scholarly journals Linking rattiness, geography and environmental degradation to spillover Leptospira infections in marginalised urban settings: an eco-epidemiological community-based cohort study in Brazil

2021 ◽  
Author(s):  
Max T Eyre ◽  
Fábio N Souza ◽  
Ticiana S. A. Carvalho-Pereira ◽  
Nivison Nery ◽  
Daiana de Oliveira ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health Intervention ◽  
Spatial Modelling ◽  
The United States ◽  
Infection Risk ◽  
Human Infection ◽  
Global Public Health ◽  
Entire Study ◽  
Urban Settings ◽  
Public Health Burden

Background: Zoonotic spillover from animal reservoirs is responsible for a significant global public health burden, but the processes that promote spillover events are poorly understood in complex urban settings. Endemic transmission of Leptospira, the agent of leptospirosis, in marginalised urban communities occurs through human exposure to an environment contaminated by bacteria shed in the urine of the rat reservoir. However, it is unclear to what extent transmission is driven by variation in the distribution of rats or by the dispersal of bacteria in rainwater runoff and overflow from open sewer systems. <br /><br />Methods: We conducted an eco-epidemiological study in a high-risk community in Salvador, Brazil, by prospectively following a cohort of 1,401 residents to ascertain serological evidence for leptospiral infections. A concurrent rat ecology study was used to collect information on the fine-scale spatial distribution of ‘rattiness’, our proxy for rat abundance and exposure of interest. We developed and applied a novel geostatistical framework for joint spatial modelling of multiple indices of disease reservoir abundance and human infection risk. <br /><br />Results: The estimated infection rate was 51.4 (95\%CI 40.4, 64.2) infections per 1,000 follow-up events. Infection risk increased with age until 30 years of age and was associated with male gender. Rattiness was positively associated with infection risk for residents across the entire study area, but this effect was stronger in higher elevation areas (OR 3.27 95\%CI 1.68, 19.07) than in lower elevation areas (OR 1.14 95\%CI 1.05, 1.53). <br /><br />Conclusions: These findings suggest that, while frequent flooding events may disperse bacteria in regions of low elevation, environmental risk in higher elevation areas is more localised and directly driven by the distribution of local rat populations. The modelling framework developed may have broad applications in delineating complex animal-environment-human interactions during zoonotic spillover and identifying opportunities for public health intervention.<br /><br />Funding: This work was supported by the Oswaldo Cruz Foundation and Secretariat of Health Surveillance, Brazilian Ministry of Health, the National Institutes of Health of the United States (grant numbers F31 AI114245, R01 AI052473, U01 AI088752, R01 TW009504 and R25 TW009338); the Wellcome Trust (102330/Z/13/Z), and by the Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB/JCB0020/2016). M.T.E is supported by an MRC doctorate studentship. F.N.S. participated in this study under a FAPESB doctorate scholarship.

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 Traumatic brain injury as a risk factor for dementia

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E Mezzalira ◽  
B Stopa ◽  
A Khawaja ◽  
S Izzy ◽  
W Gormley
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
The United States ◽  
Age Group ◽  
Global Public Health ◽  
Public Health Burden ◽  
Increased Risk

Abstract Introduction The Centers for Disease Control and Prevention (CDC) reports that there were 2.87 million cases of traumatic brain injury (TBI) in the United States in 2014, 69 million worldwide. Some studies suggest a connection between TBI and increased risk of dementia, but it remains unclear whether the risk increases with age and TBI severity. Given our aging population, it is essential to better characterize the link between TBI and dementia. Methods We conducted a retrospective cohort study of two major academic medical centers for years 2000-2015. We identified all patients with TBI, aged 45 and older. Variables included age, TBI severity, pre-existing dementia, dementia diagnosed after TBI, years to dementia, and follow-up time. TBI severity was determined by head/neck AIS score, using ICD-PIC software. Mild TBI was defined as AIS 0-2, and Moderate/Severe as AIS 3-6. Analysis was done in R.v.3.0.1 software. Results Overall, there were 14,199 patients with TBI, of which 9,938 (70%) were mild and 4,261 (30%) were moderate/severe. Mean age was 70.5 (±14.0). There were 1,422 cases (10%) of pre-existing dementia, and 850 (6%) cases of dementia diagnosed after TBI. The mean follow-up time was 1,129 (±1,474) days. The 75-84 age group had the highest incidence of TBI (28%). When compared by age group and TBI severity, the proportion of moderate/severe TBI increased with increasing age. The proportion of pre-existing dementia increased with age, as expected. Notably, there is increased incidence of dementia after TBI in patients aged 65 and older (7-10%, p &lt; 0.001). There was no observed effect of TBI severity on the risk of dementia after TBI. Conclusions Our results indicate that TBI is a risk factor for the development of dementia, especially in patients aged 65 and older. Given the global public health burden of these two diseases it is critical to develop effective TBI primary prevention strategies. Key messages TBI is a risk factor for the development of dementia. Need for public health measures to mitigate the risk of TBI in the patient population 65 and older.

scholarly journals Advancing the Science of Tick and Tick-Borne Disease Surveillance in the United States

Insects ◽  
2019 ◽  
Vol 10 (10) ◽  
pp. 361 ◽  
Author(s):  
Samantha Wisely ◽  
Gregory Glass
Keyword(s):  
Public Health ◽  
United States ◽  
Workforce Development ◽  
Disease Surveillance ◽  
The United States ◽  
Centers Of Excellence ◽  
Public Health Burden ◽  
Vector Borne Disease ◽  
Tick Borne Disease ◽  
Vector Borne

Globally, vector-borne diseases are an increasing public health burden; in the United States, tick-borne diseases have tripled in the last three years. The United States Centers for Disease Control and Prevention (CDC) recognizes the need for resilience to the increasing vector-borne disease burden and has called for increased partnerships and sustained networks to identify and respond to the most pressing challenges that face vector-borne disease management, including increased surveillance. To increase applied research, develop communities of practice, and enhance workforce development, the CDC has created five regional Centers of Excellence in Vector-borne Disease. These Centers are a partnership of public health agencies, vector control groups, academic institutions, and industries. This special issue on tick and tick-borne disease surveillance is a collection of research articles on multiple aspects of surveillance from authors that are affiliated with or funded by the CDC Centers of Excellence. This body of work illustrates a community-based system of research by which participants share common problems and use integrated methodologies to produce outputs and effect outcomes that benefit human, animal and environmental health.

scholarly journals Epidemiological surveillance of West Nile virus in the world and Brazil

2020 ◽  
Vol 56 (4) ◽  
pp. e164335
Author(s):  
Erica Azevedo Costa ◽  
José Joffre Martins Bayeux ◽  
Aila Solimar Gonçalves Silva ◽  
Guilherme Alves De Queiroz ◽  
Beatriz Senra Álvares da Silva Santos ◽  
...  
Keyword(s):  
Public Health ◽  
West Nile Virus ◽  
Animal Health ◽  
Public Health Intervention ◽  
The United States ◽  
World Health ◽  
West Nile ◽  
Serological Screening ◽  
The World ◽  
Health Organization

West Nile virus (WNV) is a neurovirulent mosquito-borne Flavivirus that is maintained in nature by a zoonotic transmissioncycle between avian hosts and ornithophilic mosquito vectors, mostly from the Culex genus. Until the 1990s, WNV wasconsidered to be an old-world arbovirus, but in 1999, WNV emerged in the United States (US) and spread rapidly, becoming amajor threat to public health. WNV adapted to the transmission cycle involving American mosquitoes and birds and reachedCentral and South America in subsequent years. In 2003, the National West Nile Fever Surveillance System was created in Brazilbased on serological screening of animals and sentinel vectors, as recommended by the Pan American Health Organization(PAHO) and the World Health Organization (WHO). Since 2008, serological evidence of WNV infection in Brazilian horseshas been reported, and the circulation of WNV has been monitored through the regular serological screening of sentinel horsesand reporting of encephalomyelitis cases. Horses are highly susceptible to WNV infection, and outbreaks of neurologicaldisease among horses often precede human cases. In this regard, equine surveillance has been essential in providing earlywarning to public and animal health authorities in several countries, including Brazil. This demonstrates the need for animaland public health intervention programs to allocate resources to make veterinarians aware of the role they can play in thehuman surveillance processes by monitoring horses. This review discusses the importance of equine surveillance and the gapthat veterinarians can fill on the front line in human surveillance, in Brazil and worldwide, in the context of “One Health”

Air pollution and your brain: what do you need to know right now

2014 ◽  
Vol 16 (04) ◽  
pp. 329-345 ◽  
Author(s):  
Lilian Calderón-Garcidueñas ◽  
Ana Calderón-Garcidueñas ◽  
Ricardo Torres-Jardón ◽  
José Avila-Ramírez ◽  
Randy J. Kulesza ◽  
...  
Keyword(s):  
Public Health ◽  
Air Pollution ◽  
Particulate Matter ◽  
Fine Particles ◽  
Public Health Problem ◽  
The United States ◽  
Global Public Health ◽  
Health Providers ◽  
Parkinson’S Diseases ◽  
The Brain

Research links air pollution mostly to respiratory and cardiovascular disease. The effects of air pollution on the central nervous system (CNS) are not broadly recognized. Urban outdoor pollution is a global public health problem particularly severe in megacities and in underdeveloped countries, but large and small cities in the United States and the United Kingom are not spared. Fine and ultrafine particulate matter (UFPM) defined by aerodynamic diameter (&lt;2.5-μm fine particles, PM2.5, and &lt;100-nm UFPM) pose a special interest for the brain effects given the capability of very small particles to reach the brain. In adults, ambient pollution is associated to stroke and depression, whereas the emerging picture in children show significant systemic inflammation, immunodysregulation at systemic, intratechal and brain levels, neuroinflammation and brain oxidative stress, along with the main hallmarks of Alzheimer and Parkinson’s diseases: hyperphosphorilated tau, amyloid plaques and misfoldedα-synuclein. Animal models exposed to particulate matter components show markers of both neuroinflammation and neurodegeneration. Epidemiological, cognitive, behavioral and mechanistic studies into the association between air pollution exposures and the development of CNS damage particularly in children are of pressing importance for public health and quality of life. Primary health providers have to include a complete prenatal and postnatal environmental and occupational history to indoor and outdoor toxic hazards and measures should be taken to prevent or reduce further exposures.

scholarly journals Public Health Burden of Sudden Cardiac Death in the United States

2014 ◽  
Vol 7 (2) ◽  
pp. 212-217 ◽  
Author(s):  
Eric C. Stecker ◽  
Kyndaron Reinier ◽  
Eloi Marijon ◽  
Kumar Narayanan ◽  
Carmen Teodorescu ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
The United States ◽  
Public Health Burden ◽  
Health Burden

scholarly journals Beware the Kindleberger Trap in Global Health Governance

2021 ◽  
pp. 1-21
Author(s):  
Jin Jiyong
Keyword(s):  
Public Health ◽  
Global Health ◽  
Public Goods ◽  
Stress Test ◽  
The United States ◽  
Global Health Governance ◽  
Global Public Health ◽  
Global Public Goods ◽  
Health Governance ◽  
Health Crisis

The Covid-19 pandemic is both a public health crisis and a stress test for global health governance. Effective health governance hinges on the provision of global public goods for health. Generally, the hegemon underwrites the operation and stability of the global public health architecture by ensuring the sustained supply of global public goods for health. But when the hegemon is unable or unwilling to shoulder this responsibility, global health governance may run the risk of falling into a Kindleberger Trap. The leadership vacuum that is opening up amid the coronavirus pandemic is accelerating the process. At present, China should adopt a three-pronged approach to promote bilateral health cooperation with leading countries like the United States, strengthen regional institution-building with ASEAN, South Korea, Japan, and Belt and Road countries, and improve the performance, credibility, and integrity of global organizations like the WHO and G-20. The Kindleberger Trap in global health governance can be overcome by adapting regional health coordination to make it more agile and effective.

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