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Rebolledo J.,U.S. Center for Disease Control and Prevention | Rebolledo J.,Health Protection Surveillance Center | Garvey P.,Health Protection Surveillance Center | Ryan A.,HSE West Northwest | And 14 more authors.
Epidemiology and Infection | Year: 2014

Rapid and wide dispersal of passengers after flights makes investigation of flight-related outbreaks challenging. An outbreak of Salmonella Heidelberg was identified in a group of Irish travellers returning from Tanzania. Additional international cases sharing the same flight were identified. Our aim was to determine the source and potential vehicles of infection. Case-finding utilized information exchange using experts' communication networks and national surveillance systems. Demographic, clinical and food history information was collected. Twenty-five additional cases were identified from Ireland, The Netherlands, Norway, USA and Canada. We conducted a case-control study which indicated a significant association between illness and consumption of milk tart (OR 10·2) and an egg dish (OR 6) served on-board the flight. No food consumed before the flight was associated with illness. Cases from countries other than Ireland provided supplementary information that facilitated the identification of likely vehicles of infection. Timely, committed international collaboration is vital in such investigations. © 2013 Cambridge University Press. Source

Smallwood C.A.H.,World Health Organization | Arbuthnott K.G.,World Health Organization | Banczak-Mysiak B.,Chief Sanitary Inspectorate | Borodina M.,WHO Virtual Inter Disciplinary Advisory Group on Mass Gatherings | And 23 more authors.
The Lancet | Year: 2014

The revised international health regulations offer a framework that can be used by host countries to organise public health activities for mass gatherings. From June 8, to July 1, 2012, Poland and Ukraine jointly hosted the Union of European Football Associations European Football Championship Finals (Euro 2012). More than 8 million people from around the world congregated to watch the games. Host countries and international public health agencies planned extensively to assess and build capacity in the host countries and to develop effective strategies for dissemination of public health messages. The effectiveness of public health services was maximised through rapid sharing of information between parties, early use of networks of experienced individuals, and the momentum of existing national health programmes. Organisers of future mass gatherings for sporting events should share best practice and their experiences through the WHO International Observer Program. Research about behaviour of large crowds is needed for crowd management and the evidence base translated into practice. A framework to measure and evaluate the legacy of Euro 2012 is needed based on the experiences and the medium-term and long-term benefits of the tournament. Source

Hartley D.M.,Georgetown University | Nelson N.P.,Georgetown University | Arthur R.R.,Centers for Disease Control and Prevention | Barboza P.,French Institute for Public Health Surveillance InVS | And 13 more authors.
Clinical Microbiology and Infection | Year: 2013

Internet biosurveillance utilizes unstructured data from diverse web-based sources to provide early warning and situational awareness of public health threats. The scope of source coverage ranges from local media in the vernacular to international media in widely read languages. Internet biosurveillance is a timely modality that is available to government and public health officials, healthcare workers, and the public and private sector, serving as a real-time complementary approach to traditional indicator-based public health disease surveillance methods. Internet biosurveillance also supports the broader activity of epidemic intelligence. This overview covers the current state of the field of Internet biosurveillance, and provides a perspective on the future of the field. © 2013 European Society of Clinical Microbiology and Infectious Diseases. Source

Kinross P.,Surveillance and Response Support Unit | Beser J.,Swedish Institute for Infectious Disease Control | Troell K.,National Veterinary Institute SVA | Silverlas C.,National Veterinary Institute SVA | And 5 more authors.
Epidemiology and Infection | Year: 2015

In March 2013, a veterinary student tested positive for Cryptosporidium; four classmates reported similar gastrointestinal symptoms. We aimed to identify source(s) and risk factors for Cryptosporidium infection in university persons symptomatic between 21 January and 14 April 2013. Sixty-four (79%) students from a cohort of 81 fourth-year veterinary students completed questionnaires, identifying 13 cases; four were Cryptosporidium parvum GP60 subtype IIaA16G1R1b, two were IIdA24G1, seven did not submit stool samples. Thirteen cases attended the university's field clinic before symptom onset (13/37 attendees, 35%); 11 visited at least one of four farms where students recalled seeing calves with diarrhoea. C. parvum subtype IIaA16G1R1b was identified in calves at one of the farms. Entering pens of calves with diarrhoea [relative risk (RR) 7·6, 95% confidence interval (CI) 1·7-33·5] and eating in clinic cars (RR 9·1, 95% CI 1·3-65·8) were associated with being a case. Washing hands at least twice per farm visit (0 cases, P = 0·03) was protective. This outbreak investigation was notable for rapid and effective collaboration between public health, veterinary and environmental sectors, leading to swift identification of a microbiological and epidemiological link between cases, infected calves and their farms. We recommend frequent hand-washing using proper technique and dissuasion from eating in clinic cars to minimize possible exposure to contaminated surfaces. © European Centre for Disease Prevention and Control (ECDC) 2015 and Cambridge University Press 2015 This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.. Source

Bull M.,Public Health England | Hall I.M.,Public Health England | Leach S.,Public Health England | Robesyn E.,Surveillance and Response Support Unit
Eurosurveillance | Year: 2012

A literature review was conducted to highlight the application and potential benefit of using geographic information systems (GIS) during Legionnaires' disease outbreak investigations. Relatively few published sources were identified, however, certain types of data were found to be important in facilitating the use of GIS, namely: patient data, locations of potential sources (e.g. cooling towers), demographic data relating to the local population and meteorological data. These data were then analysed to gain a better understanding of the spatial relationships between cases and their environment, the cases' proximity to potential outbreak sources, and the modelled dispersion of contaminated aerosols. The use of GIS in an outbreak is not a replacement for traditional outbreak investigation techniques, but it can be a valuable supplement to a response. ©2007-2011. All rights reserved. Source

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