The human health burden of non-typhoidal Salmonella enterica and Vibrio parahaemolyticus foodborne gastroenteritis in Shanghai, east China

Information on the burden of disease due to foodborne pathogens in China is quite limited. To understand the incidence of foodborne gastroenteritis due to non-typhoidal Salmonella enterica and Vibrio parahaemolyticus, population survey and sentinel hospital surveillance were conducted during July 2010 to June 2011 in Shanghai, east China, and a model for calculating disease burden was established. The multiplier for gastroenteritis caused by these pathogens was estimated at 59 [95% confidence interval (CI) 30–102]. Annual incidence per 100,000 population in Shanghai was estimated as 48 (95% CI 24–83) and 183 (95% CI 93–317) cases for foodborne non-typhoidal salmonellosis and V. parahaemolyticus gastroenteritis, respectively, illustrating that bacterial gastroenteritis due to these two pathogens poses a substantial health burden. There is a significant difference between our simulated incidence and the data actually reported for foodborne diseases, indicating significant underreporting and underdiagnosis of non-typhoidal S. enterica and V. parahaemolyticus gastroenteritis in the surveillance area. The present research demonstrates basic situation of the health burden caused by major foodborne pathogens in the surveillance area. Enhanced laboratory-based sentinel hospital surveillance is one of the effective ways to monitor food safety in east China.

Characteristics Associated With Invasive Staphylococcus aureus Infection Rates in Nursing Homes, Emerging Infections Program

Background: Most invasive methicillin-resistant Staphylococcus aureus (iMRSA) infections have onset in the community but are associated with healthcare exposures. More than 25% of cases with healthcare exposure occur in nursing homes (NHs) where facility-specific iMRSA rates vary widely. We assessed associations between nursing home characteristics and iMRSA incidence rates to help target prevention efforts in NHs. Methods: We used active, laboratory- and population-based surveillance data collected through the Emerging Infections Program during 2011–2015 from 25 counties in 7 states. NH-onset cases were defined as isolation of MRSA from a normally sterile site in a surveillance area resident who was in a NH within 3 days before the index culture. We calculated MRSA incidence (cases per NH resident day) using Centers for Medicare & Medicaid Services (CMS) skilled nursing facility cost reports and described variation in iMRSA incidence by NH. We used Poisson regression with backward selection, assessing variables for collinearity, to estimate adjusted rate ratios (aRRs) for NH characteristics (obtained from the CMS minimum dataset) associated with iMRSA rates. Results: Of 590 surveillance area NHs included in analysis, 89 (15%) had no NH-onset iMRSA infections. Rates ranged from 0 to 23.4 infections per 100,000 resident days. Increased rate of NH-onset iMRSA infection occurred with increased percentage of residents in short stay ≤30 days (aRR, 1.09), exhibiting wounds or infection (surgical wound [aRR, 1.08]; vascular ulcer/foot infection [aRR, 1.09]; multidrug-resistant organism infection [aRR, 1.13]; receipt of antibiotics [aRR, 1.06]), using medical devices or invasive support (ostomy [aRR, 1.07]; dialysis [aRR, 1.07]; ventilator support [aRR, 1.17]), carrying neurologic diagnoses (cerebral palsy [aRR, 1.14]; brain injury [aRR, 1.1]), and demonstrating debility (requiring considerable assistance with bed mobility [aRR, 1.05]) (Table). iMRSA rates decreased with increased percentage of residents receiving influenza vaccination (aRR, 0.96) and with the presence of any patients in isolation for any active infection (aRR, 0.83). Conclusions: iMRSA incidence varies greatly across nursing homes, with many NH patient and facility characteristics associated with NH-onset iMRSA rate differences. Some associations (short stay, wounds and infection, medical device use and invasive support) suggest that targeted interventions utilizing known strategies to decrease transmission may help to reduce infection rates, while others (neurologic diagnoses, influenza vaccination, presence of patients in isolation) require further exploration to determine their role. These findings can help identify NHs in other areas more likely to have higher rates of NH-onset iMRSA who could benefit from interventions to reduce infection rates.Funding: NoneDisclosures: None

Strategies of Health Surveillance in the construction of a support network for breastfeeding women

In 2018 the Municipal Health Department of the city of Diadema, São Paulo, Brazil, started the implementation of strategies to promote, protect and support breastfeeding in health surveillance actions. Supervised compliance with the Brazilian Standards of Commercialization of Foods for Infants and Children of 1st Childhood, nipples, pacifiers and bottles and encouraged the installation of breast-feeding support rooms in public and private workplaces in the city, aiming to intervene in the infant mortality rates. According to the Global Strategy of the World Health Organization (WHO/UNICEF), for the Feeding of Infants and Children in the First Childhood, only 35% of children worldwide are breastfed exclusively during the first four months of life. What are the contributions of the surveillance area in encouraging the installation of breast-feeding facilities in the workplace? What are the responsibilities of the Health Surveillance to promote breastfeeding? The strategies implemented aimed to create a culture of respect and support for breastfeeding as a way to promote the health of the working woman and her baby, bringing direct benefits to society.The importance of women in promoting breastfeeding is evident, but it is essential to implement public policies. The surveillance began to integrate the municipal network of incentive to breastfeeding in search of the integrality of the attention aiming to contribute to increase the rates of breastfeeding in the city. Measures of a supervisory nature were implemented to comply with the rules that protect the practice of breastfeeding, in order to avoid early weaning and to reduce infant mortality. Intra and intersectoral strategies, permanent education and awareness-raising among professionals and the population were used. Isolated and fragmented initiatives do not contribute to structuring a breastfeeding support network in the workplace and many companies have not expressed an interest in promoting breastfeeding space. Key messages Dissemination of the pro-breastfeeding culture in which the workplace is a mainstay for a network of support for working women. Surveillance Area acted in the Network of Women’s and Children’s Health Care contributing to the reduction of maternal and infant mortality and healthy infant development.

Globally Controlled Robot using IoT

Nowadays, robots in military have become an alternative to human soldiers. Theses robots are in a position to handle different types of operations. They should be able work in different situations and areas. This paper presents the development of a robot with sensors, surveillance camera and a microcontroller. The main purpose of the robot is to prevent the terrorist attack throughout the world by monitoring and controlling of mobile robot via internet. An Arduino microcontroller board has been use of for this. The control and monitoring of robot is through an application, connected to web page. The Camera connected to the robot acts as the eye and the PIR sensor will detect the person or object that enters into the surveillance area. Whenever a suspicious person or object is found, an alarm would be generated and sent to defined authorities. These robot can be controlled from anywhere in the world by using IOT.

Burden of Candidemia in the United States, 2017

Background Candidemia is a common healthcare-associated bloodstream infection with high morbidity and mortality. There are no current estimates of candidemia burden in the United States (US). Methods In 2017, the Centers for Disease Control and Prevention conducted active population-based surveillance for candidemia through the Emerging Infections Program in 45 counties in 9 states encompassing approximately 17 million persons (5% of the national population). Laboratories serving the catchment area population reported all blood cultures with Candida, and a standard case definition was applied to identify cases that occurred in surveillance area residents. Burden of cases and mortality were estimated by extrapolating surveillance area cases to national numbers using 2017 national census data. Results We identified 1226 candidemia cases across 9 surveillance sites in 2017. Based on this, we estimated that 22 660 (95% confidence interval [CI], 20 210–25 110) cases of candidemia occurred in the US in 2017. Overall estimated incidence was 7.0 cases per 100 000 persons, with highest rates in adults aged ≥ 65 years (20.1/100 000), males (7.9/100 000), and those of black race (12.3/100 000). An estimated 3380 (95% CI, 1318–5442) deaths occurred within 7 days of a positive Candida blood culture, and 5628 (95% CI, 2465–8791) deaths occurred during the hospitalization with candidemia. Conclusions Our analysis highlights the substantial burden of candidemia in the US. Because candidemia is only one form of invasive candidiasis, the true burden of invasive infections due to Candida is higher. Ongoing surveillance can support future burden estimates and help assess the impact of prevention interventions.