Infectious Disease

Contact tracing is an important strategy employed in surveillance to aid prompt detection of infectious disease and control outbreaks. It involves the identification of those who have come in contact with an infectious person and following them up for the duration of the incubation period of the disease to promptly detect symptoms and signs and institute treatment thus reducing chances of disease spread to other susceptible individuals. It is a primary means of disease prevention. The importance of cooperation from contacts being traced cannot be overemphasized as they are required to promptly report symptoms, avoid gatherings and travelling until they are cleared by the surveillance team. The follow-up should also link contacts who become symptomatic to designated care centers. In 2014, during the Ebola outbreak in Nigeria, the disease spread from Lagos to another State in the country by a contact who travelled out of Lagos to Rivers state. To identify risk factors among contacts of Lassa fever cases which can predispose to disease spread and institute control measures, we interviewed primary contacts of Lassa fever cases during an outbreak response in Kogi State Nigeria, 2016.

Objective: To identify risk factors among contacts of Lassa fever cases which can predispose to disease spread and institute control measures.

Nepal being a developing country has many health problems, which escalate in intensity at different times of the year or in epidemic form. Amebiasis is one of the infectious diseases that is highly seen in rural area of Nepal caused by Entamoeba species. Recent reports show that open defecation, drinking untreated water, unsanitary habits and lack of basic health knowledge cause higher mortality and morbidity in our country. E. histolytica is an anaerobic pathogenic parasitic. However, E. dispar and E.moshkovskii exits as non-pathogenic. Likewise, E. histolytica, E. dispar and E. moshkovskii are morphologically identical but genetically distinct species.

Objective: To find out the prevalence of Entamoeba species in rural community of Nepal. The purpose of the study is to evaluate Nested PCR, microscopic examination and Elisa assay for detection and differentiation of Entamoeba species.

Arboviral infections have become a significant public health problem with the emergence and re-emergence of arboviral diseases worldwide in recent decades. Given the increasing number of cases, geographic spread, but also health, social and economic impact of arboviral outbreaks, estimating their true burden represents a crucial issue but remains a difficult task. In French Guiana, the epidemiology of arboviral diseases has been marked by the occurrence several major dengue fever (DENV) outbreaks over the past few decades, recent emergences of Chikungunya (CHKV) and Zika virus (ZIKV) and the circulation of Mayaro virus (MAYV).

Objective: To assess the level of circulation of DENV, CHIKV, ZIKV, MAYV in French Guiana.

Particular family of tandem repeats, such as Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) found in a wide range of prokaryotic genomes. CRISPRs consist of highly conserved repeats interspaced with non-repetitive elements or "spacers" usually of viral origin. In the Yersinia pestis genome, three CRISPR elements YPa, YPb and YPc are found. The distribution of spacers and their arrays in Y. pestis strains is region and focus specific and can provide important information for genotyping and evolutionary research of bacteria.

Objective: The purpose of our study was CRISPR-based analysis of Y. pestis isolates from Georgia and neighboring countries.

Although cases of acute HAV have declined in recent years, elevated numbers of HAV infections began to be reported by California and Michigan in the fall of 2016.1,2 Since this time, associated outbreaks have been reported in 9 additional states (Arizona, Utah, Kentucky, Missouri, Tennessee, Indiana, Ohio, Arkansas, and West Virginia).3 No common source of food, beverages or drugs have been identified and transmission appears to be primarily person-to-person with high-risk individuals including people experiencing homelessness, those who use illicit drugs and their close direct contacts. In June 2018, CDC issued a Health Alert Network Advisory providing additional guidance on identification and prevention of HAV and updates on the outbreaks.4 This prompted our office to more closely review our HAV surveillance, to identify Veterans who may be part of these outbreaks, and assess risk factors and outcomes of HAV infection.

Objective: To conduct surveillance for acute Hepatitis A virus (HAV) infections in Veterans from states reporting outbreaks among high-risk individuals beginning in fiscal year (FY) 2017.

Since hepatitis A vaccination became widely recommended in the US in the mid-1990's, rates of acute hepatitis A virus (HAV) infection have steadily declined, however, since 2011, incidence of new cases of HAV appears to be increasing1, often linked with foodborne outbreaks and socio-economic trends such as homelessness and substance abuse.2 In 2016, the CDC reported vaccination coverage among adults aged > 19 was 9.5%, 19-49 was 13.4%, and > 50 was 5.4%3. CDC issued a Health Alert Network Advisory in June 2018 with additional guidance on identification and prevention of HAV and updates on outbreaks in multiple states4 which prompted our program to conduct a more formal review of HAV infections in VHA. Herein we describe recent trends in HAV infection, vaccination and associated risk factors among Veterans.

Objective: To describe the epidemiology of hepatitis A virus (HAV) within the Veterans Health Administration (VHA).

Administrative data refers to data generated during the processes of health care. These data are a rich source of patient health information, including diagnoses and problem lists, laboratory and diagnostic tests, and medications. Established standards are used to code each data into the appropriate coding systems. The International Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification (ICD-9-CM and ICD-10-CM) codes are the coding standard for diagnoses and have been frequently used to identify cases for the creation of cohorts in examining care delivery, screening, prevalence, and risk factors. However, while some studies have assessed the validity and reliability of ICD-CM codes to identify various conditions such as cerebral palsy and rheumatoid arthritis3,4, the evidence for using ICD codes to accurately identify sexually transmitted infection (STI) cases is largely unexamined. The purpose of this study is to review the extant literature for evidence on the validity of ICD codes for identifying cases of chlamydia, gonorrhea, and syphilis. Our findings will inform efforts to improve the use of administrative data for STI-related health service and surveillance researches.

Objective: The purpose of this study is to review the extant literature for evidence on the validity of ICD-9-CM and -10-CM codes for the purpose of identifying cases of chlamydia, gonorrhea, and syphilis.