Services for Mothers and Newborns During the Ebola Outbreak in Liberia: The Need for Improvement in Emergencies
Conclusion
From the DHIS2 data, it is clear that Bong and Margibi Counties in Liberia experienced a large drop in utilization of maternal health care services during what now appears to be the height of the Ebola outbreak. Sadly, these drops correlate temporally with the peaks in infections amongst health workers in Bong and Margibi county health facilities.11 While the decrease could be due to lack of reporting, it is likely a reflection of a real change in usage in the context of disruption of healthcare services. The decline in care-seeking is likely due to both supply and demand factors modified by the outbreak, includ...
Source: PLOS Currents Outbreaks - April 16, 2015 Category: Epidemiology Authors: piyengar Source Type: research
Control of a Reassortant Pandemic 2009 H1N1 Influenza Virus Outbreak in an Intensive Swine Breeding Farm: Effect of Vaccination and Enhanced Farm Management Practices
Conclusions
Although our study design was sub-optimal for evaluating the effectiveness of the intervention, we provided suggestive evidence that H1N1pdm-targeted vaccination in sows/gilts, enhanced biosecurity, lengthening of weaning cycles, and constrains in cross-fostering of piglets may prove useful in controlling a reassortant H1N1pdm outbreak in an intensive swine breeding farm without possibility of applying an all-in/all-out system. Maternally-derived immunity was elicited and further virus circulation in piglets dropped to undetectable levels, while keeping farm productivity at full. The present field study also su...
Source: PLOS Currents Outbreaks - April 13, 2015 Category: Epidemiology Authors: Lapo Mughini-Gras Source Type: research
Public Knowledge, Perception and Source of Information on Ebola Virus Disease – Lagos, Nigeria; September, 2014
Conclusions
The survey surpassed mere academic exercise by providing evidenced-based information that guided the implementation of social mobilization activities and dissemination of appropriate public health information as part of the EVD response in Nigeria. We recommend development of health messages focusing on the mode of spread and preventive measures, demonstration of hand-washing techniques and social mobilization campaigns to prevent stigmatization of EVD cases and contacts. Radio and television should be used to disseminate relevant accurate health information to the public. A repeat survey should be done to moni...
Source: PLOS Currents Outbreaks - April 8, 2015 Category: Epidemiology Authors: Saheed Gidado Source Type: research
Modeling the 2014 Ebola Virus Epidemic – Agent-Based Simulations, Temporal Analysis and Future Predictions for Liberia and Sierra Leone
DISCUSSION
To approximate the dynamics of the current EVD epidemic in Liberia and Sierra Leone from an early date (May 27) to December 21, 2014, we propose the use of an agent-based model. The dynamics of the model evolve on a small-world network,16 the size of which matches the demographics of each country, while its density is adjustable to account for the impact of interventions. By exploiting the Equation-Free framework for multi-scale analysis,15 we estimated the evolution of the structure and the density of the EBOV transmission network that best fitted the data reported by WHO for the cumulative number of infected c...
Source: PLOS Currents Outbreaks - March 9, 2015 Category: Epidemiology Authors: Constantinos Source Type: research
Hesitancy, Trust and Individualism in Vaccination Decision-Making
The article is part of the PLOS Currents Outbreaks “Vaccine Hesitancy Collection“.
Editorial
Based on recent trends, outbreaks of measles and other vaccine-preventable diseases could be more commonplace in the coming years, even in countries where such diseases have been considered eliminated or under control. In 2014, the United States reported over 600 cases of measles, far and away the highest number over the past decade.1 In the European Union, where measles is still endemic, this figure is an order of magnitude higher, with 3840 reported cases in the rolling twelve month period between December 2013 and ...
Source: PLOS Currents Outbreaks - February 25, 2015 Category: Epidemiology Authors: jonathansuk Source Type: research
Vaccine Narratives and Public Health: Investigating Criticisms of H1N1 Pandemic Vaccination
Conclusions
In order to understand the ways in which individuals make decisions regarding vaccine use, it is important to access the public discourse surrounding vaccination. Such narratives incorporate ideas about vaccinations which, while contrary to medical and scientific viewpoints, underpins the public understanding of vaccines. As such, it is important to see vaccine hesitancy as much a result of public discourse as it is a problem of individual decision-making.
The Council of Europe’s criticisms of the use of vaccines during the H1N1 Pandemic reflect many dominant discourses – lay understandings of vaccination a...
Source: PLOS Currents Outbreaks - February 25, 2015 Category: Epidemiology Authors: abeysinghe Source Type: research
Why Are Young Adults Affected? Estimating Measles Vaccination Coverage in 20-34 Year Old Germans in Order to Verify Progress Towards Measles Elimination
Discussion
We minimized sampling bias by providing detailed instructions to population registries. To avoid study participants from providing deviant answers the questionnaire was developed being non-judgmental and data-protection issues were stressed in the cover letter. Nevertheless, a questionnaire based survey is susceptible to refusal bias especially by philosophical objectors. The latter are generally un- or undervaccinated. A refusal to participate would lead to overestimated vaccination coverage. Philosophical objectors are however a minority in the German population (3-5%) and their effect on overall coverage in t...
Source: PLOS Currents Outbreaks - February 25, 2015 Category: Epidemiology Authors: schusterm Source Type: research
Factors Associated with Intention to Receive Influenza and Tetanus, Diphtheria, and Acellular Pertussis (Tdap) Vaccines during Pregnancy: A Focus on Vaccine Hesitancy and Perceptions of Disease Severity and Vaccine Safety
This study has some important limitations. Since data were collected by self-report and not verified with medical records or vaccine registry data, there is potential for recall bias. Any recall bias which may have been introduced is assumed to have been non-differential with respect to characteristics likely to be associated with intention to receive antenatal influenza and/or Tdap vaccines. Additionally, while we excluded women who indicated having received an influenza and/or Tdap vaccine before completing her baseline survey, some women enrolled from intervention arm practices could have been exposed to the vaccine pro...
Source: PLOS Currents Outbreaks - February 25, 2015 Category: Epidemiology Authors: achamberlain Source Type: research
Vaccine Hesitancy: Clarifying a Theoretical Framework for an Ambiguous Notion
Conclusion
In this paper, we have discussed some of the ambiguities and contradictions of the notion of vaccine hesitancy. We have argued that it is currently more a catchall category than a real concept. This lack of consistence is likely to hamper both research and interventions. Therefore, as a supplement to the previous work carried out by the SAGE working group, we propose grounding the notion of vaccine hesitancy in an explicit theoretical framework that takes some major structural features of contemporary societies into account. We consider VH to be a kind of decision-making process that depends on people’s level ...
Source: PLOS Currents Outbreaks - February 25, 2015 Category: Epidemiology Authors: patrick.peretti-watel at inserm.fr Source Type: research
Measuring Vaccine Confidence: Introducing a Global Vaccine Confidence Index
Conclusion
The first conclusion to draw from these findings is that medium-to-high confidence in vaccines and immunisation programmes is the norm, and vaccine hesitancy and refusals are relatively rare. Nonetheless, even small groups of hesitant or refusing individuals can severely undermine an immunisation programme in certain circumstances, such as when political actors in Nigeria and Pakistan mobilised local boycotts that have had both national and international repercussions. This begs the question, “How much confidence is enough?”
Second, the finding that higher confidence in immunisation programmes correlates wit...
Source: PLOS Currents Outbreaks - February 25, 2015 Category: Epidemiology Authors: heidi.larson at lshtm.ac.uk Source Type: research
Assessing the Direct Effects of the Ebola Outbreak on Life Expectancy in Liberia, Sierra Leone and Guinea
Discussion
Whereas prior outbreaks of EVD in sub-Saharan countries have had limited impact on mortality at the population-level, the 2014 West African EVD outbreak likely caused significant declines in life expectancy in Liberia and Sierra Leone. EVD deaths in 2014 likely resulted in e0 reductions between 1.63 to 5.56 years in Liberia and between 1.38 to 5.10 years in Sierra Leone, depending on assumptions about the under-reporting and the mortality of EVD cases. Compared to IHME estimates of trends in life expectancy since 1990 in LSLG,32 life expectancy may thus have declined in Sierra Leone and Liberia to levels these t...
Source: PLOS Currents Outbreaks - February 19, 2015 Category: Epidemiology Authors: Stephane Helleringer Source Type: research
Whole Genome Sequencing for the Retrospective Investigation of an Outbreak of Salmonella Typhimurium DT 8
Discussion
Salmonella remains a major cause of food poisoning in the UK and has been associated with both sporadic cases and larger outbreaks. Phage typing is a phenotypic method traditionally used for surveillance and subtyping of salmonellae but is performed in only a few laboratories due to the requirement for standardised phage panels. Subsequently, DNA fingerprinting techniques such as pulsed-field gel electrophoresis (PFGE) or multi-locus variable-number tandem-repeat analysis (MLVA), are often employed reactively in outbreak investigations to supplement phage typing data where further strain discrimination is requi...
Source: PLOS Currents Outbreaks - February 10, 2015 Category: Epidemiology Authors: Phil Ashton Source Type: research
Temporal Changes in Ebola Transmission in Sierra Leone and Implications for Control Requirements: a Real-time Modelling Study
In this study we used a mathematical model of Ebola virus transmission to estimate how the reproduction number, R, defined as the average number of secondary cases generated by a typical infectious host, varied between August 2014 and January 2015 in the nine districts of Sierra Leone with the most active transmission. As a large number of additional ETC and EHC beds were introduced in Sierra Leone in December 20143, we also used the model to estimate how many cases would be present in the community by the end of March 2015, and evaluate whether beds currently in place will be sufficient to meet demand.
Methods
We used a...
Source: PLOS Currents Outbreaks - February 10, 2015 Category: Epidemiology Authors: Anton Camacho Source Type: research
Estimating Drivers of Autochthonous Transmission of Chikungunya Virus in its Invasion of the Americas
We describe our application of this model to weekly case reports from countries in the Americas during the first year of CHIKV invasion there. In doing so, we establish direct relationships between climatic drivers and transmission, and we propose a platform for future work that will allow for inference of more nuanced links between transmission and putative drivers and for forecasting the continued spread of CHIKV throughout the Americas.
Methods
The goal of our analysis was to understand drivers of spatial and temporal variation in the potential for autochthonous transmission, rather than drivers of pathogen movement a...
Source: PLOS Currents Outbreaks - February 10, 2015 Category: Epidemiology Authors: talexperkins Source Type: research
High-resolution Genomic Surveillance of 2014 Ebolavirus Using Shared Subclonal Variants
Conclusions
Genomic surveillance promises to shed light on outbreak dynamics; however, when the rate of outbreak expansion exceeds the evolutionary rate, there may be insufficient resolution in consensus analysis to adequately track phylogenetic relationships. Advances in sequencing technologies now allow discovering very rare variants present in 1 out of 1,000 viral particles in each patient.6 The study of viral evolutionary dynamics will benefit from treating patients as populations of viruses rather than a collection of single genomes. Our application of Nei’s standard genetic distance in reconstruction phylogenet...
Source: PLOS Currents Outbreaks - February 9, 2015 Category: Epidemiology Authors: hosseinkhiabanian Source Type: research
