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Pathogen agnostic sequencing, also known as metagenomic sequencing, is a useful tool for biodefense and public health surveillance. It involves sequencing genetic material in a sample to detect and monitor infectious diseases. Next-generation sequencing technologies have made this method more affordable and accessible. The US Department of Defense's Global Emerging Infections Surveillance program has successfully integrated pathogen agnostic sequencing into its infectious disease surveillance network. The program has established a consortium to promote collaboration and standardization, conducted proficiency testing exercises, and funded surveillance activities using this method. The text discusses the challenges and opportunities associated with pathogen agnostic sequencing, highlighting the need for standardized protocols and methods, as well as collaboration between the biodefense and public health communities. The conclusion emphasizes the value of past investments in this technology and the need for continued investment to prepare for future threats. [Extracted from the article]

Abstract Background The role of host immunity has been recognized as not only playing a fundamental role in the interaction between the host and pathogen but also in influencing host infectiousness and the ability to shed pathogens. Despite the interest in this area of study, and the development of theoretical work on the immuno-epidemiology of infections, little is known about the immunological processes that influence pathogen shedding patterns. Results We used the respiratory bacterium Bordetella bronchiseptica and its common natural host, the rabbit, to examine the intensity and duration of oro-nasal bacteria shedding in relation to changes in the level of serum antibodies, blood cells, cytokine expression and number of bacteria colonies in the respiratory tract. Findings show that infected rabbits shed B. bronchiseptica by contact up to 4.5 months post infection. Shedding was positively affected by number of bacteria in the nasal cavity (CFU/g) but negatively influenced by serum IgG, which also contributed to the initial reduction of bacteria in the nasal cavity. Three main patterns of shedding were identified: i- bacteria were shed intermittently (46% of individuals), ii- bacteria shedding fell with the progression of the infection (31%) and iii- individuals never shed bacteria despite being infected (23%). Differences in the initial number of bacteria shed between the first two groups were associated with differences in the level of serum antibodies and white blood cells. These results suggest that the immunological conditions at the early stage of the infection may play a role in modulating the long term dynamics of B. bronchiseptica shedding. Conclusions We propose that IgG influences the threshold of bacteria in the oro-nasal cavity which then affects the intensity and duration of individual shedding. In addition, we suggest that a threshold level of infection is required for shedding, below this value individuals never shed bacteria despite being infected. The mechanisms regulating these interactions are still obscure and more studies are needed to understand the persistence of bacteria in the upper respiratory tract and the processes controlling the intensity and duration of shedding.

While the broad relationship between violence, poor health outcomes, and firearms is wellestablished, there is limited research in the public health field on the source of guns collected by police departments, many of which are used for violent crime that results in injury or death. This data could be valuable for purposes of improving surveillance around violent crime and health outcomes as well as for evaluating prevention strategies and future programs that aim to reduce gun violence. The objectives of this study are to describe how guns come into police possession, identify the primary source of these guns, determine how guns leave possession of lawful owners, and determine disposition of guns and perpetrators. In order to meet the objectives, we analyzed data on 762 cases in which a gun was recovered by the Pittsburgh Bureau of Police Firearm Tracking Unit (FTU). Descriptive analyses were conducted. Most cases involve a single perpetrator. Traffic stop and street patrol accounted for 31% of method of recovery. Most perpetrators (79%) were carrying a gun that did not belong to them. More than 30% of the guns recovered were reported stolen by owners when the FTU contacted them. For 44% of the guns, whether the gun was stolen was either unknown or not able to be determined. In most cases, individual owners did not know how they lost possession of their firearm (62%). Currently there is no way to track firearms from a legal purchase into hands that do not have legal ownership, even through official police data. A large number of guns recovered are taken from persons who are not the lawful owner of the gun. In the majority of cases, the guns were privately owned, as opposed to being traced back to a dealer. How the guns left the possession of their lawful owners is unknown, and collecting this data proves to be challenging. Future studies should be conducted to assess the pathway in which guns travel from legal to illegal ownership. [ABSTRACT FROM AUTHOR]

Excessive alcohol consumption, the fourth leading preventable cause of death in the United States, resulted in approximately 88,000 deaths and 2.5 million years of potential life lost (YPLL) annually during 2006-2010 and cost an estimated $223.5 billion in 2006. To estimate state-specific average annual rates of alcohol-attributable deaths (AAD) and YPLL caused by excessive alcohol use, 11 states analyzed 2006-2010 data (the most recent data available) using the CDC Alcohol-Related Disease Impact (ARDI) application. The age-adjusted median AAD rate was 28.5 per 100,000 population (range = 50.9 per 100,000 in New Mexico to 22.4 per 100,000 in Utah). The median YPLL rate was 823 per 100,000 (range = 1,534 YPLL per 100,000 for New Mexico to 634 per 100,000 in Utah). The majority of AAD (median = 70%) and YPLL (median = 82%) were among working-age (20-64 years) adults. Routine monitoring of alcohol-attributable health outcomes, including deaths and YPLL, in states could support the planning and implementation of evidence-based prevention strategies recommended by the Community Preventive Services Task Force to reduce excessive drinking and related harms. Such strategies include increasing the price of alcohol, limiting alcohol outlet density, and holding alcohol retailers liable for harms related to the sale of alcoholic beverages to minors and intoxicated patrons (dram shop liability).