Microsporidial keratoconjunctivitis after rugby tournament, Singapore.

We investigated an outbreak of 47 probable and 6 confirmed cases of microsporidial keratoconjunctivitis involving participants of an international rugby tournament in Singapore in April 2012.The mode of transmission was eye contact with soil. Vittaforma corneae was identified in 4 of 6 corneal scrapings and in 1 of 12 soil water samples.

The association between acute lymphoblastic leukemia in children and Helicobacter pylori as the marker for sanitation.

BACKGROUND: Greaves "delayed infection" hypothesis suggested that Acute Lymphoblastic Leukemia (ALL) in children is caused by a lack of exposure to infection in infancy, which may be due higher standards of sanitation. We have conducted an ecologic analysis of the relationship between sanitation, using Helicobacter pylori (H. pylori) as the marker, and the incidence of childhood ALL in 127 cancer registries from 28 countries. RESULTS: There were inverse associations between H. pylori prevalence and ALL incidence rates in children. These associations were minor and only significant for ALL incidence rates for all cancer registries. They became non-significant and smaller in magnitude when the population source and/or the GNP per capita were added to the relationship. Furthermore, these results were unchanged when the associations were examined using the Generalized Estimating Equations. CONCLUSIONS: Although the findings showed lower prevalence of H. pylori and improved sanitation is associated with increased incidence of childhood ALL, they do not conclusively support Greaves "delayed infection" hypothesis.

Possible nosocomial transmission of measles in unvaccinated children in a Singapore public hospital.

INTRODUCTION: Measles is an acute, highly communicable viral disease, with measles outbreaks usually occurring in settings where there are unvaccinated populations. After being notified of a cluster of five measles cases in a Singapore public hospital in August 2011, the Ministry of Health Singapore conducted an outbreak investigation. METHODS: Active case detection was conducted, and all notified cases' movement history within the hospital were reviewed to determine any common exposures in place and time. Cases were classified as nosocomial if they had contact with other measles cases in the hospital seven to 21 days before onset dates. Laboratory testing included serological and molecular diagnostic methods. RESULTS: Of the 14 cases, seven cases were nosocomial cases. Investigations identified two wards where cases were epidemiologically linked. Two cases in Ward A were of D8 genotype and genotypically 100% identical, thus confirming a common source of infection. The six cases in Ward B (including one transferred from Ward A) had overlapping periods of admission and three cases were of the same D8 genotype, with a single nucleotide difference. DISCUSSION: The epidemiological linkages of the cases and laboratory findings suggest nosocomial transmission in Wards A and B. As a result of this investigation, the hospital implemented a new policy of isolating suspected measles cases instead of waiting until they had been laboratory confirmed. This investigation emphasizes the importance of early identification and isolation of suspected measles cases within health care institutions and reinforces the requirement for high measles vaccination coverage of health care workers.

Pandemic influenza planning by videoconference.

Collaboration between nations and sectors is crucial to improve regional preparedness against pandemic influenza. In 2008, a Virtual Symposium was organized in the Asia-Pacific region by the Asia-Pacific Economic Cooperation Emerging Infections Network (APEC EINet) to discuss pandemic preparedness. The multipoint videoconference lasted approximately 4.5 hours and was attended by 16 APEC members who shared best practices in public-private partnerships for pandemic influenza preparedness planning. Twelve of the 16 APEC members who participated responded to a post-event survey. The overall experience of the event was rated highly. Partnering public health, technology and business communities to discuss best practices in preparedness using videoconferencing may be an effective way to improve regional preparedness. Utilization of videoconferencing on a routine basis should be considered to improve preparedness among APEC members and enhance its usability during a pandemic.