Infectious Disease

Mitigating the spread of infectious disease is of great importance for policy makers. Taking the recent outbreak of Ebola as an example, it was difficult for policy makers to identify the best course of action based on the cost-effectiveness of what was available. In effort to address the needs of policy makers to mitigate the spread of infectious disease before an outbreak becomes uncontrollable, we have devised a cost-benefit disease control model to simulate the effect of various control methods on disease incidence and the cost associated with each of the scenarios. Here, we present a case study of Ebola used to quantify the cost effectiveness of vaccination and isolation methods to minimize the spread of the disease.

Objective

We evaluate the impact of changing strategy levels on the incidence of the disease and address the benefits of choosing one strategy over the other with regards to cost of vaccine and isolation.

MERS-CoV was discovered in 2012 in the Middle East and human cases around the world have been carefully reported by the WHO. MERS-CoV virus is a novel betacoronavirus closely related to a virus (NeoCov) hosted by a bat, Neoromicia capensis. MERS-CoV infects humans and camels. In 2015, MERS-CoV spread from the Middle East to South Korea which sustained an outbreak. Thus, it is clear that the virus can spread among humans in areas in which camels are not husbanded.

Objective

Here we use novel methods of phylogenetic transmission graph analysis to reconstruct the geographic spread of MERS-CoV. We compare these results to those derived from text mining and visualization of the World Health Organization’s (WHO) Disease Outbreak News.

Accumulation of C. botulinum in soil occurs through excretion of bacterial spores from the intestines of humans, animals, birds and fish. In Georgia, during the winter season, the population consumes homemade vegetable preserves, which are made of locally produced (as well as imported) vegetables. Historical surveys confirmed that the presence of C. botulinum in the soil is widespread. Some researchers consider C. botulinum a characteristic component of soil flora.

Objective

The main focus of this study was to study the spread of botulism in Georgia and the biological characteristics of the strains of Clostridium botulinum isolated from territories in the country.

The Bureau of Communicable Disease (BCD) at the NYC Department of Health and Mental Hygiene performs daily automated analyses using SaTScan to detect spatio-temporal clusters for 37 reportable diseases. Initially, we analyzed one address per patient, prioritizing home address if available. On September 25, 2015, a BCD investigator noticed two legionellosis cases with similar work addresses. A third case was identified in a nearby residential facility, and an investigation was initiated to identify a common exposure source. Four days later, after additional cases living nearby were reported, the SaTScan analysis detected a corresponding cluster.  In response to this signaling delay, we implemented a multiple address (MA) analysis to improve upon single address (SA) analyses by using all location data available on possible exposure sites.

Objective

To improve timeliness and sensitivity of legionellosis cluster detection in New York City (NYC) by using all addresses available for each patient in one analysis.

Traditional infectious disease epidemiology is built on the foundation of high quality and high accuracy data on disease and behavior. Digital infectious disease epidemiology, on the other hand, uses existing digital traces, re-purposing them to identify patterns in health-related processes. Medical claims are an emerging digital data source in surveillance; they capture patient-level data across an entire population of healthcare seekers, and have the benefits of medical accuracy through physician diagnoses, and fine spatial and temporal resolution in near real-time. Our work harnesses the large volume and high specificity of diagnosis codes in medical claims to improve our understanding of the mechanisms driving spatial variation in reported influenza activity each year. The mechanisms hypothesized to drive these patterns are as varied as: environmental factors affecting transmission or virus survival, travel flows between different populations, population age structure, and socioeconomic factors linked to healthcare access and quality of life. Beyond process mechanisms, the nature of surveillance data collection may affect our interpretation of spatial epidemiological patterns, particularly since influenza is a non-reportable disease with non-specific symptoms ranging from asymptomatic to severe. Considering the ways in which medical claims are generated, biases may arise from healthcare-seeking behavior, insurance coverage, and medical claims database coverage in study populations.

Objective

To assess the use of medical claims records for surveillance and epidemiological inference through a case study that examines how ecological and social determinants and measurement error contribute to spatial heterogeneity in reports of influenza-like illness across the United States.

Zoonotic diseases are an important cause of human morbidity and mortality; around 75% of recently emerging human infectious diseases are zoonoses. Herein we report the first seroprevalence study to include a range of emerging or re-emerging zoonotic pathogens of economic concern (including: Bacillus anthracis, Coxiella burnetii, Francisella spp., Brucella spp., and Crimean-Congo hemorrhagic fever virus (CCHFV)) affecting domestic animals (e.g., cattle, sheep, goat, and dog) in Georgia.

Objective

The purpose of this research was to study the seroprevalence of zoonotic diseases among farm animals in the Kvemo Kartli region of Georgia.

Rubella virus causes -“German measles,” also known as “three-day measles.” This is usually a milder disease than red measles. Red/Hard measles or just measles is caused by Rubeola virus. The result of acute infection of the virus is a benign systematic rash which is significantly pathogenic to humans. This virus is a, positive-strand RNA virus that replicates in the cytoplasm of the infected cell. (Brooks et al., 2007). If placental infection of the virus spread during 8-10 weeks gestation it causes a chronic infection of the fetus leading to the development of congenital rubella syndrome (CRS) (Matthews et al., 2011) The effect of the infection of the several organ systems which include the eyes, ears, heart, brain, and endocrine system is known as congenital rubella infection (CRI) (Chantler et, al.,2001) Rubella is endemic in Nigeria. Studies among women of child bearing age in Nigeria put seroprevalence at 66.6% in Imo, 77% in Lagos and 93.5% in Oyo (8-10). Thus as part of the control measure, the availability of an effective vaccine to prevent Rubella infection and therefore CRS, is necessary to evaluate the burden of disease in a country where MMR vaccine is not covered in the immunization schedule or in vaccination strategy.

Objective

To determine the IgM and IgG antibodies of rubella virus circulating among pregnant women in Kaduna State Nigeria.

Assigning causes of deaths to seasonal infectious diseases is difficult in part due to laboratory testing prior to death being uncommon. Since influenza (and other common respiratory pathogens) are therefore notoriously underreported as a (contributing) cause of death in deathcause statistics modeling studies are commonly used to estimate the impact of influenza on mortality.

Objective

To estimate mortality attributable to influenza adjusted for other common respiratory pathogens, baseline seasonal trends and extreme temperatures.

The primary goal of syndromic surveillance is early recognition of disease trends, in order to identify and control infectious disease outbreaks, such as influenza. For surveillance of influenza-like illness (ILI), public health departments receive data from multiple sources with varying degrees of patient acuity, including outpatient clinics and emergency departments. However, the lack of standardization of these data sources may lead to varying baseline levels of ILI activity within a local area.

Objective

To examine the baseline influenza-like illness (ILI) rates in the emergency departments (ED) of a large academic medical center (AMC), community hospital (CH), and neighboring adult and pediatric primary care clinics.

Anthrax is endemic in the South Caucasus region. There is a lack of understanding of the regional epidemiology of the causative pathogen, Bacillus anthracis, and the trans-boundary factors related to its persistence.

Objective

The purpose of this study was to describe anthrax foci along the Georgia-Azerbaijan border and to describe control measures in identified areas.