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The article presents a report on West Nile virus (WNV) activity in the U.S. as reported to the Centers for Disease Control and Prevention (CDC) in 2009. 720 cases of WNV disease were reported from a total of 38 states and the District of Columbia. It lists the five states with the highest incidence of WNV neuroinvasive disease including Mississippi and South Dakota. A figure that shows the annual incidence of cases of WNV neuroinvasive disease in the country from 1999 to 2009 is presented.

We describe the results of a comparison of reference standards between the National Institute of Standards and Technology (NIST-USA) and Centro Nacional De Metrología (CENAM-Mexico). Open beam (free field) and optical-fiber-based measurements at wavelengths of 1302 nm and 1546 nm are reported. Both laboratories' reference standards were compared by means of a temperature-controlled optical trap detector. Measurements showed a largest difference of less than 3.4 parts in 103, which is within the combined expanded (k = 2) uncertainty for the laboratories' reference standards. [ABSTRACT FROM AUTHOR]

The article summarizes provisional West Nile virus (WNV) surveillance data for 2006 reported to the U.S. Centers for Disease Control & Prevention. In 2006, WNV transmission to humans or animals expanded into 52 counties that had not previously reported transmission. There were 1,491 cases of WNV neuroinvasive disease reported in the U.S. during the period. A total of 4,106 dead WNV-infected birds were reported from 701 counties in 43 states during 2006.

The article presents an update on the detection, transmission and control of the West Nile virus (WNV) in the U.S. as of December 2005. The number of cases of WNV disease in humans reportedly increased in the U.S. Statistical data from the U.S. Centers for Disease Control and Prevention regarding WNV human infection are presented. Surveillance data on WNV-infected animals are provided.

The article presents a study which compared national HIV/AIDS reporting system (HARS) data on race/ethnicity and transmission mode to self-reported data collected during a survey of people with AIDS in the U.S., to assess the accuracy of 12 HARS variables. The study also examined the association between HIV reporting policies and timeliness of testing and medical care using data from the AIDS Patient Survey conducted in Arizona, Colorado, Mississippi, Missouri, New Mexico, North Carolina, Oregon and Texas. Data from HARS and the AIDS Patient Survey were compared.

Examines the proportions of high-risk persons tested for HIV infection in the U.S. Factors affecting the decision of patients to undergo HIV testing; Comparison of the incidence of HIV infection among men engaging sex with men; injection drug users and heterosexuals; Identification of the HIV risk factors.

Name-based surveillance of HIV infection is the law in 31 U.S. states but remains controversial. This policy can be advocated solely to support surveillance of the epidemic, but a frequent argument is that it also provides a public health benefit by allowing follow-up of HIV-infected persons. These persons can then receive timely medical care and can be assisted with notifying sex and needle-sharing partners. Few comparative data are available to evaluate the outcomes of these interventions. In five states with name-based surveillance of HIV infection, the Multistate Evaluation of Surveillance for HIV Study Group surveyed a cross-sectional probability sample of persons with AIDS who tested positive for HIV before the date of their AIDS diagnosis. Health department follow-up of a reported HIV infection was not associated with more timely receipt of medical care after a positive HIV test result. Only 8.6% of persons who delayed medical care after their first positive HIV test result gave concern about being reported by name as a reason; no person gave it as the main reason. Persons who were tested anonymously and those who were tested confidentially did not differ in the mean number of sex and needle-sharing partners notified: Those tested anonymously reported personally notifying 3.85 sex and needle-sharing partners, and those tested confidentially reported notifying-personally and through the health department-3.80 partners. Many researchers and policymakers believe that name-based surveillance of HIV infection will have positive or negative effects on partner notification and access to health care. These results suggest that the potential for such effects has been exaggerated. [ABSTRACT FROM AUTHOR]

National unlinked sentinel surveillance data were used to describe trends in prevalent human immunodeficiency virus infection among injection drug users entering drug treatment programs in the United States from 1988 through 1993. During this 6-year period, unlinked testing was performed on 70,882 specimens from injection drug users at 60 sentinel sites. The annual change in seroprevalence was estimated for each site by odds ratios obtained from logistic regression models fit within site-specific age and race/ethnicity subgroups. Overall trends for age and race/ethnicity subgroups across sites were described by summary odds ratios calculated using the inverse variance method. A decrease was observed among younger (age less than 30 years) whites both in areas with high (10% or higher) and low (less than 10%) prevalence, although this decrease was significant only in high-prevalence areas (odds ratio = 0.90, 95% confidence interval 0.81−0.99). Seroprevalence also decreased among older whites in high-prevalence areas, although this decrease was not significant (odds ratio = 0.95, 95% confidence interval 0.89−1.00). Seroprevalence remained stable among all other age and race/ethnicity subgroups. Stable seroprevalence among the dynamic population of injection drug users entering treatment suggests continued transmission among these individuals in both high- and low-prevalence areas of the United States. [ABSTRACT FROM AUTHOR]

Argues that American national security strategy needs major overhaul, with substantial reduction in numbers of strategic and theater nuclear weapons. Reconfiguration away from heavy positional forces; Toward more flexible and deployable forces; Need for higher percentage of reserve manning; Interdependence; New spectrum of deterrence; Naval forces; Airlift forces; Sealift forces; Land-based tactical air forces; Ground forces; Marine corps; Post-Cold War military configuration.

The article presents an update on West Nile virus activity (WNV) in the U.S. reported to the Centers for Disease Control and Prevention (CDC) in 2009. It is noted that 720 cases of WNV disease have been reported in 38 states and the District of Columbia (DC). There have been 298 reported veterinary cases of the disease, affecting equine, squirrels, and canine. The species of mosquitoes considered as the principal vectors of the disease include Culex pipiens. A CDC editorial note on the WNV disease is also presented.

The article presents a summary of information about dengue cases that were reported to the U.S. Centers for Disease Control and Prevention (CDC) from 2006 to 2008 through two CDC-maintained passive surveillance systems. Such systems include the ArboNET surveillance system and a system maintained by the CDC Dengue Branch (CDCDB). It is noted that 529 specimens from 524 patients were received by CDCDB during the period from 41 states and the District of Columbia (DC). A CDC editorial note on the dengue cases is also presented. INSET: Dengue surveillance and diagnosis.

The article provides an overview of West Nile Virus (WNV). Although first identified in 1937 in Africa, the article states, the first detection of WNV in the western hemisphere occurred in New York City in 1999. Topics of discussion include seasonal epidemics in the U.S. of febrile illness and neurologic disease, cases of WNV neuroinvasive disease (WNND), and mosquito control. Also discussed are personal protection from mosquito bites, research into prevention strategies, and WNV surveillance data for 2007.

The article reports on the diagnosis of international travelers who have Chikungunya fever in the U.S. in the period 2005-2006. The disease is caused by an alphavirus common in Africa and Asia. It can be transmitted to humans through the bite of infected mosquitoes. The epidemic cycle of the disease is similar to dengue fever.

The article discusses West Nile Virus (WNV), which is a cause of arboviral encephalitis in the United States. WNV activity during January 1-December 1, 2005 included WNV neuroinvasive disease (WNND). Demographic data indicates there were outbreaks of WWND and WNV disease in California, Illinois, Texas, Louisiana, South Dakota, Nebraska, North Dakota, and the New York City metropolitan area. The CDC editorial note focuses on the endemic transmission of WNV in people and animals, as well as the effectiveness of the ArboNET surveillance system in detecting increased transmission of the virus.

The article presents a study involving the future estimates of HIV prevalence, incidence, and infections averted in the U.S. It says that the study uses HIV-related information in 2006 based from Centers for Disease Control and Prevention (CDC), and simulates 10-year trends for several base-case scenarios and HIV intervention scenarios. Moreover, it says that HIV prevalence will increase in 10 years but intervention may decrease more infections when halving the transmission rate in five years.

Racism is embedded in the fabric of society at structural, disciplinary, hegemonic, and interpersonal levels, working as a mechanism that drives health disparities. In particular, stigmatized views of substance use get entangled with racialization, serving as a tool to uphold oppressive systems. While national health institutions have made commitments to dismantle these systems in the United States, anti-racism has not been integrated into biomedical research practice. The ways in which substance use researchers use and interpret race data-without engaging in structural racism as a mechanism of health inequity-can only be described as inadequate. Drawing upon concepts from the Public Health Critical Race praxis, QuantCrit, and an anti-racism research framework, we recommend a set of guidelines to help biomedical researchers conceptualize and engage with race more responsibly in substance use research., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Lehman, Balangoy, Mejia, Cardenas-Iniguez, Marek and Randolph.)

Colorado tick fever (CTF) virus is an arbovirus maintained in an enzootic cycle between Rocky Mountain wood ticks (Dermacentor andersoni) and rodent species in the western United States. Individuals with CTF typically present with symptoms including fever, headache, myalgia, and lethargy, with a biphasic illness frequently occurring. We reviewed data on CTF cases reported to the national U.S. arboviral disease surveillance system and identified through testing at the CDC to characterize the epidemiology of CTF from 2013-2022. During this period, 148 CTF cases were identified, all likely infected in an endemic area in one of six states (Montana, Wyoming, Oregon, Colorado, Utah, Idaho). A median of 11 cases (range: 5-37) were identified per year, with an average annual national incidence of 0.04 cases per million population. The median age of cases was 55 years (range: 1-84 years), and 96 (65%) were male. Most (n = 145; 98%) cases acquired infection from April through July. The hospitalization rate was 16% (16 of 102 cases with data), and no deaths were reported. These findings substantiate the continued circulation of CTF virus in the western United States, highlighting the importance of implementing approaches to ensure CTF awareness for medical providers and providing education on tick bite prevention strategies for residents and visitors to risk areas.

Background: Mis/disinformation has reached an epidemic level with the COVID-19 virus and can be largely attributed to the growing digitalization of information and its rapid transmission via social media. Approximately 96% of Canadians and 80% of Americans report encountering COVID-19 dis/misinformation on at least one social media site/app. COVID-19 dis/misinformation promotes scepticism and a lack of confidence in COVID-19 interventions. Black people have been disproportionately affected by the COVID-19 pandemic in terms of negative impacts on their livelihoods and are also more likely to be hesitant to receive the COVID-19 vaccine. Dis/misinformation contributes to high rates of COVID-19 infection and low uptake of COVID-19 vaccination. Hence, the purpose of this scoping review was to map out the nature and extent of current research on COVID-19 disinformation among Blacks in Africa and the African diaspora., Methods: We searched and reviewed articles from major databases such as MEDLINE, EMBASE, and CINAHL. Our search strategy involved the following concepts: 1) COVID-19, including variants; 2) misinformation, conspiracy theories, and fake news, and modes of misinformation transmission such as social media; and 3) Blacks or people of African descent, or the African diaspora. We retrieved 600 articles that were independently screened by two researchers. We included studies focusing on 1) Black people living inside or outside Africa; and 2) COVID-19 online dis/misinformation among this population. A total of 19 studies fit our inclusion criteria. We used a thematic analysis to analyse qualitative data., Results: Our findings indicate Black people are accessing and often sharing online disinformation and misinformation primarily through social media platforms such as WhatsApp, Facebook, Twitter, YouTube, and Instagram. Dis/misinformation concerns the origin of COVID-19, transmission, prevention, and treatment of COVID-19, assertions of race immunity to the virus, distrust in government and health organizations, and intervention research and programming., Conclusions: There is a global paucity of literature addressing COVID-19 online dis/misinformation among Black people. Dis/misinformation can fuel vaccine hesitancy and threaten the goal of herd immunity. Knowledge of the impact and implications of COVID-19 online dis/misinformation is necessary to inform public health interventions in Black communities., Competing Interests: Competing interests: The authors have completed the ICMJE Competing Interest Form (available upon request from the corresponding author) and declare no conflicts of interest., (Copyright © 2022 by the Journal of Global Health. All rights reserved.)

Arthropodborne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes and ticks. West Nile virus (WNV) is the leading cause of domestically acquired arboviral disease in the continental United States (1). Other arboviruses, including eastern equine encephalitis, Jamestown Canyon, La Crosse, Powassan, and St. Louis encephalitis viruses, cause sporadic cases of disease and occasional outbreaks. This report summarizes surveillance data reported to CDC for 2018 on nationally notifiable arboviruses. It excludes dengue, chikungunya, and Zika viruses because they are primarily nondomestic viruses typically acquired through travel. In 2018, 48 states and the District of Columbia (DC) reported 2,813 cases of domestic arboviral disease, including 2,647 (94%) WNV disease cases. Of the WNV disease cases, 1,658 (63%) were classified as neuroinvasive disease (e.g., meningitis, encephalitis, and acute flaccid paralysis), for a national incidence of 0.51 cases of WNV neuroinvasive disease per 100,000 population. Because arboviral diseases continue to cause serious illness and have no definitive treatment, maintaining surveillance is important to direct and promote prevention activities. Health care providers should consider arboviral infections in patients with aseptic meningitis or encephalitis, perform appropriate diagnostic testing, and report cases to public health authorities., Competing Interests: All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Background: Undifferentiated pleomorphic sarcoma (UPS) encompasses rare neoplasms that can arise either in the dermis or in the subfascial soft tissue. The behavior of UPS ranges from indolent to aggressive, but data predicting outcomes are limited., Objective: Identify predictors of poor outcomes by analyzing a large collection of UPS cases., Methods: We evaluated all available cases of UPS (including those termed atypical fibroxanthoma, malignant fibrous histiocytoma, pleomorphic dermal sarcoma, and subfascial UPS) across 3 tertiary care centers., Results: Among the 319 patients, 45 experienced recurrence, 33 experienced metastasis, and 96 died of any cause. Risk factors for recurrence were clinical tumor size larger than 5 cm and invasion beyond subcutaneous fat. Risk factors for distant metastases were tumor site, tumor size larger than 2 cm, invasion beyond subcutaneous fat, and lymphovascular invasion. Risk factors for overall mortality were age, immunosuppression, tumor size larger than 2 cm, and lymphovascular invasion. History of skin cancer was associated with a lower risk of recurrence and metastasis., Limitations: This was a retrospective study., Conclusions: Using the unbiased approach of pooling all UPS cases regardless of terminology, we identified clinical and histologic factors predicting poor outcomes. We propose subcategorization of UPS (into superficial versus deep UPS), which is consistent with the American Joint Committee on Cancer staging of soft-tissue sarcoma., (Published by Elsevier Inc.)

Background: The Affordable Care Act of 2010 establishes American Health Benefit Exchanges. The benefit design of insurance plans in state health insurance exchanges will be based on the structure of existing small-employer-sponsored plans., Objective: The purpose of this study was to describe the structure of the physical therapy benefit in a typical Blue Cross Blue Shield (BCBS) preferred provider organization (PPO) health insurance plan available in the individual insurance market in 2011., Design: A cross-sectional survey design was used., Methods: The physical therapy benefit within 39 BCBS PPO plans in 2011 was studied for a standard consumer with a standard budget. First, whether physical therapy was a benefit in the plan was determined. If so, then the structure of the benefit was described in terms of whether the physical therapy benefit was a stand-alone benefit or part of a combined-discipline benefit and whether a visit or financial limit was placed on the physical therapy benefit., Results: Physical therapy was included in all BCBS plans that were studied. Ninety-three percent of plans combined physical therapy with other disciplines. Two thirds of plans placed a limit on the number of visits covered., Limitations: The results of the study are limited to 1 standard consumer, 1 association of insurance companies, 1 form of insurance (a PPO), and 1 PPO plan in each of the 39 states that were studied., Conclusions: Physical therapy is a covered benefit in a typical BCBS PPO health insurance plan. Physical therapy most often is combined with other therapy disciplines, and the number of covered visits is limited in two thirds of plans.

Through sequential cross-sectional surveys, we examined intent to use home HIV test collection kits, actual use and barriers to use among persons at high risk for HIV infection. Interest in kits was assessed in the 1995-96 HIV Testing Survey (HITS, n=1683). Kit use, knowledge of kits and barriers to use were assessed in the 1998-99 HITS (n=1788), after kits had become widely available. When asked to choose among future testing options, 19% of 1995-96 participants intended to use kits. Untested participants were more likely than previously tested HIV-negative participants to choose kits for their next HIV test (p < 0.001). Among 1998-99 participants, only 24 (1%) had used kits; 46% had never heard of kits. Predictors of not knowing about kits included never having been HIV tested and black or Latino race. Common reasons for not using kits among participants aware of home test kits were concerns about accuracy, lack of in-person counselling and cost. Despite high rates of anticipated use, kits have had minimal impact on the testing behaviour of persons at high risk for HIV infection. Increasing awareness of kits, reducing price and addressing concerns about kit testing procedures may increase kit use, leading to more HIV testing by at-risk individuals.

Objectives: Homeless persons have an increased risk of HIV infection because of a high prevalence of HIV-related risk behaviors. These include drug use, sexual contact with persons at risk for HIV infection, and the exchange of sex for drugs. The objectives of this investigation were to describe HIV seroprevalence rates in homeless adults and runaway youth., Methods: In 1989, the Centers for Disease Control and Prevention began collaboration with state and local health departments to conduct HIV seroprevalence surveys in homeless populations. Unlinked HIV seroprevalence surveys were conducted in 16 sites; 11 provided medical services primarily to homeless adults, and five to runaway youth aged < 25 years., Results: From January 1989 through December 1992, annual surveys were conducted in 16 sites in 14 cities. Site-specific seroprevalence rates ranged from 0-21.1% (median, 3.3%). Among homeless adults in three sites, rates were higher among men who had sex with other men and those who injected drugs than among persons with other risk exposures (28.9 versus 5.3%). In general, rates were higher for heterosexual men than for women and higher among African Americans than whites. In sites providing services to homeless youth, HIV seroprevalence rates ranged from 0-7.3% (median, 2.3%)., Conclusions: These data indicate that HIV infection among homeless adults and runaway youth is an important public health problem. HIV prevention and treatment should be integrated into comprehensive health and medical programs serving homeless populations.

Objective: To describe HIV seroprevalence among non-injecting drug users (non-IDU) entering sentinel drug treatment centers in the United States., Design: Anonymous, blinded (unlinked) HIV seroprevalence surveys., Setting: Sixty-eight sentinel drug treatment centers in 37 United States metropolitan areas., Participants: Consecutive sample of clients admitted to sentinel drug treatment centers from January 1989 through December 1992. Of 84,617 clients, 37,633 (44.5%) had used illicit drugs but reported no injecting drug use since 1978., Main Outcome Measures: Center-specific, metropolitan area-specific, and national median HIV seroprevalence rates., Results: National median center-specific HIV seroprevalence among non-IDU was 3.2% (range, 0-15.2%). Rates varied widely by geographic area. Median rates were highest in the northeast (5.6%; range, 0-15.2%), intermediate in the south (3.4%; range, 0.6-8.0%), and generally lower throughout the rest of the country: midwest (1.3%; range, 0-3.1%) and west (1.8%; range, 0-14.5%). When stratified by treatment center, there were few statistically significant differences in seroprevalence among African Americans, Hispanics and whites. The median rate was 3.4% among men and 2.7% among women. Rates among non-IDU were lower than among IDU attending the same drug treatment centers, but consistently higher than among heterosexual patients attending sexually transmitted disease clinics in the same metropolitan areas., Conclusions: HIV seroprevalence among non-IDU entering drug treatment is high in many metropolitan areas. HIV prevention and education efforts in drug treatment centers should target sexual as well as drug-use risk reduction for all clients.

While traveling in a rural province of the People's Republic of China, an American scientist had an acute myocardial infarction that was complicated by ventricular tachycardia and congestive heart failure. Medical personnel were rapidly mobilized, and an improvised coronary care unit was created around the patient. He survived due to the organization, training, and skill of the Chinese medical staff.