Total plate count of commercial pasteurized milk sold by street vendors in Mulyorejo sub-district Surabaya

Food and nutritional quality of society is one of mine focuses of the government. Milk have complete nutrients but also can be the source food borne disease. The Veterinary Public Health itself has the responsibility to provide guarantees of food safety from animal resources which is called ASUH (safe, healthy, wholesome and halal) to be consumed by society. This study aimed to know the Total Plate Count of commercial pasteurized milk sold by street vendors in Mulyorejo Sub-district Surabaya. The study was conducted from January until February 2018 at the Laboratory of Veterinary Public Health Department, Faculty of Veterinary Medicine, Universitas Airlangga. Thirty samples of commercial pasteurized milk were bought from three street vendors then examined using Pour Plate Method of Total Plate Count. Total Plate Count result showed that the number of bacteria in commercial pasteurized milk sold by street vendors in Mulyorejo Sub-district Surabaya was 1.0 x 104 CFU/ml, that met the National Standard of Indonesia (SNI) 01-3951-1995.

ROLE OF MEDIA COVERAGE IN MITIGATING AN EPIDEMIC OUTBREAK: AN OPTIMAL CONTROL MODEL

Flu is an acute respiratory infection caused by the influenza virus. The outbreak usually occurs every year in temperate region during the fall and winter seasons, but it is present year-round in tropics. Perceived risk of infection, affordability and lack of awareness among the population results in a low level of vaccination coverage. To control disease transmission and promote vaccination, public health officials use media coverage to spread awareness on vaccine safety, vaccine coverage, disease prevalence in the population through public health websites, advertisements, and other social media web pages. Media coverage acts as an incentive as it helps to decrease overall transmission potential and also at the same time increases the vaccination coverage in the population. Since the public health department has a limited budget, it needs to make optimum allocation of its effort to reduce the total cost of infection. Our paper investigates the effect of media coverage using SIR model of disease transmission. We look at three possible functional relationships — linear, exponential, and hyperbolic — the way media coverage may affect the disease transmission and vaccination rate. We derive necessary conditions of optimal solution using Optimal Control Theory and Pontryagin Maximum Principle (PMP) to minimize the total cost for infection. Analysis of our paper demonstrates that the cost of optimal management is four times less than the cost of constant control effort, and putting more effort into reducing transmission is optimal rather than an effort to increase vaccination at the beginning of the outbreak. Analysis of the role of media coverage under three different scenarios may help in formulating policies for public health programs in mitigating the influenza outbreak.

Randomized clinical trial: does using zinc and zinc ionophore EGCG as supplements improve outcome of active pulmonary tuberculosis

Tuberculosis is a big health challenge especially during the Covid-19 pandemic because of the similarity of symptoms between the two diseases, active pulmonary T.B is associated with malnutrition. Tuberculosis is still a global disease burden worldwide especially at low-income countries affecting families and health authorities because of the cost of medicine and health costs. There are growing numbers of multidrug resistants’ T.B patients. Epigallocatechin-3-gallate (EGCG) as antioxidant and inhibition of mycobacterium life in macrophages increase the potency of rifampicin oral anti-tuberculous drug. EGCG is an iron chelator which can be useful in T.B patients (1). Zinc is the most abundant trace element in the human body, Dabbagh-Bazarbachi et al. (2014) have demonstrated that EGCG can act as an ionophore that helps transport zinc to across cell membrane and exert cytotoxicity effect. EGCG can enhance the cytotoxicity of zinc ions to cancer. It is possible that the zinc(ii)-EGCG complex reduces the pH inside organelles, and might bind effectively to DNA in the nucleus. At our study use of EGCG and zinc as adjuvant therapy to national protocol may help at malnutrition and accelerate of sputum conversion to negative and faster improvement and less risk for infection transmission and lower the inflammatory cytokines like il-6 and increase weight of patients. Methodology: The objective of our study is to evaluate oral zinc administration as zinc sulfate 50 mg and zinc ionophore EGCG 200 mg in new smear positive active pulmonary tuberculosis patients above 18 year old for one month in an open labeled randomized controlled clinical trial (RCT) in line with directly observed treatment short course (DOTS) strategy recommended by WHO. We will do sputum tests at 0 and 2 weeks and 1 month for evaluation of conversion of positive to negative samples and also measure the serum zinc levels before the start of treatment, and serum interleukin 6 as cytokine marker. We are conducting this study at cat I patients as WHO classification of tuberculosis having active lung tuberculosis to see efficacy and change in immunological parameters. Place of study: Saudia Arabia – Ministry of health, public health department, First health cluster, Riyadh, Tuberculosis clinics of Mobile team tuberculosis program.Informed Consent will be taken from patients before the start the study.The clinical trial registration number for this trial is NCT05116098.

Assessment of Educational Status of Periodontics and Oral Health and Community Dentistry Departments in Yazd Dental School Using CIPP Model in 2018

Introduction: Considering the changes, which implemented in the dental education program in recent years and also the importance of reviewing their feedback in educational affairs, the purpose of this study was to evaluate the periodontics and dental public health departments of Dental School based on the CIPP evaluation model in 2018. Methods: The present study was performed in a descriptive cross-sectional format on the target population of dental students of 10-12 semesters and professors of the mentioned groups. Context, input, process and product were assessed using a questionnaire consistent with the CIPP pattern checklist. Data were analyzed by ANOVA and T-test via SPSS 16 software. Results: The average scores of professors and students in different areas of the Periodontology Department were as followed: the context (75, 58.6); input (18.9, 1.37); process (68.7, 8.37) and product (56.2, 1.37) fields, respectively. In the Dental Public Health Department, the average scores also included context (50, 3.64); input (25, 5.63); process (100, 58) and product (75, 3.58) areas, respectively. Conclusion: In the Department of Periodontics, the input as well as process and output were undesirable for the students and the input was undesirable for the professors. In the Dental Public Health Department, just input was unfavorable for professors and relatively desirable for students in all four areas.

COVID-19 Breakthrough Infections and Transmission Risk: Real-World Data Analyses from Germany’s Largest Public Health Department (Cologne)

Background and Methods: Vaccination is currently considered the most successful strategy for combating the SARS-CoV-2 virus. According to short-term clinical trials, protection against infection is estimated to reach up to 95% after complete vaccination (≥14 days after receipt of all recommended COVID-19 vaccine doses). Nevertheless, infections despite vaccination, so-called breakthrough infections, are documented. Even though they are more likely to have a milder or even asymptomatic course, the assessment of further transmission is highly relevant for successful containment. Therefore, we calculated the real-world transmission risk from fully vaccinated patients (vaccination group, VG) to their close contacts (CP) compared with the risk from unvaccinated reference persons matched according to age, sex, and virus type (control group = CG) utilizing data from Cologne’s health department. Results: A total of 357 breakthrough infections occurred among Cologne residents between 27 December 2020 (the date of the first vaccination in Cologne) and 6 August 2021. Of the 979 CPs in VG, 99 (10.1%) became infected. In CG, 303 of 802 CPs (37.8%) became infected. Factors promoting transmission included non-vaccinated status (β = 0.237; p < 0.001), male sex (β = 0.079; p = 0.049), the presence of symptoms (β = −0.125; p = 0.005), and lower cycle threshold value (β = −0.125; p = 0.032). This model explained 14.0% of the variance (corr. R2). Conclusion: The number of transmissions from unvaccinated controls was three times higher than from fully vaccinated patients. These real-world data underscore the importance of vaccination in enabling the relaxation of stringent and restrictive general pandemic control measures.

US Local Public Health Department Spending Between 2008 and 2016 Did Not Increase for Communities in Need

BackgroundGreater US local public health department (LPHD) spending has been associated with decreases in population-wide mortality. We examined the association between changes in LPHD spending between 2008 and 2016 and county-level sociodemographic indicators of public health need.MethodsMultivariable linear regression was used to estimate the association between changes in county-level per-capita LPHD spending and 2008 sociodemographic indicators of interest: percent of population that was over 65 years old, Black, Hispanic, in poverty, unemployed, and uninsured. A second model assessed the relationship between changes in LPHD spending and sociodemographic shifts between 2008 and 2016.ResultsLPHD spending increases were associated with higher percentage points of 2008 adults over 65 years of age (+$0.53 per higher percentage point; 95% CI: +$0.01 to +$1.06) and unemployment (+$1.31; 95% CI: -$2.34 to -$0.27). Spending did not increase for communities with a higher proportion of people who identified as Black or Hispanic, or those with a greater proportion of people in poverty or uninsured, using either baseline or sociodemographic shifts between 2008 and 2016.ConclusionFuture LPHD funding decisions should consider increasing investments in counties serving disadvantaged communities to counteract the social, political, and structural barriers which have historically prevented these communities from achieving better health.

1201. Diphtheria in Veterans Health Administration (VHA), 2000-2021

Background Diphtheria is caused by Corynebacterium diphtheriae and can cause respiratory or skin infections. Transmission occurs primarily person-to-person via respiratory tract and rarely from skin lesions or fomites. In the Veterans Health Administration (VHA), we perform surveillance for nationally notifiable diseases such as diphtheria. In early 2021, there were 4 alerts for C. diphtheriae. Therefore, we investigated diphtheria prevalence in VHA over the last 20 years. Methods Isolates of C. diphtheriae were identified from VHA data sources from 1/1/2000-2/28/2021. Patient demographics, co-morbidities, microbiologic data, treatment, outcomes, and vaccination status were obtained via electronic medical record (EMR) review. Results 33 C. diphtheriae isolates were identified representing 32 unique individuals. 17 isolates were identified from 2000-2015 and 16 were identified from 2016-2021. Isolates were from cutaneous (16), blood (10), urine (4), pulmonary (2), and throat (1) specimens. In 11 individuals, clinical significance was unclear (no antibiotics given, note mentioned that it was being considered a contaminant - i.e., isolate may have been incorrectly labeled as “C. diphtheriae” instead of “diphtheroid”). Only 3 isolates had toxin testing documented. One C. diphtheriae biovar gravis blood isolate was associated with sepsis without another source identified. The throat isolate was a nontoxigenic strain. No cutaneous isolates underwent susceptibility testing, but all 15 individuals received antibiotics (1 patient had 2 isolates). 11 had additional organisms identified in addition to C. diphtheriae. Table 1 describes demographics, co-morbidities, and vaccination status of cutaneous cases. Only 1 case (in 2021) had EMR documentation of local public health department reporting. Table 1. Characteristics of Unique Individuals with Cutaneous Diphtheria Isolates in VHA, 2000-2021 Conclusion Nearly as many isolates have been identified in the last 5.5 years compared to the previous 15 years which may be related to more robust molecular identification methods available in VHA. Most C. diphtheriae isolated was from cutaneous sources that were acute in onset. About 33% were identified as C. diphtheriae but were not treated. EMR documentation of toxin production and public health department reporting was lacking. Disclosures All Authors: No reported disclosures

1207. Coronavirus Disease, 2019 (COVID-19) in Long-Term Care Facilities (LTCF): One Large County’s Response, California 2020-2021

Background The coronavirus-19 disease (COVID-19) outbreak has had a particularly devasting effect on skilled nursing facility (SNF) residents and healthcare workers (HCWs). While representing only 11% of COVID-19 cases, the residents accounted for 43% of deaths in the United States. Methods We report a retrospective review of the support provided by our local health department (LHD) to long-term care facilities in response to the COVID-19 pandemic. This group comprised of staff from healthcare-associated infections (HAI); the Medical Operations Center (MOC); Testing, Tracing, and Treatment (T3); and the Healthcare Provider Status Taskforce (Table 1 outlines their functions). The HAI team with the State Public Health Department provided infection prevention and control (IPC) outbreak investigation, education, recommendations, and ongoing access to technical assistance. The T3 team focused on rapid response testing and tracing; the HPSTF team collected data and issued questionnaires; the MOC responded to staffing and PPE requests; and the Long-Term Care Facility sector presented routine telebriefings to update the facilities on public health guidance, share resources, and answer questions during and in between briefings. Table 1. Sectors and Function of Response Teams to COVID-19 Results From March 2020 through May 2021, there were 504 outbreaks in LTCFs; the HAI team performed 281 outbreak investigations (Figure 1). In the same period, 308,264 molecular tests were performed using various platforms; laboratory services were outsourced during peak testing requests (Figure 2); “strike teams were deployed to facilitate testing on 404 occasions. Self-reported fully vaccination rate for SNF staff was 73% (March 2021) and 76% for residents (April 2021). There were 568 staff requested; total orders for PPE were 4,839 and 16,892,823 PPE items were fulfilled (Figure 3). In addition to knowledge gaps in IPC, other challenges included shifting IPC guidance, PPE shortages, timeliness of test results that impacted cohorting, community acquisition of disease with transmission to residents, interfacility spread among staff, staffing shortages, and vaccine hesitancy issues. Figure 1. Number of Outbreaks and Number of Outbreak Investigations Figure 2. Number of Tests Performed by the Public Health Laboratory and the Number of Visits by “Strike Teams” Figure 3. Personal Protective Equipment Fulfillment during COVID-19 Pandemic Conclusion The management of the recent COVID-19 outbreaks required a multi-pronged approach. Lessons learned are applicable to other highly transmissible infectious diseases. Disclosures All Authors: No reported disclosures