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Khan IA, Bashar MA, Mohsin S, Shrivastava DK. Prevalence of delayed initiation of rabies postexposure prophylaxis and factors influencing it among animal bite victims from Eastern Uttar Pradesh, India. Trans R Soc Trop Med Hyg 2024:trae002. [PMID: 38324406 DOI: 10.1093/trstmh/trae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/06/2023] [Accepted: 01/12/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND In a rabies-endemic country like India, every animal bite is potentially taken as rabid exposure and timely and appropriate postexposure prophylaxis (PEP) is crucial as rabies is an almost 100% fatal disease. METHODS A retrospective record-based study was conducted at an anti-rabies clinic (ARC) in Eastern Uttar Pradesh, India. Data of the animal bite victims attending the ARC for PEP from January to December 2022 were extracted from the records. A semistructured questionnaire was used for collecting information regarding the interval between exposure and the initiation of anti-rabies PEP, age, gender, residence, the bite site on the body, category of exposure and other risk factors associated with the delay in PEP. RESULTS Most of the victims were male (67.6%), from an urban background (61.3%) and aged up to 20 y (43.9%). Out of the 222 victims, 62 (27.9%) had delayed initiation of PEP (>48 h after exposure). Factors found to be significantly associated with delayed initiation of PEP were residence (p=0.01), age (p=0.04) and the type of biting animal (p=0.002). CONCLUSIONS Delayed initiation of PEP is common among animal bite victims in this region of India, although PEP is affordable. Educational programmes and awareness-raising campaigns for timely administration of PEP should be a priority, especially targeting rural residents, those aged<18 y and those bitten by animals other than dogs.
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Affiliation(s)
- Imran Ahmed Khan
- Department of Community Medicine, BRD Medical College, Gorakhpur 273013, Uttar Pradesh, India
| | - Md Abu Bashar
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur 273008, Uttar Pradesh, India
| | - Sufiya Mohsin
- Department of Community Medicine, BRD Medical College, Gorakhpur 273013, Uttar Pradesh, India
| | - D K Shrivastava
- Department of Community Medicine, BRD Medical College, Gorakhpur 273013, Uttar Pradesh, India
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Dhawan V, Chakraborty AB, Dhandore S, Dhalaria P, Agarwal D, Singh AK. Mission Indradhanush and Intensified Mission Indradhanush-Success Story of India's Universal Immunization Program and the Role of Mann Ki Baat in Bridging the Immunization Gap. Indian J Community Med 2023; 48:823-827. [PMID: 38249699 PMCID: PMC10795861 DOI: 10.4103/ijcm.ijcm_251_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/25/2023] [Indexed: 01/23/2024] Open
Abstract
Child immunization is crucial for reducing the morbidity and mortality associated with vaccine-preventable diseases (VPDs). The program grew over the years, however, progress towards full immunization coverage (FIC) remained slow, with only 44% of children fully immunized in 1992-1993, and 62% in 2015-2016, as reported in the National Family Health Survey. To address this challenge, Government of India launched Routine Immunization intensification drive- Mission Indradhanush (MI) in 2014, with the aim of achieving 90% FIC. The success of MI led to the launch of Intensified Mission Indradhanush (IMI) in 2017, with more intensive planning, monitoring, review, and inter-sectoral partnerships.
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Affiliation(s)
- Veena Dhawan
- Immunization Division, Ministry of Health and Family Welfare Government of India, New Delhi, India
| | - Ashish B. Chakraborty
- Immunization Division, Ministry of Health and Family Welfare Government of India, New Delhi, India
| | - Suhas Dhandore
- Immunization Division, Ministry of Health and Family Welfare Government of India, New Delhi, India
| | - Pritu Dhalaria
- Immunization Technical Support Unit, Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - Disha Agarwal
- Immunization Technical Support Unit, Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - Ajeet Kumar Singh
- Immunization Technical Support Unit, Ministry of Health and Family Welfare, Government of India, New Delhi, India
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3
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Esu DJ, Kicha DI. [The evaluation of quality of immunization services of children in Primary Medical Sanitary Centers in Oron, Akwa Ibom state, Nigeria]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2023; 31:1028-1034. [PMID: 37898895 DOI: 10.32687/0869-866x-2023-31-5-1028-1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 05/30/2023] [Indexed: 10/31/2023]
Abstract
Nigeria, with its low routine immunization coverage and wild poliovirus reservoir, significantly contributes to overall regional burden of vaccine-preventable diseases. Since introduction of the EPI in 1974 (which later became the National Program of Immunization), Nigeria's immunization program suffered from declining coverage. The poor quality of immunization affects service utilization, even where they are provided for free, just as immunization services are. The quality assessment will provide both notion of degree of satisfaction of clients with services and framework for revision of program priorities, strategies and components Purpose of the study is to evaluate quality of immunization services provided to children in primary health centers in Oron, Akwa Ibom State, Nigeria. The study targets to identify strengths and weaknesses of immunization services, to evaluate level of compliance with national and international standards of immunization and to develop corresponding recommendations. The study seeks to contribute to body of knowledge about quality of children immunization services in Nigeria, particularly in context of primary health centers. The study may help to improve delivery of immunization services in the region and to ensure that more children will be vaccinated and protected against vaccine-preventable diseases. The cross-sectional descriptive study of quality of immunization services in primary health centers was carried on in Akwa Ibom State, Nigeria. The variables as indicators such as physical environment, resource availability, client satisfaction etc. were utilized and included into questionnaire. The study covered 402 caregivers and 152 medical workers in 12 primary health centers. The client questionnaire, facility staff questionnaire, facility checklist, personal observation,focus group discussion guide and client flow chart were applied. The results demonstrated that quality of immunization services was poor. The caregivers were dissatisfied both with reception by providers and too long waiting time. The attitude of health care providers was also mentioned as cause of dissatisfaction. This study demonstrated that community health extension workers constituted majority (39.4%) of immunization service providers. Out of 152 health care providers that participated in the study, 92 (60.9%) had attended in-service training on immunization within previous two years. The comparison of staff categories with attendance at in-service training established statistically significant difference (p=0.0072), suggesting that whether one attended in-service training or not depended on category of staff one belongs to. Of all staff, 112 workers (73.3%) knew proper vaccine storage temperature while 40 (26.7%) did not. The health care providers who do not know proper vaccine storage temperature may administer vaccines with compromised potency. Most of health care providers (149 or 98.0%) were aware that clients have particular rights that in overall is referred as client rights. Only by knowing rights of clients providers would be expected to respect these rights. The client right with which most of providers were agreed was right to information (105 or 70.2%). While right with which most providers were disagree (52 or 34.0%)) was right to choice of where and when access immunization services. The study conducted thorough quality assessment of children imunization services in primary health centers in Oron, Akwa Ibom State, Nigeria. The results revealed both strengths and weaknesses in delivery of immunization services to children in the region. While there were areas of average performance due to experienced and trained health care workers, there were also areas of concern with inadequate cold chain storage and insufficient record-keeping practices. The study recommends to improve quality of immunization services in the region, including strengthening cold chain system, ensuring adequate record-keeping practices and implementing regular training and supervision of medical workers. These measures are crucial to ensure that more children are vaccinated and protected against vaccine-preventable diseases. The results of the study contribute to body of knowledge on quality of children immunization services in Nigeria and emphasize importance to continue efforts improving delivery of immunization services to children. There is hope that proposed recommendations will become a basis for policy decisions making and ultimately will result in better health outcomes for children in Oron, Akwa Ibom State and beyond.
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Affiliation(s)
- D J Esu
- The Federal State Autonomous Educational Institution of Higher Education "The Patrice Lumumba Peoples' Friendship University of Russia" of Minobrnauka of Russia (RUDN University), 117198, Moscow, Russia
| | - D I Kicha
- The Federal State Autonomous Educational Institution of Higher Education "The Patrice Lumumba Peoples' Friendship University of Russia" of Minobrnauka of Russia (RUDN University), 117198, Moscow, Russia,
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Mandomando I, Mwenda JM, Nakamura T, de Gouveia L, von Gottberg A, Kwambana-Adams BA, Antonio M, Messa A, Litt D, Seaton S, Weldegebriel GG, Biey JNM, Serhan F. Evaluation of Laboratories Supporting Invasive Bacterial Vaccine-Preventable Disease (IB-VPD) Surveillance in the World Health Organization African Region, through the Performance of Coordinated External Quality Assessment. Trop Med Infect Dis 2023; 8:413. [PMID: 37624351 PMCID: PMC10459392 DOI: 10.3390/tropicalmed8080413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023] Open
Abstract
(1) Background: Laboratories supporting the invasive bacteria preventable disease (IB-VPD) network are expected to demonstrate the capacity to identify the main etiological agents of pediatric bacterial meningitis (PBM) (Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae) on Gram stains and in phenotypic identification. Individual reports of sentinel site (SSL), national (NL) and regional reference (RRL) laboratories participating in the World Health Organization (WHO)-coordinated external quality assessment, distributed by the United Kingdom National External Quality Assessment (EQA) Services (UK NEQAS) for Microbiology between 2014 and 2019 were analyzed. (2) Methods: The panels consisted of (1) unstained bacterial smears for Gram staining, (2) viable isolates for identification and serotyping/serogrouping (ST/SG) and (3) simulated cerebral spinal fluid (CSF) samples for species detection and ST/SG using polymerase chain reaction (PCR). SSLs and NLs tested for Gram staining and species identification (partial panel). RRLs, plus any SSLs and NLs (optionally) also analyzed the simulated CSF samples (full panel). The passing score was ≥75% for NLs and SSLs, and ≥90% for RRLs and NLs/SSLs testing the full panel. (3) Results: Overall, 63% (5/8) of the SSLs and NLs were able to correctly identify the targeted pathogens, in 2019; but there were challenges to identify Haemophilus influenzae either on Gram stains (35% of the labs failed 2014), or in culture. Individual performance showed inconsistent capacity, with only 39% (13/33) of the SSLs/NLs passing the EQA exercise throughout all surveys in which they participated. RRLs performed well over the study period, but one of the two failed to reach the minimal passing score in 2016 and 2018; while the SSLs/NLs that optionally tested the full panel scored between 75% and 90% (intermediate pass category). (4) Conclusions: We identified a need for implementing a robust quality management system for timely identification of the gaps and then implementing corrective and preventive actions, in addition to continuous refresher training in the SSLs and NLs supporting the IB-VPD surveillance in the World Health Organization, Regional Office for Africa (WHO AFRO).
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Affiliation(s)
- Inacio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo P.O. Box 1929, Mozambique; (I.M.)
- Instituto Nacional de Saúde (INS), Maputo P.O. Box 3943, Mozambique
- ISGlobal, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Jason M. Mwenda
- World Health Organization (WHO), Regional Office for Africa, Brazzaville P.O. Box 06, Congo
| | - Tomoka Nakamura
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan
- Department of Immunization, Vaccines and Biologicals, World Health Organization, 1202 Geneva, Switzerland;
| | - Linda de Gouveia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg 2131, South Africa; (L.d.G.); (A.v.G.)
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg 2131, South Africa; (L.d.G.); (A.v.G.)
| | - Brenda A. Kwambana-Adams
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul P.O. Box 273, The Gambia; (B.A.K.-A.); (M.A.)
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L7 8XZ, UK
| | - Martin Antonio
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul P.O. Box 273, The Gambia; (B.A.K.-A.); (M.A.)
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
- Centre for Epidemic Preparedness and Response, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Augusto Messa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo P.O. Box 1929, Mozambique; (I.M.)
| | - David Litt
- Respiratory and Vaccine Preventable Bacteria Reference Unit, United Kingdom Health Security Agency (Formerly Public Health England), London NW9 5EQ, UK;
- World Health Organization Collaborating Centre for Haemophilus Influenzae and Streptococcus Pneumoniae, United Kingdom Health Security Agency (Formerly Public Health England), London SW1P 3JR, UK
| | - Shila Seaton
- United Kingdom National External Quality Assessment Service (UK NEQAS) for Microbiology, United Kingdom Health Security Agency (Formerly Public Health England), London NW9 1GH, UK;
| | | | - Joseph Nsiari-Muzeyi Biey
- World Health Organization (WHO), Inter Country Support Team (IST), Ouagadougou 03 BP 7019, Burkina Faso;
| | - Fatima Serhan
- Department of Immunization, Vaccines and Biologicals, World Health Organization, 1202 Geneva, Switzerland;
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Hofmeister MG, Yin S, Nelson NP, Weng MK, Gupta N. Trends and Opportunities: Hepatitis A Virus Infection, Seroprevalence, and Vaccination Coverage-United States, 1976-2020. Public Health Rep 2023:333549231184007. [PMID: 37480244 DOI: 10.1177/00333549231184007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023] Open
Abstract
OBJECTIVES The incidence of hepatitis A declined in the United States following the introduction of hepatitis A vaccines, before increasing in the setting of recent widespread outbreaks associated with person-to-person transmission. We describe the hepatitis A epidemiology in the United States, identify susceptible populations over time, and demonstrate the need for improved hepatitis A vaccination coverage, especially among adults at increased risk for hepatitis A. METHODS We calculated the hepatitis A incidence rates for sociodemographic characteristics and percentages for risk factors and clinical outcomes for hepatitis A cases reported to the National Notifiable Diseases Surveillance System during 1990-2020. We generated nationally representative estimates and 95% CIs of hepatitis A seroprevalence during 1976-March 2020 and self-reported hepatitis A vaccination coverage during 1999-March 2020 for the noninstitutionalized civilian US population using data from the National Health and Nutrition Examination Survey. RESULTS Overall, the rate per 100 000 population of reported cases of hepatitis A virus infection in the United States declined 17.3-fold, from 10.4 during 1990-1998 to 0.6 during 2007-2015, and then increased to 2.8 during 2016-2020. The overall hepatitis A seroprevalence in the United States increased from 38.2% (95% CI, 36.2%-40.1%) during 1976-1980 to 47.3% (95% CI, 45.4%-49.2%) during 2015-March 2020. The prevalence of self-reported hepatitis A vaccination coverage in the United States increased more than 2.5-fold, from 16.3% (95% CI, 15.0%-17.7%) during 1999-2006 to 41.9% (95% CI, 40.2%-43.7%) during 2015-March 2020. CONCLUSIONS Hepatitis A epidemiology in the United States changed substantially during 1976-2020. Improved vaccination coverage, especially among adults recommended for vaccination by the Advisory Committee on Immunization Practices, is vital to stop current hepatitis A outbreaks associated with person-to-person transmission in the United States and prevent similar future recurrences.
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Affiliation(s)
- Megan G Hofmeister
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shaoman Yin
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Noele P Nelson
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mark K Weng
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Neil Gupta
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Trubin M, Eichinger SE, Abraham A, Shankaran S. A Rare Case of Locally Contracted Cutaneous Corynebacterium diphtheriae. Cureus 2023; 15:e40854. [PMID: 37492820 PMCID: PMC10363648 DOI: 10.7759/cureus.40854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 07/27/2023] Open
Abstract
A 32-year-old man with a history of intravenous heroin use and housing instability presented with three years of worsening left forearm and wrist "infection," which had progressed over the past few months with worsening purulence, pain, and deformity. In the emergency department, he was afebrile with stable vitals. Superficial cultures drawn demonstrated polymicrobial growth, including heavy growth of Corynebacterium diphtheriae. He was treated with vancomycin and then IV penicillin to complete 10 days of therapy. Given the uncharacteristic appearance of the lesion, a biopsy was recommended, but the patient left against medical advice. Later, the diphtheria isolate was identified as C. diphtheriae var. mitis by the Centers for Disease Control and Prevention (CDC). This describes an atypical case of cutaneous diphtheria, a disease that is infrequently seen in the United States due to the high prevalence of routine vaccination.
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Affiliation(s)
- Marc Trubin
- Internal Medicine, Rush University Medical Center, Chicago, USA
| | - Sarah E Eichinger
- Internal Medicine/Primary Care, Rush University Medical Center/John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | - Annette Abraham
- Infectious Disease, Rush University Medical Center, Chicago, USA
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Kusuma YS, Kumari A, Rajbangshi P, Ganie A, Sarala R, Kumar D, Kalaiselvi S, Kanungo S, Jain N, Singh R, Tiwari SK, Gupta SD, Babu BV. Vaccination and associated factors among tribal children of 1 year age in nine Indian districts: A cross-sectional study. Trop Med Int Health 2023. [PMID: 37246307 DOI: 10.1111/tmi.13902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To report on vaccination status by 12 months of age among tribal children from nine districts of India. METHODS Cross-sectional study of 2631 tribal women having a child aged 12 months or below from nine Indian districts with a considerable proportion of the tribal population. Socio-demographic details, reception of various vaccines by 12 months of age, mother's antenatal care utilisation and health system-related details were collected through a pre-tested, interviewer-administered questionnaire from mothers. Multiple logistic regression analysis was used to identify the factors associated with complete vaccination by 12 months of age. RESULTS Only 52% of children were fully vaccinated by the age of 12 months among the tribal populations; 11% did not receive any vaccine, and 37% of the tribal children received some vaccines. The age-appropriate vaccination was unsatisfactory as only 75% of the infants received all birth dose vaccines, and only 60.5% received all doses by 14 weeks. Only 73% were vaccinated against measles. Illness of the child, home births and communication gaps concerning vaccination were the main reasons for an infant not being vaccinated appropriately. Frequency of health worker's visits to the village, hospital birth, reception of advice on vaccination and educational status of the head of the households were significantly associated with full vaccination status. CONCLUSION A relatively low proportion of children were fully vaccinated among the tribal populations. Health systems factors, mainly the outreach services and advice by the health workers, were positively and significantly associated with a child being fully vaccinated by 12 months of age. Improving outreach services is crucial to improve vaccination coverage in tribal areas, and there is a need to address the social determinants in the long run.
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Affiliation(s)
- Yadlapalli S Kusuma
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anjali Kumari
- Socio-Behavioural, Health Systems and Implementation Research Division, Indian Council of Medical Research, New Delhi, India
| | - Preety Rajbangshi
- Global Women' Health Programme, The George Institute for Global Health, New Delhi, India
| | - Ashraf Ganie
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - R Sarala
- Research & Publications Division, Indian Institute for Health Management Research, Bangalore, India
| | - Dinesh Kumar
- Social Sciences & Ethnomedicine Department, Indian Council of Medical Research-National Institute of Research in Tribal Health, Jabalpur, India
| | - S Kalaiselvi
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Srikanta Kanungo
- Public Health Division, Indian Council of Medical Research-Regional Medical Research Centre, Bhubaneswar, India
| | - Nutan Jain
- Centre for Gender Studies (NJ), Trustee Secretary (SDG), Indian Institute for Health Management Research University, Jaipur, India
| | - Rajesh Singh
- Christian Hospital, Garhwal Community Development & Welfare Society, Tehri-Garhwal, India
| | - Satish Kumar Tiwari
- Health Management Research Division, International Institute for Health Management Research, New Delhi, India
| | - Shiv Dutt Gupta
- Centre for Gender Studies (NJ), Trustee Secretary (SDG), Indian Institute for Health Management Research University, Jaipur, India
| | - Bontha V Babu
- Socio-Behavioural, Health Systems and Implementation Research Division, Indian Council of Medical Research, New Delhi, India
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Silveira MM, Crespo da Silva PA, Conrad NL, Oliveira TL, Hartwig DD, Trotter C. Surveillance of invasive meningococcal disease in southern Brazil: considerations of an immunization programme. J Med Microbiol 2023; 72. [PMID: 36753430 DOI: 10.1099/jmm.0.001658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Invasive meningococcal disease (IMD) is a major cause of meningitis and septicaemia worldwide. Changes in serogroup predominance contribute to the unpredictable nature of the disease, with significant health impact. This study aimed to determine the epidemiological profile of IMD in Rio Grande do Sul, Santa Catarina and Paraná, three states in southern Brazil. We analysed 1024 IMD cases that had been confirmed by clinical and/or laboratory criteria and reported to the national information system for notifiable diseases between 2015 and 2019. Additionally, we calculated the proportions of serogroup and incidence by age. Of 1024 cases, 562 (55 %) were caused by serogroup C. Furthermore, serogroup W was responsible for almost half of the cases among children younger than 5 years between 2017 and 2018, with an overall incidence of 1.5 cases/100 000 infants. IMD remains a significant healthcare issue in southern Brazil despite reduced serogroup C incidence after the introduction of the meningococcal C conjugate vaccine into the childhood immunization programme. Changes in disease epidemiology were observed, and serogroup W was the most common serogroup among children younger than 5 years in 2017 and 2018. Although future cost-effectiveness studies are necessary, our results could have future implications for meningococcal vaccination programmes.
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Affiliation(s)
- Marcelle Moura Silveira
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Neida Lucia Conrad
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Thaís Larré Oliveira
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Daiane Drawanz Hartwig
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil.,Biology Institute, Department of Microbiology and Parasitology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Caroline Trotter
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Vora A, Di Pasquale A, Kolhapure S, Agrawal A, Agrawal S. The need for vaccination in adults with chronic (noncommunicable) diseases in India - lessons from around the world. Hum Vaccin Immunother 2022; 18:2052544. [PMID: 35416747 PMCID: PMC9225226 DOI: 10.1080/21645515.2022.2052544] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Worldwide, chronic diseases (noncommunicable diseases [NCDs]) cause 41 million (71%) deaths annually. They are the leading cause of mortality in India, contributing to 60% of total deaths each year. Individuals with these diseases are more susceptible to vaccine-preventable diseases (VPDs) and have an increased risk of associated disease severity and complications. This poses a substantial burden on healthcare systems and economies, exemplified by the COVID-19 pandemic. Vaccines are an effective strategy to combat these challenges; however, utilization rates are inadequate. With India running one of the world’s largest COVID-19 vaccination programs, this presents an opportunity to improve vaccination coverage for all VPDs. Here we discuss the burden of VPDs in those with NCDs, the benefit of vaccinations, current challenges and possible strategies that may facilitate implementation and accessibility of vaccination programs. Effective vaccination will have a significant impact on the disease burden of both VPDs and NCDs and beyond.
What is already known on this topic?
Annually, chronic or noncommunicable diseases (NCDs) cause >40 million deaths worldwide and 60% of all deaths in India Adults with these diseases are more susceptible to vaccine-preventable diseases (VPDs); however, vaccine utilization is inadequate in this population
What is added by this report?
We highlight the benefits of vaccination in adults with NCDs that extend beyond disease prevention We discuss key challenges in implementing adult vaccination programs and provide practical solutions
What are the implications for public health practice?
Raising awareness about the benefits of vaccinations, particularly for those with NCDs, and providing national guidelines with recommendations from medical societies, will increase vaccine acceptance Adequate vaccine acceptance will reduce the VPD burden in this vulnerable population
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Affiliation(s)
- Agam Vora
- Department of Chest & TB, Dr. R. N. Cooper Municipal General Hospital, Mumbai, India
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Melkonyan N, Badalyan A, Hovhannisyan H, Poghosyan K. Impact of the COVID-19 pandemic on routine immunization services in Yerevan and vaccinations against COVID-19 in Armenia. J Infect Dev Ctries 2022; 16:1687-1695. [PMID: 36449639 DOI: 10.3855/jidc.17028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/03/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION The coronavirus disease (COVID-19) has led to millions of deaths around the world. The indirect effects of the pandemic, include disruption of routine immunization services. METHODOLOGY We conducted a retrospective review to assess the impact of the pandemic on routine immunization in Yerevan and the vaccinations against COVID-19 in Armenia. We compared the number of administered doses of DPT/VHB/HIB/IPV1,2,3, Pneumococcal1,2,3, Rotarix1,2, and MMR1 vaccines in target groups in 2020 and 2021 and the total vaccination coverage in 2019, 2020, and 2021. We also analyzed the number of COVID-19 vaccines administered in Armenia from 17 May 2021 to 6 February 2022. RESULTS There was a decline in the number of administered doses of vaccines at the beginning of the pandemic due to restrictive quarantine measures: 16 ± 4.5 (95% CI, 11.8-20.2), p < 0.05, during the second wave 18 ± 2.6 (95% CI, 15.6-20.4), p < 0.05 and during the interruption due to COVID-19 vaccine delivery 16 ± 7.4 (95% CI, 9.1-22.9), p < 0.05. There was no significant decrease in the number of vaccinations during the first, third, and fourth pandemic waves (p > 0.05) Overall, the COVID-19 vaccination process was slow and only 30% of the population were vaccinated. CONCLUSIONS The COVID-19 pandemic led to disruptions in the routine immunization process, but there was no significant decrease in the total vaccine coverage due to rapid scaling up of the vaccination services and catch-up vaccinations. Thus, the restrictions imposed during the pandemic did not affect the overall progress of vaccination.
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Affiliation(s)
- Naira Melkonyan
- Epidemiology Department, Faculty of Public Health, Yerevan State Medical University, Yerevan, Armenia.
| | - Arman Badalyan
- Epidemiology Department, Faculty of Public Health, Yerevan State Medical University, Yerevan, Armenia
| | - Hasmik Hovhannisyan
- Epidemiology Department, Faculty of Public Health, Yerevan State Medical University, Yerevan, Armenia
| | - Karine Poghosyan
- Infectious and Non-Infectious Diseases Department, National Center for Disease Control and Prevention, Ministry of Health of the Republic of Armenia, Yerevan, Armenia
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11
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Badenschier F, Berger A, Dangel A, Sprenger A, Hobmaier B, Sievers C, Prins H, Dörre A, Wagner-Wiening C, Külper-Schiek W, Wichmann O, Sing A. Outbreak of imported diphtheria with Corynebacterium diphtheriae among migrants arriving in Germany, 2022. Euro Surveill 2022; 27:2200849. [PMID: 36398576 PMCID: PMC9673234 DOI: 10.2807/1560-7917.es.2022.27.46.2200849] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/17/2022] [Indexed: 07/25/2023] Open
Abstract
From July 2022, cases of imported diphtheria with toxigenic Corynebacterium diphtheriae remarkably increased among migrants arriving in Germany. Up to 30 September 2022, 44 cases have been reported to the national public health institute, all laboratory-confirmed, male, and mainly coming from Syria (n = 21) and Afghanistan (n = 17). Phylogeny and available journey information indicate that most cases (n = 19) were infected along the Balkan route. Active case finding, increased laboratory preparedness and epicentre localisation in countries along this route are important.
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Affiliation(s)
- Franziska Badenschier
- Department of Infectious Disease Epidemiology, Postgraduate Training for Applied Epidemiology, Robert Koch Institute (RKI), Berlin, Germany
- ECDC Fellowship Programme, EPIET Associated Programme, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anja Berger
- National Consiliary Laboratory for Diphtheria, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
- Unit of Bacteriology, Public Health Microbiology, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Alexandra Dangel
- NGS Core Unit, Public Health Microbiology, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Annika Sprenger
- NGS Core Unit, Public Health Microbiology, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Bernhard Hobmaier
- Unit of Bacteriology, Public Health Microbiology, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Claudia Sievers
- Department of Infectious Disease Epidemiology, Postgraduate Training for Applied Epidemiology, Robert Koch Institute (RKI), Berlin, Germany
- ECDC Fellowship Programme, EPIET Associated Programme, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Henrieke Prins
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Achim Dörre
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Wiebe Külper-Schiek
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Ole Wichmann
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Andreas Sing
- National Consiliary Laboratory for Diphtheria, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
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12
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Yoshida S, Fujii N, Kamoi C, Kitamura W, Fujiwara H, Asada N, Nishimori H, Fujii K, Matsuoka KI, Maeda Y. Analysis of Immunity against Measles, Mumps, Rubella, and Varicella Zoster in Adult Recipients of Allogeneic Hematopoietic Stem Cell Transplantation: A Single-Center Experience. Acta Med Okayama 2022; 76:247-253. [PMID: 35790354 DOI: 10.18926/amo/63718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Vaccine-preventable disease (VPD) infections are more severe in immunocompromised hosts. Vaccination against measles, mumps, rubella, and varicella zoster (VZV) (MMRV) is therefore recommended for hematopoietic stem cell transplantation (HCT) recipients. However, studies on adult HCT recipients with VPD infections are limited. At our institution, we have systematically conducted serological MMRV tests as a part of check-up examinations during long-term follow-up (LTFU) after HCT since 2015. This retrospective study aimed to evaluate changes in the serostatus between before and 2 years after allogeneic HCT. Among 161 patients, the pre-transplant seropositivity was 82.7% for measles, 86.8% for mumps, 84.2% for rubella, and 94.3% for VZV. Among 56 patients who underwent LTFU including serological MMRV tests at 2 years after HCT, the percentages maintaining seroprotective antibody levels for measles, mumps, rubella and VZV were 71.5% (40/56), 51.8% (29/56), 48.2% (27/56), and 60.7% (34/56), respectively. Vaccination was recommended for 22 patients, and 12 were vaccinated. Among the 12 vaccinated patients, rates of seroconversion were examined in 2-6 patients for each of the four viruses. They were 100% (3/3) for measles, 33.3% (1/3) for mumps, 50% (3/6) for rubella, and 0% (0/2) for VZV. Further studies are warranted to clarify the effect of vaccination in adult HCT recipients.
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Affiliation(s)
- Shohei Yoshida
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Nobuharu Fujii
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
- Division of Transfusion, Okayama University Hospital
| | - Chihiro Kamoi
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
- Division of Transfusion, Okayama University Hospital
| | - Wataru Kitamura
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Hideaki Fujiwara
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Noboru Asada
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Hisakazu Nishimori
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Keiko Fujii
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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13
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Del Cid Fratti J, Salazar M, Argueta-Sosa EE. Vaccine-preventable disease hospitalized patients with heart failure with reduced ejection fraction. Clin Cardiol 2022; 45:474-481. [PMID: 35266175 PMCID: PMC9045068 DOI: 10.1002/clc.23800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/09/2022] Open
Abstract
Background Over five million Americans suffer from heart failure (HF), and this is associated with multiple chronic comorbidities and recurrent decompensation. Currently, there is an increased incidence in vaccine‐preventable diseases (VPDs). We aim to investigate the impact of HF with reduced ejection fraction (HFrEF) in patients hospitalized with VPDs. Hypothesis Patient with HFrEF are at higher risk for VPDs and they carry a higher risk for in‐hospital complications. Methods Retrospective analysis from all hospital admissions from the 2016‐2018 National Inpatient Sample (NIS) using the ICD‐10CM codes for patients admitted with a primary diagnosis of VPDs with HFrEF and those without reduced ejection fraction. Outcomes evaluated were in‐hospital mortality, length of stay (LOS), healthcare utilization, frequency of admissions, and in‐hospital complications. Multivariate regression analysis was conducted to adjust for confounders. Results Out of 317 670 VPDs discharges, we identified 12 130 (3.8%) patients with HFrEF as a comorbidity. The most common admission diagnosis for VPDs was influenza virus (IV) infection (75.0% vs. 64.1%; p < .01), followed by pneumococcal pneumonia (PNA) (13% vs. 9.4%; p < .01). After adjusting for confounders, patients with HFrEF had higher odds of having diagnosis of IV (adjusted [aOR], 1.42; p < .01) and PNA (aOR, 1.27; p < .01). Patients with VPDs and HFrEF had significantly higher odds of mortality (aOR, 1.76; p < .01), LOS, respiratory failure requiring mechanical ventilation, and mechanical ventilation for less than 96 h. Conclusion Influenza and PNA were the most common VPDs admitted to the hospital in patients with a concomitant diagnosis of HFrEF. They were associated with increased mortality and in‐hospital complications.
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Affiliation(s)
- Juan Del Cid Fratti
- Cardiology Department, OSF Healthcare, University of Illinois at Peoria, Peoria, Illinois, USA
| | - Miguel Salazar
- Medicine Department, University Hospitals of Cleveland Medical Center, Case Wester Reserve University, Cleveland, Ohio, USA
| | - Erwin E Argueta-Sosa
- Cardiology Department, Texas Tech University Health Science, Lubbock, Texas, USA
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14
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Domai FM, Agrupis KA, Han SM, Sayo AR, Ramirez JS, Nepomuceno R, Suzuki S, Villanueva AMG, Salva EP, Villarama JB, Ariyoshi K, Mulholland K, Palla L, Takahashi K, Smith C, Miranda E. Measles outbreak in the Philippines: epidemiological and clinical characteristics of hospitalized children, 2016-2019. Lancet Reg Health West Pac 2022; 19:100334. [PMID: 34977832 PMCID: PMC8686022 DOI: 10.1016/j.lanwpc.2021.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Measles outbreaks increased worldwide during 2017-19. The largest outbreak in the World Health Organisation Western Pacific region occurred in the Philippines where first-dose measles-containing vaccine (MCV1) coverage had reduced to 75% in 2018. The aim of this study was to summarise paediatric measles admissions to the national infectious diseases referral hospital in Manila during 2016 to 2019. METHODS A retrospective single-centre observational study including 5,562 children aged under five years admitted with measles from January 2016 to December 2019. We summarised sociodemographic and clinical characteristics, vaccine status, reported exposures, and outcomes. Univariable and multivariable logistic regression analyses were undertaken to assess associations between different characteristics of hospitalised children and death. FINDINGS The median age of children hospitalised with measles was 11 months (interquartile range: 7-28). 84·5% of cases were reported not to have received any MCV. The risk of mortality was 3·2%, with 41% of deaths occurring among children aged less than 9 months. No children died who had received two MCV. The following characteristics were significantly associated with mortality in the multivariable analysis: age group, residence outside of the national capital region, not having received any MCV, duration between onset of fever and hospital admission of 7-14 days compared with 0-3 days, not receiving vitamin A supplementation, having pneumonia, and gastroenteritis. INTERPRETATION The Philippines remains at risk of future measles epidemics. Routine immunization needs to be strengthened and earlier timing of MCV1 requires further evaluation to reduce measles incidence and mortality.
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Affiliation(s)
- Fleurette M. Domai
- School of Tropical Medicine and Global Health, Nagasaki University, Japan, 852-8523
| | - Kristal An Agrupis
- San Lazaro Hospital-Nagasaki University Collaborative Research Office, Manila, Philippines
| | - Su Myat Han
- School of Tropical Medicine and Global Health, Nagasaki University, Japan, 852-8523
| | | | | | - Raphael Nepomuceno
- School of Tropical Medicine and Global Health, Nagasaki University, Japan, 852-8523
| | - Shuichi Suzuki
- School of Tropical Medicine and Global Health, Nagasaki University, Japan, 852-8523
- San Lazaro Hospital-Nagasaki University Collaborative Research Office, Manila, Philippines
| | - Annavi Marie G Villanueva
- School of Tropical Medicine and Global Health, Nagasaki University, Japan, 852-8523
- San Lazaro Hospital, Manila, Philippines
| | | | | | - Koya Ariyoshi
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Kim Mulholland
- School of Tropical Medicine and Global Health, Nagasaki University, Japan, 852-8523
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC 3051, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Luigi Palla
- School of Tropical Medicine and Global Health, Nagasaki University, Japan, 852-8523
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, Rome, Italy
| | - Kensuke Takahashi
- School of Tropical Medicine and Global Health, Nagasaki University, Japan, 852-8523
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Acute & Critical Care Unit, Nagasaki University Hospital, Nagasaki, Japan
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Japan, 852-8523
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Department of Clinical Research, London School of Hygiene and Tropical Medicine
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15
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Forster DP, Leder K. Typhoid fever in travellers: estimating the risk of acquisition by country. J Travel Med 2021; 28:6383558. [PMID: 34619766 PMCID: PMC8715417 DOI: 10.1093/jtm/taab150] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND Typhoid fever is a notifiable disease within Australia. Although studies in endemic regions give an indication of acquisition risk, many countries lack reliable data, and little is known of the absolute or relative risk in Australian travellers. By combining notified case data with travel statistics provided by the Australian Bureau of Statistics, the aim of this study was to give an indication of risk for typhoid acquisition among Australian travellers. METHODS Australian typhoid notifications between 1st January 2010 and 30th June 2017 were grouped by country of acquisition and age category (<15 or ≥15 years). Australian travel data were used to inform time at risk and incidence rate of Australian typhoid notifications pertaining to country and region of acquisition. Salmonella Paratyphi infections, though notifiable, were excluded as the focus was vaccine preventable illness. Data from New South Wales and Victoria were used to examine the incidence in those acquiring infection in their country of birth (COB) against travellers who did not. RESULTS Nine hundred twenty-three cases of typhoid were notified over the period of review, 96% of which were acquired overseas. The greatest determinant of risk was travel destination, with countries in south Asia associated with highest crude incidence rate (252 per 100 000 person-years), particularly Bangladesh. Younger age and immigrants returning to their COB were generally associated with higher risk of acquisition. CONCLUSIONS The risk of typhoid fever in Australian travellers to endemic regions is considerable. Immigrants returning to their COB appear to be at higher risk and it is likely that this risk extends to their traveling dependents. These findings help clinicians and public health officials to plan and advise pre-travel vaccination strategies with at-risk individuals and groups. Additional sociodemographic data collection with Australian typhoid notifications would enhance the surveillance of differing international travel risk groups leaving Australia.
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Affiliation(s)
- Daniel P Forster
- Public Events, COVID-19 Response, Engagement & Delivery, Department of Health, VIC, Melbourne, Australia.,Victorian Infectious Diseases Service, Royal Melbourne Hospital at the Doherty Institute for Infection and Immunity, VIC, Melbourne, Australia
| | - Karin Leder
- Victorian Infectious Diseases Service, Royal Melbourne Hospital at the Doherty Institute for Infection and Immunity, VIC, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, VIC, Melbourne, Australia
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16
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Martinón-Torres F, García-Sastre A, Pollard AJ, Martín C, Osterhaus A, Ladhani SN, Ramilo O, Gómez Rial J, Salas A, Bosch FX, Martinón-Torres M, Mina MJ, Cherry J. TIPICO XI: report of the first series and podcast on infectious diseases and vaccines (aTIPICO). Hum Vaccin Immunother 2021; 17:4299-4327. [PMID: 34762551 PMCID: PMC8828069 DOI: 10.1080/21645515.2021.1953351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
TIPiCO is an annual expert meeting and workshop on infectious diseases and vaccination. The edition of 2020 changed its name and format to aTIPiCO, the first series and podcasts on infectious diseases and vaccines. A total of 13 prestigious experts from different countries participated in this edition launched on the 26 November 2020. The state of the art of coronavirus disease-2019 (COVID-19) and the responsible pathogen, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and the options to tackle the pandemic situation were discussed in light of the knowledge in November 2020. Despite COVID-19, the status of other infectious diseases, including influenza infections, respiratory syncytial virus disease, human papillomavirus infection, measles, pertussis, tuberculosis, meningococcal disease, and pneumococcal disease, were also addressed. The essential lessons that can be learned from these diseases and their vaccines to use in the COVID-19 pandemic were also commented with the experts.
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Affiliation(s)
- Federico Martinón-Torres
- Department of Paediatrics Translational Paediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, Universidad de Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Carlos Martín
- Department of Microbiology, Faculty of Medicine, IIS Aragon, Universidad de Zaragoza, CIBERES, Instituto de Salud Carlos III, Madrid, Spain
| | - Albert Osterhaus
- Research Center Emerging Infections and Zoonoses (RIZ, University of Veterinary Medicine Hannover, Hannover, Germany
| | | | - Octavio Ramilo
- Nationwide Children's Hospital and the Ohio State University, Columbus, Ohio, US
| | - Jose Gómez Rial
- Immunology Department, Hospital Clínico Universitario de Santiago de Compostela, Spain
| | - Antonio Salas
- Unidade de Xenética, Instituto de Ciencias Forenses (INCIFOR), Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigacinó Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain
| | | | | | - Michael J Mina
- Harvard School of Public Health and Harvard Medical School, Boston, MA, US
| | - James Cherry
- The David Geffen School of Medicine at UCLA, Los Angeles, CA, US
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17
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Chen J, Jia H, Cai Z, Zhou Y, Ma S, Chen Y, Chen C, Pan W. Economic burden of measles and its influencing factors in Fujian, China. Hum Vaccin Immunother 2021; 17:5367-5371. [PMID: 34714722 DOI: 10.1080/21645515.2021.1989917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Measles is a highly-contagious, serious diseases that can lead to potentially fatal illness, disability and death . We conducted an investigation to calculate the economic burden of measles cases from 2018 to 2019 and to analyze factors that influenced the total costs of measles cases in Fujian Province, China. METHODS We investigated confirmed cases of measles by telephone interview, from 2018 to 2019, including demographic characteristics, therapeutic measures, self-treatment and nutritional supplement expenditure, transportation fees, and lost wages. Medical expenses in the hospitals were obtained from the hospital service charge system. RESULTS A total of 131 measles cases were investigated, the average direct cost, indirect cost, and total cost were $518, $284, and $802, respectively. The total cost was 15.5% of Annual Per Capita Disposable Income of Households ($5 162) in Fujian. Hospitalization (OR = 98.6, 95%CI: 21.1 ~ 460.6) and complication (OR = 8.7, 95%CI: 1.3 ~ 58.0) significantly influenced the total cost according to binary logistic regression, and an outbreak of measles may pose a significant threat to household finances in a short term. CONCLUSIONS The economic burden of measles was high when compared with Annual Per Capita Disposable Income of Households. The resurgence of measles and measles outbreaks increased economic burden of household finances.
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Affiliation(s)
- Junlei Chen
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Haimei Jia
- Department of Immunization Program, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Zhikun Cai
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Yong Zhou
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Shanshan Ma
- Department of Immunization Program, Xiamen Center for Disease Control and Prevention, Xiamen, China
| | - Yahong Chen
- Department of Immunization Program, Quanzhou Center for Disease Control and Prevention, Quanzhou, China
| | - Changfu Chen
- Department of Immunization Program, City Center for Disease Control and Prevention, Ningde, China
| | - Weiyi Pan
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
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18
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Frau N, Meloni F, Fostinelli J, Portas L, Portoghese I, Sala E, Pilia I, Lecca LI, De Palma G, Campagna M. Seroepidemiology of Measles, Mumps, Rubella and Varicella in Italian Female School Workers: A Cross-Sectional Study. Vaccines (Basel) 2021; 9:1191. [PMID: 34696299 DOI: 10.3390/vaccines9101191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Determining the proportion of susceptible workers can represent a first step to the biological risk assessment related to measles, mumps, rubella and varicella exposure. This study aimed to assess the immunity against measles, mumps, rubella and varicella viruses in a cohort of female school workers. METHODS A cross-sectional seroepidemiological study in a sample of 263 school workers undergoing routine annual workplace health surveillance program was conducted. As part of the health surveillance program, serum samples were collected and tested for measles, mumps, rubella and varicella IgG antibodies. RESULTS Overall seropositivity was 90.5%, 85.2%, 94.7% and 97.3% for measles, mumps, rubella and varicella, respectively. In relation to mumps occupation-specific seropositivity, a statistically significant difference was observed, showing the lowest prevalence of protected individuals in other occupation groups. Moreover, in relation to rubella, school workers born in Centre Italy had the lowest seropositivity of protective antibodies and the difference between groups was statistically significant. Measles and rubella seropositivity showed a significant decrease after 2015. CONCLUSIONS This study showed a relevant proportion of school workers susceptible to the aforementioned diseases. These results highlighted the need for proper health surveillance and immunological controls in school workers, especially for females, and provided useful insights to policymakers to select effective strategies aimed at containing the risk of vaccine-preventable diseases at schools.
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Lin D, Ho Mi Fane B, Squires SG, Dickson C. Describing the burden of diphtheria in Canada from 2006 to 2017, using hospital administrative data and reportable disease data. ACTA ACUST UNITED AC 2021; 47:414-21. [PMID: 34737673 DOI: 10.14745/ccdr.v47i10a03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background Canada has maintained a low incidence of toxigenic diphtheria since the 1990s, supported by continued commitment to publicly funded vaccination programs. Objective To determine whether hospitalization data, complemented with notifiable disease data, can describe the toxigenic respiratory and cutaneous diphtheria burden in Canada, and to assess if Canada is meeting its diphtheria vaccine-preventable disease-reduction target of zero annual cases of locally transmitted respiratory diphtheria. Methods Diphtheria-related hospital discharge data from 2006 to 2017 were extracted from the Discharge Abstract Database (DAD), and diphtheria case counts for the same period were retrieved from the Canadian Notifiable Disease Surveillance System (CNDSS), for descriptive analyses. As data from the province of Québec are not included in the DAD, CNDSS cases from Québec were excluded. Results A total of 233 diphtheria-related hospitalizations were recorded in the DAD. Of these, diphtheria was the most responsible diagnosis in 23. Half the patients were male (52%), and 57% were 60 years and older. Central region (Ontario) accounted for the most discharge records (61%), followed by Prairie region (Alberta, Manitoba and Saskatchewan; 23%). Cutaneous diphtheria accounted for 43% of records, and respiratory diphtheria accounted for 3%, with the remainder being other diphtheria complications or site unspecified. Two records with diphtheria as the most responsible diagnosis resulted in inpatient deaths. Eighteen cases of diphtheria were reported through CNDSS. Cases occurred in all age groups, with the largest proportions among those aged 20 to 59 years (39%) and those aged 19 years and younger (33%). Cases were only reported in the Prairie (89%) and West Coast (British Columbia; 11%) regions. Conclusion Hospital administrative data are consistent with the low incidence of diphtheria reported in CNDSS, and a low burden of respiratory diphtheria in Canada. Although Canada appears to be on track to meet its disease-reduction target, information on endemic transmission is not available.
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Abstract
Rotavirus is a major cause of severe pediatric diarrhea worldwide. In 2006, two live, oral rotavirus vaccines, Rotarix and RotaTeq, were licensed for use in infants and were rapidly adopted in many high- and middle-income settings where efficacy had been demonstrated in clinical trials. Following completion of additional successful trials in low-income settings, the World Health Organization (WHO) recommended rotavirus vaccination for all infants globally in 2009. In 2018, two new rotavirus vaccines, Rotasiil and Rotavac, were prequalified by WHO, further expanding global availability. As of March 2021, rotavirus vaccines have been introduced nationally in 106 countries. Since introduction, rotavirus vaccines have demonstrated effectiveness against severe disease and mortality, even among age groups not eligible for vaccination. Cross-genotypic protection has also been demonstrated, and the favorable benefit-risk profile of these vaccines continues to be confirmed via post-marketing surveillance. Ongoing research seeks to better understand reasons for the lower effectiveness observed in lower-resource settings, and to use these findings to optimize vaccine strategies worldwide.
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Affiliation(s)
- Rachel M Burke
- Viral Gastroenteritis Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jacqueline E Tate
- Viral Gastroenteritis Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Umesh D Parashar
- Viral Gastroenteritis Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
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21
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Bollaerts K, Fletcher MA, Suaya JA, Hanquet G, Baay M, Gessner BD. Vaccine-Preventable Disease Incidence Based on Clinically, Radiologically and Etiologically Confirmed Outcomes: Systematic Literature Review and Re-analysis of Pneumococcal Conjugate Vaccine Efficacy Trials. Clin Infect Dis 2021; 74:1362-1371. [PMID: 34313721 PMCID: PMC9049266 DOI: 10.1093/cid/ciab649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Indexed: 11/14/2022] Open
Abstract
Background Vaccine regulatory decision making is based on vaccine efficacy against etiologically confirmed outcomes, which may underestimate the preventable disease burden. To quantify this underestimation, we compared vaccine-preventable disease incidence (VPDI) of clinically defined outcomes with radiologically/etiologically confirmed outcomes. Methods We performed a systematic review of efficacy trials for several vaccines (1997–2019) and report results for pneumococcal conjugate vaccines. Data were extracted for outcomes within a clinical syndrome, organized from most sensitive to most specific. VPDI was determined for each outcome, and VPDI ratios were calculated, with a clinically defined outcome (numerator) and a radiologically/etiologically confirmed outcome (denominator). Results Among 9 studies, we calculated 27 VPDI ratios; 24 had a value >1. Among children, VPDI ratios for clinically defined versus vaccine serotype otitis media were 0.6 (95% CI not calculable), 2.1 (1.5–3.0), and 3.7 (1.0–10.2); the VPDI ratios comparing clinically defined with radiologically confirmed pneumonia ranged from not calculable to 2.7 (1.2–10.4); the VPDI ratio comparing clinically suspected invasive pneumococcal disease (IPD) with laboratory-confirmed IPD was 3.8 (95% CI not calculable). Among adults, the ratio comparing clinically defined with radiologically confirmed pneumonia was 1.9 (−6.0 to 9.1) and with vaccine serotype–confirmed pneumonia was 2.9 (.5–7.8). Conclusions While there is substantial uncertainty around individual point estimates, there is a consistent trend in VPDI ratios, most commonly showing under-ascertainment of 1.5- to 4-fold, indicating that use of clinically defined outcomes is likely to provide a more accurate estimate of a pneumococcal conjugate vaccine’s public health value.
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Affiliation(s)
| | - Mark A Fletcher
- Pfizer Inc., Emerging Markets Medical Affairs, Paris, France
| | - Jose A Suaya
- Pfizer Inc., Vaccines Medical Development & Scientific/Clinical Affairs, New York, NY, United States of America
| | | | - Marc Baay
- P95 Epidemiology and Pharmacovigilance, Leuven, Belgium
| | - Bradford D Gessner
- Pfizer Inc., Scientific Affairs, Collegeville, PA, United States of America
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22
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Kohlmaier B, Schweintzger NA, Sagmeister MG, Švendová V, Kohlfürst DS, Sonnleitner A, Leitner M, Berghold A, Schmiedberger E, Fazekas F, Pichler A, Rejc-Marko J, Růžek D, Dufková L, Čejková D, Husa P, Pýchová M, Krbková L, Chmelík V, Štruncová V, Zavadska D, Karelis G, Mickiene A, Zajkowska J, Bogovič P, Strle F, Zenz W, The Eu-Tick-Bo Study Group. Clinical Characteristics of Patients with Tick-Borne Encephalitis (TBE): A European Multicentre Study from 2010 to 2017. Microorganisms 2021; 9:1420. [PMID: 34209373 DOI: 10.3390/microorganisms9071420] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 12/25/2022] Open
Abstract
Tick-borne encephalitis (TBE) virus is a major cause of central nervous system infections in endemic countries. Here, we present clinical and laboratory characteristics of a large international cohort of patients with confirmed TBE using a uniform clinical protocol. Patients were recruited in eight centers from six European countries between 2010 and 2017. A detailed description of clinical signs and symptoms was recorded. The obtained information enabled a reliable classification in 553 of 555 patients: 207 (37.3%) had meningitis, 273 (49.2%) meningoencephalitis, 15 (2.7%) meningomyelitis, and 58 (10.5%) meningoencephalomyelitis; 41 (7.4%) patients had a peripheral paresis of extremities, 13 (2.3%) a central paresis of extremities, and 25 (4.5%) had single or multiple cranial nerve palsies. Five (0.9%) patients died during acute illness. Outcome at discharge was recorded in 298 patients. Of 176 (59.1%) patients with incomplete recovery, 80 (27%) displayed persisting symptoms or signs without recovery expectation. This study provides further evidence that TBE is a severe disease with a large proportion of patients with incomplete recovery. We suggest monitoring TBE in endemic European countries using a uniform protocol to record the full clinical spectrum of the disease.
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23
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Salama M, Indenbaum V, Nuss N, Savion M, Mor Z, Amitai Z, Yoabob I, Sheffer R. A Measles Outbreak in the Tel Aviv District, Israel, 2018-2019. Clin Infect Dis 2021; 72:1649-1656. [PMID: 32619227 DOI: 10.1093/cid/ciaa931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/30/2020] [Indexed: 11/14/2022] Open
Abstract
During a national measles outbreak in 2018-2019, the Tel Aviv District suffered a major upsurge of cases, with 413 patients reported. Among them, 100 (24%) were <1 year, 92 (22%) patients were aged 12 months to 4 years, 47 (11%) were 5-18 years, 169 (41%) were 19-60 years, and 5 (1%) patients were older than 61 years (born before 1957). Among all cases, 230 (56%) were part of the Ultra-Orthodox Jewish community, 55 (13%) were among undocumented African immigrants. Despite high vaccination coverage, sustained measles transmission occurred, due in part to importations and numerous exposures in medical settings by a susceptible birth cohort. The Ultra-Orthodox Jewish community was particularly afflicted due to its condense population, high birth rates, and multiple exposures in crowded religious settings. This outbreak demonstrates the necessity of addressing immunity gaps as well optimal healthcare planning in order to prevent future outbreaks.
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Affiliation(s)
- Matanelle Salama
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
| | - Vicki Indenbaum
- Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Naama Nuss
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
| | - Michal Savion
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
| | - Zohar Mor
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel.,School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Ziva Amitai
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
| | - Irina Yoabob
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
| | - Rivka Sheffer
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
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24
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Pițigoi D, Săndulescu O, Crăciun MD, Drăgănescu A, Jugulete G, Streinu-Cercel A, Vișan A, Rîciu C, Rafila A, Aramă V, Luminos M, Streinu-Cercel A. Measles in Romania - clinical and epidemiological characteristics of hospitalized measles cases during the first three years of the 2016-ongoing epidemic. Virulence 2021; 11:686-694. [PMID: 32507005 PMCID: PMC7549973 DOI: 10.1080/21505594.2020.1771948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A large measles epidemic has been ongoing in Romania and many European countries, since 2016. We report case-based surveillance data for all patients (n = 1371) with laboratory-confirmed and epidemiologically-confirmed measles hospitalized in a major infectious diseases hospital in Bucharest Romania during the first three years of the current measles epidemic (July 2016–July 2019). More than half of the patients (57.6%) had ages below 5 years; 6% (n = 82) had preexisting comorbidities. Only 1.5% of the patients had been fully vaccinated, 5.9% had received only one vaccine dose, while 92.8% had not been vaccinated at all against measles. The rate of measles-related complications was 93.4%; complications occurred more frequently among patients who were not eligible for vaccination due to young age or underlying diseases, and among children, who developed pneumonia and enterocolitis more frequently than adults. The median hospital length-of-stay was 6 days. Eight cases (0.6%) required intensive care and mechanical ventilation, and three deaths (0.2%) were recorded. Measles disproportionately affects patient groups who are not eligible for vaccination. During the current epidemic in Romania, 98.5% of the patients hospitalized for measles had not been vaccinated and among these, 75.7% would have been eligible for vaccination. For the remaining pool of unvaccinated children, supplementary immunization activities are urgently needed.
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Affiliation(s)
- Daniela Pițigoi
- Department of Epidemiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy , Bucharest, Romania.,National Institute for Infectious Diseases "Prof. Dr. Matei Balș" , Bucharest, Romania
| | - Oana Săndulescu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș" , Bucharest, Romania.,Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
| | - Maria Dorina Crăciun
- Department of Epidemiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
| | - Anca Drăgănescu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș" , Bucharest, Romania
| | - Gheorghiță Jugulete
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș" , Bucharest, Romania.,Department of Infectious Diseases, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
| | - Anca Streinu-Cercel
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș" , Bucharest, Romania.,Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
| | - Angelica Vișan
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș" , Bucharest, Romania.,Department of Infectious Diseases, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
| | - Claudia Rîciu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș" , Bucharest, Romania
| | - Alexandru Rafila
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș" , Bucharest, Romania.,Department of Microbiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
| | - Victoria Aramă
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș" , Bucharest, Romania.,Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
| | - Monica Luminos
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș" , Bucharest, Romania.,Department of Infectious Diseases, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
| | - Adrian Streinu-Cercel
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș" , Bucharest, Romania.,Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy , Bucharest, Romania
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25
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Silveira MM, Crespo da Silva PA, Conrad NL, Oliveira TL, Hartwig DD, Trotter C. Surveillance of invasive meningococcal disease in the south of Brazil: considerations of immunization programme. J Med Microbiol 2021; 70. [PMID: 33544069 DOI: 10.1099/jmm.0.001323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Invasive meningococcal disease (IMD) is a major cause of meningitis and septicaemia worldwide. The switches in serogroup predominance contribute to the unpredictable nature of the disease with significant health impacts. The aim of this study was to determine the epidemiological profile of IMD in Rio Grande do Sul, Santa Catarina and Paraná, three states in the south of Brazil. All meningitis cases confirmed by clinical and/or laboratory criteria notified to the national information system for notifiable diseases between 2015 and 2019 were analysed. Proportions of serogroup and incidence by age were calculated. A total of 17 894 cases of IMD were reported during this period. Of these, 9029 cases (50 %) were due to serogroup C. Furthermore, serogroup W was responsible for almost half of the cases among children younger than 5 years old during 2017 and 2018, with an overall incidence of 33.3 cases per 100 000 infants. Despite the reduction in serogroup C after the introduction of meningococcal C conjugate vaccine into a childhood immunization programme in Brazil, it remains a significant healthcare issue in the south of the country. Changes in disease epidemiology were observed and serogroup W was the most common among children below 5 years of age in 2017 and 2018. Although future cost-effectiveness studies are necessary, our results could have future implications for meningococcal vaccination programmes.
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Affiliation(s)
- Marcelle Moura Silveira
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Neida Lucia Conrad
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Thaís Larré Oliveira
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Daiane Drawanz Hartwig
- Biology Institute, Department of Microbiology and Parasitology, Federal University of Pelotas, Pelotas, RS, Brazil.,Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Caroline Trotter
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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26
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Yu JH, Jeong HJ, Kim SJ, Lee JY, Choe YJ, Choi EH, Cho EH. Sustained Vaccination Coverage during the Coronavirus Disease 2019 Epidemic in the Republic of Korea. Vaccines (Basel) 2020; 9:2. [PMID: 33375172 DOI: 10.3390/vaccines9010002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/17/2020] [Accepted: 12/19/2020] [Indexed: 01/27/2023] Open
Abstract
Amid the COVID-19 pandemic, vaccination coverage may decline due to limited accessibility to healthcare. We assessed the impact of the COVID-19 pandemic on vaccination coverage and the incidence of vaccine-preventable diseases (VPDs) in the Republic of Korea. National vaccination coverage of 10 essential vaccines administered to children between January-June 2019 and January-June 2020 was analyzed. The national incidence of selected VPDs was compared for the corresponding periods. During the COVID-19 outbreak, the vaccination rate in children aged 0-35 months in Korea did not decrease significantly, whereas the vaccination rate for children aged 4-6 years decreased by 1.4-1.9%. The overall incidence of VPDs decreased by 10-50% between 2019 and 2020, especially with varicella. Thus, the COVID-19 pandemic did not result in a decrease in vaccination coverage among Korean children, which prevented a surge in VPD incidence. Maintaining essential vaccination coverage without interruption is important during the response to the COVID-19 pandemic.
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27
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Yun HE, Ryu BY, Choe YJ. Impact of social distancing on incidence of vaccine-preventable diseases, South Korea. J Med Virol 2020; 93:1814-1816. [PMID: 33079384 DOI: 10.1002/jmv.26614] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/29/2020] [Accepted: 10/16/2020] [Indexed: 11/06/2022]
Abstract
While vaccination remains the cornerstone of controlling vaccine-preventive diseases (VPD), little is known about the effect of social distancing on incidence of VPDs. We investigated the impact of social distancing practiced during the coronavirus disease 2019 (COVID-19) pandemic on the incidence of selected VPDs in South Korea. National surveillance data on monthly incidence of hepatitis A, hepatitis B, varicella, mumps, invasive pneumococcal disease (IPD), and pertussis were retrieved and compared the VPD incidences in 2020 to the average of the last 4 years (2015-2019) of the corresponding months. In 2020, there were 44% decline for mumps, 44% decline for varicella, 28% decline for pertussis, 22% decline for IPD, 14% decline in incidence of hepatitis A, and no change for hepatitis B incidences, compared to baseline years (2015-2019). The largest decline of total VPDs was in April (65%) and in May (67%), during the intensified social distancing measures. In the setting of sustained vaccination coverage, social distancing may provide additional public health benefit in controlling the VPDs.
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Affiliation(s)
- Hyo Eun Yun
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Korea
| | - Bo Young Ryu
- Division of Infectious Disease Response, Gyeongnam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Busan, Korea
| | - Young June Choe
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Korea
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28
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Nasir M, Vinsard DG, Wakefield D, Karagozian R. The important role of immunization in alcoholic and non-alcoholic chronic liver disease: A population-based study. J Dig Dis 2020; 21:583-592. [PMID: 32729256 DOI: 10.1111/1751-2980.12926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine differences in frequencies of vaccine-preventable diseases between alcoholic liver disease (ALD) and non-alcoholic liver disease (NALD) patients. METHODS This population-based cohort study used USA national inpatient sample ICD-9 codes from January 2012 to September 2015. Frequencies of admissions for ALD and NALD in patients with pneumococcal pneumonia, influenza, herpes zoster virus, varicella zoster virus, hepatitis A, hepatitis B, human papilloma virus, meningococcal meningitis, diphtheria, pertussis and tetanus were measured. Frequencies and patients' characteristics were compared for ALD and NALD using χ2 test and multivariate logistic regression analysis. RESULTS There was no difference in admissions for hepatitis A and pneumococcal pneumonia between the ALD and NALD groups. There were fewer admissions for hepatitis B (1.17% vs 1.80%, odds ratio [OR] 0.64, P < 0.01), herpes zoster (0.12% vs 0.17%, OR 0.69, P < 0.01), influenza (0.16% vs 0.26%, OR 0.59, P < 0.01) and all others (0.005% vs 0.015%, OR 0.36, P = 0.01) in the ALD group than the NALD group. The extreme all patient refined-diagnosis related groups mortality risk was 15.24% in ALD and 7.77% in NALD admissions (P < 0.0001). CONCLUSIONS The most frequent vaccine-preventable disease in both groups was hepatitis B. Patients with NALD had higher odds of admissions for hepatitis B, herpes zoster virus, influenza and other vaccine-preventable disease than ALD patients. However, the ALD group had a higher risk of mortality when admitted to hospital with a vaccine-preventable disease than the NALD group.
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Affiliation(s)
- Myra Nasir
- Division of Internal Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Daniela Guerrero Vinsard
- Division of Internal Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Dorothy Wakefield
- Center of Aging, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Raffi Karagozian
- Division of Gastroenterology and Hepatology, Tufts University School of Medicine, Boston, Massachusetts, USA
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29
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Abstract
The COVID-19 pandemic has posed multiple substantial challenges, affecting not only public health but also economic systems, socio-cultural patterns, and political institutions. Studies have focused on the relationships between complex emergencies and natural disasters with outbreaks of infectious diseases. However, there is a dearth of relevant literature on the impact of a global pandemic on vaccination programs - an important topic because delays or stops in such programs are likely to result in outbreaks and epidemics of other infectious diseases. Thus, this article discusses the negative and positive impacts that the COVID-19 pandemic may exert on vaccination for vaccine-preventable diseases (VPDs). Negative impacts include the increased risk of VPD outbreaks in low-resource countries where vaccination programs must be temporarily halted to prevent the spread of infection. Positive effects include the strong possibility that the universally-recognized need for a coronavirus vaccine may increase people's appreciation for vaccines in general, resulting in improved vaccination uptake once the pandemic passes. Concerned stakeholders, such as governments and the World Health Organization (WHO), should seize this moment to effectively build on these positive impacts by planning renewed and revitalized post-COVID vaccination programs.
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Affiliation(s)
- Inayat Ali
- Department of Social and Cultural Anthropology, University of Vienna , Vienna Austria
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30
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Kandi V, Katoch A, Miniskar H, Jaripiti S, Rv SS, Burugu HR, Reddy AV, Bhasin A. Adequate Knowledge and Low Vaccination Rates of Hepatitis B Virus Infection Among Students, Medical, and Paramedical Persons in a Tertiary Care Teaching Hospital. Cureus 2020; 12:e9121. [PMID: 32789062 PMCID: PMC7417095 DOI: 10.7759/cureus.9121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Introduction Hepatitis B virus (HBV) is probably the only vaccine-preventable virus transmitted from one person to the other by blood transfusion, sex, and contact with blood and blood products. HBV is highly transmissible, where the infection has been noted to transmit among the household contacts. HBV is also transmitted from the mother to the child through the transplacental barrier. Clinical infection with HBV may be chronic and could remain for a lifetime. Most exposures with HBV are automatically resolved, but a few infected people may become carriers and may transmit infections. Although HBV can be treated, complete elimination of the virus and the morbidity and mortality associated with chronic infection should be considered as a cause of serious concern. Because healthcare workers are predisposed to HBV infection, adequate knowledge about the virus and the vaccine to prevent the infection is necessary. This study is carried out to assess the knowledge of HBV infection and the status of vaccination among medical, paramedical students, laboratory technicians, and doctors. Methods The study included 256 participants attending a tertiary care teaching hospital in Telangana, South India. The participants belonged to three groups, the MBBS students (first, second-, and third-year students), the doctors (the postgraduates, medical teachers, and the clinicians), and the paramedical personnel. All the participants in the study were included after oral consent, and the study was approved by the Institutional Ethics Committee. A questionnaire containing 13 points was used for the study. Seven questions were asked to know the respondent’s knowledge of HBV infection, and the other six were used to know the participant's knowledge and status of HBV vaccination. The study participants filled in the responses with their current understanding of the HBV infection and the vaccine. All the responses were analyzed using Microsoft Office Excel and drawing means and percentages. Results Among the 94 medical students, 79 (84%) knew about HBV infection. There was a significant improvement in the knowledge of HBV infection among MBBS students, with first-year MBBS (68%) to the final-year MBBS (100%). The knowledge of HBV among the doctors (postgraduates, medical teachers, and clinicians) was 100%. Among the paramedical participants that included the laboratory technicians and the nursing students, all (100%) knew about HBV infection. Very few MBBS students (12%), 28% of paramedical persons, and 45% of doctors were tested for HBV infection. The knowledge of HBV vaccination was best among the doctors (100%) followed by the paramedical personnel (89%) and the MBBS students (72%). The teaching faculty including the postgraduate students (83%) were vaccinated followed by the paramedical persons (66%), and only 24% of MBBS students were vaccinated. Conclusions The study participants had a reasonably good knowledge of HBV infection, and low vaccination rates were observed among various participants. There is an urgent need to understand the significance of HBV infection, especially among healthcare workers. Being easily transmissible and because of the availability of an effective vaccine, healthcare workers should be adequately vaccinated to prevent the spread of infection.
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Affiliation(s)
- Venkataramana Kandi
- Clinical Microbiology, Prathima Institute of Medical Sciences, Karimnagar, IND
| | - Abhilasha Katoch
- Medicine, Prathima Institute of Medical Sciences, Karimnagar, IND
| | | | - Sneha Jaripiti
- Medicine, Prathima Institute of Medical Sciences, Karimnagar, IND
| | - Sai Supreethi Rv
- Medicine, Prathima Institute of Medical Sciences, Karimnagar, IND
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31
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Top KA, Macartney K, Bettinger JA, Tan B, Blyth CC, Marshall HS, Vaudry W, Halperin SA, McIntyre P. Active surveillance of acute paediatric hospitalisations demonstrates the impact of vaccination programmes and informs vaccine policy in Canada and Australia. ACTA ACUST UNITED AC 2020; 25. [PMID: 32613939 PMCID: PMC7331140 DOI: 10.2807/1560-7917.es.2020.25.25.1900562] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Sentinel surveillance of acute hospitalisations in response to infectious disease emergencies such as the 2009 influenza A(H1N1)pdm09 pandemic is well described, but recognition of its potential to supplement routine public health surveillance and provide scalability for emergency responses has been limited. We summarise the achievements of two national paediatric hospital surveillance networks relevant to vaccine programmes and emerging infectious diseases in Canada (Canadian Immunization Monitoring Program Active; IMPACT from 1991) and Australia (Paediatric Active Enhanced Disease Surveillance; PAEDS from 2007) and discuss opportunities and challenges in applying their model to other contexts. Both networks were established to enhance capacity to measure vaccine preventable disease burden, vaccine programme impact, and safety, with their scope occasionally being increased with emerging infectious diseases’ surveillance. Their active surveillance has increased data accuracy and utility for syndromic conditions (e.g. encephalitis), pathogen-specific diseases (e.g. pertussis, rotavirus, influenza), and adverse events following immunisation (e.g. febrile seizure), enabled correlation of biological specimens with clinical context and supported responses to emerging infections (e.g. pandemic influenza, parechovirus, COVID-19). The demonstrated long-term value of continuous, rather than incident-related, operation of these networks in strengthening routine surveillance, bridging research gaps, and providing scalable public health response, supports their applicability to other countries.
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Affiliation(s)
- Karina A Top
- These authors contributed equally.,Canadian Center for Vaccinology, IWK Health Centre, Halifax, Canada.,Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Kristine Macartney
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,National Centre for Immunisation Research and Surveillance and The Children's Hospital Westmead, Sydney, Australia.,These authors contributed equally
| | - Julie A Bettinger
- University of British Columbia and Vaccine Evaluation Center, British Columbia Children's Hospital, Vancouver, Canada
| | - Ben Tan
- University of Saskatchewan, Royal University Hospital, Saskatoon, Canada
| | - Christopher C Blyth
- Telethon Kids Institute and School of Medicine, University of Western Australia and Perth Children's Hospital, Perth, Australia
| | - Helen S Marshall
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide and VIRTU Women's and Children's Health Network, Adelaide, Australia
| | - Wendy Vaudry
- University of Alberta, Stollery Children's Hospital, Edmonton, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, IWK Health Centre, Halifax, Canada.,Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Peter McIntyre
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,National Centre for Immunisation Research and Surveillance and The Children's Hospital Westmead, Sydney, Australia
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- The IMPACT and PAEDS investigators are acknowledged at the end of this article
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Koul PA, Swaminathan S, Rajgopal T, Ramsubramanian V, Joseph B, Shanbhag S, Mishra A, Raut SK. Adult Immunization in Occupational Settings: A Consensus of Indian Experts. Indian J Occup Environ Med 2020; 24:3-15. [PMID: 32435109 PMCID: PMC7227733 DOI: 10.4103/ijoem.ijoem_50_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 12/18/2022] Open
Abstract
There is an increasing focus on instituting wellness programs at the workplace among organizations in India. Such programs are aimed at improving employee health, which in turn, helps in reducing absenteeism, as well as in increasing work productivity and improving employee engagement. Of note, adult vaccination plays a significant role in ensuring the well-being of employees, as well as in keeping an organization profitable. The burden of vaccine-preventable diseases (VPDs) in adults is increasing in India, causing significant morbidity and disability. Moreover, adult immunization is an underpublicized concept in India. There is an urgent need to create awareness about adult immunization in India, particularly in occupational health settings-both at the employee and employer levels. In view of this, an expert meeting was held under the aegis of the Indian Association of Occupational Health (IAOH) to discuss key issues pertaining to the burden of VPDs in the working population in India and to formulate guidelines on adult vaccination in occupational health settings. This consensus guideline document may act as a guide for organizations across India to create awareness about adult vaccination and also to design workplace vaccination programs to promote better health among employees.
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Affiliation(s)
- Parvaiz A. Koul
- Professor and Head, Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Subramanium Swaminathan
- Senior Consultant, Infectious Diseases, Gleneagles Global Health City, Chennai, Tamil Nadu, India
| | - Thirumalai Rajgopal
- Vice President, Global Medical and Occupational Health, Unilever, Mumbai, Maharashtra, India
| | - V. Ramsubramanian
- Senior Consultant, Infectious Diseases and Tropical Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Bobby Joseph
- Professor, Community Health; Head, Occupational Health Services, St. John's Medical College, Bangalore, Karnataka, India
| | - Shrinivas Shanbhag
- Medical Advisor, Chairman's Office, Reliance Industries Limited, Mumbai, Maharashtra, India
| | - Ashish Mishra
- Health Director – Europe, Middle East, Africa and India, Dow Chemical International Pvt. Ltd. and President, Indian Association of Occupational Health, Mumbai Branch, Maharashtra, India
| | - Sidram K. Raut
- Director, Noble Hospital; Head of Blood Bank, Corporate and Overseas Business and Clinical Research, Noble Hospital, Pune, Maharashtra and President, Indian Association of Occupational Health, India
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Vinsard DG, Wakefield D, Vaziri H, Karagozian R. Vaccine-Preventable Diseases in Hospitalized Patients With Inflammatory Bowel Disease: A Nationwide Cohort Analysis. Inflamm Bowel Dis 2019; 25:1966-1973. [PMID: 31067308 DOI: 10.1093/ibd/izz093] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) entails a higher risk of infections, including those that could be prevented with immunizations. Current Advisory Committee on Immunization Practices and American College of Gastroenterology vaccine recommendations for patients with IBD are based on low levels of evidence. METHODS We conducted a population-based descriptive cohort study using the US National Inpatient Sample ICD-9 codes from 2012 to 2015. We measured the frequency of patients with IBD who were admitted to the hospital with a vaccine-preventable disease (VPD). Frequencies and demographics were determined and compared between patients with IBD and patients without IBD. RESULTS Of discharges, 596,485 (2.08%) were secondary to a VPD, and 7180 (1.2%) were found to have both a VPD and IBD (including Crohn disease and ulcerative colitis). The most common VPDs among patients with IBD were herpes zoster virus (HZV) (34.9%) and hepatitis B virus (31.6%), followed by influenza (22.1%). Pneumococcal pneumonia (9.1%) and hepatitis A virus (2.4%) were less common. Inpatients with IBD were twice as likely to have HZV when compared to non-IBD inpatients (odds ratios [OR] = 2.30 [95% CI, 2.06-2.58], P < 0.0001) This finding was consistent for every study year. Pneumococcal pneumonia [OR = 0.62 (95% CI, 0.52-0.74), P < 0.0001] and influenza [OR = 0.72 (95% CI, 0.63-0.81), P < 0.0001] were significantly lower in the IBD population. There was no difference for other VPDs. CONCLUSIONS HZV was the most frequent VPD in IBD inpatients. Patients with IBD have a higher rate of hospital admissions with HZV and a lower rate of pneumococcal pneumonia and influenza admissions when compared with non-IBD patients. For other VPDs, patients with IBD have the same rate of admission as the general population.
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Affiliation(s)
- Daniela Guerrero Vinsard
- Division of Internal Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Dorothy Wakefield
- Center on Aging, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Haleh Vaziri
- Division of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Raffi Karagozian
- Division of Gastroenterology and Hepatology, Tufts University School of Medicine, Boston, Massachusetts, USA.,Division of Gastroenterology and Hepatology, Saint Francis Hospital, Hartford, Connecticut, USA
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Costantino C, Ledda C, Genovese C, Contrino E, Vitale E, Maida CM, Squeri R, Vitale F, Rapisarda V. Immunization Status against Measles of Health-Care Workers Operating at Three Sicilian University Hospitals: An Observational Study. Vaccines (Basel) 2019; 7:vaccines7040175. [PMID: 31684158 PMCID: PMC6963751 DOI: 10.3390/vaccines7040175] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 11/16/2022] Open
Abstract
Measles is a highly contagious vaccine-preventable disease (VPD) that also commonly affects health-care workers (HCWs). Measles immunization of HCWs was strongly recommended by international health authorities, in order to limit the spreading of the illness to susceptible patients and colleagues. An observational study, evaluating the immunization and vaccination status against measles of HCWs working at three Sicilian university hospitals, was conducted. All subjects not completely immune (vaccinated with only one dose in their lifetime), not immune (not vaccinated or not naturally immunized), and with an unknown immunization status were considered not immunized. Among HCWs operating in the three Sicilian university hospitals, 54.6% were not immune against measles. The average age of not immune HCWs was 51.3 (SD ± 9.8), ranging between 25 and 71 years old. In particular, 46.9% of HCWs not immunized worked in “at-risk” hospital units, based on medical conditions of patients which increases the probability of contracting an infection. Vaccination coverage rates observed against measles are considerably lower than other European countries and inadequate. It is therefore crucial to tackle vaccine hesitancy among HCWs, promoting strategies targeted to evaluate immunization status against VPDs and to significantly increase vaccine coverages, such as tailored training and vaccination offer or compulsory vaccination programs.
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Affiliation(s)
- Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Cristina Genovese
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, 98125 Messina, Italy.
| | - Eleonora Contrino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
| | - Ermanno Vitale
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Carmelo Massimo Maida
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
| | - Raffaele Squeri
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional images, University of Messina, 98125 Messina, Italy.
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
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35
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Al Gunaid M, Lami F, Jarour N. A Collaborative Initiative to Strengthen Sustainable Public Health Capacity for Polio Eradication and Routine Immunization Activities in the Eastern Mediterranean Region. JMIR Public Health Surveill 2019; 5:e14664. [PMID: 31663863 PMCID: PMC6913771 DOI: 10.2196/14664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 09/01/2019] [Accepted: 09/25/2019] [Indexed: 11/13/2022] Open
Abstract
The many challenges in the Eastern Mediterranean region put the involved countries at risk of polio transmission and affect their ability to meet progress targets in eliminating vaccine-preventable diseases. The Global Health Development (GHD) and Eastern Mediterranean Public Health Network (EMPHNET) are working together on the project "Strengthening sustainable public health capacity in the Eastern Mediterranean region for polio eradication and routine immunization activities" with an overall goal of improving routine immunization, eradicating poliovirus, and controlling/eliminating or eradicating other vaccine-preventable diseases in the Eastern Mediterranean region. The aim of this manuscript is to describe the project and the achievements of GHD/EMPHNET over the last 3 years (2016-2018) to build effective surveillance and immunization systems in the Eastern Mediterranean region through the development of a sustainable and competent public health system to eradicate polio and control/eliminate vaccine-preventable diseases. This project assists the targeted Eastern Mediterranean region countries to build effective surveillance and immunization systems in an effort to expand their capacities to eradicate polio and control/eliminate other vaccine-preventable diseases. The project is streamlined with the Global Polio Eradication Initiative, the Centers for Disease Control and Prevention's Strategic Framework for Global Immunization 2016-2020, and the Polio Eradication and Endgame Strategic Plan 2013-2018. The project also supports the Global Health Security Agenda by focusing on efforts to accelerate progress toward a world safe and secure from infectious disease threats. Project activities were designed to respond to countries' needs and assist them in building their institutional and workforce capacity to effectively plan, implement, and evaluate activities to eradicate polio and strengthen routine immunization activities. The project activities covered a set of areas including surveillance of acute flaccid paralysis and other vaccine-preventable diseases, family and community engagement, workforce capacity building, improvement of data quality, management and use of information systems, use of polio assets to control/eliminate other vaccine-preventable diseases, support of countries to develop national strategies, piloting of innovative initiatives, program evaluation and accountability, and immunization strengthening. The project adopts the Global Polio Eradication Initiative strategies for assisting countries to strengthen routine immunization services, maintain highly sensitive acute flaccid paralysis surveillance, and sustain polio eradication functions.
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Affiliation(s)
- Magid Al Gunaid
- Polio and Immunization Team, Global Health Development/Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Faris Lami
- Department of Community and Family Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Najwa Jarour
- Polio and Immunization Team, Global Health Development/Eastern Mediterranean Public Health Network, Amman, Jordan
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Abstract
Influenza, an infectious disease of the respiratory system, represents a major burden for public health. This disease affects all age groups with different prognosis, being life threatening for vulnerable individuals. Despite influenza being a vaccine-preventable disease, the control of the infection needs annual vaccination campaigns and constant improvements. Herein, the main challenges of influenza in relation to the pathogenic agent, the available vaccines and the health impact identified during the Light on Vax event, an expert meeting organized by the Asociación Española de Vacunología [Spanish Vaccinology Association] (AEV), are reported. Further possible steps in the control of influenza are also suggested. Ideally, the development of innovative and universal vaccines that would confer life-lasting and broader-spectrum immunity is highly desirable.
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Affiliation(s)
- Francisco Álvarez
- Health Center of Llanera (Asturias), Medicine Department, University of Oviedo, Asturias, Spain
| | - Filipe Froes
- Intensive Care Unit, Hospital Pulido Valente, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | | | - David Moreno-Perez
- Department of Pediatrics, Pediatric Infectology & Immunodeficiency Unit, Regional University Children´s Hospital of Malaga, Malaga, Spain.,IBIMA Multidisciplinary Group for Pediatric Research of Malaga, Malaga University, Malaga, Spain
| | - Federico Martinón-Torres
- Department of Paediatrics, Translational Paediatrics & Infectious Diseases, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain.,Instituto de Investigación Sanitaria de Santiago, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
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37
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Shetty S, Murmann M, Tuite AR, Watts AG, Bogoch I, Khan K. Measles and the 2019 Hajj: risk of international transmission. J Travel Med 2019; 26:5549356. [PMID: 31407794 DOI: 10.1093/jtm/taz058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 11/13/2022]
Affiliation(s)
| | | | - Ashleigh R Tuite
- BlueDot, Toronto M5J 1A7, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto M5T 3M7, Canada
| | | | - Isaac Bogoch
- Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto M5G 2C4, Canada
| | - Kamran Khan
- BlueDot, Toronto M5J 1A7, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto M5T 3M7, Canada.,Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto M5G 2C4, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto M5B 1T8, Canada
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Abstract
The transmission of infectious agents within healthcare settings is a priority public health problem. Although the main burden of healthcare-associated infections is commonly caused by Gram-negative bacteria and fungi, vaccine-preventable diseases represent an additional infectious risk for patients attending healthcare facilities. Hepatitis B, rotavirus gastroenteritis, influenza, measles, pertussis and pneumococcal and meningococcal invasive bacterial infections still represent a threat, notwithstanding the presence of universal vaccination programs. For this reason, healthcare worker immunization is an important strategy to limit the risk of vaccine-preventable diseases in such a fragile population.
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Affiliation(s)
- Lara Tavoschi
- Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
| | - Filippo Quattrone
- Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
| | - Antonella Agodi
- Department of Medical & Surgical Sciences & Advanced Technologies 'GF Ingrassia', University of Catania, via S. Sofia, 87, 95123, Catania, Italy
| | - Pier L Lopalco
- Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
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39
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Su QR, Yao KH. [Epidemiological and clinical features of vaccine-preventable diseases in vaccine era]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:195-198. [PMID: 30907338 PMCID: PMC7389355 DOI: 10.7499/j.issn.1008-8830.2019.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
In countries and regions with high vaccination coverage, several vaccine-preventable diseases have been resurged in recent years, such as measles, varicella, pertussis and mumps. Some studies have found that the clinical manifestation and epidemiological characteristics of these diseases were different from those in pre-vaccine era. This article reviewed the clinical and epidemiological features of vaccine-preventable diseases before and after wide immunization implementation, focusing on the situation in China, in order to attract the attention of clinicians, raise awareness, strengthen prevention and control, and promote in-depth research for these diseases.
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Affiliation(s)
- Qi-Ru Su
- Department of Pediatric Research Institute, Shenzhen Children's Hospital, Shenzhen, Guangdong 518038, China.
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40
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Abstract
We reported previously that the annual average mortality rate in the United States in 2008-2011 for varicella listed as the underlying cause declined 87% compared with the prevaccine period (1990-1994). Here, we update the analysis with five additional years of data. We used varicella death data from the 2012-2016 Mortality Multiple Cause-of Death records to calculate mortality rates during 2012-2016 and trends since the prevaccine period and end of 1-dose vaccination program (2005-2007). The annual average age-adjusted mortality rate for varicella as the underlying cause was 0.03 per million population during 2012-2016, a 94% reduction from prevaccine years and a 47% reduction from 2005-2007. Varicella deaths continue to decline due to the varicella vaccination program in the United States.
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Affiliation(s)
| | - Mona Marin
- a National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , GA , USA
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41
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Malo JA, Colbran C, Young M, Vasant B, Jarvinen K, Viney K, Lambert SB. An outbreak of Q fever associated with parturient cat exposure at an animal refuge and veterinary clinic in southeast Queensland. Aust N Z J Public Health 2018; 42:451-455. [PMID: 29644762 DOI: 10.1111/1753-6405.12784] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/01/2017] [Accepted: 02/01/2018] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To determine the source of a Q fever outbreak in humans at an animal refuge and veterinary clinic in southeast Queensland from October to December 2016. METHODS Case interviews and a retrospective cohort study of animal refuge and veterinary clinic staff using a self-administered questionnaire related to clinical history of Q fever, Q fever vaccination status and workplace activities during the exposure period. RESULTS Seven cases (six confirmed, one probable) were identified. Forty-three questionnaires were completed (92% response rate). Workplace activities associated with the greatest risk of illness were the disposal of deceased cats or dogs (RR, 14.0; 95%CI, 1.9-104.1) and participating in euthanasia of cats or dogs (RR, 4.6; 95%CI, 1.3-16.9). Five feline birthing events occurred at the animal refuge from 25 September to 19 October 2016, each with subsequent euthanasia of the queen cat and litter. All cases had likely exposure to a specific queen cat and her litter that were euthanised the same day as the birthing event. CONCLUSIONS A parturient cat was the most likely source of the outbreak. Implications for public health: Occupational groups and others with regular exposure to feline or canine parturient products should receive Q fever vaccine.
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Affiliation(s)
- Jonathan A Malo
- Queensland Health - Communicable Diseases Branch, Queensland.,National Centre for Epidemiology and Population Health, The Australian National University, Australian Capital Territory
| | | | | | - Bhakti Vasant
- Metro South Public Health Unit, Queensland.,Metro North Public Health Unit, Queensland
| | | | - Kerri Viney
- National Centre for Epidemiology and Population Health, The Australian National University, Australian Capital Territory
| | - Stephen B Lambert
- Queensland Health - Communicable Diseases Branch, Queensland.,UQ Child Health Research Centre, The University of Queensland
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42
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Heil J, Ter Waarbeek HLG, Hoebe CJPA, Jacobs PHA, van Dam DW, Trienekens TAM, Cals JWL, van Loo IHM, Dukers-Muijrers NHTM. Pertussis surveillance and control: exploring variations and delays in testing, laboratory diagnostics and public health service notifications, the Netherlands, 2010 to 2013. ACTA ACUST UNITED AC 2018; 22:30571. [PMID: 28749331 PMCID: PMC5545763 DOI: 10.2807/1560-7917.es.2017.22.28.30571] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 02/22/2017] [Indexed: 11/20/2022]
Abstract
Pertussis is most severe among unvaccinated infants (< 1 year of age), and still leads to several reported deaths in the Netherlands every year. In order to avoid pertussis-related infant morbidity and mortality, pertussis surveillance data are used to guide pertussis control measures. However, more insight into the accuracy of pertussis surveillance and control, and into the range of healthcare and public health-related factors that impede this are needed. We analysed a unique combination of data sources from one Dutch region of 1.1 million residents, including data from laboratory databases and local public health notifications between 2010 and 2013. This large study (n = 12,090 pertussis tests) reveals possible misdiagnoses, substantial under-notification (18%, 412/2,301 laboratory positive episodes) and a delay between patient symptoms and notification to the local public health services (median 34 days, interquartile range (IQR): 27–54). It is likely that the misdiagnoses, under-notification and overall delay in surveillance data are not unique to this area of the Netherlands, and are generalisable to other countries in Europe. In addition to preventive measures such as maternal immunisation, based on current findings, we further recommend greater adherence to testing guidelines, standardisation of test interpretation guidelines, use of automatic notification systems and earlier preventive measures.
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Affiliation(s)
- Jeanne Heil
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, Geleen, the Netherlands.,Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Henriëtte L G Ter Waarbeek
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, Geleen, the Netherlands.,Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, Geleen, the Netherlands.,Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Peter H A Jacobs
- Department of Infectious Diseases Control, North Limburg Public Health Service, Venlo, the Netherlands
| | - Dirk W van Dam
- Department of Medical Microbiology and Infection Prevention, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
| | - Thera A M Trienekens
- Department of Medical Microbiology, VieCuri Medical Centre, Venlo, the Netherlands
| | - Jochen W L Cals
- Department of General Practice, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Inge H M van Loo
- Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, Geleen, the Netherlands.,Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
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43
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Abstract
This study assessed pediatric residents' reported knowledge of and self-confidence in identifying/treating 8 vaccine-preventable diseases. Pediatric residents nationwide (n = 385) reported (1) if they had previously diagnosed measles, mumps, rubella, diphtheria, tetanus, pertussis, varicella, and/or polio; (2) their comfort level in treating these diseases; (3) the likelihood of identifying symptoms; and (4) 16 disease-related statements as true/false. More than 25% of residents were not comfortable treating 5 of the 8 diseases. More than 25% reported themselves as unlikely/extremely unlikely to identify symptoms of 3 of these diseases. Third- or fourth-year residents did not feel more confident in identifying disease symptoms than first-year residents, except for pertussis ( P ≤ .01). True/false statement accuracy ranged from 56.8% correct (polio) to 94.6% correct (pertussis). Most residents (73.3%) were "extremely concerned" regarding parental vaccine refusal, and 96.0% felt that they would benefit from receiving more information. Increased emphasis on this subject in residency education is essential for the management of potential disease outbreaks.
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Affiliation(s)
- Kyla Cordrey
- 1 Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
| | - Laura McLaughlin
- 1 Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
| | - Prithwijit Das
- 1 Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
| | - Ruth Milanaik
- 1 Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
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44
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Tuite AR, Thomas-Bachli A, Acosta H, Bhatia D, Huber C, Petrasek K, Watts A, Yong JHE, Bogoch II, Khan K. Infectious disease implications of large-scale migration of Venezuelan nationals. J Travel Med 2018; 25:5091517. [PMID: 30192972 PMCID: PMC6142906 DOI: 10.1093/jtm/tay077] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 08/21/2018] [Accepted: 09/04/2018] [Indexed: 01/20/2023]
Abstract
Background The ongoing economic and political crisis in Venezuela has resulted in a collapse of the healthcare system and the re-emergence of previously controlled or eliminated infectious diseases. There has also been an exodus of Venezuelan international migrants in response to the crisis. We sought to describe the infectious disease risks faced by Venezuelan nationals and assess the international mobility patterns of the migrant population. Methods We synthesized data on recent infectious disease events in Venezuela and among international migrants from Venezuela, as well as on current country of residence among the migrant population. We used passenger-level itinerary data from the International Air Transport Association to evaluate trends in outbound air travel from Venezuela over time. We used two parameter-free mobility models, the radiation and impedance models, to estimate the expected population flows from Venezuelan cities to other major Latin American and Caribbean cities. Results Outbreaks of measles, diphtheria and malaria have been reported across Venezuela and other diseases, such as HIV and tuberculosis, are resurgent. Changes in migration in response to the crisis are apparent, with an increase in Venezuelan nationals living abroad, despite an overall decline in the number of outbound air passengers. The two models predicted different mobility patterns, but both highlighted the importance of Colombian cities as destinations for migrants and also showed that some migrants are expected to travel large distances. Despite the large distances that migrants may travel internationally, outbreaks associated with Venezuelan migrants have occurred primarily in countries proximate to Venezuela. Conclusions Understanding where international migrants are relocating is critical, given the association between human mobility and the spread of infectious diseases. In data-limited situations, simple models can be useful for providing insights into population mobility and may help identify areas likely to receive a large number of migrants.
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Affiliation(s)
- Ashleigh R Tuite
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Andrea Thomas-Bachli
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Hernan Acosta
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Deepit Bhatia
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Carmen Huber
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Kieran Petrasek
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Alexander Watts
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Jean H E Yong
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
| | - Isaac I Bogoch
- Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Canada
- Divisions of General Internal Medicine and Infectious Diseases, University Health Network, Toronto, Canada
| | - Kamran Khan
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- BlueDot, Toronto, Canada
- Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Canada
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Chen LH, Leder K, Barbre KA, Schlagenhauf P, Libman M, Keystone J, Mendelson M, Gautret P, Schwartz E, Shaw M, MacDonald S, McCarthy A, Connor BA, Esposito DH, Hamer D, Wilson ME. Business travel-associated illness: a GeoSentinel analysis. J Travel Med 2018; 25:4841826. [PMID: 29462444 PMCID: PMC5824651 DOI: 10.1093/jtm/tax097] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 01/02/2018] [Indexed: 01/23/2023]
Abstract
Background Analysis of a large cohort of business travelers will help clinicians focus on frequent and serious illnesses. We aimed to describe travel-related health problems in business travelers. Methods GeoSentinel Surveillance Network consists of 64 travel and tropical medicine clinics in 29 countries; descriptive analysis was performed on ill business travelers, defined as persons traveling for work, evaluated after international travel 1 January 1997 through 31 December 2014. Results Among 12 203 business travelers seen 1997-2014 (14 045 eligible diagnoses), the majority (97%) were adults aged 20-64 years; most (74%) reported from Western Europe or North America; two-thirds were male. Most (86%) were outpatients. Fewer than half (45%) reported a pre-travel healthcare encounter. Frequent regions of exposure were sub-Saharan Africa (37%), Southeast Asia (15%) and South Central Asia (14%). The most frequent diagnoses were malaria (9%), acute unspecified diarrhea (8%), viral syndrome (6%), acute bacterial diarrhea (5%) and chronic diarrhea (4%). Species was reported for 973 (90%) of 1079 patients with malaria, predominantly Plasmodium falciparum acquired in sub-Saharan Africa. Of 584 (54%) with malaria chemoprophylaxis information, 92% took none or incomplete courses. Thirteen deaths were reported, over half of which were due to malaria; others succumbed to pneumonia, typhoid fever, rabies, melioidosis and pyogenic abscess. Conclusions Diarrheal illness was a major cause of morbidity. Malaria contributed substantial morbidity and mortality, particularly among business travelers to sub-Saharan Africa. Underuse or non-use of chemoprophylaxis contributed to malaria cases. Deaths in business travelers could be reduced by improving adherence to malaria chemoprophylaxis and targeted vaccination for vaccine-preventable diseases. Pre-travel advice is indicated for business travelers and is currently under-utilized and needs improvement.
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Affiliation(s)
- Lin H. Chen
- Mount Auburn Hospital, Cambridge, Massachusetts, and Harvard Medical School, Boston, MA, USA
| | - Karin Leder
- Royal Melbourne Hospital and School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kira A. Barbre
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers’ Health, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
| | - Michael Libman
- Montreal General Hospital and McGill University, Montreal, Quebec, Canada
| | - Jay Keystone
- Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Marc Mendelson
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Philippe Gautret
- Aix Marseille Université, IHU—Méditerranée Infection, Marseille, France
| | - Eli Schwartz
- The Chaim Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine Tel-Aviv University, Israel
| | - Marc Shaw
- Worldwise Travellers Health Centres New Zealand and James Cook University, Australia
| | - Sue MacDonald
- Medicine and Quality, Interior Health, and University of British Columbia, Kelowna, British Columbia, Canada
| | - Anne McCarthy
- Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada
| | - Bradley A. Connor
- The New York Center for Travel and Tropical Medicine and Weill Medical College of Cornell University, New York, NY, USA
| | - Douglas H. Esposito
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Davidson Hamer
- Center for Global Health and Development, Boston University School of Public Health, and Boston University School of Medicine, Boston, MA, USA
| | - Mary E. Wilson
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA
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Thompson KM, Duintjer Tebbens RJ. Framework for Optimal Global Vaccine Stockpile Design for Vaccine-Preventable Diseases: Application to Measles and Cholera Vaccines as Contrasting Examples. Risk Anal 2016; 36:1487-1509. [PMID: 25109229 DOI: 10.1111/risa.12265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Managing the dynamics of vaccine supply and demand represents a significant challenge with very high stakes. Insufficient vaccine supplies can necessitate rationing, lead to preventable adverse health outcomes, delay the achievements of elimination or eradication goals, and/or pose reputation risks for public health authorities and/or manufacturers. This article explores the dynamics of global vaccine supply and demand to consider the opportunities to develop and maintain optimal global vaccine stockpiles for universal vaccines, characterized by large global demand (for which we use measles vaccines as an example), and nonuniversal (including new and niche) vaccines (for which we use oral cholera vaccine as an example). We contrast our approach with other vaccine stockpile optimization frameworks previously developed for the United States pediatric vaccine stockpile to address disruptions in supply and global emergency response vaccine stockpiles to provide on-demand vaccines for use in outbreaks. For measles vaccine, we explore the complexity that arises due to different formulations and presentations of vaccines, consideration of rubella, and the context of regional elimination goals. We conclude that global health policy leaders and stakeholders should procure and maintain appropriate global vaccine rotating stocks for measles and rubella vaccine now to support current regional elimination goals, and should probably also do so for other vaccines to help prevent and control endemic or epidemic diseases. This work suggests the need to better model global vaccine supplies to improve efficiency in the vaccine supply chain, ensure adequate supplies to support elimination and eradication initiatives, and support progress toward the goals of the Global Vaccine Action Plan.
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Affiliation(s)
- Kimberly M Thompson
- Kid Risk, Inc, 10524 Moss Park Rd., Ste. 204-364, Orlando, FL, USA
- University of Central Florida, College of Medicine, Orlando, FL, USA
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Abstract
The highest burden of pediatric vaccine-preventable disease is found in developing nations where resource constraints pose the greatest challenge, impacting disease diagnosis and surveillance as well as the implementation of large scale vaccination programmes. In November 2012, a Working Group Meeting convened in Casablanca to describe and discuss the status with respect to 8 vaccine-preventable diseases (pertussis, pneumococcal disease, measles-mumps-rubella-varicella (MMRV), rotavirus and meningococcal meningitis) to identify and consider ways of overcoming obstacles to pediatric vaccine implementation. Experts from Europe, Russia, the Commonwealth of Independent States, the Middle East, Africa and South East Asia participated in the meeting. A range of region-specific needs and barriers to uptake were discussed. The aim of this article is to provide a summary of the ongoing status with respect to pediatric vaccine preventable disease in the countries represented, and the experts' opinions and recommendations with respect to pediatric vaccine implementation.
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Affiliation(s)
- Ghassan Dbaibo
- a Center for Infectious Diseases Research, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center , Riad El Solh , Beirut , Lebanon
| | | | - Peter Wutzler
- c Friedrich Schiller University of Jena, Institute of Virology and Antiviral Therapy , Jena , Germany
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Abstract
Pertussis, caused by Bordetella (B.) pertussis, a Gram-negative bacterium, is a highly contagious airway infection. Especially in infants, pertussis remains a major health concern. Acute infection with B. pertussis can cause severe illness characterized by severe respiratory failure, pulmonary hypertension, leucocytosis, and death. Over the past years, rising incidence rates of intensive care treatment in young infants were described. Due to several virulence factors (pertussis toxin, tracheal cytotoxin, adenylate cyclase toxin, filamentous hemagglutinin, and lipooligosaccharide) that promote bacterial adhesion and invasion, B. pertussis creates a unique niche for colonization within the human respiratory tract. The resulting long-term infection is mainly caused by the ability of B. pertussis to interfere with the host's innate and adaptive immune system. Although pertussis is a vaccine-preventable disease, it has persisted in vaccinated populations. Epidemiological data reported a worldwide increase in pertussis incidence among children during the past years. Either acellular pertussis (aP) vaccines or whole-cell vaccines are worldwide used. Recent studies did not detect any differences according to pertussis incidence when comparing the different vaccines used. Most of the currently used aP vaccines protect against acute infections for a period of 6-8 years. The resurgence of pertussis may be due to the lack of herd immunity caused by missing booster immunizations among adolescents and adults, low vaccine coverages in some geographic areas, and genetic changes of different B. pertussis strains. Due to the rising incidence of pertussis, probable solution strategies are discussed. Cocooning strategies (vaccination of close contact persons) and immunizations during pregnancy appear to be an approach to reduce neonatal contagiousness. During the past years, studies focused on the pathway of the immune modulation done by B. pertussis to provide a basis for the identification of new therapeutic targets to enhance the host's immune response and to probably modulate certain virulence factors.
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Affiliation(s)
- Manuela Zlamy
- Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
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Abstract
Because some parents are choosing to not vaccinate or only partially vaccinate their children, vaccine-preventable diseases that once were rarely seen in pediatric practice must now be considered part of the differential diagnosis when caring for these children. Measles, mumps, varicella, meningococcal disease, pertussis, and influenza are reviewed. Recommendations for prevention and treatment of these vaccine-preventable diseases are discussed.
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Leung J, Bialek SR, Marin M. Trends in varicella mortality in the United States: Data from vital statistics and the national surveillance system. Hum Vaccin Immunother 2015; 11:662-8. [PMID: 25714052 DOI: 10.1080/21645515.2015.1008880] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
This manuscript describes trends in US varicella mortality using national vital statistics system data for 2008-2011, the first years of the routine 2-dose varicella vaccination program, and characteristics of varicella deaths reported to CDC during 1996-2013. We obtained data on deaths with varicella as underlying or contributing cause from the 2008-2011 Mortality Multiple Cause-of Death records and calculated rates to compare with the prevaccine and mature 1-dose varicella vaccination program eras. We also reviewed available records of varicella deaths reported to CDC through the national varicella death surveillance. The annual average age-adjusted mortality rate for varicella as the underlying cause was 0.05 per million population during 2008-2011, an 87% reduction from the prevaccine years. Varicella deaths among persons aged <20 y declined by 99% in 2008-2011 compared with prevaccine years. There was a 70% decline in varicella mortality rates among those <20 y in 2008-2011 compared to 2005-2007. Among the 83 deaths reported to CDC during 1996-2013 classified as likely due to varicella, 24 (29%) were among immunocompromised individuals. Five were among persons previously vaccinated with 1 dose of varicella vaccine. In conclusion, although the US varicella vaccination program has significantly reduced varicella disease burden, there are still opportunities to prevent varicella and its associated morbidity and mortality through routine varicella vaccination, catch-up vaccination, and ensuring that household contacts of immunocompromised persons have evidence of immunity.
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Affiliation(s)
- Jessica Leung
- a National Center for Immunization and Respiratory Diseases; Centers for Disease Control and Prevention ; Atlanta , GA USA
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