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Background Human adenoviruses (HAdVs) can cause outbreaks of flu-like illness in university settings. Most infections in healthy young adults are mild; severe illnesses rarely occur. In Fall 2022, an adenovirus outbreak was identified in university students. Methods HAdV cases were defined as university students 17–26 years old who presented to the University Health Service or nearby emergency department with flu-like symptoms (eg, fever, cough, headache, myalgia, nausea) and had confirmed adenovirus infections by polymerase chain reaction (PCR). Demographic and clinical characteristics were abstracted from electronic medical records; clinical severity was categorized as mild, moderate, severe, or critical. We performed contact investigations among critical cases. A subset of specimens was sequenced to confirm the HAdV type. Results From 28 September 2022 to 30 January 2023, 90 PCR-confirmed cases were identified (51% female; mean age, 19.6 years). Most cases (88.9%) had mild illness. Seven cases required hospitalization, including 2 critical cases that required intensive care. Contact investigation identified 44 close contacts; 6 (14%) were confirmed HAdV cases and 8 (18%) reported symptoms but never sought care. All typed HAdV-positive specimens (n = 36) were type 4. Conclusions While most students with confirmed HAdV had mild illness, 7 otherwise healthy students had severe or critical illness. Between the relatively high number of hospitalizations and proportion of close contacts with symptoms who did not seek care, the true number of HAdV cases was likely higher. Our findings illustrate the need to consider a wide range of pathogens, even when other viruses are known to be circulating. [ABSTRACT FROM AUTHOR]

Background: Haemophilus influenzae type b (Hib) vaccine and pneumococcal conjugate vaccine (PCV) are relatively expensive, newly introduced vaccines in China. This study evaluates the impact of residency and urbanicity on Hib vaccine and PCV coverage for children aged 2 to 7 years living in Shanghai, China, in August 2012. Methods: In this exploratory cohort study, a sample of children aged 2 to 7 years, all of whom were eligible to have received the complete series of Hib vaccine and PCV, was obtained from the Shanghai Immunization Program Information System. Three measures of vaccination coverage for Hib vaccine and PCV were examined: dose 1 coverage, series completion, and timeliness of dose 1 vaccination. Multivariable binomial regression was used to estimate the difference in vaccination coverage between locals and the floating population. Results: Dose 1 coverage was 50.9% for Hib vaccine and 11.4% for PCV for the 28,141 abstracted pediatric records. For both vaccines, dose 1 coverage was higher in locals than in the floating population. The disparity in coverage between locals and the floating population was greater in suburban areas than urban areas. Of all children who received dose 1, 79.7% completed the Hib vaccine series, and 91.3% completed the PCV series. Timely dose 1 coverage was 8.2% for Hib vaccine and 0.5% for PCV. Conclusion: Low vaccination coverage and extremely low levels of timely dose 1 vaccination indicate that current vaccination efforts are inadequate to reduce the burden of Hib and pneumococcal disease among Chinese children, especially infants. Government funding of the Hib vaccine and PCV through the Expanded Program on Immunization would increase uptake and could also ensure that improvement in the timeliness of administration and series completion is targeted for all demographic groups. [ABSTRACT FROM AUTHOR]

The University of Michigan School of Public Health provided community-based research (CBR) opportunities to masters-level students through week-long field experiences in two communities in Mississippi through interdisciplinary collaboration with Delta State University. This article examines the learning outcomes of those field experiences in the context of CBR and the value that those experiences added to their public health proficiency. Quantitative and qualitative data from post-deployment evaluations were examined to determine strengths and weaknesses of this approach to the public health learning process. Overall, students found this approach to provide a rich context for research, help put a face to the numbers, and broaden their perspective of how research is of value to communities and community organizations. [ABSTRACT FROM AUTHOR]

To examine the effect of highly active antiretroviral therapy (HAART) on the occurrence of primary brain lymphoma (PBL), determine the risk factors for PBL, and assess the difference in survival between individuals who did and did not develop PBL, data were analyzed from the Michigan Adult/Adolescent Spectrum of HIV Disease project (ASD). Among 4,026 HIV-infected individuals enrolled in ASD between January 1990 and December 2000, 64 (1.6%) were diagnosed with PBL. The incidence rate of PBL declined from 5.6 cases per 1000 person-year in the pre-HAART era to 2.1 cases per 1000 person-year in post-HAART era. In the multivariate analysis, individuals whose CD4 count at entry in ASD was either <50 cells/μL (OR: 5.0) or 50-200 cells/μL (OR: 2.3) were significantly more likely to develop PBL than those with a CD4 count ≥ 200 cells/μL. PBL was a terminal condition in these patients. The median survival time was consistently shorter among individuals who developed PBL than those who did not, regardless of their CD4 count at entry into ASD. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To plan for continuity of operations, it is important to know which types of position vacancies within health departments are likely to occur and the kind of training needed to ensure protection of the public's health. METHODS:: To describe anticipated gaps in the public health workforce and to identify specific areas of training needed to ensure a highly skilled workforce, the authors surveyed Michigan state employees with public health responsibilities in spring 2007. RESULTS:: More than half (54%) of surveyed public health professionals reported they plan to leave the workforce within 10 years. Preparedness-specific topics were generally viewed as less important than more general public health topics. Some preparedness-funded tools have become integrated into daily operations, whereas others were viewed as more important in an everyday, rather than emergency preparedness, context. CONCLUSIONS:: Framing preparedness activities beyond the scope of preparedness to directly relate them to daily public health operations would encourage public health professionals to perceive them as more important. For public health preparedness to be fully realized, it must be considered a central component of public health operations, allowing for seamless integration during emergencies small and large.

Background: Early diagnosis of HIV infection provides the opportunity for treatment to prevent progression to AIDS and for intervention to prevent further transmission. The impact of routine screening of pregnant women and other factors on the stage of HIV disease at diagnosis were evaluated., Methods: Data were collected in 1992-2002 from the medical records of persons presenting for HIV-related care at 2 major medical centers in Detroit, Michigan. Patients were included in the analysis if they had a CD4+ T-cell count recorded within 6 months of their first positive HIV test (N = 1858)., Results: Half of the patients (49%) had a first CD4+ T-cell count of < 200 cells/mm3 and 19% had an AIDS-defining illness at the time of HIV diagnosis. In the multivariate model, pregnant women were less likely than nonpregnant women to enter care with a CD4+ T-cell count of < 200 cells/mm3 (odds ratio, .24; 95% confidence interval, .14-.41). Even after adjusting for pregnancy, female sex was protective, as was age < 30 years. HIV-transmission risk factors, race, and time period of HIV diagnosis were not significantly associated with first CD4+ T-cell counts of < 200 cells/mm3., Conclusion: Routinely offering HIV testing in prenatal care, as required by Michigan law, resulted in earlier diagnoses of HIV in pregnant women, as indicated by their higher CD4+ T-cell counts. Increasing routine HIV testing of all persons seeking medical care may increase the overall proportion of HIV diagnoses that are made early in the disease process.