Framework for a Community Health Observing System for the Gulf of Mexico Region: Preparing for Future Disasters.

The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop.

Complete Genomic Sequence of Dengue virus 1, Isolated from Plasma Collected from a Haitian Child in 2014.

An outbreak of dengue fever followed a chikungunya fever outbreak in Haiti in 2014. We detected Dengue virus 1 (DENV-1) in plasma samples collected between May 2014 and February 2015. A representative isolate was fully sequenced, and phylogenetic analyses indicate that it groups within the genotype V South American and Caribbean DENV-1 clades.

Perfil clínico y microbiológico de las infecciones entéricas por Yersinia entero colitica en niños de Santiago, Chile / Clinical and microbiological aspects of Yersinia enterocolitica enteric infections in children from Santiago, Chile

Yersinia enterocolitica es causa frecuente de infecciones intestinales endémicas en países de Europa y Norteamérica, pero la información sobre ella en Iberoamérica es escasa. El propósito de este estudio fue describir la incidencia y características clínicas de infecciones intestinales por Y. enterocolitica en 3 cohortes de niños menores de 4 años de familias de bajos recursos de Santiago. Los niños fueron vigilados activamente con visitas domiciliarias dos veces por semana, se les tomaron muestras de deposiciones en cada episodio de diarrea, como también a controles pareados por edad y sexo. Entre febrero 1987 y enero 1990 se estudiaron 1.795 episodios de diarrea. La incidencia de Y. enterocolitica en los casos de diarrea fue de 1,4% versus 0,3% en 1.780 controles (p<0,005). La diarrea asociada a Y. enterocolitica se caracterizó por deposiciones líquidas o mucosas; en ningún caso hubo síndrome disentérico, pero 11,5% evolucionaron como diarrea persistente (> 14 días); en 26,9% de los pacientes se observó fiebre (* 38-C) y ninguno requirió hospitalización. De las cepas de Yersinia aisladas, 73% correspondieron a serotipo 0:3, biotipo 4, y las restantes a los serotipos 0:7,8, 0:10 y 0:6. No se apreciaron claras diferencias estacionales, pero 50% de los aislamientos se concentraron en los meses fríos de junio, julio, agosto, septiembre. Si bien la incidencia de Y. enterocolitica en diarrea aguda infantil es baja, es importante buscarla en forma sistemática y con medios selectivos en niños menores de 2 años, considerando que puede provocar enfermedad de curso prolongado