scholarly journals Investigation of Events Related to Laboratory-Confirmed Contamination of Pharmaceutical Products: Summary of CDC Consultation

2020 ◽  
Vol 41 (S1) ◽  
pp. s10-s11
Author(s):  
Lina Elbadawi ◽  
Nadine Shehab ◽  
Jennifer N. Lind ◽  
Alexander Kallen ◽  
Melissa K. Schaefer ◽  
...  
Keyword(s):  
Public Health ◽  
Burkholderia Cepacia ◽  
Infection Type ◽  
Critical Role ◽  
Public Health Intervention ◽  
The United States ◽  
Pharmaceutical Products ◽  
Waterborne Pathogens ◽  
Control And Prevention ◽  
Pharmaceutical Contamination

Background: Contaminated pharmaceutical products pose serious infection risks to patients and can lead to significant morbidity and mortality. Contamination at the point of manufacturing or compounding (intrinsic contamination) has the potential to affect large numbers of patients. Public health plays a critical role in detecting and investigating such events. We identified investigations involving intrinsically contaminated pharmaceuticals to characterize the burden and scope of harm associated with these events. Methods: We reviewed Centers for Disease Control and Prevention records to identify US investigations between January 1, 2009, and December 31, 2018, involving laboratory-confirmed contamination of manufactured medications and pharmacy-compounded preparations (P-CPs), using relevant search terms (eg, “medication contamination”). Laboratory confirmation was defined as identification of a pathogen from a manufactured medication or P-CP. We determined the number and type of patient infections associated with these investigations, the number of states involved, pathogens identified, type of medication (sterile or nonsterile), route of administration, and how the contamination event was first identified. We excluded investigations when the mode of production was unknown. Results: We identified 20 investigations in at least 20 states involving laboratory-confirmed contamination of manufactured medications (n = 12) and P-CPs (n = 8). Patient infections were identified in 16 (80%) investigations (9 involving manufactured medications and 7 involving P-CPs) resulting in at least 1,183 infections and at least 73 deaths. Bloodstream infections were the most common infection type (n = 7, 44%). Waterborne pathogens (eg, Serratia marcescens, Burkholderia cepacia) were cultured from medications in 83% (n = 10) of investigations involving manufactured medications and 75% (n = 6) of investigations involving P-CPs. Contamination of sterile pharmaceutical products occurred in 14 (70%) investigations; 11 (79%) of these involved injectables. Information regarding how contaminated pharmaceuticals were first identified was documented for 18 investigations; most cases (n = 14, 78%) started with investigation of patient infections by facilities, public health, or both, which led to laboratory testing of pharmaceuticals and confirmation of contamination. Conclusions: The events summarized here likely underestimate the frequency of intrinsic contamination of pharmaceutical products in the United States. These events can have devastating consequences that impact patients across the country. Waterborne pathogens appear to be the most frequently identified source of contamination in both manufactured medications and P-CPs.Detection, investigation, control, and prevention of pharmaceutical contamination events benefit from collaboration between state and federal public health authorities; without public health intervention. Such contamination may have gone undetected and could have harmed additional patients.Funding: NoneDisclosures: None

scholarly journals Users’ Beliefs Toward Physical Distancing in Facebook Pages of Public Health Authorities During COVID-19 Pandemic in Early 2020

2021 ◽  
pp. 109019812110144
Author(s):  
Soon Guan Tan ◽  
Aravind Sesagiri Raamkumar ◽  
Hwee Lin Wee
Keyword(s):  
Public Health ◽  
Health Belief Model ◽  
United States Public Health ◽  
Health Belief ◽  
The United States ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Control And Prevention ◽  
Belief Model ◽  
The Health Belief Model

This study aims to describe Facebook users’ beliefs toward physical distancing measures implemented during the Coronavirus disease (COVID-19) pandemic using the key constructs of the health belief model. A combination of rule-based filtering and manual classification methods was used to classify user comments on COVID-19 Facebook posts of three public health authorities: Centers for Disease Control and Prevention of the United States, Public Health England, and Ministry of Health, Singapore. A total of 104,304 comments were analyzed for posts published between 1 January, 2020, and 31 March, 2020, along with COVID-19 cases and deaths count data from the three countries. Findings indicate that the perceived benefits of physical distancing measures ( n = 3,463; 3.3%) was three times higher than perceived barriers ( n = 1,062; 1.0%). Perceived susceptibility to COVID-19 ( n = 2,934; 2.8%) was higher compared with perceived severity ( n = 2,081; 2.0%). Although susceptibility aspects of physical distancing were discussed more often at the start of the year, mentions on the benefits of intervention emerged stronger toward the end of the analysis period, highlighting the shift in beliefs. The health belief model is useful for understanding Facebook users’ beliefs at a basic level, and it provides a scope for further improvement.

scholarly journals Linking rattiness, geography and environmental degradation to spillover Leptospira infections in marginalised urban settings: an eco-epidemiological community-based cohort study in Brazil

2021 ◽  
Author(s):  
Max T Eyre ◽  
Fábio N Souza ◽  
Ticiana S. A. Carvalho-Pereira ◽  
Nivison Nery ◽  
Daiana de Oliveira ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health Intervention ◽  
Spatial Modelling ◽  
The United States ◽  
Infection Risk ◽  
Human Infection ◽  
Global Public Health ◽  
Entire Study ◽  
Urban Settings ◽  
Public Health Burden

Background: Zoonotic spillover from animal reservoirs is responsible for a significant global public health burden, but the processes that promote spillover events are poorly understood in complex urban settings. Endemic transmission of Leptospira, the agent of leptospirosis, in marginalised urban communities occurs through human exposure to an environment contaminated by bacteria shed in the urine of the rat reservoir. However, it is unclear to what extent transmission is driven by variation in the distribution of rats or by the dispersal of bacteria in rainwater runoff and overflow from open sewer systems. <br /><br />Methods: We conducted an eco-epidemiological study in a high-risk community in Salvador, Brazil, by prospectively following a cohort of 1,401 residents to ascertain serological evidence for leptospiral infections. A concurrent rat ecology study was used to collect information on the fine-scale spatial distribution of ‘rattiness’, our proxy for rat abundance and exposure of interest. We developed and applied a novel geostatistical framework for joint spatial modelling of multiple indices of disease reservoir abundance and human infection risk. <br /><br />Results: The estimated infection rate was 51.4 (95\%CI 40.4, 64.2) infections per 1,000 follow-up events. Infection risk increased with age until 30 years of age and was associated with male gender. Rattiness was positively associated with infection risk for residents across the entire study area, but this effect was stronger in higher elevation areas (OR 3.27 95\%CI 1.68, 19.07) than in lower elevation areas (OR 1.14 95\%CI 1.05, 1.53). <br /><br />Conclusions: These findings suggest that, while frequent flooding events may disperse bacteria in regions of low elevation, environmental risk in higher elevation areas is more localised and directly driven by the distribution of local rat populations. The modelling framework developed may have broad applications in delineating complex animal-environment-human interactions during zoonotic spillover and identifying opportunities for public health intervention.<br /><br />Funding: This work was supported by the Oswaldo Cruz Foundation and Secretariat of Health Surveillance, Brazilian Ministry of Health, the National Institutes of Health of the United States (grant numbers F31 AI114245, R01 AI052473, U01 AI088752, R01 TW009504 and R25 TW009338); the Wellcome Trust (102330/Z/13/Z), and by the Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB/JCB0020/2016). M.T.E is supported by an MRC doctorate studentship. F.N.S. participated in this study under a FAPESB doctorate scholarship.

scholarly journals Age-Standardized Mortality of Persons on Probation, in Jail, or in State Prison and the General Population, 2001-2012

2019 ◽  
Vol 134 (6) ◽  
pp. 660-666 ◽  
Author(s):  
Christopher Wildeman ◽  
Alyssa W. Goldman ◽  
Emily A. Wang
Keyword(s):  
Public Health ◽  
United States ◽  
Age Distribution ◽  
Correctional Facility ◽  
Well Being ◽  
The United States ◽  
Mortality Rates ◽  
State Prison ◽  
Control And Prevention ◽  
Standardized Mortality Ratios

Objectives: The number of adults in the United States being held on probation—persons convicted of crimes and serving their sentence in the community rather than in a correctional facility—approached 4 million at the end of 2016 and continues to grow, yet little is known about the health and well-being of this population. We compared the standardized mortality ratios of persons on probation in the United States with persons in jail, persons in state prison, and the general US population. Methods: We used administrative data from 2001-2012 from the Bureau of Justice Statistics and the Centers for Disease Control and Prevention WONDER database and indirect standardization techniques to compare the mortality rates of persons on probation in 15 states with the mortality rates of persons in jail, persons in state prison, and the general US population. We applied the age-specific mortality rates of 3 populations (general US population, persons in jail, and persons in state prison) to the age distribution of persons on probation to estimate standardized mortality ratios. Results: Persons on probation died at a rate 3.42 times higher than persons in jail, 2.81 times higher than persons in state prison, and 2.10 times higher than the general US population, after standardizing the age distribution of persons on probation relative to the other 3 groups. Conclusions: Public health interventions should target persons on probation, who have received less attention from the public health community than persons serving sentences in jails and prisons.

scholarly journals Epidemiological surveillance of West Nile virus in the world and Brazil

2020 ◽  
Vol 56 (4) ◽  
pp. e164335
Author(s):  
Erica Azevedo Costa ◽  
José Joffre Martins Bayeux ◽  
Aila Solimar Gonçalves Silva ◽  
Guilherme Alves De Queiroz ◽  
Beatriz Senra Álvares da Silva Santos ◽  
...  
Keyword(s):  
Public Health ◽  
West Nile Virus ◽  
Animal Health ◽  
Public Health Intervention ◽  
The United States ◽  
World Health ◽  
West Nile ◽  
Serological Screening ◽  
The World ◽  
Health Organization

West Nile virus (WNV) is a neurovirulent mosquito-borne Flavivirus that is maintained in nature by a zoonotic transmissioncycle between avian hosts and ornithophilic mosquito vectors, mostly from the Culex genus. Until the 1990s, WNV wasconsidered to be an old-world arbovirus, but in 1999, WNV emerged in the United States (US) and spread rapidly, becoming amajor threat to public health. WNV adapted to the transmission cycle involving American mosquitoes and birds and reachedCentral and South America in subsequent years. In 2003, the National West Nile Fever Surveillance System was created in Brazilbased on serological screening of animals and sentinel vectors, as recommended by the Pan American Health Organization(PAHO) and the World Health Organization (WHO). Since 2008, serological evidence of WNV infection in Brazilian horseshas been reported, and the circulation of WNV has been monitored through the regular serological screening of sentinel horsesand reporting of encephalomyelitis cases. Horses are highly susceptible to WNV infection, and outbreaks of neurologicaldisease among horses often precede human cases. In this regard, equine surveillance has been essential in providing earlywarning to public and animal health authorities in several countries, including Brazil. This demonstrates the need for animaland public health intervention programs to allocate resources to make veterinarians aware of the role they can play in thehuman surveillance processes by monitoring horses. This review discusses the importance of equine surveillance and the gapthat veterinarians can fill on the front line in human surveillance, in Brazil and worldwide, in the context of “One Health”

scholarly journals Understanding the Public Discussion About the Centers for Disease Control and Prevention During the COVID-19 Pandemic Using Twitter Data: Text Mining Analysis Study

10.2196/25108 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e25108
Author(s):  
Joanne Chen Lyu ◽  
Garving K Luli
Keyword(s):  
Public Health ◽  
Disease Control ◽  
The United States ◽  
Data Set ◽  
Public Discussion ◽  
The Public ◽  
Twitter Data ◽  
The World ◽  
Control And Prevention ◽  
Centers For Disease Control

Background The Centers for Disease Control and Prevention (CDC) is a national public health protection agency in the United States. With the escalating impact of the COVID-19 pandemic on society in the United States and around the world, the CDC has become one of the focal points of public discussion. Objective This study aims to identify the topics and their overarching themes emerging from the public COVID-19-related discussion about the CDC on Twitter and to further provide insight into public's concerns, focus of attention, perception of the CDC's current performance, and expectations from the CDC. Methods Tweets were downloaded from a large-scale COVID-19 Twitter chatter data set from March 11, 2020, when the World Health Organization declared COVID-19 a pandemic, to August 14, 2020. We used R (The R Foundation) to clean the tweets and retain tweets that contained any of five specific keywords—cdc, CDC, centers for disease control and prevention, CDCgov, and cdcgov—while eliminating all 91 tweets posted by the CDC itself. The final data set included in the analysis consisted of 290,764 unique tweets from 152,314 different users. We used R to perform the latent Dirichlet allocation algorithm for topic modeling. Results The Twitter data generated 16 topics that the public linked to the CDC when they talked about COVID-19. Among the topics, the most discussed was COVID-19 death counts, accounting for 12.16% (n=35,347) of the total 290,764 tweets in the analysis, followed by general opinions about the credibility of the CDC and other authorities and the CDC's COVID-19 guidelines, with over 20,000 tweets for each. The 16 topics fell into four overarching themes: knowing the virus and the situation, policy and government actions, response guidelines, and general opinion about credibility. Conclusions Social media platforms, such as Twitter, provide valuable databases for public opinion. In a protracted pandemic, such as COVID-19, quickly and efficiently identifying the topics within the public discussion on Twitter would help public health agencies improve the next-round communication with the public.

scholarly journals Enhancing Community Engagement by Schools and Programs of Public Health in the United States

2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Mindi B. Levin ◽  
Janice V. Bowie ◽  
Steven K. Ragsdale ◽  
Amy L. Gawad ◽  
Lisa A. Cooper ◽  
...  
Keyword(s):  
Public Health ◽  
Service Learning ◽  
Community Engagement ◽  
Learning Community ◽  
Community Based Participatory Research ◽  
Well Being ◽  
The United States ◽  
Annual Review ◽  
Publication Date ◽  
Control And Prevention

The US Centers for Disease Control and Prevention define community engagement as “the process of working collaboratively with and through groups of people” in order to improve their health and well-being. Central to the field of public health, community engagement should also be at the core of the work of schools and programs of public health. This article reviews best practices and emerging innovations in community engagement for education, for research, and for practice, including critical service-learning, community-based participatory research, and collective impact. Leadership, infrastructure, and culture are key institutional facilitators of successful academic efforts. Major challenges to overcome include mistrust by community members, imbalance of power, and unequal sharing of credit. Success in this work will advance equity and improve health in communities all around the world. Expected final online publication date for the Annual Review of Public Health, Volume 42 is April 1, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Alcohol and Other Drugs: Public Health Ethics Issues

2019 ◽  
pp. 510-523
Author(s):  
Brendan Saloner
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Ethical Issues ◽  
Personal Responsibility ◽  
Public Health Intervention ◽  
Cost Effective ◽  
The United States ◽  
Health Intervention ◽  
Individual Liberty ◽  
Alcohol And Other Drugs

This chapter examines ethical principles that guide public health intervention to reduce the harms of alcohol and other drugs, including justice-based concerns regarding intervention. While many egalitarian moral theories support public health measures to reduce these harms, and thereby protect individual capability and opportunity, there are opposing arguments to limit public health intervention based on either individual liberty or personal responsibility. The chapter also reviews ethical issues related to prevention, treatment, harm reduction, and decriminalization/legalization. Prevention through education is politically appealing, but is not always evidence-based and can be stigmatizing. Treatment can be highly cost-effective, but some approaches are controversial, such as legally coerced treatment. Harm reduction approaches, such as needle exchange, can reduce many of the negative health consequences of alcohol and drug use, but they require a more direct government role in illicit behaviors. Marijuana legalization is a growing movement in the United States, but it poses complex regulatory challenges.

Wassermann Before Wedding Bells: Premarital Examination Laws in the United States, 1937–1950

2019 ◽  
Author(s):  
Deborah B Doroshow
Keyword(s):  
Public Health ◽  
Blood Test ◽  
Communicable Disease ◽  
Public Health Intervention ◽  
Public Health Problem ◽  
The United States ◽  
Men And Women ◽  
Blood Tests ◽  
Private Lives ◽  
Definition Of

Abstract In the late 1930s, states began to pass laws requiring men and women applying for marriage licences to demonstrate proof of a blood test showing that they did not harbour communicable syphilis. Advocates of the laws positioned marriage as a public health checkpoint to identify new cases of syphilis as part of a broader effort to approach the disease as a public health problem, rather than a moral one. Although the laws appeared to have broad popular support, in reality they were a failed public health intervention. Couples rushed to the altar before laws went into effect and border-hopped to marry in states without blood test laws. The blood tests used to detect syphilis were difficult to interpret and physicians could not agree on a standard definition of communicable disease. But for over 30 years, premarital examination laws represented a tangible government presence in the private lives of most Americans.

scholarly journals The Check and Report Ebola (CARE+) Program to Monitor Travelers for Ebola After Arrival to the United States, 2014-2016

2019 ◽  
Vol 134 (6) ◽  
pp. 592-598 ◽  
Author(s):  
Heather A. Joseph ◽  
Abbey E. Wojno ◽  
Kelly Winter ◽  
Onalee Grady-Erickson ◽  
Erin Hawes ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
West Africa ◽  
Emerging Infectious Diseases ◽  
Care Program ◽  
The United States ◽  
The Us ◽  
Us Government ◽  
Public Health Authorities ◽  
Control And Prevention

The 2014-2016 Ebola epidemic in West Africa influenced how public health officials considered migration and emerging infectious diseases. Responding to the public’s concerns, the US government introduced enhanced entry screening and post-arrival monitoring by public health authorities to reduce the risk of importation and domestic transmission of Ebola while continuing to allow travel from West Africa. This case study describes a new initiative, the Check and Report Ebola (CARE+) program that engaged travelers arriving to the United States from countries with Ebola outbreaks. The Centers for Disease Control and Prevention employed CARE ambassadors, who quickly communicated with incoming travelers and gave them practical resources to boost their participation in monitoring for Ebola. The program aimed to increase travelers’ knowledge of Ebola symptoms and how to seek medical care safely, increase travelers’ awareness of monitoring requirements, reduce barriers to monitoring, and increase trust in the US public health system. This program could be adapted for use in future outbreaks that involve the potential importation of disease and require the education and active engagement of travelers to participate in post-arrival monitoring.

scholarly journals Using photos for public health communication: A computational analysis of the Centers for Disease Control and Prevention Instagram photos and public responses

2020 ◽  
Vol 26 (3) ◽  
pp. 2159-2180 ◽  
Author(s):  
Yunhwan Kim ◽  
Jang Hyun Kim
Keyword(s):  
Public Health ◽  
Disease Control ◽  
The United States ◽  
Public Health Communication ◽  
Cognitive Services ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Control And Prevention ◽  
Centers For Disease Control ◽  
Human Faces

This study aims to explore the use of Instagram by the Centers for Disease Control and Prevention, one of the representative public health authorities in the United States. For this aim, all of the photos uploaded on the Centers for Disease Control and Prevention Instagram account were crawled and the content of them were analyzed using Microsoft Azure Cognitive Services. Also, engagement was measured by the sum of numbers of likes and comments to each photo, and sentiment analysis of comments was conducted. Results suggest that the photos that can be categorized into “text” and “people” took the largest share in the Centers for Disease Control and Prevention Instagram photos. And it was found that the Centers for Disease Control and Prevention’s major way of delivering messages on Instagram was to imprint key messages that call for actions for better health on photos and to provide the source of complementary information on text component of each post. It was also found that photos with more and bigger human faces had lower level of engagement than the others, and happiness and neutral emotions expressed on the faces in photos were negatively associated with engagement. The features whose high value would make the photos look splendid and gaudy were negatively correlated with engagement, but sharpness was positively correlated.

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