Pub Date : 2022-10-01DOI: 10.5365/wpsar.2022.13.4.987
Jozica Skufca, Leila Bell, J C Pal Molino, Dina Saulo, Chin-Kei Lee, Satoko Otsu, May Chiew, Phetdavanh Leuangvilay, Sarika Patel, Asheena Khalakdina, Vanra Ieng, Tamano Matsui, Babatunde Olowokure
Avian influenza subtype A(HxNy) viruses are zoonotic and may occasionally infect humans through direct or indirect contact, resulting in mild to severe illness and death. Member States in the Western Pacific Region (WPR) communicate and notify the World Health Organization of any human cases of A(HxNy) through the International Health Regulations (IHR 2005) mechanism. This report includes all notifications in the WPR with illness onset dates from 1 November 2003 to 31 July 2022. During this period, there were 1972 human infections with nine different A(HxNy) subtypes notified in the WPR. Since the last report, an additional 134 human avian influenza infections were notified from 1 October 2017 to 31 July 2022. In recent years there has been a change in the primary subtypes and frequency of reports of human A(HxNy) in the region, with a reduction of A(H7N9) and A(H5N1), and conversely an increase of A(H5N6) and A(H9N2). Furthermore, three new subtypes A(H7N4), A(H10N3) and A(H3N8) notified from the People's Republic of China were the first ever recorded globally. The public health risk from known A(HxNy) viruses remains low as there is no evidence of person-to-person transmission. However, the observed changes in A(HxNy) trends reinforce the need for effective and rapid identification to mitigate the threat of a pandemic from avian influenza if person-to-person transmission were to occur.
{"title":"An epidemiological overview of human infections with HxNy avian influenza in \u2028the Western Pacific Region, 2003-2022.","authors":"Jozica Skufca, Leila Bell, J C Pal Molino, Dina Saulo, Chin-Kei Lee, Satoko Otsu, May Chiew, Phetdavanh Leuangvilay, Sarika Patel, Asheena Khalakdina, Vanra Ieng, Tamano Matsui, Babatunde Olowokure","doi":"10.5365/wpsar.2022.13.4.987","DOIUrl":"https://doi.org/10.5365/wpsar.2022.13.4.987","url":null,"abstract":"<p><p>Avian influenza subtype A(HxNy) viruses are zoonotic and may occasionally infect humans through direct or indirect contact, resulting in mild to severe illness and death. Member States in the Western Pacific Region (WPR) communicate and notify the World Health Organization of any human cases of A(HxNy) through the International Health Regulations (IHR 2005) mechanism. This report includes all notifications in the WPR with illness onset dates from 1 November 2003 to 31 July 2022. During this period, there were 1972 human infections with nine different A(HxNy) subtypes notified in the WPR. Since the last report, an additional 134 human avian influenza infections were notified from 1 October 2017 to 31 July 2022. In recent years there has been a change in the primary subtypes and frequency of reports of human A(HxNy) in the region, with a reduction of A(H7N9) and A(H5N1), and conversely an increase of A(H5N6) and A(H9N2). Furthermore, three new subtypes A(H7N4), A(H10N3) and A(H3N8) notified from the People's Republic of China were the first ever recorded globally. The public health risk from known A(HxNy) viruses remains low as there is no evidence of person-to-person transmission. However, the observed changes in A(HxNy) trends reinforce the need for effective and rapid identification to mitigate the threat of a pandemic from avian influenza if person-to-person transmission were to occur.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9390196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.5365/wpsar.2022.13.4.972
Kyung Hyun Oh, Maria Imelda Quelapio, Fukushi Morishita, Kalpeshsinh Rahevar, Manami Yanagawa, Tauhid Islam
Background: Diagnosis and treatment of drug-resistant tuberculosis (DR-TB) have radically changed in accordance with recommendations from the World Health Organization (WHO) in the past decade, allowing rapid and simple diagnosis and shorter treatment duration with new and repurposed drugs.
Methods: A descriptive analysis of the status and progress of DR-TB diagnosis and treatment in six priority countries in the Western Pacific Region was conducted using information from interviews with countries and the WHO TB database.
Results: Over the past decade, the use of Xpert MTB/RIF has increased in the six priority countries, in parallel with implementation of national policies and algorithms to use Xpert MTB/RIF as an initial diagnostic test for TB and detection of rifampicin resistance. This has resulted in increases in the number of people diagnosed with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB). Shorter treatment regimens with new and repurposed drugs have also been adopted for MDR/RR-TB cases, alongside a decentralized model of care, leading to improved treatment outcomes.
Discussion: The Western Pacific Region has achieved considerable progress in the diagnosis and treatment of DR-TB, in line with the evolving WHO recommendations in the past decade. The continued commitment of Member States is needed to address remaining challenges, such as the impact of the coronavirus disease pandemic, suboptimal management and health system issues.
{"title":"Progress on diagnosis and treatment of drug-resistant tuberculosis in line with World Health Organization recommendations in six priority countries in the Western Pacific Region.","authors":"Kyung Hyun Oh, Maria Imelda Quelapio, Fukushi Morishita, Kalpeshsinh Rahevar, Manami Yanagawa, Tauhid Islam","doi":"10.5365/wpsar.2022.13.4.972","DOIUrl":"https://doi.org/10.5365/wpsar.2022.13.4.972","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis and treatment of drug-resistant tuberculosis (DR-TB) have radically changed in accordance with recommendations from the World Health Organization (WHO) in the past decade, allowing rapid and simple diagnosis and shorter treatment duration with new and repurposed drugs.</p><p><strong>Methods: </strong>A descriptive analysis of the status and progress of DR-TB diagnosis and treatment in six priority countries in the Western Pacific Region was conducted using information from interviews with countries and the WHO TB database.</p><p><strong>Results: </strong>Over the past decade, the use of Xpert MTB/RIF has increased in the six priority countries, in parallel with implementation of national policies and algorithms to use Xpert MTB/RIF as an initial diagnostic test for TB and detection of rifampicin resistance. This has resulted in increases in the number of people diagnosed with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB). Shorter treatment regimens with new and repurposed drugs have also been adopted for MDR/RR-TB cases, alongside a decentralized model of care, leading to improved treatment outcomes.</p><p><strong>Discussion: </strong>The Western Pacific Region has achieved considerable progress in the diagnosis and treatment of DR-TB, in line with the evolving WHO recommendations in the past decade. The continued commitment of Member States is needed to address remaining challenges, such as the impact of the coronavirus disease pandemic, suboptimal management and health system issues.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9390198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.5365/wpsar.2022.13.4.964
Nashika Sharma, Dashika Balak, Shaneel Prakash, Julia Maguire
Objective: There is limited published information about deaths due to coronavirus disease 2019 (COVID-19) in Fiji, the World Health Organization's Western Pacific Region and low- and middle-income countries. This report descriptively analyses deaths directly associated with COVID-19 in Fiji by age group, sex, ethnicity, geographical location, vaccination status and place of death for the first 7 months of the 2021 community outbreak.
Methods: A retrospective analysis was conducted of deaths directly associated with COVID-19 that occurred from 15 April to 14 November 2021 in Fiji. Death rates per 100 000 population were calculated by using divisional population estimates obtained from medical zone nurses in 2021.
Results: A total of 1298 deaths relating to COVID-19 were reported, with 696 directly associated with COVID-19 and therefore included in the analysis. Of these, 71.1% (495) were reported from the Central Division, 54.6% (380) occurred among males, 75.6% (526) occurred among people of indigenous (iTaukei) ethnicity and 79.5% (553) occurred among people who were unvaccinated. Four deaths were classified as maternal deaths. The highest percentage of deaths occurred in those aged 370 years (44.3%, 308), and the majority of deaths (56.6%, 394) occurred at home.
Discussion: At-risk populations for COVID-19 mortality in Fiji include males, iTaukei peoples, and older (370 years) and unvaccinated individuals. A high proportion of deaths occurred either at home or during the first 2 days of hospital admission, potentially indicating both a reluctance to seek medical care and a health-care system that was stressed during the peak of the outbreak.
{"title":"Descriptive analysis of deaths associated with COVID-19 in Fiji, 15 April to 14 November 2021.","authors":"Nashika Sharma, Dashika Balak, Shaneel Prakash, Julia Maguire","doi":"10.5365/wpsar.2022.13.4.964","DOIUrl":"https://doi.org/10.5365/wpsar.2022.13.4.964","url":null,"abstract":"<p><strong>Objective: </strong>There is limited published information about deaths due to coronavirus disease 2019 (COVID-19) in Fiji, the World Health Organization's Western Pacific Region and low- and middle-income countries. This report descriptively analyses deaths directly associated with COVID-19 in Fiji by age group, sex, ethnicity, geographical location, vaccination status and place of death for the first 7 months of the 2021 community outbreak.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of deaths directly associated with COVID-19 that occurred from 15 April to 14 November 2021 in Fiji. Death rates per 100 000 population were calculated by using divisional population estimates obtained from medical zone nurses in 2021.</p><p><strong>Results: </strong>A total of 1298 deaths relating to COVID-19 were reported, with 696 directly associated with COVID-19 and therefore included in the analysis. Of these, 71.1% (495) were reported from the Central Division, 54.6% (380) occurred among males, 75.6% (526) occurred among people of indigenous (iTaukei) ethnicity and 79.5% (553) occurred among people who were unvaccinated. Four deaths were classified as maternal deaths. The highest percentage of deaths occurred in those aged <sup>3</sup>70 years (44.3%, 308), and the majority of deaths (56.6%, 394) occurred at home.</p><p><strong>Discussion: </strong>At-risk populations for COVID-19 mortality in Fiji include males, iTaukei peoples, and older (<sup>3</sup>70 years) and unvaccinated individuals. A high proportion of deaths occurred either at home or during the first 2 days of hospital admission, potentially indicating both a reluctance to seek medical care and a health-care system that was stressed during the peak of the outbreak.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9390200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Both tuberculosis (TB) and melioidosis are endemic to certain parts of the world, including Brunei Darussalam, with TB being more widespread. Despite this, coinfection with TB and melioidosis is rarely encountered and reported. Although still uncommon, there has been an increase in the number of cases of this coinfection reported during the past 10 years, all of which have been in India and the World Health Organization's Western Pacific Region. We report a case of coinfection with pulmonary TB and melioidosis in a patient with poorly controlled diabetes mellitus. This 64-year-old man presented with symptoms and radiological features of pulmonary TB, confirmed by sputum smear, but sputum culture also yielded Burkholderia pseudomallei, the pathogen that causes melioidosis. Coinfection was detected due to our practice of routinely screening for other infections in patients suspected or confirmed to have pulmonary TB. This highlights the importance of awareness of melioidosis and the need to consider screening for infection, especially in endemic regions.
{"title":"Pulmonary tuberculosis and melioidosis coinfection in Brunei Darussalam: the importance of awareness and screening.","authors":"Abdur Rahman Rubel, Babu Ivan Mani, Panduru Venkata Kishore, Vui Heng Chong","doi":"10.5365/wpsar.2022.13.4.957","DOIUrl":"https://doi.org/10.5365/wpsar.2022.13.4.957","url":null,"abstract":"<p><p>Both tuberculosis (TB) and melioidosis are endemic to certain parts of the world, including Brunei Darussalam, with TB being more widespread. Despite this, coinfection with TB and melioidosis is rarely encountered and reported. Although still uncommon, there has been an increase in the number of cases of this coinfection reported during the past 10 years, all of which have been in India and the World Health Organization's Western Pacific Region. We report a case of coinfection with pulmonary TB and melioidosis in a patient with poorly controlled diabetes mellitus. This 64-year-old man presented with symptoms and radiological features of pulmonary TB, confirmed by sputum smear, but sputum culture also yielded <i>Burkholderia pseudomallei</i>, the pathogen that causes melioidosis. Coinfection was detected due to our practice of routinely screening for other infections in patients suspected or confirmed to have pulmonary TB. This highlights the importance of awareness of melioidosis and the need to consider screening for infection, especially in endemic regions.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9326123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.5365/wpsar.2022.13.4.941
Shi Ying Tan, Shyh Poh Teo, Muhd Syafiq Abdullah, Pui Lin Chong, Rosmonaliza Asli, Babu Ivan Mani, Natalie Riamiza Momin, Adrian Chin Ann Lim, Noor Affizan Rahman, Chee Fui Chong, Vui Heng Chong
Objective: This retrospective, cross-sectional, observational study assessed the duration of coronavirus disease 2019 (COVID-19) symptoms during the second wave in Brunei Darussalam.
Methods: Data from COVID-19 cases admitted to the National Isolation Centre during 7-30 August 2021 were included in the study. Symptom onset and daily symptom assessments were entered into a database during hospitalization and disease was categorized by severity. The time between symptom onset and hospital admission, the duration of symptoms and length of hospitalization were assessed separately by age group, disease severity and vaccination status using one-way analysis of variance with Bonferroni post hoc corrections.
Results: Data from 548 cases were included in the study: 55.7% (305) of cases were male, and cases had a mean age of 33.7 years. Overall, 81.3% (446) reported symptoms at admission (mean number of symptoms and standard deviation: 2.8 ± 1.6), with cough (59.1%; 324), fever (38.9%; 213) and sore throat (18.4%; 101) being the most common. Being older, having more severe disease and being unvaccinated were significantly associated with the time between symptom onset and hospital admission, symptom duration and length of hospitalization.
Discussion: Knowing which factors predict the duration of COVID-19 symptoms can help in planning management strategies, such as the duration of isolation, predict the length of hospitalization and treatment, and provide more accurate counselling to patients regarding their illness.
{"title":"COVID-19 symptom duration: associations with age, severity and vaccination status in Brunei Darussalam, 2021.","authors":"Shi Ying Tan, Shyh Poh Teo, Muhd Syafiq Abdullah, Pui Lin Chong, Rosmonaliza Asli, Babu Ivan Mani, Natalie Riamiza Momin, Adrian Chin Ann Lim, Noor Affizan Rahman, Chee Fui Chong, Vui Heng Chong","doi":"10.5365/wpsar.2022.13.4.941","DOIUrl":"https://doi.org/10.5365/wpsar.2022.13.4.941","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective, cross-sectional, observational study assessed the duration of coronavirus disease 2019 (COVID-19) symptoms during the second wave in Brunei Darussalam.</p><p><strong>Methods: </strong>Data from COVID-19 cases admitted to the National Isolation Centre during 7-30 August 2021 were included in the study. Symptom onset and daily symptom assessments were entered into a database during hospitalization and disease was categorized by severity. The time between symptom onset and hospital admission, the duration of symptoms and length of hospitalization were assessed separately by age group, disease severity and vaccination status using one-way analysis of variance with Bonferroni post hoc corrections.</p><p><strong>Results: </strong>Data from 548 cases were included in the study: 55.7% (305) of cases were male, and cases had a mean age of 33.7 years. Overall, 81.3% (446) reported symptoms at admission (mean number of symptoms and standard deviation: 2.8 ± 1.6), with cough (59.1%; 324), fever (38.9%; 213) and sore throat (18.4%; 101) being the most common. Being older, having more severe disease and being unvaccinated were significantly associated with the time between symptom onset and hospital admission, symptom duration and length of hospitalization.</p><p><strong>Discussion: </strong>Knowing which factors predict the duration of COVID-19 symptoms can help in planning management strategies, such as the duration of isolation, predict the length of hospitalization and treatment, and provide more accurate counselling to patients regarding their illness.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9326128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.5365/wpsar.2022.13.4.951
William T Wang, Hwang Ching Chan, Jyoti Somani, See Ming Lim
In response to a COVID-19 outbreak within a hospital in Singapore, a single mass swab exercise was conducted at another tertiary hospital to detect possible inter-hospital transmission. The exercise yielded no positive results, demonstrating non-targeted mass testing as an impractical strategy to track inter-hospital transmission.
{"title":"Mass COVID-19 testing of asymptomatic health-care workers in a tertiary hospital during an outbreak in another hospital in Singapore: an effective strategy?","authors":"William T Wang, Hwang Ching Chan, Jyoti Somani, See Ming Lim","doi":"10.5365/wpsar.2022.13.4.951","DOIUrl":"https://doi.org/10.5365/wpsar.2022.13.4.951","url":null,"abstract":"In response to a COVID-19 outbreak within a hospital in Singapore, a single mass swab exercise was conducted at another tertiary hospital to detect possible inter-hospital transmission. The exercise yielded no positive results, demonstrating non-targeted mass testing as an impractical strategy to track inter-hospital transmission.","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9326125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.5365/wpsar.2022.13.4.932
Sumaira Zafar, Hans J Overgaard, Tiengkham Pongvongsa, Nanthasane Vannavong, Sysavanh Phommachanh, Oleg Shipin, Joacim Rocklöv, Richard E Paul, Md Siddikur Rahman, Mayfong Mayxay
Dengue is a public health issue in tropical south-eastern Asia responsible for significant morbidity and mortality. Information on dengue epidemiology is necessary for developing strategies to control infections effectively. In the Lao People’s Democratic Republic (Lao PDR), Champasak and Savannakhet provinces account for around 30% of the national dengue burden. In this study, the dengue epidemiological profile in these two southern provinces of Lao PDR was described by analysing seasonal and spatial dengue notification data from 2003–2020 using the long-term mean (LTM) method. Savannakhet had a higher LTM (132.0 cases/month, 95% confidence interval [Cl]: 92.2–171.7) than Champasak (113.3 cases/month, 95% CI: 86.0–140.5), with peaks in dengue notifications following the rainy season in both provinces. The highest notification rates were observed in July to September; these months were also when the LTM was most frequently exceeded. Previously, dengue notifications were largely confined to the western districts of Savannakhet and the northern districts of Champasak, but more recently, notifications have increased in the eastern districts of Savannakhet and southern districts of Champasak. While the notification rate remained high in children and young adults (5–30 years), especially among students and farmers, a shift in the age structure of dengue cases was observed, with a greater proportion of notifications now occurring in those aged over 30 years. Community-based vector control and prevention programmes are needed to restrict the spread of dengue into new geographical areas in the southern provinces of Lao PDR.
{"title":"Epidemiological profile of dengue in Champasak and Savannakhet provinces, Lao People's Democratic Republic, 2003-2020.","authors":"Sumaira Zafar, Hans J Overgaard, Tiengkham Pongvongsa, Nanthasane Vannavong, Sysavanh Phommachanh, Oleg Shipin, Joacim Rocklöv, Richard E Paul, Md Siddikur Rahman, Mayfong Mayxay","doi":"10.5365/wpsar.2022.13.4.932","DOIUrl":"https://doi.org/10.5365/wpsar.2022.13.4.932","url":null,"abstract":"Dengue is a public health issue in tropical south-eastern Asia responsible for significant morbidity and mortality. Information on dengue epidemiology is necessary for developing strategies to control infections effectively. In the Lao People’s Democratic Republic (Lao PDR), Champasak and Savannakhet provinces account for around 30% of the national dengue burden. In this study, the dengue epidemiological profile in these two southern provinces of Lao PDR was described by analysing seasonal and spatial dengue notification data from 2003–2020 using the long-term mean (LTM) method. Savannakhet had a higher LTM (132.0 cases/month, 95% confidence interval [Cl]: 92.2–171.7) than Champasak (113.3 cases/month, 95% CI: 86.0–140.5), with peaks in dengue notifications following the rainy season in both provinces. The highest notification rates were observed in July to September; these months were also when the LTM was most frequently exceeded. Previously, dengue notifications were largely confined to the western districts of Savannakhet and the northern districts of Champasak, but more recently, notifications have increased in the eastern districts of Savannakhet and southern districts of Champasak. While the notification rate remained high in children and young adults (5–30 years), especially among students and farmers, a shift in the age structure of dengue cases was observed, with a greater proportion of notifications now occurring in those aged over 30 years. Community-based vector control and prevention programmes are needed to restrict the spread of dengue into new geographical areas in the southern provinces of Lao PDR.","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9326126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.5365/wpsar.2022.13.4.960
Denmarc R Aranas, Bernard A Demot, Thea Pamela T Cajulao
Ralstonia insidiosa is an opportunistic pathogen considered an emerging problem among clinically vulnerable populations such as those with chronic kidney disease. This study presents three cases of Ralstonia bacteraemia among chronic kidney disease patients in a haemodialysis unit in Baguio City, the Philippines. Case 1 was an elderly male who experienced chills during two concurrent dialysis sessions. Case 2 was a young female who also experienced chills and dizziness during a dialysis session; as this was thought to be related to hypotension, she was admitted. Case 3 was an elderly female with known hypertension and diabetes who had been newly diagnosed with chronic kidney disease; she was brought to the emergency department hypotensive, dyspnoeic and disoriented with deranged laboratory parameters and was admitted to the intensive care unit. All three cases had blood cultures positive for R. insidiosa with an attack rate of 1.67%. Drug and device tracing were conducted and environmental samples collected to identify the source of infection. A sample from the faucet of the reprocessing machine in the haemodialysis unit that was positive for Ralstonia spp. was the source of the outbreak. Control measures were implemented and the haemodialysis unit was thoroughly cleaned. No further cases were reported, with active surveillance continuing until January 2022. Taken with previously published outbreaks, these findings suggest that medical products and devices can be contaminated with Ralstonia spp. and cause illness. Early identification of cases and the source of infection is required to prevent large outbreaks in this vulnerable population.
{"title":"Outbreak of <i>Ralstonia</i> bacteraemia among chronic kidney disease patients in a haemodialysis unit in the Philippines.","authors":"Denmarc R Aranas, Bernard A Demot, Thea Pamela T Cajulao","doi":"10.5365/wpsar.2022.13.4.960","DOIUrl":"https://doi.org/10.5365/wpsar.2022.13.4.960","url":null,"abstract":"<p><p><i>Ralstonia insidiosa</i> is an opportunistic pathogen considered an emerging problem among clinically vulnerable populations such as those with chronic kidney disease. This study presents three cases of <i>Ralstonia</i> bacteraemia among chronic kidney disease patients in a haemodialysis unit in Baguio City, the Philippines. Case 1 was an elderly male who experienced chills during two concurrent dialysis sessions. Case 2 was a young female who also experienced chills and dizziness during a dialysis session; as this was thought to be related to hypotension, she was admitted. Case 3 was an elderly female with known hypertension and diabetes who had been newly diagnosed with chronic kidney disease; she was brought to the emergency department hypotensive, dyspnoeic and disoriented with deranged laboratory parameters and was admitted to the intensive care unit. All three cases had blood cultures positive for <i>R. insidiosa</i> with an attack rate of 1.67%. Drug and device tracing were conducted and environmental samples collected to identify the source of infection. A sample from the faucet of the reprocessing machine in the haemodialysis unit that was positive for <i>Ralstonia spp</i>. was the source of the outbreak. Control measures were implemented and the haemodialysis unit was thoroughly cleaned. No further cases were reported, with active surveillance continuing until January 2022. Taken with previously published outbreaks, these findings suggest that medical products and devices can be contaminated with <i>Ralstonia spp</i>. and cause illness. Early identification of cases and the source of infection is required to prevent large outbreaks in this vulnerable population.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9326124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: We described the characteristics of children reported as having influenza across five consecutive influenza seasons and investigated the usefulness of setting influenza thresholds in two satellite cities of Tokyo, Japan.
Methods: An annual survey was conducted among parents of children at preschools (kindergartens and nursery schools), elementary schools and junior high schools in Toda and Warabi cities, Saitama prefecture, at the end of the 2014-2018 influenza seasons. Using the World Health Organization method, we established seasonal, high and alert thresholds.
Results: There were 64 586 children included in the analysis. Over the five seasons, between 19.1% and 22% of children annually were reported as having tested positive for influenza. Influenza type A was reported as the dominant type, although type B was also reported in more than 40% of cases in the 2015 and 2017 seasons. The median period of the seasonal peak was 3 weeks in mid-January, regardless of school level. Of the five surveyed seasons, the high threshold was reached in 2014 and 2018, with no season exceeding the alert threshold.
Discussion: This study provides insights into the circulation of influenza in children in the study areas of Toda and Warabi, Japan, from 2014 to 2018. Although we were able to utilize these annual surveys to calculate influenza thresholds from five consecutive seasons, the prospective usefulness of these thresholds is limited as the survey is conducted at the end of the influenza season.
{"title":"Epidemiological survey to establish thresholds for influenza among children in satellite cities of Tokyo, Japan, 2014-2018.","authors":"Ayako Matsuda, Kei Asayama, Taku Obara, Naoto Yagi, Takayoshi Ohkubo","doi":"10.5365/wpsar.2022.13.3.911","DOIUrl":"https://doi.org/10.5365/wpsar.2022.13.3.911","url":null,"abstract":"<p><strong>Objective: </strong>We described the characteristics of children reported as having influenza across five consecutive influenza seasons and investigated the usefulness of setting influenza thresholds in two satellite cities of Tokyo, Japan.</p><p><strong>Methods: </strong>An annual survey was conducted among parents of children at preschools (kindergartens and nursery schools), elementary schools and junior high schools in Toda and Warabi cities, Saitama prefecture, at the end of the 2014-2018 influenza seasons. Using the World Health Organization method, we established seasonal, high and alert thresholds.</p><p><strong>Results: </strong>There were 64 586 children included in the analysis. Over the five seasons, between 19.1% and 22% of children annually were reported as having tested positive for influenza. Influenza type A was reported as the dominant type, although type B was also reported in more than 40% of cases in the 2015 and 2017 seasons. The median period of the seasonal peak was 3 weeks in mid-January, regardless of school level. Of the five surveyed seasons, the high threshold was reached in 2014 and 2018, with no season exceeding the alert threshold.</p><p><strong>Discussion: </strong>This study provides insights into the circulation of influenza in children in the study areas of Toda and Warabi, Japan, from 2014 to 2018. Although we were able to utilize these annual surveys to calculate influenza thresholds from five consecutive seasons, the prospective usefulness of these thresholds is limited as the survey is conducted at the end of the influenza season.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9671205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40504948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03eCollection Date: 2022-07-01DOI: 10.5365/wpsar.2022.13.3.874
Vannida Douangboupha, Philippa L Binns, Bouaphanh Khamphaphongphane, Virasack Som Oulay, Khanxay Sengsaiya, Thounchay Boupphaphanh, Phonepadith Xangsayarath
Objective: An increase in measles cases was reported in the north-western of the Lao People's Democratic Republic beginning in January 2019, with outbreaks quickly spreading throughout the country. Following identification of two laboratory-confirmed cases in Xaisomboun Province, we conducted an outbreak investigation to identify factors contributing to the measles outbreak in hard-to-reach Village X.
Methods: Active case-finding was undertaken at the provincial hospital and primary health care centre via a retrospective search through admission logbooks and house-to-house surveys in Village X and surrounding villages. Clinical samples were collected from suspected cases, and data were collected using a standard case investigation form. Vaccine coverage data were reviewed.
Results: Of the 40 suspected measles cases with rash onset during 12 February-27 April 2019, 83% (33/40) resided in Village X and 98% (39/40) were of Hmong-Lu Mien ethnicity. Ages ranged from 22 days to 5 years, with 70% (28) aged < 24 months. Almost half of cases aged 9 to < 18 months (5/11) and 67% (8/12) of cases aged 324 months had received a measles-containing vaccine (MCV). Reported MCV coverage in Xaisomboun for children aged < 1 year in 2017-2018 was < 50%. In 55% (22/40) of cases, case notification was delayed by 36 days. The final case classification comprised 10% laboratory-confirmed, 20% clinically compatible, 60% epidemiologically linked and 10% non-cases.
Discussion: This measles outbreak was likely associated with low immunization coverage, compounded by delays in reporting. Effective strategies are needed to address beliefs about and health literacy barriers to immunization and measles awareness. Such strategies may improve MCV coverage and early diagnosis, enabling timely public health interventions and reducing mortality and morbidity.
{"title":"Factors contributing to a measles outbreak in a hard-to-reach rural village in Xaisomboun Province, \u2028Lao People's Democratic Republic.","authors":"Vannida Douangboupha, Philippa L Binns, Bouaphanh Khamphaphongphane, Virasack Som Oulay, Khanxay Sengsaiya, Thounchay Boupphaphanh, Phonepadith Xangsayarath","doi":"10.5365/wpsar.2022.13.3.874","DOIUrl":"https://doi.org/10.5365/wpsar.2022.13.3.874","url":null,"abstract":"<p><strong>Objective: </strong>An increase in measles cases was reported in the north-western of the Lao People's Democratic Republic beginning in January 2019, with outbreaks quickly spreading throughout the country. Following identification of two laboratory-confirmed cases in Xaisomboun Province, we conducted an outbreak investigation to identify factors contributing to the measles outbreak in hard-to-reach Village X.</p><p><strong>Methods: </strong>Active case-finding was undertaken at the provincial hospital and primary health care centre via a retrospective search through admission logbooks and house-to-house surveys in Village X and surrounding villages. Clinical samples were collected from suspected cases, and data were collected using a standard case investigation form. Vaccine coverage data were reviewed.</p><p><strong>Results: </strong>Of the 40 suspected measles cases with rash onset during 12 February-27 April 2019, 83% (33/40) resided in Village X and 98% (39/40) were of Hmong-Lu Mien ethnicity. Ages ranged from 22 days to 5 years, with 70% (28) aged < 24 months. Almost half of cases aged 9 to < 18 months (5/11) and 67% (8/12) of cases aged <sup>3</sup>24 months had received a measles-containing vaccine (MCV). Reported MCV coverage in Xaisomboun for children aged < 1 year in 2017-2018 was < 50%. In 55% (22/40) of cases, case notification was delayed by <sup>3</sup>6 days. The final case classification comprised 10% laboratory-confirmed, 20% clinically compatible, 60% epidemiologically linked and 10% non-cases.</p><p><strong>Discussion: </strong>This measles outbreak was likely associated with low immunization coverage, compounded by delays in reporting. Effective strategies are needed to address beliefs about and health literacy barriers to immunization and measles awareness. Such strategies may improve MCV coverage and early diagnosis, enabling timely public health interventions and reducing mortality and morbidity.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9583712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40459491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}