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Changes in vancomycin-resistant Enterococcus faecium causing outbreaks in Brazil

PALAZZO, I. C. V.; Silva, André Pitondo da; LEVY, C. E.; DARINI, A. L. da Costa
Fonte: W B SAUNDERS CO LTD Publicador: W B SAUNDERS CO LTD
Tipo: Artigo de Revista Científica
ENG
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Enterococci have been implicated in severe human infections as a consequence of associated determinants of virulence and antimicrobial resistance. The majority of vancomycin-resistant Enterococcus faecium (VRE(fm)) connected to outbreaks worldwide pertains to the clonal complex 17 (CC17). In Brazil, the majority of VRE(fm) involved in outbreaks reported so far are not related to CC17. VRE(fm) strains responsible for an outbreak and sporadic cases in hospitals located in the city of Campinas, Brazil, were compared to other VRE(fm) strains in the country. Twenty-two out of 23 E. faecium were vancomycin-resistant and harboured the vanA gene. One vancomycin-susceptible E. faecium (VSE(fm)) strain was included in this study because it was isolated from a patient who one week later harboured a VRE(fm). All strains, except VSE, showed the same alteration in the VanA element characterised by deletion of the left extremity of the transposon and insertion of IS1251 between the vanS and vanH genes. Genes codifying virulence factors such as collageneadhesin protein, enterococcal surface protein and hyaluronidase were detected in the VRE(fm) and VSE(fm) studied. Both pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) revealed that VRE(fm) and VSE(fm) strains have a clonal relationship. New sequence types (STs) were identified by MLST as ST447...

Changes in vancomycin-resistant Enterococcus faecium causing outbreaks in Brazil

PALAZZO, I. C. V.; PITONDO-SILVA, A.; LEVY, C. E.; DARINI, A. L. da Costa
Fonte: W B SAUNDERS CO LTD Publicador: W B SAUNDERS CO LTD
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.74%
Enterococci have been implicated in severe human infections as a consequence of associated determinants of virulence and antimicrobial resistance. The majority of vancomycin-resistant Enterococcus faecium (VRE(fm)) connected to outbreaks worldwide pertains to the clonal complex 17 (CC17). In Brazil, the majority of VRE(fm) involved in outbreaks reported so far are not related to CC17. VRE(fm) strains responsible for an outbreak and sporadic cases in hospitals located in the city of Campinas, Brazil, were compared to other VRE(fm) strains in the country. Twenty-two out of 23 E. faecium were vancomycin-resistant and harboured the vanA gene. One vancomycin-susceptible E. faecium (VSE(fm)) strain was included in this study because it was isolated from a patient who one week later harboured a VRE(fm). All strains, except VSE, showed the same alteration in the VanA element characterised by deletion of the left extremity of the transposon and insertion of IS1251 between the vanS and vanH genes. Genes codifying virulence factors such as collageneadhesin protein, enterococcal surface protein and hyaluronidase were detected in the VRE(fm) and VSE(fm) studied. Both pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) revealed that VRE(fm) and VSE(fm) strains have a clonal relationship. New sequence types (STs) were identified by MLST as ST447...

Outbreaks of human-herpes virus 6 (HHV-6) infection in day-care centers in Belém, Pará, Brazil

FREITAS,Ronaldo B.; MONTEIRO,Talita A.F.; LINHARES,Alexandre C.
Fonte: Instituto de Medicina Tropical Publicador: Instituto de Medicina Tropical
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2000 EN
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A total of 730 children aged less than 7 years, attending 8 day-care centers (DCCs) in Belém, Brazil were followed-up from January to December 1997 to investigate the occurrence of human-herpes virus 6 (HHV-6) infection in these institutional settings. Between October and December 1997 there have been outbreaks of a febrile- and -exanthematous disease, affecting at least 15-20% of children in each of the DCCs. Both serum- and- plasma samples were obtained from 401 (55%) of the 730 participating children for the detection of HHV-6 antibodies by enzyme-linked immunosorbent assay (ELISA), and viral DNA amplification through the nested-PCR. Recent HHV-6 infection was diagnosed in 63.8% (256/401) of them, as defined by the presence of both IgM and IgG-specific antibodies (IgM+/IgG+); of these, 114 (44.5%) were symptomatic and 142 (55.5%) had no symptoms (p = 0.03). A subgroup of 123 (30.7%) children were found to be IgM-/IgG+, whereas the remaining 22 (5.5%) children had neither IgM nor IgG HHV-6- antibodies (IgM-/IgG-). Of the 118 children reacting strongly IgM-positive ( > or = 30 PANBIO units), 26 (22.0%) were found to harbour the HHV-6 DNA, as demonstrated by nested-PCR. Taken the ELISA-IgM- and- nested PCR-positive results together...

Malaria outbreaks in a non-endemic area of Brazil, 2005

Limongi,Jean Ezequiel; Chaves,Kátia Maria; Paula,Márcia Beatriz Cardoso de; Costa,Fabíola Corrêa da; Silva,Alcides de Assis e; Lopes,Íris de Sousa; Pajuaba Neto,Adalberto de Albuquerque; Sales,José Maria; Rodrigues,Fernando; Resende,Maria Angélica
Fonte: Sociedade Brasileira de Medicina Tropical - SBMT Publicador: Sociedade Brasileira de Medicina Tropical - SBMT
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2008 EN
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In March 2005, a resident of the municipality of Monte Alegre de Minas, State of Minas Gerais, without any history of traveling to endemic areas for malaria, was diagnosed with Plasmodium vivax infection and local mosquito-borne transmission was suspected. The epidemiological investigation identified another 10 cases with local transmission and all of them were related to the imported malaria case that was detected in this region. The potential exposure site was the banks of the river Tejuco, an area frequented by mineral prospectors. Some of these prospectors were known to have come from states with malaria transmission. In the autochthonous cases, Plasmodium vivax and Plasmodium falciparum were diagnosed. Entomological investigation identified Anopheles (Nyssorhynchus) darlingi, Anopheles (Nyssorhynchus) albitarsis, Anopheles (Nyssorhynchus) triannulatus and Anopheles (Nyssorhynchus) parvus. After the first outbreak, another three autochthonous cases were notified in municipality of Monte Alegre de Minas, in the same year. The occurrence of these outbreaks highlights the importance of surveillance systems in areas that are nonendemic for malaria.

Predictors of local malaria outbreaks: an approach to the development of an early warning system in Colombia

Mateus,Julio César; Carrasquilla,Gabriel
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2011 EN
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Risk factor surveillance is a complementary tool of morbidity and mortality surveillance that improves the likelihood that public health interventions are implemented in a timely fashion. The aim of this study was to identify population predictors of malaria outbreaks in endemic municipalities of Colombia with the goal of developing an early warning system for malaria outbreaks. We conducted a multiple-group, exploratory, ecological study at the municipal level. Each of the 290 municipalities with endemic malaria that we studied was classified according to the presence or absence of outbreaks. The measurement of variables was based on historic registries and logistic regression was performed to analyse the data. Altitude above sea level [odds ratio (OR) 3.65, 95% confidence interval (CI) 1.34-9.98], variability in rainfall (OR 1.85, 95% CI 1.40-2.44) and the proportion of inhabitants over 45 years of age (OR 0.17, 95% CI 0.08-0.38) were factors associated with malaria outbreaks in Colombian municipalities. The results suggest that environmental and demographic factors could have a significant ability to predict malaria outbreaks on the municipal level in Colombia. To advance the development of an early warning system, it will be necessary to adjust and standardise the collection of required data and to evaluate the accuracy of the forecast models.

Update on oral Chagas disease outbreaks in Venezuela: epidemiological, clinical and diagnostic approaches

Noya,Belkisyolé Alarcón de; Díaz-Bello,Zoraida; Colmenares,Cecilia; Ruiz-Guevara,Raiza; Mauriello,Luciano; Muñoz-Calderón,Arturo; Noya,Oscar
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/05/2015 EN
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Orally transmitted Chagas disease has become a matter of concern due to outbreaks reported in four Latin American countries. Although several mechanisms for orally transmitted Chagas disease transmission have been proposed, food and beverages contaminated with whole infected triatomines or their faeces, which contain metacyclic trypomastigotes of Trypanosoma cruzi, seems to be the primary vehicle. In 2007, the first recognised outbreak of orally transmitted Chagas disease occurred in Venezuela and largest recorded outbreak at that time. Since then, 10 outbreaks (four in Caracas) with 249 cases (73.5% children) and 4% mortality have occurred. The absence of contact with the vector and of traditional cutaneous and Romana’s signs, together with a florid spectrum of clinical manifestations during the acute phase, confuse the diagnosis of orally transmitted Chagas disease with other infectious diseases. The simultaneous detection of IgG and IgM by ELISA and the search for parasites in all individuals at risk have been valuable diagnostic tools for detecting acute cases. Follow-up studies regarding the microepidemics primarily affecting children has resulted in 70% infection persistence six years after anti-parasitic treatment. Panstrongylus geniculatus has been the incriminating vector in most cases. As a food-borne disease...

Outbreaks, persistence, and high mortality rates of multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions

Gomes,Marisa Zenaide Ribeiro; Machado,Carolina Romero; Conceição,Magda de Souza da; Ortega,Jois Alves; Neves,Sonia Maria Ferraz M; Lourenço,Maria Cristina da Silva; Asensi,Marise Dutra
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2011 EN
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INTRODUCTION: Authors have reported increased incidence of multiresistant Pseudomonas aeruginosa (MR-PA) infections worldwide over the last decade. Researchers have proposed multifaceted approaches to control MR-PA infections, but none have been reported in the acquired immunodeficiency syndrome (AIDS) setting. OBJECTIVE AND METHODS: Herein we report the impact of a multifaceted intervention for controlling MR-PA over five years in a hospital with AIDS-predominant admissions and describe the clinical characteristics of MR-PA infection in our patient population. The clinical outcomes of infected patients and molecular characteristics of the isolated strains were used as tools for controlling MR-PA infection rates. RESULTS: Significant temporary decrease of new infections was achieved after intervention, although a high level of diagnostic suspicion of nosocomial infection was maintained. We obtained 35 P. aeruginosa isolates with multiresistant profiles from 13 infected and 3 colonized patients and 2 environmental samples. Most of the patients (94%) were immunocompromised with AIDS (n = 10) or HTLV-1 infections (n = 5). Of the followed patients, 67% had persistent and/or recurrent infections, and 92% died. We observed differences in the antibiotic-resistance pattern of MR-PA infection/colonization during two outbreaks...

Outbreaks associated to bloodstream infections with Staphylococcus aureus and coagulase-negative Staphylococcus spp in premature neonates in a university hospital from Brazil

Brito,Denise Von Dolinger de; Oliveira,Elias Jose; Darini,Ana Lúcia da Costa; Abdallah,Vânia Olivetti Steffen; Gontijo Filho,Paulo P.
Fonte: Sociedade Brasileira de Microbiologia Publicador: Sociedade Brasileira de Microbiologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2006 EN
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Staphylococcus aureus and coagulase-negative staphylococci (CoNS) are among the most important nosocomial pathogens in patients from neonatal intensive care units, mainly in bloodstream infections. The main objective of this study is to determine the occurrence of nosocomial infections by these microorganisms using two surveillance systems (Laboratorial Surveillance and National Nosocomial Infection Surveillance System) and to determine the most important risk factors during a two-year period (2001-2002). Two outbreaks by both methicillin susceptible S. aureus (MSSA) (1.5%) and methicillin resistant CoNS (MRCoNS) (1.0%) were observed, from January to February/02 and August to September/02. Endemic incidence rates of 3.77% and 5.16% of S. aureus and CoNS, respectively were detected. Risk factors included age <=7 days, hospitalization > or = 7 days and utilization of polietilene central vascular catheter (CVC) through vein dissection (phlebotomy), but none of these independent factors were confirmed by the multivariate analysis. However, oxacillin resistant CoNS prevailed (66.0%) in the epidemic episodes. Molecular analysis by pulsed field gel electrophoresis showed the polyclonal nature of S. aureus isolates. In conclusion, two outbreaks were identified of mixed etiology by MSSA and MRCoNS associated to the lack of an adequate material (central venous catheter) for neonates...

Etiological Role of Viruses in Outbreaks of Acute Gastroenteritis in The Netherlands from 1994 through 2005▿

Svraka, Sanela; Duizer, Erwin; Vennema, Harry; de Bruin, Erwin; van der Veer, Bas; Dorresteijn, Bram; Koopmans, Marion
Fonte: American Society for Microbiology Publicador: American Society for Microbiology
Tipo: Artigo de Revista Científica
EN
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Acute gastroenteritis is one of the most common diseases worldwide. In developed countries, viruses, particularly noroviruses, are recognized as the leading cause. In The Netherlands, the surveillance of gastroenteritis outbreaks with suspected viral etiologies (as determined by Kaplan criteria) was established by the National Institute for Public Health and the Environment in 1994. This paper presents an overview of viral gastroenteritis outbreaks reported from 1994 through 2005. A minimum epidemiological data set consisting of the associated setting(s), the probable transmission mode, the date of the first illness and the date of sampling, the number of persons affected, and the number of hospitalizations was requested for each reported outbreak. Stool samples were tested for the presence of norovirus, sapovirus, rotavirus, astrovirus, adenovirus, and Aichi virus by electron microscopy, enzyme-linked immunosorbent assay, and/or reverse transcription-PCR. A total of 6,707 stool samples from 941 gastroenteritis outbreaks were investigated. Noroviruses were detected as the causative agent in 735 (78.1%) of the outbreaks, and rotaviruses, adenoviruses, and astroviruses were found to be responsible for 46 (4.9%), 9 (1.0%), and 5 (0.5%) outbreaks...

Genetic Diversity among Food-Borne and Waterborne Norovirus Strains Causing Outbreaks in Sweden▿

Lysén, Maria; Thorhagen, Margareta; Brytting, Maria; Hjertqvist, Marika; Andersson, Yvonne; Hedlund, Kjell-Olof
Fonte: American Society for Microbiology (ASM) Publicador: American Society for Microbiology (ASM)
Tipo: Artigo de Revista Científica
EN
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A total of 101 food-borne and waterborne outbreaks that were caused by norovirus and that resulted in more than 4,100 cases of illness were reported to the Swedish Institute for Infectious Disease Control from January 2002 to December 2006. Sequence and epidemiological data for isolates from 73 outbreaks were analyzed. In contrast to health care-related outbreaks, no clear seasonality could be observed. Sequence analysis showed a high degree of genetic variation among the noroviruses detected. Genogroup II (GII) viruses were detected in 70% of the outbreaks, and of those strains, strains of GII.4 were the most prevalent and were detected in 25% of all outbreaks. The GII.4 variants detected in global outbreaks in health care settings during 2002, 2004, and 2006 were also found in the food-borne outbreaks. GI strains totally dominated as the cause of water-related (drinking and recreational water) outbreaks and were found in 12 of 13 outbreaks. In 14 outbreaks, there were discrepancies among the polymerase and capsid genotype results. In four outbreaks, the polymerase of the recombinant GII.b virus occurred together with the GII.1 or GII.3 capsids, while the GII.7 polymerase occurred together with the GII.6 and GII.7 capsids. Mixed infections were observed in six outbreaks; four of these were due to contaminated water...

The use of clinical profiles in the investigation of foodborne outbreaks in restaurants: United States, 1982–1997

HEDBERG, C. W.; PALAZZI-CHURAS, K. L.; RADKE, V. J.; SELMAN, C. A.; TAUXE, R. V.
Fonte: Cambridge University Press Publicador: Cambridge University Press
Tipo: Artigo de Revista Científica
EN
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Improving the efficiency of outbreak investigation in restaurants is critical to reducing outbreak-associated illness and improving prevention strategies. Because clinical characteristics of outbreaks are usually available before results of laboratory testing, we examined their use for determining contributing factors in outbreaks caused by restaurants. All confirmed foodborne outbreaks reported to the Centers for Disease Control and Prevention (CDC) from 1982 to 1997 were reviewed. Clinical profiles were developed based on outbreak characteristics. We compared the percentage of contributing factors by known agent and clinical profile to their occurrence in outbreaks of unclassified aetiology. In total, 2246 foodborne outbreaks were included: 697 (31%) with known aetiology and 1549 (69%) with aetiology undetermined. Salmonella accounted for 65% of outbreaks with a known aetiology. Norovirus-like clinical profiles were noted in 54% of outbreaks with undetermined aetiology. Improper holding times and temperatures were associated with outbreaks caused by Clostridium perfringens, Bacillus cereus, Staphylococcus aureus, and Salmonella, and also with outbreaks of undetermined aetiology that fitted diarrhoea-toxin and vomiting-toxin clinical profiles. Poor personal hygiene was associated with norovirus...

On SARS Type Economic Effects During Infectious Disease Outbreaks

Brahmbhatt, Milan; Dutta, Arindam
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
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Infectious disease outbreaks can exact a high human and economic cost through illness and death. But, as with severe acute respiratory syndrome (SARS) in East Asia in 2003, or the plague outbreak in Surat, India, in 1994, they can also create severe economic disruptions even when there is, ultimately, relatively little illness or death. Such disruptions are commonly the result of uncoordinated and panicky efforts by individuals to avoid becoming infected, of preventive activity. This paper places these "SARS type" effects in the context of research on economic epidemiology, in which behavioral responses to disease risk have both economic and epidemiological consequences. The paper looks in particular at how people form subjective probability judgments about disease risk. Public opinion surveys during the SARS outbreak provide suggestive evidence that people did indeed at times hold excessively high perceptions of the risk of becoming infected, or, if infected, of dying from the disease. The paper discusses research in behavioral economics and the theory of information cascades that may shed light on the origin of such biases. The authors consider whether public information strategies can help reduce unwarranted panic. A preliminary question is why governments often seem to have strong incentives to conceal information about infectious disease outbreaks. The paper reviews recent game-theoretic analysis that clarifies government incentives. An important finding is that government incentives to conceal decline the more numerous are non-official sources of information about a possible disease outbreak. The findings suggest that honesty may indeed be the best public policy under modern conditions of easy mass global communications.

Epidemiologic Investigation of Foodborne Outbreaks in Pharmacies: A Pilot Study

Torre, Carla; Brazão, Roberto; Guerreiro, José; Gomes, Marta; Costa, Suzete; Oliveira, Luisa; Viegas, Silvia
Fonte: Instituto Nacional de Saúde Doutor Ricardo Jorge Publicador: Instituto Nacional de Saúde Doutor Ricardo Jorge
Tipo: Conferência ou Objeto de Conferência
Publicado em /04/2015 ENG
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Introduction: The analysis of Foodborne Outbreaks (FBO) investigation data provides knowledge on food vehicles and contributive factors of human infections allowing their risk management. However, FBO are commonly underreported and alternative sources of information may prove useful. Purpose: To test the adequacy of Pharmacies as an information source to identify foods involved in FBO, their confection type and acquisition place as well as the main symptoms and medicines taken. Methods: Application of a FBO epidemiologic investigation inquiry to individuals with FBD suggestive symptoms that went to 249 Pharmacies all over Portugal looking for treatment, between 18th August and 15th de November 2014. Descriptive statistical analysis of the results was performed and absolute and relative frequencies measures of location and dispersion were calculated in the program SAS version 9.1. Results: From 270 validated inquiries collected online until 29 October, 72.9% of the individuals went to the Pharmacy as the first health resort (average age 44.1 years), 56.3% individuals reported moderate symptoms, namely diarrhea and 58.0% of individuals took anti-diarrheal. The most frequent place of consumption of the suspect food was home (51.5 %)...

Epidemiology of Foodborne Disease Outbreaks Caused by Clostridium perfringens, United States, 1998–2010

Grass, Julian E.; Gould, L. Hannah; Mahon, Barbara E.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
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Clostridium perfringens is estimated to be the second most common bacterial cause of foodborne illness in the United States, causing one million illnesses each year. Local, state, and territorial health departments voluntarily report C. perfringens outbreaks to the U.S. Centers for Disease Control and Prevention through the Foodborne Disease Outbreak Surveillance System. Our analysis included outbreaks confirmed by laboratory evidence during 1998–2010. A food item was implicated if C. perfringens was isolated from food or based on epidemiologic evidence. Implicated foods were classified into one of 17 standard food commodities when possible. From 1998 to 2010, 289 confirmed outbreaks of C. perfringens illness were reported with 15,208 illnesses, 83 hospitalizations, and eight deaths. The number of outbreaks reported each year ranged from 16 to 31 with no apparent trend over time. The annual number of outbreak-associated illnesses ranged from 359 to 2,173, and the median outbreak size was 24 illnesses. Outbreaks occurred year round, with the largest number in November and December. Restaurants (43%) were the most common setting of food preparation. Other settings included catering facility (19%), private home (16%), prison or jail (11%)...

Obligations to Report Outbreaks of Foodborne Disease under the International Health Regulations (2005)

Kirk, Martyn; Musto, Jennie; Gregory, Joy; Fullerton, Kathleen
Fonte: US National Centre for Infectious Diseases Publicador: US National Centre for Infectious Diseases
Tipo: Artigo de Revista Científica
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Every year, Australia identifies 2-3 outbreaks associated with imported foods. To examine national authorities' obligations under the International Health Regulations (2005), we reviewed outbreaks in 2001-2007 that implicated internationally distributed f

Genetic procedures for identification of enterotoxigenic strains of Staphylococcus aureus from three food poisoning outbreaks

Martín, M. Cruz; Fueyo Mendoza, José María; González-Hevia, M. A.; Mendoza, M. Carmen
Fonte: Elsevier Publicador: Elsevier
Tipo: Artículo Formato: 22195 bytes; application/pdf
ENG
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Final full-text version of the paper available at: http://dx.doi.org/10.1016/j.ijfoodmicro.2004.01.011.; Three food poisoning restaurant outbreaks due to Staphylococcus aureus, occurring during June–October 2002 in the Principality of Asturias (PA), Spain, provided the basis for investigating some aspects of the molecular epidemiology of this organism. The methods applied to identify strains and lineages included multiplex-polymerase chain reaction (PCR) to detect nine enterotoxin (se) genes, and three DNA fingerprinting procedures: pulsed-field gel electrophoresis (PFGE) with SmaI, randomly amplified polymorphic DNA (RAPD) with two selected primers, and plasmid restriction analysis with HindIII. Thirty-two isolates were differentiated into three non-se and 12 se strains, which were outbreak-specific, except for one that was represented in two of the outbreaks. In outbreak 1, the 16 food isolates analyzed had sec, seg and sei genes and generated a distinctive DNA fingerprint, being assigned to a single strain. This strain could be categorized as endemic in the PA and associated to manually handled dairy products and nasal carriers. In outbreak 2, the four food isolates analyzed fell into three strains, each one displaying a different se-gene profile (sea...

AN EVALUATION OF MOUNTAIN PINE BEETLE OUTBREAKS IN COLORADO AND WYOMING UNDER CLIMATE CHANGE USING GEOSPATIAL ANALYSIS

Allen, Natalie
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Masters' project
Publicado em 26/04/2011 EN
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In the past two decades, the native mountain pine beetle (Dendroctonus ponderosae) has decimated the pine forests of Colorado and Wyoming. These infestations are an issue for local communities because of the loss of ecosystem services that these forests provide, the potential for increased fire risk in the dead stands, and the unattractive appearance of these dead trees, which result in lower property values and is an eyesore for the local population. Previous research has linked climate change to increased outbreak levels and the range expansion of this beetle. In my study, a geospatial analysis was used to identify susceptible forests under current and future climate conditions based on the mountain pine beetle’s temperature tolerance and host vegetation requirements. A climate envelope model was used, and thus the results determine the potential for mountain pine beetle attack but do not evaluate the results of future attacks. Historically, cold winter temperatures limited the range and magnitude of outbreaks; however, under the IPCC’s A1B climate scenario, nearly all of the pine forests in the study area will be susceptible by 2050. Under this scenario, some 400,000 additional acres of forest will become susceptible to outbreaks by 2050...

Surtos epidêmicos associados à infecção pelo herpesvírus tipo 6 (HHV-6) em creches comunitárias de Belém, Pará, Brasil; Outbreaks of human-herpes virus 6 (HHV-6) infection in day-care centers in Belém, Pará, Brazil

FREITAS, Ronaldo B.; MONTEIRO, Talita A.F.; LINHARES, Alexandre C.
Fonte: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo Publicador: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/12/2000 ENG
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Um total de 730 crianças com menos de 7 anos de idade, matriculadas em oito creches comunitárias (CCS) em Belém, Brasil foi acompanhado de janeiro a dezembro de 1997, com objetivo de se investigar a ocorrência de epidemias de infecção pelo HHV-6. Entre os meses de outubro e dezembro de 1997 foram registrados surtos de doença febril- exantemática acometendo cerca de 15-20% da população de cada CC. Amostras de soro e plasma foram obtidas de 401 (55,0%) das 730 crianças participantes, tendo como finalidade a detecção de anticorpos para o HHV-6 e amplificação do DNA viral, utilizando-se o método imunoenzimático (ELISA) e as provas de biologia molecular: reação em cadeia da polimerase (PCR) nested PCR. Infecção recente para o HHV-6 foi diagnosticada em 63,8% (256/401) das crianças, as quais, apresentaram anticorpos IgM e IgG (IgM+/IgG+). Dessas, 114 (44,5%) foram sintomáticas e 142 (55,5%) assintomáticas (p=0,03). Um subgrupo de 123 (30,7%) menores foi identificado como previamente imune (IgM-/IgG+) e 22 (5,5%) crianças não apresentaram anticorpos IgM e IgG (IgM-/IgG-). O DNA do HHV-6 foi detectado em 26 (22,0%) das 118 crianças selecionadas, apresentando resultados expressivos quanto à detecção de anticorpos IgM ( >; ou = 30 unidades PANBIO). Os resultados obtidos no ELISA e nested PCR comprovaram a ocorrência de infecção recente em 5 das 8 CCs sob acompanhamento. Evidência sorológica de infecção recente para o vírus de Epstein-Barr (EBV) e parvovírus B19 foi identificada em 2...

The use of hospital-based nurses for the surveillance of potential disease outbreaks

Durrheim,David N.; Harris,Bernice N.; Speare,Rick; Billinghurst,Kelvin
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 EN
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OBJECTIVE: To study a novel surveillance system introduced in Mpumalanga Province, a rural area in the north-east of South Africa, in an attempt to address deficiences in the system of notification for infectious conditions that have the potential for causing outbreaks. METHODS: Hospital-based infection control nurses in all of Mpumalanga’s 32 public and private hospitals were trained to recognize, report, and respond to nine clinical syndromes that require immediate action. Sustainability of the system was assured through a schedule of regular training and networking, and by providing feedback to the nurses. The system was evaluated by formal review of hospital records, evidence of the effective containment of a cholera outbreak, and assessment of the speed and appropriateness of responses to other syndromes. FINDINGS: Rapid detection, reporting and response to six imported cholera cases resulted in effective containment, with only 19 proven secondary cholera cases, during the two-year review period. No secondary cases followed detection and prompt response to 14 patients with meningococcal disease. By the end of the first year of implementation, all facilities were providing weekly zero-reports on the nine syndromes before the designated time. Formal hospital record review for cases of acute flaccid paralysis endorsed the value of the system. CONCLUSION: The primary goal of an outbreak surveillance system is to ensure timely recognition of syndromes requiring an immediate response. Infection control nurses in Mpumalanga hospitals have excelled in timely weekly zero-reporting...

Safety of community drinking-water and outbreaks of waterborne enteric disease: Israel, 1976-97

Tulchinsky,Theodore H.; Burla,Etti; Clayman,Marla; Sadik,Chantal; Brown,Alex; Goldberger,Shalom
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2000 EN
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Waterborne disease remains a major public health problem in many countries. We report findings on nearly three decades of waterborne disease in Israel and the part these diseases play in the total national burden of enteric disease. During the 1970s and 1980s, Israel’s community water supplies were frequently of poor quality according to the microbiological standards at that time, and the country experienced many outbreaks of waterborne enteric disease. New regulations raised water quality standards and made chlorination of community water supplies mandatory, as well as imposing more stringent guidelines on maintaining water sources and distribution systems for both surface water and groundwater. This was followed by improved compliance and water quality, and a marked decline in the number of outbreaks of waterborne disease; no outbreaks were detected between 1992 and 1997. The incidence of waterborne salmonellosis, shigellosis, and typhoid declined markedly as proportions of the total burden of these diseases, but peaked during the time in which there were frequent outbreaks of waterborne disease (1980-85). Long-term trends in the total incidence of reported infectious enteric diseases from all sources, including typhoid, shigellosis...