88 results on '"Dueger E"'
Search Results
2. PCR36 Vaccinate or Not Vaccinate? Comparative Patient Reported Outcomes on the Severity of Influenza-like-Symptoms in an Australian Community Screening Program.
- Author
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Bartelt-Hofer, J., Dueger, E., Stocks, N., Chilver, M., and Edwards, J.
- Published
- 2024
- Full Text
- View/download PDF
3. Estimating the national burden of hospitalizations for influenza-associated severe acute respiratory infection in the Lao People's Democratic Republic, 2016
- Author
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Khamphaphongphane, B, Chiew, M, Mott, JA, Khamphanoulath, S, Khanthamaly, V, Vilivong, K, Sisouk, T, Bell, L, Dueger, E, Sullivan, S, Iuliano, AD, Tsuyuoka, R, Keosavanh, O, Khamphaphongphane, B, Chiew, M, Mott, JA, Khamphanoulath, S, Khanthamaly, V, Vilivong, K, Sisouk, T, Bell, L, Dueger, E, Sullivan, S, Iuliano, AD, Tsuyuoka, R, and Keosavanh, O
- Abstract
OBJECTIVE: Estimates of the burden of influenza are needed to inform prevention and control activities for seasonal influenza, including to support the development of appropriate vaccination policies. We used sentinel surveillance data on severe acute respiratory infection (SARI) to estimate the burden of influenza-associated hospitalizations in the Lao People's Democratic Republic. METHODS: Using methods developed by the World Health Organization, we combined data from hospital logbook reviews with epidemiological and virological data from influenza surveillance from 1 January to 31 December 2016 in defined catchment areas for two sentinel sites (Champasack and Luang Prabang provincial hospitals) to derive population-based estimates of influenza-associated SARI hospitalization rates. Hospitalization rates by age group were then applied to national age-specific population estimates using 2015 census data. RESULTS: We estimated the overall influenza-associated SARI hospitalization rate to be 48/100 000 population (95% confidence interval [CI]: 44-51) or 3097 admissions (95% CI: 2881-3313). SARI hospitalization rates were estimated to be as low as 40/100 000 population (95% CI: 37-43) and as high as 92/100 000 population (95% CI: 87-98) after accounting for SARI patient underascertainment in hospital logbooks. Influenza-associated SARI hospitalization rates were highest in children aged < 5 years (219; 95% CI: 198-241) and persons aged 3 65 years (106; 95% CI: 91-121). DISCUSSION: Our findings have identified age groups at higher risk for influenza-associated SARI hospitalization, which will support policy decisions for influenza prevention and control strategies, including for vaccination. Further work is needed to estimate the burdens of outpatient influenza and influenza in specific high-risk subpopulations.
- Published
- 2021
4. Comparison of Salmonella enterica serovar distribution and antibiotic resistance patterns in wastewater at municipal water treatment plants in two California cities
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Berge, A. C.B., Dueger, E. L., and Sischo, W. M.
- Published
- 2006
5. Preparedness for influenza vaccination during a pandemic in the World Health Organization Western Pacific Region.
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Bell, L, Peters, L, Heffelfinger, JD, Sullivan, SG, Vilajeliu, A, Shin, J, Bresee, J, Dueger, E, Bell, L, Peters, L, Heffelfinger, JD, Sullivan, SG, Vilajeliu, A, Shin, J, Bresee, J, and Dueger, E
- Abstract
The use of seasonal influenza vaccine remains an important factor of influenza prevention as well as for pandemic preparedness. This was demonstrated in Fiji in 2016, where a strong global influenza network was able to detect and respond to an unusual seasonal influenza event. However, despite the known importance of seasonal influenza vaccination, in the World Health Organization Western Pacific Region, the number of doses distributed per 1000 population has decreased over the past years. There are several efforts ongoing to address this gap in use of seasonal influenza vaccine and continued collaboration is needed to ensure we are best prepared for the next pandemic.
- Published
- 2018
6. Prevalence of enteric infections among hospitalized patients in two referral hospitals in Ghana
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Akuffo, R., primary, Armah, G., additional, Clemens, M., additional, Kronmann, K. C., additional, Jones, A. H., additional, Agbenohevi, P., additional, Sagoe, K., additional, Puplampu, N., additional, Talla Nzussouo, N., additional, Ampofo, W., additional, Koram, K., additional, Duplessis, C., additional, and Dueger, E., additional
- Published
- 2017
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7. Crimean-Congo hemorrhagic fever virus in livestock ticks and animal handler seroprevalence at an abattoir in Ghana
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Akuffo, R., primary, Brandful, J. A. M., additional, Zayed, A., additional, Adjei, A., additional, Watany, N., additional, Fahmy, N. T., additional, Hughes, R., additional, Doman, B., additional, Voegborlo, S. V., additional, Aziati, D., additional, Pratt, D., additional, Awuni, J. A., additional, Adams, N., additional, and Dueger, E., additional
- Published
- 2016
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8. Effect of Rumen Transfaunation on Selected Rumen Parameters, Blood Metabolites and Feed Intake in Dairy Cows with Left Displaced Abomasums
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Rager, K. R., George, L., and Dueger, E. L.
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Rumen ,animal structures ,Animal science ,Transfaunation ,Energy metabolism ,medicine ,food and beverages ,Fermentation ,Anorexia ,medicine.symptom ,Biology - Abstract
Transfaunation for the treatment of rumen disorders and for prolonged anorexia has been utilized for over 30 years and is becoming increasingly popular. There has been no work evaluating its efficacy. The objective of this study was to determine if ruminal transfaunation of cows surgically treated for left displaced abomasums increases the rate at which rumen fermentation, energy metabolism, and feed intake returns to normal levels compared to non-transfaunated cows., American Association of Bovine Practitioners Proceedings of the Annual Conference, 2001
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- 2001
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9. Efficacy of Florfenicol for the Treatment of Naturally Occurring Infectious Bovine Keratoconjunctivitis (Pinkeye)
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Angelos, J. A., Dueger, E. L., George, L. W., Carrier, T., Mihalyi, J., Cosgrove, S., and Johnson, J.
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Double blind ,Florfenicol ,chemistry.chemical_compound ,chemistry ,Infectious bovine keratoconjunctivitis ,business.industry ,Medicine ,business ,medicine.disease ,Virology ,Keratoconjunctivitis - Abstract
A randomized double blind controlled clinical field trial was conducted to determine the efficacy of florfenicol for the treatment of naturally occurring infectious bovine keratoconjunctivitis (IBK; pinkeye)., American Association of Bovine Practitioners Proceedings of the Annual Conference, 1998
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- 1998
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10. Respiratory Syncytial Virus Circulation in Seven Countries With Global Disease Detection Regional Centers
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Haynes, A. K., primary, Manangan, A. P., additional, Iwane, M. K., additional, Sturm-Ramirez, K., additional, Homaira, N., additional, Brooks, W. A., additional, Luby, S., additional, Rahman, M., additional, Klena, J. D., additional, Zhang, Y., additional, Yu, H., additional, Zhan, F., additional, Dueger, E., additional, Mansour, A. M., additional, Azazzy, N., additional, McCracken, J. P., additional, Bryan, J. P., additional, Lopez, M. R., additional, Burton, D. C., additional, Bigogo, G., additional, Breiman, R. F., additional, Feikin, D. R., additional, Njenga, K., additional, Montgomery, J., additional, Cohen, A. L., additional, Moyes, J., additional, Pretorius, M., additional, Cohen, C., additional, Venter, M., additional, Chittaganpitch, M., additional, Thamthitiwat, S., additional, Sawatwong, P., additional, Baggett, H. C., additional, Luber, G., additional, and Gerber, S. I., additional
- Published
- 2013
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11. Epidemiology and etiology of acute flaccid paralysis of infectiou/INS;s origin in Georgia
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Akhvlediani, T., primary, Rowlinson, E., additional, Shakarishvili, R., additional, Tsertsvadze, T., additional, Tatishvili, N., additional, Kvirkvelia, N., additional, Chkhartishvili, D., additional, Kapianidze, M., additional, Akiashvili, N., additional, Beradze, N., additional, Dzigua, L., additional, Malania, L., additional, Farrell, M., additional, Dueger, E., additional, and Sejvar, J., additional
- Published
- 2013
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12. Etiologic agents of central nervous system infections in Georgia
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Akhvlediani, T., primary, Rowlinson, E., additional, Bautista, C., additional, Farrell, M., additional, Kuchuloria, T., additional, Tsertsvadze, T., additional, Shakarishvili, R., additional, Tatishvili, N., additional, Kvirkvelia, N., additional, Dvali, N., additional, Karchava, M., additional, Tsintsadze, T., additional, Kandashvili, L., additional, Chlikadze, R., additional, Imnadze, P., additional, Hepburn, M., additional, Pimentel, G., additional, House, B., additional, Dueger, E., additional, and Rivard, R., additional
- Published
- 2013
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13. P3.276 Neisseria Gonorrhoeae(GC) Resistance Surveillance in Selected Populations of Five Countries
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Tsai, A Y, primary, Dueger, E, additional, Macalino, G E, additional, Montano, S M, additional, Mbuchi, M, additional, Puplampu, N, additional, McClelland, R S, additional, and Sanchez, J L, additional
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- 2013
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14. A Review of Zoonotic Disease Surveillance Supported by the Armed Forces Health Surveillance Center
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Burke, R. L., primary, Kronmann, K. C., additional, Daniels, C. C., additional, Meyers, M., additional, Byarugaba, D. K., additional, Dueger, E., additional, Klein, T. A., additional, Evans, B. P., additional, and Vest, K. G., additional
- Published
- 2011
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15. Salmonella DNA Adenine Methylase Mutants Elicit Protective Immune Responses to Homologous and Heterologous Serovars in Chickens
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Dueger, E. L., primary, House, J. K., additional, Heithoff, D. M., additional, and Mahan, M. J., additional
- Published
- 2001
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16. Effect of Rumen Transfaunation on Selected Rumen Parameters, Blood Metabolites and Feed Intake in Dairy Cows with Left Displaced Abomasums
- Author
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Rager, K. R., primary, George, L., additional, and Dueger, E. L., additional
- Published
- 2001
- Full Text
- View/download PDF
17. Efficacy of Florfenicol for the Treatment of Naturally Occurring Infectious Bovine Keratoconjunctivitis (Pinkeye)
- Author
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Angelos, J. A., primary, Dueger, E. L., additional, George, L. W., additional, Carrier, T., additional, Mihalyi, J., additional, Cosgrove, S., additional, and Johnson, J., additional
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- 1998
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- View/download PDF
18. Enzyme-linked immunoelectrotransfer blot assay for diagnosis of hydatidosis (Echinococcus granulosus ) in sheep
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Moro, P., primary, Verastegui, M., additional, Gilman, R. H., additional, Falcon, N., additional, Bernal, T., additional, Gavidia, C., additional, Gonzalez, A., additional, Malqui, V., additional, Moro, M. H., additional, and Dueger, E., additional
- Published
- 1997
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19. Etiologic agents of central nervous system infections in Georgia
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Rowlinson, E., Bautista, C., Farrell, M., Kuchuloria, T., Tsertsvadze, T., Shakarishvili, R., Tatishvili, N., Kvirkvelia, N., Dvali, N., Karchava, M., Tsintsadze, T., Kandashvili, L., Chlikadze, R., Imnadze, P., Hepburn, M., Pimentel, G., House, B., Dueger, E., and Rivard, R.
- Published
- 2013
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20. Epidemiology and etiology of acute flaccid paralysis of infectiou/INS;s origin in Georgia
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Rowlinson, E., Shakarishvili, R., Tsertsvadze, T., Tatishvili, N., Kvirkvelia, N., Chkhartishvili, D., Kapianidze, M., Akiashvili, N., Beradze, N., Dzigua, L., Malania, L., Farrell, M., Dueger, E., and Sejvar, J.
- Published
- 2013
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21. Reply
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Glaser, C., primary, Angulo, F., additional, Dueger, E., additional, and Ford, R. B., additional
- Published
- 1995
- Full Text
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22. A Review of Zoonotic Disease Surveillance Supported by the Armed Forces Health Surveillance Center.
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Burke, R. L., Kronmann, K. C., Daniels, C. C., Meyers, M., Byarugaba, D. K., Dueger, E., Klein, T. A., Evans, B. P., and Vest, K. G.
- Subjects
ZOONOSES ,ARMED Forces ,ANIMAL diseases ,DISEASE prevalence ,PUBLIC health surveillance ,ANIMAL populations - Abstract
The Armed Forces Health Surveillance Center (AFHSC), Division of Global Emerging Infections Surveillance and Response System conducts disease surveillance through a global network of US Department of Defense research laboratories and partnerships with foreign ministries of agriculture, health and livestock development in over 90 countries worldwide. In 2010, AFHSC supported zoonosis survey efforts were organized into four main categories: (i) development of field assays for animal disease surveillance during deployments and in resource limited environments, (ii) determining zoonotic disease prevalence in high-contact species which may serve as important reservoirs of diseases and sources of transmission, (iii) surveillance in high-risk human populations which are more likely to become exposed and subsequently infected with zoonotic pathogens and (iv) surveillance at the human-animal interface examining zoonotic disease prevalence and transmission within and between human and animal populations. These efforts have aided in the detection, identification and quantification of the burden of zoonotic diseases such as anthrax, brucellosis, Crimean Congo haemorrhagic fever, dengue fever, Hantaan virus, influenza, Lassa fever, leptospirosis, melioidosis, Q fever, Rift Valley fever, sandfly fever Sicilian virus, sandfly fever Naples virus, tuberculosis and West Nile virus, which are of military and public health importance. Future zoonotic surveillance efforts will seek to develop local capacity for zoonotic surveillance focusing on high risk populations at the human-animal interface. [ABSTRACT FROM AUTHOR]
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- 2012
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23. SalmonellaDNA Adenine Methylase Mutants Elicit Protective Immune Responses to Homologous and Heterologous Serovars in Chickens
- Author
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Dueger, E. L., House, J. K., Heithoff, D. M., and Mahan, M. J.
- Abstract
ABSTRACTSalmonellaDNA adenine methylase (Dam) mutants that lack or overproduce Dam are highly attenuated for virulence in mice and confer protection against murine typhoid fever. To determine whether vaccines based on Dam are efficacious in poultry, aSalmonellaDam−vaccine was evaluated in the protection of chicken broilers against oral challenge with homologous and heterologous Salmonellaserovars. A Salmonella entericaserovar Typhimurium Dam−vaccine strain was attenuated for virulence in day-of-hatch chicks more than 100,000-fold. Vaccination of chicks elicited cross-protective immune responses, as evidenced by reduced colonization (10- to 10,000-fold) of the gastrointestinal tract (ileum, cecum, and feces) and visceral organs (bursa and spleen) after challenge with homologous (Typhimurium F98) and heterologous (Enteritidis 4973 and S. entericaO6,14,24: e,h-monophasic) Salmonellaserovars that are implicated in Salmonellainfection of poultry. The protection conferred was observed for the organ or the maximum CFU/tissue/bird as a unit of analysis, suggesting that Dam mutant strains may serve as the basis for the development of efficacious poultry vaccines for the containment of Salmonella.
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- 2001
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24. In vitro antibiotic susceptibility testing of Brucella isolates from Egypt between 1999 and 2007 and evidence of probable rifampin resistance
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Abdel-Maksoud Mohamed, House Brent, Wasfy Momtaz, Abdel-Rahman Bassem, Pimentel Guillermo, Roushdy Gehan, and Dueger Erica
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Brucella ,Brucellosis ,MIC ,Rifampin ,Ceftriaxone ,E-test ,Egypt ,Therapeutics. Pharmacology ,RM1-950 ,Infectious and parasitic diseases ,RC109-216 ,Microbiology ,QR1-502 - Abstract
Abstract Background Brucellosis poses a significant public health problem in Mediterranean countries, including Egypt. Treatment of this disease is often empirical due to limited information on the antibiotic susceptibility profiles of Brucella spp. in this region of the world. The aim of this study was to determine the antibiotic susceptibility profiles of Brucella blood isolates in Egypt, a country endemic for brucellosis. Methods Brucella spp. isolates were identified from the blood cultures of acute febrile illness (AFI) patients presenting to a network of infectious disease hospitals from 1999–2007. Minimum inhibitory concentrations were determined for tetracycline, gentamicin, doxycycline, trimethoprim-sulfamethoxazole, streptomycin, ceftriaxone, ciprofloxacin and rifampin using the E-test. Interpretations were made according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results A total of 355 Brucella spp. isolates were analyzed. All were susceptible to tetracycline, doxycycline, trimethoprim-sulfamethoxazole, streptomycin and ciprofloxacin; probable resistance to rifampin and ceftriaxone was observed among 277 (64%) and 7 (2%) of the isolates, respectively. Percentages of isolates showing probable resistance to rifampin were significantly lower before 2001 than in the following years (7% vs. >81%, p Conclusions Despite the high burden of brucellosis in Egypt and frequent empirical treatment, isolates have remained susceptible to the majority of tested antibiotics. However, this is the first report of high rates of probable resistance to rifampin among Brucella isolates from Egypt. Patients should be closely monitored while following standard treatment regimens. Continued surveillance, drug susceptibility studies and updated CLSI interpretive criteria are needed to monitor and update antibiotic prescribing policies for brucellosis.
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- 2012
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25. Epidemiology and etiology of acute flaccid paralysis of infectiou/INS;s origin in Georgia.
- Author
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Anonymous, Rowlinson, E., Shakarishvili, R., Tsertsvadze, T., Tatishvili, N., Kvirkvelia, N., Chkhartishvili, D., Kapianidze, M., Akiashvili, N., Beradze, N., Dzigua, L., Malania, L., Farrell, M., Dueger, E., and Sejvar, J.
- Published
- 2013
- Full Text
- View/download PDF
26. Etiologic agents of central nervous system infections in Georgia.
- Author
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Anonymous, Rowlinson, E., Bautista, C., Farrell, M., Kuchuloria, T., Tsertsvadze, T., Shakarishvili, R., Tatishvili, N., Kvirkvelia, N., Dvali, N., Karchava, M., Tsintsadze, T., Kandashvili, L., Chlikadze, R., Imnadze, P., Hepburn, M., Pimentel, G., House, B., Dueger, E., and Rivard, R.
- Published
- 2013
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27. Home-Based Testing as an Approach to Estimate Influenza Vaccine Effectiveness in South Africa, 2021-2022-A Pilot Study.
- Author
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Moyes J, Makhazi M, Walaza S, Ntombela P, Moosa F, von Gottberg A, Wolter N, du Plessis M, Hunt G, Cawood C, Dueger E, and Cohen C
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- Humans, South Africa epidemiology, Pilot Projects, Adult, Male, Female, Middle Aged, Young Adult, Adolescent, SARS-CoV-2 immunology, SARS-CoV-2 genetics, SARS-CoV-2 isolation & purification, Vaccine Efficacy, Aged, Vaccination statistics & numerical data, Respiratory Syncytial Virus Infections prevention & control, Respiratory Syncytial Virus Infections diagnosis, Respiratory Syncytial Virus Infections epidemiology, Surveys and Questionnaires, Influenza, Human prevention & control, Influenza, Human diagnosis, Influenza Vaccines immunology, Influenza Vaccines administration & dosage, COVID-19 prevention & control, COVID-19 diagnosis, COVID-19 epidemiology
- Abstract
Background: Surveillance programmes for influenza and other respiratory pathogens are important to generate vaccine effectiveness (VE) estimates and to inform vaccine composition. We aimed to explore the feasibility and acceptability of home-based testing., Methods: In three out of nine provinces in South Africa, we established a self-referral system for individuals aged ≥ 18 years with respiratory symptoms of ≤ 10 days duration. Following consent, swab collection material was delivered to participants who also completed a questionnaire including self-reported vaccination status. Swabs were tested by PCR for influenza, respiratory syncytial virus (RSV) and SARS-CoV-2. A test-negative methodology was used to estimate influenza VE., Results: Of 1456 samples collected between 19 November 2021 and 3 September 2022, 73 (5%) tested positive for influenza, 38 (3%) tested positive for RSV and 394 (27%) for SARS-CoV-2. We subtyped 55% (40/73) of the influenza positive specimens; 16/40 (40%) were influenza A(H1N1)pdm09; 10/40 (25%)A(H3N2)) and all 14/40(35%) influenza B were B/Victoria. Only 20% (279/1451) of participants reported influenza-like illness case definition symptoms of fever and cough. Influenza vaccine coverage was 11% (157/1454). The overall influenza VE was 26% (95% confidence interval: -73%, 69%). Of the completed acceptability questionnaires, 123/127 (97%) participants would make use of the service again; 90% (1306) were recruited via the COVID-19 testing centre (call in, social media, webpage), and 7% (99/1306) through CoughWatchSA., Conclusions: Home-based swabbing was feasible and acceptable. We were able to calculate an influenza VE, although a larger sample size and verification of vaccine status may improve the VE estimates in the future., (© 2024 The Author(s). Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.)
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- 2024
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28. The impact of the SARS-CoV-2 pandemic on global influenza surveillance: Insights from 18 National Influenza Centers based on a survey conducted between November 2021 and March 2022.
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Staadegaard L, Del Riccio M, Wiegersma S, El Guerche-Séblain C, Dueger E, Akçay M, Casalegno JS, Dückers M, Caini S, and Paget J
- Subjects
- Humans, SARS-CoV-2, Pandemics, Surveys and Questionnaires, Influenza, Human epidemiology, COVID-19 epidemiology
- Abstract
Background: National Influenza Centers (NICs) have played a crucial role in the surveillance of SARS-CoV-2. The FluCov project, covering 22 countries, was initiated to monitor the impact of the SARS-CoV-2 pandemic on influenza activity., Methods: This project consisted of an epidemiological bulletin and NIC survey. The survey, designed to assess the impact of the pandemic on the influenza surveillance system, was shared with 36 NICs located across 22 countries. NICs were invited to reply between November 2021 and March 2022., Results: We received 18 responses from NICs in 14 countries. Most NICs (76%) indicated that the number of samples tested for influenza decreased. Yet, many NICs (60%) were able to increase their laboratory testing capacity and the "robustness" (e.g., number of sentinel sites) (59%) of their surveillance systems. In addition, sample sources (e.g., hospital or outpatient setting) shifted. All NICs reported a higher burden of work following the onset of the pandemic, with some NICs hiring additional staff or partial outsourcing to other institutes or departments. Many NICs anticipate the future integration of SARS-CoV-2 surveillance into the existing respiratory surveillance system., Discussion: The survey shows the profound impact of SARS-CoV-2 on national influenza surveillance in the first 27 months of the pandemic. Surveillance activities were temporarily disrupted, whilst priority was given to SARS-CoV-2. However, most NICs have shown rapid adaptive capacity underlining the importance of strong national influenza surveillance systems. These developments have the potential to benefit global respiratory surveillance in the years to come; however, questions about sustainability remain., Competing Interests: JP, MDR, SC, and LS declare that Nivel has previously received RSV research grants from Sanofi Pasteur/AstraZeneca, the Foundation for Influenza Epidemiology, and the European Union's Innovative Medicines Initiative. CEG, ED, and MA are Sanofi employees and may hold shares and/or stock options in the company. The other authors have no conflicts of interest to declare., (© 2023 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)
- Published
- 2023
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29. Estimating the national burden of hospitalizations for influenza-associated severe acute respiratory infection in the Lao People's Democratic Republic, 2016.
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Khamphaphongphane B, Chiew M, Mott JA, Khamphanoulath S, Khanthamaly V, Vilivong K, Sisouk T, Bell L, Dueger E, Sullivan S, Iuliano AD, Tsuyuoka R, and Keosavanh O
- Subjects
- Child, Hospitalization, Humans, Infant, Risk Factors, Sentinel Surveillance, Influenza, Human epidemiology, Respiratory Tract Infections epidemiology
- Abstract
Objective: Estimates of the burden of influenza are needed to inform prevention and control activities for seasonal influenza, including to support the development of appropriate vaccination policies. We used sentinel surveillance data on severe acute respiratory infection (SARI) to estimate the burden of influenza-associated hospitalizations in the Lao People's Democratic Republic., Methods: Using methods developed by the World Health Organization, we combined data from hospital logbook reviews with epidemiological and virological data from influenza surveillance from 1 January to 31 December 2016 in defined catchment areas for two sentinel sites (Champasack and Luang Prabang provincial hospitals) to derive population-based estimates of influenza-associated SARI hospitalization rates. Hospitalization rates by age group were then applied to national age-specific population estimates using 2015 census data., Results: We estimated the overall influenza-associated SARI hospitalization rate to be 48/100 000 population (95% confidence interval [CI]: 44-51) or 3097 admissions (95% CI: 2881-3313). SARI hospitalization rates were estimated to be as low as 40/100 000 population (95% CI: 37-43) and as high as 92/100 000 population (95% CI: 87-98) after accounting for SARI patient underascertainment in hospital logbooks. Influenza-associated SARI hospitalization rates were highest in children aged < 5 years (219; 95% CI: 198-241) and persons aged
3 65 years (106; 95% CI: 91-121)., Discussion: Our findings have identified age groups at higher risk for influenza-associated SARI hospitalization, which will support policy decisions for influenza prevention and control strategies, including for vaccination. Further work is needed to estimate the burdens of outpatient influenza and influenza in specific high-risk subpopulations., ((c) 2021 The authors; licensee World Health Organization.)- Published
- 2021
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30. Comparison of common acute respiratory infection case definitions for identification of hospitalized influenza cases at a population-based surveillance site in Egypt.
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Rowlinson E, Peters L, Mansour A, Mansour H, Azazzy N, Said M, Samy S, Abbas E, Abu Elsood H, Fahim M, Eid A, Reaves E, Van Beneden C, Hamid S, Olsen S, Fitzner J, and Dueger E
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Egypt epidemiology, Female, Hospitalization, Humans, Male, Middle Aged, Young Adult, Influenza, Human diagnosis, Influenza, Human epidemiology, Pandemics, Sentinel Surveillance
- Abstract
Background: Multiple case definitions are used to identify hospitalized patients with community-acquired acute respiratory infections (ARI). We evaluated several commonly used hospitalized ARI case definitions to identify influenza cases., Methods: The study included all patients from a population-based surveillance site in Damanhour, Egypt hospitalized for a broad set of criteria consistent with community acquired ARIs. Naso- and oropharyngeal (NP/OP) swabs were tested for influenza using RT-PCR. Sensitivity, specificity and PPV for influenza identification was compared between the 2014 WHO Severe Acute Respiratory Infection (SARI) definition (fever ≥38°C and cough with onset within 10 days), the 2011 WHO SARI definition (fever ≥38°C and cough with onset within 7 days), the 2006 PAHO SARI definition, the International Emerging Infections Program (IEIP) pneumonia case definition, and the International Management of Childhood Illness (IMCI) case definitions for moderate and severe pneumonia., Results: From June 2009-December 2012, 5768 NP/OP swabs were obtained from 6113 hospitalized ARI patients; 799 (13.9%) were influenza positive. The 2014 WHO SARI case definition captured the greatest number of ARI patients, influenza positive patients and ARI deaths compared to the other case definitions examined. Sensitivity for influenza detection was highest for the 2014 WHO SARI definition with 88.6%, compared to the 2011 WHO SARI (78.2%) the 2006 PAHO SARI (15.8%) the IEIP pneumonia (61.0%) and the IMCI moderate and severe pneumonia (33.8% and 38.9%) case definitions (IMCI applies to <5 only)., Conclusions: Our results support use of the 2014 WHO SARI definition for identifying influenza positive hospitalized SARI cases as it captures the highest proportion of ARI deaths and influenza positive cases. Routine use of this case definition for hospital-based surveillance will provide a solid, globally comparable foundation on which to build needed response efforts for novel pandemic viruses., Competing Interests: The authors have declared that no competing interests exist.
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- 2021
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31. The Pandemic Influenza Preparedness (PIP) Framework: strengthening laboratory and surveillance capacities in the Western Pacific Region, 2014-2017.
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Chugh H, Samaan G, Resnikoff T, Bergeri I, Barragan J, and Dueger E
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- Asia, Western epidemiology, Humans, Influenza, Human epidemiology, Pacific Islands epidemiology, World Health Organization, Capacity Building organization & administration, Influenza, Human prevention & control, Laboratories organization & administration, Pandemics prevention & control, Public Health Surveillance
- Published
- 2020
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32. Marking the 1918 influenza pandemic centennial: addressing regional influenza threats through the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies.
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Dueger E, Peters L, and Ailan L
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- Asia epidemiology, Civil Defense, Global Health, History, 20th Century, Humans, Influenza Pandemic, 1918-1919 mortality, Pandemics history, Pandemics statistics & numerical data, Public Health, World Health Organization, Influenza Pandemic, 1918-1919 history, International Cooperation, Pandemics prevention & control
- Published
- 2019
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33. Preparedness for influenza vaccination during a pandemic in the World Health Organization Western Pacific Region.
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Bell L, Peters L, Heffelfinger JD, Sullivan SG, Vilajeliu A, Shin J, Bresee J, and Dueger E
- Subjects
- Asia, Australia, Global Health, Humans, Immunization Programs legislation & jurisprudence, Pandemics economics, Vaccination Coverage standards, Immunization Programs standards, Influenza Vaccines supply & distribution, Pandemics prevention & control
- Published
- 2018
- Full Text
- View/download PDF
34. Strategies for combating avian influenza in the Asia-Pacific.
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Peters L, Greene C, Azziz-Baumgartner E, Zhou S, Lupisan S, Dayan W, Hammond A, Claes F, Mumford E, and Dueger E
- Subjects
- Animals, Asia, Disaster Planning, Humans, Influenza, Human prevention & control, International Cooperation, Disease Outbreaks prevention & control, Influenza A Virus, H7N9 Subtype, Influenza in Birds prevention & control, Poultry
- Published
- 2018
- Full Text
- View/download PDF
35. PanStop: a decade of rapid containment exercises for pandemic preparedness in the WHO Western Pacific Region.
- Author
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Moturi E, Horton K, Bell L, Breakwell L, and Dueger E
- Subjects
- Asia, Australasia, Humans, Influenza, Human prevention & control, Disaster Planning methods, Global Health, International Cooperation, Pandemics prevention & control
- Published
- 2018
- Full Text
- View/download PDF
36. From H5N1 to HxNy: An epidemiologic overview of human infections with avian influenza in the Western Pacific Region, 2003-2017.
- Author
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Hamid S, Arima Y, Dueger E, Konings F, Bell L, Lee CK, Luo D, Otsu S, Olowokure B, and Li A
- Subjects
- Adolescent, Adult, Age Distribution, Aged, Animals, Asia epidemiology, Child, Child, Preschool, Epidemics statistics & numerical data, Female, Humans, Infant, Infant, Newborn, Influenza A virus isolation & purification, Male, Middle Aged, Poultry, Sex Distribution, Young Adult, Influenza in Birds epidemiology, Influenza, Human epidemiology
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- 2018
- Full Text
- View/download PDF
37. Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection.
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Fitzner J, Qasmieh S, Mounts AW, Alexander B, Besselaar T, Briand S, Brown C, Clark S, Dueger E, Gross D, Hauge S, Hirve S, Jorgensen P, Katz MA, Mafi A, Malik M, McCarron M, Meerhoff T, Mori Y, Mott J, Olivera MTDC, Ortiz JR, Palekar R, Rebelo-de-Andrade H, Soetens L, Yahaya AA, Zhang W, and Vandemaele K
- Subjects
- Child, Child, Preschool, Cough, Hospitalization, Humans, Infant, Influenza A Virus, H1N1 Subtype, Respiratory Tract Infections virology, Influenza, Human diagnosis, Respiratory Tract Infections diagnosis
- Abstract
The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of the condition involved and improvements in diagnostic testing. Optimal case definitions also need to have a balance of sensitivity and specificity that reflects their intended use. After the 2009-2010 H1N1 influenza pandemic, the World Health Organization (WHO) initiated a technical consultation on global influenza surveillance. This prompted improvements in the sensitivity and specificity of the case definition for influenza - i.e. a respiratory disease that lacks uniquely defining symptomology. The revision process not only modified the definition of influenza-like illness, to include a simplified list of the criteria shown to be most predictive of influenza infection, but also clarified the language used for the definition, to enhance interpretability. To capture severe cases of influenza that required hospitalization, a new case definition was also developed for severe acute respiratory infection in all age groups. The new definitions have been found to capture more cases without compromising specificity. Despite the challenge still posed in the clinical separation of influenza from other respiratory infections, the global use of the new WHO case definitions should help determine global trends in the characteristics and transmission of influenza viruses and the associated disease burden.
- Published
- 2018
- Full Text
- View/download PDF
38. Using a hospital admission survey to estimate the burden of influenza-associated severe acute respiratory infection in one province of Cambodia-methods used and lessons learned.
- Author
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Stewart RJ, Ly S, Sar B, Ieng V, Heng S, Sim K, Machingaidze C, Roguski K, Dueger E, Moen A, Tsuyuoka R, and Iuliano AD
- Subjects
- Adolescent, Adult, Cambodia epidemiology, Child, Child, Preschool, Humans, Infant, Infant, Newborn, Middle Aged, Sentinel Surveillance, Young Adult, Hospitalization statistics & numerical data, Influenza, Human complications, Influenza, Human epidemiology
- Abstract
Background: Understanding the burden of influenza-associated severe acute respiratory infection (SARI) is important for setting national influenza surveillance and vaccine priorities. Estimating influenza-associated SARI rates requires hospital-based surveillance data and a population-based denominator, which can be challenging to determine., Objectives: We present an application of the World Health Organization's recently developed manual (WHO Manual) including hospital admission survey (HAS) methods for estimating the burden of influenza-associated SARI, with lessons learned to help others calculate similar estimates., Methods: Using an existing SARI surveillance platform in Cambodia, we counted influenza-associated SARI cases during 2015 at one sentinel surveillance site in Svay Rieng Province. We applied WHO Manual-derived methods to count respiratory hospitalizations at all hospitals within the catchment area, where 95% of the sentinel site case-patients resided. We used HAS methods to adjust the district-level population denominator for the sentinel site and calculated the incidence rate of influenza-associated SARI by dividing the number of influenza-positive SARI infections by the adjusted population denominator and multiplying by 100 000. We extrapolated the rate to the provincial population to derive a case count for 2015. We evaluated data sources, detailed steps of implementation, and identified lessons learned., Results: We estimated an adjusted influenza-associated 2015 SARI rate of 13.5/100 000 persons for the catchment area of Svay Rieng Hospital and 77 influenza-associated SARI cases in Svay Rieng Province after extrapolation., Conclusions: Methods detailed in the WHO Manual and operationalized successfully in Cambodia can be used in other settings to estimate rates of influenza-associated SARI., (© 2018 The Authors. Influenza and Other Respiratory Viruses. Published by John Wiley & Sons Ltd.)
- Published
- 2018
- Full Text
- View/download PDF
39. Incidence and etiology of hospitalized acute respiratory infections in the Egyptian Delta.
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Rowlinson E, Dueger E, Mansour A, Azzazy N, Mansour H, Peters L, Rosenstock S, Hamid S, Said MM, Geneidy M, Abd Allah M, and Kandeel A
- Subjects
- Acute Disease epidemiology, Adolescent, Adult, Aged, Child, Child, Preschool, Egypt epidemiology, Female, Humans, Incidence, Infant, Infant, Newborn, Influenza, Human epidemiology, Influenza, Human virology, Male, Metapneumovirus pathogenicity, Middle Aged, Oropharynx virology, Orthomyxoviridae pathogenicity, Respiratory Syncytial Virus Infections epidemiology, Respiratory Syncytial Virus Infections virology, Respiratory Syncytial Virus, Human pathogenicity, Respiratory Tract Infections virology, Seasons, Young Adult, Hospitalization statistics & numerical data, Population Surveillance, Respiratory Tract Infections epidemiology, Respiratory Tract Infections etiology
- Abstract
Introduction: Acute Respiratory Infections (ARI) are responsible for nearly two million childhood deaths worldwide. A limited number of studies have been published on the epidemiology of viral respiratory pathogens in Egypt., Methods: A total of 6113 hospitalized patients >1 month of age with suspected ARI were enrolled between June 23, 2009 and December 31, 2013. Naso- and oropharyngeal specimens were collected and tested for influenza A and B, respiratory syncytial virus, human metapneumovirus, adenovirus, and parainfluenza viruses 1-3. Blood specimens from children 1-11 months were cultured and bacterial growth was identified by polymerase chain reaction. Results from a healthcare utilization survey on the proportion of persons seeking care for ARI was used to calculate adjusted ARI incidence rates in the surveillance population., Results: The proportion of patients with a viral pathogen detected decreased with age from 67% in patients age 1-11 months to 19% in patients ≥65 years of age. Influenza was the dominant viral pathogen detected in patients ≥1 year of age (13.9%). The highest incidence rates for hospitalized ARI were observed in children 1-11 months (1757.9-5537.5/100 000 population) and RSV was the most commonly detected pathogen in this age group., Conclusion: In this study population, influenza is the largest viral contributor to hospitalized ARIs and children 1-11 months of age experience a high rate of ARI hospitalizations. This study highlights a need for surveillance of additional viral pathogens and alternative detection methods for bacterial pathogens, which may reveal a substantial proportion of as yet unidentified etiologies in adults., (© 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.)
- Published
- 2017
- Full Text
- View/download PDF
40. Incidence of medically attended influenza among residents of Shai-Osudoku and Ningo-Prampram Districts, Ghana, May 2013 - April 2015.
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Ntiri MP, Duque J, McMorrow ML, Frimpong JA, Parbie P, Badji E, Nzussouo NT, Benson EM, Adjabeng M, Dueger E, Widdowson MA, Dawood FS, Koram K, and Ampofo W
- Subjects
- Adolescent, Adult, Child, Female, Ghana epidemiology, Health Surveys, Humans, Incidence, Infant, Influenza Vaccines, Influenza, Human prevention & control, Male, Respiratory Tract Infections prevention & control, Retrospective Studies, Sentinel Surveillance, Vaccination trends, World Health Organization, Influenza, Human epidemiology, Internship and Residency, Respiratory Tract Infections epidemiology
- Abstract
Background: Influenza vaccination is recommended by the World Health Organization for high risk groups, yet few data exist on influenza disease burden in West Africa., Methods: We estimated medically attended influenza-associated illness rates among residents of Shai-Osudoku and Ningo Pram-Pram Districts (SONPD), Ghana. From May 2013 to April 2015, we conducted prospective surveillance for severe acute respiratory illness (SARI) and influenza-like illness (ILI) in 17 health facilities. In 2015, we conducted a retrospective assessment at an additional 18 health facilities to capture all SONPD SARI and ILI patients during the study period. We applied positivity rates to those not tested to estimate total influenza cases., Results: Of 612 SARI patients tested, 58 (9%) were positive for influenza. The estimated incidence of influenza-associated SARI was 30 per 100,000 persons (95% CI: 13-84). Children aged 0 to 4 years had the highest influenza-associated SARI incidence (135 per 100,000 persons, 95% CI: 120-152) and adults aged 25 to 44 years had the lowest (3 per 100,000 persons, 95% CI: 1-7) (p < 0.01). Of 2,322 ILI patients tested, 407 (18%) were positive for influenza. The estimated incidence of influenza-associated ILI was 844 per 100,000 persons (95% CI: 501-1,099). The highest incidence of influenza-associated ILI was also among children aged 0 to 4 years (3,448 per 100,000 persons, 95% CI: 3,727 - 3,898). The predominant circulating subtype during May to December 2013 and January to April 2015 was influenza A(H3N2) virus, and during 2014 influenza B virus was the predominant circulating type., Conclusions: Influenza accounted for 9% and 18% of medically attended SARI and ILI, respectively. Rates were substantive among young children and suggest the potential value of exploring the benefits of influenza vaccination in Ghana, particularly in this age group.
- Published
- 2016
- Full Text
- View/download PDF
41. Qualitative interviews with non-national tuberculosis patients in Cairo, Egypt: understanding the financial and social cost of treatment adherence.
- Author
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Lohiniva AL, Mokhtar A, Azer A, Elmoghazy E, Kamal E, Benkirane M, and Dueger E
- Subjects
- Egypt, Humans, Qualitative Research, Social Support, Social Stigma, Treatment Adherence and Compliance, Tuberculosis drug therapy
- Abstract
Limited data are available about the challenges of non-national TB patients undergoing long-term treatment courses in an urban setting. This study aimed to understand the financial and social cost of adherence of non-national TB patients in Cairo, Egypt as a means to inform the development of context-specific interventions to support treatment adherence. In 2011, 22 in-depth interviews were conducted with TB patients from Sudan, Ethiopia, Eritrea, Somalia and Djibouti to obtain qualitative data. Analysis was based on thematic analysis that aimed to identify recurrent themes and codes from the narratives. The study identified a number of factors that influence TB treatment adherence. Uncertain financial status due to limited or no employment was frequently discussed in interviews, which resulted in fear of not being able to support family, loss of pride, dependence on family and friends, fear of losing housing, food insecurity and limited food options. Respondents also feared infecting other household members and longed for opportunities to discuss their illness and treatment experiences with other individuals but their social networks were often limited. TB-related stigma was driven by shame and blame of infection. Respondents also believed stigma was based on their foreign origin. Stigma manifested in distancing and exclusion in various ways, resulting in isolation, psychological distress and reluctance to disclose TB status to others. Poverty-related factors and social context with a special focus on stigma should be considered when developing strategies for supporting long-term treatment courses for non-national patients in Cairo and other similar urban settings., (© 2015 John Wiley & Sons Ltd.)
- Published
- 2016
- Full Text
- View/download PDF
42. Evidence of Rickettsia and Orientia Infections Among Abattoir Workers in Djibouti.
- Author
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Horton KC, Jiang J, Maina A, Dueger E, Zayed A, Ahmed AA, Pimentel G, and Richards AL
- Subjects
- Abattoirs, Adult, Animals, Cattle, Djibouti epidemiology, Female, Humans, Male, Middle Aged, Orientia tsutsugamushi classification, Orientia tsutsugamushi genetics, Orientia tsutsugamushi immunology, Polymerase Chain Reaction, Rickettsia classification, Rickettsia genetics, Rickettsia immunology, Rickettsia Infections epidemiology, Rickettsia Infections immunology, Rickettsia Infections microbiology, Scrub Typhus epidemiology, Scrub Typhus immunology, Scrub Typhus microbiology, Ticks microbiology, Workforce, Antibodies, Bacterial blood, DNA, Bacterial genetics, Orientia tsutsugamushi isolation & purification, Rickettsia isolation & purification, Rickettsia Infections diagnosis, Scrub Typhus diagnosis
- Abstract
Of 49 workers at a Djiboutian abattoir, eight (16%, 95% confidence interval [CI]: 9-29) were seropositive against spotted fever group rickettsiae (SFGR), two (4%, 95% CI: 1-14) against typhus group rickettsiae, and three (6%, 95% CI: 2-17) against orientiae. One worker (9%, 95% CI: 2-38) seroconverted against orientiae during the study period. This is the first evidence of orientiae exposure in the Horn of Africa. SFGR were also identified by polymerase chain reaction in 32 of 189 (11%, 95% CI: 8-15) tick pools from 26 of 72 (36%) cattle. Twenty-five (8%, 95% CI: 6-12) tick pools were positive for Rickettsia africae, the causative agent of African tick-bite fever. Health-care providers in Djibouti should be aware of the possibility of rickettsiae infections among patients, although further research is needed to determine the impact of these infections in the country., (© The American Society of Tropical Medicine and Hygiene.)
- Published
- 2016
- Full Text
- View/download PDF
43. Influenza hospitalization epidemiology from a severe acute respiratory infection surveillance system in Jordan, January 2008-February 2014.
- Author
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Al-Abdallat M, Dawson P, Haddadin AJ, El-Shoubary W, Dueger E, Al-Sanouri T, Said MM, and Talaat M
- Subjects
- Acute Disease, Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Infant, Influenza, Human mortality, Influenza, Human virology, Jordan epidemiology, Male, Middle Aged, Nasopharynx virology, Real-Time Polymerase Chain Reaction, Respiratory Tract Infections virology, Seasons, Young Adult, Hospitalization statistics & numerical data, Influenza, Human epidemiology, Respiratory Tract Infections epidemiology, Sentinel Surveillance
- Abstract
Background: Acute respiratory infections (ARIs) are a major cause of morbidity and mortality worldwide. Influenza typically contributes substantially to the burden of ARI, but only limited data are available on influenza activity and seasonality in Jordan., Methods: Syndromic case definitions were used to identify individuals with severe acute respiratory infections (SARI) admitted to four sentinel hospitals in Jordan. Demographic and clinical data were collected. Nasopharyngeal and oropharyngeal swabs were tested for influenza using real-time reverse transcription polymerase chain reaction and typed as influenza A or B, with influenza A further subtyped., Results: From January 2008-February 2014, 2891 SARI cases were tested for influenza, and 257 (9%) were positive. While 73% of all SARI cases were under 5 years of age, only 57% of influenza-positive cases were under 5 years of age. Eight (3%) influenza-positive cases died. An annual seasonal pattern of influenza activity was observed. The proportion of influenza-positive cases peaked during November-January (14-42%) in the non-pandemic years., Conclusions: Influenza is associated with substantial morbidity and mortality in Jordan. The seasonal pattern of influenza aligns with known Northern Hemisphere seasonality. Further characterization of the clinical and financial burden of influenza in Jordan will be critical in supporting decisions regarding disease control activities., (© 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.)
- Published
- 2016
- Full Text
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44. Outbreak of henipavirus infection, Philippines, 2014.
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Ching PK, de los Reyes VC, Sucaldito MN, Tayag E, Columna-Vingno AB, Malbas FF Jr, Bolo GC Jr, Sejvar JJ, Eagles D, Playford G, Dueger E, Kaku Y, Morikawa S, Kuroda M, Marsh GA, McCullough S, and Foxwell AR
- Subjects
- Adolescent, Adult, Animal Diseases epidemiology, Animal Diseases virology, Animals, Base Sequence, Child, Child, Preschool, Female, Henipavirus genetics, Henipavirus Infections diagnosis, Henipavirus Infections history, History, 21st Century, Humans, Male, Middle Aged, Molecular Sequence Data, Molecular Typing, Philippines epidemiology, Phylogeny, Population Surveillance, Sequence Alignment, Serotyping, Viral Proteins chemistry, Viral Proteins genetics, Young Adult, Disease Outbreaks, Henipavirus classification, Henipavirus Infections epidemiology
- Abstract
During 2014, henipavirus infection caused severe illness among humans and horses in southern Philippines; fatality rates among humans were high. Horse-to-human and human-to-human transmission occurred. The most likely source of horse infection was fruit bats. Ongoing surveillance is needed for rapid diagnosis, risk factor investigation, control measure implementation, and further virus characterization.
- Published
- 2015
- Full Text
- View/download PDF
45. Etiologic agents of central nervous system infections among febrile hospitalized patients in the country of Georgia.
- Author
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Akhvlediani T, Bautista CT, Shakarishvili R, Tsertsvadze T, Imnadze P, Tatishvili N, Davitashvili T, Samkharadze T, Chlikadze R, Dvali N, Dzigua L, Karchava M, Gatserelia L, Macharashvili N, Kvirkvelia N, Habashy EE, Farrell M, Rowlinson E, Sejvar J, Hepburn M, Pimentel G, Dueger E, House B, and Rivard R
- Subjects
- Adolescent, Adult, Cerebrospinal Fluid microbiology, Cerebrospinal Fluid virology, Child, Child, Preschool, Cohort Studies, DNA, Bacterial analysis, DNA, Viral analysis, Encephalitis microbiology, Encephalitis virology, Enterovirus genetics, Enterovirus isolation & purification, Female, Georgia (Republic), Haemophilus influenzae genetics, Haemophilus influenzae isolation & purification, Herpesvirus 1, Human genetics, Herpesvirus 1, Human isolation & purification, Herpesvirus 2, Human genetics, Herpesvirus 2, Human isolation & purification, Herpesvirus 3, Human genetics, Herpesvirus 3, Human isolation & purification, Hospitalization, Humans, Male, Meningitis microbiology, Meningitis virology, Multiplex Polymerase Chain Reaction, Neisseria meningitidis genetics, Neisseria meningitidis isolation & purification, Patients, Streptococcus pneumoniae genetics, Streptococcus pneumoniae isolation & purification, Young Adult, Encephalitis diagnosis, Meningitis diagnosis
- Abstract
Objectives: There is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS) infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis., Methods: Children and adults patients clinically diagnosed with meningitis or encephalitis were enrolled at four reference health centers. Cerebrospinal fluid (CSF) was collected for bacterial culture, and in-house and multiplex RT-PCR testing was conducted for herpes simplex virus (HSV) types 1 and 2, mumps virus, enterovirus, varicella zoster virus (VZV), Streptococcus pneumoniae, HiB and Neisseria meningitidis., Results: Out of 140 enrolled patients, the mean age was 23.9 years, and 58% were children. Bacterial or viral etiologies were determined in 51% of patients. Five Streptococcus pneumoniae cultures were isolated from CSF. Based on in-house PCR analysis, 25 patients were positive for S. pneumoniae, 6 for N. meningitidis, and 1 for H. influenzae. Viral multiplex PCR identified infections with enterovirus (n = 26), VZV (n = 4), and HSV-1 (n = 2). No patient was positive for mumps or HSV-2., Conclusions: Study findings indicate that S. pneumoniae and enteroviruses are the main etiologies in this patient cohort. The utility of molecular diagnostics for pathogen identification combined with the knowledge provided by the investigation may improve health outcomes of CNS infection cases in Georgia.
- Published
- 2014
- Full Text
- View/download PDF
46. A qualitative study of vaccine acceptability and decision making among pregnant women in Morocco during the A (H1N1) pdm09 pandemic.
- Author
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Lohiniva AL, Barakat A, Dueger E, Restrepo S, and El Aouad R
- Subjects
- Adult, Female, Humans, Morocco, Pregnancy, Pregnancy Complications, Infectious epidemiology, Pregnancy Complications, Infectious prevention & control, Qualitative Research, Surveys and Questionnaires, Influenza A Virus, H1N1 Subtype immunology, Influenza Vaccines immunology, Influenza, Human epidemiology, Influenza, Human prevention & control, Patient Acceptance of Health Care, Vaccination
- Abstract
Vaccination uptake of pregnant women in Morocco during the A (H1N1) pdm09 pandemic was lower than expected. A qualitative study using open-ended questions was developed to explore the main determinants of acceptance and non-acceptance of the monovalent A (H1N1) pdm09 vaccine among pregnant women in Morocco and to identify information sources that influenced their decision-making process. The study sample included 123 vaccinated and unvaccinated pregnant women who were in their second or third trimester between December 2009 and March 2010. They took part in 14 focus group discussions and eight in-depth interviews in the districts of Casablanca and Kenitra. Thematic qualitative analysis identified reasons for vaccine non-acceptance: (1) fear of the monovalent A (H1N1) pdm09 vaccine, (2) belief in an A (H1N1) pdm09 pandemic conspiracy, (3) belief in the inapplicability of the monovalent A (H1N1) pdm09 vaccine to Moroccans, (4) lack of knowledge of the monovalent A (H1N1) pdm09 vaccine, and (5) challenges of vaccination services/logistics. Reasons for vaccine acceptance included: (1) perceived benefits and (2) modeling. Decision-making was strongly influenced by family, community, mass media, religious leaders and health providers suggesting that broad communication efforts should also be used to advocate for vaccination. Meaningful communication for future vaccine campaigns must consider these context-specific findings. As cultural and religious values are shared across many Arab countries, these findings may also provide valuable insights for seasonal influenza vaccine planning in the Middle East and North Africa region at large.
- Published
- 2014
- Full Text
- View/download PDF
47. Serosurvey for zoonotic viral and bacterial pathogens among slaughtered livestock in Egypt.
- Author
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Horton KC, Wasfy M, Samaha H, Abdel-Rahman B, Safwat S, Abdel Fadeel M, Mohareb E, and Dueger E
- Subjects
- Animals, Antibodies, Bacterial blood, Antibodies, Viral blood, Brucellosis epidemiology, Brucellosis veterinary, Buffaloes, Camelus, Cattle, Egypt epidemiology, Female, Hemorrhagic Fever, Crimean epidemiology, Humans, Leptospirosis epidemiology, Leptospirosis veterinary, Male, Q Fever epidemiology, Q Fever veterinary, Rift Valley Fever epidemiology, Seroepidemiologic Studies, Sheep, Zoonoses microbiology, Zoonoses transmission, Zoonoses virology, Brucella immunology, Coxiella burnetii immunology, Hemorrhagic Fever Virus, Crimean-Congo immunology, Leptospira immunology, Livestock microbiology, Rift Valley fever virus immunology
- Abstract
Introduction: Zoonotic diseases are an important cause of human morbidity and mortality. Animal populations at locations with high risk of transmission of zoonotic pathogens offer an opportunity to study viral and bacterial pathogens of veterinary and public health concern., Methods: Blood samples were collected from domestic and imported livestock slaughtered at the Muneeb abattoir in central Egypt in 2009. Samples were collected from cattle (n=161), buffalo (n=153), sheep (n=174), and camels (n=10). Samples were tested for antibodies against Leptospira spp. by a microscopy agglutination test, Coxiella burnetii by enzyme immunoassay, Brucella spp. by standard tube agglutination, and Rift Valley Fever virus (RVFV), Crimean-Congo hemorrhagic fever virus (CCHFV), sandfly fever Sicilian virus (SFSV), and sandfly fever Naples virus (SFNV) by enzyme-linked immunosorbent assay., Results: Antibodies against Leptospira spp. were identified in 64 (40%) cattle, 45 (29%) buffalo, 71 (41%) sheep, and five (50%) camels; antibodies against C. burnetii in six (4%) buffalo, 14 (8%) sheep, and seven (70%) camels; and antibodies against Brucella spp. in 12 (8%) cattle, one (1%) buffalo, seven (4%) sheep, and one (10%) camel. Antibodies against RVFV were detected in two (1%) cattle and five (3%) buffalo, and antibodies against CCHFV in one (1%) cow. No antibodies against SFSV or SFNV were detected in any species., Discussion: RESULTS indicate that livestock have been exposed to a number of pathogens, although care must be taken with interpretation. It is not possible to determine whether antibodies against Leptospira spp. and RVFV in cattle and buffalo are due to prior vaccination or natural exposure. Similarly, antibodies identified in animals less than 6 months of age may be maternal antibodies transferred through colostrum rather than evidence of prior exposure. RESULTS provide baseline evidence to indicate that surveillance within animal populations may be a useful tool to monitor the circulation of pathogens of veterinary and public health concern in Egypt.
- Published
- 2014
- Full Text
- View/download PDF
48. Incidence and clinical features of respiratory syncytial virus infections in a population-based surveillance site in the Nile Delta Region.
- Author
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Rowlinson E, Dueger E, Taylor T, Mansour A, Van Beneden C, Abukela M, Zhang X, Refaey S, Bastawy H, and Kandeel A
- Subjects
- Adult, Egypt epidemiology, Female, Hospitalization statistics & numerical data, Humans, Incidence, Infant, Male, Middle Aged, Respiratory Syncytial Virus Infections virology, Respiratory Syncytial Virus, Human genetics, Reverse Transcriptase Polymerase Chain Reaction, Young Adult, Population Surveillance methods, Respiratory Syncytial Virus Infections epidemiology, Respiratory Syncytial Virus, Human isolation & purification
- Abstract
Background: Most reports about respiratory syncytial virus (RSV) in developing countries rely on sentinel surveillance, from which population incidence is difficult to infer. We used the proportion of RSV infections from population-based surveillance with data from a healthcare utilization survey to produce estimates of RSV incidence in Damanhour district, Egypt., Methods: We conducted population-based surveillance in 3 hospitals (2009-2012) and 3 outpatient clinics (2011-2012) in Damanhour district. Nasopharyngeal and oropharyngeal specimens from hospitalized patients with acute respiratory illness and outpatients with influenza-like illness were tested by real-time reverse transcriptase polymerase chain reaction for RSV. We also conducted a healthcare utilization survey in 2011-2012 to determine the proportion of individuals who sought care for respiratory illness., Results: Among 5342 hospitalized patients and 771 outpatients, 12% and 5% tested positive for RSV, respectively. The incidence of RSV-associated hospitalization and outpatient visits was estimated at 24 and 608 (per 100 000 person-years), respectively. Children aged <1 year experienced the highest incidence of RSV-associated hospitalizations (1745/100 000 person-years)., Conclusions: This study demonstrates the utility of combining a healthcare utilization survey and population-based surveillance data to estimate disease incidence. Estimating incidence and outcomes of RSV disease is critical to establish the burden of RSV in Egypt.
- Published
- 2013
- Full Text
- View/download PDF
49. Expanded sexually transmitted infection surveillance efforts in the United States military: a time for action.
- Author
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Sánchez JL, Agan BK, Tsai AY, Macalino GE, Wurapa E, Mbuchi M, Dueger E, Horton KC, Montano-Torres SM, Tilley DH, Saylors KE, Puplampu N, Duplessis CC, Harrison DJ, Putnam SD, Garges EC, Espinosa BJ, Dejli J, Meyers M, Yingst SL, Jerse AE, Maktabi HH, Burke RL, Jordan NN, Nowak G, Hsu K, Soge OO, Holmes KK, McClelland RS, MacDonald MR, Pavlin JA, Gaydos JC, and Tramont EC
- Subjects
- Biomedical Research, Humans, Incidence, Prevalence, Sexually Transmitted Diseases microbiology, United States, Drug Resistance, Bacterial, Military Personnel, Neisseria gonorrhoeae drug effects, Population Surveillance methods, Sexually Transmitted Diseases diagnosis, Sexually Transmitted Diseases epidemiology
- Published
- 2013
- Full Text
- View/download PDF
50. Poultry rearing and slaughtering practices in rural Egypt: an exploration of risk factors for H5N1 virus human transmission.
- Author
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Lohiniva AL, Dueger E, Talaat M, Refaey S, Zaki A, Chisholm Horton K, and Kandeel A
- Subjects
- Adolescent, Adult, Animals, Chickens, Child, Child, Preschool, Egypt, Female, Humans, Infant, Male, Risk Factors, Rural Population, Young Adult, Animal Husbandry methods, Influenza A Virus, H5N1 Subtype isolation & purification, Influenza in Birds transmission, Zoonoses prevention & control, Zoonoses transmission
- Abstract
Background: Highly pathogenic avian influenza (H5N1) virus continues to cause infections in Egypt. This study describes the practices associated with raising and slaughtering household poultry to identify risk factors for H5N1 infection and reasons for non-compliance with preventive measures., Methods: An investigation was conducted of 56 households with household flocks (19 households with human H5N1 cases, 19 with poultry H5N1 cases, and 18 with no reported poultry or human H5N1 cases). Data were collected via structured observations and in-depth interviews., Results: Half of the households kept at least some free-range poultry and mixed at least some different species of poultry as it was considered beneficial for the poultry. Feeding and cleaning practices exposed children to contact with poultry; slaughtering contaminated homes; use of personal protective barriers was not a norm; waste management exposed the communities to slaughtering waste and dead chickens; and reporting of sick and dead poultry was not a practice. Only minor changes in poultry-handling took place following H5N1 virus outbreaks., Discussion: H5N1 virus prevention in Egypt represents both an epidemiological and socio-cultural challenge. Traditional poultry-rearing practices that likely increase exposures to H5N1-infected poultry are common throughout Egypt. Despite education campaigns following sporadic H5N1 outbreaks, no differences in these practices could be detected between households with previous H5N1 human or poultry cases and those households with any previous experience with H5N1. Development of H5N1 infection-related education campaign strategies should focus on perceptions underlying traditional practices in order to tailor public awareness messages that are meaningful for communities., (Published 2012. This article is a US Government work and is in the public domain in the USA.)
- Published
- 2013
- Full Text
- View/download PDF
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