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Human noroviruses are the leading cause of outbreaks of acute gastroenteritis, associated with [approximately equal to] 50% of all outbreaks worldwide (1). Norovirus outbreaks are frequently reported in semiclosed institutions, [...]

Problem The earthquake that struck Haiti in January 2010 caused 1.5 million people to be displaced to temporary camps. The Haitian Ministry of Public Health and Population and global immunization partners developed a plan to deliver vaccines to those residing in these camps. A strategy was needed to determine whether the immunization targets set for the campaign were achieved. Approach Following the vaccination campaign, staff from the Ministry of Public Health and Population interviewed convenience samples of households--in specific predetermined locations in each of the camps--regarding receipt of the emergency vaccinations. A camp was targeted for 'mop-up vaccination'--i.e. repeat mass vaccination--if more than 25% of the children aged 9 months to 7 years in the sample were found not to have received the emergency vaccinations. Local setting Rapid monitoring was implemented in camps located in the Port-au-Prince metropolitan area. Camps that housed more than 5000 people were monitored first. Relevant changes By the end of March 2010, 72 (23%) of the 310 vaccinated camps had been monitored. Although 32 (44%) of the monitored camps were targeted for mop-up vaccination, only six of them had received such repeat mass vaccination when checked several weeks after monitoring. Lessons learnt Rapid monitoring was only marginally beneficial in achieving immunization targets in the temporary camps in Port-au-Prince. More research is needed to evaluate the utility of conventional rapid monitoring, as well as other strategies, during post-disaster vaccination campaigns that involve mobile populations, particularly when there is little capacity to conduct repeat mass vaccination. Probleme Le seisme qui a frappe Haiti en janvier 2010 a cause le deplacement de 1,5 million de personnes dans des camps temporaires. Le ministere de la Sante publique et de la Population d'Haiti et les partenaires mondiaux de vaccination ont elabore un plan pour fournir des vaccins aux personnes qui resident dans ces camps. Une strategie a ete necessaire pour determiner si les objectifs de vaccination definis pour la campacjne ont ete atteints. Approche Apres la campagne de vaccination, le personnel du ministere de la Sante publique et de la Population a interroge un echantillon representatif de menages--dans des lieux predetermines specifiques dans chacun des camps--en ce qui concernait la reception des vaccinations d'urgence. Un camp faisait l'objet d'une <>--c'est-a-dire une vaccination de masse repetee --si plus de 25% des enfants ages de 9 mois a 7 ans dans l'echantillon n'avaient pas recu les vaccinations d'urgence. Environnement local Le suivi rapide a ete mis en oeuvre dans les camps situes dans la zone metropolitaine de Port-au-Prince. Les camps accueillant plus de 5 000 personnes etaient surveilles en premier. Changements significatifs A la fin du mois de mars 2010, 72 (23,2%) des 310 camps vaccines avaient ete surveilles. Bien que 32 (44%) des camps surveilles aient fait l'objet d'une campagne de ratissage, seulement 6 d'entre eux avaient beneficie d'une telle vaccination de masse repetee Iors du controle effectue plusieurs semaines apres le suivi. Lecons tirees Le suivi rapide n'a ete que peu benefique dans la realisation des objectifs de vaccination dans les camps temporaires de Port-au-Prince. II est necessaire d'effectuer plus de recherches pour evaluer l'utilite du suivi rapide traditionnel, ainsi que de mettre en place d'autres strategies, pendant les campagnes de vaccination post-catastrophe, qui impliquent des populations mobiles, en particulier Iorsqu'il y a peu de capacite pour mener a bien des vaccinations de masse repetees. Situacion El terremoto que asolo Haiti en enero de 2010 provoco el desplazamiento de 1,5 millones de personas a campamentos provisionales. El Ministro de Sanidad Publica y Poblacion haitiano y las partes implicadas internacionales desarrollaron un plan para el reparto de vacunas entre los residentes de los campamentos. Fue necesario desarrollar una estrategia a fin de determinar si se habian logrado los objetivos de inmunizacion de la campana. Enfoque Siguiendo la campana de vacunacion, el personal dei Ministerio de Salud Publica y Poblacion entrevisto muestras por conveniencia de hogares en emplazamientos predeterminados especificos de cada uno de los campamentos sobre la recepcion de las vacunas de emergencia. Se seleccionaron los campamentos en los que mas dei 25 % de los ninos con edades comprendidas entre 9 meses y 7 anos de la muestra no habian recibido las vacunas de emergencia para una inmunizacion <>, esto es, una vacunacion masiva repetida. Marco regional La vigilancia rapida se puso en marcha en campamentos situados en la zona metropolitana de Port-au-Prince. En primer lugar se supervisaron los campamentos que acogian a mas de 5000 personas. Cambios importantes A finales de marzo de 2012 se habian vigilado 72 (23,2 %) de los 310 campamentos vacunados. Aunque se habian seleccionado 32 (44 %) de los campamentos supervisados para la inmunizacion <>, solo seis de ellos habian recibido la vacunacion masiva cuando se efectuo un control varias semanas tras la supervision. Lecciones aprendidas La supervision rapida unicamente ofrecio ventajas marginales en la consecucion de los objetivos de inmunizacion en los campamentos temporales de Port-au-Prince. Es necesario llevar a cabo mas investigaciones para evaluar ta utilidad de la vigilancia rapida tradicional y otras estrategias durante las campanas de vacunacion l:ras desastres en los que se vean involucradas poblaciones moviles, en particular, en los casos en los que haya poca capacidad para efectuar inmunizaciones masivas repetidas., Introduction The severe earthquake that struck Haiti on 12 January 2010 led to the development of both planned and spontaneous temporary camps that together housed an estimated 1.5 million internally [...]

Swimmer's itch (cercarial dematitis) affects people engaged in open-water activities. We report incidence and risk factors for a US lake. Water exposures and Swimmer's itch experience were reported daily for riparian household residents and guests at Douglas Lake, Michigan, in July 2000. Incidence of swimmer's itch was 6.8 episodes per 700 water exposure days. Positive risks were (1) exposures in shallow Water and in areas with onshore winds and (2) more days of lake use in July. Further epidemiological studies will help public health agencies address this bothersome problem at recreational lakes. (Am J Public Health. 2004;94:738-741)

CaliciNet China, a network of provincial, county, and city laboratories coordinated by the Chinese Centers for Disease Control and Prevention, was launched in October 2016 to monitor the epidemiology and genotype distribution of norovirus outbreaks in China. During October 2016-September 2018, a total of 556 norovirus outbreaks were reported, and positive fecal samples from 470 (84.5%) outbreaks were genotyped. Most of these outbreaks were associated with person-to-person transmission (95.1%), occurred in childcare centers or schools (78.2%), and were reported during November-March of each year (63.5%). During the 2-year study period, 81.2% of all norovirus outbreaks were typed as GII.2[P16]. In China, most norovirus outbreaks are reported by childcare centers or schools; GII.2[P16] is the predominant genotype. Ongoing surveillance by CaliciNet China will provide information about the evolving norovirus genotype distribution and outbreak characteristics important for the development of effective interventions, including vaccines. [ABSTRACT FROM AUTHOR]

Objective The WHO estimates that almost 40% of patients diagnosed with tuberculosis (TB) are not reported. We implemented this study to assess TB under-reporting and delayed treatment registration in nine counties in China. Design A retrospective inventory study (record review). Setting Counties were selected using purposive sampling from nine provinces distributed across eastern, central and western regions of China in 2015. Primary and secondary outcome measures Underreporting was calculated as the percentage of patients with TB not reported to TB Information Management System (TBIMS) within 6 months of diagnosis. Delayed registration was estimated as the percentage of reported cases initiating treatment 7 or more days after diagnosis. Multivariable logistic regression and an alpha level of 0.05 were used to examine factors associated with these outcomes. Results Of the 5606 patients with TB identified from project health facilities and social insurance systems, 1082 (19.3%) were not reported to TBIMS. Of the 4524 patients successfully reported, 1416 (31.3%) were not registered for treatment within 7 days of diagnosis. Children, TB pleurisy, patients diagnosed in the eastern and central regions and patients with a TB diagnosis recorded in either health facilities or social insurance system--but not both--were statistically more likely to be unreported. Delayed treatment registration was more likely for previously treated patients with TB, patients with negative or unknown sputum results and for patients diagnosed in the eastern region. Conclusion Almost one in every five patients diagnosed with TB in this study was unknown to local or national TB control programmes. We recommend strengthening TB data management practices, particularly in the eastern and central regions, and developing specific guidelines for reporting paediatric TB and TB pleurisy. Patient education and follow-up by diagnosing facilities could improve timely treatment registration. Additional studies are needed to assess under-reporting elsewhere in China. [ABSTRACT FROM AUTHOR]