scholarly journals On the Role of Different Age Groups and Pertussis Vaccines During the 2012 Outbreak in Wisconsin

2018 ◽  
Vol 5 (5) ◽  
Author(s):  
Edward Goldstein ◽  
Colin J Worby ◽  
Marc Lipsitch
Keyword(s):  
Protective Effect ◽  
Age Groups ◽  
Vaccination Status ◽  
Relative Role ◽  
Age Group ◽  
Limited Information ◽  
Infection Transmission ◽  
Status Analysis ◽  
The Impact

Abstract Background There is limited information on the roles of different age groups in propagating pertussis outbreaks, and on the impact of vaccination on pertussis transmission in the community. Methods The relative roles of different age groups in propagating the 2012 pertussis outbreak in Wisconsin were evaluated using the relative risk (RR) statistic that measures the change in the group’s proportion among all detected cases before vs after the epidemic peak. The impact of vaccination in different age groups against infection (that is potentially different from the protective effect against detectable disease) was evaluated using the odds ratios (ORs), within each age group, for being vaccinated vs undervaccinated before vs after the outbreak’s peak. Results The RR statistic suggests that children aged 13–14 years played the largest relative role during the outbreak’s ascent (with estimates consistent across the 3 regions in Wisconsin that were studied), followed by children aged 7–8, 9–10, and 11–12 years. Young children and older teenagers and adults played more limited relative roles during the outbreak. Results of the vaccination status analysis for the fifth dose of DTaP (for children aged 7–8 years: OR, 0.44; 95% confidence interval [CI], 0.23–0.86; for children aged 9–10 years: OR, 0.51; 95% CI, 0.27–0.95); and for Tdap for children aged 13–14 years (OR, 0.38, 95% CI, 0.16–0.89) are consistent with protective effect against infection. Conclusions While our epidemiological findings for the fifth dose of DTaP and for Tdap are consistent with protective effect against infection, further studies, including those estimating vaccine effectiveness against infection/transmission to others particularly for pertussis vaccines for adolescents, are needed to evaluate the impact of vaccination on the spread of pertussis in the community.

scholarly journals On the relative role of different age groups during influenza A epidemics in Germany, 2002-2017

2017 ◽  
Author(s):  
Edward Goldstein
Keyword(s):  
Influenza A ◽  
Communicable Disease ◽  
Age Groups ◽  
School Age Children ◽  
Relative Role ◽  
School Age ◽  
Limited Information ◽  
School Students ◽  
Using Data

AbstractBackgroundThere is limited information about the role of different age groups, particularly subgroups of school-age children and younger adults in propagating influenza epidemics.MethodsFor a communicable disease outbreak, some subpopulations may play a disproportionate role during the ascent of the outbreak due to increased susceptibility and/or contact rates. Such subpopulations can be identified by considering the proportion that cases in a subpopulation represent among all cases in the population occurring before the epidemic peak (Bp), the corresponding proportion after the epidemic peak (Ap), to calculate the relative risk for a subpopulation, RR=Bp/Ap. We estimated RR for several age groups using data on reported influenza A cases in Germany between 2002-2017.ResultsChildren aged 14-17y had the highest RR estimates for 7 out of 15 influenza A epidemics in the data, including the 2009 pandemic, and the large 2016/17, 2008/09, and 2006/07 seasons. Children aged 10-13y had the highest RR estimates during 3 epidemics, including the large 2014/15 and 2004/05 seasons. Children aged 6-9y had the highest RR estimates during two epidemics, including the large 2012/13 season. Children aged 2-5y had the highest RR estimate during the moderate 2015/16 season; adults aged 18-24y had the highest RR estimate during the small 2005/06 season; adults aged 25-34y had the highest RR estimate during the large, 2002/03 season.ConclusionsOur results support the prominent role of all school-age children, particularly the oldest ones, in propagating influenza epidemics in the community. We note that national vaccination coverage levels among older school-age children were lower than among younger school-age children during the recent influenza seasons in the US, and influenza vaccination program in England has not been phased in yet for secondary school students.

scholarly journals On the role of different age groups during pertussis epidemics in California, 2010 and 2014

2018 ◽  
Author(s):  
Ayesha Mahmud ◽  
Marc Lipsitch ◽  
Edward Goldstein
Keyword(s):  
Age Groups ◽  
Temporal Changes ◽  
Age Group ◽  
Limited Information ◽  
Strong Signal ◽  
Older Adolescents

AbstractBackgroundThere is limited information on the roles of different age groups in propagating pertussis outbreaks, and the temporal changes in those roles since the introduction of acellular pertussis vaccines.MethodsThe relative roles of different age groups in propagating the 2010 and the 2014 pertussis epidemics in California were evaluated using the RR statistic that measures the change in the group’s proportion among all detected cases before-vs.-after the epidemic peak.ResultsFor the 2010-11 epidemic, evidence for a predominant transmission age group was weak, with the largest RR estimates being 1.26(95%CI (1.08,1.46)) (aged 11-13y); 1.19(1.01,1.4) (aged 9-10y); 1.17(0.86,1.59) (aged 14-15y); 1.12(0.86,1.46) (aged 16-19y); and 1.1(0.89,1.36) (aged 7-8y). The 2014 epidemic showed a strong signal of the role of older adolescents, with the highest RR estimate being in those aged 14-15y (RR=1.83(1.61,2.07)), followed by adolescents aged 16-19y (RR=1.41(1.24,1.61)) and 11-13y (RR=1.26(1.12,1.41)), with lower RR estimates in other age groups.ConclusionsAs the time following introduction of acellular pertussis vaccines in California progressed, older adolescents played an increasing role in transmission during the major pertussis outbreaks. Booster pertussis vaccination for older adolescents with vaccines effective against pertussis transmission should be considered with the aim of mitigating future pertussis epidemics in the community.

scholarly journals On the role of different age groups during pertussis epidemics in California, 2010 and 2014

2019 ◽  
Vol 147 ◽  
Author(s):  
A. S. Mahmud ◽  
M. Lipsitch ◽  
E. Goldstein
Keyword(s):  
Relative Risk ◽  
Age Groups ◽  
Temporal Changes ◽  
Age Group ◽  
Limited Information ◽  
Strong Signal ◽  
Older Adolescents

AbstractThere is limited information on the roles of different age groups in propagating pertussis outbreaks, and the temporal changes in those roles since the introduction of acellular pertussis vaccines. The relative roles of different age groups in propagating the 2010 and the 2014 pertussis epidemics in California were evaluated using the relative risk (RR) statistic that measures the change in the group's proportion among all detected cases beforevs. after the epidemic peak. For the 2010–11 epidemic, evidence for a predominant transmission age group was weak, with the largest RR estimates being 1.26 (95% CI 1.08–1.46) (aged 11–13 years); 1.19 (1.01–1.4) (aged 9–10 years); 1.17 (0.86–1.59) (aged 14–15 years); 1.12 (0.86–1.46) (aged 16–19 years) and 1.1 (0.89–1.36) (aged 7–8 years). The 2014 epidemic showed a strong signal of the role of older adolescents, with the highest RR estimate being in those aged 14–15 years (RR = 1.83, 1.61–2.07), followed by adolescents aged 16–19 years (RR = 1.41, 1.24–1.61) and 11–13 years (RR = 1.26, 1.12–1.41), with lower RR estimates in other age groups. As the time following introduction of acellular pertussis vaccines in California progressed, older adolescents played an increasing role in transmission during the major pertussis outbreaks. Booster pertussis vaccination for older adolescents with vaccines effective against pertussis transmission should be considered with the aim of mitigating future pertussis epidemics in the community.

The Health of Refugees

2019 ◽  
Keyword(s):  
Age Groups ◽  
Refugee Health ◽  
Mass Movements ◽  
Ethical Challenges ◽  
Displaced Populations ◽  
Political Landscape ◽  
The Media ◽  
Multidisciplinary Perspective ◽  
The Impact

There have been significant changes in the numbers, patterns, and circumstances of refugees and in the political landscape to support humanitarianism since the publication of the first edition of this collection. Like the first edition, this volume provides a multidisciplinary perspective on refugee health, tracing the health repercussions on individuals and populations from the drivers of forced mass movements of populations from situations of conflict and other disasters through to the process of resettlement in countries other than their countries of origin. Drawing on the expertise of academics, practitioners, and UN frontline experts, the collection covers three main aspects of refugee health: the concepts, definitions, and context from a human rights, humanitarianism, and social determinants of health perspective; the intersection of vulnerabilities across age groups and settings; and the ethical challenges for practitioners and researchers working with forcibly displaced populations seeking to resettle. The collection concludes with an analysis of the role of the media in shaping our perceptions of refugees and the impact on policy and access to care.

scholarly journals Seasonality in extra-pulmonary tuberculosis notifications in Germany 2004-2014- a time series analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tanja Charles ◽  
Matthias Eckardt ◽  
Basel Karo ◽  
Walter Haas ◽  
Stefan Kröger
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Disease Onset ◽  
Age Groups ◽  
Age Group ◽  
Pulmonary Tb ◽  
Series Analysis ◽  
Disease Site ◽  
Extra Pulmonary

Abstract Background Seasonality in tuberculosis (TB) has been found in different parts of the world, showing a peak in spring/summer and a trough in autumn/winter. The evidence is less clear which factors drive seasonality. It was our aim to identify and evaluate seasonality in the notifications of TB in Germany, additionally investigating the possible variance of seasonality by disease site, sex and age group. Methods We conducted an integer-valued time series analysis using national surveillance data. We analysed the reported monthly numbers of started treatments between 2004 and 2014 for all notified TB cases and stratified by disease site, sex and age group. Results We detected seasonality in the extra-pulmonary TB cases (N = 11,219), with peaks in late spring/summer and troughs in fall/winter. For all TB notifications together (N = 51,090) and for pulmonary TB only (N = 39,714) we did not find a distinct seasonality. Additional stratified analyses did not reveal any clear differences between age groups, the sexes, or between active and passive case finding. Conclusion We found seasonality in extra-pulmonary TB only, indicating that seasonality of disease onset might be specific to the disease site. This could point towards differences in disease progression between the different clinical disease manifestations. Sex appears not to be an important driver of seasonality, whereas the role of age remains unclear as this could not be sufficiently investigated.

scholarly journals Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031598 ◽  
Author(s):  
Clare Meernik ◽  
Hannah M Baker ◽  
Sarah D Kowitt ◽  
Leah M Ranney ◽  
Adam O Goldstein
Keyword(s):  
Systematic Review ◽  
Risk Perceptions ◽  
Longitudinal Research ◽  
Age Groups ◽  
Experimental Studies ◽  
Final Analysis ◽  
Eligibility Criteria ◽  
Product Appeal ◽  
The Impact

ObjectivesGiven the exponential increase in the use of e-cigarettes among younger age groups and in the growth in research on e-cigarette flavours, we conducted a systematic review examining the impact of non-menthol flavoured e-cigarettes on e-cigarette perceptions and use among youth and adults.DesignPubMed, Embase, PyscINFO and CINAHL were systematically searched for studies published and indexed through March 2018.Eligibility criteriaQuantitative observational and experimental studies that assessed the effect of non-menthol flavours in e-cigarettes on perceptions and use behaviours were included. Specific outcome measures assessed are appeal, reasons for use, risk perceptions, susceptibility, intention to try, initiation, preference, current use, quit intentions and cessation.Data extraction and synthesisThree authors independently extracted data related to the impact of flavours in tobacco products. Data from a previous review were then combined with those from the updated review for final analysis. Results were then grouped and analysed by outcome measure.ResultsThe review included 51 articles for synthesis, including 17 published up to 2016 and an additional 34 published between 2016 and 2018. Results indicate that non-menthol flavours in e-cigarettes decrease harm perceptions (five studies) and increase willingness to try and initiation of e-cigarettes (six studies). Among adults, e-cigarette flavours increase product appeal (seven studies) and are a primary reason many adults use the product (five studies). The role of flavoured e-cigarettes on smoking cessation remains unclear (six studies).ConclusionThis review provides summary data on the role of non-menthol flavours in e-cigarette perceptions and use. Consistent evidence shows that flavours attract both youth and adults to use e-cigarettes. Given the clear findings that such flavours increase product appeal, willingness to try and initiation among youth, banning non-menthol flavours in e-cigarettes may reduce youth e-cigarette use. Longitudinal research is needed to examine any role flavours may play in quit behaviours among adults.

scholarly journals TET2 mutations as a part of DNA dioxygenase deficiency in myelodysplastic syndromes

2021 ◽  
Author(s):  
Carmelo Gurnari ◽  
Simona Pagliuca ◽  
Yihong Guan ◽  
Vera Adema ◽  
Courtney E Hershberger ◽  
...  
Keyword(s):  
Myelodysplastic Syndromes ◽  
Prognostic Significance ◽  
Age Groups ◽  
Feedback Mechanism ◽  
Dna Demethylation ◽  
Compensatory Mechanisms ◽  
Poor Outcomes ◽  
Relationship Of ◽  
The Impact

Decrease in DNA dioxygease activity generated by TET2 gene family is crucial in myelodysplastic syndromes (MDS). The general down-regulation of 5-hydroxymethylcytosine (5-hmC) argues for a role of DNA demethylation in MDS beyond TET2 mutations, which albeit frequent, do not convey any prognostic significance. We investigated TETs expression to identify factors which can modulate the impact of mutations and thus 5-hmC levels on clinical phenotypes and prognosis of MDS patients. DNA/RNA-sequencing and 5-hmC data were collected from 1,665 patients with MDS and 91 controls. Irrespective of mutations, a significant fraction of MDS patients exhibited lower TET2 expression, while 5-hmC levels were not uniformly decreased. In searching for factors explaining compensatory mechanisms, we discovered that TET3 was up-regulated in MDS and inversely correlated with TET2 expression in wild-type cases. While TET2 was reduced across all age-groups, TET3 levels were increased in a likely feedback mechanism induced by TET2 dysfunction. This inverse relationship of TET2 and TET3 expression also corresponded to the expression of L-2-hydroxyglutarate dehydrogenase, involved in agonist/antagonist substrate metabolism. Importantly, elevated TET3 levels influenced the clinical phenotype of TET2-deficiency whereby the lack of compensation by TET3 (low TET3 expression) was associated with poor outcomes of TET2 mutant carriers.

scholarly journals Vaccine impact and effectiveness of meningococcal serogroup ACWY conjugate vaccine implementation in the Netherlands: a nationwide surveillance study

2021 ◽  
Author(s):  
Milou Ohm ◽  
Susan J M Hahné ◽  
Arie van der Ende ◽  
Elizabeth A M Sanders ◽  
Guy A M Berbers ◽  
...  
Keyword(s):  
The Netherlands ◽  
Incidence Rate ◽  
Vaccination Programme ◽  
Screening Method ◽  
Age Groups ◽  
Incidence Rates ◽  
Age Group ◽  
Mass Campaign ◽  
Conjugate Vaccination ◽  
The Impact

Abstract Background In response to the recent serogroup W invasive meningococcal disease (IMD-W) epidemic in the Netherlands, meningococcal serogroup C (MenC) conjugate vaccination for 14-month-olds was replaced with a MenACWY conjugate vaccination, and a mass campaign targeting 14-18 year-olds was executed. We investigated the impact of MenACWY vaccination implementation in 2018-2020 on incidence rates and estimated vaccine effectiveness (VE). Methods We extracted all IMD cases diagnosed between July 2014 and December 2020 from the national surveillance system. We calculated age group-specific incidence rate ratios by comparing incidence rates before (July 2017-March 2018) and after (July 2019-March 2020) MenACWY vaccination implementation. We estimated VE in vaccine-eligible cases using the screening method. Results Overall, IMD-W incidence rate lowered by 61% (95%CI 40-74). It declined by 82% (95%CI 18-96) in vaccine-eligible age group (15-36 month-olds and 14-18 year-olds) and by 57% (95%CI 34-72) in vaccine non-eligible age groups. VE was 92% (95%CI -20-99.5) against IMD-W vaccine-eligible toddlers. No IMD-W cases were reported in vaccine-eligible teenagers after the campaign. Conclusions The MenACWY vaccination programme was effective in preventing IMD-W in the target population. The IMD-W incidence reduction in vaccine non-eligible age groups may be caused by indirect effects of the vaccination programme. However, disentangling natural fluctuation from vaccine-effect was not possible. Our findings encourage the use of toddler- and teenager MenACWY vaccination in national immunization programmes especially when implemented together with a teenager mass campaign during an epidemic.

scholarly journals The influence of sex on the olfactory function in healthy subjects

2002 ◽  
pp. 83-89
Author(s):  
Slobodan Savovic ◽  
Vladimir Pilija ◽  
Slobodanka Lemajic ◽  
Maja Buljcik ◽  
Dejan Nincic ◽  
...  
Keyword(s):  
Sex Hormones ◽  
Ethyl Alcohol ◽  
Mental State ◽  
Healthy Subjects ◽  
Age Groups ◽  
Protective Role ◽  
Olfactory Function ◽  
Age Group ◽  
Phenyl Ethyl Alcohol

The sense of smell is the least examined of all senses. The significance of the organs of smell is in their influence on the mental state as well as on the vegetative, visceral and sexual functions. The objective of this experiment was to define the influence of sex on the olfactory function. It was performed on 120 subjects (60 females and 60 males) divided into three age groups (20 - 30; 31 - 40; 41 - 50 years of age). The experiment was carried out by the Fortunato-Niccolini olfactometric method using six odorous experimental substances: A - anethol, PH - phenyl-ethyl-alcohol, C citral, M - menthol, V- vanillin and P - pyridine, the thresholds of perception (TP) and identification (TI) being defined for each odorous substance. The examined females had slightly lower thresholds of perception (TP) and identification (TI) in relation to the males of the same age group. However, the differences were not statistically significant except for the group of subjects between 41 and 50 years of age where the females, being in the pre-menopause, had significantly better olfactory functions. The results can be explained by the weakening of the olfactory power as a result of ageing in both sexes, however, the females still experienced the protective role of sex hormones.

scholarly journals Pedestrian Mortality Trends In Children Over Four Decades In Transitional Lithuania

2016 ◽  
Vol 26 (5) ◽  
pp. 13-19
Author(s):  
Birutė Strukčinskienė ◽  
Robert Bauer ◽  
Sigitas Griškonis ◽  
Vaiva Strukčinskaitė
Keyword(s):  
Time Series ◽  
Young People ◽  
Road Safety ◽  
Road Traffic ◽  
Age Groups ◽  
Age Group ◽  
Prevention Measures ◽  
Mortality Trends ◽  
Road Users ◽  
The Impact

The aim of the study was to examine the long-term trends in pedestrian mortality for children (aged 0 to 14 years) and young people (aged 15 to 19 years) over four decades in transitional Lithuania. Methods. Road traffic fatality data were obtained from Statistics Lithuania and the Archives of Health Information Centre. Trends were analysed by linear regression using “Independence” as a slopechanging intervention in 1991 and population as a further explanatory factor in structural time series models. Results. The impact of the interventions, along with the reforms and changes related with the Independence, on pedestrian fatality trends in our time series model was found highly statistically significant for children 0 to 14 years (p<0.001) and still significant for young people 15 to 19 years (p<0.05). No significant impact on the trend of road traffic deaths was found for the “control-groups” of non-pedestrian road users in the age group 0 to 14 years and adult pedestrians (over 19 years of age). For the age group 15 to 19 years the effect of reforms was also significant for non-pedestrians (p<0.05). These results indicate that the effect of measures and changes used in the post-independence period was more specific in children that participated in road traffic as pedestrians than in adult pedestrians, or in nonpedestrian road users. Conclusions. Pedestrian deaths in Lithuania fell significantly in the age groups 0-14 and 15-19 years. A declining trend was found in road traffic fatalities and in pedestrian deaths in transitional Lithuania in the post-independence period. Socioeconomic and political transformations, systematic reforms in healthcare along with sustainable preventive measures may have contributed to this decrease. Targeted road safety measures were road traffic regulations, pedestrian education and environmentally based prevention measures. As child pedestrians are the most vulnerable group of road users, continued road safety education and promotion are recommended in order to maintain this trend, and to involve adult pedestrians in this development.

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