The natural history of EVD has shown that the disease may pose a problem to developed countries and may present a thread to individuals. Emerg Infect Dis. Almqvist); Umeå University, Umeå, Sweden (J. Rocklöv). Thus, the most cost-effective strategy would be to directly tackle the underlying drivers of an IDTE rather than deal with the actual IDTE after the fact (10). disease outbreak, transmission, and surveillance as an important area of study. This outbreak was not unexpected, given the highly infectious nature of measles paired with the Somali community’s steadily decreasing MMR vaccination rates in young children. Cholera is caused by the bacterium Vibrio cholerae, a tiny microbe that can infect the intestines. Of 7 malaria threat events, 5 included autochthonous cases (in Spain, Greece, and Belgium). As an example, a contaminated batch of heroin (global trade driver) caused 31 anthrax infections among heroin users in Scotland (vulnerable groups, lifestyle, sociodemographic drivers) (30). B. This paper is dedicated to the memory of Dr. James Mendlein (1950–2015), whose commitment to global health and passion for social justice was an inspiration to all of us ( Would you like email updates of new search results? Am J Trop Med Hyg. Discuss the risk factors involved. However, more important, the likelihood of IDTEs originating in the first place can be reduced by intervening directly on their underlying drivers. At the time the outbreak began, the MMR rate for 24 month-old Somali children born in Minnesota was at 42%; and 36% in Hennepin County. Foodborne and waterborne diseases and vectorborne diseases were the most commonly occurring drivers in combinations of 2 and 3 drivers. That toxin disrupts the way cells absorb and process fluids and electrolytes, forcing them to go in just one direction: out. Large multistate outbreak of norovirus gastroenteritis associated with frozen strawberries, Germany, 2012. 4. Four of these IDTEs consisted of the first autochthonous WNV cases in 4 different European countries and 1 large outbreak in southeastern Europe with >260 cases (16). NLM The Disease Outbreak Channel of Exchange Rate Return ... among others, as key determinants of equilibrium exchange rates (Iyke 2018). In autumn 2009, an outbreak of 93 cases of E. coli O157 (verotoxin-producing E. coli) infection in southern England was related to environmental and animal exposure on a petting farm visited by families and children (tourism, vulnerable groups, animal health, and natural environment drivers) (Figure 2, panel C) (22). Historically, novel pathogens have emerged and reemerged repeatedly in human populations and affected public health; similarly, pathogens that have been present in a population at low levels have increased rapidly in incidence or geographic range with equally grave consequences (3). The IDTEs were sorted into 10 categories (Table 2). You will be subject to the destination website's privacy policy when you follow the link. Assistant Professor of Epidemiology. Cluster dendrogram from hierarchical cluster analysis of drivers contributing to observed infectious disease threat events (IDTEs), Europe, 2008–2013. The hierarchical cluster analysis revealed several similarly clustered segments, such as climate and natural environment and migration and social inequality, indicating that these drivers are more related to each other than to the other drivers. This is the first ever practical guide to the valuable role that health promotion can play in disease outbreaks and health emergencies. Measles is a highly contagious, albeit vaccine-preventable, disease that can lead to serious complications. Ebola virus disease - pathogenesis, clinical presentation and management. The context of infectious disease emergence has changed over the centuries, but Europe has remained and even intensified as a hot spot for emerging infectious diseases over recent decades (4). MATERIALS AND METHODS: We used an existing software platform to simulate waterborne disease outbreaks of varying duration and magnitude. This charge is accomplished through epidemic intelligence, a process to detect, verify, analyze, assess, and investigate events that may represent a threat to public health. The captured events are then filtered and verified before they are assessed and investigated. Social determinants-such as education, race/ethnicity, socioeconomic status, access to health care services and vaccination, neighborhood-level stressors, and workplace or school policies-can impact influenza illness and outbreaks in the United States. In this analysis of epidemic intelligence data, travel and tourism was not only the most distinct but also the most recurrent driver implicated in the emergence of IDTEs. If need be, a Public Health Event is declared to initiate control measures. An outbreak of Legionnaires’ disease associated with a contaminated air-conditioning cooling tower. Emerging infections: a perpetual challenge. 4. Despite repeated outbreaks, the disease is not given much importance in medical undergraduate and … Aerosol? Social Determinants of EBV Outbreak in West Africa The population health is determined by the outcome of the interplay between the population and social environment. 1. What is this type of curve seen with? Seventeen drivers were identified and categorized into 3 groups: globalization and environment, sociodemographic, and public health systems. Large ongoing Q fever outbreak in the south of the Netherlands, 2008.  |  PLoS One. We hypothesise that SEP plays an important role in the COVID-19 pandemic either directly or indirectly via occupation, living conditions, health-related behaviours, presence of comorbidities and immune functioning. Toward the goal of understanding and improving the health of people with diabetes through addressing SDOH, a writing … 3. Epidemiology is a scientific discipline with sound methods of scientific inquiry at its foundation. Number of observed infectious disease threat events (IDTEs) in relation to number of drivers for each IDTE group, Europe, 2008–2013. Ten IDTEs, including measles, mumps, rubella, and pertussis outbreaks, were reported for the vaccine-preventable IDTE category. (See the Major Article by Bartsch et al, on pages 920–31; Rosenberg et al, on pages 932–40.). QUICK TAKE Measles Outbreak and Herd Immunity 02:30. WNV infection and malaria are notifiable diseases in the EU and, thus, subject to indicator surveillance; however, special threat events are picked up by event-based surveillance as well. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. SEP has been previously established as a potential determinant of infectious diseases in general. The following persons have contributed to the epidemic intelligence activities at the European Centre for Disease Prevention and Control: Sergio Brusin, Alastair Donachie, Assimoula Economopoulou, Alice Friaux, Kaja Kaasik Aaslav, Peter Kreidl, Jas Mantero, Thomas Mollet, Otilia Sfetcu, Bertrand Sudre, and Edit Szegedi. The strongest driver in this IDTE group was food and water quality, implicating the food industry and water treatment infrastructure, often in combination with the travel and tourism or global trade drivers (Figure 2, panel A). Discordant assessments were resolved by consensus. SEP has been previously established as a potential determinant of infectious diseases in general. Although Aedes aegypti, the mosquito-vector responsible for this particular outbreak, is extinct in mainland Europe, climatic and globalization trends have eased the … Please use the form below to submit correspondence to the authors or contact them at the following address: Jan C. Semenza, European Centre for Disease Prevention and Control, Tomtebodavägen 11A, SE-171 83 Stockholm, Sweden. 10 A propagated source epidemic curve indicates what? Analyze the epidemiological determinants of the outbreak. This understanding can inform communication strategies aimed at minimizing the impact and spread of the disease. After a devastating 7.0 magnitude earthquake in January 2010, CDC’s support expanded to address Haiti’s critical health needs, such as cholera, as … National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Epidemiology is data-driven and relies on a systematic and unbiased approach to the collection, analysis, and interpretation of data. doi: 10.1371/journal.pone.0179356. Additional information is gathered through direct contact with epidemiologists and health authorities in the EU and abroad. Analyze the epidemiological determinants and risk factors associated with the outbreak. Table of Contents – Volume 22, Number 4—April 2016. Discuss the route of transmission of the disease. Our analysis identified human-made environments, in particular contaminated cooling towers or spa pools, to be the overarching driver of Legionella infection events (31). Contact? We examined the epidemiological and genomic determinants of two well-characterized tuberculosis outbreaks attributed to two super-spreaders among First Nations in the province of Alberta. Vice-President of Membership and Co-Chair Global Working Group on the Social Determinants of Health, IUHPE, Paris, France. Crowded and poorly ventilated living and working environments often associated with poverty constitute direct risk factors for tuberculosis transmission. Global trends in emerging infectious diseases. The 2012 Madeira Dengue Outbreak: Epidemiological Determinants and Future Epidemic Potential. ), virulence (how deadly is it? EPI 201 Outbreak Investigation and Response (5) I&S/NW, QSR J. BASEMAN Provides an introduction to infectious disease outbreaks of both domestic and global significance. Suboptimal food safety systems, even if they are distant to the outbreak, become an international public health issue in an interconnected world in which food and humans move freely (Figure 2) (37). Discuss any risk factors involved. The evolution of Ebola virus disease outbreaks. Seventeen drivers were identified and categorized into 3 groups: globalization and environment, sociodemographic, and public health systems. Nearly half of the 27 IDTEs within the vectorborne and rodentborne IDTE category were caused by West Nile virus (WNV) infections. During May 16–21, the team attempted to conduct a telephone interview with a parent or guardian in each student household. Measles outbreak in Bulgaria: poor maternal educational attainment as a risk factor for medical complications. Similarly, pathogen introduction into competent vector populations can result in local transmission and threaten the safety of the blood supply (35). Factors related to baseline and outbreak cases are fundamental determinants of detection. Clipboard, Search History, and several other advanced features are temporarily unavailable. Earlier, it was maintained that plague had ceased to exist in India after 1966 . A retrospective cohort of COVID-19 patients from four hospitals in three provinces in China was established, and 598 patients were included from 1 January … Once you have found a specific outbreak, you can discuss the epidemiological determinants of thisoutbreak more fully. Students will learn about modern outbreaks, historic outbreaks of significance and will explore the tools that outbreak investigators use to stop the spread of outbreaks in populations and to prevent future outbreaks. Eurogin 2010 roadmap on cervical cancer prevention. INTRODUCTION. A local outbreak of plague had occurred in Himachal Pradesh (2002) and Uttaranchal (2004). With the increased mobility of human populations, diseases can quickly spread around the world. Previously reported predictors of psychiatric complications during communicable disease outbreaks include sociodemographic variables [e.g., being a health care worker (HCW)] [ 4, 5 ], severe outbreaks of infectious diseases locally [ 11 ], health beliefs toward infectious diseases [e.g., perceived risk or threat of infection] [ 12, 13 ], and psychosocial variables [e.g., social support, medical history of … The foodborne and waterborne category included all types of diseases transmitted through food or water (Table 1) and was responsible for the most IDTEs. The current study aims to identify the determinants of illness severity of COVID-19 based on ordinal responses. Determinants of Disease 3. ARLINGTON, Va., Nov. 2, 2020 /PRNewswire/ -- Today, the American Diabetes Association® (ADA), the nation’s leading organization for all people living with diabetes, published a scientific review addressing social determinants of health (SDOH) and diabetes. Most IDTEs had a combination of drivers: 51% had 2 drivers, and 25% had 3 drivers (Figure 1). Ebola virus infection; chain of infection; determinants; replication number; risk factor; source; spread; transmission. Nat Rev Dis Primers. The paper summarizes available evidence regarding the determinants of spread of Ebola virus disease, including health care and community related risk factors. a. Natural History of Disease … Seventeen drivers were identified and categorized into 3 groups: globalization and environment, sociodemographic, and public health systems. While this has led to a growing body of research studying the effects of a variety of international and domestic factors on disease outbreaks, very little research has inverted this relationship by studying the effects of disease outbreaks on international systems. Jacob ST, Crozier I, Fischer WA 2nd, Hewlett A, Kraft CS, Vega MA, Soka MJ, Wahl V, Griffiths A, Bollinger L, Kuhn JH. 3. ( NewMediaWire) - December 03, 2020 - DALLAS - Researchers from University of Michigan and University of Alabama studying the impact of in-person college classes on community COVID-19 cases and the affect social determinants of health play in virus outbreaks and deaths won the top awards in the American Heart Association’s first ever COVID-19 data challenge. The events in the multidrug resistance–associated IDTE group consisted of a nosocomial outbreak of multidrug-resistant carbapenemase-producing Klebsiella pneumoniae infection in 2 hospitals in Ireland and 69 infections with New Delhi metallo-β-lactamase-1 carbapenemase-producing Enterobacteriaceae in persons in the United Kingdom with a travel history to India or Pakistan (26). 2015 Sep;93(3):438-40. doi: 10.4269/ajtmh.15-0229. Source: Franceschi S, Denny L, Irwin KL, Jeronimo J, Lopalco PL, Monsonego J, Peto J, Ronco G, Sasieni P, Wheeler CM. The driver category globalization and environment contributed to 61% of individual IDTEs, and the top 5 individual drivers of all IDTEs were travel and tourism, food and water quality, natural environment, global trade, and climate. B. Epidemic profile of Shiga-toxin–producing. Although observed modes of transmission mainly include direct contact and contaminated staff, high case fatality ratio and frequent contacts among individuals in developed countries are among determinants which may lead to the development of the EVD outbreak. Dissimilarity between clusters of IDTE drivers were described graphically by using tree diagrams (dendrograms) to visualize the similarity and dissimilarity of drivers in the occurrence of the IDTE. The utility of such predictive models has been documented on several occasions: environmental drivers of IDTE with prediction tools have been made available by ECDC through the E3 (European Environment and Epidemiology) Geoportal ( (40). However, very little research has been conducted to explore the determinants of behavioural responses to infectious disease outbreaks [1, 2]. The most common cause of the observed foodborne and waterborne outbreaks in Europe was norovirus, followed by hepatitis A and Escherichia coli (hemolytic uremic syndrome and Shiga-like toxin–producing E. coli infections) (14,15). We analyzed underlying drivers of 116 IDTEs detected in Europe during 2008–2013 by epidemic intelligence at the European Centre of Disease Prevention and Control. Discuss how the outbreak could affect your community at a systems level (i.e. Upgrading water treatment and distribution systems can prevent communitywide outbreaks (38). An overall frequency ranking of all events ranked the individual contribution of the top 5 drivers in the following order: travel and tourism, food and water quality, natural environment, global trade, and climate. Although the 3 groups are somewhat artificial and not entirely mutually exclusive, they can serve as a framework for the interpretation of infectious disease threat events (IDTEs) in Europe. The volume of international travelers on commercial flights with a final destination in Europe has increased steadily over the years; >103 million travelers entered Europe in 2010 alone, and this number will probably continue to grow (34). 2. In 2008, for the first time in 14 years, measles was declared endemic in the UK, meaning that the disease was sustained within the population. 2016;22(4):581-589. The Centers for Disease Control and Prevention (CDC) established an office in Haiti in 2002 with an initial focus on HIV/AIDS. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. There was an unexpected error. There was no evidence of an increased risk of infectious disease transmission in the host population in Europe during the 2015 influx of migrants or asylum seekers; however, ECDC advocated for the implementation of basic public health measures, health assessments, and vaccination to address the health needs of migrants (25). Multidrug Resistance– and Healthcare-Associated IDTEs, IgG2 in Adults with Acute Melioidosis, Thailand, Novel 6-Month Treatment for Drug-Resistant Tuberculosis, United States, More articles on Antimicrobial Resistance,,,,, Determinants and Drivers of Infectious Disease Threat Events in Europe, U.S. Department of Health & Human Services, Semenza JC, Lindgren E, Balkanyi L, Espinosa L, Almqvist MS, Penttinen P, et al. You are asked to choose ONE of the following communicable diseases to … The number of events and deaths for other event categories was far below the actual number expected for Europe. The research found that the socioeconomically deprived counties and counties with a high proportion of immigrant populations reported poor health and had higher prevalence of chronic diseases. (2016). Social Determinants of Infectious Disease Allison E. Aiello, PhD, MS. John G. Searle Assistant Professor of Public Health. - Exposure followed by "waves" of secondary and tertiary cases. European Centre for Disease Prevention and Control. Water distribution system and diarrheal disease transmission: a case study in Uzbekistan. Risk Factors and Transmission are both epidemiological determinants. Int J Cancer. This finding is consistent with other findings that show environmental and climatic determinants play contributing roles in WNV infection outbreaks (17). NIH Semenza, J. C., Lindgren, E., Balkanyi, L., Espinosa, L., Almqvist, M. S., Penttinen, P....Rocklöv, J. Basic epidemiologic methods tend to rely on careful observation and use of valid comparison groups to assess whether what was observed, such as the number of cases of disease in a particular area during a particular time period or the frequency of an exposure among persons with … Proper maintenance of the physical infrastructure can prevent these IDTEs. They may also be more directly amenable to interventions. However, these types of infections were not captured by epidemic intelligence due to reporting disincentives (e.g., legal and financial). The 3 IDTE categories are represented by green (globalization and environment), red (sociodemographic), and blue (public health systems) symbols,... Of 274 IDTEs that occurred within the EU during July 2008–December 2013, a total of 116 met the study inclusion criteria. However, epidemic intelligence detects IDTEs, not endemic infectious diseases, to which these drivers contribute substantially. IDTEs included in this study were restricted to outbreaks affecting >5 persons in the EU (excluding Croatia, which was not yet an EU member). Changes in the natural environment are increasing on a nonlinear scale with habitat destruction and loss of ecosystem services ( The challenge … Monitoring and modeling such disease drivers can help anticipate future IDTEs and strengthen control measures. We found globalization and environment to be the most noteworthy driver category for IDTEs in Europe. Hypotheses about the determinants of disease arise from considering the characteristics of person, place, and time and looking for differences, similarities, and correlations. An ECDC point-prevalence survey of healthcare-associated infections and antimicrobial use in long-term care facilities in Europe showed that ≈4.1 million patients contract a healthcare-associated infection in the EU each year, and ≈37,000 deaths occur annually as a direct consequence of these infections (27). Especially in the early phases of a possible epidemic, compliance to precautionary behaviours among the populations at risk is often the only means of prevention of a further spread of the disease. herd immunity. Figure 3. The arrows indicate the flow of information in the surveillance process. how it will affect the functioning of schools local government businesses hospitals). The drivers for the influenza IDTE group of both seasonal and pandemic influenza were travel and tourism, vulnerable groups, social and demographic, and surveillance and reporting. The event was reported from 3 countries and consisted of invasive meningococcal disease among men who have sex with men; the men had been infected while traveling or through contacts from abroad. The distance between clusters measure how similar, or dissimilar, different drivers are in their co-occurrences in outbreaks. ), mode of transmission (Vector? ), climate considerations (i.e. We examined the epidemiological and genomic determinants of two well-characterized tuberculosis outbreaks attributed to two super-spreaders among First Nations in the province of Alberta. Due to strong tourism links, 81 cases were introduced into continental Europe in a short period of three months.  |  The relatively few healthcare-associated IDTEs picked up by ECDC’s epidemic intelligence represent only a fraction of the expected number in Europe. Epub 2015 Jul 14. Epidemiology is also used to search for determinants, which are the causes and other factors that influence the occurrence of disease and other health-related events. Outbreaks often occurred among farm and animal workers. The Middle East respiratory syndrome coronavirus, or MERS, coronavirus outbreak, and the large Ebola outbreak in West Africa are striking examples of how emerging and reemerging Fruit bats are believed to be a key reservoir of Ebolavirus, which can also cause illness and death in non-human primates such as in apes and monkeys. Centers for Disease Control and Prevention. Describe the outbreak of the disease selected in part A, including each of the following: • name of the disease • the countries involved • the date the outbreak was discovered • the dates the disease reached each involved country. The occurrence of an IDTE can potentially be mitigated by addressing this driver. Our data also included the large dengue outbreak in Madeira, Portugal, with >2,000 cases (18) driven by climate, natural environment, and travel and tourism (Figure 2, panel B). Disadvantaged socioeconomic position (SEP) is widely associated with disease and mortality, and there is no reason to think this will not be the case for the newly emerged coronavirus disease 2019 (COVID-19) that has reached a pandemic level. We then used a set of dissimilarities for the distances between drivers to perform a hierarchical cluster analysis (11). We hypothesise that SEP plays an important role in the COVID-19 pandemic either directly or indirectly via occupation, living conditions, health-related behaviours, presence of … This site needs JavaScript to work properly. Specific vaccination strategies are often necessary for these populations to protect children and adults from infectious diseases, prevent spread of infection due to crowded living conditions, and ensure continuity of childhood immunization schedules. Intervening to reduce inequalities in infections in Europe. Keywords: Ebola virus infection; chain of infection; determinants; replication number; risk factor; source; spread; transmission. Multidrug-resistant tuberculosis cases were identified as single case events and therefore did not meet our inclusion criteria in this study. The number of people at risk in whom a certain illness develops divided by total number of ppl at risk. However, it is desirable to proactively prevent possible public health emergencies rather than respond to IDTE after they have occurred. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Outbreak investigation is an essential function of public health professionals. Therefore, our analysis pertains only to the drivers of IDTEs rather than endemic infectious diseases that are not recorded by epidemic intelligence. The present series of papers present a first qualitative and social–epidemiological exploration. Determinants and Drivers of Infectious Disease Threat Events in Europe. Ten IDTEs were reported for the airborne IDTE category. The 2014 Ebola Virus Disease epidemic is the largest in history, affecting the United States, Central and West Africa. The research explored county-level patterns in COVID-19 outbreaks and fatality associated with social determinants of health such as housing, education, economic factors and race. The ECDC is an EU agency with a mission to identify, assess, and communicate current and emerging threats to human health posed by infectious diseases. What are epidemiological determinants? Monitoring and modeling these drivers can serve as early warning systems of IDTEs and accelerate responses (39,40). a. A social environment, as described by David Satcher, is the place where people are born, grow, live, work and age. Role of health determinants in a measles outbreak in Ecuador: a case-control study with aggregated data BMC Public Health. Drivers of IDTEs can arise as epidemic precursors of IDTEs. Discuss how an outbreak would have affected your community at a systems level (i.e., the functioning of schools, local government, businesses, hospitals) if an outbreak had occurred in your community. Hierarchical cluster analysis of all drivers identified travel and tourism as a distinctly separate driver. Steep rise in notified hantavirus infections in Germany, April 2010. Social determinants of infectious diseases. This strategy is supported by the findings from this analysis, in which migration was a comparatively infrequent driver of IDTEs, relative to travel and tourism (Figure 3). Seven deaths occurred among 49 detected cases; 6 deaths were in newborns who had been infected while in hospitals (healthcare system, vulnerable groups, human-made environment drivers). a. Data collection for epidemic intelligence at ECDC was standardized in 2008; thus, we analyzed the epidemiologic characteristics of each IDTE in Europe from July 1, 2008, through December 31, 2013. An example was the norovirus epidemic that affected >11,000 schoolchildren in 6 countries; the origin of the epidemic was traced to contaminated frozen strawberries (16). Drivers were subjected to descriptive analyses (individually or in combinations), including frequency rates and ranking of the drivers, in relation to different types of IDTEs. In the face of an outbreak of pandemic influenza, it is important to understand factors that influence how people behave in order to decrease the likelihood of infection, transmission, and disease severity.

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