Abstract
Ecologic and economic factors, as well as changes in human behavior, have resulted in the emergence of new and the reemergence of existing but forgotten infectious diseases during the past 20 years. Flea-borne disease organisms (e.g., Yersinia pestis, Rickettsia typhi, R. felis, and Bartonella henselae) are widely distributed throughout the world in endemic-disease foci, where components of the enzootic cycle are present. However, flea-borne diseases could reemerge in epidemic form because of changes in vector-host ecology due to environmental and human behavior modification. The changing ecology of murine typhus in southern California and Texas over the past 30 years is a good example of urban and suburban expansion affecting infectious disease outbreaks. In these areas, the classic rat-flea-rat cycle of R. typhi has been replaced by a peridomestic animal cycle involving, e.g., free-ranging cats, dogs, and opossums and their fleas. In addition to the vector-host components of the murine typhus cycle, we have uncovered a second typhuslike rickettsia, R. felis. This agent was identified from the blood of a hospitalized febrile patient and from opossums and their fleas. We reviewed the ecology of R. typhi and R. felis and present recent data relevant to the vector biology, immunology, and molecular characterization and phylogeny of flea-borne rickettsioses.
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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