Plague and Pregnancy: Why Special Considerations Are Needed

Abstract Pregnant women are an important at-risk population to consider during public health emergencies. These women, like nonpregnant adults, may be faced with the risk of acquiring life-threatening infections during outbreaks or bioterrorism (BT) events and, in some cases, can experience increased severity of infection and higher morbidity compared with nonpregnant adults. Yersinia pestis, the bacterium that causes plague, is a highly pathogenic organism. There are 4 million births annually in the United States, and thus the unique needs of pregnant women and their infants should be considered in pre-event planning for a plague outbreak or BT event.

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Biodefense and Emergency Use Authorization: Different Originations, Purposes, and Evolutionary Paths of Institutions in the United States and South Korea

10.21203/rs.3.rs-1214856/v1 ◽

2022 ◽

Author(s):

HyunJung Kim

Keyword(s):

Public Health ◽

United States ◽

South Korea ◽

Driving Forces ◽

The United States ◽

Lessons Learned ◽

Post Exposure Prophylaxis ◽

Meso Level ◽

Public Health Emergencies ◽

Level Analysis

Abstract Background: Historical institutionalism (HI) determines that institutions have been transformed by a pattern of punctuated evolution due to exogenous shocks. Although scholars frequently emphasize the role of agency - endogenous factors – when it comes to institutional changes, but the HI analytic narratives still remain in the meso-level analysis in the context of structure and agency. This article provides domestic and policy-level accounts of where biodefense institutions of the United States and South Korea come from, seeing through emergency-use-authorization (EUA) policy, and how the EUA policies have evolved by employing the policy-learning concepts through the Event-related Policy Change Model. Results: By employing the Birkland’s model, this article complements the limitation of the meso-level analysis in addressing that the 2001 Amerithrax and the 2015 Middle East Respiratory Syndrome (MERS) outbreak rooted originations and purposes of the biodefense respectively. Since the crisis, a new post-crisis agenda in society contributed to establishing new domestic coalition, which begin to act as endogenous driving forces that institutionalize new biodefense institutions and even reinforce them through path dependent way when the institutions evolved. Therefore, EUA policy cores (Post-Exposure Prophylaxis (PEP) in the United States and Non-Pharmaceutical Intervention (NPI) in South Korea keep strengthened during the policy revisions. Conclusions: The United States and South Korea have different originations and purposes of biodefense, which are institutions evolving through self-reinforce dependent way based on the lessons learned from past crises. In sum, under the homeland security biodefense institution, the US EUA focuses on the development of specialized, unlicensed PEP in response to public health emergencies; on the other hand, under the disease containment-centric biodefense institution, the Korean EUA is specialized to conduct NPI missions in response to public health emergencies.

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Vaping Restrictions: Is Priority to the Young Justified?

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa175 ◽

2020 ◽

Cited By ~ 1

Author(s):

Monica Magalhaes

Keyword(s):

Public Health ◽

United States ◽

At Risk ◽

Young People ◽

Harm Reduction ◽

Ethical Dilemma ◽

The United States ◽

Youth Smoking ◽

Health Authorities ◽

Public Health Authorities

Abstract The vast majority of smokers become dependent on nicotine in youth. Preventing dependence has therefore been crucial to the recent decline in youth smoking. The advent of vaping creates an opportunity for harm reduction to existing smokers (mostly adults) but simultaneously also undermines prevention efforts by becoming a new vehicle for young people to become dependent on nicotine, creating an ethical dilemma. Restrictions to access to some vaping products enacted in response to the increase in vaping among youth observed in the United States since 2018 have arguably prioritized prevention of new cases of dependence—protecting the young—over harm reduction to already dependent adults. Can this prioritization of the young be justified? This article surveys the main bioethical arguments for prioritizing giving health benefits to the young and finds that none can justify prioritizing dependence prevention over harm reduction: any reasons for prioritizing the current cohort of young people at risk from vaping will equally apply to current adult smokers, who are overwhelmingly likely to have become nicotine-dependent in their own youth. Public health authorities’ current tendency to prioritize the young, therefore, does not seem to be ethically justified. Implications This article argues that commonsense reasons for prioritizing the young do not apply to the ethical dilemma surrounding restricting access to vaping products.

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Concepts and Terms for Addressing Disparities in Public Health Emergencies: Accounting for the COVID-19 Pandemic and the Social Determinants of Health in the United States

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.181 ◽

2021 ◽

pp. 1-25

Author(s):

Cheryl A. Levine ◽

Daire R. Jansson

Keyword(s):

Public Health ◽

United States ◽

Social Determinants Of Health ◽

Social Determinants ◽

The United States ◽

Determinants Of Health ◽

Public Health Emergencies ◽

Wide Range ◽

Conceptual Shift ◽

Systemic Health

Abstract Public health emergencies, including the coronavirus (COVID-19) pandemic, highlight disproportionate impacts faced by populations with existing disparities. Concepts and terms used to describe populations disproportionately impacted in emergencies vary over time and across disciplines, but United States (U.S.) federal guidance and law require equal access to our nation’s emergency resources. At all levels of emergency planning, public health and their partners must be accountable to populations with existing inequities, which requires a conceptual shift towards using the data-driven social determinants of health (SDOH). SDOH are conditions in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks. This article reviews the historic use of concepts and terms to describe populations disproportionately impacted by emergencies. It also recommends a shift in emergency activities towards interventions that target the SDOH to adequately address long-standing systemic health disparities and socioeconomic inequities in the U.S.

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Genetic background contributions to the disproportion of vitamin A deficiency in pregnant women of certain ethnicities in populations of the United States.

10.21203/rs.3.rs-49188/v1 ◽

2020 ◽

Author(s):

Masako Suzuki ◽

Tao Wang ◽

Diana J Garretto ◽

Carmen R. Isasi ◽

Wellington V Cardoso ◽

...

Keyword(s):

United States ◽

At Risk ◽

Vitamin A ◽

Pregnant Women ◽

Ethnic Groups ◽

Latin American ◽

Vitamin A Deficiency ◽

The United States ◽

Serum Retinol ◽

Pregnant Females

Abstract Vitamin A is an essential micronutrient that plays critical roles in many biological functions of the body. Limited access to vitamin A-rich food or supplements severely affects tissue and blood levels of vitamin A. Therefore, low serum vitamin A and poverty levels are strongly associated in vitamin A deficiency (VAD) studies that have focused mainly on developing countries. The current national prevalence rate of vitamin A deficiency in the United States is reported to be very low (< 1%). However, several studies, including ours, have suggested that people from certain ethnic groups still face a higher proportion of vitamin A deficiency. Here, we re-analyzed two different datasets of serum retinol levels of pregnant females to assess the VAD status differences between women of different ancestries. We found that pregnant females with non-Hispanic Black and with Latin American/Afro-Caribbean ancestry have strikingly high proportions of vitamin A deficiency. Moreover, we identified candidate genetic variants that associate with the disproportions between these different ancestries. Maternal vitamin A deficiency increases the risk of adverse health outcomes for both the mother and offspring later in life. Measuring serum retinol levels of pregnant women in the higher risk groups and provision of food interventions based on genetic information to improve the vitamin A status of at-risk women are needed. Our study strongly suggests that emergency actions need to be taken to reduce vitamin A deficiency in specific, at-risk ethnic groups.

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Epilogue

10.5406/illinois/9780252039843.003.0011 ◽

2017 ◽

Author(s):

Guenter B. Risse

Keyword(s):

Public Health ◽

United States ◽

At Risk ◽

Severe Acute Respiratory Syndrome ◽

National Security ◽

Critical Issue ◽

The United States ◽

Political Unrest

This concluding chapter turns to more recent threats to public health—new epidemics such as severe acute respiratory syndrome (SARS), as well as a contemporary resurgence of bioterror. With national security at risk, governments like the United States had begun to consider measures to counter such potential dangers in an era of rapid globalization and political unrest. Prominent among them were medical and public health provisions designed to counter the spread of lethal microorganisms. Under such circumstances, the traditional subject of quarantine and isolation acquired new importance. Given the near impossibility of initially distinguishing persons at risk from those already exposed, balancing the rights of the uninfected with the rights of the infected reemerged as a critical issue.

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The Centers for Disease Control and Prevention's public health response to monitoring Tdap safety in pregnant women in the United States

Human Vaccines & Immunotherapeutics ◽

10.1080/21645515.2015.1072664 ◽

2015 ◽

Vol 11 (12) ◽

pp. 2872-2879 ◽

Cited By ~ 15

Author(s):

Pedro L Moro ◽

Michael M McNeil ◽

Lakshmi Sukumaran ◽

Karen R Broder

Keyword(s):

Public Health ◽

United States ◽

Disease Control ◽

Pregnant Women ◽

The United States ◽

Public Health Response ◽

Health Response ◽

Centers For Disease Control

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How the United States Flunked the COVID-19 Test: Some Observations and Several Lessons

The American Review of Public Administration ◽

10.1177/0275074020941701 ◽

2020 ◽

Vol 50 (6-7) ◽

pp. 568-576

Author(s):

H. Daniel Xu ◽

Rashmita Basu

Keyword(s):

Public Health ◽

United States ◽

Disease Surveillance ◽

Health Care Policy ◽

Intergovernmental Relations ◽

Human Life ◽

The United States ◽

Federal State ◽

Public Health Emergencies ◽

Key Issues

The unprecedented COVID-19 pandemic has already caused enormous economic and human life losses in the United States and it is still ravaging the country. In this article, the authors argue that the pandemic has exposed key issues of concern in several areas of the American government system ranging from federalist intergovernmental relations to public health system and to health care policy. These issues of concern include the strained federal-state relations in emergency management, inadequate data collection and data reporting for disease surveillance and control, politicization and diminished role of science and evidence in administrative decision making, and underinvestment in public health programs especially in minority health. Based on their analysis, the authors admonish that it is critically important for the U.S. government to learn from the failed response to the pandemic and offer several recommendations for improving its response to future public health emergencies and research in public administration.

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Evolutionary Aspects of Emerging Lyme Disease in Canada

Applied and Environmental Microbiology ◽

10.1128/aem.01671-15 ◽

2015 ◽

Vol 81 (21) ◽

pp. 7350-7359 ◽

Cited By ~ 15

Author(s):

N. H. Ogden ◽

E. J. Feil ◽

P. A. Leighton ◽

L. R. Lindsay ◽

G. Margos ◽

...

Keyword(s):

Public Health ◽

United States ◽

At Risk ◽

North America ◽

Lyme Disease ◽

Severe Disease ◽

The United States ◽

Sensu Stricto ◽

Content Type ◽

Evolutionary Aspects

ABSTRACTIn North America, Lyme disease (LD) is a tick-borne zoonosis caused by the spirochete bacteriumBorrelia burgdorferisensu stricto, which is maintained by wildlife. Tick vectors and bacteria are currently spreading into Canada and causing increasing numbers of cases of LD in humans and raising a pressing need for public health responses. There is no vaccine, and LD prevention depends on knowing who is at risk and informing them how to protect themselves from infection. Recently, it was found in the United States that some strains ofB. burgdorferisensu strictocause severe disease, whereas others cause mild, self-limiting disease. While many strains occurring in the United States also occur in Canada, strains in some parts of Canada are different from those in the United States. We therefore recognize a need to identify which strains specific to Canada can cause severe disease and to characterize their geographic distribution to determine which Canadians are particularly at risk. In this review, we summarize the history of emergence of LD in North America, our current knowledge ofB. burgdorferisensu strictodiversity, its intriguing origins in the ecology and evolution of the bacterium, and its importance for the epidemiology and clinical and laboratory diagnosis of LD. We propose methods for investigating associations betweenB. burgdorferisensu strictodiversity, ecology, and pathogenicity and for developing predictive tools to guide public health interventions. We also highlight the emergence ofB. burgdorferisensu strictoin Canada as a unique opportunity for exploring the evolutionary aspects of tick-borne pathogen emergence.

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Scientometric Analysis of Public Health Emergencies: 1994–2020

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19020640 ◽

2022 ◽

Vol 19 (2) ◽

pp. 640

Author(s):

Jing Liu ◽

Yujie Wang ◽

Qian Zhang ◽

Jianxiang Wei ◽

Haihua Zhou

Keyword(s):

Public Health ◽

United States ◽

Emergency Preparedness ◽

The United States ◽

Scientometric Analysis ◽

Knowledge Mapping ◽

Public Health Emergencies ◽

Detection Analysis ◽

Central Value ◽

Leading Position

The purpose of this paper is to summarize the research hotspots and frontiers in the field of public health emergencies (PHE) between 1994–2020 through the scientometric analysis method. In total, 2247 literature works retrieved from the Web of Science core database were analyzed by CiteSpace software, and the results were displayed in knowledge mapping. The overall characteristics analysis showed that the number of publications and authors in the field of PHE kept an upward trend during the past decades, and the United States was in the leading position, followed by China and England. Switzerland has the highest central value and plays an important intermediary role in promoting the integration and exchange of international PHE research achievements. The keyword co-occurrence analysis indicated that COVID-19 was the most high-frequency keyword in this field, and there had been no new keywords for a long time until the outbreak of COVID-19 in 2019. The burst detection analysis showed that the top five burst keywords in terms of burst intensity were zika virus, Ebola, United States, emergency preparedness and microcephaly. The results indicated that the research theme of PHE is closely related to the major infectious diseases in a specific period. It will continue to develop with more attention paid to public health. The conclusions can provide help and reference for the PHE potential researchers.

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