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\"In the wake of COVID, it's more important than ever to understand epidemics-how they emerge and what we can do to fight back\"-- Provided by publisher.

As a medical student Archivist learnt that the Sal’K’ polio vaccine [the inactivated polio vaccine (IPV)] was the ‘K’illed injected preparation and Sabin, live attenuated, polio vaccine was the oral preparation, often given to graduates of neonatal units on discharge! Oral polio vaccines have many advantages, they do induce systemic antibodies and mucosal immunity and they do prevent prolonged excretion of the virus and community transmission. The main worry is that some circulating vaccine-derived polioviruses (cVDPVs) lose attenuating mutations and they then cause paralytic disease. Ochoge M et al (The Lancet 2024;403:1164–1175. https://doi.org/10.1016/S0140-6736(23)02844-1) have examined a novel oral poliovirus vaccine type 2 (nOPV2) that has been manufactured to improve the genetic stability of the Sabin oral poliovirus vaccine (OPV) and reduce the emergence of circulating vaccine-derived polioviruses. It is a phase three trial and they recruited 2345 infants and 600 young children recruited from MRC Unit of the The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia. Those recruited were randomly assigned to receive one or two lots of one of three doses of nOPV2 or one lot of bivalent OPV (bOPV). At the height of the COVID-19 epidemic between February and October, 2021, they showed that seroconversion rates ranged from 48.9% to 49.2% across the three doses. Of those seronegative at baseline, 143 (85.6%) of 167 (95% CI 79.4–90.6) infants and 54 (83.1%) of 65 (71.7–91.2) young children seroconverted over the two-dose nOPV2 schedule. The post-two-dose seroprotection rates, including participants who were both seronegative and seropositive at baseline, were 604 (92.9%) of 650 (95% CI 90.7–94.8) in infants and 276 (95.5%) of 289 (92.4–97.6) in young children. No safety concerns were identified. 7 days post-dose one, 78 (41.7%) of 187 (95% CI 34.6–49.1) infants were excreting the type two poliovirus. These data support that nOPV2 was immunogenic and safe in infants and young children in The Gambia and support the licensure and WHO prequalification of nOPV2. This is the first clinical trial of nOPV2 in Africa, showing that there is equivalance of three lots of OPV2 based on single dose conversion in infants primed with a single inactivated poliovirus vaccine. Cooper LV and Blake IM (The Lancet 2024;403:1113–1115. https://doi.org/10.1016/S0140-6736(24)00053-9) give a useful commentary. They discuss the Global Polio Eradication Initiative and describe the challenge of the phenomenon often occuring in communities with low population immunity, that some OPV, which is a live attenuated vaccine, circulates in the community for long enough to lose its attenuating mutations, and then regain transmissibility and pathogenicitiy similar to wild poliovirus, resulting in outbreaks of circulating vaccine-derived poliovirus (cVDPV) and paralysis. All study recruits, received at least one dose of inactivated poliovirus vaccine (IPV) before enrolment, meaning that participants were humorally primed for type two poliovirus response. This could have allowed for a stronger immune response than would have been observed in a vaccine-naive population. So it looks like nOPV2 will continue to be an essential tool to stop cVDPV2 circulation,

A few years ago we were all confronted by an increase in cases of scarlet fever and a number of cases of more invasive and severe Streptococcal infections. It was interesting to read that due to a very well established global surveillance system, this raise in Streptococcal pyogenes (S pyogenes) infections has been described in detail by Lynsky NN et al . [Lancet Infect Dis 2019; 19: 1209–18 http://dx.doi.org/10.1016/S1473-3099(19)30446-3] First, this is a great paper on scarlet fever and is a very interesting historical review. Up until the beginning of the 20th century it was associated a significant mortality. Long before the use of antibiotics, the incidence and severity of scarlet fever started to fall, the reason for this remains unexplained. Scarlet fever notifications in England in the period 2014–18 have been the highest seen since 1960. It is possible that the streptococcal bacteria causing the disease might have undergone a pathogenetic change and this led to a reduction in the invasive and more severe sequelae of the illness.

A one-of-a-kind reference book, Tennessee Tragedies examines a wide variety of disasters that have occurred in the Volunteer State over the past several centuries. Intended for both general readers and emergency management professionals, it covers natural disasters such as floods, tornadoes, and earthquakes; technological events such as explosions, transportation wrecks, and structure fires; and societal incidents including labor strikes, political violence, lynchings, and other hate crimes. At the center of the book are descriptive accounts of 150 of the state’s most severe events. These range from smallpox epidemics in the eighteenth century to the epic floods of 1936–37, from the Sultana riverboat disaster of 1865 (the worst inland marine accident in U.S. history) to the 1968 assassination of Dr. Martin Luther King Jr. Included as well are stories of plane crashes, train wrecks, droughts, economic panics, and race riots. An extensive chronology provides further details on more than 900 incidents, the most complete listing ever compiled for a single state. The book’s introduction examines topics that include our fascination with such tragedies; major causes of death, injury, and destruction; and the daunting problems of producing accurate accountings of a disaster’s effects, whether in numbers of dead and injured or of economic impact. Among the other features are a comprehensive glossary that defines various technical terms and concepts and tables illustrating earthquake, drought, disease, and tornado intensity scales. A work of great historical interest that brings together for the first time an impressive array of information, Tennessee Tragedies will prove exceptionally useful for those who must respond to inevitable future disasters.

In 2006–2007 there were several outbreaks of measles affecting in particular Switzerland, Germany, Spain and Romania, together with localised outbreaks in groups such as the Roma and Sinti communities in Italy, Roma and immigrant families in Greece, orthodox Jewish communities in Belgium and the UK, and Traveller communities in the UK and Norway. Preliminary data show that measles was again prevalent in Europe during the first half of 2008.

Williams syndrome associated with complete atrioventricular septal defect S.Nakamoto, T Saga, T Shinohara Williams syndrome is a genetic disorder associated with characteristic facies, supravalvar aortic stenosis, peripheral pulmonary stenosis, mental retardation, hypertension, premature aging of skin, and congenital cardiac defects.

SUMMARY Estimation of the unknown size of a multinomial distribution is required in some important applications. It has been previously shown that the maximum likelihood estimators of the size and other parameters in the multinomial distribution are asymptotically normal under suitable regularity conditions. Unfortunately, one of these conditions is difficult to verify in practice. Here we present an alternative regularity condition that is straightforwardly verifiable. An application to the backcalculation estimates of aids incidence is presented. Explicit formulae are given for the asymptotic variances and covariances of the backcalculation estimators. The associated confidence interval for the size of the hiv infected population is comparable to the likelihood-ratio-test-based interval given in Brookmeyer & Gail (1988). A simulation study shows that the asymptotic normal interval is highly accurate in terms of coverage probability.

The use of a mixture model to estimate the probability of developing AIDS after HIV infection and the distribution of incubation time is investigated. The possibility of left truncation and an uncertain time of infection is incorporated into the analysis. The efficiency losses associated with uncertain infection times are investigated. An example is given.

SUMMARY An exact formula is given for carrier-borne epidemics which relates the probability that, starting with ξ susceptibles, x remains uninfected, to the corresponding probability for a different epidemic that, starting with ξ− x susceptibles, none remains uninfected. It is a generalization of a similar result given for the closed epidemic with removals (Daniels, 1967) and it is established both by the method of that paper and also by the probabilistie approach of Downton (1967α).