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The epidemiology of fascioliasis in Malawi: I. The epidemiology in the intermediate host.

Fasciola gigantica Cobbold was studied in the intermediate host snail. On snail survey Lymnaea natalensis Krauss was the species found responsible for the transmission of Fasciola gigantica in Malawi. The ecology of this snail was studied at 5 different habitats spread throughout Malawi. The snail population was recorded high from April to October. The epidemiological cycle of Fasciola gigantica in the snail was determined and it was shown that snail infection was high in April and May and thus more metacercariae are released in August to October following such an infection. To complete the epidemiological picture studies reported separately were done involving the definitive host.

Animals

Frequency, serodiagnosis and epidemiological features of subacute sclerosing panencephalitis (SSPE) and epidemiology and vaccination policy for measles in the Federal Republic of Germany (FRG).

In the FRG, SSPE, a slow infection of the brain in children and young adults, known to be associated with a chronic measles virus infection, has an estimated incidence of 2.6 cases per million total population (61 million) and 9.7 cases per million population below the age of 19 years (16 million). In the 156 SSPE cases between 1968 and 1977 the characteristic clinical, epidemiological and serological features were found. Measles antibodies were present in the CSF and the serum titers as measured in conventional (CF--HI--IFA) and new (RIA and ELISA) tests were significantly higher than those in siblings, parents, age-matched controls as well as in patients with recent measles or after live measles vaccination. Only in children with recent wild virus infection after previous vaccination with inactivated Split measles vaccine were similar elevated serum antibody levels observed. In the SSPE cases as well as in the former group, antibodies of the IgM-class were seldom detectable and isolation of infectious measles virus from brain tissue and lymphnode derived cell cultures was rarely accomplished. The search for a co-factor or triggering agent of SSPE such as inactivated or live measles virus vaccination, concomitant childhood infection or vaccination with onset of measles or SSPE was inclusive. The seroepidemiological observation of higher frequency and titer levels of EBV- and toxoplasmosis antibody in SSPE patients as compared to siblings and parents and the suspicion that arbor virus infection may have some influence on triggering SSPE must be further substantiated. It appears that this relatively rare disease arises after an early, normal measles infection in an immunologically competent child without special genetic characteristics, mainly belonging to the lower socio-economic group, by a change of the measles virus and the immune response of the host.

Adolescent

[Experience with epidemiologic studies of pyocyaneus infections. I. Feasibility of using serotypes and antibiotic resistance as a epidemiologic label for clinical strains].

The authors carried out serological typing of 98 Pseudomonas aeruginosa strains, isolated from patients of burn department of the Sklifosovsky First Aid Institute in January-July, 1974, and of 215 strains obtained from other sources; their sensitivity to 13 antibiotics was determined. Pseudomonas aeruginosa cultures isolated from the patients were typed with O-sera of 10 serological types. The presence of several hospital strains of Pseudomonas aeruginosa was found by means of serological typing; along with these there were revealed cultures of this causative agent sporadically appearing in the department. Sensitivity to some antibiotics could serve as an additional criterion for differentiation of Pseudomonas aeruginosa strains of the same serological type.

Adult

Incorporating Epidemiological Data into the Genomic Analysis of Partially Sampled Infectious Disease Outbreaks.

Pathogen genomic data are increasingly being used to investigate transmission dynamics in infectious disease outbreaks. Combining genomic data with epidemiological data should substantially increase our understanding of outbreaks, but this is highly challenging when the outbreak under study is only partially sampled, so that both genomic and epidemiological data are missing for intermediate links in the transmission chains. Here, we present a new dynamic programming algorithm to perform this task efficiently. We implement this methodology into the well-established TransPhylo framework to reconstruct partially sampled outbreaks using a combination of genomic and epidemiological data. We use simulated datasets to show that including epidemiological data can improve the accuracy of the inferred transmission links compared with inference based on genomic data only. This also allows us to estimate parameters specific to the epidemiological data (such as transmission rates between particular groups), which would otherwise not be possible. We then apply these methods to two real-world examples. First, we use genomic data from an outbreak of tuberculosis in Argentina, for which data was also available on the HIV status of sampled individuals, in order to investigate the role of HIV coinfection in the spread of this tuberculosis outbreak. Second, we use genomic and geographical data from the 2003 epidemic of avian influenza H7N7 in the Netherlands to reconstruct its spatial epidemiology. In both cases, we show that incorporating epidemiological data into the genomic analysis allows us to investigate the role of epidemiological properties in the spread of infectious diseases.

Humans

ScITree: Scalable Bayesian inference of transmission tree from epidemiological and genomic data.

Phylodynamic models capture joint epidemiological-evolutionary dynamics during an outbreak, providing a powerful tool to enhance understanding and management of disease transmission. Existing phylodynamic approaches, however, mostly rely on various non-mechanistic or semi-mechanistic approximations of the underlying epidemiological-evolutionary process. Previous work by Lau and colleagues has shown that full Bayesian mechanistic models, without relying on these approximations, can enable highly accurate joint inference of the epidemiological-evolutionary dynamics including the unobserved transmission tree. However, the Lau method faces major computational bottlenecks. As the volume of genomic data collected during outbreaks continues to grow, it is crucial to develop scalable yet accurate phylodynamic methods. Here we propose a new Bayesian phylodynamic model, overcoming the major scalability issue in the previous method and enabling a readily deployable, yet accurate, phylodynamic modeling framework. Specifically, we develop a scalable spatio-temporal phylodynamic framework for inferring the transmission tree (ScITree) and other key epidemiological parameters considering the infinite sites assumption in modeling mutation on the sequence level, in contrast to the Lau method in which mutation was modeled explicitly on the nucleotide level. Our approach features full Bayesian implementation utilizing an exact likelihood to mechanistically integrate epidemiological and evolutionary processes. We develop a computationally-efficient data-augmentation Markov Chain Monte Carlo algorithm, inferring key model parameters and unobserved dynamics including the transmission tree. We assess performance of our method using multiple simulated outbreak datasets. Our results indicate that our method can achieve high inference accuracy, comparable to the performance of the Lau method. Additionally, our method scales significantly more efficiently for large outbreaks, with computing time increasing linearly with outbreak size, compared to the exponential scaling of the Lau method. We also demonstrate our method's utility by applying our validated modeling framework to a dataset describing a foot-and-mouth disease outbreak in the UK. Our results show that our method is able to generate estimates of the transmission dynamics consistent with those from the prior method, further demonstrating the robustness of our new approach. In summary, our method provides a computationally-efficient, highly scalable, accurate modeling framework for inferring the joint spatio-temporal dynamics of epidemiological and evolutionary processes, facilitating timely and effective outbreak responses in space and time. Our method is implemented in our R package ScITree.

Bayes Theorem

Industrial epidemiology.

Industrial epidemiology is a specialized discipline concerned with the study of disease occurrence in specific subgroups of the general population, i.e., of relatively healthy members of the work force for whom adequate records are available. Although the ultimate purpose of industrial epidemiology--the prevention of disease--is a logical extension of programs of industrial medicine and occupational and community health, epidemiologic methods must draw on interdisciplinary skills. The existence of centralized records kept in the course of business may make it easier to collect information about industrial populations than to gather data relative to other population subgroups. Many deficiencies in epidemiologic studies of worker groups, however, can be related to poor methods of data-gathering, inadequate record keeping, and an incomplete data base. Sources of information for epidemiologic studies of worker groups may include personnel and medical records, government reports, insurance files, production records, industrial hygiene measurements, surveys and questionnaires, and an organized follow-up program. In some cases, the ready availability of multiple sources of information may lead to differential information bias, and this should be avoided.

Animals

New Delhi metallo-β-lactamase-producing Acinetobacter baumannii in the USA from October, 2013, to March, 2022: a retrospective molecular epidemiological analysis.

BACKGROUND: Most US carbapenem-resistant Acinetobacter baumannii (CRAB) isolates harbour carbapenem-hydrolysing class D β-lactamases. Other carbapenemases, such as New Delhi metallo-β-lactamase (NDM), are uncommon but emerging. We describe the epidemiology of NDM-producing CRAB reported to the US Centers for Disease Control and Prevention (CDC). METHODS: We defined cases as A baumannii with blaNDM confirmed by molecular testing and isolated from any specimen source from a patient in the USA between Oct 1, 2013, and March 31, 2022, and passively reported to the CDC from regional, state, local public health, and CDC laboratories. Epidemiologically linked cases had epidemiological linkage (eg, overlapping health-care facility stay) with one or more other cases. We assessed case relatedness through analysis of whole-genome sequence data using traditional multilocus sequence typing (MLST; Oxford scheme [sequence typeOX]) and core genome MLST. To understand the potential origins of NDM-CRAB in the USA, we compared sequences of cases to US CRAB without NDM and to NDM-CRAB from non-US locations. FINDINGS: We identified 327 NDM-CRAB cases from 264 patients in 21 US states. Among patients with available epidemiological information, 192 (90%) of 214 had epidemiological linkage to at least one additional case and 13 (7%) of 193 were hospitalised outside the USA 12 months or less before index specimen collection. Five regionally distinct sequence type clusters were identified among the 264 case patients; three (sequence type OX218, sequence type OX281, and sequence type OX1697) were closely related to international NDM-CRAB isolates. INTERPRETATION: We identified regionally distinct NDM-CRAB strains, suggesting localised transmission in the USA. Some NDM-CRAB strains in the USA are closely related to strains identified outside the USA, suggesting that spread followed importation. FUNDING: None.

Acinetobacter baumannii