herpes virus infection that is generally asymptomatic in healthy individuals. The majority of older adults possess serum antibodies against the virus indicating latent infection. Age-related changes in T-cell-mediated immunity are augmented by CMV infection and may be associated with more serious complications of influenza infection. This review focuses on the impact of aging and CMV on immune cell function, the response to influenza infection and vaccination, and how the current understanding of aging and CMV can be used to design a more effective influenza vaccine for older adults. It is anticipated that efforts in this field will address the public health need for improved protection against influenza in older adults, particularly with regard to the serious complications leading to loss of independence.

  20. The herpes zoster subunit vaccine.

    PubMed

    Cunningham, Anthony L

    2016-01-01

    Herpes zoster (HZ) causes severe pain and rash in older people and may be complicated by prolonged pain (postherpetic neuralgia; PHN). HZ results from reactivation of latent varicella-zoster virus (VZV) infection, often associated with age related or other causes of decreased T cell immunity. A concentrated live attenuated vaccine boosts this immunity and provides partial protection against HZ, but this decreases with age and declines over 5-8 years. The new HZ subunit (HZ/su or Shingrix) vaccine combines a key surface VZV glycoprotein (E) with T cell boosting adjuvant (AS01B). It is highly efficacious in protection (97%) against HZ in immunocompetent subjects, with no decline in advancing age and protection maintained for >3 years. Phase I-II trials showed safety and similar immunogenicity in severely immunocompromised patients. Local injection site pain and swelling can be severe in a minority (9.5%) but is transient (2 days). The HZ/su vaccine appears very promising in immunocompetent patients in the ZoE-50 controlled trial. The unblinding of the current ZoE-50 trial and publication of results from the accompanying ZoE-70 trial will reveal more about its mechanism of action and its efficacy against PHN, particularly in subjects >70 years. Phase III trial results in immunocompromised patients are eagerly awaited.

  1. Clinical features and phylogenetic analysis of Coxsackievirus A9 in Northern Taiwan in 2011

    PubMed Central

    2013-01-01

    Background Coxsackievirus A9 (CA9) was one of the most prevalent serotype of enteroviral infections in Taiwan in 2011. After several patient series were reported in the 1960s and 1970s, few studies have focused on the clinical manifestations of CA9 infections. Our study explores and deepens the current understanding of CA9. Methods We analyzed the clinical presentations of 100 culture-proven CA9-infected patients in 2011 by reviewing their medical records and depicted the CA9 phylogenetic tree. Results Of the 100 patients with culture-proven CA9 infections, the mean (SD) age was 4.6 (3.4) years and the male to female ratio was 1.9. For clinical manifestations, 96 patients (96%) had fever and the mean (SD) duration of fever was 5.9 (3.4) days. Sixty one patients (61%) developed a skin rash, and the predominant pattern was a generalized non-itchy maculopapular rash without vesicular changes. While most patients showed injected throat, oral ulcers were found in only 19 cases (19%), among whom, 6 were diagnosed as herpangina. Complicated cases included: aseptic meningitis (n=8), bronchopneumonia (n=6), acute cerebellitis (n=1), and polio-like syndrome (n=1). Phylogenetic analysis for current CA9 strains is closest to the CA9 isolate 27-YN-2008 from the border area of mainland China and Myanmar. Conclusions The most common feature of CA9 during the 2011 epidemic in Taiwan is generalized febrile exanthema rather than herpangina or hand, foot, and mouth disease. Given that prolonged fever and some complications are possible, caution should be advised in assessing patients as well as in predicting the clinical course. PMID:23347781

  2. High cumulative incidence of urinary tract transitional cell carcinoma after kidney transplantation in Taiwan.

    PubMed

    Wu, Ming-Ju; Lian, Jong-Da; Yang, Chi-Rei; Cheng, Chi-Hung; Chen, Cheng-Hsu; Lee, Wen-Chin; Shu, Kuo-Hsiung; Tang, Ming-Jer

    2004-06-01

    Cancer is a well-documented complication after kidney transplantation. Increased incidence of bladder cancer had been reported in long-term hemodialysis patients in Taiwan. Herein, the authors report a very high cumulative incidence of transitional cell carcinoma (TCC) of the urinary tract after kidney transplantation in Taiwan. The authors retrospectively reviewed the clinical data, medical records, and outcome of 730 kidney transplant (KT) recipients. The cumulative incidence of TCC was computed. The Cox regression method was used to analysis the role of potential risk factors. After a mean follow-up duration of 72.2 +/- 54.4 months, 69 cancers were diagnosed in 63 (8.6%) KT recipients. Of them, 30 cases (4.1%) were TCC. The cumulative incidence for TCC was 3.0% after 3 years of graft survival, increasing to 7.2% at 6 years and 17.5% at 10 years. Compared with the general population in Taiwan, the standardized mortality ratio was 398.4 (male, 192.6; female, 875.6). Painless gross hematuria was the cardinal initial symptom in 22 (73.3%) of the 30 KT recipients with TCC. Another 4 (13.3%) KT recipients with TCC presented with chronic urinary tract infection (UTI). Bilateral nephroureterectomy with removal of bladder cuffs was performed in 18 (60%) patients. Synchronous TCC in bilateral upper urinary tracts was confirmed in 11 (36.7%) of KT recipients with TCC. The age at the time of KT, female sex, compound analgesics usage, Chinese herb usage, and underground water intake had statistical significance as risk factors (P < 0.05). The KT recipients are at extremely high risk for TCC in Taiwan, with an incidence of 4.1%. This study indicates that hematuria and chronic UTI are the initial presentation of TCC in KT recipients. Carefully urologic screening is indicated for patients with high risk for TCC, including those with older age, compound analgesics usage, Chinese herbs usage, and underground water intake as well as women.

  3. A material flow of lithium batteries in Taiwan.

    PubMed

    Chang, T C; You, S J; Yu, B S; Yao, K F

    2009-04-30

    Li batteries, including secondary and cylindrical/button primary Li batteries, are used worldwide in computers, communications and consumer electronics products. However, there are several dangerous issues that occur during the manufacture, shipping, and storage of Li batteries. This study analyzes the material flow of lithium batteries and their valuable heavy metals in Taiwan for the year 2006 by material flow analysis. According to data from the Taiwan Environmental Protection Administration, Taiwan External Trade Development Council, Bureau of Foreign Trade, Directorate General of Customs, and the Li batteries manufactures/importers/exporters. It was found that 2,952,696 kg of Li batteries was input into Taiwan for the year 2006, including 2,256,501 kg of imported Li batteries and 696,195 kg of stock Li batteries in 2005. In addition, 1,113,867 and 572,215 kg of Li batteries was domestically produced and sold abroad, revealing that 3,494,348 kg of different types of Li batteries was sold in Taiwan. Of these domestically sold batteries, 504,663 and 146,557 kg were treated domestically and abroad. Thus, a total of 2,843,128 kg of Li batteries was stored by individual/industry users or illegally disposed. In addition, it was also observed that 2,120,682 kg of heavy metals contained in Li batteries, including Ni, Co, Al, Cu and Ni, was accumulated in Taiwan, with a recycled value of 38.8 million USD. These results suggest that these heavy metals should be recovered by suitable collection, recycling and reuse procedures.

  4. Canine distemper virus in wild ferret-badgers of Taiwan.

    PubMed

    Chen, Chen-Chih; Pei, Kurtis Jai-Chyi; Liao, Ming-Huei; Mortenson, Jack A

    2008-04-01

    Canine distemper is an acute or subacute, highly contagious, febrile disease that is caused by canine distemper virus (CDV). Two CDV-infected wild Taiwan ferret-badgers (Melogale moschata subauantiaca) were found in Kaohsiung County, southern Taiwan, in 2005. Each case was confirmed by detecting CDV RNA in lung and brain tissues. A suspected third case was detected based on clinical signs and histology. These cases are the first record of wildlife infected by CDV in Taiwan. It is believed that domestic dogs or coexisting wild carnivores infected with the virus were the most likely source, and a serologic survey is needed to fully understand the host range of this virus in Taiwan. In addition, further genetic sequencing is needed to determine the source of these CDV cases.

  5. Vaccines today, vaccines tomorrow: a perspective.

    PubMed

    Loucq, Christian

    2013-01-01

    Vaccines are considered as one of the major contributions of the 20th century and one of the most cost effective public health interventions. The International Vaccine Institute has as a mission to discover, develop and deliver new and improved vaccines against infectious diseases that affects developing nations. If Louis Pasteur is known across the globe, vaccinologists like Maurice Hilleman, Jonas Salk and Charles Mérieux are known among experts only despite their contribution to global health. Thanks to a vaccine, smallpox has been eradicated, polio has nearly disappeared, Haemophilus influenzae B, measles and more recently meningitis A are controlled in many countries. While a malaria vaccine is undergoing phase 3, International Vaccine Institute, in collaboration with an Indian manufacturer has brought an oral inactivated cholera vaccine to pre-qualification. The field of vaccinology has undergone major changes thanks to philanthropists such as Bill and Melinda Gates, initiatives like the Decade of Vaccines and public private partnerships. Current researches on vaccines have more challenging targets like the dengue viruses, malaria, human immunodeficiency virus, the respiratory syncytial virus and nosocomial diseases. Exciting research is taking place on new adjuvants, nanoparticles, virus like particles and new route of administration. An overcrowded infant immunization program, anti-vaccine groups, immunizing a growing number of elderlies and delivering vaccines to difficult places are among challenges faced by vaccinologists and global health experts.

  6. [Vaccines and autism: a myth to debunk?].

    PubMed

    Battistella, Melania; Carlino, Cristiana; Dugo, Valentina; Ponzo, Patrizia; Franco, Elisabetta

    2013-01-01

    Thanks to vaccinations the incidence of many seriously debilitating or life threatening diseases and the resulting infant mortality or disability have been drastically reduced. In populations, who are no more aware of the risk of these infections, the attitude of suspicion and fear towards the vaccinations is expanding and in some cases reaches a worldwide media coverage as was the case for the measles, mumps and rubella vaccine (MMR). In 1998, a British doctor, Andrew Wakefield, and co-authors, published in "Lancet" a study in which he suggested the existence of "a new variant of autism" associated with intestinal inflammation. He proposed the administration of the MMR vaccine as a possible. cause of the inflammatory process. The hypothesis suggested by Wakefield led to a drastic drop in vaccination coverage in the UK and to the failure to achieve adequate levels of immunization in many countries, with a consequent increase in the incidence of measles and its complications. Wakefield work stimulated a broad discussion in the scientific community and many studies conducted over the next few years contradicted the research results of the English physician. In 2004, journalist Brian Deer conducted an accurate investigation that revealed how the Wakefield research presented many not regular aspects and was performed with predominantly economic objectives. In 2010, Wakefield was expelled from the General Medical Council, while the "Lancet" retracted the paper. The scientific research conducted in recent years confirm the inconsistency of the relationship between MMR vaccine and autism. The possible association with other factors, such as autoimmune processes, hyperactivation of mast cells in the hypothalamus, use of paracetamol in genetically predisposed children are currently investigated.

  7. Methods and Protocols for Developing Prion Vaccines.

    PubMed

    Marciniuk, Kristen; Taschuk, Ryan; Napper, Scott

    2016-01-01

    Prion diseases denote a distinct form of infectivity that is based in the misfolding of a self-protein (PrP(C)) into a pathological, infectious conformation (PrP(Sc)). Efforts to develop vaccines for prion diseases have been complicated by the potential dangers that are associated with induction of immune responses against a self-protein. As a consequence, there is considerable appeal for vaccines that specifically target the misfolded prion conformation. Such conformation-specific immunotherapy is made possible through the identification of vaccine targets (epitopes) that are exclusively presented as a consequence of misfolding. An immune response directed against these targets, termed disease-specific epitopes (DSEs), has the potential to spare the function of the native form of the protein while clearing, or neutralizing, the infectious isomer. Although identification of DSEs represents a critical first step in the induction of conformation-specific immune responses, substantial efforts are required to translate these targets into functional vaccines. Due to the poor immunogenicity that is inherent to self-proteins, and that is often associated with short peptides, substantial efforts are required to overcome tolerance-to-self and maximize the resultant immune response following DSE-based immunization. This often includes optimization of target sequences in terms of immunogenicity and development of effective formulation and delivery strategies for the associated peptides. Further, these vaccines must satisfy additional criteria from perspectives of specificity (PrP(C) vs. PrP(Sc)) and safety (antibody-induced template-driven misfolding of PrP(C)). The emphasis of this report is on the steps required to translate DSEs into prion vaccines and subsequent evaluation of the resulting immune responses.

  8. Healthcare Professionals' Knowledge of Influenza and Influenza Vaccination: Results of a National Survey in Poland.

    PubMed

    Kuchar, Ernest; Ludwikowska, Kamila; Antczak, Adam; Nitsch-Osuch, Aneta

    2018-01-01

    In Poland, the seasonal influenza vaccination rate is just barely 3% which may be related to the unsatisfactory knowledge of influenza among healthcare professionals, poor recognition of the benefits of influenza immunization and the fear of side effects. To address these issues, we surveyed healthcare professionals through an online questionnaire consisting of 18 closed-ended items. The questionnaire was completed by 495 healthcare professionals, mostly physicians (83%). The results revealed gaps in the knowledge concerning influenza diagnosis, complications, risk groups, and prognostic factors. On average, respondents only answered 4.8 of the 18 questions correctly (27%). Only 10% of respondents passed the threshold of 50% correct answers. The knowledge of contraindications to vaccination far outweighed the knowledge of indications for vaccination. Poor knowledge with a focus on the adverse effects of immunization may be a significant factor responsible for the low vaccination rate in Poland. To increase vaccination rate, healthcare professionals need to be educated about influenza-related risks and benefits of vaccination.

  9. Epidemiology of organophosphate pesticide poisoning in Taiwan.

    PubMed

    Lin, Tzeng Jih; Walter, Frank Gardner; Hung, Dong Zong; Tsai, Jin Lian; Hu, Sheng Chuan; Chang, Jung San; Deng, Jou-Fang; Chase, Jung San; Denninghoff, Kurt; Chan, Hon Man

    2008-11-01

    The nationwide epidemiology of organophosphate pesticide (OP) poisoning has never been reported in detail for Taiwan. This study retrospectively reviewed all human OP exposures reported to Taiwan's Poison Control Centers (PCCs) from July 1985 through December 2006. There were 4799 OP exposures. Most OP exposures were acute (98.37%) ingestions (74.50%) of a single OP (80.37%) to attempt suicide (64.72%) in adults (93.25%). Males were the most common gender (64.95%). Most patients (61.97%) received atropine and/or pralidoxime. The mortality rate for all 4799 OP exposures was 12.71%. Exposures to single OPs without co-intoxicants caused 524 deaths; of these, 63.36% were due to dimethyl OPs. Dimethyl OPs cause the majority of deaths in Taiwan.

  10. Trends in Childhood Influenza Vaccination Coverage—U.S., 2004–2012

    PubMed Central

    Lu, Peng-Jun; O'Halloran, Alissa; Meghani, Ankita; Grabowsky, Mark; Singleton, James A.

    2014-01-01

    Objective We compared estimates of childhood influenza vaccination coverage by health status, age, and racial/ethnic group across eight consecutive influenza seasons (2004 through 2012) based on two survey systems to assess trends in childhood influenza vaccination coverage in the U.S. Methods We used National Health Interview Survey (NHIS) and National Immunization Survey-Flu (NIS-Flu) data to estimate receipt of at least one dose of influenza vaccination among children aged 6 months to 17 years based on parental report. We computed estimates using Kaplan-Meier survival analysis methods. Results Based on the NHIS, overall influenza vaccination coverage with at least one dose of influenza vaccine among children increased from 16.2% during the 2004–2005 influenza season to 47.1% during the 2011–2012 influenza season. Children with health conditions that put them at high risk for complications from influenza had higher influenza vaccination coverage than children without these health conditions for all the seasons studied. In seven of the eight seasons studied, there were no significant differences in influenza vaccination coverage between non-Hispanic black and non-Hispanic white children. Influenza vaccination coverage estimates for children were slightly higher based on NIS-Flu data compared with NHIS data for the 2010–2011 and 2011–2012 influenza seasons (4.1 and 4.4 percentage points higher, respectively); both NIS-Flu and NHIS estimates had similar patterns of decreasing vaccination coverage with increasing age. Conclusions Although influenza vaccination coverage among children continued to increase, by the 2011–2012 influenza season, only slightly less than half of U.S. children were vaccinated against influenza. Much improvement is needed to ensure all children aged ≥6 months are vaccinated annually against influenza. PMID:25177053

  11. Vaccine-Preventable Diseases In Pediatric Patients: A Review Of Measles, Mumps, Rubella, And Varicella.

    PubMed

    Levine, Deborah A

    2016-12-01

    Vaccine-preventable diseases such as measles, mumps, rubella, and varicella continue to plague children and adults worldwide. Although public health programs have helped decrease the prevalence and sequelae of these diseases, outbreaks still occur. To limit the spread of these diseases, emergency clinicians must be able to readily identify the characteristic presentations of the rashes associated with measles, rubella, and varicella, as well as the common presenting features associated with mumps. Diagnostic laboratory studies are not usually necessary, as a complete history and physical examination usually lead to an accurate diagnosis. Treatment for these vaccine-preventable diseases usually consists of supportive care, but, in some cases, severe complications and death may occur. This issue provides a review of the clinical features, differential diagnoses, potential complications, and treatment options for measles, mumps, rubella, and varicella.

  12. The impact of 2-dose routine measles, mumps, rubella, and varicella vaccination in France on the epidemiology of varicella and zoster using a dynamic model with an empirical contact matrix.

    PubMed

    Ouwens, Mario J N M; Littlewood, Kavi J; Sauboin, Christophe; Téhard, Bertrand; Denis, François; Boëlle, Pierre-Yves; Alain, Sophie

    2015-04-01

    Varicella has a high incidence affecting the vast majority of the population in France and can lead to severe complications. Almost every individual infected by varicella becomes susceptible to herpes zoster later in life due to reactivation of the latent virus. Zoster is characterized by pain that can be long-lasting in some cases and has no satisfactory treatment. Routine varicella vaccination can prevent varicella. The vaccination strategy of replacing both doses of measles, mumps, and rubella (MMR) with a combined MMR and varicella (MMRV) vaccine is a means of reaching high vaccination coverage for varicella immunization. The objective of this analysis was to assess the impact of routine varicella vaccination, with MMRV in place of MMR, on the incidence of varicella and zoster diseases in France and to assess the impact of exogenous boosting of zoster incidence, age shift in varicella cases, and other possible indirect effects. A dynamic transmission population-based model was developed using epidemiological data for France to determine the force of infection, as well as an empirically derived contact matrix to reduce assumptions underlying these key drivers of dynamic models. Scenario analyses tested assumptions regarding exogenous boosting, vaccine waning, vaccination coverage, risk of complications, and contact matrices. The model provides a good estimate of the incidence before varicella vaccination implementation in France. When routine varicella vaccination is introduced with French current coverage levels, varicella incidence is predicted to decrease by 57%, and related complications are expected to decrease by 76% over time. After vaccination, it is observed that exogenous boosting is the main driver of change in zoster incidence. When exogenous boosting is assumed, there is a temporary increase in zoster incidence before it gradually decreases, whereas without exogenous boosting, varicella vaccination leads to a gradual decrease in zoster incidence

  13. Earthquake-induced gravitational potential energy change in the active Taiwan orogenic belt

    NASA Astrophysics Data System (ADS)

    Lo, Chung-Liang; Hsu, Shu-Kun

    2005-07-01

    The Philippine Sea Plate is converging against the Eurasian Plate near Taiwan at a velocity of 7-8 cm yr-1 this has caused the Taiwan orogenesis and induced abundant earthquakes. In this study we examine the corresponding change of gravitational potential energy (ΔGPE) using 757 earthquakes from the earthquake catalogue of the Broadband Array in Taiwan for Seismology (BATS) from 1995 July to 2003 December. Our results show that the variation of the crustal ΔGPE strongly correlates with the different stages of the orogenesis. Except for the western Okinawa Trough and southern Taiwan, most of the Taiwan convergent region exhibits a gain of crustal ΔGPE. In contrast, the lithospheric ΔGPE in the Taiwan region exhibits a reverse pattern. For the whole Taiwan region, the earthquake-induced crustal ΔGPE and the lithospheric ΔGPE during the observation period are 1.03 × 1017 J and -1.15 × 1017 J, respectively. The average rate of the whole ΔGPE in the Taiwan region is very intense and equal to -2.07 × 1010 W, corresponding to about 1 per cent of the global GPE loss induced by earthquakes.

  14. Advances in our understanding of immunization and vaccines for patients with systemic lupus erythematosus.

    PubMed

    Bragazzi, Nicola Luigi; Watad, Abdulla; Sharif, Kassem; Adawi, Mohammad; Aljadeff, Gali; Amital, Howard; Shoenfeld, Yehuda

    2017-10-01

    Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease. In SLE, immune system dysfunction is postulated to result by virtue of the disease itself as well as by the impact of treatment modalities employed. A myriad of immune dysregulations occur including complement system dysfunction among others. Infectious agents are known to complicate the disease course in close to 25-45% of SLE patients. Areas covered: In this review a discussion of the immunogenicity and safety of viral and bacterial vaccinations in SLE was performed. The search included ISI Web of Science (WoS), Scopus, MEDLINE/PubMed, Google-Scholar, DOAJ, EbscoHOST, Scirus, Science Direct, Cochrane Library and ProQuest. Proper string made up of a key-words including 'SLE', 'vaccination', 'safety' and 'efficacy' was used. Expert commentary: Vaccination of SLE patients is proven to be immunogenic. Concerns regarding vaccine safety are postulated, yet no direct relationship between vaccination and disease exacerbation were established. While live virus vaccines are generally contraindicated in immunosuppressive states, generally live attenuated vaccinations are recommended in SLE patients on a case-to-case basis. In SLE patients, clinical parameters such as vaccination during disease exacerbations have not been intensively studied and therefore while apparently safe, vaccination is generally recommended while disease is quiescent.

  15. Footrot vaccines and vaccination.

    PubMed

    Dhungyel, Om; Hunter, James; Whittington, Richard

    2014-05-30

    Research on footrot in small ruminants, which is caused by Dichelobacter nodosus, has led to development of vaccines and their application for control, treatment and eradication of the disease in sheep. Footrot vaccines have evolved over decades to contain monovalent whole cell, multivalent recombinant fimbrial, and finally mono or bivalent recombinant fimbrial antigens. Initially whole cell vaccines made against the few known serogroups of D. nodosus were found to be inefficient in control of the disease in the field, which was attributed to the presence of other unidentified serogroups and also the use of inefficient adjuvants. Fimbriae or pili, which are the basis for antigenic variation, were found to be the major protective and also curative antigens but they are not cross protective between the different serogroups. Multivalent vaccines incorporating all the known serogroups have been proven to be of limited efficacy due to the phenomenon of antigenic competition. Recent studies in Nepal, Bhutan and Australia have shown that outbreak-specific vaccination which involves targeting identified serogroups with mono- or bivalent recombinant fimbrial vaccines, can be very effective in sheep and goats. Where multiple serogroups are present in a flock, antigenic competition can be overcome by sequentially targeting the serogroups with different bivalent vaccines every 3 months. A common antigen which would confer immunity to all serogroups would be the ideal immunogen but the initial studies were not successful in this area. Until universal antigen/s are available, flock specific mono or bivalent fimbrial vaccines are likely to be the most effective tool for control and eradication of footrot in sheep and goats. Future research in footrot vaccines should be focused on improving the duration of prophylaxis by incorporating new and emerging immunomodulators or adjuvants with modified delivery vehicles, discovering a common antigen and understanding the mechanisms of

  16. Motorcycle pollution control in Taiwan, Republic of China

    SciTech Connect

    Chen, H.W.; Hsiao, H.C.; Walsh, M.P.

    1998-12-31

    The Taiwan EPA has developed a comprehensive approach to motor vehicle pollution control. Building on its early adoption of US `83 standards for light duty vehicles (starting July 1, 1990) it recently moved to US `87 requirements, which include the 0.2 gram per mile particulate standard, as of July 1, 1995. Heavy duty diesel particulate standards almost as stringent as US `90, 6.0 grams per brake horsepower hour NO{sub x} and 0.7 particulate, using the US transient test procedure, went into effect on July 1, 1993. It is intended that US`94 standards, 5.0 NO{sub x} and 0.25 particulate, will bemore » adopted soon. Clearly the most distinctive feature of the Taiwan program, however, is its motorcycle control effort, reflecting the fact that motorcycles dominate the vehicle fleet and are a substantial source of emissions. This paper will summarize Taiwan`s extensive efforts to address this problem.« less

  17. Meningitis complicated by subdural empyema and deafness caused by pneumoccoccal serotype 7F in a 17-month-old child: a case report.

    PubMed

    Bosis, S; Semino, M; Picciolli, I; Pinzani, R; Genitori, L; Principi, N; Esposito, S

    2012-06-01

    Despite the availability of effective antibacterial agents and vaccines, pneumococcal meningitis and sepsis are still associated with high mortality rates and a high risk of neurological sequelae. We describe the case of a 17-month-old boy vaccinated with heptavalent pneumococcal conjugate vaccine (PCV7) who developed bacterial meningitis complicated by subdural empyema and deafness caused by Streptococcus pneumoniae serotype 7F. The 7F strain is not contained in PCV7 (the only vaccine on the market at the time of the onset of meningitis) but is included in the new pediatric 13-valent PCV, which may therefore prevent cases such as this in the future.

  18. Classification management plan of groundwater quality in Taiwan

    NASA Astrophysics Data System (ADS)

    Chen, Chun Ming; Chen, Yu Ying; Pan, Shih Cheng; Li, Hui Jun; Hsiao, Fang Ke

    2017-04-01

    Taiwan Environmental Protection Administration has been monitoring regional water quality for 14 years. Since the beginning of 2002 till now, there are 453 regional groundwater monitoring wells in ten groundwater subregions in Taiwan, and the monitoring of groundwater quality has been carried out for a long time. Currently, water quality monitoring project has reached 50 items, while the number of water quality monitoring data has reached more than 20,000. In order to use the monitoring data efficiently, this study constructed the localized groundwater quality indicators of Taiwan. This indicator takes into account the different users' point of view, incorporating the Taiwan groundwater pollution monitoring standards (Category II), irrigation water quality standard and drinking water source water quality standard. 50 items of water quality monitoring projects were simplified and classified. The groundwater quality parameters were divided into five items, such as potability for drinking water, salting, external influence, health influences and toxicity hazard. The weight of the five items of groundwater was calculated comprehensively, and the groundwater quality of each monitoring well was evaluated with three grades of good, ordinary, and poor. According to the monitoring results of the groundwater monitoring wells in October to December of 2016, about 70% of groundwater quality in Taiwan is in good to ordinary grades. The areas with poor groundwater quality were mostly distributed in coastal, agriculture and part of the urban areas. The conductivity or ammonia nitrogen concentration was higher in those regions, showing that groundwater may be salinized or affected by external influences. Groundwater quality indicators can clearly show the current comprehensive situation of the groundwater environment in Taiwan and can be used as a tool for groundwater quality classification management. The indicators can coordinate with the Taiwan land planning policy in the

  19. Influenza Vaccination is Associated with Lower Risk of Acute Coronary Syndrome in Elderly Patients with Chronic Kidney Disease.

    PubMed

    Chen, Chang-I; Kao, Pai-Feng; Wu, Mei-Yi; Fang, Yu-Ann; Miser, James S; Liu, Ju-Chi; Sung, Li-Chin

    2016-02-01

    Elderly patients with chronic kidney disease (CKD) are at a higher risk of hospitalization for cardiovascular diseases (CVD). Previous studies have showed that influenza vaccination could reduce the risk of recurrent major cardiovascular events in patients with CVD. However, the effects of influenza vaccination on the reduction of first hospitalizations for acute coronary syndrome (ACS) in elderly patients with CKD remain unknown.We conducted a cohort study using data from the Taiwan Longitudinal Health Insurance Database 1997 to 2008. This cohort study comprised elderly patients (ages ≥55 years) with a recorded diagnosis of CKD (n = 4406) between January 1, 1999, and December 31, 2007. Each patient was followed up until the end of 2008. To minimize the selection bias of vaccine therapy, a propensity score adjustment was applied. The hazard ratio (HR) and 95% confidence interval (CI) for the association between the influenza vaccination and the occurrence of first hospitalization for ACS was evaluated by Cox proportional hazards regression. We further categorized the patients into 4 groups according to their vaccination status (unvaccinated, and total number of vaccinations: 1, 2-3, and ≥4).We found that elderly CKD patients without prior CVD history receiving influenza vaccination exhibited a lower risk of hospitalization for ACS (adjusted HR = 0.35, 95% CI 0.30-0.42; P < 0.001). We observed consistent protective effects regardless of age groups (55-64, 65-74, and ≥75), gender, and seasonality of influenza. When the patients were stratified according to the total number of vaccinations, the adjusted HRs for first ACS hospitalization were 0.62 (95% CI 0.52-0.81), 0.35 (95% CI 0.28-0.45), and 0.13 (95% CI 0.09-0.19) for patients who received 1, 2 to 3, and ≥4 vaccinations. There was a significant trend of decreasing risk of ACS hospitalization with an increasing number of vaccinations.The results of our observational study could strengthen the

  20. Pregnancy Outcomes after a Mass Vaccination Campaign with an Oral Cholera Vaccine in Guinea: A Retrospective Cohort Study

    PubMed Central

    Grout, Lise; Martinez-Pino, Isabel; Ciglenecki, Iza; Keita, Sakoba; Diallo, Alpha Amadou; Traore, Balla; Delamou, Daloka; Toure, Oumar; Nicholas, Sarala; Rusch, Barbara; Staderini, Nelly; Serafini, Micaela; Grais, Rebecca F.; Luquero, Francisco J.

    2015-01-01

    Introduction Since 2010, WHO has recommended oral cholera vaccines as an additional strategy for cholera control. During a cholera episode, pregnant women are at high risk of complications, and the risk of fetal death has been reported to be 2–36%. Due to a lack of safety data, pregnant women have been excluded from most cholera vaccination campaigns. In 2012, reactive campaigns using the bivalent killed whole-cell oral cholera vaccine (BivWC), included all people living in the targeted areas aged ≥1 year regardless of pregnancy status, were implemented in Guinea. We aimed to determine whether there was a difference in pregnancy outcomes between vaccinated and non-vaccinated pregnant women. Methods and Findings From 11 November to 4 December 2013, we conducted a retrospective cohort study in Boffa prefecture among women who were pregnant in 2012 during or after the vaccination campaign. The primary outcome was pregnancy loss, as reported by the mother, and fetal malformations, after clinical examination. Primary exposure was the intake of the BivWC vaccine (Shanchol) during pregnancy, as determined by a vaccination card or oral history. We compared the risk of pregnancy loss between vaccinated and non-vaccinated women through binomial regression analysis. A total of 2,494 pregnancies were included in the analysis. The crude incidence of pregnancy loss was 3.7% (95%CI 2.7–4.8) for fetuses exposed to BivWC vaccine and 2.6% (0.7–4.5) for non-exposed fetuses. The incidence of malformation was 0.6% (0.1–1.0) and 1.2% (0.0–2.5) in BivWC-exposed and non-exposed fetuses, respectively. In both crude and adjusted analyses, fetal exposure to BivWC was not significantly associated with pregnancy loss (adjusted risk ratio (aRR = 1.09 [95%CI: 0.5–2.25], p = 0.818) or malformations (aRR = 0.50 [95%CI: 0.13–1.91], p = 0.314). Conclusions In this large retrospective cohort study, we found no association between fetal exposure to BivWC and risk of pregnancy loss or

  1. Three depositional states and sedimentary processes of the western Taiwan foreland basin system

    NASA Astrophysics Data System (ADS)

    Lin, Yi-Jung; Wu, Pei-Jen; Yu, Ho-Shing

    2010-05-01

    The western Taiwan foreland basin formed during the Early Pliocene as the flexural response to the loading of Taiwan orogen on the Eurasian plate. What makes Taiwan interesting is the oblique collision, which allows the foreland basin to be seen at different stages in its evolution at the present day. Due to oblique arc-continent collision from north to south, the western Taiwan foreland basin has evolved into three distinct subbasins: an over-filled basin proximal to the Taiwan orogen, mainly distributed in the Western Foothills and Coastal Plain provinces, a filled basin occupying the shallow Taiwan Strait continental shelf west of the Taiwan orogen and an under-filled basin distal to the Taiwan orogen in the deep marine Kaoping Slope offshore southwest Taiwan, respectively. The over-filled depositional phase is dominated by fluvial environments across the structurally controlled piggy-back basins. The filled depositional state in the Taiwan Strait is characterized by shallow marine environments and is filled by Pliocene-Quaternary sediments up to 4,000 m thick derived from the Taiwan orogen with an asymmetrical and wedge-shaped cross section. The under-filled depositional state is characteristic of deep marine environments in the wedge-top basins accompanied by active structures of thrust faults and mud diapers. Sediments derived from the Taiwan orogen have progressively filled the western Taiwan foreland basin across and along the orogen. Sediment dispersal model suggests that orogenic sediments derived from oblique dischronous collisional highlands are transported in two different ways. Transport of fluvial and shallow marine sediments is perpendicular to hill-slope and across-strike in the fluvial and shallow marine environments proximal to the orogen. Fine-grained sediments mainly longitudinally transported into the deep marine environments distal to the orogen. The present sedimentary processes in the over-filled basin on land are dominated by fluvial

  2. Influenza A(H6N1) Virus in Dogs, Taiwan

    PubMed Central

    Lin, Hui-Ting; Wang, Ching-Ho; Chueh, Ling-Ling; Su, Bi-Ling

    2015-01-01

    We determined the prevalence of influenza A virus in dogs in Taiwan and isolated A/canine/Taiwan/E01/2014. Molecular analysis indicated that this isolate was closely related to influenza A(H6N1) viruses circulating in Taiwan and harbored the E627K substitution in the polymerase basic 2 protein, which indicated its ability to replicate in mammalian species. PMID:26583707

  3. Education in Taiwan (Formosa). Bulletin, 1956, No. 3

    ERIC Educational Resources Information Center

    Sassani, Abul H. K.

    1956-01-01

    "Education in Taiwan (Formosa)" is based mostly on official reports of the Ministry of Education published in Taiwan, including other official and private reports which are not yet published. The text has been supplemented with additional data and information obtained from other official sources and through interviews with Chinese…

  4. Program Changes in Technology Teacher Education in Taiwan.

    ERIC Educational Resources Information Center

    Lai, Chih-Chien Steven

    Taiwan has two technology teacher departments: one at the National Taiwan Normal University (NTNU) and the other at National Kaohsiung Normal University (NKNU). In recent years, both universities' technology teacher education programs have simultaneously followed two lines of development: the transition from an industrial arts education program to…

  5. Mandatory influenza vaccination for all healthcare personnel: a review on justification, implementation and effectiveness.

    PubMed

    Wang, Tiffany L; Jing, Ling; Bocchini, Joseph A

    2017-10-01

    As healthcare-associated influenza is a serious public health concern, this review examines legal and ethical arguments supporting mandatory influenza vaccination policies for healthcare personnel, implementation issues and evidence of effectiveness. Spread of influenza from healthcare personnel to patients can result in severe harm or death. Although most healthcare personnel believe that they should be vaccinated against seasonal influenza, the Centers for Disease Control and Prevention (CDC) report that only 79% of personnel were vaccinated during the 2015-2016 season. Vaccination rates were as low as 44.9% in institutions that did not promote or offer the vaccine, compared with rates of more than 90% in institutions with mandatory vaccination policies. Policies that mandate influenza vaccination for healthcare personnel have legal and ethical justifications. Implementing such policies require multipronged approaches that include education efforts, easy access to vaccines, vaccine promotion, leadership support and consistent communication emphasizing patient safety. Mandatory influenza vaccination for healthcare personnel is a necessary step in protecting patients. Patients who interact with healthcare personnel are often at an elevated risk of complications from influenza. Vaccination is the best available strategy for protecting against influenza and evidence shows that institutional policies and state laws can effectively increase healthcare personnel vaccination rates, decreasing the risk of transmission in healthcare settings. There are legal and ethical precedents for institutional mandatory influenza policies and state laws, although successful implementation requires addressing both administrative and attitudinal barriers.

  6. How Influenza Vaccination Policy May affect Vaccine Logistics

    PubMed Central

    Assi, Tina-Marie; Rookkapan, Korngamon; Rajgopal, Jayant; Sornsrivichai, Vorasith; Brown, Shawn T.; Welling, Joel S.; Norman, Bryan A.; Connor, Diana L.; Chen, Sheng-I; Slayton, Rachel B.; Laosiritaworn, Yongjua; Wateska, Angela R.; Wisniewski, Stephen R.; Lee, Bruce Y.

    2012-01-01

    Background When policymakers make decision about the target populations and timing of influenza vaccination, they may not consider the impact on the vaccine supply chains, which may in turn affect vaccine availability. Purpose Our goal is to explore the effects on the Thailand vaccine supply chain of introducing influenza vaccines and varying the target populations and immunization time-frames. Methods Utilized our custom-designed software HERMES (Highly Extensible Resource for Modeling Supply Chains), we developed a detailed, computational discrete-event simulation model of the Thailand's National Immunization Program (NIP) supply chain in Trang Province, Thailand., A suite of experiments simulated introducing influenza vaccines for different target populations and over different time-frames prior to and during the annual influenza season. Results Introducing influenza vaccines creates bottlenecks that reduce the availability of both influenza vaccines as well as the other NIP vaccines, with provincial to district transport capacity being the primary constraint. Even covering only 25% of the Advisory Committee on Immunization Practice-recommended population while administering the vaccine over six months hinders overall vaccine availability so that only 62% of arriving patients can receive vaccines. Increasing the target population from 25% to 100% progressively worsens these bottlenecks, while increasing influenza vaccination time - frame from 1 to 6 months decreases these bottlenecks. Conclusion Since the choice of target populations for influenza vaccination and the time-frame to deliver this vaccine can substantially affect the flow of all vaccines, policy-makers may want to consider supply chain effects when choosing target populations for a vaccine. PMID:22537993

  7. Taiwan Ascii and Idl_save Data Archives (AIDA) for THEMIS

    NASA Astrophysics Data System (ADS)

    Lee, B.; Hsieh, W.; Shue, J.; Angelopoulos, V.; Glassmeier, K. H.; McFadden, J. P.; Larson, D.

    2008-12-01

    THEMIS (Time History of Events and their Macroscopic Interactions during Substorms) is a satellite mission that aims to determine where and how substorms are triggered. The space research team in Taiwan has been involved in data promotion and scientific research. Taiwan Ascii and Idl_save Data Archives (AIDA) for THEMIS is the main work of the data promotion. Taiwan AIDA is developed for those who are not familiar with the Interactive Data Language (IDL) data analysis and visualization software, and those who have some basic IDL concepts and techniques and want more flexibilities in reading and plotting the THEMIS data. Two kinds of data format are stored in Taiwan AIDA: one is ASCII format for most users and the other is IDL SAVE format for IDL users. The public can download THEMIS data in either format through the Taiwan AIDA web site, http://themis.ss.ncu.edu.tw/e_data_download.php. Taiwan AIDA provides (1) plasma data including number density, average temperature, and velocity of ions and electrons, (2) magnetic field data, and (3) state information including the position and velocity of five THEMIS probes. On the Taiwan AIDA web site there are two data-downloading options. The public can download a large amount of data for a particular instrument in the FTP equivalent option; the public can also download all the data for a particular date in the Data Search option.

  8. Democratic Reforms in Taiwan: Issues for Congress

    DTIC Science & Technology

    2010-05-26

    stationed in Taiwan were happy under martial law. For local citizens, the Taiwan Garrison Command tried defendants for alleged civilian crimes ...of dissidents; sentencing of an average of 10 years for several hundred political prisoners; use of martial law to try a variety of crimes in...military courts; limited freedom of speech , political assembly, freedom of the press, and labor strikes; lengthy detentions incommunicado and without

  9. Induced abortion in Taiwan.

    PubMed

    Wang, P D; Lin, R S

    1995-04-01

    Induced abortion is widely practised in Taiwan; however, it had been illegal until 1985. It was of interest to investigate induced abortion practices in Taiwan after its legalization in 1985 in order to calculate the prevalence rate and ratio of induced abortion to live births and to pregnancies in Taiwan. A study using questionnaires through personal interviews was conducted on more than seventeen thousand women who attended a family planning service in Taipei metropolitan areas between 1991 and 1992. The reproductive history and sexual behaviour of the subjects were especially focused on during the interviews. Preliminary findings showed that 46% of the women had a history of having had an induced abortion. Among them, 54.8% had had one abortion, 29.7% had had two, and 15.5% had had three or more. The abortion ratio was 379 induced abortions per 1,000 live births and 255 per 1,000 pregnancies. The abortion ratio was highest for women younger than 20 years of age, for aboriginal women and for nulliparous women. When logistic regression was used to control for confounding variables, we found that the number of previous live births is the strongest predictor relating to women seeking induced abortion. In addition, a significant positive association exists between increasing number of induced abortions and cervical dysplasia.

  10. 76 FR 72722 - Helical Spring Lock Washers From China and Taiwan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-25

    ... Spring Lock Washers From China and Taiwan Determination On the basis of the record \\1\\ developed in the... antidumping duty orders on helical spring lock washers from China and Taiwan would be likely to lead to... with respect to helical spring lock washers from Taiwan. Background The Commission instituted these...

  11. An Evaluation of Taiwan Vocational and Technical Education Programs in Agriculture.

    ERIC Educational Resources Information Center

    Meaders, O. Donald; Chi-ho, Hu

    Presented in both English and Chinese, this study of the system of agricultural education in Taiwan secondary and postsecondary schools resulted from the author's five-month stay in Taiwan and subsequent visits. Focus of the study is on evaluation of Taiwan's vocational agriculture education programs with information about students, faculties,…

  12. Transient facial nerve paralysis (Bell's palsy) following administration of hepatitis B recombinant vaccine: a case report.

    PubMed

    Paul, R; Stassen, L F A

    2014-01-01

    Bell's palsy is the sudden onset of unilateral transient paralysis of facial muscles resulting from dysfunction of the seventh cranial nerve. Presented here is a 26-year-old female patient with right lower motor neurone facial palsy following hepatitis B vaccination. Readers' attention is drawn to an uncommon cause of Bell's palsy, as a possible rare complication of hepatitis B vaccination, and steps taken to manage such a presentation.

  13. Skewed risk perceptions in pregnant women: the case of influenza vaccination.

    PubMed

    Bödeker, Birte; Betsch, Cornelia; Wichmann, Ole

    2015-12-29

    Pregnant women and their newborns have an increased risk of developing severe influenza and influenza-related complications. In Germany, seasonal influenza vaccination is recommended for pregnant women since 2010. However, little is known about pregnant women's vaccination-related knowledge and attitudes, as well as their risk perceptions. This study therefore assessed pregnant women's vaccination-related knowledge, risk perceptions related to influenza disease and influenza vaccination during pregnancy, and aimed to identify determinants of influenza vaccination uptake during pregnancy in Germany. Between 2012 and 2014, a nationwide web-based prospective cohort study with follow-up interviews was conducted in initially pregnant women who gave birth over the study period. Control groups were set up in a cross-sectional fashion during the follow-up interviews. Women who participated in both, the baseline interview before giving birth and in the 1st interview after giving birth were included in the analysis. Univariate and multiple logistic regression were used to identify associations between influenza vaccination uptake and sociodemographic characteristics as well as items assessing attitude and knowledge. In total, 838 women were included in the analyses. Pregnant women had a positive attitude towards vaccination in general, but only modest vaccination knowledge. Overall, 10.9 % of women were vaccinated against seasonal influenza during pregnancy. While pregnant women perceived classical childhood diseases to be more risky than the respective vaccinations, this relation reversed for influenza: The risk of vaccination was perceived higher than the risk of the disease. These two types of risk perceptions independently determined influenza vaccination uptake-higher perception of disease risk and lower perceptions of vaccination-related risks increased uptake. Additionally, knowledge about the vaccination recommendation for pregnant women and a positive gynaecologist

  14. Vaccine-preventable diseases, vaccines and Guillain-Barre' syndrome.

    PubMed

    Principi, Nicola; Esposito, Susanna

    2018-06-04

    Guillain-Barré syndrome (GBS) is an acute, immune-mediated polyradiculoneuropathy. Infections and vaccines have been hypothesized to play a role in triggering GBS development. These beliefs can play a role in reducing vaccination coverage. In this report, data concerning this hypothesis are discussed. It is shown that an association between vaccine administration and GBS has never been proven for most of debated vaccines, although it cannot be definitively excluded. The only exception is the influenza vaccine, at least for the preparation used in 1976. For some vaccines, such as measles/mumps/rubella, human papillomavirus, tetravalent conjugated meningococcal vaccine, and influenza, the debate between supporters and opponents of vaccination remains robust and perception of vaccines' low safety remains a barrier to achieving adequate vaccination coverage. Less than 1 case of GBS per million immunized persons might occur for these vaccines. However, in some casesimmunization actually reduces the risk of GBS development. In addition, the benefits of vaccination are clearly demonstrated by the eradication or enormous decline in the incidence of many vaccine-preventable diseases. These data highlight that the hypothesized risks of adverse events, such as GBS, cannot be considered a valid reason to avoid the administration of currently recommended vaccines. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Factors Associated with Parental Refusal of Routine Vaccination in the Czech Republic.

    PubMed

    Dáňová, Jana; Šálek, Jiří; Kocourková, Aneta; Čelko, Alexander M

    2015-12-01

    Routine vaccination is one of the most important preventive methods which is responsible for the decreasing trend of morbidity and mortality of vaccine preventable infectious diseases, their complications and sequelae. The impact of vaccination on declining trend of these diseases is well known and confirmed by a large number of epidemiological studies. In the Czech Republic, there is high vaccination coverage in regards to most vaccine preventable diseases. However, during the last decade proportion of parents refusing routine vaccination of their children due to different factors is increasing. The presented study evaluates current situation in the Czech Republic and describes the most significant factors in parents decision making. The study was conducted between 1 July 2013 and 31 March 2014 as a questionnaire based survey (cross-sectional study). The questionnaire was created with multiple choice answers. Questions were addressed to parents or legal representatives of children aged 0-18 years. Types of questions were divided into several subgroups. The study was performed in the Czech Republic in two different districts of Prague and Zlín. In the sample size (n=480) we detected 11 parents who refused vaccination of 11 children (2.29%). The most often refused vaccines in the prevalence study were hexavaccine (1st dose) and measles, mumps and rubella vaccine (1st dose). The hexavaccine includes tetanic anatoxin, diphtheric anatoxin, acellular pertussis vaccine, conjugate vaccine against Haemophilus influenzae b, inactivated polio vaccine, and recombinant vaccine against viral hepatitis B. The measles, mumps, rubella vaccine contains live attenuated viruses of measles, mumps, rubella. We observed increasing trend of routine vaccination refusal in children during the last ten years (compared to situation in the year 2004, p<0.001). The most important factors associated with this progression were distrust to vaccination, fear of some vaccine components and fear of

  16. Intercultural Training for US Business Expatriates in Taiwan

    ERIC Educational Resources Information Center

    Chien, Tien-Chen; McLean, Gary N.

    2011-01-01

    Purpose: This study aims to explore the intercultural training needs for US business expatriates on assignment in Taiwan. The study assesses Taiwan culture-specific training needs of US expatriates from the perspectives of both US expatriates and their Taiwanese colleagues and compares the perceived importance of these intercultural training needs…

  17. Development of Taiwan Undergraduates' Volunteer Service Motivation Scale

    ERIC Educational Resources Information Center

    Ho-Tang, Wu; Chin-Tang, Tu; Mei-Ju, Chou; Jing-Fang, Hou; Meng-Shan, Lei

    2016-01-01

    This study aims to develop Taiwan undergraduates' volunteer service motivation scale. To begin with, item pool was proposed on the basis of literature. After discussing with three Taiwan undergraduates, item pool, exploratory factor analysis (EFA) (N = 150) was proceeded, where three tests were conducted EFA: 1. Item analysis: comparisons of…

  18. Marker vaccine strategies and candidate CSFV marker vaccines.

    PubMed

    Dong, Xiao-Nan; Chen, Ying-Hua

    2007-01-04

    Classical swine fever (CSF) is an economically important highly contagious disease of swine worldwide. Classical swine fever virus (CSFV) is its etiological agent, and the only natural hosts are domestic pigs and wild boars. Although field CSFV strains vary in the virulence, they all result in serious losses in pig industry. Highly virulent field strains generally cause acute disease and high mortality; moderately virulent field strains raise subacute or chronic infections; postnatal infection by low virulent field strains produces subclinical infection and mortality in the new-born piglets. CSFV can cross the placental barrier, and this transplacental transmission usually results in mortality of fetuses and birth of congenitally infected pigs with a late-onset disease and death. Two main strategies to control CSF epidemic are systematic prophylactic vaccination with live attenuated vaccines (such as C-strain) and non-vaccination stamping-out policy. But neither of them is satisfying enough. Marker vaccine and companion serological diagnostic test is thought to be a promising strategy for future control and eradication of CSF. During the past 15 years, various candidate marker vaccines were constructed and evaluated in the animal experiments, including recombinant chimeric vaccines, recombinant deletion vaccines, DNA vaccines, subunit vaccines and peptide vaccines. Among them, two subunit vaccines entered the large scale marker vaccine trial of EU in 1999. Although they failed to fulfil all the demands of the Scientific Veterinary Committee, they successfully induced solid immunity against CSFV in the vaccinated pigs. It can be expected that new potent marker vaccines might be commercially available and used in systematic prophylactic vaccination campaign or emergency vaccination in the next 15 years. Here, we summarized current strategies and candidate CSFV marker vaccines. These strategies and methods are also helpful for the development of new

  19. Scrap computer recycling in Taiwan

    SciTech Connect

    Lee, C.H.; Chang, S.L.; Wang, K.M.

    1999-07-01

    It is estimated that approximately 700,000 scrap personal computers will be generated each year in Taiwan. The disposal of such a huge amount of scrap computers presents a difficult task for the island due to the scarcity of landfills and incineration facilities available locally. Also, the hazardous materials contained in the scrap computers may cause serious pollution to the environment, if they are not properly disposed. Thus, EPA of Taiwan has declared scrap personal computers as a producer responsibility recycling product on July 1997 to mandate that the manufacturers, importers and sellers of personal computers have to recover and recyclemore » their scrap computers properly. Beginning on June 1, 1998, a scrap computer recycling plan is officially implemented on the island. Under this plan, consumers can deliver their unwanted personal computers to the designated collection points to receive reward money. Currently, only six items are mandated to be recycled in this recycling plan. They are notebooks, monitor and the hard disk, power supply, printed circuit board and shell of the main frame of the personal computer. This paper presents the current scrap computer recycling system in Taiwan.« less

  20. 76 FR 58040 - Certain Polyester Staple Fiber From Korea and Taiwan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ... Polyester Staple Fiber From Korea and Taiwan Determination On the basis of the record \\1\\ developed in the... antidumping duty orders on certain polyester staple fiber from Korea and Taiwan would be likely to lead to...), entitled Certain Polyester Staple Fiber From Korea and Taiwan: Investigation Nos. 731-TA-825 and 826...

  1. Preclinical immunogenicity and safety of a Group A streptococcal M protein-based vaccine candidate.

    PubMed

    Batzloff, Michael R; Fane, Anne; Gorton, Davina; Pandey, Manisha; Rivera-Hernandez, Tania; Calcutt, Ainslie; Yeung, Grace; Hartas, Jon; Johnson, Linda; Rush, Catherine M; McCarthy, James; Ketheesan, Natkunam; Good, Michael F

    2016-12-01

    Streptococcus pyogenes (group A streptococcus, GAS) causes a wide range of clinical manifestations ranging from mild self-limiting pyoderma to invasive diseases such as sepsis. Also of concern are the post-infectious immune-mediated diseases including rheumatic heart disease. The development of a vaccine against GAS would have a large health impact on populations at risk of these diseases. However, there is a lack of suitable models for the safety evaluation of vaccines with respect to post-infectious complications. We have utilized the Lewis Rat model for cardiac valvulitis to evaluate the safety of the J8-DT vaccine formulation in parallel with a rabbit toxicology study. These studies demonstrated that the vaccine did not induce abnormal pathology. We also show that in mice the vaccine is highly immunogenic but that 3 doses are required to induce protection from a GAS skin challenge even though 2 doses are sufficient to induce a high antibody titer.

  2. Preclinical immunogenicity and safety of a Group A streptococcal M protein-based vaccine candidate

    PubMed Central

    Batzloff, Michael R.; Fane, Anne; Gorton, Davina; Pandey, Manisha; Rivera-Hernandez, Tania; Calcutt, Ainslie; Yeung, Grace; Hartas, Jon; Johnson, Linda; Rush, Catherine M.; McCarthy, James; Ketheesan, Natkunam; Good, Michael F.

    2016-01-01

    ABSTRACT Streptococcus pyogenes (group A streptococcus, GAS) causes a wide range of clinical manifestations ranging from mild self-limiting pyoderma to invasive diseases such as sepsis. Also of concern are the post-infectious immune-mediated diseases including rheumatic heart disease. The development of a vaccine against GAS would have a large health impact on populations at risk of these diseases. However, there is a lack of suitable models for the safety evaluation of vaccines with respect to post-infectious complications. We have utilized the Lewis Rat model for cardiac valvulitis to evaluate the safety of the J8-DT vaccine formulation in parallel with a rabbit toxicology study. These studies demonstrated that the vaccine did not induce abnormal pathology. We also show that in mice the vaccine is highly immunogenic but that 3 doses are required to induce protection from a GAS skin challenge even though 2 doses are sufficient to induce a high antibody titer. PMID:27541593

  3. Mumps and mumps vaccine: a global review.

    PubMed

    Galazka, A M; Robertson, S E; Kraigher, A

    1999-01-01

    Mumps is an acute infectious disease caused by a paramyxovirus. Although the disease is usually mild, up to 10% of patients can develop aseptic meningitis; a less common but more serious complication is encephalitis, which can result in death or disability. Permanent deafness, orchitis, and pancreatitis are other untoward effects of mumps. Based on data reported to WHO up to April 1998, mumps vaccine is routinely used by national immunization programmes in 82 countries/areas: 23 (92%) of 25 developed countries, 19 (86%) of 22 countries with economies in transition (mainly the Newly Independent States of the former Soviet Union), and 40 (24%) of 168 developing countries. Countries that have achieved high coverage have shown a rapid decline in mumps morbidity. Furthermore, in many of these countries, mumps-associated encephalitis and deafness have nearly vanished. This review considers the disease burden due to mumps; summarizes studies on the immunogenicity, efficacy, and safety of different strains of mumps vaccine; and highlights lessons learned about implementing mumps immunization in different countries. Countries already using mumps vaccine should monitor immunization coverage and establish routine mumps surveillance with investigation of outbreaks. Where mumps is targeted for elimination, countries need to add a second dose of mumps vaccine for children, keeping in mind that the disease may still occur in susceptible adults.

  4. Mumps and mumps vaccine: a global review.

    PubMed Central

    Galazka, A. M.; Robertson, S. E.; Kraigher, A.

    1999-01-01

    Mumps is an acute infectious disease caused by a paramyxovirus. Although the disease is usually mild, up to 10% of patients can develop aseptic meningitis; a less common but more serious complication is encephalitis, which can result in death or disability. Permanent deafness, orchitis, and pancreatitis are other untoward effects of mumps. Based on data reported to WHO up to April 1998, mumps vaccine is routinely used by national immunization programmes in 82 countries/areas: 23 (92%) of 25 developed countries, 19 (86%) of 22 countries with economies in transition (mainly the Newly Independent States of the former Soviet Union), and 40 (24%) of 168 developing countries. Countries that have achieved high coverage have shown a rapid decline in mumps morbidity. Furthermore, in many of these countries, mumps-associated encephalitis and deafness have nearly vanished. This review considers the disease burden due to mumps; summarizes studies on the immunogenicity, efficacy, and safety of different strains of mumps vaccine; and highlights lessons learned about implementing mumps immunization in different countries. Countries already using mumps vaccine should monitor immunization coverage and establish routine mumps surveillance with investigation of outbreaks. Where mumps is targeted for elimination, countries need to add a second dose of mumps vaccine for children, keeping in mind that the disease may still occur in susceptible adults. PMID:10063655

  5. Earthquake-induced gravitational potential energy change at convergent plate boundary near Taiwan

    NASA Astrophysics Data System (ADS)

    Lo, C.; Hsu, S.

    2004-12-01

    The coseismic displacement induced by earthquakes will change the gravitational potential energy (GPE). Okamoto and Tanimoto (2002) have shown that the gain of {Δ GPE} corresponds to the compressional stress regime while the loss of {Δ GPE} corresponds to the extensional stress regime. Here we show an example at a convergent plate boundary near Taiwan. The Philippine Sea Plate is converging against the Eurasian Plate with a velocity of 7-8 cm/yr near Taiwan, which has caused the active Taiwan orogeny and induced abundant earthquakes. We have examined the corresponding change of gravitational potential energy by using 757 earthquakes from the earthquake catalogue of the Broadband Array in Taiwan for Seismology (BATS) from July 1995 to December 2003. The results show that the variation of the crustal Δ GPE strongly correlates with the different stage of the orogenesis. Except for the western Okinawa Trough and the southern Taiwan, most of the Taiwan convergent region exhibits a gain of crustal Δ GPE. In contrast, the lithospheric Δ GPE in the Taiwan region exhibits a reverse pattern. For the whole Taiwan region, the earthquake-induced crustal Δ GPE and the lithospheric Δ GPE during the observation period are 1.03×1017 joules and -1.15×1017 joules, respectively. The average rate of the whole Δ GPE in the Taiwan region is very intense and equal to -2.07×1010 watts, corresponding to about one percent of the global Δ GPE loss induced by earthquakes.

  6. Production of monoclonal antibody against ORF72 of koi herpesvirus isolated in Taiwan.

    PubMed

    Tu, Chien; Lu, Yi-Ping; Hsieh, Chia-Yu; Huang, Su-Ming; Chang, Shao-Kuang; Chen, Meei-Mei

    2014-03-01

    A monoclonal antibody (MAb) was generated against the capsid protein (ORF 72) of koi herpesvirus (KHV) isolated from diseased koi Cyprinus carpio in Taiwan. The clone of MAb-B2 was obtained by immunizing mice with whole virus particles and further identified using indirect enzyme-linked immunosorbent assay and Western blot assay. In addition, it detected KHV in KHV-infected cells but not in those of mock-infected cells as demonstrated by indirect immunofluorescence assay. The neutralization test showed that MAb-B2 neutralized KHV. Furthermore, we uncovered that MAb-B2 recognizes the ORF72 of KHV as revealed by liquid chromatography-tandem mass spectrometry and Western blot assays. Additionally, MAb-B2 has been used as a diagnostic tool for detection of KHV in clinical samples by immunohistochemistry. Collectively, our results indicated that MAb-B2 could be used in the development of a diagnostic kit for diagnosis of KHV infections and ORF72 protein of KHV might be a candidate for future vaccine development.

  7. Knowledge of and Attitudes to Influenza Vaccination in Healthy Primary Healthcare Workers in Spain, 2011-2012

    PubMed Central

    Domínguez, Angela; Godoy, Pere; Castilla, Jesús; Soldevila, Núria; Toledo, Diana; Astray, Jenaro; Mayoral, José María; Tamames, Sonia; García-Gutiérrez, Susana; González-Candelas, Fernando; Martín, Vicente; Díaz, José; Torner, Nuria

    2013-01-01

    Annual influenza vaccination is recommended for healthcare workers, but many do not follow the recommendation. The objective of this study was to investigate the factors associated with seasonal influenza vaccination in the 2011–2012 season. We carried out an anonymous web survey of Spanish primary healthcare workers in 2012. Information on vaccination, and knowledge and attitudes about the influenza vaccine was collected. Workers with medical conditions that contraindicated vaccination and those with high risk conditions were excluded. Multivariate analysis was performed using unconditional logistic regression. We included 1,749 workers. The overall vaccination coverage was 50.7% and was higher in workers aged ≥ 55 years (55.7%), males (57.4%) and paediatricians (63.1%). Factors associated with vaccination were concern about infection at work (aOR 4.93; 95% CI 3.72–6.53), considering that vaccination of heathcare workers is important (aOR 2.62; 95%CI 1.83–3.75) and that vaccination is effective in preventing influenza and its complications (aOR 2.40; 95% CI 1.56–3.67). No association was found between vaccination and knowledge of influenza or the vaccine characteristics. Educational programs should aim to remove the misconceptions and attitudes that limit compliance with recommendations about influenza vaccination in primary healthcare workers rather than only increasing knowledge about influenza and the characteristics of the vaccine. PMID:24260560

  8. Knowledge of and attitudes to influenza vaccination in healthy primary healthcare workers in Spain, 2011-2012.

    PubMed

    Domínguez, Angela; Godoy, Pere; Castilla, Jesús; Soldevila, Núria; Toledo, Diana; Astray, Jenaro; Mayoral, José María; Tamames, Sonia; García-Gutiérrez, Susana; González-Candelas, Fernando; Martín, Vicente; Díaz, José; Torner, Nuria

    2013-01-01

    Annual influenza vaccination is recommended for healthcare workers, but many do not follow the recommendation. The objective of this study was to investigate the factors associated with seasonal influenza vaccination in the 2011-2012 season. We carried out an anonymous web survey of Spanish primary healthcare workers in 2012. Information on vaccination, and knowledge and attitudes about the influenza vaccine was collected. Workers with medical conditions that contraindicated vaccination and those with high risk conditions were excluded. Multivariate analysis was performed using unconditional logistic regression. We included 1,749 workers. The overall vaccination coverage was 50.7% and was higher in workers aged ≥ 55 years (55.7%), males (57.4%) and paediatricians (63.1%). Factors associated with vaccination were concern about infection at work (aOR 4.93; 95% CI 3.72-6.53), considering that vaccination of heathcare workers is important (aOR 2.62; 95%CI 1.83-3.75) and that vaccination is effective in preventing influenza and its complications (aOR 2.40; 95% CI 1.56-3.67). No association was found between vaccination and knowledge of influenza or the vaccine characteristics. Educational programs should aim to remove the misconceptions and attitudes that limit compliance with recommendations about influenza vaccination in primary healthcare workers rather than only increasing knowledge about influenza and the characteristics of the vaccine.

  9. Effect of Probiotics and Prebiotics on Immune Response to Influenza Vaccination in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    PubMed

    Lei, Wei-Te; Shih, Pei-Ching; Liu, Shu-Jung; Lin, Chien-Yu; Yeh, Tzu-Lin

    2017-10-27

    We conducted a meta-analysis to evaluate the effects of probiotics and prebiotics on the immune response to influenza vaccination in adults. We conducted a literature search of Pubmed, Embase, the Cochrane Library, the Cumulative Index to Nursing and Allied Health (CINAHL), Airiti Library, and PerioPath Index to Taiwan Periodical Literature in Taiwan. Databases were searched from inception to July 2017. We used the Cochrane Review risk of bias assessment tool to assess randomized controlled trial (RCT) quality. A total of 20 RCTs comprising 1979 adults were included in our systematic review. Nine RCTs including 623 participants had sufficient data to be pooled in a meta-analysis. Participants who took probiotics or prebiotics showed significant improvements in the H1N1 strain seroprotection rate (with an odds ratio (OR) of 1.83 and a 95% confidence interval (CI) of 1.19-2.82, p = 0.006, I ² = 0%), the H3N2 strain seroprotection rate (OR = 2.85, 95% CI = 1.59-5.10, p < 0.001, I ² = 0%), and the B strain seroconversion rate (OR = 2.11, 95% CI = 1.38-3.21, p < 0.001, I ² = 0%). This meta-analysis suggested that probiotics and prebiotics are effective in elevating immunogenicity by influencing seroconversion and seroprotection rates in adults inoculated with influenza vaccines.

  10. Leadership styles and nursing faculty job satisfaction in Taiwan.

    PubMed

    Chen, Hsiu-Chin; Beck, Susan L; Amos, Linda K

    2005-01-01

    To examine nursing faculty job satisfaction and their perceptions of nursing deans' and directors' leadership styles, and to explore how the perceptions of leadership styles relate to faculty job satisfaction in Taiwan. Descriptive, correlational, and cross-sectional study with self-administered questionnaires. The sample was recruited from 18 nursing programs, and 286 questionnaires were returned. Faculty perceived that Taiwan's nursing deans and directors showed more transformational than transactional leadership. Taiwan's nursing faculty were moderately satisfied in their jobs, and they were more satisfied with deans or directors who practiced the transactional leadership style of contingent reward and the transformational style of individualized consideration. A style with negative effect was passive management by exception. Three types of leadership behaviors explained significant variance (21.2%) in faculty job satisfaction in Taiwan, indicating the need for further attention to training and development for effective leadership behaviors.

  11. Vaccine hesitancy

    PubMed Central

    Dubé, Eve; Laberge, Caroline; Guay, Maryse; Bramadat, Paul; Roy, Réal; Bettinger, Julie A.

    2013-01-01

    Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of individuals. Lack of confidence in vaccines is now considered a threat to the success of vaccination programs. Vaccine hesitancy is believed to be responsible for decreasing vaccine coverage and an increasing risk of vaccine-preventable disease outbreaks and epidemics. This review provides an overview of the phenomenon of vaccine hesitancy. First, we will characterize vaccine hesitancy and suggest the possible causes of the apparent increase in vaccine hesitancy in the developed world. Then we will look at determinants of individual decision-making about vaccination. PMID:23584253

  12. Taiwan Teacher Preparation Program Evaluation: Some Critical Perspectives

    ERIC Educational Resources Information Center

    Liu, Tze-Chang

    2015-01-01

    This paper focuses on the influences and changes of recent Taiwan teacher preparation program evaluation (TTPPE) as one of the national evaluation projects conducted by the Higher Education Evaluation and Accreditation Council of Taiwan. The main concerns are what kind of ideology is transformed through the policy by means of evaluation, and what…

  13. Budget-Impact Analysis of Alternative Herpes Zoster Vaccine Strategies: A U.S. HMO Perspective.

    PubMed

    Graham, Jonathan; Mauskopf, Josephine; Kawai, Kosuke; Johnson, Kelly D; Xu, Ruifeng; Acosta, Camilo J

    2016-07-01

    vaccination or related to herpes zoster. Specifically, vaccination could cause adverse events that would require the use of health care resources. Patients who developed zoster could experience postherpetic neuralgia or develop nonpain complications that would require the use of health care resources. Vaccine costs, zoster cases (with and without postherpetic neuralgia or nonpain complication), and vaccine-related adverse events for the 2 vaccination scenarios were estimated for each budget year. For a managed care organization population of 5 million members, the model estimated that a vaccination program that included patients over age 50 years instead of a program limiting vaccination to those over age 60 years was associated with a decrease in the number of patients developing zoster (2,372-3,392 cases avoided over 5 years). Annual incremental per-member-per-month (PMPM) costs associated with this vaccination program change were estimated to range from $0.08 to $0.14. When the vaccination program was kept at age 60 years and over and coverage was increased, the model estimated that the annual incremental PMPM costs ranged from $0.04 to $0.06. Differences in costs were driven primarily by vaccination costs. The results of the scenario analyses showed that lower vaccination costs because of the application of copayments for a managed care organization reduced the magnitude of the total cost increase associated with the increase in uptake. Vaccinating individuals aged 50 to 59 years with the herpes zoster vaccine would likely have an impact on a health plan's budget because of the expected increase in the total number of individuals being vaccinated in the population, with limited cost savings because of fewer cases of herpes zoster. Higher coverage of vaccinations resulted in a greater increase in total costs each year. However, increasing coverage would also result in a decrease in the number of individuals developing zoster and associated postherpetic neuralgia and

  14. Transformation of Taiwan’s Reserve Force

    DTIC Science & Technology

    2017-01-01

    force roles, missions, and capabilities, based on the requirement to counter People’s Republic of China advan- tages in air and maritime power -projection... people on Taiwan increasingly identify themselves as citizens of a state that is separate and distinct from the PRC. As a result, the Chinese Communist...including short- comings in the PLA’s ability to project power significantly across the Taiwan Strait, technological advantages of Taiwan’s armed

  15. [THE INDIVIDUAL AND SOCIAL FACTORS EFFECTING REFUSAL FROM VACCINATION OF CHILDREN IN THE TOWN OF SEMEII OF THE REPUBLIC OF KAZAKHSTAN].

    PubMed

    Baibusinova, A J; Musakhanova, A K; Shalgumbaeva, G M; Dauletiarova, M A; Tokanova, Sh E; Nurtasina, S K

    2015-01-01

    The number of cases of refusal from vaccination increases all over the world. In the Republic of Kazakhstan many studies are devoted to epidemiology of propagation of vaccine-controllable infections, medical aspects ofimmunization, analysis of immunological status and complications of immunization. The issues of awareness of population of the Republic of Kazakhstan about vaccination and refusal of it are investigated insufficiently. This occurrence became a cause of studying the given problem. The study was carried out to investigate attitude ofpopulation to vaccination and main factors of risk of refusal from vaccination of children residing in the city of Semeii and rural districts of the Eastern Kazakhstan oblast. The single-stage longitudinal study was carried out in the Centers of primary medical social care ofpopulation ofcity of Semeii and in polyclinic of the Abaiiskii district of the Eastern Kazakhstan oblast. The period of study continued from April 7 2015 to May 31 2015. The criteria of inclusion were conditionally healthy children. The questionnaire survey included 1184 respondents (mothers) with average age of 27.2 years. The sampling predominantly consisted ofKazakhs (805), Russians (307), representatives ofother nationalities (72). Among mothers, most of them had specialized secondary education (43.7%), the higher education had 30.5%, undergraduate higher education - 1.4%, secondary education - 21.6% and basic school education --2.8%. The results of study demonstrated that families refused from vaccination have negative attitude to vaccination in general though they are satisfied with functioning of vaccination room. The refusal of vaccination is more characterized to urban full families with satisfied income and having girls as children. The respondents consider that information about vaccination received by themfrom medical personnel contains surplus data concerning complications. They are not enouzh for activities in case of deterioration of

  16. Vaccines.gov

    MedlinePlus

    ... Vaccine Safety Vaccines Work Vaccine Types Vaccine Ingredients Vaccines by Disease Chickenpox ... Typhoid Fever Whooping Cough (Pertussis) Yellow Fever Who and When Infants, Children, and Teens ...

  17. Immunologic considerations for generating memory CD8 T cells through vaccination.

    PubMed

    Butler, Noah S; Nolz, Jeffrey C; Harty, John T

    2011-07-01

    Following infection or vaccination, naïve CD8 T cells that receive the appropriate integration of antigenic, co-stimulatory and inflammatory signals undergo a programmed series of biological changes that ultimately results in the generation of memory cells. Memory CD8 T cells, in contrast to naïve cells, more effectively limit or prevent pathogen re-infection because of both qualitative and quantitative changes that occur following their induction. Unlike vaccination strategies aimed at generating antibody production, the ability to generate protective memory CD8 T cells has proven more complicated and problematic. However, recent experimental results have revealed important principles regarding the molecular and genetic basis for memory CD8 T cell formation, as well as identified ways to manipulate their development through vaccination, resulting in potential new avenues to enhance protective immunity. © 2011 Blackwell Publishing Ltd.

  18. A Crowdsourcing-based Taiwan Scientific Earthquake Reporting System

    NASA Astrophysics Data System (ADS)

    Liang, W. T.; Lee, J. C.; Lee, C. F.

    2017-12-01

    To collect immediately field observations for any earthquake-induced ground damages, such as surface fault rupture, landslide, rock fall, liquefaction, and landslide-triggered dam or lake, etc., we are developing an earthquake damage reporting system which particularly relies on school teachers as volunteers after taking a series of training courses organized by this project. This Taiwan Scientific Earthquake Reporting (TSER) system is based on the Ushahidi mapping platform, which has been widely used for crowdsourcing on different purposes. Participants may add an app-like icon for mobile devices to this website at https://ies-tser.iis.sinica.edu.tw. Right after a potential damaging earthquake occurred in the Taiwan area, trained volunteers will be notified/dispatched to the source area to carry out field surveys and to describe the ground damages through this system. If the internet is available, they may also upload some relevant images in the field right away. This collected information will be shared with all public after a quick screen by the on-duty scientists. To prepare for the next strong earthquake, we set up a specific project on TSER for sharing spectacular/remarkable geologic features wherever possible. This is to help volunteers get used to this system and share any teachable material on this platform. This experimental, science-oriented crowdsourcing system was launched early this year. Together with a DYFI-like intensity reporting system, Taiwan Quake-Catcher Network, and some online games and teaching materials, the citizen seismology has been much improved in Taiwan in the last decade. All these constructed products are now either operated or promoted at the Taiwan Earthquake Research Center (TEC). With these newly developed platforms and materials, we are aiming not only to raise the earthquake awareness and preparedness, but also to encourage public participation in earthquake science in Taiwan.

  19. Joint Local/Teleseismic Tomographic Inversion in Taiwan Using TAIGER and Other Data

    NASA Astrophysics Data System (ADS)

    Lee, E.; Wu, F. T.; Huang, B.; Liang, W.; Wang, C.; Rawlinson, N.; Okaya, D. A.

    2008-12-01

    Taiwan, one of the most active orogenic belts, is at the intersection of two subduction zones. In southern Taiwan, the South China Sea Slab (SCSS), part of Eurasian Plate (EP), subducts beneath the Luzon arc along the Manila trench. In northern Taiwan, the Philippine Sea Plate (PSP) subducts beneath the Ryukyu arc along the Ryukyu trench. The thin skinned model and lithospheric deformation model have been proposed to explain the formation of orogeny. To distinguish between these two geodynamically possible processes, imaging of the deep structures below Taiwan is necessary. In this study, explosion data, local/regional earthquakes and teleseisms are used to invert the velocity structures of Taiwan from surface to about 150 km. Temporary passive broadband (on land and at the ocean bottom), active sources array datasets of the TAIGER (TAiwan Integrated GEodynamics Research) project and permanent array datasets of the BATS (Broadband Array in Taiwan for Seismology) and CWB (Central Weather Bureau) are used in this study. FMTOMO (fast marching tomography) of Rawlinson et al. (2006) is employed to invert the 3D P-wavespeed beneath Taiwan. The derived velocity perturbations dVp (dVp= Vfinal-Vinital) are clearly related to geology and tectonics. At shallow depth (< 10km), dVp >0 under the Central Range (Pre-Tertiary metamorphic rocks) and dVp < 0 under the Foothills (Pliocene sedimentary). Below a depth about 20 km, the placement of the high and low anomalies is reversed, i.e., dVp>0 under the Foothills and dVp<0 under the Central Range; the low velocity core of the Central Ranges extend down to about 50 km, forming the mountain root. A steeply dipping high velocity zone lies under the thickening 'mountain root' in central Taiwan. In southern Taiwan, the high velocity zone dips eastward coinciding with the Benioff Zone. The geometry of the high velocity zones in the upper mantle are key to understanding the Taiwan orogeny.

  20. A brief history of vaccines & vaccination in India.

    PubMed

    Lahariya, Chandrakant

    2014-04-01

    The challenges faced in delivering lifesaving vaccines to the targeted beneficiaries need to be addressed from the existing knowledge and learning from the past. This review documents the history of vaccines and vaccination in India with an objective to derive lessons for policy direction to expand the benefits of vaccination in the country. A brief historical perspective on smallpox disease and preventive efforts since antiquity is followed by an overview of 19 th century efforts to replace variolation by vaccination, setting up of a few vaccine institutes, cholera vaccine trial and the discovery of plague vaccine. The early twentieth century witnessed the challenges in expansion of smallpox vaccination, typhoid vaccine trial in Indian army personnel, and setting up of vaccine institutes in almost each of the then Indian States. In the post-independence period, the BCG vaccine laboratory and other national institutes were established; a number of private vaccine manufacturers came up, besides the continuation of smallpox eradication effort till the country became smallpox free in 1977. The Expanded Programme of Immunization (EPI) (1978) and then Universal Immunization Programme (UIP) (1985) were launched in India. The intervening events since UIP till India being declared non-endemic for poliomyelitis in 2012 have been described. Though the preventive efforts from diseases were practiced in India, the reluctance, opposition and a slow acceptance of vaccination have been the characteristic of vaccination history in the country. The operational challenges keep the coverage inequitable in the country. The lessons from the past events have been analysed and interpreted to guide immunization efforts.

  1. A brief history of vaccines & vaccination in India

    PubMed Central

    Lahariya, Chandrakant

    2014-01-01

    The challenges faced in delivering lifesaving vaccines to the targeted beneficiaries need to be addressed from the existing knowledge and learning from the past. This review documents the history of vaccines and vaccination in India with an objective to derive lessons for policy direction to expand the benefits of vaccination in the country. A brief historical perspective on smallpox disease and preventive efforts since antiquity is followed by an overview of 19th century efforts to replace variolation by vaccination, setting up of a few vaccine institutes, cholera vaccine trial and the discovery of plague vaccine. The early twentieth century witnessed the challenges in expansion of smallpox vaccination, typhoid vaccine trial in Indian army personnel, and setting up of vaccine institutes in almost each of the then Indian States. In the post-independence period, the BCG vaccine laboratory and other national institutes were established; a number of private vaccine manufacturers came up, besides the continuation of smallpox eradication effort till the country became smallpox free in 1977. The Expanded Programme of Immunization (EPI) (1978) and then Universal Immunization Programme (UIP) (1985) were launched in India. The intervening events since UIP till India being declared non-endemic for poliomyelitis in 2012 have been described. Though the preventive efforts from diseases were practiced in India, the reluctance, opposition and a slow acceptance of vaccination have been the characteristic of vaccination history in the country. The operational challenges keep the coverage inequitable in the country. The lessons from the past events have been analysed and interpreted to guide immunization efforts. PMID:24927336

  2. Country Profiles, Taiwan.

    ERIC Educational Resources Information Center

    Keeny, S. M.; And Others

    A profile of Taiwan is sketched in this paper. Emphasis is placed on the nature, scope, and accomplishments of population activities in the country. Topics and sub-topics include: location and description of the country; population (size, growth patterns, age structure, urban/rural distribution, ethnic and religious composition, migration,…

  3. Efficacy of varicella (VZV) vaccination: an update for the clinician

    PubMed Central

    Wang, Lili; Zhu, Lucy; Zhu, Hua

    2016-01-01

    Varicella-zoster virus (VZV) infection causes two distinct clinical conditions. Primary varicella infection results in chickenpox, a contagious rash illness typically seen among children. VZV can reactivate years after the initial infection to cause herpes zoster (HZ) and lead to post-herpetic neuralgia, a common complication resulting in persistent pain that may last for years after the zoster rash resolves. A person’s risk of having longer lasting and more severe pain associated with HZ increases with age. Since the introduction of VZV vaccines, the rates of infection, hospitalizations, and mortality have declined. In this review, we discuss in detail current VZV vaccines available for the prevention of VZV and HZ infections. Varilrix (GSK Biologicals, UK), Varivax (Merck, USA) and the combined measles, mumps, rubella, and varicella (MMRV) vaccine contain the live attenuated Oka strain of VZV for routine varicella vaccination. While Zostavax is the only HZ vaccine currently approved for use in the United States and the European Union [EMEA, 2011], a subunit vaccine candidate called HZ/su has recently shown improved efficacy for zoster prevention in two clinical trial phase III studies. VariZIG, a post-exposure prophylactic, uses zoster immune globulin to prevent VZV infection in those who have recently been in contact with VZV but lack evidence of varicella immunity and are contraindicated to receive the varicella vaccine. Further, we discuss the skin tropic and neurotropic factor VZV ORF7 gene and its involvement in varicella infection, reactivation and latency in ganglia. Ultimately, these studies can contribute to the development of a neuroattenuated vaccine candidate against varicella or a vector for delivery of other virus antigens. PMID:27551429

  4. Ethical and legal challenges of vaccines and vaccination: Reflections.

    PubMed

    Jesani, Amar; Johari, Veena

    2017-01-01

    Vaccines and vaccination have emerged as key medical scientific tools for prevention of certain diseases. Documentation of the history of vaccination shows that the initial popular resistance to universal vaccination was based on false assumptions and eventually gave way to acceptance of vaccines and trust in their ability to save lives. The successes of the global eradication of smallpox, and now of polio, have only strengthened the premier position occupied by vaccines in disease prevention. However, the success of vaccines and public trust in their ability to eradicate disease are now under challenge, as increasing numbers of people refuse vaccination, questioning the effectiveness of vaccines and the need to vaccinate.

  5. A dataset from bottom trawl survey around Taiwan

    PubMed Central

    Shao, Kwang-Tsao; Lin, Jack; Wu, Chung-Han; Yeh, Hsin-Ming; Cheng, Tun-Yuan

    2012-01-01

    Abstract Bottom trawl fishery is one of the most important coastal fisheries in Taiwan both in production and economic values. However, its annual production started to decline due to overfishing since the 1980s. Its bycatch problem also damages the fishery resource seriously. Thus, the government banned the bottom fishery within 3 nautical miles along the shoreline in 1989. To evaluate the effectiveness of this policy, a four year survey was conducted from 2000–2003, in the waters around Taiwan and Penghu (Pescadore) Islands, one region each year respectively. All fish specimens collected from trawling were brought back to lab for identification, individual number count and body weight measurement. These raw data have been integrated and established in Taiwan Fish Database (http://fishdb.sinica.edu.tw). They have also been published through TaiBIF (http://taibif.tw), FishBase and GBIF (website see below). This dataset contains 631 fish species and 3,529 records, making it the most complete demersal fish fauna and their temporal and spatial distributional data on the soft marine habitat in Taiwan. PMID:22707908

  6. Evolving trends of neonatal and childhood bacterial meningitis in northern Taiwan.

    PubMed

    Lin, Meng-Chin; Chiu, Nan-Chang; Chi, Hsin; Ho, Che-Sheng; Huang, Fu-Yuan

    2015-06-01

    The epidemiology of bacterial meningitis varies in different areas, age groups, and times. To know the trend of neonatal and childhood bacterial meningitis in northern Taiwan, we performed this 29-year-long assessment. Eligible patients were aged 18 years or younger, hospitalized in Mackay Memorial Hospital between 1984 and 2012, and proven by positive cerebrospinal fluid bacterial cultures. Analysis included the patient numbers and pathogens in different age groups, periods, complications, and outcomes. Males were predominant in all the age groups through the years. Almost half of the patients were in the neonatal period. Patient numbers went up in the early study period and declined after 1993-1997. Group B Streptococcus and Escherichia coli were the most common pathogens in neonates, whereas in childhood were Streptococcus pneumoniae and Haemophilus influenzae type b (Hib). Patient numbers of Group B Streptococcus, S. pneumoniae, and Hib meningitis declined in the late study period, but E. coli meningitis increased. The mortality rate decreased but sequela rate increased. Among the four most common pathogens, S. pneumoniae had the worst outcome and had highest mortality rate. All Hib meningitis patients survived, but their sequela rate was the highest. This study provides an epidemiological data on trends of neonatal and childhood bacterial meningitis in northern Taiwan during the past 29 years, including male and neonatal predominance, decrease of total patient number in recent years, change of major pathogens, and declined mortality but raised morbidity. Copyright © 2013. Published by Elsevier B.V.

  7. Chickenpox in a Swiss prison: susceptibility, post-exposure vaccination and control measures.

    PubMed

    Gétaz, Laurent; Siegrist, Claire-Anne; Stoll, Béat; Humair, Jean-Paul; Scherrer, Yvan; Franziskakis, Constantin; Sudre, Philippe; Gaspoz, Jean-Michel; Wolff, Hans

    2010-12-01

    After the occurrence of a case of chickenpox in Switzerland's largest pre-trial prison, protective measures including post-exposure vaccination were implemented, as chickenpox can cause severe complications in adults. Serology for chickenpox was carried out for all contacts of the index case and rapid post-exposure vaccination proposed to all prisoners with a negative history for chickenpox. Susceptibility was found in 14 out of 110 prisoners (12.7%; 95% confidence interval 6.5-18.9). The positive predictive value of a history of chickenpox was 90%. In this predominantly migrant population, susceptibility to chickenpox was approximately 6 times higher than in the general Swiss adult population. Since the attack rate among susceptible household contacts is usually high, preventive measures such as vaccination and quarantine probably allowed containment of the spread of infection.

  8. HPV vaccine

    MedlinePlus

    ... HPV; Gardasil; HPV2; HPV4; Vaccine to prevent cervical cancer; Genital warts - HPV vaccine; Cervical dysplasia - HPV vaccine; Cervical cancer - HPV vaccine; Cancer of the cervix - HPV vaccine; ...

  9. [An outline medical history of Taiwan (I): the period of folklore medicine and witch doctor].

    PubMed

    Li, C

    1997-01-01

    The paper makes a correlated analysis on the origin of health folklore between Chinese in mainland and Taiwan island. After quoting literatures written by authors living in the Qing dynasty in Taiwan, this paper analyses health condition among aboriginals of Taiwan during the witchcraft age. Along with the increasing immigration from China mainland to Taiwan island, health of folklore and gods from China mainland were introduced into Taiwan, hence the period of witch doctor in Taiwan, featuring the correlation of both. Though modern medicine in Taiwan is so advanced, yet there are still witch doctors elsewhere.

  10. A synthesized biophysical and social vulnerability assessment for Taiwan

    NASA Astrophysics Data System (ADS)

    Lee, Yung-Jaan

    2017-11-01

    Taiwan, located in the Western Pacific, is a country that is one of the most vulnerable to disasters that are associated with the changing climate; it is located within the Ring of Fire, which is the most geologically active region in the world. The environmental and geological conditions in Taiwan are sensitive and vulnerable to such disasters. Owing to increasing urbanization in Taiwan, floods and climate-related disasters have taken an increasing toll on human lives. As global warming accelerates the rising of sea levels and increasing of the frequency of extreme weather events, disasters will continue to affect socioeconomic development and human conditions. Under such circumstances, researchers and policymakers alike must recognize the importance of providing useful knowledge concerning vulnerability, disaster recovery and resilience. Strategies for reducing vulnerability and climate-related disaster risks and for increasing resilience involve preparedness, mitigation and adaptation. In the last two decades, extreme climate events have caused severe flash floods, debris flows, landslides, and other disasters and have had negative effects of many sectors, including agriculture, infrastructure and health. Since climate change is expected to have a continued impact on socio-economic development, this work develops a vulnerability assessment framework that integrates both biophysical and social vulnerability and supports synthesized vulnerability analyses to identify vulnerable areas in Taiwan. Owing to its geographical, geological and climatic features, Taiwan is susceptible to earthquakes, typhoons, droughts and various induced disasters. Therefore, Taiwan has the urgent task of establishing a framework for assessing vulnerability as a planning and policy tool that can be used to identify not only the regions that require special attention but also hotspots in which efforts should be made to reduce vulnerability and the risk of climate-related disaster. To

  11. [Current situation of the standardization of acupuncture and moxibustion in Taiwan].

    PubMed

    Pan, Li-Jia; Cui, Rui; Zhan, Bi-Yu; Liao, Cai-Yan; Cao, Qi-Hua; Li, Gui-Lan; Guo, Yi

    2012-09-01

    The current situation of the standardization of acupuncture and moxibustion in the Taiwan region is introduced in this paper from the three aspects, named the development state of standard of acupuncture and moxibustion in Taiwan, the implementation of Taiwan district standard and the standardization of acupuncture and moxibustion in Taiwan. At present, the relevant standards of acupuncture and moxibustion in Taiwan just include the standard operation procedure of acupuncture and moxibustion, the reference guideline of the safe operation in the medical service centers of traditional Chinese medicine, and the faculty standard of Chinese medicine hospital, etc. It is concluded that the current situation of the standardization of acupuncture and moxibusiton presented the weak awareness of the standardization of acupuncture and moxibustion in the industry, insufficient enterprise standard, less-quantity of the implemented standards and narrow coverage.

  12. [Results of Booster Vaccination in Children with Primary Vaccine Failure after Initial Varicella Vaccination].

    PubMed

    Ozakiv, Takao; Nishimura, Naoko; Gotoh, Kensei; Funahashi, Keiji; Yoshii, Hironori; Okuno, Yoshinobu

    2016-05-01

    In October 2014, the varicella vaccination policy in Japan was changed from a single voluntary inoculation to two routine inoculations. This paper reports the results of booster vaccination in children who did not show seroconversion after initial vaccination (i.e., primary vaccine failure : PVF) over a 7-year period prior to the introduction of routine varicella vaccination. Between November 2007 and May 2014, 273 healthy children aged between 1.1 and 14.5 years (median : 1.7 years) underwent varicella vaccination. Before and 4 to 6 weeks after vaccination, the antibody titers were measured using an immune adherence hemagglutination (IAHA) assay and a glycoprotein-based enzyme-linked immunosorbent assay (gpELISA). In addition, side reactions were examined during the four-week period after vaccination. Children who did not show IAHA seroconversion (PVF) were recommended to receive a booster vaccination, and the measurement of antibody titers and an assessment of side reactions were performed after the booster dose. In May 2015, a questionnaire was mailed to each of the 273 participants to investigate whether they had developed varicella and/or herpes zoster after vaccination. After initial vaccination, the IAHA seroconversion rate was 75% and the mean antibody titer (Log2) with seroconversion was 4.7, while the gpELISA seroconversion rate was 84% and the mean antibody titer (Log10) with seroconversion was 2.4. Among children with PVF, 54 received booster vaccination within 81 to 714 days (median : 139 days) after the initial vaccination. After booster vaccination, the IAHA seroconversion rate was 98% and the mean antibody titer (Log2) with seroconversion was 5.8. Both the seroconversion rate and the antibody titer were higher compared with the values after the initial vaccination (p < 0.01). After booster vaccination, the gpELISA seropositive rate was 100% and the mean positive antibody titer (Log 10) was 3.6 ; similar results were obtained for the IAHA assay, with

  13. Vaccination against a Virus-Encoded Cytokine Significantly Restricts Viral Challenge

    PubMed Central

    Eberhardt, Meghan K.; Deshpande, Ashlesha; Chang, W. L. William; Barthold, Stephen W.

    2013-01-01

    Identification of immune correlates of protection for viral vaccines is complicated by multiple factors, but there is general consensus on the importance of antibodies that neutralize viral attachment to susceptible cells. Development of new viral vaccines has mostly followed this neutralizing antibody paradigm, but as a recent clinical trial of human cytomegalovirus (HCMV) vaccination demonstrated, this singular approach can yield limited protective efficacy. Since HCMV devotes >50% of its coding capacity to proteins that modulate host immunity, it is hypothesized that expansion of vaccine targets to include this part of the viral proteome will disrupt viral natural history. HCMV and rhesus cytomegalovirus (RhCMV) each encode an ortholog to the cellular interleukin-10 (cIL-10) cytokine: cmvIL-10 and rhcmvIL10, respectively. Despite extensive sequence divergence from their host's cIL-10, each viral IL-10 retains nearly identical functionality to cIL-10. Uninfected rhesus macaques were immunized with engineered, nonfunctional rhcmvIL-10 variants, which were constructed by site-directed mutagenesis to abolish binding to the cIL-10 receptor. Vaccinees developed antibodies that neutralized rhcmvIL-10 function with no cross-neutralization of cIL-10. Following subcutaneous RhCMV challenge, the vaccinees exhibited both reduced RhCMV replication locally at the inoculation site and systemically and significantly reduced RhCMV shedding in bodily fluids compared to controls. Attenuation of RhCMV infection by rhcmvIL-10 vaccination argues that neutralization of viral immunomodulation may be a new vaccine paradigm for HCMV by expanding potential vaccine targets. PMID:23946461

  14. Vaccine Hesitancy.

    PubMed

    Jacobson, Robert M; St Sauver, Jennifer L; Finney Rutten, Lila J

    2015-11-01

    Vaccine refusal received a lot of press with the 2015 Disneyland measles outbreak, but vaccine refusal is only a fraction of a much larger problem of vaccine delay and hesitancy. Opposition to vaccination dates back to the 1800 s, Edward Jenner, and the first vaccine ever. It has never gone away despite the public's growing scientific sophistication. A variety of factors contribute to modern vaccine hesitancy, including the layperson's heuristic thinking when it comes to balancing risks and benefits as well as a number of other features of vaccination, including falling victim to its own success. Vaccine hesitancy is pervasive, affecting a quarter to a third of US parents. Clinicians report that they routinely receive requests to delay vaccines and that they routinely acquiesce. Vaccine rates vary by state and locale and by specific vaccine, and vaccine hesitancy results in personal risk and in the failure to achieve or sustain herd immunity to protect others who have contraindications to the vaccine or fail to generate immunity to the vaccine. Clinicians should adopt a variety of practices to combat vaccine hesitancy, including a variety of population health management approaches that go beyond the usual call to educate patients, clinicians, and the public. Strategies include using every visit to vaccinate, the creation of standing orders or nursing protocols to provide vaccination without clinical encounters, and adopting the practice of stating clear recommendations. Up-to-date, trusted resources exist to support clinicians' efforts in adopting these approaches to reduce vaccine hesitancy and its impact. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  15. Subviral Particle as Vaccine and Vaccine Platform

    PubMed Central

    Tan, Ming; Jiang, Xi

    2014-01-01

    Recombinant subvirual particles retain similar antigenic features of their authentic viral capsids and thus have been applied as nonreplicating subunit vaccines against viral infection and illness. Additionally, the self-assembled, polyvalent subviral particles are excellent platforms to display foreign antigens for immune enhancement for vaccine development. These subviral particle-based vaccines are noninfectious and thus safer than the conventional live attenuated and inactivated vaccines. While several VLP vaccines are available in the markets, numerous others, including dual vaccines against more than one pathogen, are under clinical or preclinical development. This article provides an update of these efforts. PMID:24662314

  16. Seasonal Patterns of Japanese Encephalitis and Associated Meteorological Factors in Taiwan.

    PubMed

    Lin, Che-Liang; Chang, Hsiao-Ling; Lin, Chuan-Yao; Chen, Kow-Tong

    2017-10-29

    The persistent transmission of Japanese encephalitis virus (JEV) in Taiwan necessitates exploring the risk factors of occurrence of Japanese encephalitis (JE). The purpose of this study was to assess the relationship between meteorological factors and the incidence of JE in Taiwan. We collected data for cases of JE reported to the Taiwan Centers for Disease Control (Taiwan CDC) from 2000 to 2014. Meteorological data were obtained from the Taiwan Central Weather Bureau. The relationships between weather variability and the incidence of JE in Taiwan were determined via Poisson regression analysis and a case-crossover methodology. During the 15-year study period, a total of 379 cases of JE were reported. The incidence of JE showed significant seasonality, with the majority of cases occurring in summertime (for oscillation, p < 0.001). The number of JE cases started to increase at temperatures of 22 °C (r² = 0.88, p < 0.001). Similarly, the number of JE cases began to increase at a relative humidity of 70-74% (r² = 0.75, p < 0.005). The number of JE cases was positively associated with mean temperature and relative humidity in the period preceding the infection. In conclusion, the occurrence of JE is significantly associated with increasing temperature and relative humidity in Taiwan. Therefore, these factors could be regarded as warning signals indicating the need to implement preventive measures.

  17. Wintertime sea surface temperature fronts in the Taiwan Strait

    NASA Astrophysics Data System (ADS)

    Chang, Yi; Shimada, Teruhisa; Lee, Ming-An; Lu, Hsueh-Jung; Sakaida, Futoki; Kawamura, Hiroshi

    2006-12-01

    We present wintertime variations and distributions of sea surface temperature (SST) fronts in the Taiwan Strait by applying an entropy-based edge detection method to 10-year (1996-2005) satellite SST images with grid size of 0.01°. From climatological monthly mean maps of SST gradient magnitude in winter, we identify four significant SST fronts in the Taiwan Strait. The Mainland China Coastal Front is a long frontal band along the 50-m isobath near the Chinese coast. The sharp Peng-Chang Front appears along the Peng-Hu Channel and extends northward around the Chang-Yuen Ridge. The Taiwan Bank Front evolves in early winter. As the winter progresses, the front becomes broad and moves toward the Chinese coast, connecting to the Mainland China Coastal Front. The Kuroshio Front extends northeastward from the northeastern tip of Taiwan with a semicircle-shape curving along the 100-m isobath.

  18. Cost-Effectiveness of Healthcare Worker Pneumococcal Polysaccharide Vaccination During Pandemic Influenza

    PubMed Central

    Smith, Kenneth J.; Raymund, Mahlon; Nowalk, Mary Patricia; Roberts, Mark S.; Zimmerman, Richard K.

    2010-01-01

    Objective In prior influenza pandemics, pneumococcal complications of influenza have caused substantial morbidity and mortality. The usefulness and cost-effectiveness of pneumococcal vaccination for healthcare workers during an influenza pandemic is unknown. Study Design Markov modeling was used to estimate the cost-effectiveness of pneumococcal polysaccharide vaccination (PPV) in previously unvaccinated healthcare workers during an influenza pandemic. Methods Invasive pneumococcal disease (IPD) incidence rates were incorporated into the model, assuming that IPD events occurred at twice the usual rate during the year of pandemic influenza. Both societal and hospital perspectives were examined. Assumptions were that: pneumococcal disease transmission from healthcare worker to patient did not occur, heightened IPD risk occurred for only 1 year, and PPV did not prevent noninvasive pneumonia, all of which potentially bias against vaccination. Results From a societal standpoint, pneumococcal vaccination of healthcare workers during an influenza pandemic is economically reasonable, costing $2,935 per quality adjusted life year gained; results were robust to variation in multiple sensitivity analyses. However, from the hospital perspective vaccinating healthcare workers was expensive, costing $1,676 per employee absence day avoided, given an IPD risk that, though increased, would still remain <1%. Conclusion Vaccinating all healthcare workers to protect against pneumococcal disease during a pandemic influenza outbreak is likely to be economically reasonable from the societal standpoint. However, pneumococcal vaccination is expensive from the hospital perspective, which might prevent implementation of a PPV program unless it is externally subsidized. PMID:20225915

  19. Influenza vaccination coverage among US children from 2004/2005 to 2015/2016.

    PubMed

    Tian, Changwei; Wang, Hua; Wang, Wenming; Luo, Xiaoming

    2018-05-15

    Quantify the influenza vaccine coverage is essential to identify emerging concerns and to immunization programs for targeting interventions. Data from National Health Interview Survey were used to estimate receipt of at least one dose of influenza vaccination among children 6 months to 17 years of age. Influenza vaccination coverage increased from 16.70% during 2004/2005 to 49.43% during 2015/2016 (3.18% per year, P < 0.001); however, the coverage increased slightly after 2010/2011. Children at high risk of influenza complications had higher influenza vaccination coverage than non at-risk children. Boys and girls had similar coverage each year. While the coverage increased from 2004/2005 to 2015/2016 for all age groups, the coverage decreased with age each year (-0.64 to -1.58% per age group). There was a higher and rapid increase of coverage in Northeast than Midwest, South and West. American Indian or Alaskan Native and Asian showed higher coverage than other race groups (White, Black/African American, Multiple race). Multivariable analysis showed that high-risk status and region had the greatest associations with levels of vaccine coverage. Although the influenza vaccination coverage among children had increased remarkably since 2004/2005, establishing more effective immunization programs are warranted to achieve the Healthy People 2020 target.

  20. Vaccination Confidence and Parental Refusal/Delay of Early Childhood Vaccines.

    PubMed

    Gilkey, Melissa B; McRee, Annie-Laurie; Magnus, Brooke E; Reiter, Paul L; Dempsey, Amanda F; Brewer, Noel T

    2016-01-01

    To support efforts to address parental hesitancy towards early childhood vaccination, we sought to validate the Vaccination Confidence Scale using data from a large, population-based sample of U.S. parents. We used weighted data from 9,354 parents who completed the 2011 National Immunization Survey. Parents reported on the immunization history of a 19- to 35-month-old child in their households. Healthcare providers then verified children's vaccination status for vaccines including measles, mumps, and rubella (MMR), varicella, and seasonal flu. We used separate multivariable logistic regression models to assess associations between parents' mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status. A substantial minority of parents reported a history of vaccine refusal (15%) or delay (27%). Vaccination confidence was negatively associated with refusal of any vaccine (odds ratio [OR] = 0.58, 95% confidence interval [CI], 0.54-0.63) as well as refusal of MMR, varicella, and flu vaccines specifically. Negative associations between vaccination confidence and measures of vaccine delay were more moderate, including delay of any vaccine (OR = 0.81, 95% CI, 0.76-0.86). Vaccination confidence was positively associated with having received vaccines, including MMR (OR = 1.53, 95% CI, 1.40-1.68), varicella (OR = 1.54, 95% CI, 1.42-1.66), and flu vaccines (OR = 1.32, 95% CI, 1.23-1.42). Vaccination confidence was consistently associated with early childhood vaccination behavior across multiple vaccine types. Our findings support expanding the application of the Vaccination Confidence Scale to measure vaccination beliefs among parents of young children.

  1. The Ticks (Acari: Ixodida: Argasidae, Ixodidae) of Taiwan: A Synonymic Checklist

    DTIC Science & Technology

    2005-01-01

    Lyme disease in Taiwan" Primary isolation of Borrelia burgdor- idae). Acarina 10:95-136. Wilson...the recent emergence of Lyme borreliosis and human babesiosis in Taiwan (Shih and Chao 1998, 1999; Shih et al. 1997, 1998), it is imperative that these...the Ixodes kuntzi Hoogstraal & Kohls, principal vector of Lyme borreliosis in 1965.35 Taiwan collections in USNTC. northeastern Asia and is

  2. Protective Effect of Maternal Influenza Vaccination on Influenza in Their Infants: A Prospective Cohort Study.

    PubMed

    Ohfuji, Satoko; Deguchi, Masaaki; Tachibana, Daisuke; Koyama, Masayasu; Takagi, Tetsu; Yoshioka, Takayuki; Urae, Akinori; Ito, Kazuya; Kase, Tetsuo; Maeda, Akiko; Kondo, Kyoko; Fukushima, Wakaba; Hirota, Yoshio

    2018-03-05

    Infants <6 months of age are too young to receive influenza vaccine, despite being at high risk for severe influenza-related complications. To examine the effectiveness of maternal influenza vaccination in preventing influenza in their infants, we conducted a prospective cohort study of 3441 infants born at participating hospitals before the 2013-2014 influenza season. At the time of recruitment, their mothers completed a questionnaire about influenza vaccination status for the 2013-2014 season. A follow-up survey was conducted after the end of the 2013-2014 season to collect information regarding influenza diagnosis and hospitalization among infants. During the 2013-2014 influenza season, 71 infants (2%) had influenza diagnosed, and 13 infants (0.4%) were hospitalized with influenza. Maternal influenza vaccination (especially prenatal vaccination) decreased the odds of influenza among infants. The effectiveness of prenatal vaccination was 61% (95% confidence interval, 16%-81%), whereas that of postpartum vaccination was 53% (-28%-83%). Although maternal influenza vaccination was also associated with a decreased odds of influenza-related hospitalization among infants, vaccine effectiveness (73%) did not reach statistical significance, owing to the limited number of infants hospitalized because of influenza. The present findings indicated that pregnant women and postpartum women should receive influenza vaccination to protect their infants. © The Author(s) 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  3. Root-Cause Analytical Survey for Measles Outbreak: Vaccination or Vaccine?- A Study From Madhepura District, Bihar, India.

    PubMed

    Basa, Sudipta; Das, Rashmi Ranjan; Khan, Javed Akhtar

    2015-06-01

    Though measles is a vaccine preventable disease, outbreaks still continue to occur because of poor immunization coverage rate at the national level. To report the survey results of an outbreak of measles in Puraini village of Madhepura district in Bihar, India. This cross-sectional survey was conducted among children aged 6 months to 12 years during an outbreak of measles in December 2008. WHO case definition criteria was used to define active measles cases. Demographic data, immunization status, and disease outcome among the cases was obtained by pre-structured questionnaires. Blood samples from 5 cases were sent for laboratory confirmation. A total of 52 cases and 8 deaths were reported with an attack rate of 28% and case fatality rate of 15.4%. Out of 35% cases of post-measles complications, dysentery with pneumonia was the most common. Anti-measles IgM antibody tested positive in all the 5 serum samples sent for confirmation. No child had received measles vaccination in the past, and the reasons were lack of awareness, lack of faith on vaccination, and unavailability of health workers. This survey calls for strengthening of disease surveillance and routine immunization coverage to achieve measles control in these communities. This has important public health implication for the whole country regarding measles elimination in near-future.

  4. Dynamic vaccine blocks relapse to compulsive intake of heroin

    PubMed Central

    Schlosburg, Joel E.; Vendruscolo, Leandro F.; Bremer, Paul T.; Lockner, Jonathan W.; Wade, Carrie L.; Nunes, Ashlee A. K.; Stowe, G. Neil; Edwards, Scott; Janda, Kim D.; Koob, George F.

    2013-01-01

    Heroin addiction, a chronic relapsing disorder characterized by excessive drug taking and seeking, requires constant psychotherapeutic and pharmacotherapeutic interventions to minimize the potential for further abuse. Vaccine strategies against many drugs of abuse are being developed that generate antibodies that bind drug in the bloodstream, preventing entry into the brain and nullifying psychoactivity. However, this strategy is complicated by heroin’s rapid metabolism to 6-acetylmorphine and morphine. We recently developed a “dynamic” vaccine that creates antibodies against heroin and its psychoactive metabolites by presenting multihaptenic structures to the immune system that match heroin’s metabolism. The current study presents evidence of effective and continuous sequestration of brain-permeable constituents of heroin in the bloodstream following vaccination. The result is efficient blockade of heroin activity in treated rats, preventing various features of drugs of abuse: heroin reward, drug-induced reinstatement of drug seeking, and reescalation of compulsive heroin self-administration following abstinence in dependent rats. The dynamic vaccine shows the capability to significantly devalue the reinforcing and motivating properties of heroin, even in subjects with a history of dependence. In addition, targeting a less brain-permeable downstream metabolite, morphine, is insufficient to prevent heroin-induced activity in these models, suggesting that heroin and 6-acetylmorphine are critical players in heroin’s psychoactivity. Because the heroin vaccine does not target opioid receptors or common opioid pharmacotherapeutics, it can be used in conjunction with available treatment options. Thus, our vaccine represents a promising adjunct therapy for heroin addiction, providing continuous heroin antagonism, requiring minimal medical m