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Sewall BJ, Turner GG, Scafini MR, Gagnon MF, Johnson JS, Keel MK, Anis E, Lilley TM, White JP, Hauer CL, Overton BE. Environmental control reduces white‐nose syndrome infection in hibernating bats. Anim Conserv 2023. [DOI: 10.1111/acv.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- B. J. Sewall
- Department of Biology Temple University Philadelphia PA USA
| | | | | | - M. F. Gagnon
- Department of Biology Temple University Philadelphia PA USA
| | - J. S. Johnson
- Department of Biological Sciences Ohio University Athens OH USA
- School of Information Technology University of Cincinnati Cincinnati OH USA
| | - M. K. Keel
- School of Veterinary Medicine University of California Davis CA USA
| | - E. Anis
- Department of Pathobiology University of Pennsylvania, School of Veterinary Medicine, New Bolton Center Kennett Square PA USA
| | - T. M. Lilley
- Finnish Museum of Natural History University of Helsinki Helsinki Finland
| | - J. P. White
- Wisconsin Department of Natural Resources Madison WI USA
| | - C. L. Hauer
- Department of Biology Temple University Philadelphia PA USA
| | - B. E. Overton
- Department of Biology Commonwealth University of Pennsylvania Lock Haven PA USA
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Tur-Sinai A, Gur-Arie R, Davidovitch N, Kopel E, Glazer Y, Anis E, Grotto I. Socioeconomic Status, Health Inequalities, and Solidarity Trends in a Mass Vaccination Campaign. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. This study analyzes the vaccination uptake rates resulting from the mass polio vaccination campaign on the basis of health inequality parameters of socioeconomic status (SES), principles of solidarity, and the Gini inequality index. The research explores understanding the value of the Gini inequality index within the context of SES and solidarity.
Methods
The study is based on data gathered from the Israeli Ministry of Health’s administrative records from mother-and-child clinics across Israel. The research population is comprised of resident infants and children whom the Ministry of Health defined as eligible for the OPV between August and December 2013.
Results
The higher the SES level of the area where the mother-and-child clinic is located, the lower the OPV vaccination uptake is. The greater the income inequality is in the municipality where the mother-and-child clinic is situated, the lower the vaccination uptake. As time passed in the vaccination campaign, vaccination uptake increased regardless of the location of the mother-and-child clinics. The highest vaccination uptake rate was found among populations of low SES and low Gini inequality index. The lowest vaccination uptake rate was found among populations of high SES/high Gini inequality index.
Conclusions
Public health professionals promoting vaccine programs need to make specially-designed efforts both in localities with high average income and in localities with a high level of income diversity/inequality. Such practice will better utilize funds, resources, and manpower dedicated to increasing vaccination uptake across varying populations and communities.
Key messages
The higher the SES in municipalities with mother-and-child clinics, the less likely children were to be vaccinated. The lower the Gini inequality index, there is a higher polio vaccination uptake among of children.
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Affiliation(s)
- A Tur-Sinai
- Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - R Gur-Arie
- Health Systems Management, Ben-Gurion University, Beer-Sheva, Israel
| | - N Davidovitch
- Health Systems Management, Ben-Gurion University, Beer-Sheva, Israel
| | - E Kopel
- School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Y Glazer
- Epidemiology, Israel Ministry of Health, Jerusalem, Israel
| | - E Anis
- Epidemiology, Israel Ministry of Health, Jerusalem, Israel
| | - I Grotto
- Epidemiology, Israel Ministry of Health, Jerusalem, Israel
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3
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Adamker G, Holzer T, Karakis I, Amitay M, Anis E, Singer SR, Barnett-Itzhaki Z. Prediction of Shigellosis outcomes in Israel using machine learning classifiers. Epidemiol Infect 2018; 146:1445-1451. [PMID: 29880081 PMCID: PMC9133678 DOI: 10.1017/s0950268818001498] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 02/18/2018] [Revised: 04/24/2018] [Accepted: 05/05/2018] [Indexed: 01/19/2023] Open
Abstract
Shigellosis causes significant morbidity and mortality in developing and developed countries, mostly among infants and young children. The World Health Organization estimates that more than one million people die from Shigellosis every year. In order to evaluate trends in Shigellosis in Israel in the years 2002-2015, we analysed national notifiable disease reporting data. Shigella sonnei was the most commonly identified Shigella species in Israel. Hospitalisation rates due to Shigella flexenri were higher in comparison with other Shigella species. Shigella morbidity was higher among infants and young children (age 0-5 years old). Incidence of Shigella species differed among various ethnic groups, with significantly high rates of S. flexenri among Muslims, in comparison with Jews, Druze and Christians. In order to improve the current Shigellosis clinical diagnosis, we developed machine learning algorithms to predict the Shigella species and whether a patient will be hospitalised or not, based on available demographic and clinical data. The algorithms' performances yielded an accuracy of 93.2% (Shigella species) and 94.9% (hospitalisation) and may consequently improve the diagnosis and treatment of the disease.
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Affiliation(s)
- G. Adamker
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel
| | - T. Holzer
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel
| | - I. Karakis
- Public Health Services, Ministry of Health, Jerusalem, Israel
- Ashkelon Academic College, Ashkelon, Israel
| | - M. Amitay
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel
| | - E. Anis
- Public Health Services, Ministry of Health, Jerusalem, Israel
| | - S. R. Singer
- Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Z. Barnett-Itzhaki
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel
- Public Health Services, Ministry of Health, Jerusalem, Israel
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Muhsen K, Anis E, Rubinstein U, Kassem E, Goren S, Shulman L, Ephros M, Cohen D. Effectiveness of rotavirus pentavalent vaccine under a universal immunization programme in Israel, 2011–2015: a case–control study. Clin Microbiol Infect 2018; 24:53-59. [DOI: 10.1016/j.cmi.2017.04.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/14/2017] [Accepted: 04/18/2017] [Indexed: 11/30/2022]
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Yaari R, Kaliner E, Grotto I, Katriel G, Moran-Gilad J, Sofer D, Mendelson E, Miller E, Huppert A, Anis E, Kopel E, Manor Y, Mor O, Shulman L, Singer R, Weil M. Modeling the spread of polio in an IPV-vaccinated population: lessons learned from the 2013 silent outbreak in southern Israel. BMC Med 2016; 14:95. [PMID: 27334457 PMCID: PMC4918056 DOI: 10.1186/s12916-016-0637-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 06/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Polio eradication is an extraordinary globally coordinated health program in terms of its magnitude and reach, leading to the elimination of wild poliovirus (WPV) in most parts of the world. In 2013, a silent outbreak of WPV was detected in Israel, a country using an inactivated polio vaccine (IPV) exclusively since 2005. The outbreak was detected using environmental surveillance (ES) of sewage reservoirs. Stool surveys indicated the outbreak to be restricted mainly to children under the age of 10 in the Bedouin population of southern Israel. In order to curtail the outbreak, a nationwide vaccination campaign using oral polio vaccine (OPV) was conducted, targeting all children under 10. METHODS A transmission model, fitted to the results of the stool surveys, with additional conditions set by the ES measurements, was used to evaluate the prevalence of WPV in Bedouin children and the effectiveness of the vaccination campaign. Employing the parameter estimates of the model fitting, the model was used to investigate the effect of alternative timings, coverages and dosages of the OPV campaign on the outcome of the outbreak. RESULTS The mean estimate for the mean reproductive number was 1.77 (95 % credible interval, 1.46-2.30). With seasonal variation, the reproductive number maximum range was between zero and six. The mean estimate for the mean infectious periods was 16.8 (8.6-24.9) days. The modeling indicates the OPV campaign was effective in curtailing the outbreak. The mean estimate for the attack rate in Bedouin children under 10 at the end of 2014 was 42 % (22-65 %), whereas without the campaign the mean projected attack rate was 57 % (35-74 %). The campaign also likely shortened the duration of the outbreak by a mean estimate of 309 (2-846) days. A faster initiation of the OPV campaign could have reduced the incidence of WPV even if a lower coverage was reached, at the risk of prolonging the outbreak. CONCLUSIONS OPV campaigns are essential for interrupting WPV transmission, even in a developed country setting with a high coverage of IPV. In this setting, establishing ES of WPV circulation is particularly crucial for early detection and containment of an outbreak.
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Affiliation(s)
- Rami Yaari
- Bio-statistical Unit, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel. .,Biomathematics Unit, Department of Zoology, Faculty of Life Sciences, Tel Aviv University, 69978, Tel Aviv, Israel.
| | - Ehud Kaliner
- Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Itamar Grotto
- Public Health Services, Ministry of Health, Jerusalem, Israel.,Faculty for Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Guy Katriel
- Department of Mathematics, ORT Braude College, Karmiel, Israel
| | - Jacob Moran-Gilad
- Public Health Services, Ministry of Health, Jerusalem, Israel.,Faculty for Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Danit Sofer
- Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Ella Mendelson
- Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Tel Hashomer, Israel.,School of Public Health, the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Elizabeth Miller
- School of Public Health, the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Public Health England Immunisation, Hepatitis and Blood Safety Department, 61, Colindale Avenue, London, UK
| | - Amit Huppert
- Bio-statistical Unit, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel.,School of Public Health, the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Levine H, Kopel E, Anis E, Givon-Lavi N, Dagan R. The impact of a national routine immunisation programme initiated in 1999 on Hepatitis A incidence in Israel, 1993 to 2012. ACTA ACUST UNITED AC 2015; 20:3-10. [PMID: 25719962 DOI: 10.2807/1560-7917.es2015.20.7.21040] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Data on long-term impact of universal national vaccination programmes against hepatitis A are lacking. We aimed at evaluating the impact on hepatitis A incidence of the Israeli toddlers-only universal routine two-dose vaccination programme against hepatitis A initiated in 1999. All hepatitis A episodes reported to the national surveillance system from 1993 to 2012 were analysed in relation to the vaccination programme and coverage. Mean vaccine coverage in Israel between 2003 and 2010 was 92% for the first dose, given at 18 months of age, and 88% for the second dose, given at 24 months. The annual hepatitis A incidence declined from a mean of 50.4 per 100,000 in the period between 1993 and 1998 to a mean of?<1.0, during the period from 2008 to 2012, representing a reduction of?>98%. The decline was evident in all ages and ethnicity groups, including unvaccinated populations. Of the 1,247 cases reported nationwide between 2002 and 2012, the vaccination status could be ascertained in 1,108 (89%). Among them, only 20 (2%) were reported be vaccinated with one dose and three (<1%) received two doses. The sustained results of this long-term impact study suggest that a toddlers-only universal routine two-dose vaccination programme is highly effective and practical. These findings underscore the importance of sustainability in both the surveillance systems and vaccination programmes and will aid to determine vaccination policies.
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Affiliation(s)
- H Levine
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
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Shulman LM, Mendelson E, Anis E, Bassal R, Gdalevich M, Hindiyeh M, Kaliner E, Kopel E, Manor Y, Moran-Gilad J, Ram D, Sofer D, Somekh E, Tasher D, Weil M, Gamzu R, Grotto I. Laboratory Challenges in Response to Silent Introduction and Sustained Transmission of Wild Poliovirus Type 1 in Israel During 2013. J Infect Dis 2014; 210 Suppl 1:S304-14. [DOI: 10.1093/infdis/jiu294] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Moran-Gilad J, Mentasti M, Lazarovitch T, Huberman Z, Stocki T, Sadik C, Shahar T, Anis E, Valinsky L, Harrison T, Grotto I. Molecular epidemiology of Legionnaires‘ disease in Israel. Clin Microbiol Infect 2014; 20:690-6. [DOI: 10.1111/1469-0691.12425] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 09/26/2013] [Accepted: 10/05/2013] [Indexed: 11/30/2022]
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Anis E, Kopel E, Singer SR, Kaliner E, Moerman L, Moran-Gilad J, Sofer D, Manor Y, Shulman LM, Mendelson E, Gdalevich M, Lev B, Gamzu R, Grotto I. Insidious reintroduction of wild poliovirus into Israel, 2013. Euro Surveill 2013; 18. [DOI: 10.2807/1560-7917.es2013.18.38.20586] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Israel was certified as polio-free country in June 2002, along with the rest of the World Health Organization European Region. Some 11 years later, wild-type polio virus 1 (WPV1) was isolated initially from routine sewage samples collected between 7 and 13 April 2013 in two cities in the Southern district. WPV1-specific analysis of samples indicated WPV1 introduction into that area in early February 2013. National supplementary immunisation with oral polio vaccine has been ongoing since August 2013.
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Affiliation(s)
- E Anis
- These authors contributed equally to this study
- Braun School of Public Health and Community Medicine, Hebrew University Hadassah Faculty of Medicine, Jerusalem, Israel
- Public Health Services, Ministry of Health, Jerusalem, Israel
- The Division of Epidemiology, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - E Kopel
- These authors contributed equally to this study
- The Division of Epidemiology, Public Health Services, Ministry of Health, Jerusalem, Israel
- Public Health Services, Ministry of Health, Jerusalem, Israel
| | - S R Singer
- These authors contributed equally to this study
- Public Health Services, Ministry of Health, Jerusalem, Israel
- The Division of Epidemiology, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - E Kaliner
- Public Health Services, Ministry of Health, Jerusalem, Israel
| | - L Moerman
- Public Health Services, Ministry of Health, Jerusalem, Israel
- The Division of Epidemiology, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - J Moran-Gilad
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Public Health Services, Ministry of Health, Jerusalem, Israel
| | - D Sofer
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Central Virology Laboratory, Public Health Services, Ministry of Health, The Chaim Sheba Medical Centre, Tel Hashomer, Israel
| | - Y Manor
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Central Virology Laboratory, Public Health Services, Ministry of Health, The Chaim Sheba Medical Centre, Tel Hashomer, Israel
| | - L M Shulman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Central Virology Laboratory, Public Health Services, Ministry of Health, The Chaim Sheba Medical Centre, Tel Hashomer, Israel
| | - E Mendelson
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Central Virology Laboratory, Public Health Services, Ministry of Health, The Chaim Sheba Medical Centre, Tel Hashomer, Israel
| | - M Gdalevich
- South District Health Office, Ministry of Health, Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - B Lev
- Ministry of Health, Jerusalem, Israel
| | - R Gamzu
- Ministry of Health, Jerusalem, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - I Grotto
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Public Health Services, Ministry of Health, Jerusalem, Israel
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Moran-Gilad J, Lazarovitch T, Mentasti M, Harrison T, Weinberger M, Mordish Y, Mor Z, Stocki T, Anis E, Sadik C, Amitai Z, Grotto I. Humidifier-associated paediatric Legionnaires' disease, Israel, February 2012. Euro Surveill 2012; 17:20293. [PMID: 23078810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
We report a fatal case of community-acquired Legionnaires' disease in an infant aged under six months. Epidemiological and microbiological investigations suggested that a free-standing cold water humidifier using domestic tap water contaminated with Legionella pneumophila serogroup 1 served as a vehicle for infection. These findings were corroborated by sequence-based typing (SBT). Humidifier-associated Legionnaires' disease can be prevented by appropriate control measures. This case also illustrates the emerging role of SBT in the investigation of legionellosis.
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Affiliation(s)
- J Moran-Gilad
- Division of Epidemiology, Public Health Services, Ministry of Health, Jerusalem, Israel.
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Moran-Gilad J, Lazarovitch T, Mentasti M, Harrison T, Weinberger M, Mordish Y, Mor Z, Stocki T, Anis E, Sadik C, Amitai Z, Grotto I. Humidifier-associated paediatric Legionnaires' disease, Israel, February 2012. Euro Surveill 2012. [DOI: 10.2807/ese.17.41.20293-en] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report a fatal case of community-acquired Legionnaires' disease in an infant aged under six months. Epidemiological and microbiological investigations suggested that a free-standing cold water humidifier using domestic tap water contaminated with Legionella pneumophila serogroup 1 served as a vehicle for infection. These findings were corroborated by sequence-based typing (SBT). Humidifier-associated Legionnaires' disease can be prevented by appropriate control measures. This case also illustrates the emerging role of SBT in the investigation of legionellosis.
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Affiliation(s)
- J Moran-Gilad
- Public Health Services, Ministry of Health, Jerusalem, Israel
- Division of Epidemiology, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - T Lazarovitch
- Department of Clinical Microbiology, Assaf Harofeh Medical Centre, Zerifin, Israel
| | - M Mentasti
- Reference Microbiology Services, Health Protection Agency (HPA), London, United Kingdom
| | - T Harrison
- Reference Microbiology Services, Health Protection Agency (HPA), London, United Kingdom
| | - M Weinberger
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Infectious Disease Unit, Assaf Harofeh Medical Centre, Zerifin, Israel
| | - Y Mordish
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Infectious Disease Unit, Assaf Harofeh Medical Centre, Zerifin, Israel
| | - Z Mor
- Ramla sub-District Health Office, Ministry of Health, Ramla, Israel
| | - T Stocki
- Reference Microbiology Services, Health Protection Agency (HPA), London, United Kingdom
| | - E Anis
- Division of Epidemiology, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - C Sadik
- Division of Epidemiology, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Z Amitai
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
| | - I Grotto
- Public Health Services, Ministry of Health, Jerusalem, Israel
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Levy I, Mor Z, Anis E, Maayan S, Leshem E, Pollack S, Chowers M, Mor O, Riesenberg K, Sthoeger Z, Ram D, Grossman Z. Men Who Have Sex With Men, Risk Behavior, and HIV Infection: Integrative Analysis of Clinical, Epidemiological, and Laboratory Databases. Clin Infect Dis 2011; 52:1363-70. [DOI: 10.1093/cid/cir244] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Abstract
BACKGROUND There is evidence of a recent resurgence of the incidence of gonorrhoea in some countries. AIM To examine trends in gonorrhoea incidence in Israel and compare them with the United States and countries in Europe METHOD The 1967-2001 annual incidence of gonorrhoea in Israel was obtained from the Israel Ministry of Health's department of epidemiology and for the United States from summary reports of the Centers for Disease Control. The incidence of gonorrhoea in European countries was extracted from the World Health Organization, Health for All database. RESULTS In Israel, following a long period of decline from 40 per 100 000 in 1970 to 0.74 per 100 000 in 1997, incidence rates began to increase in 1998 to 13.8 per 100 000 in 2001. This pattern parallels those observed in a number of European countries and to some extent, in the United States. Most reported morbidity in Israel occurs among males aged 20-44 years. CONCLUSIONS The resurgence of gonorrhoea does not appear to be explained solely by behavioural changes. Transmission of the disease should be further studied among different subpopulations in order to develop new prevention strategies.
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Affiliation(s)
- M S Green
- Israel Center for Disease Control, Ministry of Health.
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14
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Abstract
Pentacyclic triterpenes (1) and (2) have been isolated from Mimusops elengi and assigned structures 3beta,6beta,19alpha,23-tetrahydroxy-urs-12-ene and 1beta-hydroxy-3beta-hexanoyllup-20 (29)-ene-23, 28-dioic acid, respectively, on the basis of spectroscopic studies including 2D-NMR. The compound 1 showed moderate inhibiting activity against beta-glucuronidase enzyme
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Affiliation(s)
- N Jahan
- International Centre for Chemical Sciences, H.E.J. Research Institute of Chemistry, University of Karachi, Pakistan
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Anis E, Leventhal A, Elkana Y, Wilamowski A, Pener H. Cutaneous leishmaniasis in Israel in the era of changing environment. Public Health Rev 2002; 29:37-47. [PMID: 11780715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a zoonotic disease, endemic and notifiable in Israel. The vectors are sandflies of the genus Phlebotomus, the hosts are mainly field rodents. The infective agents are Leishmania parasites. Ph. papatasi is the recognized vector of L. major, while Ph. sergenti is considered to be the vector of L. tropica. AIM To increase awareness of leishmaniasis, enhance surveillance, and improve reporting. METHODS Morbidity data were obtained from disease notifications reported to the Department of Epidemiology of the Israeli Ministry of Health. RESULTS The annual number of reported CL cases during the period 1961-2000 varied between less than 10 to over 250, with rates varying between 0.13 to over 7 per 100,000. Two peaks, between 1967-1969 and 1980-1982, are clearly seen. These peaks reflect environmental changes caused by the introduction of non-immune people (mainly Jews) into the area of endemic foci, enhanced urbanization by expansion of settlements bordering this area, agricultural/industrial projects, and most probably the effect of Global Warming. Recently, an increasing trend in the prevalence of the disease has been reported also by the Palestinian Authority and countries in the Mediterranean basin, reflecting shared changes in modern demographic and environmental conditions. These factors include population growth and movements, as well as ecological changes. CONCLUSIONS Cooperation of the Ministries of Health and Environment of the countries of the whole Middle East region in combating the vectors and the reservoirs in animal hosts are a major need.
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Affiliation(s)
- E Anis
- Department of Infectious Diseases, Israel Ministry of Health, Jerusalem.
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16
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Green MS, Aharonowitz G, Shohat T, Levine R, Anis E, Slater PE. The changing epidemiology of viral hepatitis A in Israel. Isr Med Assoc J 2001; 3:347-51. [PMID: 11411199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND Between 1970 and 1979, there was an increase in the incidence of viral hepatitis in Israel with a shift of peak incidence to an older age in the Jewish population, followed by a declining trend during the early 1980s. In July 1999 universal immunization of infants against hepatitis A was introduced. OBJECTIVE To evaluate the chan-ges in the epidemiology of viral hepatitis A in Israel during the past decade. METHODS Viral hepatitis is a notifiable disease in Israel and cases are reported to the regional health offices, which in turn provide summary reports to the Ministry of Health's Department of Epidemiology. The data in this study were derived from the summary reports and from results of seroprevalence studies. RESULTS Following the increase in the incidence of reported viral hepatitis (mainly due to type A) between 1970 and 1979, the rates then stabilized and around 1984 began to decline until 1992. Since then there has been a slight increase. Whereas until 1987 the rates were consistently higher in the Jewish population, since then they are higher in the Arab population. The shift in the peak age-specific incidence from the 1-4 to the 5-9 year age group observed in the Jewish population around 1970 occurred 20 years later in the Arab population. The previously described seasonality is no longer evident. Recent seroprevalence studies indicate that by age 18 years only about 30-40% of the Jewish population have anti-hepatitis A antibodies. CONCLUSIONS The decline in the incidence of hepatitis probably reflects the changing socioeconomic condition occurring at different times in the two major population groups. Since hepatitis A accounts for almost all the acute viral hepatitis in Israel, the universal vaccination of infants introduced in 1999 should substantially lower the morbidity within the next few years.
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Affiliation(s)
- M S Green
- Israel Center for Disease Control, Ministry of Health, Tel-Hashomer, Israel.
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Slater PE, Leventhal A, Anis E. The elimination of smallpox from Israel. Isr Med Assoc J 2001; 3:71-2. [PMID: 11344812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- P E Slater
- Department of Epidemiology, Ministry of Health, Jerusalem, Israel.
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Slater PE, Anis E, Leventhal A. Measles control in Israel: a decade of the two-dose policy. Public Health Rev 2000; 27:235-41. [PMID: 10832486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND AND METHODS The introduction of routine measles immunization in Israel in 1967 was followed by a 95% reduction in reported measles incidence. In 1990, a second measles immunization dose was instituted, and up until the end of 1999, 16 birth cohorts were offered the second dose. We present here changes in reported measles incidence in Israel following institution of the two-dose policy. RESULTS First-dose coverage is 94%, and coverage for the second school-based dose exceeds 95%. A further 90% reduction in measles incidence has been observed and, following a modest national outbreak in 1994, measles incidence for 1995-99 stands at less than 3/100,000/year. CONCLUSIONS Since measles is highly contagious, very high immunization coverage rates will be required to preserve these accomplishments, and measles elimination is still years away, but there is tentative evidence that measles containment is at hand. Even greater measles control can be anticipated as vaccine immunogenicity improves and successive cohorts of children come under the 2-dose regimen.
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Affiliation(s)
- P E Slater
- Department of Epidemiology, Ministry of Health, Jerusalem, Israel
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Mustafa G, Anis E, Ahmed S, Anis I, Ahmed H, Malik A, Shahzad-ul-Hassan S, Choudhary MI. Lupene-type triterpenes from Periploca aphylla. J Nat Prod 2000; 63:881-883. [PMID: 10869229 DOI: 10.1021/np990426v] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Two new lupane derivatives, 3beta,6alpha-dihydroxylup-20(29)-ene (1) and 6alpha-hydroxylup-20(29)-en-3beta-octadecanoate (2), have been isolated from the stems of Periploca aphylla, in addition to beta-sitosterol and lupeol. The structures of 1 and 2 were determined by spectral and chemical methods. Compound 1 showed strong inhibition of alpha-glucosidase type VI and a moderate antibacterial activity.
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Affiliation(s)
- G Mustafa
- International Center for Chemical Sciences, HEJ Research Institute of Chemistry, University of Karachi, Karachi-75270, Pakistan
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20
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Anis E, Leventhal A, Roitman M, Slater PE. [Introduction of routine hepatitis A immunization in Israel--the first in the world]. Harefuah 2000; 138:177-80, 272. [PMID: 10883087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Notification of hepatitis A, which is endemic in Israel, has been compulsory since the establishment of the State. From 1992-98 an average of 2,600 cases were reported annually. Many infections are asymptomatic and mild, especially in children. In general, severity increases with age; in Western countries the case fatality rate is 1.5/1,000 among children less than 5 years old and 27/1,000 among those over 50. Until 1987 incidence in Israel was higher in Jews than in non-Jews, but since 1988 incidence has been about 50% higher in non-Jews. Among Jews highest age specific rates shifted from children 1-4 years old to children 5-9 years old in 1970, and in non-Jews in 1989. Improved sanitary conditions and personal hygiene have reduced very early childhood exposure and hence increased the proportion of susceptible older children and adults, in whom symptomatic disease is more prevalent. Israel is the first country in the world to include hepatitis A vaccine in its routine immunization schedule. The vaccine is given in 2 doses: at 18 months and 24-30 months of age, and there will be epidemiologic and serologic follow-up. A significant decrease in hepatitis A morbidity is expected in small children within 5 years. The percentage of reported cases in older children and in adults is expected to increase, although the absolute incidence among these groups will decrease.
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Affiliation(s)
- E Anis
- Dept. of Epidemiology and Public Health Services, Israel Ministry of Health, Jerusalem
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Abstract
During the summer of 1997, 2 confirmed and several suspected fatal cases of spotted fever (SF) occurred in previously healthy young adults in Israel. This unusual cluster of events stimulated the current study. The incidence of SF in Israel from 1971-98 was analyzed. Incidence increased until 1980, declined until 1994, and increased slightly from 1994-97. Incidence was higher during the summer, among children aged 0-9 years, and in rural settlements in central Israel. From 1971-1997, 31 deaths were reported, mostly in the elderly. The deaths that occurred in 1997 are a reminder that, despite the fact that morbidity due to SF is described mainly in children, SF can have a rapidly fatal outcome in healthy young adults. Thus, even during periods of low incidence, careful monitoring and high awareness for prompt diagnosis and treatment are needed.
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Affiliation(s)
- G Aharonowitz
- Israel Center for Disease Control, Gertner Institute, Tel Hashomer 52621, Israel.
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Abstract
BACKGROUND Measles-mumps-rubella (MMR) vaccine replaced monovalent measles vaccine in the routine childhood vaccination schedule in Israel in December 1988, primarily to achieve the elimination of the congenital rubella syndrome. In this observational study, we report on changes in reported mumps incidence in Israel from the time of the introduction of MMR vaccine until the end of 1998. METHODS The report is based upon passive national surveillance of mumps incidence, which has been notifiable in Israel since 1977. RESULTS Reported mumps incidence in Israel is now less than 2% the pre-vaccine incidence. CONCLUSIONS In the decade since the introduction of routine mumps vaccination in 1-year-olds in Israel, mumps control has been achieved. Although small outbreaks occur and may continue to occur in future years, because of under-vaccination of children, primary vaccine failure and waning immunity, it can tentatively be said that mumps is no longer a public health problem in Israel.
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Affiliation(s)
- P E Slater
- Department of Epidemiology, Ministry of Health, Jerusalem, Israel
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Dagan R, Fraser D, Roitman M, Slater P, Anis E, Ashkenazi S, Kassis I, Miron D, Leventhal A. Effectiveness of a nationwide infant immunization program against Haemophilus influenzae b. The Israeli Pediatric Bacteremia and Meningitis Group. Vaccine 1999; 17:134-41. [PMID: 9987147 DOI: 10.1016/s0264-410x(98)00165-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
An ongoing nationwide prospective surveillance program for invasive H. influenzae b (Hib) disease in Israel enabled us to study the effectiveness of a national infant Hib immunization program, which included all infants born since January 1994. The vaccine used was Hib polysaccharide conjugated to outer membrane protein complex of Neisseria meningitidis b (PRP-OMPC). For the cohort born during the 3 years since January 1994, the vaccine effectiveness was 94.9% for all invasive Hib diseases and 96.6% for meningitis. The efficacy in fully immunized subjects was 98.7 and 99.5%, respectively. A herd immunity effect could be observed, since a reduction in cases also occurred among infants too young to be immunized. No increase in invasive cases caused by S. pneumoniae and N. meningitidis was observed during the study period. This is the first report outside North America and Western Europe that demonstrates a nationwide extensive reduction of invasive Hib disease within a short time of the introduction of Hib conjugate vaccines to the infant immunization program.
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Affiliation(s)
- R Dagan
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel
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Farid Z, Kamal M, Karam M, Mousa M, Anis E, Mateczun AJ. Splenic tuberculosis in patients with fever of unknown origin. J Egypt Public Health Assoc 1997; 72:1-10. [PMID: 17265622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Splenic tuberculosis is uncommon. We report here splenic tuberculosis in 5 patients with fever of over 3 weeks duration. In the 5 patients, abdominal ultrasonography and/or abdominal computed tomography revealed multiple hypoechoic and hypodense splenic lesions. Diagnosis required biopsy of cervical lymph nodes in four cases and splenectomy in one. Despite vigorous antituberculous therapy with isoniazid, rifampin, and ethambutol, the clinical condition of 2 of these patients worsened and splenectomy was done. Histological examination of a tissue specimen of the spleen showed multiple caseating granulomas.
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Affiliation(s)
- Z Farid
- U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
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Ostroi P, Anis E, Green MS. Shigellosis in Israel--update 1995. Public Health Rev 1996; 24:213-25. [PMID: 9038099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION The incidence of shigellosis in Israel was fairly stable until around 1974, when it gradually began to increase to a peak in 1985. This was accompanied by a shift in the maximum incidence in the Jewish population from the age group < 1 to 1-4 years. AIM To update the epidemiology of shigellosis in Israel 1986-1995. METHODS Only laboratory-confirmed cases of shigellosis in the civilian population were analyzed. Data were obtained from the weekly reports of the subdistricts. Antibiotic sensitivity data were obtained from several hospitals and the General Workers' Sick Fund laboratories in Jerusalem, Haifa, and Tel Aviv. RESULTS From 1986 to 1991, shigellosis incidence per 100,000 decreased by about 50%, and the decrease occurred mainly in the Jewish population. Several regional outbreaks in 1992 reversed this decline, but by 1995, the incidence was similar to that observed prior to 1974. The disease still occurs mainly in the summer, with an occasional winter outbreak. Higher incidence rates occurred in the northern subdistricts. The peak incidence in the non-Jewish population moved from the < 1-year-olds to the 1-4 year-old group, similar to the pattern in the Jewish population in 1970. In 1991, for the first time, the rate in the age group 5-9 years among non-Jews exceeded that of those < 1 year old. Marked decreases in sensitivity to several antibiotics were found in peripheral and hospital laboratories. An increase in the sensitivity to tetracycline was noted since 1991. Case fatality rates remain low, with a mean of 0.05% for the decade of the 1980s. CONCLUSIONS Shigellosis remains a highly endemic disease in Israel, but changes in the age-related peak incidence indicate that the pattern of spread is becoming more similar to other developed countries.
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Affiliation(s)
- P Ostroi
- Department of Epidemiology, Ministry of Health, Jerusalem
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Modan B, Shpilberg O, Baruch Y, Sikuler E, Anis E, Ashur Y, Chetrit A, Luxenburg O, Rosenberg E, Rosenthol N. The need for liver transplantation: a nationwide estimate based on consensus review. Lancet 1995; 346:660-2. [PMID: 7658818 DOI: 10.1016/s0140-6736(95)92279-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Orthotopic liver transplantation (OLT) is widely practised in developed countries. The procedure is costly, the supply of donor organs limited, and it is not known how many patients need transplantation. A community-wide estimate of the needs for OLT was performed over two years in all general hospitals in Israel. Records of 1851 patients with liver disease were screened to identify those who might eventually need OLT. The annual estimate of transplantation needs in the country was 10-15.5 per million population, with equal numbers of males and females. The addition of patients with nonreformed alcoholism and end-stage liver disease, originally set as an exclusion criteria, would have added 20% to this estimate. 37% of potential candidates were under 40 years of age at diagnosis, and about 50% were 55-64 years old. Almost 80% of patients had cirrhosis of the liver and 13.6% had fulminant hepatitis. These findings provide a basis for a national plan of OLT in Israel, and similar studies might be useful in other countries.
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Affiliation(s)
- B Modan
- Department of Clinical Epidemiology, Chaim Sheba Medical Center, Tel Aviv University Medical School, Tel Hashomer, Israel
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