Investigating an outbreak of measles in Kamwenge District, Uganda, July 2015
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Globalization has opened many fronts for disease outbreaks because of the quick movement of people and porous borders around the world. The emergence of zoonotic diseases and other communicable diseases highlights the need for implementation of the Global Health Security Agenda packages if countries are to achieve compliance with International Health Regulations (IHR 2005). Health workforce development is one of the critical components that must be addressed with utmost urgency if gaps in early disease detection and response are to be addressed. In this regard, this case study is based on a measles outbreak investigation in Uganda simulating a real-life outbreak investigation by field epidemiologists and seeks to demonstrate the principles of applied epidemiology outlining the critical steps in outbreak investigations and generation of evidence for decision making. It aims to shore up the health workforce capacity by providing practical training for field epidemiology students and professionals that builds their skills in outbreak investigation. This case study can be completed in less than three hours.Keywords:
International Health Regulations
Pandemic
Objective To investigate effective prevention of measles of children.Methods The investigator analyzed retrospectively the data of 108 measle patients hospitalized from January 1999 to December 2003.Results The incidence of measles showed increasing trend,for example,the incidence of measles in 2003 was 2.7 times that in 2002.The incidence of measles of infants(under 8 months) was 22.2%,the incidence of measles of floating population was 11.11%.It was found that the incidence of measles among the patients with measles vaccination was 45.37%,meanwhile the incidence of measles among the patients without measles vaccination was 44.44%.10.19% of the patients were not sure whether they had measles vaccination or not.87.04% of the cases had not contacted measles patients.Some cases were atypical.Conclusion The in creasing trend of child measles merits attention.
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Surveillance of general outbreaks of infectious gastroenteritis was introduced in 1998 by the Food Safety Authority of Ireland (FSAI), in co-operation with the eight health boards. A total of 67 general outbreaks of gastroenteritis in Ireland were reported to the FSAI in 1998 and 1999. Over 1900 people were ill as a result of these outbreaks. Four percent required hospitalisation and there were two deaths. The duration of the outbreaks varied between one day and 38 days. Salmonellae (44%) and small round structured viruses (SRSV) (12%) were the most commonly reported pathogens. In 25% of the outbreaks the aetiology was unknown. The commonest settings were restaurants, hotels and take-aways, which accounted for 45% (30/67) of all outbreaks. Sixteen percent of all outbreaks occurred in hospitals and residential institutions. Over half of the outbreaks were reported to be foodborne, 63% of which were due to various serotypes of Salmonella enterica. Eggs were implicated as the vehicle of infection in 13% of all outbreaks. An infected food handler was identified in almost one third of outbreaks, although it could not be established if this had contributed directly to the outbreak.
Salmonella Food Poisoning
Etiology
Salmonella enterica
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Etiology
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Abstract Enteroinvasive Escherichia coli (EIEC) outbreaks are uncommon in Europe. In June 2014, two EIEC outbreaks occurred in Nottingham, UK, within 2 days; outbreak A was linked to a takeaway restaurant and outbreak B to a wedding party. We conducted 2 analytical studies: a case–control study for outbreak A and a cohort study for outbreak B. We tested microbiological and environmental samples, including by using whole-genome sequencing. For both outbreaks combined, we identified 157 probable case-patients; 27 were laboratory-confirmed as EIEC O96:H19–positive. Combined epidemiologic, microbiological, and environmental findings implicated lettuce as the vehicle of infection in outbreak A, but the source of the organism remained unknown. Whole-genome sequencing identified the same organism in cases from both outbreaks, but no epidemiologic link was confirmed. These outbreaks highlight that EIEC has the capacity to cause large and severe gastrointestinal disease outbreaks and should be considered as a potential pathogen in foodborne outbreaks in Europe.
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Objective This study is to analyze the epidemiology of measles in Heze in 2005,and to revise the strategy for measles control as well as its vaccination.Methods The data comes from routine report system for infectious disease and annual statistics.Results 479 suspected measles cases were reported in 2005,416 measles cases were confirmed.Of the epidemiological modes,sporadic cases and outbreak cases coexisted.The measles in some districts had affected the measles morbidity of the whole city.Measles cases mainly happened among preschool children and adults.In confirmed measles cases,19.23% had measles vaccine immunization history,36.30% were non-vaccined and 44.47% were uncertain.Conclusion The age distribution and vaccination status of measles cases remind that the routine immunization service should be strengthended.At the same time the measles campaign should be implemented to adult.In addition,perfecting measles surveillance system must be taken.
Routine immunization
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Abstract Background The origins of Ebola disease outbreaks remain enigmatic. Historically outbreaks have been attributed to spillover events from wildlife. However, recent data suggest that some outbreaks may originate from human-to-human transmission of prior outbreak strains instead of spillover. Clarifying the origins of Ebola disease outbreaks could improve detection and mitigation of future outbreaks. Methods We reviewed the origins of all Ebola disease outbreaks from 1976 to 2022 to analyze the earliest cases and characteristics of each outbreak. The epidemiology and phylogenetic relationships of outbreak strains were used to further identify the likely source of each outbreak. Results From 1976 to 2022 there were 35 Ebola disease outbreaks with 48 primary/index cases. While the majority of outbreaks were associated with wildlife spillover, resurgence of human-to-human transmission could account for roughly a quarter of outbreaks caused by Ebola virus. Larger outbreaks were more likely to lead to possible resurgence, and nosocomial transmission was associated with the majority of outbreaks. Conclusions While spillover from wildlife has been a source for many Ebola disease outbreaks, multiple outbreaks may have originated from flare-ups of prior outbreak strains. Improving access to diagnostics as well as identifying groups at risk for resurgence of ebolaviruses will be crucial to preventing future outbreaks.
Ebolavirus
Ebola Hemorrhagic Fever
Spillover effect
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Objective To understand the characteristics of influenza-like illness(ILI) outbreaks in Yunnan province and provide evidence for the development of scientific and effective control measures.Methods The data of ILI outbreaks in Yunnan in 2009 were collected and analyzed Results Totally 72 ILI outbreaks occurred in Yunnan,resulting in 7 628 ILI cases.The attack rate ranged from 1.79% to 49.45%.The disease occurred all the year round with peak in Autumn.Twenty six outbreaks occurred in Zhaotong,Sixty eight outbreaks occurred in schools.The influenza viruses were isolated from the cases in 37 out of 54 outbreaks,including influenza H3N2 virus(in 12 outbreaks),influenza B virus(in 11 outbreaks),2009 pandemic influenza A(H1N1) virus(in 9 outbreaks) and influenza A(H1N1) virus(in 5 outbreaks).The interval between the finding of the first case and the response and the duration of epidemic was positive correlated.(r=0.896,P0.05).Conclusion More ILI outbreaks occurred in Yunnan in 2009 than in 2008,and 94% of the outbreaks occurred in schools.It is necessary to strengthen the ILI outbreak surveillance and reporting in schools and improve the sample collection and laboratory detection.
Influenza-like illness
Attack rate
Pandemic
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Objective The data of measles reported by the measles surveillance system in Zhejiang Province. Methods From January,2001 to December,2003,the data of measles were analyzed to direct the measles control in the futrue. Results The results showed that the average measles incidence rate in 2001-2003 was higher than that of 1998-2000.Both the sporadic and epidemic measles in some districts existed at the same time and the reported measles cases extensively distributed in all districts of Zhejiang Province. The measles in some districts had affected the measles morbidity of the whole Province. The prevalent season was from March to June,the incidence of measles between 0-2 years old and between 6-8 years old groups were higher than that of the other age groups. Conclusion We concluded that 30% of the total measles cases were not immunized and 30% without vaccination records through analyzing the measles cases vaccination history.The age distribution and vaccination status of measles cases remind that the routine immunization service should be strengthened,at the same time the measles campaign should be implemented to adult. In addition,prefecting measles surveillance system must be taken.
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All outbreaks of infectious intestinal disease reported to the authorities were entered on a computer database with outbreak control teams being established to investigate larger or more significant incidents. The outbreak database and, when set up, the notes of outbreak team meetings were examined for the 279 outbreaks reported in a three-year period (2003-2005). Faeces specimens submitted as part of an outbreak were examined for microbial pathogens and the results cross-matched to the outbreak number. Almost half of the general outbreaks reported (137) occurred in long-term care facilities for the elderly, 51 outbreaks were recorded in hospitals and 31 occurred in the wider community. In 76 outbreaks no specimen was logged. A microbial cause was confirmed in about one-third of outbreaks, with noroviruses being the most common (19%). Salmonellas accounted for 12 of the 21 community outbreaks linked to social events and all were foodborne. Suggestions for improving notification and surveillance are discussed.
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[Objective] To analyze the changing of age characteristic of measles cases in Baoding City from 1999-2007 in order to provide reference to the strategy adjustments for measles surveillance and immunization to eliminate measles. [Meth-ods] Age characteristics of measles cases from 1999 to 2007 were analyzed with epidemiological analysis. [Results] Measles cases of 1-14 years old accounted for 75.90% in 1999-2002, 45.95% in 2003-2007, which descended gradually. Measles cas-es of under 1 year old accounted for 0.92% in 1999-2002, 22.33% in 2003-2007, which was a increasing tendency. Measles cases of over 15 years old accounted for 14.86% in 1999-2002, 30.72% in 2003-2007, which was a increasing tendency. [Conclusion] Though accelerated measles control, measles mainly takes place in people aged under 1 and over 15 years ole and age distribution of measles cases is remarkably different in different areas in Baoding. We should pay attention to the tran-sient population on measles immunization and surveillance.
Morbillivirus
Age groups
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