CIENCIASMEDICASNEWS: enero 2010

domingo, 31 de enero de 2010

DIRECTORIO DE DOCUMENTOS de ENERO 2010

DOMINGO 31 DE ENERO DE 2010
DIRECTORIO DE DOCUMENTOS de ENERO 2010

CIENCIAS MÉDICAS NEWS©: Directorio de Documentos editados en ENERO 2010
http://elbiruniblogspotcom.blogspot.com
un blog del conjunto salud equitativa®
http://herenciageneticayenfermedad.blogspot.com
http://saludequitativa.blogspot.com

Documentos editados durante 2009: 4.504
Consultas realizadas durante el año 2009: 118.241 (aproximadas)
Consultas acumuladas por el grupo de blogs de salud equitativa®, hasta el fin de enero de 2010: 376.805

CIENCIAS MÉDICAS NEWS©: Directorio de documentos editados en ENERO de 2010

Creado el 10 de enero de 2009, el blog ha tomado entidad internacional a lo largo de su primer año de vida. Indudablemente aquella idea que me movió a crearlo, no estaba muy alejada de la realidad. Durante la última década del Siglo XX, América Latina recibía numerosas publicaciones médicas en idioma español que confluían desde distintas fuentes, pero esencialmente a través de editoriales que reproducían los contenidos según los derechos oportunamente comprometidos. A pesar de la repercusión que dicha presencia había generado en el cuerpo médico, la debilidad económica creciente en la región fue deformando el escenario haciendo desaparecer dicha fuente de información altamente calificada.
La inestabilidad económica y jurídica subsiguiente dio lugar a la casi total extinción de las mencionadas publicaciones tanto como de las empresas que las representaban y difundían. Ello se vio acompañado por un significativo deterioro del honorario médico, aspecto no menor que contribuyó a una notable caída en las suscripciones.
Ese corte comunicacional, acompañado por el crecimiento de la expansión de los servicios de internet produjo baches de información que han afectado a la comunidad médica tanto como a todos los miembros del equipo de salud. Países con economías deterioradas fueron generadores de aislamientos en el acceso a los conocimientos.
Internet trajo aparejado un importante aporte de información “deformada” de fuentes no calificadas pero de muy fácil acceso público lo que profundizó la brecha entre conocimiento e información, confrontando a las partes (médicos versus pacientes) y facilitando que la confusión creciente favoreciera negocios dañinos a la salud humana y por ende a la ética que debe regir a las ciencias.
Dado que durante muchos años he desarrollado tareas relacionadas con la información médica altamente calificada, decidí entonces investigar las fuentes americanas y europeas (a las que he tenido acceso desde mucho antes de la creación de internet como herramienta) a efectos de diseñar un mecanismo de información que sostenga continuidad brindando acceso a las guías clínicas, algoritmos, protocolos médicos, investigaciones, y proyectos relacionados con las materias médicas.
Existiendo ya “nichos” de calidad científica los fui adoptando como fuentes y me sorprendí de la repercusión inicial en América Latina tanto como en España. He ido aprendiendo de mis propias falencias ya que estoy muy lejos de ser un conocedor de internet como herramienta, pero la buena voluntad me ha habilitado a ir comprendiendo algunos mecanismos sutiles que ofrece todo este universo electrónico. Algunos amigos me han ayudado mucho a entender las bases y lo que no he logrado perfeccionar se debe a dos motivos esenciales: falta del tiempo adecuado para dar la atención que el tema amerita, y luego de ello, incapacidad económica para transformarlo en un motor de mayor envergadura.
A pesar de las manifiestas falencias, esta herramienta ha tomado entidad y me ha superado brindándome tantas satisfacciones que me genera un peculiar placer poder reunir a las fuentes y diseminar los accesos a una información que usualmente se pierde porque los profesionales de la salud están cortos de tiempo para poder tomar contacto con ella.
A pesar de mi resistencia inicial, fui descubriendo que se busca tanta información en idioma español como en idioma inglés. Hubiese preferido que la llave la constituyese el español pero me he ido convenciendo que ello es técnicamente imposible y en lo personal, no me da el tiempo para traducir la cantidad de documentos que me llegan diariamente. Dado que la medicina está invadida y dominada por documentos en inglés, este es la lengua que ofrece mayor cantidad de los contenidos incluidos en este blog.
Finalmente, una vez más agradezco profundamente a todas y cada una de las fuentes: Agencia Europea de Medicamentos, Food and Drug Administration-USA, National Institute of Health-USA; CDC-USA; AHRQ-USA; NGC-USA; NQMC-USA; Sociedad Internacional de Enfermedades Infecciosas [ISID], IntraMed, El Hospital (usa), El Médico Interactivo (España), Jano.es/Elsevier (España), Diario Médico (España), y a todas las demás instituciones del gobierno de los Estados Unidos de Norteamérica y Europa, que nos aportan diariamente con información altamente calificada.
Pido disculpas por aquellas eventuales transgresiones o errores involuntarios que pudiese cometer en el afán de difundir conocimientos que asumo como de importancia.
Este blog se nutre de información en red que se distribuye gratuitamente y no monetiza los contenidos por respeto a las necesidades de los profesionales del equipo de la salud. Por dicho motivo, tengo la libertad de administrar la información que recibo sin emitir opinión (salvo excepciones que atentan contra la ética y/o bioética explícitas, o bien que invaden mis convicciones) y sin calificar como así tampoco descalificar a las fuentes. En lo personal entiendo que la información científico-médica debe ser de acceso universal ya que ello habilita a la discusión y al crecimiento del conocimiento. Cerasale©. ENERO 31, 2010.-

ranking de consultas hasta el 31 de ENERO de 2010:
1. Argentina: 23.647 – 17,8 %
2. España: 21.549 - 16,2%
3. México: 18.949 – 14,2 %
4. Estados Unidos: 12.037 - 9,0 %
5. Perú: 8.338 - 6,3 %
6. Venezuela: 8.098 - 6,1 %
7. Colombia: 7.471 - 5,6 %
8. Chile: 5.036 - 3,8 %
9. Ecuador: 3.494 - 2,6 %
10. Bolivia: 2.424 - 1,8%
el resto: 22.125 - 16,6 %
total: 133.168 - 100,0 %

ARCHIVO DEL BLOG
• ▼ 2010 (509)
o ▼ enero (509)
 ARNET: INFORME SOBRE DEFICIENCIAS DE SERVICIO EN L...
 0510. Extensive Mammalian Ancestry of Pandemic (H1N1) 20...
 0509. New Hypothesis for Cause of Epidemic among Native ...
 0508. Statewide School-located Influenza Vaccination Pro...
 0507. Human Hendra Virus Encephalitis Associated with Eq...
 0506. Household Responses to Pandemic (H1N1) 2009–relate...
 0505. January 2010 (special pre-congress edition) of the...
 0504. Zyprexa (olanzapine): Use in Adolescents
 0503. Enerocytozoon bieneusi, Czech Republic | CDC EID
 0502. P. falciparum Malaria, Southern Algeria, 2007 | CD...
 0501. The February 2010 MedSun Newsletter
 0500. Opinions on medicines for use outside the European...
 0499. Agency for Healthcare Research and Quality (AHRQ) ...
 0498. AHRQ News and Numbers: January 29, 2010
 0497. HIV/AIDS Update - Videx EC/Videx (didanosine) labe...
 0496. FDA Drug Safety Communication: Serious liver disor...
 0495. Drug Information Update - Serious Liver Disorder A...
 0494. → European Medicines Agency - Human Medicines - Medi...
 0493. → Lopinavir (+ ritonavir) // EPARs for authorised me...
 0492. Call for Public Review: Technology Assessment (TA)...
 0491. Edwards Lifesciences Aquarius Hemodialysis System:...
 0490. Using Museum Collections to Detect Pathogens | CDC...
 0489. Human African Trypanosomiasis in Areas without Sur...
 0488. Domestic Animals and Visceral Leishmaniasis, Nepal...
 0487. Sin Nombre Virus, Colorado, USA | CDC EID
 0486. Mycobacterium tuberculosis Beijing Strain, Bamako,...
 0485. Nontuberculous Mycobacteria, Taiwan | CDC EID
 0484. M. tuberculosis Strains and Phenotypes | CDC EID
 0483. XDR TB and Treatment Adherence | CDC EID
 0482. HIV/AIDS Update - Prezista (darunavir) labeling ch...
 0481. AHRQ and American College of Cardiology Collaborat...
 0480. Outbreaks of 2009 Pandemic Influenza A (H1N1) Amon...
 0479. Effects of Switching from Whole to Low-Fat/Fat-Fre...
 0478. Bacterial Meningitis After Intrapartum Spinal Anes...
 0477. Imágenes intraoculares con ultrasonido // El Hospi...
 0476. → insulin glargine [2] - EPARs for authorised medici...
 0475. → Insulin aspart - EPARs for authorised medicinal ...
 0474. → insulin glargine - EPARs for authorised medicina...
 0473. → Sirolimus - EPARs for authorised medicinal product...
 0472. → fentanyl - EPARs for authorised medicinal products...
 0471. CA-MRSA in Outpatients, United States, 1999–2006, ...
 0470. European Medicines Agency - Human Medicines - Orph...
 0469. Coronavirus Infections in Children | CDC EID
 0468. Vol. 16, No. 2 Cover: Bird's Eye View of Emerging ...
 0467. Risk of preterm delivery and other adverse perinat...
 0466. 5th European Conference on Rare Diseases ECRD 2010...
 0465. Cord Blood Licensure: A Workshop
 0464. Centro de Terapia Estratégica - Seminario de Giorg...
 0463. Assessment of Abuse Potential of Drugs, by FDA
 0462. ▲ New Zealand Guidelines Group: Suspected Cancer in ...
 0461. Liraglutide - Questions and Answers - Safety Requi...
 0460. Vaccines: Recs/Schedules/Child Schedule main page
 0459. Vaccines: Adult Immunization Scheduler
 0458. Guidance for Relief Workers and Others Traveling t...
 0457. →Irbesartan/ Hydrochlorothiazide - EPARs for auth...
 0456. → irbesartan / hydrochlorothiazide - EPARs for auth...
 0455. → Ziconotide - EPARs for authorised medicinal produc...
 0454. → European Medicines Agency - Withdrawals of Marketi...
 0453. → Human Insulin - EPARs for authorised medicinal p...
 0452. → Pregabalin - EPARs for authorised medicinal prod...
 0451. → Interferon beta-1a //EPARs for authorised medicina...
 0450. → clopidogrel - EPARs for authorised medicinal produ...
 0449. → fentanyl citrate - EPARs for authorised medicinal...
 0448. NCTR Research Highlights
 0447. Call for Public Review: Systematic Reviews on Sele...
 0446. FDA Approves Morphine Sulfate Oral Solution for Re...
 0445. Blood Establishment Computer Software: Understandi...
 0444. Rho(D) Immune Globulin Intravenous (Human) - WinRh...
 0443. Infusion Set Needles [Manufactured by Nipro for Ex...
 0442. Velcade (bortezomib): Starting Dose Adjustments fo...
 0441. 1) Screening for breast cancer: U.S. Preventive Se...
 0440. Using nontraditional risk factors in coronary hear...
 0439. Sunitinib for the first-line treatment of advanced...
 0438. Rivaroxaban for the prevention of venous thromboem...
 0437. Endovascular stent-grafts for the treatment of abd...
 0436. Amantadine, oseltamivir and zanamivir for the trea...
 0435. Management of labor.
 0434. Major depression in adults in primary care.
 0433. Liraglutide (marketed as Victoza) Information
 0432. Children Ages 9 and Younger Need Two Doses of H1N1...
 0431. Las células sanas podrán sobrevivir al daño que le...
 0430. Evidence-based care guideline for pneumocystis car...
 0429. Evidence-based care guideline for therapy manageme...
 0428. Best evidence statement (BESt). Intra-hospital reg...
 0427. Best evidence statement (BESt). Inpatient support ...
 0426. Best evidence statement (BESt). Failure to thrive ...
 0425. National Vaccine Advisory Committee
 0424. COPD, Even When Mild, Limits Heart Function - NHL...
 0423. ► FUNDACIÓN FAVALORO: COMUNICACIÓN
 0422. → European Medicines Agency - Human Medicines - Orph...
 0421. Gene linked to schizophrenia may reduce cancer ris...
 0420. A Variant Of The Gene GFI1 Predisposes To A Subtyp...
 0419. Personal Health - Living With C.M.L, a Formerly Fa...
 0418. The Cancer Genome Atlas Data Portal
 0417. The Cancer Genome Atlas Identifies Distinct Subtyp...
 0416. → ustekinumab - EPARs for authorised medicinal produ...
 0415. Homodimer of B-chain of recombinant human platelet...
 0414. → European Medicines Agency - Human Medicines - Medi...
 0413. FDA Approves Left Ventricular Assist System for Se...
 0412. X-Ray Technician Schools: guides
 0411. ANTRAX - BROTE - ISID/UE
 0410. SARM - ISID/resistencia y subtipos
 0409. MALARIA - ISID / COLOMBIA: aumento de casos
 0408. Exercise-induced Bronchoconstriction and Asthma: S...
 0407. Efficacy and Comparative Effectiveness of Off-Labe...
 0406. Counterfeit Product containing undeclared drug, si...
 0405. dalfampridine: Improve Walking in Adults with Mult...
 0404. ISMP medication error report analysis - AHRQ Patie...
 0403. Improving follow-up of abnormal cancer screens usi...
 0402. → natalizumab - EPARs for authorised medicinal produ...
 0401. ☼ November 18-19, 2009: Vaccines and Related Biologi...
 0400. → European Medicines Agency - Human Medicines - Refe...
 0399. → European Medicines Agency - Human Medicines - CHMP...
 0398. → Human Medicines - Herbal Medicinal Products - HMPC...
 0397. → Human Medicines - Herbal Medicinal Products - Adop...
 0396. → Ivabradine - EPARs for authorised medicinal produc...
 0395. → Ivabradine - EPARs for authorised medicinal prod...
 0394. → Aprepitant - EPARs for authorised medicinal produc...
 0393. → Peginterferon alfa-2b // EPARs for authorised medi...
 0392. → ribavirin SP - EPARs for authorised medicinal pro...
 0391. → Peginterferon alfa-2b // EPARs for authorised medi...
 0390. → ribavirin - EPARs for authorised medicinal produ...
 0389. → nilotinib - EPARs for authorised medicinal product...
 0388. → Hepatitis B surface antigen (rDNA) (adjuvanted, ad...
 0387. → atosiban acetate - EPARs for authorised medicina...
 0386. → palivizumab - EPARs for authorised medicinal produ...
 0385. → Botulinum Toxin Type B - EPARs for authorised me...
 0384. CDC - Seasonal Influenza (Flu) - Weekly Report: In...
 0383. Update: Influenza Activity --- United States, Augu...
 0382. Comunidades Microbianas Humanas - ISID
 0381. Association between pre-diagnostic circulating vit...
 0380. Staphylococcus aureus resistente a la meticilina E...
 0379. DENGUE - ISID - VENEZUELA
 0378. WHO | Pandemic (H1N1) 2009/2010 - update 84
 0377. FDA - CDER's Small Business Assistance Bulletin
 0376. Medical, Statistical, and Clinical Pharmacology Re...
 0375. Guide to Clinical Preventive Services, 2009
 0374. Screening for Obesity in Children and Adolescents
 0373. 10 Patient Safety Tips for Hospitals
 0372. Emerging Arboviruses: Evaluating the Threat to Tra...
 0371. ▲ DENGUE - UN ESPECIAL DE SCIENCE REPORT / ENERO 201...
 0370. Long-Term Follow-Up Guidelines for Survivors of Ch...
 0369. Update on Chemotherapy for Stage IV Non-Small Cell...
 0368. Entrenamiento para el Diagnóstico y el Manejo Clín...
 0367. H1N1 - gripe porcina - ISID / TAILANDIA
 0366. Grants Focused on Health Care-Associated Infection...
 0365. November 18-19, 2009: Vaccines and Related Biologi...
 0364. "'Choking Game' Awareness and Participation Among ...
 0363. Interim Results: Influenza A (H1N1) 2009 Monovalen...
 0362. Update: Influenza Activity
 0361. Transfusion-Related Transmission of Yellow Fever V...
 0360. Prevalence of Abnormal Lipid Levels Among Youths
 0359. Tasa muerte infantil H1N1, mucho mayor en Gran Bre...
 0358. Drug Information Update- Follow-Up to the November...
 0357. FDA Warns Consumers about Counterfeit Alli
 0356. sibutramine hydrochloride: New contraindication to...
 0355. Meeting of the NIH Blue Ribbon
 0354. Adult Immunization Schedule - (Anyone over 18 yea...
 0353. → fosaprepitant dimeglumine - EPARs for authorised...
 0352. → tacrolimus - EPARs for authorised medicinal prod...
 0351. → certolizumab pegol - EPARs for authorised medici...
 0350. → darifenacin hydrobromide - EPARs for authorised me...
 0349. Systemic Administration of Antiretrovirals Prior t...
 0348. G protein–coupled receptor kinase 2 (GRK2) modulat...
 0347. Impact of Body Mass Index and the Metabolic Syndro...
 0346. The Role of Transjugular Intrahepatic Portosystemi...
 0345. Chronic Hepatitis B: Update 2009
 0344. AHRQ Child and Adolescent Health Update
 0343. Systematic Reviews on Selected Pharmacogenetic Tes...
 0342. → sitaxentan sodium - EPAR´s for human use
 0341. → sildenafil (as citrate) - EPAR´s for human use
 0340. → Etanercept - EPAR´s for human use
 0339. → Desirudin - EPAR´s for human use
 0338. → Withdrawals of Application - Medicinal Products fo...
 0337. International Medical Corps
 0336. → temsirolimus - EPAR´s for human use
 0335. USDA Confirms Pork From Pigs Exposed to H1N1 Virus...
 0334. ►Autism Autism Autism Autism Autism Autism Autism
 0333. Work-related proximal median nerve entrapment (PMN...
 0332. Work-related acute cauda equina syndrome (CES) dia...
 0331. Managing chronic non-terminal pain including presc...
 0330. Diagnosis and pharmacological management of Parkin...
 0329. Management of genital Chlamydia trachomatis infect...
 0328. Rehabilitation after critical illness. - NGC / AHR...
 0327. (1) Donepezil, galantamine, rivastigmine (review) ...
 0326. Medicines adherence. Involving patients in decisio...
 0325. Antisocial personality disorder. Treatment, manage...
 0324. ◊ Diagnosis and management of type 2 diabetes mellit...
 0323. ► Antithrombotic therapy supplement. - NGC AHRQ
 0322. ◊ Intrapartum fetal heart rate monitoring: nomenclat...
 0321. ▲ Induction of labor - NGC/AHRQ -
 0320. Investigators Identify Gene Mutations That Predisp...
 0319. Discovery at JGH opens door to new treatments for ...
 0318. Complex genomic rearrangements in breast cancer - ...
 0317. SNPs In C-Reactive Protein Are Not Associated With...
 0316. Researchers Discover Genetic Differences Between L...
 0315. Genetic Factors Can Increase Leukaemia Risk Seven-...
 0314. Gene Mutations Reveal Potential New Targets For Tr...
 0313. HANTAVIRUS - ISID / CHILE: actualización
 0312. Unas 14000 personas han fallecido por gripe A en e...
 0311. Vaccines: Recs/Schedules/Adult Schedule main page
 0310. → fluticasone furoate - EPARs for authorised medici...
 0309. → fluticasone furoate - EPARs for authorised medicin...
 0308. → Duloxetine hydrochloride - EPARs for authorised me...
 0307. → Duloxetine hydrochloride - EPARs for authorised m...
 0306. → Human Medicines - Herbal Medicinal Products - Guid...
 0305. Red Book® Online -- Vaccine Status Table
 0304. Journal Articles: Potential New Vaccines
 0303. Breast cancer multigene test helping patients avoi...
 0302. Genetic Variant Associated With Aggressive Form Of...
 0301. EGFR Gene Signature Predicts Non-Small Cell Lung C...
 0300. Drug That Modifies Gene Activity Could Help Some O...
 0299. Genetic aspects of pancreatitis. [Annu Rev Med. 20...
 0298. Multistage Genomewide Association Study Identifies...
 0297. Genetic variation in IL28B Is Associated with Chro...
 0296. Genetic causes of syndromic and non-syndromic auti...
 0295. Pharmacogenetic influences in obstetric anaesthesi...
 0294. Pharmacogenetics of drug dependence: role of gene ...
 0293. Gene-environment interactions in asthma and allerg...
 0292. Pharmacogenomics of taxane/platinum therapy in ova...
 0291. FDA's MedWatch Safety Alerts: December 2009
 0290. PARACETAMOL - ACETAMINOPHEN: ISID / USA
 0289. ▲ Detección de cáncer gástrico temprano - El Hospita...
 0288. * 2 - HEPATOLOGÍA: Servicio de Gastroenterología y H...
 0287. HAITÍ: CATÁSTROFE HUMANITARIA - IntraMed - Artícul...
 0286. * HEPATITIS - Puesta al día en Hepatitis - IntraMed ...
 0285. * 1 - GASTROENTEROLOGÍA: Servicio de Gastroenterolog...
 0284. Serious Psychological Distress and Mental Health S...
 0283. Fact Sheet: Information on HHS BPA Announcement
 0281. Interim Results: Influenza A (H1N1) 2009 Monovalen...
 0280. Hipotermia en pacientes psiquiátricos - ISID / CUB...
 0279. infecciones nosocomiales - ISID / IRLANDA
 0278. SÍFILIS - ISID / ESPAÑA
 0277. Guidelines for Responding to Mental Health Crisis ...
 0275. McNeil Consumer Healthcare Announces Voluntary Rec...
 0274. February 22, 2010: Meeting of the Vaccines and Rel...
 0273. McNeil Consumer Healthcare Over-The-Counter Produc...
 0272. Commissioners Letter to Health Care Professionals
 0271. → European Medicines Agency - Withdrawals of Applica...
 0270. Magnitude 7.0 Earthquake Strikes Haiti
 0269. ► Disaster Medicine and Public Health Preparedness ...
 0268. → pandemic influenza vaccine (whole virion, vero cel...
 0267. → Pandemic influenza vaccine (surface antigen, inact...
 0266. → Ritonavir - EPARs for authorised medicinal produ...
 0265. → Amprenavir - EPARs for authorised medicinal pro...
 0264. Un hígado virtual para una cirugía personalizada -...
 0263. AHRQ Activities Using Community-Based Participator...
 0262. SOCIEDAD ARGENTINA de MEDICINA: comunicación
 0261. Follow-Up to the October 2008 Updated Early Commun...
 0260. FDA Updates Earlier Guidance on Respiratory Treatm...
 0259. QuickStats: Pregnancy, Birth, Abortion, and Fetal ...
 0258. Notices to Readers: New Look for MMWR Weekly Publi...
 0257. Recommended Adult Immunization Schedule --- United...
 0256. Announcements: National Glaucoma Awareness Month -...
 0255. Outbreak of Adenovirus 14 Respiratory Illness --- ...
 0254. "Choking Game" Awareness and Participation Among 8...
 0253. ╠ Trompa de Falopio humana: una nueva fuente de célu...
 0252. ▲ Densitómetros óseos - El Hospital: Información par...
 0251. → Sevelamer - EPARs for authorised medicinal product...
 0250. * IntraMed - Puntos de vista - Integración del medio...
 0249. NEJM -- Comparison of Ustekinumab and Etanercept f...
 0248. NCSDR : Sleep-Related Data Resources
 0247. Influenza A (H1N1) 2009 Monovalent Vaccine Live, I...
 0246. Adverse drug events among hospitalized Medicare pa...
 0245. Diagnostic error and clinical reasoning - AHRQ Pat...
 0244. Quality and Safety Competencies in Nursing Educati...
 0243. Obstetric Issues - AHRQ Patient Safety Network
 0242. ANTIBIÓTICOS: uso irracional - ISID / ITALIA
 0241. Influenza A pandemic (H1N1) 2009 virus infection i...
 0240. RABIA - República Dominicana / ISID
 0239. LEGIONELLA - ISID / ALEMANIA
 0238. CHAGAS en BRASIL [ISID]
 0237. Search for Guides, Reviews, and Reports - AHRQ Eff...
 0236. → brinzolamide/timolol - EPARs for authorised medici...
 0235. → trabectedin - EPARs for authorised medicinal produ...
 0234. → nelarabine - EPARs for authorised medicinal produ...
 0233. → Alglucosidase alfa - EPARs for human use - Myozy...
 0232. → Efavirenz - EPARs for authorised medicinal product...
 0231. → Efavirenz - EPARs for authorised medicinal produc...
 0230. → Lopinavir (+ ritonavir) - EPARs for authorised med...
 0229. → lopinavir / ritonavir - Opinions on medicines for ...
 0228. Cocaine-related sudden death: a prospective invest...
 0227. JAMA -- Abstract: Association of a Functional Poly...
 0226. Obesity is associated with a higher risk of clear-...
 0225. Prevention of venous thromboembolism (VTE): does t...
 0224. Methods Reference Guide for Effectiveness and Comp...
 0223. Using GRADE for International Guidelines on Kidney...
 0222. Interpreting the U.S. Preventive Services Task For...
 0221. Shortage of Erythromycin (0.5%) Ophthalmic Ointmen...
 0220. Hormonal Contraceptives Offer Benefits Beyond Preg...
 0219. ♣ Management of meconium at birth.
 0218.♣ Management guidelines for obstetric patients and n...
 0217. ♣ Antithrombotic therapies in spine surgery.
 0216. Prophylaxis against infective endocarditis. Antimi...
 0215. Call for Public Review: ECG-based Signal Analysis ...
 0214. Personalized Medicine — Method Developed To Identi...
 0213. FDA's MedWatch Safety Alerts: December 2009
 0212. FDA Unveils First Phase of Transparency Initiative...
 0211. Zinc acetate dihydrate - EPARs for authorised med...
 0210. FDA Approves New Drug for Rheumatoid Arthritis
 0209. Risk of tuberculosis in patients treated with tumo...
 0208. MGH-KI-Cell Press Days of Molecular Medicine - mee...
 0207. Ebolavirus VP35 uses a bimodal strategy to bind ds...
 0206. A gene therapy approach for long-term normalizatio...
 0205. Research Activities, January 2010: Mental Health: ...
 0204. ▲ Diabetes in pregnancy. Management of diabetes and ...
 0203. Routine preventive services for infants and childr...
 0202. Routine preventive services for children and adole...
 0201. Prevention of unintended pregnancy in adults 18 ye...
 0200. ► Management of overweight and obesity in the adult....
 0199. ► Guidelines for the practice of diabetes education....
 0198. * IntraMed - Puntos de vista - Utilidad del método e...
 0197. * IntraMed - Artículos - Chagas: ¡Tenemos que hacer ...
 0196. FDA Approves New Drug for Rheumatoid Arthritis
 0195. WHO | Pandemic (H1N1) 2009/2010 - update 82
 0194. CDC H1N1 Flu | Flu information for People with Dia...
 0193. FDA MedWatch - December 2009 Drug Safety Labeling ...
 0192. sirolimus: Drug Monitoring Recommendations-Switchi...
 0191. Pandemic (H1N1) 2009 Cases, Buenos Aires, Argentin...
 0190. Extensive Mammalian Ancestry of Pandemic (H1N1) 20...
 0189. Pandemic (H1N1) 2009 Outbreak on a Pig Farm, Argen...
 0188. ► Management of anticoagulants: does the hospital ha...
 0187. ► Management of anticoagulants: does the hospital ha...
 0186. ► Primary biliary cirrhosis.
 0185. ► Management of adult patients with ascites due to c...
 0184. ▲Diagnosis, management, and treatment of hepatitis ...
 0183. Interferón pegilado alfa-2a más ribavirina muestra...
 0182. Los 'stent' con everolimus son mejores que los de ...
 0181. → etravirine - EPARs for authorised medicinal produ...
 0180. → maraviroc - EPARs for authorised medicinal product...
 0179. → Posaconazole - EPARs for authorised medicinal pro...
 0178. Technology Assessment: Report on the Relative Effi...
 0177. Technology Assessment: Report on the Relative Effi...
 0176. Technology Assessment: Report on the Relative Effi...
 0175. Technology Assessment: Report on the Relative Effi...
 0174. Spinal Fusion for the Treatment of Low Back Pain S...
 0173. Pediatric adverse drug events in the outpatient se...
 0172. An In Depth Investigation into Causes of Prescribi...
 0171. Contraindicated medication use in dialysis patient...
 0170. A small step towards personalized medicine for non...
 0169. Novel loci for major depression identified by geno...
 0168. Advances in molecular genetics of panic disorder. ...
 0167. Common genetic variation and the control of HIV-1 ...
 0166. Famly history of cancer and risk of pancreatic can...
 0165. Familial risk for chronic disease and intent to sh...
 0164. Prioritizing genes for follow-up from genome wide ...
 0163. Genetics of cholestatic liver disease in 2010. [Cu...
 0162. Synopsis and Data Synthesis of Genetic Association...
 0161. Genome-Wide Association Studies of MRI-Defined Bra...
 0160. H1N1 - gripe porcina - ISID / USA: análisis de mor...
 0159. Rabia Humana - Perú / ISID
 0158. ◊ Science Report - Revista Digital de CEDEPAP TV / ...
 0157. Detecting Adverse Events in Dermatologic Surgery. ...
 0156. How Safe Is Your Hospital? - AHRQ Patient Safety ...
 0155. GMC | An in depth investigation into causes of pre...
 0154. FDA Awards Contract to Harvard Pilgrim to Develop ...
 0153. Human Genome Epidemiology
 0152. Genetic risk of breast cancer. [Minerva Endocrinol...
 0151. The Hindu : Sci-Tech : Genomic differences identif...
 0150. Hereditary Factors Contribute To Aneurysm Formatio...
 0149. Gene Found for Childhood Asthma | Ivanhoe's Medica...
 0148. New key factor identified in the development of Al...
 0147. PHG Foundation | First report of vCJD without susc...
 0146. Microcephaly Genes Associated With Human Brain Siz...
 0145. New Chromosomal Screening Strategy May Overcome Pr...
 0144. News: Scientists Pinpoint New Target for Prostate ...
 0143. High Risk Of Colorectal, Endometrial And Lynch Syn...
 0142. Chicago Cancer Genome Project Studies Genetics Of ...
 0141. 'Junk DNA' Could Spotlight Breast And Bowel Cancer...
 0140. Israeli Medical Research Offers New Hope For Treat...
 0139. CSHL scientist discovers how bookmarking protein t...
 0138. Genes implicated in twins' autism - baltimoresun.c...
 0137. * IntraMed - Investigaciones IntraMed - Estudio DELP...
 0136. * IntraMed - Noticias médicas - Conclusiones de las ...
 0135. Disquinesia ciliar primaria: estado actual de los ...
 0134. Recall: Influenza A (H1N1) 2009 Monovalent Vaccine...
 0133. Rotavirus Vaccine, Live, Oral - ROTARIX
 0132. InterSol Solution/Platelet Additive Solution 3
 0131. CDC | TB Notes 4, 2009 | Highlights from state and...
 0130. CDC | TB Notes 4, 2009 | MYCOBACTERIOLOGY LABORATO...
 0129. CDC | TB Notes 4, 2009 | New CDC Publications
 0128. HIV/AIDS Update - Atripla label update reflects ne...
 0127. AHRQ Innovations Exchange | Remote Screening, Diag...
 0126. → tocilizumab - EPARs for authorised medicinal produ...
 0125. → adalimumab - EPARs for authorised medicinal produc...
 0124. → Parecoxib sodium - EPARs for authorised medicinal...
 0123. En breve se secuenciarán los primeros diez genomas...
 0122. ► Breast Cancer Screening With Imaging: Recommendati...
 0121. Vaccines: Vac-Gen/Side Effects
 0120. → European Medicines Agency - Human Medicines - CHMP...
 0119. FDA MedWatch - January 2010 FDA Patient Safety New...
 0118. QuickStats: Late Preterm Birth Rates,* by Pluralit...
 0117. Recommended Immunization Schedules for Persons Age...
 0116. Announcement: National Birth Defects Prevention Mo...
 0115. Announcement: National Influenza Vaccination Week ...
 0114. Outbreak of 2009 Pandemic Influenza A (H1N1) at a ...
 0113. Patients Hospitalized with 2009 Pandemic Influenza...
 0112. Multistate Outbreak of Human Salmonella Typhimuriu...
 0111. Hispanic Diabetes Disparities Learning Network in ...
 0110. El glaucoma no sólo afecta a los ojos, sino tambié...
 0109. Announcement: National Influenza Vaccination Week ...
 0108. Recommended Immunization Schedules for Persons Age...
 0107. The clinical effectiveness and cost-effectiveness ...
 0106. Genomic toggle switches divide autoimmune diseases...
 0105. H pylori activa una enzima relacionada con el canc...
 0104. * IntraMed - Artículos - Efecto de solución oftálmic...
 0103. * IntraMed - Noticias médicas - Nuevo descubrimiento...
 0102. * IntraMed - Noticias médicas - Alerta por la aparic...
 0101. ►NGC - Compare - Comparison / TOBACCO USE CESSATION...
 0100. Research Activities, January 2010: Mental Health: ...
 0099. Research Activities, January 2010: Mental Health: ...
 0098. Research Activities, January 2010: Patient Safety ...
 0097. El nivel de microalbuminuria en orina no permite d...
 0096. La misma proteína que le quita el calcio a los hue...
 0095. Use of Atypical Antipsychotic Drugs Increases Risk...
 0094. AHRQ Electronic Newsletter, Issue #285 - Today’s H...
 0093. CDC H1N1 Flu | Fact Sheet: Safety of the Flu Vacci...
 0092. Massachusetts Department of Mental Retardation hea...
 0091. ♦ (1) Clinical practice guideline for the management...
 0090. ☼ Pediatric eye evaluations: I. Screening. II. Compr...
 0089. ☼ Primary angle closure.
 0088. ☼ Screening for glaucoma: recommendation statement.
 0087. ☼Primary open-angle glaucoma.
 0086. ☼ Primary open-angle glaucoma suspect.
 0085. ☼ Adult preventive services (ages 50 - 65+).
 0084. ☼ Cervical cancer screening guideline: October 2006....
 0083. ☼ Screening for cervical cancer. In: Canadian consen...
 0082. H1N1 - ISID / INMUNIZACIÓN con respuesta inadecuad...
 0081. HANTAVIRUS - ISID / CHILE: actualización
 0080. Why don't we have all the evidence on oseltamivir?...
 0079. ▲ Antidepressant Medicines - A Guide for Adults With...
 0078. Navigating the Health Care System: Comparing Medic...
 0077. Horizon Scan Reports of Genetic Tests Currently Av...
 0076. [PEPFAR - INDIA]
 0075. Vaccines: Events/Calendar of Upcoming Meetings-Con...
 0074. ev3 Endovascular Inc. Trailblazer Support Catheter...
 0073. Biologics Sentinel Initiative Projects
 0072. →aripiprazole - European Medicines Agency - Withdra...
 0071. → lisuride - European Medicines Agency - Withdrawals...
 0070. The Rho/Rac exchange factor Vav2 controls nitric o...
 0069. Statewide school-located influenza vaccination pro...
 0068. HOY en GESTIÓN EN SALUD PÚBLICA
 0067. ♦ TUBERCULOSIS 14: Treatment strategies for MDR-TB a...
 0066. ♦ TUBERCULOSIS 13: Treatment of DR-TB in special con...
 0065. ♦ TUBERCULOSIS 12: Treatment delivery and community-...
 0064. ♦ TUBERCULOSIS 11: Mono-resistant and poly-resistant...
 0063. ♦ TUBERCULOSIS 10: Managing DR-TB through patient-ce...
 0062. ♦ TUBERCULOSIS 9: Management of second-line antitube...
 0061. ♦ TUBERCULOSIS 8: Management of patients after MDR-T...
 0060. ♦ TUBERCULOSIS 7: Management of contacts of MDR-TB p...
 0059. ♦ TUBERCULOSIS 6: Laboratory aspects. In: Guidelines...
 0058. ♦ TUBERCULOSIS 5: Initial evaluation, monitoring of ...
 0057. ♦ TUBERCULOSIS 4: Drug resistance and infection cont...
 0056. ♦ TUBERCULOSIS 3: DR-TB and HIV infection. In: Guide...
 0055. ♦ TUBERCULOSIS 2: Category IV recording and reportin...
 0054. ♦ TUBERCULOSIS 1 - Case-finding strategies. In: Guid...
 0053. ▲ Management of acute lower gastrointestinal (GI) bl...
 0052.► - KIDNEY NGC - Expert Resources - Expert Co...
 0051. ANMAT / PROYECTOS INNOVADORES DE PROCESOS Y PRODUC...
 0050. Un estudio del Valle de Hebrón confirma que la rel...
 0049. → thrombin alfa - European Medicines Agency - Withdr...
 0048. → iclaprim - European Medicines Agency - Withdrawals...
 0047. → ethyl eicosapent - European Medicines Agency - Wit...
 0046. → stiripentol - EPARs for authorised medicinal prod...
 0045. → European Medicines Agency - Human Medicines - Medi...
 0044. → European Medicines Agency - Human Medicines - Medi...
 0043. Listening to tailor-made notched music reduces tin...
 0042. NEJM -- Variants of DENND1B Associated with Asthma...
 0041. MALARIA - ISID / VENEZUELA: aumento de casos
 0040. → Paediatric Regulation / European Medicines Agency ...
 0039. → CHILDREN / European Medicines Agency - Human Medic...
 0038. → European Medicines Agency - Human Medi...
 0037. Rabia Humana - Colombia / ISID
 0036. Pfizer interrumpe un ensayo en fase III con figitu...
 0035. Construyendo puentes, pacientes, mucho más que enf...
 0034. ♣ ICSI - Menopause and Hormone Therapy (HT): Collabo...
 0033. Broken Genomes Behind Breast Cancers - Genome Rear...
 0032. CHAGAS - ISID / ARGENTINA: subestimación
 0031. Clostridium difficile, creciente infección extra-h...
 0030. ♣ ICSI - Perioperative (Protocol)
 0029. ♣ ICSI - Safe Site Invasive Procedure – Non-Operatin...
 0028. ♣ ICSI - Surgical Site Infection Prevention in Child...
 0027. ♣ ICSI - Surgical Site Infection Prevention in Adult...
 0026. ICSI - ACS: Chest Pain and Acute Coronary Syndrome...
 0025. Glutathione-S-transferase genes and asthma phenoty...
 0024. Development of a Pharmacogenetic Predictive Test i...
 0023. Eating disorders: the current status of molecular ...
 0022. Value of genetic testing in the otological approac...
 0021. The clinical effectiveness and cost-effectiveness ...
 0020. Disclosing the disclosure: factors associated with...
 0019. Zinc Fingers Could Be Key to Reviving Gene Therapy...
 0018. Is The Future Of Genomic Sciences Large-Scale Sequ...
 0017. Yale Researchers Create New Way To Locate Big Gene...
 0016. An investigation of patients' motivations for thei...
 0015. The promises and challenges of epigenetic epidemio...
 0014. Genetics research in systemic lupus erythematosus ...
 0013. Genetic polymorphisms in non-alcoholic fatty liver...
 0012. Genetic polymorphisms in dilated cardiomyopathy. [...
 0011. Cohorts for Heart and Aging Research in Genomic Ep...
 0010. Subjective versus objective risk in genetic counse...
 0009. Navigating the Teen Years: A Parent's Handbook for...
 0008. Women's Mental Health: What It Means to You
 0007. Action Steps for Improving Women’s Mental Health
 0006. MedSun update: Newsletter #44, January 2010 by FDA...
 0005. ▲ MEPREP: FDA, Health Organizations to Study Safety ...
 0004. Hepatitis A Vaccine, Inactivated: Havrix by FDA
 0003. Hepatitis B Vaccine (Recombinant): Engerix-B by FD...
 0002. von Willebrand Factor/Coagulation Factor VIII Comp...
 0001. Nzu, Traditional Remedy for Morning Sickness
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 4491. MEPREP: Medication Exposure in Pregnancy Risk Eval...
 4490. WHO | Pandemic (H1N1) 2009 - update 81
 4489. La ÉTICA por sobre TODAS las COSAS
 4488. CIENCIAS MÉDICAS NEWS: DIRECTORIO DE DOCUMENTOS de...

sábado, 30 de enero de 2010

ARNET: INFORME SOBRE DEFICIENCIAS DE SERVICIO EN LA CONEXIÓN

INFORME SOBRE DEFICIENCIAS DE SERVICIO EN LA CONEXIÓN

Lamentablemente, me veo en la obligación de informar a Usted/es que desde el lunes próximo pasado, la conexión internet de ARNET a pesar de ser costosa, se corta a frecuencias regulares durante varios segundos para luego recuperar la conexión por escasos segundos y cortarse nuevamente. Dado que Arnet no da acceso a los reclamos, y dado que no tengo ningún soporte económico diferencial, colateral, suplementario, NI TAMPOCO AMIGOS QUE COLABOREN DESDE DENTRO DE LA ORGANIZACIÓN, etc. que me permita recibir las ayudas que corresponderían a un servicio comercial responsable, me encuentro atrapado entre mi blog creado para servir a la población médica y del equipo de salud (enfermeros, farmacéuticos, bioquímicos, técnicos, etc.) que han sido olvidados por las crecientes negligencias del sistema, y la imposibilidad de editar la información que me llega y a la cual no puedo acceder, o en caso de poder hacerlo, no me permite transferir los vínculos dado el escaso lapso en que se sostiene la deficiente conexión... Para mí, ignorante de estos problemas, no encuentro manera de resolverlo ya que quien debería dar el soporte técnico, no lo hace. Una vez más se declama la atención al cliente, pero luego se le da la espalda. Una vez más, al igual que cuando la Cancillería Argentina no atendió mis 28 reclamos de renovación de los dominios, estoy indefenso. Cerasale. Enero 30, 2010.-

Extensive Mammalian Ancestry of Pandemic (H1N1) 2009 Virus

EID Journal Home > Volume 16, Number 2–February 2010

Volume 16, Number 2–February 2010
Dispatch
Extensive Mammalian Ancestry of Pandemic (H1N1) 2009 Virus
Natalia A. Ilyushina,1 Jeong-Ki Kim,1 Nicholas J. Negovetich,1 Young-Ki Choi,1 Victoria Lang, Nicolai V. Bovin, Heather L. Forrest, Min-Suk Song, Philippe Noriel Q. Pascua, Chul-Joong Kim, Robert G. Webster, and Richard J. Webby
Author affiliations: St. Jude Children's Research Hospital, Memphis, Tennessee, USA (N.A. Ilyushina, J.-K. Kim, N.J. Negovetich, V. Lang, H.L. Forrest, R.G. Webster, R.J. Webby); D.I. Ivanovsky Institute of Virology, Moscow, Russia (N.A. Ilyushina); Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea (J.-K. Kim); Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Republic of Korea (Y.-K. Choi, M-S Song, P.N.Q. Pascua); Shemyakin Institute of Bioorganic Chemistry, Moscow (N.V. Bovin); Chungnam National University College of Veterinary Medicine, Daejeon (C.-J. Kim); and University of Tennessee Health Science Center, Memphis (R.G. Webster, R.J. Webby)

Suggested citation for this article

Abstract
We demonstrate that the novel pandemic influenza (H1N1) viruses have human virus–like receptor specificity and can no longer replicate in aquatic waterfowl, their historic natural reservoir. The biological properties of these viruses are consistent with those of their phylogenetic progenitors, indicating longstanding adaptation to mammals.

Pandemic (H1N1) 2009 virus strains were recently reported to be reassortants of the North American and European swine lineages (6). Phylogenetic evidence suggests that this reassortment event occurred 10–17 years ago (7). These data suggest that the current pandemic (H1N1) 2009 virus strains should have receptor specificity typically found in the HA of mammalian viruses (Neu5Acα2,6Gal). In addition, they may have lost the ability to replicate in avian hosts, the natural reservoir species. To test these hypotheses, we examined the biological properties of pandemic (H1N1) 2009 virus, including receptor specificity, erythrocyte binding, and ability to replicate in avian species.

The Study
We first tested species-specific erythrocyte agglutination by the pandemic (H1N1) 2009 isolates A/California/04/2009 and A/Tennessee/1-560/2009 and by other isolates from humans, swine, and birds (Table 1). The pandemic (H1N1) 2009 isolates showed reduced or absent agglutination of goose and chicken erythrocytes. Human and swine H1N1 viruses were agglutinated by turkey, guinea pig, chicken, and goose erythrocytes, and all erythrocytes we tested except those of swine were agglutinated by avian isolates (Table 1).

We next measured the receptor binding of the 2 pandemic (H1N1) 2009 isolates to sialic substrates, both natural (fetuin) and synthetic (3´-sialyllactose [3´SL] and 6´-sialyllactosamine [6´SLN] attached to a polyacrylic carrier) (Figure). The binding pattern to fetuin was identical among all isolates tested (association constant Kass ≈ 5.8 ± 0.5, 1/μM sialic acid). The currently circulating human and pandemic influenza (H1N1) viruses showed a preference for 6´SLN and negligible binding to the avian-type 3´SL. A similar pattern was observed for 2 recent swine viruses, which bound only to 6´SLN receptors with nearly equal affinity as pandemic (H1N1) 2009 isolates. As expected, the 2 avian H1 viruses bound strongly only to 3´SL (Figure).

To assess the infectivity and pathogenicity of pandemic (H1N1) 2009 virus strain A/California/04/2009 in terrestrial (chickens, quails) and aquatic (domestic and wild ducks) avian species, we inoculated 10 birds of each species by intranasal, intraocular, and intratracheal instillation with ≈106.0 of the 50% egg infectious dose (EID50) of the virus. We then observed the birds for the next 2 weeks for death and for viral shedding and signs of illness. No birds showed obvious clinical signs of disease. Virus was detected only on postinoculation day 1 in infected chickens and ducks and only in tracheal samples at low titers (<1.7 log10 of the EID50/mL [8]) (Table 2). However, no later shedding of virus was observed, indicating that the virus detected on postinoculation day 1 could have been caused by residual virus particles after inoculation. In contrast, our results revealed that the A/California/04/2009 strain efficiently infected quails with significantly higher titers (<3.4 log10 EID50/mL until postinoculation day 5; p<0.05) in both oropharyngeal and cloacal swab specimens (Table 2). The virus was detected in the trachea (1.7 log10 EID50/g), lungs (2.3 log10 EID50/g), and cecal tonsil (0.8 log10 EID50/g) of quails on postinoculation day 5.

The potential bird-to-bird intraspecies transmission of the A/California/04/2009 pandemic (H1N1) 2009 virus strain in avian species was also examined by introducing 3 contact birds to the inoculated birds' cages on postinoculation day 1. There was no subsequent evidence of viral shedding through the upper respiratory tract or fecal-oral route in any group of birds except 1 of 3 contact quails (Table 2). Oropharyngeal virus titers in this quail were l.7 and 1.5 log10 EID50/mL on postinoculation days 3 and 5, indicating that productive viral replication was occurring.

Suggested Citation for this Article
Ilyushina NA, Kim J-K, Negovetich NJ, Choi Y-K, Lang V, Bovin NV, et al. Extensive mammalian ancestry of pandemic (H1N1) 2009 virus. Emerg Infect Dis [serial on the Internet]. 2010 Feb [date cited]. http://www.cdc.gov/EID/content/16/2/314.htm

DOI: 10.3201/eid1602.091141

abrir aquí para acceder al documento CDC EID completo del cual se reproduce una pequeña parte:
http://www.cdc.gov/eid/content/16/2/314.htm

New Hypothesis for Cause of Epidemic among Native Americans, New England, 1616–1619

EID Journal Home > Volume 16, Number 2–February 2010

Volume 16, Number 2–February 2010
Historical Review
New Hypothesis for Cause of Epidemic among Native Americans, New England, 1616–1619
John S. Marr and John T. Cathey
Author affiliations: Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA (J.S. Marr); and King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (J.T. Cathey)

Suggested citation for this article

Abstract
In the years before English settlers established the Plymouth colony (1616–1619), most Native Americans living on the southeastern coast of present-day Massachusetts died from a mysterious disease. Classic explanations have included yellow fever, smallpox, and plague. Chickenpox and trichinosis are among more recent proposals. We suggest an additional candidate: leptospirosis complicated by Weil syndrome. Rodent reservoirs from European ships infected indigenous reservoirs and contaminated land and fresh water. Local ecology and high-risk quotidian practices of the native population favored exposure and were not shared by Europeans. Reduction of the population may have been incremental, episodic, and continuous; local customs continuously exposed this population to hyperendemic leptospiral infection over months or years, and only a fraction survived. Previous proposals do not adequately account for signature signs (epistaxis, jaundice) and do not consider customs that may have been instrumental to the near annihilation of Native Americans, which facilitated successful colonization of the Massachusetts Bay area.

Retrospective studies have inherent, sometimes insurmountable, biases, but speculation on past events by historians and anthropologists is commonplace and offers grist for future studies. We offer an alternative hypothesis for the cause of an epidemic among Native Americans in the years immediately before the arrival of the Pilgrims in Massachusetts. During 1616–1619, many persons died of a disease that presumably spared nearby European fishermen and traders (1). The more severe manifestations were fever, headache, epistaxis, jaundice, and skin lesions. Speculations as to the cause have included plague, yellow fever, and smallpox (2–7), as well as influenza, chickenpox, typhus, typhoid fever, trichinosis, cerebrospinal meningitis, and syndemic infection of hepatitis B virus (HBV) and hepatitis D virus (HDV) (Table 1) (6–11). We propose another disease: leptospirosis, accompanied by Weil syndrome. With its more severe manifestations, this syndrome is consistent with available clinical information, the nidality of Leptospira organisms, the introduction of rodent reservoirs, and the presence of favorable ecologic niches. Practices of the local population placed it repeatedly in high-risk exposures to epidemic and hyperendemic environments.

Epidemiology
The limited information available notes the following clinical manifestations of the illness: headache and fever with visible signs of epistaxis and jaundice. Mode of transmission was not known. Weather and seasonality are unknown, although tree ring data suggest greater than average rainfall in eastern Massachusetts during 1615–1625 (12). The duration of the epidemic (or epidemics) reportedly ranged from 3 to 6 years. Estimated death rates (which lack reliable numerator and denominator data) range from one third of the local population to as high as 90% (1,13). The Patuxet (Plimouth) Native American village was severely depopulated (14). Referring to conditions along the Newfoundland and Maine coasts, where some believe the epidemic may have originated, Pierre Biard, a Jesuit missionary, noted: "They [the Indians] are astonished and often complain that since the French mingle and carry on trade with them, they are dying fast, and the population is thinning out" (15). In New England, Smith noted "three plagues in three years successively neere two hundred miles along the coast" of southern Massachusetts to Cape Cod and inland for 15 miles (16). Bennett suggested a 50–60-mile interior extension, which corresponds to the area of native corn horticulture (17).

Suggested Citation for this Article
Marr JS, Cathey JT. New hypothesis for cause of an epidemic among Native Americans, New England, 1616–1619. Emerg Infect Dis [serial on the Internet]. 2010 Feb [date cited]. http://www.cdc.gov/EID/content/16/2/281.htm

DOI: 10.3201/eid1602.090276

abrir aquí para acceder al documento CDC EID completo del cual se reproduce una pequeña parte:
http://www.cdc.gov/eid/content/16/2/281.htm

Statewide School-located Influenza Vaccination Program for Children 5–13 Years of Age, Hawaii, USA

EID Journal Home > Volume 16, Number 2–February 2010

Volume 16, Number 2–February 2010
Research
Statewide School-located Influenza Vaccination Program for Children 5–13 Years of Age, Hawaii, USA
Paul V. Effler,1 Carl Chu, Howard He, Kate Gaynor, Steve Sakamoto, Marcia Nagao, Lisa Mendez, and Sarah Y. Park
Author affiliation: State of Hawaii Department of Health, Honolulu, Hawaii, USA

Suggested citation for this article

Abstract
New guidance recommends annual influenza vaccination for all children 5–18 years of age in the United States. During 2007–2008, Hawaii offered inactivated and live attenuated influenza vaccine at school-located clinics for grades kindergarten through 8. Most (90%) public and private schools participated, and 622 clinics were conducted at 340 schools. Of 132,775 children 5–13 years of age, 60,760 (46%) were vaccinated. The proportion vaccinated peaked at 54% for those 6 years of age and declined for older cohorts. More than 90% of schoolchildren transited the clinic in <10 minutes. A total of 16,920 staff-hours were expended; estimated cost per dose administered was $27 and included vaccine purchase and administration, health staffing resources, printing costs, data management, and promotion. This program demonstrates the feasibility of conducting mass school-located influenza vaccination programs in public and private schools statewide, as might be indicated to respond to pandemic influenza.

Seasonal influenza reportedly results in 200,000 hospitalizations and 36,000 deaths annually in the United States (1). In addition, ≈31 million outpatient visits are attributable to influenza during seasonal epidemics; annual projected direct medical costs are $10.4 billion and lost earnings are $16.3 billion (2). Although schoolchildren are not considered at high risk of dying from influenza, annual illness attack rates in schoolchildren were >40% in some years (3,4). In addition, children 5–18 years of age may be the primary source of communitywide influenza transmission (5–7). Focused prevention of influenza infection among children may not only prevent childhood illness but also decrease school absenteeism and reduce the negative impact of influenza infection among working adults and elderly persons (8–10). Disease modeling suggests that if influenza vaccine was limited, as might be expected during a pandemic, vaccinating schoolchildren might be the most efficient approach to reducing overall numbers of influenza infections (11–14).

On February 27, 2008, the Advisory Committee on Immunization Practices (ACIP) expanded the recommended ages for annual influenza vaccination of children to include all children 6 months–18 years of age (15). Nationwide, this new recommendation added ≈30 million children to the cohorts targeted for annual influenza vaccination and invoked calls to consider alternatives to the physician's office for administering the vaccine (16,17).

School-located influenza vaccination (SLIV) clinics have been proposed as a way to get more children vaccinated. Results from several trial SLIV programs indicate that vaccinated schoolchildren and their families experience lower rates of influenza-associated illnesses (18–20). However, many recent studies used only live attenuated influenza vaccine (LAIV), administered as a nasal spray, donated by the manufacturer (6,21). LAIV is currently not recommended for use in children with asthma or other underlying medical conditions that predispose them to complications from wild-type influenza infection; yet these potentially high-risk children may derive the most direct benefit from vaccination against influenza.

As a result, during the 2006–07 school year, the State of Hawaii Department of Health (DOH) conducted a pilot project to assess the feasibility of providing a choice of intranasal LAIV or intramuscular trivalent influenza vaccine (TIV) to students at 3 elementary schools. The pilot project achieved an overall vaccination rate of 35%. On the basis of this success, DOH conducted a statewide SLIV program during the 2007–08 influenza season. We present data on the logistics and outcomes of implementing this large-scale public health program; these data may be relevant to jurisdictions planning annual seasonal influenza vaccination programs for children and for responding to recent ACIP recommendations that place school-aged children among the top priority groups for receiving Influenza A (H1N1) 2009 Monovalent Vaccine (22,23).

Methods
The 2007–08 SLIV program focused on all children 5–13 years of age in Hawaii. Public and private elementary and middle schools were identified through the databases of the Hawaii Department of Education, Hawaii Association of Independent Schools, and Hawaii Catholic Schools. All schools were invited to participate and could register online.

Influenza vaccination was voluntary and required written consent from the child's parent or guardian. Information packets contained an explanatory letter, the 2007–08 Influenza Vaccine Information Statements for both vaccine formulations, and a consent form. A parent or guardian could specifically consent to their child receiving TIV or LAIV or indicate that either formulation was acceptable. To guide the parental decision, the consent form asked about potential contraindications to each formulation. If the child was <9 years of age and had not been vaccinated with 2 doses of influenza vaccine in any previous year (or if the parent, medical provider, or both were uncertain), parents were asked to consent to 2 doses of influenza vaccine administered >6 weeks apart. The packets were distributed to children at participating schools in August 2008; the consent forms were collected by the schools ≈4 weeks later. The packets were available online in 11 languages other than English commonly spoken in Hawaii (www.stopfluatschool.com). Families incurred no cost and received no incentive for participation. DOH provided the vaccine and all clinic supplies. School-based faculty and staff also were offered influenza vaccination at no cost through SLIV clinics.

Vaccines were administered at school during normal school hours over 59 working days from October 15, 2007, through January 31, 2008. School clinic dates and times were established through dialogue with the principal or other administrator of each school. School administrators at participating schools were asked to provide a large room for up to 4 hours (two 4-hour sessions >6 weeks apart for elementary schools), notify parents of the date and time of the scheduled vaccination clinic, and escort students to and from clinics. DOH staff, assisted by contract courier services, transported clinic supplies from DOH offices to each school 1 day before the clinic. DOH paid for all vaccine from state and federal funds and arranged all clinic staffing. No money was billed to third-party payers or collected on site.

Each school clinic required 1 clinic manager and >1 registration personnel and vaccinators, according to the number of vaccinations anticipated there. Staffing data (position, affiliation, hours spent) were determined prospectively and available for 92% of all clinics. For the remainder, we imputed their values from the mean value of the clinics with data available.

Participating DOH personnel, volunteers, and contract staff received DOH-developed training tailored to their respective program responsibilities. DOH verified that all vaccinators were licensed health professionals in good standing; the exception was nursing school students who worked under the on-site supervision of licensed faculty preceptors. In accordance with Hawaii state law, volunteers for DOH, including Medical Reserve Corps volunteers, were considered state employees for liability purposes.

We defined student age in years as date of first influenza vaccination administered by this program minus the child's date of birth divided by 365.25. Student population size for the cohort of children aged 5–13 years residing in Hawaii on July 1, 2007, was obtained using publicly available census estimates (24).

To calculate school-level participation rates, the number of children enrolled in grades kindergarten through 8 (K–8) at individual schools was obtained from the Hawaii Council of Private Schools, Private School Enrollment Report 2007–2008, and the State of Hawaii Department of Education Official 2007–08 Enrollment. To calculate the proportion of school staff vaccinated, we obtained the total number of personnel employed at each school from the participating schools.

To calculate clinic throughput times, a nonrandomized subset of children were given a card documenting the time they arrived at the registration area. The card was collected and exit time noted as the child left the clinic area after vaccination. The difference between exit and arrival times, rounded to the nearest minute, was the clinic throughput time. Although we did not randomly select these students, we tried to obtain a representative sample by distributing the time-stamped cards to 10 children spread over the operational period at each of nearly 200 clinics, totaling ≈3% of vaccinated students.

We collected reports of potential adverse events after vaccination sent to the national passive surveillance system (Vaccine Adverse Event Reporting System) (25). We also maintained records of calls DOH received directly from parents, clinicians, or schools regarding potential adverse events.

Costs were estimated from the DOH perspective so that in-kind contributions from schools whose staff disseminated or collected consent materials and/or escorted students to clinics were not included. We estimated the cost of in-kind contributions of DOH staff and volunteers using 2007 salary data available from the US Department of Labor Bureau of Labor Statistics (26). Clinic manager hourly costs were defined as the national hourly wage for registered nurses at the 75th percentile ($35.18); vaccine administrator hourly costs were defined as the median hourly wage for registered nurses ($30.44), and registration personnel hourly costs were defined as the median hourly wage for medical records and health information technicians ($14.08).

We used Epi Info 2000 to calculate means and standard deviations for computing 95% confidence intervals (CIs); Epi Info version 6 χ2 test for trend was used to assess trends in proportions over successive age cohorts (27). Correlation coefficients were calculated by using Excel (Microsoft, Redmond, WA, USA).

Results
Of 67,203 schoolchildren for whom consent was obtained, 63,153 (94%) received >1 doses of influenza vaccine. Of schoolchildren receiving at least 1 influenza vaccination, 1,078 (1.7%) were <5 years of age, 60,760 (96%) were 5–13 years of age, and 1,136 (1.8%) were >13 years of age; age information was missing for 179 (0.3%) children. Thus, 46% of 5–13-year-old children in Hawaii, as determined by census data (n = 132,775), were vaccinated against influenza at SLIV clinics.

Twenty-nine percent (n = 18,173) of children who received a first influenza vaccination at an SLIV clinic received a second dose, representing 60% of the 30,357 children <9 years of age who participated in the program. A total of 81,326 first or second vaccine doses were provided to children at SLIV clinics.

In addition, 9,306 (43%) of the 21,625 school staff members and 1,054 clinic volunteers were vaccinated at SLIV clinics, bringing the overall total number of influenza vaccinations administered through the program to 91,686. These 2 groups represented 14% of vaccinated persons.

A total of 340 (90%) of 377 elementary and middle schools in Hawaii participated in the program. This number constitutes 242 (96%) of 251 public schools and 98 (78%) of 126 private schools.

A total of 622 SLIV clinics were conducted; 345 (55%) were first-dose clinics during October through December 2007; 5 large schools had 2 first-dose clinics because of the number of vaccinees anticipated. Another 277 (45%) were second-dose clinics conducted at elementary schools in January 2008 to fully vaccinate children <9 years of age who had never received 2 doses of influenza vaccine in a prior year.

Figure 1

Figure 1. Number and proportion of children 5–13 years of age receiving >1 doses of influenza vaccine at school-located clinics, by county, Hawaii, USA, 2007–08 influenza season...

Figure 2

Figure 2. Number and percentage of children 5–13 years of age receiving at least 1 dose of influenza vaccine through a school-located clinic, by year of age, Hawaii, USA, 2007–08 influenza season...

Figure 3

Figure 3. Vaccination rate ranking, by school (grades K–8), public and private schools, Hawaii, USA, 2007–08 influenza season...

Figure 4

Figure 4. Proportion of children enrolled in grades K–8 at each school who received at least 1 dose of influenza vaccine, by school size, Hawaii, USA, 2007–08 influenza season...

Figure 5

Figure 5. Proportion of children receiving at least 1 dose of influenza vaccine in school-located clinics, by age and vaccine formulation selected, Hawaii, USA, 2007–08 influenza season...

Unless indicated otherwise, the following analyses are restricted to children 5–13 years of age. In Honolulu County, 48% of schoolchildren were vaccinated; in Hawaii's other counties, 39%–42% were vaccinated (Figure 1).

Vaccinations peaked at 54% for children 6 years of age. In successive age cohorts, the vaccination rates gradually declined to 30% for children 13 years of age (Figure 2).

Grade-level enrollment data required for calculation of school-level participation rates were available for 291 (86%) of the 340 participating schools. The proportion of children vaccinated at individual schools ranged from 3% to 84% (Figure 3). However, the mean proportion of schoolchildren vaccinated was similar between the 208 public (43.4%; 95% CI 42.1%–44.7%) and 83 private (45.0%; 95% CI 41.5%–48.5%) schools. School size, as measured by the number of students in grades K–8, correlated poorly with vaccination coverage rates obtained at the school (correlation coefficient: –0.05, Figure 4).

Most (56%) parents selected TIV for their child; 27% chose LAIV; and 17% consented to have their child receive either formulation (p<0.001). Vaccine formulation preference did not differ significantly by student sex (p = 0.19). However, the trend for parents to select TIV (only) over LAIV or either vaccine in successive annual age cohorts was significant (p<0.001, Figure 5).

Clinic throughput times were obtained for 1,970 schoolchildren vaccinated at 199 separate clinics. Median throughput time was 4 minutes; >90% of schoolchildren transited the clinic in <10 minutes.

Physicians submitted vaccine adverse event reports for 3 children who received TIV through the school program; no events were medically serious or required hospitalization. In addition, DOH staff were informed of 4 other minor incidents, of which 3 were vasovagal syncopal episodes after TIV administration.

A total of 16,920 person-hours were expended to conduct 345 first-dose clinics and 277 second-dose clinics (Table 1). Mean duration of the first-dose clinic was 3.1 hours and typically required 1 clinic manager, 5 or 6 registration staff members, and 6 vaccinators. Second-dose clinics averaged 2.3 hours and used 2 registration staff members and 2 or 3 vaccinators.

DOH public health nurses accounted for 80% of clinic manager person-hours; other DOH staff provided almost 75% of person-hours for registration (Table 1). Contract nurses accounted for almost 50% of all vaccinator staff hours; DOH public health nurses and nursing school students filled most of the remaining need. Other organizations providing substantial staff support included the Hawaii Medical Reserve Corps and the US Department of Defense.

Program operation costs were estimated to be $2,480,493; nearly half was used to purchase vaccine. Forty-six percent of vaccine doses were acquired through the federal Vaccines for Children program (Table 2). The all-inclusive cost of administering 90,632 doses of influenza vaccine to participating children and school staff, comprising vaccine purchase and administration, healthcare staff resources, printing costs, data management, media promotion, and schoolchild participation rewards, was $27.37 per dose.

Suggested Citation for this Article
Effler PV, Chu C, He H, Gaynor K, Sakamoto S, Nagao M, et al. Statewide school-located influenza vaccination program for children 5–13 years of age, Hawaii, USA. Emerg Infect Dis [serial on the Internet]. 2010 Feb [date cited]. http://www.cdc.gov/EID/content/16/2/244.htm

DOI: 10.3201/eid1602.091375

1Current affiliation: Department of Health, Perth, Western Australia, Australia.

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Human Hendra Virus Encephalitis Associated with Equine Outbreak, Australia, 2008

EID Journal Home > Volume 16, Number 2–February 2010

Volume 16, Number 2–February 2010
Research
Human Hendra Virus Encephalitis Associated with Equine Outbreak, Australia, 2008
Elliott G. Playford, Brad McCall, Greg Smith, Vicki Slinko, George Allen, Ina Smith, Frederick Moore, Carmel Taylor, Yu-Hsin Kung, and Hume Field
Author affiliations: Pathology Queensland, Brisbane, Queensland, Australia (E.G. Playford); University of Queensland, Brisbane (E.G. Playford, B. McCall); Forensic and Scientific Services, Brisbane (G. Smith, I. Smith, F. Moore, C. Taylor); Brisbane South Public Health, Brisbane (B. McCall, V. Slinko); Princess Alexandra Hospital, Brisbane (E.G. Playford, G. Allen); and Department of Primary Industries and Fisheries, Brisbane (Y.-H. Kung, H. Field)

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Abstract
A recent Hendra virus outbreak at a veterinary clinic in Brisbane, Queensland, Australia, involved 5 equine and 2 human infections. In contrast to previous outbreaks, infected horses had predominantly encephalitic, rather than respiratory, signs. After an incubation period of 9–16 days, influenza-like illnesses developed in the 2 persons before progressing to encephalitis; 1 died. Both patients were given ribavirin. Basal serum and cerebrospinal fluid levels were 10–13 mg/L after intravenous administration and 6 mg/L after oral administration (isolate 90% inhibitory concentration 64 mg/L). Both patients were exposed to infected horses, 1 during the late incubation period in a horse. The attack rate for veterinary clinic staff exposed to infected horses was 10%. An isolate from this outbreak showed genetic heterogeneity with isolates from a concurrent, but geographically remote, outbreak and from previous outbreaks. Emergence of Hendra virus is a serious medical, veterinary, and public health challenge.

The genus Henipavirus of the family Paramyxoviridae contains 2 recently described viruses, Hendra virus and Nipah virus, whose natural reservoir is fruit bats of the genus Pteropus (1). Hendra virus has caused serious respiratory infections in horses and respiratory and neurologic infections in humans. After 2 Hendra virus outbreaks in 1994, which involved 22 horses and 3 humans (2,3), a total of 7 additional equine infections and 1 human infection were documented up to 2008 (4,5); all occurred in coastal Queensland and northern New South Wales in Australia. Of the 4 persons with documented Hendra virus infection, 2 recovered from influenza-like illnesses (ILIs) (2,5) and 2 died, 1 from respiratory failure (2) and 1 from encephalitis 13 months after initial aseptic meningitis (3). The estimated incubation period in humans of 7–8 days was based on these cases.

The Outbreak
In early July 2008, a veterinary practice (clinic) in Thornlands, Queensland, was quarantined after 2 acutely ill horses were provisionally diagnosed with Hendra virus infection. Four horses eventually died from the infection, and another was humanely killed after it recovered, in accordance with established national veterinary practice (6). In contrast to previous equine outbreaks, horses in this outbreak showed predominantly neurologic (ataxia, head tilt, limb paresis), rather than respiratory, symptoms (1). We report 2 additional human cases of Hendra virus encephalitis, 1 fatal, in veterinary workers associated with this equine outbreak.

Patient 1
A 33-year-old man (equine veterinarian) at the clinic had a 2-day history of an ILI (fever, myalgia, and headache) in mid-July 2008. Clinical examination showed only a fever (38°C); mild neutropenia (0.7 × 109 cells/L) and thrombocytopenia (79 × 109 cells/L); a normal chest radiograph; and negative PCR results for respiratory viruses, including influenza, on a nasopharyngeal aspirate (NPA) specimen. Hendra virus RNA was detected by reverse transcription–PCR (RT-PCR) in serum and NPA specimens. The patient remained clinically well and showed defervescence on day 4 of illness.

By day 5, mild confusion, ataxia, bilateral ptosis, but no other neurologic signs, developed. Magnetic resonance imaging (MRI) showed multifocal (bilateral, cerebral, cortical, right pontine, scattered white matter) hyperintense lesions on T2 flair images associated with evidence of infarction on diffusion weighted images. A cerebrospinal fluid (CSF) sample had a leukocyte count of 4 × 106 cells/L, a protein level of 600 mg/L, and a glucose level of 3.7 mmol/L; Hendra virus RNA was detected by RT-PCR. An electroencephalogram (EEG) showed bilateral high-voltage slow waves but no epileptiform activity. He was treated with intravenous ribavirin (30 mg/kg initial dose, then 15 mg/kg every 6 h for 4 days, and 8 mg/kg every 8 h thereafter); enteric aspirin (100 mg/day); and because of progressive confusion and ataxia, intravenous dexamethasone (4 mg every 6 h).

Suggested Citation for this Article
Playford EG, McCall B, Smith G, Slinko V, Allen G, Smith I, et al. Human Hendra virus encephalitis associated with equine outbreak, Australia. Emerg Infect Dis [serial on the Internet]. 2010 Feb [date cited]. http://www.cdc.gov/EID/content/16/2/219.htm

DOI: 10.3201/eid1602.090552

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Household Responses to Pandemic (H1N1) 2009–related School Closures, Perth, Western Australia

EID Journal Home > Volume 16, Number 2–February 2010

Volume 16, Number 2–February 2010
Research
Household Responses to Pandemic (H1N1) 2009–related School Closures, Perth, Western Australia
Paul V. Effler, Dale Carcione, Carolien Giele, Gary K. Dowse, Leigh Goggin, and Donna B. Mak
Author affiliations: Associate Editor, Emerging Infectious Diseases journal, Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P.V. Effler); and Department of Health, Perth, Western Australia, Australia (P.V. Effler, D. Carcione, C. Giele, G.K. Dowse, L. Goggin, D.B. Mak)

Suggested citation for this article

Abstract
School closure is often purported to reduce influenza transmission, but little is known about its effect on families. We surveyed families affected by pandemic (H1N1) 2009–related school closures in Perth, Western Australia, Australia. Surveys were returned for 233 (58%) of 402 students. School closure was deemed appropriate by 110 parents (47%); however, 91 (45%) parents of 202 asymptomatic students reported taking >1 day off work to care for their child, and 71 (35%) had to make childcare arrangements because of the class closures. During the week, 172 (74%) students participated in activities outside the home on >1 occasion, resulting in an average of 3.7 out-of-home activities for each student. In our survey, activities outside the home were commonly reported by students affected by school closure, the effect on families was substantial, and parental opinion regarding school closures as a means to mitigate the outbreak of pandemic (H1N1) 2009 was divided.

On Friday, June 5, 2009, the Western Australia Department of Health received its third notification of confirmed infection with influenza A pandemic (H1N1) 2009. The patient was an elementary school student from Perth, Western Australia, Australia, who had recently returned from a sporting club excursion to Victoria, another Australian state, which had already experienced >600 cumulative confirmed cases of pandemic influenza (1).

Over the next 3 days (June 6–8), vigorous contact tracing and testing confirmed 11 more pandemic (H1N1) 2009 infections among schoolchildren; all had either visited Victoria or were close contacts of confirmed case-patients who had traveled to Victoria. These 11 children attended 3 schools located within 2 km of each other in a socioeconomically advantaged area of Western Australia's capital, Perth, which has a population of 1.7 million (2). On Sunday, June 7, in accordance with Australian public health practice at the time, the Department of Health advised the 3 schools to cancel classes for the coming week. School A, a public school, closed entirely; schools B and C, both private, cancelled classes for grade 5 and grades 5–7, respectively. The grades closed at schools B and C were those in which at least 1 student was confirmed as having pandemic (H1N1) 2009 virus infection.

School closure (i.e., either closure of school or dismissal of classes) is a nonpharmaceutical intervention often recommended for mitigating virus transmission during an influenza pandemic (3,4). However, little is known about the effect of school closures on students and families. We describe the activities of students affected by school closure, the effect of school closure on families, and parental opinions regarding school closures implemented in response to influenza A pandemic (H1N1) 2009.

Methods
Parents of all students excluded from attendance at schools A, B, and C were surveyed to ascertain the age of their child; the onset of illness, if any, in their child during the school closure period; the need for special childcare arrangements due to the closure; whether the child went out of the home during the school closure period; and parental perspectives on the consequences and appropriateness of the school closure. Parents were asked to complete a written questionnaire for their child; no personal identifiers were obtained. Surveys were distributed by schools on June 22, 2009 (10 days after school closure ended), and collected on July 3, 2009.

A case-patient was defined as a student with PCR results positive for influenza A pandemic (H1N1) 2009 virus. A contact was defined as a student who had been in a classroom with a case-patient for >4 hours or who had had another period of close physical proximity (e.g., sitting within 1 m of the case-patient for at least 15 min) during the case-patient's infectious period (i.e., 1 day before until 7 days after symptom onset). Other students affected by the closure but who did not meet case-patient or contact criteria were defined as school peers.

Influenza-like illness (ILI) was defined as an illness with fever and cough and/or sore throat. Upper respiratory infection (URI) was defined as an illness not meeting ILI criteria but exhibiting >1 of the following signs or symptoms: sore throat, cough or runny nose. Asymptomatic students were defined as contacts and peers in whom ILI or URI did not develop during the period of school closure. Ill students were defined as case-patients, contacts, and peers who developed ILI or URI during the school closure period.

Suggested Citation for this Article
Effler PV, Carcione D, Giele c, Dowse GK, Goggin L, Mak DB. Household responses to pandemic (H1N1) 2009–related school closures, Perth, Western Australia. Emerg Infect Dis [serial on the Internet]. 2010 Feb [date cited]. http://www.cdc.gov/EID/content/16/2/205.htm

DOI: 10.3201/eid1602.091372

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January 2010 (special pre-congress edition) of the ISID NEWS

The January 2010 (special pre-congress edition) of the ISID NEWS (the official newsletter of the International Society for Infectious Diseases) is now available online at http://www.isid.org/publications/ISIDnewsletter201001.shtml.

In this issue we invite you to join us at the 14th International Congress on Infectious Diseases in Miami, Florida, USA. The Congress will be host to an outstanding program with international leaders in the field of infectious diseases delivering plenary lectures and experts from around the globe in numerous exciting symposia. They will address current topics of interest in international public health, emerging infectious diseases, infection control, basic science, as well as the latest in vaccines and therapeutics. Click on the link below for complete details of this exciting program.

ISIDNEWS
An official publication of the International Society for Infectious Diseases

14th International Congress on Infectious Diseases (ICID) in Miami, Florida
March 9-12, 2010
The 14th ICID website http://www.isid.org/14th_ICID/ has more detailed program information and links for registration.

Plenary Lectures
Jarbas Barbosa da Silva (Brazil)
"Emerging Infectious Diseases in Latin America"

Françoise Barré-Sinoussi (France)
"The Discovery of HIV: An Example of Translational Research on Response to an Emerging Epidemic"

Martin Cetron (United States)
"The Changing Patterns of Global Migration and the Impact on Infectious Diseases"

Myron S. Cohen (United States)
"Transmission and Prevention of Transmission of HIV: Clues from the Early 21st Century"

Keith Klugman (United States)
"Pneumococcal Infections in Children and their Impact on Adults"

Roberto Kolter (United States)
"Microbial Chemical Ecology and the Future of Antibiotics"

Prof. Louis Loutan (Switzerland)
"The Challenges of Travel Medicine in the 21st Century"

Christopher V. Plowe (United States)
"Malaria Eradication"

Symposia
Oral Presentations

14th ICID Member-Generated Symposia by Young Investigators

Satellite Symposia

Meet the Expert Sessions

14th ICID Awardees Announced

14th ICID Sponsors

IMED 2011 (International Meeting on Emerging Diseases & Surveillance)

The next IMED meeting will be held in Vienna, Austria, from February 4 to 7, 2011. You can sign up for the mailing list and follow updates at the IMED website:
http://imed.isid.org/

ISID-NTD 2011 (ISID-Neglected Tropical Diseases Meeting)

The FIRST ISID-NTD meeting will be held in Boston, Massachusetts, USA, from July 8 to 10, 2011. You can sign up for the mailing list and follow updates at the ISID-NTD website:
http://ntd.isid.org/

Zyprexa (olanzapine): Use in Adolescents

Zyprexa (olanzapine): Use in Adolescents - Clinicians should consider potential long-term risks when prescribing to adolescents

Zyprexa (olanzapine): Use in Adolescents
Audience: Neuropsychiatric healthcare professionals
Lilly and FDA notified healthcare professionals of changes to the Prescribing Information for Zyprexa related to its indication for use in adolescents (ages 13-17) for treatment of schizophrenia and bipolar I disorder [manic or mixed episodes]. The revised labeling states that:

Section 1, Indications and Usage: When deciding among the alternative treatments available for adolescents, clinicians should consider the increased potential (in adolescents as compared with adults) for weight gain and hyperlipidemia. Clinicians should consider the potential long-term risks when prescribing to adolescents, and in many cases this may lead them to consider prescribing other drugs first in adolescents.

Section 17.14, Need for comprehensive Treatment Program in Pediatric Patients: Zyprexa is indicated as an integral part of a total treatment program for pediatric patients with schizophrenia and bipolar disorder that may include other measures (psychological, educational, social) for patients with the disorder. Effectiveness and safety of ZYPREXA have not been established in pediatric patients less than 13 years of age.
Read the complete MedWatch 2010 Safety summary, including links to the Dear Healthcare Professional letter and revised Prescribing Information, at:
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm198402.htm

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Zyprexa (olanzapine): Use in Adolescents

viernes, 29 de enero de 2010

Enerocytozoon bieneusi, Czech Republic | CDC EID

EID Journal Home > Volume 16, Number 2–February 2010

Volume 16, Number 2–February 2010
Dispatch
Seropositivity for Enterocytozoon bieneusi, Czech Republic
Bohumil Sak, Zuzana Kučerová, Martin Kváč, Dana Květoňová, Michael Rost, and Evan W. Secor
Author affiliations: Biology Centre of the Academy of Sciences of the Czech Republic, České Budějovice, Czech Republic (B. Sak, M. Kváč, D. Květoňová); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (Z. Kučerová, E.W. Secor); and University of South Bohemia in České Budějovice, České Budějovice (M. Kváč, M. Rost)

Suggested citation for this article

Abstract
To determine seropositivity for Enterocytozoon bieneusi in the Czech Republic, we tested 115 serum samples from various groups. We found that 20% from HIV-positive persons, 33% from persons with occupational exposure to animals, and 10% from healthy persons were positive by indirect immunofluorescence assay. Proteins of 32 kDa were detected in serum samples from seropositive persons.

Microsporidia are small, single-celled, obligate intracellular parasites that were initially characterized as eukaryotic protozoa, but they have recently been reclassified as fungi. Since 1985, microsporidia have been identified as a cause of opportunistic infections associated with persistent diarrhea and weight loss in persons with AIDS (1). Because of heightened awareness and improved diagnostic methods, microsporidia infections have been recognized in a wide range of human populations, including organ transplant recipients, travelers, children, contact lens wearers, the elderly, and immunocompetent persons with no known risk factors (2).

Of the 14 species of microsporidia known to infect humans, Enterocytozoon bieneusi is the most common and is associated with diarrhea and systemic disease (3). Symptomatic E. bieneusi infections are primarily found in immunodeficient persons, although infection in immunocompetent populations is increasingly detected (4). It is unclear whether asymptomatic microsporidia infections persist in immunocompetent persons and can reactivate during conditions of immune compromise and are than able to be transmitted to others at risk, such as during pregnancy or through organ donation.

Studies focusing on risk factors associated with microsporidiosis will help define more clearly the sources of microsporidia that pose a risk for transmission in the environment so that preventive strategies can be implemented. To determine seropositivity for E. bieneusi in the Czech Republic, we used 2 serologic assays for detecting E. bieneusi–specific antibodies in serum specimens from HIV-positive and HIV-negative persons and from blood donors and persons with occupational exposure to animals.

The Study
The National Institute of Public Health in Prague provided anonymous serum samples, originally collected for HIV diagnostics in 2007, from HIV-positive persons (n = 70) and healthy blood donors (n = 30). In addition, serum specimens from persons who worked with animals and animal excrement were collected after informed consent was obtained in 2007 (n = 15). Every specimen in the study was supplemented with data on the patient's clinical symptoms (e.g., indigestion, abdominalgia). The study was approved by the Hospital České Budějovice, a.s. ethics committee (protocol no. 202/07). The serum specimens were frozen directly after recovery and were stored at –20°C. Patient identifiers were removed from the samples before testing.

E. bieneusi spores were purified from positive stool samples, originally obtained from an HIV/AIDS patient from Lima, Peru (provided by G.S. Visvesvara, Centers for Disease Control and Prevention, Atlanta, GA, USA), by using Percoll and cesium chloride gradient centrifugation as previously described (5). The spore suspension was stored in phosphate-buffered saline (PBS) supplemented with antimicrobial drugs at 4°C. The purity of spore suspension was tested by using light microscopy (optical brightener staining), and the background reactivity of serum specimens with bacteria was observed by using indirect immunofluorescence antibody (IFA) assay.

IFA was performed with purified whole E. bieneusi spores at a concentration of 105/well. The serum samples were diluted in PBS by serial dilution, 1:10, 1:50, 1:100, 1:200, and 1:400, and results were compared with negative (1:100) and positive (1:400) control serum specimens. Serum specimens with titers >100 were considered positive on the basis of positive control serum titration. A total of 115 human serum samples were examined by IFA for antimicrosporidial immunoglobulin G. Specific antibodies against E. bieneusi were detected for 22 persons (19%; 95% confidence interval [CI] 12%–28%); 20% of HIV-positive persons (CI 11%–31%), 10% of blood donors (CI 2%–26%), and 33% of persons with animal risk exposure were positive (CI 11%–61%). CIs were calculated by the Clopper-Pearson formula for binominal counts (Table). None of the persons had demonstrated any clinical symptoms (e.g., loose stool, indigestion). The titers were higher (400) for HIV-positive persons and 1 animal keeper; the highest titer in blood donors was 200. No background reactivity was observed in tested serum samples with bacteria present in spore suspension.

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Enerocytozoon bieneusi, Czech Republic | CDC EID