A perfect #storm in the #Caribbean requires a concerted #response (Lancet, summary)

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

A perfect storm in the Caribbean requires a concerted response

Sandeep Maharaj, Terence Seemungal, Martin McKee

Published: September 17, 2019 / DOI: https://doi.org/10.1016/S0140-6736(19)31822-7


The countries of the Caribbean are facing a perfect storm of events that pose a severe threat to the health of their people. 2018 was the third consecutive year of above average meteorological activity, with several countries, including Anguilla and the British Virgin Islands, devastated by major hurricanes. The effects of climate change mean the situation can only get worse.



We declare no competing interests.

Keywords: Public Health; Hurricanes; Caribbean; Society; Poverty.



Evidence of #Background #Checks in an #Online #Firearms #Marketplace (Am J Prev Med., abstract)

[Source: American Journal of Preventive Medicine, full page: (LINK). Abstract, edited.]

Evidence of Background Checks in an Online Firearms Marketplace

Coleman Drake, PhD1, Ashley M. Hernandez, MSPH2, Yang Liu, PhD3, Adam H. Schwartz, PhD2, Maria E. Sundaram, MSPH, PhD4

DOI: https://doi.org/10.1016/j.amepre.2019.06.006

Published online: September 16, 2019



Injuries and deaths from firearms are increasingly recognized as a public health crisis in the U.S.1 Studies investigating whether background check requirements reduce firearm-related homicide and suicide have been inconclusive,2 though some studies suggest these requirements may be effective at reducing firearm deaths.3,4 Currently, federal regulations require that firearm dealers with a federal firearms license conduct a background check before sales.5,6 However, although some states require private sellers to conduct a background check, federal regulations do not require private sellers to conduct background checks.

© 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Keywords: USA; Society; Firearms.


Long-term #dynamics of #measles in #London: Titrating the impact of #wars, the 1918 #pandemic, and #vaccination (PLoS Comput Biol., abstract)

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

PLoS Comput Biol. 2019 Sep 12;15(9):e1007305. doi: 10.1371/journal.pcbi.1007305. eCollection 2019 Sep.

Long-term dynamics of measles in London: Titrating the impact of wars, the 1918 pandemic, and vaccination.

Becker AD1, Wesolowski A2, Bjørnstad ON3,4, Grenfell BT1,4,5.

Author information: 1 Department of Ecology and Evolutionary Biology, Princeton, New Jersey, United States of America. 2 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America. 3 Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, Pennsylvania, United States of America. 4 Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America. 5 Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, New Jersey, United States of America.



A key question in ecology is the relative impact of internal nonlinear dynamics and external perturbations on the long-term trajectories of natural systems. Measles has been analyzed extensively as a paradigm for consumer-resource dynamics due to the oscillatory nature of the host-pathogen life cycle, the abundance of rich data to test theory, and public health relevance. The dynamics of measles in London, in particular, has acted as a prototypical test bed for such analysis using incidence data from the pre-vaccination era (1944-1967). However, during this timeframe there were few external large-scale perturbations, limiting an assessment of the relative impact of internal and extra demographic perturbations to the host population. Here, we extended the previous London analyses to include nearly a century of data that also contains four major demographic changes: the First and Second World Wars, the 1918 influenza pandemic, and the start of a measles mass vaccination program. By combining mortality and incidence data using particle filtering methods, we show that a simple stochastic epidemic model, with minimal historical specifications, can capture the nearly 100 years of dynamics including changes caused by each of the major perturbations. We show that the majority of dynamic changes are explainable by the internal nonlinear dynamics of the system, tuned by demographic changes. In addition, the 1918 influenza pandemic and World War II acted as extra perturbations to this basic epidemic oscillator. Our analysis underlines that long-term ecological and epidemiological dynamics can follow very simple rules, even in a non-stationary population subject to significant perturbations and major secular changes.

PMID: 31513578 DOI: 10.1371/journal.pcbi.1007305

Keywords: Pandemic Influenza; Spanish Flu; Wars; Society; Measles.


#Risk for Invasive #Streptococcal #Infections among #Adults Experiencing #Homelessness, #Anchorage, #Alaska, #USA, 2002–2015 (Emerg Infect Dis., abstract)

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

Volume 25, Number 10—October 2019 / CME ACTIVITY – Research

Risk for Invasive Streptococcal Infections among Adults Experiencing Homelessness, Anchorage, Alaska, USA, 2002–2015

Emily Mosites  , Tammy Zulz, Dana Bruden, Leisha Nolen, Anna Frick, Louisa Castrodale, Joseph McLaughlin, Chris Van Beneden, Thomas W. Hennessy, and Michael G. Bruce

Author affiliations: Centers for Disease Control and Prevention, Anchorage, Alaska, USA (E. Mosites, T. Zulz, D. Bruden, L. Nolen, T.W. Hennessy, M.G. Bruce); Alaska Department of Health and Social Services, Anchorage (A. Frick, L. Castrodale, J. McLaughlin); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C. Van Beneden)

CME Editor: Jude Rutledge, BA, Technical Writer/Editor, Emerging Infectious Diseases. Disclosure: Jude Rutledge has disclosed no relevant financial relationships.

CME Author: Charles P. Vega, MD, Health Sciences Clinical Professor of Family Medicine, University of California, Irvine School of Medicine, Irvine, California. Disclosure: Charles P. Vega, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Genentech, Inc.; GlaxoSmithKline; Johnson & Johnson Pharmaceutical Research & Development, L.L.C.; served as a speaker or a member of a speakers bureau for Shire.

Authors Disclosures: Emily Mosites, PhD, MPH; Tammy Zulz, MPH; Dana Bruden, MS; Leisha Nolen, MD, PhD; Anna Frick, MPH; Louisa Castrodale, DVM, MPH; Joe McLaughlin, MD, MPH; Chris A. Van Beneden, MD, MPH; Thomas Hennessy, MD, MPH; and Michael G. Bruce, MD, MPH, have disclosed no relevant financial relationships.



The risk for invasive streptococcal infection has not been clearly quantified among persons experiencing homelessness (PEH). We compared the incidence of detected cases of invasive group A Streptococcus infection, group B Streptococcus infection, and Streptococcus pneumoniae (pneumococcal) infection among PEH with that among the general population in Anchorage, Alaska, USA, during 2002–2015. We used data from the Centers for Disease Control and Prevention’s Arctic Investigations Program surveillance system, the US Census, and the Anchorage Point-in-Time count (a yearly census of PEH). We detected a disproportionately high incidence of invasive streptococcal disease in Anchorage among PEH. Compared with the general population, PEH were 53.3 times as likely to have invasive group A Streptococcus infection, 6.9 times as likely to have invasive group B Streptococcus infection, and 36.3 times as likely to have invasive pneumococcal infection. Infection control in shelters, pneumococcal vaccination, and infection monitoring could help protect the health of this vulnerable group.

Keywords: Streptococcus pneumoniae; Invasive Streptococcal Disease; Society; USA; Alaska.


A qualitative study to understand how #Ebola Virus Disease affected #nutrition in #SierraLeone—A #food value-chain #framework for improving future response #strategies (PLoS Negl Trop Dis., abstract)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]


A qualitative study to understand how Ebola Virus Disease affected nutrition in Sierra Leone—A food value-chain framework for improving future response strategies

Stephen R. Kodish , Frank Bio, Rachel Oemcke, James Conteh, Jean Max Beauliere, Solade Pyne-Bailey, Fabian Rohner, Ismael Ngnie-Teta, Mohammad B. Jalloh, James P. Wirth

Published: September 10, 2019 / DOI: https://doi.org/10.1371/journal.pntd.0007645




This study sought understand how the 2014–2016 EVD Virus Disease (EVD) outbreak impacted the nutrition sector in Sierra Leone and use findings for improving nutrition responses during future outbreaks of this magnitude.


This qualitative study was iterative and emergent. In-depth interviews (n = 42) were conducted over two phases by purposively sampling both key informants (n = 21; government stakeholders, management staff from United Nations (UN) agencies and non-governmental organizations (NGO)), as well as community informants (n = 21; EVD survivors, health workers, community leaders) until data saturation. Multiple analysts collaborated in a team-based coding approach to identify key themes using Dedoose software. Findings are presented as both quotations and tables/figures.


The EVD outbreak effects and the related response strategies, especially movement restriction policies including 21-day quarantines, contributed to disruptions across the food value-chain in Sierra Leone. System-wide impacts were similar to those typically seen in large-scale disasters such as earthquakes. Participants described an array of direct and indirect effects on agricultural production and food storage and processing, as well as on distribution, transport, trade, and retailing. Secondary data were triangulated by interviews which described the aggregate negative effect of this outbreak on key pillars of food security, infant and young child feeding practices, and nutrition. During the humanitarian response, nutrition-specific interventions, including food assistance, were highly accepted, although sharing was reported. Despite EVD impacts across the entire food value-chain, nutrition-sensitive interventions were not central to the initial response as EVD containment and survival took priority. Culturally-appropriate social and behavior change communications were a critical response component for improving health, nutrition, and hygiene-related behaviors through community engagement.


Infectious diseases such as EVD have far-reaching effects that impact health and nutrition through interrelated pathways. In Sierra Leone, the entire food value-chain was broken to the extent that the system-wide damage was on par with that typically resulting from large natural disasters. A food value-chain approach, at minimum, offers a foundational framework from which to position nutrition preparedness and response efforts for outbreaks in similar resource constrained settings.


Author summary

The 2014–2016 EVD outbreak has greatly impacted the population health and nutrition of affected countries in West Africa, including that of Sierra Leone. Since this recent outbreak, the humanitarian community acknowledges the need for improved solutions to better prepare for, and respond. Despite the importance of nutrition during outbreaks, there has been little systematic research conducted for understanding lessons learned and improving upon the typical nutrition response options currently available. This study used qualitative interviews to collect in-depth narratives from government officials, front-line health workers, non-government organization management, and community members including local leaders and EVD survivors. Findings reveal the unprecedented magnitude of this outbreak, which had systems-wide impacts not dissimilar to those felt by natural disasters. Interviews with people who lived through this event in Sierra Leone described EVD effects which revealed the importance and fragility of multiple, interconnected systems comprising the food value-chain for optimal nutrition in Sierra Leone. Findings across the food value-chain reveal how this interconnected system was impacted at every level with consequences for population-level nutrition. In preparation for future outbreaks of this magnitude, such a framework may prove useful for policy and planning, including improved guidelines development for employing coordinated nutrition-specific and nutrition–sensitive approaches that address immediate and underlying determinants of nutritional status.


Citation: Kodish SR, Bio F, Oemcke R, Conteh J, Beauliere JM, Pyne-Bailey S, et al. (2019) A qualitative study to understand how Ebola Virus Disease affected nutrition in Sierra Leone—A food value-chain framework for improving future response strategies. PLoS Negl Trop Dis 13(9): e0007645. https://doi.org/10.1371/journal.pntd.0007645

Editor: Ruth Kutalek, Medizinische Universitat Wien, AUSTRIA

Received: May 15, 2017; Accepted: July 19, 2019; Published: September 10, 2019

Copyright: © 2019 Kodish et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Data are available from Groundwork. Because the original audio files cannot be anonymized, participant confidentiality is at risk should the files be made publicly available. Therefore, only anonymized transcripts can be shared with interested parties upon request by emailing contact@groundworkhealth.org.

Funding: UNICEF funded this research project. UNICEF supported both Groundwork and FOCUS 1000 research team members during study design, data collection and analysis, decision to publish, and preparation of this manuscript.

Competing interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: JMB and IN-T are employees of UNICEF and SP-B is a Ministry of Health official in Sierra Leone.

Keywords: Ebola; Sierra Leone; Food safety; Society.


The #monetary value of #human lives lost through #Ebola virus disease in the #DRC in 2019 (BMC Public Health, abstract)

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

BMC Public Health. 2019 Sep 3;19(1):1218. doi: 10.1186/s12889-019-7542-2.

The monetary value of human lives lost through Ebola virus disease in the Democratic Republic of Congo in 2019.

Kirigia JM1, Muthuri RNDK2, Muthuri NG3.

Author information: 1 African Sustainable Development Research Consortium (ASDRC), P.O. Box 6994 00100 GPO, Nairobi, Kenya. muthurijoses68@gmail.com. 2 Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa. 3 School of Business, United States International University, Nairobi, Kenya.




Between 8 May 2018 and 27 May 2019, cumulatively there were 1286 deaths from Ebola Virus Disease (EVD) in the Democratic Republic of Congo (DRC). The objective of this study was to estimate the monetary value of human lives lost through EVD in DRC.


Human capital approach was applied to monetarily value years of life lost due to premature deaths from EVD. The future losses were discounted to their present values at 3% discount rate. The model was reanalysed using 5 and 10% discount rates. The analysis was done alternately using the average life expectancies for DRC, the world, and the Japanese females to assess the effect on the monetary value of years of life lost (MVYLL).


The 1286 deaths resulted in a total MVYLL of Int$17,761,539 assuming 3% discount rate and DRC life expectancy of 60.5 years. The average monetary value per EVD death was of Int$13,801. About 44.7 and 48.6% of the total MVYLL was borne by children aged below 9 years and adults aged between 15 years and 59 years, respectively. Re-estimation of the algorithm with average life expectancies of the world (both sexes) and Japanese females, holding discount rate constant at 3%, increased the MVYLL by Int$ 3,667,085 (20.6%) and Int$ 7,508,498 (42.3%), respectively. The application of discount rates of 5 and 10%, holding life expectancy constant at 60.5 years, reduced the MVYLL by Int$ 4,252,785 (- 23.9%) and Int$ 9,658,195 (- 54.4%) respectively.


The EVD outbreak in DRC led to a considerable MVYLL. There is an urgent need for DRC government and development partners to disburse adequate resources to strengthen the national health system and other systems that address social determinants of health to end recurrence of EVD outbreaks.

KEYWORDS: Democratic Republic of Congo (DRC); Ebola virus disease (EVD) deaths; Gross domestic product; Human capital; Monetary value of life; Years of life lost

PMID: 31481050 DOI: 10.1186/s12889-019-7542-2

Keywords: Ebola; DRC; Society.


How Localized #Outbreaks and Changes in #Media Coverage Affect #Zika #Attitudes in National and Local Contexts (Health Commun., abstract)

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

Health Commun. 2019 Sep 2:1-12. doi: 10.1080/10410236.2019.1662556. [Epub ahead of print]

How Localized Outbreaks and Changes in Media Coverage Affect Zika Attitudes in National and Local Contexts.

Haglin K1, Chapman D2, Motta M3, Kahan D4.

Author information: 1 Department of History, Political Science and International Studies, University of Minnesota-Duluth. 2 Annenberg Public Policy Center, University of Pennsylvania. 3 Department of Political Science, Oklahoma State University. 4 Yale Law School, Yale University.



Public opinion researchers often find changing attitudes about pressing public health issues to be a difficult task and even when attitudes do change, behaviors often do not. However, salient real-world events have the ability to bring public health crises to the fore in unique ways. To assess the impact of localized public health events on individuals’ self-reported behavior, this paper examines Floridians’ intentions to take preventative measures against the Zika virus before and after the first locally transmit- ted case of Zika emerged in Florida. We find that local and national media coverage of Zika increased significantly following its first transmission in the U.S. Critically, we also find that Floridians surveyed after this increase in media coverage were more likely to pay attention to Zika-related news, and self-report intentions to take protective action against the virus. These results suggest that behavioral intentions can shift as health threats become more proximate.

PMID: 31475575 DOI: 10.1080/10410236.2019.1662556

Keywords: Zika Virus; Society; USA; Florida.