Search Results (54)

The lack of a universally accepted definition of a pandemic hinders a comprehensive understanding of and effective response to these global health crises. Current definitions often lack quantitative criteria, rendering them vague and limiting their utility. Here, we propose a refined definition that considers the likelihood of susceptible individuals contracting an infectious disease that culminates in widespread global transmission, increased morbidity and mortality, and profound societal, economic, and political consequences. Applying this definition retrospectively, we identify 22 pandemics that occurred between 165 and 2024 AD and were caused by a variety of diseases, including smallpox (Antonine and American), plague (Justinian, Black Death, and Third Plague), cholera (seven pandemics), influenza (two Russian, Spanish, Asian, Hong Kong, and swine), AIDS, and coronaviruses (SARS, MERS, and COVID-19). This work presents a comprehensive analysis of past pandemics caused by both emerging and re-emerging pathogens, along with their epidemiological characteristics, societal impact, and evolution of public health responses. We also highlight the need for proactive measures to reduce the risk of future pandemics. These strategies include prioritizing surveillance of emerging zoonotic pathogens, conserving biodiversity to counter wildlife trafficking, and minimizing the potential for zoonotic spillover events. In addition, interventions such as promoting alternative protein sources, enforcing the closure of live animal markets in biodiversity-rich regions, and fostering global collaboration among diverse stakeholders are critical to preventing future pandemics. Crucially, improving wildlife surveillance systems will require the concerted efforts of local, national and international entities, including laboratories, field researchers, wildlife conservationists, government agencies and other stakeholders. By fostering collaborative networks and establishing robust biorepositories, we can strengthen our collective capacity to detect, monitor, and mitigate the emergence and transmission of zoonotic pathogens. Full article

Vaccination Week in the Americas (VWA) is a yearly regional initiative that promotes the benefits of vaccination to all persons in the region. In its 22-year history, more than 1.15 billion people have been reached under the framework of VWA across more than 40 countries and territories. This review examines multiple PAHO and WHO data points, documents and reports related to measles/rubella vaccination coverage and VWA since its inception. Its goal is to document the impact that the VWA has had in maintaining and accelerating measles and rubella disease elimination, in the context of PAHO’s Disease Elimination Initiative. The results suggest that VWA’s contributions to measles and rubella elimination have been substantial. Every year, VWA promotes (a) renewed political commitment to the immunization program from the highest political authorities of Member States; (b) vaccination operations to close immunity gaps, recover under-vaccinated persons, and reach chronically underserved populations; and (c) the dissemination of messages on the benefits of vaccination through regional and national communications campaigns. VWA will continue to be an important contributor to disease elimination efforts in the Americas, even as new targets are set in response to the evolving epidemiological landscape. Full article

The elimination of both measles and rubella remains a priority for all 53 Member States of the World Health Organization (WHO) European Region. To provide an update on the epidemiological status of measles and rubella in the Region, we reviewed surveillance data on both diseases for 2023 submitted monthly by national surveillance institutions. We analyzed the cases of measles and rubella for 2023 by age group, case classification, vaccination, hospitalization, and importation status and report on measles-related deaths. In 2023, 60,860 measles cases, including 13 fatal cases, were reported in 41 countries. Most cases (95%; n = 57,584) were reported by six countries: Azerbaijan, Kazakhstan, Kyrgyzstan, Romania, the Russian Federation, and Türkiye. Of the 60,848 cases with data on age, 19,137 (31%) were 1–4 years old and 12,838 (21%) were 5–9 years old. A total of 10,412 (17%) were 20 years and older. The genotypes identified in the Region were largely dominated by D8 variants (n = 1357) and the remainder were B3 variants (n = 221). In 2023, 345 rubella cases were reported by 17 countries, mostly from Poland, Kyrgyzstan, Tajikistan, Türkiye, and Ukraine. A total of 262 cases (76%) were classified as clinically compatible and 79 (23%) were laboratory-confirmed. To achieve the elimination of measles and rubella in the Region, political commitment needs to be revived to enable urgent efforts to increase vaccination coverage, improve surveillance and outbreak preparedness, and respond immediately to outbreaks. Full article

Global discussions on the future of high streets, especially today in times of epidemiological, political, and market turmoil, emphasize the importance of high streets as laboratories for urban walkability, resilience, and sustainability. The major condition, however, is a collaborative, cross-sectoral approach towards high street development. Such efforts have been recently undertaken in Warsaw, Poland, to develop a lively but organized shopping street almost from scratch—a few promising joint initiatives with this goal have been undertaken in Warsaw over the last two decades. Building upon a broad document review and in-depth interviews with sixteen pioneers (business consultants, public authority leaders, and planning experts) directly involved in the development of high streets in Warsaw, this study reconstructs and analyzes their efforts in urban collaboration through the lens of Urban Regime Theory. By discussing strengths and weaknesses of the regime structuring process, this paper points at critical difficulties in high street sustainable development (and consequently, also to overall urban walkability, resilience, and sustainability) which are the inertia of mutual perception by stakeholders, dependency on singular leaders and their personal motivation, the necessity to reinvent the very idea of a high street anew, lack of adequate legal tools for cross-sectoral collaboration, and the stiffening effect of previously set guidelines. Full article

Background. Urban planning is a key tool to promote health in cities. The COVID-19 emergency accelerated several social, environmental, and digital challenges, stressing the importance of some issues regarding housing, urban mobility, green areas, and health service networks, urban health policies, and actions. These issues were the subject of an intensive residential course (the 57th) held in Erice, Sicily, in June 2021 in the “International School of Epidemiology and Preventive Medicine G. D’Alessandro”, and the main findings are described here. Methods. Lectures presented the topics, subsequently developed them, and argued them in parallel practical sessions using the World Café technique, since it is well suited for the interaction of participants and the involvement of groups. Results. The World Café provides new insights into how to improve the livability and health of urban spaces, and a set of strategies and actions were proposed for each topic. Discussion and Conclusions. All attendees agreed on the importance of participation in the planning processes, but also on the need for strong political support to ensure the resources needed and a full integration of health with other local policies. A multidisciplinary approach to developing systemic operational capacities and health literacy is considered pivotal to raising awareness and participation. Full article

Vaccination has been the most effective way to control the outbreak of the COVID-19 pandemic. The numbers and types of vaccines have reached considerable proportions, even if the question of vaccine procedures and frequency still needs to be resolved. We have come to learn the necessity of defining vaccination distribution strategies with regard to COVID-19 that could be used for any future pandemics of similar gravity. In fact, vaccine monitoring implies the existence of a strategy that should be measurable in terms of input and output, based on a mathematical model, including death rates, the spread of infections, symptoms, hospitalization, and so on. This paper addresses the issue of vaccine diffusion and strategies for monitoring the pandemic. It provides a description of the importance and take up of vaccines and the links between procedures and the containment of COVID-19 variants, as well as the long-term effects. Finally, the paper focuses on the global scenario in a world undergoing profound social and political change, with particular attention on current and future health provision. This contribution would represent an example of vaccination experiences, which can be useful in other pandemic or epidemiological contexts. Full article

One Health is the collaborative efforts of multiple disciplines to attain optimal health for people, animals and the environment, a concept that historically owes much to the study of brucellosis, including recent political and ethical considerations. Brucellosis One Health actors include Public Health and Veterinary Services, microbiologists, medical and veterinary practitioners and breeders. Brucellosis awareness, and the correct use of diagnostic, epidemiological and prophylactic tools is essential. In brucellosis, One Health implementation faces inherited and new challenges, some aggravated by global warming and the intensification of breeding to meet growing food demands. In endemic scenarios, disease awareness, stakeholder sensitization/engagement and the need to build breeder trust are unresolved issues, all made difficult by the protean characteristics of this zoonosis. Extended infrastructural weaknesses, often accentuated by geography and climate, are critically important. Capacity-building faces misconceptions derived from an uncritical adoption of control/eradication strategies applied in countries with suitable means, and requires additional reference laboratories in endemic areas. Challenges for One Health implementation include the lack of research in species other than cattle and small ruminants, the need for a safer small ruminant vaccine, the need to fill in the infrastructure gap, the need for realistic capacity-building, the creation of reference laboratories in critical areas, and the stepwise implementation of measures not directly transposed from the so-called developed countries. Full article

Background: Public health policies are crossed by economic and political interests that can affect the maintenance of the immunization programs and their vaccination coverages. The aim was to investigate the political and economic conditions that marked the trajectory of the Brazilian immunization program from 1980 to 2018. Methods: Documentary research gathered data on public expenditures with epidemiological surveillance and vaccine procurement and nationwide estimates of vaccine coverage. The scientific literature on the program’s implementation and the country’s political and economic conditions was examined. The theoretical approach was based on historical institutionalism. Results: The results showed rising, high rates maintaining and falling vaccination coverages in the period. As of 2010, there was a tendency for a reduction in total federal spending on epidemiological surveillance, putting pressure on the budgets of the sub-national governments in their respective areas of coverage, and on federal spending in dollars for the acquisition of immunobiologicals and inputs. Conclusions: The amplitude and complexity of the program’s trajectory have been crossed by diverse dynamics conditioned by economic and political interests reflecting at a deeper level the advance of capitalism through fiscal austerity measures over democracy’s aspirations for greater balance and justice in the distribution of resources. Full article

During the last decade, gambling (online and offline) regulation has become a social and epidemiological problem all around Europe. The aftermaths of this addiction have increased since the so-called “responsible gambling law”, in the second decade of the 21st century. The Overton window (OW) strategy is a political theory that describes how the perception of public opinion can be modified so that ideas that are inconceivable for society become accepted over time. The objective of this study is to identify whether an OW has been used to bias the adequacy of the gambling debate, as well as its scientific, legal, and political bases and the main consequences for both the general population and the major risk groups, especially the consequences in social and health contexts. The study was conducted by the application of the historical-logical method as the central axis of analysis and reflection, and the technique of qualitative research content analysis as a procedure in the process of execution of the scientific task, related to a historical trend study of the research object. The main consequences found were: the political acceptance of gambling for economical causes and taxes benefits, the use of popular characters to increase the acceptance of the pattern of behavior, the inclusion of the gambling operators as agents in the risks control, and the absence of intervention until the main consequences have been transformed into an epidemiological problem (with social aftermaths higher than the previously identified related to the gambling problems). Furthermore, the results suggest the need to implement prevention and health promotion strategies and the adoption of specific legal measures that regulate the access and the marketing of gambling operators’ activities. Full article

When an epidemic breaks out, many health, economic, social, and political problems arise that require a prompt and effective solution. It would be useful to obtain all information about the virus, including epidemiological ones, as soon as possible. In a previous study of our group, the analysis of the positive-alive was proposed to estimate the epidemic duration. It was stated that every epidemic ends when the number of positive-alive (=infected-healed-dead) glides toward zero. In fact, if with the contagion everyone can enter the epidemic phenomenon, only by healing or dying can they get out of it. In this work, a different biomathematical model is proposed. A necessary condition for the epidemic to be resolved is that the mortality reaches the asymptotic value, from there, remains stable. At that time, the number of positive-alive must also be close to zero. This model seems to allow us to interpret the entire development of the epidemic and highlight its phases. It is also more appropriate than the previous one, especially when the spread of the infection is so rapid that the increase in live positives is staggering. Full article

There are great variations between population subgroups, notably in poorer countries, leading to substantial inconsistencies with those predicted by the classical epidemiologic transition theory. In this context, using public data, we aimed to determine how the singular case of French Guiana fit and transitioned in the epidemiologic transition framework. The data show a gradual decline in infant mortality to values above 8 per 1000 live births. Premature mortality rates were greater but declined more rapidly in French Guiana than in mainland France until 2017 when they reascended in a context of political turmoil followed by the COVID-19 pandemic and strong reluctance to get vaccinated. Although infections were a more frequent cause of death in French Guiana, there is a marked decline and circulatory and metabolic causes are major causes of premature death. Fertility rates remain high (>3 live births per woman), and the age structure of the population is still pyramid-shaped. The singularities of French Guiana (rich country, universal health system, widespread poverty) explain why its transition does not fit neatly within the usual stages of transition. Beyond gradual improvements in secular trends, the data also suggest that political turmoil and fake news may have detrimentally affected mortality in French Guiana and reversed improving trends. Full article

Introduction: Eastern equine encephalitis virus (EEEV) and Venezuelan equine encephalitis virus (VEEV) viruses are zoonotic pathogens affecting humans, particularly equines. These neuroarboviruses compromise the central nervous system and can be fatal in different hosts. Both have significantly influenced Colombia; however, few studies analyse its behaviour, and none develop maps using geographic information systems to characterise it. Objective: To describe the temporal-spatial distribution of those viruses in Colombia between 2008 and 2019. Methods: Retrospective cross-sectional descriptive study, based on weekly reports by municipalities of the ICA, of the surveillance of both arboviruses in equines, in Colombia, from 2008 to 2019. The data were converted into databases in Microsoft Access 365^®, and multiple epidemiological maps were generated with the Kosmo RC1^®3.0 software coupled to shape files of all municipalities in the country. Results: In the study period, 96 cases of EEE and 70 of VEE were reported, with 58% of EEE cases occurring in 2016 and 20% of EEV cases in 2013. The most affected municipalities for EEE corresponded to the department of Casanare: Yopal (20), Aguazul (16), and Tauramena (10). In total, 40 municipalities in the country reported ≥1 case of EEE. Conclusions: The maps allow a quick appreciation of groups of neighbouring municipalities in different departments (1° political division) and regions of the country affected by those viruses, which helps consider the expansion of the disease associated with mobility and transport of equines between other municipalities, also including international borders, such as is the case with Venezuela. In that country, especially for EEV, municipalities in the department of Cesar are bordering and at risk for that arboviral infection. there is a high risk of equine encephalitis outbreaks, especially for VEE. This poses a risk also, for municipalities in the department of Cesar, bordering with Venezuela. Full article

Big search data offers the opportunity to identify new and potentially real-time measures and predictors of important political, geographic, social, cultural, economic, and epidemiological phenomena, measures that might serve an important role as leading indicators in forecasts and nowcasts. However, it also presents vast new risks that scientists or the public will identify meaningless and totally spurious ‘relationships’ between variables. This study is the first to quantify that risk in the context of search data. We find that spurious correlations arise at exceptionally high frequencies among probability distributions examined for random variables based upon gamma (1, 1) and Gaussian random walk distributions. Quantifying these spurious correlations and their likely magnitude for various distributions has value for several reasons. First, analysts can make progress toward accurate inference. Second, they can avoid unwarranted credulity. Third, they can demand appropriate disclosure from the study authors. Full article

The COVID-19 pandemic has affected the entire world population at multiple levels. Within the most vulnerable population, the elderly have seen their usual fragilities worsened in an epidemiological context. Thus, it was necessary to reinforce the gerontological response to aging at home, or in place, framed in situations of comorbidities, health problems, economic need and isolation, among other situations of premeditated situations of aging fragility. Objective: Seeking to explain a model of gerontological response to aging-in-place in future pandemic situations. For that purpose, we have explored, through a scientific literature review, the relationship between public participation and the gerontological response to aging-in-place during COVID-19, considering the four main European welfare models. During this analysis we also intended to identify the reconfigurations from those responses, considering their place-based/neutral order. Methodology: To proceed in this analysis, we used a Systematic Literature Review (SLR) to identify a series of articles that add value to this problem. Next, in order to identify current research trends, we undertook a Bibliometric Analysis (BA), using the metadata from the same set of articles collected from Scopus and Web of Science. Results: The literature on the subject is interdisciplinary, dispersed throughout areas such as health; social sciences; politics; and computational, molecular, and even environmental fields of study. Through the use of keywords, the literature found on the relationship between the type of gerontological responses to aging-in-place and providence systems is still insufficient. There are, however, other research possibilities, such as exploring indicators of gerontological responses, of public expenditure or of the type of support from interlocutor stakeholders through a comparative study between countries, which allowed us to robustly answer the central question: Is there any relationship between the different public welfare systems and the public participation model, which included community participation, in the gerontological response to aging-in-place during the COVID-19 pandemic? Full article

It is widely acknowledged that the 10-year World Bank Loan Project (WBLP) on schistosomiasis control in the People’s Republic of China played an important role in raising the public and political profile of schistosomiasis, particularly regarding its prevention, control, and elimination. The WBLP adopted large-scale administration of praziquantel as the main control measure. At the end of the 10-year project in 2001, data from high-, medium-, and low-endemic areas suggested that the infection rates of both humans and domestic animals had fallen to the expected levels. However, major floods in the Yangtze River basin, coupled with reduced funding for schistosomiasis control, resulted in a rebound of the disease in endemic areas. Since 2005, a steady decline in infection rates was observed and it was hypothesized that the experiences and technological advances accumulated during the WBLP played a role. Nonetheless, relatively little is known about the long-term effects of the WBLP on schistosomiasis, particularly management mechanisms, technological innovations, epidemiological changes, and long-term economic impact. To fill these gaps, we systematically searched the literature for articles in English and Chinese on the WBLP on schistosomiasis from 1 January 1992 to 30 July 2022. Relevant studies were analyzed for short-, mid-, and long-term epidemiological and economic effects of the WBLP on schistosomiasis prevention, control, and elimination. Overall, 81 articles met our inclusion criteria, of which 17 were related to management mechanism reform, 20 pertained to technological innovation, and 44 examined epidemiological changes and economic effects. Most papers documented the WBLP as a positive contribution to schistosomiasis prevention and control in the People’s Republic of China. Regarding the long-term effects, there was a significant contribution to the national schistosomiasis control and elimination programme in terms of renewed management mechanisms, talent development, and technological innovation. In conclusion, the WBLP contributed to enhanced control of schistosomiasis and shaped the ultimate response towards schistosomiasis elimination in the People’s Republic of China. Experiences and lessons learned might guide schistosomiasis control and elimination elsewhere. Full article