scholarly journals First Mildly Ill, Nonhospitalized Case of Coronavirus Disease 2019 (COVID-19) Without Viral Transmission in the United States—Maricopa County, Arizona, 2020

2020 ◽  
Vol 71 (15) ◽  
pp. 807-812 ◽  
Author(s):  
Sarah E Scott ◽  
Karen Zabel ◽  
Jennifer Collins ◽  
Katherine C Hobbs ◽  
Melissa J Kretschmer ◽  
...  
Keyword(s):  
Public Health ◽  
High Risk ◽  
The United States ◽  
Asymptomatic Infection ◽  
Illness Severity ◽  
Risk Exposure ◽  
Intimate Contact ◽  
Maricopa County ◽  
Medium Risk ◽  
County Resident

Abstract Background Coronavirus disease 2019 (COVID-19) causes a range of illness severity. Mild illness has been reported, but whether illness severity correlates with infectivity is unknown. We describe the public health investigation of a mildly ill, nonhospitalized COVID-19 case who traveled to China. Methods The case was a Maricopa County resident with multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–positive specimens collected on 22 January 2020. Contacts were persons exposed to the case on or after the day before case diagnostic specimen collection. Contacts were monitored for 14 days after last known exposure. High-risk contacts had close, prolonged case contact (≥ 10 minutes within 2 m). Medium-risk contacts wore all US Centers for Disease Control and Prevention–recommended personal protective equipment during interactions. Nasopharyngeal and oropharyngeal (NP/OP) specimens were collected from the case and high-risk contacts and tested for SARS-CoV-2. Results Paired case NP/OP specimens were collected for SARS-CoV-2 testing at 11 time points. In 8 pairs (73%), ≥ 1 specimen tested positive or indeterminate, and in 3 pairs (27%) both tested negative. Specimens collected 18 days after diagnosis tested positive. Sixteen contacts were identified; 11 (69%) had high-risk exposure, including 1 intimate contact, and 5 (31%) had medium-risk exposure. In total, 35 high-risk contact NP/OP specimens were collected for SARS-CoV-2 testing; all 35 pairs (100%) tested negative. Conclusions This report demonstrates that SARS-CoV-2 infection can cause mild illness and result in positive tests for up to 18 days after diagnosis, without evidence of transmission to close contacts. These data might inform public health strategies to manage individuals with asymptomatic infection or mild illness.

scholarly journals Assessing Diazinon Pollution in the Three Major Rivers Flowing into the Caspian Sea (Iran)

Water ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 335
Author(s):  
Reza Dahmardeh Behrooz ◽  
Abbas Esmaili-sari ◽  
Magdalena Urbaniak ◽  
Paromita Chakraborty
Keyword(s):  
High Risk ◽  
Organophosphorus Pesticides ◽  
Aquatic Organisms ◽  
The United States ◽  
The Caspian Sea ◽  
Worst Case ◽  
Pollution Levels ◽  
Haraz River ◽  
Significant Difference ◽  
Medium Risk

The aim of this study was to investigate the seasonal and spatial variations in the concentrations of a widely used organophosphorous pesticide (OPP), diazinon, and the associated risk posed by this OPP in the surface water from the three largest rivers located in the northern province of Iran: the Haraz, the Talar and the Babolrood rivers. These rivers are located in the agriculture province of Mazandaran, and are exposed to high doses of organophosphorus pesticides, especially diazinon. The concentration of diazinon was determined using gas chromatography, while the potential risk posed by diazinon was elucidated using a Risk Quotient (RQ) calculated for general (RQm) and worst-case (RQex) scenarios. The obtained results demonstrated that the average diazinon concentrations ranged from 41 ± 76 ng/L in the Talar River and 57 ± 116 ng/L in the Haraz River, to 76.5 ± 145 ng/L in the Babolrood River, with a significant difference noted between summer and autumn seasons for all three rivers. For some stations, the concentration of diazinon is higher than the standard guidelines of Australian/New Zealand Guidelines for Fresh and Marine Water Quality (FMWQ) and the United States Criteria Maximum Concentration (CMC). The calculated RQs indicated a medium risk of diazinon, RQm = 0.73 and RQex = 2.27, in the Talar River; RQm = 1.02 and RQex = 2.49 in the Haraz River; and RQm = 1.35 and RQex = 4.54 in the Babolrood River. The overall exposure of diazinon was defined to have a high risk (RQm and RQex > 1); however, the summer sampling revealed a high risk (RQm and RQex > 1), while the autumn had a medium risk (RQm and RQex < 1). The obtained results revealed not only elevated concentrations of diazinon in the studied rivers but most importantly the high risk posed by this OPP for the aquatic organisms and the wellbeing of the whole river ecosystem. The current study showed that development and implementation of appropriate standards and regulations toward diazinon in countries such as Iran are required to reduce the pollution levels and risks related to elevated concentrations of the studied pesticide.

scholarly journals Emerging Antimicrobial-Resistant High-Risk Klebsiella pneumoniae Clones ST307 and ST147

2020 ◽  
Vol 64 (10) ◽  
Author(s):  
Gisele Peirano ◽  
Liang Chen ◽  
Barry N. Kreiswirth ◽  
Johann D. D. Pitout
Keyword(s):  
Public Health ◽  
High Risk ◽  
Klebsiella Pneumoniae ◽  
The United States ◽  
Medical Community ◽  
Global Public Health ◽  
African Countries ◽  
Content Type ◽  
Public Health Burden ◽  
Worldwide Distribution

ABSTRACT There is an enormous global public health burden due to antimicrobial-resistant (AMR) Klebsiella pneumoniae high-risk clones. K. pneumoniae ST307 and ST147 are recent additions to the family of successful clones in the species. Both clones likely emerged in Europe during the early to mid-1990s and, in a relatively short time, became prominent global pathogens, spreading to all continents (with the exception of Antarctica). ST307 and ST147 consist of multiple clades/clusters and are associated with various carbapenemases (i.e., KPCs, NDMs, OXA-48-like, and VIMs). ST307 is endemic in Italy, Colombia, the United States (Texas), and South Africa, while ST147 is endemic in India, Italy, Greece, and certain North African countries. Both clones have been introduced into regions of nonendemicity, leading to worldwide nosocomial outbreaks. Genomic studies showed ST307 and ST147 contain identical gyrA and parC mutations and likely obtained plasmids with blaCTX-M-15 during the early to mid-2000s, which aided in their global distribution. ST307 and ST147 then acquired plasmids with various carbapenemases during the late 2000s, establishing themselves as important AMR pathogens in certain regions. Both clones are likely underreported due to restricted detection methodologies. ST307 and ST147 have the ability to become major threats to public health due to their worldwide distribution, ability to cause serious infections, and association with AMR, including panresistance. The medical community at large, especially those concerned with antimicrobial resistance, should be aware of the looming threat posed by emerging AMR high-risk clones such as K. pneumoniae ST307 and ST147.

scholarly journals Cardiovascular Risk estimates in ten years in the Brazilian population, a population-based study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Carvalho Malta ◽  
P Cisalpino ◽  
R Teixeira ◽  
I Eloah Machado ◽  
F Malta dos Santos ◽  
...  
Keyword(s):  
Public Health ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Laboratory Data ◽  
Population Based ◽  
Brazilian Population ◽  
Population Based Study ◽  
Medium Risk ◽  
Low Cardiovascular Risk ◽  
Years Of Schooling

Abstract Background Cardiovascular diseases are the leading cause of morbidity and mortality, high health costs and significant economic losses. The Framingham score has been widely used to stratify the risk of the evaluated individuals, identifying those at higher risk for the implementation of prevention measures directed to this group. Objective Estimate the cardiovascular risk of developing cardiovascular event in 10 years, in the adult Brazilian population. Methods Cross-sectional study using laboratory data from da National Health Survey, 2014 and 2015, were used to calculate cardiovascular risk (CVR). Algorithms proposed by D`Agostino (2008) were used, based on the Framingham study, stratified by sex, was used. According to the guidelines of the Brazilian cardiology society, the following cutoff points for cardiovascular risk in 10 years were used: a) low CVR &lt;5%, medium CVR (5 to &lt; 20%) and high CVR (≥ 20%). The study estimated the general cardio vascular risk and the respective confidence intervals (95% CI). Results Most women 58.4% had low cardiovascular risk, 32.9% medium risk and 8.7% high risk. Among men, 36.5% had low cardiovascular risk, 41.9% medium risk and 21.6% high risk. The risk increased with age. The difference in CVR according to years of schooling was about five times, between high schooling (12 years of schooling and more) and (&lt;8 years of schooling) (3.2%: 95% CI 2.4 - 4.4 versus 15, 7%: 95% CI 13.5-18.3). Black women had a higher proportion in the highest risk group ( &gt; = 20%), 14.4% (95% CI 9.7-20.9), than white women, 7.3 (95% CI 5.8 - 9.1). The poor self-rated health showed the greatest difference, the population that self-rated with very good health 2.9% (95% CI 1.3-3.6) and very poor health 25.6% (12.7-45, 0). Conclusions The risk score is useful to support the prevention practices of these diseases, considering the clinical and epidemiological context. Key messages This is the first national population-based study to estimate RCV for the Brazilian adult population using laboratory data, being useful to identify the priority population for public health. Population with less education has a higher risk cardiovascular, and should be a priority for prevention actions in public health.

scholarly journals Lack of Knowledge about Colonoscopy in High Risk Patients: Clinical and Public Health Challenges

2020 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Public Health ◽  
Colorectal Cancer ◽  
High Risk ◽  
The United States ◽  
Colorectal Polyps ◽  
High Risk Patients ◽  
Public Health Challenges ◽  
Risk Patients ◽  
Public Health Officials ◽  
Subsequent Risk

In the United States and worldwide, public health officials are publishing guidelines for the management of high risk patients with biopsy proven colorectal polyps [1]. With respect to high risk patients with colorectal polyps , they have 20.6%risk of developing a recurrence in 3 years when compared with those without this diagnosis following an initial colonoscopy Further, such high risk patients who are diagnosed with advanced colorectal polyps have a 3 fold higher subsequent risk of developing colorectal cancer [2, 3]. These alarming increased rates of recurrence of colorectal polyps as well as colorectal cancer pose clinical and public health challenges.

scholarly journals Lack of Knowledge about Colonoscopy in High Risk Patients: Clinical and Public Health Challenges

2020 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Public Health ◽  
Colorectal Cancer ◽  
High Risk ◽  
The United States ◽  
Colorectal Polyps ◽  
High Risk Patients ◽  
Public Health Challenges ◽  
Risk Patients ◽  
Public Health Officials ◽  
Subsequent Risk

In the United States and worldwide, public health officials are publishing guidelines for the management of high risk patients with biopsy proven colorectal polyps [1]. With respect to high risk patients with colorectal polyps , they have 20.6%risk of developing a recurrence in 3 years when compared with those without this diagnosis following an initial colonoscopy Further, such high risk patients who are diagnosed with advanced colorectal polyps have a 3 fold higher subsequent risk of developing colorectal cancer [2, 3]. These alarming increased rates of recurrence of colorectal polyps as well as colorectal cancer pose clinical and public health challenges.

scholarly journals Vaccine hesitancy: Don’t blame the public

2021 ◽  
Author(s):  
Adam Urato
Keyword(s):  
Public Health ◽  
United States ◽  
High Risk ◽  
Pregnant Women ◽  
The United States ◽  
Vaccine Hesitancy ◽  
The Public ◽  
General Concern

As a Maternal-Foetal Medicine specialist, I take care of high-risk pregnant women every day in the United States. Nowadays, several times each day in my office, I am asked about the Covid-19 vaccine by these patients. In my discussions with these women and their partners, many of them show real concerns about vaccines. It is understandable that pregnant women would proceed with caution with a new vaccine. However, my discussions with these families reveal something much broader: a general concern about vaccines and other recommended public health approaches.

scholarly journals Addressing Future Epidemics: Historical Human Rights Lessons from the AIDS Pandemic

2016 ◽  
Vol 1 (1) ◽  
pp. 1 ◽  
Author(s):  
Ambar Mehta ◽  
Thomas C. Quinn
Keyword(s):  
Public Health ◽  
Human Rights ◽  
High Risk ◽  
Federal Government ◽  
Healthcare Workers ◽  
The United States ◽  
Medical Community ◽  
Policy Makers ◽  
The Public ◽  
Aids Pandemic

Introduction: The Ebola epidemic in West Africa sparked many ethical and polarizing public health questions on how to adequately control transmission of the virus. These deliberations had and will continue to influence patients, healthcare workers, public perceptions of disease, and governmental responses. Such extensive and potential ramifications warranted an analysis of prior epidemics to sufficiently inform policy makers and prepare them and other authorities for future epidemics. We analyzed how the general public, medical institutions, federal government, and patients themselves responded during the early stages of the AIDS pandemic in two different countries and cultures, the United States and India.Discussion: Our analysis identified four key findings pertaining to the human rights of patients and healthcare workers and to the crucial roles of the government and medical community. The first demands that authoritative officials acknowledge the presence of high-risk behaviors and properly educate the public without stigmatizing groups of individuals. For this task, the medical community and federal government must form and display to the public a respectful and collaborative partnership towards battling the epidemic. These two synergistic endeavors will then allow appropriate officials to implement effective, yet civil, interventions for limiting transmission. Finally, the same officials must ensure that their interventions maintain the human rights of high-risk populations and of healthcare workers.Conclusions: Applying these findings to future epidemics of infectious diseases can aid policy makers in navigating complicated ethical and public health questions, and help prevent them from repeating past mistakes in handling epidemics.

The Rise of Anchor Institutions and the Threat to Community Health: Protecting Community Wealth, Building Community Power

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Lawrence T. Brown ◽  
Ashley Bachelder ◽  
Marisela B. Gomez ◽  
Alicia Sherrell ◽  
Imani Bryan
Keyword(s):  
Public Health ◽  
Economic Development ◽  
Local Governments ◽  
The United States ◽  
Public Health Research ◽  
Ethical Implications ◽  
Anchor Institutions ◽  
Health Related Research ◽  
Research Parks ◽  
Wealth Building

Academic institutions are increasingly playing pivotal roles in economic development and community redevelopment in cities around the United States. Many are functioning in the role of anchor institutions and building technology, biotechnology, or research parks to facilitate biomedical research. In the process, universities often partner with local governments, implementing policies that displace entire communities and families, thereby inducing a type of trauma that researcher Mindy Thompson Fullilove has termed “root shock.” We argue that displacement is a threat to public health and explore the ethical implications of university-led displacement on public health research, especially the inclusion of vulnerable populations into health-related research. We further explicate how the legal system has sanctioned the exercise of eminent domain by private entities such as universities and developers.Strategies that communities have employed in order to counter such threats are highlighted and recommended for communities that may be under the threat of university-led displacement. We also offer a critical look at the three dominant assumptions underlying university-sponsored development: that research parks are engines of economic development, that deconcentrating poverty via displacement is effective, and that poverty is simply the lack of economic or financial means. Understanding these fallacies will help communities under the threat of university-sponsored displacement to protect community wealth, build power, and improve health.

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