scholarly journals Invasive Pneumococcal Disease in Persons With Predisposing Factors is Dominated by Non-vaccine Serotypes in Southwest Sweden

2020 ◽  
Author(s):  
Karin Bergman ◽  
Tor Härnqvist ◽  
Erik Backhaus ◽  
Birger Trollfors ◽  
Mats S Dahl ◽  
...  
Keyword(s):  
Pneumococcal Disease ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Health Agency ◽  
Predisposing Factors ◽  
The Public ◽  
Serotype 1 ◽  
Pneumococcal Serotype ◽  
Gel Diffusion ◽  
Child Vaccination

Abstract Background: The pneumococcal conjugate vaccine PCV7 was introduced in Southwest Sweden in the child vaccination program in 2009, followed by PCV13 in 2010 and PCV10 in 2015. In this study we assessed the pneumococcal serotype distribution in relation to predisposing factors, clinical manifestations and outcome during seven years after PCV introduction. Methods: Clinical data from 1,278 patients with 1,304 episodes of IPD between January 2009 and December 2015 in Region Västra Götaland, Sweden, were retrospectively collected from medical records. Pneumococcal isolates were serotyped by gel diffusion and/or Quellung reactions performed at the Public Health Agency in Sweden. Results: With the exception of serotype 3, the prevalence of PCV13 serotypes decreased during the study period, from 76% of all IPD episodes in 2009 to 25% in 2015 (p<0.001) while non-PCV13 serotypes increased, mainly among patients ≥ 65 years and in patients with predisposing factors (p<0.001 for both). Patients with predisposing factors were more likely to have IPD caused by a serotype not included in PCV13 rather than a vaccine-included serotype. Serotype 3 was associated with intensive care unit admissions while serotype 1 and 7F caused IPD among healthier and younger patients. PCV13 serotypes were associated with invasive pneumonia, and non-PCV13 serotypes were associated with bacteremia with unknown focus and with manifestations other than pneumonia or meningitis. Conclusions: Non-PCV13 serotypes caused the majority of IPD cases in Southwest Sweden, especially in patients ≥65 years and in patients with predisposing factors. Serotype 3, included in PCV13, was prevalent and often caused severe disease.

scholarly journals Invasive pneumococcal disease in persons with predisposing factors is dominated by non-vaccine serotypes in Southwest Sweden

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karin Bergman ◽  
Tor Härnqvist ◽  
Erik Backhaus ◽  
Birger Trollfors ◽  
Mats S. Dahl ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Health Agency ◽  
Predisposing Factors ◽  
Chi Square ◽  
Exact Test ◽  
Serotype 1 ◽  
Chi Square Test

Abstract Background The pneumococcal conjugate vaccine PCV7 was introduced in Southwest Sweden in the child vaccination program in 2009, followed by PCV13 in 2010 and PCV10 in 2015. In this retrospective cohort study we assessed the pneumococcal serotype distribution in relation to predisposing factors, clinical manifestations and outcome during seven years after PCV introduction. Methods Clinical data from 1278 patients with 1304 episodes of invasive pneumococcal disease (IPD) between January 2009 and December 2015 in Region Västra Götaland, Sweden, were retrospectively collected from medical records. Pneumococcal isolates were serotyped by gel diffusion and/or Quellung reactions performed at the Public Health Agency in Sweden. Associations between serotypes and clinical characteristics were statistically evaluated by use of Fisher’s exact test, Mann-Whitney U test and Logistic regression analysis, whereas IPD episodes caused by serotypes over time were analyzed by Mantel-Haenszel chi-square test. Results With the exception of serotype 3, the prevalence of PCV13 serotypes decreased during the study period, from 76% (n = 157) of all IPD episodes in 2009 to 25% (n = 42) in 2015 (p < 0.001) while non-PCV13 serotypes increased, mainly among patients ≥65 years and in patients with predisposing factors, including cardiovascular disease, pulmonary disease and malignancy (p < 0.001 for all). Patients with predisposing factors, including those with malignancy, immune deficiency or renal disease, were more likely to have IPD caused by a serotype not included in PCV13 rather than a vaccine-included serotype. Serotype 3 was associated with intensive care unit admissions while serotype 1 and 7F caused IPD among healthier and younger patients. PCV13 serotypes were associated with invasive pneumonia, and non-PCV13 serotypes were associated with bacteremia with unknown focus and with manifestations other than pneumonia or meningitis. Conclusions Non-PCV13 serotypes caused the majority of IPD cases in Southwest Sweden, especially in patients ≥65 years and in patients with predisposing factors. Serotype 3, included in PCV13, was prevalent and often caused severe disease.

Emergence of pneumococcal 19A empyema in UK children

2012 ◽  
Vol 97 (12) ◽  
pp. 1070-1072 ◽  
Author(s):  
Matthew F Thomas ◽  
Carmen L Sheppard ◽  
Malcolm Guiver ◽  
Mary P E Slack ◽  
Robert C George ◽  
...  
Keyword(s):  
Pneumococcal Disease ◽  
Pneumococcal Serotypes ◽  
Protection Agency ◽  
Surveillance Programme ◽  
Severity Of Disease ◽  
Serotype 1 ◽  
The Usa ◽  
Pneumococcal Serotype ◽  
The Uk ◽  
Substantial Morbidity

IntroductionInvasive pneumococcal disease due to serotype 19A has become a major concern, particularly in the USA and Asia. We describe the characteristics of pneumococcal serotype 19A related empyema and changes in its incidence in the UK.MethodsData from paediatric empyema patients between September 2006 and March 2011 were collected from 17 respiratory centres in the UK. Pneumococcal serotypes were identified as part of the Health Protection Agency enhanced paediatric empyema surveillance programme.ResultsFour serotypes accounted for over 80% of 136 cases (Serotype 1 : 43%, 3 : 21%, 7 : 11% and 19A:10%). The incidence of empyema due to serotype 19A quadrupled from 0.48 (0.16–1.13) cases per million children in 2006/2007 to 2.02 (1.25–3.09) in 2010/2011. Severity of disease was significantly increased in children with 19A infection when compared to other serotypes.ConclusionsThe incidence of empyema due to pneumococcal serotype 19A infection has increased significantly and is associated with substantial morbidity.

scholarly journals Changes in Invasive Pneumococcal Disease Caused by Streptococcus pneumoniae Serotype 1 following Introduction of PCV10 and PCV13: Findings from the PSERENADE Project

2021 ◽  
Vol 9 (4) ◽  
pp. 696 ◽  
Author(s):  
Julia Bennett ◽  
Marissa Hetrich ◽  
Maria Garcia Quesada ◽  
Jenna Sinkevitch ◽  
Maria Deloria Knoll ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Incidence Rate ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Mixed Effects ◽  
Data Availability ◽  
Serotype Replacement ◽  
Serotype 1 ◽  
Pneumococcal Serotype ◽  
Rate Ratios

Streptococcus pneumoniae serotype 1 (ST1) was an important cause of invasive pneumococcal disease (IPD) globally before the introduction of pneumococcal conjugate vaccines (PCVs) containing ST1 antigen. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project gathered ST1 IPD surveillance data from sites globally and aimed to estimate PCV10/13 impact on ST1 IPD incidence. We estimated ST1 IPD incidence rate ratios (IRRs) comparing the pre-PCV10/13 period to each post-PCV10/13 year by site using a Bayesian multi-level, mixed-effects Poisson regression and all-site IRRs using a linear mixed-effects regression (N = 45 sites). Following PCV10/13 introduction, the incidence rate (IR) of ST1 IPD declined among all ages. After six years of PCV10/13 use, the all-site IRR was 0.05 (95% credibility interval 0.04–0.06) for all ages, 0.05 (0.04–0.05) for <5 years of age, 0.08 (0.06–0.09) for 5–17 years, 0.06 (0.05–0.08) for 18–49 years, 0.06 (0.05–0.07) for 50–64 years, and 0.05 (0.04–0.06) for ≥65 years. PCV10/13 use in infant immunization programs was followed by a 95% reduction in ST1 IPD in all ages after approximately 6 years. Limited data availability from the highest ST1 disease burden countries using a 3 + 0 schedule constrains generalizability and data from these settings are needed.

scholarly journals COVID-19 pandemic containment in the Caribbean Region: A review of case-management and public health strategies

2021 ◽  
Vol 8 (4) ◽  
pp. 665-681
Author(s):  
Srikanth Umakanthan ◽  
◽  
Anuradha Chauhan ◽  
Madan Mohan Gupta ◽  
Pradeep Kumar Sahu ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Manifestations ◽  
Health Agency ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Caribbean Region ◽  
Member States ◽  
The Public ◽  
Regional Collaboration ◽  
The Caribbean

<abstract> <p>COVID-19 emerged initially from Wuhan, Hubei province, China, in late December 2019, and since then, it has spread globally to be declared a pandemic by the World Health Organization. The Caribbean region started reporting COVID-19 cases in early March 2020, triggering new regional public health crises. The initial suspects and confirmed cases across the Caribbean countries were mainly imported cases and from cruise ships. The clinical manifestations varied from fever, cough, and malaise in mild cases to acute respiratory distress syndrome (ARDS) and shock in severe cases. The Caribbean Public Health Agency has provided frequent updates on the preventive strategies and quarantine measures across the Caribbean member states. COVID-19 has had a serious impact on the Caribbean region's health system, economy, and psychology. This review presents the Caribbean perspective of COVID-19, detailing the epidemiology, clinical manifestations, diagnosis, management, and preventive and surveillance measures. Vaccine hesitancy was found to be a major challenge that needs appropriate health education strategies to address the public. Strong leadership and regional collaboration among the Caribbean member states are necessary to provide optimal real-time data to the public and implement appropriate and effective guidelines in the island states.</p> </abstract>

Developmental Disorders in Canada

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Sarah Palmeter
Keyword(s):  
Public Health ◽  
Developmental Disorders ◽  
Health Agency ◽  
The Public ◽  
Age Of Diagnosis ◽  
High Level ◽  
Project Objectives ◽  
Disability Severity ◽  
Occupational Function ◽  
Improve Health

In the completion of my practicum at the Public Health Agency of Canada (PHAC) this summer, I worked to develop a surveillance knowledge product to support the national surveillance of developmental disorders. This project used Statistics Canada’s 2017 Canadian Survey on Disability to investigate the burden of developmental disorders in Canada. Developmental disorders are conditions with onset in the developmental period. They are associated with developmental deficits and impairments of personal, social, academic, and occupational function. The project objectives are to estimate the prevalence of developmental disorders in Canadians 15 years of age or older, overall and by age and sex, as well as report on the age of diagnosis, disability severity, and disability co-occurrence in those with developmental disorders. The majority of the analysis has been completed and preliminary results completed, which cannot be released prior to PHAC publication. Although not highly prevalent, developmental disorders are associated with a high level of disability in young Canadians. Early detection and interventions have been shown to improve health and social outcomes among affected individuals. Understanding the burden of developmental disorders in Canada is essential to the development of public health policies and services.

Multiple Myeloma or Brucellosis: A Case Report

2020 ◽  
Vol 20 (1) ◽  
pp. 102-105 ◽  
Author(s):  
Hossein A. Rahdar ◽  
Mansoor Kodori ◽  
Mohamad R. Salehi ◽  
Mahsa Doomanlou ◽  
Morteza Karami-Zarandi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Brucella Melitensis ◽  
Severe Disease ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Bone Marrow Aspiration ◽  
Major Health Problem ◽  
Brucella Infection ◽  
Wide Range ◽  
Parental Treatment

Background: Brucellosis, a major health problem in developing countries, is a multisystem infection with a broad spectrum of clinical manifestations. Hematological complications, ranging from an intravascular coagulopathy to mild homeostasis disorders (such as gammopathy), have been reported in brucella infection. These signs and symptoms may lead to misdiagnosis of brucellosis with other hematological diseases. Case: A 65-year-old male whose occupation was shepherding was referred to our hospital as a known case of multiple myeloma with continuous fever, muscle weakness, and night sweating after taking 2 courses of chemotherapy. The laboratory diagnosis of multiple myeloma had been based on the observation of a high percent of plasma cells in the bone marrow aspiration. At follow- up, the result of patient's fever workup, with 2 sets of blood cultures, was positive for Brucella melitensis. Isolated brucella was confirmed as B. melitensis by 16S rRNA sequencing. Brucellosis serologic test was performed by agglutination test and positive results were obtained. The patient was discharged with the cessation of fever and general improvement after the end of the parental treatment phase of brucella bacteremia. Conclusions: Brucella infection may cause a severe disease, mimicking a primary hematological disease, which could complicate the correct diagnosis. In brucellosis cases, due to the wide range of symptoms, in addition to cultivation and serological methods, molecular methods should also be used to prevent inappropriate diagnosis and additional costs.

The Public Health Crisis Survival Guide

2018 ◽  
Author(s):  
Joshua M. Sharfstein
Keyword(s):  
Public Health ◽  
Police Officers ◽  
Health Agency ◽  
Health Improvement ◽  
Strong Response ◽  
Popular Imagination ◽  
Health Crisis ◽  
The Public ◽  
Public Health Crisis ◽  
Critical Skills

Firefighters fight fires. Police officers race to crime scenes, sirens blaring. And health officials? Health officials respond to crises. There are infectious disease crises, budget crises, environmental health crises, human resources crises—and many more. At such critical moments, what happens next really matters. A strong response can generate greater credibility and authority for a health agency and its leadership, while a bungled response can lead to humiliation and even resignation. Health officials must be able to manage and communicate effectively as emotions run high, communities become engaged, politicians lean in, and journalists circle. In popular imagination, leaders intuitively rise to the challenge of a crisis: Either they have what it takes or they do not. In fact, preparation is invaluable, and critical skills can be learned and practiced. Students and health officials alike can prepare not only to avoid catastrophe during crises, but to take advantage of new opportunities for health improvement. The Public Health Crisis Survival Guide provides historical perspective, managerial insight, and strategic guidance to help health officials at all levels not just survive but thrive in the most challenging of times.

scholarly journals Genetic polymorphism for IFNγ +874T/A in patients with acute toxoplasmosis

2012 ◽  
Vol 45 (6) ◽  
pp. 757-760 ◽  
Author(s):  
Elizabeth de Souza Neves ◽  
André Luis Land Curi ◽  
Maira Cavalcanti de Albuquerque ◽  
Cassius Schnel Palhano-Silva ◽  
Laura Berriel da Silva ◽  
...  
Keyword(s):  
Single Nucleotide Polymorphism ◽  
Case Control Study ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Nucleotide Polymorphism ◽  
Gene Encoding ◽  
Single Nucleotide ◽  
Duration Of Disease ◽  
Acute Toxoplasmosis ◽  
Control Study

INTRODUCTION: A single nucleotide polymorphism (SNP) in the gene encoding gamma interferon influences its production and is associated with severity of infectious diseases. This study aimed to evaluate the association of IFNγ+874T/A SNP with duration of disease, morbidity, and development of retinochoroiditis in acute toxoplasmosis. METHODS: A case-control study was conducted among 30 patients and 90 controls. RESULTS: Although statistical associations were not confirmed, A-allele was more common among retinochoroiditis cases and prolonged illness, while T-allele was more frequent in severe disease. CONCLUSIONS: Despite few cases, the results could indicate a relation between IFNγ+874T/A single nucleotide polymorphism and clinical manifestations of toxoplasmosis.

scholarly journals COVID-19 in obstetrics 2020: the experience at a New York City medical center

2020 ◽  
Vol 48 (9) ◽  
pp. 892-899
Author(s):  
Ashlesha K. Dayal ◽  
Armin S. Razavi ◽  
Amir K. Jaffer ◽  
Nishant Prasad ◽  
Daniel W. Skupski
Keyword(s):  
New York ◽  
Medical Center ◽  
Severe Disease ◽  
Infection Rates ◽  
Health Crisis ◽  
The Public ◽  
Public Health Crisis ◽  
Asymptomatic Carriage ◽  
Global Spread ◽  
Workforce Flexibility

AbstractThe global spread of the SARS-CoV-2 virus during the early months of 2020 was rapid and exposed vulnerabilities in health systems throughout the world. Obstetric SARS-CoV-2 disease was discovered to be largely asymptomatic carriage but included a small rate of severe disease with rapid decompensation in otherwise healthy women. Higher rates of hospitalization, Intensive Care Unit (ICU) admission and intubation, along with higher infection rates in minority and disadvantaged populations have been documented across regions. The operational gymnastics that occurred daily during the Covid-19 emergency needed to be translated to the obstetrics realm, both inpatient and ambulatory. Resources for adaptation to the public health crisis included workforce flexibility, frequent communication of operational and protocol changes for evaluation and management, and application of innovative ideas to meet the demand.

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