Infection prevention and control and the refugee population: Experiences from the University of Louisville Global Health Center.

BACKGROUND: During 2016, approximately 140,000 individuals entered the United States as part of the federal government refugee resettlement program and established themselves in communities in virtually every state. No national database regarding refugee health currently exists; therefore, little is known about existing infectious diseases, conditions, and cultural practices that impact successful acculturation. The objective of this report is to identify what is currently known about refugees and circumstances important to infection prevention and control with respect to their roles as new community members, employees, and consumers of health care. METHODS: Using data from the University of Louisville Global Health Center's Newly Arriving Refugee Surveillance System, health issues affecting refugees from the perspective of a community member, an employee, and a patient were explored. RESULTS: Lack of immunity to vaccine-preventable diseases is the most widespread issue impacting almost every adult, adolescent, and child refugee resettled in Kentucky. Health issues of concern from an infection prevention and control perspective include latent tuberculosis infection, HIV, hepatitis B, hepatitis C, syphilis, and parasites. Other health conditions that may also be important include anemia, obesity, oral health, diabetes, and cardiovascular disease. CONCLUSIONS: Refugee resettlement provides motivation for collaborative work among those responsible for infection prevention and control in all settings, their public health partners, and those responsible for and interested in community workforce concerns.

Thermal taster status: Evidence of cross-modal integration.

Thermal taster status refers to the finding that, in some individuals, thermal stimulation of the tongue elicits a phantom taste. Little is known regarding the mechanism for this, it is hypothesised to be a result of cross-wiring between gustatory and trigeminal nerves whose receptors co-innervate papillae on the tongue. To address this, we use functional magnetic resonance imaging to perform the first study of whether the cortical response to gustatory-trigeminal samples is altered with thermal taster status. We study the response to cold (6°C) gustatory (sweet) samples at varying levels of trigeminal stimulation elicited by CO2 (no CO2 , low CO2 , high CO2 ) in thermal taster (TT) and thermal non-taster (TnT) groups, and evaluate associated behavioural measures. Behaviourally, the TT group perceived gustatory and trigeminal stimuli significantly more intense than TnTs, and were significantly more discriminating of CO2 level. fMRI data revealed elevated cortical activation to the no CO2 sample for the TT group compared to TnT group in taste, oral somatosensory and reward areas. In TnTs, a significant positive modulation in cortical response with increasing level of CO2 was found across taste, somatosensory and reward areas. In contrast, in TTs, a reduced positive modulation with increasing level of CO2 was found in somatosensory areas (SI, SII), whilst a significant negative modulation was found in taste (anterior insula) and reward (ACC) areas. This difference in cortical response to trigeminal stimuli supports cross-modal integration in TTs, with gustatory and trigeminal nerves highly stimulated by cold gustatory samples due to their intertwined nature. Hum Brain Mapp 37:2263-2275, 2016. © 2016 Wiley Periodicals, Inc.