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1.
Epidemiol Infect ; 143(4): 804-12, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24901443

RESUMO

RSV is the most important viral cause of pneumonia and bronchiolitis in children worldwide and has been associated with significant disease burden. With the renewed interest in RSV vaccines, we provide realistic estimates on duration, and influencing factors on RSV shedding which are required to better understand the impact of vaccination on the virus transmission dynamics. The data arise from a prospective study of 47 households (493 individuals) in rural Kenya, followed through a 6-month period of an RSV seasonal outbreak. Deep nasopharyngeal swabs were collected twice each week from all household members, irrespective of symptoms, and tested for RSV by multiplex PCR. The RSV G gene was sequenced. A total of 205 RSV infection episodes were detected in 179 individuals from 40 different households. The infection data were interval censored and assuming a random event time between observations, the average duration of virus shedding was 11·2 (95% confidence interval 10·1-12·3) days. The shedding durations were longer than previous estimates (3·9-7·4 days) based on immunofluorescence antigen detection or viral culture, and were shown to be strongly associated with age, severity of infection, and revealed potential interaction with other respiratory viruses. These findings are key to our understanding of the spread of this important virus and are relevant in the design of control programmes.


Assuntos
Coinfecção/virologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sincicial Respiratório Humano/fisiologia , Eliminação de Partículas Virais , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Quênia/epidemiologia , Masculino , Estudos Prospectivos , Infecções por Vírus Respiratório Sincicial/etiologia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios , Fatores de Tempo , Adulto Jovem
2.
J Med Virol ; 85(11): 2020-5, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23983183

RESUMO

The kinetics of respiratory syncytial virus (RSV) neutralizing antibodies following birth, primary and secondary infections are poorly defined. The aims of the study were to measure and compare neutralizing antibody responses at different time points in a birth cohort followed-up over three RSV epidemics. Rural Kenyan children, recruited at birth between 2002 and 2003, were monitored for RSV infection over three epidemic seasons. Cord and 3-monthly sera, and acute and convalescent sera following RSV infection, were assayed in 28 children by plaque reduction neutralization test (PRNT). Relative to the neutralizing antibody titers of pre-exposure control sera (1.8 log10 PRNT), antibody titers following primary infection were (i) no different in sera collected between 0 and 0.4 months post-infection (1.9 log10 PRNT, P=0.146), (ii) higher in sera collected between 0.5 and 0.9 (2.8 log10 PRNT, P<0.0001), 1.0-1.9 (2.5 log10 PRNT, P<0.0001), and 2.0-2.9 (2.3 log10 PRNT, P<0.001) months post-infection, and (iii) no different in sera collected at between 3.0 and 3.9 months post-infection (2.0 log10 PRNT, P=0.052). The early serum neutralizing response to secondary infection (3.02 log10 PRNT) was significantly greater than the early primary response (1.9 log10 PRNT, P<0.0001). Variation in population-level virus transmission corresponded with changes in the mean cohort-level neutralizing titers. It is concluded that following primary RSV infection the neutralizing antibody response declines to pre-infection levels rapidly (~3 months) which may facilitate repeat infection. The kinetics of the aggregate levels of acquired antibody reflect seasonal RSV occurrence, age, and infection history.


Assuntos
Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Infecções por Vírus Respiratório Sincicial/imunologia , Vírus Sincicial Respiratório Humano/imunologia , Estudos de Coortes , Seguimentos , Humanos , Lactente , Recém-Nascido , Quênia/epidemiologia , Testes de Neutralização , Infecções por Vírus Respiratório Sincicial/epidemiologia , População Rural , Ensaio de Placa Viral
3.
Am J Epidemiol ; 176(9): 794-802, 2012 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-23059788

RESUMO

This study aimed to quantify the effect of age, time since last infection, and infection history on the rate of respiratory syncytial virus infection and the effect of age and infection history on the risk of respiratory syncytial virus disease. A birth cohort of 635 children in Kilifi, Kenya, was monitored for respiratory syncytial virus infections from January 31, 2002, to April 22, 2005. Predictors of infection were examined by Cox regression and disease risk by binomial regression. A total of 598 respiratory syncytial virus infections were identified (411 primary, 187 repeat), with 409 determined by antigen assay and 189 by antibody alone (using a "most pragmatic" serologic definition). The incidence decreased by 70% following a primary infection (adjusted hazard ratio = 0.30, 95% confidence interval: 0.21, 0.42; P < 0.001) and by 59% following a secondary infection (hazard ratio = 0.41, 95% confidence interval: 0.22, 0.73; P = 0.003), for a period lasting 6 months. Relative to the age group <6 months, all ages exhibited a higher incidence of infection. A lower risk of severe disease following infection was independently associated with increasing age (P < 0.001) but not reinfection. In conclusion, observed respiratory syncytial virus incidence was lowest in the first 6 months of life, immunity to reinfection was partial and short lived, and disease risk was age related.


Assuntos
Infecções por Vírus Respiratório Sincicial/epidemiologia , Fatores Etários , Antígenos Virais , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Quênia/epidemiologia , Masculino , Infecções por Vírus Respiratório Sincicial/virologia , Fatores de Risco , Índice de Gravidade de Doença
4.
Epidemiol Infect ; 140(2): 231-46, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21524342

RESUMO

A meta-analysis was performed using all published and one unpublished long-term infection-challenge experiments to quantify the age- and dose-dependence of early and late shedding of Mycobacterium avium subsp. paratuberculosis (MAP) in cattle. There were 194 animals from 17 studies that fulfilled the inclusion criteria, of which 173 received a known dose of MAP and 21 were exposed naturally. Results from parametric time-to-event models indicated that challenging older calves or using multiple-exposure experimental systems resulted in a smaller proportion and shorter duration of early shedding as well as slower transition to late shedding from latent compartments. Calves exposed naturally showed variable infection progression rates, not dissimilar to other infection routes. The log-normal distribution was most appropriate for modelling infection-progression events. The infection pattern revealed by the modelling allowed better understanding of low-grade endemicity of MAP in cattle, and the parameter estimates are the basis for future transmission dynamics modelling.


Assuntos
Doenças dos Bovinos/transmissão , Bovinos , Transmissão de Doença Infecciosa/veterinária , Mycobacterium avium subsp. paratuberculosis/isolamento & purificação , Paratuberculose/transmissão , Fatores Etários , Animais , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/microbiologia , Fezes/virologia , Feminino , Modelos Biológicos , Paratuberculose/epidemiologia , Paratuberculose/microbiologia
5.
Parasitology ; 139(4): 441-53, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22309815

RESUMO

A mathematical model that describes the transmission dynamics of Theileria annulata is proposed that consists of 2 host components: the Hyalomma tick population and a compartmental model of T. annulata infection in the cattle population. The model was parameterized using data describing tick infestation and the infection status of cattle in Turkey from 2006 to 2008. The tick attachment rates are highly seasonal and because of the temporal separation of infectious and susceptible ticks virtually all ticks are infected by carrier cattle, so that annual peaks of disease in cattle do not impact on infection in the Hyalomma tick population. The impact of intervention measures that target the tick population both on the host and in the environment and their impact on the transmission of T. annulata were investigated. Interventions that have a limited 'one-off' impact and interventions that have a more permanent impact were both considered. The results from the model show the importance of targeting ticks during the period when they have left their first host as nymphs but have yet to feed on their second host.


Assuntos
Vetores Aracnídeos/parasitologia , Doenças dos Bovinos/transmissão , Ixodidae/parasitologia , Modelos Biológicos , Theileria annulata , Theileriose/transmissão , Infestações por Carrapato/veterinária , Animais , Vetores Aracnídeos/crescimento & desenvolvimento , Portador Sadio/parasitologia , Portador Sadio/transmissão , Bovinos , Doenças dos Bovinos/parasitologia , Ixodidae/crescimento & desenvolvimento , Ninfa/crescimento & desenvolvimento , Estações do Ano , Theileria annulata/isolamento & purificação , Theileria annulata/fisiologia , Theileriose/parasitologia , Infestações por Carrapato/transmissão , Turquia
6.
Epidemics ; 41: 100648, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36343495

RESUMO

OBJECTIVES: Disease transmission models are used in impact assessment and economic evaluations of infectious disease prevention and treatment strategies, prominently so in the COVID-19 response. These models rarely consider dimensions of equity relating to the differential health burden between individuals and groups. We describe concepts and approaches which are useful when considering equity in the priority setting process, and outline the technical choices concerning model structure, outputs, and data requirements needed to use transmission models in analyses of health equity. METHODS: We reviewed the literature on equity concepts and approaches to their application in economic evaluation and undertook a technical consultation on how equity can be incorporated in priority setting for infectious disease control. The technical consultation brought together health economists with an interest in equity-informative economic evaluation, ethicists specialising in public health, mathematical modellers from various disease backgrounds, and representatives of global health funding and technical assistance organisations, to formulate key areas of consensus and recommendations. RESULTS: We provide a series of recommendations for applying the Reference Case for Economic Evaluation in Global Health to infectious disease interventions, comprising guidance on 1) the specification of equity concepts; 2) choice of evaluation framework; 3) model structure; and 4) data needs. We present available conceptual and analytical choices, for example how correlation between different equity- and disease-relevant strata should be considered dependent on available data, and outline how assumptions and data limitations can be reported transparently by noting key factors for consideration. CONCLUSIONS: Current developments in economic evaluations in global health provide a wide range of methodologies to incorporate equity into economic evaluations. Those employing infectious disease models need to use these frameworks more in priority setting to accurately represent health inequities. We provide guidance on the technical approaches to support this goal and ultimately, to achieve more equitable health policies.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Política de Saúde , Saúde Pública , Análise Custo-Benefício
7.
Nat Med ; 7(5): 619-24, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11329065

RESUMO

Hepatitis-B virus infection is globally ubiquitous, but its distribution is very heterogeneous, with prevalence of serological markers in various nations ranging from less than 1% to more than 90%. We propose an explanation for this diversity using a mathematical model of hepatitis-B virus transmission dynamics that shows, for the first time, 'catastrophic' behavior using realistic epidemiological processes and parameters. Our major conclusion is that the prevalence of infection is largely determined by a feedback mechanism that relates the rate of transmission, average age at infection and age-related probability of developing carriage following infection. Using the model we identify possible, highly non-linear, consequences of chemotherapy and immunization interventions, for which the starting prevalence of carriers is the most influential, predictive quantity. Taken together, our results demand a re-evaluation of public health policy towards hepatitis-B.


Assuntos
Hepatite B/epidemiologia , Portador Sadio , Hepatite B/virologia , Humanos , Prevalência
8.
Vet Parasitol ; 162(3-4): 306-13, 2009 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-19346076

RESUMO

The high prevalence of resistance of Haemonchus contortus to all major anthelmintic groups has prompted investigations into alternative control methods in South Africa, including the use of copper oxide wire particle (COWP) boluses. To assess the efficacy of COWP against H. contortus in indigenous South African goats, 18 male faecal egg-count-negative goats were each given ca.1200 infective larvae of H. contortus three times per week during weeks 1 and 2 of the experiment. These animals made up an "established" infection group (ESTGRP). At the start of week 7, six goats were each given a 2-g COWP bolus orally; six goats received a 4-g COWP bolus each and six animals were not treated. A further 20 goats constituted a "developing" infection group (DEVGRP). At the beginning of week 1, seven of the DEVGRP goats were given a 2-g COWP bolus each; seven goats were treated with a 4-g COWP bolus each and no bolus was given to a further six animals. During weeks 1-6, each of these DEVGRP goats was given ca. 400 H. contortus larvae three times per week. All 38 goats were euthanized for worm recovery from the abomasa and small intestines in week 11. In the ESTGRP, the 2-g and 4-g COWP boluses reduced the worm burdens by 95% and 93%, respectively compared to controls (mean burden+/-standard deviation, SD: 23+/-33, 30+/-56 and 442+/-518 worms, P=0.02). However, in the DEVGRP goats, both the 2-g and 4-g COWP treatments were ineffective in reducing the worm burdens relative to the controls (mean burdens+/-SD: 1102+/-841, 649+/-855, 1051+/-661 worms, P=0.16). Mean liver copper levels did not differ between the ESTGRP goats treated with 2-g COWP, 4-g COWP or no COWP (mean+/-standard error of the mean, SEM, in ppm: 93.7+/-8.3; 101.5+/-8.3; 71.8+/-8.3, P=0.07) nor did they differ between the DEVGRP goats (mean+/-SEM, in ppm: 74.1+/-9.1; 75.4+/-9.1; 74.9+/-10.0, P>0.99). The copper values were considered adequate, but not high, for goats. The COWP boluses have the potential to be used in the place of conventional anthelmintics for the control of established H. contortus infections in indigenous South African goats, but their use as part of an integrated approach to control H. contortus in the field must be fully investigated.


Assuntos
Antinematódeos/uso terapêutico , Cobre/uso terapêutico , Gastroenteropatias/veterinária , Doenças das Cabras/tratamento farmacológico , Hemoncose/veterinária , Animais , Antinematódeos/administração & dosagem , Cobre/administração & dosagem , Fezes/parasitologia , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/parasitologia , Doenças das Cabras/epidemiologia , Cabras , Hemoncose/tratamento farmacológico , Hemoncose/epidemiologia , Haemonchus , Masculino , Contagem de Ovos de Parasitas , África do Sul/epidemiologia
9.
Prev Vet Med ; 88(3): 213-9, 2009 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-19135273

RESUMO

Data from a cross-sectional study of 113 British pig herds carried out in 2004 were used to investigate the associations between postweaning multisystemic wasting (PMWS) in pigs and herds and porcine circovirus 2 (PCV2) antigen score and antibody titre, and associated histological signs in lymph nodes. The sensitivity and specificity of published herd definitions for PMWS were tested on the study farms to consider the role of PCV2 in PMWS. Herds were defined as PMWS-affected, -unaffected or -recovered based on current and past postweaning mortality (PWM), grower pigs with clinical signs of rapid wasting, hairiness and pallor and no other known cause of death on the farm. PCV2 antigen and antibody were not used in the definition of PMWS. In each PMWS-affected herd, up to three sick pigs with the clinical signs above and one healthy pig of a similar age were taken for postmortem examination (PME). In all other herds at least one healthy pig was taken for PME. Lymph nodes were analysed for PCV2 antigen and histological changes, and serum samples were analysed for PCV2 antibody. PCV2 antibody was present in all the herds sampled. There was a non-linear association between PCV2 antigen and antibody. There was no association between the presence of high scores of PCV2 antigen in pigs and the presence of high PWM in herds. PCV2 antigen score was significantly higher in sick than healthy pigs within farms, and high PCV2 score was associated with giant cells, coalescence and absence of germinal centres in lymph nodes. These results did not vary by PMWS-affected, -unaffected or -recovered farms. PCV2 antigen was present at high scores in approximately 10% of healthy pigs on all farms. All three herd definitions of PMWS were highly sensitive, defining PMWS-affected herds as affected, but had a specificity ranging from 23% to 43%. We conclude that the current diagnostic tests for PCV2 indicated higher scores of virus in sick pigs but were not useful to define pigs or herds with PMWS. The ubiquity of PCV2 and the lack of specificity of the PCV2 tests indicate that PCV2 may be a necessary but not sufficient cause of PMWS disease. Linking this with the knowledge that the herd breakdowns occurred in a space time epidemic indicates that another infectious co-factor may be necessary for disease to occur.


Assuntos
Antígenos Virais/imunologia , Infecções por Circoviridae/veterinária , Circovirus/imunologia , Linfonodos/virologia , Síndrome Definhante Multissistêmico de Suínos Desmamados/imunologia , Animais , Anticorpos Antivirais/sangue , Infecções por Circoviridae/embriologia , Infecções por Circoviridae/imunologia , Infecções por Circoviridae/virologia , Estudos Transversais , Imuno-Histoquímica/veterinária , Linfonodos/imunologia , Síndrome Definhante Multissistêmico de Suínos Desmamados/epidemiologia , Síndrome Definhante Multissistêmico de Suínos Desmamados/virologia , Curva ROC , Estatísticas não Paramétricas , Suínos , Reino Unido/epidemiologia
10.
J R Soc Interface ; 5(29): 1481-90, 2008 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-18477541

RESUMO

Repeated measures data for rotavirus infection in children within 14 day care centres (DCCs) in the Oxfordshire area, UK, are used to explore aspects of rotavirus transmission and immunity. A biologically realistic model for the transmission of infection is presented as a set of probability models suitable for application to the data. Two transition events are modelled separately: incidence and recovery. The complexity of the underlying mechanistic model is reflected in the choice of the fixed variables in the probability models. Parameter estimation was carried out using a Bayesian Markov chain Monte Carlo method. We use the parameter estimates obtained to build a profile of the natural history of rotavirus reinfection in an individual child. We infer that rotavirus transmission in children in DCCs is dependent on the DCC prevalence, with symptomatic infection of longer duration, but no more infectious per day of infectious period, than asymptomatic infection. There was evidence that a recent previous infection reduces the risk of disease and, to a lesser extent, reinfection, but not duration of infection. The results provide evidence that partial immunity to rotavirus infection develops over several time scales.


Assuntos
Creches , Modelos Imunológicos , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/imunologia , Infecções por Rotavirus/transmissão , Rotavirus/imunologia , Teorema de Bayes , Pré-Escolar , Simulação por Computador , Inglaterra/epidemiologia , Humanos , Imunidade/imunologia , Prevalência
11.
Prev Vet Med ; 84(1-2): 85-93, 2008 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-18164499

RESUMO

The foot and mouth disease (FMD) epidemic of 2001 was used to investigate herd breakdown (HBD) with bovine tuberculosis (bTB) in totally restocked herds of cattle. By August 2004, 2941 restocked cattle herds, with cattle movements from before and after 2001, had been tested for bTB for the first time since restocking. A total of 6% (177) of these herds broke down at the first bTB test. A binomial logistic regression model with HBD (at least one reactor bovine) at the first test after restocking as the outcome was used to investigate risks associated with HBD. The final model contained three risk factors. There was an increased risk for HBD in restocked herds with every log increase in herd size with an OR=1.38 (CI 1.16-1.64) to a maximum OR of 10.75. When there was a history of bTB on the restocked farm before 2001 the OR, with CI not including unity, were 5.92, 4.63, 3.8 and 2.9 for last HBD in 2000, 1999, 1998 and 1997, respectively, indicating a persistence in increased risk for restocked herds from farms with a history of HBD in the previous herd before restocking, i.e. a different population of cattle. Finally, for every log increase in the number of cattle purchased from herds with a greater than biennial frequency of testing for bTB in the previous 8 years (i.e. perceived high risk herds for bTB) there was an OR=1.35 (95% CI 1.22-1.49). The maximum OR was 9.27. These results indicate that both introduction of bTB through the purchase of cattle from farms with a high perceived risk of bTB infection and persistence of bTB on the restocked farm, (not the farm's original herd), were associated with an increased risk of HBD in the newly formed herds after restocking.


Assuntos
Agricultura , Surtos de Doenças/veterinária , Febre Aftosa/epidemiologia , Tuberculose Bovina/epidemiologia , Criação de Animais Domésticos , Animais , Bovinos , Modelos Logísticos , Modelos Biológicos , Fatores de Risco , Fatores de Tempo , Reino Unido/epidemiologia
12.
Prev Vet Med ; 83(3-4): 242-59, 2008 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-18164500

RESUMO

Caseous lymphadenitis (CLA) is an infectious disease of sheep caused by Corynebacterium pseudotuberculosis. It is prevalent in most sheep producing countries and was introduced into the UK sheep population in 1991. The pathogen invades the host through epithelium and forms an abscess in the local draining lymph node. Typically, disease presents as clinical, with overt (externally visible) swollen lymph nodes (the parotid, submandibular, prefemoral, prescapular, popliteal or mammary) or sub-clinical, with abscesses in the lungs and associated thoracic (bronchial and mediastinal) lymph nodes. We present a mathematical model in which disease is categorised as overt and/or respiratory (sub-clinical), using the above groupings. In both situations sheep may be infected and may or may not be infectious. In the model, overt abscesses may resolve and respiratory abscesses are considered to be present for life. Using the location of the abscesses, three routes of transmission are postulated: overt to overt, respiratory to overt and respiratory to respiratory. Data from four naturally infected flocks were used to describe populations of sheep with epidemic CLA and to estimate transmission coefficients for each of the postulated transmission routes. The infection process parameters were derived from literature where possible. Parameters were estimated using maximum likelihood methods and compared to the data using a multinomial distribution. The distribution of abscesses in the flocks was similar to endemic data reported in other studies. In the model most infected sheep developed abscesses, and approximately 36% of sheep with overt abscesses recovered from infection. The average time for respiratory abscesses to become infectious was 41 days. In these data, overt to overt transmission was the most frequent route of transmission since it had the highest coefficient in the model compared with respiratory to overt and respiratory to respiratory transmission. Transmission coefficients specific for each flock significantly (P<0.05) improved the model fit to the data. In simulations using values of best-fitting parameter combinations, the proportion of sheep infected was between 0.39 and 0.60 at equilibrium. This is the first mathematical model of C. pseudotuberculosis infection, the parameter estimates indicate that aspects of the infection process could be utilised to design control strategies.


Assuntos
Infecções por Corynebacterium/veterinária , Corynebacterium pseudotuberculosis/patogenicidade , Linfadenite/veterinária , Modelos Biológicos , Doenças dos Ovinos/transmissão , Abscesso/epidemiologia , Abscesso/microbiologia , Abscesso/veterinária , Animais , Simulação por Computador , Infecções por Corynebacterium/epidemiologia , Infecções por Corynebacterium/prevenção & controle , Infecções por Corynebacterium/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Transmissão de Doença Infecciosa/veterinária , Funções Verossimilhança , Linfadenite/epidemiologia , Linfadenite/microbiologia , Matemática , Prevalência , Índice de Gravidade de Doença , Ovinos , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/prevenção & controle , Fatores de Tempo , Reino Unido/epidemiologia
13.
J Dairy Sci ; 91(4): 1403-15, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18349232

RESUMO

This study investigated cow characteristics, farm facilities, and herd management strategies during the dry period to examine their joint influence on somatic cell counts (SCC) in early lactation. Data from 52 commercial dairy farms throughout England and Wales were collected over a 2-yr period. For the purpose of analysis, cows were separated into those housed for the dry period (6,419 cow-dry periods) and those at pasture (7,425 cow-dry periods). Bayesian multilevel models were specified with 2 response variables: ln SCC (continuous) and SCC >199,000 cells/mL (binary), both within 30 d of calving. Cow factors associated with an increased SCC after calving were parity, an SCC >199,000 cells/mL in the 60 d before drying off, increasing milk yield 0 to 30 d before drying off, and reduced DIM after calving at the time of SCC estimation. Herd management factors associated with an increased SCC after calving included procedures at drying off, aspects of bedding management, stocking density, and method of pasture grazing. Posterior predictions were used for model assessment, and these indicated that model fit was generally good. The research demonstrated that specific dry-period management strategies have an important influence on SCC in early lactation.


Assuntos
Bovinos/fisiologia , Indústria de Laticínios/métodos , Lactação/fisiologia , Leite/citologia , Modelos Estatísticos , Animais , Inglaterra/epidemiologia , Feminino , Abrigo para Animais , Período Pós-Parto , Fatores de Risco , País de Gales/epidemiologia
14.
J Hosp Infect ; 65 Suppl 2: 93-9, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17540250

RESUMO

Theoretical modelling has shown that patient movements in and out of hospitals are likely to affect nosocomial transmission dynamics considerably. The community acts as a "reservoir" and readmission of individuals colonised during previous admissions can result in sporadic transmission episodes within hospitals. We investigated patient movement patterns and frequency of readmissions using seven years of complete data from the University Hospitals of Leicester NHS Trust. Sufficient information is held on individual patients to study the heterogeneity in readmission. Overall, we found that an infected person has a 44.2% chance of being readmitted to the Trust while still infected. This value is far higher than previous estimates (3.7% [Cooper et al., Health Technol Assess 2003;7(39)]), highlighting the potential importance of transmission driven by hospital admissions. For this reason we believe consideration of readmissions from the community population to be critical to the success of hospital acquired infection control.


Assuntos
Infecção Hospitalar/epidemiologia , Resistência a Meticilina , Modelos Estatísticos , Readmissão do Paciente/estatística & dados numéricos , Infecções Estafilocócicas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/transmissão , Infecção Hospitalar/transmissão , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Infecções Estafilocócicas/transmissão , Reino Unido/epidemiologia
15.
Math Biosci ; 209(1): 222-39, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17335858

RESUMO

The nature and role of re-infection and partial immunity are likely to be important determinants of the transmission dynamics of human respiratory syncytial virus (hRSV). We propose a single model structure that captures four possible host responses to infection and subsequent reinfection: partial susceptibility, altered infection duration, reduced infectiousness and temporary immunity (which might be partial). The magnitude of these responses is determined by four homotopy parameters, and by setting some of these parameters to extreme values we generate a set of eight nested, deterministic transmission models. In order to investigate hRSV transmission dynamics, we applied these models to incidence data from eight international locations. Seasonality is included as cyclic variation in transmission. Parameters associated with the natural history of the infection were assumed to be independent of geographic location, while others, such as those associated with seasonality, were assumed location specific. Models incorporating either of the two extreme assumptions for immunity (none or solid and lifelong) were unable to reproduce the observed dynamics. Model fits with either waning or partial immunity to disease or both were visually comparable. The best fitting structure was a lifelong partial immunity to both disease and infection. Observed patterns were reproduced by stochastic simulations using the parameter values estimated from the deterministic models.


Assuntos
Transmissão de Doença Infecciosa , Modelos Imunológicos , Infecções por Vírus Respiratório Sincicial/transmissão , Vírus Sincicial Respiratório Humano/fisiologia , Humanos , Incidência , Lactente , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/imunologia
16.
Prev Vet Med ; 78(2): 172-8, 2007 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-17092589

RESUMO

A total of 160 ewes on one farm in England were studied for 18 months. The incidence of footrot and interdigital dermatitis in individually identified sheep and treatment and flock control measures were recorded. A binomial mixed effect model with the incidence of footrot or interdigital dermatitis as the outcome was used to investigate patterns of association between treatments, flock control measures and the incidence of footrot or interdigital dermatitis. In this one flock, the incidence of footrot and interdigital dermatitis was positively associated with the incidence of footrot and interdigital dermatitis and with trimming of feet and negatively associated with the use of parenteral antibiotics and topical antibiotic sprays in either the first and/or second 2-week period prior to the incidence of interest. These results provide two hypotheses: one that 'footrot and interdigital dermatitis are infectious diseases that can be controlled, in part, through the use of antibiotic therapy, which acts to reduce the infectious period of diseased sheep' and two, that 'routine trimming of diseased and healthy feet exacerbate disease, through environmental contamination and/or through increased susceptibility of sheep with recently trimmed feet'.


Assuntos
Criação de Animais Domésticos/métodos , Dermatoses do Pé/veterinária , Pododermatite Necrótica dos Ovinos/prevenção & controle , Casco e Garras , Doenças dos Ovinos/prevenção & controle , Animais , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Inglaterra/epidemiologia , Feminino , Dermatoses do Pé/epidemiologia , Dermatoses do Pé/prevenção & controle , Pododermatite Necrótica dos Ovinos/epidemiologia , Casco e Garras/patologia , Estudos Longitudinais , Estudos Prospectivos , Fatores de Risco , Ovinos , Doenças dos Ovinos/epidemiologia
17.
J Dairy Sci ; 90(8): 3764-76, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17638988

RESUMO

The purpose of the research was to investigate cow characteristics, farm facilities, and herd management strategies during the dry period to examine their joint influence on the rate of clinical mastitis after calving. Data were collected over a 2-yr period from 52 commercial dairy farms throughout England and Wales. Cows were separated for analysis into those housed for the dry period (8,710 cow-dry periods) and those at pasture (9,964 cow-dry periods). Multilevel models were used within a Bayesian framework with 2 response variables, the occurrence of a first case of clinical mastitis within the first 30 d of lactation and time to the first case of clinical mastitis during lactation. A variety of cow and herd management factors were identified as being associated with an increased rate of clinical mastitis and these were found to occur throughout the dry period. Significant cow factors were increased parity and at least one somatic cell count > or = 200,000 cells/mL in the 90 d before drying off. A number of management factors related to hygiene were significantly associated with an increased rate of clinical mastitis. These included measures linked to the administration of dry-cow treatments and management of the early and late dry-period accommodation and calving areas. Other farm factors associated with a reduced rate of clinical mastitis were vaccination with a leptospirosis vaccine, selection of dry-cow treatments for individual cows within a herd rather than for the herd as a whole, routine body condition scoring of cows at drying off, and a pasture rotation policy of grazing dry cows for a maximum of 2 wk before allowing the pasture to remain nongrazed for a period of 4 wk. Models demonstrated a good ability to predict the farm incidence rate of clinical mastitis in a given year, with model predictions explaining over 85% of the variability in the observed data. The research indicates that specific dry-period management strategies have an important influence on the rate of clinical mastitis during the next lactation.


Assuntos
Indústria de Laticínios/métodos , Mastite Bovina/epidemiologia , Modelos Estatísticos , Animais , Bovinos , Inglaterra/epidemiologia , Feminino , Abrigo para Animais , Incidência , Estimativa de Kaplan-Meier , Lactação , Mastite Bovina/prevenção & controle , Período Pós-Parto , Fatores de Risco , Estatística como Assunto , Inquéritos e Questionários , País de Gales/epidemiologia
18.
Vet Rec ; 160(22): 751-62, 2007 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-17545645

RESUMO

A retrospective cohort study of 116 British pig farms was undertaken to investigate the epidemiological risk factors associated with herd breakdowns with postweaning multisystemic wasting syndrome (PMWS). Farmers reported the PMWS status of their herd (case definition 1) and, where applicable, when the disease was first suspected and what they observed; they described a prolonged increase in mortality in six to 16-week-old pigs that was not attributable to any disease known to be on their farm. There was over 90 per cent agreement on the farmers' PMWS status between the farmers and their veterinarians. Approximately 70 per cent of the breakdowns were confirmed at the laboratory (case definition 2) except during the outbreak of foot-and-mouth disease (FMD) in 2001 when it was reduced to 30 per cent. Porcine circovirus type 2 antigen was detected in pigs examined postmortem (case definition 3) in approximately 90 per cent of the farms with increased mortality. The breakdowns occurred initially in the south of England and spread west and north, as well as locally in a radial pattern from the affected farms, and there was strong statistical evidence that there was non-random space-time clustering. The risk of herd breakdowns with PMWS was not constant; therefore, for each case definition, three survival models were developed with outcome variable time to breakdown of between January 2000 and January 2001, February 2001 to September 2001 (during FMD) or October 2001 to December 2003. Exposures with a bivariable significance of P<0.20 were tested in three multivariable Cox proportional hazard models. From January 2000 to January 2001 the risk of a herd breakdown with PMWS for definitions 1, 2 and 3 was greater for farms with 600 or more breeding sows, and for definitions 1 and 3 there was an increased risk associated with the purchase of replacement gilts rather than using homebred replacements. For definitions 1 and 3 the farms where the nearest pig farm had no breeding pigs were at greater risk of a breakdown than those where the nearest farm had breeding stock, as were the farms where visitors were not requested to avoid pigs for more than three days before visiting the farm during the FMD outbreak. From October 2001, the associated risks were identical for all three case definitions; farms were at greater risk when they had 600 or more breeding sows, if visitors had not avoided contact with pigs for more than three days before visiting the farm, and when there was a farm with PMWS less than five miles away. The affected farms were more likely to have disease associated with porcine parvovirus, porcine reproduction and respiratory syndrome virus, erysipelas, Escherichia coli and salmonella. These exposures were positively associated with large herds and the farm being close to other pig farms, but did not remain in the final models for breakdown with PMWS, indicating that such farms may be at greater risk of many infectious diseases.


Assuntos
Síndrome Definhante Multissistêmico de Suínos Desmamados/epidemiologia , Síndrome Definhante Multissistêmico de Suínos Desmamados/prevenção & controle , Animais , Animais Recém-Nascidos , Estudos de Coortes , Demografia , Inglaterra/epidemiologia , Síndrome Definhante Multissistêmico de Suínos Desmamados/etiologia , Síndrome Definhante Multissistêmico de Suínos Desmamados/mortalidade , Registros/veterinária , Estudos Retrospectivos , Fatores de Risco , Estações do Ano , Análise de Sobrevida , Suínos , País de Gales/epidemiologia
19.
Math Biosci ; 200(1): 28-43, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16466754

RESUMO

Assessment of immunological status is a powerful tool in the surveillance and control of infectious pathogens in livestock and human populations. The distribution of immunity levels in the population provides information on time and age dependent transmission. A stochastic model is developed for a livestock population which relates the dynamics of the distribution of immunity levels at the population level to those of pathogen transmission. A general model with K immunity level categories is first proposed, taking into account the increase of the immunity level due to an infection or a re-exposure, the decrease of the immunity level with time since infection or exposure, and the effect of immunity level on the susceptibility and the infectivity of individuals. Numerical results are presented in the particular cases with K=2 and K=3 immunity level categories. We demonstrate that for a given distribution of the immunity levels at the population level, the model can be used to identify quantities such as most likely periods of time since introduction of infection. We discuss this approach in relation to analysis of serological data.


Assuntos
Bovinos/imunologia , Imunidade/imunologia , Modelos Imunológicos , Algoritmos , Animais , Doenças dos Bovinos/imunologia , Doenças dos Bovinos/transmissão , Simulação por Computador , Dinâmica Populacional , Probabilidade , Processos Estocásticos , Fatores de Tempo
20.
Vet Parasitol ; 139(1-3): 180-91, 2006 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-16621291

RESUMO

In order to evaluate the epidemiology of parasitism in farmed ruminants in the changed agricultural context in Kazakhstan, 505 cattle, sheep and goats were surveyed for gastrointestinal parasitism using coprological examination, and a further thirty sheep and four goats using post mortem extraction of helminths. The dominant helminth genera were Marshallagia, Nematodirus and Trichostrongylus. Haemonchus was also present. Faecal egg counts were low (mean abundance 0-115 eggs per gram in different groups), and there was no relationship between faecal egg density and body condition score. Eggs of Nematodirus spp. were more common in sheep less than 1 yr of age, whereas those of the Trichostrongylidae were generally more common in adult sheep. Based on faecal egg counts, sheep grazing on common land close to permanent human settlements were generally no more heavily infected than those grazing the remote open plains. This could be due to a non-linear relationship between livestock numbers and stocking density. We suggest that cessation of strategic nematode control in the region following post-Soviet agricultural reform was offset by a general reduction in stocking density, such that parasite burdens remained low. However, recovery in livestock numbers is likely to lead to increased levels of infection and production loss unless sustainable control strategies are put in place.


Assuntos
Animais Domésticos/parasitologia , Doenças dos Bovinos/epidemiologia , Doenças das Cabras/epidemiologia , Helmintíase Animal/epidemiologia , Enteropatias Parasitárias/epidemiologia , Doenças dos Ovinos/epidemiologia , Fatores Etários , Criação de Animais Domésticos/métodos , Animais , Bovinos , Fezes/parasitologia , Feminino , Cabras , Cazaquistão/epidemiologia , Masculino , Contagem de Ovos de Parasitas/veterinária , Densidade Demográfica , Ovinos , Especificidade da Espécie
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