PubMed · 14679653
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Robert O'Connor. Ever ready.. https://pubmed.ncbi.nlm.nih.gov/14679653/
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During the course of an epidemic of a potentially fatal disease, it is important that the case fatality ratio be well estimated. The authors propose a novel method for doing so based on the Kaplan-Meier survival procedure, jointly considering two outcomes (death and recovery), and evaluate its performance by using data from the 2003 epidemic of severe acute respiratory syndrome in Hong Kong, People's Republic of China. They compare this estimate obtained at various points in the epidemic with the case fatality ratio eventually observed; with two commonly quoted, naïve estimates derived from cumulative incidence and mortality statistics at single time points; and with estimates in which a parametric mixture model is used. They demonstrate the importance of patient characteristics regarding outcome by analyzing subgroups defined by age at admission to the hospital.
The epidemiology of invasive fungal infection is evolving. Yeasts other than Candida albicans and molds other than Aspergillus fumigatus have emerged as significant causes of invasive mycoses in severely immunocompromised patients. Although, in some instances, these changes may be related to medical interventions, such as the use of antifungal agents in prophylaxis, in the majority of cases, they seem to be a consequence of changes in the host, such as more-severe immunosuppression or different types of immunosuppression impacting both risk periods and the infections that occur. These factors have altered the epidemiology of infection in organ transplant recipients, premature newborns, and critically ill patients. This review discusses the epidemiology of some fungal infections that have emerged in the past few years, with an emphasis on the potential factors associated with their emergence and on practical implications of these epidemiological changes.
The report 'Emerging zoonoses' of the Health Council of the Netherlands was written on request from the Minister of Health, Welfare and Sport. It gives an expert view on how to anticipate zoonoses that could emerge in the near future by addressing questions regarding risk assessment, prevention, early detection, control and communication. Further emphasis in the report is given to developments within the European Union (EU). The report had to serve as the basis for a European policy conference on 16 and 17 September 2004 during the Dutch presidency of the EU. Some important developments announced by the Minister are: establishment of a National Centre for Infectious Diseases to advise the Minister and coordinate crisis control during outbreaks, measures to strengthen the regional structure of public health in the Netherlands, and a budget for the strengthening of public health research.