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Volume 18, Number 7—July 2012
PDF Version [PDF - 6.15 MB - 191 pages]
Perspective
The regulations have substantially helped prevent and control the international spread of diseases, but their full potential has yet to be realized.
People and goods travel rapidly around the world, and so do infectious organisms. Sometimes a disease has already become widespread before it is detected and reported, which makes control efforts much more difficult. In response to this threat, the World Health Assembly enacted International Health Regulations that require participating countries to report public health events of international concern to the World Health Organization within 72 hours of detection. These health regulations went into effect in 2007 for all WHO Member States including the United States. By December 2011, 24 events reported by the United States were posted on a secure WHO web site, 12 of which were associated with influenza. Others reported were salmonellosis outbreaks, botulism, E. coli infections, Guillain-Barré syndrome, contaminated heparin, Lassa fever, an oil spill, and typhoid fever. International Health Regulations have improved global connectivity through rapid information exchange and increased awareness of threatening situations.
Focus on goals and metrics for 4 core capacities illustrates 1 approach to implementing IHR.
Synopses
The strengths and weaknesses of this response can inform planning for pandemics and other prolonged public health emergencies.
Research
Seroprevalence was highest in the eastern part of the country, bordering Germany, where the virus was first identified.
Methicillin-resistant Staphylococcus aureus (MRSA) in the bloodstream is often fatal. Vancomycin is the most frequently prescribed drug for treatment of MRSA infections with demonstrated efficacy. Recently, however, some MRSA infections have not been responding to vancomycin, even those caused by strains considered susceptible. To provide optimal treatment and avoid vancomycin resistance, therapy should be tailored, especially for patients at highest risk for death. But who are these patients? A study that looked back at medical records and 699 frozen isolates found that risk for death from MRSA infection was highest among certain populations, including the elderly, nursing home residents, patients with severe sepsis, and patients with liver or kidney disease. Risk for death was not affected by the type of MRSA strain (vancomycin susceptible, heteroresistant, or intermediate resistant). Risk was lower among those who had consulted an infectious disease specialist. Thus, when choosing treatment for patients with MRSA infection, it is crucial to look at patient risk factors, not just MRSA strain type. For those at high risk, consultation with an infectious disease specialist is recommended.
Isolates contained fiber genes similar to those of adenovirus strains that cause infectious diarrhea in humans.
Mutations can occur erratically and accompany tropism changes, resulting in unpredictable new diseases.
Transmission routes and reservoirs need to be elucidated.
Restoring protection requires innovation combining pyrethroids and novel insecticides.
Measures had substantial effects on contacts and household members.
Use of more prescriptive criteria and training of persons responsible for reporting could improve results.
Costs can be estimated by identifying functional pathways toward achieving all 8 core capacities and global indicators.
Dispatches
Dengue, a potentially fatal disease, is spreading around the world. An estimated 2.5 billion people in tropical and subtropical regions are at risk. Early detection of outbreaks is crucial to prevention and control of dengue virus and other viruses. Case reporting may often take weeks or months. Therefore, researchers explored whether electronic sources of real-time information (such as Internet news outlets, health expert mailing lists, social media sites, and queries to online search engines) might be faster, and they were. Although information from unofficial sources should be interpreted with caution, when used in conjunction with traditional case reporting, real-time electronic surveillance can help public health authorities allocate resources in time to avert full-blown epidemics.
Plague, a rare but severe disease spread by rodents and fleas, has been traditionally associated with poor, unsanitary living conditions. To test this association, researchers in New Mexico used census data to determine the geographic and socioeconomic status of plague patients. Although they confirmed that most cases occurred in areas where the habitat supports rodents and fleas, they also found a surprising shift to more middle- to upper-class neighborhoods. In the 1980s, most cases occurred where housing conditions were poor. By the 2000s, cases were occurring in the affluent Santa Fe and Albuquerque regions. Although the cause of this shift is unknown, possibilities include relocation of affluent families to plague-prone areas or improved socioeconomic conditions among those already living in plague-prone areas.
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ICEID 2012 Abstracts |
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Public Health Events and International Health RegulationsListen now or download MP3 Length: 14:45 |
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