Infectious Disease

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.

Legionellosis is a respiratory illness that is mostly (80-90%) caused by the bacterium Legionella pneumophila. It is associated with a mild febrile illness, Pontiac fever, or Legionnaires'™ disease (1), a source of severe, community-acquired pneumonia. Legionella bacteria mostly affect elderly persons specifically those with underlying debilitating illnesses and with lowered immune systems. Water is the major natural reservoir for Legionella, and the pathogen is found in many different natural and artificial aquatic environments such as cooling towers or water systems in buildings, including hospitals. An abrupt increase in the incidence of Legionnaires' has been noted since 2003 throughout the nation. According to CDC, about 6,000 cases of Legionnaires' disease were reported in the United State in 2015 (1). Incidence rates of Legionnaires for the year 2015 were 1.06 and 1.90 (ref) for Texas and the United States respectively (2). Increased number of reported cases might be due to the fact of an older population, more at risk individuals, aging plumbing infrastructure, and increased testing for Legionnaires' disease by various hospitals and laboratories.

Objective: To study trends and patterns in legionnaires' disease cases in Houston, Texas, from 2014-2017.

West Nile virus (WNV) is considered the leading cause of domestically acquired arboviral disease and is spread through mosquitoes. In general, the majority of the cases are asymptomatic. One in five people infected will display mild symptoms like fever, headache, body ache, nausea, and vomiting. Only about 1 in 150 people infected will develop serious neurologic complications such as encephalitis and meningitis. According to CDC, in 2017, there were 133 confirmed cases including 5 deaths and 14 presumptive blood donors reported in the State of Texas. Out of the confirmed cases, there were 85 neuroinvasive and 48 non-neuroinvasive disease cases.

Objective: To demonstrate an overview of the epidemiological and clinical distribution of reportable West Nile cases in Houston, Texas, from 2015-2017.