scholarly journals Vector Surveillance, Host Species Richness, and Demographic Factors as West Nile Disease Risk Indicators

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 934
Author(s):  
John M. Humphreys ◽  
Katherine I. Young ◽  
Lee W. Cohnstaedt ◽  
Kathryn A. Hanley ◽  
Debra P. C. Peters
Keyword(s):  
Risk Assessment ◽  
Species Richness ◽  
Host Species ◽  
Disease Risk ◽  
The United States ◽  
Risk Indicators ◽  
Vector Surveillance ◽  
West Nile ◽  
Risk Of Death ◽  
The Us

West Nile virus (WNV) is the most common arthropod-borne virus (arbovirus) in the United States (US) and is the leading cause of viral encephalitis in the country. The virus has affected tens of thousands of US persons total since its 1999 North America introduction, with thousands of new infections reported annually. Approximately 1% of humans infected with WNV acquire neuroinvasive West Nile Disease (WND) with severe encephalitis and risk of death. Research describing WNV ecology is needed to improve public health surveillance, monitoring, and risk assessment. We applied Bayesian joint-spatiotemporal modeling to assess the association of vector surveillance data, host species richness, and a variety of other environmental and socioeconomic disease risk factors with neuroinvasive WND throughout the conterminous US. Our research revealed that an aging human population was the strongest disease indicator, but climatic and vector-host biotic interactions were also significant in determining risk of neuroinvasive WND. Our analysis also identified a geographic region of disproportionately high neuroinvasive WND disease risk that parallels the Continental Divide, and extends southward from the US–Canada border in the states of Montana, North Dakota, and Wisconsin to the US–Mexico border in western Texas. Our results aid in unraveling complex WNV ecology and can be applied to prioritize disease surveillance locations and risk assessment.

scholarly journals 338. Analysis of Etiologies of Aseptic Meningitis within a Nation-Wide Hospital Network

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S239-S239
Author(s):  
Arunmozhi S Aravagiri ◽  
Scott Kubomoto ◽  
Ayutyanont Napatkamon ◽  
Sarah Wilson ◽  
Sudhakar Mallela
Keyword(s):  
United States ◽  
West Nile Virus ◽  
Aseptic Meningitis ◽  
Epidemiologic Study ◽  
The United States ◽  
Positive Test ◽  
Diagnostic Tools ◽  
West Nile ◽  
Varicella Zoster ◽  
The Us

Abstract Background Aseptic meningitis can be caused by an array of microorganisms, both bacterial and non-bacterial, as well as non-infectious conditions. Some etiologies of aseptic meningitis require treatment with antibiotics, antiviral, antifungals, anti-parasitic agents, immunosuppressants, and or chemotherapy. There are limited diagnostic tools for diagnosing certain types of aseptic meningitis, therefore knowing the differential causes of aseptic meningitis, and their relative percentages may assist in diagnosis. Review of the literature reveals that there are no recent studies of etiologies of aseptic meningitis in the United States (US). This is an epidemiologic study to delineate etiologies of aseptic meningitis in a large database of 185 HCA hospitals across the US. Methods Data was collected from January 2016 to December 2019 on all patients diagnosed with meningitis. CSF PCR studies, and CSF antibody tests were then selected for inclusion. Results Total number of encounters were 3,149 hospitalizations. Total number of individual labs analyzed was 10,613, and of these 262 etiologies were identified. 23.6% (62) of cases were due to enterovirus, 18.7% (49) due to HSV-2, 14.5% (38) due to West Nile virus, 13.7% (36) due to Varicella zoster (VZV), 10.5% (27) due to Cryptococcus. Additionally, we analyzed the rate of positive test results by region. Nationally, 9.7% of tests ordered for enterovirus were positive. In contrast, 0.5% of tests ordered for HSV 1 were positive. The southeastern United States had the highest rate of positive tests for HSV 2 (7% of tests ordered for HSV 2 were positive). The central United States had the highest rate of positive test for West Nile virus (11% of tests ordered for West Nile were positive). The northeastern region and the highest rate of positive tests for varicella zoster (18%). Table 1: Percentage of positive CSF tests (positive tests/tests ordered) Table 2: Lists the number of HIV patients and transplant patients that had positive CSF PCR/serologies Figure 1: Percentage of positive CSF tests in each region Conclusion Approximately 40% of aseptic meningitis population had treatable etiologies. A third of the Cryptococcus meningitis population had HIV. Furthermore, enteroviruses had the majority of cases within the US, which are similar to studies done in other parts of the world. Disclosures All Authors: No reported disclosures

Framework for Colorectal Cancer Health Needs Assessment in North and Central Asian Countries

2021 ◽  
Vol 6 (09) ◽  
pp. 569-575
Author(s):  
Rebecca Pratiti
Keyword(s):  
Colorectal Cancer ◽  
Risk Assessment ◽  
Disease Risk ◽  
Population Attributable Risk ◽  
National Income ◽  
Risk Indicators ◽  
Asian Countries ◽  
Central Asian ◽  
Central Asian Countries ◽  
Per Capita

Colorectal cancer (CRC) is the third leading cause for cancer worldwide. Prevalence of CRC is increasing in North and Central Asian Countries (NCAC). European guidelines encourage member countries to allocate resources for primary prevention of CRC through screening. Though, cost-effective screening is becoming a priority. A framework for health priority determination to prioritize CRC screening was developed. Public health websites were accessed to abstract epidemiologic data. The framework included prioritization by absolute risk (incidence, prevalence), relative risk (CRC ranking for national cancer deaths) and population attributable risk for the disease. Risk indicators were identified for the NCAC. Further detailed risk assessment scoring was completed to assess the CRC disease burden. Statistical analysis was performed for correlation. Variables included in risk assessment were population, life expectancy, gross national income per capita, percent GDP spent on health expenditure, total expenditure on health per capita, age standardized mortality to incidence ratio, cancer ranking by incidence and smoking prevalence. Risk assessment showed Kyrgyzstan, Georgia, Belarus and Armenia have more than expected CRC burden. Tajikistan, Turkmenistan and Latvia have lower than expected CRC burden. Conclusion: Identifying high CRC burden countries to prioritize screening is important. Uniform and comparable CRC risk indicators for the region is needed. Health need assessment and priority setting is important for better distribution of resources. Countries with lower risk score may implement preventive policy to reduce CRC risk factors and countries with higher risk could adapt mitigating policy for early diagnosis of CRC.

scholarly journals VALIDATION OF RISK INDICATORS IN ASSESSING THE SAFETY OF ELECTRICAL EQUIPMENT BOILER HOUSE IN THUNDERSTORM

Fire Safety ◽  
2021 ◽  
Vol 38 ◽  
pp. 24-31
Author(s):  
Yu. Rudyk ◽  
O. Nazarovets ◽  
I. Golovatchuk ◽  
N. Beznos
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Electrical Equipment ◽  
Risk Indicators ◽  
Economic Losses ◽  
Individual Risk ◽  
Lightning Protection ◽  
Protection Measures ◽  
Risk Of Death ◽  
Boiler Environment

Introduction. Today requires the introduction and arrangement of modern enterprises automation of the technological process using various electronic and electrical equipment. The breakdown of one sensor leads to a stoppage of the technical process and thousands of losses. This equipment is sensitive to impulse overvoltages that occur for various reasons, as well as when hit by lightning. There is a misconception that the danger of lightning arises only when struck directly, forgetting about the socalled secondary phenomena, namely electromagnetic and electrostatic pulses. Pulse overvoltage is a short-term increase in voltage above the allowable value. Lightning protection systems are designed and designed to protect objects from dangerous lightning.Purpose. Given the automation of the process and the saturation of boilers with electronic and electrical equipment, there is a high risk of lightning and high potentials, which can lead to large-scale accidents. The purpose of this article is to validate the risk indicators for the boiler environment that occur during a thunderstorm.Methods. The use of various methods of calculation, assessment and ordering of risks during the design and layout of the system allows to implementation system lightning protection of buildings, equipment and people. General principles of risk assessment for the boiler environment must take into account: risk and determine the need for protection; the contribution of various risk components to the overall risk; the effect of various protection measures to reduce risk; selection of protection measures taking into account their economic efficiency.Results. Neglecting the high risk of a dangerous event leads to excessive damage and m irreparable losses, with which a person or community will not be able to achieve sustainable development. Therefore, it is a comprehensive, systematic approach to achieving safety, starting from the assessment stage, should take into account both the characteristics of the hazard, including a fire in the relevant facilities, and personal, the individual risk of death or injury. Lightning is an unpredictable natural event, no one in the world fully understands the mechanism of lightning and it is impossible to provide 100% protection under any circumstances under any standardization. For this purpose, the following calculations are given: loss of human life, including injuries; loss of the ability to provide public services; losses of cultural heritage and economic value of the building (structure) and economic losses required for the installation and operation of the system. Based on the obtained data, it is seen how the reduction of each risk is achieved depending on the proposed solution and the economic effect in general.Conclusion. Statistics on deaths and injuries from lightning hazards, losses from damage to property, buildings and struc-tures confirm that in risk assessment, which is standardized in DSTU EN 62305-2, it is necessary to introduce a methodology that would meet the conditions of Ukraine. The arrangement of the lightning protection system depends on the risk assessment, the reaction of the owner, the influence of control bodies. Therefore, it is important to decide on fire protection measures in lightning risk assessment procedures, but it can also be taken regardless of the results of the risk assessment where there is a desire to avoid unacceptable risk. Equipment that is often associated with two different services, e.g. power lines and data lines suffer a lot of surge damage. This case is not covered by the RX risk component. However, appropriate protection measures can be selected and established (see IEC 62305-4).

scholarly journals Integrating Spatiotemporal Epidemiology, Eco-Phylogenetics, and Distributional Ecology to Assess West Nile Disease Risk in Horses

Viruses ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1811
Author(s):  
John M. Humphreys ◽  
Angela M. Pelzel-McCluskey ◽  
Lee W. Cohnstaedt ◽  
Bethany L. McGregor ◽  
Kathryn A. Hanley ◽  
...  
Keyword(s):  
Community Dynamics ◽  
Disease Risk ◽  
Bird Species ◽  
Integrated Approach ◽  
The United States ◽  
Host Community ◽  
Avian Host ◽  
West Nile ◽  
Phylogenetic Structure ◽  
Vaccination Programs

Mosquito-borne West Nile virus (WNV) is the causative agent of West Nile disease in humans, horses, and some bird species. Since the initial introduction of WNV to the United States (US), approximately 30,000 horses have been impacted by West Nile neurologic disease and hundreds of additional horses are infected each year. Research describing the drivers of West Nile disease in horses is greatly needed to better anticipate the spatial and temporal extent of disease risk, improve disease surveillance, and alleviate future economic impacts to the equine industry and private horse owners. To help meet this need, we integrated techniques from spatiotemporal epidemiology, eco-phylogenetics, and distributional ecology to assess West Nile disease risk in horses throughout the contiguous US. Our integrated approach considered horse abundance and virus exposure, vector and host distributions, and a variety of extrinsic climatic, socio-economic, and environmental risk factors. Birds are WNV reservoir hosts, and therefore we quantified avian host community dynamics across the continental US to show intra-annual variability in host phylogenetic structure and demonstrate host phylodiversity as a mechanism for virus amplification in time and virus dilution in space. We identified drought as a potential amplifier of virus transmission and demonstrated the importance of accounting for spatial non-stationarity when quantifying interaction between disease risk and meteorological influences such as temperature and precipitation. Our results delineated the timing and location of several areas at high risk of West Nile disease and can be used to prioritize vaccination programs and optimize virus surveillance and monitoring.

scholarly journals Reviewing Disasters: Hospital Evacuations in the United States from 2000 to 2017

2019 ◽  
Vol 34 (s1) ◽  
pp. s22-s22
Author(s):  
Aishwarya Sharma ◽  
Sharon Mace
Keyword(s):  
United States ◽  
Risk Assessment ◽  
The United States ◽  
Mortality Rates ◽  
National Registry ◽  
External Threats ◽  
The Us ◽  
States Data ◽  
External Causes ◽  
Bomb Threats

Introduction:Between 2000 to 2017, there were over 150 hospital evacuations in the United States. Data received from approximately 35 states were primarily concentrated in California, Florida, and Texas. This analysis will provide disaster planners and administrators statistics on hazards that cause disruptions to hospital facilities.Aim:The aim of this study is to investigate US hospital evacuations by compiling the data into external, internal, and man-made disasters thus creating a risk assessment for disaster planning.Methods:Hospital reports were retrieved from LexisNexis, Google, and PubMed databases and categorized according to evacuees, duration, location, and type. These incidents were grouped into three classifications: external, internal, and man-made. Both partial and full evacuations were included in the study design.Results:There were a total of 154 reported evacuations in the United States. 110 (71%) were due to external threats, followed by 24 (16%) man-made threats, and 20 (13%) internal threats. Assessing the external causes, 60 (55%) were attributed to hurricanes, 21 (19%) to wildfires, and 8 (7%) to storms. From the internal threats, 8 (40%) were attributed to hospital fires and 4 (20%) chemical fumes. From the man-made threats, 6 (40%) were attributed to bomb threats and 4 (27%) gunmen. From the 20 total reported durations of evacuations, 9 (45%) lasted between 2 to 11:59 hours, 6 (30%) lasted over 24 hours, and 5 (25%) lasted up to 1:59 hours.Discussion:Over 70% of hospital evacuations in the US were due to natural disasters. Compared to 1971-1999, there was an increase in internal and man-made threats. Exact statistics on evacuees, durations, injuries, and mortality rates were unascertainable due to a lack of reporting. It is critical to implement a national registry to report specifics on incidences of evacuations to further assist with disaster and infrastructure planning.

scholarly journals LNTgate

2017 ◽  
Vol 1 ◽  
pp. 239784731769499 ◽  
Author(s):  
Edward J Calabrese
Keyword(s):  
Risk Assessment ◽  
Biological Effects ◽  
The United States ◽  
Cancer Risk Assessment ◽  
Response Model ◽  
Historical Evidence ◽  
National Academy Of Sciences ◽  
Linear Dose ◽  
The Us ◽  
Academy Of Sciences

This commentary summarizes a spate of recent papers that provide historical evidence that the 1956 recommendation of the US National Academy of Sciences Biological Effects of Atomic Radiation I Genetics Panel to switch from a threshold to a linear dose–response model for risk assessment was an ideologically motivated decision based on deliberate falsification and fabrication of the research record. The recommendation by the Genetics Panel had far-reaching influence, affecting cancer risk assessment, risk communication strategies, community public health, and numerous medical practices in the United States and worldwide. This commentary argues that the toxicology, risk assessment, and regulatory communities examine this issue, addressing how these new historical evaluations affect the history and educational practices of these fields as well as carcinogen regulation.

Evaluating Prognostic Factors for Liver Transplantation Among United States Patients With Hereditary Transthyretin-Mediated (hATTR) Amyloidosis Using National Registry Data

2019 ◽  
Vol 29 (3) ◽  
pp. 213-219
Author(s):  
Danielle Brandman ◽  
Hollis Lin ◽  
Anastasia McManus ◽  
Sonalee Agarwal ◽  
Larry M. Gache ◽  
...  
Keyword(s):  
United States ◽  
Liver Transplantation ◽  
Prognostic Factors ◽  
Selection Criterion ◽  
Reference Population ◽  
The United States ◽  
Transplant Survival ◽  
Post Transplant ◽  
Risk Of Death ◽  
The Us

Introduction: Orthotopic liver transplantation has been used as a treatment for hereditary transthyretin-mediated (hATTR) amyloidosis, a rare, progressive, and multisystem disease. Research Question: The objective is to evaluate survival outcomes post-liver transplantation in patients with hATTR amyloidosis in the United States and assess whether previously published prognostic factors of patient survival in hATTR amyloidosis are generalizable to the US population. Design: This cohort study examined patients with hATTR amyloidosis undergoing liver transplant in the United States (N = 168) between March 2002 and March 2016 using data reported to the Organ Procurement and Transplantation Network (UNOS)/United Network for Organ Sharing (OPTN). Results: A multivariable Cox hazards regression model showed among all factors tested, only modified body mass index (kg/m2 × g/L) at the time of transplant was significantly associated with survival. Higher modified BMI was associated with lower risk of death relative to a reference population (<600) with historically poor post-transplant outcomes. Patients with modified BMI 1000 to <1200 (hazard ratio [HR] = 0.27; 95% confidence interval [CI] = 0.10-0.73), 1200 to <1400 (HR = 0.20; 95% CI = 0.06-0.75), and ≥1400 (HR = 0.15; 95% CI = 0.04-0.61) exhibited improved adjusted 5-year post-transplant survival of 74%, 80%, and 85%, respectively, versus 33% in the reference population. Discussion: The association between a higher modified BMI threshold at the time of transplant and improved post-transplant survival suggests that the previously published patient selection criterion for modified BMI may not be applicable to the US population.

scholarly journals Assessing Ultra-Fine-Scale Factors to Improve Human West Nile Virus Disease Models in the Chicago Area

2020 ◽  
Author(s):  
Johnny Uelmen ◽  
Patrick Irwin ◽  
William Brown ◽  
Surendra Karki ◽  
Marilyn O'Hara Ruiz ◽  
...  
Keyword(s):  
United States ◽  
West Nile Virus ◽  
Disease Risk ◽  
The United States ◽  
Cook County ◽  
Scale Model ◽  
Fine Scale ◽  
West Nile ◽  
Chicago Area ◽  
Mosquito Infection

Abstract Background: Since 1999, West Nile virus (WNV) has moved rapidly across the United States, resulting in tens of thousands of human cases. Both the number of human cases and the level of mosquito infection (MIR) vary across time and space and are related to numerous abiotic and biotic forces, ranging from differences in microclimates to socio-demographic factors. Because the interactions among these multiple factors affect the locally variable risk of WNV illness, it has been especially difficult to model human disease risk across varying spatial and temporal scales. Cook and DuPage Counties, comprising the city of Chicago and surrounding suburbs, are among the areas hardest hit by WNV in the United States. Despite active mosquito control efforts, there is consistent annual WNV presence, resulting in more than 285 confirmed WNV human cases and 20 deaths in the past 5 years in Cook County alone. Methods: A previous WNV model for the greater Chicago area identified the fifty-five most high and low risk study areas in the Northwest Mosquito Abatement District (NWMAD), an enclave ¼ the size of the previous study area. In these locations, human WNV risk was stratified by strength of predictive success, as indicated by differences in studentized residuals. Within these areas, an additional two-years of field collections and data processing was added to a 10-year WNV dataset and assessed by an ultra-fine-scale multivariate logistic regression model.Results: Multivariate statistical approaches revealed that this ultra-fine-scale model resulted in fewer explanatory variables while improving upon the fit of the existing model. Beyond mosquito infection rates and climatic factors, efforts to acquire additional covariates only slightly improve model predictive performance. Conclusions: These results suggest human WNV illness in the Chicago area may be associated with fewer, but increasingly critical, key variables at finer scales. Given limited resources, this study suggests a large variation in the significance to model performance, and provides guidance in covariate selection for optimal WNV human illness modeling.

scholarly journals A  framework for surveillance of emerging pathogens  at the human-animal interface: pigs and coronaviruses as a case study            

2020 ◽  
Author(s):  
Kim Pepin ◽  
Ryan Miller ◽  
Mark Wilber
Keyword(s):  
Risk Assessment ◽  
Disease Risk ◽  
Population Level ◽  
The United States ◽  
Surveillance Program ◽  
Intermediate Hosts ◽  
Emerging Pathogens ◽  
New Information ◽  
Spatio Temporal ◽  
Using Data

Pigs (Sus scrofa) may be important surveillance targets for risk assessment and risk-based control planning against emerging zoonoses. Pigs have high-contact rates with humans and other animals, transmit similar pathogens as humans including CoVs, and serve as reservoirs and intermediate hosts for notable human pandemics.Wild and domestic pigs both interface with humans and each other but have unique ecologies that demand different surveillance strategies. Three fundamental questions shape any surveillance program: where, when, and how can surveillance be conducted to optimize the surveillance objective? Using theory of mechanisms of zoonotic spillover and data on risk factors, we propose a framework for determining where surveillance might begin initially to maximize a detection in each host species at their interface. We illustrate the utility of the framework using data from the United States. We then discuss variables to consider in refining when and how to conduct surveillance. Recent advances in accounting for opportunistic sampling designs and in translating serology samples into infection times provide promising directions for extracting spatio-temporal estimates of disease risk from typical surveillance data. Such robust estimates of population-level disease risk allow surveillance plans to be updated in space and time based on new information (adaptive surveillance) thus optimizing allocation of surveillance resources to maximize the quality of risk assessment insight.

Sign in / Sign up

Export Citation Format

Share Document