Abstract
From 1995 to 1998, outbreaks of bubonic plague occurred annually in the coastal city of Mahajanga, Madagascar. A total of 1,702 clinically suspected cases of bubonic plague were reported, including 515 laboratory confirmed by Yersinia pestis isolation (297), enzyme-linked immunosorbent assay, or both. Incidence was higher in males and young persons. Most buboes were inguinal, but children had a higher frequency of cervical or axillary buboes. Among laboratory-confirmed hospitalized patients, the case-fatality rate was 7.9%, although all Y. pestis isolates were sensitive to streptomycin, the recommended antibiotic. In this tropical city, plague outbreaks occur during the dry and cool season. Most cases are concentrated in the same crowded and insanitary districts, a result of close contact among humans, rats, and shrews. Plague remains an important public health problem in Madagascar, and the potential is substantial for spread to other coastal cities and abroad.
Highlights
Despite our increasing knowledge of the role of patient race/ethnicity in drug prescribing practice for specific conditions, how or whether these specific effects translate into overall antimicrobial drug use by race/ethnicity remains unclear. We address this gap in knowledge by describing the extent of racial/ethnic disparities in overall antimicrobial drug prescription fill rates in the United States
We found a large disparity in antimicrobial drug fill rates by race/ethnicity: white persons reported making twice as many antimicrobial drug prescription fills as persons who were not white
The survey measures reported antimicrobial drug fills and not actual use [8]; the fill rates we report are substantially lower than those measured by others using sales data [1] or other national surveys [9]
Summary
We aimed to accurately map current and new BU-endemic areas and compare and contrast the changing incidence in these locations, to document disease severity and associate this with diagnostic delay, and to identify times of increased transmission risk. We aimed to clarify year-to-year changes in capsular serotypes, genotypes of penicillin and macrolide resistance, and diversity of sequence types (STs) in all pneumococcal isolates collected throughout Japan during April 2010–March 2017. We aimed to explore the genetic relationships of the 2015 and 2016 isolates from CAR with this reported population structure of NmW/cc. We aimed to estimate the influenza-associated severe acute respiratory infection (SARI) hospitalization using the methods recommended by the World Health Organization (5)
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