Sickness presenteeism in healthcare workers during the coronavirus disease 2019 (COVID-19) pandemic: An observational cohort study.

Sickness presenteeism among healthcare workers (HCW) risks nosocomial infection, but its prevalence among HCW with COVID-19 is unknown. Contemporaneous interviews revealed a sickness presenteeism prevalence of 49.8% among 255 HCW with symptomatic COVID-19. Presenteeism prevalence did not differ among HCW with and without specific COVID-19 symptoms or direct patient care.

Poliomyelitis-related case-fatality ratio in India, 2002-2006.

BACKGROUND: On the basis of studies from developed countries, the case-fatality ratio (CFR) of poliomyelitis generally ranges from 2%-5% among children <5 years of age to 10%-30% among adults. However, little information is available for poliomyelitis-related CFR in developing countries. We conducted a study to determine the CFR in India, 1 of the 4 remaining countries with endemic wild poliovirus (WPV) circulation, during outbreaks of WPV infection during 2002 and 2006 and during the inter-epidemic years of 2003-2005. METHODS: We conducted a descriptive analysis with use of data from the acute flaccid paralysis surveillance system in India. Variables analyzed included age, caregiver-reported vaccination status, date of paralysis onset, laboratory results, final case classification, and survival outcome. Our analysis also accounted for surveillance changes that occurred in 2005, impacting case definitions and final classification. RESULTS: In 2006, 45 deaths occurred among 676 WPV cases in India, yielding a CFR of 6.7%. By comparison, in 2002, there were 66 deaths among 1600 reported WPV cases (CFR, 4.2%) and during 2002-2005, CFR was 1.5%-5.2%. All 45 deaths were among 644 (95%) WPV cases in children aged <5 years (CFR, 7.0%). Among those who died, 33 (73%) were children aged <2 years (CFR, 7.1%). CONCLUSIONS: The CFR among children aged <2 years in India is high compared with previously published CFRs for young children, in part because of improved case finding through enhanced surveillance techniques. Fatal cases emphasize the lethal nature of the disease and the importance of achieving polio eradication in India.

Ongoing measles and rubella transmission in Georgia, 2004-05: implications for the national and regional elimination efforts.

BACKGROUND: In 2004-05, Georgia experienced large-scale concurrent measles and rubella outbreaks. We analysed measles and rubella epidemiology in Georgia to describe disease trends, determine the cause of the outbreaks, identify challenges to achieving disease elimination goals and propose interventions to overcome them. METHODS: We reviewed national measles and rubella surveillance and vaccination coverage data, focusing on the 2004-05 outbreaks, and conducted a measles vaccine effectiveness (VE) study using data from a 2004 school-based outbreak. RESULTS: Before 2004, the last large measles outbreak after measles vaccination was introduced (in 1966) in Georgia, was in 1988 (incidence rate, 36/100 000); the highest year for rubella was 1985 (110/100 000). During 2004-05, 8391 measles cases and 5151 rubella cases were reported (most of them diagnosed clinically). Of 358 suspected measles cases tested, 181 (51%) were positive for measles-IgM antibody; of 240 suspected rubella cases tested, 50 (21%) were positive for rubella-IgM antibody. Over 90% of measles cases were in persons born after 1979; 90% of rubella cases were in persons born after 1987. Approximately 41% of measles cases and 88% of rubella cases were unvaccinated. Estimated measles VE (>/=1 vs 0 doses) was 86% (95% CI, 58-96%). CONCLUSIONS: The outbreak likely resulted from failure to vaccinate rather than vaccine failure. Susceptible persons likely accumulated due to the long absence of large outbreaks and decreased coverage after the collapse of Soviet Union. To interrupt measles and rubella transmission in Georgia and achieve disease elimination goals by 2010, supplementary immunization activities should target children and young adults.