Infectious Disease

Mongolia is one of countries in the WHO Western Pacific Region with a high TB burden. The National Stop TB Strategy 2010-2015 implemented and developed strong surveillance and response system in the country. However, new TB incidence and deaths have not decreased significantly.Political commitment is critical for effective TB surveillance and that commitment can be demonstrated by a country's legal framework, which governs the practice of prevention and control. Therefore, this study is aimed at investigating the legal underpinnings for disease surveillance to help identify what policy changes have occurred in Tuberculosis surveillance.

Objective: In order to track progress towards TB goals, weinvestigated the legal framework for disease surveillance, specifically policy changes for TB surveillance in Mongolia during the MDGs and the SDGs era.

The 2017 - 2018 influenza season was classified by the Centers for Disease Control and Prevention (CDC) as "high severity"™ across all age groups. Furthermore, CDC noted that this was the first year to be categorized as such, with the highest peak percentage of influenza-like-illnesses (ILI), since 2009. In Harris County alone, there were 2,665 positive flu tests reported in comparison to the previous season at 1,395 positive tests. In response to the severity of this year's flu season, Harris County Public Health (HCPH) collaborated across the department to deploy five pop up influenza vaccination events utilizing our Mobile Fleets open to the general public. HCPH epidemiologists are able to collect influenza data from multiple systems and compile it into useful reports/tools. These data include latitudinal and longitudinal data, allowing us to create highly localized maps of where influenza has had impacted communities the hardest. This granular data allowed HCPH to target 5 areas with our Mobile Fleet that had a) high levels of influenza and b) generally limited healthcare/public health infrastructure. Our Mobile Fleet is made up of 8 different Recreational Vehicles that have been retrofitted to offer various public health services including: immunizations, medical visits, dental visits, pet adoptions, mosquito and vector control education, and a fresh food market. The Fleet allows HCPH to offer a full menu of public health services anywhere within the County. While our efforts for this abstract were focused on controlling the influenza outbreak, we leveraged the opportunity to engage with the public on multiple issues such as environmental, veterinary, mosquito control, dental health, and accessible healthy food options.

Objective: During this session, participants will be able to understand how Harris County Public Health utilized data to make informed decisions on how to combat the influenza season.

Leptospirosis is one of the most important zoonotic diseases based on the severity of the clinical course, frequency of fatal outcome and long-term clinical consequences. In Ukraine, leptospirosis is one of the most widespread natural-focal infectious diseases. Based on data of the Public Health Center of the Ministry of Health of Ukraine in 2017, the incidence rate was 0.77 per 100,000 population (330 cases), mortality rate was 0,08 per 100 000 population (case fatality rate was 10,9 %). In Lviv Oblast, the disease was registered as sporadic cases that were not related to each other (in 2017, the incidence rate was 0.72 per 100,000 population. Laboratory testing of samples collected from patients and environmental objects that may be the source of the pathogen is an integral part of the epidemiological surveillance of leptospirosis. Modern laboratory diagnostics of leptospirosis is based on microbiological, immunological and molecular-biological methods used in various combinations. Molecular genetic diagnostic methods that allow detection of the Leptospira spp. RNA/DNA are the most promising for diagnosis of leptospirosis in the early stages of the disease. Investigation of environmental objects allows timely detection of the pathogen in natural foci and conducting a set of anti-epidemic necessary measures.

Objective: To estimate effectiveness of PCR method for epidemiology surveillance for leptospirosis in Lviv Oblast and compare it with microscopic agglutination test (MAT).

Lack of knowledge of rational use of antimalarial drugs among dispensers is a serious problem, especially in areas of intense transmission thus increasing the risk of resistance and adverse drug reactions.

Objective: This study was aimed at assessing the knowledge of malaria as well as perception and dispensing practices of antimalarials among vendors in Buea community.

West Nile virus (WNV) is the leading cause of autochthonous arboviral disease in the United States. The virus is primarily spread to people through the bite of infected Culex species of mosquitos. WNV was first identified in Harris County, Texas, in 20022. Since then, the mosquito-borne virus has become endemic in the region, with surges in 2012 and 2014. Although majority of individuals infected are asymptomatic, WNV induced neuroinvasive infections often result in hospitalizations and adverse outcomes3-7, thus may pose a significant concern in public health and healthcare. The Harris County Public Health (HCPH) Surveillance and Epidemiology Unit (SEU) conducts surveillance of WNV in humans, in collaboration with Mosquito and Vector Control Division (MVCD) that monitors the virus in mosquito populations and birds. Mosquito abatement activities are implemented in areas where positive mosquitoes and human cases are identified. In this integrated model, clusters of WNV positive mosquito pools in relation with human cases provide comprehensive surveillance data to guide targeted efforts of mosquito control, disease prevention, and community education.

Objective: This abstract aims to: 1) describe human WNV infections in Harris County excluding the City of Houston, Texas, 2003 to 2018; 2) explore geographical distributions of WNV positive mosquito pools in relation to human cases; 3) provide a brief overview of the county's rigorous multidisciplinary WNV surveillance and control in mosquitoes and humans.

Hepatitis C virus (HCV) infection is the most common blood-borne infection in the US, and a leading cause of liver-related morbidity and mortality. Approximately 3.5 million individuals in the US were estimated to have been living with hepatitis C in 2010, and approximately half of them were unaware that they were infected. Among HCV infected individuals, those born between 1945 and 1965 (usually referred to as the baby boomer cohort) represent approximately 75% of current cases. Because of the substantial burden of disease among this age group, CDC expanded its existing hepatitis C risk-based testing recommendations to include a one-time HCV antibody test for all persons born between 1945 and 1965. The United States Preventive Services Task Force (USPSTF) subsequently made the same recommendation in June 2013.

Objective: We estimated the rate of hepatitis C testing between 2011 and 2017 among persons with commercial health insurance coverage and compared rates by birth cohort.

In Reunion Island, a French overseas territory located in the southwestern of Indian Ocean, the dengue virus circulation is sporadic. Since 2004, between 10 and 221 probable and confirmed autochthonous dengue fever cases have been reported annually. Since January 2018, the island has experienced a large epidemic of DENV serotype 2. As of 4 September 2018, 6,538 confirmed and probable autochthonous cases have been notified1. From the beginning of the epidemic, the regional office of National Public Health Agency (ANSP) in Indian Ocean enhanced the syndromic surveillance system in order to monitor the outbreak and to provide hospital morbidity data to public health authorities.

Objective: To describe the characteristics of ED vitis related to dengue fever and to show how the syndromic surveillance system can be flexible for the monitoring of this outbreak.

Infectious disease outbreaks, such as the Ebola outbreak in West Africa, highlight the need for surveillance systems to quickly detect outbreaks and provide data to prevent future pandemics. The World Health Organization (WHO) developed the Joint External Evaluation (JEE) tool to conduct country-level assessments of surveillance capacity. However, considering that outbreaks begin and are first detected at the local level, national-level evaluations may fail to identify capacity improvements for outbreak detection. The gaps in local surveillance system processes illuminate a need for investment in on-the-ground surveillance improvements that may be lower cost than traditional surveillance improvement initiatives, such as enhanced training or strengthening data transfer mechanisms before building new laboratory facilities. To explore this premise, we developed a methodology for assessing surveillance systems with special attention to the local level and applied this methodology to the malaria outbreak surveillance system in Mashonaland East, Zimbabwe.

Objective: To conduct a field-based assessment of the malaria outbreak surveillance system in Mashonaland East, Zimbabwe.

The prevalence of persons living and diagnosed with HIV infection in the United States in 2010 to 2014 increased in number and rate (Center for Disease Control & Prevention (CDC), 2016). In 2015, persons aged 25-29 years had the highest rate (33.4), followed by persons aged 20-24 years (31.2) (CDC, 2016). Consistent reduced viral load is associated with reduced morbidity and mortality and a lower likelihood of transmitting HIV to sex partners (CDC, 2011). Retention into HIV care promotes life and decreases the risk for HIV transmission (Yehia et. al. 2015). Preventing HIV transmission, prevention intervention strategy is critical and should be ongoing to all HIV patients consistently. New cases of HIV in the United States are increasing by approximately 30, 000 per year and with this increase, more providers are needed (Weiser et al.2016).

Objective: To povide knowledge on the factors that predict retention in care and health outmomes among HIV patients and be able to understand viral load and its relation to retention in care.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral disease in East-Asian countries, including China, Japan, and the Republic of Korea (ROK). The causative agent of SFTS is the SFTS virus (SFTSV) transmitted by hematophagous ticks.

Objective: To survey the distribution of Ixodid tick and infection of severe fever with thrombocytopenia syndrome virus (SFTSV) in natural environments from Deogyusan national parks in Korea.