Residency Training at the Front of the West African Ebola Outbreak: Adapting for a Rare Opportunity
We describe the successful four-week deployment to Liberia of a first year infectious diseases trainee via the Global Outbreak Alert and Response Network (GOARN) of the World Health Organisation (WHO), which received prospective approval from the residency supervisory committees and employing hospital management.
International electives, despite being widely recognized for their theoretical benefits in residency training, are often entwined with problems in practice2. Training bodies must reconcile accreditation requirements with unique educational opportunities and ensure that the quality of training is not limited by...
Source: PLOS Currents Outbreaks - February 2, 2016 Category: Epidemiology Authors: Yin Mo Source Type: research
Epidemiology of Chikungunya Virus in Bahia, Brazil, 2014-2015
Article
The Chikungunya virus (CHIKV) is an alphavirus that belongs to the Semliki Forest Virus antigenic complex1. Local outbreaks of CHIKV-like disease have been documented since the eighteenth century2 and the virus was discovered in 1952 in Tanzania3 . Over the last 50 years, CHIKV has spread beyond its African heartlands and caused explosive outbreaks comprising millions of cases in Indian Ocean islands and Asia.4The virus is mosquito-borne and transmission is associated with the vector species Aedes albopictus and Ae. aegypti, which are responsible for transmission cycles in urban and peri-urban environments5. Clinic...
Source: PLOS Currents Outbreaks - February 1, 2016 Category: Epidemiology Authors: Nuno Faria Source Type: research
Historical Parallels, Ebola Virus Disease and Cholera: Understanding Community Distrust and Social Violence with Epidemics
In conclusion the recent adverse reactions to EVD in Western Africa have not been new to history or unique to Africa. Instead, the distrust and violence seen in Guinea, Liberia, and Sierra Leone in 2014/15 parallel Europe’s long encounters with cholera from 1830 into the twentieth century. This European past combined with recent events in West Africa can provide lessons for policy makers. First, authorities and health workers must recognize that some diseases have greater potential to spark distrust and violence than others, and the former tend to be ones with high fatality rates, when victims enter health facilities but...
Source: PLOS Currents Outbreaks - January 26, 2016 Category: Epidemiology Authors: ruth1 Source Type: research
Validating the Use of Google Trends to Enhance Pertussis Surveillance in California
We examined the possible role of a delay to pertussis diagnosis (from symptom onset) limiting the model performance, but an extended models using lagged observed pertussis time series did not show improvement of model fit. This may indicate that the model is detecting real-time Google activity performed around the time patients receive a pertussis diagnosis (rather than detecting Google activity about pertussis symptoms before seeking healthcare).
Since the launch of Google Flu Trends in 2009, there have been numerous other applications of Google Trends to a broad number of communicable diseases as diverse as Ebola and...
Source: PLOS Currents Outbreaks - October 19, 2015 Category: Epidemiology Authors: spollett Source Type: research
Improved Discrimination of Influenza Forecast Accuracy Using Consecutive Predictions
Discussion
Our findings indicate that use of forecast streak, in addition to forecast lead and ensemble variance, further discriminates the accuracy of our influenza predictions. This discrimination can be applied in real-time so that operational forecasts of influenza incidence are more precisely segregated. By better distinguishing good and bad forecasts, our predictions are not only well calibrated (i.e. reliable), but they are also ‘sharp’–that is, outcomes are associated with more precise certainties.
This idea of sharpness is important. It is the ability to distinguish high and low probability events. A...
Source: PLOS Currents Outbreaks - October 5, 2015 Category: Epidemiology Authors: jls106 Source Type: research
Whole Genome Sequence Analysis of Salmonella Enteritidis PT4 Outbreaks from a National Reference Laboratory’s Viewpoint
Discussion
S. Enteritidis remains linked to egg-related outbreaks, albeit in the described outbreaks to non-commercial eggs from privately owned laying hens. In response to two geographically separated outbreaks occurring in the same time period in Belgium, the NRL-FBO received food samples from which Salmonella was isolated and the NRCSS received Salmonella isolates from human cases of these outbreaks. With the traditional epidemiological and microbiological investigations, i.e. phage typing and MLVA, the isolates of both outbreaks were classified as PT4 and variant PT4a, and as profile 3-10-5-4-1. Phage type PT4 and MLVA...
Source: PLOS Currents Outbreaks - September 11, 2015 Category: Epidemiology Authors: vwuyts Source Type: research
The Tortoise and the Hare: Guinea Worm, Polio and the Race to Eradication
Introduction
Smallpox is no longer with us. Rinderpest, a measles-like virus of cattle, was formally declared extinct in 2011.1 What other diseases might follow? This paper looks at some clear candidates that were due for eradication this year and explores the chances of success and remaining obstacles for guinea worm and polio. The race is on.
The classic fable of Æsop is known almost universally by both children and adults. Somehow the tale of an overconfident hare losing a race to a much maligned and slower tortoise has entered our consciousness, although the exact moral lesson is ambiguous. Should we accept the co...
Source: PLOS Currents Outbreaks - August 31, 2015 Category: Epidemiology Authors: brettsutton Source Type: research
Novel Human-like Influenza A Viruses Circulate in Swine in Mexico and Chile
Discussion
Through new surveillance efforts and phylogenetic analysis of IAV-S in Mexico and Chile, we have expanded our understanding of the extensive IAV-S diversity that circulates in swine in Latin America. Most notably, we have identified multiple novel clades of H3N2 and H1N1 viruses of human origin in Mexico and Chile that have not been identified in swine previously, highlighting the importance of the human-swine interface in the evolution of IAV-S diversity in Latin America. The presence of two different IAV-S lineages in Mexico that are related to North American IAV-S (classical H1N1 and H3-cluster IV) also demon...
Source: PLOS Currents Outbreaks - August 13, 2015 Category: Epidemiology Authors: minelson22 Source Type: research
Rapid Assessment of Ebola-Related Implications for Reproductive, Maternal, Newborn and Child Health Service Delivery and Utilization in Guinea
Conclusions
This assessment of RMNCH service delivery and utilization was based on data abstraction and brief structured interviews at a selection of health care facilities in 12 prefectures and three city districts in Guinea from January to February 2015. Quality control measures implemented during data collection helped to ensure that the information collected was as complete and accurate as was feasible.
Though not necessarily representative of the country as a whole, the assessment in Guinea revealed a number of important findings. First, there was an overall decline in service utilization, as seen in the median nu...
Source: PLOS Currents Outbreaks - August 4, 2015 Category: Epidemiology Authors: Janine Source Type: research
Surveillance of Acute Respiratory Infections Using Community-Submitted Symptoms and Specimens for Molecular Diagnostic Testing
This study represents an advance with respect to the field of participatory public health surveillance systems. To-date, reports in the literature of online participatory studies have been limited to self-reported syndromic information only. Some studies have combined self-reported influenza symptoms with serology to understand attack rates in the population. However, linkage to symptoms has been limited in self-sampling studies, and although other studies have demonstrated that individuals can obtain a nasal swab specimen from themselves, we report here that individuals prefer saliva and initial results indicate that it c...
Source: PLOS Currents Outbreaks - May 27, 2015 Category: Epidemiology Authors: chunara Source Type: research
The Role of Social Mobilization in Controlling Ebola Virus in Lofa County, Liberia
We present a network-based model of EVD transmission, in which we combine isolation of cases in ETUs with a change in the public’s cooperation with preventative measures to control EVD spread. This model builds upon previous models that merge disease transmission and social processes 16,17,18,19, including several models that address social processes affecting emerging infectious disease transmission 20,21,22. While many EVD models have addressed behavior change and other time-varying properties of the disease dynamics 12,13,14,15,23,24, this model is among the first to explicitly account for the change in attitudes ...
Source: PLOS Currents Outbreaks - May 15, 2015 Category: Epidemiology Authors: sfast Source Type: research
Assessing Measles Transmission in the United States Following a Large Outbreak in California
Discussion
Except for the substantial initial transmission event that occurred within the Disney theme parks, the transmission of measles seen in the recent outbreak is relatively consistent with data from the past decade. In particular, amplification from 40 cases to 91 additional cases is consistent with subcritical transmission, with each case failing, on average, to replace itself, but playing out over several generations of transmission. Our primary estimate of the reproduction number, 0.69, is higher than the number obtained from US national data for 2001-2011 (0.52), but the difference is not statistically significa...
Source: PLOS Currents Outbreaks - May 7, 2015 Category: Epidemiology Authors: Seth Blumberg Source Type: research
Epidemiological and Surveillance Response to Ebola Virus Disease Outbreak in Lofa County, Liberia (March-September, 2014); Lessons Learned
CONCLUSION
The experience from Lofa County, Liberia highlights that socio-cultural factors, lack of community participation and weakness of the health systems are risk factors for propagating epidemics. A number of lessons learnt are highlighted that could be helpful in guiding interventions should such or similar epidemics occur. The involvement of local authorities, community leaders and civil societies, and other partners working in synergy made a remarkable and positive impact in the response to the EVD outbreak. This outbreak demonstrates that in this interconnected and globalized world, the spread of infectious disea...
Source: PLOS Currents Outbreaks - May 6, 2015 Category: Epidemiology Authors: kouadiok at who.int Source Type: research
2014 Ebola Outbreak: Media Events Track Changes in Observed Reproductive Number
Commentary
The ongoing Ebola epidemic in West Africa is significantly larger and more widespread than any other in history. While previous outbreaks in small villages have burned out due to the local depletion of susceptible individuals, this epidemic has spread across entire countries, and thus can only be curtailed by interventions aimed at reducing new infections across all locations.1 The efficacy of large-scale interventions for an Ebola epidemic of this scale has not yet been studied. Here, we describe the relationship between various media reported events – including interventions – and changes in epidemic behav...
Source: PLOS Currents Outbreaks - April 28, 2015 Category: Epidemiology Authors: Maimuna S. Majumder Source Type: research
Understanding the Emergence of Ebola Virus Disease in Sierra Leone: Stalking the Virus in the Threatening Wake of Emergence
Discussion
These events make up the beginning of the EVD outbreak in Sierra Leone, the third major step of the virus, after Guinea and Liberia, towards developing the largest EVD epidemic in history. The identification on May 25thof the first confirmed case of EVD in Sierra Leone prompted local health authorities to immediately conduct extensive investigations, searching for suspected cases and to inform and engage the international community such as the WHO or Medecins Sans Frontières (MSF) in all response activities. Despite previous in-country experience with Lassa fever, a rapid response by well-informed field teams, ...
Source: PLOS Currents Outbreaks - April 20, 2015 Category: Epidemiology Authors: nwauquier at metabiota.com Source Type: research
