Subject(s)
Homosexuality, Male , Lymphogranuloma Venereum/epidemiology , AIDS-Related Opportunistic Infections/complications , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/microbiology , Anti-Bacterial Agents/administration & dosage , Communicable Disease Control , Diagnosis, Differential , Doxycycline/administration & dosage , Erythromycin/administration & dosage , Humans , Incidence , Lymphogranuloma Venereum/diagnosis , Lymphogranuloma Venereum/transmission , Male , Proctitis/diagnosis , Proctitis/microbiology , Sweden/epidemiologyABSTRACT
In 2001, an increase of HIV-1 diagnoses among intravenous drug users (IVDU) was reported in Sweden. In nearby countries, Finland, Russia and the Baltic states, recent outbreaks had been described. Since there was a concern that these outbreaks would carry over to Sweden a study was initiated to determine the factors leading to the Swedish increase of HIV-1 diagnosed IVDUs. HIV-1 env V3 sequences were obtained from 97 patients enrolled in ongoing epidemiological studies encompassing the years 1987--2004 with a focus on 2001--2002. The sequences were used for maximum likelihood and Bayesian inference of the molecular epidemiology. Among the virus spreading in 2001--2002, we found that four different subtypes/CRFs were present in the Swedish IVDU population (A, B, CRF01_AE and CRF06_cpx). Subtype B constituted 85% of the infections, established by 12 independent introductions into the IVDU population. The worrisome increase in 2001 was mainly not a result of import of the outbreaks in nearby countries, but rather a higher detection rate of secondary cases due to efficient epidemiological tracing of the generally slow spread of established forms of subtype B in the IVDU community. However, a few of the non-subtype B cases were linked to the outbreaks in Finland, Estonia and Latvia. Because HIV-1 outbreaks can easily be exported from one country to another amongst IVDUs, this prompts continued surveillance in the Baltic Sea Region.
Subject(s)
HIV Infections/epidemiology , HIV Infections/virology , HIV-1/genetics , HIV-1/isolation & purification , Substance Abuse, Intravenous/epidemiology , Substance Abuse, Intravenous/virology , Europe/epidemiology , Female , HIV Infections/transmission , HIV-1/classification , Humans , Male , Molecular Epidemiology , Phylogeny , Reproducibility of Results , Sweden/epidemiology , Time FactorsABSTRACT
In 1995, a disease control and intervention project was initiated in Malmöhus county in southern Sweden to limit the spread of penicillin-resistant pneumococci. Since most of the carriers of pneumococci are preschool children, and since most of the spread is believed to take place in day-care, a mathematical model, in the form of a stochastic process, for the spread in a day-care group was constructed. Effects of seasonal variation and size of the day-care group were particularly considered. The model was then used for comparing results from computer simulations without and with intervention. Results indicate that intervention is highly effective in day-care groups with more than ten children during the second half of the year.
Subject(s)
Child Day Care Centers , Models, Statistical , Pneumococcal Infections/transmission , Biometry , Child, Preschool , Computer Simulation , Disease Outbreaks/prevention & control , Disease Outbreaks/statistics & numerical data , Humans , Likelihood Functions , Penicillin Resistance , Pneumococcal Infections/epidemiology , Pneumococcal Infections/prevention & control , Seasons , Stochastic Processes , Streptococcus pneumoniae/drug effects , Sweden/epidemiologySubject(s)
Disease Outbreaks , Salmonella Food Poisoning/epidemiology , Adult , Denmark/epidemiology , Drug Resistance, Multiple, Bacterial , Feces/microbiology , Food Microbiology , Humans , Restaurants , Salmonella Food Poisoning/drug therapy , Salmonella Food Poisoning/microbiology , Salmonella typhimurium/classification , Salmonella typhimurium/isolation & purificationABSTRACT
In response to increasing frequencies of penicillin-nonsusceptible pneumococci (PNSP), for which the MIC of penicillin was >0.12 mg/L, in Skåne County, southern Sweden, national recommendations were initiated in 1995 to limit the spread of pneumococci with high MICs (> or =0.5 mg/L) of penicillin (PRP), especially among children of preschool age. Traditional communicable disease control measures were combined with actions against inappropriate antimicrobial drug use. During the first 6 years that these recommendations were applied in Skåne County, the average frequency of penicillin-resistant pneumococci has been stable at =2.6%, as has the average PNSP frequency (7.4%). However, PNSP have been unevenly distributed in the county, with the highest frequencies in the southwest. Simultaneously, the rate of antimicrobial drug use for children <6 years of age was reduced by 20%. Thus the spread of PNSP between and within the municipalities in the county has been limited.