#Zika virus: #Epidemiological study and its association with #publichealth #risk (J Infect Public Health, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Infect Public Health. 2018 Apr 26. pii: S1876-0341(18)30043-1. doi: 10.1016/j.jiph.2018.04.007. [Epub ahead of print]

Zika virus: Epidemiological study and its association with public health risk.

Noor R1, Ahmed T2.

Author information: 1 Department of Microbiology, Stamford University Bangladesh, 51 Siddeswari Road, Dhaka 1217, Bangladesh. Electronic address: rashednoor@stamforuniversity.edu.bd. 2 Department of Microbiology, Stamford University Bangladesh, 51 Siddeswari Road, Dhaka 1217, Bangladesh. Electronic address: tasniaahned@stamforduniversity.edu.bd.



Propagation of Zika virus has become an alarming global public health issue. The infection is spreading rapidly to different countries by several methods, especially by the transmission through traveling. Bangladesh is also at a risk to be affected with such newly viral infections. Though the virus initially appears to cause mild problems, the long term effects are more devastating to the next generation as seen in case of the delivery of the microcephalic babies. Current review discussed the epidemiologic era of the virus; i.e., the administration of Zika virus in the non-human mammals and finally to the human host across the world. Typical sign-symptoms which can often be considered as dengue or chikungunya for their similarities have been stated. The diagnosis of Zika virus, the protective measures taken by mass people as well as the actions that should be endorsed to prevent acquisition of the infection from travelers are discussed.

KEYWORDS: Bangladesh; Epidemic transmission; Microcephaly; Public health risk; Zika virus

PMID: 29706319 DOI: 10.1016/j.jiph.2018.04.007

Keywords: Zika Virus; Public Health.


How Is #CDC Funded to Respond to #PublicHealth #Emergencies? Federal Appropriations and Budget Execution Process for Non-Financial Experts (Health Secur., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Health Secur. 2017 May/Jun;15(3):307-311. doi: 10.1089/hs.2017.0009. Epub 2017 Jun 2.

How Is CDC Funded to Respond to Public Health Emergencies? Federal Appropriations and Budget Execution Process for Non-Financial Experts.

Fischer LS, Santibanez S, Jones G, Anderson B, Merlin T.



The federal budgeting process affects a wide range of people who work in public health, including those who work for government at local, state, and federal levels; those who work with government; those who operate government-funded programs; and those who receive program services. However, many people who are affected by the federal budget are not aware of or do not understand how it is appropriated or executed. This commentary is intended to give non-financial experts an overview of the federal budget process to address public health emergencies. Using CDC as an example, we provide: (1) a brief overview of the annual budget formulation and appropriation process; (2) a description of execution and implementation of the federal budget; and (3) an overview of emergency supplemental appropriations, using as examples the 2009 H1N1 influenza pandemic, the 2014-15 Ebola outbreak, and the 2016 Zika epidemic. Public health emergencies require rapid coordinated responses among Congress, government agencies, partners, and sometimes foreign, state, and local governments. It is important to have an understanding of the appropriation process, including supplemental appropriations that might come into play during public health emergencies, as well as the constraints under which Congress and federal agencies operate throughout the federal budget formulation process and execution.

KEYWORDS: Epidemic management/response; Legal aspects; Legislative issues; Public health preparedness/response

PMID: 28574728 PMCID: PMC5510675 DOI: 10.1089/hs.2017.0009 [Indexed for MEDLINE]  Free PMC Article

Keywords: USA; US CDC; Pandemic Preparedness.


Mapping the #burden of #cholera in #subSaharan #Africa and implications for control: an analysis of data across geographical scales (Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

Mapping the burden of cholera in sub-Saharan Africa and implications for control: an analysis of data across geographical scales

Justin Lessler, PhD†, , Sean M Moore, PhD†, Francisco J Luquero, PhD, Heather S McKay, PhD, Rebecca Grais, PhD, Myriam Henkens, MD, Martin Mengel, MD, Jessica Dunoyer, MSc, Maurice M’bangombe, MSc, Elizabeth C Lee, PhD, Mamoudou Harouna Djingarey, MD, Bertrand Sudre, MD, Didier Bompangue, MD, Robert S M Fraser, BMeEng, Abdinasir Abubakar, MD, William Perea, MD, Dominique Legros, MD, Andrew S Azman, PhD

†Contributed equally

Published: 01 March 2018 / Open Access  / DOI: https://doi.org/10.1016/S0140-6736(17)33050-7

© 2018 The Author(s). Published by Elsevier Ltd.




Cholera remains a persistent health problem in sub-Saharan Africa and worldwide. Cholera can be controlled through appropriate water and sanitation, or by oral cholera vaccination, which provides transient (∼3 years) protection, although vaccine supplies remain scarce. We aimed to map cholera burden in sub-Saharan Africa and assess how geographical targeting could lead to more efficient interventions.


We combined information on cholera incidence in sub-Saharan Africa (excluding Djibouti and Eritrea) from 2010 to 2016 from datasets from WHO, Médecins Sans Frontières, ProMED, ReliefWeb, ministries of health, and the scientific literature. We divided the study region into 20 km × 20 km grid cells and modelled annual cholera incidence in each grid cell assuming a Poisson process adjusted for covariates and spatially correlated random effects. We combined these findings with data on population distribution to estimate the number of people living in areas of high cholera incidence (>1 case per 1000 people per year). We further estimated the reduction in cholera incidence that could be achieved by targeting cholera prevention and control interventions at areas of high cholera incidence.


We included 279 datasets covering 2283 locations in our analyses. In sub-Saharan Africa (excluding Djibouti and Eritrea), a mean of 141 918 cholera cases (95% credible interval [CrI] 141 538–146 505) were reported per year. 4·0% (95% CrI 1·7–16·8) of districts, home to 87·2 million people (95% CrI 60·3 million to 118·9 million), have high cholera incidence. By focusing on the highest incidence districts first, effective targeted interventions could eliminate 50% of the region’s cholera by covering 35·3 million people (95% CrI 26·3 million to 62·0 million), which is less than 4% of the total population.


Although cholera occurs throughout sub-Saharan Africa, its highest incidence is concentrated in a small proportion of the continent. Prioritising high-risk areas could substantially increase the efficiency of cholera control programmes.


The Bill & Melinda Gates Foundation.

Keywords: Cholera; Africa Region.


#Plague in #Madagascar — A #Tragic #Opportunity for Improving #PublicHealth (N Engl J Med., extract)

[Source: The New England Journal of Medicine, full page: (LINK). Excerpt, edited.]

Plague in Madagascar — A Tragic Opportunity for Improving Public Health

Paul S. Mead, M.D., M.P.H.

December 20, 2017 / DOI: 10.1056/NEJMp1713881


When plague first arrived in Madagascar in November 1898, its appearance mirrored events in port cities around the world. Alexandria, Bombay, Buenos Aires, San Francisco, Saigon, and Sydney were all affected as part of the “third pandemic,” a global event that began in China but spread widely with the aid of long-distance steamships. Like the Justinian Plague of 542 c.e. and the Black Death of 1346 c.e., the third pandemic took millions of lives and disrupted societies. Although the disease eventually died out in some regions, enzootic foci established during the third pandemic persist in many areas, including the western United States and the central highlands of Madagascar.



Disclosure forms provided by the author are available at NEJM.org.

The views expressed in this article are those of the author and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.

This article was published on December 20, 2017, at NEJM.org.

Source Information: From the Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO.

Keywords: Plague; Madagascar; Public Health.


#Morbidity and #mortality in #homeless individuals, #prisoners, #sexworkers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis (Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis

Dr Robert W Aldridge, PhD, Alistair Story, PhD, Prof Stephen W Hwang, MD, Prof Merete Nordentoft, DMSc, Serena A Luchenski, FFPH, Greg Hartwell, MFPH, Emily J Tweed, MFPH, Dan Lewer, MSc, Srinivasa Vittal Katikireddi, PhD, ProfAndrew C Hayward, MD

Published: 11 November 2017 / Open Access / DOI: http://dx.doi.org/10.1016/S0140-6736(17)31869-X

© 2017 The Author(s). Published by Elsevier Ltd.




Inclusion health focuses on people in extremely poor health due to poverty, marginalisation, and multimorbidity. We aimed to review morbidity and mortality data on four overlapping populations who experience considerable social exclusion: homeless populations, individuals with substance use disorders, sex workers, and imprisoned individuals.


For this systematic review and meta-analysis, we searched MEDLINE, Embase, and the Cochrane Library for studies published between Jan 1, 2005, and Oct 1, 2015. We included only systematic reviews, meta-analyses, interventional studies, and observational studies that had morbidity and mortality outcomes, were published in English, from high-income countries, and were done in populations with a history of homelessness, imprisonment, sex work, or substance use disorder (excluding cannabis and alcohol use). Studies with only perinatal outcomes and studies of individuals with a specific health condition or those recruited from intensive care or high dependency hospital units were excluded. We screened studies using systematic review software and extracted data from published reports. Primary outcomes were measures of morbidity (prevalence or incidence) and mortality (standardised mortality ratios [SMRs] and mortality rates). Summary estimates were calculated using a random effects model.


Our search identified 7946 articles, of which 337 studies were included for analysis. All-cause standardised mortality ratios were significantly increased in 91 (99%) of 92 extracted datapoints and were 11·86 (95% CI 10·42–13·30; I2=94·1%) in female individuals and 7·88 (7·03–8·74; I2=99·1%) in men. Summary SMR estimates for the International Classification of Diseases disease categories with two or more included datapoints were highest for deaths due to injury, poisoning, and other external causes, in both men (7·89; 95% CI 6·40–9·37; I2=98·1%) and women (18·72; 13·73–23·71; I2=91·5%). Disease prevalence was consistently raised across the following categories: infections (eg, highest reported was 90% for hepatitis C, 67 [65%] of 103 individuals for hepatitis B, and 133 [51%] of 263 individuals for latent tuberculosis infection), mental health (eg, highest reported was 9 [4%] of 227 individuals for schizophrenia), cardiovascular conditions (eg, highest reported was 32 [13%] of 247 individuals for coronary heart disease), and respiratory conditions (eg, highest reported was 9 [26%] of 35 individuals for asthma).


Our study shows that homeless populations, individuals with substance use disorders, sex workers, and imprisoned individuals experience extreme health inequities across a wide range of health conditions, with the relative effect of exclusion being greater in female individuals than male individuals. The high heterogeneity between studies should be explored further using improved data collection in population subgroups. The extreme health inequity identified demands intensive cross-sectoral policy and service action to prevent exclusion and improve health outcomes in individuals who are already marginalised.


Wellcome Trust, National Institute for Health Research, NHS England, NHS Research Scotland Scottish Senior Clinical Fellowship, Medical Research Council, Chief Scientist Office, and the Central and North West London NHS Trust.

Keywords: Society; Poverty; Public Health.


#Socioeconomic #status and #impact of the #economic #crisis on #dietary #habits in #Italy: results from the INHES study (J Public Health, abstract)

[Source: Journal of Public Health, full page: (LINK). Abstract, edited.]

Socioeconomic status and impact of the economic crisis on dietary habits in Italy: results from the INHES study

Marialaura Bonaccio, Augusto Di Castelnuovo, Americo Bonanni, Simona Costanzo, Mariarosaria Persichillo, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello, on behalf of the INHES Study Investigators on behalf of the INHES Study Investigators

Journal of Public Health, https://doi.org/10.1093/pubmed/fdx144

Published: 08 November 2017 – Received: 11 May 2017 – Revision Received: 07 September 2017 – Accepted: 10 October 2017

Citation: Marialaura Bonaccio, Augusto Di Castelnuovo, Americo Bonanni, Simona Costanzo, Mariarosaria Persichillo, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello, on behalf of the INHES Study Investigators; Socioeconomic status and impact of the economic crisis on dietary habits in Italy: results from the INHES study, Journal of Public Health, https://doi.org/10.1093/pubmed/fdx144

© 2017 Oxford University Press




There is lack of evidence about the likely impact of the economic crisis on dietary habits in Western societies. We aimed to assess dietary modifications that possibly occurred during the recession and to investigate major socioeconomic factors associated with such modifications.


Cross-sectional analysis on 1829 subjects from the general population recruited in the larger INHES study (n = 9319) a telephone-based survey on nutrition and health conducted in Italy from 2010 to 2013. Association of socioeconomic (education, household income, occupation) with self-reported impact of the economic crisis on dietary habits was tested by multivariable logistic regression analysis.


Low-educated subjects (OR = 2.30; 95% CI: 1.39–3.80), those with poor income (OR = 5.71; 95% CI: 3.68–8.85), and unemployed (OR = 3.93; 95% CI: 1.62–9.56) had higher odds of reporting undesirable dietary changes due to recession. Adherence to the Mediterranean diet was lower in subjects reporting a negative impact of the crisis on diet as compared to those declaring no effect, whereas the quality of grocery items was higher in the latter.


Undesirable dietary changes due to the economic crisis were mainly reported by lower socioeconomic groups. Subjects perceiving a negative impact of the recession on their diet also showed a lower adherence to Mediterranean diet and reduced quality of grocery products.

epidemiology, food and nutrition, socioeconomics factors

Issue Section: Original Article

© The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Keywords: Society; Poverty; Public Health; Italy; Economic Recession.


#Global #Disease #Detection—#Achievements in Applied Public Health Research, Capacity Building, and Public Health #Diplomacy, 2001–2016 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 23, Supplement—December 2017 / Research

Global Disease Detection—Achievements in Applied Public Health Research, Capacity Building, and Public Health Diplomacy, 2001–2016

Carol Y. Rao  , Grace W. Goryoka, Olga L. Henao, Kevin R. Clarke, Stephanie J. Salyer, and Joel M. Montgomery

Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C.Y. Rao, G.W. Goryoka, O.L. Henao, K.R. Clarke, S.J. Salyer, J.M. Montgomery); Emory University, Atlanta (G.W. Goryoka)



The US Centers for Disease Control and Prevention has established 10 Global Disease Detection (GDD) Program regional centers around the world that serve as centers of excellence for public health research on emerging and reemerging infectious diseases. The core activities of the GDD Program focus on applied public health research, surveillance, laboratory, public health informatics, and technical capacity building. During 2015–2016, program staff conducted 205 discrete projects on a range of topics, including acute respiratory illnesses, health systems strengthening, infectious diseases at the human–animal interface, and emerging infectious diseases. Projects incorporated multiple core activities, with technical capacity building being most prevalent. Collaborating with host countries to implement such projects promotes public health diplomacy. The GDD Program continues to work with countries to strengthen core capacities so that emerging diseases can be detected and stopped faster and closer to the source, thereby enhancing global health security.

Keywords: Emerging Diseases; Infectious Diseases; Global Health; Public Health; International Cooperation.