In an infectious animal disease outbreak, effective management of the event requires timely and accurate information collection, processing, storage and distribution. This thesis focuses on the tools to assist information collection and management. The first study describes the comparison of questionnaire methodology for the information collection in the initial epidemiologic investigation of a Canadian federally reportable disease. The second study defines attributes of an animal disease outbreak information management system (IMS). The studies were performed within a one-year period (July 2013-July 2014). The first study performed two comparisons to determine differences in the information quality (completeness and accuracy) between differing questionnaire methodology and modes of completion (hard copy and electronic). The study was conducted with 24 Canadian Food Inspection Agency (CFIA) inspectors and veterinarians using a fictitious Canadian reportable disease scenario. The first comparison used a hard copy of a Canadian Food Inspection Agency (CFIA) questionnaire designed to be applicable (or generic) for all highly infectious reportable disease investigations with a supplementary disease specific section compared to an electronic disease specific reportable disease questionnaire. There was no significant difference in the information quality (N = 22; P = 0.09). The mean difference in completeness and accuracy scores was 3.5% (95% CI -0.6, 7.6). The second comparison focused on the hard copy disease questionnaire and assessed differences in information quality between using only the generic sections of the questionnaire compared to the supplementation of a disease specific section. A difference in information quality was determined (N = 24; P < 0.0001). The mean completeness and accuracy score for the generic only sections was 50.2% (95% CI 43.6, 57.2) compared to 80.2% (95% CI 76.2, 84.5) with the inclusion of the disease-specific section. The greatest difference in information quality occurred in the tracing specific information categories (P < 0.0001) with a mean difference of completeness and accuracy scores of 67.7% (95% CI 52.0, 83.4) for the trace-in (exposure history) category and 38.3% (95% CI 28.3, 48.3) for the trace-out (potential spread of disease) category. The absence of disease-specific questions were determined to be the primary factor in the difference in information quality. The second study determined a comprehensive list of user-defined attributes of an animal disease outbreak IMS and further identified the most important (key) attributes. A list of 34 attributes and associated definitions were determined through a series of focus group sessions and two surveys of Canadian animal health stakeholders. The animal health stakeholders included federal and provincial governments, veterinary academia and animal production industry representatives. The key attributes of an animal disease outbreak IMS identified were: ‘user friendly’, ‘effectiveness’, ‘accessibility’, ‘data accuracy’, ‘reliability’ and ‘timeliness’. ‘User friendly’ received the highest frequency of ranking as the most important attribute, followed by ‘effectiveness’. Information management was identified as the main purpose of an animal disease outbreak IMS with a median rating of 10 (rating scale of 0-10 with 10 = strongly agree). The occurrence of a federally reportable disease or a large-scale animal disease outbreak can have a great impact on the animal agriculture sector, regulatory government agencies and the economy. Information collection and management are essential to assist with the epidemiologic investigation and disease control measures. The study provided a novel opportunity to study information management for an animal disease outbreak from a Canadian perspective. The knowledge obtained will add value to the future development of tools and systems designed for information collection and management involving an animal disease outbreak.

Background and Purpose: School nurses have the critical task of overseeing the health and wellness of school-aged students. Utah is 1 of 17 states which allow parents to exempt their children from vaccines. The most common parental reason for exempting children from vaccines is personal choice. With the number of students without vaccinations on the rise, school nurses are tasked with responsibilities related to the spread of vaccine-preventable diseases. However, few studies have explored the role of school nurses in managing a disease outbreak. Therefore, the purpose of this study was to 1) explore the responsibilities of Utah school nurses during a disease outbreak; 2) review disease outbreak training for Utah school nurses; 3) identify groups with which the Utah school nurse would collaborate during a disease outbreak; and 4) identify Utah school nurse concerns while attempting to manage a disease outbreak. Methods: A qualitative descriptive design was used with a semi-structured interview guide for focus groups (3 focus groups, 24 total participants) of Utah school nurses. Qualitative analysis of content and themes was utilized. Results: School nurses' responses revealed their collaborative role and cited strong teamwork with the local health department; lack of standardized disease outbreak training; high student-to-nurse ratios; and concerns with communication with parents and community. Thematic descriptions with illustrative quotes are presented as well as perceived challenges and barriers Utah school nurses faced during a disease outbreak. Conclusion: Utah school nurses face barriers that prevent them from working effectively during a disease outbreak. Most barriers are due to communication difficulties and lack of training for school nurses. Findings of this study have implications for standardized training, funding to decrease the high nurse-to-student ratio and for further education in the community to raise awareness of outbreak guidelines.

Introdução: As doenças transmitidas por alimentos (DTA) constituem um grave problema de saúde pública a nível mundial. A Organização Mundial da Saúde estima que mais de um terço da população, incluindo a dos países desenvolvidos, é acometida por surtos de DTA anualmente, embora a maioria dos casos não seja notificada às autoridades sanitárias locais. Objetivo: Analisar a evolução das DTA nas diferentes regiões do Brasil entre 2000 e 2015. Metodologia: O presente estudo, de caráter descritivo, consistiu na análise de dados do Ministério da Saúde e de artigos científicos que tratam das DTA no contexto nacional, no período de janeiro de 2000 a dezembro de 2015. A primeira fase do estudo foi caracterizada pela coleta de dados sobre DTA disponíveis pelo Ministério da Saúde. Na segunda fase, foi realizado o levantamento e análise geral da produção científica brasileira nas seguintes bases de dados: LILACS, SciELO, Scopus, Web of Science, Pubmed e Embase. E na terceira fase do estudo foi traçado o panorama das DTA nas diferentes regiões do Brasil, relacionando os dados oficiais do Ministério da Saúde com os dados das pesquisas publicadas. Resultados: Entre 2000 e 2015 foram registrados no Ministério da Saúde 11.524 surtos de DTA com 219.909 doentes e 167 óbitos e publicados 50 artigos científicos sobre surtos de DTA no Brasil. Foi possível verificar que a região Sudeste apresentou maior prevalência no número de trabalhos publicados e de surtos de DTA. Na análise dos dados do MS observou-se que os alimentos mistos (12,4 por cento ) foram os mais envolvidos nos surtos, seguidos por aqueles preparados com ovos e produtos à base de ovos (8,7 por cento ); o agente etiológico não foi identificado em 57,8 por cento dos surtos e quando identificado, a Salmonella spp. foi o mais frequente (14,4 por cento ) e a maioria dos surtos ocorreram nas residências (36,6 por cento ). Considerando os dados dos artigos, a água foi o alimento que mais surtos de DTA causou (22 por cento ), o agente etiológico mais estudado foi a Salmonella spp. (22 por cento ) e as residências foram os locais mais envolvidos nos surtos (48 por cento ). Conclusões: Os dados obtidos indicam a necessidade de novas políticas públicas de incentivo a notificação dos surtos, bem como o desenvolvimento de programas de orientação e educação em boas práticas de manipulação de alimentos para a população e estabelecimentos produtores de alimentos / Introduction: Foodborne disease is a significant public health problem worldwide. The World Health Organization estimates that more than a third of the world\'s population, including those living in developed countries, is affected by foodborne disease, although many cases are not reported to the local health authority. Purpose: This study aimed to evaluate the occurrence of foodborne disease around different regions of Brazil between 2000 and 2015. Methodology: This is a descriptive study, based on analysis of data from the Brazilian Ministry of Health and from scientific manuscripts regarding foodborne disease at a national level, occurred between January 2000 and December 2015. Data from both sources were evaluated and compared to map the panorama of foodborne disease outbreaks in Brazil. Results: In the period of 2000 to 2015, a total of 11,524 foodborne outbreaks were reported to the Brazilian Ministry of Health, involving 219,909 cases and 167 deaths. In the same period, 50 manuscripts dealing with this topic were published. The largest prevalence of foodborne outbreaks was observed in the Southeast region of Brazil. Based on data from the Brazilian Ministry of Health, mixed foods were the most involved in the outbreaks (12.4 per cent ), followed by those foods prepared with eggs and egg products (8.7 per cent ). In most of the cases, the etiologic agent was not identified (57.8 per cent ). Among those identified, Salmonella spp. was the most frequent (14.4 per cent ), while homes were the main site of occurrence (36,6 per cent ). Based on data from the manuscripts, water was the most involved in the outbreaks (22 per cent ), while Salmonella spp. was the most reported pathogen (22 per cent ) and homes the main site of occurrence (48 per cent ). Conclusion: Notification of foodborne disease outbreaks is one of the fundamental duties to facilitate public health action and needs to be encouraged

To protect public health, drinking water systems are monitored for indicator organisms that correlate with fecal contamination and suggest the presence of human pathogens. Total coliforms, fecal coliforms, and E. coli are the most commonly used indicator organisms. These bacteria generally colocate with fecal pollution, but some limitations exist. In particular, the ability of indicator bacteria to predict the presence of enteric viruses is questionable because of distinct transport and survival characteristics of bacteria and viruses. Although viral indicators of enteric viruses have been proposed, none have been implemented into the current regulatory framework. In this thesis, the correlation of bacteria and viruses in drinking water sources and treatment systems is reviewed, and the potential of Torque Teno virus (TTV) to qualify as an indicator virus is discussed. TTV is unique among enteric viruses as it infects approximately 80% of healthy individuals worldwide, is transmitted by the fecal-oral route, causes no observable illness, and lacks seasonal fluctuations.

This research formed a descriptive frame of the current levels of emergency preparedness and applied Hallahan's Issues Processes Model to examine the relationship between knowledge, involvement, and emergency preparedness among the participants. The variables were measured in the context of self-perception. The research method involved a survey of students who are just becoming responsible for their personal emergency preparedness. The results suggest that students lack overall emergency preparedness measures and show that self-perceived knowledge is positively related to self-perceived emergency preparedness. Yet, higher self-perceived knowledge is negatively related to actual emergency preparedness actions. Thus, the more knowledgeable the participants believed themselves to be the less likely they were to have an active household emergency plan. The results did not support involvement as a predictor of personal emergency preparedness. The findings highlight a serious deficiency among the population sample. Knowledge of personal emergency preparedness and related motivators can improve overall preparedness on local, state, and federal levels. Little is known about the relationship between knowledge and personal emergency preparedness. This paper presents findings that may assist public relations professionals in creating messages that account for the lack of preparedness and the contrary relationship between perceived knowledge and actual personal emergency preparedness.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Introdução: As doenças transmitidas por alimentos (DTA) constituem um grave problema de saúde pública a nível mundial. A Organização Mundial da Saúde estima que mais de um terço da população, incluindo a dos países desenvolvidos, é acometida por surtos de DTA anualmente, embora a maioria dos casos não seja notificada às autoridades sanitárias locais. Objetivo: Analisar a evolução das DTA nas diferentes regiões do Brasil entre 2000 e 2015. Metodologia: O presente estudo, de caráter descritivo, consistiu na análise de dados do Ministério da Saúde e de artigos científicos que tratam das DTA no contexto nacional, no período de janeiro de 2000 a dezembro de 2015. A primeira fase do estudo foi caracterizada pela coleta de dados sobre DTA disponíveis pelo Ministério da Saúde. Na segunda fase, foi realizado o levantamento e análise geral da produção científica brasileira nas seguintes bases de dados: LILACS, SciELO, Scopus, Web of Science, Pubmed e Embase. E na terceira fase do estudo foi traçado o panorama das DTA nas diferentes regiões do Brasil, relacionando os dados oficiais do Ministério da Saúde com os dados das pesquisas publicadas. Resultados: Entre 2000 e 2015 foram registrados no Ministério da Saúde 11.524 surtos de DTA com 219.909 doentes e 167 óbitos e publicados 50 artigos científicos sobre surtos de DTA no Brasil. Foi possível verificar que a região Sudeste apresentou maior prevalência no número de trabalhos publicados e de surtos de DTA. Na análise dos dados do MS observou-se que os alimentos mistos (12,4 por cento ) foram os mais envolvidos nos surtos, seguidos por aqueles preparados com ovos e produtos à base de ovos (8,7 por cento ); o agente etiológico não foi identificado em 57,8 por cento dos surtos e quando identificado, a Salmonella spp. foi o mais frequente (14,4 por cento ) e a maioria dos surtos ocorreram nas residências (36,6 por cento ). Considerando os dados dos artigos, a água foi o alimento que mais surtos de DTA causou (22 por cento ), o agente etiológico mais estudado foi a Salmonella spp. (22 por cento ) e as residências foram os locais mais envolvidos nos surtos (48 por cento ). Conclusões: Os dados obtidos indicam a necessidade de novas políticas públicas de incentivo a notificação dos surtos, bem como o desenvolvimento de programas de orientação e educação em boas práticas de manipulação de alimentos para a população e estabelecimentos produtores de alimentos / Introduction: Foodborne disease is a significant public health problem worldwide. The World Health Organization estimates that more than a third of the world\'s population, including those living in developed countries, is affected by foodborne disease, although many cases are not reported to the local health authority. Purpose: This study aimed to evaluate the occurrence of foodborne disease around different regions of Brazil between 2000 and 2015. Methodology: This is a descriptive study, based on analysis of data from the Brazilian Ministry of Health and from scientific manuscripts regarding foodborne disease at a national level, occurred between January 2000 and December 2015. Data from both sources were evaluated and compared to map the panorama of foodborne disease outbreaks in Brazil. Results: In the period of 2000 to 2015, a total of 11,524 foodborne outbreaks were reported to the Brazilian Ministry of Health, involving 219,909 cases and 167 deaths. In the same period, 50 manuscripts dealing with this topic were published. The largest prevalence of foodborne outbreaks was observed in the Southeast region of Brazil. Based on data from the Brazilian Ministry of Health, mixed foods were the most involved in the outbreaks (12.4 per cent ), followed by those foods prepared with eggs and egg products (8.7 per cent ). In most of the cases, the etiologic agent was not identified (57.8 per cent ). Among those identified, Salmonella spp. was the most frequent (14.4 per cent ), while homes were the main site of occurrence (36,6 per cent ). Based on data from the manuscripts, water was the most involved in the outbreaks (22 per cent ), while Salmonella spp. was the most reported pathogen (22 per cent ) and homes the main site of occurrence (48 per cent ). Conclusion: Notification of foodborne disease outbreaks is one of the fundamental duties to facilitate public health action and needs to be encouraged

In recent decades, a number of foot-and-mouth disease (FMD) outbreaks have occurred in countries that had been FMD-free for many years. The last FMD outbreak in the United States occurred in 1929 and the country contains a naïve livestock population, meaning it is susceptible to an outbreak. In the event of an FMD outbreak in the United States, the speed at which the source and contacts between livestock can be identified impacts both the implementation and effectiveness of mitigation strategies. The purpose of this thesis was to analyze the impact of higher levels of animal traceability on the immediate welfare losses resulting from an FMD outbreak originating in Utah. An epidemiological model was used to simulate the spread of the disease throughout the livestock population of Utah and estimate a mean number of animals depopulated over 1000 iterations for low, medium and high levels of trace intensity. This number of animals depopulated was then used to create supply shocks in an equilibrium displacement model. This model revealed the welfare losses across four marketing levels for beef, three for pork and two for pork. The research contained in this thesis determined that the adoption of a high intensity trace system can prevent immediate welfare losses of between $131 and $190 million for the United States beef industry, including $49 million to the Utah fed cattle, feeder cattle and market hog marketing levels

Today, infectious animal diseases and the propagation speeds of these diseaseshave been threatening the human health. Threats from animal disease outbreakssuch as Avian Influenza have increased in both number and complexity. So, it is extremely important to determine the animal diseases at first appearances and totake precautions according to propagation speeds of the diseases. Geographic Information Systems (GIS) have become an important tool inveterinary epidemiology, surveillance and monitoring of animal diseases. Such approaches can be used for public health planning and predicting disease risks. This study aims to build a GIS web-based animal health surveillance system in Turkey in order to monitor and analyse disease outbreaks. Different sources of data / geographical data, animal holding locations, disease outbreak recordings, reporting information and special GIS functions have been incorporated in the application. It enables to determine the first, second and third degree risk zones of a disease, query the animals, holdings and disease events, create thematic maps and show the results of explored landscape features associated with Avian Influenza outbreak of 2006 and present graphically illustrated reports. This study will make the management of the disease outbreak situation easier, enhance the response mechanism of the decision makers, help to make better decisions, control the disease as quickly as possible, protect both the animals and humans against diseases, also provide a tool to evaluate different strategies to prevent the spread of infectious diseases. So, in an infectious disease case, emergency precautions can be taken and control strategies can be planned.

Orientador: Luiz Jacintho da Silva / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-07T07:21:41Z (GMT). No. of bitstreams: 1 Kemp_Brigina_D.pdf: 3166494 bytes, checksum: 2892c145ef2c179f3d05514db4d4bc8b (MD5) Previous issue date: 2005 / Resumo: Em 2002, Campinas (São Paulo, Brasil) registrou a sua maior epidemia de dengue até então. O Sistema de Vigilância Epidemiológica Municipal recebeu cerca de 10 mil notificações de casos suspeitos de dengue. Mais de 70% dos casos foram descartados por critério laboratorial (MAC-ELISA). No pico da epidemia, na área de maior incidência, ocorreu um óbito em um indivíduo adulto. A suspeita inicial de dengue hemorrágico foi descartada depois de confirmada infecção por Rickettsia ssp, grupo da febre maculosa (Imunofluorescência indireta e PCR). Diante da grande proporção de casos não confirmados e da ocorrência de um óbito em razão da infecção por Rickettsia spp, duas hipóteses foram formuladas: a de uma epidemia, sobreposta ou a ocorrência de viés ou falha na confirmação laboratorial dos casos. Com o objetivo de avaliar essas hipóteses, a posteriori foram comparados os casos confirmados com os descartados, considerando o intervalo de tempo entre início dos sintomas e coleta de sorologia, de pacientes residentes no município, com data de início de sintomas de primeiro de janeiro até sete de outubro de 2002. A fonte foi o Sistema de Informação de Agravos de Notificação (SINAN). Os soros estocados, que resultaram negativos para dengue, foram novamente testados para dengue (MAC-ELISA, reagente comercial) e para riquetsiose dos grupos tifo e febre maculosa (imunofluorescência indireta). Os resultados obtidos das análises epidemiológicas e dos testes laboratoriais não permitiram esclarecer as questões iniciais. A hipótese de que haveria circulação de riquétsias do grupo tifo ou do grupo da febre maculosa não foi confirmada. A possibilidade de uma epidemia sobreposta, porém não pode ser descartada. Em oito por cento dos soros, inicialmente negativos para dengue, demonstrou-se a presença de anticorpos específicos, proporção não suficiente para aceitar a hipótese de inadequação do diagnóstico laboratorial. Fica evidente a necessidade de se implantar sistemas mais abrangentes de vigilância epidemiológica, quando se investigam agravos cujo diagnóstico diferencial é amplo, como no caso da dengue, sistemas que possam não só confirmar ou afastar o diagnóstico principal, como fazer o de outras infecções. Sistemas de vigilância sindrômica são particularmente indicados para esclarecer problemas dessa natureza.Outros elementos e ferramentas de trabalho devem ser agregados ao trabalho da vigilância, principalmente aqueles que possam ajudar as equipes específicas da área, também as de nível local, a ampliar e aprofundar o conhecimento dos problemas que afetam a saúde da população. A utilização de sistemas de informações geográficas e de outras metodologias que permitam trabalhar com áreas geográficas menores, possibilitando identificar diferentes riscos e adotar medidas mais direcionadas, podem ser auxiliares importantes para um controle mais efetivo dos problemas de saúde pública / Abstract: In 2002 the city of Campinas, SP, Brazil reported its greatest dengue epidemic. The Epidemiological Surveillance System received about 10,000 notifications of possible dengue cases. Over 70% of the cases were not confirmed by laboratory methods (MAC-ELISA, performed at the Instituto Adolfo Lutz, the state public health laboratory). During the peak of the outbreak, one adult died. The initially suspected diagnosis of dengue haemorrhagic fever was not confirmed, and a diagnosis of a spotted fever group rickettsiosis was confirmed by indirect immunofluorescent antibody assay and polymerase chain-reaction (PCR). Due to the high number of unconfirmed cases and the death by spotted-fever, two hypotheses were raised: either an overlapping, unsuspected epidemic or an inadequacy in the laboratory diagnosis. In order to clarify these issues, a posteriori of the epidemics, an epidemiological analysis was performed comparing the confirmed and unconfirmed cases, taking into consideration the time interval between the onset of symptoms and serologic investigation, among patients living in the municipality of Campinas who started having symptoms from January 1st through October 7th, 2002. The data source was SINAN-W, the national web-based data bank of notified diseases. Stored sera, negative for dengue fever, were tested again for dengue (MAC-ELISA, commercial reagent) and for rickettsial infection both typhus and spotted fever groups (indirect immunofluorescent antibody assay). Neither the epidemiological analysis nor the serological were able to suggest a parallel outbreak of rickettsial disease or that there had been an excessive amount of false-negative dengue tests. In only eight percent of the initially negative sera for dengue fever the presence of specific antibody was demonstrated, a proportion not sufficient to support the hypothesis of an inadequate laboratorial diagnosis. However, the possibility of an overlapping epidemic of an unknown nature could not be excluded. An explanation for the unconfirmed cases would be an over-zealous tendency to notify any fever as dengue during an epidemic.The need for more a more sensitive epidemiological surveillance system becomes obvious when investigating diseases with similar clinical symptoms, making an adequate differential diagnoses difficult. Syndrome-based surveillance systems are possibly better for situations such as these. It became obvious that current routine surveillance is not adequately sensitive and does not discriminate between all possibilities, leaving public health officials with a large amount of unanswered questions, like the one presently discussed. Other surveillance tools should be employed to increase the sensitivity of current methods. Geographical information systems should be introduced in the routine surveillance work. Current procedures are inadequate to cope with a dynamic epidemiological context, particularly when we regard the emerging infectious diseases / Doutorado / Epidemiologia / Doutor em Saude Coletiva