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Sakaue T, Sugawara T, Mukasa K, Nohara M. Varicella outbreak at nursery school under routine immunization in Japan in 2017 and 2018 and vaccine effectiveness. Vaccine 2024; 42:2637-2645. [PMID: 38480103 DOI: 10.1016/j.vaccine.2024.02.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/19/2024] [Accepted: 02/24/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND In Japan, routine administration to one-year-old children of two-dose immunization for varicella was introduced in October 2014. Object The object of this study was to report outbreaks of varicella under routine immunization at a nursery school and in its surrounding area using data of surrounding areas from the (Nursery) School Absenteeism Surveillance System. Then, we measured the effectiveness of routine two-dose immunization for varicella to onset. We tentatively assessed its severity in a nursery school. METHOD The study period extended from April 2017 through March 2018. The study area comprised Nursery school B and other nursery schools, and elementary and junior high schools in City A. Subjects in Nursery school B were 120 children. We analyzed vaccine effectiveness (VE) as an observational study and assessed severity using Fisher's exact test. We also assessed VE for severity using linear regression. Severity was defined as the length of nursery school absence attributable to varicella infection. RESULTS During the one month preceding a period of two weeks before the initial case at Nursery school B, there were 16 cases of varicella infection in nursery schools, 45 cases in elementary schools, and one case in junior high schools in City A. For children who had received one vaccine dose or more, VE was 48.1% for all ages and 49.2% among children three years old and older. No significant VE against infection was found. Vaccination using one dose or more can reduce severity significantly. DISCUSSION AND CONCLUSION Because many nursery school children who had received two doses of vaccine were infected, VE was estimated as low in the nursery school and not significant. Although VE for severity with more than one dose was confirmed, a second dose might not reduce severity compared to one dose.
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Affiliation(s)
| | - Tamie Sugawara
- National Institute of Infectious Diseases, Tokyo, Japan.
| | - Kyoko Mukasa
- Department of Social Welfare, Faculty of Humanities and Social Science, Showa Women's University, Tokyo, Japan
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Patel SS, Neylan JH, Bavaro K, Chai PR, Goralnick E, Erickson TB. Chemical, biological, radiological, nuclear, and explosives (CBRNEs) preparedness for sporting event mass gatherings: A systematic review of the literature. Am J Disaster Med 2022; 17:57-74. [PMID: 35913184 DOI: 10.5055/ajdm.2022.0420] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Sporting events often constitute mass gatherings (MGs) featuring large crowds of spectators and participants. Our objective is to understand the current state of emergency preparedness for sporting events by examining past MG sporting events to evaluate mitigation, preparedness, response, and recovery against chemical, biological, radiological, nuclear, and explosive (CBRNE) events. METHODS In accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was carried out among 10 literature databases. The quality and risk of bias in each reviewed publication was assessed using the Mixed Methods Appraisal Tool. RESULTS A total of 5,597 publications were identified. Of these, 81 papers were selected for full text reads and 25 publications were accepted. The included articles documented sporting events worldwide, ranging from incidents occurring from 1972 to 2020. Cross-cutting themes found in best practices and recommendations were strategic communication, surveillance, planning and preparedness, and training and response. CONCLUSION More evidence-based guidelines are needed to ensure best practices in response and recovery for CBRNE incidents at sporting events. Public health risks as well as implementation barriers and opportunities to prepare for potential CBRNE threats at sporting event MGs require further investigation.
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Affiliation(s)
- Sonny S Patel
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts; Transcultural Conflict and Violence Initiative, Georgia State University, Atlanta, Georgia. ORCID: https://orcid.org/0000-0002-9810-0055
| | - Julian H Neylan
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts
| | - Katerina Bavaro
- Health Studies Program, University College, University of Toronto - St. George, Toronto, Canada
| | - Peter R Chai
- Division of Medical Toxicology, Department of Emergency Medicine, Mass General Brigham, Harvard Medical School, Boston, Massachusetts
| | - Eric Goralnick
- Ariadne Labs, Brigham and Women's Hospital, Boston, Massachusetts; Harvard T.H. Chan School of Public Health Boston, Boston, Massachusetts; Department of Emergency Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Timothy B Erickson
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts; Division of Medical Toxicology, Department of Emergency Medicine, Brigham Health, Harvard Medical School, Boston, Massachusetts
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Annear M, Kidokoro T, Shimizu Y. Existential threats to the Summer Olympic and Paralympic Games? a review of emerging environmental health risks. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:159-166. [PMID: 34981705 DOI: 10.1515/reveh-2020-0141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/22/2020] [Indexed: 06/14/2023]
Abstract
This review highlights two intersecting environmental phenomena that have significantly impacted the Tokyo Summer Olympic and Paralympic Games: infectious disease outbreaks and anthropogenic climate change. Following systematic searches of five databases and the gray literature, 15 studies were identified that addressed infectious disease and climate-related health risks associated with the Summer Games and similar sports mega-events. Over two decades, infectious disease surveillance at the Summer Games has identified low-level threats from vaccine-preventable illnesses and respiratory conditions. However, the COVID-19 pandemic and expansion of vector-borne diseases represent emerging and existential challenges for cities that host mass gathering sports competitions due to the absence of effective vaccines. Ongoing threats from heat injury among athletes and spectators have also been identified at international sports events from Asia to North America due to a confluence of rising Summer temperatures, urban heat island effects and venue crowding. Projections for the Tokyo Games and beyond suggest that heat injury risks are reaching a dangerous tipping point, which will necessitate relocation or mitigation with long-format and endurance events. Without systematic change to its format or staging location, the Summer Games have the potential to drive deleterious health outcomes for athletes, spectators and host communities.
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Affiliation(s)
- Michael Annear
- Faculty of Sport Sciences, Waseda University, 2-7-5 Higashi-Fushimi, Nishitokyo city, Tokyo202-0021, Japan
| | - Tetsuhiro Kidokoro
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Hachioji, Tokyo, Japan
| | - Yasuo Shimizu
- Division of Arts & Sciences, International Christian University, Mitaka, Tokyo, Japan
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Duijster JW, Doreleijers SDA, Pilot E, van der Hoek W, Kommer GJ, van der Sande MAB, Krafft T, van Asten LCHI. Utility of emergency call centre, dispatch and ambulance data for syndromic surveillance of infectious diseases: a scoping review. Eur J Public Health 2020; 30:639-647. [PMID: 31605491 PMCID: PMC7446941 DOI: 10.1093/eurpub/ckz177] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Syndromic surveillance can supplement conventional health surveillance by analyzing less-specific, near-real-time data for an indication of disease occurrence. Emergency medical call centre dispatch and ambulance data are examples of routinely and efficiently collected syndromic data that might assist in infectious disease surveillance. Scientific literature on the subject is scarce and an overview of results is lacking. METHODS A scoping review including (i) review of the peer-reviewed literature, (ii) review of grey literature and (iii) interviews with key informants. RESULTS Forty-four records were selected: 20 peer reviewed and 24 grey publications describing 44 studies and systems. Most publications focused on detecting respiratory illnesses or on outbreak detection at mass gatherings. Most used retrospective data; some described outcomes of temporary systems; only two described continuously active dispatch- and ambulance-based syndromic surveillance. Key informants interviewed valued dispatch- and ambulance-based syndromic surveillance as a potentially useful addition to infectious disease surveillance. Perceived benefits were its potential timeliness, standardization of data and clinical value of the data. CONCLUSIONS Various dispatch- and ambulance-based syndromic surveillance systems for infectious diseases have been reported, although only roughly half are documented in peer-reviewed literature and most concerned retrospective research instead of continuously active surveillance systems. Dispatch- and ambulance-based syndromic data were mostly assessed in relation to respiratory illnesses; reported use for other infectious disease syndromes is limited. They are perceived by experts in the field of emergency surveillance to achieve time gains in detection of infectious disease outbreaks and to provide a useful addition to traditional surveillance efforts.
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Affiliation(s)
- Janneke W Duijster
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, The Netherlands
| | - Simone D A Doreleijers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, The Netherlands
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Eva Pilot
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, The Netherlands
| | - Geert Jan Kommer
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, The Netherlands
| | - Marianne A B van der Sande
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thomas Krafft
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- Institute of Environment Education and Research, Bharati Vidyapeeth University, Pune, India
| | - Liselotte C H I van Asten
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, The Netherlands
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Kurita J, Sugawara T, Matsumoto K, Ohkusa Y. Cost-effectiveness analysis of (Nursery) School Absenteeism Surveillance System. Pediatr Int 2019; 61:1257-1260. [PMID: 31630471 DOI: 10.1111/ped.14023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/25/2019] [Accepted: 10/16/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Our earlier report reported that the (Nursery) School Absenteeism Surveillance System ((N)SASSy) can decrease numbers of patients. This study evaluates (N)SASSy's cost-effectiveness. METHODS A social perspective is taken for economic evaluation. For simplicity, 8,000 yen is assumed for direct medical costs. We assume the home health care duration to be 6 days, with 30 000 yen as the indirect opportunity cost of family nursing. Benefit-cost ratios are used as indicators of cost-effectiveness. RESULTS By multiplying the disease burden per patient by the reduced number of patients, the (N)SASSy effect was estimated as 206.9 billion yen, with 95% confidence interval of [67.3,346.6] billion yen. The total cost attributable to (N)SASSy throughout Japan is expected to be 2.63 billion yen. The benefit-cost ratio is expected to be approximately 60. CONCLUSIONS The estimated benefit-cost ratio is much higher than that for the routine immunization of children.
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Affiliation(s)
- Junko Kurita
- Center for Medical Sciences School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Tamie Sugawara
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | | | - Yasushi Ohkusa
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
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Sugishita Y, Sugawara T, Ohkusa Y, Ishikawa T, Yoshida M, Endo H. Syndromic surveillance using ambulance transfer data in Tokyo, Japan. J Infect Chemother 2019; 26:8-12. [PMID: 31611069 DOI: 10.1016/j.jiac.2019.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/08/2019] [Accepted: 09/15/2019] [Indexed: 11/28/2022]
Abstract
Bioterrorism attacks become more probable when important high-profile international or political events are held, such as G7 summit meetings or mass gathering events including Olympic and Paralympic games and FIFA World Cup tournaments. Outbreaks of infectious disease and widespread incidents of food poisoning are also public health concerns at such times. In Japan, the Tokyo Metropolitan Government operates Ambulance Transfer Syndromic Surveillance (ATSS), which can help monitor such incidents. The present study presents and assesses the ATSS framework. During the study period of October 2017 through November 2018, we monitored 33 areas for symptoms of 9 categories: vomiting/nausea, dizziness, palpitation, unconsciousness, breathing disorder, fever, spasm/paralysis, collapse/weakness, and bloody emesis/nasal hemorrhage. Among all symptoms, we found 9929 low-level aberrations, 2537 medium-level aberrations, and 577 high-level aberrations, with respective frequencies of 9.2%, 2.3%, and 0.5%. Of those, Tokyo Metropolitan Institute of Public Health reported the information to Tokyo Metropolitan Government 28 times during the period. Of the 28 identified clusters, Tokyo Metropolitan Government judged the necessity for investigating 7. All of those were investigated at hospitals by the jurisdictional public health center. Because ATSS covers almost the entire Tokyo metropolitan area, with about 13.8 million residents, it is definitely the largest syndromic surveillance in the world.
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Affiliation(s)
- Yoshiyuki Sugishita
- National Institute of Infectious Diseases, Japan; Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, Japan.
| | | | | | | | - Michihiko Yoshida
- Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, Japan
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Sugishita Y, Sugawara T, Ohkusa Y. Association of influenza outbreak in each nursery school and community in a ward in Tokyo, Japan. J Infect Chemother 2019; 25:695-701. [PMID: 30962116 DOI: 10.1016/j.jiac.2019.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/19/2019] [Accepted: 03/18/2019] [Indexed: 11/29/2022]
Abstract
In nursery schools, influenza outbreaks have occurred every year. However, influenza characteristics of its diffusion among nursery schools, within each nursery school, and among classes of different ages in nursery schools remains unclear. This paper presents an examination of these matters using the Nursery School Absenteeism Surveillance System (NSASSy). All nursery schools in ward A in Tokyo introduced to the NSASSy in 2015. The study period was November 2015 through March 2016. The data of influenza patients were extracted from NSASSy. We examined four definitions of 'starting date of community outbreak' (SDCO) of influenza: 1) the first recorded day of influenza patients (SDCO1), 2) the last day of influenza patients recorded for two consecutive days (SDCO2), 3) three consecutive days (SDCO3), and 4) four consecutive days (SDCO4). We evaluated those four definitions by duration of the initial case at each nursery school from SDCO and evaluated the proportion of nursery schools at which the initial case occurred before SDCO. The average durations of initial cases at respective nursery schools from SDCO1-4 were 40.3, 26.3, 23.1 and 13.3 days. The respective proportions of nursery schools at which the initial case occurred before SDCO1-4 were 3.1%, 6.4%, 9.4% and 40.6%. Results demonstrate that SDCO3 is an appropriate definition of SDCO. Robustness checks for other areas, seasons, and population size constitute the next challenge for research in this area.
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Nohora M, Kurita J, Sugawara T, Ohkusa Y. Providing Infectious Disease Information to Child-Rearing Families and Its Evaluation. Health (London) 2019. [DOI: 10.4236/health.2019.119087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kurita J, Nagasu N, Nagata N, Okuno H, Sugawara T, Ohkusa Y. Outbreak of Human Metapneumovirus in Ibaraki, Japan and Its Descriptive Epidemiology. Health (London) 2018. [DOI: 10.4236/health.2018.106057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Proposition of real-time precise prediction model of infectious disease patients from Prescription Surveillance using the National Database of Electronic Medical Claims. J Infect Chemother 2015; 21:776-82. [PMID: 26320387 DOI: 10.1016/j.jiac.2015.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/14/2015] [Accepted: 07/15/2015] [Indexed: 11/20/2022]
Abstract
The incidence of common pediatric infectious diseases has been monitored officially at sentinel medical institutions in Japan. However, the numbers of affected patients are not provided. Prescription Surveillance (PS), which infers the number of patients with influenza, varicella, and gastrointestinal infections from data related to prescriptions at external pharmacies, provides estimates to the public the following morning. This study assessed the prediction ability of the incidence of common pediatric infectious diseases from PS information using the National Database of Electronic Medical Claims (NDBEMC): the number of patients prescribed neuraminidase inhibitors, anti-herpes virus drugs, antibiotic drugs, antipyretic analgesics, and multi-ingredient cold medications. The diseases include RS virus infection, pharyngoconjunctival fever, hand, foot and mouth disease, erythema infectiosum, exanthem subitum, pertussis, herpangina, influenza, varicella, and gastrointestinal infection. For comparison, we used the estimated number of patients who were prescribed neuraminidase inhibitor in PS, which had been confirmed already for precision, and provided estimates to the general public via the internet. The discrepancy rates of all considered diseases between the reported number in NDBEMC and the predicted numbers of patients from PS were less than the value in NI counts and the coefficients of determination in the estimation were from .8109 to .9825. These predictions were sufficiently precise to provide to the general public.
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