VIRO-TypeNed, systematic molecular surveillance of enteroviruses in the Netherlands between 2010 and 2014
VIRO-TypeNed is a collaborative molecular surveillance platform facilitated through a web-based database. Genetic data in combination with epidemiological, clinical and patient data are shared between clinical and public health laboratories, as part of the surveillance underpinning poliovirus eradication. We analysed the combination of data submitted from 2010 to 2014 to understand circulation patterns of non-polio enteroviruses (NPEV) of public health relevance. Two epidemiological patterns were observed based on VIRO-TypeNed data and classical surveillance data dating back to 1996: (i) endemic cyclic, characterised by predictable upsurges/outbreaks every two to four years, and (ii) epidemic, where rare virus types caused upsurges/outbreaks. Genetic analysis suggests continuous temporal displacement of virus lineages due to the accumulation of (silent) genetic changes. Non-synonymous changes in the antigenic B/C loop suggest antigenic diversification, which may affect population susceptibility. Infections were frequently detected at?an age under three months and at an older, parenting age (25-49 years) pointing to a distinct role of immunity in the circulation patterns. Upsurges were detected in the summer and winter which can promote increased transmissibility underlying new (cyclic) upsurges and requires close monitoring. The combination of data provide a better understanding of NPEV circulation required to control and curtail upsurges and outbreaks.
Despite the increasing morbidity and mortality of the opioid epidemic, the rates of pain medication use among the urogynecology patient population is not known. Our objective was to describe the baseline prevalence of preoperative opioid and neuropathic pain medication use in patients presenting for urogynecologic surgery and to determine whether this rate changed before and after passage of anti-opioid state legislation.
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A painless progressive verrucous skin plaque in an endemic area should raise suspicion for blastomycosis resulting in prompt biopsy with fungal stains and culture. Skin is a common extrapulmonary site. Itraconazole is treatment of choice. AbstractA painless progressive verrucous skin plaque in an endemic area should raise suspicion for blastomycosis resulting in prompt biopsy with fungal stains and culture. Skin is a common extrapulmonary site. Itraconazole is treatment of choice.
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A government whistleblower has filed a complaint alleging that some federal workers did not have the necessary protective gear or training when they were deployed to help Americans evacuated from China during the coronavirus outbreak.Associated Press
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