To calculate the burden of 2009 pandemic influenza A (pH1N1) in the United States, we extrapolated from the Centers for Disease Control and Prevention's Emerging Infections Program ...laboratory-confirmed hospitalizations across the entire United States, and then corrected for underreporting. From 12 April 2009 to 10 April 2010, we estimate that approximately 60.8 million cases (range: 43.3-89.3 million), 274 304 hospitalizations (195 086—402 719), and 12 469 deaths (8868-18 306) occurred in the United States due to pH1N1. Eighty-seven percent of deaths occurred in those under 65 years of age with children and working adults having risks of hospitalization and death 4 to 7 times and 8 to 12 times greater, respectively, than estimates of impact due to seasonal influenza covering the years 1976—2001. In our study, adults 65 years of age or older were found to have rates of hospitalization and death that were up to 75% and 81%, respectively, lower than seasonal influenza. These results confirm the necessity of a concerted public health response to pH1N1.
Group B streptococci garnered attention during the 1970s when they surpassed Escherichia coli and Staphylococcus aureus to become the principal causes of sepsis in early infancy. During the 1980s, ...several clinical trials demonstrated that administration of antimicrobial agents during labor could interrupt vertical transmission and prevent invasive disease in the first week of life (i.e., early-onset disease). However, prophylaxis was not widely used during the next 10 years. On the basis of efforts by clinician-researchers, professional organizations, community-based parent advocacy groups, and the public health community, consensus recommendations for group B streptococcal prophylaxis were finally issued in 1996. By the end of 1999, the incidence of early-onset disease in selected counties within the United States had decreased by 70%, and the gap between black and white persons with disease narrowed by 75%. This recent triumph leaves the professional community treading lightly, alert to the need to monitor for unintended consequences that may threaten recent progress.
To analyse trends in reported invasive Haemophilus influenzae disease in South Africa within the first five years of introduction of conjugate Haemophilus influenzae type b (Hib) vaccine in the ...routine child immunization schedule.
We used national laboratory-based surveillance data to identify cases of invasive H. influenzae disease between July 1999 and June 2004, and submitted isolates for serotyping and antimicrobial susceptibility testing.
The absolute number of Hib cases (reported to the national surveillance system) among children below one year of age decreased by 65%, from 55 cases in 1999-2000 to 19 cases in 2003-04. Enhanced surveillance initiated in 2003, identified human immunodeficiency virus (HIV)-infection and incomplete vaccination as contributing factors for Hib transmission. The total number of laboratory-confirmed cases of H. influenzae remained unchanged because non-type b disease was being increasingly reported to the surveillance system concomitant with system enhancements. Children with non-typable disease were more likely to be HIV-positive (32 of 34, 94%) than children with Hib disease (10 of 14, 71%), P = 0.051. Recent Hib isolates were more likely to be multidrug resistant (2% in 1999-2000 versus 19% in 2003-04, P = 0.001).
Data from a newly established national laboratory-based surveillance system showed a decrease in Hib disease burden among South African children following conjugate vaccine introduction and identified cases of non-typable disease associated with HIV infection.
COVID-19: towards controlling of a pandemic Bedford, Juliet; Enria, Delia; Giesecke, Johan ...
The Lancet (British edition),
03/2020, Letnik:
395, Številka:
10229
Journal Article
Recenzirano
Odprti dostop
Most national response strategies include varying levels of contact tracing and self-isolation or quarantine; promotion of public health measures, including handwashing, respiratory etiquette, and ...social distancing; preparation of health systems for a surge of severely ill patients who require isolation, oxygen, and mechanical ventilation; strengthening health facility infection prevention and control, with special attention to nursing home facilities; and postponement or cancellation of large-scale public gatherings. ...all countries should consider a combination of response measures: case and contact finding; containment or other measures that aim to delay the onset of patient surges where feasible; and measures such as public awareness, promotion of personal protective hygiene, preparation of health systems for a surge of severely ill patients, stronger infection prevention and control in health facilities, nursing homes, and long-term care facilities, and postponement or cancellation of large-scale public gatherings. ...countries with no or a few first cases of COVID-19 should consider active surveillance for timely case finding; isolate, test, and trace every contact in containment; practise social distancing; and ready their health-care systems and populations for spread of infection.
During the 1990s, the incidence of disease caused by mother-to-child transmission of group B streptococcus fell by 65 percent, from 1.7 to 0.6 case per 1000 live births.
1
The decline stemmed from ...the increased use of penicillin during labor in women at high risk for transmitting the infection to their newborns. Given this striking reduction in incidence, where do we go from here?
Group B streptococcus became the leading cause of life-threatening infections in newborns during the 1970s. One woman in five is colonized with group B streptococcus in the gastrointestinal or genital tract. Infants become ill through aspiration of . . .
Abstract The introduction of Haemophilus influenzae type b (Hib) vaccine in developing countries has suffered from a long delay. Between 2005 and 2009, a surge in Hib vaccine adoption took place, ...particularly among GAVI-eligible countries. Several factors contributed to the increase in Hib vaccine adoption, including support provided by the Hib Initiative, a project funded by the GAVI Alliance in 2005 to accelerate evidence-informed decisions for use of Hib vaccine. This paper reviews the strategy adopted by the Hib Initiative and the lessons learned in the process, which provide a useful model to accelerate uptake of other new vaccines.
Group B streptococcus SCHUCHAT, A
The Lancet (British edition),
01/1999, Letnik:
353, Številka:
9146
Journal Article
Recenzirano
During the 1990s the focus of group B streptococcus (GBS) disease research has shifted to prevention. Increased use of intrapartum antimicrobial prophylaxis in North America and Australia has led to ...substantial declines in perinatal disease. Vaccine development (initiated two decades earlier) has yielded results--for example, polysaccharide-protein conjugate vaccines given to women of reproductive age proved to be highly immunogenic and well tolerated. Also economic evaluations have assessed the cost-effectiveness of prevention strategies in different populations. Although GBS has traditionally been considered a perinatal pathogen, the burden of invasive GBS disease among nonpregnant adults has been measured. Adverse outcomes of pregnancy attributable to GBS were addressed through a multicentre study which confirmed the important role of heavy colonisation with GBS in preterm low-birthweight deliveries. Finally, the pathogen itself has continued to evolve: new capsular serotypes described in the past decade are now causing an important proportion of clinical infections.
Invasive group B streptococcal (GBS) infection is a major health problem among infants and adults. The formulation of GBS vaccines depends on knowledge of the GBS serotype distribution. Serotype V ...GBS infection appears to have recently emerged, suggesting that the serotype distribution changes over time. GBS isolates from 210 pediatric patients, 23 pregnant women, and 314 nonpregnant adults with invasive infection in Maryland were studied. The predominant serotypes from infants with early-onset disease were as follows: serotype III, 38% of isolates; serotype Ia, 36%; serotype V, 13%; and serotype II, 11%. Although the majority (60%) of isolates among infants with late-onset infection were serotype III, serotype Ia (23%) was also common. The predominant serotype among isolates from nonpregnant adult patients was serotype V, accounting for 29% of the isolates. The serotype distribution differs between pediatric patients and adults and is changing over time. The inclusion of a relatively small number of serotypes in a GBS vaccine could provide protection against the vast majority of isolates.
Background. Pneumococcal disease is most prevalent among young children and elderly adults. We explored whether similarities exist in the serotypes that cause disease in these 2 high-risk groups. ...Methods. With use of US population-based data from 1998–1999 (before the introduction of the 7-valent pneumococcal conjugate vaccine PCV7 as routine immunization for infants) from the Centers for Disease Control and Prevention's Active Bacterial Core surveillance, we evaluated whether the rate of invasive pneumococcal disease caused by the pediatric serotypes (6B, 9V, 14, 19F, and 23F) increased among elderly persons. We adjusted for potential confounders in multivariable logistic regression. Results. We analyzed 2987 pneumococcal isolates recovered from adults. The risk of infection with pediatric serotypes increased from 32.5% in 35–49-year-old persons to 51.2% in ⩾85-year-old persons (P < .001). Compared with 35–49-year-old persons, the risk of infection with pediatric serotypes was significantly elevated among 65–74-year-old persons (relative risk RR, 1.68; 95% confidence interval CI, 1.29–2.20) and increased progressively among persons aged 75–84 years (RR, 1.82; 95% CI, 1.41–2.36) and ⩾85 years (RR, 2.29; 95% CI, 1.72–3.05), with adjustment for sex, race, geographic location, underlying illness, and penicillin resistance. The rate of penicillin resistance was also elevated in the elderly population but was not significant after adjustment for serotype and race. Conclusions. The increased proportion of severe pneumococcal disease caused by pediatric serotypes in the elderly population might indicate opportunities for prevention with use of PCV7.
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