Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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To assess the value of rotavirus vaccination in India, we determined the potential impact and cost-effectiveness of a national rotavirus vaccination program. ⋯ A national rotavirus vaccination program in India would prevent substantial rotavirus morbidity and mortality and would be highly cost-effective at a range of vaccine prices. Public health officials can use this locally derived data to evaluate how this highly cost-effective intervention might fit into India's long-term health care goals.
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Ventilator-associate pneumonia (VAP) is the most common nosocomial infection in patients in intensive care units (ICU). Because of its association with unwanted clinical outcomes, preventive measures have been studied intensively in the past 25 years. Unfortunately, a large amount of clinical trials yielded disappointingly few clear-cut answers. ⋯ Only topical antimicrobial prophylaxis (either alone in the oropharynx or in combination with intestinal decontamination) has been demonstrated to improve patient outcome resulting from prevention of VAP. However, this was demonstrated in not-so-average circumstances-in ICUs with extremely low levels of antibiotic resistance. Despite the obvious challenges with using antibiotics as preventive measures, careful evaluation of these strategies in settings with higher drug-resistance levels is now justified, and future studies should be designed to demonstrate outcome benefits rather than reductions in VAP rates.
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A model survey for assessing 2009 pandemic influenza A (H1N1) virus disease burden in the workplace.
Emergence of 2009 pandemic influenza A (H1N1) (pH1N1) virus in 2009 raised concern about the potential impact of widespread or severe disease on the nation's workforce. The Centers for Disease Control and Prevention recommended that employers develop flexible pandemic response plans. We used the Behavioral Risk Factor Surveillance System's influenza module as a model for a brief workplace survey to ascertain the influenza-like illness (ILI) burden on epidemiology staff in Centers for Disease Control and Prevention Emergency Operations Center. ⋯ The 10 respondent ILI cases missed 24 total work days, although none sought medical care. Eleven (14%) of 77 household contacts also had ILI, but no ILI case was hospitalized. This survey enabled us to rapidly obtain information about our workforce ILI burden and evaluate the potential need for additional resources because of employee absence.
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During August through September 2009, a surge in emergency department (ED) visits for 2009 pandemic influenza A (pH1N1) illness occurred in Georgia, particularly among children. To understand surge preparedness and capacity, we obtained influenza-like illness (ILI) ED visit data from the Georgia State Electronic Notifiable Disease Surveillance System (SendSS) and conducted a retrospective, Internet-based survey among all 26 metro Atlanta ED managers with reference to the period 1 July-1 October 2009. ⋯ Most (92%) of the facilities had current pandemic influenza plans. Pandemic planning can help to ensure preparedness for natural and man-made disasters and for future influenza pandemics.