scholarly journals Cholera in travellers: improving vaccination guidance in Europe

2020 ◽  
Author(s):  
Rogelio López-Vélez ◽  
Danilo Presotto
Keyword(s):  
United States ◽  
The United States ◽  
Travel Health ◽  
General Terms ◽  
Vaccination Recommendations ◽  
Vulnerable People ◽  
Control And Prevention ◽  
Low Incidence ◽  
Cholera Vaccination ◽  
Source Of Information

Abstract Background Cholera is endemic in ~50 countries worldwide and remains a disease associated with poverty, causing illness and death in the poorest and most vulnerable people. In travellers, cholera is considered a low-incidence disease, but the true impact on travellers is difficult to assess. Cholera vaccination may improve safety for certain European travellers at risk. Effective vaccines are available; however, vaccination recommendations in Europe vary considerably between countries. Methods In this review, a comparison of cholera vaccination recommendations from 29 advice reference bodies across key European countries (United Kingdom, Germany, Spain, Italy, Portugal, Switzerland, Sweden, Finland, Norway, France and Denmark) is presented. The differences in perceived cholera risk are highlighted, and a comparison with the United States Centers for Disease Control and Prevention (CDC) recommendations is included. Results In general terms, the recommendations from European organizations are ambiguous and differ widely. This contrasts with the situation in the United States, where the CDC publishes a consistent set of guidelines. Conclusion With the ease of intra-European travel, it would seem sensible to harmonize the recommendations for cholera vaccination and risk perception across Europe, providing pre-travel health advisers with a trusted source of information that allows them to provide consistent recommendations.

scholarly journals Influenza incidence prediction for the United States: an update for the 2018-2019 season

2018 ◽  
Author(s):  
Xiangjun Du ◽  
Yousong Peng ◽  
Mi Liu ◽  
Mercedes Pascual
Keyword(s):  
United States ◽  
Real Time ◽  
Seasonal Influenza ◽  
Sequence Data ◽  
The United States ◽  
Influenza B ◽  
H3n2 Subtype ◽  
Epidemic Size ◽  
Control And Prevention ◽  
Low Incidence

AbstractIntroduction:Seasonal influenza causes a high disease burden every year in the United States and worldwide. Anticipating epidemic size ahead of season can contribute to preparedness and more targetted control and prevention of seasonal influenza.Methods:A recently developed process-based epidemiological model that incorporates evolutionary change of the virus and generates incidence forecasts for the H3N2 subtype ahead of the season, was previously validated by several statistical criteria, including an accurate real-time prediction for the 2016-2017 influenza season. With this model, a new forecast is generated here for the upcoming 2018-2019 season. The accuracy of predictions published for the 2017-2018 season is also retrospectively evaluated.Results:For 2017-2018, the model correctly predicted the dominance of the H3N2 subtype and its higher than average incidence. Based on surveillance and sequence data up to June 2018, the new forecast for the upcoming 2018-2019 season indicates low levels for H3N2, and suggests an H1N1 dominant season with low incidence of influenza B.Discussion:Real-time forecasts, those generated with a model that was parameterized based on data preceding the predicted season, allows valuable evaluation of the approach. Anticipating the dominant subtype and the size of the upcoming epidemic ahead of season informs disease control. Further studies are needed to promote more accurate ahead-of-season forecasts and extend the approach to multiple subtypes.

scholarly journals 1428. Lyme Disease Treatment in the United States: Prescribing Patterns from a Nationwide Commercial Insurance Database, 2016-2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S720-S720
Author(s):  
Amy M Beeson ◽  
Grace E Marx ◽  
Amy M Schwartz ◽  
Alison F Hinckley
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Standard Treatment ◽  
Age Distribution ◽  
Public Health Problem ◽  
The United States ◽  
Adverse Outcomes ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Low Incidence

Abstract Background Lyme disease (LD) is the most common vector-borne disease in the United States and is a significant public health problem. The use of non-standard antibiotic treatment regimens for LD has been associated with adverse effects; however, the overall landscape of treatment has not been described previously. We aimed to describe real-world antibiotic prescribing patterns for LD. Methods We performed a retrospective analysis of the MarketScan commercial claims database of outpatient encounters from 2016-2018 in the United States. We identified all individuals with a visit that included an LD diagnosis code and a prescription within 30 days of the visit for one or more of 12 antibiotics that may be prescribed for LD. We then categorized each individual as having received either standard or non-standard treatment during the two-year period. Standard treatment was defined as treatment with a first, second or third-line antibiotic for LD, for no longer than 30 days, and for no more than two episodes during the study period. Descriptive and multivariable analyses were performed to compare characteristics of people who received standard vs non-standard treatment for LD. Results A total of 84,769 prescriptions met criteria for inclusion, written for 45,926 unique patients. The mean duration of prescriptions was 21.4 days (SD 10.8). Most individuals (84.5%) treated for LD received standard treatment during the study period. Female gender (OR 1.5, p< 0.0001) and age 19-45 (p=0.0003) were significantly associated with being prescribed non-standard LD treatment. Treatment in low-incidence states (OR 2.2 compared to high-incidence states, p< 0.0001) and during non-summer months (OR 2.2, p< 0.0001) was more likely to be non-standard. Age distribution of patients receiving treatment for Lyme disease, by gender and age at first prescription Seasonality of standard versus non-standard treatment of Lyme disease Conclusion In this population of employed, young, and insured patients, young and middle-aged women were at the highest risk of receiving non-standard LD treatment. Treatments prescribed in states with low incidence of LD or during non-summer months were also more likely to be non-standard, a trend which likely reflects misdiagnosis or overtreatment of LD. Future studies are needed to further define prescriber and patient factors associated with non-standard LD treatment and related adverse outcomes. Disclosures All Authors: No reported disclosures

The Under-Enrollment of HIV-infected Foster Children in Clinical Trials and Protocols and the Need for Corrective State Action

1994 ◽  
Vol 20 (3) ◽  
pp. 231-249
Author(s):  
Briar McNutt
Keyword(s):  
United States ◽  
New York ◽  
Hiv Infection ◽  
The United States ◽  
Hiv And Aids ◽  
Medical Community ◽  
State Action ◽  
Pediatric Aids ◽  
Control And Prevention ◽  
Year 2000

The incidence of HIV infection and AIDS in children has grown at an alarming rate. Approximately one million children worldwide have HIV infection. By the year 2000, an estimated ten million children will suffer from the disease. Currently, the United States has a population of an estimated 10,000 to 20,000 HIV-infected children. As of June 30, 1993, the Centers for Disease Control and Prevention (CDC) reported 4,710 known AIDS cases in children twelve years-old and younger. At that point, New York City reported 1,124 pediatric AIDS cases which represented twenty-four percent of all cases in the United States.With the rising number of HIV-infected children, the medical community in the United States has begun to search for HIV-and AIDS-related treatments particularized for children. In addition to establishing guidelines for HIV-infected children's frequent check-ups and timely immunizations, the medical community has initiated research studies involving HIV-infected children.

The American Perception of the Palestine-Israel Conflict

2021 ◽  
Author(s):  
Israa Daas ◽  
Keyword(s):  
United States ◽  
Middle East ◽  
Political Party ◽  
The United States ◽  
The Us ◽  
The World ◽  
Us Government ◽  
Source Of Information

Abstract The Palestine-Israel conflict is probably one of the most pressing problems in the Middle East. Moreover, the United States has been involved in this conflict since the 1970s. Therefore, the present research aims to learn more about the American perception of the Palestinian-Israeli conflict. It was conducted using a survey that addressed Americans from different backgrounds, focusing on four variables: the American government’s position, solutions, the Israeli settlements, and Jerusalem. The research suggests a correlation between political party and the American perception of the conflict. It appears that Republicans seem to be against the withdrawal of the Israeli settlements, and they believe that the US government is not biased toward Israel. Nevertheless, Democrats tend to believe that the US government is biased in favor of Israel, and they support withdrawing the Israeli settlements. Moreover, there might be another correlation between the American perception and the source of information they use to learn about the conflict. Most of the surveyed Americans, whatever their resource of information that they use to learn about the conflict is, tend to believe that the US is biased in favor of Israel. It is crucial to know about the American perception when approaching to a solution to the conflict as the US is a mediator in this conflict, and a powerful country in the world. Especially because it has a permanent membership in the UN council. KEYWORDS: American Perception, Palestine-Israel Conflict, Jerusalem, Israeli settlements

Abstract P636: Social Determinants of Stroke Hospitalization and Mortality in the United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Randhir Sagar Yadav ◽  
Durgesh Chaudhary ◽  
Shima Shahjouei ◽  
Jiang Li ◽  
Vida Abedi ◽  
...  
Keyword(s):  
United States ◽  
Income Inequality ◽  
Social Determinants ◽  
Hemorrhagic Stroke ◽  
The United States ◽  
Care Physician ◽  
County Level ◽  
Medicare Beneficiaries ◽  
Level Data ◽  
Control And Prevention

Introduction: Stroke hospitalization and mortality are influenced by various social determinants. This ecological study aimed to determine the associations between social determinants and stroke hospitalization and outcome at county-level in the United States. Methods: County-level data were recorded from the Centers for Disease Control and Prevention as of January 7, 2020. We considered four outcomes: all-age (1) Ischemic and (2) Hemorrhagic stroke Death rates per 100,000 individuals (ID and HD respectively), and (3) Ischemic and (4) Hemorrhagic stroke Hospitalization rate per 1,000 Medicare beneficiaries (IH and HH respectively). Results: Data of 3,225 counties showed IH (12.5 ± 3.4) and ID (22.2 ± 5.1) were more frequent than HH (2.0 ± 0.4) and HD (9.8 ± 2.1). Income inequality as expressed by Gini Index was found to be 44.6% ± 3.6% and unemployment rate was 4.3% ± 1.5%. Only 29.8% of the counties had at least one hospital with neurological services. The uninsured rate was 11.0% ± 4.7% and people living within half a mile of a park was only 18.7% ± 17.6%. Age-adjusted obesity rate was 32.0% ± 4.5%. In regression models, age-adjusted obesity (OR for IH: 1.11; HH: 1.04) and number of hospitals with neurological services (IH: 1.40; HH: 1.50) showed an association with IH and HH. Age-adjusted obesity (ID: 1.16; HD: 1.11), unemployment (ID: 1.21; HD: 1.18) and income inequality (ID: 1.09; HD: 1.11) showed an association with ID and HD. Park access showed inverse associations with all four outcomes. Additionally, population per primary-care physician was associated with HH while number of pharmacy and uninsured rate were associated with ID. All associations and OR had p ≤0.04. Conclusion: Unemployment and income inequality are significantly associated with increased stroke mortality rates.

scholarly journals Levofloxacin-Resistant Invasive Streptococcus pneumoniae in the United States: Evidence for Clonal Spread and the Impact of Conjugate Pneumococcal Vaccine

2004 ◽  
Vol 48 (9) ◽  
pp. 3491-3497 ◽  
Author(s):  
Mathias W. R. Pletz ◽  
Lesley McGee ◽  
James Jorgensen ◽  
Bernard Beall ◽  
Richard R. Facklam ◽  
...  
Keyword(s):  
United States ◽  
Streptococcus Pneumoniae ◽  
The United States ◽  
Fluoroquinolone Resistance ◽  
Active Efflux ◽  
Vaccine Serotypes ◽  
Drug Classes ◽  
Control And Prevention ◽  
Clonal Spread ◽  
The Impact

ABSTRACT The emergence of fluoroquinolone resistance in sterile-site isolates of Streptococcus pneumoniae is documented in this study characterizing all invasive levofloxacin-resistant (MIC, ≥8 mg/liter) S. pneumoniae isolates (n = 50) obtained from the Centers for Disease Control and Prevention Active Bacterial Core Surveillance from 1998 to 2002. Resistance among all isolates increased from 0.1% in 1998 to 0.6% in 2001 (P = 0.008) but decreased to 0.4% in 2002, while resistance among vaccine serotypes continued to increase from 0.3% in 1998 to 1.0% in 2002, suggesting that fluoroquinolones continue to exert selective pressure on these vaccine serotypes. Only 22% of resistant isolates were not covered by the conjugate vaccine serogroups. Multilocus sequence typing revealed that 58% of resistant strains were related to five international clones identified by the Pneumococcal Molecular Epidemiology Network, with the Spain23F-1 clone being most frequent (16% of all isolates). Thirty-six percent of the isolates were coresistant to penicillin, 44% were coresistant to macrolides, and 28% were multiresistant to penicillin, macrolides, and fluoroquinolones. Fifty percent of the isolates were resistant to any three drug classes. Ninety-four percent of the isolates had multiple mutations in the quinolone resistance-determining regions of the gyrA, gyrB, parC, and parE genes. In 16% of the isolates, there was evidence of an active efflux mechanism. An unusual isolate was found that showed only a single parE mutation and for which the ciprofloxacin MIC was lower (2 mg/liter) than that of levofloxacin (8 mg/liter). Our results suggest that invasive pneumococcal isolates resistant to levofloxacin in the United States show considerable evidence of multiple resistance and of clonal spread.

scholarly journals The relationship between drugs use and risk behaviors in brazilian university students

2005 ◽  
Vol 13 (spe2) ◽  
pp. 1169-1176 ◽  
Author(s):  
Sandra Cristina Pillon ◽  
Beverley O'Brien ◽  
Ketty Aracely Piedra Chavez
Keyword(s):  
Drug Use ◽  
University Students ◽  
Risk Behaviors ◽  
The United States ◽  
Male Students ◽  
First Year ◽  
First Year Students ◽  
Violent Behaviors ◽  
Control And Prevention ◽  
Low Incidence

The aim was to describe relationships between gender and drug use as well as risk behaviors that may be associated with drug use among first-year students at the University of São Paulo-Ribeirão Preto. The Youth Risk Behavior Survey (YRBS) is an anonymous survey that was used for this descriptive correlational study. It was developed by the Centers for Disease Control and Prevention in the United States. The sample (n=200) included (50%) males and (50%) females. Their ages ranged from 18 to 26 years. Results showed that more female than male students use alcohol and tobacco, but that the probability of heavy consumption is higher among men. There was a low incidence of illicit drug use for both groups. Male students were more likely to drive under the influence of alcohol than female students and more men were involved in violent behaviors such as fights with friends and police. In relation to sexual behavior, male students were likely to have more partners and less protection while under influence of alcohol. It was concluded that gender is associated with recreational drug use, specifically tobacco and alcohol, as well as other risk behaviors in university students.

scholarly journals REFLECTION ON COLLECTIVE MEMORY IN THE MUSEUM

2020 ◽  
Keyword(s):  
United States ◽  
Discourse Analysis ◽  
Collective Memory ◽  
Age Differences ◽  
The United States ◽  
Museum Visitors ◽  
Holocaust Memorial ◽  
Memorial Museum ◽  
The Holocaust ◽  
Source Of Information

The article describes visitors’ interpretation and understanding of the narrative about the Holocaust in the United States Holocaust Memorial Museum. Visitors comments were the material for the analysis, used methodology was discourse analysis. Different discourses were singled out in visitors’ comments. Differences between visitors’ comments given in different years were ascertained. Age differences and differences among narratives of various groups of the Museum visitors were shown. It can be concluded that the Museum fulfills various functions. Besides being a place of commemoration, it accomplishes its educational function and serves as a source of information about the Holocaust.

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