Investigating the Geographic Distribution of Shigellosis Among Men and Women in Massachusetts: Possible Implications for Men Who Have Sex With Men.

Shigellosis has emerged as a nontraditional sexually transmitted infection with high rates among men who have sex with men. Although anecdotal evidence has surfaced regarding shigellosis clustering among men who have sex with men in Massachusetts, little scientific research documents these occurrences. We present the first spatial distribution of shigellosis across Massachusetts.

Identifying and characterizing hepatitis C virus hotspots in Massachusetts: a spatial epidemiological approach.

BACKGROUND: Hepatitis C virus (HCV) infections have increased during the past decade but little is known about geographic clustering patterns. METHODS: We used a unique analytical approach, combining geographic information systems (GIS), spatial epidemiology, and statistical modeling to identify and characterize HCV hotspots, statistically significant clusters of census tracts with elevated HCV counts and rates. We compiled sociodemographic and HCV surveillance data (n = 99,780 cases) for Massachusetts census tracts (n = 1464) from 2002 to 2013. We used a five-step spatial epidemiological approach, calculating incremental spatial autocorrelations and Getis-Ord Gi* statistics to identify clusters. We conducted logistic regression analyses to determine factors associated with the HCV hotspots. RESULTS: We identified nine HCV clusters, with the largest in Boston, New Bedford/Fall River, Worcester, and Springfield (p < 0.05). In multivariable analyses, we found that HCV hotspots were independently and positively associated with the percent of the population that was Hispanic (adjusted odds ratio [AOR]: 1.07; 95% confidence interval [CI]: 1.04, 1.09) and the percent of households receiving food stamps (AOR: 1.83; 95% CI: 1.22, 2.74). HCV hotspots were independently and negatively associated with the percent of the population that were high school graduates or higher (AOR: 0.91; 95% CI: 0.89, 0.93) and the percent of the population in the "other" race/ethnicity category (AOR: 0.88; 95% CI: 0.85, 0.91). CONCLUSION: We identified locations where HCV clusters were a concern, and where enhanced HCV prevention, treatment, and care can help combat the HCV epidemic in Massachusetts. GIS, spatial epidemiological and statistical analyses provided a rigorous approach to identify hotspot clusters of disease, which can inform public health policy and intervention targeting. Further studies that incorporate spatiotemporal cluster analyses, Bayesian spatial and geostatistical models, spatially weighted regression analyses, and assessment of associations between HCV clustering and the built environment are needed to expand upon our combined spatial epidemiological and statistical methods.

Revisiting Ebola Virus Disease infection control protocols at an academic level I trauma center: Successes, challenges, and ways ahead.

In the decade since the largest Ebola Virus Disease (EVD) outbreak in history, hospitals within the United States have discovered deficiencies in EVD infection control protocols. A large academic level I trauma medical center and frontline EVD receiving hospital in northeast Florida conducted a large-scale review and revision of the facility's EVD infection control protocols to increase preparedness. The revision process revealed opportunities for improvement and highlighted the need for excellent resource management and interdepartmental communication.

Identification and infection control response to Candida auris at an academic level I trauma center.

Candida auris, an emerging fungal pathogen with significant morbidity and mortality, can be difficult for health care facilities to identify, isolate, and control. We present our identification and infection control response to Candida auris at a 695-bed academic level I trauma center in Florida.

Shigellosis in men who have sex with men: an overlooked opportunity to counsel with pre-exposure prophylaxis for HIV.

In the absence of other epidemiological exposures, shigellosis in men who have sex with men (MSM) suggests engagement in high-risk sexual encounters. Infection and diagnosis of shigellosis in MSM presents a potentially overlooked opportunity to discuss the availability of pre-exposure prophylaxis medications to prevent incident HIV infections.

Mayfly diversity in the brazilian tropical headwaters of Serra do Cipó

Os objetivos foram avaliar a distribuição espaço-temporal, estrutura de assembléias e associações de ninfas de Ephemeroptera com substratos em 5 ecossistemas lóticos nas nascentes das bacias dos rios Doce e São Francisco, Brasil. As amostragens foram realizadas em 24 estações, nos períodos de chuvas e seca de 1998. No total, 7,066 organismos foram coletados, pertencentes a 27 gêneros e 6 famílias. Os taxa dominantes foram Americabaetis, Paracloeodes, Leptohyphes e Hagenulus. No período de chuvas foram observados maiores valores dos indices de riqueza taxonômica, diversidade e equitabilidade na bacia do rio São Francisco, enquanto que no período de seca, a riqueza taxonômica foi maior na bacia do rio Doce. Não foram encontradas diferenças significativas dos valores dos indices de riqueza, equitabilidade, diversidade e densidade de ninfas de Ephemeroptera entre os dois períodos estudados. Os resultados obtidos sugerem que a diversidade das assembléias de Ephemeroptera nas cabeceiras da Serra do Cipó são provavelmente devido a características ecológicas dos ecossistemas aquáticos e bacias hidrográficas estudadas.