Predicting outbreaks: a spatial risk assessment of West Nile virus in British Columbia

PubMed Central

Tachiiri, Kaoru; Klinkenberg, Brian; Mak, Sunny; Kazmi, Jamil

2006-01-01

Background West Nile virus (WNv) has recently emerged as a health threat to the North American population. After the initial disease outbreak in New York City in 1999, WNv has spread widely and quickly across North America to every contiguous American state and Canadian province, with the exceptions of British Columbia (BC), Prince Edward Island and Newfoundland. In this study we develop models of mosquito population dynamics for Culex tarsalis and C. pipiens, and create a spatial risk assessment of WNv prior to its arrival in BC by creating a raster-based mosquito abundance model using basic geographic and temperature data. Among the parameters included in the model are spatial factors determined from the locations of BC Centre for Disease Control mosquito traps (e.g., distance of the trap from the closest wetland or lake), while other parameters were obtained from the literature. Factors not considered in the current assessment but which could influence the results are also discussed. Results Since the model performs much better for C. tarsalis than for C. pipiens, the risk assessment is carried out using the output of C. tarsalis model. The result of the spatially-explicit mosquito abundance model indicates that the Okanagan Valley, the Thompson Region, Greater Vancouver, the Fraser Valley and southeastern Vancouver Island have the highest potential abundance of the mosquitoes. After including human population data, Greater Vancouver, due to its high population density, increases in significance relative to the other areas. Conclusion Creating a raster-based mosquito abundance map enabled us to quantitatively evaluate WNv risk throughout BC and to identify the areas of greatest potential risk, prior to WNv introduction. In producing the map important gaps in our knowledge related to mosquito ecology in BC were identified, as well, it became evident that increased efforts in bird and mosquito surveillance are required if more accurate models and maps are to be

Age and significance of earthquake-induced liquefaction near Vancouver, British Columbia, Canada

USGS Publications Warehouse

Clague, J.J.; Naesgaard, E.; Nelson, A.R.

1997-01-01

In late 1994, sand dykes, large sand blows, and deformed strata were exposed in the walls of an excavation at Annacis Island on the Fraser River delta near Vancouver, British Columbia. The features record liquefaction during a large earthquake about 1700 years ago; this was perhaps the largest earthquake to affect the Vancouver area in the last 3500 years. Similar, less well-dated features have been reported from several other sites on the Fraser delta and may be products of the same earthquake. Three radiocarbon ages that closely delimit the time of liquefaction on Annacis Island are similar to the most precise radiocarbon ages on coseismically subsided marsh soils at estuaries in southern Washington and Oregon. Both the liquefaction and the subsidence may have been produced by a single great plate-boundary earthquake at the Cascadia subduction zone. Alternatively, liquefaction at Annacis Island may have been caused by a large crustal or subcrustal earthquake of about the same age as a plate-boundary earthquake farther west. The data from Annacis Island and other sites on the Fraser delta suggest that earthquakes capable of producing extensive liquefaction in this area are rare events. Further, liquefaction analysis using historical seismicity suggests that current assessment procedures may overestimate liquefaction risk.

A dengue outbreak on a floating village at Cat Ba Island in Vietnam.

PubMed

Le Viet, Thanh; Choisy, Marc; Bryant, Juliet E; Vu Trong, Duoc; Pham Quang, Thai; Horby, Peter; Nguyen Tran, Hien; Tran Thi Kieu, Huong; Nguyen Vu, Trung; Nguyen Van, Kinh; Le Quynh, Mai; Wertheim, Heiman F L

2015-09-22

A dengue outbreak in an ecotourism destination spot in Vietnam, from September to November 2013, impacted a floating village of fishermen on the coastal island of Cat Ba. The outbreak raises questions about how tourism may impact disease spread in rural areas. Epidemiological data were obtained from the Hai Phong Preventive Medical Center (PMC), including case histories and residential location from all notified dengue cases from this outbreak. All household addresses were geo-located. Knox test, a spatio-temporal analysis that enables inference dengue clustering constrained by space and time, was performed on the geocoded locations. From the plasma available from two patients, positive for Dengue serotype 3 virus (DENV3), the Envelope (E) gene was sequenced, and their genetic relationships compared to other E sequences in the region. Of 192 dengue cases, the odds ratio of contracting dengue infections for people living in the floating villages compared to those living on the island was 4.9 (95 % CI: 3.6-6.7). The space-time analyses on 111 geocoded dengue residences found the risk of dengue infection to be the highest within 4 days and a radius of 20 m of a given case. Of the total of ten detected clusters with an excess risk greater than 2, the cluster with the highest number of cases was in the floating village area (24 patients for a total duration of 31 days). Phylogenetic analysis revealed a high homology of the two DENV3 strains (genotype III) from Cat Ba with DENV3 viruses circulating in Hanoi in the same year (99.1 %). Our study showed that dengue transmission is unlikely to be sustained on Cat Ba Island and that the 2013 epidemic likely originated through introduction of viruses from the mainland, potentially Hanoi. These findings suggest that prevention efforts should be focused on mainland rather than on the island.

Geological Evidence That Resolves the Baja-BC Controversy: Detrital Zircons Indicate That Vancouver Island Was Adjacent to Southern California in the Late Cretaceous

NASA Astrophysics Data System (ADS)

Guest, B.; Matthews, W.; Coutts, D. S.; Bain, H.; Hubbard, S. M.

2015-12-01

The Baja-BC hypothesis is at the center of a great earth sciences controversy. It stems from paleomagnetic observations that require large-scale displacements of continental crust from low latitudes (Baja, California) to moderate latitudes (British Columbia). Many geologists dispute the scale of the displacements due to a lack of corroborating geological evidence. We provide a robust, geological dataset that confirms the paleomagnetic observations. Detrital zircons from Cretaceous to Paleocene sandstone of the Nanaimo Group, which crops out in western Vancouver Island and the Gulf Islands of southwest British Columbia, are analyzed. The data show a clear transition from local <300 Ma western Coast Plutonic Complex sources in the Campanian, to sources that include a significant component of >300 Ma grains in the Maastrichtian-Paleogene. An identical pattern is observed in detrital zircon datasets from southern California forearc basin deposits, and schists interpreted as the subducted remnants of forearc deposits. With a high-n dataset (n=3041) we are able to rule out possible >300 Ma source regions in Canada and the northern United States, and uniquely tie Nanaimo Group rocks to the Mojave-Sonora region of SW United States. This implies that at the end of the Cretaceous, Vancouver Island and western mainland BC were adjacent to southern California and northwestern Mexico, requiring 1900 km of displacement during the latest Cretaceous and Paleocene, consistent with paleomagnetic results. An implication of this result is that the western Coast Batholith of southwest BC was positioned between the northern Peninsular Ranges and southern Sierra Nevada batholiths in the late Cretaceous, and likely represents a displaced segment of a once continuous Cordilleran arc batholith. These results have broad implications for our understanding of episodic arc magmatism in the Cordillera, the tectonic evolution of western North America, Laramide orogenesis, the development and

An Outbreak of Vibrio cholerae O1 infections on Ebeye Island, Republic of the Marshall Islands, associated with use of an adequately chlorinated water source.

PubMed

Beatty, Mark E; Jack, Tom; Sivapalasingam, Sumathi; Yao, Sandra S; Paul, Irene; Bibb, Bill; Greene, Kathy D; Kubota, Kristy; Mintz, Eric D; Brooks, John T

2004-01-01

In December 2000, physicians in the Republic of the Marshall Islands reported the first known outbreak of Vibrio cholerae O1 infection (biotype El Tor, serotype Ogawa) from this country. In a matched case-control study on Ebeye Island, patients with cholera (n=53) had greater odds than persons without cholera (n=104) to have drunk adequately chlorinated water collected from a US military installation on neighboring Kwajalein Island and transported back to Ebeye (matched odds ratio [MOR], 8.0; P=.01). Transporting or storing drinking water in a water cooler with a spout and a tight-fitting lid was associated with reduced odds of illness (MOR, 0.24; P<.01), as was drinking bottled water (MOR, 0.08; P<.01), boiled water (MOR, 0.47; P=.02), or water flavored with powdered drink mixes (MOR, 0.18; P<.01). No cases of cholera were reported among Kwajalein residents. This outbreak highlights the critical importance of handling and storing drinking water safely, especially during outbreaks of gastrointestinal illness.

Vancouver Island Health Authority (VIHA) in house Perioperative Nursing Program.

PubMed

Christensen, Fern

2005-12-01

The Vancouver Island Health Authority (VIHA) in liaison with the University of Victoria (UVIC) offers an introduction to Perioperative Nursing Program to 4th Year undergraduate nursing students. The aim of this program is to help recruit Registered Nurses to the Operating Room. It has been advantageous to the recruitment and retention of nurses graduating from UVIC. Its importance is increased by the fact that a significant quantity of Victoria's perioperative nurses will be retiring in the next few years. Due to the high cost of nursing education and the financial investment that has already been committed by nursing students, the Perioperative nursing program is free to the student as the program can be included, for the successful candidate, as part of the UVIC nursing course. The intention is to encourage participation by reducing the financial burden, stress, and anxiety for the new graduate who intends to specialize. In return, the student is required to work in the VIHA for a minimum of one year, thus supporting the retention efforts of the hospital. For eligible nursing students, this program provides access to extensive perioperative nursing experience. Over the course of 3 months they are exposed to extensive theory in a classroom setting as well as clinical practice through a preceptorship program. The mentoring relationships that develop between perioperative nurses and students lead to meaningful relationships and professional growth for staff. The perioperative focus of the program improves the knowledge and skill set of nursing students. The intent is to increase nursing student's interest in pursuing a career as a perioperative nurse and to help ensure continued growth of the perioperative nursing profession in Victoria.

33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Safety Zone; Fort Vancouver... Thirteenth Coast Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. (a) Location. The following area is a safety zone: All waters of the Columbia River...

33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Safety Zone; Fort Vancouver... Thirteenth Coast Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. (a) Location. The following area is a safety zone: All waters of the Columbia River...

33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Safety Zone; Fort Vancouver... Thirteenth Coast Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. (a) Location. The following area is a safety zone: All waters of the Columbia River...

33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Safety Zone; Fort Vancouver... Thirteenth Coast Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. (a) Location. The following area is a safety zone: All waters of the Columbia River...

33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Safety Zone; Fort Vancouver... Thirteenth Coast Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. (a) Location. The following area is a safety zone: All waters of the Columbia River...

An outbreak of dengue fever in St. Croix (U. S. Virgin Islands), 2005.

USDA-ARS?s Scientific Manuscript database

In the summer of 2005, an outbreak of dengue virus serotype-2 with cases of dengue hemorrhagic fever (DHF) occurred in St. Croix, US Virgin Islands. The medical records of all dengue laboratory-positive patients either seen in the Emergency Department of or admitted to the Governor Juan F. Luis Hosp...

A report on the outbreak of Zika virus on Easter Island, South Pacific, 2014.

PubMed

Tognarelli, J; Ulloa, S; Villagra, E; Lagos, J; Aguayo, C; Fasce, R; Parra, B; Mora, J; Becerra, N; Lagos, N; Vera, L; Olivares, B; Vilches, M; Fernández, J

2016-03-01

Zika virus (ZIKV) is an emerging mosquito-borne flavivirus circulating in Asia and Africa. In 2013, a large outbreak was reported on the archipelago of French Polynesia. In this study, we report the detection and molecular characterization of Zika virus for the first time in Chile from an outbreak among the inhabitants of Easter Island. A total of 89 samples from patients suspected of having ZIKV infection were collected between the period from January to May, 2014. Molecular diagnosis of the virus was performed by RT-PCR followed by the sequencing of the region containing the NS5 gene. A comparison of the viral nucleic acid sequence with those of other strains of ZIKA virus was performed using the MEGA software. Fifty-one samples were found positive for ZIKV by RT-PCR analysis. Further analysis of the NS5 gene revealed that the ZIKV strains identified in Easter Island were most closely related to those found in French Polynesia (99.8 to 99.9% nt and 100% aa sequence identity). These results strongly suggest that the transmission pathway leading to the introduction of Zika virus on Easter Island has its origin in French Polynesia.

Increased Rotavirus Prevalence in Diarrheal Outbreak Precipitated by Localized Flooding, Solomon Islands, 2014.

PubMed

Jones, Forrest K; Ko, Albert I; Becha, Chris; Joshua, Cynthia; Musto, Jennie; Thomas, Sarah; Ronsse, Axelle; Kirkwood, Carl D; Sio, Alison; Aumua, Audrey; Nilles, Eric J

2016-05-01

Flooding on 1 of the Solomon Islands precipitated a nationwide epidemic of diarrhea that spread to regions unaffected by flooding and caused >6,000 cases and 27 deaths. Rotavirus was identified in 38% of case-patients tested in the city with the most flooding. Outbreak potential related to weather reinforces the need for global rotavirus vaccination.

Discharge, water temperature, and selected meteorological data for Vancouver Lake, Vancouver, Washington, water years 2011-13

USGS Publications Warehouse

Foreman, James R.; Marshall, Cameron A.; Sheibley, Rich W.

2014-01-01

The U.S. Geological Survey partnered with the Vancouver Lake Watershed Partnership in a 2-year intensive study to quantify the movement of water and nutrients through Vancouver Lake in Vancouver, Washington. This report is intended to assist the Vancouver Lake Watershed Partnership in evaluating potential courses of action to mitigate seasonally driven blooms of harmful cyanobacteria and to improve overall water quality of the lake. This report contains stream discharge, lake water temperature, and selected meteorological data for water years 2011, 2012, and 2013 that were used to develop the water and nutrient budgets for the lake.

Late Quaternary dynamics of forest vegetation on northern Vancouver Island, British Columbia, Canada

NASA Astrophysics Data System (ADS)

Lacourse, Terri

2005-01-01

Pollen analysis of radiocarbon-dated lake sediment from northern Vancouver Island, southwest British Columbia reveals regional changes in forest vegetation over the last 12,200 14C yr (14,900 cal yr). Between at least 12,200 and 11,700 14C yr BP (14,900-13,930 cal yr BP), open woodlands were dominated by Pinus contorta, Alnus crispa, and various ferns. As P. contorta decreased in abundance, Alnus rubra and more shade-tolerant conifers (i.e., Picea and Tsuga mertensiana) increased. Increases in T. mertensiana, P. contorta, and A. crispa pollen accumulation rates (PARs) between 10,600 and 10,400 14C yr BP (11,660-11,480 cal yr BP) reflect a cool and moist climate during the Younger Dryas chronozone. Orbitally induced warming around 10,000 14C yr BP (11,090 cal yr BP) allowed the northward extension of Pseudotsuga menziesii, although Picea, Tsuga heterophylla, and A. rubra dominated early Holocene forests. By 7500 14C yr BP (8215 cal yr BP), shade-tolerant T. heterophylla was the dominant forest tree. Cupressaceae ( Thuja plicata and Chamaecyparis nootkatensis) was present by 7500 14C yr BP but reached its maximum after 3500 14C yr BP (3600 cal yr BP), when a cooler and wetter regional climate facilitated the development of temperate rainforest. The highest rates of vegetation change are associated with Lateglacial climate change and species with rapid growth rates and short life spans.

Low Oxygen and Ocean Acidification on the Vancouver Island Shelf

NASA Astrophysics Data System (ADS)

Bianucci, L.; Denman, K.

2008-12-01

In the recent years hypoxic events have been observed along the west coast of North America (off Oregon and California). Although a common cause of coastal hypoxia is usually anthropogenic eutrophication, in these upwelling regions the advection of oxygen-depleted waters from offshore is a key mechanism. Moreover, the high productivity typical of these margins generates a large flux of sinking particular organic matter. The remineralization of this matter below the euphotic zone produces an elevated consumption of oxygen. When concentrations become lower than certain threshold, hypoxia leads to a major change in the ecosystem and the affected areas are called 'dead zones'. Furthermore, the two processes that drive oxygen levels down (physical upwelling and biological demand) also increase dissolved inorganic carbon in the shelf, which leads to a pH reduction. Ocean acidification and hypoxia can severely affect ecosystems, and the links between these phenomena have not been explored. This presentation will discuss a model study of the carbon and oxygen coupling on the Vancouver Island shelf, with focus on the connection between acidification and hypoxia. Moreover, the role of biology versus physics will be investigated. This region comprises the northern end of the wind-driven upwelling margin off western North America, where low oxygen events have not been extensively studied. However, the proximity to an Oxygen Minimum Zone offshore and the observed decline of oxygen in the Northeast Pacific turns this shelf into a potential candidate to suffer from low-oxygen events. The model used is the Regional Ocean Modeling System (ROMS) in a quasi-2D configuration of the shelf (across-shore section with uniform properties alongshore). The biogeochemical model has carbon, oxygen, and nitrogen as state variables, and includes cycling of dissolved organic matter. Carbon and oxygen cycles are coupled through ecosystem processes such as photosynthesis and remineralization, while

Massive Microbiological Groundwater Contamination Associated with a Waterborne Outbreak in Lake Erie, South Bass Island, Ohio

PubMed Central

Fong, Theng-Theng; Mansfield, Linda S.; Wilson, David L.; Schwab, David J.; Molloy, Stephanie L.; Rose, Joan B.

2007-01-01

Background A groundwater-associated outbreak affected approximately 1,450 residents and visitors of South Bass Island, Ohio, between July and September 2004. Objectives To examine the microbiological quality of groundwater wells located on South Bass Island, we sampled 16 wells that provide potable water to public water systems 15–21 September 2004. Methods We tested groundwater wells for fecal indicators, enteric viruses and bacteria, and protozoa (Cryptosporidium and Giardia). The hydrodynamics of Lake Erie were examined to explore the possible surface water–groundwater interactions. Results All wells were positive for both total coliform and Escherichia coli. Seven wells tested positive for enterococci and Arcobacter (an emerging bacterial pathogen), and F+-specific coliphage was present in four wells. Three wells were positive for all three bacterial indicators, coliphages, and Arcobacter; adenovirus DNA was recovered from two of these wells. We found a cluster of the most contaminated wells at the southeast side of the island. Conclusions Massive groundwater contamination on the island was likely caused by transport of microbiological contaminants from wastewater treatment facilities and septic tanks to the lake and the subsurface, after extreme precipitation events in May–July 2004. This likely raised the water table, saturated the subsurface, and along with very strong Lake Erie currents on 24 July, forced a surge in water levels and rapid surface water–groundwater interchange throughout the island. Landsat images showed massive influx of organic material and turbidity surrounding the island before the peak of the outbreak. These combinations of factors and information can be used to examine vulnerabilities in other coastal systems. Both wastewater and drinking water issues are now being addressed by the Ohio Environmental Protection Agency and the Ohio Department of Health. PMID:17589591

Environmental Scanning, Vancouver Community College.

ERIC Educational Resources Information Center

Yao, Min

This 1994 environmental scanning report from Vancouver Community College (VCC) reviews the expected effects of the separation of VCC into a new Vancouver Community College and Langara College (LC). The report examines the projected service area student-intake capacity; student characteristics; population growth trends; other postsecondary…

Porcine abortion outbreak associated with Toxoplasma gondii in Jeju Island, Korea.

PubMed

Kim, Jae Hoon; Kang, Kyung Il; Kang, Wan Cheul; Sohn, Hyun Joo; Jean, Young Hwa; Park, Bong Kyun; Kim, Yongbaek; Kim, Dae Yong

2009-06-01

This report deals with the acute onset of an abortion outbreak and high sow mortality in one pig herd consisted of 1,200 pigs and 120 sows on Jeju Island, Korea. Affected pregnant sows showed clinical signs, including high fever, gradual anorexia, vomiting, depression, recumbency, prostration, abortion, and a few deaths. Four dead sows, five aborted fetuses from the same litter, and 17 sera collected from sows infected or normal were submitted to the Pathology Division of the National Veterinary Research and Quarantine Service for diagnostic investigation. Grossly, hepatomegaly and splenomegaly were observed in sows. Multiple necrotic foci were scattered in the lungs, liver, spleen, and lymph nodes. Microscopically, multifocal necrotizing lesions and protozoan tachyzoites were present in the lesions. Tachyzoites of Toxoplasma (T.) gondii were detected immunohistochemically. Latex agglutination showed that the sera of 7 of 17 (41.2%) sows were positive for antibody to T. gondii. The disease outbreak in this herd was diagnosed as epizootic toxoplasmosis. To our knowledge, this is the first report of porcine toxoplasmosis with a high abortion rate and sow mortality in Korea.

Occurrence and structural characterization of gas hydrates associated with a cold vent field, offshore Vancouver Island

NASA Astrophysics Data System (ADS)

Lu, Hailong; Moudrakovski, Igor; Riedel, Michael; Spence, George; Dutrisac, Regent; Ripmeester, John; Wright, Fred; Dallimore, Scott

2005-10-01

Gas hydrate samples recovered from a cold vent field offshore Vancouver Island were studied in detail both by macroscopic observations and instrumental methods (powder X-ray diffraction method (PXRD), nuclear magnetic resonance (NMR), and Raman spectroscopy). It was found that gas hydrates were massive from 2.64 to 2.94 m below seafloor (mbsf), elongated, nodular and tabular from 4.60 to 4.81 mbsf, and vein-like from 5.48 to 5.68 mbsf, showing a trend of decreasing hydrate content with increasing depth. All samples were determined to be structure I hydrate from PXRD, NMR, and Raman spectroscopies. The hydration numbers were estimated to be 6.1 ± 0.2 on average as determined from the methane distribution over the cage sites from NMR and Raman analytical results. Estimates of conversion levels indicated that ˜78% of the water in the massive samples was hydrate, down to a low value of ˜0.4% for the pore hydrate samples. The results are compared with measurements on synthetic hydrates and samples recovered from below the permafrost on the Mallik site. Differences in methane content and lattice parameters for synthetic and natural samples are relatively minor. Additional work is needed to address the presence of minor gas components and the heterogeneity of natural hydrate samples.

The reproductive endocrinology and behavior of Vancouver Island marmot (Marmota vancouverensis).

PubMed

Keeley, T; Goodrowe, K L; Graham, L; Howell, C; MacDonald, S E

2012-01-01

The Vancouver Island marmot (Marmota vancouverensis; VIM) is one of North America's most endangered species with fewer than 150 individuals remaining in the wild. A captive breeding program was established across four facilities in Canada as an insurance population and source of animals for reintroduction to the wild. The purpose of this study was to gather information about the basic reproductive biology and behavior of this species, which is essential to improve captive breeding programs. Regular fecal samples were obtained from adult female (n = 14) and male (n = 10) marmots, 2 years of age and older, over 1-3 breeding seasons (2-3 months duration posthibernation) for steroid hormone analysis. Enzyme immunoassays were validated for quantifying fecal testosterone metabolite concentrations for males, and fecal estrogen and progesterone metabolite concentrations for females. Results indicated that fecal progesterone metabolite concentrations can be used to monitor ovulation and pregnancy. Behavioral monitoring through infrared video surveillance was conducted in four breeding pairs over a 2-year period (n = 7 behavioral profiles). Breeding behaviors correlated strongly with changes in reproductive endocrine profiles. A high frequency of play behavior or "wrestling" was observed in conjunction with breeding activity before an elevation in progesterone metabolite concentrations. Impending parturition was associated with increased aggression and exclusion of the male from the maternal nestbox as well as an increase in nesting activity. Observational data combined with hormonal analysis suggest that female VIMs are induced ovulators and that multiple breeding attempts may be required for ovulation and conception. Gestation appears to be approximately 34 days from peak breeding activity (32 days from estimated ovulation). Fecal testosterone concentrations suggest that testicular activity is seasonal with the reproductive activity occurring immediately posthibernation

Building better healthcare facilities through evidence-based design: breaking new ground at Vancouver Island Health Authority.

PubMed

Waldner, Howard; Johnson, Bart; Sadler, Blair

2012-01-01

Many of today's healthcare facilities were constructed at least 50 years ago, and a growing number have outlived their useful lives. Despite renovations and renewals, they often fall short of providing an appropriate care setting. Clinicians and staff develop a mixture of compromises and workarounds simply to make things function. Evidence-based design principles are often absent from new healthcare facilities, perhaps because of lack of awareness of the principles or because implementing them may fall foul of short-term and short-sighted budgetary decisions. In planning a new healthcare facility in 2008, the executive team at Vancouver Island Health Authority decided to adopt the evidence-based design approach. They conducted site visits to newly constructed hospitals across North America and beyond, to determine best practices in terms of design and construction. These engagements resulted in the implementation of 102 evidence-based design principles and attributes in Victoria's Royal Jubilee hospital, a 500-bed Patient Care Centre. This $350M project was completed on time and on budget, showing that using evidence need not result in delays or higher costs. To date, the results of the evidence-based design are promising, with accolades coming from patients, staff and clinical partners, and a number of immediate and practical benefits for patients, families and care teams alike. Copyright © 2012 Longwoods Publishing.

Characteristics of a dengue outbreak in a remote pacific island chain--Republic of The Marshall Islands, 2011-2012.

PubMed

Sharp, Tyler M; Mackay, Andrew J; Santiago, Gilberto A; Hunsperger, Elizabeth; Nilles, Eric J; Perez-Padilla, Janice; Tikomaidraubuta, Kinisalote S; Colon, Candimar; Amador, Manuel; Chen, Tai-Ho; Lalita, Paul; Muñoz-Jordán, Jorge L; Barrera, Roberto; Langidrik, Justina; Tomashek, Kay M

2014-01-01

Dengue is a potentially fatal acute febrile illness caused by four mosquito-transmitted dengue viruses (DENV-1-4). Although dengue outbreaks regularly occur in many regions of the Pacific, little is known about dengue in the Republic of the Marshall Islands (RMI). To better understand dengue in RMI, we investigated an explosive outbreak that began in October 2011. Suspected cases were reported to the Ministry of Health, serum specimens were tested with a dengue rapid diagnostic test (RDT), and confirmatory testing was performed using RT-PCR and IgM ELISA. Laboratory-positive cases were defined by detection of DENV nonstructural protein 1 by RDT, DENV nucleic acid by RT-PCR, or anti-DENV IgM antibody by RDT or ELISA. Secondary infection was defined by detection of anti-DENV IgG antibody by ELISA in a laboratory-positive acute specimen. During the four months of the outbreak, 1,603 suspected dengue cases (3% of the RMI population) were reported. Of 867 (54%) laboratory-positive cases, 209 (24%) had dengue with warning signs, six (0.7%) had severe dengue, and none died. Dengue incidence was highest in residents of Majuro and individuals aged 10-29 years, and ∼95% of dengue cases were experiencing secondary infection. Only DENV-4 was detected by RT-PCR, which phylogenetic analysis demonstrated was most closely related to a virus previously identified in Southeast Asia. Cases of vertical DENV transmission, and DENV/Salmonella Typhi and DENV/Mycobacterium leprae co-infection were identified. Entomological surveys implicated water storage containers and discarded tires as the most important development sites for Aedes aegypti and Ae. albopictus, respectively. Although this is the first documented dengue outbreak in RMI, the age groups of cases and high prevalence of secondary infection demonstrate prior DENV circulation. Dengue surveillance should continue to be strengthened in RMI and throughout the Pacific to identify and rapidly respond to future outbreaks.

Epidemiology of the Zika Virus Outbreak in the Cabo Verde Islands, West Africa.

PubMed

Lourenço, José; de Lourdes Monteiro, Maria; Valdez, Tomás; Monteiro Rodrigues, Júlio; Pybus, Oliver; Rodrigues Faria, Nuno

2018-03-15

The Zika virus (ZIKV) outbreak in the island nation of Cabo Verde was of unprecedented magnitude in Africa and the first to be associated with microcephaly in the continent. Using a simple mathematical framework we present a first epidemiological assessment of attack and observation rates from 7,580 ZIKV notified cases and 18 microcephaly reports between July 2015 and May 2016. In line with observations from the Americas and elsewhere, the single-wave Cabo Verdean ZIKV epidemic was characterized by a basic reproductive number of 1.85 (95% CI, 1.5 - 2.2), with overall the attack rate of 51.1% (range 42.1 - 61.1) and observation rate of 2.7% (range 2.29 - 3.33). Current herd-immunity may not be sufficient to prevent future small-to-medium epidemics in Cabo Verde. Together with a small observation rate, these results highlight the need for rapid and integrated epidemiological, molecular and genomic surveillance to tackle forthcoming outbreaks of ZIKV and other arboviruses.

Earthquake relocation near the Leech River Fault, southern Vancouver Island

NASA Astrophysics Data System (ADS)

Li, G.; Liu, Y.; Regalla, C.

2015-12-01

The Leech River Fault (LRF), a northeast dipping thrust, extends across the southern tip of Vancouver Island in Southwest British Columbia, where local tectonic regime is dominated by the subduction of the Juan de Fuca plate beneath the North American plate at the present rate of 40-50 mm/year. British Columbia geologic map (Geoscience Map 2009-1A) shows that this area also consists of many crosscutting minor faults in addition to the San Juan Fault north of the LRF. To investigate the seismic evidence of the subsurface structures of these minor faults and of possible hidden active structures in this area, precise earthquake locations are required. In this study, we relocate 941 earthquakes reported by Canadian National Seismograph Network (CNSN) catalog from 2000 to 2015 within a 100km x 55km study area surrounding the LRF. We use HypoDD [Waldhauser, F., 2001] double-difference relocation method by combining P/S phase arrivals provided by the CNSN at 169 stations and waveform data with correlation coefficient values greater than 0.7 at 50 common stations and event separation less than 10km. A total of 900 out of the 931 events satisfy the above relocation criteria. Velocity model used is a 1-D model extracted from the Ramachandran et al. (2005) model. Average relative location errors estimated by the bootstrap method are 546.5m (horizontal) and 1128.6m (in depth). Absolute errors reported by SVD method for individual clusters are ~100m in both dimensions. We select 5 clusters visually according to their epicenters (see figure). Cluster 1 is parallel to the LRF and a thrust FID #60. Clusters 2 and 3 are bounded by two faults: FID #75, a northeast dipping thrust marking the southwestern boundary of the Wrangellia terrane, and FID #2 marking the northern boundary. Clusters 4 and 5, to the northeast and northwest of Victoria respectively, however, do not represent the surface traces of any mapped faults. The depth profile of Cluster 5 depicts a hidden northeast

[Dengue fever in the Reunion Island and in South Western islands of the Indian Ocean].

PubMed

D'Ortenzio, E; Balleydier, E; Baville, M; Filleul, L; Renault, P

2011-09-01

South Western islands of the Indian Ocean are permanently threatened by dengue fever outbreaks. On the Reunion Island, two dengue outbreaks were biologically documented (1977-1978 and 2004). And since July 2004 there has been an inter-epidemic period for the island with sporadic cases and clusters. Between January 1, 2007 and October 5, 2009, the epidemiologic surveillance system detected five confirmed autochthonous cases, five confirmed imported cases (South-East Asia), and 71 probable cases. All the five autochthonous confirmed cases occurred in Saint-Louis during two consecutive clusters. In other South Western islands of the Indian Ocean, several dengue fever outbreaks have been reported. Importation of dengue virus from South-East Asia is a major risk for a new outbreak on the island. The introduction of a new serotype could lead to the emergence of new and severe clinical forms, including dengue hemorrhagic fever. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Epidemiological investigation into the re-emergence and control of an outbreak of infectious salmon anaemia in the Shetland Islands, Scotland.

PubMed

Murray, Alexander G; Munro, Lorna A; Wallace, I Stuart; Berx, Barbara; Pendrey, Daniel; Fraser, David; Raynard, Rob S

2010-09-17

Infectious salmon anaemia (ISA) is an orthomyxoviral disease, primarily affecting marine-phase farmed Atlantic salmon, which can result in high levels of mortality. ISA first emerged in Norway in the 1980s and subsequently has occurred in Canada, the USA, the Faeroe Islands and Chile. An outbreak occurred in Scotland in 1998-1999, but was eradicated at a cost of over pounds sterling 20M. The epidemiology of a new outbreak of ISA in the Scottish Shetland Islands during 2008-2009 is described. Six sites have been confirmed ISA-positive. Spread of the virus via transport of fish between marine sites, harvest vessels, smolts and wild fish appears to have been of little or no importance, with spread primarily associated with marine water currents. The use of management areas by Marine Scotland to control the event appears to have been effective in restricting spread to a small area. This localised outbreak contrasts with the 1998-1999 outbreak that spread over a wide geographic area with transported fish and harvest vessels. The development and application of industry codes of good practice, good husbandry and biosecurity practices, limited marine site-to-site movement of live fish and improved disinfection of vessels and processing plant waste that occurred subsequent to the 1998-1999 outbreak may explain the localised spread of infection in 2008-2009. Depopulation of confirmed sites has been achieved within 7 wk (mean = 3.7 wk); however, it is likely that subclinical infection persisted undetected for months on at least 1 site. The origin of the 2008-2009 outbreak remains unknown. Potential sources include evolution from a local reservoir of infection or importation. Synchronous fallowing of management areas, with good husbandry and biosecurity, reduces the risk of ISA recurring. Movement of fish between sites in different management areas represents the greatest risk of regional-scale spread, should this occur.

Whole-Genome Sequencing of Measles Virus Genotypes H1 and D8 During Outbreaks of Infection Following the 2010 Olympic Winter Games Reveals Viral Transmission Routes.

PubMed

Gardy, Jennifer L; Naus, Monika; Amlani, Ashraf; Chung, Walter; Kim, Hochan; Tan, Malcolm; Severini, Alberto; Krajden, Mel; Puddicombe, David; Sahni, Vanita; Hayden, Althea S; Gustafson, Reka; Henry, Bonnie; Tang, Patrick

2015-11-15

We used whole-genome sequencing to investigate a dual-genotype outbreak of measles occurring after the XXI Olympic Winter Games in Vancouver, Canada. By sequencing 27 complete genomes from H1 and D8 genotype measles viruses isolated from outbreak cases, we estimated the virus mutation rate, determined that person-to-person transmission is typically associated with 0 mutations between isolates, and established that a single introduction of H1 virus led to the expansion of the outbreak beyond Vancouver. This is the largest measles genomics project to date, revealing novel aspects of measles virus genetics and providing new insights into transmission of this reemerging viral pathogen. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Opportunities and obstacles to collecting wildlife disease data for public health purposes: Results of a pilot study on Vancouver Island, British Columbia

PubMed Central

Stitt, Tyler; Mountifield, Julie; Stephen, Craig

2007-01-01

Existing sources of wildlife morbidity and mortality data were evaluated and 3 pilot active surveillance projects were undertaken to compare and contrast methods for collecting wildlife disease data on Vancouver Island for public health purposes. Few organizations could collect samples for diagnostic evaluation, fewer still maintained records, and none regularly characterized or reported wildlife disease for public health purposes. Wildlife rehabilitation centers encountered the greatest variety of wildlife from the largest geographic area and frequently received submissions from other organizations. Obstacles to participation included the following: permit restrictions; financial disincentives; staff safety; no mandate to collect relevant data; and lack of contact between wildlife and public health agencies. Despite these obstacles, modest investments in personnel allowed novel pathogens of public health concern to be tracked. Targeted surveillance for known pathogens in specific host species, rather than general surveys for unspecified pathogens, was judged to be a more effective and efficient way to provide useful public health data. PMID:17310627

Seismic wave triggering of nonvolcanic tremor, episodic tremor and slip, and earthquakes on Vancouver Island

NASA Astrophysics Data System (ADS)

Rubinstein, Justin L.; Gomberg, Joan; Vidale, John E.; Wech, Aaron G.; Kao, Honn; Creager, Kenneth C.; Rogers, Garry

2009-02-01

We explore the physical conditions that enable triggering of nonvolcanic tremor and earthquakes by considering local seismic activity on Vancouver Island, British Columbia during and immediately after the arrival of large-amplitude seismic waves from 30 teleseismic and 17 regional or local earthquakes. We identify tremor triggered by four of the teleseismic earthquakes. The close temporal and spatial proximity of triggered tremor to ambient tremor and aseismic slip indicates that when a fault is close to or undergoing failure, it is particularly susceptible to triggering of further events. The amplitude of the triggering waves also influences the likelihood of triggering both tremor and earthquakes such that large amplitude waves triggered tremor in the absence of detectable aseismic slip or ambient tremor. Tremor and energy radiated from regional/local earthquakes share the same frequency passband so that tremor cannot be identified during these smaller, more frequent events. We confidently identify triggered local earthquakes following only one teleseism, that with the largest amplitude, and four regional or local events that generated vigorous aftershock sequences in their immediate vicinity. Earthquakes tend to be triggered in regions different from tremor and with high ambient seismicity rates. We also note an interesting possible correlation between large teleseismic events and episodic tremor and slip (ETS) episodes, whereby ETS events that are "late" and have built up more stress than normal are susceptible to triggering by the slight nudge of the shaking from a large, distant event, while ETS events that are "early" or "on time" are not.

Epidemiology of the Zika Virus Outbreak in the Cabo Verde Islands, West Africa

PubMed Central

Lourenço, José; de Lourdes Monteiro, Maria; Valdez, Tomás; Monteiro Rodrigues, Júlio; Pybus, Oliver; Rodrigues Faria, Nuno

2018-01-01

Introduction: The Zika virus (ZIKV) outbreak in the island nation of Cabo Verde was of unprecedented magnitude in Africa and the first to be associated with microcephaly in the continent. Methods: Using a simple mathematical framework we present a first epidemiological assessment of attack and observation rates from 7,580 ZIKV notified cases and 18 microcephaly reports between July 2015 and May 2016. Results: In line with observations from the Americas and elsewhere, the single-wave Cabo Verdean ZIKV epidemic was characterized by a basic reproductive number of 1.85 (95% CI, 1.5 - 2.2), with overall the attack rate of 51.1% (range 42.1 - 61.1) and observation rate of 2.7% (range 2.29 - 3.33). Conclusion: Current herd-immunity may not be sufficient to prevent future small-to-medium epidemics in Cabo Verde. Together with a small observation rate, these results highlight the need for rapid and integrated epidemiological, molecular and genomic surveillance to tackle forthcoming outbreaks of ZIKV and other arboviruses. PMID:29637009

Enhanced surveillance during a public health emergency in a resource-limited setting: Experience from a large dengue outbreak in Solomon Islands, 2016-17.

PubMed

Craig, Adam T; Joshua, Cynthia A; Sio, Alison R; Teobasi, Bobby; Dofai, Alfred; Dalipanda, Tenneth; Hardie, Kate; Kaldor, John; Kolbe, Anthony

2018-01-01

Between August-2016 and April-2017, Solomon Islands experienced the largest and longest-running dengue outbreak on record in the country, with 12,329 suspected cases, 877 hospitalisations and 16 deaths. We conducted a retrospective review of related data and documents, and conducted key informant interviews to characterise the event and investigate the adaptability of syndromic surveillance for enhanced and expanded data collection during a public health emergency in a low resource country setting. While the outbreak quickly consumed available public and clinical resources, we found that authorities were able to scale up the conventional national syndrome-based early warning surveillance system to support the increased information demands during the event demonstrating the flexibility of the system and syndromic surveillance more broadly. Challenges in scaling up included upskilling and assisting staff with no previous experience of the tasks required; managing large volumes of data; maintaining data quality for the duration of the outbreak; harmonising routine and enhanced surveillance data and maintaining surveillance for other diseases; producing information optimally useful for response planning; and managing staff fatigue. Solomon Islands, along with other countries of the region remains vulnerable to outbreaks of dengue and other communicable diseases. Ensuring surveillance systems are robust and able to adapt to changing demands during emergencies should be a health protection priority.

Characteristics of a Dengue Outbreak in a Remote Pacific Island Chain – Republic of the Marshall Islands, 2011–2012

PubMed Central

Sharp, Tyler M.; Mackay, Andrew J.; Santiago, Gilberto A.; Hunsperger, Elizabeth; Nilles, Eric J.; Perez-Padilla, Janice; Tikomaidraubuta, Kinisalote S.; Colon, Candimar; Amador, Manuel; Chen, Tai-Ho; Lalita, Paul; Muñoz-Jordán, Jorge L.; Barrera, Roberto; Langidrik, Justina; Tomashek, Kay M.

2014-01-01

Dengue is a potentially fatal acute febrile illness caused by four mosquito-transmitted dengue viruses (DENV-1–4). Although dengue outbreaks regularly occur in many regions of the Pacific, little is known about dengue in the Republic of the Marshall Islands (RMI). To better understand dengue in RMI, we investigated an explosive outbreak that began in October 2011. Suspected cases were reported to the Ministry of Health, serum specimens were tested with a dengue rapid diagnostic test (RDT), and confirmatory testing was performed using RT-PCR and IgM ELISA. Laboratory-positive cases were defined by detection of DENV nonstructural protein 1 by RDT, DENV nucleic acid by RT-PCR, or anti-DENV IgM antibody by RDT or ELISA. Secondary infection was defined by detection of anti-DENV IgG antibody by ELISA in a laboratory-positive acute specimen. During the four months of the outbreak, 1,603 suspected dengue cases (3% of the RMI population) were reported. Of 867 (54%) laboratory-positive cases, 209 (24%) had dengue with warning signs, six (0.7%) had severe dengue, and none died. Dengue incidence was highest in residents of Majuro and individuals aged 10–29 years, and ∼95% of dengue cases were experiencing secondary infection. Only DENV-4 was detected by RT-PCR, which phylogenetic analysis demonstrated was most closely related to a virus previously identified in Southeast Asia. Cases of vertical DENV transmission, and DENV/Salmonella Typhi and DENV/Mycobacterium leprae co-infection were identified. Entomological surveys implicated water storage containers and discarded tires as the most important development sites for Aedes aegypti and Ae. albopictus, respectively. Although this is the first documented dengue outbreak in RMI, the age groups of cases and high prevalence of secondary infection demonstrate prior DENV circulation. Dengue surveillance should continue to be strengthened in RMI and throughout the Pacific to identify and rapidly respond to future outbreaks. PMID

Nocturnal Ozone Depletion Events at the Amphitrite Point Observatory on West Vancouver Island

NASA Astrophysics Data System (ADS)

Garner, N.; Brownsey, D. K.; Tokarek, T. W.; Ye, C. Z.; Yordanov, N. R.; Osthoff, H. D.; Schiller, C. L.; Vingarzan, R.

2015-12-01

Routine monitoring stations on the West coast of North America serve to monitor baseline levels of criteria pollutants such as ozone (O3) arriving from the Pacific Ocean. In Canada, the Amphitrite Point Observatory (APO) in Ucluelet on the West coast of Vancouver Island has been added to this network to provide regional baseline measurements. Recently, McKendry and coworkers have reported frequent episodes of nocturnal O3 depletion events (ODEs) at APO (range: 5-20 ppbv) that generally correlate with alongshore winds, elevated levels of carbon dioxide (CO2), and low vertical entrainment but whose cause(s) has (have) remained unclear. In this work, results from the Ozone-depleting reactions in a coastal atmosphere (ORCA) campaign, which took place at APO from July 6 - 31, 2015, are presented. In addition to the long-term measurements that include aerosol size distribution and composition measurements, mixing ratios of speciated monoterpenes (e.g., α- and β-pinene, limonene), molecular halogens (i.e., Cl2, I2), halogen oxides (i.e., OIO), plus a full suite of nitrogen oxides (including N2O5, PAN, PPN, ΣPN, ΣAN, HNO3, HONO, and ClNO2) were quantified. Synoptic conditions at the site varied greatly between nights. During westerly flow of relatively clean marine air, O3 was generally conserved at night, indicating that deposition of O3 to the ocean surface is a minor loss pathway. When the air mass originated from other sectors, episodes of nocturnal ODEs were observed on several occasions, in which mixing ratios of biogenic VOCs were enhanced. These included air masses that originated from densely forested areas to the East, air masses polluted by marine traffic emissions from the southeast, and air masses from the NW that have traveled parallel to the coastline. In this sector, the air was likely in contact with terrestrial vegetation via land-sea breeze circulations. The results suggest that nocturnal ODEs at APO are mainly driven by local or regional processes

Studying levels of Fukushima-derived radioactivity in sockeye salmon collected on the west coast of Vancouver Island

NASA Astrophysics Data System (ADS)

Domingo, T.; Starosta, K.; Chester, A.; Williams, J.; Ross, P. S.

2017-11-01

To investigate potential radioisotope contamination from the Fukushima nuclear accident, measurements of 10 sockeye salmon (Oncorhynchus nerka) collected on June 21 and June 31, 2014 in the Alberni Inlet on the west coast of Vancouver Island, British Columbia, Canada were performed using low-background gamma-ray spectroscopy. Activity concentrations of the anthropogenic radioisotopes 134Cs and 137Cs as well as the naturally occurring radioisotope 40K were measured. Detection of 137Cs occurred in half of the sockeye with activity concentrations ranging from 0.23 to 1.43 Bq/kg dry weight. The 134Cs isotope was detected in a single sockeye salmon with activity concentrations (±σ) measured in the two subsamples of 0.31(8) and 0.37(10) Bq/kg dry weight. The dose contribution from each of the measured radionuclides was calculated. In the sockeye salmon with the greatest radiocesium concentrations, the dose contribution from anthropogenic radiocesium (134Cs+137Cs) was found to be 450 times less than the dose from naturally occurring radionuclides in the same sample. In conclusion, the total radiocesium activity concentration in every sample is at least 500 times lower than Health Canada's action levels for radioactively contaminated food following a nuclear emergency. Assuming all seafood has as much radiocesium as the most contaminated sample measured, the added annual dose from radiocesium to an adult individual with an average Canadian level of seafood consumption would be 0.046 μSv per year.

Natural transmission of dengue virus serotype 3 by Aedes albopictus (Skuse) during an outbreak in Havelock Island: Entomological characteristics.

PubMed

Sivan, Arun; Shriram, A N; Sugunan, A P; Anwesh, Maile; Muruganandam, N; Kartik, C; Vijayachari, P

2016-04-01

From May to June 2014, an outbreak of dengue virus (DENV) illness occurred in the Havelock Island, South Andaman. Entomological investigations were undertaken during the peak of the outbreak, from 26th May-4th June, to identify the primary vector(s) involved in the transmission so that appropriate public health measures could be implemented. Adult mosquitoes were collected by BG-Sentinel traps in houses and neighborhoods of clinically ill patients. Water holding containers were inspected for the presence of mosquito larvae and pupae. Adult mosquitoes were analyzed by RT-PCR for the presence of nucleic acids of DENV and CHIKV. A total of 498 mosquitoes were collected and processed in 27 pools. The species composition comprised of 58.3% Aedes albopictus, 7.5% Aedes aegypti and 4.2% Aedes edwardsi and 3.1% constituted others. Two A. albopictus pools were found to be positive for DENV RNA. Sequencing of the RT PCR 511 base pair amplicon positive samples showed homology with DENV-3, suggesting that serotype-3 was responsible for the outbreak and A. albopictus was the primary vector responsible. This was supported by high container (10.1%), premise (25.4%) and Breteau (27.9) indices, with miscellaneous receptacles (2.4%), tree holes (1.2%) and discarded tires (1.2%) registering relatively higher container indices. This is the first report of detection of DENV in A. albopictus from Andaman and Nicobar Islands. Copyright © 2016 Elsevier B.V. All rights reserved.

Vancouver Olympic Site Captures a Gold for Natural Grandeur

NASA Image and Video Library

2010-02-16

On Feb. 12, 2010, the 21st Winter Olympic Games opened in the city of Vancouver, British Columbia, Canada. NASA Terra spacecraft acquired this image of the city of Vancouver, British Columbia, Canada, on Sept. 29, 2008.

Outbreak of IMI-1 Carbapenemase-producing colistin-resistant Enterobacter cloacae on the French island of Mayotte (Indian Ocean).

PubMed

Miltgen, Guillaume; Bonnin, Rémy A; Avril, Catherine; Benoit-Cattin, Thierry; Martak, Daniel; Leclaire, Alexandre; Traversier, Nicolas; Roquebert, Bénédicte; Jaffar-Bandjee, Marie-Christine; Lugagne, Nathalie; Filleul, Laurent; Subiros, Marion; de Montera, Anne-Marie; Cholley, Pascal; Thouverez, Michelle; Dortet, Laurent; Bertrand, Xavier; Naas, Thierry; Hocquet, Didier; Belmonte, Olivier

2018-05-25

The spread of carbapenemase-producing Enterobacteriaceae (CPE) in the Southwest Indian Ocean islands is poorly known. We describe here an outbreak of colistin-resistant Enterobacter cloacae harboring bla IMI-1 in the French overseas department of Mayotte. Between October 2015 and January 2017, all isolates of imipenem-non-susceptible E. cloacae at the Mayotte Medical Center and University Hospital of Reunion Island were screened for carbapenemase production. Positive isolates were typed by pulsed-field gel electrophoresis and WGS-based MLST and all β-lactamase genes identified by PCR and sequencing. The resistance profiles were determined by agar diffusion and E-tests. Genetic support of the bla IMI-1 gene was determined by WGS. We detected 18 isolates of E.cloacae harboring the bla IMI-1 gene in 17 patients from Mayotte. PFGE analysis showed 16 of the 18 strains to be clonally-related and belonging to sequence type ST820. Based on clinical data, this outbreak most likely had a community origin. The bla IMI-1 gene in the 18 isolates was carried by a new variant of an integrative mobile element involving the Xer recombinases, called EcloIMEX-8. The mcr-1 to mcr-5 genes were absent from the collection. These isolates belong to E. cloacae cluster XI, known to be colistin heteroresistant. We report here the first outbreak of IMI-1-producing Enterobacteriaceae. IMI-1 producers may be under-detected in microbiology laboratories because of their unusual antibiotic resistance profile (resistant to imipenem, but with intermediate resistance to ertapenem and susceptible to extended-spectrum cephalosporins) and the absence of bla IMI-1 in the panel of genes targeted by molecular diagnostic kits. Copyright © 2018. Published by Elsevier B.V.

Impact of a Dengue Outbreak Experience in the Preventive Perceptions of the Community from a Temperate Region: Madeira Island, Portugal

PubMed Central

Nazareth, Teresa; Sousa, Carla Alexandra; Porto, Graça; Gonçalves, Luzia; Seixas, Gonçalo; Antunes, Luís; Silva, Ana Clara; Teodósio, Rosa

2015-01-01

The ability to effectively modify behaviours is increasingly relevant to attain and maintain a good health status. Current behaviour-change models and theories present two main approaches for (healthier) decision-making: one analytical/logical, and one experiential/emotional/intuitive. Therefore, to achieve an integral and dynamic understanding of the public perceptions both approaches should be considered: community surveys should measure cognitive understanding of health-risk contexts, and also explore how past experiences affect this understanding. In 2011, community perceptions regarding domestic source reduction were assessed in Madeira Island. After Madeira’s first dengue outbreak (2012) a unique opportunity to compare perceptions before and after the outbreak-experience occurred. This was the aim of this study, which constituted the first report on the effect of an outbreak experience on community perceptions regarding a specific vector-borne disease. A cross-sectional survey was performed within female residents at the most aegypti-infested areas. Perceptions regarding domestic source reduction were assessed according to the Essential Perception (EP)-analysis tool. A matching process paired individuals from studies performed before and after the outbreak, ensuring homogeneity in six determinant variables. After the outbreak, there were more female residents who assimilated the concepts considered to be essential to understand the proposed behaviour. Nevertheless, no significant difference was observed in the number of female residents who achieved the defined ‘minimal understanding’’. Moreover, most of the population (95.5%) still believed at least in one of the identified myths. After the outbreak some myths disappeared and others appeared. The present study quantified and explored how the experience of an outbreak influenced the perception regarding a dengue-preventive behaviour. The outbreak experience surprisingly led to the appearance of new

Impact of a dengue outbreak experience in the preventive perceptions of the community from a temperate region: Madeira Island, Portugal.

PubMed

Nazareth, Teresa; Sousa, Carla Alexandra; Porto, Graça; Gonçalves, Luzia; Seixas, Gonçalo; Antunes, Luís; Silva, Ana Clara; Teodósio, Rosa

2015-03-01

The ability to effectively modify behaviours is increasingly relevant to attain and maintain a good health status. Current behaviour-change models and theories present two main approaches for (healthier) decision-making: one analytical/logical, and one experiential/emotional/intuitive. Therefore, to achieve an integral and dynamic understanding of the public perceptions both approaches should be considered: community surveys should measure cognitive understanding of health-risk contexts, and also explore how past experiences affect this understanding. In 2011, community perceptions regarding domestic source reduction were assessed in Madeira Island͘. After Madeira's first dengue outbreak (2012) a unique opportunity to compare perceptions before and after the outbreak-experience occurred. This was the aim of this study, which constituted the first report on the effect of an outbreak experience on community perceptions regarding a specific vector-borne disease. A cross-sectional survey was performed within female residents at the most aegypti-infested areas. Perceptions regarding domestic source reduction were assessed according to the Essential Perception (EP)-analysis tool. A matching process paired individuals from studies performed before and after the outbreak, ensuring homogeneity in six determinant variables. After the outbreak, there were more female residents who assimilated the concepts considered to be essential to understand the proposed behaviour. Nevertheless, no significant difference was observed in the number of female residents who achieved the defined 'minimal understanding''. Moreover, most of the population (95.5%) still believed at least in one of the identified myths. After the outbreak some myths disappeared and others appeared. The present study quantified and explored how the experience of an outbreak influenced the perception regarding a dengue-preventive behaviour. The outbreak experience surprisingly led to the appearance of new myths

The basic reproduction number R0 and effectiveness of reactive interventions during dengue epidemics: the 2002 dengue outbreak in Easter Island, Chile.

PubMed

Chowell, Gerardo; Fuentes, R; Olea, A; Aguilera, X; Nesse, H; Hyman, J M

2013-01-01

We use a stochastic simulation model to explore the effect of reactive intervention strategies during the 2002 dengue outbreak in the small population of Easter Island, Chile. We quantified the effect of interventions on the transmission dynamics and epidemic size as a function of the simulated control intensity levels and the timing of initiation of control interventions. Because no dengue outbreaks had been reported prior to 2002 in Easter Island, the 2002 epidemic provided a unique opportunity to estimate the basic reproduction number R0 during the initial epidemic phase, prior to the start of control interventions. We estimated R0 at 27.2 (95%CI: 14.8, 49.3). We found that the final epidemic size is highly sensitive to the timing of start of interventions. However, even when the control interventions start several weeks after the epidemic onset, reactive intervention efforts can have a significant impact on the final epidemic size. Our results indicate that the rapid implementation of control interventions can have a significant effect in reducing the epidemic size of dengue epidemics.

Human Activity and Habitat Characteristics Influence Shorebird Habitat Use and Behavior at a Vancouver Island Migratory Stopover Site.

PubMed

Murchison, Colleen R; Zharikov, Yuri; Nol, Erica

2016-09-01

Pacific Rim National Park Reserve on Vancouver Island, British Columbia, Canada, has 16 km of coastal beaches that attract many thousands of people and shorebirds (S.O. Charadrii) every year. To identify locations where shorebirds concentrate and to determine the impact of human activity and habitat characteristics on shorebirds, we conducted shorebird and visitor surveys at 20 beach sectors (across 20 total km of beach) during fall migration in 2011-2014 and spring migration in 2012 and 2013. Using zero-inflated negative binomial regression and a model selection approach, we found that beach width and number of people influenced shorebird use of beach sectors (Bayesian information criterion weight of top model = 0.69). Shorebird absence from beaches was associated with increasing number of people (parameter estimate from top model: 0.38; 95 % CI 0.19, 0.57) and decreasing beach width (parameter estimate: -0.32; 95 % CI -0.47, -0.17). Shorebirds spent more time at wider beaches (parameter estimate: 0.68; 95 % CI 0.49, 0.87). Close proximity to people increased the proportion of time shorebirds spent moving, while shorebirds spent more time moving and less time foraging on wider beaches than on narrower ones. Shorebird disturbance increased with proximity of people, activity speed, and presence of dogs. Based on our findings, management options, for reducing shorebird disturbance at Pacific Rim National Park Reserve and similar shorebird stopover areas, include mandatory buffer distances between people and shorebirds, restrictions on fast-moving activities (e.g., running, biking), prohibiting dogs, and seasonal closures of wide beach sections.

Human Activity and Habitat Characteristics Influence Shorebird Habitat Use and Behavior at a Vancouver Island Migratory Stopover Site

NASA Astrophysics Data System (ADS)

Murchison, Colleen R.; Zharikov, Yuri; Nol, Erica

2016-09-01

Pacific Rim National Park Reserve on Vancouver Island, British Columbia, Canada, has 16 km of coastal beaches that attract many thousands of people and shorebirds (S.O. Charadrii) every year. To identify locations where shorebirds concentrate and to determine the impact of human activity and habitat characteristics on shorebirds, we conducted shorebird and visitor surveys at 20 beach sectors (across 20 total km of beach) during fall migration in 2011-2014 and spring migration in 2012 and 2013. Using zero-inflated negative binomial regression and a model selection approach, we found that beach width and number of people influenced shorebird use of beach sectors (Bayesian information criterion weight of top model = 0.69). Shorebird absence from beaches was associated with increasing number of people (parameter estimate from top model: 0.38; 95 % CI 0.19, 0.57) and decreasing beach width (parameter estimate: -0.32; 95 % CI -0.47, -0.17). Shorebirds spent more time at wider beaches (parameter estimate: 0.68; 95 % CI 0.49, 0.87). Close proximity to people increased the proportion of time shorebirds spent moving, while shorebirds spent more time moving and less time foraging on wider beaches than on narrower ones. Shorebird disturbance increased with proximity of people, activity speed, and presence of dogs. Based on our findings, management options, for reducing shorebird disturbance at Pacific Rim National Park Reserve and similar shorebird stopover areas, include mandatory buffer distances between people and shorebirds, restrictions on fast-moving activities (e.g., running, biking), prohibiting dogs, and seasonal closures of wide beach sections.

The First Reported Outbreak of Chikungunya in the U.S. Virgin Islands, 2014–2015

PubMed Central

Feldstein, Leora R.; Ellis, Esther M.; Rowhani-Rahbar, Ali; Halloran, M. Elizabeth; Ellis, Brett R.

2016-01-01

The chikungunya virus (CHIKV) epidemic in the Americas is of significant public health importance due to the lack of effective control and prevention strategies, severe disease morbidity among susceptible populations, and potential for persistent arthralgia and long-term impaired physical functionality. Using surveillance data of suspected CHIKV cases, we describe the first reported outbreak in the U.S. Virgin Islands. CHIKV incidence was highest among individuals aged 55–64 years (13.1 cases per 1,000 population) and lowest among individuals aged 0–14 years (1.8 cases per 1,000 population). Incidence was higher among women compared to men (6.6 and 5.0 cases per 1,000 population, respectively). More than half of reported laboratory-positive cases experienced fever lasting 2–7 days, chills/rigor, myalgia, anorexia, and headache. No clinical symptoms apart from the suspected case definition of fever ≥ 38°C and arthralgia were significantly associated with being a reported laboratory-positive case. These results contribute to our knowledge of demographic risk factors and clinical manifestations of CHIKV disease and may aid in mitigating future CHIKV outbreaks in the Caribbean. PMID:27402523

Cost of a measles outbreak in a remote island economy: 2014 Federated States of Micronesia measles outbreak.

PubMed

Pike, Jamison; Tippins, Ashley; Nyaku, Mawuli; Eckert, Maribeth; Helgenberger, Louisa; Underwood, J Michael

2017-10-13

After 20years with no reported measles cases, on May 15, 2014 the Centers for Disease Control and Prevention (CDC) was notified of two cases testing positive for measles-specific immunoglobulin M (IgM) antibodies in the Federated States of Micronesia (FSM). Under the Compact of Free Association, FSM receives immunization funding and technical support from the United States (US) domestic vaccination program managed by the Centers for Disease Control and Prevention (CDC). In a collaborative effort, public health officials and volunteers from FSM and the US government worked to respond and contain the measles outbreak through an emergency mass vaccination campaign, contact tracing, and other outbreak investigation activities. Contributions were also made by United Nations Children's Emergency Fund (UNICEF) and World Health Organization (WHO). Total costs incurred as a result of the outbreak were nearly $4,000,000; approximately $10,000 per case. Direct medical costs (≈$141,000) were incurred in the treatment of those individuals infected, as well as lost productivity of the infected and informal caregivers (≈$250,000) and costs to contain the outbreak (≈$3.5 million). We assessed the economic burden of the 2014 measles outbreak to FSM, as well as the economic responsibilities of the US. Although the US paid the majority of total costs of the outbreak (≈67%), examining each country's costs relative to their respective economy illustrates a far greater burden to FSM. We demonstrate that while FSM was heavily assisted by the US in responding to the 2014 Measles Outbreak, the outbreak significantly impacted their economy. FSM's economic burden from the outbreak is approximately equivalent to their entire 2016 Fiscal Year budget dedicated to education. Published by Elsevier Ltd.

A waterborne outbreak of campylobacteriosis in the South Island of New Zealand due to a failure to implement a multi-barrier approach.

PubMed

Bartholomew, Nadia; Brunton, Cheryl; Mitchell, Peter; Williamson, Judy; Gilpin, Brent

2014-09-01

Outbreaks of waterborne gastroenteritis continue to occur in developed countries. Darfield, a rural town in the South Island of New Zealand experienced an outbreak of campylobacteriosis following a transgression of Escherichia coli on 16 August 2012. A descriptive outbreak investigation was performed. As a result, 29 cases had a laboratory-confirmed diagnosis of campylobacteriosis and 138 were identified as probable cases. Heavy rains, contamination of water with animal effluent from nearby paddocks and failures in the treatment of drinking water led to pathogens being distributed through the town's water supply. A multi-barrier approach is advocated to ensure the quality of water and many countries have legislation or programmes to address this. Although legislation for water safety plans based on a multi-barrier approach is in place in New Zealand, at the time of the outbreak it was not a requirement for the Darfield water supply. In addition, despite the awareness of the importance of a multi-barrier approach, competing interests, including those from the agricultural industry and financial restraints on water suppliers, can prevent it from being implemented. Governments need to be more willing to enforce legislation and standards to protect the public from waterborne disease.

Climate teleconnections and recent patterns of human and animal disease outbreaks

USDA-ARS?s Scientific Manuscript database

Recent clusters of outbreaks of mosquito-borne diseases (Rift Valley fever and chikungunya) in Africa and parts of the Indian Ocean islands illustrate how interannual climate variability influences the changing risk patterns of disease outbreaks. Extremes in rainfall (drought and flood) during the p...

Health assessment for ALCOA (Vancouver Smelter), Vancouver, Clark County, Washington, Region 10. CERCLIS No. WAD009045279. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1990-05-09

The ALCOA (also known as Vancouver Smelter) site, located on the northern bank of the Columbia River about 4 miles west of Interstate 5 in Vancouver, Clark County, Washington, has been proposed for the National Priorities List. The site consists of three waste piles containing about 66,000 tons of waste (spent potlinings and alumina insulation) that were deposited on the north bank of the Columbia River by ALCOA between 1973 and 1981. ALCOA has since sold the aluminum smelter to another company, VANALCO. The contaminants detected in the groundwater in the area surrounding the piles include cyanide, fluoride, and trichloroethenemore » (TCE). The ALCOA site is of potential public health concern because humans may be exposed to hazardous substances at concentrations that may result in adverse health effects.« less

An outbreak of tinea gladiatorum in Lanzarote.

PubMed

Pique, E; Copado, R; Cabrera, A; Olivares, M; Fariña, M C; Escalonilla, P; Soriano, M L; Requena, L

1999-01-01

Canary Islands wrestling is a variant of the sport played exclusively in that region, and is associated with close participant contact. An outbreak of a fungal infection, so-called tinea gladiatorum, amongst such wrestlers in Lanzarote, one island in the archipelago is now described. 102 wrestlers from the eight teams on the island were examined; some of the clubs are 50 km apart; 45 wrestlers (44.1% of those examined) were noted to be affected. To our knowledge, this is the largest reported series of patients with tinea gladiatorum and the only one to demonstrate such infection in a variety of geographical locations.

Tidally controlled gas bubble emissions: A comprehensive study using long-term monitoring data from the NEPTUNE cabled observatory offshore Vancouver Island

NASA Astrophysics Data System (ADS)

Römer, Miriam; Riedel, Michael; Scherwath, Martin; Heesemann, Martin; Spence, George D.

2016-09-01

Long-term monitoring over 1 year revealed high temporal variability of gas emissions at a cold seep in 1250 m water depth offshore Vancouver Island, British Columbia. Data from the North East Pacific Time series Underwater Networked Experiment observatory operated by Ocean Networks Canada were used. The site is equipped with a 260 kHz Imagenex sonar collecting hourly data, conductivity-temperature-depth sensors, bottom pressure recorders, current meter, and an ocean bottom seismograph. This enables correlation of the data and analyzing trigger mechanisms and regulating criteria of gas discharge activity. Three periods of gas emission activity were observed: (a) short activity phases of few hours lasting several months, (b) alternating activity and inactivity of up to several day-long phases each, and (c) a period of several weeks of permanent activity. These periods can neither be explained by oceanographic conditions nor initiated by earthquakes. However, we found a clear correlation of gas emission with bottom pressure changes controlled by tides. Gas bubbles start emanating during decreasing tidal pressure. Tidally induced pressure changes also influence the subbottom fluid system by shifting the methane solubility resulting in exsolution of gas during falling tides. These pressure changes affect the equilibrium of forces allowing free gas in sediments to emanate into the water column at decreased hydrostatic load. We propose a model for the fluid system at the seep, fueled by a constant subsurface methane flux and a frequent tidally controlled discharge of gas bubbles into the ocean, transferable to other gas emission sites in the world's oceans.

Surveillance for malaria outbreak on malaria-eliminating islands in Tafea Province, Vanuatu after Tropical Cyclone Pam in 2015.

PubMed

Chan, C W; Iata, H; Yaviong, J; Kalkoa, M; Yamar, S; Taleo, G; Isozumi, R; Fukui, M; Aoyama, F; Pomer, A; Dancause, K N; Kaneko, A

2017-01-01

The risk of malaria outbreak surfaced in Vanuatu after Tropical Cyclone (TC) Pam in March 2015. In June and July 2015 we conducted malariometric surveys on the islands of Tanna, Aneityum, and Erromango in Tafea Province, where malaria elimination had been targeted, to determine if malaria incidence had increased after TC Pam. No Plasmodium infection was detected by microscopy and PCR in 3009 survey participants. Only 6·3% (190/3007) of participants had fever. Spleen rates in children aged ⩽12 years from Aneityum and Tanna were low, at 3·6% (14/387) and 5·3% (27/510), respectively. Overall bed net use was high at 72·8% (2175/2986); however, a significantly higher (P < 0·001) proportion of participants from Aneityum (85·9%, 796/927) reported net use than those from Tanna (67·1%, 751/1119) and Erromango (66·8%, 628/940). A recent decrease in malaria incidence in Tafea Province through comprehensive intervention measures had reduced the indigenous parasite reservoir and limited the latter's potential to spur an outbreak after TC Pam. The path towards malaria elimination in Tafea Province was not adversely affected by TC Pam.

A 3D, finite element model for baroclinic circulation on the Vancouver Island continental shelf

USGS Publications Warehouse

Walters, R.A.; Foreman, M.G.G.

1992-01-01

This paper describes the development and application of a 3-dimensional model of the barotropic and baroclinic circulation on the continental shelf west of Vancouver Island, Canada. A previous study with a 2D barotropic model and field data revealed that several tidal constituents have a significant baroclinic component (the K1 in particular). Thus we embarked on another study with a 3D model to study the baroclinic effects on the residual and several selected tidal constituents. The 3D model uses a harmonic expansion in time and a finite element discretization in space. All nonlinear terms are retained, including quadratic bottom stress, advection and wave transport (continuity nonlinearity). The equations are solved as a global and a local problem, where the global problem is the solution of the wave equation formulation of the shallow water equations, and the local problem is the solution of the momentum equation for the vertical velocity profile. These equations are coupled to the advection-diffusion equation for density so that density gradient forcing is included in the momentum equations. However, the study presented here describes diagnostic calculations for the baroclinic residual circulation only. The model is sufficiently efficient that it encourages sensitivity testing with a large number of model runs. In this sense, the model is akin to an extension of analytical solutions to the domain of irregular geometry and bottom topography where this parameter space can be explored in some detail. In particular, the consequences of the sigma coordinate system used by the model are explored. Test cases using an idealized representation of the continental shelf, shelf break and shelf slope, lead to an estimation of the velocity errors caused by interpolation errors inherent in the sigma coordinate system. On the basis of these estimates, the computational grid used in the 2D model is found to have inadequate resolution. Thus a new grid is generated with increased

[Outbreak of influenza A(H1N1)/2009: description of cases and crisis management in a ICU in Reunion Island].

PubMed

Parcevaux, M; Boisson, V; Lemant, J; Antok, E; Thibault, L; Garcia, C; Bugnon, O; Tixier, F; Belin, N; André, H; Michaud, A; Braunberger, E; Vandroux, D; Ocquidant, P; Rouanet, J F; Ingles, M; Filleul, L; Winer, A

2010-12-01

to describe the characteristics, treatment and outcome of critically ill patients with influenza A(H1N1) infection at St Pierre Hospital in Reunion Island during the 2009 outbreak, as well as the measures of care reorganization implemented to face them. prospective observational study of probable and confirmed cases of influenza A (H1N1)/2009 infection concerning hospitalized patients in a polyvalent intensive care unit (ICU). thirteen patients have been included between August and September 2009. Three (23 %) didn't have any medical history. The median age was 42 [22-69]. Eleven have required pulmonary ventilation for 10.3 days (± 8). Three (23 %) have developed an ARDS. Three patients (23 %) died. To cope with the influx of cases and considering our situation of geographic isolation, it has been needed to totally rework the organization of care: set-up of a specific welcoming channel, division into sectors of the department, opening of additional beds, new on-duty assignment, inter and intra hospital cooperation. reunion Island has been an experimental lab of crisis management during the H1N1/2009 epidemic, several months ahead of the mother country. To anticipate the reorganization of care in intensive care units during an outbreak period, particularly in small units or units isolated like ours, looks to us a must so to quietly face a sharp influx of patients. 2010 Elsevier Masson SAS. All rights reserved.

[The Vancouver regulations and publishing in biomedical journals].

PubMed

Brkić, S; Pejić, M

1996-01-01

The paper deals with structure, importance and advantage as well as the path of development of the Uniform requirements for manuscripts submitted to biomedical journals (Vancouver style) from 1978, when they were established and firstly published, through changes and amendments up to their last--fourth edition. Authorship, abstract, key words and literature citation are fields dealt with in detail with appropriate discussions. The 16 year long existence of the Vancouver style, a great number of journals with high impact factor which conform to its requirements, as well as its advantages presented in the paper, should be a sufficient reason for scientists, explorers and editors of biomedical journals to conform to the requirements if they have not conformed to them yet.

Traveling to Canada for the Vancouver 2010 Winter Olympic and Paralympic Games.

PubMed

Heggie, Travis W

2009-07-01

The 21st Winter Olympic Games will be held in Vancouver, British Columbia, Canada from February 12 to 28, 2010. Following the Winter Olympic Games, the Winter Paralympic Games will be held from March 12 to 21, 2010. There will be 86 winter sporting events hosted in Vancouver with 5500 athletes staying in two Olympic Villages. Another 2800 members of the media, 25,000 volunteers, and 1 million spectators are expected in attendance. This paper reviews health and safety issues for all travelers to Canada for the 2010 Vancouver Winter Olympic Games with a specific focus on pre-travel planning, road and transportation safety in British Columbia, natural and environmental hazards, Olympic medical facilities, safety and security, and infectious disease.

Informal Recyclers' Health Inequities in Vancouver, BC.

PubMed

Wittmer, Josie; Parizeau, Kate

2018-01-01

We explore informal recyclers' perceptions and experiences of the social determinants of health in Vancouver, Canada, and investigate the factors that contribute to the environmental health inequities they experience. Based on in-depth interviews with 40 informal recyclers and 7 key informants, we used a social determinants of health framework to detail the health threats that informal recyclers associated with their work and the factors that influenced their access to health-related resources and services. Our analysis reveals that the structural factors influencing environmental health inequities included insufficient government resources for low-income urbanites; the potential for stigma, clientization, and discrimination at some health and social service providers; and the legal marginalization of informal recycling and associated activities. We conclude that Vancouver's informal recyclers experience inequitable access to health-related resources and services, and they are knowledgeable observers of the factors that influence their own health and well-being.

Bottom trawling and oxygen minimum zone influences on continental slope benthic community structure off Vancouver Island (NE Pacific)

NASA Astrophysics Data System (ADS)

De Leo, Fabio C.; Gauthier, Maéva; Nephin, Jessica; Mihály, Steven; Juniper, S. Kim

2017-03-01

Understanding responses of benthic ecosystems to cumulative impacts of natural stressors, long-term ocean change and increasing resource exploitation is an emerging area of interest for marine ecologists and environmental managers. Few, if any, studies have quantitatively addressed cumulative effects in the deep sea. We report here on a study from the continental slope off Vancouver Island (Canada) in the northeast Pacific Ocean, where the Oxygen Minimum Zone impinges on seabed habitats that are subjected to widespread bottom trawling, primarily by the fishery for thornyhead (Sebastolobus ssp.). We examined how the benthic megafauna in this area was influenced by varying levels of dissolved oxygen and trawling activity, along a depth gradient that was also likely to shape community composition. Continuous video and sonar records from two ROV surveys (50 linear km total; depth range 300-1400 m) respectively provided data on faunal attributes (composition, abundance and diversity) and the frequency of trawl door marks on the seabed. Faunal and trawl data were compiled in a geo-referenced database along with corresponding dissolved oxygen data, and pooled into 500 m segments for statistical analysis. Trawl mark occurrence peaked between 500 and 1100 m, corresponding to areas of slope subjected to hypoxia (<1.4 ml l-1) and severe hypoxia (<0.5 ml l-1). A combined total of 266,251 megafauna organisms from 87 taxa were enumerated in the two transects. Significant megafaunal assemblages according to depth, trawling intensity and bottom water dissolved oxygen concentration were identified by PERMANOVA analyses, with characterizing taxa identified for all three factors. Depth, dissolved oxygen and trawl mark density accounted for 21% to 52% of the variability in benthic community structure according to multiple regression (DISTLM) models. Species richness was highest at intermediate depths and in areas subject to intermediate levels of trawling, and higher under hypoxia

An outbreak investigation of congenital rubella syndrome in Solomon Islands, 2013.

PubMed

Durski, Kara N; Tituli, Carol; Ogaoga, Divi; Musto, Jennie; Joshua, Cynthia; Dofai, Alfred; Leydon, Jennie; Nilles, Eric

2016-01-01

During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented. Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013. Retrospective case finding by reviewing medical records was also undertaken to identify additional cases born between January and March 2013 for the same wards and clinics. Cases were identified using established World Health Organization case definitions for CRS. A total of 13 CRS cases were identified, including two laboratory-confirmed, four clinically confirmed and seven suspected cases. Five CRS cases were retrospectively identified, including four suspected and one clinically confirmed case. There was no geospatial clustering of residences. The mothers of the cases were aged between 20 and 36 years. Three of the six mothers available for interview recalled an acute illness with rash during the first trimester of pregnancy. Additional CRS cases not captured in this investigation are likely. Caring for CRS cases is a challenge in resource-poor settings. Rubella vaccination is safe and effective and can prevent the serious consequences of CRS. Well planned and funded vaccination activities can prevent future CRS cases.

Ancient dispersal of the human fungal pathogen Cryptococcus gattii from the Amazon rainforest.

PubMed

Hagen, Ferry; Ceresini, Paulo C; Polacheck, Itzhack; Ma, Hansong; van Nieuwerburgh, Filip; Gabaldón, Toni; Kagan, Sarah; Pursall, E Rhiannon; Hoogveld, Hans L; van Iersel, Leo J J; Klau, Gunnar W; Kelk, Steven M; Stougie, Leen; Bartlett, Karen H; Voelz, Kerstin; Pryszcz, Leszek P; Castañeda, Elizabeth; Lazera, Marcia; Meyer, Wieland; Deforce, Dieter; Meis, Jacques F; May, Robin C; Klaassen, Corné H W; Boekhout, Teun

2013-01-01

Over the past two decades, several fungal outbreaks have occurred, including the high-profile 'Vancouver Island' and 'Pacific Northwest' outbreaks, caused by Cryptococcus gattii, which has affected hundreds of otherwise healthy humans and animals. Over the same time period, C. gattii was the cause of several additional case clusters at localities outside of the tropical and subtropical climate zones where the species normally occurs. In every case, the causative agent belongs to a previously rare genotype of C. gattii called AFLP6/VGII, but the origin of the outbreak clades remains enigmatic. Here we used phylogenetic and recombination analyses, based on AFLP and multiple MLST datasets, and coalescence gene genealogy to demonstrate that these outbreaks have arisen from a highly-recombining C. gattii population in the native rainforest of Northern Brazil. Thus the modern virulent C. gattii AFLP6/VGII outbreak lineages derived from mating events in South America and then dispersed to temperate regions where they cause serious infections in humans and animals.

Extending the fossil record of Polytrichaceae: Early Cretaceous Meantoinea alophosioides gen. et sp. nov., permineralized gametophytes with gemma cups from Vancouver Island.

PubMed

Bippus, Alexander C; Stockey, Ruth A; Rothwell, Gar W; Tomescu, Alexandru M F

2017-04-01

Diverse in modern ecosystems, mosses are dramatically underrepresented in the fossil record. Furthermore, most pre-Cenozoic mosses are known only from compression fossils, lacking detailed anatomical information. When preserved, anatomy vastly improves resolution in the systematic placement of fossils. Lower Cretaceous deposits at Apple Bay (Vancouver Island, British Columbia, Canada) contain a diverse anatomically preserved flora that includes numerous bryophytes, many of which have yet to be characterized. Among them is a polytrichaceous moss that is described here. Fossil moss gametophytes preserved in four carbonate concretions were studied in serial sections prepared using the cellulose acetate peel technique. We describe Meantoinea alophosioides gen. et sp. nov., a polytrichaceous moss with terminal gemma cups containing stalked, lenticular gemmae. Leaves with characteristic costal anatomy, differentiated into sheathing base and free lamina and bearing photosynthetic lamellae, along with a conducting strand in the stem, place Meantoinea in family Polytrichaceae. The bistratose leaf lamina with an adaxial layer of mamillose cells, short photosynthetic lamellae restricted to the costa, and presence of gemma cups indicate affinities with basal members of the Polytrichaceae, such as Lyellia , Bartramiopsis , and Alophosia . Meantoinea alophosioides enriches the documented moss diversity of an already-diverse Early Cretaceous plant fossil assemblage. This is the third moss described from the Apple Bay plant fossil assemblage and represents the first occurrence of gemma cups in a fossil moss. It is also the oldest unequivocal record of Polytrichaceae, providing a hard minimum age for the group of 136 million years. © 2017 Botanical Society of America.

INTERPOLATING VANCOUVER'S DAILY AMBIENT PM 10 FIELD

EPA Science Inventory

In this article we develop a spatial predictive distribution for the ambient space- time response field of daily ambient PM10 in Vancouver, Canada. Observed responses have a consistent temporal pattern from one monitoring site to the next. We exploit this feature of the field b...

Their Spirits Live within Us: Aboriginal Women in Downtown Eastside Vancouver Emerging into Visibility

ERIC Educational Resources Information Center

Culhane, Dara

2003-01-01

The intersection of Main and Hastings streets--known locally as "Pain and Wastings"--marks the heart of Vancouver's inner-city neighborhood: the Downtown Eastside. Since 1997, when the City of Vancouver Health Department declared a public health emergency in response to reports that HIV infection rates among residents exceeded those…

Origins of the rabies viruses associated with an outbreak in Newfoundland during 2002-2003.

PubMed

Nadin-Davis, Susan; Muldoon, Frances; Whitney, Hugh; Wandeler, Alexander I

2008-01-01

After being free of rabies of terrestrial mammals since 1988, an outbreak of rabies occurred on the Island of Newfoundland in December 2002 and continued into the middle of 2003. Twenty-one cases, all due to the arctic fox strain of rabies virus, were reported. To explore the immediate origins of this outbreak, viruses from the Newfoundland epizootic were genetically compared to two other rabies viruses recovered in mid-2002 from Cartwright, a mainland coastal community near the Island. While all Island isolates from the 2002-03 outbreak were genetically very similar, consistent with a single introduction from the mainland, they were phylogenetically quite distant from the two samples from Cartwright. A broader-based study examined the relationships between the Island viruses and arctic fox strain viruses originating from across Canada over a period of 14 yr. This analysis indicated that the Newfoundland outbreak viruses were most similar to a variant identified in Labrador in 2004 but also widely distributed in northern Quebec both before and after the Newfoundland incursion. The eastern coastline of mainland Labrador has harbored a particularly large number of variants during the study period, some of which have not been detected elsewhere. A small number of Greenland isolates included in this study were dispersed within the clades of the Canadian samples rather than forming a discrete cluster, an observation that may underline the relative ease of movement of the rabies arctic lineage between these two countries as a result of animal movements over pack ice.

An outbreak investigation of congenital rubella syndrome in Solomon Islands, 2013

PubMed Central

Durski, Kara N; Tituli, Carol; Ogaoga, Divi; Joshua, Cynthia; Dofai, Alfred; Leydon, Jennie; Nilles, Eric

2016-01-01

Introduction During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented. Methods Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013. Retrospective case finding by reviewing medical records was also undertaken to identify additional cases born between January and March 2013 for the same wards and clinics. Cases were identified using established World Health Organization case definitions for CRS. Results A total of 13 CRS cases were identified, including two laboratory-confirmed, four clinically confirmed and seven suspected cases. Five CRS cases were retrospectively identified, including four suspected and one clinically confirmed case. There was no geospatial clustering of residences. The mothers of the cases were aged between 20 and 36 years. Three of the six mothers available for interview recalled an acute illness with rash during the first trimester of pregnancy. Discussion Additional CRS cases not captured in this investigation are likely. Caring for CRS cases is a challenge in resource-poor settings. Rubella vaccination is safe and effective and can prevent the serious consequences of CRS. Well planned and funded vaccination activities can prevent future CRS cases. PMID:27757248

Dengue virus type 3, South Pacific Islands, 2013.

PubMed

Cao-Lormeau, Van-Mai; Roche, Claudine; Musso, Didier; Mallet, Henri-Pierre; Dalipanda, Tenneth; Dofai, Alfred; Nogareda, Francisco; Nilles, Eric J; Aaskov, John

2014-06-01

After an 18-year absence, dengue virus serotype 3 reemerged in the South Pacific Islands in 2013. Outbreaks in western (Solomon Islands) and eastern (French Polynesia) regions were caused by different genotypes. This finding suggested that immunity against dengue virus serotype, rather than virus genotype, was the principal determinant of reemergence.

Green Islands - nutrition not predation -an alternative hypothesis.

PubMed

White, T C R

1985-10-01

Mountain birch trees are said to survive as "green islands" around nests of red ants in Finnish Lapland because the ants kill larvae which would defoliate trees during outbreaks of the moth O. autumnata. An alternative hypothesis says that because the ants will concentrate soil nutrients (and possibly ameliorate soil moisture and temperature) in and around their nests, they provide a more favourable site for trees growing nearby. These trees are therefore less stressed and a poorer source of food for defoliators at times of outbreaks. Few if any young O. autumnata larvae survive on the trees which then survive in green islands around ant nests.

Command and Control Analysis of the South West Provincial Regional Emergency Operations Centre during Vancouver 2010

DTIC Science & Technology

2011-06-01

Venue Site WACC - Whistler Area Command Centre OTHER GPPAG - Government Partners Public Affairs Group 18 ANNEX B. Interview questions...Vancouver Vancouver Richmond WACC Decision Authority Link Information Sharing Link DOC’s 2010 Provincial Games Secretariat GPPAG CCG

Climate Teleconnections and Recent Patterns of Human and Animal Disease Outbreaks

NASA Technical Reports Server (NTRS)

Anyamba, Assaf; Linthicum, Kenneth J.; Small, Jennifer L.; Collins, Katherine M.; Tucker, Compton J.; Pak, Edwin W.; Britch, Seth C.; Eastman, James Ronald; Pinzon, Jorge E.; Russell, Kevin L.

2011-01-01

Recent clusters of outbreaks of mosquito-borne diseases (Rift Valley fever and chikungunya) in Africa and parts of the Indian Ocean islands illustrate how interannual climate variability influences the changing risk patterns of disease outbreaks. Extremes in rainfall (drought and flood) during the period 2004 - 2009 have privileged different disease vectors. Chikungunya outbreaks occurred during the severe drought from late 2004 to 2006 over coastal East Africa and the western Indian Ocean islands and in the later years India and Southeast Asia. The chikungunya pandemic was caused by a Central/East African genotype that appears to have been precipitated and then enhanced by global-scale and regional climate conditions in these regions. Outbreaks of Rift Valley fever occurred following excessive rainfall period from late 2006 to late 2007 in East Africa and Sudan, and then in 2008 - 2009 in Southern Africa. The shift in the outbreak patterns of Rift Valley fever from East Africa to Southern Africa followed a transition of the El Nino/Southern Oscillation (ENSO) phenomena from the warm El Nino phase (2006-2007) to the cold La Nina phase (2007-2009) and associated patterns of variability in the greater Indian Ocean basin that result in the displacement of the centres of above normal rainfall from Eastern to Southern Africa. Understanding the background patterns of climate variability both at global and regional scale and their impacts on ecological drivers of vector borne-diseases is critical in long-range planning of appropriate response and mitigation measures.

Vancouver, Canada 2010

NASA Image and Video Library

2017-12-08

The Thematic Mapper on the Landsat 5 satellite captured this image of Vancouver on September 7, 2011. Flowing through braided channels, the Fraser River meanders toward the sea, emptying through multiple outlets. Moe info: earthobservatory.nasa.gov/IOTD/view.php?id=77368 NASA Earth Observatory image created by Robert Simmon and Jesse Allen, using Landsat data provided by the United States Geological Survey. Instrument: Landsat 5 - TM Credit: NASA Earth Observatory NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Pseudomonas syringae pv. actinidiae from Recent Outbreaks of Kiwifruit Bacterial Canker Belong to Different Clones That Originated in China

PubMed Central

Butler, Margi I.; Stockwell, Peter A.; Black, Michael A.; Day, Robert C.; Lamont, Iain L.; Poulter, Russell T. M.

2013-01-01

A recently emerged plant disease, bacterial canker of kiwifruit (Actinidia deliciosa and A. chinensis), is caused by Pseudomonas syringae pv. actinidiae (PSA). The disease was first reported in China and Japan in the 1980s. A severe outbreak of PSA began in Italy in 2008 and has spread to other European countries. PSA was found in both New Zealand and Chile in 2010. To study the evolution of the pathogen and analyse the transmission of PSA between countries, genomes of strains from China and Japan (where the genus Actinidia is endemic), Italy, New Zealand and Chile were sequenced. The genomes of PSA strains are very similar. However, all strains from New Zealand share several single nucleotide polymorphisms (SNPs) that distinguish them from all other PSA strains. Similarly, all the PSA strains from the 2008 Italian outbreak form a distinct clonal group and those from Chile form a third group. In addition to the rare SNPs present in the core genomes, there is abundant genetic diversity in a genomic island that is part of the accessory genome. The island from several Chinese strains is almost identical to the island present in the New Zealand strains. The island from a different Chinese strain is identical to the island present in the strains from the recent Italian outbreak. The Chilean strains of PSA carry a third variant of this island. These genomic islands are integrative conjugative elements (ICEs). Sequencing of these ICEs provides evidence of three recent horizontal transmissions of ICE from other strains of Pseudomonas syringae to PSA. The analyses of the core genome SNPs and the ICEs, combined with disease history, all support the hypothesis of an independent Chinese origin for both the Italian and the New Zealand outbreaks and suggest the Chilean strains also originate from China. PMID:23555547

The history of brucellosis in the Pacific Island Countries and Territories and its re-emergence.

PubMed

Tukana, Andrew; Warner, Jeffrey; Hedlefs, Robert; Gummow, Bruce

2015-11-01

There are few publications on brucellosis within the Pacific Island Countries and Territories (PICTs). The reason is possibly because the cattle population has been reportedly free of the disease for many years until a re-emergence occurred in the Fiji Islands (Viti Levu) in 2009. This paper reports on the outbreak of brucellosis in Fiji and its progression between 2009 and 2013 in the context of an overview of brucellosis in the Pacific Island community. Review of the literature found only 28 articles with the oldest record of brucellosis being in 1965 in Papua New Guinea (PNG) and from human cases in Tonga in 1980. The Fiji outbreak of Brucella abortus occurred in cattle in 2009 (Wainivesi basin) in the Tailevu province. Prior to the outbreak, Fiji declared freedom from B. abortus to OIE in 1996 after a successful eradication campaign. During the course of the outbreak investigation, serum samples were collected from between 9790 and 21,624 cattle per annum between 2009 and 2013 from 87 farms on the main island of Fiji (Viti Levu). Blood samples were tested for brucellosis using the Rose Bengal Test (RBT) in 2009 and the indirect ELISA test in subsequent years. At the time of the outbreak in Fiji (2009) the apparent prevalence in cattle was 1.50% and this has fluctuated since the outbreak. The True Prevalence (TP) for the main island in Fiji for the indirect ELISA tests was 2.40% in 2010, reached a peak of 3.49% in 2011 then reduced to 0.12% by 2013. The significant reduction in prevalence compared to 2010 is most likely due to the control programs being implemented in Fiji. The re-emergence of B. abortus in Fiji could be attributed to the lack of monitoring for the disease until 2009 combined with inadequate management of exposed animals, thus illustrating how important it is for authorities not to become complacent. Continued awareness and monitoring for brucellosis is essential if future outbreaks are to be avoided. Copyright © 2015 Elsevier B.V. All rights

Fit for the fight? Illnesses in the Norwegian team in the Vancouver Olympic Games.

PubMed

Hanstad, Dag Vidar; Rønsen, Ola; Andersen, Svein S; Steffen, Kathrin; Engebretsen, Lars

2011-06-01

The development of strategies to prevent illnesses before and during Olympic Games provides a basis for improved health and Olympic results. (1) To document the efficacy of a prevention programme on illness in a national Olympic team before and during the 2010 Vancouver Olympic Winter Games (OWG), (2) to compare the illness incidence in the Norwegian team with Norwegian incidence data during the Turin 2006 OWG and (3) to compare the illness incidence in the Norwegian team with illness rates of other nations in the Vancouver OWG. Information on prevention measures of illnesses in the Norwegian Olympic team was based on interviews with the Chief Medical Officer (CMO) and the Chief Nutrition and Sport Psychology Officers, and on a review of CMO reports before and after the 2010 OWG. The prevalence data on illness were obtained from the daily reports on injuries and illness to the International Olympic Committee. The illness rate was 5.1% (five of 99 athletes) compared with 17.3% (13 out of 75 athletes) in Turin (p=0.008). A total of four athletes missed one competition during the Vancouver Games owing to illness, compared with eight in Turin. The average illness rate for all nations in the Vancouver OWG was 7.2%. Conclusions Although no definite cause-and-effect link between the implementation of preventive measures and the prevalence of illness in the 2010 OWG could be established, the reduced illness rate compared with the 2006 OWG, and the low prevalence of illnesses compared with other nations in the Vancouver OWG suggest that the preparations were effective.

3D Finite Element Modeling for Possible Creeping Behavior of Gas Hydrate-related Slipstream Submarine Slide, offshore Vancouver Island, Canada

NASA Astrophysics Data System (ADS)

LONG, S.; He, T.; Lan, K.; Spence, G.; Yelisetti, S.

2017-12-01

Natural gas hydrate-related submarine landslides have been identified on worldwide continental slope. Being a potential risk for marine environment and engineering projects, it has been a hot topic of hydrate research in recent decades. The study target is Slipstream submarine landslide, one of the slope failures on the frontal ridges of the Northern Cascadia accretionary margin, off Vancouver Island, Canada. The previous studies of P- & S-wave velocity structure based on OBS (Ocean Bottom Seismometer) data of SeaJade (Seafloor Earthquake Array - Japan Canada Cascadia Experiment) project indicated that there are two high concentration gas-hydrate layers within the ridge, one is at a depth of 100 mbsf (meter beneath the seafloor) with anomalous high P-wave velocities and the other is just above the prominent BSR (bottom-simulating reflector) at a depth of 265-275 mbsf. In this study we investigated the possible creeping behavior of gas hydrate layer to examine the critical instability of the ridge slope using the finite element method for self weight and additional stress (e.g., mega earthquake) conditions. The elastic and elasticoplasticity moduli of gas hydrate layer were obtained from laboratory measurements for different uniaxial pressure tests, which indicated that the sediments behave elastically for uniaxial pressures below 6 MPa, but elasticoplastically between 6-6.77 MPa. The modeled shear stress distribution indicated that the current sliding surface is more likely connected with the shallow high-velocity gas hydrate layer and sliding process related with gas hydrate starts from the toe of the slope and then progressively retreats to the place of current headwall, in a series of triangular blocks or wedges. Since the study area is in the earthquake belt, the large seismic acceleration will greatly affect the stress field and pore pressure distribution within the ridge, and the landslide is going to happen and supposedly at the shallow high-velocity gas

Exploring Mosquito Fauna of Majuro Atoll (Republic of Marshall Islands) in the Context of Zika Outbreak.

PubMed

Marie, Jérôme; Perera, Devika; Garstang, Helentina; Bossin, Herve C; Bourtzis, Kostas

2018-04-09

First autochthonous Zika clinical case was reported in the Republic of Marshall Islands (RMI) on Majuro Atoll in February 2016. An entomological survey of mosquito larvae and adult populations was carried out in four areas of Majuro, the most populated atoll of RMI encompassing different habitats (forest, rural, or urban) including some with confirmed clinical Zika cases to evaluate which mosquito species could be involved in the Zika transmission. A total of 2,367 immature and adult mosquito specimens were collected and identified to the species level. In total, five mosquito species were detected, Aedes aegypti (Linnaeus), Aedes albopictus (Skuse), Aedes marshallensis (Stone and Bohart), Culex quinquefasciatus (Say), and Culex annulirostris (Skuse) (Diptera: Culicidae), a first record for RMI. The most abundant species was Ae. aegypti presumed to be the main vector of Zika virus followed by Ae. albopictus. Improved management of breeding containers through better public awareness and community engagement, mosquito surveillance and innovative mosquito control strategies using the sterile insect technique (SIT) and/or the incompatible insect technique (IIT) could help prevent outbreaks of arboviruses in the RMI.

Giardiasis Outbreak Associated with Asymptomatic Food Handlers in New York State, 2015.

PubMed

Figgatt, Mary; Mergen, Kimberly; Kimelstein, Deborah; Mahoney, Danielle M; Newman, Alexandra; Nicholas, David; Ricupero, Kristen; Cafiero, Theresa; Corry, Daniel; Ade, Julius; Kurpiel, Philip; Madison-Antenucci, Susan; Anand, Madhu

2017-04-12

Giardia duodenalis is a protozoan that causes a gastrointestinal illness called giardiasis. Giardiasis outbreaks in the United States are most commonly associated with waterborne transmission and are less commonly associated with food, person-to-person, and zoonotic transmission. During June to September 2015, an outbreak of 20 giardiasis cases occurred and were epidemiologically linked to a local grocery store chain on Long Island, New York. Further investigation revealed three asymptomatic food handlers were infected with G. duodenalis , and one food handler and one case were coinfected with Cryptosporidium spp. Although G. duodenalis was not detected in food samples, Cryptosporidium was identified in samples of spinach dip and potato salad. The G. duodenalis assemblage and subtype from one of the food handlers matched two outbreak cases for which genotyping could be performed. This outbreak highlights the potential role of asymptomatically infected food handlers in giardiasis outbreaks.

Altered environment and risk of malaria outbreak in South Andaman, Andaman & Nicobar Islands, India affected by tsunami disaster

PubMed Central

Krishnamoorthy, Kaliannagoun; Jambulingam, Purushothaman; Natarajan, R; Shriram, AN; Das, Pradeep K; Sehgal, SC

2005-01-01

Background Pools of salt water and puddles created by giant waves from the sea due to the tsunami that occurred on 26th December 2004 would facilitate increased breeding of brackish water malaria vector, Anopheles sundaicus. Land uplifts in North Andaman and subsidence in South Andaman have been reported and subsidence may lead to environmental disturbances and vector proliferation. This warrants a situation analysis and vector surveillance in the tsunami hit areas endemic for malaria transmitted by brackish water mosquito, An. sundaicus to predict the risk of outbreak. Methods An extensive survey was carried out in the tsunami-affected areas in Andaman district of the Andaman and Nicobar Islands, India to assess the extent of breeding of malaria vectors in the habitats created by seawater flooding. Types of habitats in relation to source of seawater inundation and frequency were identified. The salinity of the water samples and the mosquito species present in the larval samples collected from these habitats were recorded. The malaria situation in the area was also analysed. Results South Andaman, covering Port Blair and Ferrargunj sub districts, is still under the recurring phenomenon of seawater intrusion either directly from the sea or through a network of creeks. Both daily cycles of high tides and periodical spring tides continue to cause flooding. Low-lying paddy fields and fallow land, with a salinity ranging from 3,000 to 42,505 ppm, were found to support profuse breeding of An. sundaicus, the local malaria vector, and Anopheles subpictus, a vector implicated elsewhere. This area is endemic for both vivax and falciparum malaria. Malaria slide positivity rate has started increasing during post-tsunami period, which can be considered as an indication of risk of malaria outbreak. Conclusion Paddy fields and fallow land with freshwater, hitherto not considered as potential sites for An. sundaicus, are now major breeding sites due to saline water. Consequently

Winter distribution, movements, and annual survival of radiomarked Vancouver Canada geese in southeast Alaska

USGS Publications Warehouse

Hupp, Jerry W.; Hodges, John I.; Conant, Bruce P.; Meixell, Brandt W.; Groves, Debbie J.

2010-01-01

Management of Pacific Flyway Canada geese (Branta canadensis) requires information on winter distribution of different populations. Recoveries of tarsus bands from Vancouver Canada geese (B. canadensis fulva) marked in southeast Alaska, USA, ≥4 decades ago suggested that ≥83% of the population was non-migratory and that annual adult survival was high (Ŝ = 0.836). However, recovery distribution of tarsus bands was potentially biased due to geographic differences in harvest intensity in the Pacific Flyway. Also, winter distribution of Vancouver Canada geese could have shifted since the 1960s, as has occurred for some other populations of Canada geese. Because winter distribution and annual survival of this population had not recently been evaluated, we surgically implanted very high frequency radiotransmitters in 166 adult female Canada geese in southeast Alaska. We captured Vancouver Canada geese during molt at 2 sites where adults with goslings were present (breeding areas) and 2 sites where we observed nonbreeding birds only. During winter radiotracking flights in southeast Alaska, we detected 98% of 85 females marked at breeding areas and 83% of 70 females marked at nonbreeding sites, excluding 11 females that died prior to the onset of winter radiotracking. We detected no radiomarked females in coastal British Columbia, or western Washington and Oregon, USA. Most (70%) females moved ≤30 km between November and March. Our model-averaged estimate of annual survival (Ŝ = 0.844, SE = 0.050) was similar to the estimate of annual survival of geese marked from 1956 to 1960. Likely <2% of Vancouver Canada geese that nest in southeast Alaska migrate to winter areas in Oregon or Washington where they could intermix with Canada geese from other populations in the Pacific Flyway. Because annual survival of adult Vancouver Canada geese was high and showed evidence of long-term consistency, managers should examine how reproductive success and recruitment may affect

Mini Schools: The New "Global City Communities" of Vancouver

ERIC Educational Resources Information Center

Yoon, Ee-Seul

2011-01-01

In recent decades, under the mutually constitutive processes of neoliberal urbanization and globalization, Vancouver has radically transformed and become a serious contender for the title of "world-class city". Against the background of this socio-spatial force reconfiguring the city, I explore how the city's unique development of…

Outbreak of Japanese encephalitis on the island of Saipan, 1990.

PubMed

Paul, W S; Moore, P S; Karabatsos, N; Flood, S P; Yamada, S; Jackson, T; Tsai, T F

1993-05-01

During October 1990, an outbreak of encephalitis occurred on Saipan. Although no virus was isolated, patients seroconverted to Japanese encephalitis (JE) virus, indicating the first known occurrence of JE on US territory since 1947. Ten cases occurred among a population of 40,000. The prevalence of antibody to JE virus among 234 lifelong Saipan residents surveyed after the outbreak was 4.2%. Age, household crowding, and lack of air conditioning were risk factors for infection. The seroprevalence in pigs, which are important amplifying hosts of JE virus, was 96% (n = 52). None of 288 stored serum specimens from lifelong Saipan residents sampled in 1984 were seropositive. These data suggest that JE virus was recently introduced onto Saipan and that peridomestic factors affected the risk of human infection. Transmission of JE virus probably ended with exhaustion of the supply of susceptible amplifying hosts. Surveillance for human cases and seroconversions in pigs during 1991 revealed no evidence of ongoing JE virus transmission.

Outbreak of Human Infection with Sarcocystis nesbitti, Malaysia, 2012

PubMed Central

Teoh, Boon-Teong; Sam, Sing-Sin; Chang, Li-Yen; Johari, Jefree; Hooi, Poh-Sim; Lakhbeer-Singh, Harvinder-Kaur; Italiano, Claire M.; Omar, Sharifah F. Syed; Wong, Kum-Thong; Ramli, Norlisah; Tan, Chong-Tin

2013-01-01

An outbreak of fever associated with myalgia and myositis occurred in 2012 among 89 of 92 college students and teachers who visited Pangkor Island, Malaysia. The Sarcocystis nesbitti 18S rRNA gene and sarcocysts were obtained from muscle tissues of 2 students. Our findings indicate emergence of S. nesbitti infections in humans in Malaysia. PMID:24274071

Defining Population Health Vulnerability Following an Extreme Weather Event in an Urban Pacific Island Environment: Honiara, Solomon Islands.

PubMed

Natuzzi, Eileen S; Joshua, Cynthia; Shortus, Matthew; Reubin, Reginald; Dalipanda, Tenneth; Ferran, Karen; Aumua, Audrey; Brodine, Stephanie

2016-08-03

Extreme weather events are common and increasing in intensity in the southwestern Pacific region. Health impacts from cyclones and tropical storms cause acute injuries and infectious disease outbreaks. Defining population vulnerability to extreme weather events by examining a recent flood in Honiara, Solomon Islands, can help stakeholders and policymakers adapt development to reduce future threats. The acute and subacute health impacts following the April 2014 floods were defined using data obtained from hospitals and clinics, the Ministry of Health and in-country World Health Organization office in Honiara. Geographical information system (GIS) was used to assess morbidity and mortality, and vulnerability of the health system infrastructure and households in Honiara. The April flash floods were responsible for 21 acute deaths, 33 injuries, and a diarrhea outbreak that affected 8,584 people with 10 pediatric deaths. A GIS vulnerability assessment of the location of the health system infrastructure and households relative to rivers and the coastline identified 75% of the health infrastructure and over 29% of Honiara's population as vulnerable to future hydrological events. Honiara, Solomon Islands, is a rapidly growing, highly vulnerable urban Pacific Island environment. Evaluation of the mortality and morbidity from the April 2014 floods as well as the infectious disease outbreaks that followed allows public health specialists and policy makers to understand the health system and populations vulnerability to future shocks. Understanding the negative impacts natural disaster have on people living in urban Pacific environments will help the government as well as development partners in crafting resilient adaptation development. © The American Society of Tropical Medicine and Hygiene.

Defining Population Health Vulnerability Following an Extreme Weather Event in an Urban Pacific Island Environment: Honiara, Solomon Islands

PubMed Central

Natuzzi, Eileen S.; Joshua, Cynthia; Shortus, Matthew; Reubin, Reginald; Dalipanda, Tenneth; Ferran, Karen; Aumua, Audrey; Brodine, Stephanie

2016-01-01

Extreme weather events are common and increasing in intensity in the southwestern Pacific region. Health impacts from cyclones and tropical storms cause acute injuries and infectious disease outbreaks. Defining population vulnerability to extreme weather events by examining a recent flood in Honiara, Solomon Islands, can help stakeholders and policymakers adapt development to reduce future threats. The acute and subacute health impacts following the April 2014 floods were defined using data obtained from hospitals and clinics, the Ministry of Health and in-country World Health Organization office in Honiara. Geographical information system (GIS) was used to assess morbidity and mortality, and vulnerability of the health system infrastructure and households in Honiara. The April flash floods were responsible for 21 acute deaths, 33 injuries, and a diarrhea outbreak that affected 8,584 people with 10 pediatric deaths. A GIS vulnerability assessment of the location of the health system infrastructure and households relative to rivers and the coastline identified 75% of the health infrastructure and over 29% of Honiara's population as vulnerable to future hydrological events. Honiara, Solomon Islands, is a rapidly growing, highly vulnerable urban Pacific Island environment. Evaluation of the mortality and morbidity from the April 2014 floods as well as the infectious disease outbreaks that followed allows public health specialists and policy makers to understand the health system and populations vulnerability to future shocks. Understanding the negative impacts natural disaster have on people living in urban Pacific environments will help the government as well as development partners in crafting resilient adaptation development. PMID:27091867

Epidemiological analysis of bovine ephemeral fever in 2012-2013 in the subtropical islands of Japan.

PubMed

Hayama, Yoko; Moriguchi, Sachiko; Yanase, Tohru; Suzuki, Moemi; Niwa, Tsuyoshi; Ikemiyagi, Kazufumi; Nitta, Yoshiki; Yamamoto, Takehisa; Kobayashi, Sota; Murai, Kiyokazu; Tsutsui, Toshiyuki

2016-03-09

Bovine ephemeral fever (BEF) is a febrile disease of cattle that is transmitted by arthropod vectors such as mosquitoes and Culicoides biting midges. An outbreak of BEF recently occurred in Ishigaki Island and surrounding islands that are located southwest of Japan. In this study, an epidemiological analysis was conducted to understand the temporal and spatial characteristics of the outbreak. Factors associated with the disease spread within Ishigaki Island were investigated by hierarchical Bayesian models. The possibility of between-island transmission by windborne vectors and transmission by long-distance migration of infected vectors were examined using atmospheric dispersion models. In September 2012, the first case of the disease was detected in the western part of Ishigaki Island. In 1 month, it had rapidly spread to the southern part of the island and to surrounding islands, and led to 225 suspected cases of BEF during the outbreak. The dispersion model demonstrated the high possibility of between-island transmission by wind. Spatial analysis showed that paddy fields, farmlands, and slope gradients had a significant impact on the 1-km cell-level incidence risk. These factors may have influenced the habitats and movements of the vectors with regard to the spread of BEF. A plausible incursion event of infected vectors from Southeast Asia to Ishigaki Island was estimated to have occurred at the end of August. This study revealed that the condition of a terrain and land use significantly influenced disease transmission. These factors are important in assessing favorable environments for related vectors. The results of the dispersion model indicated the likely transmission of the infected vectors by wind on the local scale and on the long-distance scale. These findings would be helpful for developing a surveillance program and developing preventive measures against BEF.

Natural attenuation of dengue virus type-2 after a series of island outbreaks: a retrospective phylogenetic study of events in the South Pacific three decades ago.

PubMed

Steel, Argon; Gubler, Duane J; Bennett, Shannon N

2010-09-30

Dengue is an expanding arboviral disease of variable severity characterized by the emergence of virus strains with greater fitness, epidemic potential and possibly virulence. To investigate the role of dengue virus (DENV) strain variation on epidemic activity we studied DENV-2 viruses from a series of South Pacific islands experiencing outbreaks of varying intensity and clinical severity. Initially appearing in 1971 in Tahiti and Fiji, the virus was responsible for subsequent epidemics in American Samoa, New Caledonia and Niue Island in 1972, reaching Tonga in 1973 where there was near-silent transmission for over a year. Based on whole-genome sequencing and phylogenetic analysis on 20 virus isolates, Tonga viruses were genetically unique, clustering in a single clade. Substitutions in the pre-membrane (prM) and nonstructural genes NS2A and NS4A correlated with the attenuation of the Tongan viruses and suggest that genetic change may play a significant role in dengue epidemic severity. Copyright 2010 Elsevier Inc. All rights reserved.

Epidemiological Investigation of a Diarrhea Outbreak in the South Pacific Island Nation of Tuvalu During a Severe La Niña–Associated Drought Emergency in 2011

PubMed Central

Emont, Jordan P.; Ko, Albert I.; Homasi-Paelate, Avanoa; Ituaso-Conway, Nese; Nilles, Eric J.

2017-01-01

The association between heavy rainfall and an increased risk of diarrhea has been well established but less is known about the effect of drought on diarrhea transmission. In 2011, the Pacific island nation of Tuvalu experienced a concurrent severe La Niña–associated drought and large diarrhea outbreak. We conducted a field investigation in Tuvalu to identify factors that contributed to epidemic transmission in the context of a drought emergency. Peak case numbers coincided with the nadir of recorded monthly rainfall, the lowest recorded since 1930. Independent factors associated with increased risk of diarrhea were households with water tank levels below 20% (odds ratio [OR] = 2.31; 95% confidence interval = 1.16–4.60) and decreased handwashing frequency (OR = 3.00 [1.48–6.08]). The resolution of the outbreak occurred after implementation of a hygiene promotion campaign, despite persistent drought and limited water access. These findings are potentially important given projections that future climate change will cause more frequent and severe droughts. PMID:28138046

An urban metabolism and ecological footprint assessment of Metro Vancouver.

PubMed

Moore, Jennie; Kissinger, Meidad; Rees, William E

2013-07-30

As the world urbanizes, the role of cities in determining sustainability outcomes grows in importance. Cities are the dominant form of human habitat, and most of the world's resources are either directly or indirectly consumed in cities. Sustainable city analysis and management requires understanding the demands a city places on a wider geographical area and its ecological resource base. We present a detailed, integrated urban metabolism of residential consumption and ecological footprint analysis of the Vancouver metropolitan region for the year 2006. Our overall goal is to demonstrate the application of a bottom-up ecological footprint analysis using an urban metabolism framework at a metropolitan, regional scale. Our specific objectives are: a) to quantify energy and material consumption using locally generated data and b) to relate these data to global ecological carrying capacity. Although water is the largest material flow through Metro Vancouver (424,860,000 m(3)), it has the smallest ecological footprint (23,100 gha). Food (2,636,850 tonnes) contributes the largest component to the ecological footprint (4,514,400 gha) which includes crop and grazing land as well as carbon sinks required to sequester emissions from food production and distribution. Transportation fuels (3,339,000 m(3)) associated with motor vehicle operation and passenger air travel comprises the second largest material flow through the region and the largest source of carbon dioxide emissions (7,577,000 tonnes). Transportation also accounts for the second largest component of the EF (2,323,200 gha). Buildings account for the largest electricity flow (17,515,150 MWh) and constitute the third largest component of the EF (1,779,240 gha). Consumables (2,400,000 tonnes) comprise the fourth largest component of the EF (1,414,440 gha). Metro Vancouver's total Ecological Footprint in 2006 was 10,071,670 gha, an area approximately 36 times larger than the region itself. The EFA reveals that

Dance K-12 in the Vancouver Schools: Innovating, Advocating, Educating

ERIC Educational Resources Information Center

Gilsdorf, Rie Algeo

2004-01-01

A history of the outstanding K-12 dance program in Vancouver, Washington, is provided, including various strategies used to promote its growth from a few pilot elementary schools through middle schools to an arts magnet high school. Numerous changes have been weathered by the professional dance staff, including certification challenges instigated…

Mapping stairwell accessibility in Vancouver's downtown core.

PubMed

Moore, Erica; Richter, Brian A; Patton, Cindy K; Lear, Scott A

2006-01-01

The increase in obesity is due in part to changes in the environment that affect behaviours such as physical activity. Stairwells in buildings present an opportunity to increase physical activity in the workplace. We characterized the stairwell accessibility in business buildings in the downtown core of Vancouver. Characteristics of the stairwells in business buildings with two or more floors were obtained. Stairwells were characterized based on their visibility from the main entrance, signage, presence of physical door, and interior lighting and space. Building completion year was obtained from the Vancouver City Hall. A total of 138 buildings in the pre-designated area were eligible for characterization. Due to security concerns, only 123 were assessed. Of those assessed, 54% had stairwells visible from the main entrance, 33% had locked doors and only 18% had signs on the stairwell doors. Of the 83 stairwells that were accessible, 54% and 36% were considered brightly lit and spacious enough for two people, respectively. Only 11% of the buildings studied had accessible stairwells that met all of our accessibility criteria. More recently built buildings tended to have a higher proportion of locked stairwell doors; otherwise, building completion year was not associated with any of the accessibility criteria. Based on their environmental characteristics, very few buildings were set up in a way that encouraged stair use. For the work environment to be conducive to increased physical activity, building policy will need to consider the implications of design on activity patterns.

Water and nutrient budgets for Vancouver Lake, Vancouver, Washington, October 2010-October 2012

USGS Publications Warehouse

Sheibley, Rich W.; Foreman, James R.; Marshall, Cameron A.; Welch, Wendy B.

2014-01-01

Vancouver Lake, a large shallow lake in Clark County, near Vancouver, Washington, has been undergoing water-quality problems for decades. Recently, the biggest concern for the lake are the almost annual harmful cyanobacteria blooms that cause the lake to close for recreation for several weeks each summer. Despite decades of interest in improving the water quality of the lake, fundamental information on the timing and amount of water and nutrients entering and exiting the lake is lacking. In 2010, the U.S. Geological Survey conducted a 2-year field study to quantify water flows and nutrient loads in order to develop water and nutrient budgets for the lake. This report presents monthly and annual water and nutrient budgets from October 2010–October 2012 to identify major sources and sinks of nutrients. Lake River, a tidally influenced tributary to the lake, flows into and out of the lake almost daily and composed the greatest proportion of both the water and nutrient budgets for the lake, often at orders of magnitude greater than any other source. From the water budget, we identified precipitation, evaporation and groundwater inflow as minor components of the lake hydrologic cycle, each contributing 1 percent or less to the total water budget. Nutrient budgets were compiled monthly and annually for total nitrogen, total phosphorus, and orthophosphate; and, nitrogen loads were generally an order of magnitude greater than phosphorus loads across all sources. For total nitrogen, flow from Lake River at Felida, Washington, made up 88 percent of all inputs into the lake. For total phosphorus and orthophosphate, Lake River at Felida flowing into the lake was 91 and 76 percent of total inputs, respectively. Nutrient loads from precipitation and groundwater inflow were 1 percent or less of the total budgets. Nutrient inputs from Burnt Bridge Creek and Flushing Channel composed 12 percent of the total nitrogen budget, 8 percent of the total phosphorus budget, and 21 percent

Legionnaires' Disease Outbreak at a Resort in Cozumel, Mexico

PubMed Central

Hampton, Lee M.; Garrison, Laurel; Kattan, Jessica; Brown, Ellen; Kozak-Muiznieks, Natalia A.; Lucas, Claressa; Fields, Barry; Fitzpatrick, Nicole; Sapian, Luis; Martin-Escobar, Teresa; Waterman, Stephen; Hicks, Lauri A.; Alpuche-Aranda, Celia; Lopez-Gatell, Hugo

2016-01-01

Background. A Legionnaires' disease (LD) outbreak at a resort on Cozumel Island in Mexico was investigated by a joint Mexico-United States team in 2010. This is the first reported LD outbreak in Mexico, where LD is not a reportable disease. Methods. Reports of LD among travelers were solicited from US health departments and the European Working Group for Legionella Infections. Records from the resort and Cozumel Island health facilities were searched for possible LD cases. In April 2010, the resort was searched for possible Legionella exposure sources. The temperature and total chlorine of the water at 38 sites in the resort were measured, and samples from those sites were tested for Legionella. Results. Nine travelers became ill with laboratory-confirmed LD within 2 weeks of staying at the resort between May 2008 and April 2010. The resort and its potable water system were the only common exposures. No possible LD cases were identified among resort workers. Legionellae were found to have extensively colonized the resort's potable water system. Legionellae matching a case isolate were found in the resort's potable water system. Conclusions. Medical providers should test for LD when treating community-acquired pneumonia that is severe or affecting patients who traveled in the 2 weeks before the onset of symptoms. When an LD outbreak is detected, the source should be identified and then aggressively remediated. Because LD can occur in tropical and temperate areas, all countries should consider making LD a reportable disease if they have not already done so. PMID:27704023

Legionnaires' Disease Outbreak at a Resort in Cozumel, Mexico.

PubMed

Hampton, Lee M; Garrison, Laurel; Kattan, Jessica; Brown, Ellen; Kozak-Muiznieks, Natalia A; Lucas, Claressa; Fields, Barry; Fitzpatrick, Nicole; Sapian, Luis; Martin-Escobar, Teresa; Waterman, Stephen; Hicks, Lauri A; Alpuche-Aranda, Celia; Lopez-Gatell, Hugo

2016-09-01

Background.  A Legionnaires' disease (LD) outbreak at a resort on Cozumel Island in Mexico was investigated by a joint Mexico-United States team in 2010. This is the first reported LD outbreak in Mexico, where LD is not a reportable disease. Methods.  Reports of LD among travelers were solicited from US health departments and the European Working Group for Legionella Infections. Records from the resort and Cozumel Island health facilities were searched for possible LD cases. In April 2010, the resort was searched for possible Legionella exposure sources. The temperature and total chlorine of the water at 38 sites in the resort were measured, and samples from those sites were tested for Legionella . Results.  Nine travelers became ill with laboratory-confirmed LD within 2 weeks of staying at the resort between May 2008 and April 2010. The resort and its potable water system were the only common exposures. No possible LD cases were identified among resort workers. Legionellae were found to have extensively colonized the resort's potable water system. Legionellae matching a case isolate were found in the resort's potable water system. Conclusions.  Medical providers should test for LD when treating community-acquired pneumonia that is severe or affecting patients who traveled in the 2 weeks before the onset of symptoms. When an LD outbreak is detected, the source should be identified and then aggressively remediated. Because LD can occur in tropical and temperate areas, all countries should consider making LD a reportable disease if they have not already done so.

Natural attenuation of Dengue Virus Type-2 after a series of island outbreaks: a re-trospective phylogenetic study of events in the South Pacific three decades ago

PubMed Central

Steel, Argon; Gubler, Duane J.; Bennett, Shannon N.

2011-01-01

Dengue is an expanding arboviral disease of variable severity characterized by the emergence of virus strains with greater fitness, epidemic potential and possibly virulence. To investigate the role of dengue virus (DENV) strain variation on epidemic activity we studied DENV-2 viruses from a series of South Pacific islands experiencing outbreaks of varying intensity and clinical severity. Initially appearing in 1971 in Tahiti and Fiji, the virus was responsible for subsequent epidemics in American Samoa, New Caledonia and Niue Island in 1972, reaching Tonga in 1973 where there was near-silent transmission for over a year. Based on whole-genome sequencing and phylogenetic analysis on 20 virus isolates, Tonga viruses were genetically unique, clustering in a single clade. Substitutions in the pre-membrane (prM) and nonstructural genes NS2A and NS4A correlated with the attenuation of the Tongan viruses and suggest that genetic change may play a significant role in dengue epidemic severity. PMID:20663532

Rapid Response to a College Outbreak of Meningococcal Serogroup B Disease: Nation's First Widespread Use of Bivalent rLP2086 Vaccine

ERIC Educational Resources Information Center

Fiorito, Theresa M.; Bornschein, Suzanne; Mihalakos, Alysia; Kelleher, Catherine M.; Alexander-Scott, Nicole; Kanadanian, Koren V.; Raymond, Patricia; Sicard, Kenneth; Dennehy, Penelope H.

2017-01-01

Objective: To outline the reasoning behind use of bivalent rLP2086 in a Rhode Island college meningococcal B disease outbreak, highlighting the timeline from outbreak declaration to vaccination clinic, emphasizing that these two time points are <3 days apart. Participants: Staff, faculty, and students at College X eligible for vaccination.…

Dengue on islands: a Bayesian approach to understanding the global ecology of dengue viruses.

PubMed

Feldstein, Leora R; Brownstein, John S; Brady, Oliver J; Hay, Simon I; Johansson, Michael A

2015-05-01

Transmission of dengue viruses (DENV), the most common arboviral pathogens globally, is influenced by many climatic and socioeconomic factors. However, the relative contributions of these factors on a global scale are unclear. We randomly selected 94 islands stratified by socioeconomic and geographic characteristics. With a Bayesian model, we assessed factors contributing to the probability of islands having a history of any dengue outbreaks and of having frequent outbreaks. Minimum temperature was strongly associated with suitability for DENV transmission. Islands with a minimum monthly temperature of greater than 14.8°C (95% CI: 12.4-16.6°C) were predicted to be suitable for DENV transmission. Increased population size and precipitation were associated with increased outbreak frequency, but did not capture all of the variability. Predictions for 48 testing islands verified these findings. This analysis clarified two key components of DENV ecology: minimum temperature was the most important determinant of suitability; and endemicity was more likely in areas with high precipitation and large, but not necessarily dense, populations. Wealth and connectivity, in contrast, had no discernable effects. This model adds to our knowledge of global determinants of dengue risk and provides a basis for understanding the ecology of dengue endemicity. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Assessment of circulation and inter-basin transport in the Salish Sea including Johnstone Strait and Discovery Islands pathways

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khangaonkar, Tarang; Long, Wen; Xu, Wenwei

The Salish Sea consisting of Puget Sound and Georgia Basin in U.S and Canadian waters has been the subject of several independent data collection and modeling studies. However, these interconnected basins and their hydrodynamic interactions have not received attention as a contiguous unit. The Strait of Juan de Fuca is the primary pathway through which Pacific Ocean water enters the Salish Sea but the role played by Johnstone Strait and the complex channels northeast of Vancouver Island, connecting the Salish Sea and the Pacific Ocean, on overall Salish Sea circulation has not been characterized. In this paper we present amore » modeling-based assessment of the two-layer circulation and transport through the multiple interconnected sub-basins within the Salish Sea including the effect of exchange via Johnstone Strait and Discovery Islands. The Salish Sea Model previously developed using the finite volume community ocean model (FVCOM) was expanded over the continental shelf for this assessment encircling Vancouver Island, including Discovery Islands, Johnstone Strait, Broughton Archipelago and the associated waterways. A computational technique was developed to allow summation of volume fluxes across arbitrary transects through unstructured finite volume cells. Tidally averaged volume fluxes were computed at multiple transects. The results were used to validate the classic model of Circulation in Embracing Sills for Puget Sound and to provide quantitative estimates of the lateral distribution of tidally averaged transport through the system. Sensitivity tests with and without exchanges through Johnstone Strait demonstrate that it is a pathway for Georgia Basin runoff and Fraser River water to exit the Salish Sea and for Pacific Ocean inflow. However the relative impact of this exchange on circulation and flushing in Puget Sound Basin is small.« less

Verification of an ENSO-Based Long-Range Prediction of Anomalous Weather Conditions During the Vancouver 2010 Olympics and Paralympics

NASA Astrophysics Data System (ADS)

Mo, Ruping; Joe, Paul I.; Doyle, Chris; Whitfield, Paul H.

2014-01-01

A brief review of the anomalous weather conditions during the Vancouver 2010 Winter Olympic and Paralympic Games and the efforts to predict these anomalies based on some preceding El Niño-Southern Oscillation (ENSO) signals are presented. It is shown that the Olympic Games were held under extraordinarily warm conditions in February 2010, with monthly mean temperature anomalies of +2.2 °C in Vancouver and +2.8 °C in Whistler, ranking respectively as the highest and the second highest in the past 30 years (1981-2010). The warm conditions continued, but became less anomalous, in March 2010 for the Paralympic Games. While the precipitation amounts in the area remained near normal through this winter, the lack of snow due to warm conditions created numerous media headlines and practical problems for the alpine competitions. A statistical model was developed on the premise that February and March temperatures in the Vancouver area could be predicted using an ENSO signal with considerable lead time. This model successfully predicted the warmer-than-normal, lower-snowfall conditions for the Vancouver 2010 Winter Olympics and Paralympics.

Adaptive mutations and replacements of virulence traits in the Escherichia coli O104:H4 outbreak population.

PubMed

Guy, Lionel; Jernberg, Cecilia; Arvén Norling, Jenny; Ivarsson, Sofie; Hedenström, Ingela; Melefors, Öjar; Liljedahl, Ulrika; Engstrand, Lars; Andersson, Siv G E

2013-01-01

The sequencing of highly virulent Escherichia coli O104:H4 strains isolated during the outbreak of bloody diarrhea and hemolytic uremic syndrome in Europe in 2011 revealed a genome that contained a Shiga toxin encoding prophage and a plasmid encoding enteroaggregative fimbriae. Here, we present the draft genome sequence of a strain isolated in Sweden from a patient who had travelled to Tunisia in 2010 (E112/10) and was found to differ from the outbreak strains by only 38 SNPs in non-repetitive regions, 16 of which were mapped to the branch to the outbreak strain. We identified putatively adaptive mutations in genes for transporters, outer surface proteins and enzymes involved in the metabolism of carbohydrates. A comparative analysis with other historical strains showed that E112/10 contained Shiga toxin prophage genes of the same genotype as the outbreak strain, while these genes have been replaced by a different genotype in two otherwise very closely related strains isolated in the Republic of Georgia in 2009. We also present the genome sequences of two enteroaggregative E. coli strains affiliated with phylogroup A (C43/90 and C48/93) that contain the agg genes for the AAF/I-type fimbriae characteristic of the outbreak population. Interestingly, C43/90 also contained a tet/mer antibiotic resistance island that was nearly identical in sequence to that of the outbreak strain, while the corresponding island in the Georgian strains was most similar to E. coli strains of other serotypes. We conclude that the pan-genome of the outbreak population is shared with strains of the A phylogroup and that its evolutionary history is littered with gene replacement events, including most recently independent acquisitions of antibiotic resistance genes in the outbreak strains and its nearest neighbors. The results are summarized in a refined evolutionary model for the emergence of the O104:H4 outbreak population.

Adaptive Mutations and Replacements of Virulence Traits in the Escherichia coli O104:H4 Outbreak Population

PubMed Central

Guy, Lionel; Jernberg, Cecilia; Arvén Norling, Jenny; Ivarsson, Sofie; Hedenström, Ingela; Melefors, Öjar; Liljedahl, Ulrika; Engstrand, Lars; Andersson, Siv G. E.

2013-01-01

The sequencing of highly virulent Escherichia coli O104:H4 strains isolated during the outbreak of bloody diarrhea and hemolytic uremic syndrome in Europe in 2011 revealed a genome that contained a Shiga toxin encoding prophage and a plasmid encoding enteroaggregative fimbriae. Here, we present the draft genome sequence of a strain isolated in Sweden from a patient who had travelled to Tunisia in 2010 (E112/10) and was found to differ from the outbreak strains by only 38 SNPs in non-repetitive regions, 16 of which were mapped to the branch to the outbreak strain. We identified putatively adaptive mutations in genes for transporters, outer surface proteins and enzymes involved in the metabolism of carbohydrates. A comparative analysis with other historical strains showed that E112/10 contained Shiga toxin prophage genes of the same genotype as the outbreak strain, while these genes have been replaced by a different genotype in two otherwise very closely related strains isolated in the Republic of Georgia in 2009. We also present the genome sequences of two enteroaggregative E. coli strains affiliated with phylogroup A (C43/90 and C48/93) that contain the agg genes for the AAF/I-type fimbriae characteristic of the outbreak population. Interestingly, C43/90 also contained a tet/mer antibiotic resistance island that was nearly identical in sequence to that of the outbreak strain, while the corresponding island in the Georgian strains was most similar to E. coli strains of other serotypes. We conclude that the pan-genome of the outbreak population is shared with strains of the A phylogroup and that its evolutionary history is littered with gene replacement events, including most recently independent acquisitions of antibiotic resistance genes in the outbreak strains and its nearest neighbors. The results are summarized in a refined evolutionary model for the emergence of the O104:H4 outbreak population. PMID:23675451

Prostitution in Vancouver: violence and the colonization of First Nations women.

PubMed

Farley, Melissa; Lynne, Jacqueline; Cotton, Ann J

2005-06-01

We interviewed 100 women prostituting in Vancouver, Canada. We found an extremely high prevalence of lifetime violence and post-traumatic stress disorder (PTSD). Fifty-two percent of our interviewees were women from Canada's First Nations, a significant overrepresentation in prostitution compared with their representation in Vancouver generally (1.7-7%). Eighty-two percent reported a history of childhood sexual abuse, by an average of four perpetrators. Seventy-two percent reported childhood physical abuse, 90% had been physically assaulted in prostitution, 78% had been raped in prostitution. Seventy-two percent met DSM-IV criteria for PTSD. Ninety-five percent said that they wanted to leave prostitution. Eighty-six percent reported current or past homelessness with housing as one of their most urgent needs. Eighty-two percent expressed a need for treatment for drug or alcohol addictions. Findings are discussed in terms of the legacy of colonialism, the intrinsically traumatizing nature of prostitution and prostitution's violations of basic human rights.

Cryptococcus gattii as an important fungal pathogen of western North America

PubMed Central

Marr, Kieren A

2012-01-01

Cryptococcus gattii, a pathogenic fungus historically appreciated to be endemic to tropical regions, was recognized to emerge in a more temperate zone of North America in the 1990s. Early reports focused on an outbreak that was first apparent on Vancouver Island (BC, Canada), involving both the veterinary and human population. More recently, it has been recognized that this organism is endemic to a wider geography in western North America, with recognized disease caused by unique molecular subtypes in both healthy and immunosuppressed human hosts and a variety of domestic and wild animals. A number of cases of disease caused by C. gattii isolates that are unrelated to the Vancouver Island–Pacific Northwest outbreak strains have also been recognized in different parts of the USA. As microbiology laboratories have historically not identified these organisms to the species level, our current understanding of the scope of this infection is probably an underestimate. Ongoing public health epidemiologic efforts will be facilitated by increased attention towards culture-confirmed diagnosis and species identification in clinical microbiology laboratories. Early experience presents a strong rationale for increasing diagnostic attention, with multiple clinical features that are unique to this infection, including variability in antifungal susceptibilities and a heightened need for aggressive management of inflammatory responses. Larger prospective studies to evaluate and optimize clinical management are needed. PMID:22734955

Emergence and Pathogenicity of Highly Virulent Cryptococcus gattii Genotypes in the Northwest United States

PubMed Central

Ma, Hansong; Voelz, Kerstin; Ren, Ping; Carter, Dee A.; Chaturvedi, Vishnu; Bildfell, Robert J.; May, Robin C.; Heitman, Joseph

2010-01-01

Cryptococcus gattii causes life-threatening disease in otherwise healthy hosts and to a lesser extent in immunocompromised hosts. The highest incidence for this disease is on Vancouver Island, Canada, where an outbreak is expanding into neighboring regions including mainland British Columbia and the United States. This outbreak is caused predominantly by C. gattii molecular type VGII, specifically VGIIa/major. In addition, a novel genotype, VGIIc, has emerged in Oregon and is now a major source of illness in the region. Through molecular epidemiology and population analysis of MLST and VNTR markers, we show that the VGIIc group is clonal and hypothesize it arose recently. The VGIIa/IIc outbreak lineages are sexually fertile and studies support ongoing recombination in the global VGII population. This illustrates two hallmarks of emerging outbreaks: high clonality and the emergence of novel genotypes via recombination. In macrophage and murine infections, the novel VGIIc genotype and VGIIa/major isolates from the United States are highly virulent compared to similar non-outbreak VGIIa/major-related isolates. Combined MLST-VNTR analysis distinguishes clonal expansion of the VGIIa/major outbreak genotype from related but distinguishable less-virulent genotypes isolated from other geographic regions. Our evidence documents emerging hypervirulent genotypes in the United States that may expand further and provides insight into the possible molecular and geographic origins of the outbreak. PMID:20421942

Airborne hunt for faults in the Portland-Vancouver area

USGS Publications Warehouse

Blakely, Richard J.; Wells, Ray E.; Yelin, Thomas S.; Stauffer, Peter H.; Hendley, James W.

1996-01-01

Geologic hazards in the Portland-Vancouver area include faults entirely hidden by river sediments, vegetation, and urban development. A recent aerial geophysical survey revealed patterns in the Earth's magnetic field that confirm the existence of a previously suspected fault running through Portland. It also indicated that this fault may pose a significant seismic threat. This discovery has enabled the residents of the populous area to better prepare for future earthquakes.

A Building-Resolved Wind Field Library for Vancouver: Facilitating CBRN Emergency Response for the 2010 Winter Olympic Games

DTIC Science & Technology

2010-06-01

Vancouver. Facilitating CBRN Emergency Response for the 2010 Winter Olympic Games E. Vee Defence R&D Canada- Suffield F.-S. Lien University of...ana a A Building-Resolved Wind Field Library for Vancouver. Facilitating CBRN Emergency Response for the 2010 Winter Olympic Games E. Yee Defence...support of emergency response applications (requiring quick turn- around times) for the 2010 Winter Olympic Games . To this purpose, mean wind and

Annual modulation of non-volcanic tremor in northern Cascadia

USGS Publications Warehouse

Pollitz, Fred; Wech, Aaron G.; Kao, Honn; Burgmann, Roland

2013-01-01

Two catalogs of episodic tremor events in northern Cascadia, one from 2006 to 2012 and the other from 1997 to 2011, reveal two systematic patterns of tremor occurrence in southern Vancouver Island: (1) most individual events tend to occur in the third quarter of the year; (2) the number of events in prolonged episodes (i.e., episodic tremor and slip events), which generally propagate to Vancouver Island from elsewhere along the Cascadia subduction zone, is inversely correlated with the amount of precipitation that occurred in the preceding 2 months. We rationalize these patterns as the product of hydrologic loading of the crust of southern Vancouver Island and the surrounding continental region, superimposed with annual variations from oceanic tidal loading. Loading of the Vancouver Island crust in the winter (when the land surface receives ample precipitation) and unloading in the summer tends to inhibit and enhance downdip shear stress, respectively. Quantitatively, for an annually variable surface load, the predicted stress perturbation depends on mantle viscoelastic rheology. A mechanical model of downdip shear stress on the transition zone beneath Vancouver Island—driven predominantly by the annual hydrologic cycle—is consistent with the 1997–2012 tremor observations, with peak-to-peak downdip shear stress of about 0.4 kPa. This seasonal dependence of tremor occurrence appears to be restricted to southern Vancouver Island because of its unique situation as an elongated narrow-width land mass surrounded by ocean, which permits seasonal perturbations in shear stress at depth.

Improving End-To-End Tsunami Warning for Risk Reduction on Canada’s West Coast

DTIC Science & Technology

2015-01-01

Association Jason Wood , B.C. Ministry of Transportation and Infrastructure Steve Waugh, Bela Coola Dave Rainnie, Canadian Broadcasting Corporation...southern tip of Banks Island to the northern tip of Vancouver Island (the western limit of the eastern boundary of Cape Scot Provincial Park.) This... Scot to Port Renfrew Beginning on the eastern boundary of Cape Scot Provincial Park on the northern tip of Vancouver Island and running in a south

Hyperhidrosis Prevalence and Demographical Characteristics in Dermatology Outpatients in Shanghai and Vancouver

PubMed Central

Kalia, Sunil; Huang, Rachel Yuanshen; Phillips, Arlie; Su, Mingwan; Yang, Sen; Zhang, Xuejun; Zhou, Pingyu; Zhou, Youwen

2016-01-01

Background There is a wide variation in the reported prevalence of primary hyperhidrosis in the literature. Further, it is unknown if primary hyperhidrosis is a lifelong condition, or if demographical factors influence hyperhidrosis prevalence. Objectives This study aims to examine the prevalence of hyperhidrosis in multiple ethnic groups from two ethnically diverse cities and to determine if the prevalence of primary hyperhidrosis changes according to age, gender, ethnicity, body mass index, and geographical locations. Methods In total, 1010 consecutive subjects attending dermatology outpatient clinics in Shanghai Skin Disease Hospital and 1018 subjects in Skin Care Center of Vancouver General Hospital were invited to fill out a questionnaire on their presenting concerns, demographical information, and sweating symptoms. The subjects were then classified to have primary hyperhidrosis using the criteria of International Hyperhidrosis Society, late-onset hyperhidrosis, or no-hyperhidrosis. The prevalence of primary HH and late-onset HH was calculated for the entire study population and in subgroups stratified according to age of examination, sex, ethnicity, presenting diagnosis, body mass index, and specific study cities. Multivariate logistic regression analyses were performed to assess the impact of these factors on HH prevalence. Results The prevalence of primary hyperhidrosis is very similar in Shanghai and in Vancouver, at 14.5% and 12.3% respectively. In addition, 4.0% of subjects in Shanghai and 4.4% subjects in Vancouver suffer from late-onset HH. Primary HH has highest prevalence in those younger than 30 years of age, decreasing dramatically in later years. Caucasian subjects are at least 2.5 times more likely to develop axillary hyperhidrosis compared to Chinese subjects. Obesity does not have much influence on primary HH presentation, although it does increase significantly the development of late-onset HH. Finally, there is no major difference of

Hyperhidrosis Prevalence and Demographical Characteristics in Dermatology Outpatients in Shanghai and Vancouver.

PubMed

Liu, Yudan; Bahar, Rayeheh; Kalia, Sunil; Huang, Rachel Yuanshen; Phillips, Arlie; Su, Mingwan; Yang, Sen; Zhang, Xuejun; Zhou, Pingyu; Zhou, Youwen

2016-01-01

There is a wide variation in the reported prevalence of primary hyperhidrosis in the literature. Further, it is unknown if primary hyperhidrosis is a lifelong condition, or if demographical factors influence hyperhidrosis prevalence. This study aims to examine the prevalence of hyperhidrosis in multiple ethnic groups from two ethnically diverse cities and to determine if the prevalence of primary hyperhidrosis changes according to age, gender, ethnicity, body mass index, and geographical locations. In total, 1010 consecutive subjects attending dermatology outpatient clinics in Shanghai Skin Disease Hospital and 1018 subjects in Skin Care Center of Vancouver General Hospital were invited to fill out a questionnaire on their presenting concerns, demographical information, and sweating symptoms. The subjects were then classified to have primary hyperhidrosis using the criteria of International Hyperhidrosis Society, late-onset hyperhidrosis, or no-hyperhidrosis. The prevalence of primary HH and late-onset HH was calculated for the entire study population and in subgroups stratified according to age of examination, sex, ethnicity, presenting diagnosis, body mass index, and specific study cities. Multivariate logistic regression analyses were performed to assess the impact of these factors on HH prevalence. The prevalence of primary hyperhidrosis is very similar in Shanghai and in Vancouver, at 14.5% and 12.3% respectively. In addition, 4.0% of subjects in Shanghai and 4.4% subjects in Vancouver suffer from late-onset HH. Primary HH has highest prevalence in those younger than 30 years of age, decreasing dramatically in later years. Caucasian subjects are at least 2.5 times more likely to develop axillary hyperhidrosis compared to Chinese subjects. Obesity does not have much influence on primary HH presentation, although it does increase significantly the development of late-onset HH. Finally, there is no major difference of hyperhidrosis between Chinese subjects in

New approaches to infection prevention and control: implementing a risk-based model regionally.

PubMed

Wale, Martin; Kibsey, Pamela; Young, Lisa; Dobbyn, Beverly; Archer, Jana

2016-06-01

Infectious disease outbreaks result in substantial inconvenience to patients and disruption of clinical activity. Between 1 April 2008 and 31 March 2009, the Vancouver Island Health Authority (Island Health) declared 16 outbreaks of Vancomycin Resistant Enterococci and Clostridium difficile in acute care facilities. As a result, infection prevention and control became one of Island Health's highest priorities. Quality improvement methodology, which promotes a culture of co-production between front-line staff, physicians and Infection Control Practitioners, was used to develop and test a bundle of changes in practices. A series of rapid Plan-Do-Study-Act cycles, specific to decreasing hospital-acquired infections, were undertaken by a community hospital, selected for its size, clinical specialty representation, and enthusiasm amongst staff and physicians for innovation and change. Positive results were incorporated into practice at the test site, and then introduced throughout the rest of the Health Authority. The changes implemented as a result of this study have enabled better control of antibiotic resistant organisms and have minimized disruption to routine activity, as well as saving an estimated $6.5 million per annum. When outbreaks do occur, they are now controlled much more promptly, even in existing older facilities. Through this process, we have changed our approach in Infection Prevention and Control (IPAC) from a rules-based approach to one that is risk-based, focusing attention on identifying and managing high-risk situations. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Velocity Structure and 3D Finite Element Modeling for Critical Instability of Gas Hydrate-related Slipstream Submarine Slide, offshore Vancouver Island, Canada

NASA Astrophysics Data System (ADS)

LONG, S.; He, T.; Lan, K.; Spence, G.; Yelisetti, S.

2016-12-01

The previous study indicated that Slipstream submarine landslide is one of a gas hydrate-related slope failures on the frontal ridges of the Northern Cascadia accretionary margin, off Vancouver Island, Canada. The OBS data collected during SeaJade project were used to derive the subseafloor Vp & Vs structures. The anomalous high Vp of about 2.0 km/s at shallow depths of 100 (± 10) mbsf closely matches the estimated depth of the glide plane. The modelled Vs above the BSR at a depth of 265-275 mbsf is about 100-150 m/s higher than a theoretical 100% water saturated background value, indicating that the hydrate acts as part of the load-bearing matrix to increase the rigidity of the sediment. Also, the Vp & Vs above BSR both indicate a consistent 40% saturation of gas hydrate. On the basis of high accurate submarine bathymetry obtained by multibeam sounding system, the submarine landform before slump is reconstructed by comparing the slump headwall geometry with surrounding ridges. Using the elastic moduli determined from Vp & Vs, the stress status was calculated by the finite element method for different conditions and confirmed that the undersea sliding process related with gas hydrate starts from the toe of the slope and then progressively retreats to the place of current headwall, in a series of triangular blocks or wedges. The shear stress are then compared with the frame shear strength of geological model, which is critical for controlling slope stability of steep frontal ridges The simulation results found that the ridge was stable under its own weight, but gas hydrate saturation decrease and pore-water pressure increase will greatly reduce shear strength of sediments and may cause a landslide. Since the study area is in the earthquake belt, the large seismic acceleration will greatly affect pore pressure distribution within the ridge. The simulation results indicated that the shallow high-velocity gas hydrate layer coincident with glide plane depth is more

The Vancouver Elementary Schools Area Counsellor Services and the Area Counsellor Training Program. A Study Prepared for the Vancouver School Board. Research Report No. 75-03.

ERIC Educational Resources Information Center

Kitley, Philip J.

This study is concerned with an examination of the area counsellor services in Vancouver elementary schools and the support program of training for area counsellors. Information, opinions and suggestions were sought from a wide number of individuals and agencies having some connection with or interest in the services. It is recognized first of all…

A cost-benefit/cost-effectiveness analysis of an unsanctioned supervised smoking facility in the Downtown Eastside of Vancouver, Canada.

PubMed

Jozaghi, Ehsan

2014-11-13

Smoking crack involves the risk of transmitting diseases such as HIV and hepatitis C (HCV). The current study determines whether the formerly unsanctioned supervised smoking facility (SSF)-operated by the grassroot organization, Vancouver Area Network of Drug Users (VANDU) for the last few years-costs less than the costs incurred for health-care services as a direct consequence of not having such a program in Vancouver, Canada. The data pertaining to the attendance at the SSF was gathered in 2012-2013 by VANDU. By relying on this data, a mathematical model was employed to estimate the number of HCV infections prevented by the former facility in Vancouver's Downtown Eastside (DTES). The DTES SSF's benefit-cost ratio was conservatively estimated at 12.1:1 due to its low operating cost. The study used 70% and 90% initial pipe-sharing rates for sensitivity analysis. At 80% sharing rate, the marginal HCV cases prevented were determined to be 55 cases. Moreover, at 80% sharing rate, the marginal cost-effectiveness ratio ranges from $1,705 to $97,203. The results from both the baseline and sensitivity analysis demonstrated that the establishment of the SSF by VANDU on average had annually saved CAD$1.8 million dollars in taxpayer's money. Funding SSFs in Vancouver is an efficient and effective use of financial resources in the public health domain; therefore, Vancouver Coastal Health should actively participate in their establishment in order to reduce HCV and other blood-borne infections such as HIV within the non-injecting drug users.

Botulism from chopped garlic: delayed recognition of a major outbreak.

PubMed

St Louis, M E; Peck, S H; Bowering, D; Morgan, G B; Blatherwick, J; Banerjee, S; Kettyls, G D; Black, W A; Milling, M E; Hauschild, A H

1988-03-01

Diagnosis of botulism in two teenaged sisters in Montreal led to the identification of 36 previously unrecognized cases of type B botulism in persons who had eaten at a restaurant in Vancouver, British Columbia, during the preceding 6 weeks. A case-control study implicated a new vehicle for botulism, commercial chopped garlic in soybean oil (P less than 10(-4)). Relatively mild and slowly progressive illness, dispersion of patients over at least eight provinces and states in three countries, and a previously unsuspected vehicle had contributed to prolonged misdiagnoses, including myasthenia gravis (six patients), psychiatric disorders (four), stroke (three), and others. Ethnic background influenced severity of illness: 60% of Chinese patients but only 4% of others needed mechanical ventilation (P less than 10(-3]. Trypsinization of serum was needed to show toxemia in one patient. Electromyography results with high-frequency repetitive stimulation corroborated the diagnosis of botulism up to 2 months after onset. Although botulism is a life-threatening disease, misdiagnosis may be common and large outbreaks can escape recognition completely.

YELLOW-BLOTCH DISEASE OUTBREAK ON REEFS OF THE SAN BLAS ISLANDS, PANAMA

EPA Science Inventory

During the post-8th International Coral Reef Symposium field trip to the eastern Caribbean region of Panama, 3-5 July 1996, we observed an extensive outbreak of a new and significant disease of the scleractinian corals Montastraea faveolata and M. annularis. The first reported si...

Telling our stories: heroin-assisted treatment and SNAP activism in the Downtown Eastside of Vancouver.

PubMed

Boyd, Susan; Murray, Dave; MacPherson, Donald

2017-05-18

This article highlights the experiences of a peer-run group, SALOME/NAOMI Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada. SNAP is a unique independent peer- run drug user group that formed in 2011 following Canada's first heroin-assisted treatment trial (HAT), North America Opiate Medication Initiative (NAOMI). SNAP's members are now made up of former research participants who participated in two heroin-assisted trials in Vancouver. This article highlights SNAP members' experiences as research subjects in Canada's second clinical trial conducted in Vancouver, Study to Assess Longer-term Opioid Medication Effectiveness (SALOME), that began recruitment of research participants in 2011. This paper draws on one brainstorming session, three focus groups, and field notes, with the SALOME/NAOMI Association of Patients (SNAP) in late 2013 about their experiences as research subjects in Canada's second clinical trial, SALOME in the DTES of Vancouver, and fieldwork from a 6-year period (March 2011 to February 2017) with SNAP members. SNAP's research draws on research principles developed by drug user groups and critical methodological frameworks on community-based research for social justice. The results illuminate how participating in the SALOME clinical trial impacted the lives of SNAP members. In addition, the findings reveal how SNAP member's advocacy for HAT impacts the group in positive ways. Seven major themes emerged from the analysis of the brainstorming and focus groups: life prior to SALOME, the clinic setting and routine, stability, 6-month transition, support, exiting the trial and ethics, and collective action, including their participation in a constitutional challenge in the Supreme Court of BC to continue receiving HAT once the SALOME trial ended. HAT benefits SNAP members. They argue that permanent HAT programs should be established in Canada because they are an effective harm reduction

Outbreak patterns of the novel avian influenza (H7N9)

NASA Astrophysics Data System (ADS)

Pan, Ya-Nan; Lou, Jing-Jing; Han, Xiao-Pu

2014-05-01

The attack of novel avian influenza (H7N9) in East China caused a serious health crisis and public panic. In this paper, we empirically analyze the onset patterns of human cases of the novel avian influenza and observe several spatial and temporal properties that are similar to other infectious diseases. More specifically, using the empirical analysis and modeling studies, we find that the spatio-temporal network that connects the cities with human cases along the order of outbreak timing emerges two-regime-power-law edge-length distribution, indicating the picture that several islands with higher and heterogeneous risk straggle in East China. The proposed method is applicable to the analysis of the spreading situation in the early stage of disease outbreak using quite limited dataset.

Technical memoranda : ITS early deployment program : I-5 Seattle to Vancouver B.C.

DOT National Transportation Integrated Search

1998-01-01

The I-5 Seattle to Vancouver B.C. study is intended to provide the Washington State Department of Transportation (WSDOT) with an implementation plan for the deployment of ITS technologies along Interstate 5 from the U.S./Canadian international border...

Formation of a Volunteer Harmful Algal Bloom Network in British Columbia, Canada, Following an Outbreak of Diarrhetic Shellfish Poisoning

PubMed Central

McIntyre, Lorraine; Cassis, David; Haigh, Nicola

2013-01-01

Evidence for shellfish toxin illness in British Columbia (BC) on the west coast of Canada can be traced back to 1793. For over two hundred years, domestically acquired bivalve shellfish toxin illnesses in BC were solely ascribed to paralytic shellfish poisonings caused by algal blooms of Alexandrium. This changed in 2011, when BC experienced its first outbreak of diarrhetic shellfish poisoning (DSP). As a result of this outbreak, Canada’s first DSP symposium was held in November, 2012, in North Vancouver, BC. Three of the objectives of the symposium were to provide a forum to educate key stakeholders on this emerging issue, to identify research and surveillance priorities and to create a DSP network. The purpose of this paper is to review what is known about shellfish poisoning in BC and to describe a novel volunteer network that arose following the symposium. The newly formed network was designed for industry shellfish growers to identify harmful algae bloom events, so that they may take actions to mitigate the effects of harmful blooms on shellfish morbidity. The network will also inform public health and regulatory stakeholders of potentially emerging issues in shellfish growing areas. PMID:24172211

Identification of Spilled Oil from the MV Marathassa (Vancouver, Canada 2015) Using Alkyl PAH Isomer Ratios.

PubMed

Morales-Caselles, Carmen; Yunker, Mark B; Ross, Peter S

2017-07-01

On the morning of April 9, 2015, citizens in Vancouver (British Columbia, Canada) awoke to the sight and smell of oil on the shores of popular downtown beaches. Because the oil also had spread over the shallow seawater intakes for the Vancouver Aquarium, a preliminary screening of samples was performed as a prompt, first response to assess the risks to the Aquarium collection and guide the emergency operational response. A subsequent, more detailed examination for the presence of spilled oil in sediment, biota and water samples from the Vancouver Harbour region was then conducted based on the analysis of a large suite of alkanes, petroleum biomarkers, parent polycyclic aromatic hydrocarbons (PAHs) and alkyl PAH isomers. Most of the commonly applied biomarker ratios exhibit similar values for the spilled oil, Alberta oil (the main petroleum source for British Columbia), and pre-spill and un-oiled sediment samples. In contrast, alkyl PAH isomer ratios showed a clear distinction between the spilled oil and pre-spill samples, with the largest differences shown by isomers of the methyl fluoranthene/pyrene alkyl PAH series. This novel use of alkyl PAH isomers for fingerprinting petroleum helped to confirm the grain carrier MV Marathassa as the source of the oil that affected beach and mussel samples to document definitively the spread of the oil and to establish which samples contained a mix of the oil and hydrocarbons linked to historical activities. Finally, an initial evaluation of the biological risks of the MV Marathassa oil spill in Vancouver Harbour showed that oiled beach sediments had priority parent PAH concentrations that are likely to harm marine life.

Variation in Ground Shaking on the Fraser River Delta (Greater Vancouver, Canada)

NASA Astrophysics Data System (ADS)

Cassidy, J. F.; Rogers, G. R.

2003-04-01

The thick, soft soils of the Fraser River delta, just south of Vancouver, Canada, are home to critical infrastructure such as one of North America's busiest port facilities, Canada's second busiest airport, and key transportation and power-transmission facilities for 2-3 million people. This area is also one of the most seismically active regions in Canada. We have utilised recent three-component, digital records of recent moderate (1996 M=5.1 at 200 km distance, 1997 M=4.3 at 40 km distance) and large (2001 M=6.8 at 300 km distance) earthquakes to examine the response to seismic shaking in the greater Vancouver, region, with an emphasis on the site response of the Fraser River delta. These suites of accelerograms have relatively low amplitudes (maximums of 0.015g for the 1996 records, 0.024g for the 1997 records, and 0.035g for the 2001 records). The 1997 data set is significant as it contains the first three-component recordings made on bedrock in greater Vancouver, and the 2001 data set is significant as it contains long-period signal (1-10 second energy). Using the method of spectral ratios, we estimate the site response for each of the strong motion instrument soil sites. Our results show frequency-dependent amplification, with factors of up to 12 times (relative to competent bedrock) near the edge of the delta. Here, the amplification is observed over a relatively narrow frequency range of 1.5-4 Hz (0.25-0.67 s period). Near the centre of the delta(where the soft soils are thickest) peak amplification of 4-10 times(relative to competent bedrock) is measured. Relative to firm soil, the peak amplification ranges from 2-5 for the thick soil delta centre sites, and 2-6 for the delta edge sites. At higher frequencies, little or no amplification, and in many cases slight attenuation is observed. The more distant earthquakes (200-300 km) present a simpler and more predictable picture of ground motion variation than that of the 1997 earthquake (40 km distant). The

In back alleys near Vancouver's AIDS conference, the disease was gaining ground.

PubMed Central

Cairney, R

1996-01-01

There was much more to this summer's international AIDS conference in Vancouver than reports by researchers. Richard Cairney says the $15-million conference attracted a mix of activists, demonstrators, physicians and business representatives, and they coexisted somewhat uneasily. Images p1161-a p1161-b p1163-a PMID:8873643

Classical Swine Fever Outbreak after Modified Live LOM Strain Vaccination in Naive Pigs, South Korea

PubMed Central

Je, Sang H.; Kwon, Taeyong; Yoo, Sung J.; Lee, Dong-Uk; Lee, SeungYoon; Richt, Juergen A.

2018-01-01

We report classical swine fever outbreaks occurring in naive pig herds on Jeju Island, South Korea, after the introduction of the LOM vaccine strain. Two isolates from sick pigs had >99% identity with the vaccine stain. LOM strain does not appear safe; its use in the vaccine should be reconsidered. PMID:29553332

Explaining rapid reinfections in multiple-wave influenza outbreaks: Tristan da Cunha 1971 epidemic as a case study

PubMed Central

Camacho, Anton; Ballesteros, Sébastien; Graham, Andrea L.; Carrat, Fabrice; Ratmann, Oliver; Cazelles, Bernard

2011-01-01

Influenza usually spreads through the human population in multiple-wave outbreaks. Successive reinfection of individuals over a short time interval has been explicitly reported during past pandemics. However, the causes of rapid reinfection and the role of reinfection in driving multiple-wave outbreaks remain poorly understood. To investigate these issues, we focus on a two-wave influenza A/H3N2 epidemic that occurred on the remote island of Tristan da Cunha in 1971. Over 59 days, 273 (96%) of 284 islanders experienced at least one attack and 92 (32%) experienced two attacks. We formulate six mathematical models invoking a variety of antigenic and immunological reinfection mechanisms. Using a maximum-likelihood analysis to confront model predictions with the reported incidence time series, we demonstrate that only two mechanisms can be retained: some hosts with either a delayed or deficient humoral immune response to the primary influenza infection were reinfected by the same strain, thus initiating the second epidemic wave. Both mechanisms are supported by previous empirical studies and may arise from a combination of genetic and ecological causes. We advocate that a better understanding and account of heterogeneity in the human immune response are essential to analysis of multiple-wave influenza outbreaks and pandemic planning. PMID:21525058

Immigrants as Active Citizens: Exploring the Volunteering Experience of Chinese Immigrants in Vancouver

ERIC Educational Resources Information Center

Guo, Shibao

2014-01-01

Despite the fact that immigration has played an important role in transforming Canada into an ethno-culturally diverse and economically prosperous nation, immigrants themselves are often criticised as passive citizens. This study attempts to deconstruct this myth by investigating the volunteering experiences of Chinese immigrants in Vancouver. The…

Adventure Education and the Acculturation of First-Generation Chinese Canadians in Vancouver, Canada

ERIC Educational Resources Information Center

Lo, Simon; Gidlow, Bob; Cushman, Grant

2014-01-01

This article reports on research that demonstrates how parents in first-generation Chinese families in Vancouver, Canada, most of them from Hong Kong, control their children's involvement in local adventure education (AE) programs and in so doing minimize the likelihood of intergenerational culture conflict involving those children. The research…

Implications for Counselling Asian Transnational Youth: The Experiences of Taiwanese Youth in Vancouver

ERIC Educational Resources Information Center

Petersen, Leah; Park-Saltzman, Jeeseon

2010-01-01

Using a phenomenological approach, this study sought to explore the long-term psychological impact of families' transnational separation on children through the lenses of Taiwanese youth in Vancouver. Over time, most participants found themselves in a position of an "ambivalent outsider," with an increased sense of uncertainty about…

Fleas of Small Mammals on Reunion Island: Diversity, Distribution and Epidemiological Consequences

PubMed Central

Guernier, Vanina; Lagadec, Erwan; LeMinter, Gildas; Licciardi, Séverine; Balleydier, Elsa; Pagès, Frédéric; Laudisoit, Anne; Dellagi, Koussay; Tortosa, Pablo

2014-01-01

The diversity and geographical distribution of fleas parasitizing small mammals have been poorly investigated on Indian Ocean islands with the exception of Madagascar where endemic plague has stimulated extensive research on these arthropod vectors. In the context of an emerging flea-borne murine typhus outbreak that occurred recently in Reunion Island, we explored fleas' diversity, distribution and host specificity on Reunion Island. Small mammal hosts belonging to five introduced species were trapped from November 2012 to November 2013 along two altitudinal transects, one on the windward eastern and one on the leeward western sides of the island. A total of 960 animals were trapped, and 286 fleas were morphologically and molecularly identified. Four species were reported: (i) two cosmopolitan Xenopsylla species which appeared by far as the prominent species, X. cheopis and X. brasiliensis; (ii) fewer fleas belonging to Echidnophaga gallinacea and Leptopsylla segnis. Rattus rattus was found to be the most abundant host species in our sample, and also the most parasitized host, predominantly by X. cheopis. A marked decrease in flea abundance was observed during the cool-dry season, which indicates seasonal fluctuation in infestation. Importantly, our data reveal that flea abundance was strongly biased on the island, with 81% of all collected fleas coming from the western dry side and no Xenopsylla flea collected on almost four hundred rodents trapped along the windward humid eastern side. The possible consequences of this sharp spatio-temporal pattern are discussed in terms of flea-borne disease risks in Reunion Island, particularly with regard to plague and the currently emerging murine typhus outbreak. PMID:25188026

Going Social at Vancouver Public Library: What the Virtual Branch Did Next

ERIC Educational Resources Information Center

Cahill, Kay

2011-01-01

Purpose: The purpose of this paper is to follow up on the 2009 publication "Building a virtual branch at Vancouver Public Library (VPL) using Web 2.0 tools" and to explore the work that VPL has been doing in the social media space over the past two years. Design/methodology/approach: Following the launch of its new web site in 2008,…

Dynamics and ecological consequences of the 2013−2014 koa moth outbreak at Hakalau Forest National Wildlife Refuge.

USGS Publications Warehouse

Banko, Paul C.; Peck, Robert W.; Yelenik, Stephanie G.; Paxton, Eben H.; Bonaccorso, Frank J.; Montoya-Aiona, Kristina; Foote, David

2014-01-01

A massive outbreak of the koa moth (Geometridea: Scotorythra paludicola) defoliated more than a third of the koa (Acacia koa) forest on Hawai‘i Island during 2013−2014. This was the largest koa moth outbreak ever recorded and the first on the island since 1953. The outbreak spread to sites distributed widely around the island between 800−2,000 m elevation and in wet rainforest to dry woodland habitats. We monitored the outbreak at two windward forest sites (Laupāhoehoe and Saddle Road Kīpuka) and one leeward forest site (Kona), and we studied the dynamics of the outbreak and its impacts on the forest ecosystem at Hakalau Forest National Wildlife Refuge, our higher elevation windward site. Study sites at Hakalau included two stands of koa that were planted (reforestation stands) in former cattle pastureland about 20 years earlier and two stands of koa that were dominated by ‘ōhi‘a (Metrosideros polymorpha) and that were naturally recovering from cattle grazing (forest stands). We observed one outbreak at Hakalau, multiple outbreaks at the two other windward sites, but no outbreak at the leeward site. Caterpillars at Hakalau reached peak estimated abundances of more than 250,000 per tree and 18,000,000 per hectare, and they removed between 64−93% of the koa canopy in managed forest stands. Defoliation was more extensive in naturally recovering forest, where ‘ōhi‘a dominated and koa was less abundant, compared to the planted stands, where koa density was high. Koa trees were still growing new foliage six months after being defoliated, and leaves were produced in greater proportion to phyllodes, especially by small koa (≤ 8 cm dbh) and by larger trees in forest stands, where light levels may have remained relatively low after defoliation due to the high cover of ‘ōhi‘a. Small branches of many trees apparently died, and canopy regrowth was absent or low in 9% of koa trees and seedlings, which indicates the likely level of mortality. Between 2

First isolation of Mycoplasma capricolum subsp. capricolum, one of the causal agents of caprine contagious agalactia, on the island of Lanzarote (Spain).

PubMed

De la Fe, C; Gutiérrez, A; Poveda, J B; Assunção, P; Ramírez, A S; Fabelo, F

2007-03-01

During an unusually long period of bad weather, several outbreaks of caprine contagious agalactia (CCA) were reported in a number of flocks on the island of Lanzarote (Canary Islands, Spain). Clinical and subclinical mastitis in lactating goats and some cases of arthritis and pneumonia in kids were observed in the affected flocks. Mycoplasma capricolum subsp. capricolum was isolated as the main causal agent of the outbreaks, associated with M. mycoides subsp. mycoides "large colony type" (Mmm LC) in two flocks. This is the first report of an isolation of M. capricolum subsp. capricolum on the island of Lanzarote. The finding is of epidemiological importance and could complicate plans to control the disease. The significance of this mycoplasma species in association with CCA must now be studied in detail.

Navigating identity, territorial stigma, and HIV care services in Vancouver, Canada: A qualitative study.

PubMed

Collins, Alexandra B; Parashar, Surita; Closson, Kalysha; Turje, Rosalind Baltzer; Strike, Carol; McNeil, Ryan

2016-07-01

This study examines the influence of territorial stigma on access to HIV care and other support services. Qualitative interviews were conducted with thirty people living with HIV (PLHIV) who use drugs recruited from the Dr. Peter Centre (DPC), an HIV care facility located in Vancouver, Canada's West End neighbourhood that operates under a harm reduction approach. Findings demonstrated that territorial stigma can undermine access to critical support services and resources in spatially stigmatized neighbourhoods among PLHIV who use drugs who have relocated elsewhere. Furthermore, PLHIV moving from spatially stigmatized neighbourhoods - in this case, Vancouver's Downtown Eastside - to access HIV care services experienced tension with different groups at the DPC (e.g., men who have sex with me, people who use drugs), as these groups sought to define who constituted a'normative' client. Collectively, these findings demonstrate the urgent need to consider the siting of HIV care services as the epidemic evolves. Copyright © 2016 Elsevier Ltd. All rights reserved.

The 2012 Madeira dengue outbreak: epidemiological determinants and future epidemic potential.

PubMed

Lourenço, José; Recker, Mario

2014-08-01

Dengue, a vector-borne viral disease of increasing global importance, is classically associated with tropical and sub-tropical regions around the world. Urbanisation, globalisation and climate trends, however, are facilitating the geographic spread of its mosquito vectors, thereby increasing the risk of the virus establishing itself in previously unaffected areas and causing large-scale epidemics. On 3 October 2012, two autochthonous dengue infections were reported within the Autonomous Region of Madeira, Portugal. During the following seven months, this first 'European' dengue outbreak caused more than 2000 local cases and 81 exported cases to mainland Europe. Here, using an ento-epidemiological mathematical framework, we estimate that the introduction of dengue to Madeira occurred around a month before the first official cases, during the period of maximum influx of airline travel, and that the naturally declining temperatures of autumn were the determining factor for the outbreak's demise in early December 2012. Using key estimates, together with local climate data, we further propose that there is little support for dengue endemicity on this island, but a high potential for future epidemic outbreaks when seeded between May and August-a period when detection of imported cases is crucial for Madeira's public health planning.

Emergence of influenza A (H1N1) PDM09 in the remote Islands of India--a molecular approach.

PubMed

Muruganandam, N; Bhattacharya, D; Chaaithanya, I K; Bhattacharya, H; Reesu, R; Maile, A; Bharathi, G S J; Sugunan, A P; Vijayachari, P

2015-01-01

A disease outbreak of A (H1N1) PDM09 was reported in Andaman and Nicobar islands in 2009 with an attack rate of 33.5% among settler population and 26.3% among the aboriginal Nicobarese tribe. During the ongoing outbreak of A (H1N1) PDM09 disease in different parts of the world, a subject working in Dubai city of Saudi Arabia, came to Port Blair, following which the pandemic triggered for the first time in these Islands. During the period August 2009 to January 2011, 30 confirmed cases of Influenza A (H1N1) PDM09 virus infection was detected. To understand the genetic relationship, the NA gene sequences of the viruses were phylogenetically analysed together along with the virus sequence isolated from other parts of the world. Formation of multiple clusters were observed, with the sequences of Andaman Islands, mainland India, Mexico, Saudi Arabia and few other counties clustering together. The sequence analysis data revealed that there was no specific mutation conferring resistance to oseltamivir among the Andaman A (H1N1) PDM09 virus isolates. The result of phylogenetic analysis have also revealed that the A (H1N1) PDM09 virus might have spread in these remote Islands of India via the subject from Saudi Arabia/Dubai. A (H1N1) PDM09 Influenza outbreak have highlighted the need to strengthen the region-specific pandemic preparedness plans and surveillance strategies.

Building a Virtual Branch at Vancouver Public Library Using Web 2.0 Tools

ERIC Educational Resources Information Center

Cahill, Kay

2009-01-01

Purpose: The purpose of this paper is to demonstrate the work undertaken by Vancouver Public Library (VPL) in an effort to convert its website into a true virtual branch, both through the functionality of the website itself and by extending its web presence on to external social networking sites. Design/methodology/approach: VPL worked with its…

First reported chikungunya fever outbreak in the republic of Congo, 2011.

PubMed

Moyen, Nanikaly; Thiberville, Simon-Djamel; Pastorino, Boris; Nougairede, Antoine; Thirion, Laurence; Mombouli, Jean-Vivien; Dimi, Yannick; Leparc-Goffart, Isabelle; Capobianchi, Maria Rosaria; Lepfoundzou, Amelia Dzia; de Lamballerie, Xavier

2014-01-01

Chikungunya is an Aedes -borne disease characterised by febrile arthralgia and responsible for massive outbreaks. We present a prospective clinical cohort study and a retrospective serological study relating to a CHIK outbreak, in the Republic of Congo in 2011. We analysed 317 suspected cases, of which 308 (97.2%) lived in the city of Brazzaville (66.6% in the South area). Amongst them, 37 (11.7%) were CHIKV+ve patients (i.e., biologically confirmed by a real-time RT-PCR assay), of whom 36 (97.3%) had fever, 22 (66.7%) myalgia and 32 (86.5%) arthralgia. All tested negative for dengue. The distribution of incident cases within Brazzaville districts was compared with CHIKV seroprevalence before the outbreak (34.4% in 517 blood donors), providing evidence for previous circulation of CHIKV. We applied a CHIK clinical score to 126 patients recruited within the two first day of illness (including 28 CHIKV+ves (22.2%)) with sensitivity (78.6%) and specificity (72.4%) values comparing with those of the referent study in Reunion Island. The negative predictive value was high (92%), but the positive predictive value (45%) indicate poor potential contribution to medical practice to identify CHIKV+ve patients in low prevalence outbreaks. However, the score allowed a slightly more accurate follow-up of the evolution of the outbreak than the criterion "fever+arthralgia". The complete sequencing of a Congolase isolate (Brazza_MRS1) demonstrated belonging to the East/Central/South African lineage and was further used for producing a robust genome-scale CHIKV phylogenetic analysis. We describe the first Chikungunya outbreak declared in the Republic of Congo. The seroprevalence study conducted amongst blood donors before outbreak provided evidence for previous CHIKV circulation. We suggest that a more systematic survey of the entomological situation and of arbovirus circulation is necessary in Central Africa for better understanding the environmental, microbiological and

First Reported Chikungunya Fever Outbreak in the Republic of Congo, 2011

PubMed Central

Pastorino, Boris; Nougairede, Antoine; Thirion, Laurence; Mombouli, Jean-Vivien; Dimi, Yannick; Leparc-Goffart, Isabelle; Capobianchi, Maria Rosaria; Lepfoundzou, Amelia Dzia; de Lamballerie, Xavier

2014-01-01

Background Chikungunya is an Aedes -borne disease characterised by febrile arthralgia and responsible for massive outbreaks. We present a prospective clinical cohort study and a retrospective serological study relating to a CHIK outbreak, in the Republic of Congo in 2011. Methodology and Findings We analysed 317 suspected cases, of which 308 (97.2%) lived in the city of Brazzaville (66.6% in the South area). Amongst them, 37 (11.7%) were CHIKV+ve patients (i.e., biologically confirmed by a real-time RT-PCR assay), of whom 36 (97.3%) had fever, 22 (66.7%) myalgia and 32 (86.5%) arthralgia. All tested negative for dengue. The distribution of incident cases within Brazzaville districts was compared with CHIKV seroprevalence before the outbreak (34.4% in 517 blood donors), providing evidence for previous circulation of CHIKV. We applied a CHIK clinical score to 126 patients recruited within the two first day of illness (including 28 CHIKV+ves (22.2%)) with sensitivity (78.6%) and specificity (72.4%) values comparing with those of the referent study in Reunion Island. The negative predictive value was high (92%), but the positive predictive value (45%) indicate poor potential contribution to medical practice to identify CHIKV+ve patients in low prevalence outbreaks. However, the score allowed a slightly more accurate follow-up of the evolution of the outbreak than the criterion "fever+arthralgia". The complete sequencing of a Congolase isolate (Brazza_MRS1) demonstrated belonging to the East/Central/South African lineage and was further used for producing a robust genome-scale CHIKV phylogenetic analysis. Conclusions/Significance We describe the first Chikungunya outbreak declared in the Republic of Congo. The seroprevalence study conducted amongst blood donors before outbreak provided evidence for previous CHIKV circulation. We suggest that a more systematic survey of the entomological situation and of arbovirus circulation is necessary in Central Africa for better

Surveillance for waterborne disease and outbreaks associated with recreational water--United States, 2003-2004.

PubMed

Dziuban, Eric J; Liang, Jennifer L; Craun, Gunther F; Hill, Vincent; Yu, Patricia A; Painter, John; Moore, Matthew R; Calderon, Rebecca L; Roy, Sharon L; Beach, Michael J

2006-12-22

Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaboratively maintained the Waterborne Disease and Outbreak Surveillance System for collecting and reporting waterborne disease and outbreak (WBDO)-related data. In 1978, WBDOs associated with recreational water (natural and treated water) were added. This system is the primary source of data regarding the scope and effects of WBDOs in the United States. Data presented summarize WBDOs associated with recreational water that occurred during January 2003-December 2004 and one previously unreported outbreak from 2002. Public health departments in the states, territories, localities, and the Freely Associated States (i.e., the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau, formerly parts of the U.S.-administered Trust Territory of the Pacific Islands) have primary responsibility for detecting, investigating, and voluntarily reporting WBDOs to CDC. Although the surveillance system includes data for WBDOs associated with drinking water, recreational water, and water not intended for drinking, only cases and outbreaks associated with recreational water are summarized in this report. During 2003-2004, a total 62 WBDOs associated with recreational water were reported by 26 states and Guam. Illness occurred in 2,698 persons, resulting in 58 hospitalizations and one death. The median outbreak size was 14 persons (range: 1-617 persons). Of the 62 WBDOs, 30 (48.4%) were outbreaks of gastroenteritis that resulted from infectious agents, chemicals, or toxins; 13 (21.0%) were outbreaks of dermatitis; and seven (11.3%) were outbreaks of acute respiratory illness (ARI). The remaining 12 WBDOs resulted in primary amebic meningoencephalitis (n = one), meningitis (n = one), leptospirosis (n = one), otitis externa (n = one), and mixed illnesses (n = eight). WBDOs associated with gastroenteritis resulted in 1,945 (72

Evolutionary history and phylogeography of rabies viruses associated with outbreaks in Trinidad.

PubMed

Seetahal, Janine F R; Velasco-Villa, Andres; Allicock, Orchid M; Adesiyun, Abiodun A; Bissessar, Joseph; Amour, Kirk; Phillip-Hosein, Annmarie; Marston, Denise A; McElhinney, Lorraine M; Shi, Mang; Wharwood, Cheryl-Ann; Fooks, Anthony R; Carrington, Christine V F

2013-01-01

Bat rabies is an emerging disease of public health significance in the Americas. The Caribbean island of Trinidad experiences periodic outbreaks within the livestock population. We performed molecular characterisation of Trinidad rabies virus (RABV) and used a Bayesian phylogeographic approach to investigate the extent to which outbreaks are a result of in situ evolution versus importation of virus from the nearby South American mainland. Trinidadian RABV sequences were confirmed as bat variant and clustered with Desmodus rotundus (vampire bat) related sequences. They fell into two largely temporally defined lineages designated Trinidad I and II. The Trinidad I lineage which included sequences from 1997-2000 (all but two of which were from the northeast of the island) was most closely related to RABV from Ecuador (2005, 2007), French Guiana (1990) and Venezuela (1993, 1994). Trinidad II comprised sequences from the southwest of the island, which clustered into two groups: Trinidad IIa, which included one sequence each from 2000 and 2007, and Trinidad IIb including all 2010 sequences. The Trinidad II sequences were most closely related to sequences from Brazil (1999, 2004) and Uruguay (2007, 2008). Phylogeographic analyses support three separate RABV introductions from the mainland from which each of the three Trinidadian lineages arose. The estimated dates for the introductions and subsequent lineage expansions suggest periods of in situ evolution within Trinidad following each introduction. These data also indicate co-circulation of Trinidad lineage I and IIa during 2000. In light of these findings and the likely vampire bat origin of Trinidadian RABV, further studies should be conducted to investigate the relationship between RABV spatiotemporal dynamics and vampire bat population ecology, in particular any movement between the mainland and Trinidad.

Embracing a New Understanding of the City: The Museum of Vancouver's Vision in Action

ERIC Educational Resources Information Center

Gosselin, Viviane

2013-01-01

The Museum of Vancouver recently undertook a major rethinking of its role in the city. New interplays are being proposed between emerging conceptions of urbanity and civic participation, and the museum's collection and function as facilitator and advocate. This short paper provides a brief overview of the museum's recent transformation, situates…

Climate teleconnections and recent patterns of human and animal disease outbreaks.

PubMed

Anyamba, Assaf; Linthicum, Kenneth J; Small, Jennifer L; Collins, Kathrine M; Tucker, Compton J; Pak, Edwin W; Britch, Seth C; Eastman, James Ronald; Pinzon, Jorge E; Russell, Kevin L

2012-01-01

Recent clusters of outbreaks of mosquito-borne diseases (Rift Valley fever and chikungunya) in Africa and parts of the Indian Ocean islands illustrate how interannual climate variability influences the changing risk patterns of disease outbreaks. Although Rift Valley fever outbreaks have been known to follow periods of above-normal rainfall, the timing of the outbreak events has largely been unknown. Similarly, there is inadequate knowledge on climate drivers of chikungunya outbreaks. We analyze a variety of climate and satellite-derived vegetation measurements to explain the coupling between patterns of climate variability and disease outbreaks of Rift Valley fever and chikungunya. We derived a teleconnections map by correlating long-term monthly global precipitation data with the NINO3.4 sea surface temperature (SST) anomaly index. This map identifies regional hot-spots where rainfall variability may have an influence on the ecology of vector borne disease. Among the regions are Eastern and Southern Africa where outbreaks of chikungunya and Rift Valley fever occurred 2004-2009. Chikungunya and Rift Valley fever case locations were mapped to corresponding climate data anomalies to understand associations between specific anomaly patterns in ecological and climate variables and disease outbreak patterns through space and time. From these maps we explored associations among Rift Valley fever disease occurrence locations and cumulative rainfall and vegetation index anomalies. We illustrated the time lag between the driving climate conditions and the timing of the first case of Rift Valley fever. Results showed that reported outbreaks of Rift Valley fever occurred after ∼3-4 months of sustained above-normal rainfall and associated green-up in vegetation, conditions ideal for Rift Valley fever mosquito vectors. For chikungunya we explored associations among surface air temperature, precipitation anomalies, and chikungunya outbreak locations. We found that chikungunya

Injecting Drugs in Tight Spaces: HIV, Cocaine and Collinearity in the Downtown Eastside, Vancouver, BC

PubMed Central

Ciccarone, Daniel; Bourgois, Philippe

2016-01-01

This commentary revisits the political turmoil and scientific controversy over epidemiological study findings linking high HIV seroincidence to syringe exchange attendance in Vancouver in the mid-1990s. The association was mobilized polemically by US politicians and hard-line drug warriors to attack needle exchange policies and funding. In turn, program restrictions limiting access to syringes at the Vancouver exchange may have interfaced with a complex conjunction of historical, geographic, political economic and cultural forces and physiological vulnerabilities to create an extraordinary HIV risk environment: 1) ghettoization of services for indigent populations in a rapidly gentrifying, post-industrial city; 2) rural-urban migration of vulnerable populations subject to historical colonization and current patterns of racism; and 3) the flooding of North America with inexpensive powder cocaine and heroin, and the popularity of crack. In fact, we will never know with certainty the precise cause for the extreme seroincidence rates in Vancouver in the early to mid-1990s. The tendency for modern social epidemiology to decontextualize research subjects and assign excessive importance to discrete, “magic bullet” variables resulted in a counterproductive scientific and political debate in the late 1990s that has obfuscated potentially useful practical lessons for organizing the logistics of harm reduction services–especially syringe exchange–to better serve the needs of vulnerable populations and to mitigate the effects of political-economically imposed HIV risk environments. We would benefit from humbly acknowledging the limits of public health science and learn to recognize the unintended consequences of well-intentioned interventions rather than sweep embarrassing histories under the rug. PMID:27117187

Environmental management of mosquito-borne viruses in Rhode Island

USGS Publications Warehouse

Ginsberg, Howard S.; Gettman, Alan; Becker, Elisabeth; Bandyopadhyay, Ananda S.; LeBrun, Roger A.

2013-01-01

West Nile Virus (WNV) and Eastern Equine Encephalitis Virus (EEEV) are both primarily bird viruses, which can be transmitted by several mosquito species. Differences in larval habitats, flight, and biting patterns of the primary vector species result in substantial differences in epidemiology, with WNV more common, primarily occurring in urban areas, and EEEV relatively rare, typically occurring near swamp habitats. The complex transmission ecology of these viruses complicates prediction of disease outbreaks. The Rhode Island Department of Environmental Management (DEM) and Department of Health (DoH) provide prevention assistance to towns and maintain a mosquito surveillance program to identify potential disease risk. Responses to potential outbreaks follow a protocol based on surveillance results, assessment of human risk, and technical consultation.

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

PubMed Central

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

2012-01-01

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

Cyanotoxins are not implicated in the etiology of coral black band disease outbreaks on Pelorus Island, Great Barrier Reef.

PubMed

Glas, Martin S; Motti, Cherie A; Negri, Andrew P; Sato, Yui; Froscio, Suzanne; Humpage, Andrew R; Krock, Bernd; Cembella, Allan; Bourne, David G

2010-07-01

Cyanobacterial toxins (i.e. microcystins) produced within the microbial mat of coral black band disease (BBD) have been implicated in disease pathogenicity. This study investigated the presence of toxins within BBD lesions and other cyanobacterial patch (CP) lesions, which, in some instances ( approximately 19%), facilitated the onset of BBD, from an outbreak site at Pelorus Island on the inshore, central Great Barrier Reef (GBR). Cyanobacterial species that dominated the biomass of CP and BBD lesions were cultivated and identified, based on morphology and 16S rRNA gene sequences, as Blennothrix- and Oscillatoria-affiliated species, respectively, and identical to cyanobacterial sequences retrieved from previous molecular studies from this site. The presence of the cyanotoxins microcystin, cylindrospermopsin, saxitoxin, nodularin and anatoxin and their respective gene operons in field samples of CP and BBD lesions and their respective culture isolations was tested using genetic (PCR-based screenings), chemical (HPLC-UV, FTICR-MS and LC/MS(n)) and biochemical (PP2A) methods. Cyanotoxins and cyanotoxin synthetase genes were not detected in any of the samples. Cyanobacterial species dominant within CP and BBD lesions were phylogenetically distinct from species previously shown to produce cyanotoxins and isolated from BBD lesions. The results from this study demonstrate that cyanobacterial toxins appear to play no role in the pathogenicity of CP and BBD at this site on the GBR.

Outbreak investigations--a perspective.

PubMed Central

Reingold, A. L.

1998-01-01

Outbreak investigations, an important and challenging component of epidemiology and public health, can help identify the source of ongoing outbreaks and prevent additional cases. Even when an outbreak is over, a thorough epidemiologic and environmental investigation often can increase our knowledge of a given disease and prevent future outbreaks. Finally, outbreak investigations provide epidemiologic training and foster cooperation between the clinical and public health communities. PMID:9452395

Torres strait islanders and Australian nationhood: Some educational perspectives

NASA Astrophysics Data System (ADS)

Williamson, Alan

1992-01-01

This article analyses the role of education in incorporating Australia's Melanesian minority, the Torres Strait Islanders, into the Australian nation. The analysis begins with the introduction of Queensland government schooling into Torres Strait in 1892, which fostered expectations of Queensland citizenship and employment opportunities available to other races in the economy of the Strait. From 1904 to the outbreak of world war II in the Pacific in 1942 these early directions were altered by educational policies which initially sought to train Islanders for a life in the Islands as a "race apart" from the rest of Australia. Subsequent syllabus reforms, paralleling but not equalling regular schooling offered in Queensland, did not meet Islanders' aspirations for "proper schooling" and the jobs they expected would flow from it. Following world war II, regulations confining Islanders to the Strait were relaxed and many migrated to the Queensland mainland in search of better jobs, better pay, and better education for their children. Those who remained in the Islands received an education which, by 1985, had been brought up to the mainland standard. Yet, neither group's educational aspirations were satisfied despite initiatives and financial incentives of the Commonwealth government aimed at keeping Islander children at school. The article concludes that the way ahead for Islanders in staking out their educational future in the Australian nation on a basis of equality with other Australians lies in educational developments in the Islands themselves, where Islanders are playing an active role in developing, managing, and guiding schooling in directions which recognise their identity and their citizenship aspirations.

The 2012 Madeira Dengue Outbreak: Epidemiological Determinants and Future Epidemic Potential

PubMed Central

Lourenço, José; Recker, Mario

2014-01-01

Dengue, a vector-borne viral disease of increasing global importance, is classically associated with tropical and sub-tropical regions around the world. Urbanisation, globalisation and climate trends, however, are facilitating the geographic spread of its mosquito vectors, thereby increasing the risk of the virus establishing itself in previously unaffected areas and causing large-scale epidemics. On 3 October 2012, two autochthonous dengue infections were reported within the Autonomous Region of Madeira, Portugal. During the following seven months, this first ‘European’ dengue outbreak caused more than 2000 local cases and 81 exported cases to mainland Europe. Here, using an ento-epidemiological mathematical framework, we estimate that the introduction of dengue to Madeira occurred around a month before the first official cases, during the period of maximum influx of airline travel, and that the naturally declining temperatures of autumn were the determining factor for the outbreak's demise in early December 2012. Using key estimates, together with local climate data, we further propose that there is little support for dengue endemicity on this island, but a high potential for future epidemic outbreaks when seeded between May and August—a period when detection of imported cases is crucial for Madeira's public health planning. PMID:25144749

Post-fire forest dynamics and climate variability affect spatial and temporal properties of spruce beetle outbreaks on a Sky Island mountain range

Treesearch

Christopher D. O' Connor; Ann M. Lynch; Donald A. Falk; Thomas W. Swetnam

2014-01-01

The spruce beetle (Dendroctonus rufipennis) is known for extensive outbreaks resulting in high spruce mortality, but several recent outbreaks in the western United States have been among the largest and most severe in the documentary record. In the Pinaleño Mountains of southeast Arizona, U.S.A., an outbreak in the mid-1990s resulted in 85% mortality of Engelmann...

Injecting drugs in tight spaces: HIV, cocaine and collinearity in the Downtown Eastside, Vancouver, Canada.

PubMed

Ciccarone, Daniel; Bourgois, Philippe

2016-07-01

This commentary revisits the political turmoil and scientific controversy over epidemiological study findings linking high HIV seroincidence to syringe exchange attendance in Vancouver in the mid-1990s. The association was mobilized polemically by US politicians and hard-line drug warriors to attack needle exchange policies and funding. In turn, program restrictions limiting access to syringes at the Vancouver exchange may have interfaced with a complex conjunction of historical, geographic, political economic and cultural forces and physiological vulnerabilities to create an extraordinary HIV risk environment: (1) ghettoization of services for indigent populations in a rapidly gentrifying, post-industrial city; (2) rural-urban migration of vulnerable populations subject to historical colonization and current patterns of racism; and (3) the flooding of North America with inexpensive powder cocaine and heroin, and the popularity of crack. In fact, we will never know with certainty the precise cause for the extreme seroincidence rates in Vancouver in the early to mid-1990s. The tendency for modern social epidemiology to decontextualize research subjects and assign excessive importance to discrete, "magic bullet" variables resulted in a counterproductive scientific and political debate in the late 1990s that has obfuscated potentially useful practical lessons for organizing the logistics of harm reduction services - especially syringe exchange - to better serve the needs of vulnerable populations and to mitigate the effects of political-economically imposed HIV risk environments. We would benefit from humbly acknowledging the limits of public health science and learn to recognize the unintended consequences of well-intentioned interventions rather than sweep embarrassing histories under the rug. Copyright © 2016 Elsevier B.V. All rights reserved.

Evolutionary History and Phylogeography of Rabies Viruses Associated with Outbreaks in Trinidad

PubMed Central

Seetahal, Janine F. R.; Velasco-Villa, Andres; Allicock, Orchid M.; Adesiyun, Abiodun A.; Bissessar, Joseph; Amour, Kirk; Phillip-Hosein, Annmarie; Marston, Denise A.; McElhinney, Lorraine M.; Shi, Mang; Wharwood, Cheryl-Ann; Fooks, Anthony R.; Carrington, Christine V. F.

2013-01-01

Bat rabies is an emerging disease of public health significance in the Americas. The Caribbean island of Trinidad experiences periodic outbreaks within the livestock population. We performed molecular characterisation of Trinidad rabies virus (RABV) and used a Bayesian phylogeographic approach to investigate the extent to which outbreaks are a result of in situ evolution versus importation of virus from the nearby South American mainland. Trinidadian RABV sequences were confirmed as bat variant and clustered with Desmodus rotundus (vampire bat) related sequences. They fell into two largely temporally defined lineages designated Trinidad I and II. The Trinidad I lineage which included sequences from 1997–2000 (all but two of which were from the northeast of the island) was most closely related to RABV from Ecuador (2005, 2007), French Guiana (1990) and Venezuela (1993, 1994). Trinidad II comprised sequences from the southwest of the island, which clustered into two groups: Trinidad IIa, which included one sequence each from 2000 and 2007, and Trinidad IIb including all 2010 sequences. The Trinidad II sequences were most closely related to sequences from Brazil (1999, 2004) and Uruguay (2007, 2008). Phylogeographic analyses support three separate RABV introductions from the mainland from which each of the three Trinidadian lineages arose. The estimated dates for the introductions and subsequent lineage expansions suggest periods of in situ evolution within Trinidad following each introduction. These data also indicate co-circulation of Trinidad lineage I and IIa during 2000. In light of these findings and the likely vampire bat origin of Trinidadian RABV, further studies should be conducted to investigate the relationship between RABV spatiotemporal dynamics and vampire bat population ecology, in particular any movement between the mainland and Trinidad. PMID:23991230

Climate Teleconnections and Recent Patterns of Human and Animal Disease Outbreaks

PubMed Central

Anyamba, Assaf; Linthicum, Kenneth J.; Small, Jennifer L.; Collins, Kathrine M.; Tucker, Compton J.; Pak, Edwin W.; Britch, Seth C.; Eastman, James Ronald; Pinzon, Jorge E.; Russell, Kevin L.

2012-01-01

Background Recent clusters of outbreaks of mosquito-borne diseases (Rift Valley fever and chikungunya) in Africa and parts of the Indian Ocean islands illustrate how interannual climate variability influences the changing risk patterns of disease outbreaks. Although Rift Valley fever outbreaks have been known to follow periods of above-normal rainfall, the timing of the outbreak events has largely been unknown. Similarly, there is inadequate knowledge on climate drivers of chikungunya outbreaks. We analyze a variety of climate and satellite-derived vegetation measurements to explain the coupling between patterns of climate variability and disease outbreaks of Rift Valley fever and chikungunya. Methods and Findings We derived a teleconnections map by correlating long-term monthly global precipitation data with the NINO3.4 sea surface temperature (SST) anomaly index. This map identifies regional hot-spots where rainfall variability may have an influence on the ecology of vector borne disease. Among the regions are Eastern and Southern Africa where outbreaks of chikungunya and Rift Valley fever occurred 2004–2009. Chikungunya and Rift Valley fever case locations were mapped to corresponding climate data anomalies to understand associations between specific anomaly patterns in ecological and climate variables and disease outbreak patterns through space and time. From these maps we explored associations among Rift Valley fever disease occurrence locations and cumulative rainfall and vegetation index anomalies. We illustrated the time lag between the driving climate conditions and the timing of the first case of Rift Valley fever. Results showed that reported outbreaks of Rift Valley fever occurred after ∼3–4 months of sustained above-normal rainfall and associated green-up in vegetation, conditions ideal for Rift Valley fever mosquito vectors. For chikungunya we explored associations among surface air temperature, precipitation anomalies, and chikungunya outbreak

Difficult decisions in times of constraint: Criteria based Resource Allocation in the Vancouver Coastal Health Authority

PubMed Central

2011-01-01

Objectives The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year 2010/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities division. Methods A standard approach to program budgeting and marginal analysis (PBMA) was taken with a priority setting working committee and a broader advisory panel. An experienced, non-vested internal project manager worked closely with the two-member external research team throughout the process. Face to face evaluation interviews were held with 10 decision makers immediately following the process. Results The recommendations of the working committee included the implementation of 44 disinvestment initiatives with an annualized value of CAD $4.9 million, as well as consideration of possible investments if the realized savings match expectations. Overall, decision makers viewed the process favorably and the primary aim of addressing the deficit gap was met. Discussion A key challenge was the tight timeline which likely lead to less evidence informed decision making then one would hope for. Despite this, decision makers felt that better decisions were made then had the process not been in place. In the end, this project adds value in finding that PBMA can be used to cover a deficit and minimize opportunity cost through systematic application of criteria whilst ensuring process fairness through focusing on communication, transparency and decision maker engagement. PMID:21756357

Risk factors associated with leptospirosis during an outbreak in Middle Andaman, India.

PubMed

Sugunan, A P; Vijayachari, P; Sharma, S; Roy, Subarna; Manickam, P; Natarajaseenivasan, K; Gupte, M D; Sehgal, S C

2009-07-01

Leptospirosis outbreaks occur frequently in North and South Andaman Islands but not in Middle Andaman. In 2002, an outbreak appeared in Middle Andaman for the first time. Although a study on risk factors was conducted in North Andaman, it used seropositivity to define leptospirosis. Since seropositivity might not indicate current leptospiral infection and as no study on risk factors was conducted in Middle Andaman, we carried out this study to identify the risk factors during the outbreak. A suspected outbreak of leptospirosis occurred in Rangat of Middle Andaman during October - November 2002. Suspected cases were screened for leptospirosis using microscopic agglutination test (MAT). Fifty two patients confirmed to have leptospirosis based on rising titres in MAT on paired sera, and 104 age, sex and neighbourhood seronegative matched controls, were included in the study. A conditional multiple regression by backward elimination process was carried out with acute leptospirosis as the dependent factor and various environmental, occupational and behavioural factors as independent factors. A stratified analysis was also carried out. The presence of cattle in the house, drinking stream water, contact with garbage, walking barefoot and standing in water while working were identified as significant factors associated with leptospirosis. Stratified analysis showed a dose response relationship between number of cattle in the house and the risk of leptospiral infection suugesting that cattle could be a source of infection. Identification of the potential risk factors would help understand the transmission dynamics of the disease and formulate public health interventions.

Coral diversity and the severity of disease outbreaks: a cross-regional comparison of Acropora white syndrome in a species-rich region (American Samoa) with a species-poor region (Northwestern Hawaiian Islands).

USGS Publications Warehouse

Aeby, G.S.; Bourne, D.G.; Wilson, B.; Work, Thierry M.

2011-01-01

The dynamics of the coral disease, Acropora white syndrome (AWS), was directly compared on reefs in the species-poor region of the Northwestern Hawaiian Islands (NWHI) and the species-rich region of American Samoa (AS) with results suggesting that biodiversity, which can affect the abundance of susceptible hosts, is important in influencing the impacts of coral disease outbreaks. The diversity-disease hypothesis predicts that decreased host species diversity should result in increased disease severity of specialist pathogens. We found that AWS was more prevalent and had a higher incidence within the NWHI as compared to AS. Individual Acropora colonies affected by AWS showed high mortality in both regions, but case fatality rate and disease severity was higher in the NWHI. The site within the NWHI had a monospecific stand of A. cytherea; a species that is highly susceptible to AWS. Once AWS entered the site, it spread easily amongst the abundant susceptible hosts. The site within AS contained numerous Acropora species, which differed in their apparent susceptibility to infection and disease severity, which in turn reduced disease spread. Manipulative studies showed AWS was transmissible through direct contact in three Acropora species. These results will help managers predict and respond to disease outbreaks.

The Geography of School Choice in a City with Growing Inequality: The Case of Vancouver

ERIC Educational Resources Information Center

Yoon, Ee-Seul; Lubienski, Christopher; Lee, Jin

2018-01-01

This analysis aims to measure the impact of school choice policy on secondary school students' enrolment patterns within the social geography of Vancouver, an increasingly polarized global city. The rationale for the study is to examine the impact of "education market" reforms on the socio-economic composition of schools in a Canadian…

Sustained outbreak of measles in New South Wales, 2012: risks for measles elimination in Australia.

PubMed

Najjar, Zeina; Hope, Kirsty; Clark, Penelope; Nguyen, Oanh; Rosewell, Alexander; Conaty, Stephen

2014-01-01

On 7 April 2012, a recently returned traveller from Thailand to Australia was confirmed to have measles. An outbreak of measles subsequently occurred in the state of New South Wales, prompting a sustained and coordinated response by public health authorities. The last confirmed case presented on 29 November 2012. This report describes the outbreak and its characteristics. Cases were investigated following Australian protocols, including case interviews and assessment of contacts for post-exposure prophylaxis. Of the 168 cases identified, most occurred in south-western and western Sydney (92.9%, n = 156). Notable features of this outbreak were the disproportionately high number of cases in the 10-19-year-old age group (29.2%, n = 49), the overrepresentation among people of Pacific Islander descent (21.4%, n = 36) and acquisition in health-care facilities (21.4%, n = 36). There were no reported cases of encephalitis and no deaths. This was the largest outbreak of measles in Australia since 1997. Its occurrence highlights the need to maintain vigilant surveillance systems for early detection and containment of measles cases and to maintain high population immunity to measles through routine childhood immunization. Vaccination campaigns targeting susceptible groups may also be necessary to sustain Australia's measles elimination status.

Multiple sclerosis in the Faroe Islands. 8. Notifiable diseases.

PubMed

Wallin, M T; Heltberg, A; Kurtzke, J F

2010-08-01

To seek evidence for a possible infectious origin of the type 1 epidemic of multiple sclerosis (MS) in the Faroe Islands. This began in 1943 coincident with their British military occupation throughout World War II. Data obtained from the Danish National Health Service were assessed for all notifiable diseases in the Faroe Islands reported from 1900 to 1977. Among 38 disorders, selective increases were found for acute infectious gastroenteritis (AIGE) and paradysentery, with outbreaks in late 1940 and in 1943 shortly after the introduction and later marked influx, respectively, of British troops. Five other infections showed elevated numbers in 1941 and 1942. There is a temporal association of AIGE and paradysentery in the Faroe Islands with the first arrival and later marked augmentation of British forces stationed there during the war. Rises in the incidence of other diseases in 1941-1942 seem more likely a consequence of increased foreign commercial travel by Faroese at that time. (c) 2009 The Authors Journal compilation (c) 2009 Blackwell Munksgaard.

Ciguatera fish poisoning on the West Africa Coast: An emerging risk in the Canary Islands (Spain).

PubMed

Boada, Luis D; Zumbado, Manuel; Luzardo, Octavio P; Almeida-González, Maira; Plakas, Steven M; Granade, Hudson R; Abraham, Ann; Jester, Edward L E; Dickey, Robert W

2010-12-01

Ciguatera fish poisoning (CFP) is endemic in certain tropical and subtropical regions of the world. CFP had not been described on the West Africa Coast until a 2004 outbreak in the Canary Islands. In 2008-2009, two additional outbreaks of ciguatera occurred. Individuals afflicted had consumed lesser amberjack (Seriola rivoliana) captured from nearby waters. Caribbean ciguatoxin-1 (C-CTX-1) was confirmed in fish samples by LC-MS/MS. Ciguatoxic fish in this region may pose a new health risk for the seafood consumer. Copyright © 2010 Elsevier Ltd. All rights reserved.

Environmental swabs as a tool in norovirus outbreak investigation, including outbreaks on cruise ships.

PubMed

Boxman, Ingeborg L A; Dijkman, Remco; te Loeke, Nathalie A J M; Hägele, Geke; Tilburg, Jeroen J H C; Vennema, Harry; Koopmans, Marion

2009-01-01

In this study, we investigated whether environmental swabs can be used to demonstrate the presence of norovirus in outbreak settings. First, a procedure was set up based on viral RNA extraction using guanidium isothiocyanate buffer and binding of nucleic acids to silica. Subsequently, environmental swabs were taken at 23 Dutch restaurants and four cruise ships involved in outbreaks of gastroenteritis. Outbreaks were selected based on clinical symptoms consistent with viral gastroenteritis and time between consumption of suspected food and onset of clinical symptoms (>12 h). Norovirus RNA was demonstrated by real-time reverse transcriptase PCR in 51 of 86 (59%) clinical specimens from 12 of 14 outbreaks (86%), in 13 of 90 (14%) food specimens from 4 of 18 outbreaks (22%), and in 48 of 119 (40%) swab specimens taken from 14 of 27 outbreaks (52%). Positive swab samples agreed with positive clinical samples in seven outbreaks, showing identical sequences. Furthermore, norovirus was detected on swabs taken from kitchen and bathroom surfaces in five outbreaks in which no clinical samples were collected and two outbreaks with negative fecal samples. The detection rate was highest for outbreaks associated with catered meals and lowest for restaurant-associated outbreaks. The use of environmental swabs may be a useful tool in addition to testing of food and clinical specimens, particularlywhen viral RNA is detected on surfaces used for food preparation.

Urban policy engagement with social sustainability in metro Vancouver.

PubMed

Holden, Meg

2012-01-01

This article presents an analysis of social sustainability in comparative theoretical context and as a challenge to the post-political interpretation of sustainability in policy practice at the urban and regional scales. Metro Vancouver provides a case study for improving our understanding of the meaning of social sustainability as a framework for social policy in that it is among the handful of cities around the world currently working to define and enact social sustainability in governance terms. Results of this participant research provide evidence that some cities are politically engaging alternative development pathways using the concept of social sustainability. For sustainable development to retain its promise as an alternative policy framework for cities, social sustainability must be at the forefront.

Engaging Language and Cultural Spaces: Latin American Parents' Reflections on Language Loss and Maintenance in Vancouver

ERIC Educational Resources Information Center

Guardado, Martin

2006-01-01

This qualitative study aims to explore the loss and maintenance of Spanish in Latin American children in Vancouver from the perspective of parents. It focuses on the experiences of children either developing bilingually (Spanish-English) or monolingually (English). The participating families were from Colombia, Guatemala, and El Salvador, and had…

Combining Forces: Fostering Sustainability Collaboration between the City of Vancouver and the University of British Columbia

ERIC Educational Resources Information Center

Munro, Alison; Marcus, Jean; Dolling, Katie; Robinson, John; Wahl, Jennifer

2016-01-01

Purpose: This paper describes the sustainability partnership between the City of Vancouver and the University of British Columbia (UBC) and, in particular, the co-curricular Greenest City Scholars graduate student internship program, which has been developed by the two organizations. Through the program, UBC graduate students work on projects at…

Forearc structure beneath southwestern British Columbia: A three-dimensional tomographic velocity model

USGS Publications Warehouse

Ramachandran, K.; Dosso, S.E.; Spence, G.D.; Hyndman, R.D.; Brocher, T.M.

2005-01-01

This paper presents a three-dimensional compressional wave velocity model of the forearc crust and upper mantle and the subducting Juan de Fuca plate beneath southwestern British Columbia and the adjoining straits of Georgia and Juan de Fuca. The velocity model was constructed through joint tomographic inversion of 50,000 first-arrival times from earthquakes and active seismic sources. Wrangellia rocks of the accreted Paleozoic and Mesozoic island arc assemblage underlying southern Vancouver Island in the Cascadia forearc are imaged at some locations with higher than average lower crustal velocities of 6.5-7.2 km/s, similar to observations at other island arc terranes. The mafic Eocene Crescent terrane, thrust landward beneath southern Vancouver Island, exhibits crustal velocities in the range of 6.0-6.7 km/s and is inferred to extend to a depth of more than 20 km. The Cenozoic Olympic Subduction Complex, an accretionary prism thrust beneath the Crescent terrane in the Olympic Peninsula, is imaged as a low-velocity wedge to depths of at least 20 km. Three zones with velocities of 7.0-7.5 km/s, inferred to be mafic and/or ultramafic units, lie above the subducting Juan de Fuca plate at depths of 25-35 km. The forearc upper mantle wedge beneath southeastern Vancouver Island and the Strait of Georgia exhibits low velocities of 7.2-7.5 km/s, inferred to correspond to ???20% serpentinization of mantle peridotites, and consistent with similar observations in other warm subduction zones. Estimated dip of the Juan de Fuca plate beneath southern Vancouver Island is ???11??, 16??, and 27?? at depths of 30, 40, and 50 km, respectively. Copyright 2005 by the American Geophysical Union.

CONTENDING WITH SPACE-TIME INTERACTION IN THE SPATIAL PREDICTION OF POLLUTION: VANCOUVER'S HOURLY AMBIENT PM 10 FIELD

EPA Science Inventory

In this article we describe an approach for predicting average hourly concentrations of ambient PM10 in Vancouver. We know our solution also applies to hourly ozone fields and believe it may be quite generally applicable. We use a hierarchal Bayesian approach. At the primary ...

Episodic eruptions of volcanic ash trigger a reversible cascade of nuisance species outbreaks in pristine coral habitats.

PubMed

Schils, Tom

2012-01-01

Volcanically active islands abound in the tropical Pacific and harbor complex coral communities. Whereas lava streams and deep ash deposits are well-known to devastate coral communities through burial and smothering, little is known about the effect of moderate amounts of small particulate ash deposits on reef communities. Volcanic ash contains a diversity of chemical compounds that can induce nutrient enrichments triggering changes in benthic composition. Two independently collected data sets on the marine benthos of the pristine and remote reefs around Pagan Island, Northern Mariana Islands, reveal a sudden critical transition to cyanobacteria-dominated communities in 2009-2010, which coincides with a period of continuous volcanic ash eruptions. Concurrently, localized outbreaks of the coral-killing cyanobacteriosponge Terpios hoshinota displayed a remarkable symbiosis with filamentous cyanobacteria, which supported the rapid overgrowth of massive coral colonies and allowed the sponge to colonize substrate types from which it has not been documented before. The chemical composition of tephra from Pagan indicates that the outbreak of nuisance species on its reefs might represent an early succession stage of iron enrichment (a.k.a. "black reefs") similar to that caused by anthropogenic debris like ship wrecks or natural events like particulate deposition from wildfire smoke plumes or desert dust storms. Once Pagan's volcanic activity ceased in 2011, the cyanobacterial bloom disappeared. Another group of well-known nuisance algae in the tropical Pacific, the pelagophytes, did not reach bloom densities during this period of ash eruptions but new species records for the Northern Mariana Islands were documented. These field observations indicate that the study of population dynamics of pristine coral communities can advance our understanding of the resilience of tropical reef systems to natural and anthropogenic disturbances.

A Search for Decolonizing Place-Based Pedagogies: An Exploration of Unheard Histories in Kitsilano Vancouver, B.C.

ERIC Educational Resources Information Center

Henry, Elizabeth Ruth

2014-01-01

This paper explores the ways that place-based pedagogies can facilitate dialogue on colonization, or some of the "dark matters" of environmental education, specifically by engaging non-Indigenous adults in decolonizing dialogues. I share findings from an action research project with Kitsilano Neighbourhood House in Vancouver, British…

Outbreak column 17: Situational Awareness for healthcare outbreaks

PubMed Central

2015-01-01

Outbreak column 17 introduces the utility of Situation Awareness (SA) for outbreak management. For any given time period, an individual or team’s SA involves a perception of what is going on, meaning derived from the perception and a prediction of what is likely to happen next. The individual or team’s SA informs, but is separate to, both the decisions and actions that follow. The accuracy and completeness of an individual or team’s SA will therefore impact on the effectiveness of decisions and actions taken. SA was developed by the aviation industry and is utilised in situations which, like outbreaks, have dynamic, i.e. continuously changing problem spaces, and wherein a loss of SA is likely to lead to both poor decision-making and actions with potentially fatal consequences. The potential benefits of using SA for outbreaks are discussed and include: (1) retrospectively to identify if poor decision-making was a result of a poor SA; (2) prospectively to identify where the system is weakest; and (3) as a teaching tool to improve the skills of individuals and teams in developing a shared understanding of the here and now. PMID:28989433

Aedes aegypti on Madeira Island (Portugal): genetic variation of a recently introduced dengue vector

PubMed Central

Seixas, Gonçalo; Salgueiro, Patrícia; Silva, Ana Clara; Campos, Melina; Spenassatto, Carine; Reyes-Lugo, Matías; Novo, Maria Teresa; Ribolla, Paulo Eduardo Martins; Pinto, João Pedro Soares da Silva; Sousa, Carla Alexandra

2013-01-01

The increasing population of Aedes aegypti mosquitoes on Madeira Island (Portugal) resulted in the first autochthonous dengue outbreak, which occurred in October 2012. Our study establishes the first genetic evaluation based on the mitochondrial DNA (mtDNA) genes [cytochrome oxidase subunit I (COI) and NADH dehydrogenase subunit 4 (ND4)] and knockdown resistance ( kdr ) mutations exploring the colonisation history and the genetic diversity of this insular vector population. We included mosquito populations from Brazil and Venezuela in the analysis as putative geographic sources. The Ae. aegypti population from Madeira showed extremely low mtDNA genetic variability, with a single haplotype for COI and ND4. We also detected the presence of two important kdr mutations and the quasi-fixation of one of these mutations (F1534C). These results are consistent with a unique recent founder event that occurred on the island of Ae. aegypti mosquitoes that carry kdr mutations associated with insecticide resistance. Finally, we also report the presence of the F1534C kdr mutation in the Brazil and Venezuela populations. To our knowledge, this is the first time this mutation has been found in South American Ae. aegypti mosquitoes. Given the present risk of Ae. aegypti re-invading continental Europe from Madeira and the recent dengue outbreaks on the island, this information is important to plan surveillance and control measures. PMID:24473797

Aedes aegypti on Madeira Island (Portugal): genetic variation of a recently introduced dengue vector.

PubMed

Seixas, Gonçalo; Salgueiro, Patrícia; Silva, Ana Clara; Campos, Melina; Spenassatto, Carine; Reyes-Lugo, Matías; Novo, Maria Teresa; Ribolla, Paulo Eduardo Martins; Silva Pinto, João Pedro Soares da; Sousa, Carla Alexandra

2013-01-01

The increasing population of Aedes aegypti mosquitoes on Madeira Island (Portugal) resulted in the first autochthonous dengue outbreak, which occurred in October 2012. Our study establishes the first genetic evaluation based on the mitochondrial DNA (mtDNA) genes [cytochrome oxidase subunit I (COI) and NADH dehydrogenase subunit 4 (ND4)] and knockdown resistance (kdr) mutations exploring the colonisation history and the genetic diversity of this insular vector population. We included mosquito populations from Brazil and Venezuela in the analysis as putative geographic sources. The Ae. aegypti population from Madeira showed extremely low mtDNA genetic variability, with a single haplotype for COI and ND4. We also detected the presence of two important kdr mutations and the quasi-fixation of one of these mutations (F1534C). These results are consistent with a unique recent founder event that occurred on the island of Ae. aegypti mosquitoes that carry kdr mutations associated with insecticide resistance. Finally, we also report the presence of the F1534C kdr mutation in the Brazil and Venezuela populations. To our knowledge, this is the first time this mutation has been found in South American Ae. aegypti mosquitoes. Given the present risk of Ae. aegypti re-invading continental Europe from Madeira and the recent dengue outbreaks on the island, this information is important to plan surveillance and control measures.

Ongoing outbreak of dengue type 1 in the Autonomous Region of Madeira, Portugal: preliminary report.

PubMed

Sousa, C A; Clairouin, M; Seixas, G; Viveiros, B; Novo, M T; Silva, A C; Escoval, M T; Economopoulou, A

2012-12-06

Following the identification of two autochthonous cases of dengue type 1 on 3 October 2012, an outbreak of dengue fever has been reported in Madeira, Portugal. As of 25 November, 1,891 cases have been detected on the island where the vector Aedes aegypti had been established in some areas since 2005. This event represents the first epidemic of dengue fever in Europe since 1928 and concerted control measures have been initiated by local health authorities.

Sustained outbreak of measles in New South Wales, 2012: risks for measles elimination in Australia

PubMed Central

Hope, Kirsty; Clark, Penelope; Nguyen, Oanh; Rosewell, Alexander; Conaty, Stephen

2014-01-01

Objective On 7 April 2012, a recently returned traveller from Thailand to Australia was confirmed to have measles. An outbreak of measles subsequently occurred in the state of New South Wales, prompting a sustained and coordinated response by public health authorities. The last confirmed case presented on 29 November 2012. This report describes the outbreak and its characteristics. Methods Cases were investigated following Australian protocols, including case interviews and assessment of contacts for post-exposure prophylaxis. Results Of the 168 cases identified, most occurred in south-western and western Sydney (92.9%, n = 156). Notable features of this outbreak were the disproportionately high number of cases in the 10–19-year-old age group (29.2%, n = 49), the overrepresentation among people of Pacific Islander descent (21.4%, n = 36) and acquisition in health-care facilities (21.4%, n = 36). There were no reported cases of encephalitis and no deaths. Discussion: This was the largest outbreak of measles in Australia since 1997. Its occurrence highlights the need to maintain vigilant surveillance systems for early detection and containment of measles cases and to maintain high population immunity to measles through routine childhood immunization. Vaccination campaigns targeting susceptible groups may also be necessary to sustain Australia’s measles elimination status. PMID:25635228

[Outbreak of pandemic virus (H1N1) 2009 in a residence for mentally disabled persons in Balearic Island, Spain].

PubMed

Giménez Duran, Jaume; Galmés Truyols, Antònia; Nicolau Riutort, Antonio; Reina Prieto, Jorge; Gallegos Álvarez, Maria de Carmen; Pareja Bezares, Antonio; Vanrell Berga, Juana María

2010-01-01

The flu season 2009-2010 has been shorter and less severe than expected. Since January 2010, influenza surveillance systems indicated rates of very low incidence of influenza without detection of virus circulation. In this context, a hospital reported a suspected outbreak of severe respiratory disease, the aetiology proved influenza A(H1N1)v. We describe the outbreak and public health measures for their control. Descriptive study of an outbreak of pandemic influenza virus in a residency home for mentally disabled. Establishment of active surveillance. The case definition of influenza was very sensitive to detect new cases early, treated early and minimize transmission. Steps were taken to contain the influenza virus infection. Among 38 cases detected 7 had serious complications(all of them with risk factors). There were no deaths. The overall attack rate was 35.2%. The first cases were workers. The residents were ill at the peak of the outbreak, and among workers the presentation was more dispersed. None of the workers and only three of residents had been vaccinated. Workers possibly have initiated and contributed to the maintenance of transmission. We emphasize the need to comply with vaccination recommendations, not just those with risk factors, but particularly for workers in contact with those.

Sarcocystis nesbitti causes acute, relapsing febrile myositis with a high attack rate: description of a large outbreak of muscular sarcocystosis in Pangkor Island, Malaysia, 2012.

PubMed

Italiano, Claire M; Wong, Kum Thong; AbuBakar, Sazaly; Lau, Yee Ling; Ramli, Norlisah; Syed Omar, Sharifah Faridah; Kahar Bador, Maria; Tan, Chong Tin

2014-05-01

From the 17th to 19th January 2012, a group of 92 college students and teachers attended a retreat in a hotel located on Pangkor Island, off the west coast of Peninsular Malaysia. Following the onset of symptoms in many participants who presented to our institute, an investigation was undertaken which ultimately identified Sarcocystis nesbitti as the cause of this outbreak. All retreat participants were identified, and clinical and epidemiological information was obtained via clinical review and self-reported answers to a structured questionnaire. Laboratory, imaging and muscle biopsy results were evaluated and possible sources of exposure, in particular water supply, were investigated. At an average of 9-11 days upon return from the retreat, 89 (97%) of the participants became ill. A vast majority of 94% had fever with 57% of these persons experiencing relapsing fever. Myalgia was present in 91% of patients. Facial swelling from myositis of jaw muscles occurred in 9 (10%) patients. The median duration of symptoms was 17 days (IQR 7 to 30 days; range 3 to 112). Out of 4 muscle biopsies, sarcocysts were identified in 3. S. nesbitti was identified by PCR in 3 of the 4 biopsies including one biopsy without observed sarcocyst. Non-Malaysians had a median duration of symptoms longer than that of Malaysians (27.5 days vs. 14 days, p = 0.001) and were more likely to experience moderate or severe myalgia compared to mild myalgia (83.3% vs. 40.0%, p = 0.002). The similarity of the symptoms and clustered time of onset suggests that all affected persons had muscular sarcocystosis. This is the largest human outbreak of sarcocystosis ever reported, with the specific Sarcocystis species identified. The largely non-specific clinical features of this illness suggest that S. nesbitti may be an under diagnosed infection in the tropics.

Outbreaks of nontuberculous mycobacteria.

PubMed

Sood, Geeta; Parrish, Nikki

2017-08-01

The purpose of this review is to summarize the emerging literature on nontuberculous mycobacteria outbreaks in healthcare settings. As our ability to identify mycobacterial species develops, we are better able to recognize epidemiologic connections and better understand the prevalence and importance of these outbreaks and pseudo-outbreaks in healthcare settings. The number of outbreaks related to nontuberculous outbreaks is increasing because of heightened awareness and better diagnostic tests for species level identification of mycobacteria. Outbreaks in healthcare settings have been related to cardiac surgery, plastic surgery, including medical tourism, colonized humidifiers and heater-cooler devices, imperfect disinfection, and hospital water sources. Mycobacteria have a predilection to form biofilms, are resistant to disinfection and are prevalent in hospital water systems. Patients with structural lung disease like cystic fibrosis patients are at particularly high risk for mycobacterial infection. It has been thought that acquisition in this patient population is from common environmental exposure; however, there is increasing evidence that transmission in this patient population can occur through either direct or indirect patient-to-patient spread. Mycobacteria outbreaks in healthcare settings have been underrecognized. As we identify additional clusters of infection with better diagnostic tools and heightened awareness, we will likely need better infection control practices to prevent infections in healthcare settings.

Community-based outbreaks of tuberculosis.

PubMed

Raffalli, J; Sepkowitz, K A; Armstrong, D

1996-05-27

Numerous recent reports have detailed outbreaks of tuberculosis in hospitals and other congregate settings. The characteristics of such settings, including high concentrations of infectious patients and immunocompromised hosts, the potential for sustained daily contact for weeks and often months, and improper precautions taken for protection, make them well suited for tuberculosis transmission. However, community-based outbreaks, which are the source of much public concern, have not been reviewed since 1964, when 109 community outbreaks were examined. Since few of the characteristics of institutional settings are present in the community, the lessons learned may not be applicable to community-based outbreaks. Furthermore, recent studies with analysis by restriction fragment length polymorphisms have documented unexpectedly high rates of primary disease in certain urban communities, suggesting that our understanding of community-based transmission may be incomplete. We reviewed all reported community-based outbreaks of tuberculosis occurring in the last 30 years to assess the basis of our current understanding of community-based transmission. More than 70 outbreaks were identified, with schools being the most common site. In most, a delay in diagnosis, sustained contact with the index case, inadequate ventilation, or overcrowding was contributory. We conclude that community-based outbreaks of tuberculosis continue to occur and that well-established risks contribute to most outbreaks. Many outbreaks can be prevented or limited by attention to basic infection control principles.

Satellite SST-Based Coral Disease Outbreak Predictions for the Hawaiian Archipelago.

PubMed

Caldwell, Jamie M; Heron, Scott F; Eakin, C Mark; Donahue, Megan J

2016-02-01

Predicting wildlife disease risk is essential for effective monitoring and management, especially for geographically expansive ecosystems such as coral reefs in the Hawaiian archipelago. Warming ocean temperature has increased coral disease outbreaks contributing to declines in coral cover worldwide. In this study we investigated seasonal effects of thermal stress on the prevalence of the three most widespread coral diseases in Hawai'i: Montipora white syndrome, Porites growth anomalies and Porites tissue loss syndrome. To predict outbreak likelihood we compared disease prevalence from surveys conducted between 2004 and 2015 from 18 Hawaiian Islands and atolls with biotic (e.g., coral density) and abiotic (satellite-derived sea surface temperature metrics) variables using boosted regression trees. To date, the only coral disease forecast models available were developed for Acropora white syndrome on the Great Barrier Reef (GBR). Given the complexities of disease etiology, differences in host demography and environmental conditions across reef regions, it is important to refine and adapt such models for different diseases and geographic regions of interest. Similar to the Acropora white syndrome models, anomalously warm conditions were important for predicting Montipora white syndrome, possibly due to a relationship between thermal stress and a compromised host immune system. However, coral density and winter conditions were the most important predictors of all three coral diseases in this study, enabling development of a forecasting system that can predict regions of elevated disease risk up to six months before an expected outbreak. Our research indicates satellite-derived systems for forecasting disease outbreaks can be appropriately adapted from the GBR tools and applied for a variety of diseases in a new region. These models can be used to enhance management capacity to prepare for and respond to emerging coral diseases throughout Hawai'i and can be modified

Satellite SST-Based Coral Disease Outbreak Predictions for the Hawaiian Archipelago

PubMed Central

Caldwell, Jamie M.; Heron, Scott F.; Eakin, C. Mark; Donahue, Megan J.

2017-01-01

Predicting wildlife disease risk is essential for effective monitoring and management, especially for geographically expansive ecosystems such as coral reefs in the Hawaiian archipelago. Warming ocean temperature has increased coral disease outbreaks contributing to declines in coral cover worldwide. In this study we investigated seasonal effects of thermal stress on the prevalence of the three most widespread coral diseases in Hawai’i: Montipora white syndrome, Porites growth anomalies and Porites tissue loss syndrome. To predict outbreak likelihood we compared disease prevalence from surveys conducted between 2004 and 2015 from 18 Hawaiian Islands and atolls with biotic (e.g., coral density) and abiotic (satellite-derived sea surface temperature metrics) variables using boosted regression trees. To date, the only coral disease forecast models available were developed for Acropora white syndrome on the Great Barrier Reef (GBR). Given the complexities of disease etiology, differences in host demography and environmental conditions across reef regions, it is important to refine and adapt such models for different diseases and geographic regions of interest. Similar to the Acropora white syndrome models, anomalously warm conditions were important for predicting Montipora white syndrome, possibly due to a relationship between thermal stress and a compromised host immune system. However, coral density and winter conditions were the most important predictors of all three coral diseases in this study, enabling development of a forecasting system that can predict regions of elevated disease risk up to six months before an expected outbreak. Our research indicates satellite-derived systems for forecasting disease outbreaks can be appropriately adapted from the GBR tools and applied for a variety of diseases in a new region. These models can be used to enhance management capacity to prepare for and respond to emerging coral diseases throughout Hawai’i and can be

Fire severity and tree regeneration following bark beetle outbreaks: the role of outbreak stage and burning conditions.

PubMed

Harvey, Brian J; Donato, Daniel C; Romme, William H; Turner, Monica G

The degree to which recent bark beetle (Dendroctonus ponderosae) outbreaks may influence fire severity and postfire tree regeneration is of heightened interest to resource managers throughout western North America, but empirical data on actual fire effects are lacking. Outcomes may depend on burning conditions (i.e., weather during fire), outbreak severity, or intervals between outbreaks and subsequent fire. We studied recent fires that burned through green-attack/red-stage (outbreaks <3 years before fire) and gray-stage (outbreaks 3–15 years before fire) subalpine forests dominated by lodgepole pine (Pinus contorta var. latifolia) in Greater Yellowstone, Wyoming, USA, to determine if fire severity was linked to prefire beetle outbreak severity and whether these two disturbances produced compound ecological effects on postfire tree regeneration. With field data from 143 postfire plots that burned under different conditions, we assessed canopy and surface fire severity, and postfire tree seedling density against prefire outbreak severity. In the green-attack/red stage, several canopy fire-severity measures increased with prefire outbreak severity under moderate burning conditions. Under extreme conditions, few fire-severity measures were related to prefire outbreak severity, and effect sizes were of marginal biological significance. The percentage of tree stems and basal area killed by fire increased with more green-attack vs. red-stage trees (i.e., the earliest stages of outbreak). In the gray stage, by contrast, most fire-severity measures declined with increasing outbreak severity under moderate conditions, and fire severity was unrelated to outbreak severity under extreme burning conditions. Postfire lodgepole pine seedling regeneration was unrelated to prefire outbreak severity in either post-outbreak stage, but increased with prefire serotiny. Results suggest bark beetle outbreaks can affect fire severity in subalpine forests under moderate burning

Workplace violence among female sex workers who use drugs in Vancouver, Canada: does client-targeted policing increase safety?

PubMed

Prangnell, Amy; Shannon, Kate; Nosova, Ekaterina; DeBeck, Kora; Milloy, M-J; Kerr, Thomas; Hayashi, Kanna

2018-02-01

Workplace violence, by clients or predators, poses serious negative health consequences for sex workers. In 2013, the Vancouver (British Columbia), Canada Police Department changed their guidelines with the goal of increasing safety for sex workers by focusing law enforcement on clients and third parties, but not sex workers. We sought to examine the trends and correlates of workplace violence among female sex workers (FSW) before and after the guideline change, using data collected from prospective cohorts of persons who use illicit drugs in Vancouver, Canada. Among 259 FSW, 21.0% reported workplace violence at least once during the study period between 2008 and 2014. There was no statistically significant change in rates of workplace violence after the guideline change. In our multivariable analysis, daily heroin use was independently associated with workplace violence. The 2013 policing guideline change did not appear to have resulted in decreased reports of workplace violence. Increased access to opioid agonist therapies may reduce workplace violence among drug-using FSW.

First Finding of Southeast Asia Topotype of Foot-and-Mouth Disease Virus in Kinmen, Taiwan, in the 2012 Outbreak

PubMed Central

LIN, Yeou-Liang; CHANG, Chia-Yi; PAN, Chu-Hsiang; DENG, Ming-Chung; TSAI, Hsiang-Jung; LEE, Fan

2014-01-01

ABSTRACT Foot-and-mouth disease virus, a member of genus Aphthovirus within the family Picornaviridae, affects cloven-hoofed animals, causing foot-and-mouth disease characterized by vesicle development. The Southeast Asia topotype, one of the topotypes within serotype O of the virus, is prevalent in some Asian countries, but had not previously been found in Taiwan. The topotype was first found in pigs in Kinmen Island, Taiwan, in 2012 and identified by nucleotide sequence comparison and phylogenetic analysis. Outbreaks were reported at 4 farms, resulting in the culling of 628 pigs and 1 cattle. Pigs were the only species infected during the outbreak. The incursion of Southeast Asia topotype into Taiwan implies the expansion of the topotype in East Asia. PMID:25056674

Yellow Fever outbreak in Darfur, Sudan in October 2012; the initial outbreak investigation report.

PubMed

Soghaier, Mohammed A; Hagar, Ahmed; Abbas, Mohammed A; Elmangory, Mutasim M; Eltahir, Khalid M; Sall, Amadou A

2013-10-01

Sudan is subject to repeated outbreaks, including Viral Hemorrhagic Fever (VHF), which is considered to be a very serious illness. Yellow Fever (YF) outbreaks in Sudan have been reported from the 1940s through 2005. In 2012, a new outbreak of YF occurred in the Darfur region. To identify the potential for an outbreak, to diagnose the disease and to be able to recognize its cause among the initial reported cases. >This is a descriptive and investigative field study that applies standard communicable disease outbreak investigation steps. The study involved clinical, serological, entomological and environmental surveys. The field investigation confirmed the outbreak and identified its cause to be YF. National surveillance systems should be strong enough to detect VHFs in a timely manner. Local health facilities should be prepared to promptly treat the initial cases because the case fatality ratios (CFRs) are usually very high among the index cases. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

[Waterborne outbreaks in Norway 2003-2012].

PubMed

Guzman-Herrador, Bernardo; de Blasio, Birgitte Freiesleben; Lund, Vidar; MacDonald, Emily; Vold, Line; Wahl, Erik; Nygård, Karin

2016-04-19

We describe the status of waterborne outbreaks notified in Norway and discuss this in the context of outbreaks recorded in previous years, to gain a better understanding of their development in Norway in recent years. We have collected information on all outbreaks notified to the Norwegian Institute of Public Health via the surveillance system for communicable diseases in the ten-year period from 2003-2012 for which drinking water was given as the suspected cause. Altogether 28 waterborne outbreaks with a total of 8,060 persons reported as ill were notified in the period. The majority of outbreaks resulted in fewer than 100 cases of illness. There were two outbreaks with more than 1,000 cases of illness: an oubreak of campylobacteriosis in Røros and an oubreak of giardiasis in Bergen. In more than half of the outbreaks, water was supplied from public water distribution systems (16/28 outbreaks, 57%). In addition, a large proportion was linked to individual households with their own water supply (12/28 outbreaks, 43%). Most of the outbreaks in the ten-year period were linked to public water distribution systems, while almost half were linked to non-disinfected water supplies to individual households. Although most of the outbreaks were small, two extensive outbreaks were also registered in the period, resulting in more than one thousand cases of illness. This underscores the need for good contingency planning and surveillance, so that suspicion of waterborne outbreaks is rapidly notified to the responsible authorities, and the importance of good protection of water sources, as well as proper maintenance of water treatment plants and distribution systems.

Outbreaks in Health Care Settings.

PubMed

Sood, Geeta; Perl, Trish M

2016-09-01

Outbreaks and pseudo-outbreaks in health care settings can be complex and should be evaluated systematically using epidemiologic tools. Laboratory testing is an important part of an outbreak evaluation. Health care personnel, equipment, supplies, water, ventilation systems, and the hospital environment have been associated with health care outbreaks. Settings including the neonatal intensive care unit, endoscopy, oncology, and transplant units are areas that have specific issues which impact the approach to outbreak investigation and control. Certain organisms have a predilection for health care settings because of the illnesses of patients, the procedures performed, and the care provided. Copyright © 2016 Elsevier Inc. All rights reserved.

The Learning Exchange: A Shared Space for the University of British Columbia and Vancouver's Downtown Eastside Communities

ERIC Educational Resources Information Center

Towle, Angela; Leahy, Kathleen

2016-01-01

The Learning Exchange was established by the University of British Columbia (UBC) in 1999 in Vancouver's Downtown Eastside (DTES). The challenge has been to create a shared space for learning exchanges between two very different communities: a research-intensive university and an inner city area most commonly depicted as a place of hopelessness.…

Outbreak of Norwalk virus in a Caribbean island resort: application of molecular diagnostics to ascertain the vehicle of infection.

PubMed Central

Brown, C. M.; Cann, J. W.; Simons, G.; Fankhauser, R. L.; Thomas, W.; Parashar, U. D.; Lewis, M. J.

2001-01-01

In 1998, an outbreak of gastroenteritis affected at least 448 persons including 122 staff at a resort hotel in Bermuda. A survey among staff indicated that gastroenteritis was associated with eating or drinking at the hotel (OR = 60, 95% CI = 2.4-15.1). Multiple specimens of drinking water had elevated faecal coliform levels and Escherichia coli present, suggestive of faecal contamination. Stools from 18 of the 19 persons with gastroenteritis that were tested were positive for genogroup-II Norwalk-like viruses (NLVs). RT-PCR analysis of a 31 specimen of water produced a genogroup-II NLV genome with a sequence identical to that of NLVs in the stools of three ill persons. This outbreak shows the value of new molecular diagnostics to link illness with a contaminated source through the use of sequence analysis. The risk of outbreaks such as these could be reduced in tourism dependent regions like Bermuda and the Caribbean by regular evaluation of data from the inspection and monitoring of drinking water supplies and waste water systems, by ensuring the chlorination of supplemental drinking water supplies and by establishing food-safety initiatives. PMID:11467799

Outbreak of Norwalk virus in a Caribbean island resort: application of molecular diagnostics to ascertain the vehicle of infection.

PubMed

Brown, C M; Cann, J W; Simons, G; Fankhauser, R L; Thomas, W; Parashar, U D; Lewis, M J

2001-06-01

In 1998, an outbreak of gastroenteritis affected at least 448 persons including 122 staff at a resort hotel in Bermuda. A survey among staff indicated that gastroenteritis was associated with eating or drinking at the hotel (OR = 60, 95% CI = 2.4-15.1). Multiple specimens of drinking water had elevated faecal coliform levels and Escherichia coli present, suggestive of faecal contamination. Stools from 18 of the 19 persons with gastroenteritis that were tested were positive for genogroup-II Norwalk-like viruses (NLVs). RT-PCR analysis of a 31 specimen of water produced a genogroup-II NLV genome with a sequence identical to that of NLVs in the stools of three ill persons. This outbreak shows the value of new molecular diagnostics to link illness with a contaminated source through the use of sequence analysis. The risk of outbreaks such as these could be reduced in tourism dependent regions like Bermuda and the Caribbean by regular evaluation of data from the inspection and monitoring of drinking water supplies and waste water systems, by ensuring the chlorination of supplemental drinking water supplies and by establishing food-safety initiatives.

Selection tool for foodborne norovirus outbreaks.

PubMed

Verhoef, Linda P B; Kroneman, Annelies; van Duynhoven, Yvonne; Boshuizen, Hendriek; van Pelt, Wilfrid; Koopmans, Marion

2009-01-01

Detection of pathogens in the food chain is limited mainly to bacteria, and the globalization of the food industry enables international viral foodborne outbreaks to occur. Outbreaks from 2002 through 2006 recorded in a European norovirus surveillance database were investigated for virologic and epidemiologic indicators of food relatedness. The resulting validated multivariate logistic regression model comparing foodborne (n = 224) and person-to-person (n = 654) outbreaks was used to create a practical web-based tool that can be limited to epidemiologic parameters for nongenotyping countries. Non-genogroup-II.4 outbreaks, higher numbers of cases, and outbreaks in restaurants or households characterized (sensitivity = 0.80, specificity = 0.86) foodborne outbreaks and reduced the percentage of outbreaks requiring source-tracing to 31%. The selection tool enabled prospectively focused follow-up. Use of this tool is likely to improve data quality and strain typing in current surveillance systems, which is necessary for identification of potential international foodborne outbreaks.

Outbreak Column 16: Cognitive errors in outbreak decision making.

PubMed

Curran, Evonne T

2015-01-01

During outbreaks, decisions must be made without all the required information. People, including infection prevention and control teams (IPCTs), who have to make decisions during uncertainty use heuristics to fill the missing data gaps. Heuristics are mental model short cuts that by-and-large enable us to make good decisions quickly. However, these heuristics contain biases and effects that at times lead to cognitive (thinking) errors. These cognitive errors are not made to deliberately misrepresent any given situation; we are subject to heuristic biases when we are trying to perform optimally. The science of decision making is large; there are over 100 different biases recognised and described. Outbreak Column 16 discusses and relates these heuristics and biases to decision making during outbreak prevention, preparedness and management. Insights as to how we might recognise and avoid them are offered.

Rubella outbreak and outbreak management in a school setting, China, 2014.

PubMed

Chang, Caiyun; Ma, Huilai; Liang, Wenjia; Hu, Pei; Mo, Xianghuan; An, Zhijie; Zheng, Huizhen

2017-04-03

An active response to a rubella outbreak may interrupt disease transmission, and outbreak response immunization (ORI) can increase immunity among persons who might otherwise not be protected. On March 17, 2014, a rubella outbreak was reported in a middle school in Guangzhou city, China. We conducted an investigation to assess impact of a policy of exclusion of cases from school and of ORI. Active surveillance was used to find cases of rubella. Investigators interviewed teachers and reviewed the absentee records to determine implementation details of school exclusion. ORI was recommended on 2 occasions during the outbreak, one small-scale and one large-scale. Laboratory confirmation tests included serum IgM and IgG measurements to distinguish between acute infection and immunity. A serological survey in 4 classes was used to determine immunity status and identify symptomatic and asymptomatic cases. From February 17 to May 23, 2014, 162 rubella cases (24 laboratory-confirmed and 138 epidemiologically linked) were detected among 1,621 students. Cases ultimately occurred in 27 classes (72.97%) across 37 classes. In 11 classes in which exclusion from school was delayed by 1 or more days, the secondary attack rate was 12.30%, compared with 2.35% in 15 classes with immediate exclusion. ORI increased vaccine coverage from 25.83 % to 86.92%, and the final case of the epidemic was reported one month later. A serological survey of 91 students in 4 classes identified 15 cases, 6 of which were asymptomatic. The outbreak happened in school with low rubella-containing vaccination coverage. Exclusion from school upon rash/fever onset was associated with lowering the secondary attack rate, but school exclusion alone was not able to stop this outbreak - a large ORI was needed. Assuring complete vaccination upon entry to school is likely to be necessary to ensure coverage is above the herd immunity threshold and prevent outbreaks from happening.

Epidemiology of Chikungunya Virus Outbreaks in Guadeloupe and Martinique, 2014: An Observational Study in Volunteer Blood Donors.

PubMed

Gallian, Pierre; Leparc-Goffart, Isabelle; Richard, Pascale; Maire, Françoise; Flusin, Olivier; Djoudi, Rachid; Chiaroni, Jacques; Charrel, Remi; Tiberghien, Pierre; de Lamballerie, Xavier

2017-01-01

During Dec-2013, a chikungunya virus (CHIKV) outbreak was first detected in the French-West Indies. Subsequently, the virus dispersed to other Caribbean islands, continental America and many islands in the Pacific Ocean. Previous estimates of the attack rate were based on declaration of clinically suspected cases. Individual testing for CHIKV RNA of all (n = 16,386) blood donations between Feb-24th 2014 and Jan-31st 2015 identified 0·36% and 0·42% of positives in Guadeloupe and Martinique, respectively. The incidence curves faithfully correlated with those of suspected clinical cases in the general population of Guadeloupe (abrupt epidemic peak), but not in Martinique (flatter epidemic growth). No significant relationship was identified between CHIKV RNA detection and age-classes or blood groups. Prospective (Feb-2014 to Jan-2015; n = 9,506) and retrospective (Aug-2013 to Feb-2014; n = 6,559) seroepidemiological surveys in blood donors identified a final seroprevalence of 48·1% in Guadeloupe and 41·9% in Martinique. Retrospective survey also suggested the absence or limited "silent" CHIKV circulation before the outbreak. Parameters associated with increased seroprevalence were: Gender (M>F), KEL-1, [RH+1/KEL-1], [A/RH+1] and [A/RH+1/KEL-1] blood groups in Martiniquan donors. A simulation model based on observed incidence and actual seroprevalence values predicted 2·5 and 2·3 days of asymptomatic viraemia in Martiniquan and Guadeloupian blood donors respectively. This study, implemented promptly with relatively limited logistical requirements during CHIKV emergence in the Caribbean, provided unique information regarding retrospective and prospective epidemiology, infection risk factors and natural history of the disease. In the stressful context of emerging infectious disease outbreaks, blood donor-based studies can serve as robust and cost-effective first-line tools for public health surveys.

Establishing an early warning alert and response network following the Solomon Islands tsunami in 2013.

PubMed

Bilve, Augustine; Nogareda, Francisco; Joshua, Cynthia; Ross, Lester; Betcha, Christopher; Durski, Kara; Fleischl, Juliet; Nilles, Eric

2014-11-01

On 6 February 2013, an 8.0 magnitude earthquake generated a tsunami that struck the Santa Cruz Islands, Solomon Islands, killing 10 people and displacing over 4700. A post-disaster assessment of the risk of epidemic disease transmission recommended the implementation of an early warning alert and response network (EWARN) to rapidly detect, assess and respond to potential outbreaks in the aftermath of the tsunami. Almost 40% of the Santa Cruz Islands' population were displaced by the disaster, and living in cramped temporary camps with poor or absent sanitation facilities and insufficient access to clean water. There was no early warning disease surveillance system. By 25 February, an EWARN was operational in five health facilities that served 90% of the displaced population. Eight priority diseases or syndromes were reported weekly; unexpected health events were reported immediately. Between 25 February and 19 May, 1177 target diseases or syndrome cases were reported. Seven alerts were investigated. No sustained transmission or epidemics were identified. Reporting compliance was 85%. The EWARN was then transitioned to the routine four-syndrome early warning disease surveillance system. It was necessary to conduct a detailed assessment to evaluate the risk and potential impact of serious infectious disease outbreaks, to assess whether and how enhanced early warning disease surveillance should be implemented. Local capacities and available resources should be considered in planning EWARN implementation. An EWARN can be an opportunity to establish or strengthen early warning disease surveillance capabilities.

From West End to Eastside: The Vancouver HIV/AIDS Epidemic, 1983-2013.

PubMed

Perry, Taylor

2016-01-01

Traditional histories of AIDS have used a few major American urban centres as proxies for the North American epidemic more broadly and have tended to frame the epidemic as a quintessentially gay and American experience. A careful examination of how the epidemic unfolded in Vancouver, British Columbia, however, reveals considerable differences, including the relative absence of local gay activist traditions prior to HIV/AIDS and the relative prominence of interventions such as Insite, North America's first sanctioned needle exchange program and safe injection site. An investigation of such differences emphasizes the local character of the epidemic and adds a Canadian perspective to the existing AIDS historiography.

A comparison of urban heat islands mapped using skin temperature, air temperature, and apparent temperature (Humidex), for the greater Vancouver area.

PubMed

Ho, Hung Chak; Knudby, Anders; Xu, Yongming; Hodul, Matus; Aminipouri, Mehdi

2016-02-15

Apparent temperature is more closely related to mortality during extreme heat events than other temperature variables, yet spatial epidemiology studies typically use skin temperature (also known as land surface temperature) to quantify heat exposure because it is relatively easy to map from satellite data. An empirical approach to map apparent temperature at the neighborhood scale, which relies on publicly available weather station observations and spatial data layers combined in a random forest regression model, was demonstrated for greater Vancouver, Canada. Model errors were acceptable (cross-validated RMSE=2.04 °C) and the resulting map of apparent temperature, calibrated for a typical hot summer day, corresponded well with past temperature research in the area. A comparison with field measurements as well as similar maps of skin temperature and air temperature revealed that skin temperature was poorly correlated with both air temperature (R(2)=0.38) and apparent temperature (R(2)=0.39). While the latter two were more similar (R(2)=0.87), apparent temperature was predicted to exceed air temperature by more than 5 °C in several urban areas as well as around the confluence of the Pitt and Fraser rivers. We conclude that skin temperature is not a suitable proxy for human heat exposure, and that spatial epidemiology studies could benefit from mapping apparent temperature, using an approach similar to the one reported here, to better quantify differences in heat exposure that exist across an urban landscape. Copyright © 2015 Elsevier B.V. All rights reserved.

Predator crown-of-thorns starfish (Acanthaster planci) outbreak, mass mortality of corals, and cascading effects on reef fish and benthic communities.

PubMed

Kayal, Mohsen; Vercelloni, Julie; Lison de Loma, Thierry; Bosserelle, Pauline; Chancerelle, Yannick; Geoffroy, Sylvie; Stievenart, Céline; Michonneau, François; Penin, Lucie; Planes, Serge; Adjeroud, Mehdi

2012-01-01

Outbreaks of the coral-killing seastar Acanthaster planci are intense disturbances that can decimate coral reefs. These events consist of the emergence of large swarms of the predatory seastar that feed on reef-building corals, often leading to widespread devastation of coral populations. While cyclic occurrences of such outbreaks are reported from many tropical reefs throughout the Indo-Pacific, their causes are hotly debated, and the spatio-temporal dynamics of the outbreaks and impacts to reef communities remain unclear. Based on observations of a recent event around the island of Moorea, French Polynesia, we show that Acanthaster outbreaks are methodic, slow-paced, and diffusive biological disturbances. Acanthaster outbreaks on insular reef systems like Moorea's appear to originate from restricted areas confined to the ocean-exposed base of reefs. Elevated Acanthaster densities then progressively spread to adjacent and shallower locations by migrations of seastars in aggregative waves that eventually affect the entire reef system. The directional migration across reefs appears to be a search for prey as reef portions affected by dense seastar aggregations are rapidly depleted of living corals and subsequently left behind. Coral decline on impacted reefs occurs by the sequential consumption of species in the order of Acanthaster feeding preferences. Acanthaster outbreaks thus result in predictable alteration of the coral community structure. The outbreak we report here is among the most intense and devastating ever reported. Using a hierarchical, multi-scale approach, we also show how sessile benthic communities and resident coral-feeding fish assemblages were subsequently affected by the decline of corals. By elucidating the processes involved in an Acanthaster outbreak, our study contributes to comprehending this widespread disturbance and should thus benefit targeted management actions for coral reef ecosystems.

Modeling Classical Swine Fever Outbreak-Related Outcomes

PubMed Central

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

2016-01-01

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

Gastroenteritis outbreaks on cruise ships: contributing factors and thresholds for early outbreak detection

PubMed Central

Mouchtouri, Varvara A; Verykouki, Eleni; Zamfir, Dumitru; Hadjipetris, Christos; Lewis, Hannah C; Hadjichristodoulou, Christos

2017-01-01

When an increased number of acute gastroenteritis (AG) cases is detected among tourists staying at the same accommodation, outbreak management plans must be activated in a timely manner to prevent large outbreaks. Syndromic surveillance data collected between 1 January 2010 and 31 December 2013 by five seagoing cruise ships were analysed to identify attack rate thresholds for early outbreak detection. The overall incidence rate of AG was 2.81 cases per 10,000 traveller-days (95% confidence interval (CI): 0.00–17.60), while the attack rate was 19.37 cases per 10,000 travellers (95% CI: 0.00–127.69). The probability of an outbreak occurring was 11% if 4 per 1,000 passengers reported symptoms within the first 2 days of the voyage, and this increased to 23 % if 5 per 1,000 passengers reported such within the first 3 days. The risk ratio (RR) for outbreak occurrence was 2.35, 5.66 and 8.63 for 1, 2 and 3 days’ delay of symptoms reporting respectively, suggesting a dose–response relationship. Shipping companies’ policies and health authorities’ efforts may consider these thresholds for initiating outbreak response measures based on the number of cases according to day of cruise. Efforts should focus on ensuring travellers report symptoms immediately and comply with isolation measures. PMID:29162205

Gastroenteritis outbreaks on cruise ships: contributing factors and thresholds for early outbreak detection.

PubMed

Mouchtouri, Varvara A; Verykouki, Eleni; Zamfir, Dumitru; Hadjipetris, Christos; Lewis, Hannah C; Hadjichristodoulou, Christos

2017-11-01

When an increased number of acute gastroenteritis (AG) cases is detected among tourists staying at the same accommodation, outbreak management plans must be activated in a timely manner to prevent large outbreaks. Syndromic surveillance data collected between 1 January 2010 and 31 December 2013 by five seagoing cruise ships were analysed to identify attack rate thresholds for early outbreak detection. The overall incidence rate of AG was 2.81 cases per 10,000 traveller-days (95% confidence interval (CI): 0.00-17.60), while the attack rate was 19.37 cases per 10,000 travellers (95% CI: 0.00-127.69). The probability of an outbreak occurring was 11% if 4 per 1,000 passengers reported symptoms within the first 2 days of the voyage, and this increased to 23 % if 5 per 1,000 passengers reported such within the first 3 days. The risk ratio (RR) for outbreak occurrence was 2.35, 5.66 and 8.63 for 1, 2 and 3 days' delay of symptoms reporting respectively, suggesting a dose-response relationship. Shipping companies' policies and health authorities' efforts may consider these thresholds for initiating outbreak response measures based on the number of cases according to day of cruise. Efforts should focus on ensuring travellers report symptoms immediately and comply with isolation measures.

Sarcocystis nesbitti Causes Acute, Relapsing Febrile Myositis with a High Attack Rate: Description of a Large Outbreak of Muscular Sarcocystosis in Pangkor Island, Malaysia, 2012

PubMed Central

Italiano, Claire M.; Wong, Kum Thong; AbuBakar, Sazaly; Lau, Yee Ling; Ramli, Norlisah; Syed Omar, Sharifah Faridah; Kahar Bador, Maria; Tan, Chong Tin

2014-01-01

Background From the 17th to 19th January 2012, a group of 92 college students and teachers attended a retreat in a hotel located on Pangkor Island, off the west coast of Peninsular Malaysia. Following the onset of symptoms in many participants who presented to our institute, an investigation was undertaken which ultimately identified Sarcocystis nesbitti as the cause of this outbreak. Methodology/Principal Findings All retreat participants were identified, and clinical and epidemiological information was obtained via clinical review and self-reported answers to a structured questionnaire. Laboratory, imaging and muscle biopsy results were evaluated and possible sources of exposure, in particular water supply, were investigated. At an average of 9–11 days upon return from the retreat, 89 (97%) of the participants became ill. A vast majority of 94% had fever with 57% of these persons experiencing relapsing fever. Myalgia was present in 91% of patients. Facial swelling from myositis of jaw muscles occurred in 9 (10%) patients. The median duration of symptoms was 17 days (IQR 7 to 30 days; range 3 to 112). Out of 4 muscle biopsies, sarcocysts were identified in 3. S. nesbitti was identified by PCR in 3 of the 4 biopsies including one biopsy without observed sarcocyst. Non-Malaysians had a median duration of symptoms longer than that of Malaysians (27.5 days vs. 14 days, p = 0.001) and were more likely to experience moderate or severe myalgia compared to mild myalgia (83.3% vs. 40.0%, p = 0.002). Conclusions/Significance The similarity of the symptoms and clustered time of onset suggests that all affected persons had muscular sarcocystosis. This is the largest human outbreak of sarcocystosis ever reported, with the specific Sarcocystis species identified. The largely non-specific clinical features of this illness suggest that S. nesbitti may be an under diagnosed infection in the tropics. PMID:24854350

Sustainability and public health nutrition at school: assessing the integration of healthy and environmentally sustainable food initiatives in Vancouver schools.

PubMed

Black, Jennifer L; Velazquez, Cayley E; Ahmadi, Naseam; Chapman, Gwen E; Carten, Sarah; Edward, Joshua; Shulhan, Stephanie; Stephens, Teya; Rojas, Alejandro

2015-09-01

To describe the development and application of the School Food Environment Assessment Tools and a novel scoring system to assess the integration of healthy and environmentally sustainable food initiatives in elementary and secondary schools. The cross-sectional study included direct observations of physical food environments and interviews with key school personnel regarding food-related programmes and policies. A five-point scoring system was then developed to assess actions across six domains: (i) food gardens; (ii) composting systems; (iii) food preparation activities; (iv) food-related teaching and learning activities; and availability of (v) healthy food; and (vi) environmentally sustainable food. Vancouver, Canada. A purposive sample of public schools (n 33) from all six sectors of the Vancouver Board of Education. Schools scored highest in the areas of food garden and compost system development and use. Regular integration of food-related teaching and learning activities and hands-on food preparation experiences were also commonly reported. Most schools demonstrated rudimentary efforts to make healthy and environmentally sustainable food choices available, but in general scored lowest on these two domains. Moreover, no schools reported widespread initiatives fully supporting availability or integration of healthy or environmentally sustainable foods across campus. More work is needed in all areas to fully integrate programmes and policies that support healthy, environmentally sustainable food systems in Vancouver schools. The assessment tools and proposed indicators offer a practical approach for researchers, policy makers and school stakeholders to assess school food system environments, identify priority areas for intervention and track relevant changes over time.

[Foodborne disease outbreaks surveillance in Chile].

PubMed

Olea, Andrea; Díaz, Janepsy; Fuentes, Rodrigo; Vaquero, Alejandra; García, Maritza

2012-10-01

Foodborne disease outbreaks are one of the main health problems globally, having an extensive impact on human welfare. The World Health Organization considers them as the main cause of morbidity and mortality in developing countries, and responsible for high levels of loss of productivity in developed countries. To describe the epidemiology of foodborne disease outbreaks according to data contained in an automated surveillance system. Descriptive observational study of notified outbreaks from the surveillance system, between 2005 and 2010 in Chile. The information was based on etiology, temporal and spatial distribution, and epidemiologic description of outbreaks during this period. There were 5,689 notified outbreaks. Most of them occurred during 2006 (1,106 outbreaks, rate 6.7 per 100,000 inhabitants) and 2008 (1,316 outbreaks, rate 7.9 per 100, 000 inhabitants) with an increase during summer. Fifty four percent occurred in the Metropolitan region. The group aged 15 to 44 years old, was the most affected one. Sixty four percent of the outbreaks had the food involved registered, of which fish and fishery products reached 42%. An 81% of the outbreaks did not have a precise etiologic diagnosis. Of all patients involved, 97% were outpatients, 3,2% were hospitalized patients, and 0,1% died. Only 49% of the outbreaks had information about the lack of food safety, with a 34,1% related to food handling procedures. Through the information on the epidemiology of foodborne diseases obtained by the Chilean surveillance system, appropriate control measures could be taken.

Epidemiological dynamics of Ebola outbreaks

PubMed Central

House, Thomas

2014-01-01

Ebola is a deadly virus that causes frequent disease outbreaks in the human population. In this study, we analyse its rate of new introductions, case fatality ratio, and potential to spread from person to person. The analysis is performed for all completed outbreaks and for a scenario where these are augmented by a more severe outbreak of several thousand cases. The results show a fast rate of new outbreaks, a high case fatality ratio, and an effective reproductive ratio of just less than 1. DOI: http://dx.doi.org/10.7554/eLife.03908.001 PMID:25217532

Forest defoliator outbreaks under climate change: effects on the frequency and severity of outbreaks of five pine insect pests.

PubMed

Haynes, Kyle J; Allstadt, Andrew J; Klimetzek, Dietrich

2014-06-01

To identify general patterns in the effects of climate change on the outbreak dynamics of forest-defoliating insect species, we examined a 212-year record (1800-2011) of outbreaks of five pine-defoliating species (Bupalus piniarius, Panolis flammea, Lymantria monacha, Dendrolimus pini, and Diprion pini) in Bavaria, Germany for the evidence of climate-driven changes in the severity, cyclicity, and frequency of outbreaks. We also accounted for historical changes in forestry practices and examined effects of past insecticide use to suppress outbreaks. Analysis of relationships between severity or occurrence of outbreaks and detrended measures of temperature and precipitation revealed a mixture of positive and negative relationships between temperature and outbreak activity. Two moth species (P. flammea and Dendrolimus pini) exhibited lower outbreak activity following years or decades of unusually warm temperatures, whereas a sawfly (Diprion pini), for which voltinism is influenced by temperature, displayed increased outbreak occurrence in years of high summer temperatures. We detected only one apparent effect of precipitation, which showed Dendrolimus pini outbreaks tending to follow drought. Wavelet analysis of outbreak time series suggested climate change may be associated with collapse of L. monacha and Dendrolimus pini outbreak cycles (loss of cyclicity and discontinuation of outbreaks, respectively), but high-frequency cycles for B. piniarius and P. flammea in the late 1900s. Regional outbreak severity was generally not related to past suppression efforts (area treated with insecticides). Recent shifts in forestry practices affecting tree species composition roughly coincided with high-frequency outbreak cycles in B. piniarius and P. flammea but are unlikely to explain the detected relationships between climate and outbreak severity or collapses of outbreak cycles. Our results highlight both individualistic responses of different pine-defoliating species to

Was infectious syphilis being misclassified in remote Australian outbreaks? Evidence that informed modification of the national case definition.

PubMed

Preston-Thomas, Annie; Ryder, Nathan; Harmen, Sonia; Fagan, Patricia

2015-12-31

To assess the ability of the national case definition to identify infectious syphilis during an outbreak affecting predominantly Aboriginal and Torres Strait Islander people in a remote Australian region. A retrospective case series study of all non-congenital syphilis cases in the region notified between 1 January 2009 and 31 December 2012 was performed. The national infectious syphilis case definition was compared with an expanded case definition derived from experienced clinician assessment and the definition proposed in the Interim Guidelines for the Public Health Management of Syphilis Outbreaks in Remote Populations in Australia from the Communicable Diseases Network Australia (CDNA). Two hundred and forty syphilis cases were notified, of which 44 (18.3%) were symptomatic. The national case definition classified 106 (44.2%) cases as infectious, compared with 182 (75.8%) using the clinician-derived expanded case definition and 165 (68.8%) by the interim guidelines case definition. Seven confirmed and 6 probable cases were diagnosed as a result of contact tracing of probable infectious cases identified using the expanded case definition. The national case definition for infectious syphilis applied in this remote Australian outbreak underestimated infectious cases when compared with experienced clinicians' evaluation by up to 76 cases (42%) and was inadequate to monitor the magnitude of a syphilis outbreak in such a setting. This may compromise surveillance and resource allocation decisions, and could reduce the capacity to interrupt transmission and contain an outbreak. A revised national case definition, informed by this analysis, was released by CDNA in July 2015.

Food Source Prediction of Shiga Toxin-Producing Escherichia coli Outbreaks Using Demographic and Outbreak Characteristics, United States, 1998-2014.

PubMed

White, Alice; Cronquist, Alicia; Bedrick, Edward J; Scallan, Elaine

2016-10-01

Foodborne illness is a continuing public health problem in the United States. Although outbreak-associated illnesses represent a fraction of all foodborne illnesses, foodborne outbreak investigations provide critical information on the pathogens, foods, and food-pathogen pairs causing illness. Therefore, identification of a food source in an outbreak investigation is key to impacting food safety. The objective of this study was to systematically identify outbreak-associated case demographic and outbreak characteristics that are predictive of food sources using Shiga toxin-producing Escherichia coli (STEC) outbreaks reported to Centers for Disease Control and Prevention (CDC) from 1998 to 2014 with a single ingredient identified. Differences between STEC food sources by all candidate predictors were assessed univariately. Multinomial logistic regression was used to build a prediction model, which was internally validated using a split-sample approach. There were 206 single-ingredient STEC outbreaks reported to CDC, including 125 (61%) beef outbreaks, 30 (14%) dairy outbreaks, and 51 (25%) vegetable outbreaks. The model differentiated food sources, with an overall sensitivity of 80% in the derivation set and 61% in the validation set. This study demonstrates the feasibility for a tool for public health professionals to rule out food sources during hypothesis generation in foodborne outbreak investigation and to improve efficiency while complementing existing methods.

Economic Assessment of Waterborne Outbreak of Cryptosporidiosis

PubMed Central

Chyzheuskaya, Aksana; Cormican, Martin; Srivinas, Raghavendra; O’Donovan, Diarmuid; Prendergast, Martina; O’Donoghue, Cathal

2017-01-01

In 2007, a waterborne outbreak of Cryptosporidium hominis infection occurred in western Ireland, resulting in 242 laboratory-confirmed cases and an uncertain number of unconfirmed cases. A boil water notice was in place for 158 days that affected 120,432 persons residing in the area, businesses, visitors, and commuters. This outbreak represented the largest outbreak of cryptosporidiosis in Ireland. The purpose of this study was to evaluate the cost of this outbreak. We adopted a societal perspective in estimating costs associated with the outbreak. Economic cost estimated was based on totaling direct and indirect costs incurred by public and private agencies. The cost of the outbreak was estimated based on 2007 figures. We estimate that the cost of the outbreak was >€19 million (≈€120,000/day of the outbreak). The US dollar equivalent based on today’s exchange rates would be $22.44 million (≈$142,000/day of the outbreak). This study highlights the economic need for a safe drinking water supply. PMID:28930007

Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015

PubMed Central

Alhamlan, F S; Majumder, M S; Brownstein, J S; Hawkins, J; Al-Abdely, H M; Alzahrani, A; Obaid, D A; Al-Ahdal, M N; BinSaeed, A

2017-01-01

Objectives As of 1 November 2015, the Saudi Ministry of Health had reported 1273 cases of Middle East respiratory syndrome (MERS); among these cases, which included 9 outbreaks at several hospitals, 717 (56%) patients recovered, 14 (1%) remain hospitalised and 543 (43%) died. This study aimed to determine the epidemiological, demographic and clinical characteristics that distinguished cases of MERS contracted during outbreaks from those contracted sporadically (ie, non-outbreak) between 2012 and 2015 in Saudi Arabia. Design Data from the Saudi Ministry of Health of confirmed outbreak and non-outbreak cases of MERS coronavirus (CoV) infections from September 2012 through October 2015 were abstracted and analysed. Univariate and descriptive statistical analyses were conducted, and the time between disease onset and confirmation, onset and notification and onset and death were examined. Results A total of 1250 patients (aged 0–109 years; mean, 50.825 years) were reported infected with MERS-CoV. Approximately two-thirds of all MERS cases were diagnosed in men for outbreak and non-outbreak cases. Healthcare workers comprised 22% of all MERS cases for outbreak and non-outbreak cases. Nosocomial infections comprised one-third of all Saudi MERS cases; however, nosocomial infections occurred more frequently in outbreak than non-outbreak cases (p<0.001). Patients contracting MERS during an outbreak were significantly more likely to die of MERS (p<0.001). Conclusions To date, nosocomial infections have fuelled MERS outbreaks. Given that the Kingdom of Saudi Arabia is a worldwide religious travel destination, localised outbreaks may have massive global implications and effective outbreak preventive measures are needed. PMID:28082362

Salmonellosis outbreak due to chicken contact leading to a foodborne outbreak associated with infected delicatessen workers.

PubMed

Hedican, Erin; Miller, Ben; Ziemer, Brian; LeMaster, Pam; Jawahir, Selina; Leano, Fe; Smith, Kirk

2010-08-01

Salmonella is the most common bacterial cause of foodborne outbreaks in the United States. Starting in June 2007, investigation of a cluster of Salmonella Montevideo cases with indistinguishable pulsed-field gel electrophoresis (PFGE) patterns resulted in the identification of an outbreak associated with contact with chickens purchased from a single hatchery. Nine Minnesota cases from May through August 2007 were part of this outbreak. Cases with the outbreak PFGE pattern of Salmonella Montevideo continued to occur in Minnesota after August, but none of these cases reported chicken contact. The majority of these cases resided in the same town in rural Minnesota. Routine interviews revealed that all cases from these counties purchased groceries from the same local grocery store, with two specifically reporting consuming items from the grocery store delicatessen in the week before illness. As a result, an investigation into the delicatessen was initiated. Illness histories and stool samples were collected from all delicatessen employees, and food and environmental samples were collected. None of the employees reported experiencing recent gastrointestinal symptoms, but the outbreak PFGE subtype of Salmonella Montevideo was identified from stool from two food workers. Food and environmental samples collected tested negative for Salmonella. One of the positive employees reported having chickens at home, but the animals did not test positive for Salmonella. The positive food workers were excluded from work until they had two consecutive negative stool cultures for Salmonella. There was no evidence of ongoing transmission thereafter. This was an outbreak of Salmonella Montevideo infections that began as an animal-contact-associated outbreak which subsequently resulted in a foodborne outbreak associated with infected food workers. These outbreaks illustrate the complex epidemiology of salmonellosis.

Great Basin insect outbreaks

Treesearch

Barbara Bentz; Diane Alston; Ted Evans

2008-01-01

Outbreaks of native and exotic insects are important drivers of ecosystem dynamics in the Great Basin. The following provides an overview of range, forest, ornamental, and agricultural insect outbreaks occurring in the Great Basin and the associated management issues and research needs.

Pre-outbreak forest conditions mediate the effects of spruce beetle outbreaks on fuels in subalpine forests of Colorado.

PubMed

Mietkiewicz, Nathan; Kulakowski, Dominik; Veblen, Thomas T

2018-03-01

Over the past 30 years, forest disturbances have increased in size, intensity, and frequency globally, and are predicted to continue increasing due to climate change, potentially relaxing the constraints of vegetation properties on disturbance regimes. However, the consequences of the potentially declining importance of vegetation in determining future disturbance regimes are not well understood. Historically, bark beetles preferentially attack older trees and stands in later stages of development. However, as climate warming intensifies outbreaks by promoting growth of beetle populations and compromising tree defenses, smaller diameter trees and stands in early stages of development now are being affected by outbreaks. To date, no study has considered how stand age and other pre-outbreak forest conditions mediate the effects of outbreaks on surface and aerial fuel arrangements. We collected fuels data across a chronosequence of post-outbreak sites affected by spruce beetle (SB) between the 1940s and the 2010s, stratified by young (<130 yr) and old (>130 yr) post-fire stands. Canopy and surface fuel loads were calculated for each tree and stand, and available crown fuel load, crown bulk density, and canopy bulk densities were estimated. Canopy bulk density and density of live canopy individuals were reduced in all stands affected by SB, though foliage loss was proportionally greater in old stands as compared to young stands. Fine surface fuel loads in young stands were three times greater shortly (<30 yr) following outbreak as compared to young stands not affected by outbreak, after which the abundance of fine surface fuels decreased to below endemic (i.e., non-outbreak) levels. In both young and old stands, the net effect of SB outbreaks during the 20th and 21st centuries reduced total canopy fuels and increased stand-scale spatial heterogeneity of canopy fuels following outbreak. Importantly, the decrease in canopy fuels following outbreaks was greater in

Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015.

PubMed

Alhamlan, F S; Majumder, M S; Brownstein, J S; Hawkins, J; Al-Abdely, H M; Alzahrani, A; Obaid, D A; Al-Ahdal, M N; BinSaeed, A

2017-01-12

As of 1 November 2015, the Saudi Ministry of Health had reported 1273 cases of Middle East respiratory syndrome (MERS); among these cases, which included 9 outbreaks at several hospitals, 717 (56%) patients recovered, 14 (1%) remain hospitalised and 543 (43%) died. This study aimed to determine the epidemiological, demographic and clinical characteristics that distinguished cases of MERS contracted during outbreaks from those contracted sporadically (ie, non-outbreak) between 2012 and 2015 in Saudi Arabia. Data from the Saudi Ministry of Health of confirmed outbreak and non-outbreak cases of MERS coronavirus (CoV) infections from September 2012 through October 2015 were abstracted and analysed. Univariate and descriptive statistical analyses were conducted, and the time between disease onset and confirmation, onset and notification and onset and death were examined. A total of 1250 patients (aged 0-109 years; mean, 50.825 years) were reported infected with MERS-CoV. Approximately two-thirds of all MERS cases were diagnosed in men for outbreak and non-outbreak cases. Healthcare workers comprised 22% of all MERS cases for outbreak and non-outbreak cases. Nosocomial infections comprised one-third of all Saudi MERS cases; however, nosocomial infections occurred more frequently in outbreak than non-outbreak cases (p<0.001). Patients contracting MERS during an outbreak were significantly more likely to die of MERS (p<0.001). To date, nosocomial infections have fuelled MERS outbreaks. Given that the Kingdom of Saudi Arabia is a worldwide religious travel destination, localised outbreaks may have massive global implications and effective outbreak preventive measures are needed. 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/.

Fault tree analysis of the causes of waterborne outbreaks.

PubMed

Risebro, Helen L; Doria, Miguel F; Andersson, Yvonne; Medema, Gertjan; Osborn, Keith; Schlosser, Olivier; Hunter, Paul R

2007-01-01

Prevention and containment of outbreaks requires examination of the contribution and interrelation of outbreak causative events. An outbreak fault tree was developed and applied to 61 enteric outbreaks related to public drinking water supplies in the EU. A mean of 3.25 causative events per outbreak were identified; each event was assigned a score based on percentage contribution per outbreak. Source and treatment system causative events often occurred concurrently (in 34 outbreaks). Distribution system causative events occurred less frequently (19 outbreaks) but were often solitary events contributing heavily towards the outbreak (a mean % score of 87.42). Livestock and rainfall in the catchment with no/inadequate filtration of water sources contributed concurrently to 11 of 31 Cryptosporidium outbreaks. Of the 23 protozoan outbreaks experiencing at least one treatment causative event, 90% of these events were filtration deficiencies; by contrast, for bacterial, viral, gastroenteritis and mixed pathogen outbreaks, 75% of treatment events were disinfection deficiencies. Roughly equal numbers of groundwater and surface water outbreaks experienced at least one treatment causative event (18 and 17 outbreaks, respectively). Retrospective analysis of multiple outbreaks of enteric disease can be used to inform outbreak investigations, facilitate corrective measures, and further develop multi-barrier approaches.

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

PubMed Central

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

2015-01-01

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

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

PubMed Central

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

2013-01-01

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

Selective Impact of Disease on Coral Communities: Outbreak of White Syndrome Causes Significant Total Mortality of Acropora Plate Corals

PubMed Central

Hobbs, Jean-Paul A.; Frisch, Ashley J.; Newman, Stephen J.; Wakefield, Corey B.

2015-01-01

Coral diseases represent a significant and increasing threat to coral reefs. Among the most destructive diseases is White Syndrome (WS), which is increasing in distribution and prevalence throughout the Indo-Pacific. The aim of this study was to determine taxonomic and spatial patterns in mortality rates of corals following the 2008 outbreak of WS at Christmas Island in the eastern Indian Ocean. WS mainly affected Acropora plate corals and caused total mortality of 36% of colonies across all surveyed sites and depths. Total mortality varied between sites but was generally much greater in the shallows (0–96% of colonies at 5 m depth) compared to deeper waters (0–30% of colonies at 20 m depth). Site-specific mortality rates were a reflection of the proportion of corals affected by WS at each site during the initial outbreak and were predicted by the initial cover of live Acropora plate cover. The WS outbreak had a selective impact on the coral community. Following the outbreak, live Acropora plate coral cover at 5 m depth decreased significantly from 7.0 to 0.8%, while the cover of other coral taxa remained unchanged. Observations five years after the initial outbreak revealed that total Acropora plate cover remained low and confirmed that corals that lost all their tissue due to WS did not recover. These results demonstrate that WS represents a significant and selective form of coral mortality and highlights the serious threat WS poses to coral reefs in the Indo-Pacific. PMID:26147291

Oversight Hearing on the Reauthorization of the Higher Education Act of 1965: Vancouver, Washington. Hearing before the Subcommittee on Postsecondary Education of the Committee on Education and Labor. House of Representatives, One Hundred Second Congress, First Session (Vancouver, WA, May 13, 1991).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and Labor.

One of 17 field hearings on the reauthorization of the Higher Education Act of 1965 occurred in Vancouver, Washington, with testimony provided by students, a parent, and educational administrators from the northwest region. The topic for the hearing was particular to the Act's Title IV which provides loans to students to enable them to attend the…

DISEASE OUTBREAKS CAUSED BY DRINKING WATER

EPA Science Inventory

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

A multi-scale approach to monitor urban carbon-dioxide emissions in the atmosphere over Vancouver, Canada

NASA Astrophysics Data System (ADS)

Christen, A.; Crawford, B.; Ketler, R.; Lee, J. K.; McKendry, I. G.; Nesic, Z.; Caitlin, S.

2015-12-01

Measurements of long-lived greenhouse gases in the urban atmosphere are potentially useful to constrain and validate urban emission inventories, or space-borne remote-sensing products. We summarize and compare three different approaches, operating at different scales, that directly or indirectly identify, attribute and quantify emissions (and uptake) of carbon dioxide (CO2) in urban environments. All three approaches are illustrated using in-situ measurements in the atmosphere in and over Vancouver, Canada. Mobile sensing may be a promising way to quantify and map CO2 mixing ratios at fine scales across heterogenous and complex urban environments. We developed a system for monitoring CO2 mixing ratios at street level using a network of mobile CO2 sensors deployable on vehicles and bikes. A total of 5 prototype sensors were built and simultaneously used in a measurement campaign across a range of urban land use types and densities within a short time frame (3 hours). The dataset is used to aid in fine scale emission mapping in combination with simultaneous tower-based flux measurements. Overall, calculated CO2 emissions are realistic when compared against a spatially disaggregated scale emission inventory. The second approach is based on mass flux measurements of CO2 using a tower-based eddy covariance (EC) system. We present a continuous 7-year long dataset of CO2 fluxes measured by EC at the 28m tall flux tower 'Vancouver-Sunset'. We show how this dataset can be combined with turbulent source area models to quantify and partition different emission processes at the neighborhood-scale. The long-term EC measurements are within 10% of a spatially disaggregated scale emission inventory. Thirdly, at the urban scale, we present a dataset of CO2 mixing ratios measured using a tethered balloon system in the urban boundary layer above Vancouver. Using a simple box model, net city-scale CO2 emissions can be determined using measured rate of change of CO2 mixing ratios

Seroadaptive Strategies of Gay & Bisexual Men (GBM) With the Highest Quartile Number of Sexual Partners in Vancouver, Canada

PubMed Central

Card, Kiffer G.; Lachowsky, Nathan J; Cui, Zishan; Sereda, Paul; Rich, Ashleigh; Jollimore, Jody; Howard, Terry; Birch, Robert; Carter, Allison; Montaner, Julio; Moore, David; Hogg, Robert S.; Roth, Eric Abella

2017-01-01

Despite continued research among men with more sexual partners, little information exists on their seroadaptive behavior. Therefore, we examined seroadaptive anal sex strategies among 719 Vancouver gay and bisexual men (GBM) recruited using respondent driven sampling (RDS). Our objectives were to (1) describe the distribution in frequency of male sexual partnering among Vancouver GBM, and (2) identify important covariates associated with the number of male sexual partners. To this aims, we provide descriptive, univariate, and multivariate adjusted statistics, stratified by HIV status, for the association between having ≥7 male anal sex partners in the past six months (Population Q3, versus <7). Sensitivity Analysis were also performed to assess the robustness of this cut-off point. Results suggest that GBM with more sexual partners are more likely to employ seroadaptive strategies than men with fewer partners. These strategies may be used in hopes of offsetting risk, assessing needs for subsequent HIV testing, and balancing personal health with sexual intimacy. Further research is needed to determine the efficacy of these strategies, assess how GBM perceive their efficacy, and understand the social and health impacts of their widespread uptake. PMID:27568338

Isabela Island, Galapagos Islands

NASA Image and Video Library

1996-01-20

STS072-732-072 (11-20 Jan. 1996) --- Three of the nineteen Galapagos Islands are visible in this image, photographed from the Earth-orbiting Space Shuttle Endeavour. The Galapagos Islands are located 600 miles (1,000 kilometers) to the west of Ecuador. The largest of the islands, Isabela, is at center (north is toward the upper right corner). The numerous circular features on the island, highlighted by clouds, are volcanoes. The Galapagos Islands owe their existence to a hot spot, or persistent heat source in the mantle, which also is located over a rift, or place where plates are separating and new crust is being created. The rift is located between the Cocos and Nazca Plates. The dark linear features on the islands are lava flows from past eruptions. The island to the left of Isabela is Fernandina, while the island to the right is San Salvador. The Galapagos Islands were visited by the English naturalist Charles Darwin in 1835.

Risk posed by the Ebola epidemic to the Pacific islands: findings of a recent World Health Organization assessment.

PubMed

Craig, Adam T; Ronsse, Axelle; Hardie, Kate; Pavlin, Boris I; Biaukula, Viema; Nilles, Eric J

2015-01-01

To assess the public health risk posed by the ongoing Ebola virus disease (EVD) epidemic in West Africa to Pacific island countries and areas and to highlight priority risk management actions for preparedness and response. The likelihood of EVD importation and the magnitude of public health impact in Pacific island countries and areas were assessed to determine overall risk. Literature about the hazard, epidemiology, exposure and contextual factors associated with EVD was collected and reviewed. Epidemiological information from the current EVD outbreak was assessed. As of 11 March 2015, there have been more than 24,200 reported cases of EVD and at least 9976 deaths in six West African countries. Three EVD cases have been infected outside of the West African region, and all have epidemiological links to the outbreak in West Africa. Pacific island countries' and areas' relative geographic isolation and lack of travel or trade links between countries with transmission means that EVD importation is very unlikely. However, should a case be imported, the health and non-health consequences would be major. The capacity of Pacific island countries and areas to respond adequately varies greatly between (and within) states but in general is limited. This risk assessment highlights the needs to enhance preparedness for EVD in the Pacific by strengthening the capacities outlined in the World Health Organization Framework for Action on Ebola. Priority areas include the ability to detect and respond to suspected EVD cases quickly, isolation and management of cases in appropriately resourced facilities and the prevention of further cases through infection prevention and control. These efforts for Ebola should enhance all-hazards public health preparedness in line with the International Health Regulations (2005).

An Assessment of Household and Individual-Level Mosquito Prevention Methods during the Chikungunya Virus Outbreak in the United States Virgin Islands, 2014-2015.

PubMed

Feldstein, Leora R; Rowhani-Rahbar, Ali; Staples, J Erin; Halloran, M Elizabeth; Ellis, Esther M

2018-03-01

Recent large-scale chikungunya virus (CHIKV) and Zika virus epidemics in the Americas pose a growing public health threat. Given that mosquito bite prevention and vector control are the main prevention methods available to reduce transmission of these viruses, we assessed adherence to these methods in the United States Virgin Islands (USVI). We interviewed 334 USVI residents between December 2014 and February 2015 to measure differences in mosquito prevention practices by gender, income, presence of CHIKV symptoms, and age. Only 27% (91/334) of participants reported having an air conditioner, and of the 91 with air-conditioners, 18 (20%) reported never using it. Annual household income > $50,000 was associated with owning and using an air conditioner (41%; 95% confidence interval [CI]: 28-53% compared with annual household income ≤ $50,000: 17%; 95% CI: 12-22%). The majority of participants reported the presence of vegetation in their yard or near their home (79%; 265) and a cistern on their property (78%; 259). Only 52 (16%) participants reported wearing mosquito repellent more than once per week. Although the majority (80%; 268) of participants reported having screens on all of their windows and doors, most (82%; 273) of those interviewed still reported seeing mosquitoes in their homes. Given the uniformly low adherence to individual- and household-level mosquito bite prevention measures in the USVI, these findings emphasize the need for improved public health messaging and investment in therapeutic and vaccine research to mitigate vector-borne disease outbreaks.

Targeted mass treatment for syphilis with oral azithromycin.

PubMed

Rekart, Michael L; Patrick, David M; Chakraborty, Bubli; Maginley, Juanita J L; Jones, H D; Bajdik, Chris D; Pourbohloul, Babak; Brunham, Robert C

2003-01-25

From mid 1997 to end of 1999, there was a sexually-transmitted infectious syphilis outbreak mainly in heterosexual people in British Columbia, Canada, that was concentrated in Vancouver. The rate across the province increased from less than 0.5 to 3.4 per 100000, and the rate in Vancouver reached 12.9 per 100000. We aimed to eliminate the syphillis outbreak by treating people at risk of infection. In 2000, a targeted mass treatment programme provided azithromycin (1.8 g orally) to 4384 at-risk residents in this city. After the programme, syphilis frequency fell significantly for 6 months (p=0.016), but rose again in 2001. Results from curve fitting analyses showed that the number of cases in 2001 (177) was higher than expected (0.0001

Phenotypic and genotypic heterogeneity among Streptococcus iniae isolates recovered from cultured and wild fish in North America, Central America and the Caribbean Islands

USDA-ARS?s Scientific Manuscript database

Streptococcus iniae, the etiological agent of streptococcosis in fish, is an important pathogen of cultured and wild fish worldwide. During the last decade outbreaks of streptococcosis have occurred in a wide range of cultured and wild fish in the Americas and Caribbean islands. To gain a better und...

Enterovirus 71 Outbreak, Brunei

PubMed Central

Sam, I-Ching; Yusof, Jaliha; Lim, Meng Keang; Misbah, Suzana; Hooi, Poh-Sim

2009-01-01

Enterovirus 71 (EV71) outbreaks occur periodically in the Asia-Pacific region. In 2006, Brunei reported its first major outbreak of EV71 infections, associated with fatalities from neurologic complications. Isolated EV71 strains formed a distinct lineage with low diversity within subgenogroup B5, suggesting recent introduction and rapid spread within Brunei. PMID:19116058

Mountains, Melting Pot, and Microcosm: Health Care Delay and Dengue/Zika Interplay on Hawaii Island.

PubMed

Baenziger, Nancy L

2016-11-01

Human history in the Hawaiian Islands offers a sobering study in the population dynamics of infectious disease. The indigenous population numbering an estimated half million people prior to Western contact in 1778 was reduced to less than 24,000 by 1920. Much of the decline occurred in the earliest decades after contact with Western diseases including measles, chicken pox, polio, tuberculosis, and venereal disease. A recent outbreak on the Island of Hawaii (also called the Big Island) of imported dengue fever, an illness endemic in 100 countries affecting an estimated 100-400 million people worldwide, provides insights into the problems and prospects for health care policy in managing mosquito-borne disease in a multicultural setting of geographic isolation and health care provider shortage. This incident represents in microcosm a practice run, applicable in many contexts, for an initial localized appearance of Zika virus infection, with important lessons for effective health care management in a rapidly moving and fluid arena.

Epidemiology of foodborne Norovirus outbreaks in Catalonia, Spain

PubMed Central

Martinez, Ana; Dominguez, Angela; Torner, Nuria; Ruiz, Laura; Camps, Neus; Barrabeig, Irene; Arias, Cesar; Alvarez, Josep; Godoy, Pere; Balaña, Pilar Jorgina; Pumares, Analia; Bartolome, Rosa; Ferrer, Dolors; Perez, Unai; Pinto, Rosa; Buesa, Javier

2008-01-01

Background Noroviruses are one of the principal biological agents associated with the consumption of contaminated food. The objective of this study was to analyse the size and epidemiological characteristics of foodborne outbreaks of gastroenteritis in Catalonia, a region in the northeast of Spain. Methods In all reported outbreaks of gastroenteritis associated with food consumption, faecal samples of persons affected were analysed for bacteria and viruses and selectively for parasites. Study variables included the setting, the number of people exposed, age, sex, clinical signs and hospital admissions. The study was carried out from October 2004 to October 2005. Results Of the 181 outbreaks reported during the study period, 72 were caused by Salmonella and 30 by norovirus (NoV); the incidence rates were 14.5 and 9.9 per 100,000 person-years, respectively. In 50% of the NoV outbreaks and 27% of the bacterial outbreaks (p = 0.03) the number of persons affected was ≥10; 66.7% of NoV outbreaks occurred in restaurants; no differences in the attack rates were observed according to the etiology. Hospitalizations were more common (p = 0.03) in bacterial outbreaks (8.6%) than in NoV outbreaks (0.15%). Secondary cases accounted for 4% of cases in NoV outbreaks compared with 0.3% of cases in bacterial outbreaks (p < 0.001) Conclusion Norovirus outbreaks were larger but less frequent than bacterial outbreaks, suggesting that underreporting is greater for NoV outbreaks. Food handlers should receive training on the transmission of infections in diverse situations. Very strict control measures on handwashing and environmental disinfection should be adopted in closed or partially-closed institutions. PMID:18410687

Zika Virus Outbreak in Haiti in 2014: Molecular and Clinical Data

PubMed Central

Lednicky, John; Beau De Rochars, Valery Madsen; El Badry, Maha; Loeb, Julia; Telisma, Taina; Chavannes, Sonese; Anilis, Gina; Cella, Eleonora; Ciccozzi, Massimo; Rashid, Mohammed; Okech, Bernard; Salemi, Marco; Morris, J. Glenn

2016-01-01

Background Zika virus (ZIKV), first isolated in Uganda in 1947, is currently spreading rapidly through South America and the Caribbean. In Brazil, infection has been linked with microcephaly and other serious complications, leading to declaration of a public health emergency of international concern; however, there currently are only limited data on the virus (and its possible sources and manifestations) in the Caribbean. Methods From May, 2014-February, 2015, in conjunction with studies of chikungunya (CHIKV) and dengue (DENV) virus infections, blood samples were collected from children in the Gressier/Leogane region of Haiti who presented to a school clinic with undifferentiated febrile illness. Samples were initially screened by RT-PCR for CHIKV and DENV, with samples negative in these assays further screened by viral culture. Findings Of 177 samples screened, three were positive for ZIKV, confirmed by viral sequencing; DENV-1 was also identified in culture from one of the three positive case patients. Patients were from two different schools and 3 different towns, with all three cases occurring within a single week, consistent with the occurrence of an outbreak in the region. Phylogenetic analysis of known full genome viral sequences demonstrated a close relationship with ZIKV from Brazil; additional analysis of the NS5 gene, for which more sequences are currently available, showed the Haitian strains clustering within a monophyletic clade distinct from Brazilian, Puerto Rican and Guatemalan sequences, with all part of a larger clade including isolates from Easter Island. Phylogeography also clarified that at least three major African sub-lineages exist, and confirmed that the South American epidemic is most likely to have originated from an initial ZIKV introduction from French Polynesia into Easter Island, and then to the remainder of the Americas. Conclusions ZIKV epidemics in South America, as well as in Africa, show complex dissemination patterns. The

[Epidemiological characteristics of influenza outbreaks in China, 2005-2013].

PubMed

Li, Ming; Feng, Luzhao; Cao, Yu; Peng, Zhibin; Yu, Hongjie

2015-07-01

To understand the epidemiological characteristics of influenza outbreaks in China from 2005 to 2013. The data of influenza-like illness outbreaks involving 10 or more cases were collected through Public Health Emergency Management Information System and National Influenza Surveillance Information System in China, and the influenza outbreaks were identified according to the laboratory detection results. Descriptive epidemiological analysis was conducted to understand the type/subtype of influenza virus and outbreak time, area, place and extent. From 2005 to 2013, a total of 3 252 influenza-like illness outbreaks were reported in the mainland of China, in which 2 915 influenza outbreaks were laboratory confirmed, and influenza A (H1N1) pdm09 virus and influenza B virus were predominant. More influenza outbreaks were reported in the influenza A (H1N1) pandemic during 2009-2010. Influenza outbreaks mainly occurred during winter-spring, and less influenza outbreaks occurred in winter and summer vacations of schools. More influenza outbreaks were reported in southern provinces, accounting for 79% of the total. Influenza outbreaks mainly occurred in primary and middle schools, where 2 763 outbreaks were reported, accounting for 85% of the total. Average 30-99 people were involved in an outbreak. A large number of influenza outbreaks occur during influenza season every year in China, the predominant virus type or subtype varies with season. Primary and middle schools are mainly affected by influenza outbreaks.

Geologic map of the Vancouver and Orchards quadrangles and parts of the Portland and Mount Tabor quadrangles, Clark County, Washington, and Multnomah County, Oregon

USGS Publications Warehouse

O'Connor, Jim E.; Cannon, Charles M.; Mangano, Joseph F.; Evarts, Russell C.

2016-06-03

IntroductionThis is a 1:24,000-scale geologic map of the Vancouver and Orchards quadrangles and parts of the Portland and Mount Tabor quadrangles in the States of Washington and Oregon. The map area is within the Portland Basin and includes most of the city of Vancouver, Washington; parts of Clark County, Washington; and a small part of northwestern Multnomah County, Oregon. The Columbia River flows through the southern part of the map area, generally forming the southern limit of mapping. Mapped Quaternary geologic units include late Pleistocene cataclysmic flood deposits, eolian deposits, and alluvium of the Columbia River and its tributaries. Older deposits include Miocene to Pleistocene alluvium from an ancestral Columbia River. Regional geologic structures are not exposed in the map area but are inferred from nearby mapping.

Coccidioidomycosis Outbreaks, United States and Worldwide, 1940-2015.

PubMed

Freedman, Michael; Jackson, Brendan R; McCotter, Orion; Benedict, Kaitlin

2018-03-01

Coccidioidomycosis causes substantial illness and death in the United States each year. Although most cases are sporadic, outbreaks provide insight into the clinical and environmental features of coccidioidomycosis, high-risk activities, and the geographic range of Coccidioides fungi. We identified reports published in English of 47 coccidioidomycosis outbreaks worldwide that resulted in 1,464 cases during 1940-2015. Most (85%) outbreaks were associated with environmental exposures; the 2 largest outbreaks resulted from an earthquake and a large dust storm. More than one third of outbreaks occurred in areas where the fungus was not previously known to be endemic, and more than half of outbreaks involved occupational exposures. Coccidioidomycosis outbreaks can be difficult to detect and challenging to prevent given the unknown effectiveness of environmental control methods and personal protective equipment; therefore, increased awareness of coccidioidomycosis outbreaks is needed among public health professionals, healthcare providers, and the public.

Food and beverage promotions in Vancouver schools: A study of the prevalence and characteristics of in-school advertising, messaging, and signage

PubMed Central

Velazquez, Cayley E.; Black, Jennifer L.; Ahmadi, Naseam

2015-01-01

The purpose of this study was to provide a descriptive profile of food-related advertising, messaging, and signage in Vancouver schools and to examine differences in the prevalence and characteristics of promotions between elementary and secondary schools. All food-related promotions were photographed in 23 diverse Vancouver public schools between November 2012 and April 2013. Key attributes, including the location, size, and main purpose of each promotion, as well as the type of food and/or beverage advertised and compliance with provincial school nutrition guidelines, were coded. Descriptive statistics assessed the prevalence and characteristics of promotions. Cross-tabulations examined whether the promotional landscape differed between elementary and secondary schools. All secondary and 80% of elementary schools contained food or beverage promotions (median = 17, range = 0–57 promotions per school). Of the 493 promotions documented, approximately 25% depicted “choose least” or “not recommended” items, prohibited for sale by provincial school nutrition guidelines. Nearly 1/3 of promotions advertised commercial items (e.g., brand name beverages such as Pepsi), in violation of the Board of Education's advertising policies and only 13% conveyed nutrition education messages. Close to half of all promotions were created by students for class projects, many of which marketed minimally nutritious items. In Vancouver schools, food-related promotions are common and are more prevalent in secondary than elementary schools. Students are regularly exposed to messaging for nutritionally poor items that are not in compliance with provincial school nutrition guidelines and which violate school board advertising policies. Stronger oversight of food-related promotional materials is needed to ensure that schools provide health promoting food environments. PMID:26844147

Food and beverage promotions in Vancouver schools: A study of the prevalence and characteristics of in-school advertising, messaging, and signage.

PubMed

Velazquez, Cayley E; Black, Jennifer L; Ahmadi, Naseam

2015-01-01

The purpose of this study was to provide a descriptive profile of food-related advertising, messaging, and signage in Vancouver schools and to examine differences in the prevalence and characteristics of promotions between elementary and secondary schools. All food-related promotions were photographed in 23 diverse Vancouver public schools between November 2012 and April 2013. Key attributes, including the location, size, and main purpose of each promotion, as well as the type of food and/or beverage advertised and compliance with provincial school nutrition guidelines, were coded. Descriptive statistics assessed the prevalence and characteristics of promotions. Cross-tabulations examined whether the promotional landscape differed between elementary and secondary schools. All secondary and 80% of elementary schools contained food or beverage promotions (median = 17, range = 0-57 promotions per school). Of the 493 promotions documented, approximately 25% depicted "choose least" or "not recommended" items, prohibited for sale by provincial school nutrition guidelines. Nearly 1/3 of promotions advertised commercial items (e.g., brand name beverages such as Pepsi), in violation of the Board of Education's advertising policies and only 13% conveyed nutrition education messages. Close to half of all promotions were created by students for class projects, many of which marketed minimally nutritious items. In Vancouver schools, food-related promotions are common and are more prevalent in secondary than elementary schools. Students are regularly exposed to messaging for nutritionally poor items that are not in compliance with provincial school nutrition guidelines and which violate school board advertising policies. Stronger oversight of food-related promotional materials is needed to ensure that schools provide health promoting food environments.

Use of serum and blood samples on filter paper to improve the surveillance of Dengue in Pacific Island Countries.

PubMed

Aubry, Maite; Roche, Claudine; Dupont-Rouzeyrol, Myrielle; Aaskov, John; Viallon, Jérôme; Marfel, Maria; Lalita, Paul; Elbourne-Duituturaga, Salanieta; Chanteau, Suzanne; Musso, Didier; Pavlin, Boris I; Harrison, Dustin; Kool, Jacob L; Cao-Lormeau, Van-Mai

2012-09-01

In Pacific Island Countries (PICs) the epidemiology of dengue is characterized by long-term transmission of a single dengue virus (DENV) serotype. The emergence of a new serotype in one island country often indicates major outbreaks with this serotype will follow in other PICs. Filter paper (FP) cards on which whole blood or serum from dengue suspected patients had been dried was evaluated as a method for transportation of this material by standard mail delivery throughout the Pacific. Twenty-two FP-dried whole blood samples collected from patients in New Caledonia and Wallis & Futuna Islands, during DENV-1 and DENV-4 transmission, and 76 FP-dried sera collected from patients in Yap State, Majuro (Republic of Marshall Islands), Tonga and Fiji, before and during outbreaks of DENV-2 in Yap State and DENV-4 in Majuro, were tested for the presence of DENV RNA, by serotype specific RT-PCR, at the Institut Louis Malardé in French Polynesia. The serotype of DENV could be determined, by a variety of RT-PCR procedures, in the FP-dried samples after more than three weeks of transport at ambient temperatures. In most cases, the sequencing of the envelope gene to genotype the viruses also was possible. The serotype and genotype of DENV can be determined from FP-dried serum or whole blood samples transported over thousands of kilometers at ambient, tropical, temperatures. This simple and low-cost approach to virus identification should be evaluated in isolated and resource poor settings for surveillance for a range of significant viral diseases. Copyright © 2012. Published by Elsevier B.V.

Outbreaks of Salmonellosis From Small Turtles.

PubMed

Walters, Maroya Spalding; Simmons, Latoya; Anderson, Tara C; DeMent, Jamie; Van Zile, Kathleen; Matthias, Laura P; Etheridge, Sonia; Baker, Ronald; Healan, Cheryl; Bagby, Rita; Reporter, Roshan; Kimura, Akiko; Harrison, Cassandra; Ajileye, Kadri; Borders, Julie; Crocker, Kia; Smee, Aaron; Adams-Cameron, Meg; Joseph, Lavin A; Tolar, Beth; Trees, Eija; Sabol, Ashley; Garrett, Nancy; Bopp, Cheryl; Bosch, Stacey; Behravesh, Casey Barton

2016-01-01

Turtle-associated salmonellosis (TAS), especially in children, is a reemerging public health issue. In 1975, small pet turtles (shell length <4 inches) sales were banned by federal law; reductions in pediatric TAS followed. Since 2006, the number of multistate TAS outbreaks has increased. We describe 8 multistate outbreaks with illness-onset dates occurring in 2011-2013. We conducted epidemiologic, environmental, and traceback investigations. Cases were defined as infection with ≥ 1 of 10 molecular subtypes of Salmonella Sandiego, Pomona, Poona, Typhimurium, and I 4,[5],12:i:-. Water samples from turtle habitats linked to human illnesses were cultured for Salmonella. We identified 8 outbreaks totaling 473 cases from 41 states, Washington DC, and Puerto Rico with illness onsets during May 2011-September 2013. The median patient age was 4 years (range: 1 month-94 years); 45% percent were Hispanic; and 28% were hospitalized. In the week preceding illness, 68% (187 of 273) of case-patients reported turtle exposure; among these, 88% (124 of 141) described small turtles. Outbreak strains were isolated from turtle habitats linked to human illnesses in seven outbreaks. Traceback investigations identified 2 Louisiana turtle farms as the source of small turtles linked to 1 outbreak; 1 outbreak strain was isolated from turtle pond water from 1 turtle farm. Eight multistate outbreaks associated with small turtles were investigated during 2011-2013. Children <5 years and Hispanics were disproportionately affected. Prevention efforts should focus on patient education targeting families with young children and Hispanics and enactment of state and local regulations to complement federal sales restrictions. Copyright © 2016 by the American Academy of Pediatrics.

[Study of tuberculosis outbreaks reported in Catalonia, 1998-2002].

PubMed

Bran, Carlos M; Caylá, Joan A; Domínguez, Angela; Camps, Neus; Godoy, Pere; Orcau, Angels; Barrabeig, Irene; Alcaide, José; Altet, Neus; Alvarez, Pep

2006-06-01

To analyze the characteristics of tuberculosis outbreaks declared under vigilance programs in Catalonia. Descriptive study of outbreaks from 1998 through 2002 for which reports were available. An outbreak was defined as 3 or more associated cases appearing within a year. For 2 health care regions, outbreaks for which there were full surveillance reports with contact tracing were compared to outbreaks identified but which had not been fully reported. Twenty-seven outbreaks were analyzed. Nineteen (70%) occurred within families. A total of 22 outbreaks were declared upon identification of the true index case and 5 upon detection of secondary cases. The mean annual incidence of outbreaks was 0.40/100,100 inhabitants. Most cases were in males 16 to 40 years of age and involved cavitary lesions and a clinically significant diagnostic delay. Twenty-seven outbreaks caused 69 secondary cases. A longer diagnostic delay was seen to correspond to a larger number of secondary cases (P=.08). In the 2 health care regions analyzed, full surveillance reports with contact tracing were issued for 2 of the 14 outbreaks detected (14.4%). Tuberculosis outbreaks are common but investigative follow-up is scarce. The size of the outbreak is related to the length of diagnostic delay. Rapid diagnosis, contact tracing, and the issuance of a public health report should be priorities in all outbreaks detected.

Increase in Multistate Foodborne Disease Outbreaks-United States, 1973-2010.

PubMed

Nguyen, Von D; Bennett, Sarah D; Mungai, Elisabeth; Gieraltowski, Laura; Hise, Kelley; Gould, L Hannah

2015-11-01

Changes in food production and distribution have increased opportunities for foods contaminated early in the supply chain to be distributed widely, increasing the possibility of multistate outbreaks. In recent decades, surveillance systems for foodborne disease have been improved, allowing officials to more effectively identify related cases and to trace and identify an outbreak's source. We reviewed multistate foodborne disease outbreaks reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System during 1973-2010. We calculated the percentage of multistate foodborne disease outbreaks relative to all foodborne disease outbreaks and described characteristics of multistate outbreaks, including the etiologic agents and implicated foods. Multistate outbreaks accounted for 234 (0.8%) of 27,755 foodborne disease outbreaks, 24,003 (3%) of 700,600 outbreak-associated illnesses, 2839 (10%) of 29,756 outbreak-associated hospitalizations, and 99 (16%) of 628 outbreak-associated deaths. The median annual number of multistate outbreaks increased from 2.5 during 1973-1980 to 13.5 during 2001-2010; the number of multistate outbreak-associated illnesses, hospitalizations, and deaths also increased. Most multistate outbreaks were caused by Salmonella (47%) and Shiga toxin-producing Escherichia coli (26%). Foods most commonly implicated were beef (22%), fruits (13%), and leafy vegetables (13%). The number of identified and reported multistate foodborne disease outbreaks has increased. Improvements in detection, investigation, and reporting of foodborne disease outbreaks help explain the increasing number of reported multistate outbreaks and the increasing percentage of outbreaks that were multistate. Knowing the etiologic agents and foods responsible for multistate outbreaks can help to identify sources of food contamination so that the safety of the food supply can be improved.

Residential eviction and exposure to violence among people who inject drugs in Vancouver, Canada

PubMed Central

Kennedy, Mary Clare; McNeil, Ryan; Milloy, M-J; Dong, Huiru; Kerr, Thomas; Hayashi, Kanna

2017-01-01

Background People who inject drugs (PWID) experience markedly elevated rates of physical and sexual violence, as well as housing instability. While previous studies have demonstrated an association between homelessness and increased exposure to violence among PWID, the relationship between residential eviction and violence is unknown. We therefore sought to examine the association between residential eviction and experiencing violence among PWID in Vancouver, Canada. Methods Data were derived from two open prospective cohort studies of PWID: the Vancouver Injection Drug Users Study (VIDUS) and the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS). We used generalized estimating equations (GEE) to estimate the relationship between residential eviction and experiencing violence among male and female PWID, respectively. Results Between June 2007 and May 2014, 1689 participants were eligible for the analysis, contributing a median of 5.5 years of follow-up. Of these, 567 (33.6%) were female. In total, 259 (45.7%) of females and 566 (50.4%) of males experienced at least one incident of violence over the study period. In multivariable GEE models, residential eviction was independently associated with greater odds of experiencing violence among both females (Adjusted Odds Ratio [AOR] = 2.09; 95% confidence interval [CI]: 1.39–3.13) and males (AOR = 1.95; 95% CI = 1.49–2.55), after adjustment for potential confounders. Conclusion Residential eviction was independently associated with an increased likelihood of experiencing violence among both male and female PWID. These findings point to the need for evidence-based social-structural interventions to mitigate housing instability and violence among PWID in this setting. PMID:28104547

Improving Metabolic and Cardiovascular Health at an Early Psychosis Intervention Program in Vancouver, Canada

PubMed Central

Fredrikson, Diane H.; Boyda, Heidi N.; Tse, Lurdes; Whitney, Zachary; Pattison, Mark A.; Ott, Fred J.; Hansen, Laura; Barr, Alasdair M.

2014-01-01

Psychotic disorders most commonly appear during the late teenage years and early adulthood. A focused and rapid clinical response by an integrated health team can help to improve the quality of life of the patient, leading to a better long-term prognosis. The Vancouver Coastal Health early psychosis intervention program covers a catchment area of approximately 800,000 people in the cities of Vancouver and Richmond, Canada. The program provides a multidisciplinary approach to supporting patients under the age of 30 who have recently experienced first-break psychosis. The program addresses the needs of the treatment environment, medication, and psychological therapies. A critical part of this support includes a program to specifically improve patients’ physical health. Physical health needs are addressed through a two-pronged, parallel approach. Patients receive routine metabolic health assessments during their first year in the program, where standard metabolic parameters are recorded. Based on the results of clinical interviews and laboratory tests, specific actionable interventions are recommended. The second key strategy is a program that promotes healthy lifestyle goal development. Patients work closely with occupational therapists to develop goals to improve cardiometabolic health. These programs are supported by an active research environment, where patients are able to engage in studies with a focus on improving their physical health. These studies include a longitudinal evaluation of the effects of integrated health coaching on maintaining cardiometabolic health in patients recently admitted to the program, as well as a clinical study that evaluates the effects of low versus higher metabolic risk antipsychotic drugs on central adiposity. An additional pharmacogenomic study is helping to identify genetic variants that may predict cardiometabolic changes following treatment with antipsychotic drugs. PMID:25249985

Synchronized and mixed outbreaks of coupled recurrent epidemics.

PubMed

Zheng, Muhua; Zhao, Ming; Min, Byungjoon; Liu, Zonghua

2017-05-25

Epidemic spreading has been studied for a long time and most of them are focused on the growing aspect of a single epidemic outbreak. Recently, we extended the study to the case of recurrent epidemics (Sci. Rep. 5, 16010 (2015)) but limited only to a single network. We here report from the real data of coupled regions or cities that the recurrent epidemics in two coupled networks are closely related to each other and can show either synchronized outbreak pattern where outbreaks occur simultaneously in both networks or mixed outbreak pattern where outbreaks occur in one network but do not in another one. To reveal the underlying mechanism, we present a two-layered network model of coupled recurrent epidemics to reproduce the synchronized and mixed outbreak patterns. We show that the synchronized outbreak pattern is preferred to be triggered in two coupled networks with the same average degree while the mixed outbreak pattern is likely to show for the case with different average degrees. Further, we show that the coupling between the two layers tends to suppress the mixed outbreak pattern but enhance the synchronized outbreak pattern. A theoretical analysis based on microscopic Markov-chain approach is presented to explain the numerical results. This finding opens a new window for studying the recurrent epidemics in multi-layered networks.

Mainstreams of Horizontal Gene Exchange in Enterobacteria: Consideration of the Outbreak of Enterohemorrhagic E. coli O104:H4 in Germany in 2011

PubMed Central

Bezuidt, Oliver; Pierneef, Rian; Mncube, Kingdom; Lima-Mendez, Gipsi; Reva, Oleg N.

2011-01-01

Background Escherichia coli O104:H4 caused a severe outbreak in Europe in 2011. The strain TY-2482 sequenced from this outbreak allowed the discovery of its closest relatives but failed to resolve ways in which it originated and evolved. On account of the previous statement, may we expect similar upcoming outbreaks to occur recurrently or spontaneously in the future? The inability to answer these questions shows limitations of the current comparative and evolutionary genomics methods. Principal Findings The study revealed oscillations of gene exchange in enterobacteria, which originated from marine γ-Proteobacteria. These mobile genetic elements have become recombination hotspots and effective ‘vehicles’ ensuring a wide distribution of successful combinations of fitness and virulence genes among enterobacteria. Two remarkable peculiarities of the strain TY-2482 and its relatives were observed: i) retaining the genetic primitiveness by these strains as they somehow avoided the main fluxes of horizontal gene transfer which effectively penetrated other enetrobacteria; ii) acquisition of antibiotic resistance genes in a plasmid genomic island of β-Proteobacteria origin which ontologically is unrelated to the predominant genomic islands of enterobacteria. Conclusions Oscillations of horizontal gene exchange activity were reported which result from a counterbalance between the acquired resistance of bacteria towards existing mobile vectors and the generation of new vectors in the environmental microflora. We hypothesized that TY-2482 may originate from a genetically primitive lineage of E. coli that has evolved in confined geographical areas and brought by human migration or cattle trade onto an intersection of several independent streams of horizontal gene exchange. Development of a system for monitoring the new and most active gene exchange events was proposed. PMID:22022434

Surveillance for waterborne-disease outbreaks--United States, 1995-1996.

PubMed

Levy, D A; Bens, M S; Craun, G F; Calderon, R L; Herwaldt, B L

1998-12-11

Since 1971, CDC and the U.S. Environmental Protection Agency have maintained a collaborative surveillance system for collecting and periodically reporting data that relate to occurrences and causes of waterborne-disease outbreaks (WBDOs). This summary includes data for January 1995 through December 1996 and previously unreported outbreaks in 1994. The surveillance system includes data about outbreaks associated with drinking water and recreational water. State, territorial, and local public health departments are primarily responsible for detecting and investigating WBDOs and for voluntarily reporting them to CDC on a standard form. For the period 1995-1996, 13 states reported a total of 22 outbreaks associated with drinking water. These outbreaks caused an estimated total of 2,567 persons to become ill. No deaths were reported. The microbe or chemical that caused the outbreak was identified for 14 (63.6%) of the 22 outbreaks. Giardia lamblia and Shigella sonnei each caused two (9.1%) of the 22 outbreaks; Escherichia coli O157:H7, Plesiomonas shigelloides, and a small round structured virus were implicated for one outbreak (4.5%) each. One of the two outbreaks of giardiasis involved the largest number of cases, with an estimated 1,449 ill persons. Seven outbreaks (31.8% of 22) of chemical poisoning, which involved a total of 90 persons, were reported. Copper and nitrite were associated with two outbreaks (9.1% of 22) each and sodium hydroxide, chlorine, and concentrated liquid soap with one outbreak (4.5%) each. Eleven (50.0%) of the 22 outbreaks were linked to well water, eight in noncommunity and three in community systems. Only three of the 10 outbreaks associated with community water systems were caused by problems at water treatment plants; the other seven resulted from problems in the water distribution systems and plumbing of individual facilities (e.g., a restaurant). Six of the seven outbreaks were associated with chemical contamination of the drinking

Trends in antibiotic utilization in Vancouver associated with a community education program on antibiotic use.

PubMed

Fuertes, Elaine Isabelle; Henry, Bonnie; Marra, Fawziah; Wong, Hubert; Patrick, David M

2010-01-01

"Do Bugs Need Drugs" (DBND) is a community education program that was implemented in British Columbia (BC) in September 2005 to decrease inappropriate antibiotic use. This study conducted descriptive analyses of the association between DBND and changes in overall, pediatric, drug-specific, and indication-specific antibiotic utilization rates in Vancouver, BC. Utilization data on all oral solid and liquid antibiotics classified as "antibacterials for systemic use" were obtained from BC PharmaNet for the years 1996 to 2008. Utilization data were linked to physician billing data to allow indication-specific analyses. Following conversion to the defined daily dose (DDD), the Holt-Winters exponential smoothing method was used to project expected antibiotic use in the period after implementation based on use prior to implementation. Differences between expected and observed utilization rates were calculated. Overall antibiotic use has stabilized in recent years (16.2 DDD/1000 population/day in 2008). Fluoroquinolone use remains high (1.5 DDD/1000 population/day), as does the steadily increasing use of newer macrolides (1.1 to 2.7 DDD/1000 population/day between 1996 and 2008). Encouraging declines in overall and indication-specific prescription rates among children were observed. Following 3 years of DBND activities, antibiotic use was 5.8% lower than expected and the number of prescriptions dispensed to children was 10.6% lower than expected. This ecological study reports improvements in antibiotic use that occurred simultaneously to the delivery of the DBND program in Vancouver. However, we did not find a lowering of all targeted classes. Policy directives limiting the use of certain antibiotics may be required.

Social influences upon injection initiation among street-involved youth in Vancouver, Canada: a qualitative study

PubMed Central

Small, Will; Fast, Danya; Krusi, Andrea; Wood, Evan; Kerr, Thomas

2009-01-01

Background Street-involved youth are a population at risk of adopting injection as a route of administration, and preventing the transition to injection drug use among street youth represents a public health priority. In order to inform epidemiological research and prevention efforts, we conducted a qualitative study to investigate the initiation of injection drug use among street-involved youth in Vancouver, Canada. Methods Qualitative interviews with street youth who inject drugs elicited descriptions of the adoption of injection as a route of administration. Interviewees were recruited from the At-Risk Youth Study (ARYS), a cohort of street-involved youth who use illicit drugs in Vancouver, Canada. Audio recorded interviews were transcribed verbatim and a thematic analysis was conducted. Results 26 youth aged 16 to 26 participated in this study, including 12 females. Among study participants the first injection episode frequently featured another drug user who facilitated the initiation of injecting. Youth narratives indicate that the transition into injecting is influenced by social interactions with drug using peers and evolving perceptions of injecting, and rejecting identification as an injector was important among youth who did not continue to inject. It appears that social conventions discouraging initiating young drug users into injection exist among established injectors, although this ethic is often ignored. Conclusion The importance of social relationships with other drug users within the adoption of injection drug use highlights the potential of social interventions to prevent injection initiation. Additionally, developing strategies to engage current injectors who are likely to initiate youth into injection could also benefit prevention efforts. PMID:19405977

Shifts in mortality during a hot weather event in Vancouver, British Columbia: rapid assessment with case-only analysis.

PubMed

Kosatsky, Tom; Henderson, Sarah B; Pollock, Sue L

2012-12-01

We assessed shifts in patterns of mortality during a hot weather event in greater Vancouver, British Columbia. We used a case-only analysis to compare characteristics of individuals who died during the hottest week of 2009 with those who died (1) during earlier summer weeks in 2009 and (2) during the same calendar weeks in the summers of 2001 through 2008. Compared with the 8 previous weeks of 2009, odds of mortality during the summer's hottest week were highest in the 65 to 74 years age category, compared with the 85 years and older category (odds ratio [OR] = 1.47; 95% confidence interval [CI] = 1.06, 2.03). The number of deaths at home increased over deaths in hospitals or institutions (OR = 1.43; 95% CI = 1.10, 1.86). Densely populated administrative health areas were more affected. A shift toward deaths at home suggests that in-home-based protective measures should be part of planning for hot weather events in greater Vancouver. Targeting should be considered for those aged 65 to 74 years. The case-only approach is quick and easy to apply and can provide useful information about localized, time-limited events.

Canadian Seismicity Catalogue - Western Canada

NASA Astrophysics Data System (ADS)

Mulder, T.

2003-04-01

The first seismograph station in western Canada was installed in Victoria, BC, in 1898, under the Meteorological Service of Canada. By 1940, seismograph installations in Canada were amalgamated under the Dominion Observatory. The first short-period instruments were installed in western Canada in the early 1950's. The first digital instruments were installed in the mid-1970's. To date there are now 54 digital stations in western Canada that are routinely used in analysis as well as 2 paper-record stations. Detection ability has increased significantly over the past 20 years. Magnitude thresholds for locations vary over space and time reflecting seismicity levels, station distribution, and staffing levels. Currently the magnitude thresholds are (these do not necessarily equate to completeness levels): M=2.5-3.0 for western Canada; M=2.0 in the St Elias Mountains, YT, the northern Coast Mountains, BC, most of southern BC, and southwestern Alberta; M=1.0-1.5 in the Queen Charlotte Islands, southern Coast Mountains, and northern Vancouver Island; M=0.7-0.8 in southern Vancouver Island and the adjacent mainland. Events have been located with a variety of location programs over the years. A number of velocity models have been in use over time, currently resulting in a generic model for all of western Canada, and a model each for offshore, the Queen Charlotte Islands, and Vancouver Island. Recently purchased Antelope software will allow improved ability to maintain and possibly extend current magnitude thresholds as much of the daily analyst housekeeping tasks are decreased. Recent additions to the catalogue are regular computation of P-nodal and moment tensor solutions.

[Reasons to recommend vaccination against dengue in Easter Island: Immunization Advisory Committee of Sociedad Chilena de Infectología].

PubMed

Fica, Alberto; Potin, Marcela; Moreno, Gabriela; Véliz, Liliana; Cerda, Jaime; Escobar, Carola; Wilhelm, Jan

2016-08-01

Dengue was first diagnosed on Easter Island on year 2002 and thereafter recurrent outbreaks have occurred involving different serotypes of dengue virus. Its vector, Aedes aegypti has not been eliminated despite the small size of the island. Conditions at the local hospital preclude adequate management of severe and hemorrhagic cases due to the absence of a Critical Care Unit as well as no availability of platelets, or plasma units for transfusion. Besides, transfer, of severely affected patients to continental Chile is cumbersome, slow and expensive. In this scenario, it is advisable to implement selective vaccination of Easter Island habitants with an available quadrivalent attenuated dengue vaccine with the aim to reduce hemorrhagic and severe dengue cases. This strategy should not replace permanent efforts to control waste disposal sites, water sources, maintain vector surveillance and increase education of the population.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-07-01

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

Early outbreaks of 'epidemic neuromyasthenia'.

PubMed

Parish, J G

1978-11-01

The literature of the outbreaks of 'epidemic neuromyasthenia' (ENM) from 1934 to 1955 has been selected to show that the disease affects other people besides young adult females in hospitals and nursing homes. There have been district epidemics, in which the male: female ratio was almost even and several male outbreaks affecting soldiers in barracks. Some outbreaks appear to have been triggered off by an epidemic of poliomyelitis, and the epidemiology of outbreaks in Iceland in 1948 and 1955 suggests that the normal cytopathological effects of poliomyelitis infection have been suppressed by the new disease. In the Durban epidemic (1955) a toxic metabolite was discovered in the urine of many patients and a markedly increased urinary excretion of creatine was noted in two New York State outbreaks. The results of the transmission of an agent from patients with ENM to monkeys suggest that the neurological disorder might be in the form of mild disseminated lesions scattered throughout the nervous system from the brain to peripheral nerves and associated with perivascular round cell infiltration without significant cellular damage. ENM infection was widespread in the North of England in 1955 and associated with lymphocyte abnormalities, which have persisted in some cases for several years. This suggests a continuous organic process.

Socio Economic Status and Traumatic Brain Injury amongst Pediatric Populations: A Spatial Analysis in Greater Vancouver

PubMed Central

Amram, Ofer; Schuurman, Nadine; Pike, Ian; Yanchar, Natalie L; Friger, Michael; McBeth, Paul B.; Griesdale, Donald

2015-01-01

Introduction: Within Canada, injuries are the leading cause of death amongst children fourteen years of age and younger, and also one of the leading causes of morbidity. Low Socio Economic Status (SES) seems to be a strong indicator of a higher prevalence of injuries. This study aims to identify hotspots for pediatric Traumatic Brain Injury (TBI) and examines the relationship between SES and pediatric TBI rates in greater Vancouver, British Columbia (BC), Canada. Methods: Pediatric TBI data from the BC Trauma Registry (BCTR) was used to identify all pediatric TBI patients admitted to BC hospitals between the years 2000 and 2013. Spatial analysis was used to identify hotspots for pediatric TBI. Multivariate analysis was used to distinguish census variables that were correlated with rates of injury. Results: Six hundred and fifty three severe pediatric TBI injuries occurred within the BC Lower Mainland between 2000 and 2013. High rates of injury were concentrated in the East, while low rate clusters were most common in the West of the region (more affluent neighborhoods). A low level of education was the main predictor of a high rate of injury (OR = 1.13, 95% CI = 1.03–1.23, p-Value 0.009). Conclusion: While there was a clear relationship between different SES indicators and pediatric TBI rates in greater Vancouver, income-based SES indicators did not serve as good predictors within this region. PMID:26670241

Outbreak of scombroid fish poisoning, Taiwan.

PubMed

Chen, K T; Malison, M D

1987-10-01

Fish implicated in outbreaks of scombroid poisoning have usually undergone prolonged storage at an inadequate temperature. We report an outbreak of scombroid poisoning in which fish stored on ice for two days caused illness after standing at room temperature for only three to four hours; fish from the same catch did not cause illness after standing at room temperature only one hour. This outbreak suggests scombrotoxins may be produced more rapidly than previously thought possible.

Disease Outbreaks Caused by Water.

ERIC Educational Resources Information Center

Craun, Gunther F.

1978-01-01

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

An Outbreak of Yersinia enterocolitica in a Captive Colony of African Green Monkeys (Chlorocebus aethiops sabaeus) in the Caribbean

PubMed Central

Soto, Esteban; Griffin, Matt; Verma, Ashutosh; Castillo-Alcala, Fernanda; Beierschmitt, Amy; Beeler-Marfisi, Janet; Arauz, Maziel; Illanes, Oscar

2013-01-01

Yersinia enterocolitica is a zoonotic gram-negative pathogen that causes mesenteric lymphadenitis, terminal ileitis, acute gastroenteritis, and septicemia in domestic animals and primates. In 2012, 46 captive African green monkeys (Chlorocebus aethiops sabaeus) died during an outbreak of acutely fatal enteric disease over a period of 1 mo on the island of St Kitts. The affected monkeys presented with a history of mucohemorrhagic diarrhea, marked dehydration, and depression. Fifteen bacterial isolates were recovered from the spleen, liver, and lungs of affected monkeys. All isolates were identified as Y. enterocolitica by biochemical analysis and sequence comparison of the 16S rRNA gene. Phenotypic and genotypic analysis of the recovered isolates revealed homogeneity among the recovered bacteria, and all isolates gave a random amplified polymorphic DNA pattern resembling that given by genotype D under serotypes O:7,8. This outbreak represents the first isolation and characterization of Y. enterocolitica as the causative agent of fatal enteric disease in primates in the Caribbean. PMID:24210021

Measles outbreak linked to European B3 outbreaks, Wales, United Kingdom, 2017.

PubMed

Currie, Jonny; Davies, Llion; McCarthy, Joanne; Perry, Malorie; Moore, Catherine; Cottrell, Simon; Bowley, Mererid; Williams, Chris; Shankar, Ananda Giri; Stiff, Rhianwen

2017-10-01

The United Kingdom achieved interrupted endemic measles transmission for 36 months in 2016. Despite this, ongoing challenges from sporadic measles cases typically imported from abroad remain. We summarise a B3 measles genotype outbreak in south-east Wales occurring between May and September 2017, linked with other European outbreaks, and lessons learnt. Seventeen confirmed cases and one probable case occurred principally in education and healthcare-settings. Six confirmed cases attended healthcare settings when infectious, without being isolated.

The reconsideration of natural history of echinococcosis at Rebun Island.

PubMed

Minagawa, T

1999-03-01

It has been believed that the outbreak of echinococcosis at Rebun Island had ceased by 1970. The first patient was diagnosed in 1936 and 131 patients have been authorized as echinococcosis so far. The conference of measures against the outbreak had been organized in 1948 and started to eradicate Echinococcus multilocularis from the Island. Medical examination to detect the patients and the capture and autopsy of dogs and cats had been carried out hard till 1970. At that time, foxes imported from Simusiru Island in the middle Kuriles during the years 1924 to 1926 had already disappeared and it has seemed to be sure that stray dogs and cats might carry E. multilocularis and excrete infectious eggs in stead of foxes. Since we have had no real data concerning the natural history of patients with echinococcosis without any treatments, it can not be recognized the time of infection and the role of dogs or cats on the spread of echinococcosis at Rebun Island. From the new data, it is concluded that the active life cycle of E. multilocularis between foxes and vole might be closed by 1940, since the last patient infected with E. multilocularis was born in 1940 and died in 1945. Furthermore, it is estimated that more than 200 patients (3 to 4% of people at the island) might die from echinococcosis, because of the fact of the unusual increase of mortality of liver disorders and oldness observed during the years of 1940 to 1960. 81 patients with the high possibility of echinococcosis detected from 1937 to 1963 can be added to 131 authorized patients. Surprisingly, it is noticed that the standard deviations of ages of death of 94 patients born in Meiji era (1880-1912) and 59 in Taisho and Showa eras (1912-1940) are 63.16 +/- 11.68, and 34.32 +/- 11.87, respectively. It means that both old and young people might be infected simultaneously but for the long period. There was no difference between the susceptibility of young and old men to E. multilocularis. The numbers of male

Waterborne outbreak of tularemia associated with crayfish fishing.

PubMed Central

Anda, P.; Segura del Pozo, J.; Díaz García, J. M.; Escudero, R.; García Peña, F. J.; López Velasco, M. C.; Sellek, R. E.; Jiménez Chillarón, M. R.; Sánchez Serrano, L. P.; Martínez Navarro, J. F.

2001-01-01

In 1997, an outbreak of human tularemia associated with hare-hunting in central Spain affected 585 patients. We describe the identification of Francisella tularensis biovar palaearctica in a second outbreak of ulceroglandular tularemia associated with crayfish (Procambarus clarkii) fishing in a contaminated freshwater stream distant from the hare-associated outbreak. The second outbreak occurred 1 year after the first. PMID:11485678

Infectious disease outbreaks in competitive sports, 2005-2010.

PubMed

Collins, Cathal James; O'Connell, Brian

2012-01-01

Old, evolving, and new infectious agents continually threaten the participation of competitors in sports. To provide an update of the medical literature on infectious disease outbreaks in sport for the last 5 years (May 2005-November 2010). A total of 21 outbreaks or clusters were identified. Methicillin-resistant Staphylococcus aureus (n = 7, 33%; mainly community acquired) and tinea (trichophytosis: n = 6, 29%) were the most common pathogens responsible for outbreaks. Skin and soft tissue was the most common site of infection (n = 15, 71%). The majority of outbreaks reported occurred in close-contact sports, mainly combat sports (ie, wrestling, judo) and American football. Twelve outbreaks (57%) involved high school or collegiate competitors. Common community outbreak pathogens, such as influenza virus and norovirus, have received little attention.

Large outbreak caused by methicillin resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital--from outbreak control to outbreak prevention.

PubMed

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

2014-01-01

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

An infectious way to teach students about outbreaks.

PubMed

Cremin, Íde; Watson, Oliver; Heffernan, Alastair; Imai, Natsuko; Ahmed, Norin; Bivegete, Sandra; Kimani, Teresia; Kyriacou, Demetris; Mahadevan, Preveina; Mustafa, Rima; Pagoni, Panagiota; Sophiea, Marisa; Whittaker, Charlie; Beacroft, Leo; Riley, Steven; Fisher, Matthew C

2018-06-01

The study of infectious disease outbreaks is required to train today's epidemiologists. A typical way to introduce and explain key epidemiological concepts is through the analysis of a historical outbreak. There are, however, few training options that explicitly utilise real-time simulated stochastic outbreaks where the participants themselves comprise the dataset they subsequently analyse. In this paper, we present a teaching exercise in which an infectious disease outbreak is simulated over a five-day period and subsequently analysed. We iteratively developed the teaching exercise to offer additional insight into analysing an outbreak. An R package for visualisation, analysis and simulation of the outbreak data was developed to accompany the practical to reinforce learning outcomes. Computer simulations of the outbreak revealed deviations from observed dynamics, highlighting how simplifying assumptions conventionally made in mathematical models often differ from reality. Here we provide a pedagogical tool for others to use and adapt in their own settings. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Outbreak of scombroid fish poisoning, Taiwan.

PubMed Central

Chen, K T; Malison, M D

1987-01-01

Fish implicated in outbreaks of scombroid poisoning have usually undergone prolonged storage at an inadequate temperature. We report an outbreak of scombroid poisoning in which fish stored on ice for two days caused illness after standing at room temperature for only three to four hours; fish from the same catch did not cause illness after standing at room temperature only one hour. This outbreak suggests scombrotoxins may be produced more rapidly than previously thought possible. PMID:3631369

Establishing a milkborne disease outbreak profile: potential food defense implications.

PubMed

Newkirk, Ryan; Hedberg, Craig; Bender, Jeff

2011-03-01

The main objectives of this study were to establish baseline characteristics for milkborne outbreaks, establish an expected milkborne outbreak profile, and identify potential indicators of food terrorism. This study used 1990-2006 data from the Centers for Disease Control and Prevention Annual Listings of Disease Outbreaks and the Foodborne Outbreak Database (FOOD) to establish epidemiologic baseline characteristics for disease outbreaks associated with fluid milk. FOOD data from 2007 were used to qualitatively validate the potential of the baseline characteristics and the expected outbreak profile. Eighty-three fluid milkborne outbreaks were reported between 1990 and 2006, resulting in 3621 illnesses. The mean number of illnesses per outbreak was 43.6 (illness range: 2-1644). Consumption of unpasteurized milk was associated with 55.4% of reported outbreaks. Campylobacter spp., Escherichia coli, and Salmonella spp. caused 51.2%, 10.8%, and 9.6% of reported outbreaks, respectively. Private homes accounted for 41.0% of outbreak locations. Number ill, outbreak location, and etiology were the primary characteristics which could signal a potential intentional contamination event. In 2007, one pasteurized milk outbreak caused by Listeria was flagged as aberrative compared with the expected outbreak profile. The creation and dissemination of expected outbreak profiles and epidemiologic baseline characteristics allow public health and Homeland Security officials to quickly assess the potential of intentional food contamination. A faster public health and medical system response can result in decreased morbidity and mortality.

Complete genome sequence of bluetongue virus serotype 4 that emerged on the French island of Corsica in December 2016.

PubMed

Sailleau, C; Breard, E; Viarouge, C; Gorlier, A; Quenault, H; Hirchaud, E; Touzain, F; Blanchard, Y; Vitour, D; Zientara, S

2018-02-01

In November 2016, sheep located in the south of Corsica island exhibited clinical signs suggestive of bluetongue virus (BTV) infection. Laboratory analyses allowed to isolate and identify a BTV strain of serotype 4. The analysis of the full viral genome showed that all the 10 genomic segments were closely related to those of the BTV-4 present in Hungary in 2014 and involved in a large BT outbreak in the Balkan Peninsula. These results together with epidemiological data suggest that BTV-4 has been introduced to Corsica from Italy (Sardinia) where BTV-4 outbreaks have been reported in autumn 2016. This is the first report of the introduction in Corsica of a BTV strain previously spreading in eastern Europe. © 2017 Blackwell Verlag GmbH.

CDC Vital Signs: Preventing Norovirus Outbreaks

MedlinePlus

... source of norovirus outbreaks using genome sequencing and analysis. State and local governments can Adopt and enforce all provisions of the FDA model Food Code to better safeguard food. Investigate norovirus outbreaks ...

Finding Outbreaks Faster

PubMed Central

Smolinski, Mark S.; Olsen, Jennifer M.

2017-01-01

Rapid detection, reporting, and response to an infectious disease outbreak are critical to prevent localized health events from emerging as pandemic threats. Metrics to evaluate the timeliness of these critical activities, however, are lacking. Easily understood and comparable measures for tracking progress and encouraging investment in rapid detection, reporting, and response are sorely needed. We propose that the timeliness of outbreak detection, reporting, laboratory confirmation, response, and public communication should be considered as measures for improving global health security at the national level, allowing countries to track progress over time and inform investments in disease surveillance. PMID:28384035

Recreational water-associated disease outbreaks--United States, 2009-2010.

PubMed

Hlavsa, Michele C; Roberts, Virginia A; Kahler, Amy M; Hilborn, Elizabeth D; Wade, Timothy J; Backer, Lorraine C; Yoder, Jonathan S

2014-01-10

Recreational water-associated disease outbreaks result from exposure to infectious pathogens or chemical agents in treated recreational water venues (e.g., pools and hot tubs or spas) or untreated recreational water venues (e.g., lakes and oceans). For 2009-2010, the most recent years for which finalized data are available, public health officials from 28 states and Puerto Rico electronically reported 81 recreational water-associated disease outbreaks to CDC's Waterborne Disease and Outbreak Surveillance System (WBDOSS) via the National Outbreak Reporting System (NORS). This report summarizes the characteristics of those outbreaks. Among the 57 outbreaks associated with treated recreational water, 24 (42%) were caused by Cryptosporidium. Among the 24 outbreaks associated with untreated recreational water, 11 (46%) were confirmed or suspected to have been caused by cyanobacterial toxins. In total, the 81 outbreaks resulted in at least 1,326 cases of illness and 62 hospitalizations; no deaths were reported. Laboratory and environmental data, in addition to epidemiologic data, can be used to direct and optimize the prevention and control of recreational water-associated disease outbreaks.

Epidemiology of restaurant-associated foodborne disease outbreaks, United States, 1998-2013.

PubMed

Angelo, K M; Nisler, A L; Hall, A J; Brown, L G; Gould, L H

2017-02-01

Although contamination of food can occur at any point from farm to table, restaurant food workers are a common source of foodborne illness. We describe the characteristics of restaurant-associated foodborne disease outbreaks and explore the role of food workers by analysing outbreaks associated with restaurants from 1998 to 2013 reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System. We identified 9788 restaurant-associated outbreaks. The median annual number of outbreaks was 620 (interquartile range 618-629). In 3072 outbreaks with a single confirmed aetiology reported, norovirus caused the largest number of outbreaks (1425, 46%). Of outbreaks with a single food reported and a confirmed aetiology, fish (254 outbreaks, 34%) was most commonly implicated, and these outbreaks were commonly caused by scombroid toxin (219 outbreaks, 86% of fish outbreaks). Most outbreaks (79%) occurred at sit-down establishments. The most commonly reported contributing factors were those related to food handling and preparation practices in the restaurant (2955 outbreaks, 61%). Food workers contributed to 2415 (25%) outbreaks. Knowledge of the foods, aetiologies, and contributing factors that result in foodborne disease restaurant outbreaks can help guide efforts to prevent foodborne illness.

Coccidioidomycosis Outbreaks, United States and Worldwide, 1940–2015

PubMed Central

Freedman, Michael; Jackson, Brendan R.; McCotter, Orion

2018-01-01

Coccidioidomycosis causes substantial illness and death in the United States each year. Although most cases are sporadic, outbreaks provide insight into the clinical and environmental features of coccidioidomycosis, high-risk activities, and the geographic range of Coccidioides fungi. We identified reports published in English of 47 coccidioidomycosis outbreaks worldwide that resulted in 1,464 cases during 1940–2015. Most (85%) outbreaks were associated with environmental exposures; the 2 largest outbreaks resulted from an earthquake and a large dust storm. More than one third of outbreaks occurred in areas where the fungus was not previously known to be endemic, and more than half of outbreaks involved occupational exposures. Coccidioidomycosis outbreaks can be difficult to detect and challenging to prevent given the unknown effectiveness of environmental control methods and personal protective equipment; therefore, increased awareness of coccidioidomycosis outbreaks is needed among public health professionals, healthcare providers, and the public. PMID:29460741

Experimental High-Resolution Land Surface Prediction System for the Vancouver 2010 Winter Olympic Games

NASA Astrophysics Data System (ADS)

Belair, S.; Bernier, N.; Tong, L.; Mailhot, J.

2008-05-01

The 2010 Winter Olympic and Paralympic Games will take place in Vancouver, Canada, from 12 to 28 February 2010 and from 12 to 21 March 2010, respectively. In order to provide the best possible guidance achievable with current state-of-the-art science and technology, Environment Canada is currently setting up an experimental numerical prediction system for these special events. This system consists of a 1-km limited-area atmospheric model that will be integrated for 16h, twice a day, with improved microphysics compared with the system currently operational at the Canadian Meteorological Centre. In addition, several new and original tools will be used to adapt and refine predictions near and at the surface. Very high-resolution two-dimensional surface systems, with 100-m and 20-m grid size, will cover the Vancouver Olympic area. Using adaptation methods to improve the forcing from the lower-resolution atmospheric models, these 2D surface models better represent surface processes, and thus lead to better predictions of snow conditions and near-surface air temperature. Based on a similar strategy, a single-point model will be implemented to better predict surface characteristics at each station of an observing network especially installed for the 2010 events. The main advantage of this single-point system is that surface observations are used as forcing for the land surface models, and can even be assimilated (although this is not expected in the first version of this new tool) to improve initial conditions of surface variables such as snow depth and surface temperatures. Another adaptation tool, based on 2D stationnary solutions of a simple dynamical system, will be used to produce near-surface winds on the 100-m grid, coherent with the high- resolution orography. The configuration of the experimental numerical prediction system will be presented at the conference, together with preliminary results for winter 2007-2008.

Police and public health partnerships: evidence from the evaluation of Vancouver's supervised injection facility.

PubMed

DeBeck, Kora; Wood, Evan; Zhang, Ruth; Tyndall, Mark; Montaner, Julio; Kerr, Thomas

2008-05-07

In various settings, drug market policing strategies have been found to have unintended negative effects on health service use among injection drug users (IDU). This has prompted calls for more effective coordination of policing and public health efforts. In Vancouver, Canada, a supervised injection facility (SIF) was established in 2003. We sought to determine if local police impacted utilization of the SIF. We used generalized estimating equations (GEE) to prospectively identify the prevalence and correlates of being referred by local police to Vancouver's SIF among IDU participating in the Scientific Evaluation of Supervised Injecting (SEOSI) cohort during the period of December 2003 to November 2005. Among 1090 SIF clients enrolled in SEOSI, 182 (16.7%) individuals reported having ever been referred to the SIF by local police. At baseline, 22 (2.0%) participants reported that they first learned of the SIF via police. In multivariate analyses, factors positively associated with being referred to the SIF by local police when injecting in public include: sex work (Adjusted Odds Ratio [AOR] = 1.80, 95%CI 1.28-2.53); daily cocaine injection (AOR = 1.54, 95%CI 1.14-2.08); and unsafe syringe disposal (AOR = 1.46, 95%CI 1.00-2.11). These findings indicate that local police are facilitating use of the SIF by IDU at high risk for various adverse health outcomes. We further found that police may be helping to address public order concerns by referring IDU who are more likely to discard used syringes in public spaces. Our study suggests that the SIF provides an opportunity to coordinate policing and public health efforts and thereby resolve some of the existing tensions between public order and health initiatives.

Outbreaks attributed to pork in the United States, 1998-2015.

PubMed

Self, J L; Luna-Gierke, R E; Fothergill, A; Holt, K G; Vieira, A R

2017-10-01

Each year in the United States, an estimated 525 000 infections, 2900 hospitalizations, and 82 deaths are attributed to consumption of pork. We analyzed the epidemiology of outbreaks attributed to pork in the United States reported to the Centers for Disease Control and Prevention (CDC) 1998-2015. During that period, 288 outbreaks were attributed to pork, resulting in 6372 illnesses, 443 hospitalizations, and four deaths. The frequency of outbreaks attributed to pork decreased by 37% during this period, consistent with a decline in total foodborne outbreaks. However, outbreaks attributed to pork increased by 73% in 2015 (19 outbreaks) compared with the previous 3 years (average of 11 outbreaks per year), without a similar increase in total foodborne outbreaks. Most (>99%) of these outbreaks occurred among people exposed in the same state. The most frequent etiology shifted from Staphylococcus aureus toxin during 1998-2001 (19%) to Salmonella during 2012-2015 (46%). Outbreaks associated with ham decreased from eight outbreaks per year during 1998-2001, to one per year during 2012-2015 (P < 0·01). Additional efforts are necessary to reduce outbreaks and sporadic illnesses associated with pork products.

Surveillance for foodborne disease outbreaks - United States, 1998-2008.

PubMed

Gould, L Hannah; Walsh, Kelly A; Vieira, Antonio R; Herman, Karen; Williams, Ian T; Hall, Aron J; Cole, Dana

2013-06-28

Foodborne diseases cause an estimated 48 million illnesses each year in the United States, including 9.4 million caused by known pathogens. Foodborne disease outbreak surveillance provides valuable insights into the agents and foods that cause illness and the settings in which transmission occurs. CDC maintains a surveillance program for collection and periodic reporting of data on the occurrence and causes of foodborne disease outbreaks in the United States. This surveillance system is the primary source of national data describing the numbers of illnesses, hospitalizations, and deaths; etiologic agents; implicated foods; contributing factors; and settings of food preparation and consumption associated with recognized foodborne disease outbreaks in the United States. 1998-2008. The Foodborne Disease Outbreak Surveillance System collects data on foodborne disease outbreaks, defined as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food. Public health agencies in all 50 states, the District of Columbia, U.S. territories, and Freely Associated States have primary responsibility for identifying and investigating outbreaks and use a standard form to report outbreaks voluntarily to CDC. During 1998-2008, reporting was made through the electronic Foodborne Outbreak Reporting System (eFORS). During 1998-2008, CDC received reports of 13,405 foodborne disease outbreaks, which resulted in 273,120 reported cases of illness, 9,109 hospitalizations, and 200 deaths. Of the 7,998 outbreaks with a known etiology, 3,633 (45%) were caused by viruses, 3,613 (45%) were caused by bacteria, 685 (5%) were caused by chemical and toxic agents, and 67 (1%) were caused by parasites. Among the 7,724 (58%) outbreaks with an implicated food or contaminated ingredient reported, 3,264 (42%) could be assigned to one of 17 predefined commodity categories: fish, crustaceans, mollusks, dairy, eggs, beef, game, pork, poultry, grains/beans, oils

Home Oxygen Program review: Regionalization in Vancouver Coastal Health and British Columbia.

PubMed

Sandberg, Dan

2015-01-01

Since its inception in the 1980s, the Home Oxygen Program in British Columbia was centrally managed by the Ministry of Health. Initially a small program with few clients across the province, it soon became a large program with many clients and increasing expenditures. A pilot program started in Victoria (British Columbia) in 1996 demonstrated that managing the program locally could offer better client care, better contract management and significant cost savings. In 2002, the pilot's model and recommendations were implemented in British Columbia's five health authorities. The present review details the experiences of regionalizing the program in the Vancouver Coastal Health authority. After fine adjustments to the model were developed and new contracts and criteria changes made, better care for clients was provided than the previous centralized model at a reduced cost to the taxpayer.

Social media in Ebola outbreak.

PubMed

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

2016-07-01

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

Surveillance for waterborne disease and outbreaks associated with recreational water use and other aquatic facility-associated health events--United States, 2005-2006.

PubMed

Yoder, Jonathan S; Hlavsa, Michele C; Craun, Gunther F; Hill, Vincent; Roberts, Virginia; Yu, Patricia A; Hicks, Lauri A; Alexander, Nicole T; Calderon, Rebecca L; Roy, Sharon L; Beach, Michael J

2008-09-12

Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaboratively maintained the Waterborne Disease and Outbreak Surveillance System for collecting and reporting data related to waterborne-disease outbreaks (WBDOs) associated with drinking water. In 1978, WBDOs associated with recreational water (natural and treated water) were added. This system is the primary source of data regarding the scope and effects of disease associated with recreational water in the United States. In addition, data are collected on individual cases of recreational water-associated illnesses and infections and health events occurring at aquatic facilities but not directly related to water exposure. Data presented summarize WBDOs and case reports associated with recreational water use that occurred during January 2005--December 2006 and previously unreported disease reports and outbreaks during 1978--2004. Public health departments in the states, territories, localities, and the Freely Associated States (i.e., the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau, formerly parts of the U.S.-administered Trust Territory of the Pacific Islands) have primary responsibility for detecting, investigating, and voluntarily reporting WBDOs to CDC. Although the surveillance system includes data for WBDOs and cases associated with drinking water, recreational water, and water not intended for drinking, only cases and outbreaks associated with recreational water and health events at aquatic facilities are summarized in this report. During 2005--2006, a total of 78 WBDOs associated with recreational water were reported by 31 states. Illness occurred in 4,412 persons, resulting in 116 hospitalizations and five deaths. The median outbreak size was 13 persons (range: 2--2,307 persons). Of the 78 WBDOs, 48 (61.5%) were outbreaks of gastroenteritis that resulted from infectious agents or

Reflection on 10 Years of Community-Engaged Scholarship in the Faculty of Land and Food Systems at the University of British Columbia-Vancouver

ERIC Educational Resources Information Center

Rojas, Alejandro; Sipos, Yona; Valley, Will

2012-01-01

In this article, the authors describe a cultural transformation to embrace community-engaged scholarship by faculty members in the Faculty of Land and Food Systems at the University of British Columbia-Vancouver. They describe a transition from community-inquiry faculty projects to community-engaged action research projects achieved through…

Overcoming barriers in evaluating outbreaks of diarrheal disease in resource poor settings: assessment of recurrent outbreaks in Chobe District, Botswana

PubMed Central

2013-01-01

Background Diarrheal illness remains a leading cause of global morbidity and mortality, with the majority of deaths occurring in children <5 years of age. Lack of resources often prohibits the evaluation of outbreak characteristics and limits progress in managing this important disease syndrome, particularly in Africa. Relying only on existing medical staff and hospital resources, we assess the use of a questionnaire survey tool to identify baseline outbreak characteristics during recurrent diarrheal outbreaks in Chobe, Botswana. Methods Using historical surveillance data (2006–2009), the temporal pattern of recurrent diarrheal outbreaks was evaluated among patients <5 years of age presenting to health facilities in Chobe District. Using a questionnaire survey tool, medical staff from selected health facilities assessed patients (all ages) presenting with diarrheal disease during two diarrheal outbreaks (2011–2012). Cluster analysis and classification and regression trees (CART) were used to evaluate patient attributes by outbreak. Results We identified a bimodal, annual pattern of acute diarrhea in children <5 years of age across years (Wilcox test, W = 456.5, p = 0.052). Historical outbreak periods appeared to coincide with major hydrological phenomena (rainfall/flood recession). Across health facilities, a significant percent of patients in the prospective study were in the ≥5 age class (44%, n = 515 and 35%, n = 333 in the dry and wet season outbreaks, respectively). Cluster analysis of questionnaire data identified two main branches associated with patient age (<5 and ≥5 years of age). Patients did not cluster by outbreak or village. CART examination identified sex and hospitalization as being most predictive of patients <5 years and household diarrhea in patients ≥5 years. Water shortages and water quality deficiencies were identified in both outbreaks. Conclusions Diarrhea is a persistent, seasonally occurring disease in Chobe

History of foster care among homeless adults with mental illness in Vancouver, British Columbia: a precursor to trajectories of risk.

PubMed

Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

2015-02-26

It is well documented that a disproportionate number of homeless adults have childhood histories of foster care placement(s). This study examines the relationship between foster care placement as a predictor of adult substance use disorders (including frequency, severity and type), mental illness, vocational functioning, service use and duration of homelessness among a sample of homeless adults with mental illness. We hypothesize that a history of foster care predicts earlier, more severe and more frequent substance use, multiple mental disorder diagnoses, discontinuous work history, and longer durations of homelessness. This study was conducted using baseline data from two randomized controlled trials in Vancouver, British Columbia for participants who responded to a series of questions pertaining to out-of-home care at 12 months follow-up (n = 442). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; vocational functioning; and service use. In multivariable regression models, a history of foster care placement independently predicted incomplete high school, duration of homelessness, discontinuous work history, less severe types of mental illness, multiple mental disorders, early initiation of drug and/or alcohol use, and daily drug use. This is the first Canadian study to investigate the relationship between a history of foster care and current substance use among homeless adults with mental illness, controlling for several other potential confounding factors. It is important to screen homeless youth who exit foster care for substance use, and to provide integrated treatment for concurrent disorders to homeless youth and adults who have both psychiatric and substance use problems. Both trials are registered with the International Standard Randomized Control Trial Number Register and were assigned ISRCTN57595077 (Vancouver At Home Study: Housing First plus

Still "at risk": An examination of how street-involved young people understand, experience, and engage with "harm reduction" in Vancouver's inner city.

PubMed

Bozinoff, Nikki; Small, Will; Long, Cathy; DeBeck, Kora; Fast, Danya

2017-07-01

Vancouver is an international leader in implementing interventions to reduce harms related to drug use. However, street-involved young people who use drugs continue to be vulnerable to overdose death, hepatitis C (HCV) infection, and high rates of syringe sharing. To better understand this in the context of the intensive public health response, we examined how young people, who are involved in the 'street drug scene', understood, experienced and engaged with harm reduction. Twelve semi-structured interviews were conducted in 2013 with 13 young people (ages 17-28) recruited from the At-Risk Youth Study, a prospective cohort of street-involved and drug-using young people. These interviews were embedded within a larger, eight-year program of ethnographic research and explored participants' understandings of harm reduction, their use of specific services, and their ideas about improving their day-to-day lives. Interviews were transcribed verbatim and a thematic analysis was performed. Young peoples' ideas about harm reduction were diverse and expansive. They articulated the limitations of existing programs, indicating that while they are positioned to reduce the risk of HIV and HCV transmission, they offer little meaningful support to improve young peoples' broader life chances. Young people described strategies to mitigate risk and harm in their own lives, including transitioning to drugs deemed less harmful and attempting to gain access to drug treatment. Finally, young people indicated that spatial considerations (e.g., distance from Vancouver's Downtown Eastside) strongly determined access to services. In Vancouver, a large, well established harm reduction infrastructure seeks to reduce HIV and HCV transmission among street-involved young people. However, young peoples' multiple understandings, experiences and engagements with harm reduction in this setting illustrate the limitations of the existing infrastructure in improving their broader life chances. Copyright

Sex-Based Differences in Rates, Causes, and Predictors of Death Among Injection Drug Users in Vancouver, Canada

PubMed Central

Hayashi, Kanna; Dong, Huiru; Marshall, Brandon D. L.; Milloy, Michael-John; Montaner, Julio S. G.; Wood, Evan; Kerr, Thomas

2016-01-01

In the present study, we sought to identify rates, causes, and predictors of death among male and female injection drug users (IDUs) in Vancouver, British Columbia, Canada, during a period of expanded public health interventions. Data from prospective cohorts of IDUs in Vancouver were linked to the provincial database of vital statistics to ascertain rates and causes of death between 1996 and 2011. Mortality rates were analyzed using Poisson regression and indirect standardization. Predictors of mortality were identified using multivariable Cox regression models stratified by sex. Among the 2,317 participants, 794 (34.3%) of whom were women, there were 483 deaths during follow-up, with a rate of 32.1 (95% confidence interval (CI): 29.3, 35.0) deaths per 1,000 person-years. Standardized mortality ratios were 7.28 (95% CI: 6.50, 8.14) for men and 15.56 (95% CI: 13.31, 18.07) for women. During the study period, mortality rates related to infection with human immunodeficiency virus (HIV) declined among men but remained stable among women. In multivariable analyses, HIV seropositivity was independently associated with mortality in both sexes (all P < 0.05). The excess mortality burden among IDUs in our cohorts was primarily attributable to HIV infection; compared with men, women remained at higher risk of HIV-related mortality, indicating a need for sex-specific interventions to reduce mortality among female IDUs in this setting. PMID:26865265

Outdoor brothel culture: the un/making of a transsexual stroll in Vancouver's West End, 1975–1984.

PubMed

Ross, Becki

2012-01-01

In the mid-1970s, following a series of police raids on prostitution inside downtown nightclubs, a community of approximately 200 sex workers moved into Vancouver's West End neighborhood, where a small stroll had operated since the early 1970s. This paper examines the contributions made by three male-to-female (MTF) transsexuals of color to the culture of on-street prostitution in the West End. The trans women's stories address themes of fashion, working conditions, money, community formation, violence, and resistance to well-organized anti-prostitution forces. These recollections enable me to bridge and enrich trans history and prostitution history – two fields of inquiry that have under-represented the participation of trans women in the sex industry across the urban West. Acutely familiar with the hazards inherent in a criminalized, stigmatized trade, trans sex workers in the West End manufactured efficacious strategies of harm reduction, income generation, safety planning, and community building. Eschewing the label of “victim”, they leveraged their physical size and style, charisma, contempt towards pimps, earning capacity, and seniority as the first workers on the stroll to assume leadership within the broader constituency of “hookers on Davie Street”. I discover that their short-lived outdoor brothel culture offered only a temporary bulwark against the inevitability of eviction via legal injunction in July 1984, and the subsequent rise in lethal violence against all prostitutes in Vancouver, including MTF transsexuals.

Effect of recycling activities on the heating value of solid waste: case study of the Greater Vancouver Regional District (Metro Vancouver).

PubMed

Abedini, Ali R; Atwater, James W; Fu, George Yuzhu

2012-08-01

Two main goals of the integrated solid waste management system (ISWMS) of Metro Vancouver (MV) include further recycling of waste and energy recovery via incineration of waste. These two very common goals, however, are not always compatible enough to fit in an ISWMS depending on waste characteristics and details of recycling programs. This study showed that recent recycling activities in MV have negatively affected the net heating value (NHV) of municipal solid waste (MSW) in this regional district. Results show that meeting MV's goal for additional recycling of MSW by 2015 will further reduce the NHV of waste, if additional recycling activities are solely focused on more extensive recycling of packaging materials (e.g. paper and plastic). It is concluded that 50% additional recycling of paper and plastic in MV will increase the overall recycling rate to 70% (as targeted by the MV for 2015) and result in more than 8% reduction in NHV of MSW. This reduction translates to up to 2.3 million Canadian dollar (CAD$) less revenue at a potential waste-to-energy (WTE) plant with 500 000 tonnes year(-1) capacity. Properly designed recycling programmes, however, can make this functional element of ISWMS compatible with green goals of energy recovery from waste. Herein an explanation of how communities can increase their recycling activities without affecting the feasibility of potential WTE projects is presented.

The first mile: community experience of outbreak control during an Ebola outbreak in Luwero District, Uganda.

PubMed

de Vries, Daniel H; Rwemisisi, Jude T; Musinguzi, Laban K; Benoni, Turinawe E; Muhangi, Denis; de Groot, Marije; Kaawa-Mafigiri, David; Pool, Robert

2016-02-16

A major challenge to outbreak control lies in early detection of viral haemorrhagic fevers (VHFs) in local community contexts during the critical initial stages of an epidemic, when risk of spreading is its highest ("the first mile"). In this paper we document how a major Ebola outbreak control effort in central Uganda in 2012 was experienced from the perspective of the community. We ask to what extent the community became a resource for early detection, and identify problems encountered with community health worker and social mobilization strategies. Analysis is based on first-hand ethnographic data from the center of a small Ebola outbreak in Luwero Country, Uganda, in 2012. Three of this paper's authors were engaged in an 18 month period of fieldwork on community health resources when the outbreak occurred. In total, 13 respondents from the outbreak site were interviewed, along with 21 key informants and 61 focus group respondents from nearby Kaguugo Parish. All informants were chosen through non-probability sampling sampling. Our data illustrate the lack of credibility, from an emic perspective, of biomedical explanations which ignore local understandings. These explanations were undermined by an insensitivity to local culture, a mismatch between information circulated and the local interpretative framework, and the inability of the emergency response team to take the time needed to listen and empathize with community needs. Stigmatization of the local community--in particular its belief in amayembe spirits--fuelled historical distrust of the external health system and engendered community-level resistance to early detection. Given the available anthropological knowledge of a previous outbreak in Northern Uganda, it is surprising that so little serious effort was made this time round to take local sensibilities and culture into account. The "first mile" problem is not only a question of using local resources for early detection, but also of making use of the

in silico Surveillance: evaluating outbreak detection with simulation models

PubMed Central

2013-01-01

Background Detecting outbreaks is a crucial task for public health officials, yet gaps remain in the systematic evaluation of outbreak detection protocols. The authors’ objectives were to design, implement, and test a flexible methodology for generating detailed synthetic surveillance data that provides realistic geographical and temporal clustering of cases and use to evaluate outbreak detection protocols. Methods A detailed representation of the Boston area was constructed, based on data about individuals, locations, and activity patterns. Influenza-like illness (ILI) transmission was simulated, producing 100 years of in silico ILI data. Six different surveillance systems were designed and developed using gathered cases from the simulated disease data. Performance was measured by inserting test outbreaks into the surveillance streams and analyzing the likelihood and timeliness of detection. Results Detection of outbreaks varied from 21% to 95%. Increased coverage did not linearly improve detection probability for all surveillance systems. Relaxing the decision threshold for signaling outbreaks greatly increased false-positives, improved outbreak detection slightly, and led to earlier outbreak detection. Conclusions Geographical distribution can be more important than coverage level. Detailed simulations of infectious disease transmission can be configured to represent nearly any conceivable scenario. They are a powerful tool for evaluating the performance of surveillance systems and methods used for outbreak detection. PMID:23343523

Estimating Chikungunya prevalence in La Réunion Island outbreak by serosurveys: Two methods for two critical times of the epidemic

PubMed Central

Gérardin, Patrick; Guernier, Vanina; Perrau, Joëlle; Fianu, Adrian; Le Roux, Karin; Grivard, Philippe; Michault, Alain; de Lamballerie, Xavier; Flahault, Antoine; Favier, François

2008-01-01

Background Chikungunya virus (CHIKV) caused a major two-wave seventeen-month-long outbreak in La Réunion Island in 2005–2006. The aim of this study was to refine clinical estimates provided by a regional surveillance-system using a two-stage serological assessment as gold standard. Methods Two serosurveys were implemented: first, a rapid survey using stored sera of pregnant women, in order to assess the attack rate at the epidemic upsurge (s1, February 2006; n = 888); second, a population-based survey among a random sample of the community, to assess the herd immunity in the post-epidemic era (s2, October 2006; n = 2442). Sera were screened for anti-CHIKV specific antibodies (IgM and IgG in s1, IgG only in s2) using enzyme-linked immunosorbent assays. Seroprevalence rates were compared to clinical estimates of attack rates. Results In s1, 18.2% of the pregnant women were tested positive for CHIKV specific antibodies (13.8% for both IgM and IgG, 4.3% for IgM, 0.1% for IgG only) which provided a congruent estimate with the 16.5% attack rate calculated from the surveillance-system. In s2, the seroprevalence in community was estimated to 38.2% (95% CI, 35.9 to 40.6%). Extrapolations of seroprevalence rates led to estimate, at 143,000 and at 300,000 (95% CI, 283,000 to 320,000), the number of people infected in s1 and in s2, respectively. In comparison, the surveillance-system estimated at 130,000 and 266,000 the number of people infected for the same periods. Conclusion A rapid serosurvey in pregnant women can be helpful to assess the attack rate when large seroprevalence studies cannot be done. On the other hand, a population-based serosurvey is useful to refine the estimate when clinical diagnosis underestimates it. Our findings give valuable insights to assess the herd immunity along the course of epidemics. PMID:18662384

Salmonella outbreak among railway and airline passengers.

PubMed

Hatakka, M

1992-01-01

A widespread outbreak by Salmonella infantis, infecting a total of 226 people, occurred in Finland at the beginning of August 1986. Of those infected, 107 were railway passengers, 91 were airline passengers and 28 were employed in a food processing establishment. The outbreak among the railway passengers was caused by egg sandwiches, the airline passengers were infected by a meal served on board and the catering employees by the breakfast served in the establishment. The outbreak was caused by food prepared in the establishment's kitchen. The employees' breakfasts had probably been contaminated by an employee who was a symptom-free Salmonella infantis carrier, and a number of the employees subsequently became infected, leading to widespread contamination of the food prepared in the establishment. The spread of the outbreak was further influenced by a heatwave at the time and by shortcomings in the cold storage facilities. The kitchen's hygiene supervision and the quality control of its output were reorganized after the outbreak.

Rolling epidemic of Legionnaires' disease outbreaks in small geographic areas.

PubMed

MacIntyre, C Raina; Dyda, Amalie; Bui, Chau Minh; Chughtai, Abrar Ahmad

2018-03-21

Legionnaires' disease (LD) is reported from many parts of the world, mostly linked to drinking water sources or cooling towers. We reviewed two unusual rolling outbreaks in Sydney and New York, each clustered in time and space. Data on these outbreaks were collected from public sources and compared to previous outbreaks in Australia and the US. While recurrent outbreaks of LD over time linked to an identified single source have been described, multiple unrelated outbreaks clustered in time and geography have not been previously described. We describe unusual geographic and temporal clustering of Legionella outbreaks in two cities, each of which experienced multiple different outbreaks within a small geographic area and within a short timeframe. The explanation for this temporal and spatial clustering of LD outbreaks in two cities is not clear, but climate variation and deteriorating water sanitation are two possible explanations. There is a need to critically analyse LD outbreaks and better understand changing trends to effectively prevent disease.

Outbreaks attributed to fresh leafy vegetables, United States, 1973-2012.

PubMed

Herman, K M; Hall, A J; Gould, L H

2015-10-01

Leafy vegetables are an essential component of a healthy diet; however, they have been associated with high-profile outbreaks causing severe illnesses. We reviewed leafy vegetable-associated outbreaks reported to the Centers for Disease Control and Prevention between 1973 and 2012. During the study period, 606 leafy vegetable-associated outbreaks, with 20 003 associated illnesses, 1030 hospitalizations, and 19 deaths were reported. On average, leafy vegetable-associated outbreaks were larger than those attributed to other food types. The pathogens that most often caused leafy vegetable-associated outbreaks were norovirus (55% of outbreaks with confirmed aetiology), Shiga toxin-producing Escherichia coli (STEC) (18%), and Salmonella (11%). Most outbreaks were attributed to food prepared in a restaurant or catering facility (85%). An ill food worker was implicated as the source of contamination in 31% of outbreaks. Efforts by local, state, and federal agencies to control leafy vegetable contamination and outbreaks should span from the point of harvest to the point of preparation.

Genetic Diversity of Bactrocera dorsalis (Diptera: Tephritidae) on the Hawaiian Islands: Implications for an Introduction Pathway Into California.

PubMed

Barr, Norman B; Ledezma, Lisa A; Leblanc, Luc; San Jose, Michael; Rubinoff, Daniel; Geib, Scott M; Fujita, Brian; Bartels, David W; Garza, Daniel; Kerr, Peter; Hauser, Martin; Gaimari, Stephen

2014-10-01

Population genetic diversity of the oriental fruit fly, Bactrocera dorsalis (Hendel), on the Hawaiian islands of Oahu, Maui, Kauai, and Hawaii (the Big Island) was estimated using DNA sequences of the mitochondrial cytochrome c oxidase subunit I gene. In total, 932 flies representing 36 sampled sites across the four islands were sequenced for a 1,500-bp fragment of the gene named the C1500 marker. Genetic variation was low on the Hawaiian Islands with >96% of flies having just two haplotypes: C1500-Haplotype 1 (63.2%) or C1500-Haplotype 2 (33.3%). The other 33 flies (3.5%) had haplotypes similar to the two dominant haplotypes. No population structure was detected among the islands or within islands. The two haplotypes were present at similar frequencies at each sample site, suggesting that flies on the various islands can be considered one population. Comparison of the Hawaiian data set to DNA sequences of 165 flies from outbreaks in California between 2006 and 2012 indicates that a single-source introduction pathway of Hawaiian origin cannot explain many of the flies in California. Hawaii, however, could not be excluded as a maternal source for 69 flies. There was no clear geographic association for Hawaiian or non-Hawaiian haplotypes in the Bay Area or Los Angeles Basin over time. This suggests that California experienced multiple, independent introductions from different sources. © 2014 Entomological Society of America.

Designing and implementing an electronic dashboard for disease outbreaks response - Case study of the 2013-2014 Somalia Polio outbreak response dashboard

PubMed Central

Kamadjeu, Raoul; Gathenji, Caroline

2017-01-01

In April 2013, a case of wild polio virus (WPV) was detected in the Somalia capital Mogadishu. This inaugurated what is now referred to as the 2013-2014 Horn of Africa Polio outbreak with cases reported in Somalia, Kenya and Ethiopia. By the notification of the last polio case in August 2014, 223 cases of WPV had been reported in Somalia, Kenya and Ethiopia of which 199 in Somalia alone. The outbreak response required timely exchange of information between the outbreak response coordination unit (in Nairobi) and local staff located in multiple locations inside the country. The need to track and timely respond to information requests, to satisfy the information/data needs of polio partners and to track key outbreak response performance indicators dictated the need to urgently set up an online dashboard. The Somalia Polio Room dashboard provided a graphical display of the polio outbreak data to track progress and inform decision making. The system was designed using free and open sources components and seamlessly integrated existing polio surveillance data for real time monitoring of key outbreak response performance indicators. In this article, we describe the design and operation of an electronic dashboard for disease surveillance in an outbreak situation and used the lessons learned to propose key design considerations and functional requirements for online electronic dashboards for disease outbreak response. PMID:29296157

Designing and implementing an electronic dashboard for disease outbreaks response - Case study of the 2013-2014 Somalia Polio outbreak response dashboard.

PubMed

Kamadjeu, Raoul; Gathenji, Caroline

2017-01-01

In April 2013, a case of wild polio virus (WPV) was detected in the Somalia capital Mogadishu. This inaugurated what is now referred to as the 2013-2014 Horn of Africa Polio outbreak with cases reported in Somalia, Kenya and Ethiopia. By the notification of the last polio case in August 2014, 223 cases of WPV had been reported in Somalia, Kenya and Ethiopia of which 199 in Somalia alone. The outbreak response required timely exchange of information between the outbreak response coordination unit (in Nairobi) and local staff located in multiple locations inside the country. The need to track and timely respond to information requests, to satisfy the information/data needs of polio partners and to track key outbreak response performance indicators dictated the need to urgently set up an online dashboard. The Somalia Polio Room dashboard provided a graphical display of the polio outbreak data to track progress and inform decision making. The system was designed using free and open sources components and seamlessly integrated existing polio surveillance data for real time monitoring of key outbreak response performance indicators. In this article, we describe the design and operation of an electronic dashboard for disease surveillance in an outbreak situation and used the lessons learned to propose key design considerations and functional requirements for online electronic dashboards for disease outbreak response.

A Bayesian system to detect and characterize overlapping outbreaks.

PubMed

Aronis, John M; Millett, Nicholas E; Wagner, Michael M; Tsui, Fuchiang; Ye, Ye; Ferraro, Jeffrey P; Haug, Peter J; Gesteland, Per H; Cooper, Gregory F

2017-09-01

Outbreaks of infectious diseases such as influenza are a significant threat to human health. Because there are different strains of influenza which can cause independent outbreaks, and influenza can affect demographic groups at different rates and times, there is a need to recognize and characterize multiple outbreaks of influenza. This paper describes a Bayesian system that uses data from emergency department patient care reports to create epidemiological models of overlapping outbreaks of influenza. Clinical findings are extracted from patient care reports using natural language processing. These findings are analyzed by a case detection system to create disease likelihoods that are passed to a multiple outbreak detection system. We evaluated the system using real and simulated outbreaks. The results show that this approach can recognize and characterize overlapping outbreaks of influenza. We describe several extensions that appear promising. Copyright © 2017 Elsevier Inc. All rights reserved.

Faster Detection of Poliomyelitis Outbreaks to Support Polio Eradication

PubMed Central

Chenoweth, Paul; Okayasu, Hiro; Donnelly, Christl A.; Aylward, R. Bruce; Grassly, Nicholas C.

2016-01-01

As the global eradication of poliomyelitis approaches the final stages, prompt detection of new outbreaks is critical to enable a fast and effective outbreak response. Surveillance relies on reporting of acute flaccid paralysis (AFP) cases and laboratory confirmation through isolation of poliovirus from stool. However, delayed sample collection and testing can delay outbreak detection. We investigated whether weekly testing for clusters of AFP by location and time, using the Kulldorff scan statistic, could provide an early warning for outbreaks in 20 countries. A mixed-effects regression model was used to predict background rates of nonpolio AFP at the district level. In Tajikistan and Congo, testing for AFP clusters would have resulted in an outbreak warning 39 and 11 days, respectively, before official confirmation of large outbreaks. This method has relatively high specificity and could be integrated into the current polio information system to support rapid outbreak response activities. PMID:26890053

Faster Detection of Poliomyelitis Outbreaks to Support Polio Eradication.

PubMed

Blake, Isobel M; Chenoweth, Paul; Okayasu, Hiro; Donnelly, Christl A; Aylward, R Bruce; Grassly, Nicholas C

2016-03-01

As the global eradication of poliomyelitis approaches the final stages, prompt detection of new outbreaks is critical to enable a fast and effective outbreak response. Surveillance relies on reporting of acute flaccid paralysis (AFP) cases and laboratory confirmation through isolation of poliovirus from stool. However, delayed sample collection and testing can delay outbreak detection. We investigated whether weekly testing for clusters of AFP by location and time, using the Kulldorff scan statistic, could provide an early warning for outbreaks in 20 countries. A mixed-effects regression model was used to predict background rates of nonpolio AFP at the district level. In Tajikistan and Congo, testing for AFP clusters would have resulted in an outbreak warning 39 and 11 days, respectively, before official confirmation of large outbreaks. This method has relatively high specificity and could be integrated into the current polio information system to support rapid outbreak response activities.

Outbreaks Associated with Treated Recreational Water - United States, 2000-2014.

PubMed

Hlavsa, Michele C; Cikesh, Bryanna L; Roberts, Virginia A; Kahler, Amy M; Vigar, Marissa; Hilborn, Elizabeth D; Wade, Timothy J; Roellig, Dawn M; Murphy, Jennifer L; Xiao, Lihua; Yates, Kirsten M; Kunz, Jasen M; Arduino, Matthew J; Reddy, Sujan C; Fullerton, Kathleen E; Cooley, Laura A; Beach, Michael J; Hill, Vincent R; Yoder, Jonathan S

2018-05-18

Outbreaks associated with exposure to treated recreational water can be caused by pathogens or chemicals in venues such as pools, hot tubs/spas, and interactive water play venues (i.e., water playgrounds). During 2000-2014, public health officials from 46 states and Puerto Rico reported 493 outbreaks associated with treated recreational water. These outbreaks resulted in at least 27,219 cases and eight deaths. Among the 363 outbreaks with a confirmed infectious etiology, 212 (58%) were caused by Cryptosporidium (which causes predominantly gastrointestinal illness), 57 (16%) by Legionella (which causes Legionnaires' disease, a severe pneumonia, and Pontiac fever, a milder illness with flu-like symptoms), and 47 (13%) by Pseudomonas (which causes folliculitis ["hot tub rash"] and otitis externa ["swimmers' ear"]). Investigations of the 363 outbreaks identified 24,453 cases; 21,766 (89%) were caused by Cryptosporidium, 920 (4%) by Pseudomonas, and 624 (3%) by Legionella. At least six of the eight reported deaths occurred in persons affected by outbreaks caused by Legionella. Hotels were the leading setting, associated with 157 (32%) of the 493 outbreaks. Overall, the outbreaks had a bimodal temporal distribution: 275 (56%) outbreaks started during June-August and 46 (9%) in March. Assessment of trends in the annual counts of outbreaks caused by Cryptosporidium, Legionella, or Pseudomonas indicate mixed progress in preventing transmission. Pathogens able to evade chlorine inactivation have become leading outbreak etiologies. The consequent outbreak and case counts and mortality underscore the utility of CDC's Model Aquatic Health Code (https://www.cdc.gov/mahc) to prevent outbreaks associated with treated recreational water.

[Waterborne diseases outbreaks in the Czech Republic, 1995-2005].

PubMed

Kozísek, F; Jeligová, H; Dvoráková, A

2009-08-01

Despite considerable advances in drinking water safety assurance and adherence to the public health standards, waterborne diaseases outbreaks have still been observed even in industrialized countries. The study objective was to map such outbreaks in the Czech Republic in 1995-2005. In this study, an outbreak is the occurrence of more cases of disease than normally expected within a specific place over a given period of time and a waterborne disease is a disease where water is the vehicle or source of infection. The data on waterborne outbreaks was obtained from the EPIDAT database (national infectious diseases reporting system) information provided by epidemiologists of all regional public health authorities and the National Reference Laboratory for Legionella. In 1995 - 2005, 33 outbreaks with water indicated as the route of transmission were recorded in the Czech Republic. The leading cause was unsafe drinking water (27 outbreaks), mainly from wells (19 outbreaks); nevertheless, the most serious consequences were observed in two outbreaks caused by microbiologically contaminated hot water. Other sources of waterborne infection were mineral water springs, a swimming pool and a brook. The total of reported cases of waterborne diseases was 1655, 356 hospitalisations and ten deaths due to legionellosis were recorded. The highest number of outbreaks (7) as well as the highest number of cases (841) were reported in 1997. Comparison of two five-year periods, i.e. 1996-2000 and 2001-2005, showed a nearly one third decrease in the total of outbreaks and a half reduction in the total of cases in the latter. In view of the limited length of monitoring, it is not possible to say with certainty whether it is a random distribution or an actual trend. Almost two thirds of cases were diagnosed as acute gastroenteritis of probable infectious origin and other frequent waterborne diseases were viral hepatitis A and bacillary dysentery. When analyzing the described outbreaks, it

Avian cholera mortality in lesser snow geese nesting on Banks Island, Northwest Territories

USGS Publications Warehouse

Samuel, M.D.; Takekawa, John Y.; Samelius, G.; Goldberg, Diana R.

1999-01-01

Avian cholera is one of the most important diseases affecting waterfowl in North America, but little is known about its ecology and its impact on waterfowl populations. We documented avian cholera mortality in breeding lesser snow geese (Chen c. caerulescens) at the Egg River colony on Banks Island, Northwest Territories, Canada, in 1995 and 1996. Area of the breeding colony, core nesting area, and number of nesting geese were greater in 1996 (colony=7,537 ha, core area=1,581 ha, 401,000 nesting geese) than in 1995 (colony=6,637 ha, core area=996 ha, 318,000 nesting geese). Density of nesting geese also was greater in the core area during 1995 (120 geese/ha) than in 1996 (90 geese/ha). Pasteurella multocida (serotype 1) was cultured from the leg bones of adult snow goose carcasses collected after outbreaks. Mortality from avian cholera began during nesting and continued until birds dispersed at hatch. Mortality appeared to be in foci scattered throughout the nesting colony, but generally was greater where there were greater densities of nesting geese. We estimated that 30,000 and 20,000 geese died in 1995 and 1996, respectively, about 5-9% of the nesting colony. Between 1991 and 1997, at least 4 avian cholera outbreaks occurred at Banks Island. It appears that avian cholera has become endemic in this population of snow geese, and these birds have the potential to transmit the disease to other waterfowl, especially on wintering areas where waterfowl are very concentrated.

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

PubMed Central

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

2014-01-01

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

Investigating outbreaks: practical guidance in the Indian scenario.

PubMed

Murhekar, Manoj; Moolenaar, Ron; Hutin, Yvan; Broome, Claire

2009-01-01

The new international Health Regulations, 2005, which came into force in 2007, establish a national focal point in each country to manage public health emergencies of international concern, including outbreaks. Investigating outbreaks is a challenging task. Often, pressure from decision-makers to hasten investigation may preclude proper evidence-based conclusions. Furthermore, the task of outbreak investigation is given to senior staff, who have limited time for field activities. The classical 10-step approach includes 4 main stages of (i) confirmation of the presence of the outbreak and of diagnosis using laboratory tests, (ii) generation of hypotheses regarding causation using descriptive epidemiology findings, (iii) hypothesis-testing using analytical epidemiology techniques, and (iv) institution of prevention measures. Peer-review at all stages of the investigation and reporting is the keystone of the quality assurance process. It is important to build capacity for outbreak Investigation. Two Field Epidemiology Training Programmes in India are trying to do this. In these programmes, epidemiologists-in-training take a lead in investigating outbreaks, while learning the ropes, with full technical support from the faculty. This training should spawn a culture of generating and using evidence for decision-making in the context of public health, and help strengthen health systems even beyond the domain of outbreaks.

Molecular Diagnostic Analysis of Outbreak Scenarios

ERIC Educational Resources Information Center

Morsink, M. C.; Dekter, H. E.; Dirks-Mulder, A.; van Leeuwen, W. B.

2012-01-01

In the current laboratory assignment, technical aspects of the polymerase chain reaction (PCR) are integrated in the context of six different bacterial outbreak scenarios. The "Enterobacterial Repetitive Intergenic Consensus Sequence" (ERIC) PCR was used to analyze different outbreak scenarios. First, groups of 2-4 students determined optimal…

Management of nosocomial scabies, an outbreak of occupational disease.

PubMed

Jungbauer, Frank H W; Veenstra-Kyuchukova, Yanka K; Koeze, Jacqueline; KruijtSpanjer, Martijn R; Kardaun, Sylvia H

2015-05-01

The optimal approach to managing institutional scabies outbreaks has yet to be defined. We report on outbreak managements are needed. We report on a large outbreak of scabies in three acute care wards in a tertiary university teaching hospital in the Netherlands. The outbreak potentially effected 460 patients and 185 health care workers who had been exposed to the index patient. Containment of an outbreak relies on a quick and strict implementation of appropriate infection control measures and should include simultaneous treatment of all infested persons and exposed contacts to prevent secondary spread and prolonged post-intervention surveillance. © 2015 Wiley Periodicals, Inc.

Pseudo-Outbreak of Actinomyces graevenitzii Associated with Bronchoscopy

PubMed Central

Peaper, David R.; Havill, Nancy L.; Aniskiewicz, Michael; Callan, Deborah; Pop, Olivia; Towle, Dana

2014-01-01

Outbreaks and pseudo-outbreaks of infection related to bronchoscopy typically involve Gram-negative bacteria, Mycobacterium species or Legionella species. We report an unusual bronchoscopy-related pseudo-outbreak due to Actinomyces graevenitzii. Extensive epidemiological and microbiological investigation failed to identify a common source. Strain typing revealed that the cluster was comprised of heterogeneous strains of A. graevenitzii. A change in laboratory procedures for Actinomyces cultures was coincident with the emergence of the pseudo-outbreak, and we determined that A. graevenitzii isolates more readily adopted a white, dry, molar tooth appearance on anaerobic colistin nalidixic acid (CNA) agar which likely facilitated its detection and identification in bronchoscopic specimens. This unusual pseudo-outbreak was related to frequent requests of bronchoscopists for Actinomyces cultures combined with a change in microbiology laboratory practices. PMID:25355767

Waterborne disease in Norway: emphasizing outbreaks in groundwater systems.

PubMed

Kvitsand, Hanne M L; Fiksdal, Liv

2010-01-01

In this study, we compiled and examined available data on waterborne disease outbreaks (1984-2007) in Norway, with emphasis on groundwater systems. A total of 102 waterborne outbreaks and 17,243 disease cases were reported during the period 1984-2007. The proportion of outbreaks related to groundwater reflected the proportion of groundwater works in Norway (40%). The proportion of disease cases corresponded to the proportion of persons supplied by groundwater (15%). Norovirus was identified as the most important disease causing agent in groundwater systems. No clear seasonal correlation was observed for Norovirus outbreaks in groundwater, but the largest outbreaks occurred during winter season. All outbreaks of campylobacteriosis occurred during March to November, with a peak in July-September, which correlates with the occurrence of coliforms in Norwegian groundwater in bedrock wells.

Foodborne illness outbreaks from microbial contaminants in spices, 1973-2010.

PubMed

Van Doren, Jane M; Neil, Karen P; Parish, Mickey; Gieraltowski, Laura; Gould, L Hannah; Gombas, Kathy L

2013-12-01

This review identified fourteen reported illness outbreaks attributed to consumption of pathogen-contaminated spice during the period 1973-2010. Countries reporting outbreaks included Canada, Denmark, England and Wales, France, Germany, New Zealand, Norway, Serbia, and the United States. Together, these outbreaks resulted in 1946 reported human illnesses, 128 hospitalizations and two deaths. Infants/children were the primary population segments impacted by 36% (5/14) of spice-attributed outbreaks. Four outbreaks were associated with multiple organisms. Salmonella enterica subspecies enterica was identified as the causative agent in 71% (10/14) of outbreaks, accounting for 87% of reported illnesses. Bacillus spp. was identified as the causative agent in 29% (4/10) of outbreaks, accounting for 13% of illnesses. 71% (10/14) of outbreaks were associated with spices classified as fruits or seeds of the source plant. Consumption of ready-to-eat foods prepared with spices applied after the final food manufacturing pathogen reduction step accounted for 70% of illnesses. Pathogen growth in spiced food is suspected to have played a role in some outbreaks, but it was not likely a contributing factor in three of the larger Salmonella outbreaks, which involved low-moisture foods. Root causes of spice contamination included contributions from both early and late stages of the farm-to-table continuum. Published by Elsevier Ltd.

Genomic Science in Understanding Cholera Outbreaks and Evolution of Vibrio cholerae as a Human Pathogen

PubMed Central

Mekalanos, John J.

2014-01-01

Modern genomic and bioinformatic approaches have been applied to interrogate the V. cholerae genome, the role of genomic elements in cholera disease, and the origin, relatedness, and dissemination of epidemic strains. A universal attribute of choleragenic strains includes a repertoire of pathogenicity islands and virulence genes, namely the CTX–ϕ prophage and Toxin Co-regulated Pilus (TCP) in addition to other virulent genetic elements including those referred to as Seventh Pandemic Islands. During the last decade, the advent of Next Generation Sequencing (NGS) has provided highly resolved and often complete genomic sequences of epidemic isolates in addition to both clinical and environmental strains isolated from geographically unconnected regions. Genomic comparisons of these strains, as was completed during and following the Haitian outbreak in 2010, reveals that most epidemic strains appear closely related, regardless of region of origin. Non-O1 clinical or environmental strains may also possess some virulence islands, but phylogenic analysis of the core genome suggests they are more diverse and distantly related than those isolated during epidemics. Like Haiti, genomic studies that examine both the Vibrio core- and pan-genome in addition to Single Nucleotide Polymorphisms (SNPs) conclude that a number of epidemics are caused by strains that closely resemble those in Asia, and often appear to originate there and then spread globally. The accumulation of SNPs in the epidemic strains over time can then be applied to better understand the evolution of the V. cholerae genome as an etiological agent. PMID:24590676

21st Session of the International Poplar Commission (IPC-2000): poplar and willow culture: meeting the needs of society and the environment; 200 September 24-28; Vancouver, WA.

Treesearch

J.G. Isebrands; J. Richardson

2000-01-01

Research results and ongoing research activities on poplar and willow breeding, diseases, insects, production, and utilization are described in 220 abstracts from the International Poplar Commission meeting in Vancouver, Washington, September 24-28, 2000.

Timeliness of Nongovernmental versus Governmental Global Outbreak Communications

PubMed Central

Mondor, Luke; Brownstein, John S.; Chan, Emily; Madoff, Lawrence C.; Pollack, Marjorie P.; Buckeridge, David L.

2012-01-01

To compare the timeliness of nongovernmental and governmental communications of infectious disease outbreaks and evaluate trends for each over time, we investigated the time elapsed from the beginning of an outbreak to public reporting of the event. We found that governmental sources improved the timeliness of public reporting of infectious disease outbreaks during the study period. PMID:22709741

Epidemiologic patterns of influenza outbreaks in institutional settings.

PubMed

Šubelj, M

2018-02-01

Congregate environments facilitate spread of influenza viruses and could result in serious outcomes among residents. We reviewed the epidemiology and identified factors that affect outbreak outcomes, using descriptive statistics and generalized estimating equations (GEE) regression. Outbreak duration, attack rate, hospitalization rate, case fatality rate, and the proportion of laboratory tests performed among infected residents were calculated by viral etiology, time to notification, and facility type and size. Between January 2011 and May 2015, the median attack rate for the 41 influenza outbreaks was highest among children in kindergarten (34%) and lowest among patients, who acquired influenza during hospitalization (17%). The median number of cases in each outbreak was 37 (range: 6-158) and a median of 199 individuals (range: 25-574) was exposed to influenza. The outbreaks lasted 2-49 days (median: 13 days). The average case fatality rate among residents for outbreaks attributed to influenza A or B was 3.1/1000 and for outbreaks attributed to influenza B 6.7/1000. Median time to notification was 10 days after the index case. In multivariate analysis, influenza outbreaks reported sooner after onset in the primary case ended sooner (P = 0.027) and had lower case fatality rates (P < 0.001). Residing in larger facilities was associated with lower proportion of laboratory tests performed (P = 0.024). Understanding whether earlier notification is a measure of a better functioning and therefore safer facility is a potentially important measure of the quality of care. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Relationship between the Cascadia fore-arc mantle wedge, nonvolcanic tremor, and the downdip limit of seismogenic rupture

USGS Publications Warehouse

McCrory, Patricia A.; Hyndman, Roy D.; Blair, James Luke

2014-01-01

Great earthquakes anticipated on the Cascadia subduction fault can potentially rupture beyond the geodetically and thermally inferred locked zone to the depths of episodic tremor and slip (ETS) or to the even deeper fore-arc mantle corner (FMC). To evaluate these extreme rupture limits, we map the FMC from southern Vancouver Island to central Oregon by combining published seismic velocity structures with a model of the Juan de Fuca plate. These data indicate that the FMC is somewhat shallower beneath Vancouver Island (36–38 km) and Oregon (35–40 km) and deeper beneath Washington (41–43 km). The updip edge of tremor follows the same general pattern, overlying a slightly shallower Juan de Fuca plate beneath Vancouver Island and Oregon (∼30 km) and a deeper plate beneath Washington (∼35 km). Similar to the Nankai subduction zone, the best constrained FMC depths correlate with the center of the tremor band suggesting that ETS is controlled by conditions near the FMC rather than directly by temperature or pressure. Unlike Nankai, a gap as wide as 70 km exists between the downdip limit of the inferred locked zone and the FMC. This gap also encompasses a ∼50 km wide gap between the inferred locked zones and the updip limit of tremor. The separation of these features offers a natural laboratory for determining the key controls on downdip rupture limits.

Outbreak of human metapneumovirus infection in psychiatric inpatients: implications for directly observed use of alcohol hand rub in prevention of nosocomial outbreaks.

PubMed

Cheng, V C C; Wu, A K L; Cheung, C H Y; Lau, S K P; Woo, P C Y; Chan, K H; Li, K S M; Ip, I K S; Dunn, E L W; Lee, R A; Yam, L Y C; Yuen, K Y

2007-12-01

Nosocomial outbreaks of infectious diseases in psychiatric facilities are not uncommon but the implementation of infection control measures is often difficult. Here, we report an outbreak of an acute respiratory illness in a psychiatric ward between 29 July and 20 August 2005 involving 31 patients. Human metapneumovirus was detected in seven (23%) patients by reverse transcription-polymerase chain reaction and nucleotide sequencing. A review of outbreak surveillance records showed that six nosocomial outbreaks occurred in the year 2005, of which four (67%) were confirmed or presumably related to a respiratory viral infection. Directly observed deliveries of alcohol hand rub 4-hourly during daytime to all psychiatric patients was instituted in December 2005. Only one nosocomial respiratory viral outbreak occurred in the following year. The total number of patients and staff involved in nosocomial outbreaks due to presumed or proven respiratory virus infections decreased significantly from 60 to six (P<0.001), whereas those due to all types of nosocomial outbreaks also decreased from 70 to 24 (P=0.004). Alcohol hand rub has been shown to have potent bactericidal and virucidal activity against a wide range of nosocomial pathogens. Regular use of directly observed alcohol hand rub may decrease the incidence and scale of nosocomial outbreaks due to enveloped respiratory viruses especially in mentally incapacitated patients.

Piloting the CANRISK tool in Vancouver Coastal Health.

PubMed

Papineau, D; Fong, M

2011-12-01

Vancouver Coastal Health Authority's Healthy Living Program implemented this pilot study to test and validate the Canadian Diabetes Risk Assessment Questionnaire (CANRISK) developed by the Public Health Agency of Canada as a screening tool for undiagnosed type 2 diabetes mellitus (DM) and prediabetes. Key objectives were to test the feasibility and acceptability of screening urban ethnic groups using the CANRISK, increase awareness of risk factors for DM and preDM and develop resources for lifestyle change. The study recruited participants through community groups and churches, intraorganizational emails, primary care clinics and word of mouth. They completed the CANRISK and an oral glucose tolerance test (OGTT) either individually or as part of a group. Groups received a brief diabetes prevention information session. Documents to support lifestyle change were distributed to all participants. Participants (n = 556) were recruited among East Asian, Caucasian, South Asian and Latin American ethnic groups. Of these, 17% had OGTT results in the preDM range and 3% in the DM range. Over 90% of participants reported that the CANRISK wording was clear and that they had received useful information about lowering their diabetes risk. The benefit of using an OGTT was in identifying 11% of the sample of participants who had impaired glucose tolerance (IGT) and did not show abnormal fasting plasma glucose (FPG) results. All participants with abnormal laboratory results were provided with follow-up educational interventions in their own language.

Measles & rubella outbreaks in Maharashtra State, India.

PubMed

Vaidya, Sunil R; Kamble, Madhukar B; Chowdhury, Deepika T; Kumbhar, Neelakshi S

2016-02-01

Under the outbreak-based measles surveillance in Maharashtra State the National Institute of Virology at Pune receives 3-5 serum samples from each outbreak and samples from the local hospitals in Pune for laboratory diagnosis. This report describes one year data on the measles and rubella serology, virus isolation and genotyping. Maharashtra State Health Agencies investigated 98 suspected outbreaks between January-December 2013 in the 20 districts. Altogether, 491 serum samples were received from 20 districts and 126 suspected cases from local hospitals. Samples were tested for the measles and rubella IgM antibodies by commercial enzyme immunoassay (EIA). To understand the diagnostic utility, a subset of serum samples (n=53) was tested by measles focus reduction neutralization test (FRNT). Further, 37 throat swabs and 32 urine specimens were tested by measles reverse transcription (RT)-PCR and positive products were sequenced. Virus isolation was performed in Vero hSLAM cells. Of the 98 suspected measles outbreaks, 61 were confirmed as measles, 12 as rubella and 21 confirmed as the mixed outbreaks. Four outbreaks remained unconfirmed. Of the 126 cases from the local hospitals, 91 were confirmed for measles and three for rubella. Overall, 93.6 per cent (383/409) confirmed measles cases were in the age group of 0-15 yr. Measles virus was detected in 18 of 38 specimens obtained from the suspected cases. Sequencing of PCR products revealed circulation of D4 (n=9) and D8 (n=9) strains. Four measles viruses (three D4 & one D8) were isolated. Altogether, 94 measles and rubella outbreaks were confirmed in 2013 in the State of Maharasthra indicating the necessity to increase measles vaccine coverage in the State.

Mitigating Infectious Disease Outbreaks

NASA Astrophysics Data System (ADS)

Davey, Victoria

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

Pseudo-outbreak of Actinomyces graevenitzii associated with bronchoscopy.

PubMed

Peaper, David R; Havill, Nancy L; Aniskiewicz, Michael; Callan, Deborah; Pop, Olivia; Towle, Dana; Boyce, John M

2015-01-01

Outbreaks and pseudo-outbreaks of infection related to bronchoscopy typically involve Gram-negative bacteria, Mycobacterium species or Legionella species. We report an unusual bronchoscopy-related pseudo-outbreak due to Actinomyces graevenitzii. Extensive epidemiological and microbiological investigation failed to identify a common source. Strain typing revealed that the cluster was comprised of heterogeneous strains of A. graevenitzii. A change in laboratory procedures for Actinomyces cultures was coincident with the emergence of the pseudo-outbreak, and we determined that A. graevenitzii isolates more readily adopted a white, dry, molar tooth appearance on anaerobic colistin nalidixic acid (CNA) agar which likely facilitated its detection and identification in bronchoscopic specimens. This unusual pseudo-outbreak was related to frequent requests of bronchoscopists for Actinomyces cultures combined with a change in microbiology laboratory practices. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Limits to Forecasting Precision for Outbreaks of Directly Transmitted Diseases

PubMed Central

Drake, John M

2006-01-01

Background Early warning systems for outbreaks of infectious diseases are an important application of the ecological theory of epidemics. A key variable predicted by early warning systems is the final outbreak size. However, for directly transmitted diseases, the stochastic contact process by which outbreaks develop entails fundamental limits to the precision with which the final size can be predicted. Methods and Findings I studied how the expected final outbreak size and the coefficient of variation in the final size of outbreaks scale with control effectiveness and the rate of infectious contacts in the simple stochastic epidemic. As examples, I parameterized this model with data on observed ranges for the basic reproductive ratio (R 0) of nine directly transmitted diseases. I also present results from a new model, the simple stochastic epidemic with delayed-onset intervention, in which an initially supercritical outbreak (R 0 > 1) is brought under control after a delay. Conclusion The coefficient of variation of final outbreak size in the subcritical case (R 0 < 1) will be greater than one for any outbreak in which the removal rate is less than approximately 2.41 times the rate of infectious contacts, implying that for many transmissible diseases precise forecasts of the final outbreak size will be unattainable. In the delayed-onset model, the coefficient of variation (CV) was generally large (CV > 1) and increased with the delay between the start of the epidemic and intervention, and with the average outbreak size. These results suggest that early warning systems for infectious diseases should not focus exclusively on predicting outbreak size but should consider other characteristics of outbreaks such as the timing of disease emergence. PMID:16435887

Outbreak or Epidemic? How Obama's Language Choice Transformed the Ebola Outbreak Into an Epidemic.

PubMed

Gesser-Edelsburg, Anat; Shir-Raz, Yaffa; Bar-Lev, Oshrat Sassoni; James, James J; Green, Manfred S

2016-08-01

Our aim was to examine in what terms leading newspapers' online sites described the current Ebola crisis. We employed a quantitative content analysis of terms attributed to Ebola. We found and analyzed 582 articles published between March 23 and September 30, 2014, on the online websites of 3 newspapers: The New York Times, Daily Mail, and Ynet. Our theoretical framework drew from the fields of health communication and emerging infectious disease communication, including such concepts as framing media literacy, risk signatures, and mental models. We found that outbreak and epidemic were used interchangeably in the articles. From September 16, 2014, onward, epidemic predominated, corresponding to when President Barack Obama explicitly referred to Ebola as an epidemic. Prior to Obama's speech, 86.8% of the articles (323) used the term outbreak and only 8.6% (32) used the term epidemic. Subsequently, both terms were used almost the same amount: 53.8% of the articles (113) used the term outbreak and 53.3% (112) used the term epidemic. Effective communication is crucial during public health emergencies such as Ebola, because language framing affects the decision-making process of social judgments and actions. The choice of one term (outbreak) over another (epidemic) can create different conceptualizations of the disease, thereby influencing the risk signature. (Disaster Med Public Health Preparedness. 2016;10:669-673).

Does homologous reinfection drive multiple-wave influenza outbreaks? Accounting for immunodynamics in epidemiological models.

PubMed

Camacho, A; Cazelles, B

2013-12-01

Epidemiological models of influenza transmission usually assume that recovered individuals instantly develop a fully protective immunity against the infecting strain. However, recent studies have highlighted host heterogeneity in the development of this immune response, characterized by delay and even absence of protection, that could lead to homologous reinfection (HR). Here, we investigate how these immunological mechanisms at the individual level shape the epidemiological dynamics at the population level. In particular, because HR was observed during the successive waves of past pandemics, we assess its role in driving multiple-wave influenza outbreaks. We develop a novel mechanistic model accounting for host heterogeneity in the immune response. Immunological parameters are inferred by fitting our dynamical model to a two-wave influenza epidemic that occurred on the remote island of Tristan da Cunha (TdC) in 1971, and during which HR occurred in 92 of 284 islanders. We then explore the dynamics predicted by our model for various population settings. We find that our model can explain HR over both short (e.g. week) and long (e.g. month) time-scales, as reported during past pandemics. In particular, our results reveal that the HR wave on TdC was a natural consequence of the exceptional contact configuration and high susceptibility of this small and isolated community. By contrast, in larger, less mixed and partially protected populations, HR alone cannot generate multiple-wave outbreaks. However, in the latter case, we find that a significant proportion of infected hosts would remain unprotected at the end of the pandemic season and should therefore benefit from vaccination. Crucially, we show that failing to account for these unprotected individuals can lead to large underestimation of the magnitude of the first post-pandemic season. These results are relevant in the context of the 2009 A/H1N1 influenza post-pandemic era. Copyright © 2013 The Authors. Published

Jail fever (epidemic typhus) outbreak in Burundi.

PubMed

Raoult, D; Roux, V; Ndihokubwayo, J B; Bise, G; Baudon, D; Marte, G; Birtles, R

1997-01-01

We recently investigated a suspected outbreak of epidemic typhus in a jail in Burundi. We tested sera of nine patients by microimmunofluorescence for antibodies to Rickettsia prowazekii and Rickettsia typhi. We also amplified and sequenced from lice gene portions specific for two R. prowazekii proteins: the gene encoding for citrate synthase and the gene encoding for the rickettsial outer membrane protein. All patients exhibited antibodies specific for R. prowazekii. Specific gene sequences were amplified in two lice from one patient. The patients had typical clinical manifestations, and two died. Molecular techniques provided a convenient and reliable means of examining lice and confirming this outbreak. The jail-associated outbreak predates an extensive ongoing outbreak of louse-borne typhus in central eastern Africa after civil war and in refugee camps in Rwanda, Burundi (1), and Zaire.

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

PubMed

Garner, Danisha; Kathariou, Sophia

2016-02-01

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

Yellow Fever Outbreak, Southern Sudan, 2003

PubMed Central

Onyango, Clayton O.; Grobbelaar, Antoinette A.; Gibson, Georgina V.F.; Sang, Rosemary C.; Sow, Abdourahmane; Swanepoel, Robert

2004-01-01

In May 2003, an outbreak of fatal hemorrhagic fever, caused by yellow fever virus, occurred in southern Sudan. Phylogenetic analysis showed that the virus belonged to the East African genotype, which supports the contention that yellow fever is endemic in East Africa with the potential to cause large outbreaks in humans. PMID:15498174

Incentives for Reporting Infectious Disease Outbreaks

ERIC Educational Resources Information Center

Malani, Anup; Laxminarayan, Ramanan

2011-01-01

The global spread of diseases such as swine flu and SARS highlights the difficult decision governments face when presented with evidence of a local outbreak. Reporting the outbreak may bring medical assistance but is also likely to trigger trade sanctions by countries hoping to contain the disease. Suppressing the information may avoid trade…

Space Radar Image of Victoria, Canada

NASA Image and Video Library

1999-04-15

This three-frequency spaceborne radar image shows the southern end of Vancouver Island on the west coast of Canada. The white area in the lower right is the city of Victoria, the capital of the province of British Columbia.

Forum of Microbial Threats

DTIC Science & Technology

2011-06-01

Cryptococcus gattii, a pathogenic environmental fungus believed to have been introduced onto Vancouver Island, British Columbia, Canada in 1999, is...factors‖ others such as Crytococcus gattii, are emerging with altered virulence and geographic ranges. Cryptococcus gattii, a pathogenic environmental

Listeriosis Outbreaks and Associated Food Vehicles, United States, 1998–2008

PubMed Central

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

2013-01-01

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

OUTBREAKS ASSOCIATED WITH RECREATIONAL WATER IN THE UNITED STATES

EPA Science Inventory

In this article, we review the causes of outbreaks associated with recreational water during 1971-2000. A bacterial or protozoan etiology was identified in three-quarters of the outbreaks; 23% of the outbreaks were of undetermined etiology. The most frequently identified agents w...

Distribution of Mosquito Larvae on Kosrae Island, Kosrae State, the Federated States of Micronesia

PubMed Central

Noda, Shinichi; Yamamoto, Sota; Toma, Takako; Taulung, Livinson

2013-01-01

Surveys of mosquito larvae were carried out in six areas of Kosrae Island, Kosrae State, the Federated States of Micronesia in December 2009 and June 2012. A total of 962 larvae of six species were collected from 106 natural and artificial habitats. They were identified as Aedes aegypti, Ae. albopictus, Ae. marshallensis, Culex quinquefasciatus, Cx. annulirostris, and Cx. kusaiensis. This is the first report from Kosrae Island for three of these species—Ae. marshallensis, Cx. quinquefasciatus, and Cx. annulirostris. The most abundant species was Ae. albopictus, followed by Ae. marshallensis, and these two species were found in all areas. Relatively large numbers of Cx. quinquefasciatus and Cx. kusaiensis were found in five areas. Fewer Cx. annulirostris were found, and only in three areas. Aedes aegypti larvae were collected from a single habitat at Tafunsak in 2009. To prevent the outbreak of dengue fever, environmental management should focus on the destruction, alteration, disposal and recycling of containers that produce larger numbers of adult Aedes mosquitoes. PMID:24478593

Developing a disease outbreak event corpus.

PubMed

Conway, Mike; Kawazoe, Ai; Chanlekha, Hutchatai; Collier, Nigel

2010-09-28

In recent years, there has been a growth in work on the use of information extraction technologies for tracking disease outbreaks from online news texts, yet publicly available evaluation standards (and associated resources) for this new area of research have been noticeably lacking. This study seeks to create a "gold standard" data set against which to test how accurately disease outbreak information extraction systems can identify the semantics of disease outbreak events. Additionally, we hope that the provision of an annotation scheme (and associated corpus) to the community will encourage open evaluation in this new and growing application area. We developed an annotation scheme for identifying infectious disease outbreak events in news texts. An event--in the context of our annotation scheme--consists minimally of geographical (eg, country and province) and disease name information. However, the scheme also allows for the rich encoding of other domain salient concepts (eg, international travel, species, and food contamination). The work resulted in a 200-document corpus of event-annotated disease outbreak reports that can be used to evaluate the accuracy of event detection algorithms (in this case, for the BioCaster biosurveillance online news information extraction system). In the 200 documents, 394 distinct events were identified (mean 1.97 events per document, range 0-25 events per document). We also provide a download script and graphical user interface (GUI)-based event browsing software to facilitate corpus exploration. In summary, we present an annotation scheme and corpus that can be used in the evaluation of disease outbreak event extraction algorithms. The annotation scheme and corpus were designed both with the particular evaluation requirements of the BioCaster system in mind as well as the wider need for further evaluation resources in this growing research area.

Cholera outbreak in Homa Bay County, Kenya, 2015.

PubMed

Githuku, Jane Njoki; Boru, Waqo Gufu; Hall, Casey Daniel; Gura, Zeinab; Oyugi, Elvis; Kishimba, Rogath Saika; Semali, Innocent; Farhat, Ghada Nadim; Mattie Park, Meeyoung

2017-01-01

Cholera is among the re-emerging diseases in Kenya. Beginning in December 2014, a persistent outbreak occurred involving 29 out of the 47 countries. Homa Bay County in Western Kenya was among the first counties to report cholera cases from January to April 2015. This case study is based on an outbreak investigation conducted by FELTP residents in Homa Bay County in February 2015. It simulates an outbreak investigation including laboratory confirmation, active case finding, descriptive epidemiology and implementation of control measures. This case study is designed for the training of basic level field epidemiology trainees or any other health care workers working in public health-related fields. It can be administered in 2-3 hours. Used as adjunct training material, the case study provides the trainees with competencies in investigating an outbreak in preparation for the actual real-life experience of such outbreaks.

Early outbreak detection by linking health advice line calls to water distribution areas retrospectively demonstrated in a large waterborne outbreak of cryptosporidiosis in Sweden.

PubMed

Bjelkmar, Pär; Hansen, Anette; Schönning, Caroline; Bergström, Jakob; Löfdahl, Margareta; Lebbad, Marianne; Wallensten, Anders; Allestam, Görel; Stenmark, Stephan; Lindh, Johan

2017-04-18

In the winter and spring of 2011 a large outbreak of cryptosporidiosis occurred in Skellefteå municipality, Sweden. This study summarizes the outbreak investigation in terms of outbreak size, duration, clinical characteristics, possible source(s) and the potential for earlier detection using calls to a health advice line. The investigation included two epidemiological questionnaires and microbial analysis of samples from patients, water and other environmental sources. In addition, a retrospective study based on phone calls to a health advice line was performed by comparing patterns of phone calls between different water distribution areas. Our analyses showed that approximately 18,500 individuals were affected by a waterborne outbreak of cryptosporidiosis in Skellefteå in 2011. This makes it the second largest outbreak of cryptosporidiosis in Europe to date. Cryptosporidium hominis oocysts of subtype IbA10G2 were found in patient and sewage samples, but not in raw water or in drinking water, and the initial contamination source could not be determined. The outbreak went unnoticed to authorities for several months. The analysis of the calls to the health advice line provides strong indications early in the outbreak that it was linked to a particular water treatment plant. We conclude that an earlier detection of the outbreak by linking calls to a health advice line to water distribution areas could have limited the outbreak substantially.

Outbreaks attributed to fresh leafy vegetables, United States, 1973–2012

PubMed Central

HERMAN, K. M.; HALL, A. J.; GOULD, L. H.

2015-01-01

SUMMARY Leafy vegetables are an essential component of a healthy diet; however, they have been associated with high-profile outbreaks causing severe illnesses. We reviewed leafy vegetable-associated outbreaks reported to the Centers for Disease Control and Prevention between 1973 and 2012. During the study period, 606 leafy vegetable-associated outbreaks, with 20 003 associated illnesses, 1030 hospitalizations, and 19 deaths were reported. On average, leafy vegetable-associated outbreaks were larger than those attributed to other food types. The pathogens that most often caused leafy vegetable-associated outbreaks were norovirus (55% of outbreaks with confirmed aetiology), Shiga toxin-producing Escherichia coli (STEC) (18%), and Salmonella (11%). Most outbreaks were attributed to food prepared in a restaurant or catering facility (85%). An ill food worker was implicated as the source of contamination in 31% of outbreaks. Efforts by local, state, and federal agencies to control leafy vegetable contamination and outbreaks should span from the point of harvest to the point of preparation. PMID:25697407

Measles & rubella outbreaks in Maharashtra State, India

PubMed Central

Vaidya, Sunil R.; Kamble, Madhukar B.; Chowdhury, Deepika T.; Kumbhar, Neelakshi S.

2016-01-01

Background & objectives: Under the outbreak-based measles surveillance in Maharashtra State the National Institute of Virology at Pune receives 3-5 serum samples from each outbreak and samples from the local hospitals in Pune for laboratory diagnosis. This report describes one year data on the measles and rubella serology, virus isolation and genotyping. Methods: Maharashtra State Health Agencies investigated 98 suspected outbreaks between January-December 2013 in the 20 districts. Altogether, 491 serum samples were received from 20 districts and 126 suspected cases from local hospitals. Samples were tested for the measles and rubella IgM antibodies by commercial enzyme immunoassay (EIA). To understand the diagnostic utility, a subset of serum samples (n=53) was tested by measles focus reduction neutralization test (FRNT). Further, 37 throat swabs and 32 urine specimens were tested by measles reverse transcription (RT)-PCR and positive products were sequenced. Virus isolation was performed in Vero hSLAM cells. Results: Of the 98 suspected measles outbreaks, 61 were confirmed as measles, 12 as rubella and 21 confirmed as the mixed outbreaks. Four outbreaks remained unconfirmed. Of the 126 cases from the local hospitals, 91 were confirmed for measles and three for rubella. Overall, 93.6 per cent (383/409) confirmed measles cases were in the age group of 0-15 yr. Measles virus was detected in 18 of 38 specimens obtained from the suspected cases. Sequencing of PCR products revealed circulation of D4 (n=9) and D8 (n=9) strains. Four measles viruses (three D4 & one D8) were isolated. Interpretation & conclusions: Altogether, 94 measles and rubella outbreaks were confirmed in 2013 in the State of Maharasthra indicating the necessity to increase measles vaccine coverage in the State. PMID:27121521

Forecasting fluctuating outbreaks in seasonally driven epidemics

NASA Astrophysics Data System (ADS)

Stone, Lewi

2009-03-01

Seasonality is a driving force that has major impact on the spatio-temporal dynamics of natural systems and their populations. This is especially true for the transmission of common infectious diseases such as influenza, measles, chickenpox, and pertussis. Here we gain new insights into the nonlinear dynamics of recurrent diseases through the analysis of the classical seasonally forced SIR epidemic model. Despite many efforts over the last decades, it has been difficult to gain general analytical insights because of the complex synchronization effects that can evolve between the external forcing and the model's natural oscillations. The analysis advanced here attempts to make progress in this direction by focusing on the dynamics of ``skips'' where we identify and predict years in which the epidemic is absent rather than outbreak years. Skipping events are intrinsic to the forced SIR model when parameterised in the chaotic regime. In fact, it is difficult if not impossible to locate realistic chaotic parameter regimes in which outbreaks occur regularly each year. This contrasts with the well known Rossler oscillator whose outbreaks recur regularly but whose amplitude vary chaotically in time (Uniform Phase Chaotic Amplitude oscillations). The goal of the present study is to develop a ``language of skips'' that makes it possible to predict under what conditions the next outbreak is likely to occur, and how many ``skips'' might be expected after any given outbreak. We identify a new threshold effect and give clear analytical conditions that allow accurate predictions. Moreover, the time of occurrence (i.e., phase) of an outbreak proves to be a useful new parameter that carries important epidemiological information. In forced systems, seasonal changes can prevent late-initiating outbreaks (i.e., having high phase) from running to completion. These principles yield forecasting tools that should have relevance for the study of newly emerging and reemerging diseases.

Signature-forecasting and early outbreak detection system

PubMed Central

Naumova, Elena N.; MacNeill, Ian B.

2008-01-01

SUMMARY Daily disease monitoring via a public health surveillance system provides valuable information on population risks. Efficient statistical tools for early detection of rapid changes in the disease incidence are a must for modern surveillance. The need for statistical tools for early detection of outbreaks that are not based on historical information is apparent. A system is discussed for monitoring cases of infections with a view to early detection of outbreaks and to forecasting the extent of detected outbreaks. We propose a set of adaptive algorithms for early outbreak detection that does not rely on extensive historical recording. We also include knowledge of infection disease epidemiology into forecasts. To demonstrate this system we use data from the largest water-borne outbreak of cryptosporidiosis, which occurred in Milwaukee in 1993. Historical data are smoothed using a loess-type smoother. Upon receipt of a new datum, the smoothing is updated and estimates are made of the first two derivatives of the smooth curve, and these are used for near-term forecasting. Recent data and the near-term forecasts are used to compute a color-coded warning index, which quantify the level of concern. The algorithms for computing the warning index have been designed to balance Type I errors (false prediction of an epidemic) and Type II errors (failure to correctly predict an epidemic). If the warning index signals a sufficiently high probability of an epidemic, then a forecast of the possible size of the outbreak is made. This longer term forecast is made by fitting a ‘signature’ curve to the available data. The effectiveness of the forecast depends upon the extent to which the signature curve captures the shape of outbreaks of the infection under consideration. PMID:18716671

Pan-genome multilocus sequence typing and outbreak-specific reference-based single nucleotide polymorphism analysis to resolve two concurrent Staphylococcus aureus outbreaks in neonatal services.

PubMed

Roisin, S; Gaudin, C; De Mendonça, R; Bellon, J; Van Vaerenbergh, K; De Bruyne, K; Byl, B; Pouseele, H; Denis, O; Supply, P

2016-06-01

We used a two-step whole genome sequencing analysis for resolving two concurrent outbreaks in two neonatal services in Belgium, caused by exfoliative toxin A-encoding-gene-positive (eta+) methicillin-susceptible Staphylococcus aureus with an otherwise sporadic spa-type t209 (ST-109). Outbreak A involved 19 neonates and one healthcare worker in a Brussels hospital from May 2011 to October 2013. After a first episode interrupted by decolonization procedures applied over 7 months, the outbreak resumed concomitantly with the onset of outbreak B in a hospital in Asse, comprising 11 neonates and one healthcare worker from mid-2012 to January 2013. Pan-genome multilocus sequence typing, defined on the basis of 42 core and accessory reference genomes, and single-nucleotide polymorphisms mapped on an outbreak-specific de novo assembly were used to compare 28 available outbreak isolates and 19 eta+/spa-type t209 isolates identified by routine or nationwide surveillance. Pan-genome multilocus sequence typing showed that the outbreaks were caused by independent clones not closely related to any of the surveillance isolates. Isolates from only ten cases with overlapping stays in outbreak A, including four pairs of twins, showed no or only a single nucleotide polymorphism variation, indicating limited sequential transmission. Detection of larger genomic variation, even from the start of the outbreak, pointed to sporadic seeding from a pre-existing exogenous source, which persisted throughout the whole course of outbreak A. Whole genome sequencing analysis can provide unique fine-tuned insights into transmission pathways of complex outbreaks even at their inception, which, with timely use, could valuably guide efforts for early source identification. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Ebola viral disease outbreak--West Africa, 2014.

PubMed

Dixon, Meredith G; Schafer, Ilana J

2014-06-27

On March 21, 2014, the Guinea Ministry of Health reported the outbreak of an illness characterized by fever, severe diarrhea, vomiting, and a high case-fatality rate (59%) among 49 persons. Specimens from 15 of 20 persons tested at Institut Pasteur in Lyon, France, were positive for an Ebola virus by polymerase chain reaction. Viral sequencing identified Ebola virus (species Zaïre ebolavirus), one of five viruses in the genus Ebolavirus, as the cause. Cases of Ebola viral disease (EVD) were initially reported in three southeastern districts (Gueckedou, Macenta, and Kissidougou) of Guinea and in the capital city of Conakry. By March 30, cases had been reported in Foya district in neighboring Liberia (1), and in May, the first cases identified in Sierra Leone were reported. As of June 18, the outbreak was the largest EVD outbreak ever documented, with a combined total of 528 cases (including laboratory-confirmed, probable, and suspected cases) and 337 deaths (case-fatality rate = 64%) reported in the three countries. The largest previous outbreak occurred in Uganda during 2000-2001, when 425 cases were reported with 224 deaths (case-fatality rate = 53%). The current outbreak also represents the first outbreak of EVD in West Africa (a single case caused by Taï Forest virus was reported in Côte d'Ivoire in 1994 [3]) and marks the first time that Ebola virus transmission has been reported in a capital city.

Healthcare-associated outbreaks due to Mucorales and other uncommon fungi.

PubMed

Davoudi, Setareh; Graviss, Linda S; Kontoyiannis, Dimitrios P

2015-07-01

Healthcare-associated outbreaks of fungal infections, especially with uncommon and emerging fungi, have become more frequent in the past decade. Here, we reviewed the history and definition of healthcare-associated outbreaks of uncommon fungal infections and discussed the principles of investigating, containing and treatment of these outbreaks. In case of these uncommon diseases, occurrence of two or more cases in a short period is considered as an outbreak. Contaminated medical devices and hospital environment are the major sources of these outbreaks. Care must be taken to differentiate a real infection from colonization or contamination. Defining and identifying cases, describing epidemiologic feature of cases, finding and controlling the source of the outbreak, treating patients, and managing asymptomatic exposed patients are main steps for outbreak elimination. These fungal outbreaks are not only difficult to detect but also hard to treat. Early initiation of appropriate antifungal therapy is strongly associated with improved outcomes in infected patients. Choice of antifungal drugs should be made based on spectrum, pharmacodynamic and pharmacokinetic characteristics and adverse effects of available drugs. Combination antifungal therapy and surgical intervention may be also helpful in selected cases. A multidisciplinary approach and close collaboration between all key partners are necessary for successful control of fungal outbreaks. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

[Hospital hygiene - outbreak management of nosocomial infections].

PubMed

Kerwat, Klaus; Wulf, Hinnerk

2012-04-01

According to §6, section 3 of the German Protection against Infections Act [Infektionsschutzgesetz (IfSG)] an outbreak is defined as the occurrence in large numbers of nosocomial infections for which an epidemiological relationship is probable or can be assumed. About 2-10% of nosocomial infections in hospitals (about 5% in intensive care wards) occur within the framework of an outbreak. The heaped occurrence of nosocomial infections can be declared according to the prescribed surveillance of nosocomial infections (§23 IfSG) when, in the course of this assessment, a statistically significant increase in the rate of infections becomes apparent. On the other hand, the occurrence of an outbreak can also be recognized through the vigilance of all involved personnel and a general sensibilization towards this subject. The names of patients involved in outbreaks need not be reported to the responsible health authorities. As a consequence of the report the health authorities become involved in the investigation to determine the cause and its elimination, and to provide support and advice. The outbreak management should be oriented on the respective recommendations of the Robert Koch Institute. © Georg Thieme Verlag Stuttgart · New York.

An outbreak of Salmonella gastroenteritis in an urban jail.

PubMed

Alcabes, P; O'Sullivan, B; Nadal, E; Mouzon, M

1988-12-01

An outbreak of gastroenteritis in New York City's largest jail involved 145 cases over a two-month period. The outbreak was unusual in that two Salmonella strains (serogroups B and D) were involved. Management of the outbreak involved screening kitchen workers by culture of stool samples, and education regarding personal hygiene. Obstacles to investigation and management of the outbreak arose out of the special nature of the jail environment; these included jurisdictional problems and high turnover of the inmate population.

Jail fever (epidemic typhus) outbreak in Burundi.

PubMed Central

Raoult, D.; Roux, V.; Ndihokubwayo, J. B.; Bise, G.; Baudon, D.; Marte, G.; Birtles, R.

1997-01-01

We recently investigated a suspected outbreak of epidemic typhus in a jail in Burundi. We tested sera of nine patients by microimmunofluorescence for antibodies to Rickettsia prowazekii and Rickettsia typhi. We also amplified and sequenced from lice gene portions specific for two R. prowazekii proteins: the gene encoding for citrate synthase and the gene encoding for the rickettsial outer membrane protein. All patients exhibited antibodies specific for R. prowazekii. Specific gene sequences were amplified in two lice from one patient. The patients had typical clinical manifestations, and two died. Molecular techniques provided a convenient and reliable means of examining lice and confirming this outbreak. The jail-associated outbreak predates an extensive ongoing outbreak of louse-borne typhus in central eastern Africa after civil war and in refugee camps in Rwanda, Burundi (1), and Zaire. PMID:9284381

Population structure of the banana weevil, an introduced pest in the Canary Islands, studied by RAPD analysis.

PubMed

Magaña, C; Beroiz, B; Hernández-Crespo, P; Montes de Oca, M; Carnero, A; Ortego, F; Castañera, P

2007-12-01

The banana weevil (BW), Cosmopolites sordidus (Coleoptera: Curculionidae), is one of the most important insect pests of bananas and plantains. The mobility and the origin of BW infestations at the Canary Islands (Tenerife, La Gomera and La Palma) have been analysed using Random Amplified Polymorphic DNA (RAPD) as molecular markers. Populations from Costa Rica, Colombia, Uganda and Madeira were also included for comparison. One hundred and fifteen reproducible bands from eight primers were obtained. The level of polymorphism in the populations from the Canary Islands (40-62%) was in the range of those found in other populations. Nei's genetic distances, pair-wise fixation index (FST) values indicate that the closest populations are Tenerife populations among themselves (Nei's genetic distance=0.054-0.100; FST=0.091-0.157) and Costa Rica and Colombia populations (Nei's genetic distance=0.049; FST=0.113). Our results indicate the existence of BW local biotypes with limited gene flow and affected by genetic drift. These results are compatible with a unique event of colonization at Tenerife; whereas, the outbreaks in La Gomera and La Palma may come from independent introductions. The Madeira population is phylogenetically and geographically closer to the Canary Islands populations, suggesting that it is the most likely source of the insects introduced in the Canary Islands.

Coping with Stress during Infectious Disease Outbreaks

MedlinePlus

· Coping With Stress During Infectious Disease Outbreaks What You Should Know When you hear, read, or watch news about an outbreak ... you may feel anxious and show signs of stress. These signs of stress are normal, and may ...

Outbreaks and Investigations

MedlinePlus

... on Facebook Tweet Share Compartir Disease detectives collecting soil samples to test for fungus When fungal disease ... a hydroelectric dam Source: related to disruption of soil contaminated with bat droppings Outbreak investigation partners: Dominican ...

Tourist visitation impacts of the accident at Three Mile Island

DOE Office of Scientific and Technical Information (OSTI.GOV)

Himmelberger, J.J.; Ogneva-Himmelberger, Y.A.; Baughman, M.L.

This paper analyzes tourist visitation impacts of the March 27, 1979 accident at Three Mile Island. A review of the literature, supplemented with recollections from Pennsylvanian public officials, are used to specify a conventional tourism impact model which holds that depressed 1979 summer tourism season was more influenced by gasoline shortages and possibly other confounding variables (such as rainy local weather conditions and a polio outbreak) than by the nuclear accident. Regression analysis using monthly visitation data for Hershey Chocolate World, Gettysburg National Park, The Pennsylvania Dutch Convention and Visitor Bureau, and several state parks as dependent variables provide supportmore » for this model. Potential tourism implications of an accident at Yucca Mountain are briefly discussed in light of our findings.« less

Chimpanzee adenoviral vectors as vaccines for outbreak pathogens

PubMed Central

2017-01-01

ABSTRACT The 2014–15 Ebola outbreak in West Africa highlighted the potential for large disease outbreaks caused by emerging pathogens and has generated considerable focus on preparedness for future epidemics. Here we discuss drivers, strategies and practical considerations for developing vaccines against outbreak pathogens. Chimpanzee adenoviral (ChAd) vectors have been developed as vaccine candidates for multiple infectious diseases and prostate cancer. ChAd vectors are safe and induce antigen-specific cellular and humoral immunity in all age groups, as well as circumventing the problem of pre-existing immunity encountered with human Ad vectors. For these reasons, such viral vectors provide an attractive platform for stockpiling vaccines for emergency deployment in response to a threatened outbreak of an emerging pathogen. Work is already underway to develop vaccines against a number of other outbreak pathogens and we will also review progress on these approaches here, particularly for Lassa fever, Nipah and MERS. PMID:29083948

Consecutive salmonella outbreaks traced to the same bakery.

PubMed Central

Evans, M. R.; Tromans, J. P.; Dexter, E. L.; Ribeiro, C. D.; Gardner, D.

1996-01-01

Two consecutive community outbreaks of Salmonella enteritidis phage type 4 (PT4) traced to the same bakery occurred in Cardiff, Wales during August-September 1992. In the first outbreak, illness was associated with eating custard slices (odds ratio 23.8, 95% confidence interval 6.5-94.4, P < 0.0001), and in the second, with eating fresh cream cakes (odds ratio 15.8, 95% confidence interval 1.6-374, P = 0.004). Environmental investigations implicated cross-contamination during preparation of the cold-custard mix as the cause of the first outbreak, and inadequate cleaning and disinfection of nozzles used for piping cream in the second outbreak. S. enteritidis PT4 was isolated from fresh cream sponge cake retained by a case and from two fresh cream cakes and four environmental swabs obtained at the bakery. This incident illustrates the hazard of widespread environmental contamination with salmonella and the need for thorough environmental cleansing for any premises implicated in an outbreak of food poisoning. PMID:8620907

A Humidity-Driven Prediction System for Influenza Outbreaks

NASA Astrophysics Data System (ADS)

Thrastarson, H. T.; Teixeira, J.

2015-12-01

Recent studies have highlighted the role of absolute (or specific) humidity conditions as a leading explanation for the seasonal behavior of influenza outbreaks in temperate regions. If the timing and intensity of seasonal influenza outbreaks can be forecast, this would be of great value for public health response efforts. We have developed and implemented a SIRS (Susceptible-Infectious-Recovered-Susceptible) type numerical prediction system that is driven by specific humidity to predict influenza outbreaks. For the humidity, we have explored using both satellite data from the AIRS (Atmospheric Infrared Sounder) instrument as well as ERA-Interim re-analysis data. We discuss the development, testing, sensitivities and limitations of the prediction system and show results for influenza outbreaks in the United States during the years 2010-2014 (modeled in retrospect). Comparisons are made with other existing prediction systems and available data for influenza outbreaks from Google Flu Trends and the CDC (Center for Disease Control), and the incorporation of these datasets into the forecasting system is discussed.

Shellfish-associated enteric virus illness: virus localization, disease outbreaks and prevention

USDA-ARS?s Scientific Manuscript database

Numerous outbreaks of shellfish-borne enteric virus illness have been reported worldwide. Most notable among the outbreaks are those involving norovirus illness and hepatitis A. Lessons learned from outbreak investigations indicate that most outbreaks are preventable. Anthropogenic sources of con...

Two Chikungunya isolates from the outbreak of La Reunion (Indian Ocean) exhibit different patterns of infection in the mosquito, Aedes albopictus.

PubMed

Vazeille, Marie; Moutailler, Sara; Coudrier, Daniel; Rousseaux, Claudine; Khun, Huot; Huerre, Michel; Thiria, Julien; Dehecq, Jean-Sébastien; Fontenille, Didier; Schuffenecker, Isabelle; Despres, Philippe; Failloux, Anna-Bella

2007-11-14

A Chikungunya (CHIK) outbreak hit La Réunion Island in 2005-2006. The implicated vector was Aedes albopictus. Here, we present the first study on the susceptibility of Ae. albopictus populations to sympatric CHIKV isolates from La Réunion Island and compare it to other virus/vector combinations. We orally infected 8 Ae. albopictus collections from La Réunion and 3 from Mayotte collected in March 2006 with two Chikungunya virus (CHIKV) from La Réunion: (i) strain 05.115 collected in June 2005 with an Alanine at the position 226 of the glycoprotein E1 and (ii) strain 06.21 collected in November 2005 with a substitution A226V. Two other CHIKV isolates and four additional mosquito strains/species were also tested. The viral titer of the infectious blood-meal was 10(7) plaque forming units (pfu)/mL. Dissemination rates were assessed by immunofluorescent staining on head squashes of surviving females 14 days after infection. Rates were at least two times higher with CHIKV 06.21 compared to CHIKV 05.115. In addition, 10 individuals were analyzed every day by quantitative RT-PCR. Viral RNA was quantified on (i) whole females and (ii) midguts and salivary glands of infected females. When comparing profiles, CHIKV 06.21 produced nearly 2 log more viral RNA copies than CHIKV 05.115. Furthermore, females infected with CHIKV 05.115 could be divided in two categories: weakly susceptible or strongly susceptible, comparable to those infected by CHIKV 06.21. Histological analysis detected the presence of CHIKV in salivary glands two days after infection. In addition, Ae. albopictus from La Réunion was as efficient vector as Ae. aegypti and Ae. albopictus from Vietnam when infected with the CHIKV 06.21. Our findings support the hypothesis that the CHIK outbreak in La Réunion Island was due to a highly competent vector Ae. albopictus which allowed an efficient replication and dissemination of CHIKV 06.21.

Two Chikungunya Isolates from the Outbreak of La Reunion (Indian Ocean) Exhibit Different Patterns of Infection in the Mosquito, Aedes albopictus

PubMed Central

Vazeille, Marie; Moutailler, Sara; Coudrier, Daniel; Rousseaux, Claudine; Khun, Huot; Huerre, Michel; Thiria, Julien; Dehecq, Jean-Sébastien; Fontenille, Didier; Schuffenecker, Isabelle; Despres, Philippe; Failloux, Anna-Bella

2007-01-01

Background A Chikungunya (CHIK) outbreak hit La Réunion Island in 2005–2006. The implicated vector was Aedes albopictus. Here, we present the first study on the susceptibility of Ae. albopictus populations to sympatric CHIKV isolates from La Réunion Island and compare it to other virus/vector combinations. Methodology and Findings We orally infected 8 Ae. albopictus collections from La Réunion and 3 from Mayotte collected in March 2006 with two Chikungunya virus (CHIKV) from La Réunion: (i) strain 05.115 collected in June 2005 with an Alanine at the position 226 of the glycoprotein E1 and (ii) strain 06.21 collected in November 2005 with a substitution A226V. Two other CHIKV isolates and four additional mosquito strains/species were also tested. The viral titer of the infectious blood-meal was 107 plaque forming units (pfu)/mL. Dissemination rates were assessed by immunofluorescent staining on head squashes of surviving females 14 days after infection. Rates were at least two times higher with CHIKV 06.21 compared to CHIKV 05.115. In addition, 10 individuals were analyzed every day by quantitative RT-PCR. Viral RNA was quantified on (i) whole females and (ii) midguts and salivary glands of infected females. When comparing profiles, CHIKV 06.21 produced nearly 2 log more viral RNA copies than CHIKV 05.115. Furthermore, females infected with CHIKV 05.115 could be divided in two categories: weakly susceptible or strongly susceptible, comparable to those infected by CHIKV 06.21. Histological analysis detected the presence of CHIKV in salivary glands two days after infection. In addition, Ae. albopictus from La Réunion was as efficient vector as Ae. aegypti and Ae. albopictus from Vietnam when infected with the CHIKV 06.21. Conclusions Our findings support the hypothesis that the CHIK outbreak in La Réunion Island was due to a highly competent vector Ae. albopictus which allowed an efficient replication and dissemination of CHIKV 06.21. PMID:18000540

Control Measures Used during Lymphogranuloma Venereum Outbreak, Europe

PubMed Central

Hulscher, Marlies E.J.L.; Vos, Dieuwke; van de Laar, Marita J.W.; Fenton, Kevin A.; van Steenbergen, Jim E.; van der Meer, Jos W.M.; Grol, Richard P.T.M.

2008-01-01

To assess the response to the reemergence of lymphogranuloma venereum, we conducted a cross-sectional survey by administering a structured questionnaire to representatives from 26 European countries. Responses were received from 18 countries. The ability to respond quickly and the measures used for outbreak detection and control varied. Evidence-based criteria were not consistently used to develop recommendations. We did not develop criteria to determine the effectiveness of the recommendations. The degree of preparedness for an unexpected outbreak, as well as the ability of countries to respond quickly to alerts, varied, which indicates weaknesses in the ability to control an outbreak. More guidance is needed to implement and evaluate control measures used during international outbreaks. PMID:18394274

The Ebola outbreak, 2013–2016: old lessons for new epidemics

PubMed Central

Lindsey, Benjamin; Ghinai, Isaac; Johnson, Anne M.; Heymann, David L.

2017-01-01

Ebola virus causes a severe haemorrhagic fever in humans with high case fatality and significant epidemic potential. The 2013–2016 outbreak in West Africa was unprecedented in scale, being larger than all previous outbreaks combined, with 28 646 reported cases and 11 323 reported deaths. It was also unique in its geographical distribution and multicountry spread. It is vital that the lessons learned from the world's largest Ebola outbreak are not lost. This article aims to provide a detailed description of the evolution of the outbreak. We contextualize this outbreak in relation to previous Ebola outbreaks and outline the theories regarding its origins and emergence. The outbreak is described by country, in chronological order, including epidemiological parameters and implementation of outbreak containment strategies. We then summarize the factors that led to rapid and extensive propagation, as well as highlight the key successes, failures and lessons learned from this outbreak and the response. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’. PMID:28396469

Outbreaks of Illness Associated with Recreational Water--United States, 2011-2012.

PubMed

Hlavsa, Michele C; Roberts, Virginia A; Kahler, Amy M; Hilborn, Elizabeth D; Mecher, Taryn R; Beach, Michael J; Wade, Timothy J; Yoder, Jonathan S

2015-06-26

Outbreaks of illness associated with recreational water use result from exposure to chemicals or infectious pathogens in recreational water venues that are treated (e.g., pools and hot tubs or spas) or untreated (e.g., lakes and oceans). For 2011-2012, the most recent years for which finalized data were available, public health officials from 32 states and Puerto Rico reported 90 recreational water-associated outbreaks to CDC's Waterborne Disease and Outbreak Surveillance System (WBDOSS) via the National Outbreak Reporting System (NORS). The 90 outbreaks resulted in at least 1,788 cases, 95 hospitalizations, and one death. Among 69 (77%) outbreaks associated with treated recreational water, 36 (52%) were caused by Cryptosporidium. Among 21 (23%) outbreaks associated with untreated recreational water, seven (33%) were caused by Escherichia coli (E. coli O157:H7 or E. coli O111). Guidance, such as the Model Aquatic Health Code (MAHC), for preventing and controlling recreational water-associated outbreaks can be optimized when informed by national outbreak and laboratory (e.g., molecular typing of Cryptosporidium) data.

Disease Outbreak News

MedlinePlus

... Iraq Nigeria Somalia South Sudan Syrian Arab Republic Yemen All emergencies » Latest » By country By disease Disease ... behavioural impact (COMBI) COMBI toolkit for behavioural and social communication in outbreak response Field workbook for COMBI ...

In-vitro susceptibility of 400 isolates of Neisseria gonorrhoeae in Vancouver, 1982-84.

PubMed Central

Bowie, W R; Shaw, C E; Chan, D G; Jones, H D; Black, W A

1986-01-01

Consecutive isolates of Neisseria gonorrhoeae obtained at a sexually transmitted disease clinic in Vancouver between June 1982 and June 1984 were tested for in-vitro susceptibility to eight antimicrobial agents. Of the 400 isolates 6 (1.5%) were penicillinase-producing N. gonorrhoeae, and for 25 (6.2%) the minimum inhibitory concentrations (MICs) of penicillin were 1.0 to 4.0 micrograms/ml. Ceftriaxone sodium was the most active agent. The MICs were higher than those reported in a Canadian study in 1973-74, except for tetracycline hydrochloride. The patterns of susceptibility of the isolates to one antimicrobial agent correlated significantly with those to each other agent, although the relation was weakest for trimethoprim-sulfamethoxazole and spectinomycin. The results reinforce the need to evaluate local in-vitro susceptibility patterns, especially since the proportion of isolates with relative and absolute resistance to penicillin is increasing. PMID:3091234

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

PubMed

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

2015-03-26

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

Anthrax Outbreaks in Bangladesh, 2009–2010

PubMed Central

Chakraborty, Apurba; Khan, Salah Uddin; Hasnat, Mohammed Abul; Parveen, Shahana; Islam, M. Saiful; Mikolon, Andrea; Chakraborty, Ranjit Kumar; Ahmed, Be-Nazir; Ara, Khorsed; Haider, Najmul; Zaki, Sherif R.; Hoffmaster, Alex R.; Rahman, Mahmudur; Luby, Stephen P.; Hossain, M. Jahangir

2012-01-01

During August 2009–October 2010, a multidisciplinary team investigated 14 outbreaks of animal and human anthrax in Bangladesh to identify the etiology, pathway of transmission, and social, behavioral, and cultural factors that led to these outbreaks. The team identified 140 animal cases of anthrax and 273 human cases of cutaneous anthrax. Ninety one percent of persons in whom cutaneous anthrax developed had history of butchering sick animals, handling raw meat, contact with animal skin, or were present at slaughtering sites. Each year, Bacillus anthracis of identical genotypes were isolated from animal and human cases. Inadequate livestock vaccination coverage, lack of awareness of the risk of anthrax transmission from animal to humans, social norms and poverty contributed to these outbreaks. Addressing these challenges and adopting a joint animal and human health approach could contribute to detecting and preventing such outbreaks in the future. PMID:22492157

Hybrid Vibrio cholerae El Tor Lacking SXT Identified as the Cause of a Cholera Outbreak in the Philippines

PubMed Central

Klinzing, David C.; Choi, Seon Young; Hasan, Nur A.; Matias, Ronald R.; Tayag, Enrique; Geronimo, Josefina; Skowronski, Evan; Rashed, Shah M.; Kawashima, Kent; Rosenzweig, C. Nicole; Gibbons, Henry S.; Torres, Brian C.; Liles, Veni; Alfon, Alicia C.; Juan, Maria Luisa; Natividad, Filipinas F.; Cebula, Thomas A.

2015-01-01

ABSTRACT Cholera continues to be a global threat, with high rates of morbidity and mortality. In 2011, a cholera outbreak occurred in Palawan, Philippines, affecting more than 500 people, and 20 individuals died. Vibrio cholerae O1 was confirmed as the etiological agent. Source attribution is critical in cholera outbreaks for proper management of the disease, as well as to control spread. In this study, three V. cholerae O1 isolates from a Philippines cholera outbreak were sequenced and their genomes analyzed to determine phylogenetic relatedness to V. cholerae O1 isolates from recent outbreaks of cholera elsewhere. The Philippines V. cholerae O1 isolates were determined to be V. cholerae O1 hybrid El Tor belonging to the seventh-pandemic clade. They clustered tightly, forming a monophyletic clade closely related to V. cholerae O1 hybrid El Tor from Asia and Africa. The isolates possess a unique multilocus variable-number tandem repeat analysis (MLVA) genotype (12-7-9-18-25 and 12-7-10-14-21) and lack SXT. In addition, they possess a novel 15-kb genomic island (GI-119) containing a predicted type I restriction-modification system. The CTXΦ-RS1 array of the Philippines isolates was similar to that of V. cholerae O1 MG116926, a hybrid El Tor strain isolated in Bangladesh in 1991. Overall, the data indicate that the Philippines V. cholerae O1 isolates are unique, differing from recent V. cholerae O1 isolates from Asia, Africa, and Haiti. Furthermore, the results of this study support the hypothesis that the Philippines isolates of V. cholerae O1 are indigenous and exist locally in the aquatic ecosystem of the Philippines. PMID:25900650

Planning for smallpox outbreaks

NASA Astrophysics Data System (ADS)

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

2003-10-01

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

Characteristics of pertussis outbreaks in Catalonia, Spain, 1997 to 2010.

PubMed

Crespo, Inma; Broner, Sonia; Soldevila, Núria; Martínez, Ana; Godoy, Pere; Sala-Farré, Maria-Rosa; Company, Maria; Rius, Cristina; Domínguez, Angela; Group Of Catalonia, The Pertussis Working

2015-01-01

In Catalonia, pertussis outbreaks must be reported to the Department of Health. This study analyzed pertussis outbreaks between 1997 and 2010 in general and according to the characteristics of the index cases. The outbreak rate, hospitalization rate and incidence of associated cases and their 95%CI were calculated. Index cases were classified in two groups according to age (<15 years and ≥15 years) and the vaccine type received: whole cell vaccine (DTwP) or acellular vaccine (DTaP). During the study period, 230 outbreaks were reported. The outbreak rate was 2.43 × 10(-6) persons-year, and outbreaks ranged from 2 to 32 cases, with a median duration of 18 days. There were 771 associated cases, with an incidence rate of 0.8 × 10(-5) persons-year.   After classifying outbreaks according to the age of the index case, 126 outbreaks (1.3 × 10(-6) persons-year) had an index case aged <15 y and 87 (0.87 × 10(-6) person-year) had an index case aged ≥15 y (RR = 1.44, 95%CI 1.10-1.90; P = 0.007). Between 2003 and 2010, after the introduction of the acellular vaccine, the index case was vaccinated with DTwP vaccine in 25 outbreaks (0.43 × 10(-6) persons-year) and with DTaP vaccine in 32 outbreaks (0.55 × 10(-6) person-year) (RR = 0.78, 95%CI 0.46-1.31; P = 0.35). Of cases, 37.2% were correctly vaccinated, suggesting waning immunity of pertussis vaccine protection and endogenous circulation of pertussis. A greater number of outbreaks had an index case aged <15 y. No changes in the disease incidence, associated cases and hospitalization rate were observed after the introduction of DTaP.

Characteristics of pertussis outbreaks in Catalonia, Spain, 1997 to 2010

PubMed Central

Crespo, Inma; Broner, Sonia; Soldevila, Núria; Martínez, Ana; Godoy, Pere; Sala-Farré, Maria-Rosa; Company, Maria; Rius, Cristina; Domínguez, Angela; Group of Catalonia, the Pertussis Working

2014-01-01

In Catalonia, pertussis outbreaks must be reported to the Department of Health. This study analyzed pertussis outbreaks between 1997 and 2010 in general and according to the characteristics of the index cases. The outbreak rate, hospitalization rate and incidence of associated cases and their 95%CI were calculated. Index cases were classified in two groups according to age (<15 years and ≥15 years) and the vaccine type received: whole cell vaccine (DTwP) or acellular vaccine (DTaP). During the study period, 230 outbreaks were reported. The outbreak rate was 2.43 × 10−6 persons-year, and outbreaks ranged from 2 to 32 cases, with a median duration of 18 days. There were 771 associated cases, with an incidence rate of 0.8 × 10−5 persons-year. After classifying outbreaks according to the age of the index case, 126 outbreaks (1.3 × 10−6 persons-year) had an index case aged <15 y and 87 (0.87 × 10−6 person-year) had an index case aged ≥15 y (RR = 1.44, 95%CI 1.10–1.90; P = 0.007). Between 2003 and 2010, after the introduction of the acellular vaccine, the index case was vaccinated with DTwP vaccine in 25 outbreaks (0.43 × 10−6 persons-year) and with DTaP vaccine in 32 outbreaks (0.55 × 10−6 person-year) (RR = 0.78, 95%CI 0.46–1.31; P = 0.35). Of cases, 37.2% were correctly vaccinated, suggesting waning immunity of pertussis vaccine protection and endogenous circulation of pertussis. A greater number of outbreaks had an index case aged <15 y. No changes in the disease incidence, associated cases and hospitalization rate were observed after the introduction of DTaP. PMID:25483541

Establishing an early warning alert and response network following the Solomon Islands tsunami in 2013

PubMed Central

Bilve, Augustine; Nogareda, Francisco; Joshua, Cynthia; Ross, Lester; Betcha, Christopher; Durski, Kara; Fleischl, Juliet

2014-01-01

Abstract Problem On 6 February 2013, an 8.0 magnitude earthquake generated a tsunami that struck the Santa Cruz Islands, Solomon Islands, killing 10 people and displacing over 4700. Approach A post-disaster assessment of the risk of epidemic disease transmission recommended the implementation of an early warning alert and response network (EWARN) to rapidly detect, assess and respond to potential outbreaks in the aftermath of the tsunami. Local setting Almost 40% of the Santa Cruz Islands’ population were displaced by the disaster, and living in cramped temporary camps with poor or absent sanitation facilities and insufficient access to clean water. There was no early warning disease surveillance system. Relevant changes By 25 February, an EWARN was operational in five health facilities that served 90% of the displaced population. Eight priority diseases or syndromes were reported weekly; unexpected health events were reported immediately. Between 25 February and 19 May, 1177 target diseases or syndrome cases were reported. Seven alerts were investigated. No sustained transmission or epidemics were identified. Reporting compliance was 85%. The EWARN was then transitioned to the routine four-syndrome early warning disease surveillance system. Lesson learnt It was necessary to conduct a detailed assessment to evaluate the risk and potential impact of serious infectious disease outbreaks, to assess whether and how enhanced early warning disease surveillance should be implemented. Local capacities and available resources should be considered in planning EWARN implementation. An EWARN can be an opportunity to establish or strengthen early warning disease surveillance capabilities. PMID:25378746

Risperidone long-acting injection in the treatment of schizophrenia spectrum illnesses: A retrospective chart review of 19 patients in the Vancouver Community Mental Health Organization (Vancouver, Canada)

PubMed Central

Ganesan, Soma; McKenna, Mario; Procyshyn, Ric M.; Zipursky, Sheldon

2007-01-01

Background: Schizophrenia is a chronic debilitating disease that affects ~110,000 Canadians (0.55% lifetime prevalence). Risperidone long-acting injection (RLAI) is the first injectable, long-acting, atypical antipsychotic drug marketed in Canada. Objective: The aim of this study was to assess the clinical effectiveness and hospitalization rates of patients with schizophrenia, schizoaffective disorder, or schizophreniform disorder treated with RLAI in a community mental health care setting. Methods: Data were collected between August 1, 2006 and September 30, 2006 via a retrospective chart review of outpatients diagnosed with schizophrenia, schizoaffective disorder, or schizophreniform disorder who received treatment from 1 of the 8 mental health teams within the Vancouver Community Mental Health Organization (VCMHO) in Vancouver, British Columbia, Canada. Collected data included: frequency and duration of institutional care, discharge and relapse rates, demographic variables, diagnosis history, RLAI medication history, and history of other medications. The overall severity of symptoms before and after RLAI treatment and the improvement in symptoms during treatment were evaluated using the Clinical Global Impression Scales for severity (CGI-S)(1 = not ill to 7 = extremely ill) and improvement (CGI-I)(1 = very much improved to 7 = very much worse). Results: Forty-four patients were identified as having received RLAI. The charts of 19 patients (10 men, 9 women; mean [SD] age at time of chart audit, 36.7 [11.7] years; mean [SD] age at primary diagnosis, 23.6 [7.4] years; race: white, 10 [52.6%]; Asian, 6 [31.6%]; American Indian, 1 [5.3%]; black, 1 [5.3%]; other, 1 [5.3%]) were included in the analysis. The majority of patients (78%) had been treated with another antipsychotic drug prior to treatment with RLAI: risperidone (77%), quetiapine (47%), zuclopenthixol (43%), olanzapine (43%), and loxapine (17%). Mean (SD) CGI-S Scale score declined significantly from 5

Giardiasis outbreaks in the United States, 1971–2011

PubMed Central

Adam, E. A.; Yoder, J. S.; Gould, L. H.; Hlavsa, M. C.; Gargano, J. W.

2016-01-01

Summary Giardia intestinalis is the leading parasitic aetiology of human enteric infections in the United States, with an estimated 1.2 million cases occurring annually. To better understand transmission, we analysed data on all giardiasis outbreaks reported to the Centers for Disease Control and Prevention for 1971–2011. The 242 outbreaks, affecting ∼41 000 persons, resulted from waterborne (74.8%), foodborne (15.7%), person-to-person (2.5%), and animal contact (1.2%) transmission. Most (74.6%) waterborne outbreaks were associated with drinking water, followed by recreational water (18.2%). Problems with water treatment, untreated groundwater, and distribution systems were identified most often during drinking water-associated outbreak investigations; problems with water treatment declined after the 1980s. Most recreational water-associated outbreaks were linked to treated swimming venues, with pools and wading pools implicated most often. Produce was implicated most often in foodborne outbreaks. Additionally, foods were most commonly prepared in a restaurant and contaminated by a food handler. Lessons learned from examining patterns in outbreaks over time can help prevent future disease. Groundwater and distribution system vulnerabilities, inadequate pool disinfection, fruit and vegetable contamination, and poor food handler hygiene are promising targets for giardiasis prevention measures. PMID:26750152

Foodborne (1973-2013) and Waterborne (1971-2013) Disease Outbreaks - United States.

PubMed

Dewey-Mattia, Daniel; Roberts, Virginia A; Vieira, Antonio; Fullerton, Kathleen E

2016-10-14

CDC collects data on foodborne and waterborne disease outbreaks reported by all U.S. states and territories through the Foodborne Disease Outbreak Surveillance System (FDOSS) (http://www.cdc.gov/foodsafety/fdoss/surveillance/index.html) and the Waterborne Disease and Outbreak Surveillance System (WBDOSS) http://www.cdc.gov/healthywater/surveillance), respectively. These two systems are the primary source of national data describing the number of reported outbreaks; outbreak-associated illnesses, hospitalizations, and deaths; etiologic agents; water source or implicated foods; settings of exposure; and other factors associated with recognized foodborne and waterborne disease outbreaks in the United States.

Clinical presentation and laboratory findings for the first autochthonous cases of dengue fever in Madeira island, Portugal, October 2012.

PubMed

Alves, M J; Fernandes, P L; Amaro, F; Osório, H; Luz, T; Parreira, P; Andrade, G; Zé-Zé, L; Zeller, H

2013-02-07

An outbreak of dengue fever in Madeira island was reported in 2012. Clinical and laboratory findings of the first two laboratory-confirmed autochthonous cases are reported. Both cases had fever (≥38 °C) and petechial rash. Symptoms also included myalgia, asthenia, nausea, vomiting, anorexia, diffuse abdominal pain, and diarrhoea. The two cases were confirmed by serology and one tested positive for a dengue viral sequence. Dengue virus serotype DEN-1 was identified with probable Central or South American origin.

Science of Nowcasting Olympic Weather for Vancouver 2010 (SNOW-V10): a World Weather Research Programme Project

NASA Astrophysics Data System (ADS)

Isaac, G. A.; Joe, P. I.; Mailhot, J.; Bailey, M.; Bélair, S.; Boudala, F. S.; Brugman, M.; Campos, E.; Carpenter, R. L.; Crawford, R. W.; Cober, S. G.; Denis, B.; Doyle, C.; Reeves, H. D.; Gultepe, I.; Haiden, T.; Heckman, I.; Huang, L. X.; Milbrandt, J. A.; Mo, R.; Rasmussen, R. M.; Smith, T.; Stewart, R. E.; Wang, D.; Wilson, L. J.

2014-01-01

A World Weather Research Programme (WWRP) project entitled the Science of Nowcasting Olympic Weather for Vancouver 2010 (SNOW-V10) was developed to be associated with the Vancouver 2010 Olympic and Paralympic Winter Games conducted between 12 February and 21 March 2010. The SNOW-V10 international team augmented the instrumentation associated with the Winter Games and several new numerical weather forecasting and nowcasting models were added. Both the additional observational and model data were available to the forecasters in real time. This was an excellent opportunity to demonstrate existing capability in nowcasting and to develop better techniques for short term (0-6 h) nowcasts of winter weather in complex terrain. Better techniques to forecast visibility, low cloud, wind gusts, precipitation rate and type were evaluated. The weather during the games was exceptionally variable with many periods of low visibility, low ceilings and precipitation in the form of both snow and rain. The data collected should improve our understanding of many physical phenomena such as the diabatic effects due to melting snow, wind flow around and over terrain, diurnal flow reversal in valleys associated with daytime heating, and precipitation reductions and increases due to local terrain. Many studies related to these phenomena are described in the Special Issue on SNOW-V10 for which this paper was written. Numerical weather prediction and nowcast models have been evaluated against the unique observational data set now available. It is anticipated that the data set and the knowledge learned as a result of SNOW-V10 will become a resource for other World Meteorological Organization member states who are interested in improving forecasts of winter weather.

Contributing factors to disease outbreaks associated with untreated groundwater.

PubMed

Wallender, Erika K; Ailes, Elizabeth C; Yoder, Jonathan S; Roberts, Virginia A; Brunkard, Joan M

2014-01-01

Disease outbreaks associated with drinking water drawn from untreated groundwater sources represent a substantial proportion (30.3%) of the 818 drinking water outbreaks reported to CDC's Waterborne Disease and Outbreak Surveillance System (WBDOSS) during 1971 to 2008. The objectives of this study were to identify underlying contributing factors, suggest improvements for data collection during outbreaks, and inform outbreak prevention efforts. Two researchers independently reviewed all qualifying outbreak reports (1971 to 2008), assigned contributing factors and abstracted additional information (e.g., cases, etiology, and water system attributes). The 248 outbreaks resulted in at least 23,478 cases of illness, 390 hospitalizations, and 13 deaths. The majority of outbreaks had an unidentified etiology (n = 135, 54.4%). When identified, the primary etiologies were hepatitis A virus (n = 21, 8.5%), Shigella spp. (n = 20, 8.1%), and Giardia intestinalis (n = 14, 5.7%). Among the 172 (69.4%) outbreaks with contributing factor data available, the leading contamination sources included human sewage (n = 57, 33.1%), animal contamination (n = 16, 9.3%), and contamination entering via the distribution system (n = 12, 7.0%). Groundwater contamination was most often facilitated by improper design, maintenance or location of the water source or nearby waste water disposal system (i.e., septic tank; n = 116, 67.4%). Other contributing factors included rapid pathogen transport through hydrogeologic formations (e.g., karst limestone; n = 45, 26.2%) and preceding heavy rainfall or flooding (n = 36, 20.9%). This analysis underscores the importance of identifying untreated groundwater system vulnerabilities through frequent inspection and routine maintenance, as recommended by protective regulations such as Environmental Protection Agency's (EPA's) Groundwater Rule, and the need for special consideration of the local hydrogeology. Published

Hantavirus pulmonary syndrome outbreak, Brazil, December 2009-January 2010.

PubMed

Terças, Ana Cláudia Pereira; Atanaka dos Santos, Marina; Pignatti, Marta Gislene; Espinosa, Mariano Martinez; Via, Alba Valéria Gomes de Melo; Menegatti, Jaqueline Aparecida

2013-11-01

An outbreak of hantavirus pulmonary syndrome occurred in the Sobradinho Indian settlement of the Kayabí ethnic group in northern Mato Grosso during December 2009-January 2010. We conducted a retrospective study to clarify the outbreak's epidemiologic and clinical characteristics. Results suggest a relationship between the outbreak and deforestation and farming expansion in indigenous areas.

Surficial sediments on the western Canadian continental shelf

NASA Astrophysics Data System (ADS)

Bornhold, Brian D.; Barrie, J. Vaughn

1991-08-01

The active continental margin off western Canada is characterized in the south by convergence between the Explorer and Juan de Fuca Plates and the America Plate, and in the north by transform fault motion between the Pacific and America Plates along the Queen Charlotte Fault. Except in some of the deepest troughs and basins shelf sediments are dominated by immature lithic arenites reflecting this tectonic setting. The Vancouver Island shelf is from 5 to 75 km wide and displays complex topography on the inner shelf and a relatively featureless mid- and outer shelf. An exception is the area off southwestern Vancouver Island where large basins bounded by morainal deposits extend more than two-thirds of the distance across the shelf. The shelf edge varies from 180 to 225 m depth and is indented by numerous canyons. Nearshore sediments consist mainly of gravels and boulders and become finer offshore such that muds are slowly accumulating in depths greater than 100 m. Off northwestern Vancouver Island calcareous sediments are abundant with carbonate values often exceeding 75%. High wave and current energies and efficient sediment trapping in coastal fiords have resulted in low rates of accumulation. Olive, glauconitic, Holocene muds and muddy sands are generally less than 0.3 m thick and accumulate only on the outer shelf over an extensive stiff, gray, glaciomarine sandy mud. Queen Charlotte Sound exhibits three broad, shallow, glacially scoured troughs, filled mainly with clayey silts and fine sands and separated by sand and gravel covered banks. Hecate Strait, between the Queen Charlotte Islands and the mainland, consists of a prominent southward-opening trough along the east side of the Strait bounded by Dogfish and Laskeek Banks on the west adjacent to Graham and Moresby Islands, respectively. The trough below 200 m is filled by silts. The banks are covered by discontinuous sands and gravels of variable calcareous content. The bank edges often display megaripples and

How can patients and their physicians contribute to an outbreak investigation? Experiences from a nationwide listeriosis outbreak in Switzerland.

PubMed

Kiefer, Sabine; Kling, Kerstin; Stephan, Roger; Bratschi, Martin W; Jost, Marianne; Bless, Philipp Justus; Schmutz, Claudia; Mäusezahl, Daniel; Wyss, Kaspar; Mäusezahl-Feuz, Mirjam; Hatz, Christoph

2016-01-01

Gathering patient information to contain an outbreak of Listeria monocytogenes is difficult because of the patients' severe illness or death. Extending the range of interviewees to acquire epidemiological data can thus be important to maximise information. We built the current analysis on a case-case outbreak investigation conducted during a Swiss listeriosis outbreak between 30 January and 11 May 2014, including 31 patients with confirmed L. monocytogenes infection. We interviewed treating physicians and patients or their next of kin to gather information on clinical aspects, eating habits and food consumption. We compared the different information sources with regards to their potential to provide specific, complete and rapid information on the affected population and their food consumption history. We obtained a 100% response rate among physicians, providing detailed information on the affected population by describing health status, underlying conditions, and signs and symptoms. Detailed information on food history could not be obtained from physicians, making the information vague and unspecific. Less than 50% of patients could be interviewed, limiting our information base. Nevertheless, patient information on the food history was sufficiently detailed and helped to identify the outbreak source CONCLUSIONS: Outbreak investigation teams confronted with limited information from patients and with small numbers of cases can enhance information on the affected population and the outbreak source by combining information from physicians and patients. Physicians provided comprehensive information on signs and symptoms, underlying conditions and the general health status. Patients remain vital to provide detailed information on the food consumption history.

Ober's Island: The Mallard Ober's Island, One of the ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Ober's Island: The Mallard - Ober's Island, One of the Review Islands on Rainy Lake, bounded on the south by The Hawk Island and on the north by The Crow Island. These islands are located seven miles east of Ranier, Minnesota, three miles west of Voyageur National Park, and one mile south of the international border of the United States of America and Canada. The legal description of Mallard Island is Lot 6, Section 19, T-17-N, R-22-W, Koochiching County, Minnesota, Ranier, Koochiching County, MN

Review of West Nile virus circulation and outbreak risk in Madagascar: Entomological and ornithological perspectives.

PubMed

Tantely, Michaël Luciano; Goodman, Steven M; Rakotondranaivo, Tsirinaina; Boyer, Sébastien

2016-01-01

West Nile fever (WNF) is a zoonotic disease, occurring nearly globally. In Madagascar, West Nile virus (WNV) was first detected in 1978 from wild birds and the virus is currently distributed across the island, but no epidemic or epizootic period has been recorded. One fatal human case of WNV infection was reported in 2011, suggesting a "tip of the iceberg" phenomenon of a possible WNF epidemic/epizootic on the island. The main objective of this literature-based survey is to review patterns of WNV circulation in Madagascar from the entomological and ornithological points of view. Among the 235 mosquito species described from Madagascar, 29 species are widely associated with WNV infection; 16 of them are found naturally infected with WNV on the island and categorized into major, candidate, and potential vectors of WNV according to their vector capacity. This study upholds the hypothesis that WNV enzooticity is independent of annual movements of migratory birds passing through Madagascar. Moreover, the lack of regular migratory bird flux between Africa and Madagascar would reduce the probability of transmission and the subsequent reintroduction of the virus into locally occurring mosquito species. Given that Palearctic migratory birds are strongly implicated in the transmission of WNV, we highlight notable differences in the movements and species diversity of these birds in Madagascar as compared to eastern and northern Africa. Risk factors from this two-pronged approach are presented for the emergence of WNF outbreak. © M.L. Tantely et al., published by EDP Sciences, 2016.

Island Formation: Constructing a Coral Island

ERIC Educational Resources Information Center

Austin, Heather; Edd, Amelia

2009-01-01

The process of coral island formation is often difficult for middle school students to comprehend. Coral island formation is a dynamic process, and students should have the opportunity to experience this process in a synergistic context. The authors provide instructional guidelines for constructing a coral island. Students play an interactive role…

Analysis of outbreaks of infectious intestinal disease in Ireland: 1998 and 1999.

PubMed

Bonner, C; Foley, B; Wall, P; Fitzgerald, M

2001-05-01

Surveillance of general outbreaks of infectious gastroenteritis was introduced in 1998 by the Food Safety Authority of Ireland (FSAI), in co-operation with the eight health boards. A total of 67 general outbreaks of gastroenteritis in Ireland were reported to the FSAI in 1998 and 1999. Over 1900 people were ill as a result of these outbreaks. Four percent required hospitalisation and there were two deaths. The duration of the outbreaks varied between one day and 38 days. Salmonellae (44%) and small round structured viruses (SRSV) (12%) were the most commonly reported pathogens. In 25% of the outbreaks the aetiology was unknown. The commonest settings were restaurants, hotels and take-aways, which accounted for 45% (30/67) of all outbreaks. Sixteen percent of all outbreaks occurred in hospitals and residential institutions. Over half of the outbreaks were reported to be foodborne, 63% of which were due to various serotypes of Salmonella enterica. Eggs were implicated as the vehicle of infection in 13% of all outbreaks. An infected food handler was identified in almost one third of outbreaks, although it could not be established if this had contributed directly to the outbreak.

Foodborne Salmonella-caused outbreaks in Catalonia (Spain), 1990 to 2003.

PubMed

Domínguez, Angela; Torner, Nuria; Ruiz, Laura; Martínez, Ana; Bartolomé, Rosa; Sulleiro, Elena; Teixidó, Angel; Plasencia, Antoni

2007-01-01

In most developed countries, nontyphoid Salmonella is an important cause of sporadic cases and outbreaks of foodborne gastroenteritis. The aim of this study was to investigate the trend of foodborne Salmonella-caused outbreaks and number of cases, hospitalizations, and deaths and compare them with those caused by other infectious agents. The study was carried out in Catalonia, a region in northeastern Spain with a population of 6.5 million inhabitants, in 2002. All information on reported outbreaks of foodborne disease from 1990 to 2003 was reviewed. For each outbreak, the following variables were collected: year; setting (household, restaurant, school, hospital, nursing home, and others); number of cases, hospitalizations, and deaths; causal agent; and food vehicle involved. Of 1652 reported outbreaks, 1078 had a known causal agent. Among them, 871 (80.8%) were caused by Salmonella, with 14,695 cases, 1534 hospitalizations, and 4 deaths. The rate of hospitalization was higher in outbreaks due to Salmonella than in those caused by other infectious agents (rate ratio, 2.54; 95% confidence interval, 2.20 to 2.94). Forty-eight percent of Salmonella-caused outbreaks were eggborne, compared with 5.3% of those caused by other infectious agents (rate ratio, 1.40; 95% confidence interval, 1.33 to 1.48). The annual number of cases in household outbreaks of eggborne Salmonella rose over time (R2 = 0.82), but the number of outbreaks produced in other settings did not. Eggborne outbreaks caused by Salmonella in households are a major cause of disease, and increased preventive efforts are necessary, especially consumer education and awareness of the risk of eating food containing raw or slightly cooked eggs.

[Norovirus outbreaks in hospitals and nursing homes in Catalonia, Spain].

PubMed

Godoy, Pere; Domínguez, Angela; Alvarez, Josep; Camps, Neus; Barrabeig, Irene; Bartolomé, Rosa; Sala, María Rosa; Ferre, Dolors; Pañella, Helena; Torres, Joan; Minguell, Sofía; Alsedà, Miquel; Pumares, Analía

2009-01-01

The low infectious dose and multiple transmission routes favour the appearance of norovirus outbreaks. The objective of this study was to compare the incidence of norovirus outbreaks in hospitals and nursing homes in Catalonia. A descriptive study of norovirus outbreaks between 15/10/2004 and 30/10/2005 was carried out. An epidemiological survey was completed for each outbreak. Norovirus in clinical samples was determined by PCR techniques. The incidence in each centre and the annual incidence of outbreaks by centre were calculated. Differences were calculated using the chi-square test and the Student's t test, taking a p value of > 0.05 as significant. Seventeen outbreaks (6 in hospitals and 11 in nursing homes) were detected. The global attack rate was 33.4% (652/1951) and was slightly higher in nursing homes (35.2%) than in hospitals (31.4%). A total of 94.1% (16/17) of outbreaks were caused by person-to-person transmission and only 5.9% (1/17) by foods. The mean number of days between the first and last case was 11.4 (SD = 6.9). The mean duration of symptoms was 2.39 days (SD=1.6), and was higher hospitals, 2.63 (SD=1.7), than in nursing homes, 1.97 (SD=1.7) (p < 0.0001). Norovirus is responsible for a large number of outbreaks due to person-to-person transmission. Control should be standardized to reduce the number and duration of outbreaks.

Cryptococcus gattii dispersal mechanisms, British Columbia, Canada.

PubMed

Kidd, Sarah E; Bach, Paxton J; Hingston, Adrian O; Mak, Sunny; Chow, Yat; MacDougall, Laura; Kronstad, James W; Bartlett, Karen H

2007-01-01

Recent Cryptococcus gattii infections in humans and animals without travel history to Vancouver Island, as well as environmental isolations of the organism in other areas of the Pacific Northwest, led to an investigation of potential dispersal mechanisms. Longitudinal analysis of C. gattii presence in trees and soil showed patterns of permanent, intermittent, and transient colonization, reflecting C. gattii population dynamics once the pathogen is introduced to a new site. Systematic sampling showed C. gattii was associated with high-traffic locations. In addition, C. gattii was isolated from the wheel wells of vehicles on Vancouver Island and the mainland and on footwear, consistent with anthropogenic dispersal of the organism. Increased levels of airborne C. gattii were detected during forestry and municipal activities such as wood chipping, the byproducts of which are frequently used in park landscaping. C. gattii dispersal by these mechanisms may be a useful model for other emerging pathogens.

Foodborne outbreaks of campylobacteriosis: the United States experience, 1980-1982.

PubMed

Finch, M J; Blake, P A

1985-08-01

During 1980-1982, 23 foodborne outbreaks of diseases caused by Campylobacter were reported to the Centers for Diseases Control through the National Foodborne Surveillance Program, which collects reports from state and territorial epidemiologists throughout the United States. These outbreaks involved 748 ill persons, of whom 4% were hospitalized. For outbreaks with six or more ill persons, the median attack rate was 41%, the mean or median incubation periods ranged from 66 to 120 hours, and the mean duration of symptoms ranged from three to seven days. Raw milk was implicated or suspected in 14 outbreaks. In four of the other outbreaks, food handling errors were identified, and in five outbreaks, poultry, eggs, or beef were implicated or suspected. In three of four outbreaks in which Campylobacter was recovered from cows at the implicated dairies, some isolates from cows were serotypically identical to isolates from ill persons. In one egg-associated outbreak, one of the isolates of Campylobacter recovered from hens at the implicated egg farm was serotypically identical to an isolate recovered from an ill person. These findings underscore the hazard of eating undercooked or raw foods of animal origin such as raw milk. Raw milk contaminated by infected cows is a major cause of foodborne campylobacteriosis in the United States.

Emerging issues, challenges, and changing epidemiology of fungal disease outbreaks.

PubMed

Benedict, Kaitlin; Richardson, Malcolm; Vallabhaneni, Snigdha; Jackson, Brendan R; Chiller, Tom

2017-12-01

Several high-profile outbreaks have drawn attention to invasive fungal infections (IFIs) as an increasingly important public health problem. IFI outbreaks are caused by many different fungal pathogens and are associated with numerous settings and sources. In the community, IFI outbreaks often occur among people without predisposing medical conditions and are frequently precipitated by environmental disruption. Health-care-associated IFI outbreaks have been linked to suboptimal hospital environmental conditions, transmission via health-care workers' hands, contaminated medical products, and transplantation of infected organs. Outbreak investigations provide important insights into the epidemiology of IFIs, uncover risk factors for infection, and identify opportunities for preventing similar events in the future. Well recognised challenges with IFI outbreak recognition, response, and prevention include the need for improved rapid diagnostic methods, the absence of routine surveillance for most IFIs, adherence to infection control practices, and health-care provider awareness. Additionally, IFI outbreak investigations have revealed several emerging issues, including new populations at risk because of travel or relocation, occupation, or immunosuppression; fungal pathogens appearing in geographical areas in which they have not been previously recognised; and contaminated compounded medications. This report highlights notable IFI outbreaks in the past decade, with an emphasis on these emerging challenges in the USA. Copyright © 2017 Elsevier Ltd. All rights reserved.

Nanopore Sequencing as a Rapidly Deployable Ebola Outbreak Tool.

PubMed

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

2016-02-01

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

Nanopore Sequencing as a Rapidly Deployable Ebola Outbreak Tool

PubMed Central

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

2016-01-01

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

Food- and waterborne disease outbreaks in Australian long-term care facilities, 2001-2008.

PubMed

Kirk, Martyn D; Lalor, Karin; Raupach, Jane; Combs, Barry; Stafford, Russell; Hall, Gillian V; Becker, Niels

2011-01-01

Abstract Food- or waterborne diseases in long-term care facilities (LTCF) can result in serious outcomes, including deaths, and they are potentially preventable. We analyzed data collected by OzFoodNet on food- and waterborne disease outbreaks occurring in LTCF in Australia from 2001 to 2008. We compared outbreaks by the number of persons affected, etiology, and implicated vehicle. During 8 years of surveillance, 5.9% (55/936) of all food- and waterborne outbreaks in Australia occurred in LTCF. These LTCF outbreaks affected a total of 909 people, with 66 hospitalized and 23 deaths. The annual incidence of food- or waterborne outbreaks was 1.9 (95% confidence intervals 1.0-3.7) per 1000 facilities. Salmonella caused 17 outbreaks, Clostridium perfringens 14 outbreaks, Campylobacter 8 outbreaks, and norovirus 1 outbreak. Residents were at higher risk of death during outbreaks of salmonellosis than for all other outbreaks combined (relative risk 7.8, 95% confidence intervals 1.8-33.8). Of 15 outbreaks of unknown etiology, 11 were suspected to be due to C. perfringens intoxication. Food vehicles were only identified in 27% (14/52) of outbreaks, with six outbreak investigations implicating pureed foods. Dishes containing raw eggs were implicated as the cause of four outbreaks. Three outbreaks of suspected waterborne disease were attributed to rainwater collected from facility roofs. To prevent disease outbreaks, facilities need to improve handling of pureed foods, avoid feeding residents raw or undercooked eggs, and ensure that rainwater tanks have a scheduled maintenance and disinfection program.

Habitat and environment of islands: primary and supplemental island sets

USGS Publications Warehouse

Matalas, Nicholas C.; Grossling, Bernardo F.

2002-01-01

The original intent of the study was to develop a first-order synopsis of island hydrology with an integrated geologic basis on a global scale. As the study progressed, the aim was broadened to provide a framework for subsequent assessments on large regional or global scales of island resources and impacts on those resources that are derived from global changes. Fundamental to the study was the development of a comprehensive framework?a wide range of parameters that describe a set of 'saltwater' islands sufficiently large to Characterize the spatial distribution of the world?s islands; Account for all major archipelagos; Account for almost all oceanically isolated islands, and Account collectively for a very large proportion of the total area of the world?s islands whereby additional islands would only marginally contribute to the representativeness and accountability of the island set. The comprehensive framework, which is referred to as the ?Primary Island Set,? is built on 122 parameters that describe 1,000 islands. To complement the investigations based on the Primary Island Set, two supplemental island sets, Set A?Other Islands (not in the Primary Island Set) and Set B?Lagoonal Atolls, are included in the study. The Primary Island Set, together with the Supplemental Island Sets A and B, provides a framework that can be used in various scientific disciplines for their island-based studies on broad regional or global scales. The study uses an informal, coherent, geophysical organization of the islands that belong to the three island sets. The organization is in the form of a global island chain, which is a particular sequential ordering of the islands referred to as the 'Alisida.' The Alisida was developed through a trial-and-error procedure by seeking to strike a balance between 'minimizing the length of the global chain' and 'maximizing the chain?s geophysical coherence.' The fact that an objective function cannot be minimized and maximized simultaneously

Tourism, Tolerance, or Hospitality? An Assessment of a Native/Non-Native, Urban/Rural Youth Exchange Program between Fort Good Hope, NWT, and East Vancouver, BC

ERIC Educational Resources Information Center

Hern, Matt

2009-01-01

This article considers and assesses a youth exchange project between two community-based youth centers: The Purple Thistle Centre in East Vancouver, British Columbia, and the K'asho Got'ine Youth Centre in Fort Good Hope, Northwest Territories. Both centers serve primarily low-income youth, but after that the similarities are very few. The…

Antimicrobial resistance in Salmonella that caused foodborne disease outbreaks: United States, 2003-2012.

PubMed

Brown, A C; Grass, J E; Richardson, L C; Nisler, A L; Bicknese, A S; Gould, L H

2017-03-01

Although most non-typhoidal Salmonella illnesses are self-limiting, antimicrobial treatment is critical for invasive infections. To describe resistance in Salmonella that caused foodborne outbreaks in the United States, we linked outbreaks submitted to the Foodborne Disease Outbreak Surveillance System to isolate susceptibility data in the National Antimicrobial Resistance Monitoring System. Resistant outbreaks were defined as those linked to one or more isolates with resistance to at least one antimicrobial drug. Multidrug resistant (MDR) outbreaks had at least one isolate resistant to three or more antimicrobial classes. Twenty-one per cent (37/176) of linked outbreaks were resistant. In outbreaks attributed to a single food group, 73% (16/22) of resistant outbreaks and 46% (31/68) of non-resistant outbreaks were attributed to foods from land animals (P < 0·05). MDR Salmonella with clinically important resistance caused 29% (14/48) of outbreaks from land animals and 8% (3/40) of outbreaks from plant products (P < 0·01). In our study, resistant Salmonella infections were more common in outbreaks attributed to foods from land animals than outbreaks from foods from plants or aquatic animals. Antimicrobial susceptibility data on isolates from foodborne Salmonella outbreaks can help determine which foods are associated with resistant infections.

How well has land-use planning worked under different governance regimes? A case study in the Portland, OR-Vancouver, WA metropolitan area, USA

Treesearch

Jeffrey D. Kline; Paul Thiers; Connie P. Ozawa; J. Alan Yeakley; Sean N. Gordon

2014-01-01

We examine land use planning outcomes over a 30-year period in the Portland, OR-Vancouver, WA (USA) metropolitan area. The four-county study region enables comparisons between three Oregon counties subject to Oregon’s 1973 Land Use Act (Senate Bill 100) and Clark County, WA which implemented land use planning under Washington’s 1990 Growth Management Act. We describe...

Heat Islands

EPA Pesticide Factsheets

EPA's Heat Island Effect Site provides information on heat islands, their impacts, mitigation strategies, related research, a directory of heat island reduction initiatives in U.S. communities, and EPA's Heat Island Reduction Program.

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

PubMed

Stahl, Hans-Christian; Butenschoen, Vicki Marie; Tran, Hien Tinh; Gozzer, Ernesto; Skewes, Ronald; Mahendradhata, Yodi; Runge-Ranzinger, Silvia; Kroeger, Axel; Farlow, Andrew

2013-11-06

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

Connecting Environmental Observations with Cholera Outbreaks in Bangladesh

NASA Astrophysics Data System (ADS)

Stack, D.; Sandborn, A.; Widmeyer, P. A.; Escobar, V. M.

2011-12-01

Research has demonstrated that cholera epidemics in Bangladesh occur seasonally. This bimodal outbreak pattern closely follows times when large monsoon events are most frequent (spring and fall). While these patterns are presented in regional data, this knowledge alone cannot forecast the severity and location of cholera outbreaks until a monsoon event occurs, or an outbreak is reported. Therefore, there can only be reactive responses to cholera outbreaks. A heightened understanding of the link between environmental factors and outbreak occurrence will greatly enhance disease management capabilities. A predictive tool capable of giving an advanced warning of the environmental hazards that lead to location specific outbreaks allows for proactive and preventative responses, minimizing negative effects. A specific goal of this research was to relate latitude-longitude data with existing points associated with V. cholerae human case data collected from four cities in Bangladesh. Remotely sensed products were used to better understand the correlation between human outbreak occurrences, chlorophyll-a estimates, sea surface temperature (SST), and rainfall. Using MODIS, SeaWiFS, and TRMM satellite data, a gridded regional image was developed. Correlation analyses of the data were studied within the context of geographically diverse locations for the four cities of interest. Seasonal relationships were found between the cholera case data and all three of the chosen remotely sensed parameters. The strongest correlation found was between chlorophyll-a concentrations and reported human cases. The primary deliverable of this project was the production of an interactive Google Earth base map for use in a pilot design study that will lead to the development of applications to connect earth science products with water and health studies. The base map, with its inherent value of merging remotely sensed data with in situ observation points, can be used as a basis for constructing

Discrimination of tornadic and non-tornadic severe weather outbreaks

NASA Astrophysics Data System (ADS)

Mercer, Andrew Edward

Outbreaks of severe weather affect the majority of the conterminous United States. An outbreak is characterized by multiple severe weather occurrences within a single synoptic system. Outbreaks can be categorized by whether or not they produce tornadoes. It is hypothesized that the antecedent synoptic signal contains important information about outbreak type. Accordingly, the scope of this research is to determine the extent that the synoptic signal can be utilized to classify outbreak type at various lead times. Outbreak types are classified using the NCEP/NCAR reanalysis data, which are arranged on a global 2.5° latitude-longitude grid, include 17 vertical pressure levels, and span from 1948 to the present (2008). Fifty major tornado outbreak (TO) cases and fifty major non-tornadic severe weather outbreak (NTO) cases are selected for this work. Two types of analyses are performed on these cases to assess discrimination ability. One analysis involves outbreak classification using the Weather Research and Forecasting (WRF) model initialized with the NCEP/NCAR reanalysis dataset. Meteorological covariates are computed from the WRF output and used in training and testing of statistical classification models. The covariate fields are depicted on a 21 X 21 gridpoint field with an 18 km grid spacing centered on the outbreak. Covariates with large discrimination potential are determined using permutation testing. A P-mode principal component analysis (PCA) is used on the subset of covariates determined by permutation testing to reduce data dimensionality, since numerous redundancies exist in the initial covariate set. Three statistical classification models are trained and tested with the resulting PC scores: a support vector machine (SVM), a logistic regression model (LogR), and a multiple linear regression model (LR). Promising results emerge from these methods, as a probability of detection (POD) of 0.89 and a false alarm ratio (FAR) of 0.13 are obtained from the

Grasshopper species composition shifts following a severe rangeland grasshopper outbreak

USDA-ARS?s Scientific Manuscript database

Little is known about how grasshopper species abundances shift during and following severe outbreaks, as sampling efforts usually end when outbreaks subside. Grasshopper densities, species composition and vegetation have infrequently been sampled during and after a severe outbreak in the western U.S...

Outbreak of Leptospirosis after a Race in the Tropical Forest of Martinique

PubMed Central

Hochedez, Patrick; Rosine, Jacques; Théodose, Rafaelle; Abel, Sylvie; Bourhy, Pascale; Picardeau, Mathieu; Quénel, Philippe; Cabié, André

2011-01-01

Three athletes who participated in a race in the tropical forest of the Caribbean island of Martinique were subsequently diagnosed with leptospirosis using polymerase chain reaction (PCR). We investigated an outbreak to evaluate possible risk factors, and to determine the appropriate public health recommendations. Of 230 athletes, we contacted 148 (64%) and 20 (13.5%) met our case definition. Five were hospitalized and none were fatal. Ten (91%) of the 11 ill athletes who were tested were confirmed by PCR or serology. Serogroup Pyrogenes was commonly found. Cutaneous cuts, reported by 14 (73.7%), was the only potential risk factor using univariate analysis. Sporting event participants in tropical areas should be made aware of specific warnings and recommendations concerning the risk of leptospirosis, especially after periods of heavy rainfall or flooding. Rapid diagnostic assays such as PCR are particularly appropriate in this setting for early diagnosis and for formulating public health recommendations. PMID:21460020

Estimated Cost to a Restaurant of a Foodborne Illness Outbreak.

PubMed

Bartsch, Sarah M; Asti, Lindsey; Nyathi, Sindiso; Spiker, Marie L; Lee, Bruce Y

Although outbreaks of restaurant-associated foodborne illness occur periodically and make the news, a restaurant may not be aware of the cost of an outbreak. We estimated this cost under varying circumstances. We developed a computational simulation model; scenarios varied outbreak size (5 to 250 people affected), pathogen (n = 15), type of dining establishment (fast food, fast casual, casual dining, and fine dining), lost revenue (ie, meals lost per illness), cost of lawsuits and legal fees, fines, and insurance premium increases. We estimated that the cost of a single foodborne illness outbreak ranged from $3968 to $1.9 million for a fast-food restaurant, $6330 to $2.1 million for a fast-casual restaurant, $8030 to $2.2 million for a casual-dining restaurant, and $8273 to $2.6 million for a fine-dining restaurant, varying from a 5-person outbreak, with no lost revenue, lawsuits, legal fees, or fines, to a 250-person outbreak, with high lost revenue (100 meals lost per illness), and a high amount of lawsuits and legal fees ($1 656 569) and fines ($100 000). This cost amounts to 10% to 5790% of a restaurant's annual marketing costs and 0.3% to 101% of annual profits and revenue. The biggest cost drivers were lawsuits and legal fees, outbreak size, and lost revenue. Pathogen type affected the cost by a maximum of $337 000, the difference between a Bacillus cereus outbreak (least costly) and a listeria outbreak (most costly). The cost of a single foodborne illness outbreak to a restaurant can be substantial and outweigh the typical costs of prevention and control measures. Our study can help decision makers determine investment and motivate research for infection-control measures in restaurant settings.

The Methanol Poisoning Outbreaks in Libya 2013 and Kenya 2014

PubMed Central

Rostrup, Morten; Edwards, Jeffrey K.; Abukalish, Mohamed; Ezzabi, Masoud; Some, David; Ritter, Helga; Menge, Tom; Abdelrahman, Ahmed; Rootwelt, Rebecca; Janssens, Bart; Lind, Kyrre; Paasma, Raido; Hovda, Knut Erik

2016-01-01

Background Outbreaks of methanol poisoning occur frequently on a global basis, affecting poor and vulnerable populations. Knowledge regarding methanol is limited, likely many cases and even outbreaks go unnoticed, with patients dying unnecessarily. We describe findings from the first three large outbreaks of methanol poisoning where Médecins Sans Frontières (MSF) responded, and evaluate the benefits of a possible future collaboration between local health authorities, a Non-Governmental Organisation and international expertise. Methods Retrospective study of three major methanol outbreaks in Libya (2013) and Kenya (May and July 2014). Data were collected from MSF field personnel, local health personnel, hospital files, and media reports. Findings In Tripoli, Libya, over 1,000 patients were poisoned with a reported case fatality rate of 10% (101/1,066). In Kenya, two outbreaks resulted in approximately 341 and 126 patients, with case fatality rates of 29% (100/341) and 21% (26/126), respectively. MSF launched an emergency team with international experts, medications and equipment, however, the outbreaks were resolving by the time of arrival. Interpretation Recognition of an outbreak of methanol poisoning and diagnosis seem to be the most challenging tasks, with significant delay from time of first presentations to public health warnings being issued. In spite of the rapid response from an emergency team, the outbreaks were nearly concluded by the time of arrival. A major impact on the outcome was not seen, but large educational trainings were conducted to increase awareness and knowledge about methanol poisoning. Based on this training, MSF was able to send a local emergency team during the second outbreak, supporting that such an approach could improve outcomes. Basic training, simplified treatment protocols, point-of-care diagnostic tools, and early support when needed, are likely the most important components to impact the consequences of methanol poisoning

The Methanol Poisoning Outbreaks in Libya 2013 and Kenya 2014.

PubMed

Rostrup, Morten; Edwards, Jeffrey K; Abukalish, Mohamed; Ezzabi, Masoud; Some, David; Ritter, Helga; Menge, Tom; Abdelrahman, Ahmed; Rootwelt, Rebecca; Janssens, Bart; Lind, Kyrre; Paasma, Raido; Hovda, Knut Erik

2016-01-01

Outbreaks of methanol poisoning occur frequently on a global basis, affecting poor and vulnerable populations. Knowledge regarding methanol is limited, likely many cases and even outbreaks go unnoticed, with patients dying unnecessarily. We describe findings from the first three large outbreaks of methanol poisoning where Médecins Sans Frontières (MSF) responded, and evaluate the benefits of a possible future collaboration between local health authorities, a Non-Governmental Organisation and international expertise. Retrospective study of three major methanol outbreaks in Libya (2013) and Kenya (May and July 2014). Data were collected from MSF field personnel, local health personnel, hospital files, and media reports. In Tripoli, Libya, over 1,000 patients were poisoned with a reported case fatality rate of 10% (101/1,066). In Kenya, two outbreaks resulted in approximately 341 and 126 patients, with case fatality rates of 29% (100/341) and 21% (26/126), respectively. MSF launched an emergency team with international experts, medications and equipment, however, the outbreaks were resolving by the time of arrival. Recognition of an outbreak of methanol poisoning and diagnosis seem to be the most challenging tasks, with significant delay from time of first presentations to public health warnings being issued. In spite of the rapid response from an emergency team, the outbreaks were nearly concluded by the time of arrival. A major impact on the outcome was not seen, but large educational trainings were conducted to increase awareness and knowledge about methanol poisoning. Based on this training, MSF was able to send a local emergency team during the second outbreak, supporting that such an approach could improve outcomes. Basic training, simplified treatment protocols, point-of-care diagnostic tools, and early support when needed, are likely the most important components to impact the consequences of methanol poisoning outbreaks in these challenging contexts.

Environmental triggers of Past Ebola Outbreaks in Africa, 1981 - 2014

NASA Astrophysics Data System (ADS)

Dartevelle, S.; NguyRobertson, A. L.

2016-12-01

Ebola virus, especially its most common and lethal form, Zaire Ebolavirus, has eluded scientists nearly 50 years. What is its primary host? Why does it go dormant to suddenly to reappear full force years later? What are the driving forces behind its intriguing dynamic? It has been surmised that local environmental factors (such as droughts, seasons) might be at play behind the on-and-off Ebola outbreak outbursts. However, so far, no clear lead has been demonstrated making Ebola a constant hidden lethal menace lurking in the environment for many African communities. We have analyzed long-term time-series of three environmental variables that influence the controlling factor behind the cycle of Ebola virus outbreaks: (i) vegetation health, as determined from the Normalized Difference Vegetation Index (NDVI) collected by AVHRR and MODIS satellite sensors, and the weather variables (ii) temperature and (iii) precipitation from the Climate Forecast System ver. 2. Time series data were averaged monthly and spatially over a 100 km grid around past known outbreak locations. Seasonal effects were removed from these time series before applying statistical analyses identifying causal linkages between NDVI, temperature, precipitation and Ebola outbreaks. Likewise, possible tipping-points prior to outbreaks (i.e., early warning signals of an upcoming outbreak) were identified. Our results indicate that there is a causal dynamic link between outbreaks and the three environmental variables examined months prior to an outbreak. This was likely due to an abnormal change in the local precipitation pattern which influence NDVI values and to a lesser extent temperature. Furthermore, our results provide evidence that these factors demonstrate early warning signals of a dynamical system at a tipping-point, prior to a future outbreak. These tipping-point or early warning models may open new ways to furthermore develop forecast models of future Ebola outbreaks. [US Government — Approved

Disease outbreaks, bleaching and a cyclone drive changes in coral assemblages on an inshore reef of the Great Barrier Reef

NASA Astrophysics Data System (ADS)

Haapkylä, J.; Melbourne-Thomas, J.; Flavell, M.; Willis, B. L.

2013-09-01

Coral disease is a major threat to the resilience of coral reefs; thus, understanding linkages between disease outbreaks and disturbances predicted to increase with climate change is becoming increasingly important. Coral disease surveys conducted twice yearly between 2008 and 2011 at a turbid inshore reef in the central Great Barrier Reef spanned two disturbance events, a coral bleaching event in 2009 and a severe cyclone (cyclone `Yasi') in 2011. Surveys of coral cover, community structure and disease prevalence throughout this 4-yr study provide a unique opportunity to explore cumulative impacts of disturbance events and disease for inshore coral assemblages. The principal coral disease at the study site was atramentous necrosis (AtN), and it primarily affected the key inshore, reef-building coral Montipora aequituberculata. Other diseases detected were growth anomalies, white syndrome and brown band syndrome. Diseases affected eight coral genera, although Montipora was, by far, the genus mostly affected. The prevalence of AtN followed a clear seasonal pattern, with disease outbreaks occurring only in wet seasons. Mean prevalence of AtN on Montipora spp. (63.8 % ± 3.03) was three- to tenfold greater in the wet season of 2009, which coincided with the 2009 bleaching event, than in other years. Persistent wet season outbreaks of AtN combined with the impacts of bleaching and cyclone events resulted in a 50-80 % proportional decline in total coral cover. The greatest losses of branching and tabular acroporids occurred following the low-salinity-induced bleaching event of 2009, and the greatest losses of laminar montiporids occurred following AtN outbreaks in 2009 and in 2011 following cyclone Yasi. The shift to a less diverse coral assemblage and the concomitant loss of structural complexity are likely to have long-term consequences for associated vertebrate and invertebrate communities on Magnetic Island reefs.

Characterization of Foodborne Outbreaks of Salmonella enterica Serovar Enteritidis with Whole-Genome Sequencing Single Nucleotide Polymorphism-Based Analysis for Surveillance and Outbreak Detection.

PubMed

Taylor, Angela J; Lappi, Victoria; Wolfgang, William J; Lapierre, Pascal; Palumbo, Michael J; Medus, Carlota; Boxrud, David

2015-10-01

Salmonella enterica serovar Enteritidis is a significant cause of gastrointestinal illness in the United States; however, current molecular subtyping methods lack resolution for this highly clonal serovar. Advances in next-generation sequencing technologies have made it possible to examine whole-genome sequencing (WGS) as a potential molecular subtyping tool for outbreak detection and source trace back. Here, we conducted a retrospective analysis of S. Enteritidis isolates from seven epidemiologically confirmed foodborne outbreaks and sporadic isolates (not epidemiologically linked) to determine the utility of WGS to identify outbreaks. A collection of 55 epidemiologically characterized clinical and environmental S. Enteritidis isolates were sequenced. Single nucleotide polymorphism (SNP)-based cluster analysis of the S. Enteritidis genomes revealed well supported clades, with less than four-SNP pairwise diversity, that were concordant with epidemiologically defined outbreaks. Sporadic isolates were an average of 42.5 SNPs distant from the outbreak clusters. Isolates collected from the same patient over several weeks differed by only two SNPs. Our findings show that WGS provided greater resolution between outbreak, sporadic, and suspect isolates than the current gold standard subtyping method, pulsed-field gel electrophoresis (PFGE). Furthermore, results could be obtained in a time frame suitable for surveillance activities, supporting the use of WGS as an outbreak detection and characterization method for S. Enteritidis. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

[Descriptive study of hepatitis outbreaks occurring in Catalonia (1999-2003)].

PubMed

Llach-Berné, Mireia; Pañella, Helena; Domínguez, Angela; Caylà, Joan-Artur; Godoy, Pere; Alvarez, Josep; Sala, Rosa; Camps, Neus

2006-01-01

The currently low endemic level of hepatitis A in Spain favors manifestation of the disease as outbreaks among specific risk groups. The aim of this study is to analyze the hepatitis A outbreaks investigated in Catalonia (Spain) during the period of 1999 to 2003. The criteria for including an outbreak were defined and outbreaks were classified according to the type of transmission. The variables analyzed were space, time, socio-demographic parameters, setting, risk factors, and preventive measures adopted. The incidence rate and rate ratio were calculated according to age and sex. Among 74 outbreaks, 73 fulfilled the inclusion criteria. Most outbreaks involved person-to-person transmission (83.8%) and the rest had a common source of infection (14.9%). In total, 334 cases were included (cumulative incidence 1999-2003: 5.27 per 100,000 inhabitants), with an average age of 24.5 years. The settings yielding the most cases were family (143), community (97) and schools/preschools (87). The number of cases per outbreak ranged from 2 to 11, except one outbreak that occurred in 83 young homosexual men with high-risk sexual practices. The main factors related to the case index or to coprimary cases included belonging to age groups with low immunity (children and young adults) and travelling to or from endemic areas. Hepatitis A outbreaks in Catalonia are still frequent. They mainly occur in the family environment, by person-to-person transmission and in the most vulnerable groups (preschool or school employees, travelers, and men who perform high-risk sexual practices with other men).

Dengue and Severe Dengue

MedlinePlus

... to the previous year for both countries. The Solomon Islands declared an outbreak with more than 7000 ... to the previous year for both countries. The Solomon Islands declared an outbreak with more than 7000 ...

Gay Men's Understanding and Education of New HIV Prevention Technologies in Vancouver, Canada.

PubMed

Klassen, Benjamin J; Lachowsky, Nathan J; Lin, Sally Yue; Edward, Joshua B; Chown, Sarah A; Hogg, Robert S; Moore, David M; Roth, Eric A

2017-10-01

Effective rollout of HIV treatment-based prevention such as pre-exposure prophylaxis and treatment as prevention has been hampered by poor education, limited acceptability, and stigma among gay men. We undertook a thematic analysis regarding the education sources and acceptability of these New Prevention Technologies (NPTs) using 15 semistructured interviews with gay men in Vancouver, Canada, who were early adopters of NPTs. NPT education was derived from a variety of sources, including the Internet, health care providers, community organizations, sexual partners, and peers; participants also emphasized their own capacities as learners and educators. Acceptable forms of NPT education featured high-quality factual information, personal testimony, and easy access. Stigma was highlighted as a major barrier. For public health, policy makers, and gay communities to optimize the personal and population benefits of NPTs, there is a need for increased community support and dialogue, antistigma efforts, early NPT adopter testimony, and personalized implementation strategies.

FOOD INSECURITY INCREASES HIV RISK AMONG YOUNG SEX WORKERS IN METRO VANCOUVER, CANADA

PubMed Central

Barreto, Daniella; Shannon, Kate; Taylor, Chrissy; Dobrer, Sabina; St. Jean, Jessica; Goldenberg, Shira M.; Duff, Putu; Deering, Kathleen N.

2017-01-01

This research aimed to determine the effect of food insecurity on sexual HIV risk with clients among youth sex workers (YSWs) <30 years in Metro Vancouver, Canada. Data were drawn from a prospective community cohort of sex workers (2010–2013). We examined the independent relationship between YSWs food insecurity and being pressured into sex without a condom by clients (“client condom refusal”). Of 220 YSWs, 34.5 % (n = 76) reported client condom refusal over the 3.5-year study period and 76.4 % (n = 168) reported any food insecurity. Adjusting for other HIV risk pathways, food insecurity retained an independent effect on client condom refusal (AOR 2.08, 95 % CI 1.23–3.51), suggesting that food insecurity is significantly associated with HIV risk among YSWs. This study indicates a critical relationship between food insecurity and HIV risk, and demonstrates YSWs particular vulnerability. Public policies for food assistance as a harm reduction measure may be key to addressing this disparity. PMID:27752869

Tularaemia outbreaks in Sakarya, Turkey: case-control and environmental studies.

PubMed

Meric, M; Sayan, M; Dundar, D; Willke, A

2010-08-01

Tularaemia is an important zoonotic disease that leads to outbreaks. This study aimed to compare the epidemiological characteristics of two tularaemia outbreaks that occurred in the Sakarya region of Turkey, analyse the risk factors for the development of outbreaks and identify Francisella (F.) tularensis in the water samples. Two tularaemia outbreaks occurred in the Kocadongel village in 2005 and 2006. A field investigation and a case-control study with 47 cases and 47 healthy households were performed during the second outbreak. Clinical samples from the patients and filtrated water samples were analysed for F. tularensis via real-time polymerase chain reaction. From the two outbreaks, a total of 58 patients were diagnosed with oropharyngeal tularaemia based on their clinical and serological results. Both outbreaks occurred between the months of January and April, and the number of patients peaked in February. Logistic regression analysis revealed that the consumption of natural spring water was the only significant risk factor for tularaemia infection (odds ratio 3.5, confidence interval 1.23-10.07). F. tularensis was detected in eight clinical samples and in the filtrated natural spring water. This study is the first report of tularaemia from this region. The results show that both tularaemia outbreaks were related to the consumption of untreated natural spring water. To prevent waterborne tularaemia, community water supplies should be treated and checked periodically.

78 FR 63975 - Notice of Effectiveness of Exempt Wholesale Generator or Foreign Utility Company Status

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

... Energy Inc FortisBC Energy (Vancouver Island) Inc. FortisBC Energy (Whistler) Inc... FortisBC Huntingdon Inc FortisBC Alternative Energy Services Inc. Fortis Generation East Limited FC13-11-000 Partnership... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Notice of Effectiveness of Exempt...

Molecular Investigation of Tularemia Outbreaks, Spain, 1997–2008

PubMed Central

Ariza-Miguel, Jaime; Johansson, Anders; Fernández-Natal, María Isabel; Martínez-Nistal, Carmen; Orduña, Antonio; Rodríguez-Ferri, Elías F.; Hernández, Marta

2014-01-01

Tularemia outbreaks occurred in northwestern Spain in 1997–1998 and 2007–2008 and affected >1,000 persons. We assessed isolates involved in these outbreaks by using pulsed-field gel electrophoresis with 2 restriction enzymes and multilocus variable number tandem repeat analysis of 16 genomic loci of Francisella tularensis, the cause of this disease. Isolates were divided into 3 pulsotypes by pulsed-field gel electrophoresis and 8 allelic profiles by multilocus variable number tandem repeat analysis. Isolates obtained from the second tularemia outbreak had the same genotypes as isolates obtained from the first outbreak. Both outbreaks were caused by genotypes of genetic subclade B.Br:FTNF002–00, which is widely distributed in countries in central and western Europe. Thus, reemergence of tularemia in Spain was not caused by the reintroduction of exotic strains, but probably by persistence of local reservoirs of infection. PMID:24750848

A large outbreak of mumps in the postvaccine era.

PubMed

Wharton, M; Cochi, S L; Hutcheson, R H; Bistowish, J M; Schaffner, W

1988-12-01

During a county-wide mumps outbreak in Nashville, Tennessee, 332 cases of mumps were identified at a public high school (attack rate, 18.8%). A pep rally 17 d before the peak of the outbreak at a single public high school may have provided an opportunity for point-source exposure. A case-control study demonstrated that vaccine efficacy was 75% (we used provider-verified records and excluded students with a history of mumps disease). Although school records were nonuniform, mumps immunization status was correct, compared with provider-verified records, in at least 85% of both cases and controls. Parental reports were much less reliable. The cost of the outbreak was estimated at $154/case. Receiving mumps vaccine at a vaccine clinic held after the outbreak had peaked was associated with a decrease in risk of mumps disease. Thus, these clinics may have a role in the control of such outbreaks.

Aleutian Islands

NASA Image and Video Library

2014-05-21

Remote, rugged and extraordinarily beautiful, Alaska’s Aleutian Islands are best known for wildlife reserves, military bases, fishing, furs and fog. The sprawling volcanic archipelago was brought into the spotlight by the Russian-supported expedition of Alexey Chirikov and Vitus Bering in 1741, and soon became controlled by the Russian-American Fur Company. In 1867 the United States purchased Alaska, including the Aleutian Islands, from Russia. By 1900 the port in Unalaska was well established as a shipping port for Alaska gold. The archipelago sweeps about 1,200 miles (1,800 km) from the tip of the Alaskan Peninsula to Attu, the most westward island. Four major island groups hold 14 large islands, about 55 smaller islands, and a large number of islets, adding up to roughly 150 islands/islets in total. This chain separates the Bering Sea (north) from the Pacific Ocean (south) and the islands are connected by the Marine Highway Ferry – at least as far as Unalaska. For the most remote islands, such as birding paradise of Attu, the western-most Aleutian Island, travel becomes trickier and relies primarily on custom charter. The Moderate Resolution Imaging Spectroradiometer (MODIS) flew over the region and captured this spectacular true-color image of the eastern Aleutian Islands on May 15, 2014. In this image, the Alaskan Peninsula protrudes from the mainland and sweeps to the southwest. The first set of islands are called the Fox Island group. Unalaska Island is part of this group and can be identified, with some imagination, as an island formed in the shape of a flying cherub, with two arms (peninsulas) outstretched towards the northeast, seemingly reaching for the round “balls” of Akutan and Akun Islands. The smallest islands in the west of the image belong to the group known as the Islands of Four Mountains. The Aleutians continue far to the west of this image. Fog surrounds the Aleutians, stretching from just off the southwestern Alaska mainland to the

Deterministic Factors Overwhelm Stochastic Environmental Fluctuations as Drivers of Jellyfish Outbreaks.

PubMed

Benedetti-Cecchi, Lisandro; Canepa, Antonio; Fuentes, Veronica; Tamburello, Laura; Purcell, Jennifer E; Piraino, Stefano; Roberts, Jason; Boero, Ferdinando; Halpin, Patrick

2015-01-01

Jellyfish outbreaks are increasingly viewed as a deterministic response to escalating levels of environmental degradation and climate extremes. However, a comprehensive understanding of the influence of deterministic drivers and stochastic environmental variations favouring population renewal processes has remained elusive. This study quantifies the deterministic and stochastic components of environmental change that lead to outbreaks of the jellyfish Pelagia noctiluca in the Mediterranen Sea. Using data of jellyfish abundance collected at 241 sites along the Catalan coast from 2007 to 2010 we: (1) tested hypotheses about the influence of time-varying and spatial predictors of jellyfish outbreaks; (2) evaluated the relative importance of stochastic vs. deterministic forcing of outbreaks through the environmental bootstrap method; and (3) quantified return times of extreme events. Outbreaks were common in May and June and less likely in other summer months, which resulted in a negative relationship between outbreaks and SST. Cross- and along-shore advection by geostrophic flow were important concentrating forces of jellyfish, but most outbreaks occurred in the proximity of two canyons in the northern part of the study area. This result supported the recent hypothesis that canyons can funnel P. noctiluca blooms towards shore during upwelling. This can be a general, yet unappreciated mechanism leading to outbreaks of holoplanktonic jellyfish species. The environmental bootstrap indicated that stochastic environmental fluctuations have negligible effects on return times of outbreaks. Our analysis emphasized the importance of deterministic processes leading to jellyfish outbreaks compared to the stochastic component of environmental variation. A better understanding of how environmental drivers affect demographic and population processes in jellyfish species will increase the ability to anticipate jellyfish outbreaks in the future.

Tenarife Island, Canary Island Archipelago, Atlantic Ocean

NASA Technical Reports Server (NTRS)

1991-01-01

Tenarife Island is one of the most volcanically active of the Canary Island archipelago, Atlantic Ocean, just off the NW coast of Africa, (28.5N, 16.5W). The old central caldera, nearly filled in by successive volcanic activity culminating in two stratocones. From those two peaks, a line of smaller cinder cones extend to the point of the island. Extensive gullies dissect the west side of the island and some forests still remain on the east side.

Tenarife Island, Canary Island Archipelago, Atlantic Ocean

NASA Image and Video Library

1991-08-11

Tenarife Island is one of the most volcanically active of the Canary Island archipelago, Atlantic Ocean, just off the NW coast of Africa, (28.5N, 16.5W). The old central caldera, nearly filled in by successive volcanic activity culminating in two stratocones. From those two peaks, a line of smaller cinder cones extend to the point of the island. Extensive gullies dissect the west side of the island and some forests still remain on the east side.

"SALOME gave my dignity back": the role of randomized heroin trials in transforming lives in the Downtown Eastside of Vancouver, Canada.

PubMed

Jozaghi, Ehsan

2014-01-01

Although numerous studies on heroin-assisted treatment (HAT) have been published in leading international journals, little attention has been given to HAT's clients, their stories, and what constitutes the most influential factor in the treatment process. The present study investigates the role of HAT in transforming the lives of injection drug users (IDUs) in Vancouver, Canada. This study is qualitative focusing on 16 in-depth interviews with patients from the randomized trials of HAT. Interviews were transcribed verbatim and analyzed thematically using NVivo 10 software. The findings revealed a positive change in many respects: the randomized trials reduce criminal activity, sex work, and illicit drug use. In addition, the trials improved the health and social functioning of its clients, with some participants acquiring work or volunteer positions. Many of the participants have been able to reconnect with their family members, which was not possible before the program. Furthermore, the relationship between the staff and patients at the project appears to have transformed the behavior of participants. Attending HAT in Vancouver has been particularly effective in creating a unique microenvironment where IDUs who have attended HAT have been able to form a collective identity advocating for their rights. The result of this research points to the need for continuation of the project beyond the current study, leading toward a permanent program.

Model-specification uncertainty in future forest pest outbreak.

PubMed

Boulanger, Yan; Gray, David R; Cooke, Barry J; De Grandpré, Louis

2016-04-01

Climate change will modify forest pest outbreak characteristics, although there are disagreements regarding the specifics of these changes. A large part of this variability may be attributed to model specifications. As a case study, we developed a consensus model predicting spruce budworm (SBW, Choristoneura fumiferana [Clem.]) outbreak duration using two different predictor data sets and six different correlative methods. The model was used to project outbreak duration and the uncertainty associated with using different data sets and correlative methods (=model-specification uncertainty) for 2011-2040, 2041-2070 and 2071-2100, according to three forcing scenarios (RCP 2.6, RCP 4.5 and RCP 8.5). The consensus model showed very high explanatory power and low bias. The model projected a more important northward shift and decrease in outbreak duration under the RCP 8.5 scenario. However, variation in single-model projections increases with time, making future projections highly uncertain. Notably, the magnitude of the shifts in northward expansion, overall outbreak duration and the patterns of outbreaks duration at the southern edge were highly variable according to the predictor data set and correlative method used. We also demonstrated that variation in forcing scenarios contributed only slightly to the uncertainty of model projections compared with the two sources of model-specification uncertainty. Our approach helped to quantify model-specification uncertainty in future forest pest outbreak characteristics. It may contribute to sounder decision-making by acknowledging the limits of the projections and help to identify areas where model-specification uncertainty is high. As such, we further stress that this uncertainty should be strongly considered when making forest management plans, notably by adopting adaptive management strategies so as to reduce future risks. © 2015 Her Majesty the Queen in Right of Canada Global Change Biology © 2015 Published by John

Outbreak of caliciviruses in the Singapore military, 2015.

PubMed

Neo, Freddy Jun Xian; Loh, Jimmy Jin Phang; Ting, Peijun; Yeo, Wei Xin; Gao, Christine Qiu Han; Lee, Vernon Jian Ming; Tan, Boon Huan; Ng, Ching Ging

2017-11-14

From 31 August to 9 September 2015, a total of 150 military personnel at a military institution in Singapore were infected with acute gastroenteritis (AGE) with an attack rate of approximately 3%. This study aimed to determine the epidemiology of the outbreak, investigate its origins, and discuss measures to prevent future occurrences. After the AGE outbreak was declared on 31 August 2015, symptom surveys, hygiene inspections, and the testing of water, food, and stool samples were initiated. We collected 86 stool samples from AGE cases and 58 samples from food-handlers during the course of the outbreak and these stool samples were tested for 8 bacterial pathogens and 2 viral pathogens (i.e., norovirus and sapovirus). We detected Sapovirus (SaV), group I Norovirus (NoV GI) and group II Norovirus (NoV GII) from the stool samples of AGE cases. Further sequence analyses showed that the AGE outbreak in August was caused mainly by three rarely reported calicivirus novel genotypes: NoV GI.7, NoV GII.17 and SaV GII.3. Control measures implemented focused on the escalation of personal and environmental hygiene, which included the separation of affected and unaffected soldiers, enforcement of rigorous hand-washing and hygiene, raising awareness of food and water safety, and disinfection of communal areas with bleach. This study identified both NoV and SaV as the causative agents for an AGE outbreak at a Singapore military camp in August 2015. This study is also the first to report SaV as one of the main causative agents, highlighting the importance of caliciviruses as causative agents of AGE outbreaks in the Singapore military. As there are no commercially available vaccines against caliciviruses, strict personal hygiene and proper disinfection of environmental surfaces remain crucial to prevent calicivirus outbreak and transmission.

Human thermal perception related to Föhn winds due to Saharan dust outbreaks in Crete Island, Greece

NASA Astrophysics Data System (ADS)

Nastos, P. T.; Bleta, A. G.; Matsangouras, I. T.

2017-05-01

Crete Island is located in the southmost border of East Mediterranean basin, facing exacerbating atmospheric conditions (mainly concentrations of particulates) due to Saharan dust outbreaks. It is worth to note that these episodes are more frequent during spring and autumn, when mild biometeorological conditions become intolerable due to the synergy of the so called Föhn winds. Cretan mountains, especially Psiloritis Mt. (summit at 2456 m), are orientated perpendicularly to the southwest air mass flow, generating the Föhn winds. Propagating from the leeward of the mountains, these dry, hot winds have an effect on prevailing biometeorological conditions. While descending to the lowlands on the leeward side of the range, the wind becomes strong, gusty, and desiccating. This wind often lasts less than an hour to several days, with gradual weakening after the first or the second day. Sometimes, it stops very abruptly. In this work, the authors examined and analyzed the abrupt changes of human thermal perception within specific case studies during which Föhn winds appeared in Heraklion city at the leeward of Psiloritis Mt, associated with extreme Saharan dust episodes, observed within the period 2006-2010. In order to verify the development of Föhn winds, Meteorological Terminal Aviation Routine Weather Reports (METARs, meteorological observations every half hour), were acquired from the Heraklion meteorological station installed by the Hellenic National Meteorological Service (HNMS). The biometeorological conditions analyzed are based on human thermal bioclimatic indices such as the Physiologically equivalent temperature (PET) and the Universal Thermal Climate Index (UTCI). METAR recordings of meteorological variables, such as air temperature, vapor pressure, wind speed, and cloudiness, were used as input variables in modeling the aforementioned thermal indices, so that to interpret the grade of the thermo-physiological stress. The PET and UTCI analysis was

Unexpected Rift Valley Fever Outbreak, Northern Mauritania

PubMed Central

El Mamy, Ahmed B. Ould; Baba, Mohamed Ould; Barry, Yahya; Isselmou, Katia; Dia, Mamadou L.; Hampate, Ba; Diallo, Mamadou Y.; El Kory, Mohamed Ould Brahim; Diop, Mariam; Lo, Modou Moustapha; Thiongane, Yaya; Bengoumi, Mohammed; Puech, Lilian; Plee, Ludovic; Claes, Filip; Doumbia, Baba

2011-01-01

During September–October 2010, an unprecedented outbreak of Rift Valley fever was reported in the northern Sahelian region of Mauritania after exceptionally heavy rainfall. Camels probably played a central role in the local amplification of the virus. We describe the main clinical signs (hemorrhagic fever, icterus, and nervous symptoms) observed during the outbreak. PMID:22000364

Cost of dengue outbreaks: literature review and country case studies

PubMed Central

2013-01-01

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

Managing outbreaks of norovirus in an NHS hospital.

PubMed

Aziz, Ann-Marie

Noroviruses are highly infectious and easily transmitted by contact with contaminated surfaces and objects, as airborne particles and by contact between individuals. While illness caused by norovirus is usually self-limiting, it can be serious in very young and elderly people, or in those who are debilitated or have a serious illness; they may require hospital treatment. Norovirus outbreaks in hospitals create significant disruption to patient care. They also have huge cost implications for NHS trusts through staff absence and ward closures, which are extremely disruptive and increase pressures on bed demand. The three most important actions during an outbreak of norovirus are effective hand hygiene, isolation of affected patients and enhanced cleaning of the environment. This article outlines how to identify norovirus infection and outbreaks, and describes how an acute trust managed outbreaks of norovirus and the procedures it adopted.

Variable global strategies for avian influenza outbreak control and eradication

USDA-ARS?s Scientific Manuscript database

Since 1959, 40 epizootics of high pathogenicity avian influenza (HPAI) have occurred with 35 outbreaks using stamping-out programs exclusively, leading to rapid eradication, and five outbreaks having also used vaccination as a control tool. The majority of the recent outbreaks of H5N1 HPAI have occu...

Mumps Cases and Outbreaks

MedlinePlus

... Providers Laboratory Testing for Mumps Infection Specimen Collection, Storage, and ... SC, TN, TX, UT, VA, VT, WA, WI, and WV **Preliminary data reported to CDC. Mumps outbreaks are not reportable. * ...

Outbreak of measles in a non-immunizing population, Alberta 2013.

PubMed

Kershaw, T; Suttorp, V; Simmonds, K; St Jean, T

2014-06-12

An outbreak of measles was declared in southern Alberta on October 18, 2013, after a case had been reported to the local public health unit in a non-immunized teenager with recent travel to the Netherlands. The teenager had had contact with a large number of unimmunized people while infectious; therefore, the risk of spread was high. The potential for an outbreak of measles in this area had been identified by the lead Medical Officer of Health for South Zone, and planning for an outbreak had begun in August 2013. Several public health measures were implemented to control the outbreak: mass immunization clinics; an outbreak dose of measles mumps and rubella (MMR) vaccine for infants 6-12 months old; communication within the affected and surrounding communities; a dedicated measles hotline; a Mobile Measles Assessment Team; and a Measles Assessment Centre. A total of 42 confirmed cases were identified during the outbreak between October 16 and November 25. Just over half the cases were male (52.4%). The average age was 12 (range < 1 to 24 years) and the median age 13 years. There was one hospitalization, and no deaths occurred. All cases were unimmunized. Cases were located in five communities immediately surrounding Lethbridge. All but two cases were epidemiologically linked within 10 households. The planning that occurred before the outbreak was essential in containing the outbreak to 10 households. To prevent future outbreaks of measles, exploring strategies for increasing immunization coverage rates in unimmunized populations is essential. When immunization acceptance is not uniform, other public health strategies should be planned for and implemented in order to prevent additional spread.

Cost-Analysis of Seven Nosocomial Outbreaks in an Academic Hospital.

PubMed

Dik, Jan-Willem H; Dinkelacker, Ariane G; Vemer, Pepijn; Lo-Ten-Foe, Jerome R; Lokate, Mariëtte; Sinha, Bhanu; Friedrich, Alex W; Postma, Maarten J

2016-01-01

Nosocomial outbreaks, especially with (multi-)resistant microorganisms, are a major problem for health care institutions. They can cause morbidity and mortality for patients and controlling these costs substantial amounts of funds and resources. However, how much is unclear. This study sets out to provide a comparable overview of the costs of multiple outbreaks in a single academic hospital in the Netherlands. Based on interviews with the involved staff, multiple databases and stored records from the Infection Prevention Division all actions undertaken, extra staff employment, use of resources, bed-occupancy rates, and other miscellaneous cost drivers during different outbreaks were scored and quantified into Euros. This led to total costs per outbreak and an estimated average cost per positive patient per outbreak day. Seven outbreaks that occurred between 2012 and 2014 in the hospital were evaluated. Total costs for the hospital ranged between €10,778 and €356,754. Costs per positive patient per outbreak day, ranged between €10 and €1,369 (95% CI: €49-€1,042), with a mean of €546 and a median of €519. Majority of the costs (50%) were made because of closed beds. This analysis is the first to give a comparable overview of various outbreaks, caused by different microorganisms, in the same hospital and all analyzed with the same method. It shows a large variation within the average costs due to different factors (e.g. closure of wards, type of ward). All outbreaks however cost considerable amounts of efforts and money (up to €356,754), including missed revenue and control measures.

Crisis prevention and management during SARS outbreak, Singapore.

PubMed

Quah, Stella R; Hin-Peng, Lee

2004-02-01

We discuss crisis prevention and management during the first 3 months of the severe acute respiratory syndrome (SARS) outbreak in Singapore. Four public health issues were considered: prevention measures, self-health evaluation, SARS knowledge, and appraisal of crisis management. We conducted telephone interviews with a representative sample of 1,201 adults, > or = 21 years of age. We found that sex, age, and attitude (anxiety and perception of open communication with authorities) were associated with practicing preventive measures. Analysis of Singapore's outbreak improves our understanding of the social dimensions of infectious disease outbreaks.

[Outbreaks of viral hepatitis E in the Czech Republic?].

PubMed

Trmal, Josef; Pavlík, Ivo; Vasícková, Petra; Matejícková, Ladislava; Simůnková, Lenka; Luks, Stanislav; Pazderková, Jana

2012-05-01

Until recently, viral hepatitis E (VHE) has typically been an imported infection, related to travel to developing countries. A number of travel-unrelated VHE cases currently diagnosed in the Czech Republic. Outcomes of the epidemiological investigations of two VHE outbreaks associated with the consumption of pork and pork products at pig-slaughtering feasts are presented. Thirteen cases have been reported in the first outbreak and eight cases in the second outbreak. The epidemiological investigations are described and the experience gained in analysing suspected biological specimens is presented. The source of infection has not been identified in the first outbreak while in the other one, a link between human cases and infection in farm pigs was revealed for the first time. Although the epidemiological investigation may not always lead to the detection of the VHE source, it must be conducted in any outbreak and can only be successful when done in cooperation of the public health authorities with the veterinary health agency.

Serratia marcescens outbreak due to contaminated 2% aqueous chlorhexidine.

PubMed

de Frutos, Mónica; López-Urrutia, Luis; Domínguez-Gil, Marta; Arias, Marta; Muñoz-Bellido, Juan Luis; Eiros, José María; Ramos, Carmen

2017-12-01

An outbreak of Serratia marcescens infections outbreak is described, as well as the epidemiological study that linked the outbreak to the use of 2% aqueous chlorhexidine antiseptic. In late November 2014 an increasing incidence of S. marcescens isolates was detected in patients treated in the emergency department. It was considered a possible outbreak, and an epidemiological investigation was started. S. marcescens was isolated in 23 samples from 16 patients and in all new bottles of two lots of 2% aqueous chlorhexidine. The contaminated disinfectant was withdrawn, and the Spanish Drugs Agency was alerted (COS 2/2014). The epidemiological study showed that strains isolated from clinical samples and from chlorhexidine belonged to the same clone. No further isolates were obtained once the disinfectant was withdrawn. The suspicion of an outbreak and the epidemiological study were essential to control the incidence. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Norovirus genotypes causing gastroenteritis outbreaks in Finland 1998-2002.

PubMed

Maunula, L; Von Bonsdorff, C-H

2005-11-01

Outbreak investigation methods for enteric viruses were improved in 1990s when gene amplification techniques were established in viral laboratories. The objective of the study was to determine the causative agents for Finnish viral gastroenteritis outbreaks. Our aim was also to further characterise the norovirus strains, reveal the temporal occurrence of norovirus (NV) genotypes and to study some epidemiological aspects concerning the outbreaks. A total of 416 Finnish viral gastroenteritis outbreaks that occurred during 5 years (1998-2002), excluding those among hospitalised children, were investigated for enteric viruses. Stool samples were screened by electron microscopy as well as analyzed by specific noro- and astrovirus RT-PCR tests. Amplicon sequence analysis was used to find out norovirus genotypes. Noroviruses caused 252 (60.6%) of the outbreaks; other viruses, astro- or rotavirus, caused four epidemics. Norovirus epidemics occurred in all kinds of settings, most often in hospitals (30.6%) and in restaurants and canteens (14.3%). Both NV genogroups were found every year, but NV GGII outbreaks always outnumbered those of GGI. All but one outbreak at hospitals and nursing homes were of genotype GII. Polymerase sequence analysis revealed a variety of NV genotypes; six GI and at least eight GII genotypes. The GI.3 Birmingham-like and GII.4 Bristol-like genotype appeared every year, whereas the other types were circulating for shorter periods or sporadically. During the study period the genotypes GII.4 (Bristol), GII.1 (Hawaii), an emerging genotype GIIb, and a new variant of GII.4 predominated in that order. Indication for rapid genetic changes in the genotype GII.4 was also noticed. Noroviruses were the most prevalent causative agents in the outbreaks. Many NV genotypes were circulating, and a shift in the predominant genotypes was evident between epidemic seasons.

Canary Islands

NASA Technical Reports Server (NTRS)

1992-01-01

This easterly looking view shows the seven major volcanic islands of the Canary Island chain (28.0N, 16.5W) and offers a unique view of the islands that have become a frequent vacation spot for Europeans. The northwest coastline of Africa, (Morocco and Western Sahara), is visible in the background. Frequently, these islands create an impact on local weather (cloud formations) and ocean currents (island wakes) as seen in this photo.

Are bark beetle outbreaks less synchronous than forest Lepidoptera outbreaks?

Treesearch

Bjorn Okland; Andrew M. Liebhold; Ottar N. Bjornstad; Nadir Erbilgin; Paal Krokene; Paal Krokene

2005-01-01

Comparisons of intraspecific spatial synchrony across multiple epidemic insect species can be useful for generating hypotheses about major determinants of population patterns at larger scales. The present study compares patterns of spatial synchrony in outbreaks of six epidemic bark beetle species in North America and Europe. Spatial synchrony among populations of the...

Surveillance of food poisoning outbreaks in Thailand 1981-1986.

PubMed

Swaddiwuthipong, W; Ittiravivongs, A; Kunasol, P; Rerk-Ngam, S

1988-06-01

In the period of 1981-1986, eighteen outbreaks of food poisoning following ingestion of insecticide contaminated food were reported to the Division of Epidemiology, Ministry of Public Health. There were 678 individuals experiencing illness, of which 9 cases died. Out of 18 outbreaks, 16 involving 615 cases resulted from carbamate (Methomyl and Propoxur) intoxications. The remaining two outbreaks were caused by organophosphate (Coumaphos) and organochlorine (DDT). The case fatality rate was much higher with Coumaphos than Methomyl; and no death was reported among Propoxur and DDT victims. Desserts and beverages were found to be the main vehicles, and private home was the most common place for the outbreaks of food poisoning caused by ingestion of insecticide contaminated food.

Large cholera outbreak in Brong Ahafo Region, Ghana.

PubMed

Noora, Charles Lwanga; Issah, Kofi; Kenu, Ernest; Bachan, Emmanuel George; Nuoh, Robert Domo; Nyarko, Kofi Mensah; Appiah, Paulina; Letsa, Timothy

2017-08-10

A nationwide outbreak of Vibrio cholerae occurred in Ghana in 2014 with Accra, the nation's capital as the epi-center. The outbreak spread to the Brong Ahafo Region (BAR) which is geographically located in the middle of the country. In this region a review of data collected during the outbreak was carried out and analyzed descriptively to determine the hot spots and make recommendations for effective response to future outbreaks. A review of patient records and line lists of cases of cholera reported in all hospitals during the period of the outbreak (July-December 2014) was conducted. Hospitals used IDSR (Integrated Disease Surveillance and Response system) standard case definitions to detect and report cases for management. The GPS coordinates of all districts and health facilities were collected and utilized in the construction of spot maps. We also obtained populations (denominators) from the BAR Health surveillance unit of the Ghana Health Service. All the data thus collected was analyzed descriptively and expressed as frequencies and rates. A total of 1035 cases were reported, 550 (53.4%) were males and the rest females. Their ages ranged from 1 to 95 years; (mean age of 28.2 ± 19.6 years). The most affected (23.5%) was the 20-29 year old age group. On the 30th July, 2014, a 26 year old male (recorded as the index case of the cholera outbreak in the Brong Ahafo region) with a history of travel from Accra reported to the Nkoranza district hospital with a history of symptoms suggestive of cholera. The reporting of cholera cases reached their peak (17.3%) in week 15 of the outbreak (this lasted 25 weeks). An overall attack rate of 71/100,000 population, and a case fatality rate of 2.4% was recorded in the region. Asutifi South district however recorded a case fatality of 9.1%, the highest amongst all the districts which recorded outbreaks. The majority of the cases reported in the region were from Atebubu-Amanten, Sene West, Pru, and Asunafo North

Surviving the housing crisis: Social violence and the production of evictions among women who use drugs in Vancouver, Canada.

PubMed

Collins, Alexandra B; Boyd, Jade; Damon, Will; Czechaczek, Sandra; Krüsi, Andrea; Cooper, Hannah; McNeil, Ryan

2018-05-01

Single room accommodation (SRA) housing is among the only forms of accessible housing to marginalized women who use illicit drugs in many urban settings. However, SRA housing environments may create specific health and drug risks for women. Little research has examined the gendered mechanisms contributing to housing vulnerability for women who use drugs and the subsequent ways they aim to mitigate harm. This study examines the gendered vulnerabilities to, and harms stemming from, evictions from SRAs in Vancouver, Canada. Qualitative interviews were conducted with 56 people who use drugs who were recently evicted (past 60 days) from SRAs in Vancouver's Downtown Eastside neighbourhood, 19 of whom identified as women which informed this analysis. Participants were recruited by Peer Researcher Assistants for baseline and follow-up interviews three to six months later. Interview transcripts were analyzed thematically and interpreted by drawing on concepts of social violence. Findings underscore how gendered violence and forms of social control operationalized within SRAs normalized violence against women and restricted their agency. Surveillance mechanisms increased women's experiences of violence as they sought to evade such interventions. Post-eviction, women faced pronounced vulnerability to harm which reinforced their social and spatial marginality within a drug scene. Collectively, women's experiences within SRAs highlight how the hybrid forms of disciplinary mechanisms used within these housing environments significantly impacted women's experiences of harm. Greater attention to the impacts of housing and building policies on women who use drugs is needed to better address the morbidity and mortality of this population. Copyright © 2018 Elsevier Ltd. All rights reserved.

Island-Trapped Waves, Internal Waves, and Island Circulation

DTIC Science & Technology

2014-09-30

from the government of Palau to allow us to deliver some water and food to the officers. Governor Patris of Hatohobei State and the Coral Reef ...Island-trapped waves , internal waves , and island circulation T. M. Shaun Johnston Scripps Institution of Oceanography University of California...large islands (Godfrey, 1989; Firing et al., 1999); • Westward propagating eddies and/or Rossby waves encounter large islands and produce boundary

Spatial analysis of harmonic oscillation of gypsy moth outbreak intensity

Treesearch

Kyle J. Haynes; Andrew M. Liebhold; Derek M. Johnson

2009-01-01

Outbreaks of many forest-defoliating insects are synchronous over broad geographic areas and occur with a period of approximately 10 years. Within the range of the gypsy moth in North America, however, there is considerable geographic heterogeneity in strength of periodicity and the frequency of outbreaks. Furthermore, gypsy moth outbreaks exhibit two significant...

Human angiostrongyliasis outbreak in Dali, China.

PubMed

Lv, Shan; Zhang, Yi; Chen, Shao-Rong; Wang, Li-Bo; Fang, Wen; Chen, Feng; Jiang, Jin-Yong; Li, Yuan-Lin; Du, Zun-Wei; Zhou, Xiao-Nong

2009-09-22

Several angiostrongyliasis outbreaks have been reported in recent years but the disease continues to be neglected in public health circles. We describe an outbreak in Dali, southwest China in order to highlight some key problems for the control of this helminth infection. All available medical records of suspected angiostrongyliasis patients visiting hospitals in Dali in the period 1 October 2007-31 March 2008 were reviewed, and tentative diagnoses of varying strengths were reached according to given sets of criteria. Snails collected from local markets, restaurants and natural habitats were also screened for the presence of Angiostrongylus cantonensis. A total of 33 patients met criteria for infection, and 11 among them were classified as clinically confirmed. An additional eight patients were identified through a surveillance system put in operation in response to the outbreak. The epidemic lasted for 8 months with its peak in February 2008. Of the 33 patients, 97.0% complained of severe headache. 84.8% patients had high eosinophil cell counts either in the peripheral blood or in cerebrospinal fluid (CSF). Three-quarters of the patients were treated with a combination of albendazole and corticosteroids, resulting in significantly improved overall conditions. Twenty-two patients reported the consumption of raw or undercooked snails prior to the onset of the symptoms, and approximately 1.0% of the Pomacea canaliculata snails on sale were found to be infected with A. cantonensis. The snails were also found in certain habitats around Dali but no parasites were detected in these populations. The import and sale of infected P. canaliculata is the likely trigger for this angiostrongyliasis outbreak. Awareness of angiostrongyliasis must be raised, and standardized diagnosis and treatment are needed in order to provide clinicians with a guide to address this disease. Health education campaigns could limit the risk, and a hospital-based surveillance system should be

Sellers’ Revisited: A Big Data Reassessment of Historical Outbreaks of Bluetongue and African Horse Sickness due to the Long-Distance Wind Dispersion of Culicoides Midges

PubMed Central

Durr, Peter A.; Graham, Kerryne; van Klinken, Rieks D.

2017-01-01

The possibility that outbreaks of bluetongue (BT) and African horse sickness (AHS) might occur via long-distance wind dispersion (LDWD) of their insect vector (Culicoides spp.) was proposed by R. F. Sellers in a series of papers published between 1977 and 1991. These investigated the role of LDWD by means of visual examination of the wind direction of synoptic weather charts. Based on the hypothesis that simple wind direction analysis, which does not allow for wind speed, might have led to spurious conclusions, we reanalyzed six of the outbreak scenarios described in Sellers’ papers. For this reanalysis, we used a custom-built Big Data application (“TAPPAS”) which couples a user-friendly web-interface with an established atmospheric dispersal model (“HYSPLIT”), thus enabling more sophisticated modeling than was possible when Sellers undertook his analyzes. For the two AHS outbreaks, there was strong support from our reanalysis of the role of LDWD for that in Spain (1966), and to a lesser degree, for the outbreak in Cyprus (1960). However, for the BT outbreaks, the reassessments were more complex, and for one of these (western Turkey, 1977) we could discount LDWD as the means of direct introduction of the virus. By contrast, while the outbreak in Cyprus (1977) showed LDWD was a possible means of introduction, there is an apparent inconsistency in that the outbreaks were localized while the dispersion events covered much of the island. For Portugal (1956), LDWD from Morocco on the dates suggested by Sellers is very unlikely to have been the pathway for introduction, and for the detection of serotype 2 in Florida (1982), LDWD from Cuba would require an assumption of a lengthy survival time of the midges in the air column. Except for western Turkey, the BT reanalyses show the limitation of LDWD modeling when used by itself, and indicates the need to integrate susceptible host population distribution (and other covariate) data into the modeling process. A

Sellers' Revisited: A Big Data Reassessment of Historical Outbreaks of Bluetongue and African Horse Sickness due to the Long-Distance Wind Dispersion of Culicoides Midges.

PubMed

Durr, Peter A; Graham, Kerryne; van Klinken, Rieks D

2017-01-01

The possibility that outbreaks of bluetongue (BT) and African horse sickness (AHS) might occur via long-distance wind dispersion (LDWD) of their insect vector ( Culicoides spp.) was proposed by R. F. Sellers in a series of papers published between 1977 and 1991. These investigated the role of LDWD by means of visual examination of the wind direction of synoptic weather charts. Based on the hypothesis that simple wind direction analysis, which does not allow for wind speed, might have led to spurious conclusions, we reanalyzed six of the outbreak scenarios described in Sellers' papers. For this reanalysis, we used a custom-built Big Data application (" TAPPAS ") which couples a user-friendly web-interface with an established atmospheric dispersal model (" HYSPLIT "), thus enabling more sophisticated modeling than was possible when Sellers undertook his analyzes. For the two AHS outbreaks, there was strong support from our reanalysis of the role of LDWD for that in Spain (1966), and to a lesser degree, for the outbreak in Cyprus (1960). However, for the BT outbreaks, the reassessments were more complex, and for one of these (western Turkey, 1977) we could discount LDWD as the means of direct introduction of the virus. By contrast, while the outbreak in Cyprus (1977) showed LDWD was a possible means of introduction, there is an apparent inconsistency in that the outbreaks were localized while the dispersion events covered much of the island. For Portugal (1956), LDWD from Morocco on the dates suggested by Sellers is very unlikely to have been the pathway for introduction, and for the detection of serotype 2 in Florida (1982), LDWD from Cuba would require an assumption of a lengthy survival time of the midges in the air column. Except for western Turkey, the BT reanalyses show the limitation of LDWD modeling when used by itself, and indicates the need to integrate susceptible host population distribution (and other covariate) data into the modeling process. A further

WATERBORNE OUTBREAK OF GASTROENTERITIS ASSOCIATED WITH A NOROVIRUS

EPA Science Inventory

The Wyoming Department of Health investigated an outbreak of acute gastroenteritis among persons who dined at a tourist saloon in central Wyoming during October 2001. Human caliciviruses (HuCVs) were suspected as the etiological agent of the outbreak based upon the incubation ...

Eco-geomorphic processes that maintain a small coral reef island: Ballast Island in the Ryukyu Islands, Japan

NASA Astrophysics Data System (ADS)

Kayanne, Hajime; Aoki, Kenji; Suzuki, Takuya; Hongo, Chuki; Yamano, Hiroya; Ide, Yoichi; Iwatsuka, Yuudai; Takahashi, Kenya; Katayama, Hiroyuki; Sekimoto, Tsunehiro; Isobe, Masahiko

2016-10-01

Landform changes in Ballast Island, a small coral reef island in the Ryukyu Islands, were investigated by remote sensing analysis and a field survey. The area of the island almost doubled after a mass coral bleaching event in 1998. Coral branches generated by the mass mortality and broken by waves were delivered and stocked on a reef flat and accumulated to expand the area of the island. In 2012 high waves generated by typhoons also changed the island's topography. Overall, the island moved in the downdrift direction of the higher waves. Waves impacting both sides of the island piled up a large volume of coral gravels above the high-tide level. Eco-geomorphic processes, including a supply of calcareous materials from the corals on the same reef especially during stormy wave conditions, were key factors in maintaining the dynamic topographic features of this small coral reef island.

[Study on the efficacy of quarantine during outbreaks of acute hemorrhagic conjunctivitis outbreaks at schools through the susceptive-infective-quarantine-removal model].

PubMed

Chen, Tian-mu; Liu, Ru-chun

2013-01-01

To assess the efficacy of quarantine for acute hemorrhagic conjunctivitis (AHC) outbreaks control in schools, by using the Compartment Model. Through combining the characters of both AHC and compartment model, we built a susceptive-infective-removal (SIR) model suited for AHC outbreaks control in schools, and then quarantine was added into the model to develop a susceptive-infective-quarantine-removal (SIQR) model. An outbreak of AHC in Changsha in 2011 was employed as a sample to assess the effect of quarantine for the prevention and control of AHC. Basic reproduction number (λ0) of the AHC outbreak without intervention was 6.80, thus the transmission speed of the disease became quite fast. If no intervention had been adopted, almost all the students, faculties and staff members would have been infected within 23 days, and the accumulative cases would become 738, with the total attack rate (TAR) as 99.73%. The peak of the outbreak was at Sep. 11th and the number of new cases was 126 on that day. The efficacy would have been different if quarantine forces had been taken at different time and differently. The bigger and earlier the quarantine force had been adopted, the lower morbidity peak and the smaller TAR would have been appeared, with better efficacy of outbreak control. If the quarantine rate had been taken at the level of 90% on the sixth day, the accumulative case would have been reduced to 132 and the TAR had become 17.84% consequently. Quarantine program could be used as a main intervention approach to be employed for ACH outbreak at schools.