Capacity of public health surveillance to comply with revised international health regulations, USA.

Public health surveillance is essential for detecting and responding to infectious diseases and necessary for compliance with the revised International Health Regulations (IHR) 2005. To assess reporting capacities and compliance with IHR of all 50 states and Washington, DC, we sent a questionnaire to respective epidemiologists; 47 of 51 responded. Overall reporting capacity was high. Eighty-one percent of respondents reported being able to transmit notifications about unknown or unexpected events to the Centers for Disease Control and Prevention (CDC) daily. Additionally, 80% of respondents reported use of a risk assessment tool to determine whether CDC should be notified of possible public health emergencies. These findings suggest that most states have systems in place to ensure compliance with IHR. However, full state-level compliance will require additional efforts.

Television and video game viewing and its association with substance use by Kentucky elementary school students, 2006.

OBJECTIVE: We sought to determine if the number of hours elementary school students viewed television (TV) and video games is associated with substance METHODS: We distributed the California Healthy Kids Survey Elementary School Questionnaire to elementary schools in Kentucky in 2006. A total of 4,691 students, primarily fourth and fifth graders, completed the survey. The students provided responses to questions on topics such as drug use, alcohol use, TV and video game viewing time, and their home life. We analyzed the survey using Chi-square tests and logistic regression. RESULTS: Approximately one-third of respondents indicated substance use, which was defined as alcohol use, illegal drug use, smoking/tobacco use, or sniffing solvents. Significantly more children (28% of those watching > or = 3 hours of TV/video games compared with 20% of those watching greater than zero but < or = 2 hours of TV/video games) reported alcohol use (p<0.05). Similar results were seen for sniffing solvents, with 9% of those watching > or = 3 hours of TV/ video games reporting they sniffed solvents compared with 4% who watched TV/video games for greater than zero but < or = 2 hours (p<0.05). The results of the logistic regression indicated that the odds of drinking alcohol (odds ratio [OR] = 1.48, 95% confidence interval [CI] 1.23, 1.79) and sniffing solvents (OR=1.97, 95% CI 1.42, 2.75) were significantly higher for those watching > or = 3 hours of TV/video games compared with those who watched TV/video games for greater than zero but < or = 2 hours. CONCLUSIONS: The hours of TV and video games viewed were associated with alcohol use and sniffing solvents for our sample. However, limitations exist due to the inability to separate TV viewing from video game viewing.

Role of CD4 count in immunity development after hepatitis A and B vaccination among HIV-infected patients: Kentucky, 2002-2007.

PURPOSE: To determine whether lower prevaccination CD4 counts decrease odds of immune development against hepatitis A virus/hepatitis B virus (HAV/HBV) among patients who receive the vaccine and examine the relationship between vaccine response and sex, race/ethnicity, health insurance status, tobacco use, substance abuse, or comorbidities. METHODS: This study was performed among patients who received the standard dose for HAV and/or HBV vaccine. RESULTS: Among 76 HIV-infected patients, immunity development to HAV or HBV increased as CD4 counts increased. In addition, males had greater vaccine response than females. Whites were observed to have higher rates of immunity than other races/ethnicities. Patients with private insurance had greater vaccine response than those with Medicaid, Medicare, or no insurance. Patients not experiencing hypertension and hyperlipidemia developed immunity more often than patients with these comorbidities. Substance abuse and tobacco use were also associated with lower vaccine response. CONCLUSIONS: Higher CD4 counts improved likelihood of patients developing an antibody response after vaccination.