National Surveillance Project Research Articles

Untangling lineage introductions, persistence and transmission drivers of HP-PRRSV sublineage 8.7

Despite a rapid expansion of Porcine reproductive and respiratory syndrome virus (PRRSV) sublineage 8.7 over recent years, very little is known about the patterns of virus evolution, dispersal, and the factors influencing this dispersal. Relying on a national PRRSV surveillance project established over 20 years ago, we expand the available genomic data of sublineage 8.7 from China. We perform independent interlineage and intralineage recombination analyses for the entire study period, which showed a heterogeneous recombination pattern. A series of Bayesian phylogeographic analyses uncover the role of Guangdong as an important infection hub within Asia. The spatial spread of PRRSV is highly linked with a composite of human activities and the heterogeneous provincial distribution of the swine industry, largely propelled by the smaller-scale Chinese rural farming systems in the past years. We sequence all four available modified live vaccines (MLVs) and perform genomic analyses with publicly available data, of which our results suggest a key “leaky” period spanning 2011–2017 with two concurrent amino acid mutations in ORF1a 957 and ORF2 250. Overall, our study provides an in-depth overview of the evolution, transmission dynamics, and potential leaky status of HP-PRRS MLVs, providing critical insights into new MLV development.

Risky identities: Digital identity challenges for stateless Rohingya in first asylum states

This article presents a case study of the Tracking Refugees Information System (TRIS) that has been introduced in Malaysia for undocumented migrants and refugees, including the large Rohingya population being hosted in the country. It argues that the TRIS digital identity management system for Rohingya and other refugees in Malaysia in this period potentially shifts these groups from the protection of UNHCR to a new national surveillance project and fundamentally changes their status. The article highlights possible risks and concerns attached to such a digital ID system, and provides a contextual history of the evolution of dispossession of the Rohingya of identity documents in their own homeland as well as issues that have emerged concerning digital identity issuance in other asylum states.

Fourth national Japanese antimicrobial susceptibility pattern surveillance program: Bacterial isolates from patients with complicated urinary tract infections

IntroductionAntimicrobial susceptibility patterns of bacterial pathogens isolated from patients with complicated urinary tract infections were analyzed using the national surveillance data, comprising 793 bacterial strains from eight clinically relevant species. Materials and methodsData were collected for the fourth national surveillance project from July 2020 to December 2021 by the Japanese Society of Chemotherapy, the Japanese Association for Infectious Disease, and the Japanese Society of Clinical Microbiology. Surveillance was supervised with the cooperation of 43 medical institutions throughout Japan. ResultsFluoroquinolone required a minimum inhibitory concentration (MIC) of 2–64 mg/L to inhibit the 330 tested Escherichia coli strains. The proportion of levofloxacin-resistant E. coli strains increased from 28.6% in 2008 to 29.6% in 2011, 38.5% in 2015, and 44.5% in 2021. The proportion of levofloxacin-resistant strains of Pseudomonas aeruginosa also increased from previous survey results, showing a continuing downward trend. Conversely, the proportion of levofloxacin-resistant strains of Enterococcus faecalis decreased relative to previous reports. Neither multidrug-resistant P. aeruginosa nor carbapenem-resistant Enterobacteriaceae were detected. For methicillin-resistant Staphylococcus aureus (MRSA), the proportion of vancomycin-susceptible strains (MIC of 2 μg/mL) decreased from 14.7% to 7.7%. DiscussionBacterial strains that produced extended-spectrum β-lactamase included E. coli (82/330 strains, 24.8%), Klebsiella pneumoniae (11/68 strains, 16.2%), and Proteus mirabilis (4/26 strains, 15.4%). As compared to previous surveillance reports, these strains showed an increase in proportion over the years.

Prepregnancy dieting and obstetrical and neonatal outcomes: Findings from a national surveillance project in the United States

Problem and BackgroundWomen with overweight or obesity are recommended to lose weight before pregnancy. Dieting is one of the most used weight control strategies. However, the health implications of dieting before pregnancy remain unclear. AimTo evaluate the associations of dieting during the year before pregnancy with obstetrical and neonatal outcomes, including gestational weight gain (GWG), gestational diabetes, low birthweight, macrosomia, small-for-gestational-age infants (SGA), large-for-gestational-age infants (LGA), and preterm birth. MethodsThis study analyzed data from the Pregnancy Risk Assessment Monitoring System (PRAMS), which is a surveillance project in the United States that collects data on maternal health before, during, and after pregnancy. Women who participated in PRAMS phase 7 with a prepregnancy body mass index ≥25 kg/m2 and a singleton birth were eligible. Statistical analyses included logistic regressions and post-hoc mediation analysis (Sobel Test). FindingsA total number of 51,399 women were included in the analysis. Women who self-reported prepregnancy dieting (42.8 %) had lower odds of SGA (adjusted odds ratio [aOR]: 0.87; 95 % CI: 0.79–0.97), and higher odds of excessive GWG vs adequate GWG (aOR: 1.42; 95 % CI: 1.32–1.52), gestational diabetes (aOR: 1.12; 95 % CI: 1.02–1.22), and LGA (aOR: 1.18; 95 % CI: 1.08–1.28). Furthermore, the association between prepregnancy dieting and LGA was mediated by excessive GWG (Sobel Test z-value = 5.72, p < 0.01). Discussion and ConclusionThis analysis revealed that prepregnancy dieting was associated with several adverse consequences, including excessive GWG, gestational diabetes, and LGA infants. Findings contribute to an improved understanding of the perinatal implications of prepregnancy dieting.

Association between the systemic immune inflammation index and periodontitis: a cross-sectional study

BackgroundPeriodontitis is a chronic oral inflammatory disease that seriously affects people's quality of life. The purpose of our study was to investigate the correlation between the systemic immune inflammation index (SII) and periodontitis by utilizing a large national survey. This will establish a reference for the early identification and management of periodontitis.MethodsThis study comprised the adult US population who participated in a national periodontitis surveillance project during the six years from 2009 to 2014. Through the utilization of univariate and multivariate weighted logistic regression, we investigated the correlation between the systemic immune inflammation index and periodontitis. Additionally, we employed sensitivity analyses to evaluate the robustness of our findings.ResultsThe study involved 10,366 participants with an average age of 51.00 years, of whom 49.45% were male (N = 5126) and 50.55% were female (N = 5240). The prevalence of periodontitis is estimated to be about 38.43% in the US adults aged 30 or older population. Our logistic regression models indicated a positive association between a SII higher than 978 × 109/L and periodontitis. The elder group (aged 50 or older) with SII higher than 978 × 109/L demonstrated a significant correlation with periodontitis in the fully adjusted model (Odds Ratio [OR] = 1.409, 95% Confidence Interval [CI] 1.037, 1.915, P = 0.022). However, there is no statistical difference among adults aged 30 to 50. The robustness of our findings was confirmed through sensitivity analyses.ConclusionsOur study highlights that SII is associated with periodontitis in a nationally representative sample of US adults. And the SII is significantly associated with a high risk of periodontitis in individuals aged 50 or older.

Risk Factors for Joint Bleeding in Severe Hemophilia a and B: Analysis of the Community Counts Longitudinal Surveillance Cohort

Background: One of the most devastating complications of Hemophilia A or B (HemA, HemB) is end-stage joint damage characterized by chronic pain and functional disability. Joint bleeding is the best predictor of joint damage in hemophilia. A wide range of new therapeutics from extended half-life factor (EHL) concentrates to non-factor therapies such as factor VIII mimetics, hemostatic rebalancers and gene therapy have been recently approved or are in late-stage clinical trials that hold the promise of decreased joint disease in severe hemophilia. Specific Aim: Given the progressive improvements in the therapeutic armamentarium of hemophilia care, this study aimed to determine current predictors of joint bleeding in individuals with severe hemophilia on continuous prophylaxis in the context of a national surveillance project. Methods: Eligible participants were males with severe HemA or HemB, aged 2 to 44 years, on continuous prophylaxis therapy and participating in Community Counts (CC) during the period December 2013 to November 30, 2022. CC is a bleeding disorders surveillance project funded by the Centers for Disease Control and Prevention and administered through the American Thrombosis and Hemostasis Network in 141 federally funded Hemophilia Treatment Centers across the United States. CC collects data on sociodemographics, bleeding episodes, treatment products, and health outcomes during patients' annual comprehensive care visits. Data were analyzed using annualized joint bleeding rates (AJBR), calculated using the number and location of all joint bleeds occurring in 10 joints (shoulders, elbows, hips, knees, ankles) during the year since the last surveillance visit based on infusion logs and/or other patient records. Age and other demographic subgroups were compared via rate ratios (RR) and 95% confidence intervals (CI). Methods accounting for multiple measurements from the same individuals over time were used for multivariate analyses. AJBR differences according to demographic and clinical variables were assessed via p values comparing Beta coefficients from these models. Results: The HemA cohort included 2505 persons, 8542 observations years and 13,224 joint bleeds for an overall AJBR of 1.55. The HemB cohort included 439 persons, 1488 observation years and 1326 joint bleeds for an overall AJBR of 0.89. Joint bleeding increased with age. In comparison to those ages 2-9 years, RRs were significantly increased for ages 10-19 and 20-44 for both HemA (1.23 [CI 1.1-1.3]) and 3.17 [CI 3-3.4], respectively), and HemB (2.2 [1.8-2.7] and 5.8 [4.8-7], respectively). Uninsured persons had higher AJBR than insured (HemA, RR 1.8 [1.6-2.1] and HemB, RR 6.9 [5.2-9.]. Table 1 compares characteristics associated with AJBR in multivariate analysis. The use of the FVIII mimetic in persons with HemA was associated with fewer joint bleeds (-1.00 joint bleeds per year). Persons with HemA showed modest decreases in AJBR with EHL therapies (-0.26), a finding not observed in persons with HemB. Worse AJBR outcomes were associated with missed doses for persons with both HemA and HemB. Joint bleeding was significantly associated with unemployment with disability for persons with HemA but not HemB. Trends in AJBR were similar between HemA and HemB for the following: adults had more joint bleeding than children, including adolescents aged 10-19 who are often engaged in team sports; compared with the Northeast, AJBR were higher in all other geographic regions; persons on Government insurance had higher AJBR than persons on Commercial insurance. Discussion: In a multivariate analysis of data on a large longitudinal cohort of persons with severe hemophilia on prophylaxis, use of the FVIII mimetic, ≥90% treatment adherence and treatment in the Northeast United States were associated with significantly lower AJBR. The increased joint bleeding rate in adults compared with children and adolescents may be related to pre-existing joint disease, less intense prophylactic regimens or decreased activity and fitness. Additional studies can further inform optimal hemophilia therapy regimens.

An Overview of Antimicrobial Resistance in Saudi Arabia (2013-2023) and the Need for National Surveillance.

Antimicrobial resistance (AMR) is a well-recognized global threat. The World Health Organization (WHO) issued a report ranking the critical types of bacterial resistance that need to be monitored. Several studies from individual institutions in Saudi Arabia have reported rates of antimicrobial resistance using automated methods. However, no national surveillance study has been conducted to date using gold standard methods for antimicrobial susceptibility testing. This review summarizes AMR rates for major bacterial pathogens in Saudi Arabia and provides a justification for the need for a national surveillance project. In Saudi Arabia, AMR rates for both Gram-positive and Gram-negative bacteria are on the rise. Surveillance studies help identify AMR trends and emergence of outbreaks. The WHO has started a program, the Global Antimicrobial Resistance Surveillance System (GLASS), encouraging its member states, including Saudi Arabia, to conduct antimicrobial surveillance studies to estimate AMR rates worldwide. Of the microbiological methods used to test antimicrobial susceptibility, only broth microdilution (BMD) is considered the "gold standard." As AMR studies in Saudi Arabia are sparse, mostly limited to single centers and were conducted using automated methods, a national AMR surveillance project is needed to evaluate the current status and to inform stewardship decisions.

Risk factors for surgically treated cervical spondylosis in male construction workers: a 20-year prospective study

BACKGROUND CONTEXTDegenerative changes due to cervical spondylosis (CS) can detrimentally affect work ability and quality of life yet understanding of how physical exposure affects disease progression is limited. PURPOSETo assess the associations between occupational physical exposures and occurrence of surgically treated cervical spondylosis (ST-CS) and early exit from the labor market via disability pension. STUDY DESIGN/SETTINGProspective register study with 20 years follow-up period. PATIENT SAMPLESwedish construction workers participating in a national health surveillance project conducted between 1971 and 1993. OUTCOME MEASURESSurgically treated cervical spondylosis (ST-CS) and early labor market exit at a minimum rate of 25% time on disability pension. METHODSAssociations between occupational physical exposures (job exposure matrix) and subsequent ST-CS (National Hospital in-patient register) and early labor market exit via disability pension (Swedish Social Insurance Agency register) were assessed in a cohort of male construction workers (n=237,699). RESULTSA total of 1381 ST-CS cases were present and a 20 years incidence rate of 35.1 cases per 100,000 person years (95% confidence interval (CI) 33.2–36.9). Increased relative risk (RR) for ST-CS was found for workers exposed to non-neutral (RR 1.40, 95% CI 1.15–1.69), and awkward neck postures (1.52, 1.19–1.95), working with the hands above shoulder height (1.30, 1.06–1.60), and high upper extremity loading (1.35, 1.15–1.59). Increased risk was also present for workers who reported frequent neck (3.06, 2.18–4.30) and upper back (3.84, 2.57–5.73) pain in the 12 months prior to survey. Among workers with elevated arm exposure, higher risk was seen in those who also had more frequent neck pain. ST-CS cases took early retirement more often (41.3%) and at a younger age (53 years) than the total study cohort (14.8% and 56 years of age, respectively). CONCLUSIONSOccupational exposure to non-neutral neck postures, work with hands above shoulders and high loads born through the upper extremities increased the risk for ST-CS and early retirement due to disability. Decreasing postural and load exposure is salient for primary, secondary, and tertiary prevention of CS. Neck pain was shown to be a prognostic factor for ST-CS, which stresses the importance of acting early and taking preventative action to reduce workplace exposure, and the need for systematic medical check-ups within primary or occupational care to mitigate disease progression and early labour market exit due to disability.

India's strategy on surveillance system- A paradigm shift from an Integrated Disease Surveillance Programme (IDSP) to an Integrated Health Information Platform (IHIP)

A well-built, national-level surveillance system for communicable and non-communicable diseases is the hour of need for any country. As part of International Health Regulation (IHR) core capacity building and to strengthen public health surveillance system, India needs a comprehensive information system to monitor emerging public health threats, disasters and mass events. India has identified the need for such a system during the mid-90s and launched the WHO-supported National Surveillance Project for Communicable Diseases (NSPCD) in 1997–98 in selected districts.

Societal Activities Associated With SARS-CoV-2 Infection – A Case-Control Study in Denmark, November 2020

Background: Quantifying the risk of infection with SARS-CoV-2 associated with community exposures, may provide an evidence base for implementing preventive measures. Here, we investigated potential determinants for infection in Denmark in a situation where society was only partially open. Methods: We conducted a national matched case-control study. Cases were recent RT-PCR test-positives, while controls, individually matched on age, sex and residence, had not previously tested positive for SARS-CoV-2. Questions concerned person contact and community exposures. Telephone interviews were performed over a seven-day period in December 2020. We included 300 cases and 317 controls and determined odds ratios (ORs) and 95% confidence intervals (95%CI) by conditional logistical regression with adjustment for household size and country of origin. Findings: Contact (OR=4·9,95%CI:2·4-10), and close contact (OR=13, 95%CI:6·7-25), with a person with a known SARS-CoV-2 infection were main determinants. Contact most often took place in the household or work place. Community determinants included: events with singing (OR=2.1, 95%CI:1·1-4·1), attending fitness centre (OR=1·8, 95%CI:1·1-2·8) and consumption of alcohol in a bar (OR=10, 95%CI:1·5-65). Other community exposures appeared not to be associated with infection, these included shopping at supermarkets, travel by public transport, dining at restaurants and private social events with few participants. Interpretations: Events with singing and fitness centres were associated with transmission risks. Other than that, the restrictions in place at the time of the study appeared to be sufficient to reduce transmission of disease in the public space, which instead took place following direct exposures to people with known SARS-CoV-2 infections. Funding Information: None. Declaration of Interests: All authors have nothing to declare. Ethics Approval Statement: The study was performed as a national disease surveillance project, registered with the Danish Data Protection Agency (reg no 20/10133) and approved regarding legal, ethical and cyber-security issues. Participation was voluntary and participants received information about the selection procedure, risks associated with participation, data security, legal rights, including the right to withdraw from the study, and the use of their information at the start of the interview. The collaboration with the polling company was regulated by a data processing agreement and carried out on commercial terms.

Canadian surveillance of COVID-19 in pregnancy: Epidemiology and maternal and infant outcomes

To describe the Canadian approach to rapid epidemic surveillance through the CANCOVID-Preg network. To assess the burden of COVID-19 in pregnancy and associated maternal and infant outcomes in Canada. We mobilized an established network of care providers in response to the global pandemic due to a paucity of data on COVID-19 in pregnancy. We engaged leads in each province/territory to develop an approach for identification of all cases of SARS-CoV-2 in pregnancy and collection of outcome data for women and infants. Women with documented infection in pregnancy are identified by public health and/or clinical identification and data collection is prospective via medical records. Data collection forms were designed to ensure harmonization between Canadian provinces/territories and with international networks (e.g. COVI-Preg, WHO). In Canada, it is not recommended that COVID-19 affected mother-infant pairs are separated. We will provide data to evaluate this practice. Data will be described using descriptive statistics. If sample size allows, comparisons of maternal/fetal outcomes will be made among variables (e.g., symptom severity, ventilation, treatments, maternal age, education, etc.) using regression analyses. The CANCOVID-Preg network and national surveillance for COVID-19 in pregnancy was rapidly implemented. Within 2 weeks of pandemic declaration, national meetings and study protocol development began. The first all-member meeting occurred at 7 weeks when organization structures had been launched in all regions. Dedicated funding was secured by 3 months. Between March 1, 2020 to June 24, 2020, 307 cases were identified in Canada, with regional distribution proportional to population. As of May 30, 2020, data have been collected for 22 pregnancies in British Columbia (BC) and 27 in Ontario (ON). In BC, mean gestational age at SARS-CoV-2 diagnosis was 20.3 weeks (±9.9, range: 5.3 - 38.3). Among those with detailed data, 31.6% (6/19) had a known positive contact in the community; 2 reported travel before diagnosis. Among 46 pregnancies (BC & ON), the most frequently documented symptoms were cough (37.0%), fever (32.6%). Two (9%) BC cases have been hospitalized due to COVID-19; no ICU admission or mechanical ventilation. Two (9%) BC and 21 (78%) ON cases have delivered. One infant (of 12 with results) in ON tested positive for SARS-CoV-2 and may represent a vertical transmission. Updated data will be presented at the IDSOG Annual Meeting. This national surveillance project was largely enabled by national care provider networks as well as provincially dedicated database software and routine perinatal data collection. Our team will provide national data on COVID-19 in pregnancy to support clinical care of pregnant women and their infants.

The third national Japanese antimicrobial susceptibility pattern surveillance program: Bacterial isolates from complicated urinary tract infection patients

The antimicrobial susceptibility patterns of bacterial pathogens isolated from patients with complicated urinary tract infections were analyzed using national surveillance data. The data consisted of 881 bacterial strains from eight clinically relevant species. The data were collected for the third national surveillance project from January 2015 to March 2016 by the Japanese Society of Chemotherapy, the Japanese Association for Infectious Disease, and the Japanese Society of Clinical Microbiology. Surveillance was undertaken with the cooperation of 41 medical institutions throughout Japan.Fluoroquinolone required a MIC90 of 2–64 mg/L to inhibit the 325 Escherichia coli strains tested and the proportion of levofloxacin resistant E. coli strains increased to 38.5% from 29.6% in 2011 and 28.6% in 2008. The proportion of levofloxacin resistant strains of Pseudomonas aeruginosa and Enterococcus faecalis decreased from previous reports and the proportion of multidrug-resistant P. aeruginosa and carbapenem-resistant Enterobacteriaceae remained low. Among methicillin-resistant Staphylococcus aureus (MRSA) strains, strains with reduced susceptibility to vancomycin (minimum inhibitory concentration, 2 μg/mL) increased to 14.7% from 5.5%.Bacterial strains that produced extended-spectrum β-lactamase included E. coli (79 of 325 strains, 24.3%), Klebsiella pneumoniae (9 of 177 strains, 7.7%), and Proteus mirabilis (6 of 55 strains, 10.9%). The proportion of extended-spectrum β-lactamase producing E. coli and K. pneumoniae strains increased from previous surveillance reports.

Canadian Assessment of Physical Literacy Second Edition: a streamlined assessment of the capacity for physical activity among children 8 to 12\xa0years of age

BackgroundThe Canadian Assessment of Physical Literacy (CAPL) assesses the capacity of children to lead a physically active lifestyle. It is comprised of a battery of standardized assessment protocols that reflect the Canadian consensus definition of physical literacy. The Royal Bank of Canada Learn to Play - Canadian Assessment of Physical Literacy study implemented the CAPL with 10,034 Canadian children (50.1% female), 8 to 12 years of age. Feedback during data collection, necessary changes identified by the coordinating centre, and recent data analyses suggested that a streamlined, second edition of the CAPL was required. The purpose of this paper is to describe the methods used to develop the CAPL second edition (CAPL-2).MethodsThe larger dataset created through the RBC–Learn to Play CAPL study enabled the re-examination of the CAPL model through factor analyses specific to Canadian children 8 to 12 years of age from across Canada. This comprehensive database was also used to examine the CAPL protocols for redundancy or variables that did not contribute significantly to the overall assessment. Removing redundancy had been identified as a priority in order to reduce the high examiner and participant burden. The “lessons learned” from such a large national surveillance project were reviewed for additional information regarding the changes that would be required to optimize the assessment of children’s physical literacy. In addition, administrative changes, improvements, and corrections were identified as necessary to improve the quality and accuracy of the CAPL manual and training materials.ResultsFor each domain of the CAPL, recommended changes based on the factor analyses, qualitative feedback and theoretical considerations significantly reduced the number of protocols. Specific protocol combinations were then evaluated for model fit within the overarching concept of physical literacy. The CAPL-2 continues to reflect the four components of the Canadian consensus definition of physical literacy: Motivation and Confidence, Physical Competence, Knowledge and Understanding, and engagement in Physical Activity Behaviour. The CAPL-2 is comprised of three Physical Competence protocols (plank, Progressive Aerobic Cardiovascular Endurance Run [PACER], Canadian Agility and Movement Skill Assessment [CAMSA]), two Daily Behaviour protocol (pedometer steps, self-reported physical activity), and a 22-item questionnaire assessing the physical literacy domains of Motivation and Confidence, and Knowledge and Understanding. Detailed information about the CAPL-2 is available online (www.capl-eclp.ca).ConclusionsThe CAPL-2 dramatically reduces examiner and participant burden (three Physical Competence protocols, two Daily Behaviour protocols, and a 22-response questionnaire; versus eight Physical Competence protocols, three Daily Behaviour protocols and a 72-response questionnaire for the original CAPL), while continuing to be a comprehensive assessment of all aspects of children’s physical literacy using the Canadian consensus definition of this term. Like the original, the CAPL-2 continues to offer maximum flexibility to practitioners, who can choose to complete the entire CAPL-2 assessment, only one or more domains, or select individual protocols. Regardless of the assessment selected, scores are available to interpret the performance of each child relative to Canadian children of the same age and sex. All of the protocols included in the CAPL-2 have published reports of validity and reliability for this age group (8 to 12 years). The detailed manual for CAPL-2 administration, along with training materials and other resources, are available free of charge on the CAPL-2 website (www.capl-eclp.ca). All CAPL-2 materials and resources, including the website, are available in both English and French.

Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009-2014

BackgroundThis report presents weighted average estimates of the prevalence of periodontitis in the adult US population during the 6 years 2009-2014 and highlights key findings of a national periodontitis surveillance project. MethodsEstimates were derived for dentate adults 30 years or older from the civilian noninstitutionalized population whose periodontitis status was assessed by means of a full-mouth periodontal examination at 6 sites per tooth on all non–third molar teeth. Results are reported according to a standard format by applying the Centers for Disease Control and Prevention/American Academy of Periodontology periodontitis case definitions for surveillance, as well as various thresholds of clinical attachment loss and periodontal probing depth. ResultsAn estimated 42% of dentate US adults 30 years or older had periodontitis, with 7.8% having severe periodontitis. Overall, 3.3% of all periodontally probed sites (9.1% of all teeth) had periodontal probing depth of 4 millimeters or greater, and 19.0% of sites (37.1% of teeth) had clinical attachment loss of 3 mm or greater. Severe periodontitis was most prevalent among adults 65 years or older, Mexican Americans, non-Hispanic blacks, and smokers. ConclusionsThis nationally representative study shows that periodontitis is a highly prevalent oral disease among US adults. Practical ImplicationsDental practitioners should be aware of the high prevalence of periodontitis in US adults and may provide preventive care and counselling for periodontitis. General dentists who encounter patients with periodontitis may refer these patients to see a periodontist for specialty care.

Analysis on the situation of schistosome infections in floating population in national schistosomiasis surveillance sites of China

To understand the situation of Schistosoma japonicum infections in foating population and its epidemiological characteristics in China, so as to provide insights into the development of the surveillance strategy and interventions for schistosomiasis. According to the protocol of national surveillance project, indirect hemagglutination test (IHA) was employed for serological screening of S. japonicum infections among the floating population in the national schistosomiasis surveillance sites of China from 2005 to 2014, and the sero-positives were subjected to parasitological examinations. In addition, epidemiological analyses were performed to describe the characteristics of schistosomiasis in the floating population. A total of 11 834 floating population were monitored at the national schistosomiasis surveillance sites of China during the study period, and 11 558 persons received serological tests, with 419 sero-positives screened. Then, 370 sero-positive floating populations were detected using parasitological examinations, and 25 stool positives were detected. The prevalence of S. japonicum infections significantly varied in time (χ2 = 15.103 7), occupations (χ2 = 115.182 7) and regions (χ2 = 13.177 5) in the study subjects during the study period (all P < 0.05) . A high adjusted prevalence of S. japonicum infections was seen in the boatmen and fishermen in several provinces. Boatmen and fishermen are at a high risk of S. japonicum infections among the floating population, and should be paid more attention to in future schistosomiasis surveillance and control activities due to their strong mobility and difficulty of monitoring.

A national surveillance project on chronic kidney disease management in Canadian primary care: a study protocol

IntroductionEffective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada,...

Longitudinal Study of Two Irish Dairy Herds: Low Numbers of Shiga Toxin-Producing Escherichia coli O157 and O26 Super-Shedders Identified.

A 12-month longitudinal study was undertaken on two dairy herds to ascertain the Shiga-toxin producing Escherichia coli (STEC) O157 and O26 shedding status of the animals and its impact (if any) on raw milk. Cattle are a recognized reservoir for these organisms with associated public health and environmental implications. Animals shedding E. coli O157 at >10,000 CFU/g of feces have been deemed super-shedders. There is a gap in the knowledge regarding super-shedding of other STEC serogroups. A cohort of 40 lactating cows from herds previously identified as positive for STEC in a national surveillance project were sampled every second month between August, 2013 and July, 2014. Metadata on any potential super-shedders was documented including, e.g., age of the animal, number of lactations and days in lactation, nutritional condition, somatic cell count and content of protein in milk to assess if any were associated with risk factors for super-shedding. Recto-anal mucosal swabs (RAMS), raw milk, milk filters, and water samples were procured for each herd. The swabs were examined for E. coli O157 and O26 using a quantitative real time PCR method. Counts (CFU swab-1) were obtained from a standard calibration curve that related real-time PCR cycle threshold (Ct) values against the initial concentration of O157 or O26 in the samples. Results from Farm A: 305 animals were analyzed; 15 E. coli O157 (5%) were recovered, 13 were denoted STEC encoding either stx1 and/or stx2 virulence genes and 5 (2%) STEC O26 were recovered. One super-shedder was identified shedding STEC O26 (stx1&2). Farm B: 224 animals were analyzed; eight E. coli O157 (3.5%) were recovered (seven were STEC) and 9 (4%) STEC O26 were recovered. Three super-shedders were identified, one was shedding STEC O157 (stx2) and two STEC O26 (stx2). Three encoded the adhering and effacement gene (eae) and one isolate additionally encoded the haemolysin gene (hlyA). All four super-shedders were only super-shedding once during the 1-year sampling period. The results of this study show, low numbers of super-shedders in the herds examined, with high numbers of low and medium shedding. Although four super-shedding animals were identified, no STEC O157 or O26 were recovered from any of the raw milk, milk filter, or water samples. The authors conclude that this study highlights the need for further surveillance to assess the potential for environmental contamination and food chain security.

Updated distribution of Aedes albopictus (Diptera: Culicidae) in Spain: new findings in the mainland Spanish Levante, 2013

In 2004, Aedes (Stegomyia) albopictus (Skuse, 1894) was observed for the first time in Catalonia, northeastern Spain. A decade later, it has spread throughout the eastern Mediterranean region of the country and the Balearic Islands. Framed within a national surveillance project, we present the results of monitoring in 2013 in the autonomous communities of the mainland Levante. The current study reveals a remarkable increase in the spread of the invasive mosquito in relation to results from 2012; the species was present and well-established in 48 municipalities, most of which were along the Mediterranean coastline from the Valencian Community to the Region of Murcia.

Occupational Exposures to Antineoplastic Drugs and Ionizing Radiation in Canadian Veterinary Settings: Findings From a National Surveillance Project

Although veterinary workers may encounter various occupational health hazards, a national characterization of exposures is lacking in Canada. This study used secondary data sources to identify veterinary exposure prevalence for ionizing radiation and antineoplastic agents, as part of a national surveillance project. For ionizing radiation, data from the Radiation Protection Bureau of Health Canada were used to identify veterinarians and veterinary technicians monitored in 2006. This was combined with Census statistics to estimate a prevalence range and dose levels. For antineoplastic agents, exposure prevalence was estimated using statistics on employment by practice type and antineoplastic agent usage rates, obtained from veterinary licensing bodies and peer-reviewed literature. In 2006, 7,013 (37% of all) Canadian veterinary workers were monitored for ionizing radiation exposure. An estimated 3.3% to 8.2% of all veterinarians and 2.4% to 7.2% of veterinary technicians were exposed to an annual ionizing radiation dose above 0.1 mSv, representing a total of between 536 and 1,450 workers. All monitored doses were below regulatory limits. For antineoplastic agents, exposure was predicted in up to 5,300 (23%) of all veterinary workers, with an estimated prevalence range of 22% to 24% of veterinarians and 20% to 21% of veterinary technicians. This is the first national-level assessment of exposure to ionizing radiation and antineoplastic agents in Canadian veterinary settings. These hazards may pose considerable health risks. Exposures appeared to be low, however our estimates should be validated with comprehensive exposure monitoring and examination of determinants across practice areas, occupations, and tasks.

TITTLE DEVELOPING MODLES OF RESIDENTIAL AND PARAOCCUPATIONAL EXPOSURE TO PESTICIDES FOR AGRICULTURAL FAMILIES

Background and Aims: CAREX Canada is a national occupational and environmental surveillance project estimating the number of Canadian exposed to carcinogens. Agricultural pesticide estimates are being developing to calculate cancer risks across the country. To facilitate these risk assessments, we examined the state of the literature on residential and para-occupational exposure and its implications for pesticide risk assessment. Methods: A search was undertaken in the published literature for data on exposures in farm homes as well for spouses and children of farmers and farmworkers, including exposure assessments and epidemiologic studies. Papers were limited to research from North America. Environmental and biological sampling and epidemiological data from these studies (n=42) were critically examined and catalogued in a matrix. Results: Para-occupational and residential pesticide exposures are clearly documented in North America. The studies showed increased exposures for farm children compared to non-farm children. A smaller increase was seen in some studies of farm spouses. Major sources of exposure included workers’ boots, clothes and vehicles. Children who were present during spraying showed even higher levels of exposure. Proximity of the home to spraying locations explained some, but not all, of the home exposure reported. Epidemiologic studies showed higher rates and risks of cancer and decreased neurobehavioral performance in children whose parents had occupational exposure to pesticides. We propose the need for a stratified farm community risk assessment model, with low (farm spouse), medium (children not present for spraying) and high (children present for spraying) exposure categories. Conclusions: (Arial, 8pt, bold) text (Arial, 8pt) dummy text, dummy text, dummy text, text, dummy text, dummy text, dummy text, dummy text, text, dummy text, dummy text, text, dummy text, dummy text, text, dummy text, dummy text, text, dummy text, dummy text, text, dummy text, dummy text, text, dummy text, dummy text, text, dummy text, dummy text, text.