PUBLIC HEALTH IN THE UNITED STATES OF AMERICA: II.--INFECTIOUS DISEASE

BMJ ◽  
1936 ◽  
Vol 2 (3952) ◽  
pp. 678-679
Author(s):  
R. M. F. Picken
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
United States ◽  
United States Of America ◽  
The United States

scholarly journals Automated Travel History Extraction From Clinical Notes for Informing the Detection of Emergent Infectious Disease Events: Algorithm Development and Validation

10.2196/26719 ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. e26719
Author(s):  
Kelly S Peterson ◽  
Julia Lewis ◽  
Olga V Patterson ◽  
Alec B Chapman ◽  
Daniel W Denhalter ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
United States ◽  
Text Processing ◽  
The United States ◽  
Language Models ◽  
Travel History ◽  
Patient Travel ◽  
Electronic Health ◽  
Automated Text Processing

Background Patient travel history can be crucial in evaluating evolving infectious disease events. Such information can be challenging to acquire in electronic health records, as it is often available only in unstructured text. Objective This study aims to assess the feasibility of annotating and automatically extracting travel history mentions from unstructured clinical documents in the Department of Veterans Affairs across disparate health care facilities and among millions of patients. Information about travel exposure augments existing surveillance applications for increased preparedness in responding quickly to public health threats. Methods Clinical documents related to arboviral disease were annotated following selection using a semiautomated bootstrapping process. Using annotated instances as training data, models were developed to extract from unstructured clinical text any mention of affirmed travel locations outside of the continental United States. Automated text processing models were evaluated, involving machine learning and neural language models for extraction accuracy. Results Among 4584 annotated instances, 2659 (58%) contained an affirmed mention of travel history, while 347 (7.6%) were negated. Interannotator agreement resulted in a document-level Cohen kappa of 0.776. Automated text processing accuracy (F1 85.6, 95% CI 82.5-87.9) and computational burden were acceptable such that the system can provide a rapid screen for public health events. Conclusions Automated extraction of patient travel history from clinical documents is feasible for enhanced passive surveillance public health systems. Without such a system, it would usually be necessary to manually review charts to identify recent travel or lack of travel, use an electronic health record that enforces travel history documentation, or ignore this potential source of information altogether. The development of this tool was initially motivated by emergent arboviral diseases. More recently, this system was used in the early phases of response to COVID-19 in the United States, although its utility was limited to a relatively brief window due to the rapid domestic spread of the virus. Such systems may aid future efforts to prevent and contain the spread of infectious diseases.

scholarly journals The Estimated Time-Varying Reproduction Numbers during the Ongoing Pandemic of the Coronavirus Disease 2019 (COVID-19) in 12 Selected Countries outside China

2020 ◽  
Author(s):  
Fu-Chang Hu
Keyword(s):  
Infectious Disease ◽  
United States ◽  
South Africa ◽  
South Korea ◽  
United States Of America ◽  
Estimation Method ◽  
The United States ◽  
Time Varying ◽  
Epidemic Curve ◽  
Almost All

Background: How can we anticipate the progression of the ongoing pandemic of the coronavirus disease 2019 (COVID-19)? As a measure of transmissibility, we aimed to estimate concurrently the time-varying reproduction number, R0(t), over time during the COVID-19 pandemic for each of the following 12 heavily-attacked countries: Singapore, South Korea, Japan, Iran, Italy, Spain, Germany, France, Belgium, United Kingdom, the United States of America, and South Africa. Methods: We downloaded the publicly available COVID-19 pandemic data from the WHO COVID-19 Dashboard website (https://covid19.who.int/) for the duration of January 11, 2020 and May 1, 2020. Then, we specified two plausible distributions of serial interval to apply the novel estimation method implemented in the incidence and EpiEstim packages to the data of daily new confirmed cases for robustly estimating R0(t) in the R software. Results: We plotted the epidemic curves of daily new confirmed cases for the 12 selected countries. A clear peak of the epidemic curve appeared in 10 of the 12 selected countries at various time points, and then the epidemic curve declined gradually. However, the United States of America and South Africa happened to have two or more peaks and their epidemic curves either reached a plateau or still climbed up. Almost all curves of the estimated R0(t) monotonically went down to be less than or close to 1.0 up to April 30, 2020 except Singapore, South Korea, Japan, Iran, and South Africa, of which the curves surprisingly went up and down at various time periods during the COVID-19 pandemic. Finally, the United States of America and South Africa were the two countries with the approximate R0(t) ≥ 1.0 at the end of April, and thus they were now facing the harshest battles against the coronavirus among the 12 selected countries. By contrast, Spain, Germany, and France with smaller values of the estimated R0(t) were relatively better than the other 9 countries. Conclusion: Seeing the estimated R0(t) going downhill speedily is more informative than looking for the drops in the daily number of new confirmed cases during an ongoing epidemic of infectious disease. We urge public health authorities and scientists to estimate R0(t) routinely during an epidemic of infectious disease and to report R0(t) daily to the public until the end of the epidemic.

Ending HIV in the United States Is Possible With the Proper Leadership and Sufficient and Targeted Resources

2021 ◽  
pp. e1-e3
Author(s):  
Carl Schmid
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
United States ◽  
The United States ◽  
The Right

After 40 years of living and, sadly, dying with HIV, the United States has become rather complacent. Perhaps this is partially attributable to our own success in treating, preventing, and responding to HIV. But imagine if we allowed another deadly infectious disease, such as COVID-19, to continue to spread for 40 years without investing the attention and resources needed to wipe it out. We must end this dangerous cycle, and we can with the right tools and leadership. But will we? (Am J Public Health. Published online ahead of print June 10, 2021: e1–e3. https://doi.org/10.2105/AJPH.2021.306349 )

Science and Medicine in the United States of America

2012 ◽  
Author(s):  
Edmund Ramsden
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
United States Of America ◽  
Rapid Growth ◽  
Large Scale ◽  
Medical Science ◽  
The United States ◽  
Biomedical Sciences ◽  
Democratic State

This article begins with great optimism expressed by Tocqueville for America's future as the embodiment of the democratic state. It discusses the opportunity to express the liberal political ideals, arguing that its success was based on a community of common sensibility. An understanding of society and politics endowed the historian with the power to help remake health care. This article explores and compares the ways in which medicine is developed and applied in a number of different social, cultural, and physical contexts. It shows rapid growth, from a period in which European ideas, methods, and structures were adapted to the American context, to one in which the United States is at the forefront of large-scale initiatives in public health, disease control, and innovation in the biomedical sciences. Finally, it mentions the contradiction, most notably between profound faith in the technical capacities of medical science and equally profound dissatisfaction with the provision of health care.

Reducing Reoccurence and Complications of Gc/Ct

2017 ◽  
Vol 2 (4) ◽  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
United States ◽  
Chlamydia Trachomatis ◽  
Sexually Transmitted Infections ◽  
The United States ◽  
Positive Test ◽  
California Department ◽  
Sexually Transmitted ◽  
Initial Episode

Gonococcal Neisseria (GC) and Chlamydia Trachomatis (CT) infections account for the largest number of reported cases of any infectious disease in the United States. The rates at which these infections occur are on the rise. Gonococcal Neisseria (GC) and Chlamydia trachomatis (CT) infections are also among the commonly curable sexually transmitted infections (STI)(California Department of Public Health, 2011). Though subsequent infections are preventable, reinfection rates are high [1]. As many as 20% of patients, especially females, reacquire GC or CT within six months after the initial positive test and treatment, and it is estimated that as many as 40% of adolescents get re-infeceted after an initial episode of GC and/or CT annually [2]. Chlamydia represents the most common reportable disease in the United States, and has comprised the largest proportion of all sexually transmitted infections (STIs) reported [3].

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