RESUMO
In Singapore, influenza vaccination is recommended for persons at higher risk of complications of seasonal influenza, including those with chronic medical conditions and the elderly (individuals aged ⩾65 years). We investigated the factors associated with influenza vaccine uptake based on a nationally representative sample of community-dwelling adults aged >50 years. The data for this study were obtained from the National Health Surveillance Survey (NHSS) 2013. The association between influenza vaccine uptake and socio-demographic and health-related variables was analysed using univariable and multivariable logistic regression models. Of 3700 respondents aged ⩾50 years in the NHSS, 15·2% had received seasonal influenza vaccination in the past year. Older age, single marital status and economic inactivity were the socio-demographic variables independently associated with vaccine uptake. Health-related factors which were predictive of influenza vaccine uptake were sufficient total physical activity, better self-rated health, having at least one medical condition at risk of influenza complications and a regular family doctor/general practitioner. Influenza vaccine uptake in community-dwelling older adults was low. Our findings are of relevance in the formulation of public health policies and targeted health promotion strategies to increase vaccine uptake in this population group.
Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Vacinação/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SingapuraRESUMO
An outbreak of gastroenteritis affected 453 attendees (attack rate 28·5%) of six separate events held at a hotel in Singapore. Active case detection, case-control studies, hygiene inspections and microbial analysis of food, environmental and stool samples were conducted to determine the aetiology of the outbreak and the modes of transmission. The only commonality was the food, crockery and cutlery provided and/or handled by the hotel's Chinese banquet kitchen. Stool specimens from 34 cases and 15 food handlers were positive for norovirus genogroup II. The putative index case was one of eight norovirus-positive food handlers who had worked while they were symptomatic. Several food samples and remnants tested positive for Escherichia coli or high faecal coliforms, aerobic plate counts and/or total coliforms, indicating poor food hygiene. This large common-source outbreak of norovirus gastroenteritis was caused by the consumption of contaminated food and/or contact with contaminated crockery or cutlery provided or handled by the hotel's Chinese banquet kitchen.
Assuntos
Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Gastroenterite/epidemiologia , Gastroenterite/virologia , Norovirus/isolamento & purificação , Adolescente , Adulto , Aerobiose , Idoso , Estudos de Casos e Controles , Criança , Pré-Escolar , Microbiologia Ambiental , Escherichia coli , Fezes/virologia , Feminino , Contaminação de Alimentos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Norovirus/classificação , Norovirus/genética , Vírus Norwalk , Singapura/epidemiologia , Adulto JovemRESUMO
BACKGROUND: In view of waning antitoxin titres over time after the last vaccine dose against diphtheria and tetanus, we determined the immunity levels in adults to identify most susceptible groups for protection in Singapore. METHODS: Our study involved residual sera from 3293 adults aged 18-79 who had participated in a national health survey in 2010. IgG antibody levels were determined using commercial enzyme-linked immunosorbent assay. RESULTS: Overall, 92.0% (95% confidence interval [CI]: 91.1-92.9%) had at least basic protection against diphtheria (antibody levels ≥0.01 IU/ml), while 71.4% (95% CI: 69.8-72.9%) had at least short-term protection against tetanus (antibody levels >0.1 IU/ml). The seroprevalence declined significantly with age for both diseases; the drop was most marked in the 50- to 59-year age group for diphtheria and 60- to 69-year age group for tetanus. There was a significant difference in seroprevalence by residency for diphtheria (92.8% among Singapore citizens versus 87.1% among permanent residents; P = 0.001). The seroprevalence for tetanus was significantly higher among males (83.2%) than females (62.4%) (P < 0.0005). CONCLUSIONS: It may be of value to consider additional vaccination efforts to protect older adults at higher risk for exposure against diphtheria and tetanus, particularly those travelling to areas where diphtheria is endemic or epidemic.
Assuntos
Anticorpos Antibacterianos/imunologia , Difteria/imunologia , Tétano/imunologia , Adolescente , Adulto , Fatores Etários , Idoso , Clostridium tetani/imunologia , Corynebacterium diphtheriae/imunologia , Suscetibilidade a Doenças/epidemiologia , Suscetibilidade a Doenças/imunologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Singapura/epidemiologia , Adulto JovemRESUMO
To assess the impact of past dengue epidemics in Singapore, we undertook a national seroepidemiological study to determine the prevalence of past dengue virus (DENV) infection in the adult population in 2010 and make comparisons with the seroprevalence in 2004. The study involved residual sera from 3293 adults aged 18-79 years who participated in a national health survey in 2010. The overall prevalence of anti-DENV IgG antibodies was 56·8% (95% confidence interval 55·1-58·5) in 2010. The seroprevalence increased significantly with age. Males had significantly higher seroprevalence than females (61·5% vs. 53·2%). Among the three major ethnic groups, Malays had the lowest seroprevalence (50·2%) compared to Chinese (57·0%) and Indians (62·0%). The age-standardized seroprevalence in adults was significantly lower in 2010 (54·4%) compared to 2004 (63·1%). Older age, male gender, Indian ethnicity, permanent residency and being home-bound were independent risk factors significantly associated with seropositivity. About 43% of the Singapore adult resident population remain susceptible to DENV infection as a result of the successful implementation of a comprehensive nationwide Aedes surveillance and control programme since the 1970s. Vector suppression and concerted efforts of all stakeholders in the community remain the key strategy in the prevention and control of dengue.
Assuntos
Dengue/epidemiologia , Adolescente , Adulto , Idoso , China/etnologia , Dengue/etnologia , Dengue/imunologia , Feminino , Humanos , Índia/etnologia , Malásia/etnologia , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Singapura/epidemiologia , Adulto JovemRESUMO
We undertook a national paediatric seroprevalence survey of measles, mumps and rubella (MMR) in Singapore to assess the impact of the national childhood immunization programme against these three diseases after introduction of the trivalent MMR vaccine in 1990. The survey involved 1200 residual sera of Singapore residents aged 1-17 years collected from two hospitals between 2008 and 2010. The overall prevalence of antibodies against measles, mumps and rubella was 83â1% [95% confidence interval (CI) 80â9-85â1], 71.8% (95% CI 69â1-74â2) and 88â5% (95% CI 86â6-90â2), respectively. For all three diseases, the lowest prevalence was in children aged 1 year (47â8-62â3%). The seroprevalence of the vaccinated children declined over time. The national MMR immunization programme is effective in raising the herd immunity of the childhood population, although certain age groups are more susceptible to infection, in particular, those who are not eligible for vaccination at age <15 months.
Assuntos
Anticorpos Antivirais/sangue , Imunoglobulina G/sangue , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Vacina contra Sarampo-Caxumba-Rubéola/imunologia , Adolescente , Fatores Etários , Anticorpos Antivirais/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Imunoglobulina G/imunologia , Lactente , Masculino , Sarampo/imunologia , Sarampo/prevenção & controle , Vírus do Sarampo/imunologia , Caxumba/imunologia , Caxumba/prevenção & controle , Vírus da Caxumba/imunologia , Prevalência , Rubéola (Sarampo Alemão)/imunologia , Rubéola (Sarampo Alemão)/prevenção & controle , Vírus da Rubéola/imunologia , Estudos Soroepidemiológicos , SingapuraRESUMO
W135 meningococcal disease was imported into Singapore in 2000 via Hajj pilgrims. Previous studies have showed sustained carriage of W135 with the potential for further transmission within communities. We therefore set out to determine whether W135 meningococcal disease would become endemic in Singapore after its introduction in 2000. Cases occurred until 2003, but no further cases have been reported since 2004.
Assuntos
Infecções Meningocócicas/epidemiologia , Neisseria meningitidis Sorogrupo W-135 , Surtos de Doenças , Humanos , Infecções Meningocócicas/transmissão , Singapura/epidemiologiaRESUMO
AIM: To examine the readiness of our hospital for the potential pandemic threat of avian influenza, we developed and implemented simulation case scenarios in our hospital. METHODS: Two volunteers, who assumed the identity of 'actual' patients, were trained to simulate acute respiratory symptoms following a visit to an avian influenza-affected area, and their identities and locations were kept confidential prior to the readiness exercise. A team of auditors was stationed at high-risk areas to assess adherence to the use of personal protective equipment (PPE) and infection control procedures. RESULTS: A total of 324 healthcare workers and 84 administrators participated in this hospital-wide exercise. Following disclosure of their symptoms, the 'patients' were masked and isolated in negative-pressure rooms. A quarantine order was enforced on 38 inpatients and 45 healthcare workers who were present in the affected wards at the time of the exercise, which mandated the use of PPE. Although all affected healthcare workers were competent in the use of PPE, we observed breaches in PPE and isolation procedures in eight medical and nursing students, and 10 healthcare attendants. The exercise concluded after H5N1 tests returned negative. CONCLUSION: We recommend the use of case simulation as an effective means of assessing potential breaches in infection control procedures.
Assuntos
Surtos de Doenças/prevenção & controle , Controle de Infecções/organização & administração , Virus da Influenza A Subtipo H5N1 , Influenza Humana/prevenção & controle , Busca de Comunicante , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Virus da Influenza A Subtipo H5N1/isolamento & purificação , Influenza Humana/epidemiologia , Isolamento de Pacientes/métodos , Isolamento de Pacientes/organização & administração , Simulação de Paciente , Roupa de Proteção/estatística & dados numéricos , Singapura/epidemiologiaRESUMO
Notified cases of dengue infections in Singapore reached historical highs in 2004 (9459 cases) and 2005 (13,817 cases) and the reason for such an increase is still to be established. We apply a mathematical model for dengue infection that takes into account the seasonal variation in incidence, characteristic of dengue fever, and which mimics the 2004-2005 epidemics in Singapore. We simulated a set of possible control strategies and confirmed the intuitive belief that killing adult mosquitoes is the most effective strategy to control an ongoing epidemic. On the other hand, the control of immature forms was very efficient in preventing the resurgence of dengue epidemics. Since the control of immature forms allows the reduction of adulticide, it seems that the best strategy is to combine both adulticide and larvicide control measures during an outbreak, followed by the maintenance of larvicide methods after the epidemic has subsided. In addition, the model showed that the mixed strategy of adulticide and larvicide methods introduced by the government seems to be very effective in reducing the number of cases in the first weeks after the start of control.
Assuntos
Dengue/epidemiologia , Dengue/prevenção & controle , Surtos de Doenças/prevenção & controle , Modelos Estatísticos , Controle de Doenças Transmissíveis , Humanos , Controle de Mosquitos , Singapura/epidemiologiaRESUMO
INTRODUCTION: Infections with Streptococcus pneumoniae cause significant morbidity and mortality. In this study, we describe the epidemiology of pneumococcal disease based on hospitalisation rates for all age groups in Singapore. This is important for evaluating prevention and control strategies of pneumococcal disease. METHODS: We conducted a retrospective study of hospitalisation cases admitted to all public and private hospitals from 1995 to 2004. 4,275 hospitalisation records were extracted, based on the International Classification of Diseases, Ninth Revision (ICD-9) codes for pneumococcal disease. We analysed the demographics, type of pneumococcal disease, length of stay and case fatality of these cases. RESULTS: Our study showed that the mean annual hospitalisation rate for pneumococcal disease was 10.9 per 100,000 population from 1995 to 2004. The mean annual hospitalisation rate was highest in the young and the elderly. CONCLUSION: Baseline information on the epidemiology of pneumococcal disease is important for the formulation and evaluation of a national prevention and control programme.
Assuntos
Hospitalização/estatística & dados numéricos , Infecções Pneumocócicas/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Singapura/epidemiologiaRESUMO
Outbreaks of gastroenteritis associated with the consumption of raw imported half-shelled frozen oysters occurred in Singapore between 16 Dec 2003 and 04 Jan 2004. A total of 305 cases were reported with clinical symptoms of diarrhoea (94%), abdominal cramps (72%), vomiting (69%) and fever (54%). The median incubation period was 30.8h and the duration of illness was 2-3 days. The overall relative risk of oyster consumption was 14.1 (95% CI: 8.3-24.0, P<0.001). Stool and oyster samples tested negative for common bacterial pathogens, including Vibrio parahaemolyticus. However, stool samples were positive for the presence of Norovirus group II RNA via RT PCR while oyster samples indicated the presence of Norovirus particles by electron microscopy. The clinical and epidemiological features were suggestive of Norovirus gastroenteritis and were subsequently confirmed by laboratory tests of stools and implicated oysters. Steps have been taken to ensure that food outlets do not thaw frozen oysters and serve them raw.
Assuntos
Surtos de Doenças , Gastroenterite/epidemiologia , Gastroenterite/virologia , Norovirus/isolamento & purificação , Ostreidae/virologia , Intoxicação por Frutos do Mar , Adolescente , Adulto , Idoso , Animais , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Singapura/epidemiologiaRESUMO
During 1999-2000, a sustained mumps outbreak in the highly vaccinated population in Singapore was attributed to vaccine failure associated with the Rubini vaccine strain. To explain this phenomenon, the complete nucleotide and amino acid sequences of the hemagglutinin-neuraminidase (HN) gene of eight mumps virus isolates from patients with parotitis in Singapore were determined and compared with those of known vaccine strains. Phylogenetic trees constructed on the basis of HN nucleotide and amino acid sequences showed that the Singapore mumps virus isolates were more closely related to the Urabe strain and belonged to a different cluster from the Rubini and Jeryl-Lynn strains. The Rubini vaccine showed only approximately 93% nucleotide and approximately 96% amino acid sequence similarity to Urabe and Singapore isolates. Compared with the vaccine strains, six of the eight isolates lacked the extracellular glycosylation site at residues 400-402. Other significant amino acid disparities (e.g., at residue 354) may also affect the antigenic properties of the HN protein. These findings suggest that the evolution and adaptation of the currently circulating mumps virus strains in the community has led to the emergence of genetically distinct viral strains. The low vaccine efficacy of the Rubini strain represents a major reason for the recent mumps resurgence and failure of mumps immunization in Singapore.
Assuntos
Proteína HN/genética , Vacina contra Caxumba/administração & dosagem , Vírus da Caxumba/classificação , Vírus da Caxumba/genética , Filogenia , Sequência de Aminoácidos , Proteína HN/química , Humanos , Dados de Sequência Molecular , Caxumba/virologia , Vírus da Caxumba/isolamento & purificação , Parotidite/virologia , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Singapura , Falha de Tratamento , VacinaçãoRESUMO
Disease management is an approach to patient care that coordinates medical resources for the patient across the entire healthcare delivery system throughout the lifetime of the patient with the disease. Stroke is suitable for disease management as it is a well-known disease with a high prevalence, high cost, variable practice pattern, poor clinical outcome, and managed by a non-integrated healthcare system. It has measurable and actionable outcomes, with available local expertise and support of the Ministry of Health. Developing the programme requires a multidisciplinary team, baseline data on target populations and healthcare services, identification of core components, collaboration with key stakeholders, development of evidence-based clinical practice guidelines and carepaths, institution of care coordinators, use of information technology and continuous quality improvement to produce an effective plan. Core components include public education, risk factor screening and management, primary care and specialist clinics, acute stroke units, inpatient and outpatient rehabilitation facilities, and supportive community services including medical, nursing, therapy, home help and support groups for patients and carers. The family physician plays a key role. Coordination of services is best done by a network of hospital and community-based care managers, and is enhanced by a coordinating call centre. Continuous quality improvement is required, with audit of processes and outcomes, facilitated by a disease registry. Pitfalls include inappropriate exclusion of deserving patients, misuse, loss of physician and patient independence, over-estimation of benefits, and care fragmentation. Collaboration and cooperative among all parties will help ensure a successful and sustainable programme.
Assuntos
Assistência Integral à Saúde/organização & administração , Procedimentos Clínicos/organização & administração , Gerenciamento Clínico , Acidente Vascular Cerebral/terapia , Humanos , Desenvolvimento de ProgramasRESUMO
Multidrug-resistant Salmonella enterica subsp. enterica serotype Typhimurium DT104L was first reported in Singapore from mid-July to mid-October 2000. Salmonella strains isolated from clinical laboratories were submitted to a reference laboratory for serotyping, phage-typing and pulsed-field gel electrophoresis (PFGE) using XbaI restriction endonuclease. An epidemiological investigation was conducted to determine the source of infection and mode of transmission using a structured questionnaire. A total of 33 cases involving mainly infants and toddlers were detected in the 3-month long outbreak. The outbreak strain was of the R-type ACGSTSu, i.e. resistant to ampicillin, chloramphenicol, gentamicin, streptomycin, tetracycline and sulphonamide. PFGE showed all isolates had an indistinguishable pattern, indicating a common source of infection. Consumption of imported dried anchovy was found to be the vehicle of transmission after adjusting for all confounding variables in the case-control study using stepwise logistic regression (OR 25.6; 95% CI 3.9-167.9; P = 0.001). Imported dried seafood should be properly processed, packed, labelled, and thoroughly cooked to prevent transmission of multidrug-resistant S. Typhimurium.
Assuntos
Surtos de Doenças , Resistência a Múltiplos Medicamentos , Contaminação de Alimentos , Infecções por Salmonella/tratamento farmacológico , Infecções por Salmonella/epidemiologia , Salmonella enteritidis/patogenicidade , Alimentos Marinhos , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Criança , Pré-Escolar , Fatores de Confusão Epidemiológicos , Culinária , Resistência a Medicamentos , Eletroforese em Gel de Campo Pulsado , Estudos Epidemiológicos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Infecções por Salmonella/patologia , Salmonella enteritidis/efeitos dos fármacos , Salmonella enteritidis/isolamento & purificação , Testes Sorológicos , Singapura/epidemiologiaRESUMO
Following the Nipah virus (NV) outbreak in March 1999 in Singapore, a serological survey was undertaken to screen individuals potentially exposed to NV. Blood samples were tested for NV IgM, IgG and neutralizing antibodies. Twenty-two (1.5%) of 1469 people tested had antibodies suggesting NV infection. Although 12 of the 22 infected people (54.6%) were symptomatic, the remaining 10 (45.4%) were clinically well and had no past history of compatible pulmonary or neurological disease. Clinical and serological findings suggested three people had been infected with NV before the outbreak was recognized. All those who were infected were male abattoir workers. None of the people who had contact with horses, and no healthcare workers exposed to infected patients and their specimens had detectable antibodies. This study provides evidence that NV causes asymptomatic infection. All of the antibody positive individuals had direct contact with pigs and there was no evidence of human to human transmission.
Assuntos
Matadouros , Surtos de Doenças , Exposição Ocupacional , Infecções por Paramyxoviridae/epidemiologia , Paramyxovirinae/patogenicidade , Adulto , Idoso , Animais , Anticorpos Antivirais/análise , Humanos , Imunoglobulina G/análise , Imunoglobulina M/análise , Masculino , Pessoa de Meia-Idade , Infecções por Paramyxoviridae/imunologia , Infecções por Paramyxoviridae/transmissão , Fatores de Risco , Estudos Soroepidemiológicos , Singapura/epidemiologia , Suínos , ZoonosesAssuntos
Infecções por Adenovirus Humanos/epidemiologia , Adenovírus Humanos/isolamento & purificação , Infecções por Adenovirus Humanos/imunologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Anticorpos Antivirais/isolamento & purificação , Criança , Pré-Escolar , Humanos , Lactente , Pessoa de Meia-Idade , Vigilância de Evento Sentinela , Estudos Soroepidemiológicos , Singapura/epidemiologiaRESUMO
Studies have shown a high prevalence of Helicobacter pylori infection in close communities and that intrafamilial spread during early childhood may be a route of transmission. A total of 72 household members from 21 families were enrolled in this study. Sera from individuals showed 50/72 (69.4%) seropositive for IgG against H. pylori by ELISA. Western blots showed diversity in the protein profiles with molecular masses ranging from approximately 8 to 130 kDa. Cohen's kappa statistical analysis of the blot patterns showed that nine families demonstrated similar profiles (100%), while 4 other families showed varying similarities (17-50%). The results support the hypothesis of intrafamilial transmission of H. pylori. Furthermore, serological studies can be used as an effective approach to determine the familial status in relation to H. pylori infection.
Assuntos
Helicobacter pylori/imunologia , Adolescente , Adulto , Idoso , Western Blotting , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Infecções por Helicobacter/imunologia , Infecções por Helicobacter/transmissão , Helicobacter pylori/genética , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , SorotipagemRESUMO
A survey was conducted between 1995 and 1997 to assess the impact of introduction of unleaded petrol and other public health measures on the blood lead level of the population. The geometric mean blood lead level of 269 government employees as determined by graphite furnace atomic absorption spectroscopy, was 66.0 microg/l, much lower than that recorded before introduction of lead-free petrol. Using multiple regression analysis, factors significantly associated with blood lead levels were: exposure to traffic, age (>50 years) and active smoking. Passive smoking, exposure to recent paint work, consumption of alcohol and traditional medicine were found not to be significantly associated with the blood lead level.
Assuntos
Chumbo/sangue , Fumar/efeitos adversos , Emissões de Veículos/efeitos adversos , Adulto , Idoso , China/etnologia , Etnicidade , Feminino , Humanos , Índia/etnologia , Modelos Lineares , Malásia/etnologia , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional , Singapura , Meios de TransporteRESUMO
OBJECTIVES: To provide intra-familial evidence on the horizontal transmission of hepatitis B virus surface antigen (HBsAg) mutant G145R. METHODS: Serum samples from family members of 10 vaccinated infants who carried this G145R mutant were collected. The presence of the mutant was analysed by polymerase chain reaction (PCR) and sequencing. RESULTS: The G145R mutant was identified in family members of three of the 10 infants. In family 1, the mutant found initially in child 1 was identified in another child and the father. In families 2 and 3, the G145R mutant detected previously in child 1 was detected in the father. Additional mutations in HBsAg were identified in at least two members in family 1 and 2, suggesting horizontal transmission of the mutant among them. The G145R mutant was found in samples with high levels of neutralizing antibody against HBV (anti-HBs). In addition, liver damage was seen in one G145R carrier infant. CONCLUSIONS: The G145R mutant could be transmitted horizontally among family members, and this could occur in the presence of high levels of anti-HBs. Improvement of detection system for the G145R and other HBsAg mutant will be needed for their effective control.
Assuntos
Transmissão de Doença Infecciosa , Antígenos de Superfície da Hepatite B/genética , Vírus da Hepatite B/genética , Hepatite B/transmissão , Hepatite B/virologia , Saúde da Família , Feminino , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B , Vírus da Hepatite B/isolamento & purificação , Humanos , Lactente , Masculino , Mutação , Testes de Neutralização , Reação em Cadeia da Polimerase , VacinaçãoRESUMO
During 10-19 March 1999, 11 workers in 1 of 2 Singaporean abattoirs developed Nipah-virus associated encephalitis or pneumonia, resulting in 1 fatality. A case-control study was conducted to determine occupational risk factors for infection. Case patients were abattoir A workers who had anti-Nipah IgM antibodies; control subjects were randomly selected abattoir A workers who tested negative for anti-Nipah IgM. All 13 case patients versus 26 (63%) of 41 control subjects reported contact with live pigs (P=.01). Swine importation from Malaysian states concurrently experiencing a Nipah virus outbreak was banned on 3 March 1999; on 19 March 1999, importation of Malaysian pigs was banned, and abattoirs were closed. No unusual illnesses among pigs processed during February-March were reported. Contact with live pigs appeared to be the most important risk factor for human Nipah virus infection. Direct contact with live, potentially infected pigs should be minimized to prevent transmission of this potentially fatal zoonosis to humans.
Assuntos
Matadouros , Surtos de Doenças , Encefalite Viral/epidemiologia , Doenças Profissionais/epidemiologia , Infecções por Paramyxoviridae/epidemiologia , Pneumonia Viral/epidemiologia , Zoonoses/transmissão , Adulto , Animais , Anticorpos Antivirais/sangue , Estudos de Casos e Controles , Encefalite Viral/diagnóstico , Encefalite Viral/transmissão , Feminino , Humanos , Imunoglobulina M/sangue , Malásia , Masculino , Doenças Profissionais/diagnóstico , Doenças Profissionais/virologia , Infecções por Paramyxoviridae/diagnóstico , Infecções por Paramyxoviridae/transmissão , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Fatores de Risco , Singapura/epidemiologia , Suínos , Doenças dos Suínos/transmissão , Doenças dos Suínos/virologiaRESUMO
The measles, mumps, and rubella vaccine containing the highly attenuated Rubini mumps virus strain conferred no protection against acute parotitis in vaccinated children in Singapore. Its introduction into the national childhood immunisation programme has resulted in a reduction in the seroprevalence of mumps to prevaccination levels.