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.

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 increasing incidence of SARS-CoV- 2 in older adolescents and younger adults during the epidemic in Mexico

2021 ◽  
Vol 63 (3 May-Jun) ◽  
pp. 422-428
Author(s):  
Dalia Stern ◽  
Martin Lajous ◽  
Blanca De la Rosa ◽  
Edward Goldstein
Keyword(s):  
Symptom Onset ◽  
Age Groups ◽  
Prevalence Ratio ◽  
Age Group ◽  
Younger Adults ◽  
Relative Incidence ◽  
Older Adolescents ◽  
Pandemic Response

Objective. To estimate temporary changes in the inciden­ce of SARS-CoV-2-confirmed hospitalizations (by date of symptom onset) by age group during and after the national lockdown. Materials and methods. For each age group g, we computed the proportion E(g) of individuals in that age group among all cases aged 10-59y during the early lock­down period (April 20-May 3, 2020), and the corresponding proportion L(g) during the late lockdown (May 18-31, 2020) and post-lockdown (June 15-28, 2020) periods and computed the prevalence ratio: PR(g)=L(g)/E(g). Results. For the late lockdown and post-lockdown periods, the highest PR values were found in age groups 15-19y (late: PR=1.69, 95%CI 1.05,2.72; post-lockdown: PR=2.05, 1.30,3.24) and 20-24y (late: PR=1.43, 1.10,1.86; post-lockdown: PR=1.49, 1.15,1.93). These estimates were higher in individuals 15-24y compared to those ≥30y. Conclusions. Adolescents and younger adults had an increased relative incidence of SARS-CoV-2 during late lockdown and post-lockdown periods. The role of these age groups should be considered when implementing future pandemic response efforts.

scholarly journals On the increasing role of older adolescents and younger adults during the SARS-CoV-2 epidemic in Mexico, April 20 – May 24, 2020

2020 ◽  
Author(s):  
D Stern ◽  
M Lajous ◽  
E Goldstein
Keyword(s):  
Public Health ◽  
Age Groups ◽  
Early Period ◽  
Relative Increase ◽  
Age Group ◽  
Risk Awareness ◽  
Younger Adults ◽  
Targeted Interventions ◽  
Older Adolescents

AbstractBackgroundThe SARS-CoV-2 epidemic in Mexico is growing, and there is uncertainty regarding the role that different age groups play in propagating the epidemic.MethodsWe used data on hospitalizations with confirmed SARS-CoV-2 infection from the Mexican Ministry of Health in ten 5-year age groups: 10-14through 55-59 years. For each age group g, we computed the proportion E(g) of individuals in that age group among all hospitalized cases aged 10-59 years during the early period (between April 20 – May 3, 2020), the corresponding proportion L(g) during the later periods (May 11-24), as well as the relative risk RR(g)= L(g)/E(g). For each pair of age groups g1,g2, RR(g1)>RR(g2) is interpreted as a relative increase in SARS-CoV-2 infections in the age group g1 compared with g2 for the later vs. early period.ResultsThe highest RR estimates belong to persons aged 15-19 years (RR=1.93(95% CI (1.19,3.12)) and 20-24 years (RR=1.40(1.07,1.83)). The RR estimates in persons aged over 30 years were significantly lower compared to persons aged 15-24 years.ConclusionsOur results suggest a temporal increase in the incidence of SARS-CoV-2 infection in older adolescents and younger adults compared to other age groups. Targeted interventions, particularly public health messaging at those age groups to increase knowledge and risk awareness may be considered.

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 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 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.

The Role of Chinese Traditional Medical Practise as a Form of Health Care in Singapore I: Preliminary Study

1980 ◽  
Vol 08 (01n02) ◽  
pp. 26-36 ◽  
Author(s):  
Suzanne Chan Ho ◽  
Kwok Chan Lun ◽  
W. K. Cheng Hin Ng
Keyword(s):  
Age Groups ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
Prevalent Disease ◽  
Singapore Chinese ◽  
Preliminary Study ◽  
Male To Female ◽  
Group Distribution

A retrospective study of 672 sampled records of patients of a major institutions providing Chinese traditional medicine in Singapore reveals that 97.3% of the patients were Chinese, with a dialect group distribution following closely that of the Singapore Chinese. The male-to-female patient ratio was 1.0:1.13. There were fewer patients of the pediatric age group and more of those from age 30 upwards. Some 43% of the patients sought treatment for ''infective'' and ''internal, emotional and weakness'' diseases. The prevalent disease conditions seen among patients from the different age groups are also analyzed and discussed in this paper.

scholarly journals Pancreatico-biliary pathologies: correlation of USG and MRCP

2019 ◽  
Vol 6 (7) ◽  
pp. 2373
Author(s):  
Priyanka Ashok Khopde ◽  
Abhimanyu Kelkar ◽  
Priscilla Joshi ◽  
Amol Bandgar ◽  
Mangal Mahajan
Keyword(s):  
Obstructive Jaundice ◽  
Imaging Modality ◽  
Correct Diagnosis ◽  
Age Groups ◽  
Biliary Disease ◽  
Age Group ◽  
Frequent Form ◽  
Ultrasound Study ◽  
Benign Pathology

Background: Obstructive jaundice is the most frequent form of hepato-biliary pathologies. The main aim is to confirm the presence of obstruction and to identify its cause, location and extent of the lesion. This study evaluated the role of USG and MRCP in hepato-biliary pathology.Methods: Twenty-five patients of all age groups with suspicion of obstructive jaundice referred for Ultrasound were included in our study. The patients with findings suggestive of biliary obstruction underwent MRCP.Results: Out of 25 patients, maximum patients were in the age group of 61-80 yrs. 52% were male and 48% were female. The jaundice was due to a benign etiology in 64% patients and malignant etiology in 36%. The most common benign pathology was choledocholithiasis (25%) and malignant pathology was periampullary carcinoma (44%). Overall 11 cases were inconclusive on ultrasound study while 2 cases were false positive for malignancy on MRCP. In 92% cases the correct diagnosis was detected on MRCP.Conclusions: USG is the initial and sometimes the only imaging modality in obstructive biliary disease. However the distal CBD which is poorly seen on USG can be well evaluated on MRCP thus improving the diagnosis in pancreatico-biliary pathologies.

Unapproved Uses of Approved Drugs: The Physician, the Package Insert, and the Food and Drug Administration: Subject Review

PEDIATRICS ◽  
1996 ◽  
Vol 98 (1) ◽  
pp. 143-145 ◽  
Author(s):  
Keyword(s):  
Drug Administration ◽  
Food And Drug Administration ◽  
Age Groups ◽  
Package Insert ◽  
Age Group ◽  
Off Label Use ◽  
Off Label ◽  
Fda Approval ◽  
Approved Drugs

Physicians who prescribe a new drug that has not been approved for a specific indication or a specific age group frequently find themselves in a quandary. Physicians who prescribe "old," time-honored drugs usually do not consult the package insert or search for US Food and Drug Administration (FDA) approval. This statement was written to clarify the legal and informational status of the package insert and the role of the FDA in approving or not approving drugs for specific indications or specific age groups. The unapproved use of approved drugs, or so-called "off-label" use, is extremely prevalent among physicians who care for children. It is important that such use of compounds be brought up to date with current FDA policies and to emphasize the responsibility of the prescribing physician in the use of these compounds.

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