Prevalence of antibodies against measles, mumps and rubella in the childhood population in Singapore, 2008–2010

2012 ◽  
Vol 141 (8) ◽  
pp. 1721-1730 ◽  
Author(s):  
L. W. ANG ◽  
F. Y. LAI ◽  
S. H. TEY ◽  
J. CUTTER ◽  
L. JAMES ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Herd Immunity ◽  
Age Groups ◽  
Childhood Immunization ◽  
Mmr Vaccine ◽  
Immunization Programme ◽  
Childhood Population ◽  
The Impact ◽  
Over Time

SUMMARYWe undertook a national paediatric seroprevalence survey of measles, mumps and rubella (MMR) in Singapore to assess the impact of the national childhood immunization programme against these three diseases after introduction of the trivalent MMR vaccine in 1990. The survey involved 1200 residual sera of Singapore residents aged 1–17 years collected from two hospitals between 2008 and 2010. The overall prevalence of antibodies against measles, mumps and rubella was 83·1% [95% confidence interval (CI) 80·9–85·1], 71·8% (95% CI 69·1–74·2) and 88·5% (95% CI 86·6–90·2), respectively. For all three diseases, the lowest prevalence was in children aged 1 year (47·8–62·3%). The seroprevalence of the vaccinated children declined over time. The national MMR immunization programme is effective in raising the herd immunity of the childhood population, although certain age groups are more susceptible to infection, in particular, those who are not eligible for vaccination at age <15 months.

scholarly journals 2714. Streptococcus pneumoniae Nasopharyngeal Carriage in Canadian Adults Hospitalized with Community-Acquired Pneumonia from 2010 to 2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S954-S955
Author(s):  
Jason J LeBlanc ◽  
May ElSherif ◽  
Amanda L S Lang ◽  
Hayley D Gillis ◽  
Lingyun Ye ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Real Time ◽  
Herd Immunity ◽  
Community Acquired Pneumonia ◽  
Serotype Distribution ◽  
Childhood Immunization ◽  
Vaccine Serotypes ◽  
Serotype Replacement ◽  
The Impact ◽  
Over Time

Abstract Background Streptococcus pneumoniae can colonizes the human nasopharynx, and can cause life-threatening infections like community-acquired pneumonia (CAP) and invasive pneumococcal diseases (IPD). In Canada, the 13-valent conjugate vaccine (PCV13) was introduced in childhood immunization since 2010, with hopes that it would not only protect the vaccinated, but also confer indirect protection to adults through herd immunity. Given data on S. pneumoniae nasopharyngeal (NP) carriage in adults is scarce, this study reports on S. pneumoniae-positivity and serotype distribution in adult carriage from years 2010 to 2017. Methods Active surveillance was performed in adults hospitalized with for CAP or IPD from December 2010 to 2017. For assessment of S. pneumoniae carriage, NP swabs were tested using lytA and cpsA real-time PCR. S. pneumoniae-positive NPs were subjected to serotyping using conventional and real-time multiplex PCRs. Results Overall, 6472 NP swabs were tested, and Spn was identified in 366 (5.7%). Of the 366 S. pneumoniae-positive NP swabs, a serotype was assigned in 355 (97.0%). From years 2010 to 2017, the proportion of S. pneumoniae-positive NP swabs declined from 8.9% to 4.3%. This was also reflected in the proportion of serotypeable results attributed to PCV13 serotypes, which also declined from 76.9% to 42.2%. The decline was primarily attributed to PCV13 serotypes 7F and 19A. PCV13 serotype 3 remained predominant throughout the study, as did non-PCV13 serotypes like 22F, 33F, and 11A. On the other hand, a proportional rise over time was noted for non-vaccine serotypes (from 15.4% to 31.1%). This was primarily attributed to serotypes 23A, 15A, and 35B. Conclusion Monitoring serotype trends is important to assess the impact of pneumococcal vaccines. While herd immunity from PCV13 childhood immunization was anticipated, few studies have assessed its impact on adult carriage. This study described Spn serotype distribution in adults over years 2010 to 2017, demonstrating not only a reduction of PCV13 serotypes over time, but a proportional rise in non-vaccine serotypes. These emerging serotypes may represent the emergence of serotype replacement. Ongoing serotype surveillance will be needed to compare S. pneumoniae carriage to serotypes associated with pneumococcal CAP and IPD. Disclosures All authors: No reported disclosures.

scholarly journals POS0774 INFLUENZA INFECTION AS A TRIGGER FOR SYSTEMIC LUPUS ERYTHEMATOSUS FLARES RESULTING IN HOSPITALIZATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 641.1-641
Author(s):  
Y. B. Joo ◽  
Y. J. Park
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Confidence Interval ◽  
Lupus Erythematosus ◽  
Influenza Infection ◽  
Age Groups ◽  
Case Series ◽  
Incidence Rates ◽  
Systemic Lupus ◽  
Control Interval ◽  
The Impact

Background:Infections have been associated with a higher risk of systemic lupus erythematosus (SLE) flares, but the impact of influenza infection on SLE flares has not been evaluated.Objectives:We evaluated the association between influenza infection and SLE flares resulting in hospitalization.Methods:SLE flares resulting in hospitalization and influenza cases were ascertained from the Korean national healthcare insurance database (2014-2018). We used a self-controlled case series design. We defined the risk interval as the first 7 days after the influenza index date and the control interval was defined as all other times during the observation period of each year. We estimated the incidence rates of SLE flares resulting in hospitalization during the risk interval and control interval and compared them using a Poisson regression model.Results:We identified 1,624 influenza infections among the 1,455 patients with SLE. Among those, there were 98 flares in 79 patients with SLE. The incidence ratio (IR) for flares during the risk interval as compared with the control interval was 25.75 (95% confidence interval 17.63 – 37.59). This significantly increased the IRs for flares during the risk interval in both women (IR 27.65) and men (IR 15.30), all age groups (IR 17.00 – 37.84), with and without immunosuppressive agent (IR 24.29 and 28.45, respectively), and with and without prior respiratory diseases (IR 21.86 and 26.82, respectively).Conclusion:We found significant association between influenza infection and SLE flares resulting in hospitalization. Influenza infection has to be considered as a risk factor for flares in all SLE patients regardless of age, sex, medications, and comorbidities.References:[1]Kwong, J. C. et al. Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. N Engl J Med 2018:378;345-353.Table 1.Incidence ratios for SLE flares resulting in hospitalization after influenza infectionRisk intervalIncidence ratio95% CIDuring risk interval for 7 days / control interval25.7517.63 – 37.59Days 1-3 / control interval21.8114.71 – 32.35Days 4-7 / control interval7.563.69 – 15.47SLE, systemic lupus erythematosus; CI, confidence intervalDisclosure of Interests:None declared

O’Cionnfaola v. the Wellcome Foundation and Daniel McCarthy

2018 ◽  
pp. 126-143
Author(s):  
Michael Dwyer
Keyword(s):  
Public Health ◽  
State Intervention ◽  
Active Immunization ◽  
Free State ◽  
Public Health Issue ◽  
Childhood Immunization ◽  
Immunization Programme ◽  
The Social ◽  
Vaccine Confidence ◽  
The Impact

Chapter six argues that by the end of 1936, the Irish Free State had come close to incepting an operational national anti-diphtheria immunization scheme. This is a noteworthy achievement, as state-backed anti-diphtheria schemes were not introduced as an intervention against this pressing public health issue in the rest of Europe until 1938 and were only pursued with any vigour when wartime conditions exacerbated the problem from 1940 onwards. If it had progressed unimpeded, the Free State intervention seemed destined to eliminate diphtheria, and to become the first established national childhood immunization programme in Europe. However, the death of Siobhán O’Cionnfaola in April 1937, and the subsequent controversy surrounding the Ring incident, asked serious questions of active immunization and ultimately undermined vaccine confidence among parents, practitioners, and politicians. This chapter will evaluate the impact of the Ring controversy and the social, political and medical implications left in the wake of the incident.

scholarly journals 2715. Pneumococcal Community-Acquired Pneumonia Attributed to PCV13 Serotypes in Hospitalized Adults: Comparison of the 50–64 and 65+ Age Groups

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S955-S955
Author(s):  
Jason J LeBlanc ◽  
May ElSherif ◽  
Lingyun Ye ◽  
Donna MacKinnon-Cameron ◽  
Ardith Ambrose ◽  
...  
Keyword(s):  
Herd Immunity ◽  
Age Groups ◽  
Outcome Data ◽  
Community Acquired Pneumonia ◽  
Childhood Immunization ◽  
Age Cohorts ◽  
Vaccine Type ◽  
Age Cohort ◽  
Canadian Provinces ◽  
Quellung Reaction

Abstract Background In healthy adults aged ≥65 years, direct immunization with the 13-valent pneumococcal conjugate vaccine (PCV13) was shown effective at preventing vaccine-type pneumococcal community-acquired pneumonia (pCAP) and invasive pneumococcal disease (IPD). Although PCV13 was licensed for use in Canadian adults aged >50 years, it was recommended for immunocompromised individuals who are at highest risk of IPD. In 2016, a recommendation was issued for use of PCV13 in immunocompetent adults aged ≥65 years, for the prevention of pCAP and IPD. This study aimed to compare pCAP cases attributed to PCV13 serotypes in adults aged 50–64 and ≥65 years. Methods Active surveillance for CAP and IPD was performed from 2010 to 2015 in adult hospitals across five Canadian provinces. To identify pCAP, blood culture, sputum culture, or a PCV13 serotype-specific urine antigen detection (ssUAD) were used. Serotype was assigned using Quellung reaction, PCR, or ssUAD. All pCAP cases were categorized by serotype and age groups. Patient demographics and outcome data were collected. Results Over years 2010–2015, 6687 CAP cases were tested. 835 pCAP cases were identified, of which 418 (50%) caused by a PCV13 serotype. The majority (74%) of PCV13-associated pCAP occurred in the adults aged ≥50 years, whereas only 41.4% (173/418) were in adults ≥65 years. PCV13 pCAP cases declined over the years, likely through herd immunity from childhood immunization. The yearly proportion of pCAP attributed to PCV13 serotypes for ages ≥50 remained high (67.5 to 80.6%), compared those occurring in the ≥65 age groups (35.1 to 49.4%). Compared with test-negative controls, pCAP cases in both age groups were more likely to be admitted to ICU, require mechanical ventilation, and had higher mortality. Of pCAP deaths, 61.4% and 82.3% were in the ≥65 and ≥50 age cohorts, respectively. Conclusion From year 2010 to 2015, adults hospitalized with PCV13 pCAP in the ≥65 age cohort accounted for less than half of the cases, whereas including the 50–64 age cohort increased the proportion to 74%. Similarly, the proportion of PCV13 pCAP deaths that occurred in adults aged ≥50 years was 82%, compared with 61% in the ≥65 age cohort. Expansion of PCV13 recommendations to include adults 50–64 years of age should be considered. Disclosures All authors: No reported disclosures.

scholarly journals Hippuric acid in urine: reference values

2002 ◽  
Vol 36 (6) ◽  
pp. 723-727 ◽  
Author(s):  
Maria Elisa PB Siqueira ◽  
Maria José N Paiva
Keyword(s):  
Standard Deviation ◽  
Confidence Interval ◽  
Reference Values ◽  
Hippuric Acid ◽  
Smoking Habit ◽  
Age Groups ◽  
Reference Value ◽  
Good Health ◽  
Southeastern Brazil ◽  
The Impact

OBJECTIVE: To establish reference values for hippuric acid (HA) excreted in the urine, and to evaluate the impact of age, gender, alcohol, and tobacco, on these levels in a population nonexposed to toluene. METHODS: Reference values for hippuric acid in urine were determined in 115 toluene nonexposed healthy volunteers, from Alfenas city, Southeastern Brazil. A questionnaire was applied to each volunteer and data on occupational and personal habits were collected. Biochemical and hematological analyses were used to confirm the volunteers' good health condition. Reference values were expressed in g HA/g urine creatinine, as mean ± standard deviation (x ± SD), median, 95% confidence interval (95%CI), 95th percentile, and upper reference value (URV, mean +2 SD). RESULTS: Reference values of hippuric acid in urine were: mean ± standard deviation =0.18±0.10; median =0.15; 95% confidence interval =0.16±0.20; 95th percentile = 0.36 and upper reference value (URV, mean +2 SD) =0.38. Statistically significant differences in urinary HA (Wilcoxon - Mann/Whitney, p<0.05) were observed for different genders and age groups. Alcohol ingestion and smoking habit did not significantly affect the results. CONCLUSIONS: The reference values of hippuric acid in urine can be used in biomonitoring programs of workers occupationally exposed to toluene, especially in the southern region of the state of Minas Gerais. Age and gender may affect the HA reference values.

scholarly journals Meningococcal carriage in children and young adults in the Philippines: a single group, cross-sectional study

2016 ◽  
Vol 145 (1) ◽  
pp. 126-132 ◽  
Author(s):  
M. L. A. GONZALES ◽  
V. BIANCO ◽  
A. VYSE
Keyword(s):  
Herd Immunity ◽  
Age Groups ◽  
Vaccine Dose ◽  
Asian Population ◽  
Cross Sectional Study ◽  
The Philippines ◽  
Valuable Insight ◽  
Cross Sectional ◽  
Immunization Programme ◽  
Children And Young Adults

SUMMARYThis cross-sectional prevalence study investigates meningococcal carriage for the first time in a Southeast Asian population. Posterior pharyngeal swabs were collected between August 2013 and March 2014 from 937 healthy Filipinos aged 5–24 years attending school or university in Manila. Of these, 35 were found to be carriers giving an overall carriage prevalence of 3·7% [95% confidence interval (CI) 2·6–5·2]. Carriage was associated with age (P < 0·001) and was highest (9·0%, 95% CI 5·5–13·8) in subjects aged 10–14 years, but was comparatively low (<3%) in all other age groups considered. This suggests that an immunization programme in the Philippines designed to reduce carriage acquisition and induce herd immunity may require a vaccine dose before the age of 10 years. Serogroup B was most commonly carried (65·7%, 95% CI 47·8–80·9), with a small number of carriers for serogroups C, Y and W also present. Two individuals (5·7%, 95% CI 0·7–19·2) who were simultaneously carrying multiple serogroups were identified. This exploratory study provides valuable insight into the asymptomatic carriage of Neisseria meningitidis in a healthy subset of the Filipino population and illustrates the importance of generating local carriage data.

scholarly journals The seroepidemiology of rubella in western Europe

2000 ◽  
Vol 125 (2) ◽  
pp. 347-357 ◽  
Author(s):  
R. G. PEBODY ◽  
W. J. EDMUNDS ◽  
M. CONYN-van SPAENDONCK ◽  
P. OLIN ◽  
G. BERBERS ◽  
...  
Keyword(s):  
General Population ◽  
The Netherlands ◽  
Western Europe ◽  
Age Groups ◽  
Congenital Rubella Syndrome ◽  
Childbearing Age ◽  
Immunization Programme ◽  
Congenital Rubella ◽  
The Impact ◽  
Selective Vaccination

Most of the countries in western Europe have now implemented mass infant rubella immunization programmes, instead of or in addition to selective vaccination in order to achieve the elimination of congenital rubella syndrome.The European countries Denmark, England and Wales, Finland, France, Germany, Italy and the Netherlands undertook large, national serological surveys collecting several thousand serum specimens during 1994–8. Antibodies against rubella virus were detected by a variety of enzyme immuno-assays. Comparability of the assay results was achieved by a standardized methodology. The age- and sex-stratified serological results were related to the schedules, coverage of rubella vaccination and the incidence in these countries.The results show widely differing levels of immunity to rubella both in the general population and in the specific age groups of males and females. A low rate (< 5%) of susceptibles in childhood and adolescents of both sexes was obtained only in Finland and the Netherlands.Countries such as Italy with only moderate coverage for the infant immunization programme currently have both high susceptibility levels in the general population and in the at-risk population. The likelihood is of continued epidemics of rubella with cases of congenital rubella syndrome. The continued implementation of selective vaccination will help to offset the impact of this ongoing transmission and to protect women on reaching childbearing age.

scholarly journals Contact surveys reveal heterogeneities in age-group contributions to SARS-CoV-2 dynamics in the United States

2021 ◽  
Author(s):  
Taylor Chin ◽  
Dennis M. Feehan ◽  
Caroline O. Buckee ◽  
Ayesha S. Mahmud
Keyword(s):  
United States ◽  
Age Groups ◽  
The United States ◽  
Contact Rate ◽  
Age Group ◽  
Contact Rates ◽  
Contact Patterns ◽  
Age Structured ◽  
The Impact ◽  
Over Time

SARS-CoV-2 is spread primarily through person-to-person contacts. Quantifying population contact rates is important for understanding the impact of physical distancing policies and for modeling COVID-19, but contact patterns have changed substantially over time due to shifting policies and behaviors. There are surprisingly few empirical estimates of age-structured contact rates in the United States both before and throughout the COVID-19 pandemic that capture these changes. Here, we use data from six waves of the Berkeley Interpersonal Contact Survey (BICS), which collected detailed contact data between March 22, 2020 and February 15, 2021 across six metropolitan designated market areas (DMA) in the United States. Contact rates were low across all six DMAs at the start of the pandemic. We find steady increases in the mean and median number of contacts across these localities over time, as well as a greater proportion of respondents reporting a high number of contacts. We also find that young adults between ages 18 and 34 reported more contacts on average compared to other age groups. The 65 and older age group consistently reported low levels of contact throughout the study period. To understand the impact of these changing contact patterns, we simulate COVID-19 dynamics in each DMA using an age-structured mechanistic model. We compare results from models that use BICS contact rate estimates versus commonly used alternative contact rate sources. We find that simulations parameterized with BICS estimates give insight into time-varying changes in relative incidence by age group that are not captured in the absence of these frequently updated estimates. We also find that simulation results based on BICS estimates closely match observed data on the age distribution of cases, and changes in these distributions over time. Together these findings highlight the role of different age groups in driving and sustaining SARS-CoV-2 transmission in the U.S. We also show the utility of repeated contact surveys in revealing heterogeneities in the epidemiology of COVID-19 across localities in the United States.

scholarly journals A herd immunity to measles and rubella viruses in the population of the Republic of Serbia

2021 ◽  
Vol 11 (1) ◽  
pp. 171-176
Author(s):  
M. A. Bichurina ◽  
S. Filipovic-Vignjevic ◽  
A. Yu. Antipova ◽  
M. Bancevic ◽  
I. N. Lavrentieva
Keyword(s):  
Measles Virus ◽  
Herd Immunity ◽  
Age Groups ◽  
Age Group ◽  
Igg Antibodies ◽  
Mmr Vaccine ◽  
Igg Antibody ◽  
Group I ◽  
Study Results ◽  
The Republic

According to the WHO Strategic Plan, measles should be eradicated in 2020 in the five WHO Regions including European Region. However, large measles outbreaks are being periodically registered in diverse European countries. In the Republic of Serbia (SRB), 5,076 measles cases were detected in 2018, among which 15 cases were fatal.Aim of the study was to examine herd immunity to measles and rubella viruses in the population of the Republic of Serbia.Materials and methods. Blood serum samples obtained in 2018 and 2019 from conditionally healthy residents of the Republic of Serbia were tested for the presence of IgG antibodies to measles and rubella viruses in five age groups: I — children from 2 to 6 years old, II — children from 8 to 14 years old, III — 15 to 24 years old, IV — 25 to 49 years old and V — over 50 years old. A total of 1000 samples were obtained, 200 sera in each group. Enzygnost® Anti-Measles virus/IgG and Enzygnost® Anti-Rubella virus/IgG ELISA test systems (Siemens Healthcare Diagnostics Products GmbH, Germany) were used according to the manufacturer's instructions.Results. Overall, around 23.0% and 33.7% of the surveyed persons had no or low level of anti-measles IgG antibody (≥ 275.0 — ≤ 1000.0 IU/1). In age group I, 60% children contained no or “low” anti-measles antibodies titer (29.5% and 30.5%, respectively). In addition, low antibody titer level was mainly detected in individuals from age group II and III (p < 0.05). A third of children under 8—14 contained high IgG-antibodies titer against measles (> 3000.0 IU/l) that might serve as an evidence that such subjects recently recovered after measles. Similar results were obtained for IgG antibodies to rubella in the same age groups.Discussion. The study results evidence about altered routine immunization against measles and rubella in children aged 12—15 months (first vaccination) and those at age of 6—7 years (revaccination) with MMR vaccine. The data obtained correlate with official data on coverage with measles and rubella vaccines in the Republic of Serbia.

scholarly journals A simulation study on the relative role of age groups under differing pertussis transmission scenarios

2018 ◽  
Author(s):  
Ana I. Bento ◽  
Aaron A. King ◽  
Pejman Rohani
Keyword(s):  
Herd Immunity ◽  
Age Groups ◽  
Transmission Model ◽  
Relative Role ◽  
Older Individuals ◽  
Age Cohorts ◽  
Relative Risks ◽  
Transmission Mechanisms ◽  
Acellular Vaccines ◽  
The Impact

AbstractPertussis has resurged in many countries where it was once regarded as under control, with the recent outbreaks showing a shift in incidence towards teens and older individuals. Here, using an age-stratified transmission model, we tested two potential causes for underlying changes in pertussis transmission dynamics. We did so assuming hypothesized mechanisms supporting present-day pertussis epidemiology: (I) improved diagnostics, (II) acellular vaccines leading to asymptomatic transmission (III) both. We used the relative risks and odds ratio methods to examine the impact of these differing assumptions on signatures of relative roles of key age groups through time, allowing us to explore those age cohorts that disproportionately account for transmission. Our findings show that for epidemics after the vaccine switch, a scenario with increased adult reporting and no asymptomatic transmission reflect a loss of signal, where no age group appears to be key. While scenarios with asymptomatic transmission, reflect a population where children (1-10 years old) are still disproportionally at risk. These results demonstrate that understanding the underlying transmission mechanisms in a population are paramount for vaccination policies in attaining herd immunity and eventually eradication.

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