Surveillance for Bloodborne Infections

1999 ◽  
Vol 82 (08) ◽  
pp. 494-499 ◽  
Author(s):  
Mary Chamberland
Keyword(s):  
Public Health ◽  
Public Health Practice ◽  
Emerging Infectious Diseases ◽  
Blood Substitute ◽  
Surveillance Systems ◽  
Institute Of Medicine ◽  
Blood Safety ◽  
Prevention Strategies ◽  
Public Health Response ◽  
The U.S

IntroductionSince blood is a biological product, it is a natural vehicle for transmission of infectious agents, and until an artificial blood substitute is developed, the risk of transfusion-transmitted infections will probably not be eliminated. Three agencies of the Department of Health and Human Services–the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and National Institutes of Health (NIH)–have collaborated with partners in local and state public health departments, academia, industry, and consumers to develop prevention strategies addressing emerging infectious disease threats to public health, including the safety of the U.S. blood supply. Four critical components of these prevention strategies are as follows: surveillance and response capabilities; integration of laboratory science and epidemiology (i.e., “applied research”) to optimize public health practice; prevention and control activities to enhance communication of public health information; and a strengthening of local, state, and federal infrastructures to support these activities.1 As highlighted by the Institute of Medicine, in its series of reports about the ongoing threat to health posed by emerging infectious diseases, surveillance is the critical lynchpin for the public health response to both known and unrecognized pathogenic threats.2 Surveillance data can be used to monitor and track temporal and demographic trends of disease, alert us to outbreaks or unexpected alterations in disease frequency or affected populations, serve as a basis for subsequent epidemiologic and laboratory investigations to describe the natural history of a disease or identify risk factors for its occurrence, and evaluate intervention strategies.2,3 This paper will review programs of surveillance in the U.S. to detect established and emerging infectious risks, with an emphasis on those that address blood safety. In addition, recent examples or case studies that illustrate the responsiveness of U.S. surveillance systems to blood safety issues will be presented.

scholarly journals Public Health Workforce Burnout in the COVID-19 Response in the U.S.

2021 ◽  
Vol 18 (8) ◽  
pp. 4369
Author(s):  
Kahler W. Stone ◽  
Kristina W. Kintziger ◽  
Meredith A. Jagger ◽  
Jennifer A. Horney
Keyword(s):  
Public Health ◽  
Health Workforce ◽  
Work Experience ◽  
Large Scale ◽  
Health Workers ◽  
Public Health Workforce ◽  
Cross Sectional Survey ◽  
Public Health Response ◽  
Cross Sectional ◽  
The U.S

While the health impacts of the COVID-19 pandemic on frontline health care workers have been well described, the effects of the COVID-19 response on the U.S. public health workforce, which has been impacted by the prolonged public health response to the pandemic, has not been adequately characterized. A cross-sectional survey of public health professionals was conducted to assess mental and physical health, risk and protective factors for burnout, and short- and long-term career decisions during the pandemic response. The survey was completed online using the Qualtrics survey platform. Descriptive statistics and prevalence ratios (95% confidence intervals) were calculated. Among responses received from 23 August and 11 September 2020, 66.2% of public health workers reported burnout. Those with more work experience (1–4 vs. <1 years: prevalence ratio (PR) = 1.90, 95% confidence interval (CI) = 1.08−3.36; 5–9 vs. <1 years: PR = 1.89, CI = 1.07−3.34) or working in academic settings (vs. practice: PR = 1.31, CI = 1.08–1.58) were most likely to report burnout. As of September 2020, 23.6% fewer respondents planned to remain in the U.S. public health workforce for three or more years compared to their retrospectively reported January 2020 plans. A large-scale public health emergency response places unsustainable burdens on an already underfunded and understaffed public health workforce. Pandemic-related burnout threatens the U.S. public health workforce’s future when many challenges related to the ongoing COVID-19 response remain unaddressed.

AHEAD: a data resource to support the Ending the HIV Epidemic in the US Initiative (Preprint)

2021 ◽  
Author(s):  
Patrick Sullivan ◽  
Cory R Woodyatt ◽  
Oskian Kouzouian ◽  
Kristen Parrish ◽  
Jennifer Taussig ◽  
...  
Keyword(s):  
Public Health ◽  
Data Visualization ◽  
Census Data ◽  
Quality Data ◽  
Surveillance Systems ◽  
Data Systems ◽  
Data Resource ◽  
Hiv Epidemic ◽  
Indicator Data ◽  
The U.S

UNSTRUCTURED Objectives: America’s HIV Epidemic Analysis Dashboard (AHEAD) is a data visualization tool that displays relevant data on the 6 HIV indicators provided by CDC that can be used to monitor progress towards ending the HIV epidemic in local communities across the U.S. The objective of AHEAD is to make data available to stakeholders that can be used to measure national and local progress towards 2025 and 2030 Ending the HIV Epidemic in the U.S. (EHE) goals and to help jurisdictions make local decisions that are grounded in high-quality data. Methods: AHEAD displays data from public health data systems (e.g., surveillance systems, Census data), organized around the six EHE indicators (incidence, knowledge of status, diagnoses, linkage to HIV medical care, viral suppression, and PrEP coverage). Data are displayed for each of the EHE priority areas (48 counties Washington, D.C. and San Juan, PR) which accounted for more than 50% of all U.S. HIV diagnoses in 2016 and 2017 and seven primarily Southern states with high rates of HIV in rural communities. AHEAD also displays data for the 43 remaining states for which data are available. Data features prioritize interactive data-visualization tools that allow users to compare indicator data stratified by sex at birth, race, age, and transmission category within a jurisdiction (when available) or compare data on EHE indicators between jurisdictions. Results: AHEAD was launched on August 14, 2020. In the 11 months since its launch, the Dashboard has been visited 26,591 times by 17,600 unique users. About a third of all users returned to the Dashboard at least once. On average, users engaged with 2.4 pages during their visit to the Dashboard, indicating that the average user goes beyond the informational landing page to engage with one or more pages of data and content. The most frequently visited content pages are the Jurisdictions webpages. Conclusions: The Ending the HIV Epidemic plan is described as a “whole of society” effort. Societal public health initiatives require objective indicators and require that all societal stakeholders have transparent access to indicator data at the level of the health jurisdictions responsible for meeting the goals of the plan. Data transparency empowers local stakeholders to track movement towards EHE goals, identify areas with needs for improvement, make data-informed adjustments to deploy the expertise and resources required to locally tailor and implement strategies to end the HIV epidemic in their jurisdiction.

scholarly journals Ethics of instantaneous contact tracing using mobile phone apps in the control of the COVID-19 pandemic

2020 ◽  
Vol 46 (7) ◽  
pp. 427-431 ◽  
Author(s):  
Michael J Parker ◽  
Christophe Fraser ◽  
Lucie Abeler-Dörner ◽  
David Bonsall
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Mobile Phone ◽  
Public Health Practice ◽  
Disease Outbreaks ◽  
Contact Tracing ◽  
Mobile Phone Data ◽  
Public Health Response ◽  
Infectious Disease Outbreaks ◽  
Ethical Implications

In this paper we discuss ethical implications of the use of mobile phone apps in the control of the COVID-19 pandemic. Contact tracing is a well-established feature of public health practice during infectious disease outbreaks and epidemics. However, the high proportion of pre-symptomatic transmission in COVID-19 means that standard contact tracing methods are too slow to stop the progression of infection through the population. To address this problem, many countries around the world have deployed or are developing mobile phone apps capable of supporting instantaneous contact tracing. Informed by the on-going mapping of ‘proximity events’ these apps are intended both to inform public health policy and to provide alerts to individuals who have been in contact with a person with the infection. The proposed use of mobile phone data for ‘intelligent physical distancing’ in such contexts raises a number of important ethical questions. In our paper, we outline some ethical considerations that need to be addressed in any deployment of this kind of approach as part of a multidimensional public health response. We also, briefly, explore the implications for its use in future infectious disease outbreaks.

scholarly journals “Back to the Future”: Time for a Renaissance of Public Health Engineering

2019 ◽  
Vol 16 (3) ◽  
pp. 387
Author(s):  
Richard J. Gelting ◽  
Steven C. Chapra ◽  
Paul E. Nevin ◽  
David E. Harvey ◽  
David M. Gute
Keyword(s):  
Public Health ◽  
Native American ◽  
Alaska Native ◽  
Environmental Protection Agency ◽  
Large Scale ◽  
Public Health Practice ◽  
The United States ◽  
Modern World ◽  
Positive Health ◽  
The U.S

Public health has always been, and remains, an interdisciplinary field, and engineering was closely aligned with public health for many years. Indeed, the branch of engineering that has been known at various times as sanitary engineering, public health engineering, or environmental engineering was integral to the emergence of public health as a distinct discipline. However, in the United States (U.S.) during the 20th century, the academic preparation and practice of this branch of engineering became largely separated from public health. Various factors contributed to this separation, including an evolution in leadership roles within public health; increasing specialization within public health; and the emerging environmental movement, which led to the creation of the U.S. Environmental Protection Agency (EPA), with its emphasis on the natural environment. In this paper, we consider these factors in turn. We also present a case study example of public health engineering in current practice in the U.S. that has had large-scale positive health impacts through improving water and sanitation services in Native American and Alaska Native communities. We also consider briefly how to educate engineers to work in public health in the modern world, and the benefits and challenges associated with that process. We close by discussing the global implications of public health engineering and the need to re-integrate engineering into public health practice and strengthen the connection between the two fields.

Prescription for a Stronger FDA

2006 ◽  
Vol 19 (5) ◽  
pp. 295-296
Author(s):  
Roy Guharoy ◽  
Gregory Cwikla ◽  
Andrew Burgdorf ◽  
Madan Joshi
Keyword(s):  
Public Health ◽  
Life Cycle ◽  
Drug Product ◽  
Drug Approval ◽  
Postmarketing Surveillance ◽  
Institute Of Medicine ◽  
Approval Process ◽  
Staff Members ◽  
The U.S ◽  
Systemic Drug

Recently, an Institute of Medicine panel concluded that years of negligence, mismanagement, inadequate resources, infighting among staff members, and lack of a systemic drug approval and postmarketing surveillance process have diluted the effectiveness of the Food and Drug Administration (FDA) in protecting public health. The panel was commissioned by the FDA to assess the U.S. drug safety system, and they recommended 25 sweeping changes, most of which would require congressional authorization. The recommendations focus on the life cycle of a drug product, rather than just the approval process, and they would go a long way in protecting public health in the future.

scholarly journals Surveillance System Evaluations Provide Evidence to Improve Public Health Practice

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Beverley J. Paterson ◽  
David N. Durrheim
Keyword(s):  
Public Health ◽  
Public Health Practice ◽  
Disease Outbreaks ◽  
Surveillance Systems ◽  
Health Practice ◽  
Outbreak Response ◽  
Local Public Health ◽  
Infectious Disease Outbreaks ◽  
The Pacific ◽  
Surveillance Practice

Surveillance evaluations of surveillance systems should provide evidence to improve public health practice. In response to surveillance evaluation findings amongst Pacific Island Countries and Territories that identified a critical need to better equip local public health officials with skills to rapidly appropriately respond to suspected infectious disease outbreaks across the Pacific, the RAPID (Response and Analysis for Pacific Infectious Diseases) project was implemented to strengthen capacity in surveillance, epidemiology and outbreak response. The RAPID project is a notable example of how evidence gathered through a surveillance evaluation can be used to improve public health surveillance practice.

scholarly journals The U.S. COVID-19 Trends and Impact Survey, 2020-2021: Continuous real-time measurement of COVID-19 symptoms, risks, protective behaviors, testing and vaccination

2021 ◽  
Author(s):  
Joshua A Salomon ◽  
Alex Reinhart ◽  
Alyssa Bilinski ◽  
Eu Jing Chua ◽  
Wichida La Motte-Kerr ◽  
...  
Keyword(s):  
Public Health ◽  
Real Time ◽  
Large Scale ◽  
Survey Methods ◽  
Health Priorities ◽  
Surveillance Systems ◽  
Cross Sectional ◽  
Essential Information ◽  
Public Health Reporting ◽  
The U.S

The U.S. COVID-19 Trends and Impact Survey (CTIS) is a large, cross-sectional, Internet-based survey that has operated continuously since April 6, 2020. By inviting a random sample of Facebook active users each day, CTIS collects information about COVID-19 symptoms, risks, mitigating behaviors, mental health, testing, vaccination, and other key priorities. The large scale of the survey -- over 20 million responses in its first year of operation -- allows tracking of trends over short timescales and allows comparisons at fine demographic and geographic detail. The survey has been repeatedly revised to respond to emerging public health priorities. In this paper, we describe the survey methods and content and give examples of CTIS results that illuminate key patterns and trends and help answer high-priority policy questions relevant to the COVID-19 epidemic and response. These results demonstrate how large online surveys can provide continuous, real-time indicators of important outcomes that are not subject to public health reporting delays and backlogs. The CTIS offers high value as a supplement to official reporting data by supplying essential information about behaviors, attitudes toward policy and preventive measures, economic impacts, and other topics not reported in public health surveillance systems.

scholarly journals MicrobeTrace: Retooling Molecular Epidemiology for Rapid Public Health Response

2020 ◽  
Author(s):  
Ellsworth M. Campbell ◽  
Anthony Boyles ◽  
Anupama Shankar ◽  
Jay Kim ◽  
Sergey Knyazev ◽  
...  
Keyword(s):  
Public Health ◽  
Molecular Epidemiology ◽  
Spanning Trees ◽  
Healthcare Providers ◽  
Contact Tracing ◽  
Surveillance Systems ◽  
Multiple Sources ◽  
Public Health Response ◽  
Link Type ◽  
Novel Approach

AbstractMotivationOutbreak investigations use data from interviews, healthcare providers, laboratories and surveillance systems. However, integrated use of data from multiple sources requires a patchwork of software that present challenges in usability, interoperability, confidentiality, and cost. Rapid integration, visualization and analysis of data from multiple sources can guide effective public health interventions.ResultsWe developed MicrobeTrace to facilitate rapid public health responses by overcoming barriers to data integration and exploration in molecular epidemiology. Using publicly available HIV sequences and other data, we demonstrate the analysis of viral genetic distance networks and introduce a novel approach to minimum spanning trees that simplifies results. We also illustrate the potential utility of MicrobeTrace in support of contact tracing by analyzing and displaying data from an outbreak of SARS-CoV-2 in South Korea in early 2020.Availability and ImplementationMicrobeTrace is a web-based, client-side, JavaScript application (https://microbetrace.cdc.gov) that runs in Chromium-based browsers and remains fully-operational without an internet connection. MicrobeTrace is developed and actively maintained by the Centers for Disease Control and Prevention. The source code is available at https://github.com/cdcgov/[email protected]

scholarly journals Combining community wastewater genomic surveillance with state clinical surveillance: A framework for SARS-CoV-2 public health practice

2021 ◽  
Author(s):  
Ted Smith ◽  
Rochelle H. Holm ◽  
Ray Yeager ◽  
Joseph B. Moore ◽  
Eric C. Rouchka ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health Practice ◽  
Policy Implications ◽  
Current Evidence ◽  
Jefferson County ◽  
Health Practice ◽  
Public Health Response ◽  
Study Objective ◽  
Clinical Surveillance ◽  
Wastewater Samples

AbstractStudy objectiveTo garner a framework for combining community wastewater surveillance with state clinical surveillance that influence confirmation of SARS-CoV-2 variants within the community, and recommend how the flow of such research evidence could be expanded and employed for public health response.Design, setting, and participantsThis work involved analyzing wastewater samples collected weekly from 17 geographically resolved locations in Louisville/Jefferson County, Kentucky from February 10 to November 29, 2021. Genomic surveillance and RT-qPCR platforms were used as screening to identify SARS-CoV-2 in wastewater, and state clinical surveillance was used for confirmation.Main resultsThe results demonstrate increased epidemiological value of combining community wastewater genomic surveillance and RT-qPCR with conventional case auditing methods. The spatial scale and temporal frequency of wastewater sampling provides promising sensitivity and specificity to be useful to gain public health screening insights about community emergence, seeding, and spread.ConclusionsBetter national surveillance systems are needed for future pathogens and variants, and wastewater-based genomic surveillance represents opportune coupling. This paper presents current evidence that complementary wastewater and clinical testing is enhanced cost-effectively when linked; making a strong case for a joint public health framework. The findings suggest significant potential for rapid progress to be made in extending this work to consider pathogens of interest as a whole within wastewater, which could be examined in either a targeted fashion as we currently do with SARS-CoV-2 or in terms of a global monitoring of all pathogens found, and developing evidence based public health practice to best support community health.Thumbnail BoxWhat is already known on this subject?The primary approach for the genomic surveillance of SARS-CoV-2 relies on the sequencing of clinical COVID-19 samples. Variants of SARS-CoV-2 can also be tracked in community wastewater.What this study adds?We propose that, for comprehensive community surveillance, the first line of community pathogen screening should involve geographically-resolved wastewater samples collected at a regular frequency and employ both Next Generation Sequencing (NGS) and RT-qPCR. These results could then be compared with state clinical surveillance. This framework is a more comprehensive and cost-effective approach for surveillance in practice to catch community emergence, seeding, and spread.Policy implicationsOur results present a framework that could support the implementation of better surveillance policies directed to solve future community pathogen and variant detection. We anticipate this work can help public health officials implement rational community sampling schemes and develop sensible coordination with other clinical surveillance. The utility of this for COVID-19 extends to many other infectious disease models and other public health hazards such as toxic exposures.

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