Temporal and Genotypic Associations of Sporadic Norovirus Gastroenteritis and Reported Norovirus Outbreaks in Middle Tennessee, 2012-2016.

BACKGROUND: In the United States, surveillance of norovirus gastroenteritis is largely restricted to outbreaks, limiting our knowledge of the contribution of sporadic illness to the overall impact on reported outbreaks. Understanding norovirus transmission dynamics is vital for improving preventive measures, including norovirus vaccine development. METHODS: We analyzed seasonal patterns and genotypic distribution between sporadic pediatric norovirus cases and reported norovirus outbreaks in middle Tennessee. Sporadic cases were ascertained via the New Vaccine Surveillance Network in a single county, while reported norovirus outbreaks from 7 middle Tennessee counties were included in the study. We investigated the predictive value of sporadic cases on outbreaks using a 2-state discrete Markov model. RESULTS: Between December 2012 and June 2016, there were 755 pediatric sporadic norovirus cases and 45 reported outbreaks. Almost half (42.2%) of outbreaks occurred in long-term care facilities. Most sporadic cases (74.9%) and reported outbreaks (86.8%) occurred between November and April. Peak sporadic norovirus activity was often contemporaneous with outbreak occurrence. Among both sporadic cases and outbreaks, GII genogroup noroviruses were most prevalent (90.1% and 83.3%), with GII.4 being the dominant genotype (39.0% and 52.8%). The predictive model suggested that the 3-day moving average of sporadic cases was positively associated with the probability of an outbreak occurring. CONCLUSIONS: Despite the demographic differences between the surveillance populations, the seasonal and genotypic associations between sporadic cases and outbreaks are suggestive of contemporaneous community transmission. Public health agencies may use this knowledge to expand surveillance and identify target populations for interventions, including future vaccines.

Patient Reported Outcomes of Pastoral Care in a Hospital Setting.

This study aimed to establish whether Pastoral Care (PC) visits were an effective component of a hospitalized patient's overall health experience. Outcomes of PC visits were reported by 369 patients in 7 sites across Australia. The patient reported outcomes of PC visits included: the patients felt they could be honest with themselves, with a sense of peace, a better perspective of their illness, less anxiety, and felt more in control. Five factors of the PC visit significantly related to higher patient's overall outcomes: (a) having more Pastoral Care visits (p < 0.5 0 R 0.778, CI 0.17-1.38); (b) the patient was able to talk about what was on their mind (p < 0.01, OR1.48, CI 0.58-2.37); (c) they had something to be hopeful about (p < 0.01 OR1.18, CI 0.51-1.85); 4); the visit focused on decisions about the patient's health care (p < 0.05, OR0.70, CI 0.05-1.35); and (d) a belief in God/Higher Being (p < 0.01, OR 1.01, CI 0.43-1.71).

Estimating the prevalence of schistosomiasis japonica in China: a serological approach.

BACKGROUND: The prevalence of schistosomiasis japonica has decreased significantly, and the responses changing from control to elimination in Jiangsu Province, P.R. China. How to estimate the change in prevalence of schistosomiasis using only serological data will be important and useful. METHODS: We collected serum samples from 2011 to 2015 to build a serum bank from Dantu County of Jiangsu, China. Serum samples were detected by enzyme-linked immunosorbent assay (ELISA), the positive rate and optical density (OD) value were obtained. The Bayesian model including the prior information of sensitivity and specificity of ELISA was established, and the estimated infection rates were obtained for different years, genders and age groups. RESULTS: There was no significant difference in the mean OD between different years and genders, but there was a significant difference between the different age groups. There were statistically significant differences in the positive rate for different years and age groups, but no significant difference at different genders. The estimated infection rate for the five years was 1.288, 1.456, 1.032, 1.485 and 1.358%, respectively. There was no significant difference between different years and between genders, but a significant difference between different age groups. CONCLUSIONS: The risk of schistosomiasis transmission in this area still exists, and risk monitoring of schistosomiasis should be strengthened.