Dengue epidemics on the Pacific Coast of Mexico

Dengue epidemics in three Mexican cities were investigated with retrospective surveys and virus isolations from acute cases. These epidemics were part of the continuing extension of dengue in Mexico since 1978 after 15 years without transmission. Serotype 1 dengue infection predominated in all epidemics, but in one city, type 2 strains were also isolated. The following findings were consistent in all three cities: 1) illness history provided evidence of presence of infection months before the epidemic became evident, 2) there was a very sharp and progressive increase of dengue illness attack rates by age, 3) there were no interpretable relationships between illness and the presence of different types of breeding sights in the home, 4) socioeconomic status was strongly negatively related to illness, and 5) geographical factors not related to the other measured variables had a strong effect on illness rates reflecting the focality of transmission. In addition, there was evidence of a strong protective effect against illness by the use of mosquito netting or the presence of screens on houses, but these relationships were not universal to all three cities.     

A predictive model for Dengue Hemorrhagic Fever epidemics

A statistical model for predicting monthly Dengue Hemorrhagic Fever (DHF) cases from the city of Makassar is developed and tested. The model uses past and present DHF cases, climate and meteorological observations as inputs. These inputs are selected using a stepwise regression method to predict future DHF cases. The model is tested independently and its skill assessed using two skill measures. Using the selected variables as inputs, the model is capable of predicting a moderately-severe epidemic at lead times of up to six months. The most important input variable in the prediction is the present number of DHF cases followed by the relative humidity three to four months previously. A prediction 1-6 months in advance is sufficient to initiate various activities to combat DHF epidemic. The model is suitable for warning and easily becomes an operational tool due to its simplicity in data requirement and computational effort.     

Inconsistent journalism: the coverage of chronic diseases in the Mexican press

The mass media are recognized by many social scientists as important sources of medical information for lay people and as a positive influence on those working in the health care professions. However, there is a lack of study about print and mass media reporting on major health problems in developing countries such as Mexico. This article presents the findings of a study conducted to identify specific messages that the Mexican print media convey to the general reader about chronic diseases, especially one of the most important and pervasive, diabetes. We undertook a comprehensive review and content analysis of secondary source media reporting in the Boletin (Bulletin)--published by the Department of Education and Health, Universidad Autónoma Metropolitana, Xochimilco. The Boletin summarizes all articles related to health matters published in 12 national daily newspapers and 3 magazines. Our study covered all issues of the Boletin from 1992 through 1996. Our findings indicate that at times the press and popular print media disseminate an incomplete and often biased picture of chronic diseases prevalent in Mexico. Specifically, the press gives equal or more important coverage of acute diseases, or to AIDS, than to other major chronic conditions. The press also reproduces the biomedical model of disease and does not address topics important to certain segments of the population, including the patient. Moreover, the media may present an overly idealized impression of the capability of health services. Consequently, this failure to address the issues of certain widespread, chronic illnesses is severe enough to ask about the role of the press in medical health care reform. We conclude by suggesting areas for further research.     

沃尔巴克氏体应用于蚊媒病控制的研究概况

随着蚊虫在全球的大量扩散,以往较为局限的蚊媒疾病变得越来越普遍。登革热、基孔肯雅热、日本脑炎、西尼罗病毒病、黄热病和寨卡等是由蚊虫传播的几种常见和新兴的病毒性疾病。当地的蚊种及种群遗传特征对当地蚊媒疾病的暴发流行有着潜在的影响,所以蚊种鉴定和种群遗传研究在疾病控制方面显得尤为重要。单核苷酸多态性（SNP）标记是第三代遗传标记物,因其具有广泛分布性、遗传稳定性、易规模化检测等特点,成为目前遗传标记研究最多、最有前景的新一代DNA分子标记物。     

'Sexy docs' and 'busty blondes': press coverage of professional misconduct cases brought before the General Medical Council

This paper presents an analysis of press coverage of the General Medical Council Professional Conduct Committee (PCC) during 1990 and 1991. All tabloid press coverage during this period was compared with PCC minutes to establish what kinds of cases were reported. The analysis reveals that the press gave undue attention to hearings involving sexual misconduct by General Practitioners and that the majority of patients reported as suffering from such misconduct were young women. The paper goes on to document the ideological assumptions underpinning this coverage and considers the consequences for the doctor-patient relationship.     

Individual versus corporate responsibility for smoking-related illness: Australian press coverage of the Rolah McCabe trial

This paper provides a thematic frame analysis of Australian newspaper reporting of the outcome and implications of the trial of Rolah McCabe versus British American Tobacco Australasia (BATA). In this trial, a Melbourne woman was awarded A$700,000 damages for smoking-attributable lung cancer when the defendant, BATA, had its case dismissed due to document destruction. In 60 commentaries from Australian national or capital city newspapers between 12 April and 9 May 2002, a total of 79 instances of eight tobacco-related frames were identified. Overall, 43% of the 79 instances were positive for tobacco control, 46% were negative for tobacco control and 11% were neutral. The most common frame that was negative for tobacco control (in 35% of articles) was the conception that smokers exert 'free will' in deciding to smoke and should therefore be personally responsible for their smoking and any disease that arises as a result of it. A related, but less commonly employed frame (in 18% of articles) was the expressed fear of a 'slippery slope' of litigation, which portrayed smoking as similar to eating fast food or other 'vices'. The most common frame that was positive for tobacco control (in 35% of articles) was the notion that the tobacco industry was 'evil' and, to a lesser extent, that the government should 'do more' to control smoking (15% of articles). These findings provide a sobering public health challenge to improve public communication efforts about the powerful forces that conspire to induce people to start smoking and keep them smoking for decades, despite a strong desire to quit. There is a need to fund public education programs and quit smoking services more adequately to address the complex education task of understanding the nature of addiction to tobacco and the enormity of the health risk.     

John's $12 tonic: press coverage of the government's selling of a private health insurance rebate

OBJECTIVE: To document representations of the 1998 introduction of a 30% rebate on private health insurance in the three most-read daily Sydney newspapers. METHODS: Thematic frame analysis of 131 newspaper articles. RESULTS: The rebate was opposed through two frames: that it was ineffective and unfair, and that it was politically motivated. Four supportive frames were more complex: the rebate was justified by claims that public health care was collapsing, that responsible citizens should pay for their own health care, and that individuals would benefit financially. There was also a focus on the political battle in the Senate. The newspaper with the readership least likely to benefit from the rebate supported it most strongly. CONCLUSIONS: Framing was strongly episodic (two dimensional, decontextualised and case-study based), limiting political accountability, and the anti-rebate case was presented less memorably. Community action around the issue was not encouraged, individual responsibility was emphasised and universal health care was not promoted as fair or necessary. Different readerships received different messages about the rebate. IMPLICATIONS: There is an urgent need to promote the value of the public health care system and make the future of Medicare compelling for news editors and the public.     

Syndromic surveillance and bioterrorism-related epidemics

To facilitate rapid detection of a future bioterrorist attack, an increasing number of public health departments are investing in new surveillance systems that target the early manifestations of bioterrorism-related disease. Whether this approach is likely to detect an epidemic sooner than reporting by alert clinicians remains unknown. The detection of a bioterrorism-related epidemic will depend on population characteristics, availability and use of health services, the nature of an attack, epidemiologic features of individual diseases, surveillance methods, and the capacity of health departments to respond to alerts. Predicting how these factors will combine in a bioterrorism attack may be impossible. Nevertheless, understanding their likely effect on epidemic detection should help define the usefulness of syndromic surveillance and identify approaches to increasing the likelihood that clinicians recognize and report an epidemic.Because of heightened concerns about the possibility of bioterrorist attacks, public health agencies are testing new methods of surveillance intended to detect the early manifestations of illness that may occur during a bioterrorism-related epidemic. Broadly labeled “syndromic surveillance,” these efforts encompass a spectrum of activities that include monitoring illness syndromes or events, such as medication purchases, that reflect the prodromes of bioterrorism-related diseases (1–9). The Centers for Disease Control and Prevention (CDC) estimates that, as of May 2003, health departments in the United States have initiated syndromic surveillance systems in approximately 100 sites throughout the country (T. Treadwell, CDC, pers. comm.). The goal of these systems is to enable earlier detection of epidemics and a more timely public health response, hours or days before disease clusters are recognized clinically, or before specific diagnoses are made and reported to public health authorities. Whether this goal is achievable remains unproved (4,5,10).Establishing a diagnosis is critical to the public health response to a bioterrorism-related epidemic, since the diagnosis will guide the use of vaccinations, medications, and other interventions. Absent a bioterrorism attack, predicting whether syndromic surveillance will trigger an investigation that yields a diagnosis before clinicians make and report a diagnosis is not possible. Our objective is to consider the mix of hypothetical factors that may affect the detection of epidemics attributable to CDC category A bioterrorism agents (11).     

Influenza epidemics and anencephaly.

To explore the postulated association between maternal influenza and congenital defects of the central nervous system, 14 virologically verified epidemics in Finland, 1969-82, were studied. Mothers of 248 anencephalic children were grouped into those whose first trimester had occurred during an epidemic period and those whose pregnancy had commenced during a non-epidemic period. No significant differences in prevalence of anencephaly were noted in these groups.