Diphtheria in Latvia, 1986-1996

After nearly two decades without a diphtheria case in Latvia, the disease reappeared in 1986. From 1990 to 1996, case counts were highest among adults 40-49 years of age, school-aged children, and adolescents. Nonetheless, the average annualized incidence of disease was highest among infants and preschoolers. In August 1995, mass vaccination efforts began to provide adults 25-60 years of age with at least one dose of vaccine. By the end of the year, a 77% coverage rate was achieved, resulting in a decrease of reported diphtheria cases by 1996. From February to September 1997, special outreach efforts were focused on hard-to-reach populations; as a result, by June 1997, 55% of adults had received three doses of vaccine. While decreases in the incidence of and morbidity from diphtheria have occurred, additional efforts still need to be concentrated on improving vaccination coverage in adults and children <2 years of age and in reducing mortality from diphtheria.     

Diphtheria in Estonia, 1991-1996

Clinical diphtheria reappeared in Estonia in 1991. Between 1991 and 1996, 61 cases and 5 deaths occurred; 19 cases were among children 5-9 years of age, and 11 were among persons 40-49 years of age. From 1993-1995, vaccine supplies donated by Finland were used in vaccination programs. In 1995, the International Federation of Red Cross and Red Crescent Societies and the Estonian Red Cross launched a mass vaccination campaign targeting the adult population. By the end of 1997, it was estimated that 46% of adults had received at least one dose of vaccine. Although the vaccination campaigns did not target the pediatric population, vaccination coverage in school-aged children remained high due to continuing routine vaccination programs. The reappearance and epidemic of clinical diphtheria cases and the mass vaccination campaign efforts demonstrated that preventive measures are important and must be maintained in order to keep diphtheria under control.     

Diphtheria epidemic in the Republic of Uzbekistan, 1993-1996

The Republic of Uzbekistan, like the other Newly Independent States in the 1990s, experienced epidemic diphtheria during the 1990s. The outbreak in Uzbekistan began in 1993 in southern regions that bordered areas of Tajikistan that were experiencing a very intense diphtheria epidemic. However, the Uzbek epidemic rapidly spread and threatened to involve the entire country. From 1993-1996, 1169 cases of diphtheria were reported, compared with 58 in 1990-1992. Unvaccinated or only partially vaccinated cases were more likely to have clinically severe forms of diphtheria than those who were fully vaccinated. Strong epidemiologic links with the Tajik diphtheria epidemic and the predominance of mitis biotype strains of Corynebacterium diphtheriae in Uzbekistan make it likely that the Uzbek outbreak arose independently of the predominantly biotype gravis epidemic that began in Russia. The epidemic appeared to be due to low population immunity and the large-scale reintroduction of toxigenic strains of C. diphtheriae. Several mass vaccination campaigns and general enhancement of routine immunization procedures led to control of the epidemic in 1996.     

Malaria surveillance in Italy : 1986-1996 analysis and 1997 provisional data

A surveillance system for malaria was established in Italy to prevent a possible return of disease transmission after the eradication. Reporting malaria and 43 other infectious diseases is mandatory. Local laboratories diagnose clinical cases of malaria m     

Diphtheria epidemic in the Republic of Georgia, 1993-1997

Epidemic diphtheria reemerged in the republic of Georgia in 1993. From 1993 to 1997, 1405 cases were reported (28 in 1993, 312 in 1994, 429 in 1995, 348 in 1996, and 288 in 1997), with a cumulative incidence of 25.8/100,000 and a case fatality ratio of 9.5%. During 1993-1997, 53% of the diphtheria cases occurred among persons >/=15 years of age. Unvaccinated patients were more likely to have toxic forms (relative risk=2.24; 95% confidence interval=1.69-2.96) or to die of diphtheria (relative risk=2.24; 95% confidence interval=1. 36-3.68) than those who had received at least one dose of diphtheria toxoid. Improvement in routine childhood vaccination coverage and implementation of mass adult vaccination campaigns have been critical to bringing the epidemic under control. By mid-1998, the overall diphtheria situation in Georgia appeared to have been controlled. Only 53 cases were reported from January to June 1998, representing a 64% decrease from the 148 cases during the corresponding period in 1997.     

Drug-resistant tuberculosis in Taipei, 1996-1999

OBJECTIVES: To determine the trends, patterns, and risk factors associated with drug-resistant tuberculosis, we conducted a hospital-based retrospective study in Taipei. METHODS: Clinical and bacteriologic data were routinely collected from 453 patients with a diagnosis of tuberculosis who were treated at Taipei Municipal Chronic Disease Hospital from January 1996 through December 1999 for whom drug-susceptibility testing was done. RESULTS: Resistance to at least one drug was identified in 154 (34%) out of the 453 patients, and 34 (7.5%) patients were resistant to at least isoniazid and rifampin. Among the 199 patients with recurrent tuberculosis, 98 (49.2%) had isolates that showed resistance to at least one drug. Among the 254 new patients, 56 (22.0%) had isolates that were drug resistant. For all 453 patients, resistance to rifampin was most common (17.4%), followed by resistance to isoniazid (13.9%), streptomycin (13.7%), ethambutol (8.2%), and kanamycin (3.5%). A history of previous tuberculosis therapy (odds ratio = 9.4; 95% CI, 2.9-28) and being born outside of Taiwan (odds ratio 3.3; 95% CI, 1.1-34) were significant risk factors for multidrug resistance. CONCLUSIONS: Our data suggest that the Taipei tuberculosis control program should be rapidly strengthened by expanded use of directly observed therapy and more careful bacteriologic and clinical follow-up, particularly in cases of recurrence and in persons born outside of Taiwan in tuberculosis endemic areas. Our results also indicate that the regular measuring of rates of drug resistance and the monitoring and guiding of tuberculosis treatment programs could increase the therapeutic response rate and prevent the appearance of newly acquired resistance in patients with tuberculosis. In addition, with high rifampin resistance (17.4%), the regulated market for rifampin is essential in Taiwan.     

Epidemiology of trichinellosis in Germany, 1996-2006

The epidemiology of trichinellosis in Germany was investigated by analyzing national surveillance data from 1996-2006. During this period, 95 laboratory-confirmed infections and 12 outbreaks were reported. The highest mean annual incidence was found in immigrants from southeast European countries (0.3 cases/100,000 vs. 0.01 cases/100,000 in the German population) with an incidence rate ratio of 26.0 (95% confidence interval 11.6-51.8). The predominant clinical symptom was muscle pain in 79 patients (83%). Mean diagnostic delay was 49 days. Among patients with reported source of infection (85%; n = 81), the consumption of pork (mostly originating from endemic countries) represented the most frequent exposure (93%; n = 75). In addition, trichinellosis cases were associated with both indigenous (n = 1) and imported (n = 5) wild boar meat. Although domestic pigs in Germany are practically free from Trichinella spp., the parasite was found in German wild animals such as wild boars, foxes, and racoon dogs. We conclude that trichinellosis still remains a public health issue in Germany, especially among individuals with a migrational background. Immigrants from endemic countries need to be educated about the risks of consuming raw or inadequately cooked pork and wild boar products from their homeland. In addition, German healthcare providers need to be aware of trichinellosis, especially in areas with a large immigrant population.     

Asthma Hospitalization Trends in California, 1983-1996

Annual asthma hospitalization rates were calculated for California's ethnically diverse population from 1983 through 1996. Trends were examined for four race/ethnicity groups: Hispanics, African-Americans, non-Hispanic Caucasians, and Asians/Pacific Islanders. The overall rate decreased by 30% during the time period. African-Americans had the highest rate, more that three times greater than the rate for Caucasians. Among children, the rates for Caucasians decreased by one-third, while rates increased for Hispanics and Asians. The rate for African-American children remained generally constant and was four times higher than the rate for Caucasians. Data from 1996 were assessed for repeat admissions, age and sex differences in rates, costs, and progress toward national goals.     

1996-2005年西班牙加利西亚省结核病流行病学

地点：西班牙加利西亚省目的：描述1996-2005年间，加利西亚省10年的结核病流行病学进展及特点。设计：利用加利西亚省结核病登记中心的数据进行的一项描述性和观察性的回顾性研究。结果：加利西亚省的结核病发病率从1996年的72．3／10万下降至2005年的37．7／10万，平均年递降率为7．0％。2005年，51.6％的结核病患者年龄在15～44岁之间，61．6％为男性，59．2％为单纯性肺结核。在肺结核患者中，63．4％未发现空洞病变，50．3％为痰涂片阳性，77．3％为培养阳性。4．4％的结核病患者感染了HIV，3．5％为吸毒者，3％为移民。将80％的痰涂片阳性病人作为指示病例，对其至少1名接触者进行了筛查。治疗成功率接近90％。结论：自结核病控制规划实施以来，加利西亚省的结核年发病率逐步下降，但仍然高于西班牙的其他地区及周边国家，结核病控制工作还需进一步加强。     

1996～2007年湖州市血吸虫病监测

1996～2007年对湖州市血吸虫病疫情监测,累计查出有螺面积90.33 hm2,无阳性钉螺;输入性急性血吸虫病1例,无本地感染病例。     

Scabies in Poland 1966-1986

In 1966-86 there were 1,675,213 cases of scabies in Poland. The highest incidence (580.5) per 100,000 inhabitants was noted in 1968, the lowest (41.7) in 1986. The highest morbidity falls on autumn and winter. The highest proportion of cases are children and teenagers (0-19 years old), the second group consists of people aged 20-64, the third--over 65 years old. Most frequent were single cases of scabies, but there occurred also group infections in families, schools, boarding schools and establishments. In the discussed period the losses brought about by this disease, in case of people 20-64 years old only, amount to 1,836,234 days of the sick leave, while the average absence in 1980 was 82,500 days.