Legacy of Polio-Use of India's Social Mobilization Network for Strengthening of the Universal Immunization Program in India.

The Social Mobilization Network (SMNet) has been lauded as one of the most successsful community engagement strategies in public health for its role in polio elimination in India. The UNICEF-managed SMNet was created as a strategy to eradicate polio by engaging >7000 frontline social mobilizers to advocate for vaccination in some of the most underserved, marginalized, and at-risk communities in India. This network focused initially on generating demand for polio vaccination but later expanded its messaging to promote routine immunization and other health and sanitation interventions related to maternal and children's health. As an impact of the network's interventions, in collaboration with other eradication efforts, these high-risk pockets witnessed an increase in full routine immunization coverage. The experience of the SMNet offers lessons for health-system strengthening for social mobilization and promoting positive health behaviors for other priority health programs like the Universal Immunization Program.

An outbreak of noninvasive group A streptococcal disease in a facility for the developmentally disabled.

BACKGROUND: Reports of outbreaks of group A streptococcal disease in long-term care facilities are uncommon. METHODS: An outbreak of noninvasive group A streptococcal disease was investigated in a large facility for the developmentally disabled. The antistreptolysin O test was used to supplement the case finding. RESULTS: Sixty-seven cases of streptococcal pharyngitis were diagnosed among residents and staff of the facility. Interventions based on enhanced infection control practices were effective, but maintaining them for several months was challenging because of the large number of staff, cognitive deficits of the residents, inconveniently placed areas for hand sanitation for the staff, and occurrence of a simultaneous outbreak of impetigo in the same population. After 4 months, the outbreak was successfully managed without chemoprophylaxis of the entire residential population and staff. CONCLUSION: Outbreaks of group A streptococcal disease in centers for persons with developmental disabilities have unique challenges superimposed on routine outbreak response measures.