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Fulltext Occurrence of Norovirus GI in green and red onion

Noor Hidayah, M.S., Tuan Zainazor, C., Pui, C.F., Noorlis, A., Noor Eliza, M.R., Naziehah, M.D., et al.

International Food Research Journal, 2011;18(2):677-681.
MyJurnal

Several Norovirus cases due to consumption of green onions have been reported during recent years but reports on red onions are not found. Onions are one of the major tastes in Malaysian food which are sometimes consuming raw especially the green onion. Viral contamination in onions can occur due to planting condition and not properly prepared food. This situation can pose the human health risk. A method was developed to detect the Norovirus that might present on different type of onions. In this study, 60 samples were collected from local market. Elution by Tryptose Phosphate Glycine broth and concentration steps using negatively charge filter were applied to enhance the detection of virus in food due to low copies of virus on food surface. The viral RNA was extracted using Qiagen Rneasy Mini kit before further detection using One-step RT-PCR. The total incidence of Norovirus in green onion and red onion was 13.33% (4/30) and 3.33 % (1/30) respectively. This is the first report of the detection of Norovirus in red and green onions in Malaysia. Based on the results, it is concluded that this method is reliable to detect Norovirus on onions and vegetables surface and hence can be applied in the laboratories for routine or food borne outbreak investigation.

Matched MeSH terms: Disease Outbreaks
Fulltext Outbreak management during the worst flood disaster of 2006–2007 in Johore, Malaysia

Arbaiah, O., Badrul, H.A.S., Marzukhi, M.I., Mohd Yusof, Badaruddin, M., Mohd Adam

Malaysian Journal of Community Health, 2009;15(3):111-118.
MyJurnal

Outbreak management in disaster has to be planned and implemented prior to, during and after the disaster is over. The risk of outbreaks following disaster is related to the size, health status and living conditions of the displaced population. The risk is increased due standing water in floods for vector borne diseases, overcrowding, inadequate water and sanitation and poor access to health care. The 2006-2007 flood in Johore resulted in 2 episodes of food poisoning and an outbreak of coxsackie A24 acute haemorrhagic conjunctivitis. Only 19,667 (12.5%) of the 157,018 displaced persons suffered from communicable diseases which comprised of acute respiratory disease 7361(28%), skin infection 4241(19%), acute gastroenteritis 1872(8%) and conjunctivitis 589 (2%). The routine disease surveillance and environmental control were enhanced to cover the relief centers and flood areas. Risk assessment of communicable disease carried out resulted in prompt control measures and good coverage of preventive activities. In conclusion the Johore State Health Department has successfully manage the outbreaks during the major flood.

Matched MeSH terms: Disease Outbreaks
Fulltext Public health preparedness and response to flood disaster in Johore, Malaysia : challenges and lessons learned

Arbaiah, O., Daud, A.R., Surinah, A., Noorhaida, U., Shaharom, N.A.M.C.D., Rahim, A.

Malaysian Journal of Community Health, 2009;15(3):126-131.
MyJurnal

Introduction : The 2006 -2007 flood in Johore which displaced more than 312,386 residents of the state was an extraordinary event and tested everyone preparedness. The disaster caused massive material, economic and environmental losses exceeded the state and local community capacity, forcing them seeks help from other states. Needs assessment, effectiveness of health services as well as leadership and nongovernment organization involvement were evaluated and constitute lessons learnt from the experiences.
Methodology : This is a descriptive review of the Johore flood. The review was based on literature search using established data and published reports of previous disasters. Discussion will focus on the 4 S’s of the surge capacity that is Structure, Staffing, Supplies and System (policies & procedures). Result : Structure- although 49 or 14% of health facilities in the state were affected by the flood, health services continued to be given. Majority of the relief centers were schools with better facilities. Funding for repairs obtained early approval as estimation of damages was timely applied. Temporary isolation centers for the conjunctivitis outbreak was appropriate implemented. Staffing- Leadership was assumed by the Johore State Health Department, the strongest and most prepared health sector. Needs assessment resulted in additional staff being deployed from other states allowing local staff to have their break from work as well as personal stress. Local staff became multi-skilled players. Training in disaster preparedness has to be of utmost priority to support such needs. Supplies- Personnel protective and pest control equipment, and medical supplies were adequately supplied. The laboratory services were well prepared. Pamphlets, posters, buntings and banners were distributed including five new health promotion materials. System- Flood disaster plan of action was well in place resulting in efficient management of the operating rooms, data management, coordination of services and disease surveillance through early warning system.
Conclusion : Public health preparedness is a matter of good governance and management based on evidence and experience. There is a need for a permanent and stable program for the Ministry of Health to prepare and coordinate the response to all disasters.

Matched MeSH terms: Disease Outbreaks
Fulltext The worst flood in 100 years : Johore experience

Marzukhi, M.I., Daud, A.R., Badrul Hisham, A.S.

Malaysian Journal of Community Health, 2009;15(3):1-14.
MyJurnal

Past major flooding events for the state of Johore, Malaysia were recorded in 1926, 1967, 1968 and 1971. However, major meteorological phenomena that hit Johore on the 19th December 2006 (first wave) and the 12th January 2007 (second wave) were claimed to be the worst flood disaster in Johore in a 100 years. All eight districts were affected displacing 157,018 and 155,368 population during the first and the second wave event respectively. The Johore Health Department deployed substantial number of medical and health personnel to deal with the Johore flood crisis. Flood-related data were collected on daily basis between 19th December 2006 and 19th February 2007 using spreadsheet format from Flood Operational Rooms located at respective District Health Offices. Among flood victims 34,530 were found to have non-communicable diseases and 19,670 with communicable diseases. No major food- and water-borne disease outbreaks, such as cholera and typhoid, were reported in Johore. High success of public health measures was depending on the workforce of medical and health personnel on the ground. On the other hand, voluntary services offered by non-governmental organisations (NGOs), private sector and other volunteers should be well coordinated without compromising regulatory and ethical requirements. Crisis guidelines and plan of actions shall be updated so that they would be more relevant to the crises encountered on the ground.

Matched MeSH terms: Disease Outbreaks
Fulltext Factors influencing consumer intentions to avoid broiler chicken meat and products in Malaysia

Huang, L.C., Goh, Y.N., Mohaidin, Z.

International Food Research Journal, 2014;21(1):181-188.
MyJurnal

Reports of bird flu outbreaks occur around the globe, posing a severe threat to the poultry
industry and consumer health. Despite the number of bird flu scares, few studies have
considered the impact on consumers’ chicken consumption intentions in a non-western context,
such as in Malaysia. The aim of this study is to determine the factors that influence consumers’
intentions to take precautions by avoiding the consumption of broiler chicken meat and
products in Malaysia when a bird flu outbreak occurs. A total of 276 online questionnaires were
disseminated using convenience sampling with 109 respondents completing the questionnaires, generating a response rate of 40.8 percent. The study results show that attitudes, subjective norms, perceived behavioral control, perceived credibility of information, and perceived risk have a significant relationship with consumer intentions to take precautions by avoiding the consumption of broiler chicken meat and products. One factor is the exception: attention towards bird flu news. These findings shed some light on understanding the extent of consumer response (i.e. consumption behavior) to future health crises (e.g. bird flu). Moreover, for policy makers, these findings may serve as a guide and a reference to food safety issues in the poultry industry, especially future bird flu scares.

Matched MeSH terms: Disease Outbreaks
Fulltext Dengue incidence and the prevention and control program in Malaysia

Rose Nani Mudi

International Medical Journal Malaysia, 2015;14(1):5-9.
MyJurnal

The trend of dengue incidence in the regions and many countries has shown an increasing trend for the past few decades. The World Health Organization (WHO) reported that the incidence increased dramatically over the last 50 years and that dengue virus infections expanded to new countries, and from urban to rural settings. Malaysia is one of the countries that experience similar situation. The trend of dengue incidence in Malaysia has continued to increase since 2001 until 2014. In 2001, the dengue incidence rate (IR) was 72 cases in 100,000 population and progressively increased to 361 cases in 100,000 populations in 2014. There were temporary decrease of the incidence rate in 2011 and 2012 to 69.9 and 76 cases per 100,000 populations. Despite the close monitoring and continuous efforts from the Ministry of Health and Municipals to conduct the prevention and control activities, the number of dengue cases continues to increase due to multiple uncontrolled factors. There are at least five major factors that influence the transmission of dengue disease which include the dengue virus, the human as the host, the environmental condition such as cleanliness, the vectors and its behavior and the climate change. Due to these multiple factors that influence the disease pathophysiology and transmission of dengue virus, the control of mosquito-borne viral infection is very challenging and different from managing other infectious diseases. In addition, the rapid urbanization, population growth and human behavior together with international travel, making the control of dengue transmission even more difficult. Based on the circumstances, Ministry of Health Malaysia has implemented the intergrated strategy for dengue prevention and control program in the National Dengue Strategic Plan (NDSP) since 2011. There are seven strategies included in the NDSP which is strengthening of the dengue surveillance, practicing intergrated vector management, emphasizing on the dengue case management, social and community mobilization towards the prevention activity, ensuring rapid response in managing the dengue outbreak and developing new innovative method through dengue research. Most of the factors that contribute to the occurrence of dengue cases are difficult to be controlled and these leave with only manipulation and intervention with the environment, vector control and changing the human behavior for the prevention and control of dengue.

Matched MeSH terms: Disease Outbreaks
Fulltext Laboratory diagnosis of dengue: a review

Sekaran SD

International Medical Journal Malaysia, 2015;14(1):17-28.
MyJurnal

Dengue is an arthropod borne disease that has become important worldwide. There is still no specific drug available for treatment and also no protective vaccine that can be used. As such, specific diagnosis is essential to enable good management and prevention of large outbreaks. Diagnosis today in many countries is still based on serology though the detection of NS1 has slowly become incorporated. Diagnosis is critical for early intervention with specific preventive health measures to prevent fatalities and also to curtail spread and reduce economic losses. Serological assays mainly detect IgM which now as a single test is invalid unless a second sample is taken to confirm. As such to effectively diagnose dengue at all stages of infection, assays with two or more markers are required or two samples taken a few days apart. Other commonly used tests include NS1 detection, nucleic acid amplification and IgG detection. However the sensitivities of the current commercial kits vary quite considerably and have to be interpreted with caution. Hence knowledge of this disease is essential when conducting diagnostics for dengue.

Matched MeSH terms: Disease Outbreaks
Fulltext Rubella and scarlet fever outbreak among trainees at a training camp in Mersing, Johor

Mohamad Nizam Subahir, Suraiti Hasim, Mohd. Badri Yacob, Mohd Rohaizat Hassan

Malaysian Journal of Public Health Medicine, 2014;14(2):50-55.
MyJurnal

Rubella is an acute and contagious disease which is mainly characterized by fever, rash, and cervical lymphadenopathy. This contagious disease spreads easily through nasopharyngeal secretions, droplet or direct contact with patients. Meanwhile clinical features of scarlet fever include a sore throat, skin rash and strawberry tongue. A descriptive study was conducted to describe the epidemiological characteristic of diseases at a Training Camp in Mersing. Data obtained on demographic details, onset and time of fever and rash or contact with ill person 14 to 21 days prior to symptoms. Screening and interview conducted for all suspected cases of Rubella. 47.4% of the cases presented on 5th June 2012 followed by 15.8% on 11th June 2012 and 13.5% on 12th June 2012. Maculo papular rash was the predominant presenting symptom among students with acute infection in this outbreak (100%) followed by fever (36.8%). Measles specific IgM was not detected in the serum taken but rubella specific IgM was detected in 66.7% (6/19) of samples. 55% (11/20) were positive for ASOT. 4 trainees had Rubella and Scarlet Fever co-infection. It was found out that the outbreak occurred among 391 residents in the camp who shared common places for activities such as lecture, physical activity and meal. Rapid dissemination was due to overcrowded environment and close contact during common activities of the residents. Theoretically co-infection would be presented with severe clinical symptoms but not in this outbreak where all affected trainees only presented with mild fever and rashes.

Matched MeSH terms: Disease Outbreaks
Fulltext Paper review of factors, surveillance and burden of food borne disease outbreak in Malaysia

Sharifa Ezat, W.P., Netty, D., Sangaran, G.

Malaysian Journal of Public Health Medicine, 2013;13(2):98-105.
MyJurnal

Food borne diseases like cholera, typhoid fever, hepatitis A, dysentery and food poisoning occur as the results of ingestion of foodstuffs contaminated with microorganisms or chemical. The true incidence of food borne disease in Malaysia is unknown, however the incidence is low ranging from 1.56 to 0.14 cases per 100,000 population and the food poisoning cases is on the rise as the evident by the incident rate of 62.47 cases per 100,000 population in 2008 and 36.17 in 2009. The rapid population growth and demographic shift toward ageing population, changing eating habit such as consumption of raw or lightly cooked food, long storage of such food, lack of education on basic rules of hygienic food preparation and food trading without appropriate microbiological safety procedure become contributing factors for food borne diseases. Food borne disease in Malaysia is in the rise and the direct and indirect cost management of FBD will become one of the most common issues to face by the government. The world is spending millions and millions in cost of treatment due to food borne diseases. The information on this paper was collected via findings of previous journals, data and statistics from the MOH of Malaysia and WHO websites. As a result, authors found that the prevention and management of the food borne disease outbreak needs to be addressed seriously.

Matched MeSH terms: Disease Outbreaks
Fulltext Acute gastroenteritis in Kinta

Lili, Z.M., Noridah, O.

Journal of Health Management, 2008;4(1):61-72.
MyJurnal

Acute Gastroenteritis (AGE) is common world wide and is a major health problem. The commonest cause is from contaminated water or food. Common infective agents are Rotavirus, Staph. aureus and Bacillus cereus. There was an AGE outbreak in Ipoh City from late August till early October 2006. Epidemiological and laboratory investigations were done. Fresh stool samples were taken from symptomatic patients. Water and food sampling were also done. Descriptive analysis of the outbreak was done. A total of 170 patients, mostly between 1 - 5 years of age, were affected. The highest incidents were seen in Bercham. Fever and diarrhea were the prominent features. Two stool samples (13.3%) were positive for E.coli and rotavirus respectively. Twelve of the twenty (60%) water samples taken were contaminated with coliform and fecal matter. Twenty-one of the eighty ((26.3%) food samples taken grew either E.coli, Staph. aureus or Bacillus cereus. It was concluded that a general source was responsible for this problem. The water supply to Ipoh City and the surrounding area is the most likely source. Novovirus was suspected as the organism involved because of the self-limiting and mild nature of the illness that occurred in this outbreak.
The AGE outbreak in Kinta District in September 2006 is due to contaminated
water supply from two water treatment

Matched MeSH terms: Disease Outbreaks
Fulltext A study of hand, food and moth epidemic in Hulu Langat district, 2000. [Tinjauan wabak penyakit tangan, kaki dan mulut (HFMD) di daerah Hulu Langat, 2000]

Meftahuddin Tarip, Jamsiah Mustafa

Malaysian Journal of Public Health Medicine, 2003;3(1):16-22.
MyJurnal

The aim of this study is to describe the epidemiological features of HFMD outbreak in the Hulu Langat District in 2000. Until November 2000, a total of 60 cases were reported and the worst ever reported to the previous years. The mean age of patients was 3.9; 5.8 years with majority of the cases aged between 1 to 4 years old (53.8 per 100,000 of population), male gender (8.3 per 100,000 of populations), and were of Chinese (12.2 per 11 100,000 of populations) and Malay ethnicity (7.2 per 100.000 of populations). All cases were uncomplicated cases and were diagnosed clinically. Most of the notified cases were front the government facilities, which are 44 cases (73.3%). Thirty-five (35) cases (58.4%) were treated as outpatient and 25 cases (41.6%) as in patients (p>0,05). Only 7 cases (11.7%) have history of contact with HFMD patients. The notified cases were mainly from the densely populated areas which were Cheras, Kajang and Ampang. No differences were noted between HFMD cases which have been breasfed for less than 6 month or more, and twenty nine (29) cases (48.3 %) had completed the immunization schedule. In conclusion, the recent emergence of HFMD brings a new challenge, which have to be faced in the prevention and surveillance activities of public health problems in the district.
Study site: Notified cases from Klinik Kesihatan, hospital, private clinics, Ulu Langat, Selangor, Malaysia

Matched MeSH terms: Disease Outbreaks
Fulltext Outbreak of dengue in Bandar Baru Bangi

Meftahuddin, T., Anisah, A.B., Mohd Faizal, A.

Malaysian Journal of Public Health Medicine, 2004;4(1):22-28.
MyJurnal

An outbreak of dengue and dengue haemorrhagic fever was studied in Bandar Baru Bangi, Hulu Langat District which started from epidemiological week 51 of December 2001 until ]anuary 2002. Altogether, 53 cases were reported to the Hulu Langat District Health Office with 24 cases detected in Section I and Section 6, and 5 cases in Section 4 of Bandar Baru Bangi respectively. Two cases were confirmed as dengue haernorrhagic fever (DHF). The majority of the cases were female Malays. The age of the cases ranged from 3 to 60 years with a mean of 29.17 : 13.18 years old. The majority of patients were mainly private sector workers from factories or companies with 29 cases (54.7%) and university students with 14 cases (26.4%). No deaths were reported in this outbreak. On the average, the duration taken for a patient to be admitted from the date of onset was about 4.4 - 2.0 days and the duration taken for notification from the date of admission was about 2.0 - 1.7 days. The majority of cases reported were based on classical clinical features of dengue fever. Only 18 cases (34%) were IgM positive for dengue. The statistical analysis showed that the majority were male (P>0.05), Malays (P>0.05) , age group of 21»30 years (P>0.05), platelets level < 100,000 per mm3 (p>0.05) and the serological specimens obtained 5 days after the date of onset (p2.0%) within residential premises in this locality with 46 Aedes mosquito breeding places identified and a total amount of RM 6500 of fines imposed.

Matched MeSH terms: Disease Outbreaks
Fulltext Vaccines and vaccination against infectious bursal disease of chickens: prospects and challenges

Liew, Pit Sze, Nurulfiza Mat Isa, Omar Abdul Rahman, Aini Ideris, Mohd HAIRBEJO

The Pertanika Journal of Scholarly Research Reviews, 2016;2(2):23-39.
MyJurnal

Infectious bursal disease (IBD), also known as the Gumboro disease, has been a great
concern for poultry industry worldwide. The first outbreak of IBD due to very virulent (vv) IBD virus
(IBDV) infection in Malaysia was reported in 1991. The major economic impact of the disease is high
mortality and poor performance. The virus causes immunosuppression where if the infected chicken
recovered from the acute disease, they become more susceptible to infections of other pathogens and
fail to respond to vaccines. Therefore, prevention is important and vaccination has become the
principal control measure of IBDV infection in chickens. The conventional attenuated live and killed
vaccines are the most commonly used vaccines. With the advancement of knowledge and technology,
new generation of genetically-engineered vaccines like viral vector and immune complex vaccines
have been commercialised. Moreover, hatchery vaccination is becoming a common practise, in
addition to farm vaccination. Currently, the disease is considerably under controlled with the
introduction of vaccination. However, occasional field outbreaks are still commonly reported. The
demand for vaccines that could suit the field situation continues to exist. The endemicity of disease,
presence of challenge in the farm and maternally derived antibody in chicks are affecting the choice
vaccine as well as the vaccine development and vaccination strategies. In this review, advances made
in various vaccines that have been commercialised or under development, and challenges that they
face, are outlined. Furthermore, how the emergence of vvIBDV affect the progress of vaccine
development and influence its vaccination strategy are discussed.

Matched MeSH terms: Disease Outbreaks
Enterovirus A71 and coxsackievirus A16 show different replication kinetics in human neuronal and non-neuronal cell lines

Yogarajah T, Ong KC, Perera D, Wong KT

Arch Virol, 2017 Mar;162(3):727-737.
PMID: 27878462 DOI: 10.1007/s00705-016-3157-4

Enterovirus A71 (EV-A71) and coxsackievirus A16 (CV-A16) are closely related enteroviruses that cause hand, foot and mouth disease (HFMD) in children. Serious neurological complications almost always occur in EV-A71 infection, but are rare in CV-A16 infection. Based on the hypothesis that this may be because EV-A71 infects neuronal cells more easily than CV-A16, we compared virus infection, replication and spread of EV-A71 and CV-A16 in SK-N-SH cells. We found that CV-A16 invariably showed significantly lower replication and caused less necrotic cell death in SK-N-SH cells, compared with EV-A71. This was not due to a lower proportion of CV-A16-infected cells, since both viruses showed similar proportions of infected cells at all time points analyzed. Furthermore, reduced replication of CV-A16 in SK-N-SH cells does not appear to be due to limited viral receptor availability, which might limit viral entry, because experiments with viral RNA-transfected cells showed the same results as for live virus infections. On the other hand, no differences were observed between EV-A71 and CV-A16 in RD cells and results were generally similar in RD cells for both viruses. Taken together, our findings suggest that the poor growth of CV-A16 and EV-A71in SK-N-SH cells, compared with RD cells, may be due to cell type-specific restrictions on viral replication and spread. Furthermore, the lower viral replication and necrotic cell death in CV-A16-infected SK-N-SH cells, compared with EV-A71-infected SK-N-SH cells, is consistent with the lower prevalence of neurotropism observed in CV-A16-associated HFMD outbreaks. Nonetheless, in vivo data and more extensive comparisons of different viral strains are essential to confirm our findings.

Matched MeSH terms: Disease Outbreaks
Outbreak of Japanese encephalitis hits Malaysia

Easton A

BMJ, 1999 Apr 03;318(7188):893.
PMID: 10102839 DOI: 10.1136/bmj.318.7188.893a
Matched MeSH terms: Disease Outbreaks
Fulltext Evolution of Nipah Virus Infection: Past, Present, and Future Considerations

Hauser N, Gushiken AC, Narayanan S, Kottilil S, Chua JV

Trop Med Infect Dis, 2021 Feb 14;6(1).
PMID: 33672796 DOI: 10.3390/tropicalmed6010024

Nipah virus (NiV) is a zoonotic paramyxovirus of the Henipavirus genus first identified in Malaysia in 1998. Henipaviruses have bat reservoir hosts and have been isolated from fruit bats found across Oceania, Asia, and Africa. Bat-to-human transmission is thought to be the primary mode of human NiV infection, although multiple intermediate hosts are described. Human infections with NiV were originally described as a syndrome of fever and rapid neurological decline following contact with swine. More recent outbreaks describe a syndrome with prominent respiratory symptoms and human-to-human transmission. Nearly annual outbreaks have been described since 1998 with case fatality rates reaching greater than 90%. The ubiquitous nature of the reservoir host, increasing deforestation, multiple mode of transmission, high case fatality rate, and lack of effective therapy or vaccines make NiV's pandemic potential increasingly significant. Here we review the epidemiology and microbiology of NiV as well as the therapeutic agents and vaccines in development.

Matched MeSH terms: Disease Outbreaks
Fulltext Trust predicts COVID-19 prescribed and discretionary behavioral intentions in 23 countries

Pagliaro S, Sacchi S, Pacilli MG, Brambilla M, Lionetti F, Bettache K, et al.

PLoS One, 2021;16(3):e0248334.
PMID: 33690672 DOI: 10.1371/journal.pone.0248334

The worldwide spread of a new coronavirus (SARS-CoV-2) since December 2019 has posed a severe threat to individuals' well-being. While the world at large is waiting that the released vaccines immunize most citizens, public health experts suggest that, in the meantime, it is only through behavior change that the spread of COVID-19 can be controlled. Importantly, the required behaviors are aimed not only at safeguarding one's own health. Instead, individuals are asked to adapt their behaviors to protect the community at large. This raises the question of which social concerns and moral principles make people willing to do so. We considered in 23 countries (N = 6948) individuals' willingness to engage in prescribed and discretionary behaviors, as well as country-level and individual-level factors that might drive such behavioral intentions. Results from multilevel multiple regressions, with country as the nesting variable, showed that publicized number of infections were not significantly related to individual intentions to comply with the prescribed measures and intentions to engage in discretionary prosocial behaviors. Instead, psychological differences in terms of trust in government, citizens, and in particular toward science predicted individuals' behavioral intentions across countries. The more people endorsed moral principles of fairness and care (vs. loyalty and authority), the more they were inclined to report trust in science, which, in turn, statistically predicted prescribed and discretionary behavioral intentions. Results have implications for the type of intervention and public communication strategies that should be most effective to induce the behavioral changes that are needed to control the COVID-19 outbreak.

Matched MeSH terms: Disease Outbreaks
Fulltext Impact of the Coronavirus Disease 2019 Pandemic on an Emergency Department Service: Experience at the Largest Tertiary Center in Taiwan

Tsai LH, Chien CY, Chen CB, Chaou CH, Ng CJ, Lo MY, et al.

Risk Manag Healthc Policy, 2021;14:771-777.
PMID: 33654444 DOI: 10.2147/RMHP.S272234

Purpose: Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) is an emerging contagious pathogen that has caused community and nosocomial infections in many countries. This study aimed to evaluate the impact of Coronavirus disease 2019 (COVID-19) on emergency services of the largest medical center in Taiwan by comparing emergency department (ED) usage, turnover, and admission rates before the COVID-19 outbreak with those during the outbreak.
Materials and Methods: A retrospective cohort study was conducted in the ED of the largest tertiary medical center in Taiwan. Trends of adult, non-trauma patients who visited the ED during February-April 2019 were compared with those during February-April 2020. The number of visits, their dispositions, crowding parameters, and turnover rates were analyzed. The primary outcome was the change in ED attendance between the two periods. The secondary outcomes were changes in hospital admission rates, crowding parameters, and turnover rates.
Results: During the outbreak, there were decreased non-trauma ED visits by 33.45% (p < 0.001) and proportion of Taiwan Triage and Acuity Scale (TTAS) 3 patients (p=0.02), with increased admission rates by 4.7% (p < 0.001). Crowding parameters and turnover rate showed significant improvements.
Conclusion: Comparison of periods before and during the COVID-19 outbreak showed an obvious decline in adult, non-trauma ED visits. The reduction in TTAS 3 patient visits and the increased hospital admission rates provide references for future public-health policy-making to optimise emergency medical resource allocations globally.

Matched MeSH terms: Disease Outbreaks
Fulltext Economic impact of a vaccine preventable disease: a scoping review on tuberculosis

Aidalina Mahmud, Azimatun Noor Aizuddin

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):254-261.
MyJurnal

Using pulmonary tuberculosis (pTB) as an example of a vaccine-preventable disease (VPD), we aimed to gather evidence on the economic impact of treating a case or managing an outbreak of a VPD. A scoping review was con- ducted. Online databases (MEDLINE and Google Scholar) were used to collate published studies from the year 2015 to 2019 on the management cost of one case or an outbreak of pTB. Keywords used were cost, treatment, outbreak, pulmonary tuberculosis, tuberculosis, economic, economic evaluation. A total of 29 studies were analysed. The costs of pTB treatment for individual patient were higher in high-income countries compared to middle-income and low-income countries. A case of pTB can result in household catastrophic health expenditure; while an outbreak can overwhelm the health system’s capacity, and disrupts the economy of a country. Therefore, accessibility of vaccines especially in low-income countries must be ensured. Also, vaccine-hesitant individuals must reconsider their stance on vaccination.

Matched MeSH terms: Disease Outbreaks
Fulltext An online time-to-event dashboard comparing the effective control of COVID-19 among continents using the inflection point on an ogive curve: Observational study

Lee KW, Chien TW, Yeh YT, Chou W, Wang HY

Medicine (Baltimore), 2021 Mar 12;100(10):e24749.
PMID: 33725830 DOI: 10.1097/MD.0000000000024749

BACKGROUND: During the COVID-19 pandemic, one of the frequently asked questions is which countries (or continents) are severely hit. Aside from using the number of confirmed cases and the fatality to measure the impact caused by COVID-19, few adopted the inflection point (IP) to represent the control capability of COVID-19. How to determine the IP days related to the capability is still unclear. This study aims to (i) build a predictive model based on item response theory (IRT) to determine the IP for countries, and (ii) compare which countries (or continents) are hit most.
METHODS: We downloaded COVID-19 outbreak data of the number of confirmed cases in all countries as of October 19, 2020. The IRT-based predictive model was built to determine the pandemic IP for each country. A model building scheme was demonstrated to fit the number of cumulative infected cases. Model parameters were estimated using the Solver add-in tool in Microsoft Excel. The absolute advantage coefficient (AAC) was computed to track the IP at the minimum of incremental points on a given ogive curve. The time-to-event analysis (a.k.a. survival analysis) was performed to compare the difference in IPs among continents using the area under the curve (AUC) and the respective 95% confidence intervals (CIs). An online comparative dashboard was created on Google Maps to present the epidemic prediction for each country.
RESULTS: The top 3 countries that were hit severely by COVID-19 were France, Malaysia, and Nepal, with IP days at 263, 262, and 262, respectively. The top 3 continents that were hit most based on IP days were Europe, South America, and North America, with their AUCs and 95% CIs at 0.73 (0.61-0.86), 0.58 (0.31-0.84), and 0.54 (0.44-0.64), respectively. An online time-event result was demonstrated and shown on Google Maps, comparing the IP probabilities across continents.
CONCLUSION: An IRT modeling scheme fitting the epidemic data was used to predict the length of IP days. Europe, particularly France, was hit seriously by COVID-19 based on the IP days. The IRT model incorporated with AAC is recommended to determine the pandemic IP.

Matched MeSH terms: Disease Outbreaks

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