Emerging Health Threats Journal[JOURNAL]
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81 papers
The public's acceptance of novel vaccines during a pandemic: a focus group study and its application to influenza H1N1.
Henrich N, Holmes B
Emerg Health Threats J · 2009 · PMID 22460289 · Full text
As influenza H1N1 spreads around the world, health officials are considering the development and use of a new vaccine to protect the public and help control the outbreak. Acceptance of novel vaccines during health crises...
As influenza H1N1 spreads around the world, health officials are considering the development and use of a new vaccine to protect the public and help control the outbreak. Acceptance of novel vaccines during health crises, however, is influenced by perceptions of a range of risks, including the risk of infection, risk of becoming severely ill or dying if infected, as well as the risk of serious side and long-term effects of the vaccine. A study on 11 focus groups was conducted with the public in Vancouver, Canada in 2006 and 2007 to explore how people assess these risks and how these assessments relate to their willingness to use novel vaccines in a pandemic. Concerns about using new vaccines during a pandemic differ from concerns about using established products in a non-crisis situation. Participants were hesitant to use novel vaccines because of a low perception of the early risk of infection in a pandemic, coupled with the many uncertainties that surround new vaccines and the emerging infectious disease, and owing to the concern that unsafe pharmaceuticals may be rushed to market during a health crisis. Understanding the public´s assessment of the risks related to, and willingness to use, novel vaccines during a pandemic can help officials promote disease-control measures in ways that improve the likelihood of acceptance by the public and may increase uptake of an H1N1 vaccine.
An assessment of bioterrorism competencies among health practitioners in Australia.
Canyon D
Emerg Health Threats J · 2009 · PMID 22460288 · Full text
Public health and medical professionals are expected to be well prepared for emergencies, as they assume an integral role in any response. They need to be aware of planning issues, be able to identify their roles in emer...
Public health and medical professionals are expected to be well prepared for emergencies, as they assume an integral role in any response. They need to be aware of planning issues, be able to identify their roles in emergency situations, and show functional competence. However, media perceptions and non-empirical publications often lack an evidence base when addressing this topic. This study attempted to assess the competencies of various health professionals by obtaining quantitative data on the state of bioterrorism preparedness and response competencies in Australia using an extensive set of competencies developed by Kristine Gebbie from the Columbia University School of Nursing Center for Health Policy with funding from the US Centres for Disease Control and Prevention. These competencies reflect the knowledge, capabilities, and skills that are necessary for best practice in public health. Sufficient data were collected to enable comparison between public health leaders, communicable disease specialists, clinicians (with and without medical degrees), and environmental health professionals. All health professionals performed well. However, the primary finding of this study was that clinicians consistently self-assessed themselves as lower in competence, and clinicians with medical degrees self-assessed themselves as the lowest in bioterrorism competence. This has important implications for health professional training, national benchmarks, standards, and competencies for the public health workforce.
Population response to the risk of vector-borne diseases: lessons learned from socio-behavioural research during large-scale outbreaks.
Setbon M, Raude J
Emerg Health Threats J · 2009 · PMID 22460287 · Full text
Vector-borne infectious diseases, such as malaria, dengue, chikungunya, and West Nile fevers are increasingly identified as major global human health threats in developing and developed countries. The success or failure...
Vector-borne infectious diseases, such as malaria, dengue, chikungunya, and West Nile fevers are increasingly identified as major global human health threats in developing and developed countries. The success or failure of vector control rests mainly on the nature and scale of the behavioural response of exposed populations. Large-scale adoption of recommended protective behaviour represents a critical challenge that cannot be addressed without a better understanding of how individuals perceive and react to the risk of infection. Recently, French overseas territories faced large-scale outbreaks: an epidemic of chikungunya fever in La Re' union and Mayotte (2005-2006) and four successive outbreaks of dengue fever in one Caribbean island, Martinique (1995-2007). To assess how these populations perceived and responded to the risk, and how the nature and scale of protection affected their clinical status, socio-epidemiological surveys were conducted on each island during the outbreaks. These surveys address three crucial and interconnected questions relevant to the period after persons infected by the virus were identified: which factors shape the risk of acquiring disease? Which socio- demographic characteristics and living conditions induce a higher likelihood of infection? What is the impact of risk perception on protective behaviours adopted against mosquito bites? Grounded on the results of these surveys, a general framework is proposed to help draw out the knowledge needed to reveal the factors associated with higher probability of infection as an outbreak emerges. The lessons learnt can inform health authorities' efforts to improve risk communication programmes, both in terms of the target and content of messages, so as to explore new strategies for ensuring sustainable protective behaviour. The authors compare three epidemics of vector-borne diseases to elucidate psychosocial factors that determine how populations perceive and respond to the risk of infectious disease.
Emerging aspects of mobile phone use.
Samkange-Zeeb F, Blettner M
Emerg Health Threats J · 2009 · PMID 22460286 · Full text
The mobile phone is a modern-day invention, which has managed to reach many parts of the world enabling telecommunications across areas where it was not possible before. Although these devices have proved to be life savi...
The mobile phone is a modern-day invention, which has managed to reach many parts of the world enabling telecommunications across areas where it was not possible before. Although these devices have proved to be life saving in certain circumstances (e.g., after accidents) and helped improve the quality of life in some sectors, concerns continue to be raised about potential adverse health impacts associated with their use. These range from cancer and cognitive deficiencies to subjective effects, such as a feeling of warmth around the ear used, headache and fatigue. We provide an overview of the concerns raised and summarise what is known about them. We conducted a literature search in Pubmed/Medline to identify published papers on health effects of mobile phones, and an intensive search on the Internet to collect data on the global use of mobile phones. In the year 2000, there were an estimated 500 million mobile phone users worldwide. Today, there are about 3.3 billion users. The use of mobile phones among young children and adolescents is also increasing. Health-risk research has mainly focused on adults and on a single outcome, brain tumours. No significant relationship has been established between mobile phone use and the incidence or growth of brain tumours. Other research indicates emerging concerns, including hearing problems and self-reported health symptoms, such as tiredness, stress, headache, anxiety, concentration difficulties and sleep disturbances, but results remain inconclusive. Currently, there is little epidemiological evidence indicating that the use of mobile phones causes adverse health effects.
The health consequences of economic crises.
Robertson A
Emerg Health Threats J · 2009 · PMID 22460285 · Full text
Abstract loading — click title to view on PubMed.
Emerging aspects of assessing lead poisoning in childhood.
Jones A
Emerg Health Threats J · 2009 · PMID 22460284 · Full text
This review covers the epidemiology of lead poisoning in children on a global scale. Newer sources of lead poisoning are identified. The methods that are used to assess a population of children exposed to lead are discus...
This review covers the epidemiology of lead poisoning in children on a global scale. Newer sources of lead poisoning are identified. The methods that are used to assess a population of children exposed to lead are discussed, together with the ways of undertaking an exposure risk assessment; this includes assessing the time course and identifying sources of lead exposure. Human assessment measures for lead toxicity, such as blood lead concentrations, deciduous tooth lead, and use of zinc protoporphyrin estimations are evaluated. The role of isotopic fingerprinting techniques for identifying environmental sources of exposure is discussed. Among emerging data on the cognitive and behavioral effects of lead on children, the review considers the growing evidence of neurocognitive dysfunction with blood lead concentrations even below 10 µg/dl. The challenge of assessing and explaining the risk that applies to an individual as opposed to a population is discussed. Intervention strategies to mitigate risk from lead are examined together with the limited role for and limitations of chelation therapy for lead. Lessons learned from managing a population lead-dust exposure event in Esperance, Western Australia in 2007 are discussed throughout the review.
Preparedness planning for pandemic influenza among large US maternity hospitals.
Beigi R, Davis G, Hodges J … +1 more , Akers A
Emerg Health Threats J · 2009 · PMID 22460283 · Full text
The objective of this investigation was to determine the state of pandemic influenza preparedness and to delineate commonly reported challenges among a sample of larger US national maternity hospitals. This was done give...
The objective of this investigation was to determine the state of pandemic influenza preparedness and to delineate commonly reported challenges among a sample of larger US national maternity hospitals. This was done given the recent emphasis on hospital disaster planning and the disproportionate morbidity and mortality that pregnant women have suffered in previous influenza pandemics. An internet-based survey was sent to all 12 members of the Council of Women's and Infants' Specialty Hospitals. Questions addressed hospital demographics and overall pandemic preparedness planning, including presence of a pandemic planning committee and the existence of written plans addressing communications, surge capacity, degradation of services, and advance supply planning. Nine of 12 (75%) hospitals responded. All had active pandemic planning committees with identified leadership. The majority (78%) had written formal plans regarding back-up communications, surge/overflow capacity, and degradation of services. However, fewer (44%) reported having written plans in place regarding supply-line/stockpiling of resources. The most common challenges noted were staff and supply coordination, ethical distribution of limited medical resources, and coordination with government agencies. In conclusion, the majority of the Council of Women's and Infants' Specialty Hospitals maternity hospitals have preliminary infrastructure for pandemic influenza planning, but many challenges exist to optimize maternal and fetal outcomes during the next influenza pandemic.
In the name of the greater good?
Kirkwood K
Emerg Health Threats J · 2009 · PMID 22460282 · Full text
In the event of a pandemic that poses widespread infection and high death rates, the utilitarian mandate to 'reduce harm' is the relevant moral value that trumps other ethical considerations. The primacy of a utilitarian...
In the event of a pandemic that poses widespread infection and high death rates, the utilitarian mandate to 'reduce harm' is the relevant moral value that trumps other ethical considerations. The primacy of a utilitarian approach dictates that those who are in a position to assist the cessation of the most serious outbreaks in whatever role they may have, must be present to provide their services, and those who administer health care must also be present to ensure that all responders are supported and protected to the highest degree.
Modeling vaccination campaigns and the Fall/Winter 2009 activity of the new A(H1N1) influenza in the Northern Hemisphere.
Bajardi P, Poletto C, Balcan D … +9 more , Hu H, Goncalves B, Ramasco J, Paolotti D, Perra N, Tizzoni M, Van den Broeck W, Colizza V, Vespignani A
Emerg Health Threats J · 2009 · PMID 22460281 · Full text
The unfolding of pandemic influenza A(H1N1) for Fall 2009 in the Northern Hemisphere is still uncertain. Plans for vaccination campaigns and vaccine trials are underway, with the first batches expected to be available ea...
The unfolding of pandemic influenza A(H1N1) for Fall 2009 in the Northern Hemisphere is still uncertain. Plans for vaccination campaigns and vaccine trials are underway, with the first batches expected to be available early October. Several studies point to the possibility of an anticipated pandemic peak that could undermine the effectiveness of vaccination strategies. Here, we use a structured global epidemic and mobility metapopulation model to assess the effectiveness of massive vaccination campaigns for the Fall/Winter 2009. Mitigation effects are explored depending on the interplay between the predicted pandemic evolution and the expected delivery of vaccines. The model is calibrated using recent estimates on the transmissibility of the new A(H1N1) influenza. Results show that if additional intervention strategies were not used to delay the time of pandemic peak, vaccination may not be able to considerably reduce the cumulative number of cases, even when the mass vaccination campaign is started as early as mid-October. Prioritized vaccination would be crucial in slowing down the pandemic evolution and reducing its burden.
Migrants and emerging public health issues in a globalized world: threats, risks and challenges, an evidence-based framework.
Gushulak B, Weekers J, Macpherson D
Emerg Health Threats J · 2009 · PMID 22460280 · Full text
International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mob...
International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mobile populations can link zones of disease emergence to lowprevalence or nonendemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, as well as civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (such as genetics/biology, behavior, environment, and socioeconomics), population-based disease prevalence differences, existing national and international health policies and regulations, as well as inter-regional shifts in population demographics and health outcomes. This paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration, and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders ranging from individual health-care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced by global health events.
Host defence peptides: antimicrobial and immunomodulatory activity and potential applications for tackling antibiotic-resistant infections.
Nijnik A, Hancock R
Emerg Health Threats J · 2009 · PMID 22460279 · Full text
The rapidly increasing incidence of multidrug-resistant infections and the alarmingly low rate of discovery of conventional antibiotics create an urgent need for alternative strategies to treat bacterial infections. Host...
The rapidly increasing incidence of multidrug-resistant infections and the alarmingly low rate of discovery of conventional antibiotics create an urgent need for alternative strategies to treat bacterial infections. Host defence peptides are short cationic molecules produced by the immune systems of most multicellular organisms; they are a class of compounds being actively researched. In this review, we provide an overview of the antimicrobial and immunomodulatory activities of natural host defence peptides, and discuss strategies for creating artificial derivatives with improved biological and pharmacological properties, issues of microbial resistance, and challenges associated with their adaptation for clinical use.
Meeting the needs of people in emergencies: a review of UK experiences and capability.
Eyre A
Emerg Health Threats J · 2008 · PMID 22460218 · Full text
This article summarises the key findings of two research studies conducted for the UK Government in 2006-2007. The first was a literature review of evidence about provisions and interventions to meet the needs of people...
This article summarises the key findings of two research studies conducted for the UK Government in 2006-2007. The first was a literature review of evidence about provisions and interventions to meet the needs of people affected by 'emergencies' as defined within the Civil Contingencies Act (2004). Drawing on both historical and contemporary research and practice, the literature review presented an assessment of people's psychosocial needs after events such as natural disasters, terrorism, and other major incidents. Although some reference was made about the needs of and consequences on disaster workers responding to these events, the main emphasis was on those directly affected as bereaved people and/or injured survivors. The review offered best practice guidelines based on the most effective methods of humanitarian assistance in the immediate, short-term, and long-term aftermath of major emergencies. The second report was a follow-up study conducted in 2007. This was a piece of primary research focusing on the UK's current capability in humanitarian assistance in terms of the extent of planning, training, exercising, and experience relating to meeting people's needs in emergencies. A variety of methods were used to gather quantitative and qualitative evidence of the nature and status of such activity across the UK, including questionnaires, focus groups, and a review of literature and documentary evidence. The report included a number of good practice case studies and made recommendations for the development of best practice in humanitarian assistance within the UK.
Hepatitis E: a complex and global disease.
Pelosi E, Clarke I
Emerg Health Threats J · 2008 · PMID 22460217 · Full text
Thirty years after its discovery, the hepatitis E virus (HEV) continues to represent a major public health problem in developing countries. In developed countries, it has emerged as a significant cause of non-travel-asso...
Thirty years after its discovery, the hepatitis E virus (HEV) continues to represent a major public health problem in developing countries. In developed countries, it has emerged as a significant cause of non-travel-associated acute hepatitis. HEV infects a wide range of mammalian species and a key reservoir worldwide appears to be swine. Genomic sequence similarity between some human HEV genotypes and swine HEV strains has been identified and we know that humans can acquire HEV infection from animals. Although for the most part the clinical course of HEV infection is asymptomatic or mild, significant risk of serious disease exists in pregnant women and those with chronic liver disease. In addition, there are data on the threat of chronic infections in immunocompromised patients. Beyond management of exposure by public health measures, recent data support that active immunisation can prevent hepatitis E, highlighting the need for vaccination programmes. Here we review the current knowledge on HEV, its epidemiology, and the management and prevention of human disease.
Chronic health effects of sulphur mustard exposure with special reference to Iranian veterans.
Balali-Mood M, Mousavi Sh, Balali-Mood B
Emerg Health Threats J · 2008 · PMID 22460216 · Full text
The widespread use of sulphur mustard (SM) as an incapacitating chemical warfare agent in the past century has proved its long-lasting toxic effects. It may also be used as a chemical terrorist agent. Therefore, all heal...
The widespread use of sulphur mustard (SM) as an incapacitating chemical warfare agent in the past century has proved its long-lasting toxic effects. It may also be used as a chemical terrorist agent. Therefore, all health professionals should have sufficient knowledge and be prepared for any such chemical attack. SM exerts direct toxic effects on the eyes, skin, and respiratory tissue, with subsequent systemic action on the nervous, immunological, haematological, digestive, and reproductive systems. SM is an alkylating agent that affects DNA synthesis, and, thus, delayed complications have been seen since the First World War. Cases of malignancies in the target organs, particularly in haematopoietic, respiratory, and digestive systems, have been reported. Important delayed respiratory complications include chronic bronchitis, bronchiectasis, frequent bronchopneumonia, and pulmonary fibrosis, all of which tend to deteriorate with time. Severe dry skin, delayed keratitis, and reduction of natural killer cells with subsequent increased risk of infections and malignancies are also among the most distressing long-term consequences of SM intoxication. However, despite a lot of research over the past decades on Iranian veterans, there are still major gaps in the SM literature. Immunological and neurological dysfunction, as well as the relationship between SM exposure and mutagenicity, carcinogenicity, and teratogenicity are important fields that require further studies, particularly on Iranian veterans with chronic health effects of SM poisoning. There is also a paucity of information on the medical management of acute and delayed toxic effects of SM poisoning-a subject that greatly challenges health care specialists.
Syphilis in China: the great comeback.
Hesketh T, Ye X, Zhu W
Emerg Health Threats J · 2008 · PMID 22460215 · Full text
China is currently witnessing a major resurgence of syphilis from the elimination of the disease in the 1960s to 5.3 per 100,000 people incidence in 2000-2005. The reasons for the elimination and subsequent resurgence of...
China is currently witnessing a major resurgence of syphilis from the elimination of the disease in the 1960s to 5.3 per 100,000 people incidence in 2000-2005. The reasons for the elimination and subsequent resurgence of syphilis in China lie at the heart of much public health debate, highlighting both the relationship between politics and public health, and the role of government in controlling disease. Were the Draconian measures to control syphilis during the early Mao years a price worth paying for the effective control? Is the recent resurgence of syphilis an inevitable consequence of economic development and greater freedom for the individual, which will ultimately lead to better health for the majority of the population? Could tougher control measures such as those of the early Mao years be re-introduced in the current social and economic climate in China? In this review, we briefly chart the history of the syphilis epidemic in China, its elimination in the 1960s, and its gradual resurgence in the past two decades. We explore the reasons for this resurgence, and we conclude with a discussion on the options for control.
Knowledge-base black holes: the next (small) big thing?
Dunn K
Emerg Health Threats J · 2008 · PMID 22460214 · Full text
Abstract loading — click title to view on PubMed.
Development of a national burn network: providing a co-ordinated response to a burn mass casualty disaster within the Australian health system.
Wood F, Edgar D, Robertson A
Emerg Health Threats J · 2008 · PMID 22460213 · Full text
With the threat of terrorist activity ever present since the incidents in Bali and Jakarta, the Australian health system must be prepared to manage another mass burn casualty disaster. The Australian and New Zealand Burn...
With the threat of terrorist activity ever present since the incidents in Bali and Jakarta, the Australian health system must be prepared to manage another mass burn casualty disaster. The Australian and New Zealand Burns Association (ANZBA) highlighted the lack of a national burn disaster response before the 2000 Olympics. With the limited number of burn beds available and the protracted length of stay after such injuries, any state or territory could be overwhelmed with relatively few patient admissions. In 2002, the Australian Health Minister's Conference called for a solution. The objective of this paper is to provide an overview of the process and development of the Australian National Burn Network, which underpins the National Burn Disaster Response (AUSBURNPLAN).
Biodefense countermeasures: the impact of Title IV of the US Pandemic and All-Hazards Preparedness Act.
Gronvall G
Emerg Health Threats J · 2008 · PMID 22460212 · Full text
The 2006 US Pandemic and All-Hazards Preparedness Act gave the Department of Health and Human Services (HHS) new authority to fund the development and procurement of medical countermeasures against chemical, biological,...
The 2006 US Pandemic and All-Hazards Preparedness Act gave the Department of Health and Human Services (HHS) new authority to fund the development and procurement of medical countermeasures against chemical, biological, radiological, and nuclear (CBRN) threats. The legislation builds on the authority the HHS gained in 2004 under Project BioShield, which established a fund to procure medical countermeasures. This article reviews the new HHS authorities and the improvements on BioShield, and it describes some of the challenges HHS will face in exercising the new authorities to fund the development and procurement of medical countermeasures against CBRN threats.
Influenza and respiratory syncytial virus infections in British Hajj pilgrims.
Rashid H, Shafi S, Booy R … +7 more , El Bashir H, Ali K, Zambon M, Memish Z, Ellis J, Coen P, Haworth E
Emerg Health Threats J · 2008 · PMID 22460211 · Full text
Viral respiratory infections including influenza and respiratory syncytial virus (RSV) have been reported during the Hajj among international pilgrims. To help establish the burden of these infections at the Hajj, we set...
Viral respiratory infections including influenza and respiratory syncytial virus (RSV) have been reported during the Hajj among international pilgrims. To help establish the burden of these infections at the Hajj, we set up a study to confirm these diagnoses in symptomatic British pilgrims who attended the 2005 Hajj. UK pilgrims with symptoms of upper respiratory tract infection (URTI) were invited to participate; after taking medical history, nasal swabs were collected for point-of-care testing (PoCT) of influenza and for subsequent PCR analysis for influenza and RSV. Of the 205 patients recruited, 37 (18%) were positive for either influenza or RSV. Influenza A (H3) accounted for 54% (20/37) of the virus-positive samples, followed by RSV 24% (9/37), influenza B 19% (7/37), and influenza A (H1) 3% (1/37). Of the influenza-positive cases, 29% (8/28) had recently had a flu immunisation. Influenza was more common in those who gave a history of contact with a pilgrim with a respiratory illness than those who did not (17 versus 9%). The overall rate of RSV was 4% (9/202). This study confirms that influenza and RSV cause acute respiratory infections in British Hajj pilgrims. Continuing surveillance and a programme of interventions to contain the spread of infection are needed at the Hajj, particularly when the world is preparing for an influenza pandemic.
Gulf War syndrome: an emerging threat or a piece of history?
Greenberg N, Wessely S
Emerg Health Threats J · 2008 · PMID 22460210 · Full text
'Gulf War syndrome' is a phrase coined after the 1991 Gulf War to group together disparate, unexplained health symptoms in Gulf veterans. This paper examines the many hypotheses that have been put forward about the origi...
'Gulf War syndrome' is a phrase coined after the 1991 Gulf War to group together disparate, unexplained health symptoms in Gulf veterans. This paper examines the many hypotheses that have been put forward about the origins of the concept and gives an overview of the studies that have attempted to explain the lasting health effects associated with Gulf service. Our review finds that although in the UK there has not yet been evidence of a new Gulf War syndrome as a result of the current conflicts in Iraq and Afghanistan, there is a rise in post-conflict psychiatric disorders now being reported in the USA. We postulate that after conflicts military personnel will always face some form of post-conflict syndrome and the nature of the threats experienced is likely to dictate the form the syndrome might take. We also postulate that media reporting is likely to have influenced and to continue unhelpfully to influence the health of service personnel.
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