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To inform prevention strategies, we assessed the extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and settings in which transmission occurred in a Georgia public school district.During 1 December 2020-22 January 2021, SARS-CoV-2-infected index cases and their close contacts in schools were identified by school and public health officials. For in-school contacts, we assessed symptoms and offered SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) testing; performed epidemiologic investigations and whole-genome sequencing to identify in-school transmission; and calculated secondary attack rate (SAR) by school setting (eg, sports, elementary school classroom), index case role (ie, staff, student), and index case symptomatic status.We identified 86 index cases and 1119 contacts, 688 (61.5%) of whom received testing. Fifty-nine of 679 (8.7%) contacts tested positive; 15 of 86 (17.4%) index cases resulted in ≥2 positive contacts. Among 55 persons testing positive with available symptom data, 31 (56.4%) were asymptomatic. Highest SARs were in indoor, high-contact sports settings (23.8% [95% confidence interval {CI}, 12.7%-33.3%]), staff meetings/lunches (18.2% [95% CI, 4.5%-31.8%]), and elementary school classrooms (9.5% [95% CI, 6.5%-12.5%]). The SAR was higher for staff (13.1% [95% CI, 9.0%-17.2%]) vs student index cases (5.8% [95% CI, 3.6%-8.0%]) and for symptomatic (10.9% [95% CI, 8.1%-13.9%]) vs asymptomatic index cases (3.0% [95% CI, 1.0%-5.5%]).Indoor sports may pose a risk to the safe operation of in-person learning. Preventing infection in staff members, through measures that include coronavirus disease 2019 vaccination, is critical to reducing in-school transmission. Because many positive contacts were asymptomatic, contact tracing should be paired with testing, regardless of symptoms.

Additional file 1: Supplementary File 1. Data abstraction tool, measles case-control study in Romania, 2016–2018.

Questionnaire of the 2014 study. (DOCX 28 kb)

Rationale: Public health and preventive medicine (PHPM) has been recognized internationally as a physician specialty, but national parallels and differences exist between training contexts. This paper reviews PHPM training and employment in Canada, France, Italy, Japan, the United Kingdom, and the USA. Methods: Information gathered from relevant accreditation bodies and literature searches was used to create descriptive profiles of national training demographics and structure and a narrative outlining trends and challenges facing the specialty. Results: Notable similarities and differences exist between national contexts. Key themes were differences in training strategies and practice scope, specialty stakeholders, certification structure, and funding. Recognition challenges faced the specialty across all six countries. Other challenges included unclear competencies and training strategies and a need for PHPM specialists to highlight their role in combating population health threats. Additional differences existed between comparator countries on the structure of training, funding sources for training programs, availability of training posts, and linkages with other physician specialties. Conclusion: Highlighting these themes is a first step to fostering training collaborations between PHPM specialist physicians to augment transnational action on global public health challenges and also supports PHPM physician educators with innovative solutions from abroad that might address domestic specialty challenges.

Background: National Immunization Technical Advisory Groups (NITAG) are multidisciplinary committees of national experts dedicated to technically guide the formulation of immunization policies at national level. Endorsing the Global Vaccine Action Plan (GVAP), the 194 member states committed to establishing functional NITAG in all Member States by 2020. The aim of this study is to assess NITAG status at global level in 2014 and the progress made since 2010, as well as to identify factors impacting this progress. Methods: 2010 to 2014 data from the WHO/UNICEF Joint Reporting Forms were used to conduct a descriptive analysis which was secondly stratified by WHO region, income level and total population. Results: In 2010, 79 (43%) member states reported a NITAG with a legislative basis and 42 (23%) of them were functional. In 2014, among the 115 (61%) established NITAG, 82 (43%) are functional. In 2014, NITAG are more often established in high income countries part of the OECD (87%) than in low income (32%) and middle income countries non eligible for Gavi support (57%). While progress stagnates in the region of the Americas and in the Pacific region, the European and the African regions are the ones progressing the most quickly with respectively, 13 and 9 newly established NITAG since 2010. Lacks of political will, of qualified human resources and of financial resources represent barriers to NITAG establishment. Conclusion: Despite progress made, the GVAP objective will not be achieved by 2020. By strengthening the understanding of NITAG role, developing dedicated networks and strengthening partners’ technical and financial support, most countries have the potential to establish a functional NITAG, in capacity to support their national authorities in strengthening their national immunization program adapted to their population., Introduction : Les Groupes Techniques Consultatifs pour la Vaccination et les Vaccins (GTCV) sont des comités multidisciplinaires d’experts nationaux apportant une aide technique sur les questions relatives aux vaccins et programmes de vaccination aux autorités sanitaires. En approuvant le Plan d’Action Mondial pour les Vaccins (PAMV), les 194 états membres de l’OMS se sont engagés à généraliser leur mise en place avant 2020. Cette étude vise à évaluer le statut des GTCV en 2014 et son évolution depuis 2010, à l’échelle internationale ainsi qu’à identifier les facteurs déterminant cette progression. Méthode : Les données du formulaire de rapport conjoint de l’OMS et de l’UNICEF des années 2010 à 2014 ont fait l’objet d’une analyse descriptive puis stratifiée selon des critères de répartition géographique, de niveau de développement économique et de taille de population des pays. Résultats : 79 (43%) pays ont rapporté l’existence d’un GTCV reposant sur une assise juridique en 2010 dont 42 (23%) étaient opérationnels. En 2014, ils sont 115 (61%) GTCV et 82 (43%) GTCV opérationnels. En 2014, les GTCV sont plus souvent établis dans les pays à revenu élevé membres de l’OCDE (87%) que dans les pays à revenu faible (32%) et intermédiaire supérieur non éligibles au soutien Gavi (57%). Les régions de l’Europe et de l’Afrique sont celles où le progrès a été le plus marqué (13 et 9 nouveaux GTCV respectivement), alors qu’il stagne dans les régions des Amériques et du Pacifique occidental. Le défaut de compréhension de l’intérêt d’un GTCV, le défaut de ressources humaines qualifiées et financières adéquates apparaissent comme des facteurs limitant leur établissement. Conclusion : Malgré les progrès réalisés, l’objectif du PAMV ne sera pas atteint en 2020. En renforçant la compréhension de l’intérêt de ces comités, en développant des réseaux dédiés et en amplifiant le soutien technique et financier des partenaires, presque tous les pays peuvent établir un GTCV. Avec un GTCV fonctionnel, les autorités nationales peuvent alors renforcer leur programme de vaccination et l’adapter aux caractéristiques de leur population.