WorldWideScience

Sample records for flu outbreak tests

  1. Swine flu - A pandemic outbreak

    Directory of Open Access Journals (Sweden)

    Jini George

    Full Text Available Hippocrates had described influenza like outbreak in 412 B.C. and since then repeated influenza like epidemics and pandemics have been recorded in recent times. One of the greatest killers of all time was the pandemic of swine flu (Spanish flu of 1918-1919, when 230 million people died. Annual influenza epidemics are estimated to affect 5–15% of the global population, resulting in severe illness in 3–5 million patients causing 250,000–500,000 deaths worldwide. Severe illness and deaths occur mainly in the high-risk populations of infants, the elderly and chronically ill patients. The 2009 outbreak of swine flu is thought to be a mutation more specifically a reassortment of four known strains of influenza A virus subtype H1N1; one endemic in humans, one endemic in birds, and two endemic in pigs. WHO officially declared the outbreak to be a pandemic on June 11, 2009, but stressed that the new designation was a result of the global "spread of the virus," not its severity. [Vet World 2009; 2(12.000: 472-474

  2. Outbreak of a New Strain of Flu at a Fair

    Centers for Disease Control (CDC) Podcasts

    2013-02-28

    Dr. Karen Wong, an EIS officer with the Centers for Disease Control and Prevention, discusses her study about flu outbreaks at agricultural fairs.  Created: 2/28/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 3/4/2013.

  3. Preparing for a Pandemic Flu Outbreak

    Science.gov (United States)

    Dittbenner, Richard

    2009-01-01

    This article discusses the things college leaders should know and do in case of a pandemic influenza outbreak. The author talks about four principles that will guide college leaders in developing a pandemic influenza plan and presents the 10 elements of an effective college pandemic planning process.

  4. Avian influenza (bird flu) outbreak news scare and its economic ...

    African Journals Online (AJOL)

    Avian influenza (bird flu) outbreak news scare and its economic implication on poultry enterprises in Adamawa state, Nigeria. MR Ja'afar-Furo, HG Balla, B Yakubu. Abstract. No Abstract. Global Journal of Agricultural Sciences Vol. 6 (1) 2007: pp. 61-68. http://dx.doi.org/10.4314/gjass.v6i1.2302 · AJOL African Journals ...

  5. Use of Protective Gear in Bird Flu Outbreak Response

    Centers for Disease Control (CDC) Podcasts

    2008-12-29

    CDC's Dr. Oliver Morgan discusses how the use of masks and other protective gear impacted whether workers dealing with an outbreak of bird flu in England became sick. The paper is published in the January 2009 issue of CDC’s journal, Emerging Infectious Diseases.  Created: 12/29/2008 by Emerging Infectious Diseases.   Date Released: 12/29/2008.

  6. How Does Seasonal Flu Differ From Pandemic Flu?

    Science.gov (United States)

    ... Past Issues How Does Seasonal Flu Differ From Pandemic Flu? Past Issues / Fall 2006 Table of Contents ... this page please turn Javascript on. Seasonal Flu Pandemic Flu Outbreaks follow predictable seasonal patterns; occurs annually, ...

  7. Flu Facts

    Science.gov (United States)

    ... spread worldwide, they're called pandemics . The H1N1 ("swine flu") outbreak of 2009–2010 was considered a ... for example, diabetes, heart problems, asthma, or other lung problems) Most teens can take acetaminophen or ibuprofen ...

  8. The impact of communications about swine flu (influenza A H1N1v) on public responses to the outbreak: results from 36 national telephone surveys in the UK.

    Science.gov (United States)

    Rubin, G J; Potts, H W W; Michie, S

    2010-07-01

    To assess the association between levels of worry about the possibility of catching swine flu and the volume of media reporting about it; the role of psychological factors in predicting likely uptake of the swine flu vaccine; and the role of media coverage and advertising in predicting other swine flu-related behaviours. Data from a series of random-digit-dial telephone surveys were analysed. A time series analysis tested the association between levels of worry and the volume of media reporting on the start day of each survey. Cross-sectional regression analyses assessed the relationships between likely vaccine uptake or behaviour and predictor variables. Thirty-six surveys were run at, on average, weekly intervals across the UK between 1 May 2009 and 10 January 2010. Five surveys (run between 14 August and 13 September) were used to assess likely vaccine uptake. Five surveys (1-17 May) provided data relating to other behaviours. Between 1047 and 1173 people aged 16 years or over took part in each survey: 5175 participants provided data about their likely uptake of the swine flu vaccine; 5419 participants provided data relating to other behaviours. All participants were asked to state how worried they were about the possibility of personally catching swine flu. Subsets were asked how likely they were to take up a swine flu vaccination if offered it and whether they had recently carried tissues with them, bought sanitising hand gel, avoided using public transport or had been to see a general practitioner, visited a hospital or called NHS Direct for a flu-related reason. The percentage of 'very' or 'fairly' worried participants fluctuated between 9.6% and 32.9%. This figure was associated with the volume of media reporting, even after adjusting for the changing severity of the outbreak [chi2(1) = 6.6, p = 0.010, coefficient for log-transformed data = 2.6]. However, this effect only occurred during the UK's first summer wave of swine flu. In total, 56.1% of

  9. Paradoxical risk perception and behaviours related to Avian Flu outbreak and education campaign, Laos

    Directory of Open Access Journals (Sweden)

    Lorvongseng Somchay

    2010-10-01

    Full Text Available Abstract Background In Laos, small backyard poultry systems predominate (90%. The first lethal human cases of highly pathogenic avian influenza (HPAI occurred in 2007. Few studies have addressed the impact of outbreaks and education campaigns on a smallholder producer system. We evaluated awareness and behaviours related to educational campaigns and the 2007 HPAI outbreaks. Methods During a national 2-stage cross-sectional randomised survey we interviewed 1098 households using a pre-tested questionnaire in five provinces representative of the Southern to Northern strata of Laos. We used multivariate analysis (Stata, version 8; Stata Corporation, College Station, TX, USA to analyse factors affecting recollection of HPAI educational messages, awareness of HPAI, and behaviour change. Results Of the 1098 participants, 303 (27.6% received training on HPAI. The level of awareness was similar to that in 2006. The urban population considered risk to be decreased, yet unsafe behaviours persisted or increased. This contrasted with an increase in awareness and safe behaviour practices in rural areas. Reported behaviour changes in rural areas included higher rates of cessation of poultry consumption and dead poultry burial when compared to 2006. No participants reported poultry deaths to the authorities. Overall, 70% could recall an educational message but the content and accuracy differed widely depending on training exposure. Washing hands and other hygiene advice, messages given during the HPAI educational campaign, were not recalled. Trained persons were able to recall only one message while untrained participants recalled a broader range of messages. Factors associated with an awareness of a threat of AI in Laos were: having received HPAI training, literacy level, access to TV, recent information, living in rural areas. Conclusion We report a paradoxical relationship between unsafe behaviours and risk perception in urban areas, as well as exposure to

  10. Swine Flu -A Comprehensive View

    Science.gov (United States)

    Singh, Vandana; Sood, Meenakshi

    2012-07-01

    The present article is aimed on comprehensive view of Swine flu. It was first isolated from pigs in 1930 in USA. Pandemic caused by H1N1 in 2009 brought it in limelight. Itís a viral respiratory disease caused by viruses that infects pigs, resulting in nasal secretions, barking cough, decreased appetite, and listless behavior. Swine virus consist of eight RNA strands, one strand derived from human flu strains, two from avian (bird) strains, and five from swine strains. Swine flu spreads from infected person to healthy person by inhalation or ingestion of droplets contaminated with virus while sneezing or coughing. Two antiviral agents have been reported to help prevent or reduce the effects of swine flu, flu shot and nasal spray. WHO recommended for pandemic period to prevent its future outbreaks through vaccines or non-vaccines means. Antiviral drugs effective against this virus are Tamiflu and Relenza. Rapid antigen testing (RIDT), DFA testing, viral culture, and molecular testing (RT-PCR) are used for its diagnosis in laboratory

  11. Key Facts about Influenza (Flu) and Flu Vaccine

    Science.gov (United States)

    ... Collection of Respiratory Specimens for Influenza Virus Testing Clinical Signs & Symptoms of Influenza Symptoms & Laboratory Diagnosis Information for ... Submit" /> Archived Flu Emails Influenza Types Seasonal Avian Swine Variant Pandemic Other ... This Page What is Influenza (also called Flu)? Signs and Symptoms of Flu How Flu Spreads Period ...

  12. A Simple Stochastic Model with Environmental Transmission Explains Multi-Year Periodicity in Outbreaks of Avian Flu

    NARCIS (Netherlands)

    Wang, R.H.; Jin, Z.; Liu, Q.X.; van de Koppel, J.; Alonso, D.

    2012-01-01

    Avian influenza virus reveals persistent and recurrent outbreaks in North American wild waterfowl, and exhibits major outbreaks at 2-8 years intervals in duck populations. The standard susceptible-infected-recovered (SIR) framework, which includes seasonal migration and reproduction, but lacks

  13. A simple stochastic model with environmental transmission explains multi-year periodicity in outbreaks of avian flu

    NARCIS (Netherlands)

    Wang, R.H.; Jin, Z.; Liu, Q.X.; Van de Koppel, J.; Alonso, D.

    2012-01-01

    Avian influenza virus reveals persistent and recurrent outbreaks in North American wild waterfowl, and exhibits major outbreaks at 2–8 years intervals in duck populations. The standard susceptible-infected- recovered (SIR) framework, which includes seasonal migration and reproduction, but lacks

  14. Flu Widget

    Science.gov (United States)

    ... What are Flu Antiviral Drugs Antiviral Drug Resistance Mixing Oseltamivir Capsules For Children What to do if ... PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple Quicktime file RealPlayer file Text ...

  15. Diagnosing Flu

    Science.gov (United States)

    ... What are Flu Antiviral Drugs Antiviral Drug Resistance Mixing Oseltamivir Capsules For Children What to do if ... PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple Quicktime file RealPlayer file Text ...

  16. Influenza (Flu)

    Science.gov (United States)

    ... develop influenza. Weakened immune system. Cancer treatments, anti-rejection drugs, corticosteroids and HIV/AIDS can weaken your ... for Disease Control and Prevention recommends annual flu vaccination for everyone over the age of 6 months. ...

  17. Pandemic Flu

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other Pandemic Influenza Language: English (US) Español Recommend on Facebook ... Planning State and Local Government Planning More 1918 Pandemic Flu Commemoration 100 years later, read about the ...

  18. Avian Flu Epidemic 2003: Public health consequences. Executive summary

    NARCIS (Netherlands)

    Bosman A; Mulder YM; Leeuw JRJ de; Meijer A; Du Ry van Beest Holle M; Kamst RA; Velden PG van der; Conyn-van Spaendonck MAE; Koopmans MPG; Ruijten MWMM; Instituut voor Psychotrauma; CIE; MGO; LIS

    2004-01-01

    Executive summary Avian flu epidemic 2003: public health consequences.Risk factors, health, well-being, health care needs and preventive measures during the H7N7 avian flu outbreak control in the Netherlands.An estimated thousand people, possibly more have been infected with avian flu during the

  19. Flu Vaccine Safety Information

    Science.gov (United States)

    ... Types Seasonal Avian Swine Variant Pandemic Other Flu Vaccine Safety Information Questions & Answers Language: English (US) Español ... of flu vaccines monitored? Egg Allergy Are flu vaccines safe? Flu vaccines have good safety record. Hundreds ...

  20. Urgent Care Facilities: Geographic Variation in Utilization and Charges for Common Lab Tests, Office Visits, and Flu Vaccines.

    Science.gov (United States)

    Dang, Jeff; Okurowski, Eric; Gelburd, Robin; Limpahan, Lorraine; Iny, Nicole

    2015-01-01

    The rapid growth of urgent care facilities (UCFs) and other types of convenient care centers has largely been attributed to increasing consumer demand for more convenient and affordable healthcare. UCFs typically treat non-emergency, acute conditions and are increasingly serving as an alternative to "traditional" care settings, such as physician offices and emergency departments (EDs). A study was conducted to characterize geographic variation in both utilization and charges for common lab tests, office visits, and flu vaccines by care settings. Based on claims data from FAIR Health's National Private Insurance Claims (FHNPIC) database, the results suggest that utilization and charge patterns for common procedures vary significantly by care setting across geographic region and over time but the variations are generally small in magnitude. For example, across geographic regions, charges for the flu vaccine are found to be higher when performed in a physician's office in contrast to being performed in a UCF.

  1. Flu (Influenza): Information for Parents

    Science.gov (United States)

    ... No, flu vaccines do not cause flu. Flu vaccine protects your child from flu illness. However, flu shots can sometimes ... will take about 2 weeks after getting his vaccine for your child to build protection against flu. Why does my ...

  2. FluView National Flu Activity Map

    Data.gov (United States)

    U.S. Department of Health & Human Services — The FluView National Flu Activity Map is a complementary widget to the state-by-state flu map widget introduced in the 2007-2008 flu season. This interactive map...

  3. Avian Flu

    International Nuclear Information System (INIS)

    Eckburg, Paul

    2006-01-01

    Since 2003, a severe form of H5N1 avian influenza has rapidly spread throughout Asia and Europe, infecting over 200 humans in 10 countries. The spread of H5N1 virus from person-to-person has been rare, thus preventing the emergence of a widespread pandemic. However, this ongoing epidemic continues to pose an important public health threat. Avian flu and its pandemic potential in humans will be discussed.

  4. 2009 H1N1 Flu Vaccine Facts

    Science.gov (United States)

    ... turn Javascript on. Feature: Flu 2009 H1N1 Flu Vaccine Facts Past Issues / Fall 2009 Table of Contents ... H1N1 flu vaccine. 1 The 2009 H1N1 flu vaccine is safe and well tested. Clinical trials conducted ...

  5. Thimerosal in Flu Vaccine

    Science.gov (United States)

    ... Avian Swine Variant Pandemic Other Thimerosal in Flu Vaccine Questions & Answers Language: English (US) Español Recommend on ... or fungi from contaminating the vaccine. Do flu vaccines contain thimerosal? Flu vaccines in multi-dose vials ...

  6. First Aid: Influenza (Flu)

    Science.gov (United States)

    ... for Educators Search English Español First Aid: The Flu KidsHealth / For Parents / First Aid: The Flu Print ... tiredness What to Do If Your Child Has Flu Symptoms: Call your doctor. Encourage rest. Keep your ...

  7. Comparison of rapid immunofluorescence procedure with TestPack RSV and Directigen FLU-A for diagnosis of respiratory syncytial virus and influenza A virus.

    OpenAIRE

    Todd, S J; Minnich, L; Waner, J L

    1995-01-01

    A rapid immunofluorescence format requiring 20 min for completion was as effective as conventional indirect and direct immunofluorescence procedures for detecting respiratory syncytial virus and influenza A virus antigens in clinical specimens. Rapid immunofluorescence was more sensitive than TestPack RSV and comparable to Directigen FLU-A immunosorbent assays, which require 20 min for completion.

  8. Grid attacks avian flu

    CERN Multimedia

    2006-01-01

    During April, a collaboration of Asian and European laboratories analysed 300,000 possible drug components against the avian flu virus H5N1 using the EGEE Grid infrastructure. Schematic presentation of the avian flu virus.The distribution of the EGEE sites in the world on which the avian flu scan was performed. The goal was to find potential compounds that can inhibit the activities of an enzyme on the surface of the influenza virus, the so-called neuraminidase, subtype N1. Using the Grid to identify the most promising leads for biological tests could speed up the development process for drugs against the influenza virus. Co-ordinated by CERN and funded by the European Commission, the EGEE project (Enabling Grids for E-sciencE) aims to set up a worldwide grid infrastructure for science. The challenge of the in silico drug discovery application is to identify those molecules which can dock on the active sites of the virus in order to inhibit its action. To study the impact of small scale mutations on drug r...

  9. 'Presenting CXR phenotype of H1N1' flu compared with contemporaneous non-H1N1, community acquired pneumonia, during pandemic and post-pandemic outbreaks'.

    Science.gov (United States)

    Minns, F C; Mhuineachain, A Ni; van Beek, E J R; Ritchie, G; Hill, A; Murchison, J T

    2015-09-01

    To review, phenotype and assess potential prognostic value of initial chest X-ray findings in patients with H1N1 influenza during seasonal outbreaks of 2009 and 2010, in comparison with non-H1N1, community acquired pneumonia (CAP). We retrospectively identified 72 patients admitted to hospital with pneumonia during the seasons of 2009 and 2010. H1N1 cases were confirmed by virology PCR. Presenting chest X-rays were jointly read by 2 radiologists, who were 'blinded' to further patient details and divided into 6 zones. Total number of opacified zones, the pattern and distribution of changes and length of hospital stay were recorded. Patients with H1N1 demonstrated more opacified zones (mean of 2.9 compared with 2.0; p=0.006), which were bilateral in two-thirds compared with a quarter of those with non-H1N1 CAP (p=0.001). H1N1 radiographs were more likely to be 'patchy' versus 'confluent' changes of non-H1N1 CAP (p=0.03) and more often demonstrated peripheral distribution (p=0.01). H1N1 patients tended to stay in hospital longer (not significant; p=0.08). A positive correlation existed between number of affected zones and length of inpatient stay, which was statistically significant for the cohorts combined (p=0.02). The findings were the same for the two evaluated seasons. H1N1 patients demonstrated more extensive disease, which was more likely bilateral, 'patchy', and peripheral in distribution. With increasing global cases of H1N1, knowledge of the typical findings of the H1N1 presenting chest X-ray may assist with early triage of patients, particularly where rapid viral testing is not available. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Bat Influenza (Flu)

    Science.gov (United States)

    ... genetic information. Reassortment can sometimes lead to the emergence of new flu viruses capable of infecting humans. Yellow-shouldered ... important for public health because bats represent a new animal species that may act as a source of flu ...

  11. Avian Influenza (Bird Flu)

    Science.gov (United States)

    ... in People Spread of Bird Flu Viruses Between Animals and People Examples of Human Infections with Avian Influenza A ... Subtypes Transmission of Avian Influenza A Viruses Between Animals and People Related Links Research Glossary of Influenza (Flu) Terms ...

  12. Avoiding the Flu

    Science.gov (United States)

    ... on. Feature: Flu Avoiding the Flu Past Issues / Fall 2009 Table of Contents Children from six months of age and young people up to 24 years of age are particularly at risk this year from the 2009 H1N1 flu. They ...

  13. The Flu (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... for Educators Search English Español Flu KidsHealth / For Kids / Flu What's in this article? What's the Flu? ...

  14. Flublok Seasonal Influenza (Flu) Vaccination

    Science.gov (United States)

    ... Vaccine Safety and Pregnant Women Febrile Seizures Following Vaccination Flu Vaccine and People with Egg Allergies Guillain- ... Flu Vaccines Quadrivalent Influenza Vaccine Intradermal Influenza (Flu) Vaccination Fluzone High-Dose Seasonal Influenza Vaccine Cell-Based ...

  15. [Epidemics and pandemics in general practice. What can we learn from the swine flu (H1N1) and EHEC outbreak?].

    Science.gov (United States)

    Eisele, M; Hansen, H; Wagner, H-O; von Leitner, E; Pohontsch, N; Scherer, M

    2014-06-01

    As primary care givers with a coordinating function, general practitioners (GP) play a key role in dealing with epidemics and pandemics. As of yet, there are no studies in Germany describing the difficulties experienced by GPs in patient care during epidemics/pandemics. This study aimed at identifying the problem areas in GPs' patient care during the H1N1 and EHEC (enterohemorrhagic strain of Escherichia coli) outbreaks. With this information, recommendations for guaranteeing proper patient care during future epidemics/pandemics can be derived. In all, 12 qualitative, semi-structured, open guideline interviews with GPs in Hamburg and Lübeck were conducted, transcribed, and evaluated with qualitative content analysis. Five areas in ambulatory patient care were identified in which changes are needed from the primary care perspective: provision of information for GPs, workload, financing of epidemic-related measures, organization of the practices, care of those taken ill. The workload of GPs in particular can and should be reduced through successful, centralized information distribution during epidemics/pandemics. The GP's function as a coordinator should be supported and consolidated, in order to relieve the in-patient sector in cases of an epidemic/pandemic. Secured financing of epidemic-associated measures can help ensure patient care.

  16. "Stomach Flu" (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Educators Search English Español "Stomach Flu" KidsHealth / For Kids / "Stomach Flu" Print Many people talk about the " ...

  17. Spreading Of Avian Flu On Duck And Its Impact On Social Economy: Lesson Learnt From Avian Flu Cases On Chicken

    Directory of Open Access Journals (Sweden)

    Nyak Ilham

    2013-06-01

    Full Text Available Bird flu disease that attacks duck dismissed the notion of duck immune to bird flu disease. Learning from the experience of bird flu disease that attacks poultry in the year of 2004-2005, necessary to measure the spread of disease prevention bird flu in ducks. This paper aims to describe the business and trade patterns of duck associated with the spread of avian influenza and predict the socio-economic impact of bird flu on duck farms in Indonesia. Duck rearing patterns mostly are in the extensive and semi-intensive system, that have large potential disease transmission occured between duck and wild. Illegal trade in the crossborder region and imports from countries that re-export it, ias alo become potential as well as the entry point to the bird flu virus in Indonesia. Ducks trade between regions by land transportation is difficult to control as well becomes the potential media to spread of the virus to a wider area. The economic impact of bird flu on duck business occured due to the death of ducks, decline in production and loss of job opportunities, while that on demand reduction was not significant. Small scale farmers that were bankrupt as a result of bird flu outbreaks may require technical assistance and access to capital for recovery. In the future, development of ducks business should be directed at duck farms into a semi-intensive and intensive system to facilitate the control of epidemic diseases

  18. Mitigation Approaches to Combat the Flu Pandemic

    Science.gov (United States)

    Chawla, Raman; Sharma, Rakesh Kumar; Madaan, Deepali; Dubey, Neha; Arora, Rajesh; Goel, Rajeev; Singh, Shefali; Kaushik, Vinod; Singh, Pankaj Kumar; Chabbra, Vivek; Bhardwaj, Janak Raj

    2009-01-01

    Management of flu pandemic is a perpetual challenge for the medical fraternity since time immemorial. Animal to human transmission has been observed thrice in the last century within an average range of 11-39 years of antigenic recycling. The recent outbreak of influenza A (H1N1, also termed as swine flu), first reported in Mexico on April 26, 2009, occurred in the forty first year since last reported flu pandemic (July 1968). Within less than 50 days, it has assumed pandemic proportions (phase VI) affecting over 76 countries with 163 deaths/35,928 cases (as on 15th June 2009). It indicated the re-emergence of genetically reassorted virus having strains endemic to humans, swine and avian (H5N1). The World Health Organisation (WHO) member states have already pulled up their socks and geared up to combat such criticalities. Earlier outbreaks of avian flu (H5N1) in different countries led WHO to develop pandemic preparedness strategies with national/regional plans on pandemic preparedness. Numerous factors related to climatic conditions, socio-economic strata, governance and sharing of information/logistics at all levels have been considered critical indicators in monitoring the dynamics of escalation towards a pandemic situation. The National Disaster Management Authority (NDMA), Government of India, with the active cooperation of UN agencies and other stakeholders/experts has formulated a concept paper on role of nonhealth service providers during pandemics in April 2008 and released national guidelines - management of biological disasters in July 2008. These guidelines enumerate that the success of medical management endeavors like pharmaceutical (anti-viral Oseltamivir and Zanamivir therapies), nonpharmaceutical interventions and vaccination development etc., largely depends on level of resistance offered by mutagenic viral strain and rationale use of pharmaco therapeutic interventions. This article describes the mitigation approach to combat flu pandemic with its

  19. Building test data from real outbreaks for evaluating detection algorithms.

    Directory of Open Access Journals (Sweden)

    Gaetan Texier

    Full Text Available Benchmarking surveillance systems requires realistic simulations of disease outbreaks. However, obtaining these data in sufficient quantity, with a realistic shape and covering a sufficient range of agents, size and duration, is known to be very difficult. The dataset of outbreak signals generated should reflect the likely distribution of authentic situations faced by the surveillance system, including very unlikely outbreak signals. We propose and evaluate a new approach based on the use of historical outbreak data to simulate tailored outbreak signals. The method relies on a homothetic transformation of the historical distribution followed by resampling processes (Binomial, Inverse Transform Sampling Method-ITSM, Metropolis-Hasting Random Walk, Metropolis-Hasting Independent, Gibbs Sampler, Hybrid Gibbs Sampler. We carried out an analysis to identify the most important input parameters for simulation quality and to evaluate performance for each of the resampling algorithms. Our analysis confirms the influence of the type of algorithm used and simulation parameters (i.e. days, number of cases, outbreak shape, overall scale factor on the results. We show that, regardless of the outbreaks, algorithms and metrics chosen for the evaluation, simulation quality decreased with the increase in the number of days simulated and increased with the number of cases simulated. Simulating outbreaks with fewer cases than days of duration (i.e. overall scale factor less than 1 resulted in an important loss of information during the simulation. We found that Gibbs sampling with a shrinkage procedure provides a good balance between accuracy and data dependency. If dependency is of little importance, binomial and ITSM methods are accurate. Given the constraint of keeping the simulation within a range of plausible epidemiological curves faced by the surveillance system, our study confirms that our approach can be used to generate a large spectrum of outbreak

  20. Influenza (the Flu)

    Science.gov (United States)

    ... About Us News Blog Chapters Facebook Twitter YouTube Instagram Email DONATE Breadcrumb Navigation Home Life With CF ... Flu Season Follow Us On Facebook Twitter YouTube Instagram Email Find Events Near You With more than ...

  1. Viral Gastroenteritis (Stomach Flu)

    Science.gov (United States)

    ... Viral gastroenteritis (stomach flu) Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  2. Fighting the Flu

    Centers for Disease Control (CDC) Podcasts

    2011-03-08

    Wes Studi, Hollywood actor, urges Native peoples to know the facts about the flu.  Created: 3/8/2011 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 3/8/2011.

  3. Flu & You: Preventive Steps

    Science.gov (United States)

    ... What are Flu Antiviral Drugs Antiviral Drug Resistance Mixing Oseltamivir Capsules For Children What to do if ... PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple Quicktime file RealPlayer file Text ...

  4. Flu - Multiple Languages

    Science.gov (United States)

    ... Care for Pandemic Flu - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Influenza - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF ...

  5. Flu Symptoms & Complications

    Science.gov (United States)

    ... in Long-Term Care Facilities Guidance: Use of Mask to Control Influenza Transmission Guidance: Prevention & Control in ... severe illness, and at times can lead to death. The flu is different from a cold. The ...

  6. Vaccination against seasonal flu

    CERN Multimedia

    2015-01-01

    The Medical Service once again recommends you to get your annual flu vaccination for the year.   Vaccination is the most effective way of avoiding the illness and any serious consequences and protecting those around you. The flu can have especially serious consequences for people with chronic conditions (diabetes, cardio-vascular disease, etc.), pregnant women, infants, and people over 65 years of age. Remember, anyone working on the CERN site who wishes to be vaccinated against seasonal flu should go to the Infirmary (Building 57, ground floor) with their vaccine. The Medical Service will issue a prescription on the day of the vaccination for the purposes of reimbursement by UNIQA. NB: The Medical Service cannot provide this vaccination service for family members or retired members of the personnel. For more information: • The "Seasonal flu" flyer by the Medical Service • Recommendations of the Swiss Federal Office of Public...

  7. Swine flu-have we learnt any lesson from the past ? | Yadav | Pan ...

    African Journals Online (AJOL)

    Abstract. The world has suffered the pandemics due to swine flu in the past. The present epidemic in India has claimed many lives. Even, after the first outbreak of swine flu in 2009 no concrete efforts are done to prevent this infection. There is an urgent need to take radical steps to prevent such epidemics. Key words: Swine ...

  8. Ethnic differences in susceptibilities to A(H1N1) flu: An epidemic ...

    African Journals Online (AJOL)

    The current A(H1N1) flu has showed sub-population dependent susceptibility and fatality as early as April and May of 2009 in its first wave of spreading. After the pandemic outbreak spreads globally for more than seven months, the subpopulation dependence of this flu, including ethnicity, age and gender selectivity, has ...

  9. H1N1 Flu & U.S. Schools: Answers to Frequently Asked Questions

    Science.gov (United States)

    US Department of Education, 2009

    2009-01-01

    A severe form of influenza known as H1N1, commonly being called swine flu, has health officials around the world concerned. In the United States, the outbreak of H1N1 has prompted school closures and cancellation of school-related events. As the flu spreads, the Department of Education encourages school leaders, parents and students to know how to…

  10. OpenFluDB, a database for human and animal influenza virus.

    Science.gov (United States)

    Liechti, Robin; Gleizes, Anne; Kuznetsov, Dmitry; Bougueleret, Lydie; Le Mercier, Philippe; Bairoch, Amos; Xenarios, Ioannis

    2010-07-06

    Although research on influenza lasted for more than 100 years, it is still one of the most prominent diseases causing half a million human deaths every year. With the recent observation of new highly pathogenic H5N1 and H7N7 strains, and the appearance of the influenza pandemic caused by the H1N1 swine-like lineage, a collaborative effort to share observations on the evolution of this virus in both animals and humans has been established. The OpenFlu database (OpenFluDB) is a part of this collaborative effort. It contains genomic and protein sequences, as well as epidemiological data from more than 27,000 isolates. The isolate annotations include virus type, host, geographical location and experimentally tested antiviral resistance. Putative enhanced pathogenicity as well as human adaptation propensity are computed from protein sequences. Each virus isolate can be associated with the laboratories that collected, sequenced and submitted it. Several analysis tools including multiple sequence alignment, phylogenetic analysis and sequence similarity maps enable rapid and efficient mining. The contents of OpenFluDB are supplied by direct user submission, as well as by a daily automatic procedure importing data from public repositories. Additionally, a simple mechanism facilitates the export of OpenFluDB records to GenBank. This resource has been successfully used to rapidly and widely distribute the sequences collected during the recent human swine flu outbreak and also as an exchange platform during the vaccine selection procedure. Database URL: http://openflu.vital-it.ch.

  11. Influenza forecasting with Google Flu Trends.

    Science.gov (United States)

    Dugas, Andrea Freyer; Jalalpour, Mehdi; Gel, Yulia; Levin, Scott; Torcaso, Fred; Igusa, Takeru; Rothman, Richard E

    2013-01-01

    We developed a practical influenza forecast model based on real-time, geographically focused, and easy to access data, designed to provide individual medical centers with advanced warning of the expected number of influenza cases, thus allowing for sufficient time to implement interventions. Secondly, we evaluated the effects of incorporating a real-time influenza surveillance system, Google Flu Trends, and meteorological and temporal information on forecast accuracy. Forecast models designed to predict one week in advance were developed from weekly counts of confirmed influenza cases over seven seasons (2004-2011) divided into seven training and out-of-sample verification sets. Forecasting procedures using classical Box-Jenkins, generalized linear models (GLM), and generalized linear autoregressive moving average (GARMA) methods were employed to develop the final model and assess the relative contribution of external variables such as, Google Flu Trends, meteorological data, and temporal information. A GARMA(3,0) forecast model with Negative Binomial distribution integrating Google Flu Trends information provided the most accurate influenza case predictions. The model, on the average, predicts weekly influenza cases during 7 out-of-sample outbreaks within 7 cases for 83% of estimates. Google Flu Trend data was the only source of external information to provide statistically significant forecast improvements over the base model in four of the seven out-of-sample verification sets. Overall, the p-value of adding this external information to the model is 0.0005. The other exogenous variables did not yield a statistically significant improvement in any of the verification sets. Integer-valued autoregression of influenza cases provides a strong base forecast model, which is enhanced by the addition of Google Flu Trends confirming the predictive capabilities of search query based syndromic surveillance. This accessible and flexible forecast model can be used by

  12. Influenza forecasting with Google Flu Trends.

    Directory of Open Access Journals (Sweden)

    Andrea Freyer Dugas

    Full Text Available BACKGROUND: We developed a practical influenza forecast model based on real-time, geographically focused, and easy to access data, designed to provide individual medical centers with advanced warning of the expected number of influenza cases, thus allowing for sufficient time to implement interventions. Secondly, we evaluated the effects of incorporating a real-time influenza surveillance system, Google Flu Trends, and meteorological and temporal information on forecast accuracy. METHODS: Forecast models designed to predict one week in advance were developed from weekly counts of confirmed influenza cases over seven seasons (2004-2011 divided into seven training and out-of-sample verification sets. Forecasting procedures using classical Box-Jenkins, generalized linear models (GLM, and generalized linear autoregressive moving average (GARMA methods were employed to develop the final model and assess the relative contribution of external variables such as, Google Flu Trends, meteorological data, and temporal information. RESULTS: A GARMA(3,0 forecast model with Negative Binomial distribution integrating Google Flu Trends information provided the most accurate influenza case predictions. The model, on the average, predicts weekly influenza cases during 7 out-of-sample outbreaks within 7 cases for 83% of estimates. Google Flu Trend data was the only source of external information to provide statistically significant forecast improvements over the base model in four of the seven out-of-sample verification sets. Overall, the p-value of adding this external information to the model is 0.0005. The other exogenous variables did not yield a statistically significant improvement in any of the verification sets. CONCLUSIONS: Integer-valued autoregression of influenza cases provides a strong base forecast model, which is enhanced by the addition of Google Flu Trends confirming the predictive capabilities of search query based syndromic surveillance. This

  13. Flu Vaccine Safety and Pregnancy

    Science.gov (United States)

    ... Types Seasonal Avian Swine Variant Pandemic Other Flu Vaccine Safety and Pregnancy Questions & Answers Language: English (US) ... allergic conditions. How is the safety of flu vaccines in pregnant women monitored? CDC and FDA conduct ...

  14. Warning Signs: Seasonal Flu

    Centers for Disease Control (CDC) Podcasts

    2010-09-29

    In this podcast, Dr. Joe Bresee describes the main symptoms of seasonal flu and when it is serious enough to seek medical help.  Created: 9/29/2010 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/29/2010.

  15. Take Three: Seasonal Flu

    Centers for Disease Control (CDC) Podcasts

    2010-09-29

    In this podcast, Dr. Joe Bresee describes how to keep from getting seasonal flu and spreading it to others by taking these three steps.  Created: 9/29/2010 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/29/2010.

  16. Colds and the Flu

    Science.gov (United States)

    ... child’s toys, door handles, and bathroom facilities with anti-bacterial disinfectant. This can help stop the spread of germs. The best way to avoid getting the flu is to get the influenza vaccine. You should get the vaccine when it becomes ...

  17. Flu and Holiday Travel

    Centers for Disease Control (CDC) Podcasts

    2010-12-13

    This podcast explains the ways people can stay healthy and avoid the flu when traveling this winter.  Created: 12/13/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 12/13/2010.

  18. Antiviral Drugs: Seasonal Flu

    Centers for Disease Control (CDC) Podcasts

    2010-09-29

    In this podcast, Dr. Joe Bresee explains the nature of antiviral drugs and how they are used for seasonal flu.  Created: 9/29/2010 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/29/2010.

  19. Oseltamivir-Resistant Flu

    Centers for Disease Control (CDC) Podcasts

    2012-04-13

    Dr. Aaron Storms, an Epidemic Intelligence Service (EIS) officer at CDC, discusses his paper about oseltamivir-resistant H1N1flu.  Created: 4/13/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/17/2012.

  20. Surveillance of illness associated with pandemic (H1N1) 2009 virus infection among adults using a global clinical site network approach: the INSIGHT FLU 002 and FLU 003 studies

    DEFF Research Database (Denmark)

    Dwyer, Dominic E; Gerstoft, Jan

    2011-01-01

    , with 1049 enrollments into the FLU 002 outpatient study and 316 into the FLU 003 hospitalization study. These 'in progress' INSIGHT influenza observational studies may act as a model for obtaining epidemiological, clinical and laboratory information in future international disease outbreaks....

  1. Swine Flu: Prevention to Pandemic

    Directory of Open Access Journals (Sweden)

    Preeti Padda

    2015-03-01

    Full Text Available Swine flu, also known as swine influenza, pig influenza, hog flu and pig flu, is a respiratory disease caused by viruses (influenza viruses that infect the respiratory tract of pigs, resulting in nasal secretions, a barking cough, decreased appetite, and listless behaviour. Swine flu produces most of the same symptoms in pigs as human flu produces in people. Mostly people who are closely associated with pigs (for example, pork processors and farmers acquire the infection and similarly pigs get infected occasionally human flu infection. The cross-species infections (swine virus to man; human flu virus to pigs have always been confined to local areas and have not spread across borders in either pigs or humans. Unfortunately, this cross-species situation with influenza viruses has had the potential to change and cause epidemics and pandemics. Most recent pandemic has been reported in 2009,  where "swine flu" strain, first seen in Mexico, was termed as H1N1 as it was mainly infecting people and exhibited two main surface antigens, H1 (hemagglutinin type 1 and N1 (neuraminidase type1. This unique eight RNA strands from novel H1N1 flu have one strand derived from human flu strains, two from avian (bird strains, and five from swine strains. Since then it has been infecting people here and there. 

  2. Recognizing flu-like symptoms from videos.

    Science.gov (United States)

    Thi, Tuan Hue; Wang, Li; Ye, Ning; Zhang, Jian; Maurer-Stroh, Sebastian; Cheng, Li

    2014-09-12

    Vision-based surveillance and monitoring is a potential alternative for early detection of respiratory disease outbreaks in urban areas complementing molecular diagnostics and hospital and doctor visit-based alert systems. Visible actions representing typical flu-like symptoms include sneeze and cough that are associated with changing patterns of hand to head distances, among others. The technical difficulties lie in the high complexity and large variation of those actions as well as numerous similar background actions such as scratching head, cell phone use, eating, drinking and so on. In this paper, we make a first attempt at the challenging problem of recognizing flu-like symptoms from videos. Since there was no related dataset available, we created a new public health dataset for action recognition that includes two major flu-like symptom related actions (sneeze and cough) and a number of background actions. We also developed a suitable novel algorithm by introducing two types of Action Matching Kernels, where both types aim to integrate two aspects of local features, namely the space-time layout and the Bag-of-Words representations. In particular, we show that the Pyramid Match Kernel and Spatial Pyramid Matching are both special cases of our proposed kernels. Besides experimenting on standard testbed, the proposed algorithm is evaluated also on the new sneeze and cough set. Empirically, we observe that our approach achieves competitive performance compared to the state-of-the-arts, while recognition on the new public health dataset is shown to be a non-trivial task even with simple single person unobstructed view. Our sneeze and cough video dataset and newly developed action recognition algorithm is the first of its kind and aims to kick-start the field of action recognition of flu-like symptoms from videos. It will be challenging but necessary in future developments to consider more complex real-life scenario of detecting these actions simultaneously from

  3. Flu season and trehalose

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2018-01-01

    Full Text Available Most of us who are practicing medicine know that we are in a very active flu season. This was brought home to me when last week trying to admit a patient to the hospital from the office. She was a bone marrow transplant patient who had severe diarrhea and dehydration probably secondary to C. difficile. Hospital admissions said the patient had to be sent to the Emergency Room because the hospital was full due to the flu epidemic. Nationwide there has been a dramatic increase in the number of hospitalizations due to influenza over the past week from 13.7 to 22.7 per 100,000 (1. Influenza A(H3N2 has been the most common form of influenza reported this season. These viruses are often linked to more severe illness, especially in children and people age 65 years and older. Fortunately, the CDC also says that the flu cases may be peaking. However, at ...

  4. Development of processes allowing near real-time refinement and validation of triage tools during the early stage of an outbreak in readiness for surge: the FLU-CATs Study.

    Science.gov (United States)

    Venkatesan, Sudhir; Myles, Puja R; McCann, Gerard; Kousoulis, Antonis A; Hashmi, Maimoona; Belatri, Rabah; Boyle, Emma; Barcroft, Alan; van Staa, Tjeerd Pieter; Kirkham, Jamie J; Nguyen Van Tam, Jonathan S; Williams, Timothy J; Semple, Malcolm G

    2015-10-01

    During pandemics of novel influenza and outbreaks of emerging infections, surge in health-care demand can exceed capacity to provide normal standards of care. In such exceptional circumstances, triage tools may aid decisions in identifying people who are most likely to benefit from higher levels of care. Rapid research during the early phase of an outbreak should allow refinement and validation of triage tools so that in the event of surge a valid tool is available. The overarching study aim is to conduct a prospective near real-time analysis of structured clinical assessments of influenza-like illness (ILI) using primary care electronic health records (EHRs) during a pandemic. This abstract summarises the preparatory work, infrastructure development, user testing and proof-of-concept study. (1) In preparation for conducting rapid research in the early phase of a future outbreak, to develop processes that allow near real-time analysis of general practitioner (GP) assessments of people presenting with ILI, management decisions and patient outcomes. (2) As proof of concept: conduct a pilot study evaluating the performance of the triage tools 'Community Assessment Tools' and 'Pandemic Medical Early Warning Score' to predict hospital admission and death in patients presenting with ILI to GPs during inter-pandemic winter seasons. Prospective near real-time analysis of structured clinical assessments and anonymised linkage to data from EHRs. User experience was evaluated by semistructured interviews with participating GPs. Thirty GPs in England, Wales and Scotland, participating in the Clinical Practice Research Datalink. All people presenting with ILI. None. Study outcome is proof of concept through demonstration of data capture and near real-time analysis. Primary patient outcomes were hospital admission within 24 hours and death (all causes) within 30 days of GP assessment. Secondary patient outcomes included GP decision to prescribe antibiotics and/or influenza

  5. Pregnant Women Need a Flu Shot

    Science.gov (United States)

    Pregnant? You Need a Flu Shot! Information for pregnant women Because you are pregnant, CDC and your ob- ... more likely to get severely ill from flu. Pregnant women who get flu are at high risk of ...

  6. Children, the Flu and the Flu Vaccine. Fact Sheet

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2008

    2008-01-01

    Flu is more dangerous than the common cold for children. Each year, flu places a large burden on the health and well-being of children and families. Children commonly need medical care because of influenza, especially before they turn 5 years old. Each year an average of 20,000 children under the age of 5 are hospitalized because of influenza…

  7. The Spanish flu in Denmark

    DEFF Research Database (Denmark)

    Kolte, Ida Viktoria; Skinhøj, Peter; Keiding, Niels

    2008-01-01

    The spread of H5N1 influenza and the similarity between this avian virus and the Spanish flu virus causes fear of a new influenza pandemic, but data from the Spanish flu may also be of guidance in planning for preventive measures. Using data on influenza cases, influenza deaths and total deaths...

  8. The Evaluations of Swine Flu Magnitudes in TV News: A Comparative Analysis of Paired Influenza Pandemics.

    Science.gov (United States)

    Pan, Po-Lin; Meng, Juan

    2015-01-01

    This study examined how major TV news networks covered two flu pandemics in 1976 and 2009 in terms of news frames, mortality exemplars, mortality subject attributes, vaccination, evaluation approaches, and news sources. Results showed that the first pandemic was frequently framed with the medical/scientific and political/legal issues, while the second pandemic was emphasized with the health risk issue in TV news. Both flu pandemics were regularly reported with mortality exemplars, but the focus in the first pandemic was on the flu virus threat and vaccination side effects, while the vaccination shortage was frequently revealed in the second outbreak.

  9. Incentives for Reporting Infectious Disease Outbreaks

    Science.gov (United States)

    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…

  10. STUDY OF FACTORS INFLUENCING EARLY SYMPTOMATIC IMPROVEMENT, RETURN TO NORMOXIA AND RADIOLOGICAL RESOLUTION IN SWINE FLU PATIENTS WITH RESPIRATORY FAILURE IN RICU

    Directory of Open Access Journals (Sweden)

    Vamsidhar Reddy Manne

    2017-05-01

    Full Text Available BACKGROUND Since 2009, swine influenza outbreaks have been recorded virtually every year, although their extent and severity have varied widely. Localised outbreaks are taking place at variable intervals, usually every 1-3 years. The most recent outbreak has been from December 2016 through April 2017. We still are in the midst of one. This study of factors influencing early clinical and radiological improvement and reversion to normoxia in swine flu patients with respiratory failure helps in saving precious lives. MATERIALS AND METHODS This is a cross-sectional study conducted at RICU, Department of Pulmonary Medicine, S.V.R.R. Government General Hospital/S.V. Medical College, Tirupathi, Andhra Pradesh, between January 2017 and April 2017. Study sample was the total number of swine flu patients admitted to the RICU of the Department of Pulmonary Medicine with respiratory failure. RESULTS Out of 42 patients who tested positive for swine flu, 37 had respiratory failure and were immediately admitted in RICU. Oxygen support, oseltamivir and higher antibiotics were immediately started, injectable steroids given where necessary. Comorbidities were meticulously managed. 19 were males and 18 were females. 21 patients (>50% were above 50 years. Cough and breathlessness were present in all patients (100%. At admission, all 37 showed SpO2 <85% and at discharge all of them were normoxic. 18 patients had either multilobar pneumonia or ARDS on CXR, which had resolved by the time of discharge. The shortest duration of stay was 7 days and the longest duration of stay was 11 days. 35 patients were discharged and 2 patients died. CONCLUSION Good oxygenation, starting of oseltamivir on day 1 of admission prevents further complications and hastens recovery. Swine flu patients with normal chest x-ray and no comorbidities can still end up with respiratory failure. Steroids decrease cough and breathlessness, but have no role in hastening recovery. No residual symptoms

  11. Initial psychological responses to Influenza A, H1N1 ("Swine flu"

    Directory of Open Access Journals (Sweden)

    Neto Felix

    2009-10-01

    Full Text Available Abstract Background The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork. We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu" in the six days following the WHO pandemic alert level 5, and regional differences in these responses. Methods 328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180 or Europe (N = 148. Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption Results 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p Conclusion Initial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may reinforce existing anxiety levels. Particular groups (homosexuals, prostitutes, the homeless are perceived as at greater risk, potentially leading to increased prejudice during a pandemic. Europeans underestimated mortality of seasonal flu, and require more information about the protection given by seasonal flu inoculation.

  12. H1N1 influenza (Swine flu)

    Science.gov (United States)

    Swine flu; H1N1 type A influenza ... The H1N1 virus is now considered a regular flu virus. It is one of the three viruses included in the regular (seasonal) flu vaccine . You cannot get H1N1 flu virus from ...

  13. The first announcement about the 1918 "Spanish flu" pandemic in Greece through the writings of the pioneer newspaper "Thessalia" almost a century ago.

    Science.gov (United States)

    Tsoucalas, Gregory; Karachaliou, Fotini; Kalogirou, Vasiliki; Gatos, Giorgos; Mavrogiannaki, Eirini; Antoniou, Antonios; Gatos, Konstantinos

    2015-03-01

    A local pioneer newspaper, "Thessalia", was the first to announce the arrival of "Spanish Flu" in Greece. It was July 19th 1918 when an epidemic outbreak occurred in the city of Patras. Until then, "Thessalia" had dealt in depth with the flu pandemic in the Greek district of Thessaly, informing the readers of the measures taken, as well as the social and economic aspects of the flu.

  14. Public views of the uk media and government reaction to the 2009 swine flu pandemic

    OpenAIRE

    Hilton, Shona; Smith, Emily

    2010-01-01

    Abstract Background The first cases of influenza A/H1N1 (swine flu) were confirmed in the UK on 27th April 2009, after a novel virus first identified in Mexico rapidly evolved into a pandemic. The swine flu outbreak was the first pandemic in more than 40 years and for many, their first encounter with a major influenza outbreak. This study examines public understandings of the pandemic, exploring how people deciphered the threat and perceived they could control the risks. Methods Purposive sam...

  15. Your child and the flu

    Science.gov (United States)

    ... of Wheat. Fruit juices that are diluted by mixing half water and half juice. Do not give ... nose, vomiting, and some wheezing. Although these symptoms sound like symptoms of the flu, the side effects ...

  16. Seasonal Flu and Staph Infection

    Science.gov (United States)

    ... What are Flu Antiviral Drugs Antiviral Drug Resistance Mixing Oseltamivir Capsules For Children What to do if ... PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple Quicktime file RealPlayer file Text ...

  17. Caring for Someone Sick (Flu)

    Science.gov (United States)

    ... What are Flu Antiviral Drugs Antiviral Drug Resistance Mixing Oseltamivir Capsules For Children What to do if ... PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple Quicktime file RealPlayer file Text ...

  18. Pregnant Women and Influenza (Flu)

    Science.gov (United States)

    ... What are Flu Antiviral Drugs Antiviral Drug Resistance Mixing Oseltamivir Capsules For Children What to do if ... PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple Quicktime file RealPlayer file Text ...

  19. FluBreaks: early epidemic detection from Google flu trends.

    Science.gov (United States)

    Pervaiz, Fahad; Pervaiz, Mansoor; Abdur Rehman, Nabeel; Saif, Umar

    2012-10-04

    The Google Flu Trends service was launched in 2008 to track changes in the volume of online search queries related to flu-like symptoms. Over the last few years, the trend data produced by this service has shown a consistent relationship with the actual number of flu reports collected by the US Centers for Disease Control and Prevention (CDC), often identifying increases in flu cases weeks in advance of CDC records. However, contrary to popular belief, Google Flu Trends is not an early epidemic detection system. Instead, it is designed as a baseline indicator of the trend, or changes, in the number of disease cases. To evaluate whether these trends can be used as a basis for an early warning system for epidemics. We present the first detailed algorithmic analysis of how Google Flu Trends can be used as a basis for building a fully automated system for early warning of epidemics in advance of methods used by the CDC. Based on our work, we present a novel early epidemic detection system, called FluBreaks (dritte.org/flubreaks), based on Google Flu Trends data. We compared the accuracy and practicality of three types of algorithms: normal distribution algorithms, Poisson distribution algorithms, and negative binomial distribution algorithms. We explored the relative merits of these methods, and related our findings to changes in Internet penetration and population size for the regions in Google Flu Trends providing data. Across our performance metrics of percentage true-positives (RTP), percentage false-positives (RFP), percentage overlap (OT), and percentage early alarms (EA), Poisson- and negative binomial-based algorithms performed better in all except RFP. Poisson-based algorithms had average values of 99%, 28%, 71%, and 76% for RTP, RFP, OT, and EA, respectively, whereas negative binomial-based algorithms had average values of 97.8%, 17.8%, 60%, and 55% for RTP, RFP, OT, and EA, respectively. Moreover, the EA was also affected by the region's population size

  20. Understanding of and possible strategies to avian influenza outbreak.

    Science.gov (United States)

    Shen, Junkang; Zhang, Andy; Xu, Huifen; Sirois, Pierre; Zhang, Jia; Li, Kai; Xiao, Li

    2013-01-01

    Swine flu and avian flu outbreaks have occurred in recent years in addition to seasonal flu. As mortality rate records are not available at the early stage of an outbreak, two parameters may be useful to assess the viral virulence : 1. the time required for the first domestic case in a newly involved region, and 2. the doubling time of new infected cases. Viral virulence is one of the most important factors in guiding short term and immediate responses. Although routine surveillance and repeated vaccination are useful efforts, some novel strategies that may be relevant to prevent and control the spread of influenza among human beings and domestic animals are discussed.

  1. Stomach Flu: How Long Am I Contagious?

    Science.gov (United States)

    ... long am I contagious if I have the stomach flu? Answers from James M. Steckelberg, M.D. ... more, depending on which virus is causing your stomach flu (gastroenteritis). A number of viruses can cause ...

  2. Planning for avian flu disruptions on global operations: a DMAIC case study.

    Science.gov (United States)

    Kumar, Sameer

    2012-01-01

    The author aims to assess the spread of avian flu, its impact on businesses operating in the USA and overseas, and the measures required for corporate preparedness. Six Sigma DMAIC process is used to analyze avian flu's impact and how an epidemic could affect large US business operations worldwide. Wal-Mart and Dell Computers were chosen as one specializes in retail and the other manufacturing. The study identifies avian flu pandemic risks including failure modes on Wal-Mart and Dell Computers global operations. It reveals the factors that reinforce avian-flu pandemic's negative impact on company global supply chains. It also uncovers factors that balance avian-flu pandemic's impact on their global supply chains. Avian flu and its irregularity affect the research outcomes because its spread could fluctuate based on so many factors that could come into play. Further, the potential cost to manufacturers and other supply chain partners is relatively unknown. As a relatively new phenomenon, quantitative data were not available to determine immediate costs. In this decade, the avian influenza H5N1 virus has killed millions of poultry in Asia, Europe and Africa. This flu strain can infect and kill humans who come into contact with this virus. An avian influenza H5N1 outbreak could lead to a devastating effect on global food supply, business services and business operations. The study provides guidance on what global business operation managers can do to prepare for such events, as well as how avian flu progression to a pandemic can disrupt such operations. This study raises awareness about avian flu's impact on businesses and humans and also highlights the need to create contingency plans for corporate preparedness to avoid incurring losses.

  3. Swine Influenza (Swine Flu) in Pigs

    Science.gov (United States)

    ... Avian Swine Variant Pandemic Other Key Facts about Swine Influenza (Swine Flu) in Pigs Language: English (US) Español Recommend on Facebook Tweet ... visit the CDC seasonal flu website . What is Swine Influenza? Swine Influenza (swine flu) is a respiratory ...

  4. Optimistic bias about H1N1 flu: testing the links between risk communication, optimistic bias, and self-protection behavior.

    Science.gov (United States)

    Cho, Hichang; Lee, Jae-Shin; Lee, Seungjo

    2013-01-01

    Using two-wave panel survey data (N = 348) collected in South Korea in the context of H1N1 flu, we explored several important aspects of optimistic bias that have been relatively unexplored in previous research, including: (a) the extent to which risk communication and indirect risk experience affect changes in optimistic bias over time; (b) the utility of the concept of optimistic bias to predict subsequent risk behavior; and (c) how optimistic bias moderates the effect of risk communication and indirect risk experience on self-protection behavior. The findings revealed that optimistic bias is rather enduring and resilient, as it changed only under one condition (high indirect risk experience combined with low interpersonal communication). Optimistic bias had a nonsignificant association with self-protection behavior, but played an important moderating role by reducing the effect of interpersonal communication on self-protection behavior.

  5. Using Google Flu Trends data in forecasting influenza-like-illness related ED visits in Omaha, Nebraska.

    Science.gov (United States)

    Araz, Ozgur M; Bentley, Dan; Muelleman, Robert L

    2014-09-01

    Emergency department (ED) visits increase during the influenza seasons. It is essential to identify statistically significant correlates in order to develop an accurate forecasting model for ED visits. Forecasting influenza-like-illness (ILI)-related ED visits can significantly help in developing robust resource management strategies at the EDs. We first performed correlation analyses to understand temporal correlations between several predictors of ILI-related ED visits. We used the data available for Douglas County, the biggest county in Nebraska, for Omaha, the biggest city in the state, and for a major hospital in Omaha. The data set included total and positive influenza test results from the hospital (ie, Antigen rapid (Ag) and Respiratory Syncytial Virus Infection (RSV) tests); an Internet-based influenza surveillance system data, that is, Google Flu Trends, for both Nebraska and Omaha; total ED visits in Douglas County attributable to ILI; and ILI surveillance network data for Douglas County and Nebraska as the predictors and data for the hospital's ILI-related ED visits as the dependent variable. We used Seasonal Autoregressive Integrated Moving Average and Holt Winters methods with3 linear regression models to forecast ILI-related ED visits at the hospital and evaluated model performances by comparing the root means square errors (RMSEs). Because of strong positive correlations with ILI-related ED visits between 2008 and 2012, we validated the use of Google Flu Trends data as a predictor in an ED influenza surveillance tool. Of the 5 forecasting models we have tested, linear regression models performed significantly better when Google Flu Trends data were included as a predictor. Regression models including Google Flu Trends data as a predictor variable have lower RMSE, and the lowest is achieved when all other variables are also included in the model in our forecasting experiments for the first 5 weeks of 2013 (with RMSE = 57.61). Google Flu Trends data

  6. Alkaline peptone water enrichment with a dipstick test to quickly detect and monitor cholera outbreaks.

    Science.gov (United States)

    Bwire, Godfrey; Orach, Christopher Garimoi; Abdallah, Dauda; Debes, Amanda Kay; Kagirita, Atek; Ram, Malathi; Sack, David A

    2017-11-21

    Detection, confirmation and monitoring of cholera outbreaks in many developing countries including Uganda is a big challenge due to lack of the required resources and the time the test takes. Culture method which takes 24-48 h to get the feedback and requires highly skilled laboratory staff plus other complex resources is the standard test. This study evaluated the new cholera rapid detection method that relies on Crystal VC dipsticks after enrichment with alkaline peptone water (APW) against the culture method for monitoring the progress of cholera outbreaks in rural setting. We conducted the study between March and June 2015. Fresh stool samples and rectal swabs were incubated in 1% APW for 6 h at room temperature before testing with RDT following the manufacturer's instruction. The same stool sample was cultured to isolate V. cholerae in the standard manner. We also reviewed patient registers to epidemiologically describe the cholera epidemic. We tested stool from 102 consenting suspected cholera patients reporting during daytime at Bwera Hospital (n = 69), Kilembe Mines Hospital (n = 4) and Kinyabwama Health Centre (n = 29). Ninety one (91) samples were positive and nine samples were negative according to both methods. One (1) sample was positive only by dipstick and one sample was positive only by culture (sensitivity of 99%, specificity of 90%, Positive Predictive Value of 99% and Negative Predictive Value of 90%). Overall, 146 suspected cholera cases and two deaths, (case fatality rate of 1.36%) were recorded during the study period. Among the cases aged 1-9 years, 63% (50/79) were males while in those aged 20-49 years, 76% (34/45) were females. Our findings showed that the modified dipstick test after enrichment with 1% APW had high level of accuracy in detection of V. cholerae and is quick, affordable alternative cholera outbreak monitoring tool in resource constrained settings. However, culture method should remain for cholera epidemic

  7. Alkaline peptone water enrichment with a dipstick test to quickly detect and monitor cholera outbreaks

    Directory of Open Access Journals (Sweden)

    Godfrey Bwire

    2017-11-01

    Full Text Available Abstract Background Detection, confirmation and monitoring of cholera outbreaks in many developing countries including Uganda is a big challenge due to lack of the required resources and the time the test takes. Culture method which takes 24–48 h to get the feedback and requires highly skilled laboratory staff plus other complex resources is the standard test. This study evaluated the new cholera rapid detection method that relies on Crystal VC dipsticks after enrichment with alkaline peptone water (APW against the culture method for monitoring the progress of cholera outbreaks in rural setting. Methods We conducted the study between March and June 2015. Fresh stool samples and rectal swabs were incubated in 1% APW for 6 h at room temperature before testing with RDT following the manufacturer’s instruction. The same stool sample was cultured to isolate V. cholerae in the standard manner. We also reviewed patient registers to epidemiologically describe the cholera epidemic. Results We tested stool from 102 consenting suspected cholera patients reporting during daytime at Bwera Hospital (n = 69, Kilembe Mines Hospital (n = 4 and Kinyabwama Health Centre (n = 29. Ninety one (91 samples were positive and nine samples were negative according to both methods. One (1 sample was positive only by dipstick and one sample was positive only by culture (sensitivity of 99%, specificity of 90%, Positive Predictive Value of 99% and Negative Predictive Value of 90%. Overall, 146 suspected cholera cases and two deaths, (case fatality rate of 1.36% were recorded during the study period. Among the cases aged 1–9 years, 63% (50/79 were males while in those aged 20–49 years, 76% (34/45 were females. Conclusions Our findings showed that the modified dipstick test after enrichment with 1% APW had high level of accuracy in detection of V. cholerae and is quick, affordable alternative cholera outbreak monitoring tool in resource constrained

  8. Public views of the uk media and government reaction to the 2009 swine flu pandemic

    Directory of Open Access Journals (Sweden)

    Smith Emily

    2010-11-01

    Full Text Available Abstract Background The first cases of influenza A/H1N1 (swine flu were confirmed in the UK on 27th April 2009, after a novel virus first identified in Mexico rapidly evolved into a pandemic. The swine flu outbreak was the first pandemic in more than 40 years and for many, their first encounter with a major influenza outbreak. This study examines public understandings of the pandemic, exploring how people deciphered the threat and perceived they could control the risks. Methods Purposive sampling was used to recruit seventy three people (61 women and 12 men to take part in 14 focus group discussions around the time of the second wave in swine flu cases. Results These discussions showed that there was little evidence of the public over-reacting, that people believed the threat of contracting swine flu was inevitable, and that they assessed their own self-efficacy for protecting against it to be low. Respondents assessed a greater risk to their health from the vaccine than from the disease. Such findings could have led to apathy about following the UK Governments recommended health protective behaviours, and a sub-optimal level of vaccine uptake. More generally, people were confused about the difference between seasonal influenza and swine flu and their vaccines. Conclusions This research suggests a gap in public understandings which could hinder attempts to communicate about novel flu viruses in the future. There was general support for the government's handling of the pandemic, although its public awareness campaign was deemed ineffectual as few people changed their current hand hygiene practices. There was less support for the media who were deemed to have over-reported the swine flu pandemic.

  9. Public views of the UK media and government reaction to the 2009 swine flu pandemic.

    Science.gov (United States)

    Hilton, Shona; Smith, Emily

    2010-11-15

    The first cases of influenza A/H1N1 (swine flu) were confirmed in the UK on 27th April 2009, after a novel virus first identified in Mexico rapidly evolved into a pandemic. The swine flu outbreak was the first pandemic in more than 40 years and for many, their first encounter with a major influenza outbreak. This study examines public understandings of the pandemic, exploring how people deciphered the threat and perceived they could control the risks. Purposive sampling was used to recruit seventy three people (61 women and 12 men) to take part in 14 focus group discussions around the time of the second wave in swine flu cases. These discussions showed that there was little evidence of the public over-reacting, that people believed the threat of contracting swine flu was inevitable, and that they assessed their own self-efficacy for protecting against it to be low. Respondents assessed a greater risk to their health from the vaccine than from the disease. Such findings could have led to apathy about following the UK Governments recommended health protective behaviours, and a sub-optimal level of vaccine uptake. More generally, people were confused about the difference between seasonal influenza and swine flu and their vaccines. This research suggests a gap in public understandings which could hinder attempts to communicate about novel flu viruses in the future. There was general support for the government's handling of the pandemic, although its public awareness campaign was deemed ineffectual as few people changed their current hand hygiene practices. There was less support for the media who were deemed to have over-reported the swine flu pandemic.

  10. Application of Humidity Data for Predictions of Influenza Outbreaks.

    Science.gov (United States)

    Teixeira, J.; Thrastarson, H. T.; Yeo, E.

    2016-12-01

    Seasonal influenza outbreaks infect millions of people, cause hundreds of thousands of deaths worldwide, and leave an immense economic footprint. Potential forecasting of the timing and intensity of these outbreaks can help mitigation and response efforts (e.g., the management and organization of vaccines, drugs and other resources). Absolute (or specific) humidity has been identified as an important driver of the seasonal behavior of influenza outbreaks in temperate regions. Building upon this result, we incorporate humidity data from both NASA's AIRS (Atmospheric Infra-Red Sounder) instrument and ERA-Interim re-analysis into a SIRS (Susceptible-Infectious-Recovered-Susceptible) type numerical epidemiological model, comprising a prediction system for influenza outbreaks. Data for influenza activity is obtained from sources such as Google Flu Trends and the CDC (Center for Disease Control) and used for comparison and assimilation. The accuracy and limitations of the prediction system are tested with hindcasts of outbreaks in the United States for the years 2005-2015. Our results give support to the hypothesis that local weather conditions drive the seasonality of influenza in temperate regions. The implementation of influenza forecasts that make use of NCEP humidity forecasts is also discussed.

  11. Using EGEE against avian flu

    CERN Multimedia

    2006-01-01

    During April 2006 avian flu was spreading across the world with the potential of turning into a pandemic, a drug to treat the deadly H5N1 strain was needed. Such a task required the huge processing power provided by EGEE, which analysed 300 000 possible drug components for their suitability. This map shows the network of computer centres and their activity during this time.

  12. Specificity tests of an oligonucleotide probe against food-outbreak salmonella for biosensor detection

    Science.gov (United States)

    Chen, I.-H.; Horikawa, S.; Xi, J.; Wikle, H. C.; Barbaree, J. M.; Chin, B. A.

    2017-05-01

    Phage based magneto-elastic (ME) biosensors have been shown to be able to rapidly detect Salmonella in various food systems to serve food pathogen monitoring purposes. In this ME biosensor platform, the free-standing strip-shaped magneto-elastic sensor is the transducer and the phage probe that recognizes Salmonella in food serves as the bio-recognition element. According to Sorokulova et al. at 2005, a developed oligonucleotide probe E2 was reported to have high specificity to Salmonella enterica Typhimurium. In the report, the specificity tests were focused in most of Enterobacterace groups outside of Salmonella family. Here, to understand the specificity of phage E2 to different Salmonella enterica serotypes within Salmonella Family, we further tested the specificity of the phage probe to thirty-two Salmonella serotypes that were present in the major foodborne outbreaks during the past ten years (according to Centers for Disease Control and Prevention). The tests were conducted through an Enzyme linked Immunosorbent Assay (ELISA) format. This assay can mimic probe immobilized conditions on the magnetoelastic biosensor platform and also enable to study the binding specificity of oligonucleotide probes toward different Salmonella while avoiding phage/ sensor lot variations. Test results confirmed that this oligonucleotide probe E2 was high specific to Salmonella Typhimurium cells but showed cross reactivity to Salmonella Tennessee and four other serotypes among the thirty-two tested Salmonella serotypes.

  13. Initial psychological responses to Influenza A, H1N1 ("Swine flu").

    Science.gov (United States)

    Goodwin, Robin; Haque, Shamsul; Neto, Felix; Myers, Lynn B

    2009-10-06

    The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu) in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork). We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu") in the six days following the WHO pandemic alert level 5, and regional differences in these responses. 328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180) or Europe (N = 148). Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p public transport use (48% Malaysia, 22% Europe, p Malaysia, 17% Europe, p Malaysia, 7% Europe), 41% Malaysia (15% Europe) intended to do so (p < .001). 63% of Europeans, 19% of Malaysians had discussed the pandemic with friends (p < .001). Groups seen as at 'high risk' of infection included the immune compromised (mentioned by 87% respondents), pig farmers (70%), elderly (57%), prostitutes/highly sexually active (53%), and the homeless (53%). In data collected only in Europe, 64% greatly underestimated the mortality rates of seasonal flu, 26% believed seasonal flu vaccination gave protection against swine flu. 7% had reduced/stopped eating pork. 3% had purchased anti-viral drugs for use at home, while 32% intended to do so if the pandemic worsened. Initial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may

  14. Of gastro and the gold standard: evaluation and policy implications of norovirus test performance for outbreak detection

    Directory of Open Access Journals (Sweden)

    Fisman David N

    2009-03-01

    Full Text Available Abstract Background The norovirus group (NVG of caliciviruses are the etiological agents of most institutional outbreaks of gastroenteritis in North America and Europe. Identification of NVG is complicated by the non-culturable nature of this virus, and the absence of a diagnostic gold standard makes traditional evaluation of test characteristics problematic. Methods We evaluated 189 specimens derived from 440 acute gastroenteritis outbreaks investigated in Ontario in 2006–07. Parallel testing for NVG was performed with real-time reverse-transcriptase polymerase chain reaction (RT2-PCR, enzyme immunoassay (EIA and electron microscopy (EM. Test characteristics (sensitivity and specificity were estimated using latent class models and composite reference standard methods. The practical implications of test characteristics were evaluated using binomial probability models. Results Latent class modelling estimated sensitivities of RT2-PCR, EIA, and EM as 100%, 86%, and 17% respectively; specificities were 84%, 92%, and 100%; estimates obtained using a composite reference standard were similar. If all specimens contained norovirus, RT2-PCR or EIA would be associated with > 99.9% likelihood of at least one test being positive after three specimens tested. Testing of more than 5 true negative specimens with RT2-PCR would be associated with a greater than 50% likelihood of a false positive test. Conclusion Our findings support the characterization of EM as lacking sensitivity for NVG outbreaks. The high sensitivity of RT2-PCR and EIA permit identification of NVG outbreaks with testing of limited numbers of clinical specimens. Given risks of false positive test results, it is reasonable to limit the number of specimens tested when RT2-PCR or EIA are available.

  15. The impact of the bird flu on public willingness to pay for the protection of migratory birds

    NARCIS (Netherlands)

    Brouwer, R.; van Beukering, P.J.H.; Sultanian, E.

    2008-01-01

    In this paper, we present the results of a unique time series analysis of contingent values and models for migratory bird protection based on an identical contingent valuation (CV) survey carried out over a three year time period since the first bird flu outbreak in 2003. Although there exists no

  16. Impact of the Yosemite hantavirus outbreak on hantavirus antibody testing at a national reference laboratory.

    Science.gov (United States)

    Prince, Harry E; Lieberman, Jay M

    2013-08-01

    In conjunction with the 2012 Yosemite hantavirus outbreak, the number of sera our facility tested for hantavirus antibodies increased. We tracked test results and used the data set to determine if a more efficient testing algorithm was possible. Sera were screened using laboratory-developed pan-hantavirus IgG and IgM enzyme immunoassays (EIAs), with an index of >1.10 defined as positive. Sera that were IgM positive by screening (screen IgM(+)) were tested for Sin Nombre virus (SNV)-specific IgM using a laboratory-developed EIA; screen IgM(+) IgG(+) sera were also tested for SNV IgG using a laboratory-developed immunoblot assay. SNV antibody-positive samples were sent to state public health laboratories (PHL) or the CDC for confirmation. Of 3,946 sera tested from July through December 2012, 205 were screen IgM(+) IgG negative (IgG(-)); 7/205 were SNV IgM(+), but only 1/5 sent to PHL/CDC was confirmed as SNV IgM(+). Of 61 screen IgM(+) IgG(+) sera, 16 were SNV antibody positive; 13/16 sera (from 11 patients) went to PHL/CDC, where SNV infection was confirmed for all patients. Of 12 confirmed patients, 7 had been exposed at Yosemite. A modified algorithm defining screen indices of ≥2.00 as positive identified 11/12 confirmed cases while reducing the number of sera requiring SNV-specific antibody testing by 65%; the patient missed was not tested until 3 months after the onset of symptoms. Hantavirus antibody testing at our facility identified 12 SNV-infected patients, including 7 exposed at Yosemite. Some screen IgM(+) IgG(-) SNV IgM(+) results were false positives, emphasizing the value of PHL/CDC confirmatory testing. We identified a modified algorithm requiring analysis of fewer specimens for SNV-specific antibodies without loss of sensitivity.

  17. The use of a Psoroptes ovis serodiagnostic test for the analysis of a natural outbreak of sheep scab

    Directory of Open Access Journals (Sweden)

    Burgess Stewart TG

    2012-01-01

    Full Text Available Abstract Background Sheep scab is a highly contagious disease of sheep caused by the ectoparasitic mite Psoroptes ovis. The disease is endemic in the UK and has significant economic impact through its effects on performance and welfare. Diagnosis of sheep scab is achieved through observation of clinical signs e.g. itching, pruritis and wool loss and ultimately through the detection of mites in skin scrapings. Early stages of infestation are often difficult to diagnose and sub-clinical animals can be a major factor in disease spread. The development of a diagnostic assay would enable farmers and veterinarians to detect disease at an early stage, reducing the risk of developing clinical disease and limiting spread. Methods Serum samples were obtained from an outbreak of sheep scab within an experimental flock (n = 480 (3 samples each from 160 sheep allowing the assessment, by ELISA of sheep scab specific antibody prior to infestation, mid-outbreak (combined with clinical assessment and post-treatment. Results Analysis of pre-infestation samples demonstrated low levels of potential false positives (3.8%. Of the 27 animals with clinical or behavioural signs of disease 25 tested positive at the mid-outbreak sampling period, however, the remaining 2 sheep tested positive at the subsequent sampling period. Clinical assessment revealed the absence of clinical or behavioural signs of disease in 132 sheep, whilst analysis of mid-outbreak samples showed that 105 of these clinically negative animals were serologically positive, representing potential sub-clinical infestations. Conclusions This study demonstrates that this ELISA test can effectively diagnose sheep scab in a natural outbreak of disease, and more importantly, highlights its ability to detect sub-clinically infested animals. This ELISA, employing a single recombinant antigen, represents a major step forward in the diagnosis of sheep scab and may prove to be critical in any future control

  18. Swine Flu and The Effect of Compulsory Class Attendance on Academic Performance

    OpenAIRE

    Goulas, Sofoklis; Megalokonomou, Rigissa

    2016-01-01

    We use a natural experiment that relaxed class attendance requirements for one school year to explore students' marginal propensity to skip class, and to examine the effects of their absences on scholastic outcomes. We exploit exogenous variation resulting from a one-time policy Greece implemented allowing high school students to miss 30 percent more class hours without penalty during the 2009-10 academic year, a period when officials feared outbreaks of swine flu. Using a new dataset, we ana...

  19. Flu

    Science.gov (United States)

    ... treating influenza in healthy adults and children. Cochrane Database Syst Rev . 2014;(4):CD008965. PMID: 24718923 www. ... member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www. ...

  20. Use of a Rapid Test for Diagnosis of Dengue during Suspected Dengue Outbreaks in Resource-Limited Regions.

    Science.gov (United States)

    Hunsperger, Elizabeth A; Sharp, Tyler M; Lalita, Paul; Tikomaidraubuta, Kini; Cardoso, Yolanda Rebello; Naivalu, Taina; Khan, Aalisha Sahu; Marfel, Maria; Hancock, W Thane; Tomashek, Kay M; Margolis, Harold S

    2016-08-01

    Dengue is major public health problem, globally. Timely verification of suspected dengue outbreaks allows for public health response, leading to the initiation of appropriate clinical care. Because the clinical presentation of dengue is nonspecific, dengue diagnosis would benefit from a sensitive rapid diagnostic test (RDT). We evaluated the diagnostic performance of an RDT that detects dengue virus (DENV) nonstructural protein 1 (NS1) and anti-DENV IgM during suspected acute febrile illness (AFI) outbreaks in four countries. Real-time reverse transcription-PCR and anti-DENV IgM enzyme-linked immunosorbent assay were used to verify RDT results. Anti-DENV IgM RDT sensitivity and specificity ranged from 55.3 to 91.7% and 85.3 to 98.5%, respectively, and NS1 sensitivity and specificity ranged from 49.7 to 92.9% and 22.2 to 89.0%, respectively. Sensitivity varied by timing of specimen collection and DENV serotype. Combined test results moderately improved the sensitivity. The use of RDTs identified dengue as the cause of AFI outbreaks where reference diagnostic testing was limited or unavailable. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  1. Attitudes of the medical students from two Czech universities to pandemic flu A (H1N1) 2009 and to influenza vaccination.

    Science.gov (United States)

    Tomáskov, Hana; Bohácová, Sylva; Slachtová, Hana

    2012-09-01

    The aim of the study was to find out the approach of students to vaccination against seasonal influenza, how they perceived risk associated with influenza pandemic, and whether the pandemic influenced their approach to vaccination against seasonal flu. Data collection was conducted through an anonymous questionnaire survey. Distribution and collection of questionnaires took place from November to December 2010 at the medical faculties of two universities. Out of the total 360 distributed questionnaires, 343 were filled. The qualitative data were analysed using chi2 test and Fisher's exact test. The analysis of variance (ANOVA) and two-sample t-test were used for the evaluation of quantitative data. Statistical tests were performed at a significance level of 5% in STATA 10. The proportion of students regularly vaccinated against seasonal flu was low (4%). Students rated the risk of pandemic influenza A (H1N1) in 2009 as relatively low and an interest in vaccination did not increase even during the pandemic and consequently only 5% expressed their interest to get vaccinated during the pandemic. However, only 3% of respondents were vaccinated at the time of vaccine availability. In the following year, only 5% of respondents planned to get vaccinated against seasonal influenza. The results of the questionnaire study indicate that young people have not perceived vaccination against influenza as an important anti-epidemic measure and their opinion have not changed even during the outbreak of pandemic influenza A (H1N1) in 2009.

  2. HIV/AIDS and the Flu

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other HIV/AIDS and the Flu Questions & Answers Language: English ( ... people with HIV and AIDS. Should people with HIV/AIDS receive the inactivated influenza vaccine? People with ...

  3. Red state, blue state, flu state: media self-selection and partisan gaps in Swine flu vaccinations.

    Science.gov (United States)

    Baum, Matthew A

    2011-12-01

    This study assesses the relationship between political partisanship and attitudes and behavior with respect to the H1N1 virus (swine flu) crisis of 2009 in general, and the U.S. mass vaccination program in particular. I argue that even seemingly nonpartisan political issues like public health are increasingly characterized by partisan polarization in public attitudes and that such polarization is attributable, at least partly, to the breakdown of the information commons that characterized the U.S. mass media from roughly the 1950s until the early 1990s. In its place has arisen an increasingly fragmented and niche-oriented media marketplace in which individuals are better able to limit their information exposure to attitudes and opinions that reinforce, rather than challenge, their preexisting beliefs. I test my argument against a variety of data sources, including opinion surveys and state-level swine flu vaccination rate data.

  4. The neuropsychiatric aspects of influenza/swine flu: A selective review.

    Science.gov (United States)

    Manjunatha, Narayana; Math, Suresh Bada; Kulkarni, Girish Baburao; Chaturvedi, Santosh Kumar

    2011-07-01

    The world witnessed the influenza virus during the seasonal epidemics and pandemics. The current strain of H1N1 (swine flu) pandemic is believed to be the legacy of the influenza pandemic (1918-19). The influenza virus has been implicated in many neuropsychiatric disorders. In view of the recent pandemic, it would be interesting to review the neuropsychiatric aspects of influenza, specifically swine flu. Author used popular search engine 'PUBMED' to search for published articles with different MeSH terms using Boolean operator (AND). Among these, a selective review of the published literature was done. Acute manifestations of swine flu varied from behavioral changes, fear of misdiagnosis during outbreak, neurological features like seizures, encephalopathy, encephalitis, transverse myelitis, aseptic meningitis, multiple sclerosis, and Guillian-Barre Syndrome. Among the chronic manifestations, schizophrenia, Parkinson's disease, mood disorder, dementia, and mental retardation have been hypothesized. Further research is required to understand the etiological hypothesis of the chronic manifestations of influenza. The author urges neuroscientists around the world to make use of the current swine flu pandemic as an opportunity for further research.

  5. The neuropsychiatric aspects of influenza/swine flu: A selective review

    Directory of Open Access Journals (Sweden)

    Narayana Manjunatha

    2011-01-01

    Full Text Available The world witnessed the influenza virus during the seasonal epidemics and pandemics. The current strain of H1N1 (swine flu pandemic is believed to be the legacy of the influenza pandemic (1918-19. The influenza virus has been implicated in many neuropsychiatric disorders. In view of the recent pandemic, it would be interesting to review the neuropsychiatric aspects of influenza, specifically swine flu. Author used popular search engine ′PUBMED′ to search for published articles with different MeSH terms using Boolean operator (AND. Among these, a selective review of the published literature was done. Acute manifestations of swine flu varied from behavioral changes, fear of misdiagnosis during outbreak, neurological features like seizures, encephalopathy, encephalitis, transverse myelitis, aseptic meningitis, multiple sclerosis, and Guillian-Barre Syndrome. Among the chronic manifestations, schizophrenia, Parkinson′s disease, mood disorder, dementia, and mental retardation have been hypothesized. Further research is required to understand the etiological hypothesis of the chronic manifestations of influenza. The author urges neuroscientists around the world to make use of the current swine flu pandemic as an opportunity for further research.

  6. Characteristics of diagnostic tests used in the 2002 low-pathogenicity avian influenza H7N2 outbreak in Virginia.

    Science.gov (United States)

    Elvinger, François; Akey, Bruce L; Senne, Dennis A; Pierson, F William; Porter-Spalding, Barbara A; Spackman, Erica; Suarez, David L

    2007-07-01

    An outbreak of low-pathogenicity avian influenza (LPAI) H7N2 occurred in 2002 in the Shenandoah Valley, a high-density poultry production region in Virginia. Infected flocks were identified through a combination of observation of clinical signs and laboratory diagnostic tests designed to detect avian influenza (AI) antibodies, virus, or H7-specific RNA. In this report, fitness for purpose of 3 virus/RNA detection assays used during the outbreak was examined: 1) antigen capture enzyme immunoassay (AC-EIA), 2) real-time reverse transcription polymerase chain reaction (RRT-PCR), and 3) virus isolation (VI). Results from testing 762 turkey and 2,216 chicken tracheal swab pooled specimens were analyzed to determine diagnostic sensitivities and specificities of these tests under field conditions using Bayesian techniques for validation of diagnostic tests in the absence of a "gold standard." Diagnostic sensitivities (with 95% probability intervals) in turkeys of AC-EIA and RRT-PCR, in reference to VI, were 65.9 (50.6; 81.3)% and 85.1 (71.9; 95.7)% and of VI 92.9 (78.0; 98.8)% in reference to AC-EIA or 88.7 (76.0; 97.2)% in reference to RRT-PCR; in chickens, diagnostic sensitivities were 75.1 (45.6; 94.2)%, 86.3 (65.9; 97.1)%, and 86.2 (65.8; 97.1)% or 86.3 (66.4; 97.2)%, respectively. Specificities were 99.1 (97.9; 99.8)%, 98.9 (98.0; 99.5)%, and 98.6 (97.4; 99.4)% or 98.8 (97.8; 99.5)% in turkeys and between 99.25% and 99.27% with probability intervals of approximately +/-0.4% for all tests in chickens. Simultaneous use of AC-EIA and RRT-PCR contributed significantly to the rapid control of the outbreak, but the AI RRT-PCR assay with >85% sensitivity and approximately 99% specificity, combined with relatively low cost and fast turnaround, could be used as the sole diagnostic test in outbreaks of LPAI.

  7. Randomised active programs on healthcare workers' flu vaccination in geriatric health care settings in France: the VESTA study.

    Science.gov (United States)

    Rothan-Tondeur, M; Filali-Zegzouti, Y; Golmard, J-L; De Wazieres, B; Piette, F; Carrat, F; Lejeune, B; Gavazzi, G

    2011-02-01

    Because of a lack of efficacy of influenza vaccination in elderly population, there are still numerous outbreaks in geriatric health care settings. The health care workers (HCW) flu vaccination is known to get herd immunity and decrease the impact of influenza in elderly population living in geriatric health care settings. However, the rates of vaccinated HCWs are still low in France. The French Geriatric Infection Risk Institute (ORIG) performed the VESTA study, a three-phase multicentre to identify factors limiting vaccination in HCWs, and to develop and implement active programs promoting HCWs influenza vaccination. To implement multicenter programs to enhance HCW influenza vaccination. It was a cluster randomised interventional studies. 43 geriatric health care settings (GHCSs), long term care and rehabilitation care settings in France. 1814 Health care workers from 20 GHCSs in the interventional group and 2,435 health care workers in 23 GHCSs in the control group. After the failure of a first educational program giving scientific information and. tested during the 2005-06 flu season in 43 HCSs, a second program was designed with the help of marketing experts, one year after Program 1. The objectives were to involve HCWs in the creation of "safety zones", and to give personal satisfaction. Program 2 was tested during the 2006-07 season. 20 of the 24 HCSs from the Program 1 cluster were included in the Program 2 cluster (1,814 HCWs), and 16 of the 19 HCSs from the Control 1 cluster, plus 7 new HCSs with interest in participating, were included in the Control 2 cluster (23 HCSs; 2,435 HCWs). The efficacy of each program was assessed by calculating and comparing the percentage of vaccinated HCWs, from all HCSs taken together, in the program and control clusters. Program 1 failed to increase the HCW vaccination coverage rate (VCR) (Program 1: 34%; Control 1: 32%; p > 0.05),). Program 2 increased the VCR in HCWs (Program 2: 44%; Control 2: 27%; Chi2 test, p active

  8. Protecting Against Influenza (Flu): Advice for Caregivers of Young Children

    Science.gov (United States)

    ... in Long-Term Care Facilities Guidance: Use of Mask to Control Influenza Transmission Guidance: Prevention & Control in ... In rare cases, flu complications can lead to death. To help prevent flu, CDC recommends that everyone ...

  9. Cold, Flu, or Allergy? Know the Difference for Best Treatment

    Science.gov (United States)

    ... October 2014 Print this issue Cold, Flu, or Allergy? Know the Difference for Best Treatment En español ... Peanut Allergy Therapy Wise Choices Cold, Flu, or Allergy? Treatment depends on which you have. A health ...

  10. Forecasting rodent outbreaks in Africa

    DEFF Research Database (Denmark)

    Leirs, Herwig; Verhagen, Ron; Verheyen, Walter

    1996-01-01

    1. Rainfall data were collated for years preceding historical outbreaks of Mastomys rats in East Africa in order to test the hypothesis that such outbreaks occur after long dry periods. 2. Rodent outbreaks were generally not preceded by long dry periods. 3. Population dynamics of Mastomys...

  11. No consistent effects of prenatal or neonatal exposure to Spanish flu on late-life mortality in 24 developed countries

    Directory of Open Access Journals (Sweden)

    Alan Cohen

    2010-04-01

    Full Text Available We test the effects of early life exposure to disease on later health by looking for differences in late-life mortality in cohorts born around the 1918-1919 flu pandemic using data from the Human Mortality Database for 24 countries. After controlling for age, period, and sex effects, residual mortality rates did not differ systematically for flu cohorts relative to surrounding cohorts. We calculate at most a 20-day reduction in life expectancy for flu cohorts; likely values are much smaller. Estimates of influenza incidence during the pandemic suggest that exposure was high enough for this to be a robust negative result.

  12. Controlling pandemic flu: the value of international air travel restrictions.

    Directory of Open Access Journals (Sweden)

    Joshua M Epstein

    2007-05-01

    Full Text Available Planning for a possible influenza pandemic is an extremely high priority, as social and economic effects of an unmitigated pandemic would be devastating. Mathematical models can be used to explore different scenarios and provide insight into potential costs, benefits, and effectiveness of prevention and control strategies under consideration.A stochastic, equation-based epidemic model is used to study global transmission of pandemic flu, including the effects of travel restrictions and vaccination. Economic costs of intervention are also considered. The distribution of First Passage Times (FPT to the United States and the numbers of infected persons in metropolitan areas worldwide are studied assuming various times and locations of the initial outbreak. International air travel restrictions alone provide a small delay in FPT to the U.S. When other containment measures are applied at the source in conjunction with travel restrictions, delays could be much longer. If in addition, control measures are instituted worldwide, there is a significant reduction in cases worldwide and specifically in the U.S. However, if travel restrictions are not combined with other measures, local epidemic severity may increase, because restriction-induced delays can push local outbreaks into high epidemic season. The per annum cost to the U.S. economy of international and major domestic air passenger travel restrictions is minimal: on the order of 0.8% of Gross National Product.International air travel restrictions may provide a small but important delay in the spread of a pandemic, especially if other disease control measures are implemented during the afforded time. However, if other measures are not instituted, delays may worsen regional epidemics by pushing the outbreak into high epidemic season. This important interaction between policy and seasonality is only evident with a global-scale model. Since the benefit of travel restrictions can be substantial while

  13. Mayaro virus: the jungle flu

    Directory of Open Access Journals (Sweden)

    Izurieta RO

    2018-04-01

    Full Text Available Ricardo O Izurieta,1 David A DeLacure,1 Andres Izurieta,2 Ismael A Hoare,1 Miguel Reina Ortiz,1,3 1Department of Global Health, College of Public Health, University of South Florida, Tampa, FL, USA; 2Department of Computer Science and Engineering, College of Engineering, University of South Florida, Tampa, FL, USA; 3Fundación Raíces, Esmeraldas, Ecuador Abstract: Mayaro fever is an emerging acute viral disease endemic in Central and South America. Mayaro virus (MAYV is classified in the Semliki Forest virus antigenic complex and shares similarities with the alphavirus Chikungunya virus and the flavivirus Dengue virus. MAYV is an arbovirus transmitted by Haemagogus janthinomys, with competence also demonstrated in Aedes aegypti, Aedes scapularis, and Anopheles quadrimaculatus. Outbreaks and small epidemics of Mayaro fever have occurred in several countries in northern South America and the Caribbean. In addition, travel-associated cases have been reported in European nationals returning from endemic areas. Clinical features of Mayaro fever include fever, chills, persistent arthralgia, retro-orbital pain, maculopapular rash, itching, dizziness, and, rarely, lymphadenopathy. Methods of control for MAYV are similar to those used for other sylvatic arboviruses. Although MAYV was discovered as long ago as the 1950s and continues to be prevalent in the tropical areas of the Americas, it remains neglected and under-studied. This paper provides a thorough and current review of the published MAYV literature ranging from its original description to modern outbreaks, and from the basic virus characteristics to the clinical and epidemiological aspects of this disease. Keywords: Mayaro virus, emerging arbovirus, dengue-like virus, arthrogenic virus

  14. Help Stop the Flu | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... and pandemic influenza, including 2009 H1N1 flu. Developing new and improved flu vaccines is a high priority of NIAID through its ... other infectious diseases. Progress is being made in new technologies that produce vaccines, including vaccines against the flu. To Find Out ...

  15. Vaccine Effectiveness - How Well Does the Seasonal Flu Vaccine Work?

    Science.gov (United States)

    ... How effective is the flu vaccine in the elderly? Older people with weaker immune systems often have a lower protective immune response after ... of flu vaccine effects have included all people aged 6 months and older recommended for an annual flu vaccination. Similar studies are ...

  16. Sensitivity and specificity of in vitro diagnostic device used for influenza rapid test in Taiwan

    Directory of Open Access Journals (Sweden)

    Kun-Teng Wang

    2014-06-01

    Full Text Available The pandemic influenza A/H1N1 outbreak resulted in 18,449 deaths in over 214 countries. In Taiwan, the influenza rapid test, an in vitro diagnostic device (Flu-IVD, only requires documented reviews for market approval by the Taiwan Food and Drug Administration. The purpose of this study was to investigate the analytical sensitivity and specificity of Flu-IVDs used in Taiwan. Analytical sensitivity and specificity tests were performed for influenza antigens A/California/7/2009 (H1N1 virus, A/Victoria/210/2009 (H3N2 virus, B/Brisbane/60/08 virus, and human coronavirus OC43. A total of seven domestic and 31 imported Flu-IVD samples were collected, of which, 20 samples had inadequate labeling, including those with removed package inserts or incorrect insert information. The analytical sensitivity of Flu-IVDs for A/H1N1, A/H3N2, and Flu B was 500–1000 ng/mL, 1000 ng/mL, and 1000 ng/mL, respectively. For the 50% cell culture infective dose (CCID50 label, the average A/H1N1 and A/H3N2 sensitivity for Flu-IVDs was log10 5.8 ± 0.5 and log10 6.6 ± 0.5 CCID50/mL, respectively. As to the specificity test, no product cross-reacted with human coronavirus OC43. This study provides important information on the Flu-IVD regulation status and can thus help the government formulate policies for the regulation of in vitro diagnostic devices in Taiwan.

  17. Deck Yourself with Flu Protection Song

    Centers for Disease Control (CDC) Podcasts

    2009-12-22

    This song (sung to the tune of Deck the Halls) describes actions you can take to protect yourself and others from the flu. Sing along!  Created: 12/22/2009 by National Center for Preparedness, Detection, and Control of Infectious Diseases (NCPDCID), Division of Global Migration and Quarantine (DGMQ).   Date Released: 12/22/2009.

  18. Key Facts about Seasonal Flu Vaccine

    Science.gov (United States)

    ... use of injectable influenza vaccines (including inactivated influenza vaccines and recombinant influenza vaccines) during 2017-2018. The nasal spray ... months and older with either the inactivated influenza vaccine (IIV) or the recombinant influenza vaccine (RIV). The nasal spray flu vaccine ( ...

  19. Personal Stories: Why Flu Vaccination Matters

    Centers for Disease Control (CDC) Podcasts

    2008-12-08

    In this podcast, moving personal stories help inform parents about the dangers of flu to children and the benefits of vaccination.  Created: 12/8/2008 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 12/8/2008.

  20. Crying wolf? Biosecurity and metacommunication in the context of the 2009 swine flu pandemic.

    Science.gov (United States)

    Nerlich, Brigitte; Koteyko, Nelya

    2012-07-01

    This article explores how the 2009 pandemic of swine flu (H1N1) intersected with issues of biosecurity in the context of an increasing entanglement between the spread of disease and the spread of information. Drawing on research into metacommunication, the article studies the rise of communication about ways in which swine flu was communicated, both globally and locally, during the pandemic. It examines and compares two corpora of texts, namely UK newspaper articles and blogs, written between 28 March and 11 June 2009, that is, the period from the start of the outbreak till the WHO announcement of the pandemic. Findings show that the interaction between traditional and digital media as well as the interaction between warnings about swine flu and previous warnings about other epidemics contributed to a heightened discourse of blame and counter-blame but also, more surprisingly, self-blame and reflections about the role the media in pandemic communication. The consequences of this increase in metacommunication for research into crisis communication are explored. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Flu and People with Asthma

    Science.gov (United States)

    ... for Laboratories Rapid Diagnostic Testing Guidance: Standard-Based Electronic Laboratory Reporting Influenza Virus Testing Methods Antiviral Drugs ... available as a generic version or under the trade name Tamiflu®) or peramivir (trade name Rapivab®) are ...

  2. Meningitis Dipstick Rapid Test: Evaluating Diagnostic Performance during an Urban Neisseria meningitidis Serogroup A Outbreak, Burkina Faso, 2007

    Science.gov (United States)

    Rose, Angela M. C.; Mueller, Judith E.; Gerstl, Sibylle; Njanpop-Lafourcade, Berthe-Marie; Page, Anne-Laure; Nicolas, Pierre; Traoré, Ramata Ouédraogo; Caugant, Dominique A.; Guerin, Philippe J.

    2010-01-01

    Meningococcal meningitis outbreaks occur every year during the dry season in the “meningitis belt” of sub-Saharan Africa. Identification of the causative strain is crucial before launching mass vaccination campaigns, to assure use of the correct vaccine. Rapid agglutination (latex) tests are most commonly available in district-level laboratories at the beginning of the epidemic season; limitations include a short shelf-life and the need for refrigeration and good technical skills. Recently, a new dipstick rapid diagnostic test (RDT) was developed to identify and differentiate disease caused by meningococcal serogroups A, W135, C and Y. We evaluated the diagnostic performance of this dipstick RDT during an urban outbreak of meningitis caused by N. meningitidis serogroup A in Ouagadougou, Burkina Faso; first against an in-country reference standard of culture and/or multiplex PCR; and second against culture and/or a highly sensitive nested PCR technique performed in Oslo, Norway. We included 267 patients with suspected acute bacterial meningitis. Using the in-country reference standard, 50 samples (19%) were positive. Dipstick RDT sensitivity (N = 265) was 70% (95%CI 55–82) and specificity 97% (95%CI 93–99). Using culture and/or nested PCR, 126/259 (49%) samples were positive; dipstick RDT sensitivity (N = 257) was 32% (95%CI 24–41), and specificity was 99% (95%CI 95–100). We found dipstick RDT sensitivity lower than values reported from (i) assessments under ideal laboratory conditions (>90%), and (ii) a prior field evaluation in Niger [89% (95%CI 80–95)]. Specificity, however, was similar to (i), and higher than (ii) [62% (95%CI 48–75)]. At this stage in development, therefore, other tests (e.g., latex) might be preferred for use in peripheral health centres. We highlight the value of field evaluations for new diagnostic tests, and note relatively low sensitivity of a reference standard using multiplex vs. nested PCR. Although the former is

  3. Meningitis dipstick rapid test: evaluating diagnostic performance during an urban Neisseria meningitidis serogroup A outbreak, Burkina Faso, 2007.

    Directory of Open Access Journals (Sweden)

    Angela M C Rose

    Full Text Available Meningococcal meningitis outbreaks occur every year during the dry season in the "meningitis belt" of sub-Saharan Africa. Identification of the causative strain is crucial before launching mass vaccination campaigns, to assure use of the correct vaccine. Rapid agglutination (latex tests are most commonly available in district-level laboratories at the beginning of the epidemic season; limitations include a short shelf-life and the need for refrigeration and good technical skills. Recently, a new dipstick rapid diagnostic test (RDT was developed to identify and differentiate disease caused by meningococcal serogroups A, W135, C and Y. We evaluated the diagnostic performance of this dipstick RDT during an urban outbreak of meningitis caused by N. meningitidis serogroup A in Ouagadougou, Burkina Faso; first against an in-country reference standard of culture and/or multiplex PCR; and second against culture and/or a highly sensitive nested PCR technique performed in Oslo, Norway. We included 267 patients with suspected acute bacterial meningitis. Using the in-country reference standard, 50 samples (19% were positive. Dipstick RDT sensitivity (N = 265 was 70% (95%CI 55-82 and specificity 97% (95%CI 93-99. Using culture and/or nested PCR, 126/259 (49% samples were positive; dipstick RDT sensitivity (N = 257 was 32% (95%CI 24-41, and specificity was 99% (95%CI 95-100. We found dipstick RDT sensitivity lower than values reported from (i assessments under ideal laboratory conditions (>90%, and (ii a prior field evaluation in Niger [89% (95%CI 80-95]. Specificity, however, was similar to (i, and higher than (ii [62% (95%CI 48-75]. At this stage in development, therefore, other tests (e.g., latex might be preferred for use in peripheral health centres. We highlight the value of field evaluations for new diagnostic tests, and note relatively low sensitivity of a reference standard using multiplex vs. nested PCR. Although the former is the current standard

  4. Outbreaks of nontuberculous mycobacteria.

    Science.gov (United States)

    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.

  5. Medical response planning for pandemic flu.

    Science.gov (United States)

    Harrison, Jeffrey P; Bukhari, Syed Zeeshan Haider; Harrison, Richard A

    2010-01-01

    This quantitative research study evaluates the health care infrastructure necessary to provide medical care in US hospitals during a flu pandemic. These hospitals are identified within the US health care system because they operate airborne infectious isolation rooms. Data were obtained from the 2006 American Hospital Association annual survey. This data file provides essential information on individual US hospitals and identifies the health care capabilities in US communities. Descriptive statistics were evaluated to examine hospitals with the appropriate infrastructure to treat a flu pandemic. In addition, geographic information system software was used to identify geographic areas where essential infrastructure is lacking. The study found 3,341 US hospitals operate airborne infectious isolation rooms, representing 69% of reporting hospitals. The results also indicate that those hospitals with airborne infectious isolation rooms are larger and are located in metropolitan areas. The study has managerial implications associated with local medical disaster response and policy implications on the allocation of disaster resources.

  6. Influenza: a world of discoveries, outbreaks and controversy.

    Science.gov (United States)

    Barclay, Wendy S

    2017-05-01

    Working in an area such as influenza is a free ticket into science communication, a pathway aided amply by the amazing evolutionary powers of the virus; regular outbreaks keep the media engaged and the audience keen. Everyone has heard of flu, and they probably already have an opinion: 'I don't take the vaccine, it gives me the flu anyway.' 'Didn't the government waste loads of money on that Tamiflu drug that doesn't work?' 'I've never had flu because I eat a banana every day and sleep with a boiled onion when I've sat next to someone on the train who was coughing.' Such muddled messages and folklore fallacies could be very damaging unless we as scientists stand up and correct them. In addition, there are wider ethical debates around sharing data from clinical trials and the acceptable limits of scientific research to which we must all contribute.

  7. Initial psychological responses to swine flu.

    Science.gov (United States)

    Goodwin, Robin; Gaines, Stanley O; Myers, Lynn; Neto, Felix

    2011-06-01

    The emergence of influenza A ("swine flu") in early 2009 led to widespread public concern. However, little research has examined the factors that underlie initial worry about infection and subsequent behavioral responses to such worry. This study seeks to model some key predictors of worry and behavioral responses in the early stages of the swine flu pandemic (WHO pandemic stage 5). A cross-sectional internet questionnaire study (N = 186). Twenty-five percent of respondents rated themselves as worried about being a victim of swine flu, 40% that they were worried of a family member contracting the virus. Twenty percent had bought, or intended to buy, preparatory materials (e.g., face masks), 20% intended to delay or cancel air travel. In a structural equation model, conservation values and family or friends perception of risks predicted worry about infection, while worry correlated with the purchase of preparatory materials, a lesser willingness to travel by public transport, and difficulty in focusing on everyday activities. While previous research on pandemic risk perception has focused on cognitive risk judgments, our data suggests that initial "emotional" concerns about infection are also significant predictors of behavioral responses to pandemic threat. Such worry is likely to be influenced by a variety of individual factors, such as personal values, as well as normative pressures. Practitioners can use and expand on such models of pandemic response when tailoring health campaigns to meet newly emergent threats.

  8. Typhoid outbreak in Songkhla, Thailand 2009-2011: clinical outcomes, susceptibility patterns, and reliability of serology tests.

    Directory of Open Access Journals (Sweden)

    Wannee Limpitikul

    Full Text Available OBJECTIVE: To determine the clinical manifestations and outcomes, the reliability of Salmonella enterica serotype Typhi (S ser. Typhi IgM and IgG rapid tests, and the susceptibility patterns and the response to treatment during the 2009-2011 typhoid outbreak in Songkhla province in Thailand. METHOD: The medical records of children aged <15 years with S ser. Typhi bacteremia were analysed. The efficacy of the typhoid IgM and IgG rapid tests and susceptibility of the S ser. Typhi to the current main antibiotics used for typhoid (amoxicillin, ampicillin, cefotaxime, ceftriaxone, co-trimoxazole, and ciprofloxacin, were evaluated. RESULTS: S ser. Typhi bacteremia was found in 368 patients, and all isolated strains were susceptible to all 6 antimicrobials tested. Most of the patients were treated with ciprofloxacin for 7-14 days. The median time (IQR of fever before treatment and duration of fever after treatment were 5 (4, 7 days and 4 (3, 5 days, respectively. Complications of ascites, lower respiratory symptoms, anemia (Hct <30%, and ileal perforation were found in 7, 7, 22, and 1 patients, respectively. None of the patients had recurrent infection or died. The sensitivities of the typhoid IgM and IgG tests were 58.3% and 25.6% respectively, and specificities were 74.1% and 50.5%, respectively. CONCLUSION: Most of the patients were diagnosed at an early stage and treated with a good outcome. All S ser. Typhi strains were susceptible to standard first line antibiotic typhoid treatment. The typhoid IgM and IgG rapid tests had low sensitivity and moderate specificity.

  9. Continue to Vaccinate Patients and Staff Against the Flu

    Centers for Disease Control (CDC) Podcasts

    2012-02-08

    This podcast is a reminder to health care providers about the importance of annual flu vaccination—it’s not too late! Health care providers should get their flu vaccine and continue offering and encouraging flu vaccination among their staff, colleagues, and patients.  Created: 2/8/2012 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 2/14/2012.

  10. Preventing Flu During Pregnancy (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-09-26

    During the influenza season, pregnant women and infants under 6 months old are especially susceptible to severe complications from the flu. The seasonal flu vaccination is the best way to protect both mother and baby. In this podcast Dr. Stacie Greby discusses the importance of pregnant women receiving the flu vaccine.  Created: 9/26/2013 by MMWR.   Date Released: 9/26/2013.

  11. Applying lessons from behavioral economics to increase flu vaccination rates.

    Science.gov (United States)

    Chen, Frederick; Stevens, Ryan

    2017-12-01

    Seasonal influenza imposes an enormous burden on society every year, yet many people refuse to obtain flu shots due to misconceptions of the flu vaccine. We argue that recent research in psychology and behavioral economics may provide the answers to why people hold mistaken beliefs about flu shots, how we can correct these misconceptions, and what policy-makers can do to increase flu vaccination rates. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Surveillance of illness associated with pandemic (H1N1) 2009 virus infection among adults using a global clinical site network approach: the INSIGHT FLU 002 and FLU 003 studies

    DEFF Research Database (Denmark)

    Dwyer, Dominic E; Nielsen, Henrik Ib

    2011-01-01

    The novel pandemic influenza A (H1H1) 2009 virus spread rapidly around the world in 2009. The paucity of prospective international epidemiologic data on predictors of clinical outcomes with pandemic (H1N1) 2009 virus infection stimulated the INSIGHT network, an international network of community...... and hospital-based investigators, to commence two worldwide clinical observational studies to describe pandemic (H1N1) 2009 virus activity. The purpose of these two studies was to estimate the percent of adult patients with illness due to laboratory-confirmed pandemic (H1N1) 2009 virus infection......, with 1049 enrollments into the FLU 002 outpatient study and 316 into the FLU 003 hospitalization study. These 'in progress' INSIGHT influenza observational studies may act as a model for obtaining epidemiological, clinical and laboratory information in future international disease outbreaks....

  13. Time to Get Your Seasonal Flu Shot | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Flu Season Time to Get Your Seasonal Flu Shot Past Issues / ... able to infect others for an even longer time. How serious is the flu? Certain people are ...

  14. Mitigation approaches to combat the flu pandemic

    Directory of Open Access Journals (Sweden)

    Raman Chawla

    2009-01-01

    The National Disaster Management Authority (NDMA, Government of India, with the active cooperation of UN agencies and other stakeholders/experts has formulated a concept paper on role of nonhealth service providers during pandemics in April 2008 and released national guidelines - management of biological disasters in July 2008. These guidelines enumerate that the success of medical management endeavors like pharmaceutical (anti-viral Oseltamivir and Zanamivir therapies, nonpharmaceutical interventions and vaccination development etc., largely depends on level of resistance offered by mutagenic viral strain and rationale use of pharmaco therapeutic interventions. This article describes the mitigation approach to combat flu pandemic with its effective implementation at national, state and local levels.

  15. Massively multiplexed microbial identification using resequencing DNA microarrays for outbreak investigation

    Science.gov (United States)

    Leski, T. A.; Ansumana, R.; Jimmy, D. H.; Bangura, U.; Malanoski, A. P.; Lin, B.; Stenger, D. A.

    2011-06-01

    Multiplexed microbial diagnostic assays are a promising method for detection and identification of pathogens causing syndromes characterized by nonspecific symptoms in which traditional differential diagnosis is difficult. Also such assays can play an important role in outbreak investigations and environmental screening for intentional or accidental release of biothreat agents, which requires simultaneous testing for hundreds of potential pathogens. The resequencing pathogen microarray (RPM) is an emerging technological platform, relying on a combination of massively multiplex PCR and high-density DNA microarrays for rapid detection and high-resolution identification of hundreds of infectious agents simultaneously. The RPM diagnostic system was deployed in Sierra Leone, West Africa in collaboration with Njala University and Mercy Hospital Research Laboratory located in Bo. We used the RPM-Flu microarray designed for broad-range detection of human respiratory pathogens, to investigate a suspected outbreak of avian influenza in a number of poultry farms in which significant mortality of chickens was observed. The microarray results were additionally confirmed by influenza specific real-time PCR. The results of the study excluded the possibility that the outbreak was caused by influenza, but implicated Klebsiella pneumoniae as a possible pathogen. The outcome of this feasibility study confirms that application of broad-spectrum detection platforms for outbreak investigation in low-resource locations is possible and allows for rapid discovery of the responsible agents, even in cases when different agents are suspected. This strategy enables quick and cost effective detection of low probability events such as outbreak of a rare disease or intentional release of a biothreat agent.

  16. Colds and flu – an overview of the management

    African Journals Online (AJOL)

    infected person or object5. Table 1: Types of influenza strains and their differences1. Virus Strain: Influenza A. Influenza B. Who can become infected: Animals and Humans Humans. Severity of infection: Causes pandemics, like swine flu and bird flu. Less severe than. Influenza A. A rapid onset of fever, headaches, myalgia, ...

  17. Preventing Flu During Pregnancy (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-09-26

    During the influenza season, pregnant women and infants under 6 months old are especially susceptible to severe complications from the flu. This podcast discusses the importance of pregnant women receiving the flu vaccine.  Created: 9/26/2013 by MMWR.   Date Released: 9/26/2013.

  18. EDITORIAL Avian Flu Pandemic Threat: Why is Ethiopia considered ...

    African Journals Online (AJOL)

    Preferred Customer

    Many zoonotic diseases have affected human beings with serious impact. Among those pandemic flu originated from birds have caused millions of human deaths at different times. The so called Spanish flu that caused about 50 million people worldwide in 1918-19 is the most devastating. That pandemic was refereed as.

  19. Flu: What to Do If You Get Sick

    Science.gov (United States)

    ... do have it. What are the emergency warning signs of flu sickness? In children Fast breathing or ... type="submit" value="Submit" /> Archived Flu Emails Influenza Types Seasonal Avian Swine Variant Pandemic Other Language: English (US) Español ...

  20. 42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Pneumococcal vaccine and flu vaccine. 410.57... § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal vaccine and its administration when reasonable and necessary for the prevention of disease, if the vaccine is ordered by a doctor...

  1. Know and Share the Facts about Flu Vaccination

    Science.gov (United States)

    Grohskopf, Lisa

    2012-01-01

    Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and sometimes can lead to death. Symptoms of flu can include fever or a feverish feeling, cough, sore throat, runny or stuffy nose, muscle or body aches, headache, fatigue, vomiting, and diarrhea. Flu…

  2. Limit Asthma Attacks Caused by Colds or Flu

    Science.gov (United States)

    Asthma: Limit asthma attacks caused by colds or flu A cold or the flu can trigger an asthma attack. Here's why — and how to keep your sneeze ... plan. If you notice warning signs of an asthma attack — such as coughing, wheezing, chest tightness or shortness ...

  3. Antivirals Use During the Pandemic H1N1 2009 Outbreak

    Centers for Disease Control (CDC) Podcasts

    2012-01-23

    Charisma Atkins, CDC public health analyst, discusses antiviral use during the 2009 H1N1 pandemic flu outbreak.  Created: 1/23/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/23/2012.

  4. Contagious equine metritis in Portugal: A retrospective report of the first outbreak in the country and recent contagious equine metritis test results.

    Science.gov (United States)

    Rocha, T

    2016-01-01

    Contagious equine metritis (CEM), a highly contagious bacterial venereal infection of equids, caused by Taylorella equigenitalis , is of major international concern, causing short-term infertility in mares. Portugal has a long tradition of horse breeding and exportation and until recently was considered CEM-free. However, in 2008, T. equigenitalis was isolated at our laboratory from a recently imported stallion and 2 mares from the same stud. Following this first reported outbreak, the Portuguese Veterinary Authority (DGVA) performed mandatory testing on all remaining equines at the stud (n=30), resulting in a further 4 positive animals. All positive animals were treated and subsequently tested negative for T. equigenitalis . Since this outbreak, over 2000 genital swabs from Portuguese horses have been tested at our laboratory, with no further positive animals identified. The available data suggests that this CEM outbreak was an isolated event and we have no further evidence of CEM cases in Portugal, however, an extended and wider epidemiological study would be needed to better evaluate the incidence of the disease in Portuguese horses.

  5. Contagious equine metritis in Portugal: A retrospective report of the first outbreak in the country and recent contagious equine metritis test results

    Directory of Open Access Journals (Sweden)

    T. Rocha

    2016-12-01

    Full Text Available Contagious equine metritis (CEM, a highly contagious bacterial venereal infection of equids, caused by Taylorella equigenitalis, is of major international concern, causing short-term infertility in mares. Portugal has a long tradition of horse breeding and exportation and until recently was considered CEM-free. However, in 2008, T. equigenitalis was isolated at our laboratory from a recently imported stallion and 2 mares from the same stud. Following this first reported outbreak, the Portuguese Veterinary Authority (DGVA performed mandatory testing on all remaining equines at the stud (n=30, resulting in a further 4 positive animals. All positive animals were treated and subsequently tested negative for T. equigenitalis. Since this outbreak, over 2000 genital swabs from Portuguese horses have been tested at our laboratory, with no further positive animals identified. The available data suggests that this CEM outbreak was an isolated event and we have no further evidence of CEM cases in Portugal, however, an extended and wider epidemiological study would be needed to better evaluate the incidence of the disease in Portuguese horses.

  6. Extracorporeal Membrane Oxygenation and Modern Detoxification Techniques in a Puerpera with Viral and Bacterial Pneumonia Caused by Flu A(H1N1 Virus

    Directory of Open Access Journals (Sweden)

    R. A. Kornelyuk

    2017-01-01

    Full Text Available Outbreaks of viral infections have become a global healthcare challenge over the last decade. The 2009—2010 flu A (H1N1 outbreak resulted in global pandemia, associated with high morbidity and mortality reaching 31%. Another flu A (H1N1 outbreak occurred in 2015—2016. There is a strong probability that it may be repeated in the future. This infection is associated with its high incidence among pregnant women. There are some published reports describing the efficacy and safety of veno%venous extracorporeal membrane oxygenation (ECMO in patients with severe acute respiratory distress syndrome that is refractory to standard therapeutic options. The article presents a clinical case of a successful use of extracorporeal membrane oxygenation and intermittent renal replacement therapy in a puerpera with acute respiratory distress syndrome caused by flu A (H1N1-related severe viral and bacterial pneumonia. The positive effects of the combination of veno%venous extracorporeal membrane oxygenation and modern detoxification techniques have been demonstrated. Revealed organizational problemswere related to selection criteria for prescription of extracorporeal gas exchange, as well as to carrying out the procedure in an institution in the deficiency of the experienced staff and corresponding equipment.

  7. Kebijakan Pemerintah Dalam Rangka Pemulihan Ekonomi Dan Keterkaitannya Dengan Merebaknya Flu Burung

    Directory of Open Access Journals (Sweden)

    Muryani Muryani

    2015-11-01

    Full Text Available The negative impact of the outbreak of bird flu on economic sectors in the sectoral and macro aspect is analized using Computable General Equilibrium (CGE models. Base on SNSE 2008 dataand some disagregation data sectors, two simulations are conducted. The result of the simulation studies indicate that there is the decrease in the production of poultry meat sector (traditional and medium-large and egg sectors impact on the micro and macro aspects of the economy. This research is the second step of my research deal with Avian flu and the economy.The first step was the negative impact of avian flu on economy which was already published on Asian Social Economic Journal by last year. The result of this research are : On the micro level in domestic market there are decresed production and increased prices in the poultry sector, eggs, other farms, restaurants and services. While in the foreign market there are decresed exports as well as imports. Similarly, there is a decline in consumption by the entire group of household due to a decline in the acceptance by all groups of households and firms. Government revenue also declined due to a decrease in taxes from households and firms.At the macro level there are a decline in GDP and a decline in the investment. The last  simulation illustrate  the increase of production and the impact of government policy on the micro aspects and the overall economy.  On the micro level in domestic market there are increased production and falling prices in the sector of poultry, eggs, other farms, restaurants and services. While in foreign market there are  increased exports and  decreased imports in almost all sectors. Similarly, there are an increase in consumption by the entire group of households due to an increse in the acceptance by all groups of households and firms. Government revenue also increased due to an increse in taxes from household and firms.

  8. FluTyper-an algorithm for automated typing and subtyping of the influenza virus from high resolution mass spectral data

    Directory of Open Access Journals (Sweden)

    Schwahn Alexander B

    2010-05-01

    Full Text Available Abstract Background High resolution mass spectrometry has been employed to rapidly and accurately type and subtype influenza viruses. The detection of signature peptides with unique theoretical masses enables the unequivocal assignment of the type and subtype of a given strain. This analysis has, to date, required the manual inspection of mass spectra of whole virus and antigen digests. Results A computer algorithm, FluTyper, has been designed and implemented to achieve the automated analysis of MALDI mass spectra recorded for proteolytic digests of the whole influenza virus and antigens. FluTyper incorporates the use of established signature peptides and newly developed naïve Bayes classifiers for four common influenza antigens, hemagglutinin, neuraminidase, nucleoprotein, and matrix protein 1, to type and subtype the influenza virus based on their detection within proteolytic peptide mass maps. Theoretical and experimental testing of the classifiers demonstrates their applicability at protein coverage rates normally achievable in mass mapping experiments. The application of FluTyper to whole virus and antigen digests of a range of different strains of the influenza virus is demonstrated. Conclusions FluTyper algorithm facilitates the rapid and automated typing and subtyping of the influenza virus from mass spectral data. The newly developed naïve Bayes classifiers increase the confidence of influenza virus subtyping, especially where signature peptides are not detected. FluTyper is expected to popularize the use of mass spectrometry to characterize influenza viruses.

  9. Red, Blue, and the Flu: Media Self-Selection and Partisan Gaps in Swine Flu Vaccinations

    OpenAIRE

    Baum, Matthew A.

    2011-01-01

    This study assesses the relationship between political partisanship and attitudes and behavior with respect to the Swine Flu crisis of 2009 in general, and the U.S. mass vaccination program in particular. I argue that even seemingly non-partisan political issues like public health are increasingly characterized by partisan polarization in public attitudes, and that such polarization is in part attributable, at least in part, to the breakdown of the information commons that characterized the A...

  10. Estimation of basic reproductive number of flu-like syndrome in a primary school in Iran

    Directory of Open Access Journals (Sweden)

    AliAkbar Haghdoost

    2012-01-01

    Full Text Available Introduction: Iran, similar to other countries, had faced H1N1 flu outbreak in 2009. In order to assess its transmission dynamic, we estimated its force of infection (β and basic reproductive number (R 0 . Methods: Within a middle size primary school in Iran, we actively followed students and detected flu-like syndrome among students and their families in the first three months of academic year; October through December 2009. We estimated the probability of disease transmission within families (β fitting random effects Poisson regression model. Moreover, R 0 within the school was computed based on the number of detected cases. Results: In 452 students, 204 influenza-like syndromes were detected. The estimated β within families was 0.10; increasing one infectious member within each family was associated with 30% increase in this number. The estimated R 0 for the first month was 1.21 (95% C.I.: 0.99, 1.47; corresponding numbers for the first two and first three months were 1.28 (95% C.I.: 1.05, 1.54 and 1.32 (95% C.I.: 1.11, 1.59, respectively. Conclusion: It seems that the dynamic transmission of H1N1 virus was more or less comparable with that in other seasonal species. Our findings showed that the virus mainly circulated among students within schools. In addition, it seems that the transmission rate within families was relatively high.

  11. A study of the swine flu (H1N1 epidemic among health care providers of a medical college hospital of Delhi

    Directory of Open Access Journals (Sweden)

    Om Prakash Rajoura

    2011-01-01

    Full Text Available Background: Influenza viruses cause annual epidemics and occasional pandemics that have claimed the lives of millions. Understanding the role of specific perceptions in motivating people to engage in precautionary behavior may help health communicators to improve their messages about outbreaks of new infectious disease generally and swine flu specifically. Objectives: To study the knowledge and practices of health care providers regarding swine flu and to study the attitudes and practices of health care providers toward the prevention of the swine flu epidemic. Materials and Methods: The present study was a cross-sectional (descriptive study and was conducted in the month of September, 2009, among doctors and nurses. A maximum of 40% of the total health care providers of GTB Hospital were covered because of feasibility and logistics, and, therefore, the sample size was 334. Results: Around 75% of the health care providers were aware about the symptoms of swine flu. Mostly, all study subjects were aware that it is transmitted through droplet infection. Correct knowledge of the incubation period of swine flu was known to 80% of the doctors and 69% of the nurses. Knowledge about high-risk groups (contacts, travelers, health care providers was observed among 88% of the doctors and 78.8% of the nurses. Practice of wearing mask during duty hours was observed among 82.6% of doctors and 85% of nurses, whereas of the total study population, only 40% were correctly using mask during duty hours. Conclusions: Significant gaps observed between knowledge and actual practice of the Health Care Provider regarding swine flu need to be filled by appropriate training. Data indicate that the health care providers are very intellectual, but they do not themselves practice what they preach.

  12. Influenza (Flu) vaccine (Live, Intranasal): What you need to know

    Science.gov (United States)

    ... nose. LAIV does not contain thimerosal or other preservatives. It is made from weakened flu virus and ... people should not get LAIV because of age, health conditions, or other reasons. Most of these people ...

  13. Guillain-Barré Syndrome (GBS) and Flu Vaccine

    Science.gov (United States)

    ... What are Flu Antiviral Drugs Antiviral Drug Resistance Mixing Oseltamivir Capsules For Children What to do if ... PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple Quicktime file RealPlayer file Text ...

  14. Preventing the Flu: Good Health Habits Can Help Stop Germs

    Science.gov (United States)

    ... What are Flu Antiviral Drugs Antiviral Drug Resistance Mixing Oseltamivir Capsules For Children What to do if ... PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple Quicktime file RealPlayer file Text ...

  15. [Pandemic without drama. Influenza vaccination and Asian flu in Germany].

    Science.gov (United States)

    Witte, Wilfried

    2013-01-01

    The history of the 1957/58 Asian flu in Germany is systematically presented for the first time. The focus is on flu vaccination, which is discussed as a yardstick of the perception of the pandemic. International expertise on influenza virology was predominantly based in Anglo-Saxon countries. German microbiologists issued no clear recommendation for preventative vaccination until 1960. Instead, quinine was relied upon as the traditional medicinal prophylaxis. Antibiotics were more frequently administered. In East Germany, little fuss was made over the Asian flu. In line with the authorities' social hygiene orientation, vaccination was accepted as a matter of principle. In the Federal Republic and West Berlin, the population rejected the vaccination largely. It was seen as a scandal that many employees were on sick leave because of the flu, thus adversely affecting the economy.

  16. Flu Vaccine Guidance for Patients with Immune Deficiency

    Science.gov (United States)

    ... Guidance for Patients with Immune Deficiency Share | Flu Vaccine Guidance for Patients with Immune Deficiency This article ... should patients with immune deficiency be given the vaccine? Immune deficient patients have a decreased resistance to ...

  17. How to be a good visitor during flu season

    Science.gov (United States)

    ... You website Home > Consumers > Monthly alerts for consumers How to be a good visitor during flu season ... as, asthma, diabetes, heart disease, and lung disease How do you prevent the spread of illness? There ...

  18. What every Hepatologist should Know about Swine Flu?

    OpenAIRE

    Kamran Bagheri Lankarani

    2009-01-01

    As world is witnessing ever fastest growing pandemic, physicians with various specialties should adopt themselves to the new situation (1). Global death toll of swine flu by November 15, 2009, has raised to 6750. Many of those who died or were hospitalized suffered from comorbid conditions which increased either the severity or the risk of acquiring the disease (2). Swine flu may change the course of many chronic diseases. Thus, all physicians in different disciplines should realize and consi...

  19. No consistent effects of prenatal or neonatal exposure to Spanish flu on late-life mortality in 24 developed countries

    DEFF Research Database (Denmark)

    Cohen, Alan; Tillinghast, J; Canudas-Romo, V

    2010-01-01

    We test the effects of early life exposure to disease on later health by looking for differences in late-life mortality in cohorts born around the 1918-1919 flu pandemic using data from the Human Mortality Database for 24 countries. After controlling for age, period, and sex effects, residual...

  20. Comparative evaluation of the CerTest VIASURE flu A, B & RSV real time RT-PCR detection kit on the BD MAX system versus a routine in-house assay for detection of influenza A and B virus during the 2016/17 influenza season

    DEFF Research Database (Denmark)

    Sydenham, Thomas Vognbjerg; Bek-Thomsen, Malene; Andersen, Signe Dalsgaard

    2018-01-01

    laboratory technician "hands on" time but also the laboratory turnaround time is of interest. OBJECTIVES: We evaluated the performance of the VIASURE Flu A, B & RSV Real Time RT-PCR Detection Kit (CerTest Biotec) for detecting Influenza A and B viruses. STUDY DESIGN: During the 2016/17 influenza season 532.......3-100) and a specificity of 99.1% (95% CI: 97.4-99.8) for detection of Influenza A virus. The positive predictive and negative predictive values were 98.5% (95% CI: 95.8-99.7) and 99.7% (95% CI: 98.3-100) respectively. Influenza B virus detection could not be evaluated due to a low positivity rate. The BD MAX platform......BACKGROUND: Diagnosing of influenza rapidly and accurately helps clinicians to initiate appropriate treatment options and isolation protocols. Unnecessary antimicrobial treatment and laboratory testing can also be reduced. Assess commercial alternatives to in-house assays that may not only reduce...

  1. Disease Outbreak News

    Science.gov (United States)

    ... MERS-CoV) Pandemic (H1N1) 2009 Influenza at the Human-Animal Interface (HAI) Related documents WHO outbreak communication guide 2008 WHO outbreak communications guidelines Outbreak communication: ...

  2. Performance of the inFLUenza Patient-Reported Outcome (FLU-PRO) diary in patients with influenza-like illness (ILI)

    Science.gov (United States)

    Bacci, Elizabeth D.; Leidy, Nancy K.; Poon, Jiat-Ling; Stringer, Sonja; Memoli, Matthew J.; Han, Alison; Fairchok, Mary P.; Coles, Christian; Owens, Jackie; Chen, Wei-Ju; Arnold, John C.; Danaher, Patrick J.; Lalani, Tahaniyat; Burgess, Timothy H.; Millar, Eugene V.; Ridore, Michelande; Hernández, Andrés; Rodríguez-Zulueta, Patricia; Ortega-Gallegos, Hilda; Galindo-Fraga, Arturo; Ruiz-Palacios, Guillermo M.; Pett, Sarah; Fischer, William; Gillor, Daniel; Moreno Macias, Laura; DuVal, Anna; Rothman, Richard; Dugas, Andrea; Guerrero, M. Lourdes

    2018-01-01

    Background The inFLUenza Patient Reported Outcome (FLU-PRO) measure is a daily diary assessing signs/symptoms of influenza across six body systems: Nose, Throat, Eyes, Chest/Respiratory, Gastrointestinal, Body/Systemic, developed and tested in adults with influenza. Objectives This study tested the reliability, validity, and responsiveness of FLU-PRO scores in adults with influenza-like illness (ILI). Methods Data from the prospective, observational study used to develop and test the FLU-PRO in influenza virus positive patients were analyzed. Adults (≥18 years) presenting with influenza symptoms in outpatient settings in the US, UK, Mexico, and South America were enrolled, tested for influenza virus, and asked to complete the 37-item draft FLU-PRO daily for up to 14-days. Analyses were performed on data from patients testing negative. Reliability of the final, 32-item FLU-PRO was estimated using Cronbach’s alpha (α; Day 1) and intraclass correlation coefficients (ICC; 2-day reproducibility). Convergent and known-groups validity were assessed using patient global assessments of influenza severity (PGA). Patient report of return to usual health was used to assess responsiveness (Day 1–7). Results The analytical sample included 220 ILI patients (mean age = 39.3, 64.1% female, 88.6% white). Sixty-one (28%) were hospitalized at some point in their illness. Internal consistency reliability (α) of FLU-PRO Total score was 0.90 and ranged from 0.72–0.86 for domain scores. Reproducibility (Day 1–2) was 0.64 for Total, ranging from 0.46–0.78 for domain scores. Day 1 FLU-PRO scores correlated (≥0.30) with the PGA (except Gastrointestinal) and were significantly different across PGA severity groups (Total: F = 81.7, pinfluenza-like illness. PMID:29566007

  3. Community response to avian flu in Central Java, Indonesia.

    Science.gov (United States)

    Padmawati, Siwi; Nichter, Mark

    2008-04-01

    This pilot study suggests that it is more appropriate to think of avian flu as a bio-social and bio-political challenge for Indonesia than merely an epidemiological challenge involving a disease of zoonotic origin. Our examination of popular perceptions of avian flu in Central Java reveals important differences of opinion about which types of fowl are responsible for avian flu transmission and the degree of risk H5N1 poses to humans. The opinions of backyard farmers and commercial poultry farmers are motivated by different forms of practical logic and are differentially influenced by media accounts, government education programmes, foreign aid and rumours about who stands to profit from the disease. Rumours reflect collective anxieties about globalization, the agenda of big business and the trustworthiness of the national government. We also illustrate how a commodity chain analysis can assist in the identification of different stake-holders in the informal and formal poultry industries. The position of each stake-holder needs to be considered in any comprehensive investigation of avian flu. An economic analysis of the capital investment of stake-holders provides insight into how each responds to government directives about the reporting of dead chickens, vaccinating birds etc. Finally, we call for research on avian flu preparedness attentive to Indonesia's de-centralized form of political rule and the social organization of communities so that clear lines of communication and command can be established and mutual assistance mobilized.

  4. Disneyland Measles Outbreak

    OpenAIRE

    Palladino, Erica

    2015-01-01

    This media information sheet analyzes print and online coverage of the 2015 Disneyland measles outbreak. The frameworks that the media used to report on the outbreak presented vaccination as the only viable option from preventing the spread of measles. Reporting also failed to mention that the 2015 Disneyland measles outbreak was smaller than U.S. measles outbreaks in 2013 and 2014.

  5. Evaluating Google Flu Trends in Latin America: Important Lessons for the Next Phase of Digital Disease Detection.

    Science.gov (United States)

    Pollett, Simon; Boscardin, W John; Azziz-Baumgartner, Eduardo; Tinoco, Yeny O; Soto, Giselle; Romero, Candice; Kok, Jen; Biggerstaff, Matthew; Viboud, Cecile; Rutherford, George W

    2017-01-01

     Latin America has a substantial burden of influenza and rising Internet access and could benefit from real-time influenza epidemic prediction web tools such as Google Flu Trends (GFT) to assist in risk communication and resource allocation during epidemics. However, there has never been a published assessment of GFT's accuracy in most Latin American countries or in any low- to middle-income country. Our aim was to evaluate GFT in Argentina, Bolivia, Brazil, Chile, Mexico, Paraguay, Peru, and Uruguay.  Weekly influenza-test positive proportions for the eight countries were obtained from FluNet for the period January 2011-December 2014. Concurrent weekly Google-predicted influenza activity in the same countries was abstracted from GFT. Pearson correlation coefficients between observed and Google-predicted influenza activity trends were determined for each country. Permutation tests were used to examine background seasonal correlation between FluNet and GFT by country.  There were frequent GFT prediction errors, with correlation ranging from r = -0.53 to 0.91. GFT-predicted influenza activity best correlated with FluNet data in Mexico follow by Uruguay, Argentina, Chile, Brazil, Peru, Bolivia and Paraguay. Correlation was generally highest in the more temperate countries with more regular influenza seasonality and lowest in tropical regions. A substantial amount of autocorrelation was noted, suggestive that GFT is not fully specific for influenza virus activity.  We note substantial inaccuracies with GFT-predicted influenza activity compared with FluNet throughout Latin America, particularly among tropical countries with irregular influenza seasonality. Our findings offer valuable lessons for future Internet-based biosurveillance tools. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  6. Swine Flu, in the Spanish Press/La ‘gripe A’, en la prensa española

    Directory of Open Access Journals (Sweden)

    Dra. Idoia Camacho Markina

    2009-01-01

    Full Text Available Abstract: Mass media are faced with an exceptional challenge when they cover an epidemic, since the role of the media is to offer the most complete and accurate information in order to avoid spreading panic. However, many media outlets have been guided by financial reasons rather than public service criteria when they have covered the latest epidemic outbreak, which has resulted in a sensationalist coverage. The goal of this paper is to analyze the news coverage given by Spanish dailies to the outbreak and spread of the Novel H1N1 Virus, commonly known as the Swine Flu. This research points to the role played by print media in the coverage of this particular issue after a content analysis of the news articles published by the main five Spanish dailies during the first week after the Swine Flu outbreak.Resumen: Informar sobre epidemias constituye una situación excepcional para los medios de comunicación, cuya función debe ser ofrecer al público la información más completa posible para evitar que se extienda el pánico. Sin embargo, en las últimas epidemias muchos medios se han guiado más por criterios económicos, buscando el sensacionalismo, que por criterios de servicio público. El presente trabajo tiene como objetivo estudiar el tratamiento informativo que la prensa escrita diaria española ha hecho del brote de epidemia del virus de influenza A (H1/N1. El análisis de contenido de las noticias publicadas por los cinco diarios españoles de mayor difusión en la primera semana desde que se conoció la epidemia nos indica qué papel ha adoptado la prensa en esta ocasión.

  7. Determinants of adults' intention to vaccinate against pandemic swine flu

    Directory of Open Access Journals (Sweden)

    Goodwin Robin

    2011-01-01

    Full Text Available Abstract Background Vaccination is one of the cornerstones of controlling an influenza pandemic. To optimise vaccination rates in the general population, ways of identifying determinants that influence decisions to have or not to have a vaccination need to be understood. Therefore, this study aimed to predict intention to have a swine influenza vaccination in an adult population in the UK. An extension of the Theory of Planned Behaviour provided the theoretical framework for the study. Methods Three hundred and sixty two adults from the UK, who were not in vaccination priority groups, completed either an online (n = 306 or pen and paper (n = 56 questionnaire. Data were collected from 30th October 2009, just after swine flu vaccination became available in the UK, and concluded on 31st December 2009. The main outcome of interest was future swine flu vaccination intentions. Results The extended Theory of Planned Behaviour predicted 60% of adults' intention to have a swine flu vaccination with attitude, subjective norm, perceived control, anticipating feelings of regret (the impact of missing a vaccination opportunity, intention to have a seasonal vaccine this year, one perceived barrier: "I cannot be bothered to get a swine flu vaccination" and two perceived benefits: "vaccination decreases my chance of getting swine flu or its complications" and "if I get vaccinated for swine flu, I will decrease the frequency of having to consult my doctor," being significant predictors of intention. Black British were less likely to intend to have a vaccination compared to Asian or White respondents. Conclusions Theoretical frameworks which identify determinants that influence decisions to have a pandemic influenza vaccination are useful. The implications of this research are discussed with a view to maximising any future pandemic influenza vaccination uptake using theoretically-driven applications.

  8. [Mathematical models as tools for studying and developing strategies in the case of a pandemic influenza outbreak].

    Science.gov (United States)

    Huppert, Amit; Katriel, Haggai; Yaari, Rami; Barnea, Oren; Roll, Uri; Stern, Eli; Balicer, Ran; Stone, Lewi

    2010-01-01

    The current spread of swine flu H1N1 raises serious concerns for public health worldwide. Mathematical modelling has proved to be an essential tool for both developing strategies in preparation for an outbreak and for predicting and evaluating the effectiveness of control policies during an outbreak. Given its growing importance, this article outlines some of the fundamental contributions of mathematical modelling in the study of infectious diseases. The authors review the classical SIR model which has become central to epidemiology, demonstrating basic concepts such as outbreak threshold, the reproductive number Ro and herd immunity. The authors show how the model can be expanded to include different intervention and mitigation strategies, and discuss other biological and social complexities that may be introduced. Finally, the paper illustrates different scenarios for the spread of swine flu in Israel and provides estimates for Reproductive rate (Ro).

  9. Dengue disease outbreak definitions are implicitly variable

    Directory of Open Access Journals (Sweden)

    Oliver J. Brady

    2015-06-01

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

  10. Monitoring influenza activity in the United States: a comparison of traditional surveillance systems with Google Flu Trends.

    Directory of Open Access Journals (Sweden)

    Justin R Ortiz

    2011-04-01

    Full Text Available Google Flu Trends was developed to estimate US influenza-like illness (ILI rates from internet searches; however ILI does not necessarily correlate with actual influenza virus infections.Influenza activity data from 2003-04 through 2007-08 were obtained from three US surveillance systems: Google Flu Trends, CDC Outpatient ILI Surveillance Network (CDC ILI Surveillance, and US Influenza Virologic Surveillance System (CDC Virus Surveillance. Pearson's correlation coefficients with 95% confidence intervals (95% CI were calculated to compare surveillance data. An analysis was performed to investigate outlier observations and determine the extent to which they affected the correlations between surveillance data. Pearson's correlation coefficient describing Google Flu Trends and CDC Virus Surveillance over the study period was 0.72 (95% CI: 0.64, 0.79. The correlation between CDC ILI Surveillance and CDC Virus Surveillance over the same period was 0.85 (95% CI: 0.81, 0.89. Most of the outlier observations in both comparisons were from the 2003-04 influenza season. Exclusion of the outlier observations did not substantially improve the correlation between Google Flu Trends and CDC Virus Surveillance (0.82; 95% CI: 0.76, 0.87 or CDC ILI Surveillance and CDC Virus Surveillance (0.86; 95%CI: 0.82, 0.90.This analysis demonstrates that while Google Flu Trends is highly correlated with rates of ILI, it has a lower correlation with surveillance for laboratory-confirmed influenza. Most of the outlier observations occurred during the 2003-04 influenza season that was characterized by early and intense influenza activity, which potentially altered health care seeking behavior, physician testing practices, and internet search behavior.

  11. Development of the Flu-PRO: a patient-reported outcome (PRO) instrument to evaluate symptoms of influenza.

    Science.gov (United States)

    Powers, John H; Guerrero, M Lourdes; Leidy, Nancy Kline; Fairchok, Mary P; Rosenberg, Alice; Hernández, Andrés; Stringer, Sonja; Schofield, Christina; Rodríguez-Zulueta, Patricia; Kim, Katherine; Danaher, Patrick J; Ortega-Gallegos, Hilda; Bacci, Elizabeth Dansie; Stepp, Nathaniel; Galindo-Fraga, Arturo; St Clair, Kristina; Rajnik, Michael; McDonough, Erin A; Ridoré, Michelande; Arnold, John C; Millar, Eugene V; Ruiz-Palacios, Guillermo M

    2016-01-05

    To develop content validity of a comprehensive patient-reported outcome (PRO) measure following current best scientific methodology to standardize assessment of influenza (flu) symptoms in clinical research. Stage I (Concept Elicitation): 1:1 telephone interviews with influenza-positive adults (≥18 years) in the US and Mexico within 7 days of diagnosis. Participants described symptom type, character, severity, and duration. Content analysis identified themes and developed the draft Flu-PRO instrument. Stage II (Cognitive Interviewing): The Flu-PRO was administered to a unique set of influenza-positive adults within 14 days of diagnosis; telephone interviews addressed completeness, respondent interpretation of items and ease of use. Samples: Stage I: N = 46 adults (16 US, 30 Mexico); mean (SD) age: 38 (19), 39 (14) years; % female: 56%, 73%; race: 69% White, 97% Mestizo. Stage II: N = 34 adults (12 US, 22 Mexico); age: 37 (14), 39 (11) years; % female: 50%, 50%; race: 58% White, 100% Mestizo. Symptoms identified by >50%: coughing, weak or tired, throat symptoms, congestion, headache, weakness, sweating, chills, general discomfort, runny nose, chest (trouble breathing), difficulty sleeping, and body aches or pains. No new content was uncovered during Stage II; participants easily understood the instrument. Results show the 37-item Flu-PRO is a content valid measure of influenza symptoms in adults with a confirmed diagnosis of influenza. Research is underway to evaluate the suitability of the instrument for children and adolescents. This work can form the basis for future quantitative tests of reliability, validity, and responsiveness to evaluate the measurement properties of Flu-PRO for use in clinical trials and epidemiology studies.

  12. Monitoring influenza activity in the United States: a comparison of traditional surveillance systems with Google Flu Trends.

    Science.gov (United States)

    Ortiz, Justin R; Zhou, Hong; Shay, David K; Neuzil, Kathleen M; Fowlkes, Ashley L; Goss, Christopher H

    2011-04-27

    Google Flu Trends was developed to estimate US influenza-like illness (ILI) rates from internet searches; however ILI does not necessarily correlate with actual influenza virus infections. Influenza activity data from 2003-04 through 2007-08 were obtained from three US surveillance systems: Google Flu Trends, CDC Outpatient ILI Surveillance Network (CDC ILI Surveillance), and US Influenza Virologic Surveillance System (CDC Virus Surveillance). Pearson's correlation coefficients with 95% confidence intervals (95% CI) were calculated to compare surveillance data. An analysis was performed to investigate outlier observations and determine the extent to which they affected the correlations between surveillance data. Pearson's correlation coefficient describing Google Flu Trends and CDC Virus Surveillance over the study period was 0.72 (95% CI: 0.64, 0.79). The correlation between CDC ILI Surveillance and CDC Virus Surveillance over the same period was 0.85 (95% CI: 0.81, 0.89). Most of the outlier observations in both comparisons were from the 2003-04 influenza season. Exclusion of the outlier observations did not substantially improve the correlation between Google Flu Trends and CDC Virus Surveillance (0.82; 95% CI: 0.76, 0.87) or CDC ILI Surveillance and CDC Virus Surveillance (0.86; 95%CI: 0.82, 0.90). This analysis demonstrates that while Google Flu Trends is highly correlated with rates of ILI, it has a lower correlation with surveillance for laboratory-confirmed influenza. Most of the outlier observations occurred during the 2003-04 influenza season that was characterized by early and intense influenza activity, which potentially altered health care seeking behavior, physician testing practices, and internet search behavior.

  13. Monitoring Influenza Activity in the United States: A Comparison of Traditional Surveillance Systems with Google Flu Trends

    Science.gov (United States)

    Ortiz, Justin R.; Zhou, Hong; Shay, David K.; Neuzil, Kathleen M.; Fowlkes, Ashley L.; Goss, Christopher H.

    2011-01-01

    Background Google Flu Trends was developed to estimate US influenza-like illness (ILI) rates from internet searches; however ILI does not necessarily correlate with actual influenza virus infections. Methods and Findings Influenza activity data from 2003–04 through 2007–08 were obtained from three US surveillance systems: Google Flu Trends, CDC Outpatient ILI Surveillance Network (CDC ILI Surveillance), and US Influenza Virologic Surveillance System (CDC Virus Surveillance). Pearson's correlation coefficients with 95% confidence intervals (95% CI) were calculated to compare surveillance data. An analysis was performed to investigate outlier observations and determine the extent to which they affected the correlations between surveillance data. Pearson's correlation coefficient describing Google Flu Trends and CDC Virus Surveillance over the study period was 0.72 (95% CI: 0.64, 0.79). The correlation between CDC ILI Surveillance and CDC Virus Surveillance over the same period was 0.85 (95% CI: 0.81, 0.89). Most of the outlier observations in both comparisons were from the 2003–04 influenza season. Exclusion of the outlier observations did not substantially improve the correlation between Google Flu Trends and CDC Virus Surveillance (0.82; 95% CI: 0.76, 0.87) or CDC ILI Surveillance and CDC Virus Surveillance (0.86; 95%CI: 0.82, 0.90). Conclusions This analysis demonstrates that while Google Flu Trends is highly correlated with rates of ILI, it has a lower correlation with surveillance for laboratory-confirmed influenza. Most of the outlier observations occurred during the 2003–04 influenza season that was characterized by early and intense influenza activity, which potentially altered health care seeking behavior, physician testing practices, and internet search behavior. PMID:21556151

  14. Coccidiosis in the Chukar Partridge ( Alectoris chukar ): A Survey of Coccidiosis Outbreaks and a Test of Anticoccidial Drugs Against Eimeria kofoidi.

    Science.gov (United States)

    Gerhold, R W; Fuller, A L; McDougald, L R

    2016-12-01

    Field isolates of coccidia from 20 natural outbreaks in the chukar partridge ( Alectoris chukar ) were received from gamebird farms in 10 U.S. states. These were propagated in the laboratory and identified by microscopy and PCR. Of 20 samples, 18 were Eimeria kofoidi, two were Eimeria legionensis only, and one was a mixture of the two species. One isolate of E. kofoidi also contained an unidentified species detected only by PCR, nucleotide sequencing, and phylogenetic analysis. The efficacy of anticoccidial drugs against chukar coccidia was tested with experimental infections in battery cages. Isolates of E. kofoidi were used to infect 2-wk-old chukars. Anticoccidial products were given in the feed at levels approved for other poultry or for chukars. Tests were terminated at 6 days postinoculation with measurement of weight gains, fecal diarrhea scores, and necropsy to observe for lesion severity. Lasalocid (120 ppm) was moderately effective in one test. When tested against four field isolates, other ionophores (monensin, salinomycin, semduramicin) showed moderate effectiveness in reducing lesions and improving weight gains. Rofenaid (a potentiated sulfa mixture), robenidine (30 ppm), diclazuril (2 ppm), and decoquinate (80 ppm) were highly effective. In a test of nine products against a highly virulent field isolate, only diclazuril (2 ppm) and clopidol (125 ppm) reduced the severity of lesions and improved weight gain relative to infected controls, suggesting the extent to which previous drug usage had selected for drug resistance.

  15. Pattern of the meningococcal meningitis outbreak in Northern Nigeria, 2009

    Directory of Open Access Journals (Sweden)

    Bassey Enya Bassey

    2016-02-01

    Conclusions: The testing of CSF samples during meningitis outbreaks is recommended in order to monitor the occurrence of the multiple meningitis serotypes during these outbreaks and to direct serotype-specific vaccination response activities.

  16. fluEvidenceSynthesis: An R package for evidence synthesis based analysis of epidemiological outbreaks.

    Science.gov (United States)

    van Leeuwen, Edwin; Klepac, Petra; Thorrington, Dominic; Pebody, Richard; Baguelin, Marc

    2017-11-01

    Public health related decisions often have to balance the cost of intervention strategies with the benefit of the reduction in disease burden. While the cost can often be inferred, forward modelling of the effect of different intervention options is complicated and disease specific. Here we introduce a package that is aimed to simplify this process. The package allows one to infer parameters using a Bayesian approach, perform forward modelling of the likely results of the proposed intervention and finally perform cost effectiveness analysis of the results. The package is based on a method previously used in the United Kingdom to inform vaccination strategies for influenza, with extensions to make it easily adaptable to other diseases and data sources.

  17. Don't Get, Don't Spread: Seasonal Flu

    Centers for Disease Control (CDC) Podcasts

    2010-09-29

    In this podcast, Dr. Joe Bresee describes how to keep from getting the seasonal flu and spreading it to others.  Created: 9/29/2010 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/29/2010.

  18. "FluSpec": A Simulated Experiment in Fluorescence Spectroscopy

    Science.gov (United States)

    Bigger, Stephen W.; Bigger, Andrew S.; Ghiggino, Kenneth P.

    2014-01-01

    The "FluSpec" educational software package is a fully contained tutorial on the technique of fluorescence spectroscopy as well as a simulator on which experiments can be performed. The procedure for each of the experiments is also contained within the package along with example analyses of results that are obtained using the software.

  19. Mathematical model for bird flu disease transmission | Yusuf ...

    African Journals Online (AJOL)

    Bird flu (Avian influenza) is a contagious disease of animals caused by viruses that normally infect only birds and, less commonly, pigs. These viruses are highly species-specific, but have, on rare occasions, crossed the species barrier to infect humans. The world at large never considered it a serious threat to mankind until ...

  20. Flu Shots, Mammogram, and the Perception of Probabilities

    NARCIS (Netherlands)

    Carman, K.G.; Kooreman, P.

    2010-01-01

    We study individuals’ decisions to decline or accept preventive health care interventions such as flu shots and mammograms. In particular, we analyze the role of perceptions of the effectiveness of the intervention, by eliciting individuals' subjective probabilities of sickness and survival, with

  1. Mathematical model for bird flu disease transmission with no bird ...

    African Journals Online (AJOL)

    In this paper a mathematical model for the transmission dynamics of bird flu among birds and humans is presented. The model assumes that there is no migration of birds in the susceptible bird population immediately the disease starts. The model formulated is analyzed using dynamical systems theory . The analysis of the ...

  2. Can mothers who have swine flu continue to breastfeed? Yes!

    African Journals Online (AJOL)

    Siegal_D

    Explain to the mother and other family members that the main way the flu virus is transmitted is by. 'droplets' from coughs and sneezes. So the family can reduce the risk of infecting each other (including mother and baby), and other people by: ▫ Washing hands with soap frequently and thoroughly, especially after sneezing.

  3. mathematical model for bird flu disease transmission with no bird ...

    African Journals Online (AJOL)

    Admin

    In this paper a mathematical model for the transmission dynamics of bird flu among birds and humans is presented. The model assumes that there is no migration of birds in the susceptible bird population immediately the disease starts. The model formulated is analyzed using dynamical systems theory. The analysis of the ...

  4. High level of political involvement 1976 flu pandemic- that never ...

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. High level of political involvement 1976 flu pandemic- that never occurred. In 1976, one patient died from an influenza, identified as swine virus. CDC Director argued forcefully in favor of immunization as only way to mitigate ensuing pandemic. President Ford on advice of ...

  5. Pandemics and networks : The case of the Mexican flu

    NARCIS (Netherlands)

    Omic, J.; Van Mieghem, P.

    2010-01-01

    The recent widespread of the new Mexican flu and SARS show the high dependency on contemporary traveling patterns. The air transport network is recognized as an important channel of epidemic propagation for different diseases. In order to predict epidemic spreading and the influence of protection

  6. Characterization of a Tsukamurella pseudo-outbreak by phenotypic tests, 16S rRNA sequencing, pulsed-field gel electrophoresis, and metabolic footprinting.

    Science.gov (United States)

    To, Kelvin K W; Fung, Ami M Y; Teng, Jade L L; Curreem, Shirly O T; Lee, Kim-Chung; Yuen, Kwok-Yung; Lam, Ching-Wan; Lau, Susanna K P; Woo, Patrick C Y

    2013-01-01

    We report a pseudo-outbreak of Tsukamurella due to improperly wrapped scissors used for processing of tissue specimens. A polyphasic approach, involving biochemical, genetic, and metabolomic techniques, was used in the laboratory investigation. This report highlights that early recognition of pseudo-outbreaks is important in preventing unnecessary and incorrect treatment of patients.

  7. CLINICAL PRESENTATION, RADIOLOGICAL FEATURES AND COURSE OF THE DISEASE IN SWINE FLU POSITIVE PATIENTS ADMITTED IN THE RESPIRATORY INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Aruna

    2015-06-01

    Full Text Available BACKGROUND : Since the 2009 pandemic of H1N1 or Swine Flu influenza , there have been respiratory emergencies every year throughout India , but in the early part of this year that is between January and April 2015 an explosion of cases was seen throughout the country , and so also in our state , Andhra Pradesh. The study of clinical presentation , radiological features and course of the disease helps in early suspicion , isolation , detection and institution of treatment in swine flu positive patients so that further spread of the disease can be co ntrolled and the patients saved . MATERIAL AND METHODS : This is a cross - sectional study conducted at the Department of Pulmonary Medicine , S.V.R.R. Govt. General Hospital , Tirupathi , between January 2015 and April 2015. Study sample was the total number of swine flu suspects who were admitted in the Respiratory Intensive Care Unit and swine flu wards of the Department of Pulmonary Medicine. SUMMARY : Out of 32 suspects admitted , 13 tested positive for swine flu. 8 of the 13 were females (61% and 5 were males (39%. Cold , cough and breathlessness were present in all the patients (100%. Sore throat was present in only 4 patients (30%. 11 out of the 13 patients were in respiratory failure (85%. 9 out of the 13 had comorbidities like diabetes , bronchial asthma and chronic kidney disease (70%. Chest X - ray and CT chest showed ARDS like pic ture and pneumonia in 11 out of the 13 patients (85%.

  8. Influenza Risk Management: Lessons Learned from an A(H1N1) pdm09 Outbreak Investigation in an Operational Military Setting

    Science.gov (United States)

    2013-07-10

    Olalla Peralta P, et al.. Pandemic Influenza (H 1 N 1) 2009 Outbreak in a Military Academy: start of community circulation in Spain. Rev Esp Salud ... Publica 84(5):597-607 5. Kapp L, Jansen DJ (2009) The role of the Department of Defense during a flu pandemic. Washington (DC): CRS Report for Congress

  9. Measles Outbreak among Unvaccinated Children in Bajura

    Directory of Open Access Journals (Sweden)

    S Sitaula

    2010-12-01

    CFR of this outbreak is higher than the national CFR. Vaccine efficacy of 50% points towards the need for investigation of vaccine logistics and cold chain system. Moreover, this laboratory test confirmed an outbreak showing that the measles virus could be imported from an endemic region and rapidly spread through a susceptible population who were previously not immunized.

  10. Preparing for the Flu (Including 2009 H1N1 Flu): A Communication Toolkit for Schools (Grades K-12)

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2010

    2010-01-01

    The purpose of "Preparing for the Flu: A Communication Toolkit for Schools" is to provide basic information and communication resources to help school administrators implement recommendations from CDC's (Centers for Disease Control and Prevention) Guidance for State and Local Public Health Officials and School Administrators for School (K-12)…

  11. Determining symptoms for chest radiographs in patients with swine flu (H1N1)

    International Nuclear Information System (INIS)

    Al-Nakshabandi, Nizar A.

    2011-01-01

    The question arises about the chest X-ray findings and clinical symptoms in swine flu and about the most important clinical finding when correlated with the chest radiograph. Should physicians order a chest X-ray in each patient suspected of having swine flu? There were 179 patients with a high suspicion of swine flu. All 179 patients had an initial chest radiograph. As many as 65 males (representing 56% of the projected study population) had a normal chest radiograph, while 35 males (representing 55.6% of the study population) had an abnormal chest X-ray. As many as 51 females (representing 44% of the population) had a normal chest X-ray, while 20 females (representing 44% of the study population) had abnormal chest X-rays. Polymerase chain reaction (PCR) was not a determining factor for normal vs. abnormal chest X-ray (CXR). Rapid antigen test was not a determining factor for normal vs. abnormal CXR. Fever was not a determining factor for normal vs. abnormal CXR. Cough appears to be a determining factor for normal vs. abnormal CXR. Sore throat appears to be a determining factor for normal vs. abnormal CXR. Chest pain was not a determining factor for normal vs. abnormal CXR. Presence of cough with PCR was statistically significant. In my opinion, chest radiographs in patients with suspected H1N1 should only be obtained if there is a cough or sore throat. Other symptoms associated with H1N1 do not warrant a chest radiograph unless absolutely necessary

  12. Pandemic H1N1 2009 ('swine flu'): diagnostic and other challenges.

    Science.gov (United States)

    Burkardt, Hans-Joachim

    2011-01-01

    Pandemic H1N1 2009 ('swine flu') virus was 'the virus of the year 2009' because it affected the lives of many people in this year. H1N1 was first described in California in April 2009 and spread very rapidly all over the globe. The fast global penetration of the swine flu caused the WHO in Geneva to call the infection with H1N1 a new pandemic with a rapid escalation of the different pandemic phases that ended on 11 June 2009, with the declaration of phase 6 (full-blown pandemic). This had far-reaching consequences for the local health authorities in the different affected countries and created awareness in the public and fear in the experts and even more so in many lay people. The consequences were: setting up reliable diagnostic tests as soon as possible; enhanced production, distribution and stock creation of the few drugs that were available to treat newly infected persons; and development, production, distribution and stock creation of new and appropriate anti-H1N1 swine flu vaccines. This all resulted in enormous costs in the local healthcare systems and also required smart and diligent logistics, because demand for all this was, in most cases, much higher than availability. Fortunately, the pandemic ended quite quickly (there was no 'second wave' as had been anticipated by some experts) and the death toll was moderate, compared with other influenza pandemic in the past and even to the regular annual appearance of the seasonal flu. This favorable outcome, however, provoked some harsh criticism that the WHO and healthcare systems in general had over-reacted and by doing so, a lot of money was thrown out of the window. This article describes the history of the H1N1 pandemic, the diagnostic challenges and resolutions, touches on treatment and vaccination very briefly and also comments on the criticism and arguments that came up immediately at the end and following the termination of the pandemic situation.

  13. Nowcasting influenza outbreaks using open-source media report.

    Energy Technology Data Exchange (ETDEWEB)

    Ray, Jaideep; Brownstein, John S. [Boston Children%3CU%2B2019%3Es Hospital, Boston, MA

    2013-02-01

    We construct and verify a statistical method to nowcast influenza activity from a time-series of the frequency of reports concerning influenza related topics. Such reports are published electronically by both public health organizations as well as newspapers/media sources, and thus can be harvested easily via web crawlers. Since media reports are timely, whereas reports from public health organization are delayed by at least two weeks, using timely, open-source data to compensate for the lag in %E2%80%9Cofficial%E2%80%9D reports can be useful. We use morbidity data from networks of sentinel physicians (both the Center of Disease Control's ILINet and France's Sentinelles network) as the gold standard of influenza-like illness (ILI) activity. The time-series of media reports is obtained from HealthMap (http://healthmap.org). We find that the time-series of media reports shows some correlation ( 0.5) with ILI activity; further, this can be leveraged into an autoregressive moving average model with exogenous inputs (ARMAX model) to nowcast ILI activity. We find that the ARMAX models have more predictive skill compared to autoregressive (AR) models fitted to ILI data i.e., it is possible to exploit the information content in the open-source data. We also find that when the open-source data are non-informative, the ARMAX models reproduce the performance of AR models. The statistical models are tested on data from the 2009 swine-flu outbreak as well as the mild 2011-2012 influenza season in the U.S.A.

  14. Spanish flu, Asian flu, Hong Kong flu, and seasonal influenza in Japan under social and demographic influence: review and analysis using the two-population model.

    Science.gov (United States)

    Yoshikura, Hiroshi

    2014-01-01

    When cumulative numbers of patients (X) and deaths (Y) associated with an influenza epidemic are plotted using the log-log scale, the plots fall on an ascending straight line generally expressed as logY = k(logX - logN0). For the 2009 H1N1 influenza pandemic, the slope k was ~0.6 for Mexico and ~2 for other countries. The two-population model was proposed to explain this phenomenon (Yoshikura H. Jpn J Infect Dis. 2012;65:279-88; Yoshikura H. Jpn J Infect Dis. 2009;62:411-2; and Yoshikura H. Jpn J Infect Dis. 2009;62:482-4). The current article reviews and analyzes previous influenza epidemics in Japan to examine whether the two-population model is applicable to them. The slope k was found to be ~2 for the Spanish flu during 1918-1920 and the Asian flu during 1957-1958, and ~1 for the Hong Kong flu and seasonal influenza prior to 1960-1961; however, k was ~0.6 for seasonal influenza after 1960-1961. This transition of the slope k of seasonal influenza plots from ~1 to ~0.6 corresponded to the shift in influenza mortality toward the older age groups and a drastic reduction in infant mortality rates due to improvements in the standard of living during the 1950s and 1960s. All the above observations could be well explained by reconstitution of the influenza epidemic based on the two-population model.

  15. Novel Isoprene Sensor for a Flu Virus Breath Monitor

    Directory of Open Access Journals (Sweden)

    Pelagia-Irene Gouma

    2017-01-01

    Full Text Available A common feature of the inflammatory response in patients who have actually contracted influenza is the generation of a number of volatile products of the alveolar and airway epithelium. These products include a number of volatile organic compounds (VOCs and nitric oxide (NO. These may be used as biomarkers to detect the disease. A portable 3-sensor array microsystem-based tool that can potentially detect flu infection biomarkers is described here. Whether used in connection with in-vitro cell culture studies or as a single exhale breathalyzer, this device may be used to provide a rapid and non-invasive screening method for flu and other virus-based epidemics.

  16. HEALTH CARE DATA WAREHOUSE SYSTEM ARCHITECTURE FOR INFLUENZA (FLU) DISEASES

    OpenAIRE

    Rajib Dutta

    2013-01-01

    Data Warehouse is the most reliable technology used by the company for planning, forecasting and management. Critical business management data was contained in several unrelated and disconnected databases, both internally managed and from external sources. Client was unable to view the data from an integrated viewpoint. The data warehousing is one of the best technique to integrate data. This paper presents the Influenza (Flu) diseases specific data warehouse architecture for h...

  17. Strategies for Fighting Pandemic Flu in Developing Countries

    Centers for Disease Control (CDC) Podcasts

    2009-03-04

    Countries throughout the world are preparing for the next influenza pandemic. Developing countries face special challenges because they don't have antiviral drugs or vaccines that more developed countries have. In this podcast, CDC's Dr. Dan Jernigan discusses new and innovative approaches that may help developing countries fight pandemic flu when it emerges.  Created: 3/4/2009 by Emerging Infectious Diseases.   Date Released: 3/4/2009.

  18. Pregnant Women: Know the Signs and Symptoms of Flu

    Centers for Disease Control (CDC) Podcasts

    2010-11-17

    This podcast is targeted to pregnant women and explains 1) the signs and symptoms of the flu, and 2) what to do if you experience and signs and symptoms. This podcast is NOT a substitute for the advice of your doctor or health care provider. It is intended for educational purposes only.  Created: 11/17/2010 by National Center for Immunization and Respiratory Diseases (NCIRD), Office of the Director (OD).   Date Released: 11/17/2010.

  19. [Analysis of the refusal of the flu vaccination (REGRIVI study)].

    Science.gov (United States)

    Méijome-Blanco, S; González-Cristobo, G; Regueiro-Martínez, A Á

    2018-02-10

    The objective of this study is to determine the reasons for refusing the flu vaccination in the Primary Care Health Centre of Vilanova de Arousa, Spain, as well as to evaluate the flu vaccination coverage after an educational intervention. A quasi-experimental before and after study was conducted after an educational intervention on a total of 73 people that included those Primary Care Health Centre patients from Vilanova de Arousa who had refused the flu vaccination in 2014, and who did not meet the exclusion criteria (death during 2014 and 2015 campaigns, non-acceptance of participation, vaccine registration mistakes, contraindication or no indication for the vaccine, inability to contact). After a brief educational intervention, vaccination data from those patients in the 2015 and 2016 campaigns were checked. A descriptive analysis of the variables under study was then carried out. Of the 73 patients initially included, 72 completed the study. The main reasons for refusing a vaccination were the concerns about the adverse effects and patient perception of good health. Vaccination coverage was 50.7% in 2015, and 48.6% in 2016. The reasons for refusing vaccination are approachable with a brief intervention since the refusal decreases by half in the long-term. Copyright © 2018 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Deciphering the Swine-Flu Pandemics of 1918 and 2009

    Science.gov (United States)

    Goldstein, Richard; Dos Reis, Mario; Tamuri, Asif; Hay, Alan

    The devastating "Spanish flu" of 1918 killed an estimated 50 million people worldwide, ranking it as the deadliest pandemic in recorded human history. It is generally believed that the virus transferred from birds directly to humans shortly before the start of the pandemic, subsequently jumping from humans to swine. By developing 'non-homogeneous' substitution models that consider that substitution patterns may be different in human, avian, and swine hosts, we can determine the timing of the host shift to mammals. We find it likely that the Spanish flu of 1918, like the current 2009 pandemic, was a 'swine-origin' influenza virus. Now that we are faced with a new pandemic, can we understand how influenza is able to change hosts? Again by modelling the evolutionary process, considering the different selective constraints for viruses in the different hosts, we can identify locations that seem to be under different selective constraints in humans and avian hosts. This allows us to identify changes that may have facilitated the establishment of the 2009 swine-origin flu in humans.

  1. Faster Detection of Poliomyelitis Outbreaks to Support Polio Eradication.

    Science.gov (United States)

    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.

  2. Pandemic flu knowledge among dormitory housed university students: a need for informal social support and social networking strategies.

    Science.gov (United States)

    Wilson, Susan L; Huttlinger, Kathleen

    2010-01-01

    The declaration of a Phase 6 pandemic of influenza A (H1N1) by the World Health Organization in June 2009, triggered the activation of preparedness responses worldwide. During 2009 spring and fall, many US universities actuated their emergency pandemic preparedness plans. This article describes a research study that used a modified community based participatory research (CBPR) approach between August and November 2009 at New Mexico State University's main Las Cruces campus to determine influenza (pandemic influenza A (H1N1) 2009 and seasonal influenza knowledge, attitudes, and health communication (informal support networks and social networking) strategies specifically related to influenza among dormitory housed (on-campus living) undergraduate students. The goal was to produce data for use in the university's pandemic illness/disaster preparedness and response plans. Following activation of the university's campus-wide efforts to educate students about pandemic flu, university community partners were asked for input regarding information for flu preparedness for the university's undergraduate students. Student participants were recruited for the present study from those housed in four campus dormitories. A purposive convenience sample was used to collect survey data from 175 students during the peak week of reported flu cases on campus. Each participant was given an anonymous, face-to-face, self-administered survey and 167 surveys were able to be analyzed. A χ² goodness of fit test was used to determine whether observed proportions of categorical variables differed from hypothesized proportions. Four categorical data were analyzed by topics: (1) demographics; (2) flu awareness; (3) flu immunization knowledge and practices; and (4) communication and health information practices. The average age was 19.6 years (SD = 1.8), with no significant differences by sex (86 males and 76 females, 5 undisclosed) or race/ethnicity (57 White, 43 Hispanic, 44 Other). All

  3. Comparison: Flu prescription sales data from a retail pharmacy in the US with Google Flu trends and US ILINet (CDC data as flu activity indicator.

    Directory of Open Access Journals (Sweden)

    Avinash Patwardhan

    Full Text Available The potential threat of bioterrorism along with the emergence of new or existing drug resistant strains of influenza virus, added to expanded global travel, have increased vulnerability to epidemics or pandemics and their aftermath. The same factors have also precipitated urgency for having better, faster, sensitive, and reliable syndromic surveillance systems. Prescription sales data can provide surrogate information about the development of infectious diseases and therefore serve as a useful tool in syndromic surveillance. This study compared prescription sales data from a large drug retailing pharmacy chain in the United States with Google Flu trends surveillance system data as a flu activity indicator. It was found that the two were highly correlated. The correlation coefficient (Pearson 'r' for five years' aggregate data (2007-2011 was 0.92 (95% CI, 0.90-0.94. The correlation coefficients for each of the five years between 2007 and 2011 were 0.85, 0.92, 0.91, 0.88, and 0.87 respectively. Additionally, prescription sales data from the same large drug retailing pharmacy chain in the United States were also compared with US Outpatient Influenza-like Illness Surveillance Network (ILINet data for 2007 by Centers for Disease Control and Prevention (CDC. The correlation coefficient (Pearson 'r' was 0.97 (95% CI, 0.95-0.98.

  4. Swine-Origin Influenza A Outbreak 2009 at Shinshu University, Japan

    Directory of Open Access Journals (Sweden)

    Washizuka Shinsuke

    2011-02-01

    Full Text Available Abstract Background A worldwide outbreak of swine flu H1N1 pandemic influenza occurred in April 2009. To determine the mechanism underlying the spread of infection, we prospectively evaluated a survey implemented at a local university. Methods Between August 2009 and March 2010, we surveyed 3 groups of subjects: 2318 children in six schools attached to the Faculty of Education, 11424 university students, and 3344 staff members. Subjects with influenza-like symptoms who were diagnosed with swine flu at hospitals or clinics were defined as swine flu patients and asked to make a report using a standardized form. Results After the start of the pandemic, a total of 2002 patients (11.7% were registered in the survey. These patients included 928 schoolchildren (40.0%, 1016 university students (8.9%, and 58 staff members (1.7%. The incidence in schoolchildren was significantly higher than in the other 2 groups (P Conclusion Schoolchildren and university students are vulnerable to swine flu, suggesting that avoidance of close contact, especially among these young people, may be effective way in controlling future severe influenza pandemics, especially at educational institutions.

  5. Social network sensors for early detection of contagious outbreaks.

    Science.gov (United States)

    Christakis, Nicholas A; Fowler, James H

    2010-09-15

    Current methods for the detection of contagious outbreaks give contemporaneous information about the course of an epidemic at best. It is known that individuals near the center of a social network are likely to be infected sooner during the course of an outbreak, on average, than those at the periphery. Unfortunately, mapping a whole network to identify central individuals who might be monitored for infection is typically very difficult. We propose an alternative strategy that does not require ascertainment of global network structure, namely, simply monitoring the friends of randomly selected individuals. Such individuals are known to be more central. To evaluate whether such a friend group could indeed provide early detection, we studied a flu outbreak at Harvard College in late 2009. We followed 744 students who were either members of a group of randomly chosen individuals or a group of their friends. Based on clinical diagnoses, the progression of the epidemic in the friend group occurred 13.9 days (95% C.I. 9.9-16.6) in advance of the randomly chosen group (i.e., the population as a whole). The friend group also showed a significant lead time (psensor method could provide significant additional time to react to epidemics in small or large populations under surveillance. The amount of lead time will depend on features of the outbreak and the network at hand. The method could in principle be generalized to other biological, psychological, informational, or behavioral contagions that spread in networks.

  6. Preparedness of elderly long-term care facilities in HSE East for influenza outbreaks.

    LENUS (Irish Health Repository)

    O'Connor, L

    2015-01-01

    Abstract We assessed preparedness of HSE East elderly long-term care facilities for an influenza outbreak, and identified Public Health Department support needs. We surveyed 166 facilities based on the HSE checklist document for influenza outbreaks, with 58% response rate. Client flu vaccination rates were > 75%; leading barriers were client anxiety and consent issues. Target flu vaccine uptake of 40% in staff occurred in 43% of facilities and was associated with staff vaccine administration by afacility-attached GP (p = 0.035), having a facility outbreak plan (p = 0.013) and being anon-HSE run facility (p = 0.013). Leading barriers were staff personal anxiety (94%) and lack of awareness of the protective effect on clients (21%). Eighty-nine percent found Public Health helpful, and requested further educational support and advocacy. Staff vaccine uptake focus, organisational leadership, optimal vaccine provision models, outbreak plans and Public Health support are central to the influenza campaign in elderly long-term care facilities.

  7. Onset of a pandemic: characterizing the initial phase of the swine flu (H1N1 epidemic in Israel

    Directory of Open Access Journals (Sweden)

    Mendelson Ella

    2011-04-01

    Full Text Available Abstract Background The swine influenza H1N1 first identified in Mexico, spread rapidly across the globe and is considered the fastest moving pandemic in history. The early phase of an outbreak, in which data is relatively scarce, presents scientific challenges on key issues such as: scale, severity and immunity which are fundamental for establishing sound and rapid policy schemes. Our analysis of an Israeli dataset aims at understanding the spatio-temporal dynamics of H1N1 in its initial phase. Methods We constructed and analyzed a unique dataset from Israel on all confirmed cases (between April 26 to July 7, 2009, representing most swine flu cases in this period. We estimated and characterized fundamental epidemiological features of the pandemic in Israel (e.g. effective reproductive number, age-class distribution, at-risk social groups, infections between sexes, and spatial dynamics. Contact data collected during this stage was used to estimate the generation time distribution of the pandemic. Results We found a low effective reproductive number (Re = 1.06, an age-class distribution of infected individuals (skewed towards ages 18-25, at-risk social groups (soldiers and ultra Orthodox Jews, and significant differences in infections between sexes (skewed towards males. In terms of spatial dynamics, the pandemic spread from the central coastal plain of Israel to other regions, with higher infection rates in more densely populated sub-districts with higher income households. Conclusions Analysis of high quality data holds much promise in reducing uncertainty regarding fundamental aspects of the initial phase of an outbreak (e.g. the effective reproductive number Re, age-class distribution, at-risk social groups. The formulation for determining the effective reproductive number Re used here has many advantages for studying the initial phase of the outbreak since it neither assumes exponential growth of infectives and is independent of the

  8. Great Basin insect outbreaks

    Science.gov (United States)

    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.

  9. Canadian survey on pandemic flu preparations

    Directory of Open Access Journals (Sweden)

    Tracy CS

    2010-03-01

    Full Text Available Abstract Background The management of pandemic influenza creates public health challenges. An ethical framework, 'Stand on Guard for Thee: ethical considerations in pandemic influenza preparedness' that served as a template for the World Health Organization's global consultation on pandemic planning, was transformed into a survey administered to a random sample of 500 Canadians to obtain opinions on key ethical issues in pandemic preparedness planning. Methods All framework authors and additional investigators created items that were pilot-tested with volunteers of both sexes and all socioeconomic strata. Surveys were telephone administered with random sampling achieved via random digit dialing (RDD. Eligible participants were adults, 18 years or older, with per province stratification equaling provincial percent of national population. Descriptive results were tabulated and logistic regression analyses were used to assess whether demographic factors were significantly associated with outcomes. Results 5464 calls identified 559 eligible participants of whom 88.5% completed surveys. Over 90% of subjects agreed the most important goal of pandemic influenza preparations was saving lives, with 41% endorsing saving lives solely in Canada and 50% endorsing saving lives globally as the highest priority. Older age (OR = 8.51, p Conclusions Results suggest trust in public health officials to make difficult decisions, providing emphasis on reciprocity and respect for individual rights.

  10. assessment of the economic and social implications of the avian flu ...

    African Journals Online (AJOL)

    Admin

    2006-01-22

    Jan 22, 2006 ... KEYWORDS: Assessment, Economic, Social Implications, Avian Flu, Nigerian Poultry. INTRODUCTION. Avian flu is a highly infectious, contagious and zoonotic disease of man, poultry and other birds caused by the avian influenza type A virus, Emmanuel et.al. (2006). The avian influenza virus belongs to ...

  11. ‘Tis the Season for Flu Vaccine (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-12-10

    Flu season typically runs from late fall through early spring. In this podcast, Dr. Lisa Grohskopf discusses the importance of getting vaccinated against the flu.  Created: 12/10/2015 by MMWR.   Date Released: 12/10/2015.

  12. An econometric analysis of SARS and Avian flu on international tourist arrivals to Asia

    NARCIS (Netherlands)

    M.J. McAleer (Michael); B-W. Huang (Bing-Wen); H-I. Kuo (Hsiao-I); C-C. Chen (Chi-Chung); C-L. Chang (Chia-Lin)

    2008-01-01

    textabstractThis paper compares the impacts of SARS and human deaths arising from Avian Flu on international tourist arrivals to Asia. The effects of SARS and human deaths from Avian Flu will be compared directly according to human deaths. The nature of the short run and long run relationship is

  13. Who Takes Advantage of Free Flu Shots? Examining the Effects of an Expansion in Coverage

    NARCIS (Netherlands)

    Carman, K.G.; Mosca, I.

    2011-01-01

    Because of the high risk of costly complications (including death) and the externalities of contagious diseases, many countries provide free flu shots to certain populations free of charge. This paper examines the expansion of the free flu shot program in the Netherlands. This program expanded in

  14. Colds and flu – an overview of the management | Ismail | South ...

    African Journals Online (AJOL)

    The common cold and flu are two very different viruses that share very similar symptoms. The common cold is a self-limiting upper respiratory tract infection and it is caused by the rhinovirus, coronavirus or the adenovirus. It usually resolves within 7-10 days. The flu is caused by the influenza virus and usually presents with ...

  15. What You Should Know and Do This Flu Season If You Are 65 Years and Older

    Science.gov (United States)

    ... during most seasons, people 65 years and older bear the greatest burden of severe flu disease. In recent years, for example, it’s estimated that between 71 percent and 85 percent of seasonal flu-related deaths have occurred in people 65 years and older ...

  16. Persuasiveness of online flu-vaccination promotional banners.

    Science.gov (United States)

    Chien, Yu-Hung

    2013-04-01

    Young people appear to have relatively little motivation to participate in flu-vaccination programs. This study assessed the effectiveness of online banners in efforts to persuade young people to get vaccinated. Specifically, a 2 x 3 between-subjects factorial design was used to examine the effects of message framing (gain vs loss) and color configuration (white text on a red background, black text on a yellow background, and white text on a blue background) on 180 college students' perceptions of the persuasiveness of flu-vaccination promotional banners. Each participant completed a four-item questionnaire, and the results of an analysis of variance showed that persuasiveness scores were higher among participants exposed to a loss-framed than to a gain-framed message, but only when the loss-framed message was presented in white text on a red background. The theoretical and practical implications of manipulating these two factors in the development of effective health-promotion materials are discussed.

  17. THE AVIAN FLU IMPACT ON THE ROMANIAN POULTRY MARKET

    Directory of Open Access Journals (Sweden)

    Silvius Stanciu

    2015-05-01

    Full Text Available Poultry meat represents one of the most dynamic branches of the local meat production. The poultry sector represents a good quality protein source, at an acceptable price as compared to other animal production domains. There has been an ascending evolution of the sector after the year 2000, although there appeared a series of discontinuities that affected agricultural production, mainly on a short-term basis. The Avian Flu led to 190 million euros’ worth losses at the level of Romanian national economy. Low consumption due to the impact was a short-term consequence, being rapidly amortized by the Romanian producers. The lack of some business continuity insurance measures can further affect the poultry meat sector, which does not have the necessary robustness needed in case of larger shocks. The following article proposes an analysis of the Avian Flu crisis economic effects on the Romanian meat sector, and it is part of a general framework of research regarding the Romanian food chain resilience to critical situations.

  18. Biosurveillance in outbreak investigations.

    Science.gov (United States)

    Kaydos-Daniels, S Cornelia; Rojas Smith, Lucia; Farris, Tonya R

    2013-03-01

    Following the terrorist attacks of September 11 and the anthrax attacks in 2001, public health entities implemented automated surveillance systems based on disease syndromes for early detection of bioterror events and to increase timeliness of responses. Despite widespread adoption, syndromic surveillance systems' ability to provide early notification of outbreaks is unproven, and there is little documentation on their role in outbreak response. We hypothesized that biosurveillance is used in practice to augment classical outbreak investigations, and we used case studies conducted in 2007-08 to determine (1) which steps in outbreak investigations were best served by biosurveillance, and (2) which steps presented the greatest opportunities for improvement. The systems used in the case studies varied in how they functioned, and there were examples in which syndromic systems had identified outbreaks before other methods. Biosurveillance was used successfully for all steps of outbreak investigations. Key advantages of syndromic systems were sensitivity, timeliness, and flexibility and as a source of data for situational awareness. Limitations of biosurveillance were a lack of specificity, reliance on chief complaint data, and a lack of formal training for users. Linking syndromic data to triage notes and medical chart data would substantially increase the value of biosurveillance in the conduct of outbreak investigations and reduce the burden on health department staff.

  19. The Non-canonical Tetratricopeptide Repeat (TPR) Domain of Fluorescent (FLU) Mediates Complex Formation with Glutamyl-tRNA Reductase.

    Science.gov (United States)

    Zhang, Min; Zhang, Feilong; Fang, Ying; Chen, Xuemin; Chen, Yuhong; Zhang, Wenxia; Dai, Huai-En; Lin, Rongcheng; Liu, Lin

    2015-07-10

    The tetratricopeptide repeat (TPR)-containing protein FLU is a negative regulator of chlorophyll biosynthesis in plants. It directly interacts through its TPR domain with glutamyl-tRNA reductase (GluTR), the rate-limiting enzyme in the formation of δ-aminolevulinic acid (ALA). Delineation of how FLU binds to GluTR is important for understanding the molecular basis for FLU-mediated repression of synthesis of ALA, the universal tetrapyrrole precursor. Here, we characterize the FLU-GluTR interaction by solving the crystal structures of the uncomplexed TPR domain of FLU (FLU(TPR)) at 1.45-Å resolution and the complex of the dimeric domain of GluTR bound to FLU(TPR) at 2.4-Å resolution. Three non-canonical TPR motifs of each FLU(TPR) form a concave surface and clamp the helix bundle in the C-terminal dimeric domain of GluTR. We demonstrate that a 2:2 FLU(TPR)-GluTR complex is the functional unit for FLU-mediated GluTR regulation and suggest that the formation of the FLU-GluTR complex prevents glutamyl-tRNA, the GluTR substrate, from binding with this enzyme. These results also provide insights into the spatial regulation of ALA synthesis by the membrane-located FLU protein. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

  20. Promotion of flu vaccination among healthcare workers in an Italian academic hospital: An experience with tailored web tools.

    Science.gov (United States)

    Conte, Alessandro; Quattrin, Rosanna; Filiputti, Elisa; Cocconi, Roberto; Arnoldo, Luca; Tricarico, Pierfrancesco; Delendi, Mauro; Brusaferro, Silvio

    2016-10-02

    Influenza causes significant mortality particularly among the elderly and high-risk groups. Healthcare workers (HCWs) are at risk of occupational exposure due to contact with patients. Aims of this study was to promote flu shot among HCWs through a multimedia campaign in a large North-Eastern Italian Hospital. The 2013/2014 flu vaccination multimedia campaign addressed to HCWs was developed by maintaining pre-existing tools (letters in pay slip and poster displayed in wards) and creating 4 on-line spots (30") delivered trough the hospital intranet. Campaign effectiveness was assessed in terms of changes in knowledge, attitude and practice comparing data of pre (10 items) and post test (20 items) survey on a randomized sample of HCWs. Response rates were 92.6% (464/501) in pre-test and 83.2% (417/501) in post-test. 93.8% (391/417) of HCWs reported to awareness of the campaign to promote vaccination. Spots were seen by 59.6% (233/391) of HCWs. Some reasons for vaccine denial, "not believing in vaccine efficacy" (34.7% to 14.9%), "not considering flu as a serious problem" (from 24% to 12.6%), "thinking not to get sick" (28.7% to 18.2%) or "being against the vaccine" (32.7% to 21%), showed a statistically significant reduction after the exposure to the campaign. The "intention to get vaccinated in the next year" instead, raised effectively (13.1% to 36.6%). Vaccinated HCWs rate in 2013-2014 season was 7.6% (221/2910), and 5.6% (164/2910) in 2012-2013 (pweb tools deserve to be better studied as effective approach to convey health information among HCWs.

  1. National Outbreak Reporting System

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Outbreak Reporting System (NORS) is a web-based platform designed to support reporting to CDC by local, state, and territorial health departments in the...

  2. Outbreaks and Investigations

    Science.gov (United States)

    ... Who Gets Fungal Infections? People living with HIV/AIDS Organ Transplant Patients Cancer Patients Hospitalized Patients Stem Cell Transplant Patients Medications that Weaken Your Immune System Outbreaks Rhizopus Investigation CDC at Work Global Fungal Diseases Cryptococcal Meningitis ...

  3. Measles & rubella outbreaks in Maharashtra State, India.

    Science.gov (United States)

    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.

  4. Measles & rubella outbreaks in Maharashtra State, India

    Science.gov (United States)

    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

  5. SERO SURVEI DAN ANALISA PENGETAHUAN SIKAP PENJAMAH UNGGAS TERHADAP PENYAKIT FLU BURUNG DI INDONESIA TAHUN 2008

    Directory of Open Access Journals (Sweden)

    Noer Endah Pracoyo

    2013-02-01

    Full Text Available Abstract The bird flu in Indonesia actually is Avian Influenza Virus H5N1 type. Is known bird flu virus in Humans occur if direct contact with infected poultry or through contact with environmental enclosure, and the carcasses of infected poultry products. The absence of the data if the handlers of poultry in the cases of bird flu virus has been exposed to the research conducted sero survey of bird flu antibody titers in handlers poultry  attitudes and knowledge of poultry against bird flu incident. The research objective measure antibodies against respondents tirer AI H5N1 virus, assess knowledge and attitudes against bird flu handlers through the interview. The study design was cross sectional. Handlers of poultry population in the region is ever going Extraordinary Cases of bird flu. Samples were responders/poultry handlers venous blood taken for H5N1 antibody titer by Ellisa, H5N1 conducted interviews using a questionnaire. The study used the respondents informed consent agreement. Research time in February to November 2007 in the island of Java. The number of samples of 80 samples of respondents. The results obtained are not found of H5N1 avian influenza antibody titer in responders. The results of the interview most of the handlers to wash Their hands after doing Their job (82.1%. A total of 52.9% residential handlers is more than a mile from where the management of poultry, (69% lived outside market handlers/Abattoir of poultry.Handler to act entered correctly (53.3%% and almost all handlers (97% would bring the patient/patient ill with signs of bird flu infection to health facilities. Keywords: poultry handlers, bird flu virus, knowledge and attitudes of poultry handlers Abstrak Yang dimaksud Flu burung di Indonesia sebetulnya adalah Virus Avian Influenza dengan tipe H5N1. Selama ini diketahui penularan virus flu burung pada manusia terjadi jika kontak langsung dengan unggas yang terinfeksi atau melalui kontak dengan lingkungan kandang

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

    Science.gov (United States)

    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.

  7. Outbreak of pandemic influenza A/H1N1 2009 in Nepal

    OpenAIRE

    Adhikari, Bal Ram; Shakya, Geeta; Upadhyay, Bishnu Prasad; Prakash KC, Khagendra; Shrestha, Sirjana Devi; Dhungana, Guna Raj

    2011-01-01

    Abstract Background The 2009 flu pandemic is a global outbreak of a new strain of H1N1 influenza virus. Pandemic influenza A (H1N1) 2009 has posed a serious public health challenge world-wide. Nepal has started Laboratory diagnosis of Pandemic influenza A/H1N1 from mid June 2009 though active screening of febrile travellers with respiratory symptoms was started from April 27, 2009. Results Out of 609 collected samples, 302 (49.6%) were Universal Influenza A positive. Among the influenza A pos...

  8. Epidemiology of Histoplasmosis Outbreaks, United States, 1938–2013

    Science.gov (United States)

    Mody, Rajal K.

    2016-01-01

    Histoplasmosis has been described as the most common endemic mycosis in the United States. However, histoplasmosis is not nationally notifiable. Its presumed geographic distribution is largely derived from skin test surveys performed during the 1940s, and information about its local features comes primarily from outbreak investigations. We conducted a literature review to assess epidemiologic features of histoplasmosis outbreaks in the United States. During 1938–2013, a total of 105 outbreaks involving 2,850 cases were reported in 26 states and the territory of Puerto Rico. Common exposure settings were chicken coops and buildings or other structures undergoing renovation or demolition. Birds, bats, or their droppings were reported to be present in 77% of outbreak settings, and workplace exposures were reported in 41% of outbreaks. The continued occurrence of histoplasmosis outbreaks, particularly work-related ones involving known disturbance of bird or bat droppings, highlights the need to increase awareness of the disease. PMID:26890817

  9. Epidemiology of Histoplasmosis Outbreaks, United States, 1938-2013.

    Science.gov (United States)

    Benedict, Kaitlin; Mody, Rajal K

    2016-03-01

    Histoplasmosis has been described as the most common endemic mycosis in the United States. However, histoplasmosis is not nationally notifiable. Its presumed geographic distribution is largely derived from skin test surveys performed during the 1940s, and information about its local features comes primarily from outbreak investigations. We conducted a literature review to assess epidemiologic features of histoplasmosis outbreaks in the United States. During 1938-2013, a total of 105 outbreaks involving 2,850 cases were reported in 26 states and the territory of Puerto Rico. Common exposure settings were chicken coops and buildings or other structures undergoing renovation or demolition. Birds, bats, or their droppings were reported to be present in 77% of outbreak settings, and workplace exposures were reported in 41% of outbreaks. The continued occurrence of histoplasmosis outbreaks, particularly work-related ones involving known disturbance of bird or bat droppings, highlights the need to increase awareness of the disease.

  10. Occurrence, significance & molecular epidemiology of cholera outbreaks in West Bengal.

    Science.gov (United States)

    Sur, Dipika; Dutta, Shanta; Sarkar, B L; Manna, B; Bhattacharya, M K; Datta, K K; Saha, A; Dutta, B; Pazhani, G P; Choudhuri, A Ray; Bhattacharya, S K

    2007-06-01

    Diarrhoeal disease outbreaks are causes of major public health emergencies in India. We carried out investigation of two cholera outbreaks, for identification, antimicrobial susceptibility testing, phage typing and molecular characterization of isolated Vibrio cholerae O1, and to suggest prevention and control measures. A total of 22 rectal swabs and 20 stool samples were collected from the two outbreak sites. The V. cholerae isolates were serotyped and antimicrobial susceptibility determined. Pulsed- field gel electrophoresis (PFGE) was performed to identify the clonality of the V. cholerae strains which elucidated better understanding of the epidemiology of the cholera outbreaks. Both the outbreaks were caused by V. cholerae O1 (one was caused by serotype Ogawa and the other by serotype Inaba). Clinically the cases presented with profuse watery diarrhoea and dehydration. All the tested V. cholerae isolates were sensitive to tetracycline, gentamycin and azithromycin but resistance for ampicillin, co-trimoxazole, nalidixic acid, and furazolidone. PFGE pattern of the isolates from the two outbreaks revealed that they were clonal in origin. Stoppage of the source of water contamination and chlorination of drinking water resulted in terminating the two outbreaks. The two diarrhoeal outbreaks were caused by V. cholerae O1 (Inaba/Ogawa). Such outbreaks are frequently seen in cholera endemic areas in many parts of the world. Vaccination is an attractive disease (cholera) prevention strategy although long-term measures like improvement of sanitation and personal hygiene, and provision of safe water supply are important, but require time and are expensive.

  11. U.S. and International Responses to the Global Spread of Avian Flu: Issues for Congress

    National Research Council Canada - National Science Library

    Salaam-Blyther, Tiaji

    2006-01-01

    .... In February 2006, the virus spread from Asia and central Europe to western Europe. By March 2006, health experts had confirmed new bird flu cases among more than 20 countries across Europe, Asia, and Africa...

  12. Influenza (flu) vaccine (Inactivated or Recombinant): What you need to know

    Science.gov (United States)

    Vaccine Information Statement. Influenza (Flu) Vaccine (Inactivated or Recombinant): What you need to know. Centers for Disease Control and Prevention website at www.cdc.gov/vaccines/hcp/vis/vis-statements/ ...

  13. Interpreting Google flu trends data for pandemic H1N1 influenza: the New Zealand experience.

    Science.gov (United States)

    Wilson, N; Mason, K; Tobias, M; Peacey, M; Huang, Q S; Baker, M

    2009-11-05

    For the period of the spread of pandemic H1N1 influenza in New Zealand during 2009, we compared results from Google Flu Trends with data from existing surveillance systems. The patterns from Google Flu Trends were closely aligned with (peaking a week before and a week after) two independent national surveillance systems for influenza-like illness (ILI) cases. It was much less congruent with (delayed by three weeks) data from ILI-related calls to a national free-phone Healthline and with media coverage of pandemic influenza. Some patterns were unique to Google Flu Trends and may not have reflected the actual ILI burden in the community. Overall, Google Flu Trends appears to provide a useful free surveillance system but it should probably be seen as supplementary rather than as an alternative.

  14. Time To Talk About Natural Products for the Flu and Colds: What Does the Science Say?

    Science.gov (United States)

    ... What Does the Science Say? Share: It’s that time of year again— cold and flu season. Each ... effects of taking probiotics for long periods of time. Most people may be able to use probiotics ...

  15. JouFLU: upgrades to the fiber linked unit for optical recombination (FLUOR) interferometric beam combiner.

    Science.gov (United States)

    Scott, N. J.; Lhomé, E.; ten Brummelaar, T. A.; Coudé du Foresto, V.; Millan-Gabet, R.; Sturmann, J.; Sturmann, L.

    2014-07-01

    The Fiber Linked Unit for Optical Recombination (FLUOR) is a precision interferometric beam combiner operating at the CHARA Array on Mt. Wilson, CA. It has recently been upgraded as part of a mission known as "Jouvence of FLUOR" or JouFLU. As part of this program JouFLU has new mechanic stages and optical payloads, new alignment systems, and new command/control software. Furthermore, new capabilities have been implemented such as a Fourier Transform Spectrograph (FTS) mode and spectral dispersion mode. These upgrades provide new capabilities to JouFLU as well as improving statistical precision and increasing observing efficiency. With these new systems, measurements of interferometric visibility to the level of 0.1% precision are expected on targets as faint as 6th magnitude in the K band. Here we detail the upgrades of JouFLU and report on its current status.

  16. Social media and outbreaks of emerging infectious diseases: A systematic review of literature.

    Science.gov (United States)

    Tang, Lu; Bie, Bijie; Park, Sung-Eun; Zhi, Degui

    2018-04-05

    The public often turn to social media for information during emerging infectious diseases (EIDs) outbreaks. This study identified the major approaches and assessed the rigors in published research articles on EIDs and social media. We searched 5 databases for published journal articles on EIDs and social media. We then evaluated these articles in terms of EIDs studied, social media examined, theoretical frameworks, methodologic approaches, and research findings. Thirty articles were included in the analysis (published between January 1, 2010, and March 1, 2016). EIDs that received most scholarly attention were H1N1 (or swine flu, n = 15), Ebola virus (n = 10), and H7N9 (or avian flu/bird flu, n = 2). Twitter was the most often studied social media (n = 17), followed by YouTube (n = 6), Facebook (n = 6), and blogs (n = 6). Three major approaches in this area of inquiry are identified: (1) assessment of the public's interest in and responses to EIDs, (2) examination of organizations' use of social media in communicating EIDs, and (3) evaluation of the accuracy of EID-related medical information on social media. Although academic studies of EID communication on social media are on the rise, they still suffer from a lack of theorization and a need for more methodologic rigor. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  17. Measles Cases during Ebola Outbreak, West Africa, 2013-2106.

    Science.gov (United States)

    Colavita, Francesca; Biava, Mirella; Castilletti, Concetta; Quartu, Serena; Vairo, Francesco; Caglioti, Claudia; Agrati, Chiara; Lalle, Eleonora; Bordi, Licia; Lanini, Simone; Guanti, Michela Delli; Miccio, Rossella; Ippolito, Giuseppe; Capobianchi, Maria R; Di Caro, Antonino

    2017-06-01

    The recent Ebola outbreak in West Africa caused breakdowns in public health systems, which might have caused outbreaks of vaccine-preventable diseases. We tested 80 patients admitted to an Ebola treatment center in Freetown, Sierra Leone, for measles. These patients were negative for Ebola virus. Measles virus IgM was detected in 13 (16%) of the patients.

  18. OSELTAMIVIR APPLICATION AMONG HIV-INFECTED CHILDREN, SUFFERING FROM THE FLU

    Directory of Open Access Journals (Sweden)

    Yu.A. Fomin

    2007-01-01

    Full Text Available The article provides the Oseltamivir application experience in flu treatment among HIV-infected children. The researchers showed that Oseltamivir is an effective medication for the given category of patients, reducing duration of the catarrhal syndrome and intoxication signs. The undesirable phenomena related to the medication intake proved to be transient and called for no cancellation of its use.Key words: children, hiv infection, flu, Oseltamivir.

  19. The European and Japanese outbreaks of H5N8 derive from a single source population providing evidence for the dispersal along the long distance bird migratory flyways

    OpenAIRE

    Andrew R. Dalby; Munir Iqbal

    2015-01-01

    The origin of recent parallel outbreaks of the high pathogenicity H5N8 avian flu virus in Europe and in Japan can be traced to a single source population, which has most likely been spread by migratory birds. By using Bayesian coalescent methods to analyze the DNA sequences of the virus to find the times for divergence and combining this sequence data with bird migration data we can show the most likely locations and migratory pathways involved in the origin of the current outbreak. This popu...

  20. Isoniazid-induced flu-like syndrome: A rare side effect

    Directory of Open Access Journals (Sweden)

    Sudipta Pandit

    2013-01-01

    Full Text Available Drug-induced flu-like syndrome is very rare. It is mainly produced by rifampicin. We report a case of pulmonary tuberculosis (PTB that developed isoniazid-induced flu-like syndrome, but could be cured with a modified regimen replacing isoniazid with levofloxacin. A 10-year-old girl with PTB was treated with isoniazid (H, rifampicin (R, ethambutol (E, and pyrazinamide (Z. She developed features of flu from the sixth day. Symptoms recurred everyday within 1 h of drug ingestion and subsided automatically by next 12 h. After admission, HREZ were continued. She developed symptoms of flu after 1 h of drug ingestion. Antitubercular therapy (ATT was stopped and symptoms subsided automatically. Individual drug was started one by one after three days. Severe symptoms of flu developed after taking isoniazid, while other drugs were tolerated well. Levofloxacin was used as an alternative to isoniazid. She was cured after 6 months of chemotherapy. Isoniazid can possibly cause flu-like syndrome and the treating physician should be aware of this possible side effect when using ATT.

  1. Waiting for the flu: cognitive inertia and the Spanish influenza pandemic of 1918-19.

    Science.gov (United States)

    Dicke, Tom

    2015-04-01

    This study looks at public awareness and understanding of the Spanish flu in the United States between June 1918, when the flu became "Spanish," and the end of September when the deadly second wave reached the majority of the country. Based on an extensive reading of local newspapers, it finds a near universal lack of preparation or panic or other signs of personal concern among those in the unaffected areas, despite extensive and potentially worrying coverage of the flu's progress. The normal reaction to news of the inexorable approach of a pandemic of uncertain virulence is anxiety and action. The Spanish flu produced neither in the uninfected areas for a month. The most likely reason appears to be cognitive inertia-the tendency of existing beliefs or habits of thought to blind people to changed realities. This inertia grew out of the widespread understanding of flu as a seasonal visitor that while frequently unpleasant almost never killed the strong and otherwise healthy. This view of the flu was powerful enough that it blinded many in the unaffected regions to the threat for weeks even in the face of daily or near daily coverage of the pandemic's spread. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Regional Differences in Pathogen Prevalence and Defensive Reactions to the “Swine Flu” Outbreak among East Asians and Westerners

    Directory of Open Access Journals (Sweden)

    Takeshi Hamamura

    2010-07-01

    Full Text Available Research has found that contagion-minimizing behavioral tendencies are amplified in pathogen-prevalent regions. We investigated whether reactions to the “swine flu” outbreak of 2009 were stronger among East Asians than Westerners, populations residing in regions that now enjoy comparable advances in healthcare but that are characterized by relatively high and low historical pathogen prevalence, respectively. In a survey, East Asians reported greater concerns about infection, especially from foreigners. Analyses of international air travel data around the time of the outbreak provided corroborating evidence: Immediately following the outbreak, airports in the Asia-Pacific region lost more international traffic relative to their Western counterparts, and East Asian airlines reported greater declines in international traffic compared to Western airlines. These differences are unlikely to reflect objective threat posed by swine flu (whose casualties were concentrated in the Americas; rather, they appear to reflect culturally adapted behavioral patterns forged and sustained by regionally variable levels of pathogen prevalence.

  3. Can aerobic exercise alleviate flu-like symptoms following interferon beta-1a injections in patients with multiple sclerosis?

    DEFF Research Database (Denmark)

    Langeskov-Christensen, Martin; Kjølhede, Tue; Stenager, Egon

    2016-01-01

    BACKGROUND: Flu-like symptoms (FLS) are common side effects of interferon beta (IFNß) treatment, and may affect the willingness to initiate therapy, the long-term acceptability, and the adherence to the treatment. Case reports suggest that aerobic exercise is able to markedly reduce FLS following...... IFNß-1a injections in persons with multiple sclerosis (PwMS). OBJECTIVE: To test the hypothesis that aerobic exercise can alleviate FLS following IFNß-1a injections in PwMS, and secondarily to examine whether or not fluctuations in circulating cytokines provide a mechanism that can explain a potential...... positive effect. METHODS: Seventeen PwMS who frequently experience FLS following IFNß-1a injections completed four days of testing. On two of the testing days they completed 35min of aerobic exercise on a bicycle-ergometer following IFNß-1a injection. On the two other testing days, no intervention took...

  4. Responding to Outbreaks

    Centers for Disease Control (CDC) Podcasts

    2009-04-27

    In this podcast, a team of CDC specialists travels to Uganda and tracks the source of an Ebola outbreak where CDC scientists are studying bats for clues to the Ebola mystery.  Created: 4/27/2009 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 4/27/2009.

  5. Swimming Associated Disease Outbreaks.

    Science.gov (United States)

    Cabelli, V. J.

    1978-01-01

    Presents a literature review of recreational waterborne outbreaks and cases of disease, covering publications of 1976-77. This review includes: (1) retrospective and prospective epidemiological studies; (2) predictive models of the risk of recreational waterborn disease. A list of 35 references is also presented. (HM)

  6. Investigating Listeria Outbreaks

    Centers for Disease Control (CDC) Podcasts

    2013-01-04

    Dr. Emily Cartwright, Infectious Disease fellow at Emory University and former EIS Officer with CDC’s Division of Foodborne, Waterborne, and Environmental Diseases discusses foodborne Listeria outbreaks.  Created: 1/4/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/8/2013.

  7. Foodborne Norovirus Outbreaks

    Centers for Disease Control (CDC) Podcasts

    2012-09-17

    Dr. Aron Hall, a CDC epidemiologist specializing in noroviruses, discusses foodborne norovirus outbreaks.  Created: 9/17/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID); National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/17/2012.

  8. The European and Japanese outbreaks of H5N8 derive from a single source population providing evidence for the dispersal along the long distance bird migratory flyways.

    Science.gov (United States)

    Dalby, Andrew R; Iqbal, Munir

    2015-01-01

    The origin of recent parallel outbreaks of the high pathogenicity H5N8 avian flu virus in Europe and in Japan can be traced to a single source population, which has most likely been spread by migratory birds. By using Bayesian coalescent methods to analyze the DNA sequences of the virus to find the times for divergence and combining this sequence data with bird migration data we can show the most likely locations and migratory pathways involved in the origin of the current outbreak. This population was most likely located in the Siberian summer breeding grounds of long-range migratory birds. These breeding grounds provide a connection between different migratory flyways and explain the current outbreaks in remote locations. By combining genetic methods and epidemiological data we can rapidly identify the sources and the dispersion pathways for novel avian influenza outbreaks.

  9. The European and Japanese outbreaks of H5N8 derive from a single source population providing evidence for the dispersal along the long distance bird migratory flyways

    Directory of Open Access Journals (Sweden)

    Andrew R. Dalby

    2015-04-01

    Full Text Available The origin of recent parallel outbreaks of the high pathogenicity H5N8 avian flu virus in Europe and in Japan can be traced to a single source population, which has most likely been spread by migratory birds. By using Bayesian coalescent methods to analyze the DNA sequences of the virus to find the times for divergence and combining this sequence data with bird migration data we can show the most likely locations and migratory pathways involved in the origin of the current outbreak. This population was most likely located in the Siberian summer breeding grounds of long-range migratory birds. These breeding grounds provide a connection between different migratory flyways and explain the current outbreaks in remote locations. By combining genetic methods and epidemiological data we can rapidly identify the sources and the dispersion pathways for novel avian influenza outbreaks.

  10. Nudges or mandates? The ethics of mandatory flu vaccination.

    Science.gov (United States)

    Dubov, Alex; Phung, Connie

    2015-05-21

    According to the CDC report for the 2012-2013 influenza season, there was a modest increase in the vaccination coverage rate among healthcare workers from 67% in 2011-2012, to 72% in 2012-2013 to the current 75% coverage. This is still far from reaching the US National Healthy People 2020 goal of 90% hospitals vaccination rates. The reported increase in coverage is attributed to the growing number of healthcare facilities with vaccination requirements with average rates of 96.5%. However, a few other public health interventions stir so much controversy and debate as vaccination mandates. The opposition stems from the belief that a mandatory flu shot policy violates an individual right to refuse unwanted treatment. This article outlines the historic push to achieve higher vaccination rates among healthcare professionals and a number of ethical issues arising from attempts to implement vaccination mandates. It then turns to a review of cognitive biases relevant in the context of decisions about influenza vaccination (omission bias, ambiguity aversion, present bias etc.) The article suggests that a successful strategy for policy-makers and others hoping to increase vaccination rates is to design a "choice architecture" that influences behavior of healthcare professionals without foreclosing other options. Nudges incentivize vaccinations and help better align vaccination intentions with near-term actions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Measles outbreak in Qassim, Saudi Arabia 2007: epidemiology and evaluation of outbreak response.

    Science.gov (United States)

    Jahan, Saulat; Al Saigul, Abdullah Mohammed; Abu Baker, Mohammed Ahmad Mohammed; Alataya, Ayman Osman; Hamed, Shamandy Abdul Rahim

    2008-12-01

    Worldwide efforts for measles elimination are made possible due to the availability of a highly effective measles vaccine. In spite of highly vaccinated population, a measles outbreak occurred in Qassim province of Saudi Arabia, during January-August 2007. An outbreak investigation was conducted to describe the epidemiology of outbreak. An audit of performance of control measures taken by the Primary Health Care team was done according to World Health Organization standards. Of 230 cases reported, more than one-third (37.8%) patients were 0-4 years of age. Children aged 6-11 months accounted for 51.7% cases amongst 0-4 years age group. The performance indicator targets of >or=80% for outbreak control measures were achieved regarding investigation of cases within 48 hours, and blood sample extraction within the optimal period. However, 66.8% cases reported within 48 hours of rash onset and only 16.4% of laboratory test results were received within 7 days of receipt of the specimen in laboratory. This outbreak demonstrates the increased susceptibility of unvaccinated children aged 6-11 months. To prevent future outbreaks, community awareness, review of measles vaccination schedule, enhanced surveillance and measles 'catch-up' mass immunization campaign to interrupt chains of transmission, are required.

  12. Use of whole-genome sequencing and evaluation of the apparent sensitivity and specificity of antemortem tuberculosis tests in the investigation of an unusual outbreak of Mycobacterium bovis infection in a Michigan dairy herd.

    Science.gov (United States)

    Bruning-Fann, Colleen S; Robbe-Austerman, Suelee; Kaneene, John B; Thomsen, Bruce V; Tilden, John D; Ray, Jean S; Smith, Richard W; Fitzgerald, Scott D; Bolin, Steven R; O'Brien, Daniel J; Mullaney, Thomas P; Stuber, Tod P; Averill, James J; Marks, David

    2017-07-15

    OBJECTIVE To describe use of whole-genome sequencing (WGS) and evaluate the apparent sensitivity and specificity of antemortem tuberculosis tests during investigation of an unusual outbreak of Mycobacterium bovis infection in a Michigan dairy herd. DESIGN Bovine tuberculosis (bTB) outbreak investigation. ANIMALS Cattle, cats, dog, and wildlife. PROCEDURES All cattle in the index dairy herd were screened for bTB with the caudal fold test (CFT), and cattle ≥ 6 months old were also screened with a γ-interferon (γIFN) assay. The index herd was depopulated along with all barn cats and a dog that were fed unpasteurized milk from the herd. Select isolates from M bovis-infected animals from the index herd and other bTB-affected herds underwent WGS. Wildlife around all affected premises was examined for bTB. RESULTS No evidence of bTB was found in any wildlife examined. Within the index herd, 53 of 451 (11.8%) cattle and 12 of 21 (57%) cats were confirmed to be infected with M bovis. Prevalence of M bovis-infected cattle was greatest among 4- to 7-month-old calves (16/49 [33%]) followed by adult cows (36/203 [18%]). The apparent sensitivity and specificity were 86.8% and 92.7% for the CFT and 80.4% and 96.5% for the γIFN assay when results for those tests were interpreted separately and 96.1% and 91.7% when results were interpreted in parallel. Results of WGS revealed that M bovis-infected barn cats and cattle from the index herd and 6 beef operations were infected with the same strain of M bovis. Of the 6 bTB-affected beef operations identified during the investigation, 3 were linked to the index herd only by WGS results; there was no record of movement of livestock or waste milk from the index herd to those operations. CONCLUSIONS AND CLINICAL RELEVANCE Whole-genome sequencing enhanced the epidemiological investigation and should be used in all disease investigations. Performing the CFT and γIFN assay in parallel improved the antemortem ability to detect M bovis

  13. Google trends: a web-based tool for real-time surveillance of disease outbreaks.

    Science.gov (United States)

    Carneiro, Herman Anthony; Mylonakis, Eleftherios

    2009-11-15

    Google Flu Trends can detect regional outbreaks of influenza 7-10 days before conventional Centers for Disease Control and Prevention surveillance systems. We describe the Google Trends tool, explain how the data are processed, present examples, and discuss its strengths and limitations. Google Trends shows great promise as a timely, robust, and sensitive surveillance system. It is best used for surveillance of epidemics and diseases with high prevalences and is currently better suited to track disease activity in developed countries, because to be most effective, it requires large populations of Web search users. Spikes in search volume are currently hard to interpret but have the benefit of increasing vigilance. Google should work with public health care practitioners to develop specialized tools, using Google Flu Trends as a blueprint, to track infectious diseases. Suitable Web search query proxies for diseases need to be established for specialized tools or syndromic surveillance. This unique and innovative technology takes us one step closer to true real-time outbreak surveillance.

  14. Galvanizing medical students in the administration of influenza vaccines: the Stanford Flu Crew

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    Rizal RE

    2015-07-01

    Full Text Available Rachel E Rizal,1,* Rishi P Mediratta,1,* James Xie,1 Swetha Kambhampati,1 Kelsey Hills-Evans,1 Tamara Montacute,1 Michael Zhang,1 Catherine Zaw,2 Jimmy He,2 Magali Sanchez,2 Lauren Pischel1 1Stanford University School of Medicine, Stanford, CA, USA; 2Stanford University, Stanford, CA, USA *These authors contributed equally to this work Abstract: Many national organizations call for medical students to receive more public health education in medical school. Nonetheless, limited evidence exists about successful service-learning programs that administer preventive health services in nonclinical settings. The Flu Crew program, started in 2001 at the Stanford University School of Medicine, provides preclinical medical students with opportunities to administer influenza immunizations in the local community. Medical students consider Flu Crew to be an important part of their medical education that cannot be learned in the classroom. Through delivering vaccines to where people live, eat, work, and pray, Flu Crew teaches medical students about patient care, preventive medicine, and population health needs. Additionally, Flu Crew allows students to work with several partners in the community in order to understand how various stakeholders improve the delivery of population health services. Flu Crew teaches students how to address common vaccination myths and provides insights into implementing public health interventions. This article describes the Stanford Flu Crew curriculum, outlines the planning needed to organize immunization events, shares findings from medical students' attitudes about population health, highlights the program’s outcomes, and summarizes the lessons learned. This article suggests that Flu Crew is an example of one viable service-learning modality that supports influenza vaccinations in nonclinical settings while simultaneously benefiting future clinicians. Keywords: immunizations, vaccine delivery, vaccinations 

  15. Eco-Evolutionary Theory and Insect Outbreaks.

    Science.gov (United States)

    Páez, David J; Dukic, Vanja; Dushoff, Jonathan; Fleming-Davies, Arietta; Dwyer, Greg

    2017-06-01

    Eco-evolutionary theory argues that population cycles in consumer-resource interactions are partly driven by natural selection, such that changes in densities and changes in trait values are mutually reinforcing. Evidence that the theory explains cycles in nature, however, is almost nonexistent. Experimental tests of model assumptions are logistically impractical for most organisms, while for others, evidence that population cycles occur in nature is lacking. For insect baculoviruses in contrast, tests of model assumptions are straightforward, and there is strong evidence that baculoviruses help drive population cycles in many insects, including the gypsy moth that we study here. We therefore used field experiments with the gypsy moth baculovirus to test two key assumptions of eco-evolutionary models of host-pathogen population cycles: that reduced host infection risk is heritable and that it is costly. Our experiments confirm both assumptions, and inserting parameters estimated from our data into eco-evolutionary insect-outbreak models gives cycles closely resembling gypsy moth outbreak cycles in North America, whereas standard models predict unrealistic stable equilibria. Our work shows that eco-evolutionary models are useful for explaining outbreaks of forest insect defoliators, while widespread observations of intense selection on defoliators in nature and of heritable and costly resistance in defoliators in the lab together suggest that eco-evolutionary dynamics may play a general role in defoliator outbreaks.

  16. Forecasting Infectious Disease Outbreaks

    Science.gov (United States)

    Shaman, J. L.

    2015-12-01

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

  17. Public anxiety and information seeking following the H1N1 outbreak: blogs, newspaper articles, and Wikipedia visits.

    Science.gov (United States)

    Tausczik, Yla; Faasse, Kate; Pennebaker, James W; Petrie, Keith J

    2012-01-01

    Web-based methodologies may provide a new and unique insight into public response to an infectious disease outbreak. This naturalistic study investigates the effectiveness of new web-based methodologies in assessing anxiety and information seeking in response to the 2009 H1N1 outbreak by examining language use in weblogs ("blogs"), newspaper articles, and web-based information seeking. Language use in blogs and newspaper articles was assessed using Linguistic Inquiry and Word Count, and information seeking was examined using the number of daily visits to H1N1-relevant Wikipedia articles. The results show that blogs mentioning "swine flu" used significantly higher levels of anxiety, health, and death words and lower levels of positive emotion words than control blogs. Change in language use on blogs was strongly related to change in language use in newspaper coverage for the same day. Both the measure of anxiety in blogs mentioning "swine flu" and the number of Wikipedia visits followed similar trajectories, peaking shortly after the announcement of H1N1 and then declining rapidly. Anxiety measured in blogs preceded information seeking on Wikipedia. These results show that the public reaction to H1N1 was rapid and short-lived. This research suggests that analysis of web behavior can provide a source of naturalistic data on the level and changing pattern of public anxiety and information seeking following the outbreak of a public health emergency.

  18. Risky Zoographies: The Limits of Place in Avian Flu Management

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    Natalie Porter

    2012-11-01

    Full Text Available Global anxieties about avian influenza stem from a growing recognition that highly-virulent, highly-mobile disease vectors infiltrate human spaces in ways that are difficult to perceive, and even more difficult to manage. This article analyses a participatory health intervention in Việt Nam to explore how avian influenza threats challenge long-held understandings of animals’ place in the environment and society. In this intervention, poultry farmers collaborated with health workers to illustrate maps of avian flu risks in their communities. Participant-observation of the risk-mapping exercises shows that health workers treated poultry as commodities, and located these animals in environments that could be transformed and dominated by humans. However, these maps did not sufficiently represent the physical and social landscapes where humans and poultry coexist in Việt Nam. As such, farmers located poultry in environments dominated by risky nonhuman forces such as winds, waterways, and other organisms. I argue that these divergent risk maps demonstrate how ecological factors, interpersonal networks, and global market dynamics combine to engender a variety of interspecies relationships, which in turn shape the location of disease risks in space. I develop the term risky zoographies to signal the emergence of competing descriptions of animals and their habitats in zoonotic disease contexts. This concept suggests that as wild animals, livestock products, and microbial pathogens continue to globalise, place-based health interventions that limit animals to particular locales are proving inadequate. Risky zoographies signal the inextricability of nonhuman animals from human spaces, and reveal interspecies interactions that transect and transcend environments.

  19. Knowledge, attitude and practices regarding swine flu among para-medical workers in a tertiary care hospital in Pondicherry.

    Science.gov (United States)

    Datta, S S; Kuppuraman, D; Boratne, A V; Abraham, S B; Singh, Z

    2011-03-01

    Para-medical workers (PMWs) are first contacts for suspected Swine flu patients and also the media to spread key messages regarding its prevention and control strategies. Present study was conducted to ascertain knowledge, attitude and practices regarding Swine flu among para-medical workers in a tertiary care hospital. A hospital based cross-sectional study was conducted among PMWs during May-July, 2010. KAP regarding Swine flu was collected through pre-designed questionnaire and information on attitude towards Swine flu was also collected through FGD-free list analysis. Data was analysed using Epi_Info and Anthropac software. A total of 237 PMWs responded. Majority of the PMWs knew about signs and symptoms (89.03%), mode of transmission (91.56%) and route of transmission (91.98%) of Swine flu. Television (67.51%) was the major source of information. 75.53% and 58.65% PMWs respectively knew about organ of the body chiefly affected and type of specimen to be collected during Swine flu. 196 (82.7%) and 191 (80.59%) PMWs respectively knew about availability of vaccine and treatment against Swine flu. 94.09% PMWs stated that extra precautions such as use of face mask, frequent handwashing, use of gloves etc. should be taken while handling any suspected Swine flu case and 73.84% PMWs do take such precautions. 80.17% PMWs opined that epidemic of Swine flu can be halted at current stage. In the present study, PMWs possessed good knowledge, attitude and practices regarding Swine flu and this fact should be utilized while designing and guiding containment strategies against existing Swine flu epidemic.

  20. Waves and synchrony in Epirrita autumnata/Operophtera brumata outbreaks. II. Sunspot activity cannot explain cyclic outbreaks.

    Science.gov (United States)

    Nilssen, A C; Tenow, O; Bylund, H

    2007-03-01

    1. In recent studies, it has been argued that sunspot activity forces the Epirrita autumnata 9-10-year outbreak periodicity in the mountain birch forest of Fennoscandia. For the following reasons, we challenge this conclusion. 2. With a 10-year outbreak cycle of E. autumnata and the 11-year sunspot cycle, it is expected that the cycles will run in-phase, out-of-phase and in-phase within 10 x 11 years. Hence, given such cycle lengths, sunspot activity should not affect outbreak periods. For a test, the E. autumnata series should be at least 110 years in length. 3. A well-documented E. autumnata outbreak series of 81 years (1888-1968; outbreak periods IV-XII) exists. This series is here lengthened to 114 years by adding outbreak frequencies for three decades (1969-2001). 4. By lengthening the series, three more E. autumnata/Operophtera brumata periods (XIII, XIV, XV) are identified. Period XV, like several earlier periods, was of the moving type, i.e. outbreaks moved in a wavelike manner from northern Fennoscandia to southern Norway. 5. As with several earlier outbreak periods in central northern Fennoscandia, the main timing of periods XIII-XV centred at the middle of the decades. In contrast, outbreaks at the extreme north-western coast of Norway centred at the decadal shifts, i.e. about 1979, 1989 and 1999. Supported by historical documents, we explain the 1979 and 1999 outbreaks as the final expressions of east-west outbreak waves that branched off from the main waves which moved southward during periods XIII and XV. These side-waves in the north are new observations. Outbreaks at the decadal shift 1989/1990 may have been of a more complex nature. 6. We find that sunspot activity does not explain outbreak waves. Furthermore, a test of our 114-year long E. autumnata series against the contemporaneous sunspot series shows that the two series run in-phase and out-of-phase. The observed interval between the two cycles coming in-phase agrees with the expected interval

  1. Global response to pandemic flu: more research needed on a critical front

    Directory of Open Access Journals (Sweden)

    Lim Meng-Kin

    2006-10-01

    Full Text Available Abstract If and when sustained human-to-human transmission of H5N1 becomes a reality, the world will no longer be dealing with sporadic avian flu borne along migratory flight paths of birds, but aviation flu – winged at subsonic speed along commercial air conduits to every corner of planet Earth. Given that air transportation is the one feature that most differentiates present day transmission scenarios from those in 1918, our present inability to prevent spread of influenza by international air travel, as reckoned by the World Health Organization, constitutes a major weakness in the current global preparedness plan against pandemic flu. Despite the lessons of SARS, it is surprising that aviation-related health policy options have not been more rigorously evaluated, or scientific research aimed at strengthening public health measures on the air transportation front, more energetically pursued.

  2. Finding a new drug and vaccine for emerging swine flu: What is the concept?

    Directory of Open Access Journals (Sweden)

    Viroj Wiwanitkit

    2009-08-01

    Full Text Available Viroj WiwanitkitWiwanitkit House, Bangkhae, Bangkok 10160Abstract: Influenza is a well known infection of the respiratory system. The main clinical manifestations of influenza include fever, sore throat, headache, cough, coryza, and malaise. Apart from the well known classical influenza, there are also groups of influenza virus infections that are called “atypical infection”. These infections are usually due to a novel influenza virus infection. In early 2009, an emerging novel influenza originating from Mexico called swine flu was reported. The World Health Organization noted a level VI precaution, the highest level precaution possible, for this newest influenza virus infection. As of June 2009, it is not known if this disease will be successfully controlled. Finding new drugs and vaccine for the emerging swine flu is still required to cope with this emerging worldwide problem.Keywords: swine flu, drug, vaccine, concept

  3. Role of non-traditional locations for seasonal flu vaccination: Empirical evidence and evaluation.

    Science.gov (United States)

    Kim, Namhoon; Mountain, Travis P

    2017-05-19

    This study investigated the role of non-traditional locations in the decision to vaccinate for seasonal flu. We measured individuals' preferred location for seasonal flu vaccination by examining the National H1N1 Flu Survey (NHFS) conducted from late 2009 to early 2010. Our econometric model estimated the probabilities of possible choices by varying individual characteristics, and predicted the way in which the probabilities are expected to change given the specific covariates of interest. From this estimation, we observed that non-traditional locations significantly influenced the vaccination of certain individuals, such as those who are high-income, educated, White, employed, and living in a metropolitan statistical area (MSA), by increasing the coverage. Thus, based on the empirical evidence, our study suggested that supporting non-traditional locations for vaccination could be effective in increasing vaccination coverage. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    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.

  5. Incentives for reporting disease outbreaks.

    Science.gov (United States)

    Laxminarayan, Ramanan; Reif, Julian; Malani, Anup

    2014-01-01

    Countries face conflicting incentives to report infectious disease outbreaks. Reports of outbreaks can prompt other countries to impose trade and travel restrictions, which has the potential to discourage reporting. However, reports can also bring medical assistance to contain the outbreak, including access to vaccines. We compiled data on reports of meningococcal meningitis to the World Health Organization (WHO) from 54 African countries between 1966 and 2002, a period is marked by two events: first, a large outbreak reported from many countries in 1987 associated with the Hajj that resulted in more stringent requirements for meningitis vaccination among pilgrims; and second, another large outbreak in Sub-Saharan Africa in 1996 that led to a new international mechanism to supply vaccines to countries reporting a meningitis outbreak. We used fixed-effects regression modeling to statistically estimate the effect of external forcing events on the number of countries reporting cases of meningitis to WHO. We find that the Hajj vaccination requirements started in 1988 were associated with reduced reporting, especially among countries with relatively fewer cases reported between 1966 and 1979. After the vaccine provision mechanism was in place in 1996, reporting among countries that had previously not reported meningitis outbreaks increased. These results indicate that countries may respond to changing incentives to report outbreaks when they can do so. In the long term, these incentives are likely to be more important than surveillance assistance in prompt reporting of outbreaks.

  6. Acute necrotizing encephalopathy of childhood: a fatal complication of swine flu

    International Nuclear Information System (INIS)

    Khan, M.R.; Maheshwari, P.K.; Haque, A.

    2010-01-01

    Acute necrotizing encephalopathy of childhood (ANEC) is a rare condition characterized by the presence of multifocal symmetrical brain lesions involving mainly thalami, brainstem, cerebellum and white matter. ANEC is a serious and life threatening complication of simple viral infections. We present a case of a young child who developed this condition with classical clinical and radiological findings consistent with ANEC, secondary to swine flu (H1N1). He needed ventilatory support and had profound motor and intellectual deficit on discharge. We report this case with aim of raising awareness about this fatal complication of swine flu which has become a global health care issue these days. (author)

  7. Evaluation of Wondfo influenza A&B fast test based on immunochromatography assay for rapid diagnosis of influenza A H1N1

    Directory of Open Access Journals (Sweden)

    Yunping Peng

    2013-04-01

    Full Text Available Influenza viruses cause significant morbidity and mortality in both children and adults during local outbreaks or epidemics. Therefore, a rapid test for influenza A&B would be useful. This study was conducted to evaluate the clinical performance of the Wondfo influenza A&B test for rapid diagnosis of influenza A H1N1 Infection. The rapid testing assay could distinguish infection of influenza A and B virus. The reference viral strains were cultured in MDCK cells while TCID50 if the viruses were determined. The analytical sensitivity of the Wondfo kit was 100 TCID50/ml. The Wondfo kit did not show cross reactivity with other common viruses. 1928 suspected cases of influenza A (H1N1 virus infection were analyzed in the Wondfo influenza A&B test and other commercially available products. Inconsistent results were further confirmed by virus isolation in cell culture. The sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV were 100%, 98.23%, 92.45%, and 100% for flu A, and 96.39%, 99.95%, 98.77%, and 99.84% for flu B respectively. 766 suspected cases of influenza A (H1N1 virus infection were analyzed in the Wondfo influenza A&B test and RT-PCR. The sensitivity, specificity, PPV and NPV were 56.5%, 99.75%, 99.52% and 71.04% for flu A, 25.45%, 99.86%, 93.33% and 94.54% for flu B respectively. These results indicate that the Wondfo influenza A&B test has high positive and negative detection rates. One hundred fifty-six specimens of influenza A (H1N1 confirmed by RT-PCR were analyzed by the Wondfo influenza A&B test and 66.67% were positive while only 18.59% were positive by the reference kit. These results indicate that our rapid diagnostic assay may be useful for analyzing influenza A H1N1 infections in patient specimen.

  8. Evaluation of Wondfo influenza A&B fast test based on immunochromatography assay for rapid diagnosis of influenza A H1N1

    Directory of Open Access Journals (Sweden)

    Yunping Peng

    Full Text Available Influenza viruses cause significant morbidity and mortality in both children and adults during local outbreaks or epidemics. Therefore, a rapid test for influenza A&B would be useful. This study was conducted to evaluate the clinical performance of the Wondfo influenza A&B test for rapid diagnosis of influenza A H1N1 Infection. The rapid testing assay could distinguish infection of influenza A and B virus. The reference viral strains were cultured in MDCK cells while TCID50 if the viruses were determined. The analytical sensitivity of the Wondfo kit was 100 TCID50/ml. The Wondfo kit did not show cross reactivity with other common viruses. 1928 suspected cases of influenza A (H1N1 virus infection were analyzed in the Wondfo influenza A&B test and other commercially available products. Inconsistent results were further confirmed by virus isolation in cell culture. The sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV were 100%, 98.23%, 92.45%, and 100% for flu A, and 96.39%, 99.95%, 98.77%, and 99.84% for flu B respectively. 766 suspected cases of influenza A (H1N1 virus infection were analyzed in the Wondfo influenza A&B test and RT-PCR. The sensitivity, specificity, PPV and NPV were 56.5%, 99.75%, 99.52% and 71.04% for flu A, 25.45%, 99.86%, 93.33% and 94.54% for flu B respectively. These results indicate that the Wondfo influenza A&B test has high positive and negative detection rates. One hundred fifty-six specimens of influenza A (H1N1 confirmed by RT-PCR were analyzed by the Wondfo influenza A&B test and 66.67% were positive while only 18.59% were positive by the reference kit. These results indicate that our rapid diagnostic assay may be useful for analyzing influenza A H1N1 infections in patient specimen.

  9. Does disease cause vaccination? Disease outbreaks and vaccination response.

    Science.gov (United States)

    Oster, Emily

    2017-11-02

    Parental fear of vaccines has limited vaccination rates in the United States. I test whether disease outbreaks increase vaccination using a new dataset of county-level disease and vaccination data. I find that pertussis (whooping cough) outbreaks in a county decrease the share of unvaccinated children entering kindergarten. These responses do not reflect changes in the future disease risk. I argue that these facts are best fit by a model in which individuals are both myopic and irrational. This suggests that better promotion of information about outbreaks could enhance the response. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Potential of Complementary and Alternative Medicine in Preventive Management of Novel H1N1 Flu (Swine Flu Pandemic: Thwarting Potential Disasters in the Bud

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    Rajesh Arora

    2011-01-01

    Full Text Available The emergence of novel H1N1 has posed a situation that warrants urgent global attention. Though antiviral drugs are available in mainstream medicine for treating symptoms of swine flu, currently there is no preventive medicine available. Even when available, they would be in short supply and ineffective in a pandemic situation, for treating the masses worldwide. Besides the development of drug resistance, emergence of mutant strains of the virus, emergence of a more virulent strain, prohibitive costs of available drugs, time lag between vaccine developments, and mass casualties would pose difficult problems. In view of this, complementary and alternative medicine (CAM offers a plethora of interesting preventive possibilities in patients. Herbs exhibit a diverse array of biological activities and can be effectively harnessed for managing pandemic flu. Potentially active herbs can serve as effective anti influenza agents. The role of CAM for managing novel H1N1 flu and the mode of action of these botanicals is presented here in an evidence-based approach that can be followed to establish their potential use in the management of influenza pandemics. The complementary and alternative medicine approach deliberated in the paper should also be useful in treating the patients with serious influenza in non pandemic situations.

  11. Disease Outbreaks Caused by Water.

    Science.gov (United States)

    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)

  12. Gastroenteritis outbreaks on cruise ships

    DEFF Research Database (Denmark)

    Mouchtouri, Varvara A; Verykouki, Eleni; Zamfir, Dumitru

    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...

  13. outbreak of hepatitis 'E' in risalpur garrison

    International Nuclear Information System (INIS)

    Sharif, T.B.; Tariq, W.U.Z.

    2007-01-01

    Hepatitis E virus is an RNA virus. It results in epidemics/outbreaks in geographical areas lacking clean water and sanitation. It is excreted in stools and is enterically transmitted (faeco-oral route). The clinical picture resembles other acute hepatitis and diagnosis is clinched by detecting anti-HEV IgM in infected individuals. It is a self-limiting disease and does not progress to chronicity. There is no vaccine available so far, to confer immunity against HEV infection. HEV is endemic in many parts of the world and has resulted in many epidemics / outbreaks worldwide. It is also endemic in Pakistan and epidemics / outbreaks have generally been under reported. To establish the cause of outbreak Blood samples of the patients (n=195), admitted in isolation ward were collected aseptically for routine baseline investigations and hepatitis screening. Separate blood samples were sent to Armed Forces Institute of pathology (AFIP), Rawalpindi for detection of antibodies to hepatitis E virus (Anti HEV IgM). Water samples collected during the outbreak were tested by multiple tube technique. MPN (Most Probable Number) method was used to determine faecal coliform bacteria per 100 ml of water sample. All the patients (n=195) on admission had raised ALT (Alanine Aminotransferase) levels along with hyperbilirubinemia, 37% had raised TLC with polymorphonuclear response. None had HBsAg (Hepatitis B surface antign) or anti-HCV (antibodies to hepatitis C virus), 23% had prolonged PT (Prothrombin Time). Samples despatched to AFIP Rawalpindi confirmed the presence of anti-HEV IgM. Follow up analysis revealed many fold increase in ALT levels. Average stay in the Hospital was 23.6 days per patient. All the water samples were declared unfit for drinking due to high coliform count. At present, no vaccine is available to protect against HEV infection. Mainstay for prevention and occurrence is to formulate cost-effective strategies for improvement of self/environmental hygiene and

  14. Long term serious olfactory loss in colds and/or flu.

    Science.gov (United States)

    de Haro-Licer, Josep; Roura-Moreno, Jordi; Vizitiu, Anabella; González-Fernández, Adela; González-Ares, Josep Antón

    2013-01-01

    In the general population, we can find 2-3% of lifelong olfactory disorders (from hyposmia to anosmia). Two of the most frequent aetiologies are the common cold and flu. The aim of this study was to show the degree of long-term olfactory dysfunction caused by a cold or flu. This study was based on 240 patients, with olfactory loss caused only by flu or a cold. We excluded all patients with concomitant illness (66 patients), the rest of patients (n=174) consisted of 51 men (29.3%) and 123 women (70.7%). They all underwent olfactometry study (i and v cranial nerve) and a nasal sinus computed tomography scan, as well as magnetic resonance imaging of the brain. Results were compared with a control group (n=120). Very significant differences in levels of olfactory impairment for the olfactory nerve (P<.00001) and trigeminal nerve (P<.0001) were confirmed. People that suffer olfactory dysfunction for more than 6 months, from flu or a cold, present serious impairment of olfactory abilities. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  15. Can movie theater advertisements promote health behaviors? Evaluation of a flu vaccination pilot campaign.

    Science.gov (United States)

    Peddecord, K Michael; Jacobson, Isabel Gomez; Engelberg, Moshe; Kwizera, Lisa; Macias, Violet; Gustafson, Kathleen W

    2008-09-01

    As part of a multimedia campaign to promote annual influenza vaccination, three slides were shown as part of the slide show of advertisements prior to the beginning of previews in movie theaters in San Diego County. Intercept surveys were conducted following the movie. The primary target groups for the campaign were adults with children 6 months to 2 years of age and adults over 50 years of age. Overall, 88% of exposed patrons reported seeing some type of movie ad. Among those who recalled any ad, 24% recalled the flu advertisement. In contrast, recall of flu-related news coverage was high, with over 95% of exposed and comparison interviewees recalling news stories during the campaign period. While 56% of those interviewed remembered one or more specific flu-related news items, individuals within this group who also had also been exposed to the movie ads were not more likely to recall flu campaign advertisements. We describe a method for estimating valid recalls and cost per valid exposure. Further research that compares movie ads with public service announcements (PSAs) in other venues is necessary to solidify our conclusions that movie advertising is a highly cost-effective medium for health communication.

  16. Modeling of the influence of humidity on H1N1 flu in China

    Science.gov (United States)

    PEI, Y.; Tian, H.; Xu, B.

    2015-12-01

    In 2009, a heavy Flu hit the whole world. It was caused by the virus H1N1. The influenza first broke out in Mexico in March and the United States in April, 2009. The World Health Organization (WHO) announced that the H1N1 influenza became pandemic, alert to a warning phase of six. By the end of 2011, 181302 H1N1 cases were reported in mainland China. To improve our understanding on the impact of environmental factors on the disease transmission, we constructed an SIR (Susceptible - Infectious - Recovered) model incorporating environmental factors. It was found that the absolute humidity was a dominant environmental factor. The study interpolated the humidity data monitored with 340 weather stations from 1951 to 2011 in mainland China. First, the break point of the trend for the absolutely humidity was detected by the BFAST (Break For Additive Season and Trend) method. Then, the SIR model with and without the absolutely humidity incorporated in the model was built and tested. Finally, the results with the two scenarios were compared. Results indicate that lower absolutely humidity may promote the transmission of the H1N1 cases. The calculated basic reproductive number ranges from 1.65 to 3.66 with a changing absolute humidity. This is consistent with the former study result with basic reproductive number ranging from 2.03 to 4.18. The average recovery duration was estimated to be 5.7 days. The average duration to get immunity from the influenza is 399.02 days. A risk map is also produced to illustrate the model results.

  17. [The seasonal flu vaccination among caregivers in geriatric units: Up-to-date].

    Science.gov (United States)

    Contal, E; Putot, A; Dipanda, M; Perrin, S; Asgassou, S; Sordet-Guépet, H; Manckoundia, P

    2016-12-01

    Flu vaccinations for healthcare professionals seems to be one of the most effective preventive actions in the face of a disease that carries a high risk of a potentially serious nosocomial epidemic in a geriatric environment. The aim of this study was to take stock of the flu vaccination status among caregivers in the geriatric units and to understand the reasons for their reluctance to be vaccinated, in order to put forward proposals to improve vaccination coverage. A literature search of articles published since 2000 in the area of geriatrics, infectious diseases or pneumology was mainly conducted on PubMed using the keywords "caregivers", "elderly", "flu", "influenza", "nosocomial" and "vaccination". After reading all abstracts in English or French and ruling out irrelevant articles, only 64 relevant articles have been listed in bibliography section. Despite official recommendations, the literature reveals insufficient vaccination coverage of healthcare personnel at both the national and international level. Vaccination coverage seems to be lower among younger female non-medical staff. The factors that determine the likelihood of vaccination are the wish to protect one's self, one's family and patients/residents, as well as the experience of earlier bouts of flu. Factors that oppose vaccination are complex and related to the fear of side effects, the use of other preventive measures, the feeling that vaccination is ineffective, poor understanding of the disease and the vaccine, forgetfulness and problems of organization. Campaigns to promote vaccination that target healthcare professionals must be multidimensional and very incentive. The pedagogical message must be centered on the benefits to the individual and adjusted to socio-professional categories. Mobile strategies in the different departments to encourage staff are a pragmatic solution to this challenge. The referring doctor has an essential role to play, as does the occupational doctor in association

  18. SARS knowledge, perceptions, and behaviors: a comparison between Finns and the Dutch during the SARS outbreak in 2003

    NARCIS (Netherlands)

    Vartti, A.M.; Oenema, A.; Schreck, M.; Uutela, A.; Zwart, de O.; Brug, J.; Aro, A.R.

    2009-01-01

    BACKGROUND: The SARS outbreak served to test both local and international outbreak management and risk communication practices. PURPOSE: The study compares SARS knowledge, perceptions, behaviors, and information between Finns and the Dutch during the SARS outbreak in 2003. METHOD: The participants

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

    Science.gov (United States)

    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.

  20. A cholera outbreak associated with drinking contaminated well water.

    Science.gov (United States)

    Ranjbar, Reza; Rahbar, Mohammad; Naghoni, Ali; Farshad, Shohreh; Davari, Amin; Shahcheraghi, Fereshteh

    2011-09-01

    Cholera has been a significant public health challenge in many communities. An outbreak of acute diarrheal illness occurred among participants in a wedding ceremony in a village in Qazvin, Iran, in 2008. We conducted an epidemiological, environmental and microbiological investigation to determine the causative agent, source and extent of this outbreak. Clinical and environmental samples were collected and analyzed for the presence of diarrhea-causing bacterial organisms, which included Vibrio cholera. The relationship between the strains was determined using enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR). The attack rate was 21.8%. Clinical and environmental samples were positive for V. cholerae serotype Inaba. All tested isolates had a similar ERIC-PCR pattern, which indicated that a single clone of V. cholerae was responsible for this outbreak. Our findings demonstrated that well water was the source of this outbreak.

  1. Toward unsupervised outbreak detection through visual perception of new patterns

    Directory of Open Access Journals (Sweden)

    Lévy Pierre P

    2009-06-01

    Full Text Available Abstract Background Statistical algorithms are routinely used to detect outbreaks of well-defined syndromes, such as influenza-like illness. These methods cannot be applied to the detection of emerging diseases for which no preexisting information is available. This paper presents a method aimed at facilitating the detection of outbreaks, when there is no a priori knowledge of the clinical presentation of cases. Methods The method uses a visual representation of the symptoms and diseases coded during a patient consultation according to the International Classification of Primary Care 2nd version (ICPC-2. The surveillance data are transformed into color-coded cells, ranging from white to red, reflecting the increasing frequency of observed signs. They are placed in a graphic reference frame mimicking body anatomy. Simple visual observation of color-change patterns over time, concerning a single code or a combination of codes, enables detection in the setting of interest. Results The method is demonstrated through retrospective analyses of two data sets: description of the patients referred to the hospital by their general practitioners (GPs participating in the French Sentinel Network and description of patients directly consulting at a hospital emergency department (HED. Informative image color-change alert patterns emerged in both cases: the health consequences of the August 2003 heat wave were visualized with GPs' data (but passed unnoticed with conventional surveillance systems, and the flu epidemics, which are routinely detected by standard statistical techniques, were recognized visually with HED data. Conclusion Using human visual pattern-recognition capacities to detect the onset of unexpected health events implies a convenient image representation of epidemiological surveillance and well-trained "epidemiology watchers". Once these two conditions are met, one could imagine that the epidemiology watchers could signal epidemiological alerts

  2. An empirical comparison of spatial scan statistics for outbreak detection

    Directory of Open Access Journals (Sweden)

    Neill Daniel B

    2009-04-01

    Full Text Available Abstract Background The spatial scan statistic is a widely used statistical method for the automatic detection of disease clusters from syndromic data. Recent work in the disease surveillance community has proposed many variants of Kulldorff's original spatial scan statistic, including expectation-based Poisson and Gaussian statistics, and incorporates a variety of time series analysis methods to obtain expected counts. We evaluate the detection performance of twelve variants of spatial scan, using synthetic outbreaks injected into four real-world public health datasets. Results The relative performance of methods varies substantially depending on the size of the injected outbreak, the average daily count of the background data, and whether seasonal and day-of-week trends are present. The expectation-based Poisson (EBP method achieves high performance across a wide range of datasets and outbreak sizes, making it useful in typical detection scenarios where the outbreak characteristics are not known. Kulldorff's statistic outperforms EBP for small outbreaks in datasets with high average daily counts, but has extremely poor detection power for outbreaks affecting more than of the monitored locations. Randomization testing did not improve detection power for the four datasets considered, is computationally expensive, and can lead to high false positive rates. Conclusion Our results suggest four main conclusions. First, spatial scan methods should be evaluated for a variety of different datasets and outbreak characteristics, since focusing only on a single scenario may give a misleading picture of which methods perform best. Second, we recommend the use of the expectation-based Poisson statistic rather than the traditional Kulldorff statistic when large outbreaks are of potential interest, or when average daily counts are low. Third, adjusting for seasonal and day-of-week trends can significantly improve performance in datasets where these trends are

  3. GHOST: global hepatitis outbreak and surveillance technology.

    Science.gov (United States)

    Longmire, Atkinson G; Sims, Seth; Rytsareva, Inna; Campo, David S; Skums, Pavel; Dimitrova, Zoya; Ramachandran, Sumathi; Medrzycki, Magdalena; Thai, Hong; Ganova-Raeva, Lilia; Lin, Yulin; Punkova, Lili T; Sue, Amanda; Mirabito, Massimo; Wang, Silver; Tracy, Robin; Bolet, Victor; Sukalac, Thom; Lynberg, Chris; Khudyakov, Yury

    2017-12-06

    Hepatitis C is a major public health problem in the United States and worldwide. Outbreaks of hepatitis C virus (HCV) infections associated with unsafe injection practices, drug diversion, and other exposures to blood are difficult to detect and investigate. Effective HCV outbreak investigation requires comprehensive surveillance and robust case investigation. We previously developed and validated a methodology for the rapid and cost-effective identification of HCV transmission clusters. Global Hepatitis Outbreak and Surveillance Technology (GHOST) is a cloud-based system enabling users, regardless of computational expertise, to analyze and visualize transmission clusters in an independent, accurate and reproducible way. We present and explore performance of several GHOST implemented algorithms using next-generation sequencing data experimentally obtained from hypervariable region 1 of genetically related and unrelated HCV strains. GHOST processes data from an entire MiSeq run in approximately 3 h. A panel of seven specimens was used for preparation of six repeats of MiSeq libraries. Testing sequence data from these libraries by GHOST showed a consistent transmission linkage detection, testifying to high reproducibility of the system. Lack of linkage among genetically unrelated HCV strains and constant detection of genetic linkage between HCV strains from known transmission pairs and from follow-up specimens at different levels of MiSeq-read sampling indicate high specificity and sensitivity of GHOST in accurate detection of HCV transmission. GHOST enables automatic extraction of timely and relevant public health information suitable for guiding effective intervention measures. It is designed as a virtual diagnostic system intended for use in molecular surveillance and outbreak investigations rather than in research. The system produces accurate and reproducible information on HCV transmission clusters for all users, irrespective of their level of bioinformatics

  4. Situation Update: Summary of Weekly FluView

    Science.gov (United States)

    ... respiratory specimens testing positive for influenza viruses in clinical laboratories during the week ending April 21 was 8. ... percent of specimens testing positive for influenza in clinical laboratories ranged from 2.7% to 16.9%. During ...

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

    Science.gov (United States)

    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

  6. A Gastroenteritis Outbreak Caused by Noroviruses in Greece

    Directory of Open Access Journals (Sweden)

    Yiannis Alamanos

    2011-08-01

    Full Text Available In June 2006, an outbreak alert regarding cases of acute gastroenteritis in a region in North Eastern Greece (population 100,882 inhabitants, triggered investigations to guide control measures. The outbreak started the first days of June, and peaked in July. A descriptive epidemiological study, a virological characterization of the viral agent identified from cases as well as a phylogenetic analysis was performed. From June 5 to September 3, 2006 (weeks 23–44, 1,640 cases of gastroenteritis (45.2% male and 54.8% female, aged 3 months to 89 years were reported. The overall attack rate for the period was 16.3 cases/1,000 inhabitants. About 57% of cases observed were under the age of 15 years. Αnalysis of faecal samples identified Norovirus GII strains. Fifteen different Norovirus GII strains were recorded, presenting a homology of 94.8% (86–97% to GII strains obtained from GenBank. The long duration of the outbreak suggests an important role of person-to-person transmission, while the emergence of the outbreak was possibly due to contaminated potable water, although no viruses were detected in any tested water samples. This outbreak underscores the need for a national surveillance system for acute non-bacterial gastroenteritis outbreaks.

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

    Directory of Open Access Journals (Sweden)

    Werber Dirk

    2012-02-01

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

  8. Medicinal plants indicated for flu and colds in the South of Brazil

    Directory of Open Access Journals (Sweden)

    Marjoriê da Costa Mendieta

    2015-09-01

    Full Text Available We sought to know the medicinal plants used for flu and colds by farmers from the South of Rio Grande do Sul State and to compare it with scientific evidence. This descriptive study was conducted with 12 farmers living at Ilha dos Marinheiros, in the city of Rio Grande, Rio Grande do Sul, Brazil. We used descriptive analysis, comparing the results with the scientific literature. Thirteen plants were cited as used for cold and flu: Achyrocline satureioides, Allium sativum, Cinnamomum zeylanicum, Citrus limon, Citrus reticulata, Citrus sinensis, Gochnatia polymorpha, Illicium verum, Mentha piperita, Mikania sp., Ocimum selloi, Origanum majorana and Verbena sp. Results show popular knowledge meeting scientific evidence for most indications, seen that 84,6% of cited plants are in agreement with the literature. Thus, we emphasize the richness of popular knowledge, the need of its appreciation and constant approximation of health professionals to this knowledge, integrated with science.

  9. ‘Presenting CXR phenotype of H1N1’ flu compared with contemporaneous non-H1N1, community acquired pneumonia, during pandemic and post-pandemic outbreaks’

    Energy Technology Data Exchange (ETDEWEB)

    Minns, F.C., E-mail: Fiona.Minns@nhslothian.scot.nhs.uk [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom); Nimhuineachain, A, E-mail: draideen@gmail.com [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom); Beek, E.J.R. van, E-mail: Edwin-vanbeek@ed.ac.uk [Clinical Research Imaging Centre, University of Edinburgh, 47 Little France Crescent, Edinburgh, Midlothian EH16 4TJ (United Kingdom); Ritchie, G., E-mail: drgillritchie@hotmail.com [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom); Hill, A., E-mail: adam.hill318@nhs.net [Department of Respiratory Medicine, New Royal Infirmary, Edinburgh (United Kingdom); Murchison, J.T., E-mail: john.murchison@nhslothian.scot.nhs.uk [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom)

    2015-09-15

    Highlights: • Patients with H1N1 pneumonia demonstrated more opacified zones on chest x-ray than patients with non-H1N1 pneumonias. • A particular ‘phenotype’ of chest x-ray changes was identified in H1N1 patients. • This H1N1 ‘phenotype’ was the same for the two evaluated ‘flu seasons, during both pandemic and post pandemic stages. - Abstract: Aims: To review, phenotype and assess potential prognostic value of initial chest X-ray findings in patients with H1N1 influenza during seasonal outbreaks of 2009 and 2010, in comparison with non-H1N1, community acquired pneumonia (CAP). Methods: We retrospectively identified 72 patients admitted to hospital with pneumonia during the seasons of 2009 and 2010. H1N1 cases were confirmed by virology PCR. Presenting chest X-rays were jointly read by 2 radiologists, who were ‘blinded’ to further patient details and divided into 6 zones. Total number of opacified zones, the pattern and distribution of changes and length of hospital stay were recorded. Results: Patients with H1N1 demonstrated more opacified zones (mean of 2.9 compared with 2.0; p = 0.006), which were bilateral in two-thirds compared with a quarter of those with non-H1N1 CAP (p = 0.001). H1N1 radiographs were more likely to be ‘patchy’ versus ‘confluent’ changes of non-H1N1 CAP (p = 0.03) and more often demonstrated peripheral distribution (p = 0.01). H1N1 patients tended to stay in hospital longer (not significant; p = 0.08). A positive correlation existed between number of affected zones and length of inpatient stay, which was statistically significant for the cohorts combined (p = 0.02). The findings were the same for the two evaluated seasons. Conclusion: H1N1 patients demonstrated more extensive disease, which was more likely bilateral, ‘patchy’, and peripheral in distribution. With increasing global cases of H1N1, knowledge of the typical findings of the H1N1 presenting chest X-ray may assist with early triage of patients

  10. ‘Presenting CXR phenotype of H1N1’ flu compared with contemporaneous non-H1N1, community acquired pneumonia, during pandemic and post-pandemic outbreaks’

    International Nuclear Information System (INIS)

    Minns, F.C.; Nimhuineachain, A; Beek, E.J.R. van; Ritchie, G.; Hill, A.; Murchison, J.T.

    2015-01-01

    Highlights: • Patients with H1N1 pneumonia demonstrated more opacified zones on chest x-ray than patients with non-H1N1 pneumonias. • A particular ‘phenotype’ of chest x-ray changes was identified in H1N1 patients. • This H1N1 ‘phenotype’ was the same for the two evaluated ‘flu seasons, during both pandemic and post pandemic stages. - Abstract: Aims: To review, phenotype and assess potential prognostic value of initial chest X-ray findings in patients with H1N1 influenza during seasonal outbreaks of 2009 and 2010, in comparison with non-H1N1, community acquired pneumonia (CAP). Methods: We retrospectively identified 72 patients admitted to hospital with pneumonia during the seasons of 2009 and 2010. H1N1 cases were confirmed by virology PCR. Presenting chest X-rays were jointly read by 2 radiologists, who were ‘blinded’ to further patient details and divided into 6 zones. Total number of opacified zones, the pattern and distribution of changes and length of hospital stay were recorded. Results: Patients with H1N1 demonstrated more opacified zones (mean of 2.9 compared with 2.0; p = 0.006), which were bilateral in two-thirds compared with a quarter of those with non-H1N1 CAP (p = 0.001). H1N1 radiographs were more likely to be ‘patchy’ versus ‘confluent’ changes of non-H1N1 CAP (p = 0.03) and more often demonstrated peripheral distribution (p = 0.01). H1N1 patients tended to stay in hospital longer (not significant; p = 0.08). A positive correlation existed between number of affected zones and length of inpatient stay, which was statistically significant for the cohorts combined (p = 0.02). The findings were the same for the two evaluated seasons. Conclusion: H1N1 patients demonstrated more extensive disease, which was more likely bilateral, ‘patchy’, and peripheral in distribution. With increasing global cases of H1N1, knowledge of the typical findings of the H1N1 presenting chest X-ray may assist with early triage of patients

  11. H1N1 influenza ('swine 'flu') in the paediatric ICU in South Africa

    African Journals Online (AJOL)

    Schoub B. Swine flu – implications for South Africa. Communicable Diseases Surveillance. Bulletin 2009;7(3):5-7. 5. Ahrens JO, Morrow BM, Argent AC. Influenza A(H1N1)pdm09 in critically ill children admitted to a paediatric intensive care unit, South Africa. S Afr J Crit Care 2015;31(1):4-7. 6. Cox CM, Blanton L, Dhara R, ...

  12. 1918 Flu Pandemic: Implications for Homeland Security in the New Millennium

    Science.gov (United States)

    2007-05-09

    descriptions of the event noted that the sky was black.13 Two days later a young and healthy soldier reported to the post hospital with a fever.14...the recent past that may mimic the potential of pandemic flu was the SARS or Severe Acute Respiratory Syndrome crisis that occurred in 2003 after...assets needed to teach and treat as needed, much as was the case in previous threats such as polio and smallpox. Relatively few physicians, nurses

  13. Factors associated with acceptance of pandemic flu vaccine by healthcare professionals in Spain, 2009-2010.

    Science.gov (United States)

    Fernández-Villa, Tania; Molina, Antonio J; Torner, Nuria; Castilla, Jesus; Astray, Jenaro; García-Gutiérrez, Susana; Mayoral, José María; Tamames, Sonia; Domínguez, Ángela; Martín, Vicente

    2017-10-01

    The A(H1N1)pdm09 influenza virus reached pandemic level in Spain in 2009, prompting a national vaccination campaign. To avoid transmission to patients, healthcare professionals' vaccination against pandemic influenza is crucial. The main objective of this study was to analyze factors associated with the failure by healthcare professionals to accept the pandemic vaccination in 2009. A cross-sectional survey was conducted of healthcare professionals in seven of Spain's autonomous regions. A questionnaire was used to collect information about personal and professional details, the respondents' flu vaccination status in the 2008-2009 and 2009-2010 seasons (seasonal and pandemic vaccines), and their knowledge and attitudes. A total of 1,661 professionals completed the survey. In the 2009-2010 season, 38.2% had both the seasonal and the pandemic vaccine, 22.1% had had only the seasonal, and 4.7% only the pandemic vaccine. The strongest predictor of not receiving the pandemic vaccine was not having had seasonal vaccinations in that year or the previous year. Those who had not received the pandemic vaccine were more often female; nurses; under 45; denied contact with at-risk groups; and had negative beliefs about the vaccine effectiveness and little concern for getting the disease, being infected at work, or passing it on to patients. It would be prudent to direct preventive campaigns not only at individuals at risk of catching flu but also at health professionals with a negative view of flu vaccine, with a particular focus on nurses, who have a key role in recommending flu vaccine. © 2017 Wiley Periodicals, Inc.

  14. The 2014 French health campaign reminds us that “flu must be taken seriously”

    CERN Multimedia

    Medical Service

    2014-01-01

    The fact is that 5-10% of the global adult population and 20-30% of children worldwide catch the flu every year. The illness can lead to hospitalisation and death, mainly in people who are considered high-risk (infants, the elderly, and those with chronic illnesses). According to the WHO, every year, flu epidemics are responsible for approximately three to five million cases of serious illness and for 250,000 to 500,000 deaths worldwide.   Vaccination is the most effective way of avoiding the illness and any serious consequences and protecting those around you. Safe and effective vaccines are available and have been used for more than 60 years. Remember, anyone working on the CERN site who wishes to be vaccinated against seasonal flu should go to the Infirmary (Building 57, ground floor) with their dose of vaccine. The Medical Service will issue a prescription on the day of the vaccination for the purposes of reimbursement through UNIQA. NB: The Medical Service cannot provide this vaccinat...

  15. A framework for the assessment and implementation of diagnostics in outbreak situations

    Directory of Open Access Journals (Sweden)

    Elliot P. Cowan

    2016-10-01

    Addressing Issues: This paper presents a pathway to the outbreak use of IVDs that can be considered by countries experiencing an outbreak situation. It takes into account recognition of the outbreak, product development, regulatory evaluation, implementation, and monitoring of the outbreak-use test. Streamlined assessment programmes for emergency-use tests have been established by the US Food and Drug Administration and the World Health Organization. These programmes take into account test requirements for the country in which the outbreak exists. Therefore, countries can consider adopting these tests without the need to conduct expensive and time consuming assessments, such as performance studies. Key responsible parties are identified for each step of the pathway, recognising that transparency and communication among all parties are critical.

  16. Genomic epidemiology of the Escherichia coli O104:H4 outbreaks in Europe, 2011

    DEFF Research Database (Denmark)

    Grad, Yonatan H; Lipsitch, Marc; Feldgarden, Michael

    2012-01-01

    The degree to which molecular epidemiology reveals information about the sources and transmission patterns of an outbreak depends on the resolution of the technology used and the samples studied. Isolates of Escherichia coli O104:H4 from the outbreak centered in Germany in May-July 2011......, and the much smaller outbreak in southwest France in June 2011, were indistinguishable by standard tests. We report a molecular epidemiological analysis using multiplatform whole-genome sequencing and analysis of multiple isolates from the German and French outbreaks. Isolates from the German outbreak showed...... remarkably little diversity, with only two single nucleotide polymorphisms (SNPs) found in isolates from four individuals. Surprisingly, we found much greater diversity (19 SNPs) in isolates from seven individuals infected in the French outbreak. The German isolates form a clade within the more diverse...

  17. Outbreak of Diarrhetic Shellfish Poisoning Associated with Mussels, British Columbia, Canada

    Science.gov (United States)

    Taylor, Marsha; McIntyre, Lorraine; Ritson, Mark; Stone, Jason; Bronson, Roni; Bitzikos, Olga; Rourke, Wade; Galanis, Eleni

    2013-01-01

    In 2011, a Diarrhetic Shellfish Poisoning (DSP) outbreak occurred in British Columbia (BC), Canada that was associated with cooked mussel consumption. This is the first reported DSP outbreak in BC. Investigation of ill individuals, traceback of product and laboratory testing for toxins were used in this investigation. Sixty-two illnesses were reported. Public health and food safety investigation identified a common food source and harvest area. Public health and regulatory agencies took actions to recall product and notify the public. Shellfish monitoring program changes were implemented after the outbreak. Improved response and understanding of toxin production will improve management of future DSP outbreaks. PMID:23697950

  18. Outbreak of caliciviruses in the Singapore military, 2015.

    Science.gov (United States)

    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.

  19. Outbreak of caliciviruses in the Singapore military, 2015

    Directory of Open Access Journals (Sweden)

    Freddy Jun Xian Neo

    2017-11-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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.

  20. MODEL SEIR UNTUK EPIDEMI FLU BABI PADA POPULASI BABI DENGAN LAJU KONTAK JENUH

    Directory of Open Access Journals (Sweden)

    M Kharis

    2012-09-01

    Full Text Available Babi merupakan inang alami dari virus influensa yang secara anatomis, fisiologis, dan imunitas mirip (similar dengan yang ada pada manusia. Virus influenza subtipe A yang ada pada manusia yaitu H1N1, H3N2 dan H1N2 merupakan enzootic pada populasi babi di dunia. babi dapat terinfeksi oleh turunan-turunan virus influenza tipe A dari manusia maupun dari burung dan dalam hal ini dianggap sebagai inang sementara (Intermediate hosts dari turunan-turunan virus flu babi yang berpotensi menyebabkan epidemi bahkan pandemi. Evolusi antigenik dari virus influenza pada babi terjadi dengan laju sekitar 6 kali lebih lambat dibandingkan dengan virus influenza pada manusia. Dalam tulisan ini akan dikaji model matematika untuk epidemi flu babi pada populasi babi. Model yang diberikan merupakan model deterministik dengan laju kontak jenuh yang merupakan perumuman dari laju kontak standar. Perumuman ini dinyatakan dengan adanya probabilitas suatu individu melakukan kontak yang dinyatakan sebagai suatu fungsi dari populasi. Pengkajian yang dilakukan meliputi penentuan titik ekuilibrium model matematika dan analisa kestabilannya. Diharapkan hasil kajian ini dapat bermanfaat dalam penanggulangan wabah flu babi pada sumber utama yaitu populasi babi sehingga dapat dilakukan pencegahan sebelum mewabah di populasi manusia. Pigs are a natural host of influenza virus that are similar anatomically, physiologically, and immunity which in humans. Influenza viruses of A subtype in humans are H1N1, H3N2 and H1N2. They are enzootic in the swine population in the world. Pigs can be infected by strains of type A influenza viruses from humans or from birds. Pigs are considered as a temporary host (intermediate hosts of the derivatives of the swine flu virus that has the potential to cause epidemics and even pandemics. Antigenic evolution of influenza viruses in pigs occurred at rate about 6 times slower than the influenza viruses in humans. In this paper the mathematical model

  1. Assessing Google flu trends performance in the United States during the 2009 influenza virus A (H1N1 pandemic.

    Directory of Open Access Journals (Sweden)

    Samantha Cook

    Full Text Available BACKGROUND: Google Flu Trends (GFT uses anonymized, aggregated internet search activity to provide near-real time estimates of influenza activity. GFT estimates have shown a strong correlation with official influenza surveillance data. The 2009 influenza virus A (H1N1 pandemic [pH1N1] provided the first opportunity to evaluate GFT during a non-seasonal influenza outbreak. In September 2009, an updated United States GFT model was developed using data from the beginning of pH1N1. METHODOLOGY/PRINCIPAL FINDINGS: We evaluated the accuracy of each U.S. GFT model by comparing weekly estimates of ILI (influenza-like illness activity with the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet. For each GFT model we calculated the correlation and RMSE (root mean square error between model estimates and ILINet for four time periods: pre-H1N1, Summer H1N1, Winter H1N1, and H1N1 overall (Mar 2009-Dec 2009. We also compared the number of queries, query volume, and types of queries (e.g., influenza symptoms, influenza complications in each model. Both models' estimates were highly correlated with ILINet pre-H1N1 and over the entire surveillance period, although the original model underestimated the magnitude of ILI activity during pH1N1. The updated model was more correlated with ILINet than the original model during Summer H1N1 (r = 0.95 and 0.29, respectively. The updated model included more search query terms than the original model, with more queries directly related to influenza infection, whereas the original model contained more queries related to influenza complications. CONCLUSIONS: Internet search behavior changed during pH1N1, particularly in the categories "influenza complications" and "term for influenza." The complications associated with pH1N1, the fact that pH1N1 began in the summer rather than winter, and changes in health-seeking behavior each may have played a part. Both GFT models performed well prior to and during pH1

  2. Assessing Google Flu Trends Performance in the United States during the 2009 Influenza Virus A (H1N1) Pandemic

    Science.gov (United States)

    Cook, Samantha; Conrad, Corrie; Fowlkes, Ashley L.; Mohebbi, Matthew H.

    2011-01-01

    Background Google Flu Trends (GFT) uses anonymized, aggregated internet search activity to provide near-real time estimates of influenza activity. GFT estimates have shown a strong correlation with official influenza surveillance data. The 2009 influenza virus A (H1N1) pandemic [pH1N1] provided the first opportunity to evaluate GFT during a non-seasonal influenza outbreak. In September 2009, an updated United States GFT model was developed using data from the beginning of pH1N1. Methodology/Principal Findings We evaluated the accuracy of each U.S. GFT model by comparing weekly estimates of ILI (influenza-like illness) activity with the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet). For each GFT model we calculated the correlation and RMSE (root mean square error) between model estimates and ILINet for four time periods: pre-H1N1, Summer H1N1, Winter H1N1, and H1N1 overall (Mar 2009–Dec 2009). We also compared the number of queries, query volume, and types of queries (e.g., influenza symptoms, influenza complications) in each model. Both models' estimates were highly correlated with ILINet pre-H1N1 and over the entire surveillance period, although the original model underestimated the magnitude of ILI activity during pH1N1. The updated model was more correlated with ILINet than the original model during Summer H1N1 (r = 0.95 and 0.29, respectively). The updated model included more search query terms than the original model, with more queries directly related to influenza infection, whereas the original model contained more queries related to influenza complications. Conclusions Internet search behavior changed during pH1N1, particularly in the categories “influenza complications” and “term for influenza.” The complications associated with pH1N1, the fact that pH1N1 began in the summer rather than winter, and changes in health-seeking behavior each may have played a part. Both GFT models performed well prior to and during pH1N1

  3. Comparing patient and healthcare worker experiences during a dengue outbreak in Singapore: understanding the patient journey and the introduction of a point-of-care test (POCT) toward better care delivery.

    Science.gov (United States)

    Tan, Qinghui; Hildon, Zoe J-L; Singh, Shweta; Jing, Jin; Thein, Tun Linn; Coker, Richard; Vrijhoef, Hubertus J M; Leo, Yee Sin

    2017-07-19

    In the aftermath of an upsurge in the number of dengue cases in 2013 and 2014, the SD BIOLINE Dengue Duo rapid diagnostic Point-of-Care Test (POCT) kit was introduced in Tan Tock Seng Hospital, Singapore in June 2013. It is known that the success of POCT usage is contingent on its implementation within the health system. We evaluated health services delivery and the Dengue Duo rapid diagnostic test kit application in Singapore from healthcare workers' perspectives and patient experiences of dengue at surge times. Focus group discussions were conducted with dengue patients, from before and after the POCT implementation period. In-depth interviews with semi-structured components with healthcare workers were carried out. A patient centred process mapping technique was used for evaluation, which mapped the patient's journey and was mirrored from the healthcare worker's perspective. Patients and healthcare workers confirmed a wide range of symptoms in adults, making it challenging to determine diagnosis. There were multiple routes to help seeking, and no 'typical patient journey', with patients either presenting directly to the hospital emergency department, or being referred there by a primary care provider. Patients groups diagnosed before and after POCT implementation expressed some differences between speed of diagnoses and attitudes of doctors, yet shared negative feelings about waiting times and a lack of communication and poor information delivery. However, the POCT did not in its current implementation do much to help waiting times. Healthcare workers expressed that public perceptions of dengue in recent years was a major factor in changing patient management, and that the POCT kit was helpful in improving the speed and accuracy of diagnoses. Health service delivery for dengue patients in Singapore was overall perceived to be of an acceptable clinical standard, which was enhanced by the introduction of the POCT. However, improvements can be focused on Adapting

  4. Estimating challenge load due to disease outbreaks and other challenges using reproduction records of sows

    NARCIS (Netherlands)

    Mathur, P.K.; Herrero-Medrano, J.; Alexandri, P.; Knol, E.F.; Napel, ten J.; Rashidi, H.; Mulder, H.A.

    2014-01-01

    A method was developed and tested to estimate challenge load due to disease outbreaks and other challenges in sows using reproduction records. The method was based on reproduction records from a farm with known disease outbreaks. It was assumed that the reduction in weekly reproductive output within

  5. Exploring racial influences on flu vaccine attitudes and behavior: Results of a national survey of White and African American adults.

    Science.gov (United States)

    Quinn, Sandra Crouse; Jamison, Amelia; Freimuth, Vicki S; An, Ji; Hancock, Gregory R; Musa, Donald

    2017-02-22

    Racial disparities in adult flu vaccination rates persist with African Americans falling below Whites in vaccine acceptance. Although the literature has examined traditional variables including barriers, access, attitudes, among others, there has been virtually no examination of the extent to which racial factors including racial consciousness, fairness, and discrimination may affect vaccine attitudes and behaviors. We contracted with GfK to conduct an online, nationally representative survey with 819 African American and 838 White respondents. Measures included risk perception, trust, vaccine attitudes, hesitancy and confidence, novel measures on racial factors, and vaccine behavior. There were significant racial differences in vaccine attitudes, risk perception, trust, hesitancy and confidence. For both groups, racial fairness had stronger direct effects on the vaccine-related variables with more positive coefficients associated with more positive vaccine attitudes. Racial consciousness in a health care setting emerged as a more powerful influence on attitudes and beliefs, particularly for African Americans, with higher scores on racial consciousness associated with lower trust in the vaccine and the vaccine process, higher perceived vaccine risk, less knowledge of flu vaccine, greater vaccine hesitancy, and less confidence in the flu vaccine. The effect of racial fairness on vaccine behavior was mediated by trust in the flu vaccine for African Americans only (i.e., higher racial fairness increased trust in the vaccine process and thus the probability of getting a flu vaccine). The effect of racial consciousness and discrimination for African Americans on vaccine uptake was mediated by perceived vaccine risk and flu vaccine knowledge. Racial factors can be a useful new tool for understanding and addressing attitudes toward the flu vaccine and actual vaccine behavior. These new concepts can facilitate more effective tailored and targeted vaccine communications

  6. Are bark beetle outbreaks less synchronous than forest Lepidoptera outbreaks?

    Science.gov (United States)

    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...

  7. Reporting and Surveillance for Norovirus Outbreaks

    Science.gov (United States)

    ... Vaccine Surveillance Network (NVSN) Foodborne Diseases Active Surveillance Network (FoodNet) National Outbreak Reporting System (NORS) Estimates of Foodborne Illness in the United States CDC's Vessel Sanitation Program CDC Feature: Surveillance for Norovirus Outbreaks Top ...

  8. A foodborne outbreak of Cryptosporidium hominis infection

    DEFF Research Database (Denmark)

    Ethelberg, S.; Lisby, M.; Vestergaard, L. S.

    2009-01-01

    Foodborne outbreaks of cryptosporidiosis are uncommon. In Denmark human cases are generally infrequently diagnosed. In 2005 an outbreak of diarrhoea affected company employees near Copenhagen. In all 99 employees were reported ill; 13 were positive for Cryptosporidium hominis infection. Two...

  9. Selection tool for foodborne norovirus outbreaks.

    Science.gov (United States)

    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.

  10. Larval outbreaks in West Greenland

    DEFF Research Database (Denmark)

    Lund, Magnus; Raundrup, Katrine; Westergaard-Nielsen, Andreas

    2017-01-01

    effects of a larval outbreak in 2011 on vegetation productivity and CO2 exchange. We estimate a decreased carbon (C) sink strength in the order of 118–143 g C m−2, corresponding to 1210–1470 tonnes C at the Kobbefjord catchment scale. The decreased C sink was, however, counteracted the following years...

  11. Controlling viral outbreaks: Quantitative strategies.

    Science.gov (United States)

    Mummert, Anna; Weiss, Howard

    2017-01-01

    Preparing for and responding to outbreaks of serious livestock infectious diseases are critical measures to safeguard animal health, public health, and food supply. Almost all of the current control strategies are empirical, and mass culling or "stamping out" is frequently the principal strategy for controlling epidemics. However, there are ethical, ecological, and economic reasons to consider less drastic control strategies. Here we use modeling to quantitatively study the efficacy of different control measures for viral outbreaks, where the infectiousness, transmissibility and death rate of animals commonly depends on their viral load. We develop a broad theoretical framework for exploring and understanding this heterogeneity. The model includes both direct transmission from infectious animals and indirect transmission from an environmental reservoir. We then incorporate a large variety of control measures, including vaccination, antivirals, isolation, environmental disinfection, and several forms of culling, which may result in fewer culled animals. We provide explicit formulae for the basic reproduction number, R0, for each intervention and for combinations. We evaluate the control methods for a realistic simulated outbreak of low pathogenic avian influenza on a mid-sized turkey farm. In this simulated outbreak, culling results in more total dead birds and dramatically more when culling all of the infected birds.

  12. Chikungunya fever outbreak, Bhutan, 2012.

    Science.gov (United States)

    Wangchuk, Sonam; Chinnawirotpisan, Piyawan; Dorji, Tshering; Tobgay, Tashi; Dorji, Tandin; Yoon, In-Kyu; Fernandez, Stefan

    2013-10-01

    In 2012, chikungunya virus (CHIKV) was reported for the first time in Bhutan. IgM ELISA results were positive for 36/210 patient samples; PCR was positive for 32/81. Phylogenetic analyses confirmed that Bhutan CHIKV belongs to the East/Central/South African genotype. Appropriate responses to future outbreaks require a system of surveillance and improved laboratory capacity.

  13. Measles (Rubeola) Cases and Outbreaks

    Science.gov (United States)

    ... Address What’s this? Submit What's this? Submit Button Measles Cases and Outbreaks Language: English (US) Español (Spanish) ... Español: Casos y brotes de sarampión Number of measles cases by year since 2010 Measles cases per ...

  14. [Water-borne disease outbreaks in Norway].

    Science.gov (United States)

    Nygård, Karin; Gondrosen, Bjørn; Lund, Vidar

    2003-12-04

    The drinking water in Norway has traditionally been considered being of good quality. However, outbreaks related to drinking water are reported every year. We review waterborne outbreaks in Norway over the last 15 years, and describe the aetiology of and contributory factors in these outbreaks. We compiled data on waterborne outbreaks reported to the Norwegian Institute of Public Health and Norwegian Food Control Authority during 1988-2002. We included all events in which two or more people fell ill and water was the suspected source of infection. Over the 15-year period. 72 outbreaks were reported, affecting a total of 10 616 persons. Campylobacter was the cause in 26% (19/72) of the outbreaks, norovirus in 18% (13/72). The causative organism was unknown in 46% (33/72). The water came from public waterworks in 32 of the 54 outbreaks for which this information was available (59%); from a private supply in the remaining 22. For 62% (16/26) of the outbreaks related to waterworks, the water was not disinfected before distribution. None of the private water supplies were disinfected. Over the last five years, there were more outbreaks related to private supplies. The most important contributory factor to waterborne outbreaks in Norway is contamination of the raw water combined with missing or faulty disinfecting procedures. To prevent future outbreaks, a continuous upgrading of small and private water supplies is needed. Reporting of outbreaks is important for the implementation of targeted and effective preventive measures.

  15. An outbreak of acute fever among steam turbine condenser cleaners.

    Science.gov (United States)

    Lauderdale, J F; Johnson, C C

    1983-03-01

    Ten of twelve men who participated in the cleaning of an electric power steam turbine condenser clogged with freshwater sponge experienced an acute febrile illness. Two similar outbreaks have been previously described, one of which has been attributed to the Legionnaires' Disease bacterium. Epidemiologic studies of this case showed a syndrome very similar to the two previously reported episodes. However, the exact etiology for this outbreak has not been identified. Environmental sampling was not initiated until after the cleaning was completed. Subsequent testing did not reveal any likely cause for the outbreak. The delayed onset of symptoms and the nature of the illness pointed to an infectious agent. In the absence of any suitable criteria for employee exposure evaluation, it is suggested that crews cleaning condensers under unusually dirty conditions, especially if eye or respiratory symptoms are reported, should be provided with respiratory protection.

  16. Sapovirus Outbreaks in Long-Term Care Facilities

    Centers for Disease Control (CDC) Podcasts

    2012-06-21

    Lore Elizabeth Lee, a clinical epidemiologist at the Oregon Public Health Division, discusses sapovirus outbreaks, testing, and treatment.  Created: 6/21/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 6/21/2012.

  17. Wetland environmental conditions associated with the risk of avian cholera outbreaks and the abundance of Pasteurella multocida

    Science.gov (United States)

    Blanchong, Julie A.; Samuel, Michael D.; Goldberg, Diana R.; Shadduck, Daniel J.; Creekmore, L.H.

    2006-01-01

    Avian cholera is a significant infectious disease affecting waterfowl across North America and occurs worldwide among various avian species. Despite the importance of this disease, little is known about the factors that cause avian cholera outbreaks and what management strategies might be used to reduce disease mortality. Previous studies indicated that wetland water conditions may affect survival and transmission of Pasteurella multocida, the agent that causes avian cholera. These studies hypothesized that water conditions affect the likelihood that avian cholera outbreaks will occur in specific wetlands. To test these predictions, we collected data from avian cholera outbreak and non-outbreak (control) wetlands throughout North America (wintera??spring 1995a??1996 to 1998a??1999) to evaluate whether water conditions were associated with outbreaks. Conditional logistic regression analysis on paired outbreak and non-outbreak wetlands indicated no significant association between water conditions and the risk of avian cholera outbreaks. For wetlands where avian cholera outbreaks occurred, linear regression showed that increased eutrophic nutrient concentrations (Potassium [K], nitrate [NO3], phosphorus [P], and phosphate [PO3]) were positively related to the abundance of P. multocida recovered from water and sediment samples. Wetland protein concentration and an El Ni??o event were also associated with P. multocida abundance. Our results indicate that wetland water conditions are not strongly associated with the risk of avian cholera outbreaks; however, some variables may play a role in the abundance of P. multocida bacteria and might be important in reducing the severity of avian cholera outbreaks.

  18. Mechanical design for positioning of GM detector for system of avian flu virus detection equipment

    International Nuclear Information System (INIS)

    Rahmat; Budi Santoso; Krismawan; Abdul Jalil

    2010-01-01

    Mechanical design for positioning of GM detector system has been done. It is used for avian flu detection equipment. The requirements for the design are to protect detection system against shock, portable, and easy to maintain. The mechanical system consists of connectors, cable assemblies, holders, casing, housing and detectors cover. The selected material should have small gamma radiation absorption property in order to give optimum counts for the detector. The design result should give a system that is easy to operate, cheap and easy to assemble. (author)

  19. FLU AS PROBLEM COMMON TO ALL MANKIND. FUTURE DIRECTIONS FOR PREVENTION AND TREATMENT OF INFLUENZA

    Directory of Open Access Journals (Sweden)

    Korovaeva I.V

    2014-06-01

    Full Text Available This article discusses the flu, as one of the most common infectious diseases affecting humanity throughout its history. The data on the structure of A influenza virus and its variability is given historical background for most famous of the pandemics, which inflicted irreparable damage to the population of the Earth, are shown the basic stages of the study for influenza virus. Are considered the types of variability of the A virus influenza, its ability to overcome interspecies barriers that form the basis of pathogen escape from the immune response. The article shows the promising areas of modern prevention and treatment of this disease

  20. [Google Flu Trends--the initial application of big data in public health].

    Science.gov (United States)

    Zou, Xiaohui; Zhu, Wenfei; Yang, Lei; Shu, Yuelong

    2015-06-01

    Google Flu Trends (GFT) was the first application of big data in the public health field. GFT was open online in 2009 and attracted worldwide attention immediately. However, GFT failed catching the 2009 pandemic H1N1 and kept overestimating the intensity of influenza-like illness in the 2012-2014 season in the United States. GFT model has been updated for three times since 2009, making its prediction bias controlled. Here, we summarized the mechanism GFT worked, the strategy GFT used to update, and its influence on public health.

  1. Surveillance for waterborne-disease outbreaks--United States, 1999-2000.

    Science.gov (United States)

    Lee, Sherline H; Levy, Deborah A; Craun, Gunther F; Beach, Michael J; Calderon, Rebecca L

    2002-11-22

    coli O157:H7 (21.4%) in freshwater venues. The increase in the number of outbreaks probably reflects improved surveillance and reporting at the local and state level as well as a true increase in the number of WBDOs. CDC and others have used surveillance data to identify the types of water systems, their deficiencies, and the etiologic agents associated with outbreaks and evaluated current technologies for providing safe drinking water and safe recreational water. Surveillance data are used also to establish research priorities, which can lead to improved water-quality regulations. Only the groundwater systems under the influence of surface water are required to disinfect their water supplies, but EPA is developing a groundwater rule that specifies when corrective action (including disinfection) is required. CDC and EPA are conducting epidemiologic studies to assess the level of waterborne illness attributable to municipal drinking water in nonoutbreak conditions. Rules under development by EPA--the Ground Water Rule (GWR), the Long Term 2 Enhanced Surface Water Treatment Rule (LT2ESWTR), and Stage 2 Disinfection Byproduct Rules (DBPR)--are expected to further protect the public from contaminants and disinfection byproducts in drinking water. Efforts by EPA under the Beaches Environmental Assessment, Closure, and Health (BEACH) program are aimed at reducing the risks for infection attributed to ambient recreational water by strengthening beach standards and testing; providing faster laboratory test methods; predicting pollution; investing in health and methods research; and improving public access to information regarding both the quality of the water at beaches and information concerning health risks associated with swimming in polluted water. EPA's Beach Watch (available at http://www.epa.gov/waterscience/beaches) provides online information regarding water quality at U.S. beaches, local protection programs, and other beach-related programs. CDC partnered with a

  2. Cryptosporidiosis Outbreak Associated With a Single Hotel.

    Science.gov (United States)

    Fill, Mary-Margaret A; Lloyd, Jennifer; Chakraverty, Tamal; Sweat, David; Manners, Judy; Garman, Katie; Hlavsa, Michele C; Roellig, Dawn M; Dunn, John R; Schaffner, William; Jones, Timothy F

    2017-05-01

    We investigated a gastrointestinal illness cluster among persons who attended a baseball tournament (>200 teams) during July 2015. We interviewed representatives of 19 teams; illness was reported among only the 9 (47%) teams that stayed at Hotel A (p Hotel A was significantly associated with illness (odds ratio: 7.3; 95% confidence interval: 3.6, 15.2). Eight out of nine (89%) stool specimens tested were positive for Cryptosporidium, with C. hominis IfA12G1 subtype identified in two specimens. The environmental health assessment detected a low free available chlorine level, and pool water tested positive for E. coli and total coliforms. A possible diarrheal contamination event, substantial hotel pool use, and use of cyanuric acid might have contributed to this outbreak and magnitude. Aquatic facilities practicing proper operation and maintenance (e.g., following the Centers for Disease Control and Prevention’s Model Aquatic Health Code) can protect the public’s health.

  3. Importance of rapid testing to combat the global threat of bird flu.

    NARCIS (Netherlands)

    Meijer, A.

    2006-01-01

    One of the important outcomes of the recently held meeting of the World Heatlh Organization (EHO), the Food and Agriculture Organization (FAO) of the United Nations, the World Organization of Animal Heath (OIE) and the World Bank in Genevan November 7- 9, 2005, on the threat of avian inluenza

  4. Rubella outbreaks among Hispanics in North Carolina: lessons learned from a field investigation.

    Science.gov (United States)

    Rangel, M C; Sales, R M; Valeriano, E N

    1999-01-01

    To describe the epidemiology and the lessons learned from two simultaneous, but unrelated, outbreaks of rubella in North Carolina affecting mostly Hispanic immigrants of Mexican origin. A case and contact investigation was conducted at industrial work sites and Hispanic communities between March 26 and June 15, 1996, using both structured and informal interviews. Active surveillance was conducted at hospitals, clinical laboratories, primary care physicians' offices, local health departments, and migrant health centers to identify additional cases. Rubella specific IgM testing was performed by the North Carolina State Laboratory to confirm cases. Vaccination clinics were conducted in communities and at work sites with a large Hispanic population in affected counties to reduce the number of susceptible persons. Eighty-three confirmed cases of rubella were reported: 75 cases from the first outbreak and 8 from the second. The mean age of cases from both outbreaks was 24 and 20 years, respectively. Only three cases occurred among children under five years of age, two in the first outbreak and one in the second. Seventy-one (95%) cases in the first outbreak and all 8 cases in the second outbreak were Hispanics; 21 (28%) cases from the first and 3 (37%) from the second outbreak were females, and a total of 65 (78%) cases from both outbreaks were industrial workers. Six women with confirmed cases in the first outbreak were pregnant at the time of exposure. No females cases were pregnant in the second outbreak. The outbreaks in North Carolina confirmed the persistent susceptibility to rubella in Hispanics and persons migrating from countries where the rubella vaccine is not used for routine childhood vaccination. The ultimate goal of rubella vaccination programs is to prevent fetal infection and congenital rubella syndrome (CRS). Thus, to eliminate rubella from the United States, efforts should focus on understanding new emerging patterns of disease transmission and

  5. Surfing the web during pandemic flu: availability of World Health Organization recommendations on prevention

    Directory of Open Access Journals (Sweden)

    Ravà Lucilla

    2010-09-01

    Full Text Available Abstract Background People often search for information on influenza A(H1N1v prevention on the web. The extent to which information found on the Internet is consistent with recommendations issued by the World Health Organization is unknown. Methods We conducted a search for "swine flu" accessing 3 of the most popular search engines through different proxy servers located in 4 English-speaking countries (Australia, Canada, UK, USA. We explored each site resulting from the searches, up to 4 clicks starting from the search engine page, analyzing availability of World Health Organization recommendations for swine flu prevention. Results Information on hand cleaning was reported on 79% of the 147 websites analyzed; staying home when sick was reported on 77.5% of the websites; disposing tissues after sneezing on 75.5% of the websites. Availability of other recommendations was lower. The probability of finding preventative recommendations consistent with World Health Organization varied by country, type of website, and search engine. Conclusions Despite media coverage on H1N1 influenza, relevant information for prevention is not easily found on the web. Strategies to improve information delivery to the general public through this channel should be improved.

  6. Surfing the web during pandemic flu: availability of World Health Organization recommendations on prevention.

    Science.gov (United States)

    Gesualdo, Francesco; Romano, Mariateresa; Pandolfi, Elisabetta; Rizzo, Caterina; Ravà, Lucilla; Lucente, Daniela; Tozzi, Alberto E

    2010-09-20

    People often search for information on influenza A(H1N1)v prevention on the web. The extent to which information found on the Internet is consistent with recommendations issued by the World Health Organization is unknown. We conducted a search for "swine flu" accessing 3 of the most popular search engines through different proxy servers located in 4 English-speaking countries (Australia, Canada, UK, USA). We explored each site resulting from the searches, up to 4 clicks starting from the search engine page, analyzing availability of World Health Organization recommendations for swine flu prevention. Information on hand cleaning was reported on 79% of the 147 websites analyzed; staying home when sick was reported on 77.5% of the websites; disposing tissues after sneezing on 75.5% of the websites. Availability of other recommendations was lower. The probability of finding preventative recommendations consistent with World Health Organization varied by country, type of website, and search engine. Despite media coverage on H1N1 influenza, relevant information for prevention is not easily found on the web. Strategies to improve information delivery to the general public through this channel should be improved.

  7. Assessing and responding in real time to online anti-vaccine sentiment during a flu pandemic.

    Science.gov (United States)

    Seeman, Neil; Ing, Alton; Rizo, Carlos

    2010-01-01

    The perceived safety of vaccination is an important explanatory factor for vaccine uptake and, consequently, for rates of illness and death. The objectives of this study were (1) to evaluate Canadian attitudes around the safety of the H1N1 vaccine during the fall 2009 influenza pandemic and (2) to consider how public health communications can leverage the Internet to counteract, in real time, anti-vaccine sentiment. We surveyed a random sample of 175,257 Canadian web users from October 27 to November 19, 2009, about their perceptions of the safety of the HINI vaccine. In an independent analysis, we also assessed the popularity of online flu vaccine-related information using a tool developed for this purpose. A total of 27,382 unique online participants answered the survey (15.6% response rate). Of the respondents, 23.4% considered the vaccine safe, 41.4% thought it was unsafe and 35.2% reported ambivalence over its safety. Websites and blog posts with anti-vaccine sentiment remained popular during the course of the pandemic. Current public health communication and education strategies about the flu vaccine can be complemented by web analytics that identify, track and neutralize anti-vaccine sentiment on the Internet, thus increasing perceived vaccine safety. Counter-marketing strategies can be transparent and collaborative, engaging online "influencers" who spread misinformation.

  8. Outbreak of Mycoplasma pneumoniae–Associated Stevens-Johnson Syndrome

    Science.gov (United States)

    Watkins, Louise K. Francois; Demirjian, Alicia; Lin, Xia; Robinson, Christine C.; Pretty, Kristin; Benitez, Alvaro J.; Winchell, Jonas M.; Diaz, Maureen H.; Miller, Lisa A.; Foo, Teresa A.; Mason, Melanie D.; Lauper, Ursula L.; Kupfer, Oren; Kennedy, Jeffrey; Glodé, Mary P.; Kutty, Preeta K.; Dominguez, Samuel R.

    2015-01-01

    BACKGROUND: Stevens-Johnson syndrome (SJS) is an uncommon, sporadic disease and outbreaks are rare. In November 2013, an outbreak of SJS was identified at Children’s Hospital Colorado. METHODS: Outbreak cases were children aged 5–21 with a discharge diagnosis of SJS admitted from September 1 to November 30, 2013. Medical charts were reviewed using standardized data collection forms. Respiratory specimens were tested for viruses and Mycoplasma pneumoniae (Mp) by polymerase chain reaction (PCR). We conducted a separate 4-year retrospective case-control study comparing hospitalized SJS cases with and without evidence of Mp infection. RESULTS: During the outbreak, 8 children met SJS criteria. Median age was 11.5 years (range 8–16 years); 5 (63%) were boys and 5 (63%) were Mp-PCR–positive. Of the 5 PCR-positive children, none had preceding medication exposure, and all had radiographic pneumonia. All outbreak Mp isolates were macrolide susceptible. The retrospective case-control analysis showed that Mp-associated SJS episodes (n = 17) were more likely to have pneumonia (odds ratio [OR] 10.0, confidence interval [CI] 1.3–5.1), preceding respiratory symptoms (OR 30.0, CI 1.6–72.6), an erythrocyte sedimentation rate ≥35 mg/dL (OR 22.8, CI 2.1–244.9), and ≤3 affected skin sites (OR 4.5, CI 1.2–17.4) than non–Mp-associated SJS episodes (n = 23). CONCLUSIONS: We report the largest outbreak of SJS in children, which was also predominately associated with Mp infection. Mp-associated SJS was associated with a distinct clinical presentation that included less extensive skin disease, an elevated erythrocyte sedimentation rate, and evidence of a preceding respiratory infection. PMID:26216320

  9. Raw grated beetroot linked to several outbreaks of sudden-onset gastrointestinal illness, Finland 2010.

    Science.gov (United States)

    Jacks, A; Toikkanen, S; Pihlajasaari, A; Johansson, T; Hakkinen, M; Hemminki, K; Hokkanen, P; Käpyaho, A; Kärnä, A; Valkola, K; Niskanen, T; Takkinen, J; Kuusi, M; Rimhanen-Finne, R

    2013-08-01

    In 2010, 7/44 (16%) reported foodborne outbreaks in Finland were linked with raw beetroot consumption. We reviewed data from the national outbreak registry in order to hypothesize the aetiology of illness and to prevent further outbreaks. In the seven outbreaks, 124 cases among 623 respondents were identified. Consumption of raw beetroot was strongly associated with gastrointestinal illness (relative risk 8∙99, 95% confidence interval 6∙06-13∙35). The illness was characterized by sudden onset of gastrointestinal symptoms; the median incubation time was 40 min and duration of illness 5 h. No common foodborne pathogens or toxins were found in either clinical or beetroot samples, but all tested beetroot samples were of poor quality according to total bacterial counts. Beta-haemolytic Pseudomonas fluorescens was detected in several beetroot samples but its effect on human health is unknown. No outbreaks were reported after the Finnish Food Safety Authority Evira advised against serving raw beetroot in institutional canteens.

  10. Computational analysis and determination of a highly conserved surface exposed segment in H5N1 avian flu and H1N1 swine flu neuraminidase

    Directory of Open Access Journals (Sweden)

    Nandy Ashesh

    2010-02-01

    Full Text Available Abstract Background Catalytic activity of influenza neuraminidase (NA facilitates elution of progeny virions from infected cells and prevents their self-aggregation mediated by the catalytic site located in the body region. Research on the active site of the molecule has led to development of effective inhibitors like oseltamivir, zanamivir etc, but the high rate of mutation and interspecies reassortment in viral sequences and the recent reports of oseltamivir resistant strains underlines the importance of determining additional target sites for developing future antiviral compounds. In a recent computational study of 173 H5N1 NA gene sequences we had identified a 50-base highly conserved region in 3'-terminal end of the NA gene. Results We extend the graphical and numerical analyses to a larger number of H5N1 NA sequences (514 and H1N1 swine flu sequences (425 accessed from GenBank. We use a 2D graphical representation model for the gene sequences and a Graphical Sliding Window Method (GSWM for protein sequences scanning the sequences as a block of 16 amino acids at a time. Using a protein sequence descriptor defined in our model, the protein sliding scan method allowed us to compare the different strains for block level variability, which showed significant statistical correlation to average solvent accessibility of the residue blocks; single amino acid position variability results in no correlation, indicating the impact of stretch variability in chemical environment. Close to the C-terminal end the GSWM showed less descriptor-variability with increased average solvent accessibility (ASA that is also supported by conserved predicted secondary structure of 3' terminal RNA and visual evidence from 3D crystallographic structure. Conclusion The identified terminal segment, strongly conserved in both RNA and protein sequences, is especially significant as it is surface exposed and structural chemistry reveals the probable role of this stretch in

  11. Gastrointestinal disease outbreak detection using multiple data streams from electronic medical records.

    Science.gov (United States)

    Greene, Sharon K; Huang, Jie; Abrams, Allyson M; Gilliss, Debra; Reed, Mary; Platt, Richard; Huang, Susan S; Kulldorff, Martin

    2012-05-01

    Passive reporting and laboratory testing delays may limit gastrointestinal (GI) disease outbreak detection. Healthcare systems routinely collect clinical data in electronic medical records (EMRs) that could be used for surveillance. This study's primary objective was to identify data streams from EMRs that may perform well for GI outbreak detection. Zip code-specific daily episode counts in 2009 were generated for 22 syndromic and laboratory-based data streams from Kaiser Permanente Northern California EMRs, covering 3.3 million members. Data streams included outpatient and inpatient diagnosis codes, antidiarrheal medication dispensings, stool culture orders, and positive microbiology tests for six GI pathogens. Prospective daily surveillance was mimicked using the space-time permutation scan statistic in single and multi-stream analyses, and space-time clusters were identified. Serotype relatedness was assessed for isolates in two Salmonella clusters. Potential outbreaks included a cluster of 18 stool cultures ordered over 5 days in one zip code and a Salmonella cluster in three zip codes over 9 days, in which at least five of six cases had the same rare serotype. In all, 28 potential outbreaks were identified using single stream analyses, with signals in outpatient diagnosis codes most common. Multi-stream analyses identified additional potential outbreaks and in one example, improved the timeliness of detection. GI disease-related data streams can be used to identify potential outbreaks when generated from EMRs with extensive regional coverage. This process can supplement traditional GI outbreak reports to health departments, which frequently consist of outbreaks in well-defined settings (e.g., day care centers and restaurants) with no laboratory-confirmed pathogen. Data streams most promising for surveillance included microbiology test results, stool culture orders, and outpatient diagnoses. In particular, clusters of microbiology tests positive for specific

  12. A Systematic Approach to Elucidate Causes of Gastroenteritis Outbreaks of Suspected Viral Etiology

    NARCIS (Netherlands)

    S. Svraka-Latifovic (Sanela)

    2011-01-01

    textabstractThe main objective of this thesis was to investigate the etiology of outbreaks of viral gastroenteritis that remained without diagnosis after testing for common viral pathogens causing gastroenteritis, e.g. noroviruses, rotaviruses, sapoviruses, adenoviruses, and astroviruses. No

  13. Measles Outbreak among Previously Immunized Adult Healthcare Workers, China, 2015

    Directory of Open Access Journals (Sweden)

    Zhengyi Zhang

    2016-01-01

    Full Text Available Measles is caused by measles virus belonging to genus Morbillivirus of the family Paramyxoviridae. Vaccination has played a critical role in controlling measles infection worldwide. However, in the recent years, outbreaks of measles infection still occur in many developing countries. Here, we report an outbreak of measles among healthcare workers and among the 60 measles infected patients 50 were healthcare workers including doctors, nurses, staff, and medics. Fifty-one patients (85% tested positive for IgM antibodies against the measles virus and 50 patients (83.3% tested positive for measles virus RNA. Surprisingly, 73.3% of the infected individuals had been previously immunized against measles. Since there is no infection division in our hospital, the fever clinics are located in the Emergency Division. In addition, the fever and rash were not recognized as measles symptoms at the beginning of the outbreak. These factors result in delay in isolation and early confirmation of the suspected patients and eventually a measles outbreak in the hospital. Our report highlights the importance of following a two-dose measles vaccine program in people including the healthcare workers. In addition, vigilant attention should be paid to medical staff with clinical fever and rash symptoms to avoid a possible nosocomial transmission of measles infection.

  14. FLU VACCINATION

    CERN Document Server

    2007-01-01

    People working on the CERN site who wish to be vaccinated may go to the Infirmary (ground-floor, bldg. 57), with their vaccine, without a prior appointment. The vaccine can be reimbursed directly by Uniqa providing you attach the receipt and the prescription that you will receive from the Medical Service the day of your injection at the infirmary. Ideally, the vaccination should take place between 1st October and 30th November 2007 (preferably between 14:00 and 16:00). CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor. Medical Service

  15. Flu Vaccination

    CERN Document Server

    2006-01-01

    People working on the CERN site who wish to be vaccinated against influenza may go to the Medical Service (ground floor, Bldg. 57) without an appointment (preferably between 14:00 and 16:00), PROVIDED THAT THEY BRING THEIR OWN VACCINE WITH THEM. Ideally, vaccination should take place between 1st October and 30th November 2006. The influenza vaccine is recommended for CERN staff aged 50 and over. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and for those convalescing from serious medical problems or major surgery. The Medical Service will not administer vaccines to family members or retired staff members, who must contact their family doctor. CERN Medical service

  16. FLU VACCINATION

    CERN Document Server

    2006-01-01

    People working on the CERN site who wish to be vaccinated against influenza may go to the Medical Service (ground floor, Bldg. 57) without an appointment (preferably between 14:00 and 16:00), PROVIDED THAT THEY BRING THEIR OWN VACCINE WITH THEM. Ideally, vaccination should take place between 1st October and 30th November 2006. The influenza vaccine is recommended for CERN staff aged 50 and over. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and for those convalescing from serious medical problems or major surgery. The Medical Service will not administer vaccines to family members or retired staff members, who must contact their family doctor. CERN Medical Service

  17. Flu vaccination

    CERN Multimedia

    CERN Medical Service

    2006-01-01

    People working on the CERN site who wish to be vaccinated against influenza may go to the Medical Service (ground floor, Bldg. 57) without an appointment (preferably between 14:00 and 16:00), PROVIDED THAT THEY BRING THEIR OWN VACCINE WITH THEM. Ideally, vaccination should take place between 1st October and 30th November 2006. The influenza vaccine is recommended for CERN staff aged 50 and over. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and for those convalescing from serious medical problems or major surgery. The Medical Service will not administer vaccines to family members or retired staff members, who must contact their family doctor.CERN Medical Service

  18. Flu Vaccination

    CERN Multimedia

    2006-01-01

    People working on the CERN site who wish to be vaccinated against influenza may go to the Medical Service (ground floor, Bldg. 57) without an appointment (preferably between 14:00 and 16:00), PROVIDED THAT THEY BRING THEIR OWN VACCINE WITH THEM. Ideally, vaccination should take place between 1st October and 30th November 2006. The influenza vaccine is recommended for CERN staff aged 50 and over. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and for those convalescing from serious medical problems or major surgery. The Medical Service will not administer vaccines to family members or retired staff members, who must contact their family doctor. CERN Medical Service

  19. BCG protects toddlers during a tuberculosis outbreak.

    LENUS (Irish Health Repository)

    Gaensbauer, J T

    2009-05-01

    In 2007, an outbreak of tuberculosis occurred in a toddler population attending two child care centres in Cork, Ireland. Of 268 children exposed, 18 were eventually diagnosed with active tuberculosis. We present the initial clinical and radiographic characteristics of the active disease group. Mantoux testing was positive in only 66% of cases. All cases were either pulmonary or involved hilar adenopathy on chest radiograph; there were no cases of disseminated disease or meningitis. 24% of the exposed children had been previously vaccinated with BCG, and no case of active disease was found in this group (p = 0.016), suggesting a profound protective effect of BCG in this population. Our experience provides evidence supporting a protective effect of BCG against pulmonary disease in young children.

  20. POSSIBILITY TO APPLY LIPOSOMAL ALPHA-2B INTERFERON FOR THE PREVENTION OF FLU AND OTHER ACUTE RESPIRATORY INFECTIONS

    Directory of Open Access Journals (Sweden)

    M.K. Erofeeva

    2007-01-01

    Full Text Available Within recent years, a special attention has been paid to the nonspecific prevention of the acute respiratory disease related to the increase of the activity of the natural mechanisms for antiviral protection. The application of the liposomal forms of the different medications contributes to the directed transportation of the biodegraded protein substances. A special interest is aroused by the opportunity to orally apply protein medications, as their injection forms quickly degrade in the stomach. New Russian liposomal recombinant alphac2b interferon has antiviral, immuno-modulating and interferonogenic activity. The work demonstrates experience of the oral application form of the liposomal medication of recombinant alphac2b interferon — reaferoncesclipint for the extra prevention of flu and other acute respiratory infections among children. The application of this medication to prevent flu and acute respiratory infections in the dose of 250,000 Ме twice a week for the 4 weeks' period proved to be efficient within the group of the preschool children (aged between 7–10 years old and manifested itself in the reduction of the flu and acute respiratory infections recurrence.Key words: flu, prevention, efficiency index, interferon.

  1. CDC Recommendations to Reduce the Risk of H3N2v Flu Virus Infection for Fairgoers and Swine Exhibitors

    Centers for Disease Control (CDC) Podcasts

    2012-09-10

    In this podcast, Dr. Lyn Finelli discusses CDC’s recommendations for reducing the risk of infection with H3N2v flu viruses for fairgoers and swine exhibitors.  Created: 9/10/2012 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/10/2012.

  2. The evolution of Ebola virus disease outbreaks.

    Science.gov (United States)

    Gałas, Aleksander

    2014-01-01

    The paper presents general information regarding descriptive epidemiology of Ebola virus disease (EVD) outbreaks. Some observations have shown the decrease in case fatality ratio after several generations of patient-to-patient passage. An increase in the frequency of EVD outbreaks across decades was also noticed. The knowledge about the past outbreaks may provide crucial information about the evolution of EVD epidemic, which may be useful for future preventions.

  3. Outbreak of ocular toxoplasmosis in Coimbatore, India

    Directory of Open Access Journals (Sweden)

    Palanisamy Manikandan

    2006-01-01

    Full Text Available Toxoplasma gondii is a protozoan parasite that infects up to a third of the world′s population. Infection is mainly acquired by ingestion of food that is contaminated with oocysts. We report an outbreak of ocular toxoplasmosis, which is an acute acquired type rather than reactivation of congenital toxoplasmosis. Our preliminary investigation points to municipal water contamination. This outbreak only proves the need of an effective public health system and health education in curtailing any outbreak.

  4. Global rise in human infectious disease outbreaks.

    Science.gov (United States)

    Smith, Katherine F; Goldberg, Michael; Rosenthal, Samantha; Carlson, Lynn; Chen, Jane; Chen, Cici; Ramachandran, Sohini

    2014-12-06

    To characterize the change in frequency of infectious disease outbreaks over time worldwide, we encoded and analysed a novel 33-year dataset (1980-2013) of 12,102 outbreaks of 215 human infectious diseases, comprising more than 44 million cases occuring in 219 nations. We merged these records with ecological characteristics of the causal pathogens to examine global temporal trends in the total number of outbreaks, disease richness (number of unique diseases), disease diversity (richness and outbreak evenness) and per capita cases. Bacteria, viruses, zoonotic diseases (originating in animals) and those caused by pathogens transmitted by vector hosts were responsible for the majority of outbreaks in our dataset. After controlling for disease surveillance, communications, geography and host availability, we find the total number and diversity of outbreaks, and richness of causal diseases increased significantly since 1980 (p outbreaks (starting 1990), the overall number of outbreaks and disease richness still increase significantly with time (p outbreaks differ based on the causal pathogen's taxonomy, host requirements and transmission mode. We discuss our preliminary findings in the context of global disease emergence and surveillance.

  5. Shigellosis outbreak at Addis Ababa University: March-April 2010.

    Science.gov (United States)

    Aragaw, Mer'awi; Tafese, Tilahun; Beyene, Zayeda; Hailemariam, Zegeye; Azaze, Aklilu; Luce, Richard; Addissie, Adamu

    2011-10-01

    Between 2006 and 2008, there have been various reports of diarrhea with blood in Ethiopia and also reports of Shigelloses outbreaks in some parts of the country. In March 2010, Addis Ababa University (AAU) Technology Campus reported occurrence of an outbreak of diarrheal illness among students. The study was conducted to identify the causative agent and the possible source of the diarrhea outbreak that occurred at Technology Campus. Active case finding and review of medical records were undertaken to characterize the outbreak. The investigation consisted of a case-control study with laboratory testing and environmental assessment. A structured questionnaire was used to collect data. Data were analyzed using Epi-info (v3.3.2). A total of 104 suspected cases were identified, based on the case definition, with an attack rate of 6.8%. Stool culture confirmed Shigella flexneri species in 5/11 (45%) of specimens tested. Risk factors associated with illness included eating specific foods at specific meal times. Food items served on Friday March 26, at lunch time (OR: 3.59, CI: 1.0- 12.7, p = 0.04) and on Saturday March 27, during dinner (OR: 2.89 CI: 1.0- 8.2, p = 0.04) were significantly associated with increased odds of illness. Water stored in a tank in the cafeteria had evidence of fecal contamination (fecal coliform count > 161 Mpn /100ml) and the hygiene and sanitary conditions in the cafeteria, kitchen, living area were unsatisfactory. Food-borne transmission and water contamination were suspected as the sources of infection. Regular supervision and inspection of the campus' food handling facilities and practices were recommended to improve food hygiene and sanitation. Improved water storage, correcting periodic water shortages in the latrine facility and promotion of hand washing could reduce potential future outbreaks.

  6. Neonatal staphylococcal scalded skin syndrome: clinical and outbreak containment review.

    LENUS (Irish Health Repository)

    Neylon, Orla

    2012-01-31

    Staphylococcal scalded skin syndrome (SSSS) is a toxin-mediated exfoliating skin condition predominated by desquamation and blistering. Neonatal outbreaks have already been reported; however, our outbreak highlights the potential for SSSS following neonatal health promotion measures such as intra-muscular vitamin K administration and metabolic screening (heel prick) as well as effective case containment measures and the value of staff screening. Between February and June 2007, five confirmed cases of neonatal SSSS were identified in full-term neonates born in an Irish regional maternity hospital. All infants were treated successfully. Analysis of contact and environmental screening was undertaken, including family members and healthcare workers. Molecular typing on isolates was carried out. An outbreak control team (OCT) was assembled and took successful prospective steps to prevent further cases. All five Staphylococcus aureus isolates tested positive for exfoliative toxin A, of which two distinct strains were identified on pulsed-field gel electrophoresis analysis. Two cases followed staphylococcal inoculation during preventive measures such as intra-muscular vitamin K administration and metabolic screening (heel prick). None of the neonatal isolates were methicillin resistant. Of 259 hospital staff (70% of staff) screened, 30% were colonised with S. aureus, and 6% were positive for MRSA carriage. This is the first reported outbreak of neonatal SSSS in Ireland. Effective case containment measures and clinical value of OCT is demonstrated. Results of staff screening underlines the need for vigilance and compliance in hand disinfection strategies in maternity hospitals especially during neonatal screening and preventive procedures.

  7. An outbreak of enterotoxigenic Escherichia coli (ETEC) infection in Norway, 2012: a reminder to consider uncommon pathogens in outbreaks involving imported products.

    Science.gov (United States)

    MacDonald, E; Møller, K E; Wester, A L; Dahle, U R; Hermansen, N O; Jenum, P A; Thoresen, L; Vold, L

    2015-02-01

    We investigated an outbreak of gastroenteritis following a Christmas buffet served on 4-9 December 2012 to ~1300 hotel guests. More than 300 people were reported ill in initial interviews with hotel guests. To identify possible sources of infection we conducted a cohort investigation through which we identified 214 probable cases. Illness was associated with consumption of scrambled eggs (odds ratio 9·07, 95% confidence interval 5·20-15·84). Imported chives added fresh to the scrambled eggs were the suspected source of the outbreak but were unavailable for testing. Enterotoxigenic Escherichia coli (ETEC) infection was eventually confirmed in 40 hotel guests. This outbreak reinforces that ETEC should be considered in non-endemic countries when the clinical picture is consistent and common gastrointestinal pathogens are not found. Following this outbreak, the Norwegian Food Safety Authority recommended that imported fresh herbs should be heat-treated before use in commercial kitchens.

  8. Atmospheric Infrared Sounder on NASA's Aqua Satellite: Applications for Volcano Rapid Response, Influenza Outbreak Prediction, and Drought Onset Prediction

    Science.gov (United States)

    Ray, S. E.; Fetzer, E. J.; Lambrigtsen, B.; Olsen, E. T.; Licata, S. J.; Hall, J. R.; Penteado, P. F.; Realmuto, V. J.; Thrastarson, H. T.; Teixeira, J.; Granger, S. L.; Behrangi, A.; Farahmand, A.

    2017-12-01

    The Atmospheric Infrared Sounder (AIRS) has been returning daily global observations of Earth's atmospheric constituents and properties since 2002. With its 15-year data record and near real-time capability, AIRS data are being used in the development of applications that fall within many of the NASA Applied Science focus areas. An automated alert system for volcanic plumes has been developed that triggers on threshold breaches of SO2, ash and dust in granules of AIRS data. The system generates a suite of granule-scale maps that depict both plume and clouds, all accessible from the AIRS web site. Alerts are sent to a curated list of volcano community members, and links to views in NASA Worldview and Google Earth are also available. Seasonal influenza epidemics are major public health concern with millions of cases of severe illness and large economic impact. Recent studies have highlighted the role of absolute or specific humidity as a likely player in the seasonal nature of these outbreaks. A quasi-operational influenza outbreak prediction system has been developed based on the SIRS model which uses AIRS and NCEP humidity data, Center for Disease Control reports on flu and flu-like illnesses, and results from Google Flu Trends. Work is underway to account for diffusion (spatial) in addition to the temporal spreading of influenza. The US Drought Monitor (USDM) is generated weekly by the National Drought Mitigation Center (NDMC) and is used by policymakers for drought decision-making. AIRS data have demonstrated utility in monitoring the development and detection of meteorological drought with both AIRS-derived standardized vapor pressure deficit and standardized relative humidity, showing early detection lead times of up to two months. An agreement was secured with the NDMC to begin a trial period using AIRS products in the production of the USDM, and in July of 2017 the operational delivery of weekly CONUS AIRS images of Relative Humidity, Surface Air Temperature

  9. Sellers to Preventive and Control Measures on Bird Flu, Benin City, Nigeria

    Directory of Open Access Journals (Sweden)

    V. Y. Adam

    2014-01-01

    Full Text Available Investigated was the knowledge of preventive measures of avian influenza from farmers, live chicken sellers, and poultry veterinarian in Benin City, Edo State, Nigeria. A cross-sectional descriptive study using standardized questionnaire was conducted. Respondents included 236 poultry farmers, live chicken sellers (LCS, and veterinarian aged 12–70 years in contact with birds through husbandry. The study duration was from October 2010 to May 2011. Participants knowledge on transmission sources showed low understanding with highest being from bird-bird (57.3%. The medium most commonly utilized was electronic media (82.5% as information source. Respondents thought that vaccination of birds (80.6% would prevent infection. Farmers’ education on bird flu needs to be improved through veterinary public health and health promotion approach. Nonpharmaceutical preventive measures such as hand washing freely and avoidance of eye, nose, and mouth touching must be improved.

  10. Emergency department and 'Google flu trends' data as syndromic surveillance indicators for seasonal influenza.

    Science.gov (United States)

    Thompson, L H; Malik, M T; Gumel, A; Strome, T; Mahmud, S M

    2014-11-01

    We evaluated syndromic indicators of influenza disease activity developed using emergency department (ED) data - total ED visits attributed to influenza-like illness (ILI) ('ED ILI volume') and percentage of visits attributed to ILI ('ED ILI percent') - and Google flu trends (GFT) data (ILI cases/100 000 physician visits). Congruity and correlation among these indicators and between these indicators and weekly count of laboratory-confirmed influenza in Manitoba was assessed graphically using linear regression models. Both ED and GFT data performed well as syndromic indicators of influenza activity, and were highly correlated with each other in real time. The strongest correlations between virological data and ED ILI volume and ED ILI percent, respectively, were 0·77 and 0·71. The strongest correlation of GFT was 0·74. Seasonal influenza activity may be effectively monitored using ED and GFT data.

  11. Ethnography of epidemiologic transition: Avian flu, global health politics and agro-industrial capitalism in Thailand.

    Science.gov (United States)

    Chuengsatiansup, Komatra

    2008-04-01

    This paper situates the ethnography of avian flu within the geo-political context of a new epidemiologic transition. Drawing on anthropological experience and insight, this paper examines areas of enquiry in which an ethnographic approach could contribute to a better implementation of prevention and control measures. Within the context of newly emerging diseases and accelerated globalization, the task of ethnography needs to extend far beyond the local. This paper reveals two major global issues that the ethnography of epidemiologic transition must take into consideration: (1) Global agro-industrial capitalism, and (2) global politics in the context of international health organizations and multi-national drug companies. The case of Thailand poses a question of how the strength of ethnographic practice could be deployed to account for the reality of the global-local interface of the new epidemiologic transition.

  12. The swine flu vaccine, public attitudes, and researcher interpretations: a systematic review of qualitative research.

    Science.gov (United States)

    Carlsen, Benedicte; Glenton, Claire

    2016-06-24

    During pandemics, health authorities may be uncertain about the spread and severity of the disease and the effectiveness and safety of available interventions. This was the case during the swine flu (H1N1) pandemic of 2009-2010, and governments were forced to make decisions despite these uncertainties. While many countries chose to implement wide scale vaccination programmes, few accomplished their vaccination goals. Many research studies aiming to explore barriers and facilitators to vaccine uptake have been conducted in the aftermath of the pandemic, including several qualitative studies. 1. To explore public attitudes to the swine flu vaccine in different countries through a review of qualitative primary studies. 2. To describe and discuss the implications drawn by the primary study authors. Systematic review of qualitative research studies, using a broadly comparative cross case-study approach. Study quality was appraised using an adaptation of the Critical Appraisal Skills Programme (CASP) quality assessment tool. The review indicates that the public had varying opinions about disease risk and prevalence and had concerns about vaccine safety. Most primary study authors concluded that participants were uninformed, and that more information about the disease and the vaccine would have led to an increase in vaccine uptake. We find these conclusions problematic. We suggest instead that people's questions and concerns were legitimate given the uncertainties of the situation at the time and the fact that the authorities did not have the necessary information to convince the public. Our quality assessment of the included studies points to a lack of reflexivity and a lack of information about study context. We suggest that these study weaknesses are tied to primary study authors' lack of acknowledgement of the uncertainties surrounding the disease and the vaccine. While primary study authors suggest that authorities could increase vaccine uptake through increased

  13. Outbreak investigation: Salmonella food poisoning.

    Science.gov (United States)

    Kunwar, R; Singh, Harpreet; Mangla, Vipra; Hiremath, R

    2013-10-01

    An outbreak of food poisoning was reported from a Military establishment on 29 May 2011 when 43 cases of food poisoning reported sick in a span of few hours. A retrospective-prospective study was conducted. Data regarding the onset of symptoms, presenting features and history of food items consumed was collected. A detailed inspection of the mess for hygiene and sanitary status, cooking and storage procedure, and rodent nuisance was also carried out. A total of 53 cases of food poisoning occurred between 29 and 31 May 2011. All cases had symptoms of diarrohea followed by fever (96.2%), headache (84.9%), abdominal pain (50.1%), nausea and vomiting (49.1%) and bodyache (39.6%) respectively. Based on the Attributable Risk (AR = 46.67%) and Relative Risk (RR = 4.5, 95% CI = 1.22-16.54) Potato-bitter gourd vegetable served during dinner on 28 May 2011 was incriminated as the food item responsible for outbreak. Symptomatology, incubation period and presence of rodent nuisance suggested contamination of Potato-bitter gourd vegetable with non-typhoidal Salmonella spp.

  14. Molecular Subtyping in Cholera Outbreak, Laos, 2010

    Science.gov (United States)

    Sithivong, Noikaseumsy; Morita-Ishihara, Tomoko; Vongdouangchanh, Arounnapha; Phouthavane, Traykhouane; Chomlasak, Khampheng; Sisavath, Lay; Khamphaphongphane, Bouaphanh; Sengkeopraseuth, Bounthanom; Vongprachanh, Phengta; Keosavanh, Onechanh; Southalack, Kongmany; Jiyoung, Lee; Tsuyuoka, Reiko; Ohnishi, Makoto

    2011-01-01

    A cholera outbreak in Laos in July 2010 involved 237 cases, including 4 deaths. Molecular subtyping indicated relatedness between the Vibrio cholerae isolates in this and in a 2007 outbreak, uncovering a clonal group of V. cholerae circulating in the Mekong basin. Our finding suggests the subtyping methods will affect this relatedness. PMID:22099098

  15. Unexpected Rift Valley fever outbreak, northern Mauritania.

    Science.gov (United States)

    El Mamy, Ahmed B O; Baba, Mohamed Ould; Barry, Yahya; Isselmou, Katia; Dia, Mamadou L; El Kory, Mohamed O B; Diop, Mariam; Lo, Modou Moustapha; Thiongane, Yaya; Bengoumi, Mohammed; Puech, Lilian; Plee, Ludovic; Claes, Filip; de La Rocque, Stephane; Doumbia, Baba

    2011-10-01

    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.

  16. Uncommon mixed outbreak of pneumococcal and meningococcal ...

    African Journals Online (AJOL)

    Objective: The Jirapa District in Ghana falls within the African meningitis belt where over 500 million people are at risk of epidemic meningitis. The district suffered an outbreak of Neisseria meningitides, W (NMW) in 2012 and a mixed outbreak of Streptococcus pneumonia and NMW in early 2016. We investigated the ...

  17. Yellow Fever Outbreak, Southern Sudan, 2003

    Science.gov (United States)

    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

  18. MRSA outbreak at a transplantation unit

    Directory of Open Access Journals (Sweden)

    RMC Romanelli

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA infections frequently complicate the post-operative course of transplant recipients, and despite nasal carriage and endemic colonization, MRSA outbreaks are not commonly described. This study reports a case of MRSA outbreak and discusses infection control measures and recommendations for this situation.

  19. Molecular Diagnostic Analysis of Outbreak Scenarios

    Science.gov (United States)

    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…

  20. Outbreak of epidemic keratoconjunctivitis caused by adenovirus in medical residents.

    Science.gov (United States)

    Melendez, Carlos Pantoja; Florentino, Margarita Matias; Martinez, Irma Lopez; Lopez, Herlinda Mejia

    2009-01-01

    The present work documents an outbreak of epidemic keratoconjunctivitis among ophthalmology residents, its influence in the presentation of the community cases, the use of molecular techniques for its diagnosis, and the implementation of successful control measures for its containment. Isolation of the etiologic agent was achieved using cultured African green monkey kidney epithelial cells (VERO). Through molecular tests, such as polymerase chain reaction (PCR) and DNA sequencing, the genotype of the isolated virus was identified. The sequences obtained were aligned with data reported in the NCBI GenBank. A scheme of outbreak control measures was designed to enforce correct sanitary measures in the clinic. The statistical program, Epi info 2002, and openepi were used to determine the attack rate. The Excel Microsoft program was used to elaborate the endemic channel. Nine of the ten samples studied were isolated from the culture and identified by Adenovirus-specifc PCR. Sequencing allowed identification of Ad8 as the agent responsible for the outbreak. The attack rate was 24.39 cases per 100. The epidemic curve allowed identification of a disseminated source in the Institute of Ophthalmology "Conde de Valenciana." It was not possible to calculate the incubation periods among the cases. The endemic channel showed the presence of an epidemic keratoconjunctivitis among the patients that had been cared for at the out-patient services of the institute. One outbreak of a disseminated source caused by Ad8 was detected in the institute among its medical residents, probably associated with relaxation of the habitual sanitary measures during an epidemic of hemorrhagic conjunctivitis among the patients cared for at the institute. The proposed scheme to control the outbreak allowed for its containment and controlled the epidemic of associated cases.

  1. Can aerobic exercise alleviate flu-like symptoms following interferon beta-1a injections in patients with multiple sclerosis?

    Science.gov (United States)

    Langeskov-Christensen, Martin; Kjølhede, Tue; Stenager, Egon; Jensen, Henrik Boye; Dalgas, Ulrik

    2016-06-15

    Flu-like symptoms (FLS) are common side effects of interferon beta (IFNß) treatment, and may affect the willingness to initiate therapy, the long-term acceptability, and the adherence to the treatment. Case reports suggest that aerobic exercise is able to markedly reduce FLS following IFNß-1a injections in persons with multiple sclerosis (PwMS). To test the hypothesis that aerobic exercise can alleviate FLS following IFNß-1a injections in PwMS, and secondarily to examine whether or not fluctuations in circulating cytokines provide a mechanism that can explain a potential positive effect. Seventeen PwMS who frequently experience FLS following IFNß-1a injections completed four days of testing. On two of the testing days they completed 35min of aerobic exercise on a bicycle-ergometer following IFNß-1a injection. On the two other testing days, no intervention took place following the injection. FLS were assessed pre-injection and 3h, 5h, 12h and 24h post-injection. Blood samples were taken pre-injection and 1h and 3h post-injection to determine levels of circulating interleukin 6 and 17 and IFNγ. The primary study endpoint was the comparison of the change in FLS severity from pre-injection to 5h post-injection between days with injection alone and days with injection followed by aerobic exercise. FLS severity change was significantly lower on days with exercise compared to days with rest. IL6 was significantly increased 3h following IFNß-1a injection and exercise compared to 1h post and pre and when compared to the resting condition. Participants reported no adverse events in addition to FLS during the study period. Data from this study suggest that moderate intensity aerobic exercise following IFNß-1a injections is safe and can alleviate the FLS severity in PwMS. Based on these results, 35min of aerobic exercise should be encouraged for PwMS who often experience FLS following IFNß-1a injections. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Multidistrict Outbreak of Marburg Virus Disease—Uganda, 2012

    OpenAIRE

    Knust, Barbara; Schafer, Ilana J.; Wamala, Joseph; Nyakarahuka, Luke; Okot, Charles; Shoemaker, Trevor; Dodd, Kimberly; Gibbons, Aridth; Balinandi, Stephen; Tumusiime, Alex; Campbell, Shelley; Newman, Edmund; Lasry, Estrella; DeClerck, Hilde; Boum, Yap

    2015-01-01

    In October 2012, a cluster of illnesses and deaths was reported in Uganda and was confirmed to be an outbreak of Marburg virus disease (MVD). Patients meeting the case criteria were interviewed using a standard investigation form, and blood specimens were tested for evidence of acute or recent Marburg virus infection by reverse transcription–polymerase chain reaction (RT-PCR) and antibody enzyme-linked immunosorbent assay. The total count of confirmed and probable MVD cases was 26, of which 1...

  3. Using network theory to identify the causes of disease outbreaks of unknown origin.

    Science.gov (United States)

    Bogich, Tiffany L; Funk, Sebastian; Malcolm, Trent R; Chhun, Nok; Epstein, Jonathan H; Chmura, Aleksei A; Kilpatrick, A Marm; Brownstein, John S; Hutchison, O Clyde; Doyle-Capitman, Catherine; Deaville, Robert; Morse, Stephen S; Cunningham, Andrew A; Daszak, Peter

    2013-04-06

    The identification of undiagnosed disease outbreaks is critical for mobilizing efforts to prevent widespread transmission of novel virulent pathogens. Recent developments in online surveillance systems allow for the rapid communication of the earliest reports of emerging infectious diseases and tracking of their spread. The efficacy of these programs, however, is inhibited by the anecdotal nature of informal reporting and uncertainty of pathogen identity in the early stages of emergence. We developed theory to connect disease outbreaks of known aetiology in a network using an array of properties including symptoms, seasonality and case-fatality ratio. We tested the method with 125 reports of outbreaks of 10 known infectious diseases causing encephalitis in South Asia, and showed that different diseases frequently form distinct clusters within the networks. The approach correctly identified unknown disease outbreaks with an average sensitivity of 76 per cent and specificity of 88 per cent. Outbreaks of some diseases, such as Nipah virus encephalitis, were well identified (sensitivity = 100%, positive predictive values = 80%), whereas others (e.g. Chandipura encephalitis) were more difficult to distinguish. These results suggest that unknown outbreaks in resource-poor settings could be evaluated in real time, potentially leading to more rapid responses and reducing the risk of an outbreak becoming a pandemic.

  4. Listeriosis Outbreaks in British Columbia, Canada, Caused by Soft Ripened Cheese Contaminated from Environmental Sources

    Science.gov (United States)

    Wilcott, Lynn; Naus, Monika

    2015-01-01

    Soft ripened cheese (SRC) caused over 130 foodborne illnesses in British Columbia (BC), Canada, during two separate listeriosis outbreaks. Multiple agencies investigated the events that lead to cheese contamination with Listeria monocytogenes (L.m.), an environmentally ubiquitous foodborne pathogen. In both outbreaks pasteurized milk and the pasteurization process were ruled out as sources of contamination. In outbreak A, environmental transmission of L.m. likely occurred from farm animals to personnel to culture solutions used during cheese production. In outbreak B, birds were identified as likely contaminating the dairy plant's water supply and cheese during the curd-washing step. Issues noted during outbreak A included the risks of operating a dairy plant in a farm environment, potential for transfer of L.m. from the farm environment to the plant via shared toilet facilities, failure to clean and sanitize culture spray bottles, and cross-contamination during cheese aging. L.m. contamination in outbreak B was traced to wild swallows defecating in the plant's open cistern water reservoir and a multibarrier failure in the water disinfection system. These outbreaks led to enhanced inspection and surveillance of cheese plants, test and release programs for all SRC manufactured in BC, improvements in plant design and prevention programs, and reduced listeriosis incidence. PMID:25918702

  5. Listeriosis Outbreaks in British Columbia, Canada, Caused by Soft Ripened Cheese Contaminated from Environmental Sources

    Directory of Open Access Journals (Sweden)

    Lorraine McIntyre

    2015-01-01

    Full Text Available Soft ripened cheese (SRC caused over 130 foodborne illnesses in British Columbia (BC, Canada, during two separate listeriosis outbreaks. Multiple agencies investigated the events that lead to cheese contamination with Listeria monocytogenes (L.m., an environmentally ubiquitous foodborne pathogen. In both outbreaks pasteurized milk and the pasteurization process were ruled out as sources of contamination. In outbreak A, environmental transmission of L.m. likely occurred from farm animals to personnel to culture solutions used during cheese production. In outbreak B, birds were identified as likely contaminating the dairy plant’s water supply and cheese during the curd-washing step. Issues noted during outbreak A included the risks of operating a dairy plant in a farm environment, potential for transfer of L.m. from the farm environment to the plant via shared toilet facilities, failure to clean and sanitize culture spray bottles, and cross-contamination during cheese aging. L.m. contamination in outbreak B was traced to wild swallows defecating in the plant’s open cistern water reservoir and a multibarrier failure in the water disinfection system. These outbreaks led to enhanced inspection and surveillance of cheese plants, test and release programs for all SRC manufactured in BC, improvements in plant design and prevention programs, and reduced listeriosis incidence.

  6. Management of a Cryptosporidium hominis outbreak in a day-care center.

    Science.gov (United States)

    Vandenberg, Olivier; Robberecht, Françoise; Dauby, Nicolas; Moens, Catherine; Talabani, Hana; Dupont, Eddy; Menotti, Jean; van Gool, Tom; Levy, Jack

    2012-01-01

    Cryptosporidium outbreaks in day-care centers (DCCs) occur commonly. However, controlling spread of infection in these settings is difficult, and data about effectiveness of different control strategies are sparse. In this study, a Cryptosporidium outbreak in a large DCC located in Brussels is described with evaluation of hygienic and therapeutic interventions. During a 3-week period, 43 of 130 children attending the DCC developed enteric symptoms. Stools from 122 children were examined for microbial pathogens. Of them, 38 (31%) were diagnosed with Cryptosporidium, 29 of them being symptomatic (76%) and 9 (24%) asymptomatic. Diagnosis was performed by microscopy, antigen tests, and real-time polymerase chain reaction. Strict infection control measures were implemented during the first week after the start of outbreak. After 4 weeks, 27/38 children (71%) were still symptomatic and Cryptosporidium positive. Because of persisting symptoms and fear of further spread of infection, all 27 children were treated with paromomycin. Two weeks later, 18 of 27 children were asymptomatic and were parasitologically negative. The remaining 9 children, still symptomatic and Cryptosporidium positive, were treated with nitazoxanide. Three weeks later, week 9 after the start of outbreak, all 38 children involved in the outbreak were asymptomatic and Cryptosporidium negative. Our study underscores the need to rule out Cryptosporidium etiology in a diarrheal outbreak in a DCC. Rapid implementation of infection control measures can most likely halt the spread of infection. The role of nitazoxanide to limit duration of shedding of oocysts deserves more attention for its use in outbreaks.

  7. Outbreak of acute hemorrhagic conjunctivitis in Yunnan, People's Republic of China, 2007

    Directory of Open Access Journals (Sweden)

    Xu Wenbo

    2010-06-01

    Full Text Available Abstract An outbreak of acute hemorrhagic conjunctivitis (AHC occurred in Yunnan Province, China between August and September in 2007. A total of 3,597 cases were officially reported and the incidence rate reached 1390.94/100,000. Descriptive epidemiological analysis of the outbreak was conducted using the data from National Disease Supervision Information Management System (NDSIMS. To determine the causative agent for this outbreak and to analyze their genetic features, 30 conjunctival swabs and 19 paired serum specimens of acute and convalescent phase were collected from 30 patients with AHC, and viral isolation, molecular typing, antibody assay and phylogenetic analysis were performed. 11 virus strains were isolated from 30 conjunctival swabs. Amplification and sequencing of the VP4 region of these strains identified that coxsackievirus A24 variant (CA24v could be the causative agent of the AHC outbreak and this was further confirmed by subsequent virus neutralizing antibody test on 19 paired serum specimens. Phylogenetic analysis based on the 3C regions showed that the Yunnan CA24v strains belonged to Group 3 and clustered with the strains isolated from worldwide AHC outbreaks after 2002. Phylogenetic analysis based on the partial VP1 revealed that the Yunnan strains differed from the strains isolated from AHC outbreak in Guangdong of China in 2007 with 2.8 - 3.0% nucleotide divergence, suggesting that two different lineages of CA24v caused the independent AHC outbreaks in Yunnan and Guangdong, respectively.

  8. A generalized-growth model to characterize the early ascending phase of infectious disease outbreaks

    OpenAIRE

    Viboud, C��cile; Simonsen, Lone; Chowell, Gerardo

    2016-01-01

    Background: A better characterization of the early growth dynamics of an epidemic is needed to dissect the important drivers of disease transmission, refine existing transmission models, and improve disease forecasts. Materials and methods: We introduce a 2-parameter generalized-growth model to characterize the ascending phase of an outbreak and capture epidemic profiles ranging from sub-exponential to exponential growth. We test the model against empirical outbreak data representing a var...

  9. [Foodborne disease outbreaks surveillance in Chile].

    Science.gov (United States)

    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.

  10. Patterns of Kingella kingae Disease Outbreaks.

    Science.gov (United States)

    El Houmami, Nawal; Minodier, Philippe; Dubourg, Grégory; Mirand, Audrey; Jouve, Jean-Luc; Basmaci, Romain; Charrel, Rémi; Bonacorsi, Stéphane; Yagupsky, Pablo; Raoult, Didier; Fournier, Pierre-Edouard

    2016-03-01

    Kingella kingae outbreaks occur sporadically in childcare centers but remain poorly understood and difficult to identify. To provide the basis of a better knowledge of K. kingae outbreaks patterns that may help to guide identification and management strategies, we collected epidemiological, clinical and laboratory data from all reported K. kingae outbreaks, and those from 2 new Israel outbreaks in 2014. Nine outbreaks were identified in the USA, Israel and France from 2003 to 2014. Twenty-seven children with a median age of 14 ± 4.1 months were affected, male:female ratio of 1.4:1. Outbreaks demonstrated seasonal patterns from the 10th to the 45th weeks, a mean duration of 13.1 ± 8.4 days, a mean attack rate of 17.3 ± 5.1% and a case-fatality rate of 3.7% (1/27). Seventy-four percentage of children had fever (20/27), and the mean values of white blood cell count and C-reactive protein level were 14.6 ± 4.5 × 10/L and 23.8 ± 24.1 mg/L, respectively. Osteoarticular infections accounted for 88.9% of cases (24/27), bacteremia 7.4% (2/27), endocarditis 3.7% (1/27) and meningitis 3.7% (1/27). Specific real-time polymerase chain reaction demonstrated higher performance than culture methods in the diagnosis of case patients and investigations of oropharyngeal K. kingae carriage among close contacts, and multilocus sequence typing methods revealed that ST-6 and ST-25 invasive strains were responsible for multiple country-dependent outbreaks. Coviral infections were identified in the majority of K. kingae outbreaks, notably those causing oral ulcers. K. kingae outbreaks displayed severe K. kingae diseases that were poorly confirmed with culture methods. We argue for the use of genomic technologies to investigate further K. kingae outbreaks.

  11. Assessment of the economic and social implications of the avian flu ...

    African Journals Online (AJOL)

    As a result of the debut incursion of the avian influenza virus into Nigeria in January 2006, severe outbreaks occurred in a number of poultry farms leading to widespread fears and a lot of apprehension. The objectives of the study were to assess, document and highlight the economic and social implications of the disease ...

  12. Characterizing zoonotic disease detection in the United States: who detects zoonotic disease outbreaks & how fast are they detected?

    Science.gov (United States)

    Allen, Heather A

    2015-01-01

    There have been many calls for improved detection of zoonoses; research has not yet characterized zoonotic disease detection in the United States, in humans or animals. This research reviewed "who detects" zoonotic disease outbreaks and "how fast" they are detected. Definitions were operationalized based on existing literature and current practice. An outbreak database was created from publicly available records: Morbidity and Mortality Weekly Reports and ProMed-Mail. Univariate and bivariate statistics--including chi-square tests, Kruskal-Wallis tests, and Dunn's method were used for analysis. From an n = 101, results showed that laboratories (human health) detected 32.7% (n = 33) of the outbreaks; physicians/clinicians (human health) detected 18.8% (n = 19). The median time to was 13 days; mean was 31.7 (range = 0-492). There was a relationship between the type of the entity (laboratory, practitioner, or state agency) and how fast the outbreak was detected; state agencies were slower in detection. There was also a significant relationship between how fast an outbreak was detected and whether the outbreak occurred in multiple regions. This research provides important empirical evidence regarding U.S. zoonotic disease outbreak detection, highlighting the difficulty in rapid detection of multi-state outbreaks and the need for rapid, sensitive diagnostic testing and astute practitioners. Copyright © 2014 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  13. Outbreak of trichinosis near Paris.

    Science.gov (United States)

    Bourée, P; Bouvier, J B; Passeron, J; Galanaud, P; Dormont, J

    1979-01-01

    A localised outbreak of trichinosis occurred in January 1976 in the southern suburbs of Paris. A total fo 125 cases was recorded including 30 children. The prominent symptoms were oedema of the face or eyelids, fever, and myalgia; diarrhoea was unusual and constipation common. An increased blood eosinophil count and raised serum concentrations of muscular enzymes strongly indicated trichinosis. This diagnosis was confirmed later immunologically. The parasite was found in only three out of 32 muscle biopsy specimens but this investigation was made relatively early in the disease. No deaths occurred. In all cases clinical recovery was fast and serum antibody titres were maximum during the first month and decreased slowly. The disease was milder and the recovery faster in children than adults. Epidemiological study suggested that horse meat was responsible for the infection, though no meat could be examined. PMID:444915

  14. FluKB: A Knowledge-Based System for Influenza Vaccine Target Discovery and Analysis of the Immunological Properties of Influenza Viruses

    DEFF Research Database (Denmark)

    Simon, Christian; Kudahl, Ulrich Johan; Sun, Jing

    2015-01-01

    responses. FluKB consists of more than 400,000 influenza protein sequences, known epitope data (357 verified T-cell epitopes, 685 HLA binders, and 16 naturally processed MHC ligands), and a collection of 28 influenza antibodies and their structurally defined B-cell epitopes. FluKB was built using amodular......FluKB is a knowledge-based system focusing on data and analytical tools for influenza vaccine discovery. The main goal of FluKB is to provide access to curated influenza sequence and epitope data and enhance the analysis of influenza sequence diversity and the analysis of targets of immune...... framework allowing the implementation of analytical workflows and includes standard search tools, such as keyword search and sequence similarity queries, as well as advanced tools for the analysis of sequence variability.The advanced analytical tools for vaccine discovery include visual mapping of T- and B...

  15. Influenza-Like-Illness and Clinically Diagnosed Flu: Disease Burden, Costs and Quality of Life for Patients Seeking Ambulatory Care or No Professional Care at All

    OpenAIRE

    Bilcke, Joke; Coenen, Samuel; Beutels, Philippe

    2014-01-01

    This is one of the first studies to (1) describe the out-of-hospital burden of influenza-like-illness (ILI) and clinically diagnosed flu, also for patients not seeking professional medical care, (2) assess influential background characteristics, and (3) formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011-2012 influenza season in Belgium. Half of the 2250 respondents so...

  16. The fluG-BrlA pathway contributes to the initialisation of autolysis in submerged Aspergillus nidulans cultures.

    Science.gov (United States)

    Emri, Tamás; Molnár, Zsolt; Pusztahelyi, Tünde; Varecza, Zoltán; Pócsi, István

    2005-07-01

    The fluG gene proved to be essential in the initialisation of autolysis in Aspergillus nidulans (teleomorph Emericella nidulans) cultures, while a loss-of-function mutation in only one out of the flbB-E genes had only minor effects on autolysis. In contrast to its important role in sporulation, brlA regulated only some, but not all, elements of the autolytic process. The tightly coupled autolytic events (chitinase and proteinase production, hyphal fragmentation, disorganisation of pellets, autolytic loss of biomass) observable in ageing cultures of A. nidulans were disconnected by loss-of-function mutations in some genes of the FluG-BrlA regulatory network. The tight correlation between pellet morphology and size and hydrolase production was also erased by these mutations. On the other hand, the mutations studied did not affect the glutathione metabolism of the fungus.

  17. New health risks and sociocultural contexts: bird flu impacts on consumers and poultry businesses in Lao PDR.

    Science.gov (United States)

    Suder, Gabriele; Inthavong, Saynakhone

    2008-02-01

    Avian flu has been identified as one of the most challenging new risks, global in impact due to the "highly interconnected and integrated world economy along with other unpredictable events such as the Asian financial crisis and global terrorism." We have chosen the case of Lao PDR to shed light on an area in which local people consume chicken as one of their staple foods. Our research analyzes consumer behavior, poultry business modification patterns in a high-risk country, and government reaction for business resilience. The geographic choice is motivated by the 2006 EIU report on Catastrophe Risk Management that indicated that Asian-Pacific companies are better prepared for such risks as bird flu than European business is, despite the many cases found in both regions.

  18. Ebola virus disease outbreak: what's going on.

    Science.gov (United States)

    Giraldi, G; Marsella, L T

    2015-01-01

    The current West African Ebola Virus Disease (EVD) outbreak was confirmed in March, 2014, and after months of slow, fragmented responses, the EVD has been recognized as a public health emergency of international concern. The early diagnosis of the disease is difficult without laboratory testing, because its symptoms can be seen in many other infections. In the wake of international agencies advices, the Italian Ministry of Health, on October 1, 2014, released to the Healthcare Professional Workers (HPWs) the Protocol about the management of cases and contacts within the national territory. Due to the increasing number of humanitarian groups and HPWs involved in the field, the probability to have new cases of contamination is higher than ever. Proven specific treatments against EVD are not yet available, however, a variety of compounds have been under testing. The most effective are select monoclonal antibodies that have a high neutralizing potential against epitopes of Ebola Virus. For facing the matter, it is important a comprehensive approach according to the recommendations proposed by the international agencies because no single institution or country has all the capacities to respond to a new and emerging infectious disease.

  19. An outbreak of trichinellosis in a military unit

    Directory of Open Access Journals (Sweden)

    Radosavljević Vladan

    2008-01-01

    Full Text Available Background/Aim. In December 2001, an outbreak of trichinellosis spreaded in a military unit. The aim of this paper was to show possibilities and consequences of trichinellosis infestations in military units during peace time, as well as to improve knowledge and awareness of medical corps personnel, commanders and soldiers about this disease. Methods. A descriptive and analytical epidemiological models were used to find out a source of outbreak and to identify the ways of its transmission. Results. This outbreak was caused by the contaminated raw smoked sausage which had not undergone health inspection and brought from civilians to a military unit. Thirty-eight persons were exposed, twenty-one affected and hospitalized. The most frequent symptoms reported were fever (76.2%, myalgia (76.2%, palpebral edema (42.8%, face edema (19.0% and diarrhea (14.3%. Test for indirect immunofluorescence was positive in 14.3% and ELISA test was positive in 28.6% of the patients. Eosinophilia was present in 85.7% of the affected. IgE values were increased in 28.6% and CPK values were increased in 61.9% of the diseased. All of the 17 exposed undiseased had negative laboratory analyses for trichinellosis. Conclusion. We propose intensifying health education and continuing the implementation of duly supervised and evaluated self-check programs. A well-tuned, fast-reacting epidemiological monitoring system has to be obligatory.

  20. Peste des petits ruminants outbreaks in White Nile State, Sudan

    Directory of Open Access Journals (Sweden)

    Osama M. Ishag

    2015-08-01

    Full Text Available Eight outbreaks of peste des petits ruminants in sheep and goats were reported in White Nile State, Sudan, between 2008 and 2009. A mortality rate of 4.2% was reported across the different outbreaks. Clinically the disease was characterised by high fever, ocular and nasal discharge, pneumonia, ulceration of the mucous membranes, diarrhoea and death. The postmortem findings included necrotic lesions in the mouth and gastrointestinal tract, and swollen, oedematous lymph nodes associated with the lungs and intestine. Of the 209 serum samples tested by competitive enzyme-linked immunosorbent assay, 113 (54% were found positive. Peste des petits ruminants virus was confirmed in tissues, nasal swabs and blood samples by immunocapture enzyme-linked immunosorbent assay, reverse-transcription polymerase chain reaction and isolation of the virus in culture of lamb testicle cells.

  1. Outbreak of human trichinellosis in Northern California caused by Trichinella murrelli.

    Science.gov (United States)

    Hall, Rebecca L; Lindsay, Ann; Hammond, Chris; Montgomery, Susan P; Wilkins, Patricia P; da Silva, Alexandre J; McAuliffe, Isabel; de Almeida, Marcos; Bishop, Henry; Mathison, Blaine; Sun, Benjamin; Largusa, Ron; Jones, Jeffrey L

    2012-08-01

    In October of 2008, an outbreak of trichinellosis occurred in northern California that sickened 30 of 38 attendees of an event at which meat from a black bear was served. Morphologic and molecular testing of muscle from the leftover portion of bear meat revealed that the bear was infected with Trichinella murrelli, a sylvatic species of Trichinella found in temperate North America. Clinical records revealed a high attack rate for this outbreak: 78% for persons consuming any bear meat and 100% for persons consuming raw or undercooked bear meat. To our knowledge, this report is the first published report of a human trichinellosis outbreak in the United States attributed to T. murrelli, and it is the second such outbreak reported worldwide.

  2. Advantage of meditation over exercise in reducing cold and flu illness is related to improved function and quality of life

    OpenAIRE

    Obasi, Chidi N.; Brown, Roger; Ewers, Tola; Barlow, Shari; Gassman, Michele; Zgierska, Aleksandra; Coe, Christopher L.; Barrett, Bruce

    2012-01-01

    Please cite this paper as: Obasi et?al. (2012) Advantage of meditation over exercise in reducing cold and flu illness is related to improved function and quality of life. Influenza and Other Respiratory Viruses 00(0), 00?00. Purpose? To examine whether apparent advantages following training in meditation over exercise can be attributed to specific symptoms, functional impairments, or quality?of?life indicators assessed by the Wisconsin Upper Respiratory Symptom Survey (WURSS?24). Methods? Res...

  3. Knowledge and attitude regarding swine flu among dental house surgeons in Belagavi city: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Shreya Nerli

    2017-01-01

    Conclusions: We concluded that dental house surgeons do not have sufficient knowledge about swine flu. It seems that traditional educational models are not efficient and government with other nongovernmental organizations should emphasize to advocate motivational education methods including health belief model and motivational interview at undergraduate levels. Younger students and dentists may have less motivation to change their attitude and behavior so that we can focus our interventions on these groups.

  4. Ebola haemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned

    Directory of Open Access Journals (Sweden)

    Borchert Matthias

    2011-12-01

    Full Text Available Abstract Background Ebola haemorrhagic fever (EHF is infamous for its high case-fatality proportion (CFP and the ease with which it spreads among contacts of the diseased. We describe the course of the EHF outbreak in Masindi, Uganda, in the year 2000, and report on response activities. Methods We analysed surveillance records, hospital statistics, and our own observations during response activities. We used Fisher's exact tests for differences in proportions, t-tests for differences in means, and logistic regression for multivariable analysis. Results The response to the outbreak consisted of surveillance, case management, logistics and public mobilisation. Twenty-six EHF cases (24 laboratory confirmed, two probable occurred between October 21st and December 22nd, 2000. CFP was 69% (18/26. Nosocomial transmission to the index case occurred in Lacor hospital in Gulu, outside the Ebola ward. After returning home to Masindi district the index case became the origin of a transmission chain within her own extended family (18 further cases, from index family members to health care workers (HCWs, 6 cases, and from HCWs to their household contacts (1 case. Five out of six occupational cases of EHF in HCWs occurred after the introduction of barrier nursing, probably due to breaches of barrier nursing principles. CFP was initially very high (76% but decreased (20% due to better case management after reinforcing the response team. The mobilisation of the community for the response efforts was challenging at the beginning, when fear, panic and mistrust had to be countered by the response team. Conclusions Large scale transmission in the community beyond the index family was prevented by early case identification and isolation as well as quarantine imposed by the community. The high number of occupational EHF after implementing barrier nursing points at the need to strengthen training and supervision of local HCWs. The difference in CFP before and after

  5. Multistate outbreak of Listeriosis linked to turkey deli meat and subsequent changes in US regulatory policy.

    Science.gov (United States)

    Gottlieb, Sami L; Newbern, E Claire; Griffin, Patricia M; Graves, Lewis M; Hoekstra, R Michael; Baker, Nicole L; Hunter, Susan B; Holt, Kristin G; Ramsey, Fred; Head, Marcus; Levine, Priscilla; Johnson, Geraldine; Schoonmaker-Bopp, Dianna; Reddy, Vasudha; Kornstein, Laura; Gerwel, Michal; Nsubuga, Johnson; Edwards, Leslie; Stonecipher, Shelley; Hurd, Sharon; Austin, Deri; Jefferson, Michelle A; Young, Suzanne D; Hise, Kelley; Chernak, Esther D; Sobel, Jeremy

    2006-01-01

    Listeriosis, a life-threatening foodborne illness caused by Listeria monocytogenes, affects approximately 2500 Americans annually. Between July and October 2002, an uncommon strain of L. monocytogenes caused an outbreak of listeriosis in 9 states. We conducted case finding, a case-control study, and traceback and microbiological investigations to determine the extent and source of the outbreak and to propose control measures. Case patients were infected with the outbreak strain of L. monocytogenes between July and November 2002 in 9 states, and control patients were infected with different L. monocytogenes strains. Outcome measures included food exposure associated with outbreak strain infection and source of the implicated food. Fifty-four case patients were identified; 8 died, and 3 pregnant women had fetal deaths. The case-control study included 38 case patients and 53 control patients. Case patients consumed turkey deli meat much more frequently than did control patients (P = .008, by Wilcoxon rank-sum test). In the 4 weeks before illness, 55% of case patients had eaten deli turkey breast more than 1-2 times, compared with 28% of control patients (odds ratio, 4.5; 95% confidence interval, 1.3-17.1). Investigation of turkey deli meat eaten by case patients led to several turkey processing plants. The outbreak strain was found in the environment of 1 processing plant and in turkey products from a second. Together, the processing plants recalled > 30 million pounds of products. Following the outbreak, the US Department of Agriculture's Food Safety and Inspection Service issued new regulations outlining a L. monocytogenes control and testing program for ready-to-eat meat and poultry processing plants. Turkey deli meat was the source of a large multistate outbreak of listeriosis. Investigation of this outbreak helped guide policy changes designed to prevent future L. monocytogenes contamination of ready-to-eat meat and poultry products.

  6. Outbreak of pandemic influenza A/H1N1 2009 in Nepal

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    Shrestha Sirjana

    2011-03-01

    Full Text Available Abstract Background The 2009 flu pandemic is a global outbreak of a new strain of H1N1 influenza virus. Pandemic influenza A (H1N1 2009 has posed a serious public health challenge world-wide. Nepal has started Laboratory diagnosis of Pandemic influenza A/H1N1 from mid June 2009 though active screening of febrile travellers with respiratory symptoms was started from April 27, 2009. Results Out of 609 collected samples, 302 (49.6% were Universal Influenza A positive. Among the influenza A positive samples, 172(28.3% were positive for Pandemic influenza A/H1N1 and 130 (21.3% were Seasonal influenza A. Most of the pandemic cases (53% were found among young people with ≤ 20 years. Case Fatality Ratio for Pandemic influenza A/H1N1 in Nepal was 1.74%. Upon Molecular characterization, all the isolated pandemic influenza A/H1N1 2009 virus found in Nepal were antigenically and genetically related to the novel influenza A/CALIFORNIA/07/2009-LIKE (H1N1v type. Conclusion The Pandemic 2009 influenza virus found in Nepal were antigenically and genetically related to the novel A/CALIFORNIA/07/2009-LIKE (H1N1v type.

  7. An assessment of the geographical risks of wild and vaccine-derived poliomyelitis outbreaks in Africa and Asia.

    Science.gov (United States)

    O'Reilly, Kathleen M; Lamoureux, Christine; Molodecky, Natalie A; Lyons, Hil; Grassly, Nicholas C; Tallis, Graham

    2017-05-26

    The international spread of wild poliomyelitis outbreaks continues to threaten eradication of poliomyelitis and in 2014 a public health emergency of international concern was declared. Here we describe a risk scoring system that has been used to assess country-level risks of wild poliomyelitis outbreaks, to inform prioritisation of mass vaccination planning, and describe the change in risk from 2014 to 2016. The methods were also used to assess the risk of emergence of vaccine-derived poliomyelitis outbreaks. Potential explanatory variables were tested against the reported outbreaks of wild poliomyelitis since 2003 using multivariable regression analysis. The regression analysis was translated to a risk score and used to classify countries as Low, Medium, Medium High and High risk, based on the predictive ability of the score. Indicators of population immunity, population displacement and diarrhoeal disease were associated with an increased risk of both wild and vaccine-derived outbreaks. High migration from countries with wild cases was associated with wild outbreaks. High birth numbers were associated with an increased risk of vaccine-derived outbreaks. Use of the scoring system is a transparent and rapid approach to assess country risk of wild and vaccine-derived poliomyelitis outbreaks. Since 2008 there has been a steep reduction in the number of wild poliomyelitis outbreaks and the reduction in countries classified as High and Medium High risk has reflected this. The risk of vaccine-derived poliomyelitis outbreaks has varied geographically. These findings highlight that many countries remain susceptible to poliomyelitis outbreaks and maintenance or improvement in routine immunisation is vital.

  8. Swine flu- a serious pandeMic threat | Rachna | IMTU Medical Journal

    African Journals Online (AJOL)

    Swine infl uenza (swine fl u) is a respiratory disease caused by type A infl uenza virus, the only pandemic strain. This new strain called swine-origin (H1N1) infl uenza A virus (SO-IAV), is transmitted to humans and spreads quickly from person to person. It emerged in Mexico and USA in April 2009. The 2009 outbreak of ...

  9. Infection control during filoviral hemorrhagic fever outbreaks

    Directory of Open Access Journals (Sweden)

    N Raabe Vanessa

    2012-01-01

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

  10. Norovirus: U.S. Trends and Outbreaks

    Science.gov (United States)

    ... patients compared with otherwise healthy people. Norovirus in Restaurants and Catered Events Most norovirus outbreaks from contaminated food occur in food service settings like restaurants. Infected food workers are frequently the source of ...

  11. Lactobacillus paracasei feeding improves the control of secondary experimental meningococcal infection in flu-infected mice.

    Science.gov (United States)

    Belkacem, Nouria; Bourdet-Sicard, Raphaëlle; Taha, Muhamed-Kkeir

    2018-04-10

    The use of probiotics to improve anti-microbial defence, such as for influenza infections, is increasingly recommended. However, no data are available on the effect of probiotics on flu-associated secondary bacterial infections. There is strong evidence of a spatiotemporal association between influenza virus infection and invasive Neisseria meningitidis. We thus investigated the effect of feeding mice Lactobacillus paracasei CNCM I-1518 in a mouse model of sequential influenza-meningococcal infection. We intranasally infected BALB/c mice with a strain of influenza A virus (IAV) H3N2 that was first adapted to mice. Seven days later, a secondary bacterial infection was induced by intranasal administration of bioluminescent N. meningitidis. During the experiment, mice orally received either L. paracasei CNCM I-1518 or PBS as a control. The effect of L. paracasei administration on secondary bacterial infection by N. meningitidis was evaluated. Oral consumption of L. paracasei CNCM I-1518 reduced the weight loss of infected mice and lowered the bioluminescent signal of infecting meningococci. This improvement was associated with higher recruitment of inflammatory myeloid cells, such as interstitial monocytes and dendritic cells, to the lungs. Our data highlight the role of the gut-lung axis. L. paracasei CNCM I-1518 may boost the defence against IAV infection and secondary bacterial infection, which should be further studied and validated in clinical trials.

  12. Foodborne outbreaks in Canada linked to produce: 2001 through 2009.

    Science.gov (United States)

    Kozak, G K; MacDonald, D; Landry, L; Farber, J M

    2013-01-01

    Foodborne disease outbreaks associated with fresh fruits and vegetables have been increasing in occurrence worldwide. Canada has one of the highest per capita consumption rates of fresh fruits and vegetables in the world. In this article, we review the foodborne disease outbreaks linked to produce consumption in Canada from 2001 through 2009. The 27 produce-related outbreaks included an estimated 1,549 cases of illness. Bacterial infection outbreaks represented 66% of the total. Among these, Salmonella was the most frequent agent (50% of outbreaks) followed by Escherichia coli (33%) and Shigella (17%). Cyclospora cayetanensis was the only parasite detected and was associated with seven outbreaks. Among the foodborne viruses, only hepatitis A was implicated in two outbreaks. The food vehicles most commonly implicated in outbreaks were leafy greens and herbs (26% of outbreaks), followed by seed sprouts (11%). Contamination sources and issues related to the future control of fresh produce-related foodborne disease outbreaks also are discussed.

  13. Nosocomial outbreak of cryptosporidiosis in AIDS patients.

    OpenAIRE

    Ravn, P; Lundgren, J D; Kjaeldgaard, P; Holten-Anderson, W; Højlyng, N; Nielsen, J O; Gaub, J

    1991-01-01

    OBJECTIVE--To describe a nosocomial outbreak of cryptosporidiosis during four months after June 1989. SETTING--A department of infectious diseases in Copenhagen, seeing about half the patients with AIDS in Denmark. SUBJECTS--73 HIV antibody negative subjects and 60 antibody positive subjects admitted as inpatients during the transmission period of the outbreak (20 June-14 August), of whom 18 (17 with AIDS, one with AIDS related complex), developed cryptosporidiosis. Two further HIV negative s...

  14. Giardiasis in Bergen. Outbreak and clinical consequences.

    OpenAIRE

    Wensaas, Knut-Arne

    2011-01-01

    Background Giardia lamblia is a common cause of waterborne disease. It is endemic in many parts of the world, especially where sanitation is poor, but in Europe and North America it is most often encountered in outbreaks following contamination of drinking water. The first registered outbreak of giardiasis affecting a large community in Norway happened in Bergen in the autumn of 2004. The reservoir “Svartediket” was the source, and the water probably held Giardia cysts for s...

  15. Efficacy of MP-AzeFlu in children with seasonal allergic rhinitis: Importance of paediatric symptom assessment.

    Science.gov (United States)

    Berger, William; Meltzer, Eli O; Amar, Niran; Fox, Adam T; Just, Jocelyne; Muraro, Antonella; Nieto, Antonio; Valovirta, Erkka; Wickman, Magnus; Bousquet, Jean

    2016-03-01

    This study aimed to assess the efficacy of MP-AzeFlu (a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate in a single spray) in children with seasonal allergic rhinitis (SAR) and explore the importance of child symptom severity assessment in paediatric allergic rhinitis (AR) trials. A total of 348 children (4-11 years) with moderate/severe SAR were randomized into a double-blind, placebo-controlled, 14-day, parallel-group trial. Efficacy was assessed by changes from baseline in reflective total nasal symptom score (rTNSS), reflective total ocular symptom score (rTOSS) and individual symptom scores over 14 days (children 6-11 years; n = 304), recorded by either children or caregivers. To determine whether a by-proxy effect existed, efficacy outcomes were assessed according to degree of child/caregiver rating. Moreover, total Paediatric Rhinitis Quality of Life Questionnaire (PRQLQ) score was compared between the groups. A statistically superior, clinically relevant efficacy signal of MP-AzeFlu versus placebo was apparent for PRQLQ overall score (diff: -0.29, 95% CI -0.55, -0.03; p = 0.027), but not for rTNSS (diff: -0.80; 95% CI: -1.75; 0.15; p = 0.099). However, as the extent of children's self-rating increased, so too did the treatment difference between MP-AzeFlu and placebo; MP-AzeFlu provided significantly better relief than placebo for rTNSS (p = 0.002), rTOSS (p = 0.009) and each individual nasal and ocular symptom assessed (except rhinorrhoea; p = 0.064) when children mostly rated their own symptoms. MP-AzeFlu is an effective treatment for AR in childhood. Caregivers are less able than children to accurately assess response to treatment with available tools. A simple paediatric-specific tool to assess efficacy in AR trials in children is needed. © 2016 The Authors. Pediatric Allergy and Immunology Published by John Wiley & Sons Ltd.

  16. Clinical evolution and diagnosis of an outbreak of European brown hare syndrome in hares reared in captivity.

    Science.gov (United States)

    Zanni, M L; Benassi, M C; Scicluna, M T; Lavazza, A; Capucci, L

    1993-09-01

    The authors studied an outbreak of an acute form of European brown hare syndrome (EBHS) in captive hares. The farm involved had shown negative results in a previous serological test for EBHS conducted on approximately 8% of the animals. Hares which succumbed during the outbreak were submitted to an anatomo-pathological examination and the livers of these animals were collected for laboratory analysis. Examination by immunoelectron microscopy and enzyme-linked immunosorbent assay confirmed the diagnosis of EBHS virus (EBHSV). An initial serological survey conducted on the survivors twenty-two days after the outbreak demonstrated an immunological response against EBHSV. During the outbreak, data were collected on morbidity, mortality, incidence of the disease in various age groups, and also on the antigenic characteristics of the virus responsible for the outbreak.

  17. A retrospective study of the extensive eradication program for brucellosis outbreaks and control in Korea, 2002-2009.

    Science.gov (United States)

    Park, Seung-Yong; Kim, Tae-Jong; Yoon, Hachung; Kim, Joon-Young; Lee, Myeong-Jin; Lee, Won-Chang

    2012-01-01

    This study concerns the quantitative analysis of brucellosis outbreaks and the related risk factors and control programs for both domestic cattle and human brucellosis infections in Korea between 2002 and 2009. There were a total of 77,082 infections of bovine brucellosis (BB) in domestic cattle with a prevalence rate (PR) of 13.3 per 1,000 cattle; during the same period there were 620 cases of human brucellosis (HB) with a PR of 0.16 per 100,000 persons. Moreover, the correlation coefficient of brucellosis outbreaks between cattle and humans was highly significant (r = +0.985). The attack ratio of HB cases was 8.04 per 1,000 BB cases. The distribution of brucellosis outbreaks was concentrated in the southeast region of Korea (P brucellosis outbreaks and control were based principally on an intensive test-and-slaughter policy and contributed significantly to the reduction in the outbreaks of brucellosis in Korea.

  18. Household Water Treatment Uptake during a Public Health Response to a Large Typhoid Fever Outbreak in Harare, Zimbabwe

    Science.gov (United States)

    Imanishi, Maho; Kweza, Patience F.; Slayton, Rachel B.; Urayai, Tanaka; Ziro, Odrie; Mushayi, Wellington; Francis-Chizororo, Monica; Kuonza, Lazarus R.; Ayers, Tracy; Freeman, Molly M.; Govore, Emmaculate; Duri, Clemence; Chonzi, Prosper; Mtapuri-Zinyowera, Sekesai; Manangazira, Portia; Kilmarx, Peter H.; Mintz, Eric; Lantagne, Daniele

    2014-01-01

    Locally manufactured sodium hypochlorite (chlorine) solution has been sold in Zimbabwe since 2010. During October 1, 2011–April 30, 2012, 4,181 suspected and 52 confirmed cases of typhoid fever were identified in Harare. In response to this outbreak, chlorine tablets were distributed. To evaluate household water treatment uptake, we conducted a survey and water quality testing in 458 randomly selected households in two suburbs most affected by the outbreak. Although 75% of households were aware of chlorine solution and 85% received chlorine tablets, only 18% had reportedly treated stored water and had the recommended protective level of free chlorine residuals. Water treatment was more common among households that reported water treatment before the outbreak, and those that received free tablets during the outbreak (P 0.05). Outbreak response did not build on pre-existing prevention programs. PMID:24664784

  19. Pelacakan Kasus Flu Burung pada Ayam dengan Reverse Transcriptase Polymerase Chain Reaction* (DETECTION OF AVIAN INFLUENZA IN CHICKENS BY REVERSE TRANSCRIPTASE POLYMERASE CHAIN REACTION

    Directory of Open Access Journals (Sweden)

    Gusti Ayu Yuniati Kencana

    2013-07-01

    Full Text Available Avian Influenza (AI or Bird Flu is a fatal zoonotic disease caused by highly pathogenic avian influenza(HPAI virus of H5N1 sub-type. The disease is still endemic in Indonesia. This study was conducted toinvestigate AI cases in chickens in Bali. Virus isolation was performed in 9 day-old embryonated chickeneggs, and then followed by serologic testing by haemaglutination (HA and Haemaglutination Inhibition(HI assay using standard microtiter procedure. All of the samples were further tested with reversetrancriptasepolymerase chain reaction (RT-PCR. All work has been done in the Biomedical and MolecularBiology Laboratory, Faculty of Veterinary Medicine, Udayana University, Denpasar, during the period2009-2011. A total of ten samples were examined A total of ten chicken samples consisting of 6 fieldsamples and 4 meat samples have been confirmed to be AIV H5N1. All field cases showed clinical signsand gross pathology that were typical to the infection of avian influenza. The result indicates that AI casesare still prevalent among chickens in Bali.

  20. The biennial cycle of respiratory syncytial virus outbreaks in Croatia

    Directory of Open Access Journals (Sweden)

    Drazenovic Vladimir

    2008-01-01

    Full Text Available Abstract The paper analyses the epidemic pattern of respiratory syncytial virus (RSV outbreaks in children in Croatia. Over a period of 11 consecutive winter seasons (1994–2005 3,435 inpatients from Zagreb County aged from infancy to 10 years who were hospitalised with acute respiratory tract infections were tested for RSV-infection. RSV was identified in nasopharyngeal secretions of patients by virus isolation in cell culture and by detection of viral antigen with monoclonal antibodies. In the Zagreb area, RSV outbreaks were proven to vary in a two-year cycle, which was repeated every 23–25 months. This biennial cycle comprised one larger and one smaller season. Climate factors correlated significantly with the number of RSV cases identified only in the large seasons, which suggests that the biennial cycle is likely to continue regardless of meteorological conditions. Knowledge of this biennial pattern should be useful in predicting the onset of RSV outbreaks in Croatia, and would facilitate planning for the prevention and control of RSV infections in the region.

  1. Clinical characteristics of acute hepatitis A outbreak in Taiwan, 2015-2016: observations from a tertiary medical center.

    Science.gov (United States)

    Chen, Nan-Yu; Liu, Zhuo-Hao; Shie, Shian-Sen; Chen, Tsung-Hsing; Wu, Ting-Shu

    2017-06-20

    Acute hepatitis A is a fecal-oral transmitted disease related to inadequate sanitary conditions. In addition to its traditional classification, several outbreaks in the men who have sex with men (MSM) population have resulted in acute hepatitis A being recognized as a sexually transmitted disease. However, few studies have clarified the clinical manifestations in these outbreaks involving the MSM population. Beginning in June 2015, there was an outbreak of acute hepatitis A involving the MSM population in Northern Taiwan. We conducted a 15-year retrospective study by recruiting 207 patients with the diagnosis of acute hepatitis A that included the pre-outbreak (January 2001 to May 2015) and outbreak (June 2015 to August 2016) periods in a tertiary medical center in Northern Taiwan. Using risk factors, comorbidities, presenting symptoms, laboratory test results and imaging data, we aimed to evaluate the clinical significance of acute hepatitis A in the MSM population, where human immunodeficiency virus (HIV) coinfection is common. There was a higher prevalence of reported MSM (p hepatitis A during the outbreak period. The outbreak population had more prominent systemic symptoms, was more icteric with a higher total bilirubin level (p hepatitis A relapse. The clinical course of acute hepatitis A during an outbreak involving the MSM and HIV-positive population is more symptomatic and protracted than in the general population.

  2. [Analysis of a disease outbreak of brucellosis in slaughterhouse workers].

    Science.gov (United States)

    Luna Sánchez, A; Rodríguez de Cepeda, A; Suárez Morano, T

    1998-01-01

    The appearance of an exceptional number of cases of Brucellosis at the end of 1996 in workers at a slaughterhouse led us to suspect an epidemic outbreak among this group. This study shows the methodology followed in the analysis of this outbreak as well as the results obtained. 1.-Epidemiological description of the outbreak: number of animals with brucellosis slaughtered, collection of information from different sources on the number of those affected: from the mutual insurance company, the record of working days lost, an epidemiological monitoring system and a survey amongst the workers. 2.-A case and control study was designed in order to determine, firstly, non-occupational risks--ingestion of fresh cheese or milk and care of animals--and secondly, occupational risks, depending on the job normally undertaken. 3.-To verify this a retrospective cohort study was designed. The exposed group was made up by workers in the slaughter area and the unexposed group comprised the remainder: any worker giving a positive result to the Rose of Bengal test and IgM brucellosis antibodies in serum was considered as a case. The description of the outbreak enabled us to establish that the cases occurred at the moment when most animals were slaughtered, that only occupational risks were relevant, that there were more symptomatic cases than notified ones, and that the slaughter line operators showed higher rates of attack than the remainder of the workers. This study analyses the possible causal relationship between analyzed exposure and the appearance of cases of brucellosis in workers--a fact which backs the existing scientific evidence on the importance of the respiratory tract as a mechanism of transmission of this disease in the workplace.

  3. An outbreak of Salmonella gastrointestinal illness in a military camp.

    Science.gov (United States)

    Lee, Vernon J; Ong, Alan E S; Auw, Matthew

    2009-03-01

    Non-typhoidal Salmonellae are important causes of bacterial food-borne infection, especially in institutional settings. An outbreak of gastrointestinal infection occurred in a military camp in January 2007, and an epidemiological outbreak investigation was conducted. A survey was conducted on soldiers in the camp on their clinical symptoms, and recent meals consumed. After determining the affected meal, a subsequent survey was conducted on those who had eaten the meal. A case-control study was then performed to determine the outbreak's likely food source. Laboratory tests were also conducted to determine the bacteriological cause. Of the 94 responders, 55 (58.5%) met our case definition of gastrointestinal illness. The dinner on 9 January was the most likely affected meal, with the onset of symptoms occurring within 6 to 36 hours. The mashed potato was the most likely food source with an attack rate of 80.7% for those who consumed it versus 32.7% for those who did not (P <0.01). From the multivariate analysis, the mashed potato remained the only food item independently and significantly associated with infection, with a relative risk of infection 9.49 times those who did not consume it (95% CI, 2.73-32.97). Salmonella group E was cultured from 4 individuals. Although no specific contamination was identified, the mashed potato was stored for more than 5 hours before the last serving. Risk during preparation of large quantities of food should be identified a priori, and measures taken to reduce them, to prevent outbreaks.

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

    Science.gov (United States)

    Werber, Dirk; Krause, Gérard; Frank, Christina; Fruth, Angelika; Flieger, Antje; Mielke, Martin; Schaade, Lars; Stark, Klaus

    2012-02-02

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

  5. A large outbreak of shigellosis commencing in an internally displaced population, Papua New Guinea, 2013.

    Science.gov (United States)

    Benny, Edwin; Mesere, Kelly; Pavlin, Boris I; Yakam, Logan; Ford, Rebecca; Yoannes, Mition; Kisa, Debbie; Abdad, Mohammad Y; Menda, Lincoln; Greenhill, Andrew R; Horwood, Paul F

    2014-01-01

    The objective of this study was to investigate a large outbreak of shigellosis in Papua New Guinea that began in a camp for internally displaced persons before spreading throughout the general community. Outbreak mitigation strategies were implemented in the affected area to curtail the spread of the disease. Data were collected from the surveillance system and analysed by time, place and person. Rectal swab samples were tested by standard culture methods and real-time polymerase chain reaction to determine the etiology of the outbreak. Laboratory analysis at two independent institutions established that the outbreak was caused by Shigella sp., with one strain further characterized as Shigella flexneri serotype 2. Approximately 1200 suspected cases of shigellosis were reported in a two-month period from two townships in Morobe Province, Papua New Guinea. The outbreak resulted in at least five deaths, all in young children. This outbreak of shigellosis highlights the threat of enteric diseases to vulnerable populations such as internally displaced persons in Papua New Guinea, as has been observed in other global settings.

  6. Molecular characterization of Hepatitis A virus causing an outbreak among Thai navy recruits.

    Science.gov (United States)

    Theamboonlers, A; Rianthavorn, P; Jiamsiri, S; Kumthong, S; Silaporn, P; Thongmee, C; Poovorawan, Y

    2009-12-01

    Hepatitis A virus (HAV) infection is a communicable disease, typically transmitted by faecal-oral contamination. HAV outbreaks usually occur in endemic areas. We report an outbreak of HAV from June to July, 2008 among Thai navy recruits who had received training at the Sattahip Navy Base, Chonburi province, Thailand. Upon conclusion of the training, the recruits were deployed to serve at several navy bases across the country. Secondary cases of HAV infection were reported among military personnel from these navy bases. To elucidate origin and distribution of these outbreaks, we characterized the genome and genotype of HAV isolated from the different navy bases. Sera and stool from the subjects were tested for antiHAV IgM, antiHAV IgG and HAV RNA. Subsequently, molecular characterization of HAV was performed by nucleotide sequencing of the VP1-P2A region, BLAST/FASTA and phylogenetic analysis. HAV RNA was detected in specimens obtained from different areas. All isolated strains clustered in the same lineage and belonged to genotype 1A. They shared nearly 100% genome homology indicating a single point source of this outbreak. This study provides essential baseline data as a reference for genetic analysis of HAV strains causing future outbreaks. Early detection of HAV infection and identification of the source by using molecular characterization and prompt preventive measures will hopefully prevent further outbreaks.

  7. Bayesian Reconstruction of Disease Outbreaks by Combining Epidemiologic and Genomic Data

    Science.gov (United States)

    Jombart, Thibaut; Cori, Anne; Didelot, Xavier; Cauchemez, Simon; Fraser, Christophe; Ferguson, Neil

    2014-01-01

    Recent years have seen progress in the development of statistically rigorous frameworks to infer outbreak transmission trees (“who infected whom”) from epidemiological and genetic data. Making use of pathogen genome sequences in such analyses remains a challenge, however, with a variety of heuristic approaches having been explored to date. We introduce a statistical method exploiting both pathogen sequences and collection dates to unravel the dynamics of densely sampled outbreaks. Our approach identifies likely transmission events and infers dates of infections, unobserved cases and separate introductions of the disease. It also proves useful for inferring numbers of secondary infections and identifying heterogeneous infectivity and super-spreaders. After testing our approach using simulations, we illustrate the method with the analysis of the beginning of the 2003 Singaporean outbreak of Severe Acute Respiratory Syndrome (SARS), providing new insights into the early stage of this epidemic. Our approach is the first tool for disease outbreak reconstruction from genetic data widely available as free software, the R package outbreaker. It is applicable to various densely sampled epidemics, and improves previous approaches by detecting unobserved and imported cases, as well as allowing multiple introductions of the pathogen. Because of its generality, we believe this method will become a tool of choice for the analysis of densely sampled disease outbreaks, and will form a rigorous framework for subsequent methodological developments. PMID:24465202

  8. Genomics-enabled sensor platform for rapid detection of viruses related to disease outbreak.

    Energy Technology Data Exchange (ETDEWEB)

    Brozik, Susan M; Manginell, Ronald P; Moorman, Matthew W; Xiao, Xiaoyin; Edwards, Thayne L.; Anderson, John Moses; Pfeifer, Kent Bryant; Branch, Darren W.; Wheeler, David Roger; Polsky, Ronen; Lopez, DeAnna M.; Ebel, Gregory D.; Prasad, Abhishek N.; Brozik, James A.; Rudolph, Angela R.; Wong, Lillian P.

    2013-09-01

    Bioweapons and emerging infectious diseases pose growing threats to our national security. Both natural disease outbreak and outbreaks due to a bioterrorist attack are a challenge to detect, taking days after the outbreak to identify since most outbreaks are only recognized through reportable diseases by health departments and reports of unusual diseases by clinicians. In recent decades, arthropod-borne viruses (arboviruses) have emerged as some of the most significant threats to human health. They emerge, often unexpectedly, from cryptic transmission foci causing localized outbreaks that can rapidly spread to multiple continents due to increased human travel and trade. Currently, diagnosis of acute infections requires amplification of viral nucleic acids, which can be costly, highly specific, technically challenging and time consuming. No diagnostic devices suitable for use at the bedside or in an outbreak setting currently exist. The original goals of this project were to 1) develop two highly sensitive and specific diagnostic assays for detecting RNA from a wide range of arboviruses; one based on an electrochemical approach and the other a fluorescent based assay and 2) develop prototype microfluidic diagnostic platforms for preclinical and field testing that utilize the assays developed in goal 1. We generated and characterized suitable primers for West Nile Virus RNA detection. Both optical and electrochemical transduction technologies were developed for DNA-RNA hybridization detection and were implemented in microfluidic diagnostic sensing platforms that were developed in this project.

  9. Infection with chikungunya virus in Italy: an outbreak in a temperate region.

    Science.gov (United States)

    Rezza, G; Nicoletti, L; Angelini, R; Romi, R; Finarelli, A C; Panning, M; Cordioli, P; Fortuna, C; Boros, S; Magurano, F; Silvi, G; Angelini, P; Dottori, M; Ciufolini, M G; Majori, G C; Cassone, A

    2007-12-01

    Chikungunya virus (CHIKV), which is transmitted by Aedes spp mosquitoes, has recently caused several outbreaks on islands in the Indian Ocean and on the Indian subcontinent. We report on an outbreak in Italy. After reports of a large number of cases of febrile illness of unknown origin in two contiguous villages in northeastern Italy, an outbreak investigation was done to identify the primary source of infection and modes of transmission. An active surveillance system was also implemented. The clinical case definition was presentation with fever and joint pain. Blood samples were gathered and analysed by PCR and serological assays to identify the causal agent. Locally captured mosquitoes were also tested by PCR. Phylogenetic analysis of the CHIKV E1 region was done. Analysis of samples from human beings and from mosquitoes showed that the outbreak was caused by CHIKV. We identified 205 cases of infection with CHIKV between July 4 and Sept 27, 2007. The presumed index case was a man from India who developed symptoms while visiting relatives in one of the villages. Phylogenetic analysis showed a high similarity between the strains found in Italy and those identified during an earlier outbreak on islands in the Indian Ocean. The disease was fairly mild in nearly all cases, with only one reported death. This outbreak of CHIKV disease in a non-tropical area was to some extent unexpected and emphasises the need for preparedness and response to emerging infectious threats in the era of globalisation.

  10. Are there any differences in clinical and laboratory findings on admission between H1N1 positive and negative patients with flu-like symptoms?

    Directory of Open Access Journals (Sweden)

    Zarogoulidis Kostas

    2011-01-01

    Full Text Available Abstract Background The World Health Organization alert for the H1N1 influenza pandemic led to the implementation of certain measures regarding admission of patients with flu-like symptoms. All these instructions were adopted by the Greek National Health System. The aim of this study was to retrospectively examine the characteristics of all subjects admitted to the Unit of Infectious Diseases with symptoms indicating H1N1 infection, and to identify any differences between H1N1 positive or negative patients. Patients from the ED (emergency department with flu-like symptoms (sore throat, cough, rhinorhea, or nasal congestion and fever >37.5°C were admitted in the Unit of Infectious diseases and gave pharyngeal or nasopharyngeal swabs. Swabs were tested with real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR. Findings Patients were divided into two groups. Group A comprised 33 H1N1 positive patients and Group B (control group comprised of 27 H1N1 negative patients. The two groups did not differ in terms of patient age, co-morbidities, length of hospitalization, temperature elevation, hypoxemia, as well as renal and liver function. There were also no significant differences in severity on admission. C-reactive protein (CRP (mean 12.8 vs. 5.74 and white blood count (WBC (mean 10.528 vs. 7.114 were significantly higher in group B than in group A upon admission. Obesity was noted in 8 patients of Group A (mean 31.67 and 14 patients of Group B (mean 37.78. Body mass index (BMI was lower in H1N1 positive than in H1N1 negative patients (mean 31.67 vs. 37.78, respectively; p = 0.009. Conclusions The majority of patients in both groups were young male adults. CRP, WBC and BMI were higher among H1N1 negative patients. Finally, clinical course of patients in both groups was mild and uneventful.

  11. A local outbreak of dengue caused by an imported case in Dongguan China

    Directory of Open Access Journals (Sweden)

    Peng Hong-Juan

    2012-01-01

    Full Text Available Abstract Background Dengue, a mosquito-borne febrile viral disease, is found in tropical and sub-tropical regions around the world. Since the first occurrence of dengue was confirmed in Guangdong, China in 1978, dengue outbreaks have been reported sequentially in different provinces in South China transmitted by.peridomestic Ae. albopictus mosquitoes, diplaying Ae. aegypti, a fully domestic vector that transmits dengue worldwide. Rapid and uncontrolled urbanization is a characteristic change in developing countries, which impacts greatly on vector habitat, human lifestyle and transmission dynamics on dengue epidemics. In September 2010, an outbreak of dengue was detected in Dongguan, a city in Guangdong province characterized by its fast urbanization. An investigation was initiated to identify the cause, to describe the epidemical characteristics of the outbreak, and to implement control measures to stop the outbreak. This is the first report of dengue outbreak in Dongguan, even though dengue cases were documented before in this city. Methods Epidemiological data were obtained from local Center of Disease Control and prevention (CDC. Laboratory tests such as real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR, the virus cDNA sequencing, and Enzyme-Linked immunosorbent assay (ELISA were employed to identify the virus infection and molecular phylogenetic analysis was performed with MEGA5. The febrile cases were reported every day by the fever surveillance system. Vector control measures including insecticidal fogging and elimination of habitats of Ae. albopictus were used to control the dengue outbreak. Results The epidemiological studies results showed that this dengue outbreak was initiated by an imported case from Southeast Asia. The outbreak was characterized by 31 cases reported with an attack rate of 50.63 out of a population of 100,000. Ae. albopictus was the only vector species responsible for the outbreak. The virus c

  12. Primary and secondary cases in Escherichia coli O157 outbreaks: a statistical analysis.

    LENUS (Irish Health Repository)

    Snedeker, Kate G

    2009-01-01

    BACKGROUND: Within outbreaks of Escherichia coli O157 (E. coli O157), at least 10-15% of cases are thought to have been acquired by secondary transmission. However, there has been little systematic quantification or characterisation of secondary outbreak cases worldwide. The aim of this study was to characterise secondary outbreak cases, estimate the overall proportion of outbreak cases that were the result of secondary transmission and to analyse the relationships between primary and secondary outbreak cases by mode of transmission, country and median age. METHODS: Published data was obtained from 90 confirmed Escherichia coli O157 outbreaks in Great Britain, Ireland, Scandinavia, Canada, the United States and Japan, and the outbreaks were described in terms of modes of primary and secondary transmission, country, case numbers and median case age. Outbreaks were tested for statistically significant differences in the number of ill, confirmed, primary and secondary cases (analysis of variance and Kruskal-Wallis) and in the rate of secondary cases between these variables (Generalised Linear Models). RESULTS: The outbreaks had a median of 13.5 confirmed cases, and mean proportion of 0.195 secondary cases. There were statistically significant differences in the numbers of ill, confirmed, primary and secondary cases between modes of primary transmission (p < 0.021), and in primary and secondary cases between median age categories (p < 0.039) and modes of secondary transmission (p < 0.001).Secondary case rates differed statistically significantly between modes of secondary and primary transmission and median age categories (all p < 0.001), but not between countries (p = 0.23). Statistically significantly higher rates of secondary transmission were found in outbreaks with a median age <6 years and those with secondary transmission via person to person spread in nurseries. No statistically significant interactions were found between country, mode of transmission and age

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

    Science.gov (United States)

    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.

  14. Regulating the 1918-19 pandemic: flu, stoicism and the Northcliffe press.

    Science.gov (United States)

    Honigsbaum, Mark

    2013-04-01

    Social historians have argued that the reason the 1918–19 ‘Spanish’ influenza left so few traces in public memory is that it was ‘overshadowed’ by the First World War, hence its historiographical characterisation as the ‘forgotten’ pandemic. This paper argues that such an approach tends to overlook the crucial role played by wartime propaganda. Instead, I put emotion words, emotives and metaphors at the heart of my analysis in an attempt to understand the interplay between propaganda and biopolitical discourses that aimed to regulate civilian responses to the pandemic. Drawing on the letters of Wilfred Owen, the diaries of the cultural historian Caroline Playne and the reporting in the Northcliffe press, I argue that the stoicism exhibited by Owen and amplified in the columns of The Times and the Daily Mail is best viewed as a performance, an emotional style that reflected the politicisation of ‘dread’ in war as an emotion with the potential to undermine civilian morale. This was especially the case during the final year of the conflict when war-weariness set in, leading to the stricter policing of negative emotions. As a protean disease that could present as alternately benign and plague-like, the Spanish flu both drew on these discourses and subverted them, disrupting medical efforts to use the dread of foreign pathogens as an instrument of biopower. The result was that, as dread increasingly became attached to influenza, it destabilised medical attempts to regulate the civilian response to the pandemic, undermining Owen’s and the Northcliffe press’s emotives of stoicism.

  15. What can digital disease detection learn from (an external revision to) Google Flu Trends?

    Science.gov (United States)

    Santillana, Mauricio; Zhang, D Wendong; Althouse, Benjamin M; Ayers, John W

    2014-09-01

    Google Flu Trends (GFT) claimed to generate real-time, valid predictions of population influenza-like illness (ILI) using search queries, heralding acclaim and replication across public health. However, recent studies have questioned the validity of GFT. To propose an alternative methodology that better realizes the potential of GFT, with collateral value for digital disease detection broadly. Our alternative method automatically selects specific queries to monitor and autonomously updates the model each week as new information about CDC-reported ILI becomes available, as developed in 2013. Root mean squared errors (RMSEs) and Pearson correlations comparing predicted ILI (proportion of patient visits indicative of ILI) with subsequently observed ILI were used to judge model performance. During the height of the H1N1 pandemic (August 2 to December 22, 2009) and the 2012-2013 season (September 30, 2012, to April 12, 2013), GFT's predictions had RMSEs of 0.023 and 0.022 (i.e., hypothetically, if GFT predicted 0.061 ILI one week, it is expected to err by 0.023) and correlations of r=0.916 and 0.927. Our alternative method had RMSEs of 0.006 and 0.009, and correlations of r=0.961 and 0.919 for the same periods. Critically, during these important periods, the alternative method yielded more accurate ILI predictions every week, and was typically more accurate during other influenza seasons. GFT may be inaccurate, but improved methodologic underpinnings can yield accurate predictions. Applying similar methods elsewhere can improve digital disease detection, with broader transparency, improved accuracy, and real-world public health impacts. Copyright © 2014. Published by Elsevier Inc.

  16. Improving Google Flu Trends estimates for the United States through transformation.

    Science.gov (United States)

    Martin, Leah J; Xu, Biying; Yasui, Yutaka

    2014-01-01

    Google Flu Trends (GFT) uses Internet search queries in an effort to provide early warning of increases in influenza-like illness (ILI). In the United States, GFT estimates the percentage of physician visits related to ILI (%ILINet) reported by the Centers for Disease Control and Prevention (CDC). However, during the 2012-13 influenza season, GFT overestimated %ILINet by an appreciable amount and estimated the peak in incidence three weeks late. Using data from 2010-14, we investigated the relationship between GFT estimates (%GFT) and %ILINet. Based on the relationship between the relative change in %GFT and the relative change in %ILINet, we transformed %GFT estimates to better correspond with %ILINet values. In 2010-13, our transformed %GFT estimates were within ± 10% of %ILINet values for 17 of the 29 weeks that %ILINet was above the seasonal baseline value determined by the CDC; in contrast, the original %GFT estimates were within ± 10% of %ILINet values for only two of these 29 weeks. Relative to the %ILINet peak in 2012-13, the peak in our transformed %GFT estimates was 2% lower and one week later, whereas the peak in the original %GFT estimates was 74% higher and three weeks later. The same transformation improved %GFT estimates using the recalibrated 2013 GFT model in early 2013-14. Our transformed %GFT estimates can be calculated approximately one week before %ILINet values are reported by the CDC and the transformation equation was stable over the time period investigated (2010-13). We anticipate our results will facilitate future use of GFT.

  17. Improving Google Flu Trends estimates for the United States through transformation.

    Directory of Open Access Journals (Sweden)

    Leah J Martin

    Full Text Available Google Flu Trends (GFT uses Internet search queries in an effort to provide early warning of increases in influenza-like illness (ILI. In the United States, GFT estimates the percentage of physician visits related to ILI (%ILINet reported by the Centers for Disease Control and Prevention (CDC. However, during the 2012-13 influenza season, GFT overestimated %ILINet by an appreciable amount and estimated the peak in incidence three weeks late. Using data from 2010-14, we investigated the relationship between GFT estimates (%GFT and %ILINet. Based on the relationship between the relative change in %GFT and the relative change in %ILINet, we transformed %GFT estimates to better correspond with %ILINet values. In 2010-13, our transformed %GFT estimates were within ± 10% of %ILINet values for 17 of the 29 weeks that %ILINet was above the seasonal baseline value determined by the CDC; in contrast, the original %GFT estimates were within ± 10% of %ILINet values for only two of these 29 weeks. Relative to the %ILINet peak in 2012-13, the peak in our transformed %GFT estimates was 2% lower and one week later, whereas the peak in the original %GFT estimates was 74% higher and three weeks later. The same transformation improved %GFT estimates using the recalibrated 2013 GFT model in early 2013-14. Our transformed %GFT estimates can be calculated approximately one week before %ILINet values are reported by the CDC and the transformation equation was stable over the time period investigated (2010-13. We anticipate our results will facilitate future use of GFT.

  18. Estimating challenge load due to disease outbreaks and other challenges using reproduction records of sows.

    Science.gov (United States)

    Mathur, P K; Herrero-Medrano, J M; Alexandri, P; Knol, E F; ten Napel, J; Rashidi, H; Mulder, H A

    2014-12-01

    A method was developed and tested to estimate challenge load due to disease outbreaks and other challenges in sows using reproduction records. The method was based on reproduction records from a farm with known disease outbreaks. It was assumed that the reduction in weekly reproductive output within a farm is proportional to the magnitude of the challenge. As the challenge increases beyond certain threshold, it is manifested as an outbreak. The reproduction records were divided into 3 datasets. The first dataset called the Training dataset consisted of 57,135 reproduction records from 10,901 sows from 1 farm in Canada with several outbreaks of porcine reproductive and respiratory syndrome (PRRS). The known disease status of sows was regressed on the traits number born alive, number of losses as a combination of still birth and mummified piglets, and number of weaned piglets. The regression coefficients from this analysis were then used as weighting factors for derivation of an index measure called challenge load indicator. These weighting factors were derived with i) a two-step approach using residuals or year-week solutions estimated from a previous step, and ii) a single-step approach using the trait values directly. Two types of models were used for each approach: a logistic regression model and a general additive model. The estimates of challenge load indicator were then compared based on their ability to detect PRRS outbreaks in a Test dataset consisting of records from 65,826 sows from 15 farms in the Netherlands. These farms differed from the Canadian farm with respect to PRRS virus strains, severity and frequency of outbreaks. The single-step approach using a general additive model was best and detected 14 out of the 15 outbreaks. This approach was then further validated using the third dataset consisting of reproduction records of 831,855 sows in 431 farms located in different countries in Europe and America. A total of 41 out of 48 outbreaks detected

  19. Response to a large rotavirus outbreak on South Tarawa, Kiribati, 2013

    Directory of Open Access Journals (Sweden)

    Teanibuaka Tabunga

    2014-05-01

    Full Text Available Introduction: In July 2013, during annual independence celebrations in Kiribati, staff at Tungaru Central Hospital on South Tarawa reported an increase in children presenting with severe diarrhoea. This report describes the outbreak investigation, findings and response. Method: After notification of the outbreak, all health facilities on South Tarawa began reporting cases of acute diarrhoea and/or vomiting through the early warning syndromic surveillance system on a daily basis. Community awareness was raised and the public was encouraged to present to a health facility if ill with acute gastroenteritis. Specimens were collected and sent for laboratory testing. Results: Between 10 and 24 July 2013, 1118 cases of gastroenteritis were reported; 103 were hospitalized and six died. The median age of cases was one year (range: 0–68 years; 93.4% were aged less than five years. Rotavirus was identified in 81% of specimens tested. The outbreak response included enhanced surveillance, community education, clinical training and changes to in-hospital patient management for infection control. Discussion: This outbreak was the largest diarrhoea outbreak in Kiribati in five years. Factors that may have contributed to the magnitude and severity of the outbreak included high household density, inadequate sanitation infrastructure and a mass gathering – all increasing the chance of transmission – as well as limited clinical response capacity. The current outbreak highlights the importance of clinical management to minimize severe dehydration and death. Rotavirus vaccination should be considered as an adjunct to other comprehensive enteric disease control measures as recommended by the World Health Organization.

  20. An Outbreak of Foodborne Botulism in Ontario

    Directory of Open Access Journals (Sweden)

    Mona R Loutfy

    2003-01-01

    Full Text Available Botulism is a rare paralytic illness resulting from a potent neurotoxin produced by Clostridium botulinum. Botulism in Canada is predominately due to C botulinum type E and affects mainly the First Nations and Inuit populations. The most recent outbreak of botulism in Ontario was in Ottawa in 1991 and was caused by C botulinum type A. We report an outbreak of foodborne type B botulism in Ontario, which implicated home-canned tomatoes. The outbreak was characterized by mild symptoms in two cases and moderately severe illness in one case. The investigation shows the importance of considering the diagnosis of botulism in patients presenting with cranial nerve and autonomic dysfunction, especially when combined with gastrointestinal complaints; it also highlights the importance of proper home canning technique.

  1. Nosocomial outbreak of cryptosporidiosis in AIDS patients

    DEFF Research Database (Denmark)

    Ravn, Pernille; Lundgren, Jens Dilling; Kjaeldgaard, P

    1991-01-01

    OBJECTIVE--To describe a nosocomial outbreak of cryptosporidiosis during four months after June 1989. SETTING--A department of infectious diseases in Copenhagen, seeing about half the patients with AIDS in Denmark. SUBJECTS--73 HIV antibody negative subjects and 60 antibody positive subjects...... admitted as inpatients during the transmission period of the outbreak (20 June-14 August), of whom 18 (17 with AIDS, one with AIDS related complex), developed cryptosporidiosis. Two further HIV negative subjects (one departmental secretary, one visiting relative) developed cryptosporidiosis. MAIN OUTCOME...... MEASURES--Cryptosporidia in stool samples, clinical symptoms, CD4 cell count, HIV antigen concentration, chemotherapeutic treatment. RESULTS--The source of the outbreak was identified as ice from an ice machine in the ward, contaminated by an incontinent, psychotic patient with cryptosporidiosis picking...

  2. Simple visit behavior unifies complex Zika outbreaks

    Directory of Open Access Journals (Sweden)

    P.D. Manrique

    2017-12-01

    Full Text Available New outbreaks of Zika in the U.S. are imminent. Human nature dictates that many individuals will continue to revisit affected ‘Ground Zero’ patches, whether out of choice, work or family reasons − yet this feature is missing from traditional epidemiological analyses. Here we show that this missing visit-revisit mechanism is by itself capable of explaining quantitatively the 2016 human Zika outbreaks in all three Ground Zero patches. Our findings reveal counterintuitive ways in which this human flow can be managed to tailor any future outbreak’s duration, severity and time-to-peak. Effective public health planning can leverage these results to impact the evolution of future outbreaks via soft control of the overall human flow, as well as to suggest best-practice visitation behavior for local residents.

  3. The Study of Campylobacter Frequency in Foodborne Disease Outbreaks in Iran

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    Mohammad Mehdi Soltan Dallal

    2017-07-01

    Full Text Available Introduction:Food-borne diseases are the widespread problems worldwide. Campylobacter species are the most important pathogens causing gastroenteritis which is generally transmitted through the food with animal origin. The aim of this study was to identify the Campylobacter spp. in diarrheal outbreaks in food-borne diseases at country level. Methods:This cross-sectional study carried out in spring and summer, 2015. In total, 305 swabs from diarrheal stool samples of 102 food-borne outbreaks were collected in various provinces of Iran. All samples were examined for the presence and growth of Campylobacter spp. The descriptive analysis, chi-square test and SPSS v.21 software were used for the analysis of results. Results:From the total of 102 foodborne outbreaks, Zanjan Province with 24 outbreaks (24.5% and Yazd Province with 70 samples of diarrhea (23% included the most reported cases. Out of 305 tested samples, 119 (39% were from food, 35 (11.5% from water and 151 (41.5% from unknown sources (p <0.001.  Two outbreaks in Yazd Province including three stool samples contained Campylobacter coli. Typical symptoms included diarrhea (30.9%, abdominal cramps (68.5%, fever (31.8%, headache (42.3%, diarrhea (5.2%, nausea (62.3% and vomiting (64.9%. Conclusion:Results from this study showed that C. coli was responsible for diarrhea rather than C. jejuni.

  4. Food-borne disease outbreak of diarrhetic shellfish poisoning due to toxic mussel consumption: the first recorded outbreak in china.

    Science.gov (United States)

    Chen, Tingrui; Xu, Xuqing; Wei, Jinjiao; Chen, Jiang; Miu, Renchao; Huang, Liming; Zhou, Xiaoxiao; Fu, Yun; Yan, Rui; Wang, Zhen; Liu, Biyao; He, Fan

    2013-01-01

    This investigation was undertaken in response to an outbreak of suspected shellfish poisoning in Zhejiang Province, China. The objectives of this project were to confirm the outbreak and to identify the aetiology, source and mode of transmission. A probable case was defined as an individual with diarrhea (≥3 times/day) plus at least one of the following symptoms: fever (≥37.5°C), vomiting, or abdominal pain after consuming seafood between May 23(rd) and May 28(th), 2011. Using a case-control study design, we compared exposures to suspected seafood items and cooking methods between 61 probable cases and 61 controls. Over 220 suspected or probable cases of diarrhetic shellfish poisoning (DSP) were identified (incidence of 18 cases per 100,000). The case control study revealed that 100% of cases and 18% of controls had eaten mussels during the exposure period (OR = ∞, χ(2) = 84.72,P = 0.000). The number of mussels consumed was related to DSP risk (P = 0.004, χ2 test for trend). Consumption of other seafood items was not associated with disease. The frequency of diarrhea and vomiting were positively correlated with the number of mussels consumed (r = 0.424 and r = 0.562, respectively). The frequency of vomiting and the incubation period were significantly correlated with the total time the mussels were boiled (r = 0.594 and r = -0.336, respectively). Mussels from 3 food markets and one family contained Okadaic acid (OA) and Dinophysistoxin-1 (DTX-1). This outbreak was attributed to the consumption of mussels contaminated by DSP-toxins (OA and DTX-1) which are produced by different species of dinoflagellates (toxic microalgae) from the genus Dinophysis or Prorocentrum. Suspension of mussel sales and early public announcements were highly effective in controlling the outbreak, although oversight of seafood quality should be a priority to prevent future contamination and outbreaks.

  5. Syndromic surveillance for local outbreaks of lower-respiratory infections: would it work?

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    Cees C van den Wijngaard

    2010-04-01

    Full Text Available Although syndromic surveillance is increasingly used to detect unusual illness, there is a debate whether it is useful for detecting local outbreaks. We evaluated whether syndromic surveillance detects local outbreaks of lower-respiratory infections (LRIs without swamping true signals by false alarms.Using retrospective hospitalization data, we simulated prospective surveillance for LRI-elevations. Between 1999-2006, a total of 290762 LRIs were included by date of hospitalization and patients place of residence (>80% coverage, 16 million population. Two large outbreaks of Legionnaires disease in the Netherlands were used as positive controls to test whether these outbreaks could have been detected as local LRI elevations. We used a space-time permutation scan statistic to detect LRI clusters. We evaluated how many LRI-clusters were detected in 1999-2006 and assessed likely causes for the cluster-signals by looking for significantly higher proportions of specific hospital discharge diagnoses (e.g. Legionnaires disease and overlap with regional influenza elevations. We also evaluated whether the number of space-time signals can be reduced by restricting the scan statistic in space or time. In 1999-2006 the scan-statistic detected 35 local LRI clusters, representing on average 5 clusters per year. The known Legionnaires' disease outbreaks in 1999 and 2006 were detected as LRI-clusters, since cluster-signals were generated with an increased proportion of Legionnaires disease patients (p:<0.0001. 21 other clusters coincided with local influenza and/or respiratory syncytial virus activity, and 1 cluster appeared to be a data artifact. For 11 clusters no likely cause was defined, some possibly representing as yet undetected LRI-outbreaks. With restrictions on time and spatial windows the scan statistic still detected the Legionnaires' disease outbreaks, without loss of timeliness and with less signals generated in time (up to 42% decline.To our

  6. Evaluation of the immunogenicity and safety of different doses and formulations of a broad spectrum influenza vaccine (FLU-v) developed by SEEK: study protocol for a single-center, randomized, double-blind and placebo-controlled clinical phase IIb trial.

    Science.gov (United States)

    van Doorn, Eva; Pleguezuelos, Olga; Liu, Heng; Fernandez, Ana; Bannister, Robin; Stoloff, Gregory; Oftung, Fredrik; Norley, Stephen; Huckriede, Anke; Frijlink, Henderik W; Hak, Eelko

    2017-04-04

    Current influenza vaccines, based on antibodies against surface antigens, are unable to provide protection against newly emerging virus strains which differ from the vaccine strains. Therefore the population has to be re-vaccinated annually. It is thus important to develop vaccines which induce protective immunity to a broad spectrum of influenza viruses. This trial is designed to evaluate the immunogenicity and safety of FLU-v, a vaccine composed of four synthetic peptides with conserved epitopes from influenza A and B strains expected to elicit both cell mediated immunity (CMI) and humoral immunity providing protection against a broad spectrum of influenza viruses. In a single-center, randomized, double-blind and placebo-controlled phase IIb trial, 222 healthy volunteers aged 18-60 years will be randomized (2:2:1:1) to receive two injections of a suspension of 500 μg FLU-v in saline (arm 1), one dose of emulsified 500 μg FLU-v in Montanide ISA-51 and water for injection (WFI) followed by one saline dose (arm 2), two saline doses (arm 3), or one dose of Montanide ISA-51 and WFI emulsion followed by one saline dose (arm 4). All injections will be given subcutaneously. Primary endpoints are safety and FLU-v induced CMI, evaluated by cytokine production by antigen specific T cell populations (flow-cytometry and ELISA). Secondary outcomes are measurements of antibody responses (ELISA and multiplex), whereas exploratory outcomes include clinical efficacy and additional CMI assays (ELISpot) to show cross-reactivity. Broadly protective influenza vaccines able to provide protection against multiple strains of influenza are urgently needed. FLU-v is a promising vaccine which has shown to trigger the cell-mediated immune response. The dosages and formulations tested in this current trial are also estimated to induce antibody response. Therefore, both cellular and humoral immune responses will be evaluated. EudraCT number 2015-001932-38 ; retrospectively registered

  7. Outbreak of Mysterious Illness Among Hospital Staff

    DEFF Research Database (Denmark)

    Jacobsen, Peter; Ebbehøj, Niels Erik

    2016-01-01

    BACKGROUND: Hospitals are rarely reported as settings for mass psychogenic illness (MPI). The present report scrutinizes an outbreak of probable MPI among hospital staff, with medical intervention reinforcing the course of the illness. CASE REPORT: Four of seven staff members in an emergency...... the following 9 days, 14 possible poisoning victims were identified, 6 of whom were transferred for HBO. After hospital stays with repeated HBO treatment and examinations without identification of significant physical disease, the majority of the 10 HBO-treated victims remained symptomatic, some on prolonged....... Outbreaks of illness in a group of symptomatic victims without indication of significant physical disease should be managed by observation and limited intervention....

  8. WKB calculation of an epidemic outbreak distribution

    International Nuclear Information System (INIS)

    Black, Andrew J; McKane, Alan J

    2011-01-01

    We calculate both the exponential and prefactor contributions in a WKB approximation of the master equation for a stochastic SIR model with highly oscillatory dynamics. Fixing the basic parameters of the model, we investigate how the outbreak distribution changes with the population size. We show that this distribution rapidly becomes highly non-Gaussian, acquiring large tails, indicating the presence of rare but large outbreaks, as the population is made smaller. The analytic results are found to be in excellent agreement with simulations until the systems become so small that the dynamics are dominated by fade-out of the disease

  9. Outbreak of Mycobacterium chelonae infection associated with tattoo ink.

    Science.gov (United States)

    Kennedy, Byron S; Bedard, Brenden; Younge, Mary; Tuttle, Deborah; Ammerman, Eric; Ricci, John; Doniger, Andrew S; Escuyer, Vincent E; Mitchell, Kara; Noble-Wang, Judith A; O'Connell, Heather A; Lanier, William A; Katz, Linda M; Betts, Robert F; Mercurio, Mary Gail; Scott, Glynis A; Lewis, Matthew A; Goldgeier, Mark H

    2012-09-13

    In January 2012, on the basis of an initial report from a dermatologist, we began to investigate an outbreak of tattoo-associated Mycobacterium chelonae skin and soft-tissue infections in Rochester, New York. The main goals were to identify the extent, cause, and form of transmission of the outbreak and to prevent further cases of infection. We analyzed data from structured interviews with the patients, histopathological testing of skin-biopsy specimens, acid-fast bacilli smears, and microbial cultures and antimicrobial susceptibility testing. We also performed DNA sequencing, pulsed-field gel electrophoresis (PFGE), cultures of the ink and ingredients used in the preparation and packaging of the ink, assessment of source water and faucets at tattoo parlors, and investigation of the ink manufacturer. Between October and December 2011, a persistent, raised, erythematous rash in the tattoo area developed in 19 persons (13 men and 6 women) within 3 weeks after they received a tattoo from a single artist who used premixed gray ink; the highest occurrence of tattooing and rash onset was in November (accounting for 15 and 12 patients, respectively). The average age of the patients was 35 years (range, 18 to 48). Skin-biopsy specimens, obtained from 17 patients, showed abnormalities in all 17, with M. chelonae isolated from 14 and confirmed by means of DNA sequencing. PFGE analysis showed indistinguishable patterns in 11 clinical isolates and one of three unopened bottles of premixed ink. Eighteen of the 19 patients were treated with appropriate antibiotics, and their condition improved. The premixed ink was the common source of infection in this outbreak. These findings led to a recall by the manufacturer.

  10. First Chikungunya Outbreak in Suriname; Clinical and Epidemiological Features.

    Science.gov (United States)

    van Genderen, Farah T; Krishnadath, Ingrid; Sno, Rachel; Grunberg, Meritha G; Zijlmans, Wilco; Adhin, Malti R

    2016-04-01

    In June 2014, Suriname faced the first Chikungunya outbreak. Since international reports mostly focus on hospitalized patients, the least affected group, a study was conducted to describe clinical characteristics of mainly outpatients including children. In addition, the cumulative incidence of this first epidemic was investigated. During August and September 2014, clinically suspected Chikungunya cases were included in a prospective follow-up study. Blood specimens were collected and tested for viral RNA presence. Detailed clinical information was gathered through multiple telephone surveys until day 180. In addition, a three stage household-based cluster with a cross-sectional design was conducted in October, December 2014 and March 2015 to assess the cumulative incidence. Sixty-eight percent of symptomatic patients tested positive for Chikungunya virus (CHIKV). Arthralgia and pain in the fingers were distinctive for viremic CHIKV infected patients. Viremic CHIKV infected children (≤12 years) characteristically displayed headache and vomiting, while arthralgia was less common at onset. The disease was cleared within seven days by 20% of the patients, while 22% of the viremic CHIKV infected patients, mostly women and elderly reported persistent arthralgia at day 180. The extrapolated cumulative CHIKV incidence in Paramaribo was 249 cases per 1000 persons, based on CHIKV self-reported cases in 53.1% of the households and 90.4% IgG detected in a subset of self-reported CHIKV+ persons. CHIKV peaked in the dry season and a drastic decrease in CHIKV patients coincided with a governmental campaign to reduce mosquito breeding sites. This study revealed that persistent arthralgia was a concern, but occurred less frequently in an outpatient setting. The data support a less severe pathological outcome for Caribbean CHIKV infections. This study augments incidence data available for first outbreaks in the region and showed that actions undertaken at the national level to

  11. First Chikungunya Outbreak in Suriname; Clinical and Epidemiological Features.

    Directory of Open Access Journals (Sweden)

    Farah T van Genderen

    2016-04-01

    Full Text Available In June 2014, Suriname faced the first Chikungunya outbreak. Since international reports mostly focus on hospitalized patients, the least affected group, a study was conducted to describe clinical characteristics of mainly outpatients including children. In addition, the cumulative incidence of this first epidemic was investigated.During August and September 2014, clinically suspected Chikungunya cases were included in a prospective follow-up study. Blood specimens were collected and tested for viral RNA presence. Detailed clinical information was gathered through multiple telephone surveys until day 180. In addition, a three stage household-based cluster with a cross-sectional design was conducted in October, December 2014 and March 2015 to assess the cumulative incidence.Sixty-eight percent of symptomatic patients tested positive for Chikungunya virus (CHIKV. Arthralgia and pain in the fingers were distinctive for viremic CHIKV infected patients. Viremic CHIKV infected children (≤12 years characteristically displayed headache and vomiting, while arthralgia was less common at onset. The disease was cleared within seven days by 20% of the patients, while 22% of the viremic CHIKV infected patients, mostly women and elderly reported persistent arthralgia at day 180. The extrapolated cumulative CHIKV incidence in Paramaribo was 249 cases per 1000 persons, based on CHIKV self-reported cases in 53.1% of the households and 90.4% IgG detected in a subset of self-reported CHIKV+ persons. CHIKV peaked in the dry season and a drastic decrease in CHIKV patients coincided with a governmental campaign to reduce mosquito breeding sites.This study revealed that persistent arthralgia was a concern, but occurred less frequently in an outpatient setting. The data support a less severe pathological outcome for Caribbean CHIKV infections. This study augments incidence data available for first outbreaks in the region and showed that actions undertaken at the

  12. First Chikungunya Outbreak in Suriname; Clinical and Epidemiological Features

    Science.gov (United States)

    van Genderen, Farah T.; Krishnadath, Ingrid; Sno, Rachel; Grunberg, Meritha G.; Zijlmans, Wilco; Adhin, Malti R.

    2016-01-01

    Background In June 2014, Suriname faced the first Chikungunya outbreak. Since international reports mostly focus on hospitalized patients, the least affected group, a study was conducted to describe clinical characteristics of mainly outpatients including children. In addition, the cumulative incidence of this first epidemic was investigated. Methodology During August and September 2014, clinically suspected Chikungunya cases were included in a prospective follow-up study. Blood specimens were collected and tested for viral RNA presence. Detailed clinical information was gathered through multiple telephone surveys until day 180. In addition, a three stage household-based cluster with a cross-sectional design was conducted in October, December 2014 and March 2015 to assess the cumulative incidence. Principal Findings Sixty-eight percent of symptomatic patients tested positive for Chikungunya virus (CHIKV). Arthralgia and pain in the fingers were distinctive for viremic CHIKV infected patients. Viremic CHIKV infected children (≤12 years) characteristically displayed headache and vomiting, while arthralgia was less common at onset. The disease was cleared within seven days by 20% of the patients, while 22% of the viremic CHIKV infected patients, mostly women and elderly reported persistent arthralgia at day 180. The extrapolated cumulative CHIKV incidence in Paramaribo was 249 cases per 1000 persons, based on CHIKV self-reported cases in 53.1% of the households and 90.4% IgG detected in a subset of self-reported CHIKV+ persons. CHIKV peaked in the dry season and a drastic decrease in CHIKV patients coincided with a governmental campaign to reduce mosquito breeding sites. Conclusions/Significance This study revealed that persistent arthralgia was a concern, but occurred less frequently in an outpatient setting. The data support a less severe pathological outcome for Caribbean CHIKV infections. This study augments incidence data available for first outbreaks in the

  13. International outbreak of multiple Salmonella serotype infections linked to sprouted chia seed powder - USA and Canada, 2013-2014.

    Science.gov (United States)

    Harvey, R R; Heiman Marshall, K E; Burnworth, L; Hamel, M; Tataryn, J; Cutler, J; Meghnath, K; Wellman, A; Irvin, K; Isaac, L; Chau, K; Locas, A; Kohl, J; Huth, P A; Nicholas, D; Traphagen, E; Soto, K; Mank, L; Holmes-Talbot, K; Needham, M; Barnes, A; Adcock, B; Honish, L; Chui, L; Taylor, M; Gaulin, C; Bekal, S; Warshawsky, B; Hobbs, L; Tschetter, L R; Surin, A; Lance, S; Wise, M E; Williams, I; Gieraltowski, L

    2017-06-01

    Salmonella is a leading cause of bacterial foodborne illness. We report the collaborative investigative efforts of US and Canadian public health officials during the 2013-2014 international outbreak of multiple Salmonella serotype infections linked to sprouted chia seed powder. The investigation included open-ended interviews of ill persons, traceback, product testing, facility inspections, and trace forward. Ninety-four persons infected with outbreak strains from 16 states and four provinces were identified; 21% were hospitalized and none died. Fifty-four (96%) of 56 persons who consumed chia seed powder, reported 13 different brands that traced back to a single Canadian firm, distributed by four US and eight Canadian companies. Laboratory testing yielded outbreak strains from leftover and intact product. Contaminated product was recalled. Although chia seed powder is a novel outbreak vehicle, sprouted seeds are recognized as an important cause of foodborne illness; firms should follow available guidance to reduce the risk of bacterial contamination during sprouting.

  14. Influenza vaccination in preventing outbreaks in schools: A long-term ecological overview.

    Science.gov (United States)

    Pan, Yang; Wang, Quanyi; Yang, Peng; Zhang, Li; Wu, Shuangsheng; Zhang, Yi; Sun, Ying; Duan, Wei; Ma, Chunna; Zhang, Man; Zhang, Xingxing; MacIntyre, C Raina

    2017-12-18

    Influenza vaccination is the most effective way to reduce the incidence of influenza infections. However, the role of influenza vaccination, such as school-based influenza vaccination, in preventing the influenza outbreaks in schools remains unclear now. In this study, a total of 286 school febrile outbreaks involving 6863 cases in the Beijing area from September 1, 2006 to March 31, 2017 were analyzed. We also tested 294 circulating strains isolated in Beijing during the same period and compared with that of vaccine strains identified every influenza season. The virological match/mismatch between vaccine strains and circulating strains, and the coverage of vaccination in schools were analyzed against outbreaks during the 11 years. It showed that over 80% school febrile outbreaks were caused by influenza A/B virus, the most frequent being A(H3N2) virus (53.25%), followed by A(H1N1)pdm09 virus (25.11%) and B virus (21.64%). More importantly, low vaccine coverage (in 2006-2007 influenza season) and vaccine mismatch (in 2014-2015 and 2015-2016 influenza season) were associated with an increased number of influenza school outbreaks. High vaccination coverage with a matched vaccine can significantly reduce influenza outbreaks in schools (OR: 0.111, p school-based influenza vaccination in preventing outbreaks using trivalent inactivated influenza vaccine in schools. Thus the school-based vaccine policy should be paid more attention in China and other countries worldwide. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    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

  16. Analysis of epidemiological data of foodborne outbreak reported in Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Soltan Dallal

    2015-02-01

    Conclusion: The knowledge of bacterial agent of foodborne diseases and determination of antimicrobial resistance pattern are helpful to reduce the rate of foodborne outbreaks, the cost of treatment. The prevention control of outbreaks is also very important.

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

    Science.gov (United States)

    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.

  18. Predictors of Ips confusus Outbreaks During a Record Drought in Southwestern USA: Implications for Monitoring and Management

    Science.gov (United States)

    Santos, Maria J.; Whitham, Thomas G.

    2010-02-01

    In many ecosystems the effects of disturbance can be cryptic and disturbance may vary in subtle spatiotemporal ways. For instance, we know that bark beetle outbreaks are more frequent in temperate forests during droughts; however, we have little idea about why they occur in some locations and not others. Understanding biotic and abiotic factors promoting bark beetle outbreaks can be critical to predicting and responding to pest outbreaks. Here we address the environmental factors which are associated with Ips confusus outbreaks during the 2002 widespread drought within the distribution range of pinyon pine woodlands in Arizona. We used univariate statistics to test if whether tree characteristics, other herbivores, stand properties, soil type, wind, and topography were associated with I. confusus outbreak, and logistic regression to create a predictive model for the outbreaks. We found that I. confusus attacks occur in low elevation stands on steeper slopes, where favorable winds for I. confusus dispersion occur. I. confusus select larger trees, in high density stands with understory shrubs that exhibit phenotypic traits characteristic of resistance to stem-boring moths. The model was highly accurate, and explained 95% of the variability in occurrence (98% of the absences and 95% of the presences). Accurate prediction of the impacts of disturbance allow us to anticipate, minimize or mitigate for and eventually counteract its effects, especially those affecting diversity and ecosystem function. Identification of outbreak risk areas can guide regional and national management towards the reduction of infestation risk and enhancing conservation of pinyon-juniper woodlands.

  19. Tracking and visualization of space-time activities for a micro-scale flu transmission study.

    Science.gov (United States)

    Qi, Feng; Du, Fei

    2013-02-07

    Infectious diseases pose increasing threats to public health with increasing population density and more and more sophisticated social networks. While efforts continue in studying the large scale dissemination of contagious diseases, individual-based activity and behaviour study benefits not only disease transmission modelling but also the control, containment, and prevention decision making at the local scale. The potential for using tracking technologies to capture detailed space-time trajectories and model individual behaviour is increasing rapidly, as technological advances enable the manufacture of small, lightweight, highly sensitive, and affordable receivers and the routine use of location-aware devices has become widespread (e.g., smart cellular phones). The use of low-cost tracking devices in medical research has also been proved effective by more and more studies. This study describes the use of tracking devices to collect data of space-time trajectories and the spatiotemporal processing of such data to facilitate micro-scale flu transmission study. We also reports preliminary findings on activity patterns related to chances of influenza infection in a pilot study. Specifically, this study employed A-GPS tracking devices to collect data on a university campus. Spatiotemporal processing was conducted for data cleaning and segmentation. Processed data was validated with traditional activity diaries. The A-GPS data set was then used for visual explorations including density surface visualization and connection analysis to examine space-time activity patterns in relation to chances of influenza infection. When compared to diary data, the segmented tracking data demonstrated to be an effective alternative and showed greater accuracies in time as well as the details of routes taken by participants. A comparison of space-time activity patterns between participants who caught seasonal influenza and those who did not revealed interesting patterns. This study

  20. Google Flu Trends Spatial Variability Validated Against Emergency Department Influenza-Related Visits.

    Science.gov (United States)

    Klembczyk, Joseph Jeffrey; Jalalpour, Mehdi; Levin, Scott; Washington, Raynard E; Pines, Jesse M; Rothman, Richard E; Dugas, Andrea Freyer

    2016-06-28

    Influenza is a deadly and costly public health problem. Variations in its seasonal patterns cause dangerous surges in emergency department (ED) patient volume. Google Flu Trends (GFT) can provide faster influenza surveillance information than traditional CDC methods, potentially leading to improved public health preparedness. GFT has been found to correlate well with reported influenza and to improve influenza prediction models. However, previous validation studies have focused on isolated clinical locations. The purpose of the study was to measure GFT surveillance effectiveness by correlating GFT with influenza-related ED visits in 19 US cities across seven influenza seasons, and to explore which city characteristics lead to better or worse GFT effectiveness. Using Healthcare Cost and Utilization Project data, we collected weekly counts of ED visits for all patients with diagnosis (International Statistical Classification of Diseases 9) codes for influenza-related visits from 2005-2011 in 19 different US cities. We measured the correlation between weekly volume of GFT searches and influenza-related ED visits (ie, GFT ED surveillance effectiveness) per city. We evaluated the relationship between 15 publically available city indicators (11 sociodemographic, two health care utilization, and two climate) and GFT surveillance effectiveness using univariate linear regression. Correlation between city-level GFT and influenza-related ED visits had a median of .84, ranging from .67 to .93 across 19 cities. Temporal variability was observed, with median correlation ranging from .78 in 2009 to .94 in 2005. City indicators significantly associated (P<.10) with improved GFT surveillance include higher proportion of female population, higher proportion with Medicare coverage, higher ED visits per capita, and lower socioeconomic status. GFT is strongly correlated with ED influenza-related visits at the city level, but unexplained variation over geographic location and time

  1. All that glitters is not gold - founder effects complicate associations of flu mutations to disease severity

    Directory of Open Access Journals (Sweden)

    Eisenhaber Frank

    2010-11-01

    Full Text Available Abstract Background The recent 2009 (H1N1 influenza A pandemic saw a rapid spread of the virus to essentially all parts of the world. In the course of its evolution, the virus acquired many mutations, some of which have been investigated in the context of increased severity due to high occurrences in fatal cases. For example, statements such as: "42.9% of individuals who died from laboratory-confirmed cases of the pandemic (H1N1 were infected with the hemagglutinin (HA Q310 H mutant virus." give the impression that HA-Q310 H would be highly dangerous or important, while careful consideration of all available data suggests that this is unlikely to be the case. Results We compare the mutations HA-Q310 H, PB2-K340N, HA-D239N and HA-D239G using whole genome phylogenetic trees, structural modeling in their 3 D context and complete epidemiological data from sequences to clinical outcomes. HA-Q310 H and PB2-K340N appear as isolated subtrees in the phylogenetic analysis pointing to founder effects which is consistent with their clustered temporal appearance as well as the lack of an immediate structural basis that could explain a change of phenotypes. Considering the prevailing viral genomic background, shared origin of samples (all from the city of Sao Paulo and narrow temporal window (all death case samples within 1 month, it becomes clear that HA-Q310 H was actually a generally common mutation in the region at that time which could readily explain its increased occurrence among the few analyzed fatal cases without requiring necessarily an association with severity. In further support of this, we highlight 3 mild cases with the HA-Q310 H mutation. Conclusions We argue that claims of severity of any current and future flu mutation need to be critically considered in the light of phylogenetic, structural and detailed epidemiological data to distinguish increased occurrence due to possible founder effects rather than real phenotypic changes.

  2. Tracking and visualization of space-time activities for a micro-scale flu transmission study

    Directory of Open Access Journals (Sweden)

    Qi Feng

    2013-02-01

    Full Text Available Abstract Background Infectious diseases pose increasing threats to public health with increasing population density and more and more sophisticated social networks. While efforts continue in studying the large scale dissemination of contagious diseases, individual-based activity and behaviour study benefits not only disease transmission modelling but also the control, containment, and prevention decision making at the local scale. The potential for using tracking technologies to capture detailed space-time trajectories and model individual behaviour is increasing rapidly, as technological advances enable the manufacture of small, lightweight, highly sensitive, and affordable receivers and the routine use of location-aware devices has become widespread (e.g., smart cellular phones. The use of low-cost tracking devices in medical research has also been proved effective by more and more studies. This study describes the use of tracking devices to collect data of space-time trajectories and the spatiotemporal processing of such data to facilitate micro-scale flu transmission study. We also reports preliminary findings on activity patterns related to chances of influenza infection in a pilot study. Methods Specifically, this study employed A-GPS tracking devices to collect data on a university campus. Spatiotemporal processing was conducted for data cleaning and segmentation. Processed data was validated with traditional activity diaries. The A-GPS data set was then used for visual explorations including density surface visualization and connection analysis to examine space-time activity patterns in relation to chances of influenza infection. Results When compared to diary data, the segmented tracking data demonstrated to be an effective alternative and showed greater accuracies in time as well as the details of routes taken by participants. A comparison of space-time activity patterns between participants who caught seasonal influenza and those who

  3. Fluência e compreensão na leitura de textos: um estudo com crianças do 4º ano do ensino fundamental

    OpenAIRE

    Puliezi, Sandra

    2015-01-01

    Estudos atuais sobre leitura mostram que existe uma relação muito forte entre compreensão e fluência na leitura, a ponto de haver influência de uma sobre a outra. Com o intuito de contribuir para o crescimento desse conhecimento, conduzimos um estudo para investigar relações entre a compreensão de textos e a fluência na leitura de crianças brasileiras que cursam o 4º ano do ensino fundamental. Os objetivos foram: verificar os efeitos de uma intervenção em compreensão; verificar os efeitos de ...

  4. Programa "Leitores do futuro" : automodelagem e leitura assistida na promoção da fluência na leitura oral

    OpenAIRE

    Agostinho, Ana Lúcia Correia

    2012-01-01

    Tese de mestrado, Psicologia (Secção de Psicologia da Educação e da Orientação), Universidade de Lisboa, Faculdade de Psicologia, 2012 A fluência na leitura oral constitui uma componente crítica da leitura proficiente, uma vez que contribui para a compreensão. Até ao 3.º ano, todos os alunos devem desenvolver competências de fluência, para que depois possam utilizar a leitura como ferramenta de aprendizagem. Torna-se, assim, imperativo identificar os alunos que apresentam dificuldades na l...

  5. [Flu symptoms and preventive measures practiced by the inhabitants of Mexico City during the AH1N1 influenza epidemic].

    Science.gov (United States)

    Cruz-Licea, Verónica; González-Domínguez, Fernando; Avila, Guillermina; Flisser, Ana

    2013-01-01

    To know the frequency of flu symptoms and describe preventive measures practiced by the inhabitants of Mexico City during the AH1N1 epidemic. A cross-sectional design was used and a survey containing demographic and health information was conducted in August and September 2009 in a sample of 4003 randomly selected people living in Mexico City. Referred flu symptoms were: 29% running nose, 25% cough, 25% throat infection, 17% muscle and joint pain, 10% respiratory problems, and 7% fever. Also 16% said having hypertension, 10% diabetes, and 2% morbid obesity. Among the preventive measures, 74% washed hands, 32% covered the nose and mouth with the forearm when coughing or sneezing, 28% used sanitizer gel five times a day in average, and 47% did not greet with a kiss or handshake. Almost all the population followed preventive measures and did not show high percentages of influenza symptoms. Useful elements for prevention were identified, such as the frequency of seasonal influenza vaccination, self-medication, and living with a person diagnosed with AH1N1. It is important to continue with mass communication to strengthen adequate hygiene and health measures.

  6. An effective quarantine measure reduced the total incidence of influenza A H1N1 in the workplace: another way to control the H1N1 flu pandemic.

    Science.gov (United States)

    Miyaki, Koichi; Sakurazawa, Hirofumi; Mikurube, Hajime; Nishizaka, Mika; Ando, Hidehiko; Song, Yixuan; Shimbo, Takuro

    2011-01-01

    To evaluate the effectiveness of a non-vaccine quarantine measure against pandemic influenza A H1N1 in workplaces. Design was quasi-cluster randomized controlled trial in two sibling companies (Cohort 1 n=6,634, Cohort 2 n=8,500). The follow-up period was from July 1st, 2009 to February 19th, 2010 (233 days). Intervention was voluntary waiting at home on full pay if the family became Influenza like Illness (ILI). The incidences of influenza A H1N1 and those of the subgroups whose families got ILI in both cohorts were compared by a Cox regression model and log-rank test. There were 189 and 270 workers who got H1N1 infection during the follow-up period in each cohort. In this period 317 workers in Cohort 1 were asked to wait at home for several days (100% obeyed). The intervention group (Cohort 1) showed a statistically significant lower risk (p for log-rank test=0.033) compared with the control (Cohort 2), and the hazard ratio of the intervention was 0.799 [0.658-0.970] after adjusting for age, sex, BMI and smoking status. The workers who were asked to wait at home showed H1N1 infection more frequently (49 out of 317) compared with the workers whose family got ILI but were not asked to wait and work regularly (77 out of 990, RR=2.17 [1.48-3.18]). The waiting on full pay policy in the workplace reduced the overall risk of influenza A H1N1 by about 20% in one flu season in Japan. This kind of non-vaccine measure will be a promising option in workplaces to control the next flu pandemic.

  7. October 2012 Multistate Fungal Meningitis Outbreak

    Centers for Disease Control (CDC) Podcasts

    2012-10-17

    This podcast gives an overview of the October 2012 multistate fungal meningitis outbreak, including symptoms to watch for and a website for up-to-date information.  Created: 10/17/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 10/17/2012.

  8. Transmission Models of Historical Ebola Outbreaks

    OpenAIRE

    Drake, John M.; Bakach, Iurii; Just, Matthew R.; O?Regan, Suzanne M.; Gambhir, Manoj; Fung, Isaac Chun-Hai

    2015-01-01

    To guide the collection of data under emergent epidemic conditions, we reviewed compartmental models of historical Ebola outbreaks to determine their implications and limitations. We identified future modeling directions and propose that the minimal epidemiologic dataset for Ebola model construction comprises duration of incubation period and symptomatic period, distribution of secondary cases by infection setting, and compliance with intervention recommendations.

  9. E. Coli: Preventing Outbreaks at Camp.

    Science.gov (United States)

    McKinney, Mary D.

    1996-01-01

    One strain of E. coli is not usually found in foods, but has been related to consumption of undercooked ground beef. Symptoms are stomach cramps and diarrhea, and 2-7% of infections lead to hemolytic uremic syndrome, which is life threatening. Camps can prevent outbreaks by avoiding uncooked meat on overnight campouts and requiring appropriate…

  10. the first outbreak of somali piracy

    African Journals Online (AJOL)

    plt

    represented a significant change from previous years, when pirate attacks had been sporadic and opportunistic. ... Previous studies addressing the outbreak have linked it to the stability of central. Somalia in 2005.2 ...... the ICU polity.k Concurrent with the organisation's territorial control evaporating followed a steady uptake ...

  11. Canine Distemper Outbreak in Rhesus Monkeys, China

    Science.gov (United States)

    Qiu, Wei; Zheng, Ying; Zhang, Shoufeng; Fan, Quanshui; Liu, Hua; Zhang, Fuqiang; Wang, Wei; Liao, Guoyang

    2011-01-01

    Since 2006, canine distemper outbreaks have occurred in rhesus monkeys at a breeding farm in Guangxi, People’s Republic of China. Approximately 10,000 animals were infected (25%–60% disease incidence); 5%–30% of infected animals died. The epidemic was controlled by vaccination. Amino acid sequence analysis of the virus indicated a unique strain. PMID:21801646

  12. First Outbreak of Dengue Hemorrhagic Fever, Bangladesh

    OpenAIRE

    Rahman, Mahbubur; Rahman, Khalilur; Siddque, A. K.; Shoma, Shereen; Kamal, A. H. M.; Ali, K. S.; Nisaluk, Ananda; Breiman, Robert F.

    2002-01-01

    During the first countrywide outbreak of dengue hemorrhagic fever in Bangladesh, we conducted surveillance for dengue at a hospital in Dhaka. Of 176 patients, primarily adults, found positive for dengue, 60.2% had dengue fever, 39.2% dengue hemorrhagic fever, and 0.6% dengue shock syndrome. The Dengue virus 3 serotype was detected in eight patients.

  13. Lessons in Outbreak a Consumer perspective

    NARCIS (Netherlands)

    Fischer, A.R.H.

    2008-01-01

    Lessons in Outbreak a Consumer perspective. Arnout Fischer Consumer risk perceptions is not necessarily the same as an economic weighing of risks and benefits. Consumers tend to be risk averse, tend to estimate catastrophic, unnatural or involuntary risks as larger, while personal lifestyle risks

  14. Acute haemorrhagic conjunctivitis epidemics and outbreaks of ...

    African Journals Online (AJOL)

    An epidemic of acute conjunctivitis in Dar es Salaam in 2010 demonstrated the importance of a strong infectious diseases epidemiological surveillance network to minimise disease outbreaks. Misunderstanding of the causes and management of diseases explains the repetitive nature of acute haemorrhagic conjunctivitis ...

  15. Fish and Shellfish Associated Disease Outbreaks.

    Science.gov (United States)

    Levin, M.

    1978-01-01

    Presents a literature review of disease outbreaks related to fish and shellfish, covering publications of 1976-77. This review covers the chemical, bacterial, and viral diseases that are transmitted by fish and shellfish. A list of 50 references is also presented. (HM)

  16. Rift Valley fever outbreak, southern Mauritania, 2012.

    Science.gov (United States)

    Sow, Abdourahmane; Faye, Ousmane; Ba, Yamar; Ba, Hampathé; Diallo, Diawo; Faye, Oumar; Loucoubar, Cheikh; Boushab, Mohamed; Barry, Yahya; Diallo, Mawlouth; Sall, Amadou Alpha

    2014-02-01

    After a period of heavy rainfall, an outbreak of Rift Valley fever occurred in southern Mauritania during September-November 2012. A total of 41 human cases were confirmed, including 13 deaths, and 12 Rift Valley fever virus strains were isolated. Moudjeria and Temchecket Departments were the most affected areas.

  17. Outbreak of Zika Virus Infections, Dominica, 2016.

    Science.gov (United States)

    Ryan, Sadie J; Carlson, Colin J; Stewart-Ibarra, Anna M; Borbor-Cordova, Mercy J; Romero, Moory M; Cox, Shelly-Ann; Mahon, Roché; Trotman, Adrian; St Ville, Sylvester; Ahmed, Shalauddin

    2017-11-01

    In February 2016, the World Health Organization declared the pandemic of Zika virus a public health emergency. On March 4, 2016, Dominica reported its first autochthonous Zika virus disease case; subsequently, 1,263 cases were reported. We describe the outbreak through November 2016, when the last known case was reported.

  18. Outbreak of Zika Virus Infections, Dominica, 2016

    OpenAIRE

    Ryan, Sadie J.; Carlson, Colin J.; Stewart-Ibarra, Anna M.; Borbor-Cordova, Mercy J.; Romero, Moory M.; Cox, Shelly-Ann; Mahon, Roché; Trotman, Adrian; St. Ville, Sylvester; Ahmed, Shalauddin

    2017-01-01

    In February 2016, the World Health Organization declared the pandemic of Zika virus a public health emergency. On March 4, 2016, Dominica reported its first autochthonous Zika virus disease case; subsequently, 1,263 cases were reported. We describe the outbreak through November 2016, when the last known case was reported.

  19. Quantifying reporting timeliness to improve outbreak control

    NARCIS (Netherlands)

    Bonačić Marinović, Axel; Swaan, Corien; van Steenbergen, Jim; Kretzschmar, MEE

    The extent to which reporting delays should be reduced to gain substantial improvement in outbreak control is unclear. We developed a model to quantitatively assess reporting timeliness. Using reporting speed data for 6 infectious diseases in the notification system in the Netherlands, we calculated

  20. How Will Climate Change Impact Cholera Outbreaks?

    Science.gov (United States)

    Nasr Azadani, F.; Jutla, A.; Rahimikolu, J.; Akanda, A. S.; Huq, A.; Colwell, R. R.

    2014-12-01

    Environmental parameters associated with cholera are well documented. However, cholera continues to be a global public health threat. Uncertainty in defining environmental processes affecting growth and multiplication of the cholera bacteria can be affected significantly by changing climate at different temporal and spatial scales, either through amplification of the hydroclimatic cycle or by enhanced variability of large scale geophysical processes. Endemic cholera in the Bengal Delta region of South Asia has a unique pattern of two seasonal peaks and there are associated with asymmetric and episodic variability in river discharge. The first cholera outbreak in spring is related with intrusion of bacteria laden coastal seawater during low river discharge. Cholera occurring during the fall season is hypothesized to be associated with high river discharge related to a cross-contamination of water resources and, therefore, a second wave of disease, a phenomenon characteristic primarily in the inland regions. Because of difficulties in establishing linkage between coarse resolutions of the Global Climate Model (GCM) output and localized disease outbreaks, the impact of climate change on diarrheal disease has not been explored. Here using the downscaling method of Support Vector Machines from HADCM3 and ECHAM models, we show how cholera outbreak patterns are changing in the Bengal Delta. Our preliminary results indicate statistically significant changes in both seasonality and magnitude in the occurrence of cholera over the next century. Endemic cholera is likely to transform into epidemic forms and new geographical areas will be at risk for cholera outbreaks.

  1. EPIDEMIOLOGY OF CHOLERA OUTBREAK IN KAMPALA ...

    African Journals Online (AJOL)

    hi-tech

    The occurrence of cases concentrated in the slums where the overcrowding and the environmental conditions resembled a refugee camp situation. Conclusion: The explosive development of the cholera outbreak in Kampala, followed by a rapid decrease of the number of cases reported is unusual in a large urban setting.

  2. Pneumonia outbreaks in calves and finishers.

    Science.gov (United States)

    2016-03-19

    Pneumonia in calves and finishers. Ovarian tumour in a calf . Abortion associated with bovine herpesvirus 1 in a suckler herd. Parasitic gastroenteritis causing illthrift and death in sheep. Outbreaks of acute fasciolosis in sheep. These are among matters discussed in the disease surveillance report for December 2015 from SAC Consulting: Veterinary Services (SAC C VS). British Veterinary Association.

  3. An Outbreak of Chikungunya in Rural Bangladesh, 2011

    Science.gov (United States)

    Khatun, Selina; Chakraborty, Apurba; Rahman, Mahmudur; Nasreen Banu, Nuzhat; Rahman, Mohammad Mostafizur; Hasan, S. M. Murshid; Luby, Stephen P.; Gurley, Emily S.

    2015-01-01

    Background The first identified Chikungunya outbreak occurred in Bangladesh in 2008. In late October 2011, a local health official from Dohar Sub-district, Dhaka District, reported an outbreak of undiagnosed fever and joint pain. We investigated the outbreak to confirm the etiology, describe the clinical presentation, and identify associated vectors. Methodology During November 2–21, 2011, we conducted house-to-house surveys to identify suspected cases, defined as any inhabitant of Char Kushai village with fever followed by joint pain in the extremities with onset since August 15, 2011. We collected blood specimens and clinical histories from self-selected suspected cases using a structured questionnaire. Blood samples were tested for IgM antibodies against Chikungunya virus. The village was divided into nine segments and we collected mosquito larvae from water containers in seven randomly selected houses in each segment. We calculated the Breteau index for the village and identified the mosquito species. Results The attack rate was 29% (1105/3840) and 29% of households surveyed had at least one suspected case: 15% had ≥3. The attack rate was 38% (606/1589) in adult women and 25% in adult men (320/1287). Among the 1105 suspected case-patients, 245 self-selected for testing and 80% of those (196/245) had IgM antibodies. In addition to fever and joint pain, 76% (148/196) of confirmed cases had rash and 38%(75/196) had long-lasting joint pain. The village Breteau index was 35 per 100 and 89%(449/504) of hatched mosquitoes were Aedes albopictus. Conclusion The evidence suggests that this outbreak was due to Chikungunya. The high attack rate suggests that the infection was new to this area, and the increased risk among adult women suggests that risk of transmission may have been higher around households. Chikungunya is an emerging infection in Bangladesh and current surveillance and prevention strategies are insufficient to mount an effective public health response

  4. [Epidemic and control strategy on nosocomial outbreak of norovirus gastroenteritis].

    Science.gov (United States)

    Xu, Qian

    2008-10-01

    Noroviruses are the leading cause of acute viral gastroenteritis in human beings and frequently cause the outbreaks of nosocomial infections. Based on the pathogenic characteristics of noroviruses, this article describes the epidemiological and clinical characteristics of norovirus gastroenteritis outbreak in hospital and explores the measures to prevent and control the nosocomial outbreak.

  5. Management of Nosocomial Scabies, an Outbreak of Occupational Disease

    NARCIS (Netherlands)

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

    Background The optimal approach to managing institutional scabies outbreaks has yet to be defined. We report on outbreak managements are needed. Methods We report on a large outbreak of scabies in three acute care wards in a tertiary university teaching hospital in the Netherlands. Results The

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

    Science.gov (United States)

    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.

  7. EDITORIAL Listeriosis outbreak in South Africa: Are we winning the ...

    African Journals Online (AJOL)

    outbreak has topped the charts as the largest outbreak in history. The first reported case of the current outbreak of listeriosis was in January. 2017. On 27 Feb 2018, the ... in the processed meat sections of food retailers and butcheries, should be ... antibiotics, primarily ampicillin and gentamicin, to which the organism is ...

  8. Cholera outbreak in districts around Lake Chilwa, Malawi: Lessons ...

    African Journals Online (AJOL)

    Cholera is endemic in Malawi with seasonal outbreaks during the wet season. People living around Lake Chilwa rely on the lake for their water supply. From May 2009 to May 2010, a cholera outbreak occurred in fishing communities around Lake Chilwa. This paper describes the outbreak response and lessons learned for ...

  9. Outbreak of Rift Valley fever affecting veterinarians and farmers in ...

    African Journals Online (AJOL)

    Background. During 2008, Rift Valley fever (RVF) virus re-emerged in South Africa as focal outbreaks in several provinces. Aims. To investigate an outbreak affecting cattle farmers and farm workers, and the staff and students of a veterinary school, assess the prevalence of infection during the outbreak, document the clinical ...

  10. A study of the 2006 Chikungunya epidemic outbreak in Mauritius ...

    African Journals Online (AJOL)

    Chikungunya epidemic outbreaks have affected more than 1 million people in 2005-2006 in many Indian Ocean islands and in India. Mauritius experienced a major outbreak in February/March 2006 following a minor outbreak in April/May 2005. No cases have been registered on the island since August 2006.

  11. Grasshopper species composition shifts following a severe rangeland grasshopper outbreak

    Science.gov (United States)

    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...

  12. Evidence of compounded disturbance effects on vegetation recovery following high-severity wildfire and spruce beetle outbreak

    Science.gov (United States)

    Carlson, Amanda R.; Sibold, Jason S.; Assal, Timothy J.; Negrón, José F.

    2017-01-01

    Spruce beetle (Dendroctonus rufipennis) outbreaks are rapidly spreading throughout subalpine forests of the Rocky Mountains, raising concerns that altered fuel structures may increase the ecological severity of wildfires. Although many recent studies have found no conclusive link between beetle outbreaks and increased fire size or canopy mortality, few studies have addressed whether these combined disturbances produce compounded effects on short-term vegetation recovery. We tested for an effect of spruce beetle outbreak severity on vegetation recovery in the West Fork Complex fire in southwestern Colorado, USA, where much of the burn area had been affected by severe spruce beetle outbreaks in the decade prior to the fire. Vegetation recovery was assessed using the Landsat-derived Normalized Difference Vegetation Index (NDVI) two years after the fire, which occurred in 2013. Beetle outbreak severity, defined as the basal area of beetle-killed trees within Landsat pixels, was estimated using vegetation index differences (dVIs) derived from pre-outbreak and post-outbreak Landsat images. Of the seven dVIs tested, the change in Normalized Difference Moisture Index (dNDMI) was most strongly correlated with field measurements of beetle-killed basal area (R2 = 0.66). dNDMI was included as an explanatory variable in sequential autoregressive (SAR) models of NDVI2015. Models also included pre-disturbance NDVI, topography, and weather conditions at the time of burning as covariates. SAR results showed a significant correlation between NDVI2015 and dNDMI, with more severe spruce beetle outbreaks corresponding to reduced post-fire vegetation cover. The correlation was stronger for models which were limited to locations in the red stage of outbreak (outbreak ≤ 5 years old at the time of fire) than for models of gray-stage locations (outbreak > 5 years old at the time of fire). These results indicate that vegetation recovery processes may be negatively impacted by severe

  13. An outbreak of leptospirosis among Peruvian military recruits.

    Science.gov (United States)

    Russell, Kevin L; Montiel Gonzalez, Marco A; Watts, Douglas M; Lagos-Figueroa, Roberto C; Chauca, Gloria; Ore, Marianela; Gonzalez, Jose E; Moron, Cecilia; Tesh, Robert B; Vinetz, Joseph M

    2003-07-01

    Acute undifferentiated febrile illnesses are common in tropical developing countries but are difficult to diagnose on clinical grounds alone. Leptospirosis is rarely diagnosed, despite evidence that sporadic cases and epidemics continue to occur worldwide. The purpose of this study was to diagnose an outbreak of acute undifferentiated febrile illness among Peruvian military recruits that developed after a training exercise in the high jungle rainforest of Peru. Of 193 military recruits, 78 developed an acute febrile illness with varied manifestations. Of these, 72 were found to have acute leptospirosis by a microscopic agglutination test (MAT). An enzyme-linked immunosorbent assay using Leptospira biflexa antigen was insensitive for the detection of anti-leptospiral IgM antibodies compared with the MAT (20 of 72, 28%). This outbreak of acute undifferentiated febrile illness among Peruvian military recruits was due to leptospirosis. High clinical suspicion, initiation of preventative measures, and performance of appropriate diagnostic testing is warranted in similar settings to identify, treat, and prevent leptospirosis.

  14. A Review of OIE Country Status Recovery Using Vaccinate-to-Live Versus Vaccinate-to-Die Foot-and-Mouth Disease Response Policies I: Benefits of Higher Potency Vaccines and Associated NSP DIVA Test Systems in Post-Outbreak Surveillance.

    Science.gov (United States)

    Barnett, P V; Geale, D W; Clarke, G; Davis, J; Kasari, T R

    2015-08-01

    To rapidly return to trade, countries with OIE status, FMD-free country where vaccination is not practised, have destroyed emergency vaccinated animals, raising ethical concerns with respect to social values, the environment, animal welfare and global food security. This two-part review explores whether science could support eligibility to return to previous OIE status in 3 months irrespective of vaccinate-to-live or vaccinate-to-die policies. Here, we examine the benefits of higher potency (≥ 6 PD50 ), high-purity vaccines formulated from antigen banks for emergency use, their efficacy and performance in differentiating infected from vaccinated animals (DIVA) assays for post-outbreak surveillance. From an intensive programme of research, we conclude that high-quality, higher potency vaccines are proven to reduce FMD virus (FMDV) subclinical circulation and the risk of carriers. Broader coverage than predicted by serology suggests the potential to hold a few 'key' vaccine strains improving logistics and reducing the financial burden of antigen banks. The OIE should adopt formal definitions for emergency vaccination and emergency vaccines. In terms of supportive tools, we consider that the lack of OIE recognition of DIVA tests other than those of PANAFTOSA in cattle is a shortcoming. There is need for research on maternal antibody interference with DIVA tests and on the use of such tests to establish whether greater purification of vaccines improves performance. We consider that alignment of waiting periods for vaccinate-to-live and vaccinate-to-die in OIE Code Article 8.5.9 1 b. and c. is feasible until an acceptable level of statistical certainty for surveillance or target probability of freedom is established to substantiate the absence of FMDV infection or circulation. It is surveillance intensity rather than waiting periods that establishes the risk of residual FMDV. EU Directive 2003/85/EC implicitly recognizes this, permitting derogation of the OIE waiting

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

    Directory of Open Access Journals (Sweden)

    Junyan Qu

    2016-01-01

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

  16. Investigating an outbreak of staphylococcal food poisoning among travellers across two Australian states.

    Science.gov (United States)

    Fletcher, Stephanie; Boonwaat, Leng; Moore, Terry; Chavada, Ruchir; Conaty, Stephen

    2015-01-01

    Staphylococcus aureus is a common cause of staphylococcal food poisoning in Australia with several outbreaks associated with foods prepared by commercial caterers. Laboratory testing on cases of gastrointestinal illness caused by enterotoxin-producing S. aureus is not routinely done as this condition is self-limiting. Hence outbreaks of such illness may go undetected. A retrospective cohort study was conducted among a group of tourists who were hospitalized in Sydney shortly after flying from Queensland. The group had consumed food prepared by a restaurant on the Gold Coast before transit. Laboratory analyses on stool specimens were conducted in Sydney. An environmental assessment of the restaurant in the Gold Coast was conducted, and environmental specimens were assessed for contamination. Epidemiological investigations linked the outbreak to a restaurant in the Gold Coast where the suspected food was produced. Stool samples from two of the hospitalized cases were confirmed to have enterotoxin-producing S. aureus, and several environmental samples were found to be contaminated with S. aureus as well. Investigations suggested that absence of hand washing and other unhygienic food handling at the implicated restaurant was the likely cause of this outbreak. Food poisoning due to toxin-mediated S. aureus is frequently undetected and underreported. Public health units should consider toxin-producing pathogens such as S. aureus when investigating outbreaks where vomiting is the predominant symptom and occurs rapidly after consuming food.

  17. Investigating an outbreak of staphylococcal food poisoning among travellers across two Australian states

    Directory of Open Access Journals (Sweden)

    Stephanie Fletcher

    2015-05-01

    Full Text Available Introduction: Staphylococcus aureus is a common cause of staphylococcal food poisoning in Australia with several outbreaks associated with foods prepared by commercial caterers. Laboratory testing on cases of gastrointestinal illness caused by enterotoxin-producing S. aureus is not routinely done as this condition is self-limiting. Hence outbreaks of such illness may go undetected. Methods: A retrospective cohort study was conducted among a group of tourists who were hospitalized in Sydney shortly after flying from Queensland. The group had consumed food prepared by a restaurant on the Gold Coast before transit. Laboratory analyses on stool specimens were conducted in Sydney. An environmental assessment of the restaurant in the Gold Coast was conducted, and environmental specimens were assessed for contamination. Results: Epidemiological investigations linked the outbreak to a restaurant in the Gold Coast where the suspected food was produced. Stool samples from two of the hospitalized cases were confirmed to have enterotoxin-producing S. aureus, and several environmental samples were found to be contaminated with S. aureus as well. Investigations suggested that absence of hand washing and other unhygienic food handling at the implicated restaurant was the likely cause of this outbreak. Conclusion: Food poisoning due to toxin-mediated S. aureus is frequently undetected and underreported. Public health units should consider toxin-producing pathogens such as S. aureus when investigating outbreaks where vomiting is the predominant symptom and occurs rapidly after consuming food.

  18. Investigating an outbreak of acute fever in Chuuk, Federated States of Micronesia

    Directory of Open Access Journals (Sweden)

    Damian Hoy

    2014-11-01

    Full Text Available Objective: In September 2012, there was an unexpected increase of acute febrile illness (AFI in Chuuk State of the Federated States of Micronesia. At the same time, dengue outbreaks were occurring in two of the Federated States of Micronesia’s other three states. The cause of AFI was suspected to be dengue; however, by the end of October, only one of 39 samples was positive for dengue. The objective of the investigation was to establish the cause of the outbreak. Methods: A line list was created and data analysed by time, place, person and clinical features. Reported symptoms were compared with the published symptoms of several diagnoses and laboratory testing undertaken. Results: Of the 168 suspected cases, 62% were less than 20 years of age and 60% were male. The clinical features of the cases were not typical for dengue but suggestive of respiratory illness. Nasopharyngeal swabs were subsequently collected and found to be positive for influenza. Public health measures were undertaken and the AFI returned to expected levels. Discussion: Clinical diagnosis of acute febrile illness (AFI can often be difficult and misleading. This can mean that opportunities for preventive measures early on in an outbreak are missed. In any outbreak, descriptive epidemiological analyses are valuable in helping to ascertain the cause of the outbreak.

  19. Outbreaks of Virulent Infectious Bursal Disease in Flocks of Battery Cage Brooding System of Commercial Chickens

    Directory of Open Access Journals (Sweden)

    H. B. Aliyu

    2016-01-01

    Full Text Available Clinical and pathological investigations were conducted on outbreaks of infectious bursal disease (IBD in pullets under brooding using the battery cage system in a commercial poultry farm in Kaduna, Nigeria. Two consecutive outbreaks of IBD on the same farm were studied. The onset of the disease and morbidity and mortality rates were recorded. Postmortem examinations were conducted and gross lesions recorded. Tissues were collected and fixed in 10% buffered formalin and processed for histopathological examinations. In the first outbreak, 80 to 100% of the chicks were affected at the age of 4 to 5 weeks and mortality rate was 95.8% and lasted for 9 days. In the second outbreak, the mortality rate was 43.3% and it also lasted for 9 days. At the onset of the disease, the birds were also 4-week-old like in case 1. The disease was diagnosed based on clinical signs, pathology, and agar gel immunodiffusion test (AGID. Clinical signs, gross lesions, and histopathological findings were characteristic of virulent infectious bursal disease. After the first outbreak (case 1 the house was disinfected using polidine® (iodophor compound, V-ox® (inorganic peroxygen compounds, CID20® (quaternary ammonium chloride, aldehydes, and alcohol, terminator III® (phenols, and glutasan® (aldehyde and quaternary ammonium chloride. But they failed to eliminate the IBD virus from the poultry pen.

  20. An outbreak of food poisoning due to egg yolk reaction-negative Staphylococcus aureus.

    Science.gov (United States)

    Miwa, N; Kawamura, A; Masuda, T; Akiyama, M

    2001-03-20

    An outbreak of staphylococcal food poisoning due to an egg yolk (EY) reaction-negative strain occurred in Japan. Twenty-one of 53 dam construction workers who ate boxed lunches prepared at their company cafeteria became ill, and eight required hospital treatment. The outbreak showed a typical incubation time (1.5-4 h with a median time of 2.7 h) and symptoms (vomiting and diarrhea) of staphylococcal food poisoning. Staphylococcus aureus, which produces staphylococcal enterotoxin (SE) A, was isolated from four fecal specimens of eight patients tested. Scrambled egg in the boxed lunches contained 20-40 ng/g of SEA, and 3.0 x 10(9)/g of viable S. aureus cells that produced this toxin. All isolates from patients and the food were EY reaction-negative, coagulase type II, and showed the same restriction fragment length polymorphism (RFLP) pattern. We concluded that the outbreak was caused by scrambled egg contaminated with EY reaction-negative S. aureus. In Japan, outbreaks of staphylococcal food poisoning are mainly caused by EY reaction-positive S. aureus, and EY reaction-negative colonies grown on agar plates containing EY are usually not analyzed further for detection of S. aureus. The present outbreak suggested that EY reaction-negative isolates should be subjected to further analysis to detect the causative agents of staphylococcal food poisoning.

  1. Predicting the herd immunity threshold during an outbreak: a recursive approach.

    Directory of Open Access Journals (Sweden)

    Nathan T Georgette

    Full Text Available BACKGROUND: The objective was to develop a novel algorithm that can predict, based on field survey data, the minimum vaccination coverage required to reduce the mean number of infections per infectious individual to less than one (the Outbreak Response Immunization Threshold or ORIT from up to six days in the advance. METHODOLOGY/PRINCIPAL FINDINGS: First, the relationship between the rate of immunization and the ORIT was analyzed to establish a link. This relationship served as the basis for the development of a recursive algorithm that predicts the ORIT using survey data from two consecutive days. The algorithm was tested using data from two actual measles outbreaks. The prediction day difference (PDD was defined as the number of days between the second day of data input and the day of the prediction. The effects of different PDDs on the prediction error were analyzed, and it was found that a PDD of 5 minimized the error in the prediction. In addition, I developed a model demonstrating the relationship between changes in the vaccination coverage and changes in the individual reproduction number. CONCLUSIONS/SIGNIFICANCE: The predictive algorithm for the ORIT generates a viable prediction of the minimum number of vaccines required to stop an outbreak in real time. With this knowledge, the outbreak control agency may plan to expend the lowest amount of funds required stop an outbreak, allowing the diversion of the funds saved to other areas of medical need.

  2. An outbreak of Serratia liquefaciens at a rural health center in The Gambia.

    Science.gov (United States)

    Ikumapayi, Usman Nurudeen; Kanteh, Abdoulie; Manneh, Jarra; Lamin, Modou; Mackenzie, Grant Austin

    2016-08-31

    Healthcare-associated infections (HAIs) are better documented in developed than in developing countries. There are emerging reports regarding the high frequency of HAIs in developing countries. We aimed to report an outbreak of an HAI caused by Serratia liquefaciens at a rural health center in The Gambia. Following an abrupt increase in the isolation of S. liquefaciens in clinical samples, laboratory and clinical consumables, as well as staff, were screened for contamination with S. liquefaciens. Conventional microbiological techniques and biochemical identification tests were used. A phenotypic typing was achieved using the Kirby-Bauer antibiotic susceptibility method. Strategies to control the outbreak were implemented. A total of 794 samples were processed during the outbreak; 44 (6%) grew S. liquefaciens. Five (25%) of the 20 suspected contaminated materials (hospital consumables and equipment) screened yielded growth of the organism. The primary source of the outbreak was hospital consumables. Three (7%) of the 44 infected children died with no other known cause than S. liquefaciens infection. Ninety-nine percent similarity of the antibiogram phenotypic typing suggests the isolates were from the same clonal origin. The outbreak was successfully controlled after the removal and sterilization of the respective contaminated fluids and equipment. This HAI was caused by poor practice in the preparation of medications for nebulization and intravenous infusion, hygiene practices, and a lack of awareness among staff about infection control. We recommend further studies to delineate the role played by HAIs in the developing world.

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

    Science.gov (United States)

    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.

  4. An outbreak of infectious hepatitis in commercially reared ostriches associated with Campylobacter coli and Campylobacter jejuni

    DEFF Research Database (Denmark)

    Stephens, C.P.; On, S.L.W.; Gibson, J.A.

    1998-01-01

    ) typing of representative isolates indicated that trade of infected birds between farms was an important factor in the spread of C. coli. Phenotypic and genotypic data suggest a clonal variant of the principal outbreak type may account for the remaining cases from which C. coli was found. Conventional...... biochemical test results and PFGE clearly distinguished the C. jejuni strain isolated from the geographically remote farm from the outbreak of C. coli type. We believe this to be the first definitive report of avian hepatitis associated with C. coli....

  5. Test

    DEFF Research Database (Denmark)

    Bendixen, Carsten

    2014-01-01

    Bidrag med en kortfattet, introducerende, perspektiverende og begrebsafklarende fremstilling af begrebet test i det pædagogiske univers.......Bidrag med en kortfattet, introducerende, perspektiverende og begrebsafklarende fremstilling af begrebet test i det pædagogiske univers....

  6. Human angiostrongyliasis outbreak in Dali, China.

    Directory of Open Access Journals (Sweden)

    Shan Lv

    Full Text Available BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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. CONCLUSIONS/SIGNIFICANCE: 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

  7. Human Angiostrongyliasis Outbreak in Dali, China

    Science.gov (United States)

    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

    2009-01-01

    Background 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. Methodology/Principal Findings 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. Conclusions/Significance 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

  8. International outbreak of Salmonella Oranienburg due to German chocolate.

    Science.gov (United States)

    Werber, Dirk; Dreesman, Johannes; Feil, Fabian; van Treeck, Ulrich; Fell, Gerhard; Ethelberg, Steen; Hauri, Anja M; Roggentin, Peter; Prager, Rita; Fisher, Ian S T; Behnke, Susanne C; Bartelt, Edda; Weise, Ekkehard; Ellis, Andrea; Siitonen, Anja; Andersson, Yvonne; Tschäpe, Helmut; Kramer, Michael H; Ammon, Andrea

    2005-02-03

    This report describes a large international chocolate-associated Salmonella outbreak originating from Germany. We conducted epidemiologic investigations including a case-control study, and food safety investigations. Salmonella (S.) Oranienburg isolates were subtyped by the use of pulsed-field gel electrophoresis (PFGE). From 1 October 2001 through 24 March 2002, an estimated excess of 439 S. Oranienburg notifications was registered in Germany. Simultaneously, an increase in S. Oranienburg infections was noted in other European countries in the Enter-net surveillance network. In a multistate matched case-control study in Germany, daily consumption of chocolate (matched odds ratio [MOR]: 4.8; 95% confidence interval [CI]: 1.3-26.5), having shopped at a large chain of discount grocery stores (MOR: 4.2; CI: 1.2-23.0), and consumption of chocolate purchased there (MOR: 5.0; CI: 1.1-47.0) were associated with illness. Subsequently, two brands from the same company, one exclusively produced for that chain, tested positive for S. Oranienburg. In two other European countries and in Canada chocolate from company A was ascertained that also contained S. Oranienburg. Isolates from humans and from chocolates had indistinguishable PFGE profiles. No source or point of contamination was identified. Epidemiological identification of chocolate as a vehicle of infections required two months, and was facilitated by proxy measures. Despite the use of improved production technologies, the chocolate industry continues to carry a small risk of manufacturing Salmonella-containing products. Particularly in diffuse outbreak-settings, clear associations with surrogates of exposure should suffice to trigger public health action. Networks such as Enter-net have become invaluable for facilitating rapid and appropriate management of international outbreaks.

  9. International outbreak of Salmonella Oranienburg due to German chocolate

    Directory of Open Access Journals (Sweden)

    Weise Ekkehard

    2005-02-01

    Full Text Available Abstract Background This report describes a large international chocolate-associated Salmonella outbreak originating from Germany. Methods We conducted epidemiologic investigations including a case-control study, and food safety investigations. Salmonella (S. Oranienburg isolates were subtyped by the use of pulsed-field gel electrophoresis (PFGE. Results From 1 October 2001 through 24 March 2002, an estimated excess of 439 S. Oranienburg notifications was registered in Germany. Simultaneously, an increase in S. Oranienburg infections was noted in other European countries in the Enter-net surveillance network. In a multistate matched case-control study in Germany, daily consumption of chocolate (matched odds ratio [MOR]: 4.8; 95% confidence interval [CI]: 1.3–26.5, having shopped at a large chain of discount grocery stores (MOR: 4.2; CI: 1.2–23.0, and consumption of chocolate purchased there (MOR: 5.0; CI: 1.1–47.0 were associated with illness. Subsequently, two brands from the same company, one exclusively produced for that chain, tested positive for S. Oranienburg. In two other European countries and in Canada chocolate from company A was ascertained that also contained S. Oranienburg. Isolates from humans and from chocolates had indistinguishable PFGE profiles. No source or point of contamination was identified. Epidemiological identification of chocolate as a vehicle of infections required two months, and was facilitated by proxy measures. Conclusions Despite the use of improved production technologies, the chocolate industry continues to carry a small risk of manufacturing Salmonella-containing products. Particularly in diffuse outbreak-settings, clear associations with surrogates of exposure should suffice to trigger public health action. Networks such as Enter-net have become invaluable for facilitating rapid and appropriate management of international outbreaks.

  10. Deciphering an outbreak of drug-resistant Mycobacterium tuberculosis.

    Science.gov (United States)

    Dahle, Ulf R; Sandven, Per; Heldal, Einar; Mannsaaker, Turid; Caugant, Dominique A

    2003-01-01

    There have been ample warnings that multidrug-resistant (MDR) tuberculosis (TB) will continue to emerge if countries do not strengthen their control of TB. In low-incidence European countries, however, these warnings have been substantiated mainly by outbreaks in association with human immunodeficiency virus (HIV)-positive patients. The aim of this study was to investigate an outbreak of infection with MDR and drug-resistant Mycobacterium tuberculosis that was diagnosed among 20 HIV-negative patients living in Norway. Of these, 19 were immigrants from East Africa and one was an ethnic Norwegian. We wanted to find out if transmission had taken place in Norway or abroad and to identify the genetic basis of drug resistance. The strains were analyzed by IS6110 restriction fragment length polymorphism, antibiotic susceptibility tests, spoligotyping, reverse hybridization to regions of the rpoB gene, and sequencing of the katG gene. Epidemiological links between the patients were mapped, and the strains were compared to those isolated in 36 other countries and regions. All strains were resistant to isoniazid and carried Ala234Gly, Ser315Thr, and Arg463Leu substitutions in the katG gene. Eleven strains were MDR and carried a Ser531Leu substitution in the rpoB gene. MDR was acquired in the index patient after arrival in Norway. Links were found among 14 patients. The strain was imported from Somalia but acquired MDR and was transmitted in Norway. This demonstrated that MDR strains are not necessarily imported from high-incidence countries and can be highly communicable. The outbreak underscores a deficiency in the TB control measures employed in many countries and challenges the adequacy of the policy of screening immigrants for TB only on arrival.

  11. Mumps outbreaks in vaccinated populations: are available mumps vaccines effective enough to prevent outbreaks?

    Science.gov (United States)

    Dayan, Gustavo H; Rubin, Steven

    2008-12-01

    Increased reports of mumps in vaccinated populations prompted a review of the performance of mumps vaccines. The effectiveness of prior vaccination with 1 dose of vaccine ranged from 72.8% to 91% for the Jeryl Lynn strain, from 54.4% to 93% for the Urabe strain, and from 0% to 33% for the Rubini strain. Vaccine effectiveness after 2 doses of mumps vaccine was reported in 3 outbreaks and ranged from 91% to 94.6%. There was evidence of waning immunity, which is a likely factor in mumps outbreaks, aggravated by possible antigenic differences between the vaccine strain and outbreak strains. Inadequate vaccine coverage or use of the Rubini vaccine strain accounted for the majority of outbreaks reviewed; however, some outbreaks could not be prevented, despite high vaccination coverage with 2 doses of the Jeryl Lynn vaccine strain. Our findings indicate the need for more-effective mumps vaccines and/or for review of current vaccination policies to prevent future outbreaks.

  12. Buffalo pox outbreak with atypical features: a word of caution and need for early intervention!

    Science.gov (United States)

    Goyal, Tarang; Varshney, Anupam; Bakshi, Surrinder Kumar; Barua, Sanjay; Bera, Bidhan Chandra; Singh, Raj Kumar

    2013-10-01

    Despite repeated outbreaks of poxvirus infections unique to the Indian subcontinent region and veterinary research work in this field, much less diagnostic awareness with resultant treatment protocols have been formulated in the human medical field. With this objective in mind, a combined human medical and veterinary study was conducted on a recent outbreak of buffalopox infection in a village in northern India. A team of doctors did the clinical examination and collected swab and serum samples from both cattle and humans, and these were subjected to viral isolation, cell culture, plaque reduction neutralization test, polymerase chain reaction, and partial genome sequencing. A clustered foci of 12 human patients aged 11-60 years, 12 buffaloes, and 10 cows were found to be affected with buffalopox infection with some atypical features. Awareness, diagnosis, education, early intervention, and formulation of disaster guidelines are needed in view of the potential epidemiologic outbreak, if this happens in the future. © 2013 The International Society of Dermatology.

  13. Drought induced tree mortality and ensuing bark beetle outbreaks in southwestern pinyon-juniper woodlands

    Science.gov (United States)

    Michael J. Clifford; Monique E. Rocca; Robert Delph; Paulette L. Ford; Neil S. Cobb

    2008-01-01

    The current drought and ensuing bark beetle outbreaks during 2002 to 2004 in the Southwest have greatly increased tree mortality in pinyon-juniper woodlands. We studied causes and consequences of the drought-induced mortality. First, we tested the paradigm that high stand densities in pinyon-juniper woodlands would increase tree mortality. Stand densities did not...

  14. An outbreak of infectious bursal disease in eight weeks old IBD ...

    African Journals Online (AJOL)

    An outbreak of infectious bursal disease (IBD) on an IBD vaccinated commercial poultry farm was investigated using clinical and pathological findings as well as antigen and antibody detection by agar gel immunodiffusion test (AGDT). Mortality was observed 3 days after the onset of clinical signs and peaked on day 5 but ...

  15. [Two Outbreaks of Yersinia enterocolitica O:8 Infections in Tokyo and the Characterization of Isolates].

    Science.gov (United States)

    Konishi, Noriko; Ishitsuka, Rie; Yokoyama, Keiko; Saiki, Dai; Akase, Satoru; Monma, Chie; Hirai, Akihiko; Sadamasu, Kenji; Kai, Akemi

    2016-01-01

    Although the number of outbreaks caused by Yersinia enterocolitica has been very small in Japan, 4 outbreaks were occurred during the 2 years between 2012 and 2013. We describe herein 2 outbreaks which were examined in Tokyo in the present study. Outbreak 1: A total of 39 people (37 high school students and 2 staff) stayed at a hotel in mountain area in Japan had experienced abdominal pain, diarrhea and fever in August, 2012. The Y. enterocolitica serogroup O:8 was isolated from 18 (64.3%) out of 28 fecal specimens of 28 patients. The infection roots could not be revealed because Y. enterocolitica was not detected from any meals at the hotel or its environment. Outbreak 2: A total of 52 students at a dormitory had diarrhea and fever in April, 2013. The results of the bacteriological and virological examinations of fecal specimens of patients showed that the Y. enterocolitica serogroup O:8 was isolated from 24 fecal specimens of 21 patients and 3 kitchen staff. We performed bacteriological and virological examination of the stored and preserved foods at the kitchen of the dormitory to reveal the suspect food. For the detection of Y. enterocolitica, food samples. together with phosphate buffered saline (PBS) were incubated at 4 degrees C for 21 days. Then, a screening test for Y. enterocolitica using realtime-PCR targeting the ail gene was performed against the PBS culture. One sample (fresh vegetable salad) tested was positive on realtime-PCR. No Y. enterocolitica was isolated on CIN agar from the PBS culture because many bacteria colonies other than Y. enterocolitica appeared on the CIN agar. After the alkaline-treatments of the culture broth or the immunomagnetic beads concentration method using anti-Y. enterocolitica O:8 antibodies, Y. enterocolitica O:8 which was the same serogroup as the patients' isolates was successfully isolated from the PBS culture. The fresh vegetable salad was confirmed as the incrimination food of this outbreak.

  16. Management of nosocomial scabies, an outbreak of occupational disease.

    Science.gov (United States)

    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.

  17. Inside the outbreak of the 2009 influenza A (H1N1)v virus in Mexico.

    Science.gov (United States)

    Zepeda-Lopez, Hector M; Perea-Araujo, Lizbeth; Miliar-García, Angel; Dominguez-López, Aarón; Xoconostle-Cázarez, Beatriz; Lara-Padilla, Eleazar; Ramírez Hernandez, Jorge A; Sevilla-Reyes, Edgar; Orozco, Maria Esther; Ahued-Ortega, Armando; Villaseñor-Ruiz, Ignacio; Garcia-Cavazos, Ricardo J; Teran, Luis M

    2010-10-08

    Influenza viruses pose a threat to human health because of their potential to cause global disease. Between mid March and mid April a pandemic influenza A virus emerged in Mexico. This report details 202 cases of infection of humans with the 2009 influenza A virus (H1N1)v which occurred in Mexico City as well as the spread of the virus throughout the entire country. From May 1st to May 5th nasopharyngeal swabs, derived from 751 patients, were collected at 220 outpatient clinics and 28 hospitals distributed throughout Mexico City. Analysis of samples using real time RT-PCR revealed that 202 patients out of the 751 subjects (26.9%) were confirmed to be infected with the new virus. All confirmed cases of human infection with the strain influenza (H1N1)v suffered respiratory symptoms. The greatest number of confirmed cases during the outbreak of the 2009 influenza A (H1N1)v were seen in neighbourhoods on the northeast side of Mexico City including Iztapalapa, Gustavo A. Madero, Iztacalco, and Tlahuac which are the most populated areas in Mexico City. Using these data, together with data reported by the Mexican Secretariat of Health (MSH) to date, we plot the course of influenza (H1N1)v activity throughout Mexico. Our data, which is backed up by MSH data, show that the greatest numbers of the 2009 influenza A (H1N1) cases were seen in the most populated areas. We speculate on conditions in Mexico which may have sparked this flu pandemic, the first in 41 years. We accept the hypothesis that high population density and a mass gathering which took in Iztapalapa contributed to the rapid spread of the disease which developed in three peaks of activity throughout the Country.

  18. Inside the outbreak of the 2009 influenza A (H1N1v virus in Mexico.

    Directory of Open Access Journals (Sweden)

    Hector M Zepeda-Lopez

    Full Text Available BACKGROUND: Influenza viruses pose a threat to human health because of their potential to cause global disease. Between mid March and mid April a pandemic influenza A virus emerged in Mexico. This report details 202 cases of infection of humans with the 2009 influenza A virus (H1N1v which occurred in Mexico City as well as the spread of the virus throughout the entire country. METHODOLOGY AND FINDINGS: From May 1st to May 5th nasopharyngeal swabs, derived from 751 patients, were collected at 220 outpatient clinics and 28 hospitals distributed throughout Mexico City. Analysis of samples using real time RT-PCR revealed that 202 patients out of the 751 subjects (26.9% were confirmed to be infected with the new virus. All confirmed cases of human infection with the strain influenza (H1N1v suffered respiratory symptoms. The greatest number of confirmed cases during the outbreak of the 2009 influenza A (H1N1v were seen in neighbourhoods on the northeast side of Mexico City including Iztapalapa, Gustavo A. Madero, Iztacalco, and Tlahuac which are the most populated areas in Mexico City. Using these data, together with data reported by the Mexican Secretariat of Health (MSH to date, we plot the course of influenza (H1N1v activity throughout Mexico. CONCLUSIONS: Our data, which is backed up by MSH data, show that the greatest numbers of the 2009 influenza A (H1N1 cases were seen in the most populated areas. We speculate on conditions in Mexico which may have sparked this flu pandemic, the first in 41 years. We accept the hypothesis that high population density and a mass gathering which took in Iztapalapa contributed to the rapid spread of the disease which developed in three peaks of activity throughout the Country.

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

    Science.gov (United States)

    2011-09-09

    Foodborne agents cause an estimated 48 million illnesses annually in the United States, including 9.4 million illnesses from known pathogens. CDC collects data on foodborne disease outbreaks submitted from all states and territories through the Foodborne Disease Outbreak Surveillance System. During 2008, the most recent year for which data are finalized, 1,034 foodborne disease outbreaks were reported, which resulted in 23,152 cases of illness, 1,276 hospitalizations, and 22 deaths. Among the 479 outbreaks with a laboratory-confirmed single etiologic agent reported, norovirus was the most common, accounting for 49% of outbreaks and 46% of illnesses. Salmonella was the second most common, accounting for 23% of outbreaks and 31% of illnesses. Among the 218 outbreaks attributed to a food vehicle with ingredients from only one of 17 defined food commodities, the top commodities to which outbreaks were attributed were poultry (15%), beef (14%), and finfish (14%), whereas the top commodities to which outbreak-related illnesses were attributed were fruits and nuts (24%), vine-stalk vegetables (23%), and beef (13%). Outbreak surveillance provides insights into the agents that cause foodborne illness, types of implicated foods, and settings where transmission occurs. Public health, regulatory, and food industry professionals can use this information to target prevention efforts against pathogens and foods that cause the most foodborne disease outbreaks.

  20. Comparative analysis of virulence and resistance profiles of Salmonella Enteritidis isolates from poultry meat and foodborne outbreaks in northern Jordan.

    Science.gov (United States)

    Jaradat, Ziad W; Abedel Hafiz, Leena; Ababneh, Mustafa M; Ababneh, Qotaibah O; Al Mousa, Waseem; Al-Nabulsi, Anas; Osaili, Tareq M; Holley, Richard

    2014-07-01

    This study was conducted to isolate Salmonella Enteritidis from poultry samples and compare their virulence and antibiotic resistance profiles to S. Enteritidis isolated from outbreaks in northern Jordan. Two hundred presumptive isolates were obtained from 302 raw poultry samples and were subjected to further analysis and confirmation. A phylogenic tree based on 16S rRNA sequencing was constructed and selected isolates representing each cluster were further studied for their virulence in normal adult Swiss white mice. The most virulent strains were isolated from poultry samples and had an LD 50 of 1.55 × 10 (5) CFU, while some of the outbreak isolates were avirulent in mice. Antibiotic resistance profiling revealed that the isolates were resistant to seven of eight antibiotics screened with each isolate resistant to multiple antibiotics (from two to six). Of the poultry isolates, 100%, 88.9%, 77.8%, 66.7%, and 50% showed resistance to nalidixic acid, ciprofloxacin, ampicillin, cephalothin, and cefoperazone, respectively. Two outbreak isolates were sensitive to all tested antibiotics, while 71.4% were resistant to cefoperazone and only 28.6% showed resistance to nalidixic acid. Salmonella outbreak isolates were genetically related to poultry isolates as inferred from the 16S rRNA sequencing, yet were phenotypically different. Although outbreak strains were similar to poultry isolates, when tested in the mouse model, some of the outbreak isolates were highly virulent while others were avirulent. This might be due to a variation in susceptibility of the mouse to different S. Enteritidis isolates.