Role of the Medical Examiner in Zika Virus and Other Emerging Infections

2016 ◽  
Vol 141 (1) ◽  
pp. 82-84 ◽  
Author(s):  
Veena D. Singh ◽  
Sarah L. Lathrop
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Zika Virus ◽  
Emerging Infectious Diseases ◽  
Hantavirus Pulmonary Syndrome ◽  
Medical Examiner ◽  
Public Health Approach ◽  
Emerging Infections ◽  
Medical Examiners

Context.—Medical examiners and coroners have long been an integral component of public health, often being the first to recognize and describe emerging infectious diseases. Given their experience and access, medical examiners and coroners will provide valuable contributions to better understanding Zika virus infection and its sequelae. Objective.—To review past examples of medical examiner/coroner involvement in recognition of emerging infectious diseases and describe how medical examiners and coroners will be critical in understanding the pathophysiology of Zika infections. Design.—Review of the existing literature on the role of medical examiners and coroners in the identification of emergent infections and the available literature on Zika virus. Results.—Medical examiners and coroners have played a crucial role in identifying numerous emerging infectious diseases such as hantavirus pulmonary syndrome and West Nile virus, and have the expertise and experience to aid in elucidating the pathophysiologic effects of Zika virus and tracking its distribution and risk factors. Conclusions.—Medical examiners and coroners will be a significant factor in the unified public health approach needed to mitigate the effects of Zika virus and other, heretofore unrecognized, infectious diseases.

scholarly journals Emerging infectious disease preparedness and response in healthcare: perspectives from COVID-19 and the role of College-Learnt Microbiology

2021 ◽  
Vol 22 (3) ◽  
pp. 312-321
Author(s):  
J. Tonui ◽  
W. Chepkutto ◽  
J. Rotich
Keyword(s):  
Health Care ◽  
Infectious Diseases ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Emerging Infectious Diseases ◽  
Microbial Pathogens ◽  
Infection Prevention And Control ◽  
Care Providers ◽  
Emerging Infections

Coronavirus disease 2019 (COVID-19) pandemic began in December 2019 in Wuhan City China where it is believed to have been transmitted to humans from an unknown animal species. The public health, social and economic impact of the pandemic world over is detrimental. Health care providers at the frontline in the fight against COVID-19 are at the greatest risk of infection and so far, many have been infected and some have already died from the disease. Thus, it is imperative that healthcare providers have adequate knowledge of infectious diseases and microbial pathogens to comprehend the scale of risk for better recognition and response. Microbiological concepts of infection prevention and control, hand hygiene and aseptic techniques are essential in slowing down the spread of the virus. COVID-19 has proven that infectious agents can emerge from any region in the world and can spread rapidly with ominous consequences to all humanity. This narrative review discusses the role of college-learnt microbiology in health care provider preparedness for emerging infectious diseases in light of the current pandemic. Keywords: Emerging; Infections; Preparedness; Response; Microbiology; COVID-19; Training

Medical Examiners, Coroners, and Public Health: A Review and Update

2006 ◽  
Vol 130 (9) ◽  
pp. 1274-1282 ◽  
Author(s):  
Randy Hanzlick
Keyword(s):  
Public Health ◽  
Criminal Justice ◽  
The United States ◽  
Background Information ◽  
Medical Examiner ◽  
Epidemiologic Research ◽  
The Public ◽  
Death Investigation ◽  
Medical Examiners

Abstract Context.—Traditionally, the emphasis of work done by medical examiners, coroners, and the death investigation community has been viewed as serving the criminal justice system. During the last several decades, however, an important role for these 3 groups has emerged within public health. Objective.—To provide important background information on death investigation systems, the evolution and framework of public health entities that rely on information gathered by medical examiners and coroners, and the role of medical examiners and coroners in epidemiologic research, surveillance, and existing public health programs and activities. Data Sources.—Previous articles on epidemiologic aspects of forensic pathology and the role of medical examiners and coroners in epidemiologic research and surveillance; a review of the Web sites of public health and safety agencies, organizations, and programs that rely on medical examiner and coroner data collected during medicolegal investigations; and a review of recent public health reports and other publications of relevance to medical examiner and coroner activities. Conclusions.—The role of medical examiners and coroners has evolved from a criminal justice service focus to a broader involvement that now significantly benefits the public safety, medical, and public health communities. It is foreseeable that the public health role of medical examiners and coroners may continue to grow and that, perhaps in the not-too-distant future, public health impact will surpass criminal justice as the major focus of medicolegal death investigation in the United States.

scholarly journals Active surveillance of acute paediatric hospitalisations demonstrates the impact of vaccination programmes and informs vaccine policy in Canada and Australia

2020 ◽  
Vol 25 (25) ◽  
Author(s):  
Karina A Top ◽  
Kristine Macartney ◽  
Julie A Bettinger ◽  
Ben Tan ◽  
Christopher C Blyth ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Active Surveillance ◽  
Influenza A ◽  
Monitoring Program ◽  
Emerging Infectious Diseases ◽  
Emerging Infections ◽  
Public Health Response ◽  
Influenza A H1n1 ◽  
The Impact

Sentinel surveillance of acute hospitalisations in response to infectious disease emergencies such as the 2009 influenza A(H1N1)pdm09 pandemic is well described, but recognition of its potential to supplement routine public health surveillance and provide scalability for emergency responses has been limited. We summarise the achievements of two national paediatric hospital surveillance networks relevant to vaccine programmes and emerging infectious diseases in Canada (Canadian Immunization Monitoring Program Active; IMPACT from 1991) and Australia (Paediatric Active Enhanced Disease Surveillance; PAEDS from 2007) and discuss opportunities and challenges in applying their model to other contexts. Both networks were established to enhance capacity to measure vaccine preventable disease burden, vaccine programme impact, and safety, with their scope occasionally being increased with emerging infectious diseases’ surveillance. Their active surveillance has increased data accuracy and utility for syndromic conditions (e.g. encephalitis), pathogen-specific diseases (e.g. pertussis, rotavirus, influenza), and adverse events following immunisation (e.g. febrile seizure), enabled correlation of biological specimens with clinical context and supported responses to emerging infections (e.g. pandemic influenza, parechovirus, COVID-19). The demonstrated long-term value of continuous, rather than incident-related, operation of these networks in strengthening routine surveillance, bridging research gaps, and providing scalable public health response, supports their applicability to other countries.

scholarly journals Serologic Tools and Strategies to Support Intervention Trials to Combat Zika Virus Infection and Disease

2019 ◽  
Vol 4 (2) ◽  
pp. 68 ◽  
Author(s):  
Matthew H. Collins
Keyword(s):  
Public Health ◽  
Virus Infection ◽  
Infectious Diseases ◽  
Zika Virus ◽  
Vaccine Development ◽  
Sexual Transmission ◽  
Emerging Infectious Diseases ◽  
World Health ◽  
Public Health Response ◽  
Zika Virus Infection

Zika virus is an emerging mosquito-borne flavivirus that recently caused a large epidemic in Latin America characterized by novel disease phenotypes, including Guillain-Barré syndrome, sexual transmission, and congenital anomalies, such as microcephaly. This epidemic, which was declared an international public health emergency by the World Health Organization, has highlighted shortcomings in our current understanding of, and preparation for, emerging infectious diseases in general, as well as challenges that are specific to Zika virus infection. Vaccine development for Zika virus has been a high priority of the public health response, and several candidates have shown promise in pre-clinical and early phase clinical trials. The optimal selection and implementation of imperfect serologic assays are among the crucial issues that must be addressed in order to advance Zika vaccine development. Here, I review key considerations for how best to incorporate into Zika vaccine trials the existing serologic tools, as well as those on the horizon. Beyond that, this discussion is relevant to other intervention strategies to combat Zika and likely other emerging infectious diseases.

scholarly journals A Quarter Century of Emerging Infectious Diseases – Where Have We Been and Where Are We Going?

2018 ◽  
Vol 47 (1) ◽  
pp. 117
Author(s):  
James W. Le Duc ◽  
Teresa E. Sorvillo
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Emerging Infectious Diseases ◽  
The United States ◽  
International Travel ◽  
Emerging Infections ◽  
Quarter Century ◽  
Public Health Programs ◽  
National Public Health ◽  
Societal Changes

<p>A quarter century ago the landmark report from the U. S. National Academies of Sciences, Engineering, and Medicine entitled <em>“</em><em>Emerging Infections, Microbial Threats to Health in the United States” </em>was released. This classic study captured the societal changes then underway in our rapidly growing world: The growth of the world’s population and changing human behavior; the advances and globalization of technology and industry; the changes in economic development and land use; the dramatic increase in speed and frequency of international travel and commerce; the adaptation of microbes and the appearance of never before seen pathogens; and the breakdown of traditional public health measures. This societal evolution has only increased and the growing frequency of outbreaks foretold in the report has come to pass. Each new disaster has precipitated changes and adaptations in our global response to infectious diseases designed to reduce risks and avoid future outbreaks. We discuss these past events and how each led to change in an effort to mitigate future threats. We also look to the future to consider what challenges might lay ahead.</p><p><strong>Conclusion. </strong>Major outbreaks over the past quarter century validated the concept of emerging infectious diseases and led to improvements in global policies and national public health programs; however, there will likely always be new diseases and the threat of reemergence of diseases once thought controlled leading to a constant need for vigilance in public health preparedness.</p>

scholarly journals Design and Construction of a Biosafety Level-3 Autopsy Laboratory

2020 ◽  
Author(s):  
Kurt B. Nolte ◽  
Timothy B. Muller ◽  
Adam M. Denmark ◽  
Ron Burstein ◽  
Yvonne A. Villalobos
Keyword(s):  
Public Health ◽  
Health Concern ◽  
Medical Examiner ◽  
Emerging Infections ◽  
Laboratory Design ◽  
Control And Prevention ◽  
Level 3 ◽  
Medical Examiners ◽  
Biosafety Level ◽  
Design And Construction

ABSTRACT Context: Autopsy pathologists including medical examiners provide valuable public health support for infectious disease deaths through surveillance for deaths of public health concern including emerging infections, identifying causative organisms for unexplained deaths, and providing insights into the pathology and pathogenesis of novel or unusual infections. However, autopsy poses biosafety risks to workers within and outside the laboratory. The highest rates of laboratory acquired infections occur in autopsy workers. Objective: To design and construct an appropriately biosafe autopsy laboratory. Design: We conducted a biosafety risk assessment for autopsy workers using the process developed by the U.S. Centers for Disease Control and Prevention and National Institutes of Health and applied these findings as the basis of laboratory design and construction. Results: Autopsy workers are unpredictably exposed to a variety of infectious organisms including hepatitis C virus, HIV and M. tuberculosis. Hazardous autopsy procedures include using and encountering sharp objects, and the generation of aerosols from dissection, fluid aspiration, rinsing tissues, and dividing bone with an oscillating saw. Conclusions: Exposure to bloodborne and airborne pathogens from procedures that can cause cutaneous inoculation and inhalation of aerosols indicates that human autopsies should be performed at Biosafety Level 3. We designed a large entirely Biosafety Level 3 medical examiner autopsy laboratory using design principles and characteristics that can be scaled to accommodate smaller academic or other hospital-based autopsy spaces. Containment was achieved through a concentric ring design, with access control at interface zones. As new autopsy laboratories are planned, we strongly recommend that they be designed to function uniformly at Biosafety Level 3.

Biosecurity and Public Health Ethics Issues Raised by Biological Threats

2019 ◽  
pp. 773-785
Author(s):  
Nicholas Evans ◽  
Thomas Inglesby
Keyword(s):  
Public Health ◽  
Resource Allocation ◽  
Infectious Diseases ◽  
Ethical Issues ◽  
Emerging Infectious Diseases ◽  
Biological Weapon ◽  
Ethical Values ◽  
Dual Use ◽  
Health Concerns ◽  
Trade Offs

This chapter introduces ethical issues that arise in the context of biosecurity: policies and actions intended to prevent the development or emergence, or mitigate the consequences, of serious biological threats. These threats could include deliberate biological weapon attacks (bioterrorism), pandemics, emerging infectious diseases, or major laboratory accidents. The basic values that underpin these public health concerns are first introduced. Ethical issues that arise before, during, and following a biosecurity crisis are then examined, including issues of resource allocation, dual-use research, and the possibility of quarantine. Their resolution requires trade-offs among different ethical values, including utility, fairness, and liberty.

scholarly journals Ocular manifestations of emerging viral diseases

Eye ◽  
2021 ◽  
Author(s):  
Ashwin Venkatesh ◽  
Ravi Patel ◽  
Simran Goyal ◽  
Timothy Rajaratnam ◽  
Anant Sharma ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Influenza A ◽  
Emerging Infectious Diseases ◽  
Global Scale ◽  
Viral Diseases ◽  
Valley Fever ◽  
Ocular Manifestations ◽  
Influenza A H1n1 ◽  
Emerging Viral Diseases

AbstractEmerging infectious diseases (EIDs) are an increasing threat to public health on a global scale. In recent times, the most prominent outbreaks have constituted RNA viruses, spreading via droplets (COVID-19 and Influenza A H1N1), directly between humans (Ebola and Marburg), via arthropod vectors (Dengue, Zika, West Nile, Chikungunya, Crimean Congo) and zoonotically (Lassa fever, Nipah, Rift Valley fever, Hantaviruses). However, specific approved antiviral therapies and vaccine availability are scarce, and public health measures remain critical. Patients can present with a spectrum of ocular manifestations. Emerging infectious diseases should therefore be considered in the differential diagnosis of ocular inflammatory conditions in patients inhabiting or returning from endemic territories, and more general vigilance is advisable in the context of a global pandemic. Eye specialists are in a position to facilitate swift diagnosis, improve clinical outcomes, and contribute to wider public health efforts during outbreaks. This article reviews those emerging viral diseases associated with reports of ocular manifestations and summarizes details pertinent to practicing eye specialists.

scholarly journals Autophagy in Zika Virus Infection: A Possible Therapeutic Target to Counteract Viral Replication

2019 ◽  
Vol 20 (5) ◽  
pp. 1048 ◽  
Author(s):  
Rossella Gratton ◽  
Almerinda Agrelli ◽  
Paola Tricarico ◽  
Lucas Brandão ◽  
Sergio Crovella
Keyword(s):  
Public Health ◽  
Viral Replication ◽  
Zika Virus ◽  
Health Concern ◽  
Mtor Signaling Pathway ◽  
Catabolic Pathway ◽  
Public Health Concern ◽  
Zikv Infection ◽  
Fundamental Process

Zika virus (ZIKV) still constitutes a public health concern, however, no vaccines or therapies are currently approved for treatment. A fundamental process involved in ZIKV infection is autophagy, a cellular catabolic pathway delivering cytoplasmic cargo to the lysosome for degradation—considered as a primordial form of innate immunity against invading microorganisms. ZIKV is thought to inhibit the Akt-mTOR signaling pathway, which causes aberrant activation of autophagy promoting viral replication and propagation. It is therefore appealing to study the role of autophagic molecular effectors during viral infection to identify potential targets for anti-ZIKV therapeutic intervention.

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