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A retrospective analysis was conducted of human cases and outbreaks of tularemia in the Republic of Armenia from 1996 to 2012 utilizing geographic information system software. A total of 266 human cases of tularemia were recorded in Armenia from 1996 to 2012, with yearly incidence ranging from 0 to 5.5 cases per 100,000 people. Cases predominantly affected the male population (62.8%), 11–20 year age group (37.2%), agricultural workers (49.6%), and persons residing in rural areas (93.6%). In 2003, a waterborne outbreak involving 158 cases occurred in Kotayk Marz, and in 2007, a foodborne outbreak with 17 cases occurred in Gegharkunik Marz, attributed to exposure of food products to contaminated hay. Geospatial analysis of all cases showed that the majority were associated with the steppe vegetation zone, elevations between 1,400 and 2,300 m, and the climate zone associated with dry, warm summers, and cold winters. Characterization of these environmental factors were used to develop a predictive risk model to improve surveillance and outbreak response for tularemia in Armenia.

After introduction of rotavirus vaccine, other pathogens might become leading causes of hospitalizations for severe diarrhea among children

BACKGROUND The Republic of Armenia was 1 of the 2 earliest countries in the Newly Independent States to introduce rotavirus vaccine into its national immunization program to reduce the burden of rotavirus disease (documented to cause 38% of acute gastroenteritis hospitalizations [AGE] among children aged

Objective The goal of this study was to identify gaps in the severe acute respiratory infection sentinel surveillance system at Surb Astvatsamayr Medical Center. Introduction Influenza is a priority in Armenia. There are two influenza surveillance systems in Armenia: population and sentinel. The medical center (MC) has been included in sentinel surveillance since 2012. In 2015 a study was undertaken to identify gaps in severe acute respiratory infection (SARI) sentinel surveillance system in Surb Astvatsamayr MC. Methods Medical records and reporting forms of SARI cases were generated for individuals meeting the case definition and analyzed for age groups, risk factors, sentinel surveillance detection methods, laboratory conformation, number of days hospitalized and reporting. Results In 2014, 3016 patients were admitted in the hospital with ARI, of whom 2982 were younger than 18 years. During the 2014-2015 influenza season (week 40, 2014-week 20, 2015), 77 swabs have been taken in total, of which five were influenza positive (4 B and 1 AH1N1). Also in the 2013-2014 influenza season, five samples tested positive (all influenza A). Sixty-one (48%) patients with respiratory disease met the WHO SARI case definition (2011), 84 (66%) of all reviewed patients would have met the SARI case definition. The numbers for the ICU (25 records reviewed) do not reflect the actual percentage of patients admitted with respiratory symptoms. The 33 additional cases taken from the sampling logbook were mainly hospitalized in the ICU. Influenza tests were performed on 34 patients (mainly ICU), five were positive for influenza (four B--all adults—and one AH1N1), and four tested positives for other respiratory pathogens (two RSV, one RV, one BV). All influenza positives had fever or a history of fever and 80% met the WHO SARI case definition (2011). Non-sampled cases generally have fewer reported symptoms, but still 44% of cases fits the WHO SARI case definition (2011). Conclusions The percentages of patients meeting the WHO SARI 2011 case definition and the WHO SARI 2014 definition shows that mainly caused by the absence of shortness of breath in the SARI 2014 definition 52% (2011) vs 66% (2014) in Surb Asvatsamayr. A large number of children from Neonatal and Children’s departments fulfil the SARI case definition and could potentially be swabbed in addition to ICU patients. There are gaps in WHO SARI case definitions. The sentinel surveillance system should be improved.

Pneumonia and diarrhea are the leading causes of child morbidity and mortality globally and are vaccine preventable. The WHO-coordinated Global Rotavirus and Invasive Bacterial Vaccine-Preventable Disease Surveillance Networks support surveillance systems across WHO regions to provide burden of disease data for countries to make evidence-based decisions about introducing vaccines and to demonstrate the impact of vaccines on disease burden. These surveillance networks help fill the gaps in data in low and middle-income countries where disease burden and risk are high but support to sustain surveillance activities and generate data is low. Through a series of country case studies, this paper reviews the successful use of surveillance data for disease caused by pneumococcus and rotavirus in informing national vaccine policy in Bangladesh, Armenia and The Gambia. The case studies delve into ways in which countries are leveraging and building capacity in existing surveillance infrastructure to monitor other diseases of concern in the country. Local institutions have been identified to play a critical role in making surveillance data available to policymakers. We recommend that countries review local or regional surveillance data in making vaccine policy decisions. Documenting use of surveillance activities can be used as advocacy tools to convince governments and external funders to invest in surveillance and make it a priority immunization activity.

Objective In the spring of 2014, people from vulnerable households in all marzes of Armenia were examined with the aim of active surveillance. Introduction Brucellosis is a serious disease caused by bacteria of the Brucella genus. It principally affects ruminants but may be transmitted to humans. Registration of cases in cattle farms causes considerable economic losses and creates favorable conditions for mass infection among humans. In Armenia the expansion of animal industries and urbanization are the main reasons for occurrence and development of brucellosis. Methods Blood was sampled from people on farms reported as having infected animals. Blood samples were tested by the Wright- Huddleston method. The standard case definition of brucellosis was used for diagnosis. A questionnaire-based interview was carried out among the population to identify the form of contact with animals and to analyze epidemiological links. During the investigation provisions were followed in governmental decree RA 19.01.2006 N480-N and brucellosis prevention, epidemiology, diagnosis, treatment, preventive measures. Results A total of 11160 people from 1054 households were enrolled in the study, of which 3625 (32.5%) underwent a laboratory examination. Nearly 6% (641) refused to be tested. Over 6% of those tested (226) were positive for antibodies to Brucellae. Of these, 129 (3.5%) had chronic brucellosis. Those testing positive for brucellosis were treated appropriately. These included 203 (90%) adults and 23 (10%) below 14 years old; 147 (65%) were male and 79 (35%) were female. Of those diagnosed with brucellosis, working in animal husbandry accounted for 46.6% (106), while those who harvested milk accounted for 37.6% (85) and those using raw milk made up 15.4% (35). Conclusions Cases were most frequently reported among people 20-55 years of age; the highest percentage of positives were among 41-45 year old males who had contact with infected animals. The main risk factor for acquiring brucellosis is animal husbandry.

We have applied GIS methodologies to create a retrospective analysis of tularemia outbreaks in the Republic of Armenia.

Vavilovia (Vavilovia Fed.) is one of the five genera in tribe Fabeae and consists of only one species, ‘beautiful’ vavilovia (Vavilovia formosa (Stev.) Fed.). The main centre of distribution is the Central and Eastern Caucasus, with a disjunct distribution among high alpine areas in the region, extending as far as West Turkey, Lebanon and Iran. In Armenia, in situ studies on Vavilovia started in the late 1930s. In July and August 2009, three expeditions were conducted to two locations: two to the Ughtasar Mountain and one to the Geghama Mountains. The first expedition to Ughtasar resulted in fresh plant collections and soil analysis for one of the sites. The expedition to Geghama established the existence of Vavilovia in the region of Lake Aknalitch. The second expedition to Ughtasar provided immature fruits and seeds. Collected plant material was transplanted into the Flora and Vegetation of Armenia plot of the Yerevan Botanic Garden established in 1940. Today, along with other plants the plot contains more than 200 species of wild relatives of cultural plants from 130 genera, including indiginous species of tribe Fabeae such as Vavilovia. The transplanted plants will continue to be monitored to see if the plants go on to successfully flower and set seed or whether further sites, possibly at higher altitudes might need to be tested to meet the long term conservation requirements of this iconic legume. These co-ordinated efforts provide a good example of an ex situ conservation strategy for Vavilovia formosa, which, if successful will improve access and utility for the whole legume research community.