Official Surveillance System Research Articles

Demographic and clinical characteristics of people diagnosed with active sexually transmitted infections among monkeypox cases in Brazil: the 2022 outbreak.

The worldwide monkeypox (mpox) outbreak in 2022 showed a high frequency of sexually transmitted infections (STI). A cross-sectional study was carried out using secondary data from the Brazilian official mpox surveillance systems. A total of 10,169 mpox cases were identified, with a median age of 32 years. Among them, 92.3% were male at birth and 57.5% were men who have sex with other men (MSM). Approximately 11% were diagnosed with STI, including 5.8% with syphilis and 2.5% with genital herpes. Individuals aged from 25 to 34 years, MSM, individuals with HIV-positive status, and those manifesting skin eruptions or penile edema were associated with STI. Laboratory investigation for mpox must be implemented as a priority in STI clinics (especially for MSM) to mitigate neglected cases, ensure appropriate treatments, and prevent misdiagnoses.

Non-linear impacts of harmful algae blooms on the coastal tourism economy

Harmful algae blooms (HABs) occur in water bodies throughout the globe and can have multi-faceted impacts on tourism. However, little is known of the magnitude of economic losses to the tourism sector as a result of HABs. There is limited understanding of the empirical relationships between HAB intensity and duration, and the effects of this phenomenon on the tourism sector. This study is based in the state of Florida, USA, a notable sun, sand, and sea destination in the western hemisphere, where blooms of a marine harmful algae are a recurrent threat to coastal tourism. The empirical framework is based on a month and county-level panel database that combines sales by tourism-related businesses with observations from the official HAB surveillance system of the state of Florida. We use time and space fixed-effects regressions to estimate the loss in tourism revenue associated with one additional day of red tide. Results indicate that impacts of HABs on tourism do not follow a linear pattern with increasing HAB concentrations, but rather appear to follow an inverted-U pattern. In other words, higher concentrations of the HAB organism do not necessarily imply higher economic losses, suggesting that the impacts of HABs on tourism are not driven solely by the biophysical element of cell density. Rather, these impacts appear to be mediated and amplified by human dimensions. The loss to tourism-related businesses due to the 2018 Florida red tide bloom was estimated to be $2.7 billion USD, which implies that HABs and their impact on tourism can be considered as a potential ‘billion-dollar’ disaster.

Use of harmonised epidemiological indicators (HEIs) for broilers in Europe

In 2012, the European Food Safety Authority (EFSA) proposed harmonised epidemiological indicators (HEIs) for poultry at different production stages: Salmonella, Campylobacter, extended-spectrum β-lactamase/AmpC β-lactamase (ESBL/AmpC) producing Enterobacteriaceae and generic Escherichia (E.) coli. The HEIs are based on existing monitoring systems or the sampling strategies provided by EFSA. To realise the full benefit of HEIs, risk managers should use them for farm and abattoir categorisation and for adapting the existing meat inspection systems. As HEIs are not legal requirements within the European Union (EU), it is unclear which HEIs are used in which country, to date. Therefore, an online survey was conducted in Europe to gather knowledge about the implementation, application and consequences following on from the HEIs in existing official and private monitoring and surveillance systems (MOSS).A total of 34 answer sets from participants working in the framework of official surveillance or as food business operators in broiler abattoirs were collected from eleven EU member states (EU-MS) and four non-EU countries.While all participants stated that testing for Salmonella is performed, HEI 4-Salmonella, which corresponds to the process hygiene criterion (PHC) for Salmonella was applied by 62% of the participants. In total, 94% of the participants reported that they test for Campylobacter. Among them, 71% stated that testing is performed for HEI 5-Campylobacter, which corresponds to PHC for Campylobacter. Although testing neck skin samples for Salmonella and Campylobacter after chilling are official and mandatory MOSS in the EU, not all participants from EU-MS (Salmonella: 6/11 EU-MS; Campylobacter: 8/11 EU-MS) confirmed to comply with. Altogether, 56% of the participants (from 6 EU-MS and 2 non-EU countries) stated that they test for E. coli. Ten of them reported that the testing is performed at the abattoir after chilling according to the suggested HEI for generic E. coli as a hygiene indicator. Consequences that result from the existing MOSS for the three examined pathogens (Salmonella, Campylobacter and E. coli) were mainly rising awareness, farm risk categorisation and feedback to the farmer.According to the answers from the participants, the HEIs suggested by EFSA for broilers are currently implemented in most EU-MS. One reason could be that some of the according MOSS are required by EU law. As intended by EFSA, the participants stated that they use HEIs for farm risk categorisation as one of the three top consequences following from MOSS for the three mentioned pathogens. For improving the knowledge and application of HEIs in the context of risk-based meat safety assurance systems, specific training could be helpful.

Factors associated with COVID-19 lethality in a hospital in the Cajamarca region in Peru.

To identify the clinical and epidemiological characteristics related to lethality in patients hospitalized for COVID-19 at the Simón Bolívar Hospital in Cajamarca, during June-August 2020. This was a retrospective cohort, that used information collected from clinical records and official epidemiological surveillance systems (NOTIWEB, SISCOVID and SINADEF), on hospitalized patients with confirmed COVID-19 diagnosis. Information was collected on sociodemographic and clinical factors, considering discharge (death/survival) and days of hospitalization as outcomes. The in-hospital fatality rate was 39.6%, and significant differences were found between hospitalization time and status at discharge in people over 60 years of age (p<0.001). Age older than 60 years (HR: 2.87; 95% CI: 1.76-4.68),) unattended ICU bed request (HR: 3.49; 95% CI: 2.02-6.05), oxygen saturation less than 80% at admission (HR: 2.73; 95% CI: 1.35-5.53) and the use of ivermectin (HR: 1.68; 95%CI 1.06-2.68) were factors associated with lethality. The chosen ML model considered that the most important variables were oxygen saturation, age over 60 years, time of hospitalization and time of the onset of symptoms. The factors that could increase lethality in patients hospitalized for COVID-19 were age, oxygen saturation less than 80%, use of ivermectin as part of hospital treatment and unattended request for ICU beds. Future studies with better representativeness could confirm these possible relationships at the regional or national level.

Incidence of acute respiratory symptoms and COVID-19 infection in children in public schools in Bogotá, Colombia, from July to November, 2020

More than 90% of children infected with COVID-19 worldwide developed mild to moderate disease. In Colombia, during 2020, COVID-19 infections in children stayed below 9.2% of the total cases, with no trends for age group or sex. To estimate the incidence of acute respiratory symptoms and COVID-19 in children from public schools in Bogotá, Colombia during the second semester of 2020. A telephone survey was conducted in over 5,000 scholar children. Antecedents and use of health services were informed. Descriptive statistics were used. A total of 151.470 persons per day accounting for an IR of 157,8 per 100,000 people; almost three times the rate reported by the official surveillance system in the city. A lack of diagnosis and consultation in children was found compared to the general population. Further research is needed to elucidate the true burden of the disease in children.

Digital Surveillance Through an Online Decision Support Tool for COVID-19 Over One Year of the Pandemic in Italy: Observational Study.

BackgroundItaly has experienced severe consequences (ie, hospitalizations and deaths) during the COVID-19 pandemic. Online decision support systems (DSS) and self-triage applications have been used in several settings to supplement health authority recommendations to prevent and manage COVID-19. A digital Italian health tech startup, Paginemediche, developed a noncommercial, online DSS with a chat user interface to assist individuals in Italy manage their potential exposure to COVID-19 and interpret their symptoms since early in the pandemic.ObjectiveThis study aimed to compare the trend in online DSS sessions with that of COVID-19 cases reported by the national health surveillance system in Italy, from February 2020 to March 2021.MethodsWe compared the number of sessions by users with a COVID-19–positive contact and users with COVID-19–compatible symptoms with the number of cases reported by the national surveillance system. To calculate the distance between the time series, we used the dynamic time warping algorithm. We applied Symbolic Aggregate approXimation (SAX) encoding to the time series in 1-week periods. We calculated the Hamming distance between the SAX strings. We shifted time series of online DSS sessions 1 week ahead. We measured the improvement in Hamming distance to verify the hypothesis that online DSS sessions anticipate the trends in cases reported to the official surveillance system.ResultsWe analyzed 75,557 sessions in the online DSS; 65,207 were sessions by symptomatic users, while 19,062 were by contacts of individuals with COVID-19. The highest number of online DSS sessions was recorded early in the pandemic. Second and third peaks were observed in October 2020 and March 2021, respectively, preceding the surge in notified COVID-19 cases by approximately 1 week. The distance between sessions by users with COVID-19 contacts and reported cases calculated by dynamic time warping was 61.23; the distance between sessions by symptomatic users was 93.72. The time series of users with a COVID-19 contact was more consistent with the trend in confirmed cases. With the 1-week shift, the Hamming distance between the time series of sessions by users with a COVID-19 contact and reported cases improved from 0.49 to 0.46. We repeated the analysis, restricting the time window to between July 2020 and December 2020. The corresponding Hamming distance was 0.16 before and improved to 0.08 after the time shift.ConclusionsTemporal trends in the number of online COVID-19 DSS sessions may precede the trend in reported COVID-19 cases through traditional surveillance. The trends in sessions by users with a contact with COVID-19 may better predict reported cases of COVID-19 than sessions by symptomatic users. Data from online DSS may represent a useful supplement to traditional surveillance and support the identification of early warning signals in the COVID-19 pandemic.

More than just a common cold: Endemic coronaviruses OC43, HKU1, NL63, and 229E associated with severe acute respiratory infection and fatality cases among healthy adults.

Respiratory viral infection can cause severe disease and hospitalization, especially among children, the elderly, and patients with comorbidities. In Brazil, the official surveillance system of severe acute respiratory infection (SARI) investigates influenza A (IAV) and B (IBV) viruses, respiratory syncytial virus (RSV), adenovirus (HAdV), and parainfluenza viruses (hPIV 1-3). In Rio Grande do Sul (RS), Brazil, many fatalities associated with SARI between 2013 and 2017 occurred among patients without underlying diseases and for whom the causative agent had not been identified using official protocols. This cross-sectional study analyzed the presence of coronaviruses (HCoV), bocavirus (HBoV), metapneumovirus (hMPV), and rhinovirus in patients who died of SARI despite not having comorbidities, and that were negative for IAV, IBV, RSV, HAdV, and hPIV. Nasopharyngeal aspirates/swabs from patients were used for nucleic acid extraction. The presence of HCoVs OC43, HKU1, NL63, and 229E; HBoV; hMPV; and rhinovirus was assessed by quantitative reverse transcription-polymerase chain reaction. Clinical data were also analyzed. Between 2013 and 2017, 16 225 cases of SARI were reported in RS; 9.8% of the patients died; 20% of all fatal cases were patients without comorbidities and for whom no pathogen was detected using standard protocols. Analysis of 271 of these cases identified HCoV in nine cases; HBoV, hMPV, and rhinovirus were detected in 3, 3, and 10 cases, respectively. Of note, patients infected with HCoV were adults. Results reinforce the importance of including coronaviruses in diagnostic panels used by official surveillance systems because besides their pandemic potential, endemic HCoVs are associated to severe disease in healthy adults.

Trade and safety issues of raw beef from the countryside of Bahia state, Brazil.

Background: Brazil is one of the world’s largest meat exporters. However, there is a paradox in this situation due to existing non-inspected meat trade and technical-sanitary failures in retail marketing.Design and methods: This study aimed at characterizing the issues of trade, food safety and quality of raw beef in the street market of a municipality in the state of Bahia. An exploratory, quantitative and census study was carried out, at 17 raw beef vending locations. A questionnaire was administered and meat samples were collected (n=34), which were submitted to a physicochemical assessment, color analysis and microbiological analyses.Results: Meat sellers were between 20 and 64 years of age, predominantly males (82.4%), with limited education and without professional training (64.7%). Medians for temperature and pH in the small butcher shops samples were 18.10ºC and 5.75 respectively, and 21.80ºC and 5.50, in small supermarkets samples. The difference in pH was significant (p<0.05). The filtration test suggested quality changes in 17.65% of the samples. No frauds were detected. Total coliform count medians were 4.90 and 4.78 log CFU/g, for the samples taken from butcher shops and supermarkets, respectively. E. coli was identified in approximately 40.0% of the samples. Salmonella spp. were confirmed in two samples collected in the butcher shops. There was a significant association between inadequate storage conditions and microorganism counts (p<0.02).Conclusions: The results evidenced a meat supply with preservation failures and non-compliance with hygiene requirements, constituting a consumers’ health hazard, not in line with an agroexporting country model.Significance for public healthThe protection of food sold in street markets is of great importance for public health and food security. In this study, the microbial load of raw beef, as well as reported conditions of trade, processing and storage indicate a need for interventions with the aim of preventing health risks, continuing training of food handlers and investments in education, which contribute to reduce cases of food poisoning and foodborne diseases. The risks to consumer health are related to the contamination, survival and multiplication of pathogenic microorganisms, which can access food through numerous pathways, reflecting precarious hygiene conditions throughout the process. Thus, strengthening Official Inspection and Health Surveillance systems can contribute to disease prevention and health promotion, minimizing healthcare expenditure and favoring the efficient allocation of resources.

Identification of COVID-19 Outbreak Signals Prior to the Traditional Disease Surveillance System

Background: New coronavirus cases and deaths are continuing to pop up worldwide. Early identifying the emergence of a novel infectious disease outbreak is of great value for a timely response. Methods: We performed a comparative study to discuss the feasibility of early warning of the outbreak of novel coronavirus (COVID-19) based on the influenza surveillance data and internet search index of keywords in order to evaluate the early warning capability and timelines of the alert signals in comparison with the traditional case reporting system and official response in China. Findings: Influenza cases notified in 2019 was significantly higher in comparison to previous years in China. An early spike of influenza was observed in 2019 winter, with a fast-growing period from November to December, suggesting that the COVID-19 cases may occur during October and November or earlier. There was a surge in searching for information related to “pneumonia” and “SARS” on 31 December 2019. However, according to the traditional official surveillance system, the risk of the potential epidemic was not taken seriously since the first group of unexplained pneumonia cases reported in Wuhan on 29 December, 2019, till 20 January, 2020. Both the unusual increase of influenza and the peak of internet search for key terms have shown earlier signals of the outbreak of COVID-19. Interpretation: The traditional disease monitoring system is effective to detect the outbreak of common infectious diseases, but it is insufficient for the discovery of novel diseases. Monitoring abnormal spike of influenza-like illness and identifying online search peak of key terms can provide early signals of a novel disease outbreak. Funding Statement: This study was funded by the National Natural Science Foundation of China (81973103), National Key R&D Program of China (2017YFC0907000), and Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD). Declaration of Interests: The authors declare no conflict of interest. Ethics Approval Statement: This study was approved by the ethics committee of Nanjing Medical University.

Involvement of Egyptian Foods in Foodborne Viral Illnesses: The Burden on Public Health and Related Environmental Risk Factors: An Overview

Foodborne viral diseases are a major public health threat and pose a huge burden on the economies of both developed and developing countries. Enteric viruses are the causative agents of most foodborne illnesses and outbreaks. Egypt is classified by WHO among the regions with intermediate to high endemicity for various enteric viruses. This is manifested by the high prevalence rates of different enteric virus infections among Egyptian population such as Hepatitis A and E viruses, human rotaviruses, human noroviruses, human astroviruses, and human adenovirus. Recently, a number of foodborne gastroenteritis and acute hepatitis outbreaks have occurred in the US, Canada, Australia, and the European Union countries. Some of these outbreaks were attributed to the consumption of minimally processed foods imported from Egypt indicating the possibility that Egyptian foods may also be partially responsible for high prevalence of enteric virus infections among Egyptian population. In the absence of official foodborne-pathogen surveillance systems, evaluating the virological safety of Egyptian foods is a difficult task. In this review, we aim to provide a preliminary evaluation of the virological safety of Egyptian foods. A comprehensive review of prevalence studies on enteric virus infections shows hyperendemicity of several enteric viruses in Egypt and provides strong evidence of implication of Egyptian foods in these infections. We also address possible environmental risk factors that may lead to the contamination of Egyptian foods with enteric viruses. In addition, we describe potential obstacles to any plan that might be considered for improving the virological safety of Egyptian foods.

Incidence and underreporting of leptospirosis comparing three diagnostic methods in the endemic region of Urabá, Colombia

Introduction: Leptospirosis represents a public health problem and is a significant cause of morbidity and mortality in the region of Urabá. However, its notification reveals diagnostic limitations. Objective: To establish the incidence of leptospirosis in the municipalities of the so-called eje bananero in the Urabá region, to describe the magnitude of underreporting, and to propose guidelines for laboratory diagnosis by the public health network. Materials and methods: Two leptospirosis information sources were used: The national official surveillance system and a cross-sectional study of 479 acute-phase patients from April, 2010, to May, 2012. The diagnosis was made using three different tests: Indirect immunofluorescence, microagglutination test, and blood cultures. The exhaustiveness percentage of each information source was calculatedusing the capture and recapture test. Results: From the total number of cases, 58% (278/479) were positive for leptospirosis at least by a test and 10.43% (29/278) of cases were positive by all three methods. The inclusion of a native strain in the microagglutination test panel increased the percentage of positivity by 15%. The cumulative incidence rate was 66.5/100,000 inhabitants and the case fatality ratio was 2.15%. The underreporting rates of leptospirosis in the Urabá region were 27.8% in morbidity and 66.6% in mortality. Conclusion: Under-registration of leptospirosis in the region highlights the necessity to use more than one diagnostic test to identify Leptospira in patients from endemic areas. Underregistration could be a common situation throughout the country.

Handling Big Data of Alien Species in Europe: The European Alien Species Information Network Geodatabase

Building and managing large datasets of alien species is crucial to research, management and control of biological invasions. To this end, the European Alien Species Information Network (EASIN) platform aggregates, integrates and harmonizes spatio-temporal data regarding alien species in Europe, including both invasive and non-invasive alien species. These data are stored in the EASIN Geodatabase after their harvesting from relevant sources in the frame of a global and European databases partnership and scientific literature. The ownership of the data remains with its source, which is properly cited and linked. The process of data harvesting is performed through the EASIN Data Broker system, which retrieves the information related to alien species data in Europe and stores them in a normalized database structure. Data are subsequently refined through validation, cleansing and standardization processes and finally stored in the EASIN Geodatabase. All data are finally visualized and shown in occurrence maps at different levels of spatial visualization. Analysis of the data contained in the EASIN Geodatabase through flexible web services offered by the system has already provided useful input in scientific works and policies on biological invasions. Data from European Union (EU) member state official surveillance systems, within the framework of the EU Regulation 1143/2014 on Invasive Alien Species, are expected to contribute to the update of the EASIN Geodatabase. In addition, data from citizen science initiatives will further enrich the Geodatabase after appropriate validation. In this article we describe and discuss the technical aspects, data flow and capabilities of the EASIN Geodatabase.

Citizen Science and Open Data: a model for Invasive Alien Species in Europe

Invasive Alien Species (IAS) are a growing threat to Europe's biodiversity. The implementation of European Union Regulation on IAS can benefit from the involvement of the public in IAS recording and management through Citizen Science (CS) initiatives. Aiming to tackle issues related with the use of CS projects on IAS topics, a dedicated workshop titled “Citizen Science and Open Data: a model for Invasive Alien Species in Europe” was organized by the Joint Research Centre (JRC) and the European Cooperation in Science and Technology (COST Association). Fifty key stakeholders from all Europe, including two Members of the European Parliament, attended the workshop. With a clear focus on IAS, the workshop aimed at addressing the following issues: a) CS and policy, b) citizen engagement, and c) CS data management. Nine short presentations provided input on CS and IAS issues. Participants discussed specific topics in several round tables (“world café” style) and reported back their conclusions to the audience and full assembly moderated discussions. Overall, the workshop enabled the sharing of ideas, approaches and best practices regarding CS and IAS. Specific opportunities and pitfalls of using CS data in the whole policy cycle for IAS were recognized. Concerning the implementation of the IAS Regulation, CS data could complement official surveillance systems, and contribute to the early warning of the IAS of Union concern after appropriate validation by the Member States’ competent authorities. CS projects can additionally increase awareness and empower citizens. Attendees pointed out the importance for further public engagement in CS projects on IAS that demonstrate specific initiatives and approaches and analyze lessons learned from past experiences. In addition, the workshop noted that the data gathered from different CS projects on IAS are fragmented. It highlighted the need for using an open and accessible platform to upload data originating from CS sources or to mirror validated data into a single, easy-to-use web service, in line with the EU Open Science Strategic Priority. The workshop provided ten key recommendations of best practices for CS projects on IAS, addressed to researchers, policy makers and implementing authorities, indicating future research and policy directions and opportunities.

Evaluation of the Danish footpad lesion surveillance in conventional and organic broilers: Misclassification of scoring

Danish legislation prescribes surveillance of footpad dermatitis (FPD) at slaughter as an indicator of on-farm broiler welfare. The 3-point scale being used was originally developed in Sweden to score feet from conventional broilers, but the extent and causes of misclassifications have not been investigated, neither in conventional nor organic broilers. Hence, we investigated the performance of the official Danish FPD scoring system in conventional and organic broilers by assessing agreement between official scores from the slaughterhouse and consecutive scoring of the same feet by a reference method. We also investigated the impact of performing an incision of the footpad during scoring. In total, 902 conventional and 897 organic broiler feet (∼100 per flock from 18 flocks) were collected at a large Danish slaughterhouse for the official FPD surveillance system. Laboratory scoring, according to predefined criteria for visual and invasive investigations of the feet derived from the official system, was compared to the official scores assigned at slaughter. Footpad lesions were primarily chronic, representing a wide range of severity. Marked differences in color, shape, and degree of papillary hypertrophy and hyperkeratosis of organic and conventional feet were observed. Low agreement primarily regarding score 2 lesions was observed when comparing official and reference foot scores in conventional (0.31) and organic (0.05) broilers. Variation in agreement when comparing flock scores suggested a non-systematic bias, which might be attributed to differences among official raters. The very low agreement in feet from organic broilers shows that these were more difficult to score than conventional. This might be due to a mismatch between lesion characteristics and scoring criteria, or because the lesions were less severe. Strictly visual examination detected 3 out of 4 score 2 lesions identified by the reference method. This study indicated that a large proportion of severe FPD lesions go unnoticed in the official Danish scoring system. The results further suggested that the complexity and impracticality of the scoring criteria impede uniform scoring among raters and production systems.

Application of discrete choice experiment to assess farmers’ willingness to report swine diseases in the Red River Delta region, Vietnam

A discrete choice experiment (DCE) is carried out to value socio-economic factors influencing the farmer’s decision to report swine diseases and to assess the willingness of farmers to report swine diseases. Data were collected between March and July 2015 in two provinces in the Red River Delta, Northern Vietnam, from 196 pig producers by face-to face interview. A conditional logit model is used to measure the relative importance of the socio-economic factors and calculate the expected probability of disease reporting under changes of levels of these factors. Results of the study indicated that the likelihood of compensation and the type of culling implemented (all or only unrecovered pigs) are the two most important factors influencing farmer reporting. Compensation level, movement restriction and delay in compensation payment also have significant impacts on farmer’s decision to report animal disease but they are not as important as the above factors. Three different scenarios including changes in six different factors (attributes) are tested to predict probability of animal disease reporting. Under the current situation (uncertainty of being compensated), only 4% of the farmers would report swine disease outbreak to the official surveillance system if the culling policy involves all pigs in affected farms. This number is increased to 26% if culling in affected farms is restricted to unrecovered pigs only. Ensuring certainty of compensation increases reporting probability by up to 50% and 90% if all or only unrecovered pigs are destroyed, respectively. The results of this study are important for improving the performance and sustainability of swine disease surveillance system in Vietnam.

Weighing serological evidence of human exposure to animal influenza viruses - a literature review.

Assessing influenza A virus strains circulating in animals and their potential to cross the species barrier and cause human infections is important to improve human influenza surveillance and preparedness. We reviewed studies describing serological evidence of human exposure to animal influenza viruses. Comparing serological data is difficult due to a lack of standardisation in study designs and in laboratory methods used in published reports. Therefore, we designed a scoring system to assess and weigh specificity of obtained serology results in the selected articles. Many studies report reliable evidence of antibodies to swine influenza viruses among persons occupationally exposed to pigs. Most avian influenza studies target H5, H7 and H9 subtypes and most serological evidence of human exposure to avian influenza viruses is reported for these subtypes. Avian influenza studies receiving a low grade in this review often reported higher seroprevalences in humans compared with studies with a high grade. Official surveillance systems mainly focus on avian H5 and H7 viruses. Swine influenza viruses and avian subtypes other than H5 and H7 (emphasising H9) should be additionally included in official surveillance systems. Surveillance efforts should also be directed towards understudied geographical areas, such as Africa and South America.

Impact of Rotavirus Vaccination on Childhood Hospitalization for Seizures.

Rotavirus vaccine (RV) might reduce the risk of hospitalization due to childhood seizures (CS). We aimed to identify and assess variations in the incidence of hospitalizations for CS among children <5 years of age before and after RV introduction. Annual hospitalization rates for any kind of CS, before and after RV introduction in 2007, were calculated using the official surveillance system for hospitalization data. Our study cohort totaled 6149 children <5 years of age admitted to the hospital between 2003 and 2013 with any kind of CS (780.3* + 779.0* + 333.2* + 345* ICD-9-CM code). The annual hospitalization rates for any kind of CS in children <5 years of age were correlated with RV coverage (r = -0.673; P = 0.033) and rotavirus acute gastroenteritis admission rates (ρ = 0.506; P = 0.001), with decrease rates ranging from 16.2% (95% confidence interval: 8.3-23.5%) in 2007 to 34.0% (27.3-40.1%) in 2010, as compared with the median rate of the pre-vaccination period (2003 to 2006). Similarly, for convulsions (780.3*ICD-9-CM code), the decrease seen in children <5 years of age was significantly correlated with the increase in RV coverage (r = -0.747; P = 0.013) and rotavirus acute gastroenteritis admission rates (ρ = 0.543; P < 0.001), with decrease rates ranging from 18.7% (9.6-26.8%) in 2007 to 42.5% (35.3-48.9%) in 2012. Significant results were also obtained for infants <12 months and infants 1-2 years of age. In the remaining age groups or diagnostic categories analyzed, changes were either not significant or not related to vaccination changes or rotavirus acute gastroenteritis admission rates. Our results show that rotavirus vaccination may have a significant impact in the decrease in seizure-related hospitalizations in childhood. This additional benefit of rotavirus vaccination seems more marked in the youngest infants.

#swineflu

The need to improve population monitoring and enhance surveillance of infectious diseases has never been more pressing. Factors such as air travel act as a catalyst in the spread of new and existing viruses. The unprecedented user-generated activity on social networks over the last few years has created real-time streams of personal data that provide an invaluable tool for monitoring and sampling large populations. Epidemic intelligence relies on constant monitoring of online media sources for early warning, detection, and rapid response; however, the real-time information available in social networks provides a new paradigm for the early warning function. The communication of risk in any public health emergency is a complex task for governments and healthcare agencies. This task is made more challenging in the current situation when the public has access to a wide range of online resources, ranging from traditional news channels to information posted on blogs and social networks. Twitter’s strength is its two-way communication nature --- both as an information source but also as a central hub for publishing, disseminating and discovering online media. This study addresses these two challenges by investigating the role of Twitter during the 2009 swine flu pandemic by analysing data collected from the SN, and by Twitter using the opposite way for dissemination information through the network. First, we demonstrate the role of the social network for early warning by detecting an upcoming spike in an epidemic before the official surveillance systems by up to two weeks in the U.K. and up to two to three weeks in the U.S. Second, we illustrate how online resources are propagated through Twitter at the time of the WHO’s declaration of the swine flu “pandemic”. Our findings indicate that Twitter does favour reputable t bogus information can still leak into the network.

Social Media and Internet‐Based Data in Global Systems for Public Health Surveillance: A Systematic Review

Context: The exchange of health information on the Internet has been heralded as an opportunity to improve public health surveillance. In a field that has traditionally relied on an established system of mandatory and voluntary reporting of known infectious diseases by doctors and laboratories to governmental agencies, innovations in social media and so-called user-generated information could lead to faster recognition of cases of infectious disease. More direct access to such data could enable surveillance epidemiologists to detect potential public health threats such as rare, new diseases or early-level warnings for epidemics. But how useful are data from social media and the Internet, and what is the potential to enhance surveillance? The challenges of using these emerging surveillance systems for infectious disease epidemiology, including the specific resources needed, technical requirements, and acceptability to public health practitioners and policymakers, have wide-reaching implications for public health surveillance in the 21st century.Methods: This article divides public health surveillance into indicator-based surveillance and event-based surveillance and provides an overview of each. We did an exhaustive review of published articles indexed in the databases PubMed, Scopus, and Scirus between 1990 and 2011 covering contemporary event-based systems for infectious disease surveillance.Findings: Our literature review uncovered no event-based surveillance systems currently used in national surveillance programs. While much has been done to develop event-based surveillance, the existing systems have limitations. Accordingly, there is a need for further development of automated technologies that monitor health-related information on the Internet, especially to handle large amounts of data and to prevent information overload. The dissemination to health authorities of new information about health events is not always efficient and could be improved. No comprehensive evaluations show whether event-based surveillance systems have been integrated into actual epidemiological work during real-time health events.Conclusions: The acceptability of data from the Internet and social media as a regular part of public health surveillance programs varies and is related to a circular challenge: the willingness to integrate is rooted in a lack of effectiveness studies, yet such effectiveness can be proved only through a structured evaluation of integrated systems. Issues related to changing technical and social paradigms in both individual perceptions of and interactions with personal health data, as well as social media and other data from the Internet, must be further addressed before such information can be integrated into official surveillance systems.

The paradox of caught-in-the-act surveillance scenes: dilemmas of police video surveillance in Rio de Janeiro

This paper reports some of the issues raised by field research conducted in the official video surveillance system in public spaces that is operated by the Military Police on behalf of the Rio de Janeiro State Department of Public Security. The research was conducted at the Command and Control Center (CCC), where the images from all the cameras in the police battalions are brought together and at the police batallion at Copacabana (19thBPM), the first area at the city where surveillance cameras were installed. This system is treated as a sociotechnical network, formed by the interaction of individuals and technological elements, further increasing the importance of an observation from two different levels of this network. Special attention is drawed on what I called “the paradox of the caught in-the-act surveillance scenes”, dilemma emerged around the conflict between the work of surveillance and the aesthetics of surveillance, and also on a main videosurveillance problem: (human and/or technical) overdetermination.