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An introduction is presented which discusses various articles within the issue on topics including the public health in the U.S., ways to achieve a health system capable to protect and improve population health, and American Health People 2020.

We compared trends of Systemic Sclerosis (SS) mortality in France and the USA over the period 1980–1998 and used an Age-Period-Cohort (APC) model to adjust on the age at death of SS patients. All deaths coded with SS as an underlying primary or secondary cause in the national French and US mortality databases from 1980 to 1998 were included in the analysis. SS age-standardized mortality rates increased from 7.2 to 10.3/million in US women (+43%), and from 3 to 3.9/million in French women (+22%). Most of the increase occurred in senior women. In contrast, SS age-standardized death rates remained stable among US men (around 3/million) and French men (around 2/million). In US women, the APC analysis shows a growing cohort effect between 1900 and 1940, tending to stabilize for following cohorts. Similar findings were obtained to a lesser extent in French women. In conclusion, SS mortality rates increased by more than 40% between 1980 and 1998 in the USA, mostly in women born between 1900 and 1940. Whether these trends reflect rising incidence of SS need to be documented. The observed dissimilarity between genders and countries underline that environmental exposure and gender-related factors likely play a major etiological role. Stabilization in the following birth cohorts suggests that the increase of mortality observed since 1980 may slow down in the near future. [ABSTRACT FROM AUTHOR]

Although syndromic surveillance systems using nonclinical data have been implemented in the United States, the approach has yet to be tested in France. We present the results of the first model based on drug sales that detects the onset of influenza season and forecasts its trend. Using weekly lagged sales of a selected set of medications, we forecast influenzalike illness (ILI) incidence at the national and regional level for 3 epidemic seasons (2000-01, 2001-02, and 2002-03) and validate the model with real-time updating on the fourth (2003-04). For national forecasts 1-3 weeks ahead, the correlation between observed ILI incidence and forecast was 0.85-0.96, an improvement over the current surveillance method in France. Our findings indicate that drug sales are a useful additional tool to syndromic surveillance, a complementary and independent source of information, and a potential improvement for early warning systems for both epidemic and pandemic planning. [ABSTRACT FROM AUTHOR]

Background: The reasons for the seasonality and annual changes in the impact of influenza epidemics remain poorly understood. A strong coherence of influenza epidemics at a hemispheric level may suggest the role of global factors, such as climate, as a driving force of seasonality. The El Nin˜o Southern Oscillation (ENSO) represents the largest signal in inter-annual climate variation, affecting global atmospheric and oceanic circulation patterns. The phenomenon undergoes cycles between warm ENSO conditions (which are extreme during El Nin˜o episodes) and cold ENSO conditions (extreme during La Nina episodes). Materials and methods: We investigated the covariations between ENSO and the impact of influenza as measured by the number of pneumonia and influenza (P&I) excess deaths in France and the USA during the winter epidemics of 1971–1997. Results: On average in France (60.2 (M) million inhabitants in 2003), 2500 P&I excess deaths occurred per season (range 0–9500) during the 1971–1997 period. An average of 6215 excess deaths (range 0–13,600) occurred in the USA (290.3 M inhabitants in 2003). In both countries, the number of P&I excess deaths was significantly higher during the 10 seasons with cold ENSO conditions (mean±S.E.; 3530±654 excess deaths in France; 8290±900 in the USA) than during the 16 seasons with warm ENSO conditions (1856±574; 4919±977) (Wilcoxon rank test for France P=0.05 and for the USA P=0.03). Conclusion: These findings suggest that the impact of influenza epidemics, in terms of excess mortality, is associated with the ENSO conditions. An understanding of the mechanisms responsible for this association could lead to improved early warning and better control of influenza. [Copyright &y& Elsevier]

Influenza epidemics occur once a year during the winter in temperate areas. Little is known about the similarities between epidemics at different locations. We have analyzed pneumonia and influenza deaths from 1972 to 1997 in the United States, France, and Australia to examine the correlation over space and time between the three countries. We found a high correlation in both areas between France and the United States (correlation in impact, Spearman's ρ= 0.76, p < 0.001, and test for synchrony in timing of epidemics, p < 0.001). We did not find a similar correlation between the United States and Australia or between France and Australia, when considering a systematic half-year lead or delay of influenza epidemics in Australia as compared with those in the United States or France. These results support a high correlation at the hemisphere level and suggest that the global interhemispheric circulation of epidemics follows an irregular pathway with recurrent changes in the leading hemisphere. [ABSTRACT FROM AUTHOR]

The first wave of coronavirus disease 2019 (COVID-19) pandemic is currently invading the world, and several countries are now struggling to fight it or trying to delay its start to help smooth its peak size for the purpose of lowering morbidity and mortality, and thereby reduce the overall tension on their health-care system. China's first major outbreaks of COVID-19 happened in January, 2020. [Extracted from the article]

Background: Despite the fact that urinary tract infection (UTI) is a very frequent disease, little is known about its seasonality in the community., Methods and Findings: To estimate seasonality of UTI using multiple time series constructed with available proxies of UTI. Eight time series based on two databases were used: sales of urinary antibacterial medications reported by a panel of pharmacy stores in France between 2000 and 2012, and search trends on the Google search engine for UTI-related terms between 2004 and 2012 in France, Germany, Italy, the USA, China, Australia and Brazil. Differences between summers and winters were statistically assessed with the Mann-Whitney test. We evaluated seasonality by applying the Harmonics Product Spectrum on Fast Fourier Transform. Seven time series out of eight displayed a significant increase in medication sales or web searches in the summer compared to the winter, ranging from 8% to 20%. The eight time series displayed a periodicity of one year. Annual increases were seen in the summer for UTI drug sales in France and Google searches in France, the USA, Germany, Italy, and China. Increases occurred in the austral summer for Google searches in Brazil and Australia., Conclusions: An annual seasonality of UTIs was evidenced in seven different countries, with peaks during the summer.