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Wildlife play a major role in the maintenance and transmission of multihost pathogens (1,2). Understanding the role of host species involved in multihost zoonotic pathogen maintenance and transmission is essential [...]

In the Peruvian Amazon, paca meat is consumed by humans. To determine human risk for polycystic echinococcosis, we examined wild pacas from 2 villages; 15 (11.7%) of 128 were infected [...]

To describe prevalence trends in hospitalized live births affected by placental transmission of alcohol and drugs, as well as prevalence trends among parturient women hospitalized for liveborn delivery and diagnosed with substance abuse problems in the United States from 1999 to 2008. Comparison of the two sets of trends helps determine whether the observed changes in neonatal problems over time were caused by shifts in maternal substance abuse problems. This study independently identified hospitalized live births and maternal live born deliveries from discharge records in the Nationwide Inpatient Sample, one of the largest hospital administrative databases. Substance-related diagnosis codes on the records were used to identify live births affected by alcohol and drugs and parturient women with substance abuse problems. The analysis calculated prevalence differences and percentage changes over the 10 years, with Loess curves fitted to 10-year prevalence estimates to depict trend patterns. Linear and quadratic trends in prevalence were simultaneously tested using logistic regression analyses. The study also examined data on costs, primary expected payer, and length of hospital stays. From 1999 to 2008, prevalence increased for narcotic- and hallucinogen-affected live births and neonatal drug withdrawal syndrome but decreased for alcohol- and cocaine-affected live births. Maternal substance abuse at delivery showed similar trends, but prevalence of alcohol abuse remained relatively stable. Substance-affected live births required longer hospital stays and higher medical expenses, mostly billable to Medicaid. The findings highlight the urgent need for behavioral intervention and early treatment for substance-abusing pregnant women to reduce the number of substance-affected live births. Keywords Alcohol * Drug * Live birth * Neonatal drug withdrawal syndrome * Trend analysis, Introduction According to the National Survey on Drug Use and Health (NSDUH) in 2007 and 2008 [1], about 14 million women of reproductive age (15--44 years) in the United States [...]

Gestational diabetes mellitus (GDM) is defined as glucose intolerance first recognized during pregnancy. Asian-American, Native Hawaiian, Pacific Islander, Hispanic, and African-American women are at a disparately higher risk for GDM [...]

There is growing interest in measuring social disability as a core element of autism spectrum disorders in medication trials. We conducted a secondary analysis on the Aberrant Behavior Checklist Social Withdrawal subscale using data from two federally-funded, multi-site, randomized trials with risperidone. Study 1 included 52 subjects assigned to placebo and 49 subjects to risperidone under double-blind conditions. Study 2 included 49 subjects assigned to risperidone only and 75 subjects assigned to risperidone plus parent training. After 8 weeks of treatment, all active treatments were superior to placebo (effect sizes ranging from 0.42 to 0.65). The findings suggest that the Social Withdrawal subscale may be a useful measure of social disability in acute treatment trials. Keywords Social disability * Autism * Research Units on Pediatric Psychopharmacology (RUPP) Autism Network * Social withdrawal * Risperidone * Aberrant Behavior Checklist, Introduction Autism Spectrum Disorders (ASDs) may affect as many as 11 per 1,000 children (Centers for Disease Control and Prevention 2012). This estimate from the 2008 survey conducted by the [...]

The use of psychotropics by categories and the reason for their prescription was investigated in a large scale study of 4,069 adults with ID, including those with autism spectrum disorder, in New York State. Similar to other studies it was found that 58 % (2,361/4,069) received one or more psychotropics. Six percent received typical, 6 % received typical, while 39 % received atypical antipsychotics. There was greater use of antidepressants (23 %), mood stabilizers (19 %), and antianxiety agents (16 %) relative to other studies. The use of anti-impulsives, stimulants and hypnotics was rare (1-2 %). Half of the psychotropics were prescribed for treatment of major psychiatric disorders, 13 % for control of challenging behaviors, and 38 % for both. Results indicated that the major psychiatric disorders, except anxiety disorder and autism, influenced the use of psychotropics and the number of medication used. These findings imply that although practitioners still rely too heavily on the use of antipsychotics in this population, there is a welcome shift in the prescription patterns relative to other studies. The practitioners appeared to use psychotropics primarily to treat diagnosed psychiatric disorders and not just to control aggressive behavior which suggests that evidence-based practice of psychiatry is playing an increasing role in the ID population. Keywords Psychotropics * Intellectual disability * Survey * Diagnosis * Challenging behavior * Aggression, Introduction Psychotropic medications have improved the function and quality of life of many persons diagnosed with different psychiatric disorders. In vulnerable populations of children and the elderly, the extensive use [...]

Murine, or endemic, typhus is primarily caused by Rickettsia typhi (typhus group rickettsiae [TGR]) and is usually manifest as a benign disease. A systemic vasculitis causes a clinical triad of [...]

Tueste des petits ruminants virus (PPRV) belongs to the genus Morbillivirus, in the family Paramyxoviridae. Like other members of the same genus, such as rinderpest virus, Canine distemper virus, Measles [...]

Objectives. We assessed changes in cardiovascular disease--related health outcomes and risk factors among American Indians and Alaska Natives by age and gender. Methods. We used cross-sectional data from the 1995 to 1996 and the 2005 to 2006 Behavioral Risk Factor Surveillance System. The respondents were 2548 American Indian and Alaska Native women and men aged 18 years or older in 1995-1996 and 11 104 women and men in 2005-2006. We analyzed the prevalence of type 2 diabetes, obesity, hypertension, cigarette smoking, sedentary behavior, and low vegetable or fruit intake. Results. From 1995-1996 to 2005-2006, the adjusted prevalence of diabetes among American Indians and Alaska Natives increased by 26.9%, from 6.7% to 8.5%, and obesity increased by 25.3%, from 24.9% to 31.2%. Hypertension increased by 5%, from 28.1% to 29.5%. Multiple logistic models showed no meaningful changes in smoking, sedentary behavior, or intake of fruits or vegetables. In 2005-2006, 79% of the population had 1 or more of the 6 risk factors, and 46% had 2 or more. Conclusions. Diabetes, obesity, and hypertension and their associated risk factors should be studied further among urban, rural, and reservation American Indian and Alaska Native populations, and effective primary and secondary prevention efforts are critical. (Am J Public Health. 2010;100:677-683. doi: 10.2105/AJPH.2009.164285)

Objectives. We estimated the prevalence of overweight and diabetes among US immigrants by region of birth. Methods. We analyzed data on 34456 US immigrant adults from the National Health Interview Survey, pooling years 1997 to 2005. We estimated age- and gender-adjusted and multivariable-adjusted overweight and diabetes prevalence by region of birth using logistic regression. Results. Both men (odds ratio [OR]=3.3; 95% confidence interval [CI]=1.9, 5.8) and women (OR=4.2; 95% CI=2.3, 7.7) from the Indian subcontinent were more likely than were European migrants to have diabetes without corresponding increased risk of being overweight. Men and women from Mexico, Central America, or the Caribbean were more likely to be overweight (men: OR=1.5; 95% CI=1.3, 1.7; women: OR=2.0; 95% CI=1.7, 2.2) and to have diabetes (men: OR=2.0; 95% CI=1.4, 2.9; women: OR=2.0; 95% CI=1.4, 2.8) than were European migrants. Conclusions. Considerable heterogeneity in both prevalence of overweight and diabetes by region of birth highlights the importance of making this distinction among US immigrants to better identify subgroups with higher risks of these conditions. (Am J Public Health. 2010;100:661-668. doi:10.2105/AJPH.2008.149492)

Adherence to antiretroviral regimens continues to be a significant problem in HIV-infected individuals facing a lifetime of therapy. Youth who were infected through perinatal transmission enter into adolescence often with a history of multiple medication regimens. Thus, adherence can be a particularly important issue in these young people, as medication options can often be limited. This was a cross-sectional, observational study to determine the prevalence of personal barriers to adherence and to identify associations among the following barriers in subjects 12 to 24 years old: mental health barriers, self-efficacy and outcome expectancy, and structural barriers. Among the 368 study participants, 274 (74.5%) were adherent and 94 (25.5%) were nonadherent to highly active antiretroviral therapy (HAART). No significant differences were found between adherent and nonadherent subjects according to mental health disorders. Adherence was associated with some but not all structural barriers. Both self-efficacy and outcome expectancy were significantly higher in adherent versus nonadherent subjects (p < 0.0001). In subjects with low self-efficacy and outcome expectancy, adherence differed according to the presence or absence of either mental health or structural barriers, similar to findings in behaviorally- infected adolescents. Interventions that address the breadth and clustering of adherence barriers in adolescents are needed to have the maximum chance for positive effects. DOI: 10.1089/apc.2009.0198

Traditional objectives of investigations of infectious disease outbreaks are to identify ways to control ongoing outbreaks and to prevent future outbreaks. However, a paucity of epidemiologic and ecologic knowledge hampers [...]

The tick-transmitted bacterium Anaplasma phagocytophilum is the causative agent of granulocytic anaplasmosis, an infection of medical and veterinary importance that is widely encountered across the temperate zones of the Northern [...]

Arenaviruses associated with rodents are known to cause fatal hemorrhagic fevers in humans in South America and West Africa. We describe a nosocomial outbreak of infection with a novel arenavirus [...]

Celiac disease (CD) is an autoimmune inflammatory disease with a relatively high prevalence especially in the western hemisphere. A strong genetic component is involved in the pathogenesis of CD with virtually all individuals that develop the disease carrying HLA-DQ alleles that encode specific HLA-DQ2 or HLA-DQ8 heterodimers. Consumption of cereals rich in gluten triggers a chronic intestinal inflammation in genetically susceptible individuals leading to the development of CD. Emerging evidence has implicated a central role for IL-15 in the orchestration and perpetuation of inflammation and tissue destruction in CD. Therefore, IL-15 represents an attractive target for development of new therapies for CD. Transgenic mice that express human IL-15 specifically in enterocytes ([T3.sup.b]-hIL-15 Tg mice) develop villous atrophy and severe duodeno-jejunal inflammation with massive accumulation of NK-like [CD8.sup.+] lymphocytes in the affected mucosa. We used these mice to demonstrate that blockade of IL-15 signaling with an antibody (TM-[beta]1) that binds to murine IL-2/IL-15Rbeta (CD122) leads to a reversal of the autoimmune intestinal damage. The present study, along with work of others, provides the rationale to explore IL-15 blockade as a test of the hypothesis that uncontrolled expression of IL-15 is critical in the pathogenesis and maintenance of refractory CD. autoimmunity | celiac disease | immunotherapy | interleukine 15 receptor

In geographical spatial epidemiology and disease surveillance, all the existing spatial scan methods for cluster detection using continuous data are designed for evaluating clusters of individuals and analyzing individual-level data. Motivated by growing demands to study the spatial heterogeneity of continuous measures in population data, such as mortality rates. survival rates, average body mass indexes and pollution at state, county, and census tract levels, we propose a weighted normal scan statistic for investigating the clusters of the cells (geographic units such as counties) with unusual high/low continuous regional measures. where the weights reflect the uncertainty of the regional measures or sample size (number of observed cases) in the cells. Power, precision, the effect of the weights, and the sensitivity of the proposed test statistic to data from various distributions are investigated through intensive simulation. The method is applied to 1988-2002 stage I and II lung cancer survival data in Los Angeles County in order to search for clusters of geographic units with high/low survival rates in a short-term/long-term survival after diagnosis, and to 1999-2003 breast cancer age-adjusted mortality rate data in the U.S. collected by the Surveillance. Epidemiology and End Results (SEER) program in order to evaluate the clustering pattern of counties with high mortality rate. The proposed method is included in the latest release of the SaTScan software (www.satscan.org). KEY WORDS: Breast cancer mortality; Cluster detection; Continuous regional data; Geographic variation; Lung cancer survival: Weighted normal spatial scan statistic.

Objectives. We sought to investigate longitudinal trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans. Methods. We determined the prevalence and predictors of mental health diagnoses among 289328 Iraq and Afghanistan veterans entering Veterans Affairs (VA) health care from 2002 to 2008 using national VA data. Results. Of 289328 Iraq and Afghanistan veterans, 106726 (36.9%) received mental health diagnoses; 62929 (21.8%) were diagnosed with posttraumatic stress disorder (PTSD) and 50432 (17.4%) with depression. Adjusted 2-year prevalence rates of PTSD increased 4 to 7 times after the invasion of Iraq. Active duty veterans younger than 25 years had higher rates of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans older than 40 years (adjusted relative risk=2.0 and 4.9, respectively). Women were at higher risk for depression than were men, but men had over twice the risk for drug use disorders. Greater combat exposure was associated with higher risk for PTSD. Conclusions. Mental health diagnoses increased substantially after the start of the Iraq War among specific subgroups of returned veterans entering VA health care. Early targeted interventions may prevent chronic mental illness. (doi:10.2105/AJPH.2008.150284)

Bipolar spectrum disorders have traditionally been thought to be chronic in course. However, recent epidemiologic research suggests that there may be developmentally limited forms of bipolar disorder. Two large, nationally representative studies reveal a strikingly high prevalence of bipolar disorders in emerging adulthood (5.5%-6.2% among 18-24-year-olds) that appear to resolve substantially during the latter half of the 3rd decade of life (3.1%-3.4% among 25-29-year-olds). Although ascertainment bias due to early mortality, institutionalization, incarceration, and homelessness may account for some of this reduction, the prevalence distribution suggests a high incidence in late adolescence and emerging adulthood that appears to resolve spontaneously in most cases. There were very few differences across age groups in symptom endorsement and comorbid diagnoses, suggesting that 18-24-year-olds that meet criteria for bipolar diagnoses experience clinically significant impairment and associated consequences of the disorder. More fine-grained longitudinal research is needed to determine whether developmentally limited forms of bipolar disorder exist and, if so, what markers might distinguish these forms of the disorder from more chronic courses. Keywords: bipolar disorder, developmental psychopathology, epidemiology

Antimicrobial drug treatment of community-acquired respiratory tract infections (RTIs) is usually initiated when the causative pathogen has not been documented. Treatment is therefore chosen empirically on the basis of potential [...]

Four dengue virus serotypes (DENV-1 to DENV-4) are transmitted to humans. In some infected persons a milder form, dengue fever (DF), may develop, whereas in a smaller proportion, the severe [...]

Cryptococcus gattii (formerly C. neoformans var. gattii) (1) is a basidiomycotic yeast acquired by inhalation. In a susceptible host, the disease (cryptococcosis), caused by C. gattii and the congeneric pathogen [...]

Rabies has been endemic to the People's Republic of China for many years; domestic dogs act as the main reservoir (1-3). After efforts to stabilize the dog population, the lowest [...]

The activation of type I IFN signaling is a major component of host defense against viral infection, but it is not typically associated with immune responses to extracellular bacterial pathogens. Using mouse and human airway epithelial cells, we have demonstrated that Staphylococcus aureus activates type I IFN signaling, which contributes to its virulence as a respiratory pathogen. This response was dependent on the expression of protein A and, more specifically, the Xr domain, a short sequence--repeat region encoded by DNA that consists of repeated 24-bp sequences that are the basis of an internationally used epidemiological typing scheme. Protein A was endocytosed by airway epithelial cells and subsequently induced IFN-[beta] expression, JAK-STAT signaling, and IL-6 production. Mice lacking IFN-[alpha]/[beta] receptor 1 (IFNAR-deficient mice), which are incapable of responding to type I IFNs, were substantially protected against lethal S. aureus pneumonia compared with wild-type control mice. The profound immunological consequences of IFN-[beta] signaling, particularly in the lung, may help to explain the conservation of multiple copies of the Xr domain of protein A in S. aureus strains and the importance of protein A as a virulence factor in the pathogenesis of staphylococcal pneumonia., Introduction Staphylococcus aureus has reemerged as a major human pathogen, and in 2005, infection due to methicillin-resistant (MRSA) strains alone caused more than 18,000 deaths in the US, many acquired [...]

Objective Iron and zinc share common food sources, and children at risk of iron deficiency may also develop zinc deficiency. We determined the prevalence of zinc and copper deficiency and examined factors associated with serum zinc and copper in young children from low-income families at risk of iron deficiency. Design A cross-sectional study design was used to assess serum zinc and copper, along with an interview-assisted survey to assess factors associated with serum zinc and copper in a convenience sample. Subjects/setting Participants were 435 children aged 12 to 36 months recruited from select clinics of the Special Supplemental Nutrition Program for Women, Infants, and Children in Contra Costa and Tulare Counties, California. Statistical analyses performed Frequencies were used to report prevalence. Multiple linear regressions were conducted to examine factors associated with serum zinc and copper, controlling for age, sex, and ethnicity. Results The prevalence of low serum zinc level (<70 [micro]g/dL [<10.7 [micro]mol/L]) was 42.8%, and low serum copper level (<90 [micro]g/dL [<14.2 [micro]mol/L]) was <1%. Mean [+ or -] standard deviation of serum copper was 150 [+ or -] 22 [micro]g/dL (23.6 [+ or -] 3.5 [micro]mol/L) and 140 [+ or -] 24 [micro]g/dL (22.1 [+ or -] 3.8 [micro]mol/L) for anemic and non-anemic children, respectively (t test, P=0.026). In multiple linear regression consumption of sweetened beverages was negatively associated with serum zinc level, and consumption of > 15 g/day meat was positively associated with serum zinc level, whereas current consumption of breast milk and >15 g/day beans were positively associated with serum copper level. Conclusions The prevalence of low serum zinc concentration in the sample was high, and warrants further investigation amongst vulnerable populations.