Suchergebnisse

Intro -- Front Matter -- 1 Introduction -- 2 The Scope of the Problem -- 3 Exploring Opportunities for, and Barriers to, Treatment and Prevention in Public Health, Hospitals, and Rural America -- 4 Exploring Opportunities in Correctional Health, Law, and Law Enforcement -- 5 Research Directions, Policy Initiatives, and Potential Ways Forward -- Appendix A Workshop Agenda -- Appendix B Speaker and Planning Committee Member Biosketches -- Appendix C Statement of Task

The resurgence of infectious diseases and the emergence of infectious diseases raise questions on how to cope with the situation. The germ or clinical approach is the hegemonic biomedical paradigm. In this article, the author argues that the spread of infectious diseases has posted a challenge to the biomedical paradigm and shows how lock-in procedures maintain alternative and complementary medicine paradigms in the backyard.

Intro -- Contents -- Introduction -- 1 Introduction -- 2 Themes -- 3 Lucky All the Time: Addressing the Challenges of Infectious Disease -- References -- Applying Lessons from the Past in Haiti: Cholera, Scientific Knowledge, and the Longest-Standing Principle of International Health Law -- 1 Introduction (of Cholera) -- 2 Cholera Comes to Haiti -- 3 The Germ of an Idea: Cholera and the First International Sanitary Conference -- 4 The Science of Cholera -- 5 The Conventional Approach: The First International Sanitary Conventions -- 6 Spreading to a New Host: The WHO and the International Health Regulations -- 7 Going Global: The Revised International Health Regulations (2005) -- 8 The Disease Spreads: Other Treaties and Frameworks -- 9 Commerce and Cholera -- 10 Cholera in Customary International Law -- 11 Cholera and the UN -- 12 Haiti: The Largest Single-Country Cholera Epidemic in a Century -- 13 Conclusion -- References -- Responding to Health Emergencies: The Ethical and Legal Considerations for Militaries -- 1 Introduction -- 2 Military Health Assistance -- 3 Legal Considerations of Military Assistance in Health Emergencies -- 3.1 IASC Global Health Cluster Provisional Guidelines -- 3.2 The Oslo and MCDA Guidelines -- 4 Ethical Considerations of Military Assistance in Health Emergencies -- 4.1 Do no Harm -- 4.2 Humanity and Military Motivations -- 4.3 Impartiality and Justice -- 5 Conclusion -- References -- The International Red Cross and Red Crescent Movement Response to the West African Ebola Outbreak 2014 -- 1 Introduction -- 2 Red Cross and Red Crescent Mandate -- 3 Ebola Outbreak 2014 -- 4 The Role of the WHO in Coordinating a Medical Humanitarian Response -- 5 WHO and Ebola 2014-2016 -- 6 The UN Relationship with Other Actors, Including the IFRC -- 7 The IFRC Response -- 8 Conclusion -- References.

Section I: Adult urgent care medicine. Headache and neurologic complaints -- Red eye, eye pain, and vision loss -- Ear, nose, and throat -- Dental and mouth pain -- Cough, shortness of breath, and chest pain -- Abdominal pain, nausea, vomiting, and diarrhea -- Genitourinary complaints -- Gynecologic complaints -- Rashes and skin infections -- Miscellaneous musculoskeletal trauma -- Miscellaneous infectious disease issues -- Section II. Pediatric urgent care medicine. Fever -- Headache -- Eye complaints -- Ear pain, nasal congestion, and sore throat -- Cough -- Neck pain and masses -- Chest pain -- Abdominal pain -- Nausea, vomiting, diarrhea, and dehydration -- Urinary complaints -- Vaginal complaints -- Skin rashes and infections -- Common newborn complaints -- Limp -- Head and neck trauma -- Chest and abdominal trauma -- Extremity trauma -- -- Section III. Sport-related complaints. Acute neck pain -- Evaluation and management of acute sprains and strains -- Acute low back pain -- The acutely swollen knee -- Acute finger and wrist injuries -- Fall on outstretched hand injuries -- When to image for sport-related complaints? -- Environmental emergencies -- The acutely injured shoulder -- Concussion -- Overuse apophyseal injuries -- The acutely limping child -- Ankle sprains -- Acute infectious disease and athletes -- Section IV. Procedures. Wound assessment, burns, and animal bites. Laceration repair -- Fracture and dislocation reductions -- Splinting procedures -- Abscess I & D -- Foreign body removal -- Dental and oral complaints and procedures -- Analgesia and sedation -- Section V. Miscellaneous. Adult emergencies presenting to urgent care centers. Pediatric emergencies presenting to urgent care centers -- Office emergency and disaster preparedness -- Diagnostic ultrasound -- Mental health urgencies -- Travel medicine -- Business of urgent care medicine.

"Since the 2014 Ebola outbreak many public- and private-sector leaders have seen a need for improved management of global public health emergencies. The effects of the Ebola epidemic go well beyond the three hardest-hit countries and beyond the health sector. Education, child protection, commerce, transportation, and human rights have all suffered. The consequences and lethality of Ebola have increased interest in coordinated global response to infectious threats, many of which could disrupt global health and commerce far more than the recent outbreak. In order to explore the potential for improving international management and response to outbreaks the National Academy of Medicine agreed to manage an international, independent, evidence-based, authoritative, multistakeholder expert commission. As part of this effort, the Institute of Medicine convened four workshops in summer of 2015 to inform the commission report. The presentations and discussions from the Workshop on Resilient and Sustainable Health Systems to Respond to Global Infectious Disease Outbreaks are summarized in this report"--Publisher description.

Front Cover -- Board Review in Preventive Medicine and Public Health -- Copyright Page -- Contents -- About the Author -- Preface -- Acknowledgements -- 1. General Public Health -- 1.1 General Public Health Questions -- 1.2 General Public Health Answers -- Bibliography -- 2. Health Policy and Management -- 2.1 Health Policy and Management Questions -- 2.2 Health Policy and Management Answers -- Bibliography -- 3. Epidemiology and Biostatistics -- 3.1 Epidemiology and Biostatistics Questions -- 3.2 Epidemiology and Biostatistics Answers -- Bibliography -- 4. Environmental Medicine -- 4.1 Environmental Medicine Questions -- 4.2 Environmental Medicine Answers -- Bibliography -- 5. Occupational and Aerospace Medicine -- 5.1 Occupational and Aerospace Medicine Questions -- 5.2 Occupational and Aerospace Medicine Answers -- Bibliography -- 6. Clinical Preventive Medicine -- 6.1 Clinical Preventive Medicine Questions -- 6.2 Clinical Preventive Medicine Answers -- Bibliography -- 7. Infectious Disease -- 7.1 Infectious Disease Questions -- 7.2 Infectious Disease Answers -- Bibliography -- 8. Emergency Preparedness -- 8.1 Emergency Preparedness Questions -- 8.2 Emergency Preparedness Answers -- Bibliography -- Index -- Back Cover

Infectious pancreatic necrosis (IPN) is a highly contagious viral disease of fish causing economic losses in farmed salmonid aquaculture worldwide. This research aimed to elucidate the epidemiological, pathological and genetic factors underlying IPNV infection occurring in farmed fish in Finland. The work was carried out by describing the epidemiology of an IPNV outbreak in Finnish inland waters in 2012–2014 and by characterizing the Finnish IPNV isolates occurring in inland waters using genetic, histopathological and immunological approaches. Furthermore, molecular characterization of Finnish IPNV isolates collected in 2000–2015 was performed. Finally, an infection trial was conducted to gather further information on the pathogenicity of three IPN genogroups in Finnish rainbow trout. IPNV genogroups 2, 5 and 6 have been found to occur in Finland. Of these, genogroup 2 is the most widespread. All three genogroups occur in the sea area. The IPNV epidemic starting in 2012 in inland waters was caused by genogroup 2. Retrospectively, a genetically similar viral strain to that of the inland strains was already found to occur in 2011 in the sea area, making it likely that the epidemic originated from the sea area. Molecular characterization of the isolated IPN viruses revealed little genetic variation within the Finnish genogroup 2 and 5 isolates. Finnish genogroup 2 isolates appeared to form their own subgroup, whereas genogroup 5 isolates formed a more consistent cluster with previously published isolates. Genogroup 6 consisted of two subgroups. The divergence of genogroup 6 IPNV within the aquabirnaviruses was further demonstrated by the sequence data from our studies. Prior to our studies, only partial VP1 genogroup 6 IPNV sequences were available at the NCBI GenBank. In our study, two IPNV genogroup 6 isolates were sequenced for the complete coding regions of viral genome segments A and B (polyprotein sequences). The Finnish IPNV isolates studied demonstrated virulence-associated amino acid patterns in the viral capsid protein (VP2) gene region previously associated with avirulence in genogroup 5, except for IPNV genogroup 6, which exhibits an amino acid pattern that has not been connected in the literature with either virulence or avirulence. In the infection trial, mortalities noted in all the treatment groups were only moderate at most. The highest mortalities were caused by the Finnish IPNV genogroup 5 (10.3% to 38.2%), whereas IPNV genogroup 2 caused variable mortalities (3.5% to 28.3%) and the Norwegian IPNV genogroup 5 virus used as a positive control caused only negligible mortalities. The IPNV genogroup 6 virus was not re-isolated in the infection trial, although some elevated mortalities were seen in one tank (8%), leaving the virulence of this genogroup still uncertain. Finnish inland waters harbour the most IPNV-susceptible life stages of fish, and here, an infection caused by a virulent strain of IPNV would thus potentially have the greatest negative economic impact on Finnish rainbow trout farming. Continuation of the legislative disease control of IPN genogroup 5 in Finnish inland waters is thus supported by this study. In general, IPN is considered a coldwater disease, with a peak in clinical disease and increased mortality at 10 °C. However, in Finland, the occurrence of virus at exceptionally high temperatures, with clinical signs of disease and histopathological changes typical of IPN, was noted at water temperatures as high as 21°C. The occurrence of IPNV in higher water temperatures has economic consequences, as it lengthens the susceptible time period for the disease. Moreover, rising water temperatures and longer warm water periods due to global warming may increase the disease-causing importance of this genogroup in the future. ; Tarttuva haimakuoliotauti IPN (Infectious Pancreatic Necrosis) on akvabirnaviruksen aiheuttama helposti leviävä kalatauti, joka aiheuttaa taloudellisia tappioita viljellyillä lohikaloilla maailmanlaajuisesti. Viruksesta esiintyy nykytietämyksen mukaan seitsemän eri taudinaiheuttamiskyvyltään vaihtelevaa genoryhmää (1–7), joista genoryhmään 5 kuuluvia viruksia on pidetty potentiaalisesti vakavimpina taudinaiheuttajina. Genoryhmän 5 IPN-virustartunta on Suomen sisävesialueilla lakisääteisesti vastustettava, valvottaviin eläintauteihin kuuluva kalatauti. Ruokaviraston Eläintautibakteriologian ja -patologian yksikössä sekä Eläintautivirologian yksikössä vuosina 2014-2021 tehdyssä tutkimuksessa selvitettiin suomalaisten IPN-virustartuntojen epidemiologiaa ja taudinaiheuttamiskykyä sekä viruskantojen geneettisiä ominaisuuksia. Tutkimuksen ensimmäisessä osa-alueessa kuvailtiin sisämaan vesistöissä vuosina 2012-2014 kalanviljelylaitoksilla todettua laajaa IPN-epidemiaa. Tutkimuksessa selvisi, että epidemian aiheutti IPNV genoryhmän 2 virus, joka geneettisen analyysin perusteella on todennäköisesti peräisin merialueelta. Virus aiheutti vähäistä kuolleisuutta, mutta taudille tyypillisiä kliinisiä muutoksia kaloissa. Lisäksi tautia todettiin esiintyvän myös kalojen virustaudeille epätyypillisen korkeissa veden lämpötiloissa, jopa 22 ⁰C. Tutkimuksen toisessa osa-alueessa selvitettiin vuosien 2000-2015 aikana kerättyjen IPN-viruskantojen perimää, etsien mahdollisia muutoksia viruskannoissa. Tutkimuksessa analysoitiin 88 viruskantaa viruskapsidiproteiini VP2 -geenin osalta. Lisäksi suoritettiin kokogenomisekvensointi 11 viruskannasta. Tutkimusten perusteella todettiin Suomessa esiintyvän kolmea IPNV-genoryhmää: genoryhmiä 2,5 ja 6. Genoryhmän 2 virusta esiintyy sisävesialueilla, kun taas merialueella esiintyy kaikkia kolmea genoryhmää. Genoryhmät 2 ja 5 osoittivat ainoastaan vähäistä ryhmien sisäistä perinnöllistä variaatiota, mutta genoryhmässä 6 todettiin kahta eriävää alaryhmää. Genoryhmä 6 suurempi geneettinen eroavuus muista genoryhmistä ilmeni kokogenomisekvensoinnissa. Kaikissa tutkituissa viruskannoissa todettiin sellaisia emäsyhdistelmiä viruksen kapsidiproteiinin (VP2) perimässä, joiden on aiempien tutkimusten perusteella todettu olevan yhteydessä vähäiseen taudinaiheuttamiskykyyn genoryhmän 5 IPN-tartunnoissa. Suomessa todetut genoryhmän 2 viruskannat olivat kuitenkin aiheuttaneet kaloissa IPN-taudin oireita sekä lisääntynyttä kuolleisuutta, ja tutkimuksen viimeisessä osa-alueessa tutkittiinkin tartuntakokeen avulla Suomessa esiintyvien kolmeen eri genoryhmään kuuluvien suomalaisten IPN-viruskantojen taudinaiheuttamiskykyä suomalaiselle kirjolohikannalle. Tartuntakokeessa todettiin genoryhmän 5 virusten aiheuttavan kohtalaista kuolleisuutta ja genoryhmän 2 vaihtelevaa, mutta vähäisempää kuolleisuutta kirjolohella. Genoryhmän 6 virusten taudinaiheuttamiskyky jäi tutkimuksessa epäselväksi. IPN on pääasiassa pienten kirjolohenpoikasten tauti. Suomalaisessa kirjolohenviljelyssä poikastuotanto on pääosin keskittynyt sisämaan kalanviljelylaitoksille. Korkean taudinaiheuttamiskyvyn omaavan viruskannan leviäminen poikaslaitoksille voisi aiheuttaa suuriakin tappioita, joten viruksen leviämisen ennaltaehkäisy on erittäin tärkeää. Taudin leviämisen ehkäisemistä voidaan edistää tehokkailla bioturvallisuustoimilla, lisäksi lakisääteinen genoryhmän 5 IPNV-tartuntojen torjunta on perusteltua myös jatkossa kotimaisen kirjolohen poikastuotannon turvaamiseksi.

Infectious diseases are caused by pathogenic micro-organisms which can be bacteria, viruses, parasites or fungi. The diseases can be spread through many different routes, either directly or indirectly. Military personnel are at high risk of contracting infections, in particular vector-borne and zoonotic infections, during overseas deployments, where they may be exposed to endemic or emerging infections to which they do not have immunity. Additionally, overcrowded settings with poor sanitation are high risks for disease. Genomics is having a transformational impact on medicine. It is enabling advances in accurate diagnosis of infectious disease, development of effective and targeted treatment strategies and opportunities to assess pathogenicity. Further, it supports the detection, surveillance of infectious diseases, the development and assessment of vaccines, as well as the assessment and prediction of anti-microbial resistance. These capabilities are all key military needs to protect personnel in this inter-connected world. The advances in sequencing technologies have resulted in an explosion of genomic data. However, making sense of genomic data requires advances in computational analysis technologies together with crossdisciplinary scientific approaches, skill sets and people. There are extensive reference databases of genomic data. One such open access database is PubMLST.org: it contains well curated genomes for more than 100 microbial species and genera integrated with provenance and phenotype information. All levels of sequence data, from single gene sequences up to and including complete, finished genomes can be accessed on this platform. This data is, however, both large and complex and intractable to analyse and understand using traditional analysis tools. This paper will discuss the challenges of analysing such genomic data for bacterial infections and consider the application of bioinformatics tools and techniques to analyse and communicate microbial genomic data in healthcare.

AbstractThe effect of drug shortages on estimating the infectivity of antiviral‐treatable disease epidemics is evaluated using an illustrative dataset. Simulation‐based analysis shows that a given outbreak can be caused by either (i) a high infectivity parameter even with sufficient and timely supply of medicines, or (ii) a low infectivity parameter and poor supply of medicines. Also, the use of a stand‐alone epidemic model is found to overestimate disease transmissibility. A compartmental epidemic model is integrated with multi‐echelon supply chain models to further investigate the impact of medicine supply chain on the epidemic dynamics. In integrated models, medicine demands for the supply chain are generated from the disease model, and the medicine supply rate controls the recovery rate of patients in the disease model. It is found that supply chain aspects have a significant effect on epidemic dynamics. Some improvement schemes for supply chain management are also highlighted.

Infectious diseases exacerbated by Antimicrobial Resistance (AMR) are of increasing concern in Sweden, with multi-drug resistant strains associated with new resistance mechanisms that are emerging and spreading worldwide. Existing research has identified that sub-optimal living conditions and poor access to healthcare are significant factors in the spread and incubation of AMR strains. The article considers this linkage and the effort to control the spread of AMR in relation to migrants, highlighting deficiencies in public policy where such individuals are often increasingly exposed to those conditions that exacerbate AMR. In many of the richest countries, those conditions are not accidental, but often direct goals of policies designed with the goal of deterring migrants from staying within host countries. Without engaging with the politics around migration control, the article points to urgent need for more holistic assessment of all public policies that may, however unintentionally, undermine AMR control through worsening living conditions for vulnerable groups. The consequences of prioritizing policies meant to deliberately worsen the living conditions of migrants over avoiding those conditions that accelerate AMR spread, are today made ever apparent where new AMR strains have the potential to dwarf the societal effects of the current Covid-19 pandemic.