Search

BackgroundYoung children are at increased risk of severe outcomes from influenza illness, including hospitalization. We conducted a case-control study to identify risk factors for influenza-associated hospitalizations among children in US Emerging Infections Program sites.MethodsCases were children 6-59 months of age hospitalized for laboratory-confirmed influenza infections during 2005-2008. Age- and zip-code-matched controls were enrolled. Data on child, caregiver and household characteristics were collected from parents and medical records. Conditional logistic regression was used to identify independent risk factors for hospitalization.ResultsWe enrolled 290 (64%) of 454 eligible cases and 1089 (49%) of 2204 eligible controls. Risk for influenza hospitalization increased with maternal age 50% of household members (OR: 2.9, 95% CI: 1.4-6.6); lack of household influenza vaccination (OR: 1.8, 95% CI: 1.2-2.5) and presence of chronic illnesses, including hematologic/oncologic (OR: 11.8, 95% CI: 4.5-31.0), pulmonary (OR: 2.9, 95% CI: 1.9-4.4) and neurologic (OR: 3.8, 95% CI: 1.6-9.2) conditions. Full influenza immunization decreased the risk among children 6-23 months of age (OR: 0.5, 95% CI: 0.3-0.9) but not among those 24-59 months of age (OR: 1.5, 95% CI: 0.8-3.0; P value for difference = 0.01).ConclusionsChronic illnesses, young maternal age, poverty, household smoking and lack of household influenza vaccination increased the risk of influenza hospitalization. These characteristics may help providers to identify young children who are at greatest risk for severe outcomes from influenza illness.

To determine frequency of methicillin-resistant Staphylococcus aureus infections caused by strains typically associated with community-acquired infections (USA300) among persons with healthcare-related risk factors (HRFs), we evaluated surveillance data. Of patients with HRFs, 18%-28% had a "community-associated" strain, primarily USA300; of patients without HRFs, 26% had a "healthcare-associated" strain, typically USA100.

During August-September 2011, a total of 85 hippopotamuses (Hippopotamus amphibius) died of suspected anthrax (Bacillus anthracis) infection in a game management area along the South Luangwa River near the district [...]

Objective: Outbreak investigations are challenging in a cross-cultural context, and outbreaks of psychiatric disease are rare in any community. We investigated a cluster of unexplained debilitating illness among Amish girls. Method: We reviewed the medical records of cases, consulted with health care providers, performed active case finding, administered open-ended and structured interviews, and met with Amish community members. A case-patient was defined as a resident of the county who was bedridden for more than 3 weeks with otherwise unexplained systemic weakness and anorexia from January 2000 to February 2002. Results: Five case-patients were identified. All were Amish girls aged 9 to 13 years. All five had debilitating voluntary motor deficits, anorexia, and weight loss. Four experienced neck weakness with inability to hold up their heads. Thorough medical evaluations failed to identify an organic etiology. All five patients met the diagnostic criteria for conversion disorder. Substantial social conflict within the Amish community preceded illness onset. Family behavioral interventions were recommended. Three months after the investigation, four of five patients demonstrated some improvement. Conclusions: Clinicians should be aware of the potential for outbreaks of psychogenic illness and work to address the challenges of developing effective intervention strategies, particularly in the cross-cultural context. J. Am. Acad. Child Adolesc. Psychiatry, 2005;44(3):291-297. Key Words: outbreak, conversion disorder, Amish, cross-cultural.

In 1988, the World Health Assembly (WHA) resolved to eradicate polio worldwide. Since then, endemic transmission of wild poliovirus (WPV) has been interrupted in all countries except Afghanistan, Nigeria and [...]

A study was conducted to as per national guidelines formulated in 2002 to screen pregnant women for colonization with group B streptococcus that could indicate the development of the disease in infants within a week after birth. Results revealed that universal screening proved to be useful in identifying mothers with group B streptococcus and could help in management of the condition in the newborns.

A study examined the effects of the pediatric heptavalent pneumococcal conjugate vaccine (PCV7) on pneumococcal meningitis among children and adults over several years. Results showed a decrease in rates of pneumococcal meningitis among adults and children since the introduction of PCV7.

A study is conducted to evaluate the efficacy of prevention guidelines in helping reduce the incidence of invasive Group B Streptococcal disease in the U.S. from 1999 to 2005. Results indicate a reduction in mortality among children from invasive Group B Streptococcal disease while on the other hand it had no effect on adults with the same disease.

Limited information exists on the incidence and characteristics of invasive group A streptococcal (GAS) infections among residents of long-term care facilities (LTCFs). We reviewed cases of invasive GAS infections occurring [...]

The study presents the incidence of invasive methicillin-resistant Staphylococcus aureus (MRSA) disease in the U.S. The results show that invasive MSRA infections affect certain populations disproportionately and are no longer restricted to medical settings only.

Linezolid was approved in 2000 for treatment of gram-positive coccal infections. We performed a case--control study during a hospital outbreak of linezolid-resistant enterococci (LRE) infections, comparing cases of LRE infection [...]

A test was conducted to determine the rates of invasive pneumococcal disease (IPD) in young infants before and after pneumococcal conjugate vaccine (PCV7) was incorporated into the childhood immunization schedule. It was seen that since PCV7 introduction, rates of IPD in young infants have decreased significantly, providing evidence that vaccinating children aged 2-23 months has led to change in pneumococcal carriage in infants too young to receive PCV7.

Five of seven serotypes in the pneumococcal conjugate vaccine, introduced for infants in the US in 2000, are responsible for most penicillin-resistant infection thus a study is conducted to examine the effect of this vaccine on invasive disease caused by resistant strains. The examination revealed that rate of antibiotic-resistant invasive pneumococcal infections decreased in young children and older persons after the introduction of the conjugate vaccine, while there is an increase in infections caused by serotypes not included in the vaccine.

Although influenza causes more hospitalizations and deaths among American children than any other vaccine-preventable disease, deriving accurate population-based estimates of disease impact is challenging. Using 2 independent surveillance systems, we [...]

A case study reveals that people having asthma are more likely to be affected with invasive pneumococcal disease. The results of this study proposes that asthma appears to be an independent risk factor for the invasive pneumococcal disease and that it should be an additional indication for the pneumococcal vaccination.

People who will be traveling to a country that has a high rate of hepatitis A should be vaccinated against the hepatitis A virus a few weeks before they travel. All children should also be vaccinated, since there are still outbreaks of hepatitis A in many western states. Hepatitis A is a liver disease caused by the hepatitis A virus.

Twenty patients who had a bronchoscopy at a Tennessee hospital between July and October, 2001 developed Pseudomonas infections in their lungs because the bronchoscope was contaminated with the bacterium. An investigation revealed that the hospital's sterilization procedures were not at fault. Instead, the bronchoscopes were found to be faulty. The manufacturer recalled about 14, 000 bronchoscopes after this outbreak occurred.

Testing all pregnant women for group B streptococcal infection will prevent more streptococcal infections in their babies than a risk-based approach, according to a study of 629,912 live births. This is the so-called screening approach, whereas the risk-based approach tries to predict which women might be infected based on their risk factors.

A community-wide media campaign in Knox County, Tennessee, highlighting the appropriate use of antibiotics led to an 11% reduction in antibiotic prescriptions compared to three other counties. The campaign was aimed at doctors, parents of young children, and the general public., Context: Overuse of antibiotics has contributed to microbial resistance, compromising the treatment of bacterial infections. Very high levels (>50%) of antibiotic resistance among invasive Streptococcus pneumoniae have been documented in Knox County, Tennessee. Objective: To determine the effectiveness of a community-wide intervention aimed at reducing inappropriate antibiotic use among children. Design, Setting, and Participants: The Knox County Health Department led a multifaceted year-long campaign (May 1997 through April 1998) aimed at decreasing unnecessary antibiotic use among children. Tennessee's 3 other major urban counties (Shelby, Hamilton, and Davidson) did not conduct similar campaigns and served as controls. Evaluation included white and black children (aged Intervention: Educational efforts were directed toward health care practitioners (primarily via peer leader presentations) and to the parents of young children and the public (primarily via printed materials). Main Outcome Measure: The intervention-attributable effect on antibiotic use, defined as the excess percentage change in oral antibiotic prescription rates in Knox County between the 12-month preintervention and postintervention periods, relative to that of control counties. Results: Antibiotic prescription rates declined 19% and 8% among Knox County and control county children, respectively, yielding an 11 % intervention-attributable decline (95% confidence interval, 8%-14%; P Conclusions: A community-wide educational intervention reduced antibiotic prescription levels among children in Knox County.

Doctors and nurses who investigated a case of possible mass psychogenic illness report the experience. Mass psychogenic illness occurs when many people experience symptoms but no environmental cause is found. It can be difficult to distinguish from a bioterrorist attack or an outbreak of infectious disease. In November, 1998, a school teacher in Tennessee became sick shortly after arriving. Several of her students began experiencing symptoms and more and more children became ill as the school was evacuated. One hundred people were affected and 38 were hospitalized. No environmental cause was found for the outbreak.