Eliminating #Cholera #Transmission in #Haiti (N Engl J Med., extract)

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


Eliminating Cholera Transmission in Haiti

Louise C. Ivers, M.D., M.P.H.

December 7, 2016 / DOI: 10.1056/NEJMp1614104


When Hurricane Matthew struck on October 4, 2016, it left 1.4 million people in southern Haiti in need of urgent humanitarian assistance; it destroyed homes and health care facilities, flooded water sources with runoff, ruined crops, killed livestock, and displaced hundreds of thousands of people. Looming as the next act in the disaster is a resurgence in endemic cholera.



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

This article was published on December 7, 2016, at NEJM.org.


Source Information

From the Division of Global Health Equity, Brigham and Women’s Hospital, Boston; and the Special Consulting Group to the Minister of Health and Population of Haiti, Port-au-Prince. The other members of the Special Consulting Group were Dr. Daphnee Delsoin Benoit, the Honorable Minister of Health and Population, Port-au-Prince, Haiti; Dr. Dennis Chao, Institute for Disease Modeling, Bellevue, WA; Dr. Donald Francois, Ministry of Health and Population, Port-au-Prince, Haiti; Dr. Jeannot Francois, Director of Expanded Program on Immunization, Ministry of Health and Population, Port-au-Prince, Haiti; Dr. Roger Glass, Fogarty International Center, National Institutes of Health (NIH), Bethesda, MD; Dr. Robert Hall, National Institute of Allergy and Infectious Diseases, NIH; Dr. Jerome H. Kim, International Vaccine Institute, Seoul, South Korea; Dr. Bernard Liautaud, Ministry of Health, Port-au-Prince, Haiti; Prof. Ira Longini, University of Florida, Gainesville; Ms. Helen Matzger, Bill and Melinda Gates Foundation, Seattle; Dr. Vittal Mogasale, International Vaccine Institute, Seoul, South Korea; Prof. Glenn Morris, University of Florida, Gainesville; Prof. Jean W. Pape, Weill Cornell Medical College, New York; Prof. David Sack, Johns Hopkins University, Baltimore; and Dr. Jordan Tappero, Centers for Disease Control and Prevention, Atlanta.

Keywords: Cholera; Haiti; Vaccines; Public Health.


#Quarantine for #Zika Virus? Where is the #Science? (Disaster Med Public Health Prep., abstract)

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

Disaster Med Public Health Prep. 2016 Oct;10(5):704-706. Epub 2016 Apr 1.

Quarantine for Zika Virus? Where is the Science?

Koenig KL1.

Author information: 1Center for Disaster Medical Sciences,University of California at Irvine,Orange,California.



In January 2016, the World Health Organization warned that Zika virus is “spreading explosively” in the Americas and that up to 4 million infections could be present worldwide within a year. Soon thereafter, some politicians and authors publicly advocated for quarantine of travelers returning from regions where mosquitoes carrying Zika virus are prevalent. The public health tool of quarantine can be used to prevent the spread of infection by restricting the movement of persons who have been exposed to a deadly disease that can be transmitted from person to person before symptom onset. With 80% of Zika virus infections being asymptomatic, no rapid test being available to detect the virus, and primary transmission being via the bites of certain mosquitoes, application of quarantine in this setting is not scientifically sound or practically feasible. Rather, public health interventions should focus on preventing bites from infected mosquitoes, counseling pregnant women on the risks of fetal microcephaly and other birth defects, and identifying patients with signs and symptoms of Guillain-Barré syndrome. As was seen in the Ebola virus disease outbreak of 2014, non-evidence-based factors can influence policy decisions. Public health experts must ensure that policy makers are informed that quarantine is not a scientifically sound approach for the control of Zika virus. (Disaster Med Public Health Preparedness. 2016;0:1-3).

KEYWORDS: Ebola; Zika; health policy; isolation; quarantine

PMID: 27032458 DOI: 10.1017/dmp.2016.56

[PubMed – in process]

Keywords: Zika Virus; Public Health; Quarantine.


#Climate and #health: joining up the pieces, scaling up the action (Lancet, summary)

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


Climate and health: joining up the pieces, scaling up the action

The Lancet / Article has an altmetric score of 10 / DOI: http://dx.doi.org/10.1016/S0140-6736(16)31852-9

© 2016 Elsevier Ltd. All rights reserved.



On Oct 18, the UK Health Alliance on Climate Change published its inaugural report, A Breath of Fresh Air, Addressing Climate Change and Air Pollution Together for Health. The report builds on the Royal College of Physicians and Royal College of Paediatrics and Child Health report Every Breath We Take, published February, 2016.

Keywords: Environmental Pollution; Climate Change; Public Health.


The #history, #geography, and #sociology of #slums and the #health #problems of people who live in slums (Lancet, abstract)

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


The history, geography, and sociology of slums and the health problems of people who live in slums

Alex Ezeh, PhD, Oyinlola Oyebode, PhD, David Satterthwaite, PhD, Yen-Fu Chen, PhD, Robert Ndugwa, PhD, Jo Sartori, BA, Blessing Mberu, PhD, G J Melendez-Torres, PhD, Tilahun Haregu, PhD, Samuel I Watson, PhD, Prof Waleska Caiaffa, PhD, Prof Anthony Capon, PhD, Prof Richard J Lilford, DS

Article has an altmetric score of 7 / DOI: http://dx.doi.org/10.1016/S0140-6736(16)31650-6

© 2016 Elsevier Ltd. All rights reserved.



Massive slums have become major features of cities in many low-income and middle-income countries. Here, in the first in a Series of two papers, we discuss why slums are unhealthy places with especially high risks of infection and injury. We show that children are especially vulnerable, and that the combination of malnutrition and recurrent diarrhoea leads to stunted growth and longer-term effects on cognitive development. We find that the scientific literature on slum health is underdeveloped in comparison to urban health, and poverty and health. This shortcoming is important because health is affected by factors arising from the shared physical and social environment, which have effects beyond those of poverty alone. In the second paper we will consider what can be done to improve health and make recommendations for the development of slum health as a field of study.

Keywords: Society; Poverty; Public Health.


#Antimicrobial #Resistance (JAMA, abstract)

[Source: The Journal of the American Medical Association, full page: (LINK). Abstract, edited.]

Special Communication | September 20, 2016 | FREE

Antimicrobial Resistance

Hilary D. Marston, MD, MPH1; Dennis M. Dixon, PhD2; Jane M. Knisely, PhD2; Tara N. Palmore, MD3; Anthony S. Fauci, MD1

JAMA. 2016;316(11):1193-1204. doi:10.1001/jama.2016.11764. Text Size: A A A




The development of antibiotics is considered among the most important advances of modern science. Antibiotics have saved millions of lives. However, antimicrobial resistance (AMR) threatens this progress and presents significant risks to human health.


To identify factors associated with AMR, the current epidemiology of important resistant organisms, and possible solutions to the AMR problem.

Data Sources, Study Selection, and Data Synthesis

PubMed (2000-2016), NIH REPORTER, and ClinicalTrials.gov databases were searched for articles and entries related to AMR, focusing on epidemiology, clinical effects of AMR, discovery of novel agents to treat AMR bacterial infections, and nonpharmacological strategies to eliminate or modify AMR bacteria. In addition to articles and entries found in these databases, selected health policy reports and public health guidance documents were reviewed. Of 217 articles, databases, and reports identified, 103 were selected for review.


The increase in AMR has been driven by a diverse set of factors, including inappropriate antibiotic prescribing and sales, use of antibiotics outside of the health care sector, and genetic factors intrinsic to bacteria. The problem has been exacerbated by inadequate economic incentives for pharmaceutical development of new antimicrobial agents. A range of specific AMR concerns, including carbapenem- and colistin-resistant gram-negative organisms, pose a clinical challenge. Alternative approaches to address the AMR threat include new methods of antibacterial drug identification and strategies that neutralize virulence factors.

Conclusions and Relevance

Antimicrobial resistance poses significant challenges for current clinical care. Modified use of antimicrobial agents and public health interventions, coupled with novel antimicrobial strategies, may help mitigate the effect of multidrug-resistant organisms in the future.

Keywords: Research; Abstracts; Antibiotics; Drugs Resistance; Public Health.


Where #economics and #epidemics collide: #migrant #workers and #emerging #infections (Lancet, summary)

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


Where economics and epidemics collide: migrant workers and emerging infections

Clarence C Tam, Mishal S Khan, Helena Legido-Quigley

DOI: http://dx.doi.org/10.1016/S0140-6736(16)31645-2

© 2016 Elsevier Ltd. All rights reserved.



Following widespread criticism about inadequate action during the Ebola epidemic in west Africa,1 the global response is once again being tested by two re-emerging infectious disease threats in the form of Zika and yellow fever viruses. The public health and scientific responses to these challenges have been unprecedented.

Keywords: Research; Migrants; Society; Public Health; Infectious Diseases.


#Developing #WHO rapid #advice #guidelines in the setting of a #publichealth #emergency (J Clin Epidemiol., abstract)

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

J Clin Epidemiol. 2016 Aug 31. pii: S0895-4356(16)30386-9. doi: 10.1016/j.jclinepi.2016.08.010. [Epub ahead of print]

Developing WHO rapid advice guidelines in the setting of a public health emergency.

Garritty CM1, Norris SL2, Moher D3.

Author information: 1Ottawa Methods Centre, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON K1H 8L6, Canada; Translational Research in Biomedicine (TRIBE) Program, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia. Electronic address: cgarritty@ohri.ca. 2World Health Organization, Av. Appia 20, CH-1211 Geneva 27, Switzerland. 3Ottawa Methods Centre, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON K1H 8L6, Canada; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Roger-Guindon Building, Ottawa, ON K1H 8M5, Canada.




We describe newly established guidance for guideline developers at the World Health Organization (WHO) on the process and procedures for developing a rapid advice guideline in the context of a public health emergency (e.g., the 2014 Ebola epidemic).


We based our approach on established rapid review methods, which were incorporated into existing WHO guideline development processes. Guidance was further informed by in-depth discussions of issues related to rapid guideline development with WHO staff (n = 6), who oversee the Organization’s response to emergencies.


We discuss criteria for considering if a rapid advice guideline is appropriate and feasible, and outline the roles of various contributors across the phases of development. Further, we describe the methods and steps involved in performing rapid reviews, which are more fluid and iterative than for a standard guideline process. In general, rapid advice guidelines involve a shorter timeline, narrower scope, and the use of abbreviated methods for the evidence review.


Important differences exist between developing a standard guideline and a rapid advice guideline. However, the core principles for WHO guidelines apply to rapid advice guidelines including minimizing bias, applying transparent processes and the use of explicit methods.

Copyright © 2016. Published by Elsevier Inc.

KEYWORDS: accelerated development; guideline; methodology; policy-making; public health; rapid reviews; recommendations

PMID: 27591906 DOI: 10.1016/j.jclinepi.2016.08.010

[PubMed – as supplied by publisher]

Keywords: Research; Abstracts; Public Health.