Epidemiology and control of monkeypox outbreak in Houston,Texas

Background:In the 2022-2023 global outbreak,the United States and state of Texas recorded a total of 31,277 and 3,085 confirmed monkeypox(Mpox)cases respectively as of November 2023.This study aims to investigate the demographic characteristics and risk factors of Mpox outbreak in Houston and document the epidemiologic control measures implemented with their outcomes.Methods:Houston Health Department received reports of suspected Mpox cases via electronic case reports and laboratory reports from healthcare providers within Houston.These were then investigated and reclassified as either positive or negative using DNA polymerase chain reaction tests.All the reported cases received between May 2022 and January 2023 were included in this study using convenient sampling methods.Descriptive statistics using frequency distribution was used to analyze the sociodemographic,clinical features and travel history of the cases.A two-sided Chi-squared test was used to determine association between Mpox test results and risk factors with significant level set at P<0.05.Other infection control measures such as community engagement,health education,tracking and contact tracing,vaccination,referrals and laboratory sample logistics support were implemented by the health department.Results:Out of the total of 1,625 suspected persons investigated for Mpox,724(44.6%)tested positive.Among the 724 confirmed cases,male was 700(96.7%),females 20(2.8%),transgender male 1(0.1%),transgender female 3(0.4%).Age groups 30-39 years constituted 43.6%,18-29 years 27.4%,40-49 years 18.2%,50-59 years was 8%.Race distribution of positive cases was Whites 43.4%,African American 38.7%,Asian 1.4%.Risk factors with P<0.05 included male gender,age groups 30-39 years and 40-49 years,travel history to Mpox endemic areas,recent sexual contact with known or suspected Mpox cases,human immunodeficiency virus seropositivity.Identifying as gay and bisexual were also statistically significant risk factors for Mpox infection.Conclusion:The timely implementation of primary and secondary prevention measures targeted at the most at-risk populations was very effective at curtailing the spread of Mpox infection within the city of Houston.

Epidemiology and current management of cerebrovascular disease in China

The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.In connection with the previous section,this fifth section of the report continues the dissection on the manage-ment of cardiovascular diseases(CVD).Cerebrovascular disease is the leading cause of death and loss of healthy life among Chinese residents.Based on the results of GBD 2019,from 1990 to 2019,the years of life lost due to premature death caused by stroke showed a decreasing trend,while the years lived with disability still increased continuously.At present,national mortal-ity surveillance system can provide national and provincial representative annual death data on cerebrovascular disease,but the national representative data on some other important epidemiological indicators(such as incidence,prevalence,disability rate,and case fatality rate)are scarce in China.With the construction of large cohort population and extension of follow-up time,re-search on stroke-related risk factors is increasing,providing a basis for the prevention and control of risk factors.Due to limited large-scale population-based intervention studies,there is a lack of epidemiological evidence to transform into feasible interven-tion strategies and measures.In recent years,great progress in endovascular treatment for basilar-artery occlusion has been achieved in China,but there is still much room for improvement of guideline-based anticoagulant treatment and lipid-lowering treatment,as well as standardized diagnosis and treatment among patients with ischemic stroke.

Investigation of the epidemiology,pathogenicity and immunogenicity of Bordetella bronchiseptica isolated from cats and dogs in China from 2021 to 2023

Bordetella bronchiseptica(Bb)is recognized as a leading cause of respiratory diseases in dogs and cats.However,epidemiological data on Bb in dogs and cats in China are still limited,and there is no commercially available vaccine.Live vaccines containing Bb that are widely used abroad are generally efective but can establish latency and potentially reactivate to cause illness in some immunodefcient vaccinated recipients,raising safety concerns.In this study,34 canine-derived and two feline-derived Bb strains were isolated from 1809 canine and 113 feline nasopharyngeal swab samples collected from eight provinces in China from 2021 to 2023.The PCR results showed that the percentage of positive Bb was 22.94%(441/1922),and more than 90%of the Bb isolates had four virulence factor-encoding genes(VFGs),namely,fhaB,prn,betA and dnt.All the isolated strains displayed a multidrug-resistant phenotype.The virulence of 10 Bb strains isolated from dogs with respiratory symptoms was tested in mice,and we found that eight isolates were highly virulent.Furthermore,the eight Bb isolates with high virulence were inactivated and intramuscularly injected into mice,and three Bb strains(WH1218,WH1203 and WH1224)with the best protective efcacy were selected.Dogs immunized with these three strains exhibited strong protection against challenge with the Bb feld strain WH1218.Ultimately,the WH1218 strain with the greatest protection in dogs was selected as the vaccine candidate.Dogs and cats that received a vaccine containing 109 CFU of the inactivated WH1218 strain showed complete protection against challenge with the Bb feld strain WH1218.This study revealed that Bb is an important pathogen that causes respiratory diseases in domestic dogs and cats in China,and all the isolates exhibited multidrug resistance.The present work contributes to the current understanding of the prevalence,antimicrobial resistance,and virulence genes of Bb in domestic dogs and cats.Additionally,our results suggest that the WH1218 strain is a promising candidate safe and efcacious inactivated Bb vaccine.

Disease Control, Prevention and On-Farm Biosecurity: The Role of Veterinary Epidemiology

Domesticated and non-domesticated animals, including wildlife, deliver significant financial and nonfinancial benefits to the human community;however, disease can have a dramatic impact on the morbidity, mortality, and productivity of these animal populations and hence can directly and indirectly affect the human communities associated with them. This manuscript provides an overview of the important features to consider for the prevention and control of disease, with a focus on livestock diseases,and highlights the key role veterinary epidemiology plays in this endeavor. Measures of disease frequency and the type of epidemiological studies required to identify risk factors for diseases are summarized,with a focus on the use of these in the implementation of measures to control disease. The importance of biosecurity in maintaining disease-free flocks/herds is discussed and the steps taken to implement good biosecurity measures are outlined. It is concluded that a sound knowledge of veterinary epidemiology is required when developing control programs for disease and implementing biosecurity programs at a farm, regional, and national level.

Epidemiology of fatty liver in an islander population of China:a population-based case-control study

BACKGROUND: Because of difficulty in evaluating fatty liver disease in islander populations, we conducted a crosssectional study to investigate the prevalence of fatty liver and its risk factors inan islander population of East China. METHODS: Randomized multistage stratified cluster sampling from the islander population was used in a population-based case-control study. Then interview, physical examination, and ultrasonography were done. RESULTS: Univariate logistic-regression analysis showed that male gender, smoking, daily alcohol intake >= 20 g, duration of drinking >= 5 years, total alcohol intake >= 36.5 kg, hypertension and obesity were closely related to fatty liver (all P < 0.05). Multivariate stepwise logistic-regression analysis showed duration of drinking >= 5 years and obesity were closely related to fatty liver (both P<0.05), the oddsratio (OR) (95% CI) was 1.954 (1.364-2.799) and 7.014 (4.919-10.002), respectively. The prevalence of fatty liver in this district was 40.0%. The prevalence of fatty liver in the non-obese and < 5 years drinking group, the non-obese and >= 5 years drinking group, the obese and < 5 years drinking group and the obese and >= 5 years drinking group were 15.43%, 26.73%, 56.78% and 71.521/6, respectively. A doseresponse relation between the duration of drinking and fatty liver was not apparent. After stratification by obesity, we found that the severity of fatty liver on ultrasonography was positively correlated with the duration of drinking level in the obese and non-obese groups, Pearson's correlation coefficients were 0.29:3 in the obese group and 0.178 in the non-obese group (both P < 0.05). CONCLUSIONS: The duration of drinking >= 5 years and obesity were two important risk factors for fatty liver in the islander population of East China. The prevalence of fatty liver in this population was high. An alcoholic threshold effect may be more important than a doseresponse effect on the morbidity offatty liver.

Nosocomial infections:Epidemiology,prevention,control and surveillance

Nosocomial infections or healthcare associated infections occur in patients under medical care.These infections occur worldwide both in developed and developing countries.Nosocomial infections accounts for 7% in developed and 10% in developing countries.As these infections occur during hospital stay,they cause prolonged stay,disability,and economic burden.Frequently prevalent infections include central line-associated bloodstream infections,catheter-associated urinary tract infections,surgical site infections and ventilator-associated pneumonia.Nosocomial pathogens include bacteria,viruses and fungal parasites.According to WHO estimates,approximately 15% of all hospitalized patients suffer from these infections.During hospitalization,patient is exposed to pathogens through different sources environment,healthcare staff,and other infected patients.Transmission of these infections should be restricted for prevention.Hospital waste serves as potential source of pathogens and about 20%–25% of hospital waste is termed as hazardous.Nosocomial infections can be controlled by practicing infection control programs,keep check on antimicrobial use and its resistance,adopting antibiotic control policy.Efficient surveillance system can play its part at national and international level.Efforts are required by all stakeholders to prevent and control nosocomial infections.

Epidemiology of Mpox Outbreaks and Implications for Surveillance in Imo State, Nigeria

Mpox disease is caused by a double-stranded DNA virus, genus Orthopoxvirus of the family Poxviridae. The incubation period is usually 6 to 13 days but can range from 5 to 21 days while symptoms and signs may persist for 2 to 5 weeks. Although, the clinical features are usually less severe when compared to the deadly smallpox, the disease can be fatal with case fatality rate between 1% and 10%. In Imo State, Nigeria, there has been a changing epidemiology of the disease in the last 6 years and the frequency and geographic distribution of cases have progressively increased. This study aims to conduct a review of the disease epidemiology between 2017 and 2023 and implications for surveillance in Imo State. Surveillance data from the Surveillance Outbreak Response and Management System (SORMAS) was extracted between January 2017 and December 2023 across the 27 Local Government Areas (LGAs) of Imo State. A line list of 231 suspected cases was downloaded into an excel template and analyzed using SPSS® version 20 software. Analysis was done using descriptive statistics and associations were tested using Fischer’s exact at 0.05 level of significance. Of the 231 suspected cases, 57.1% (132) were males, 42.9% (99) were females and the modal age group was between the ages of 0 - 4 (32.5%). Eight (8) LGAs (districts) accounted for 71% (n = 164) of all the suspected cases. 21.2% (49) were confirmed positive, 27 males (55.1%) and 22 females (44.9%) (p > 0.05). Modal age group was 20 - 24 (22.4%, n = 11), 18% (9) were children under 14 years, p > 0.05. Case fatality rate was 8% (n = 4). There was no significant association between mortality and age group. Five (5) LGAs accounted for about 60% (29) of all confirmed cases. These LGAs contribute only 20% to the total population in the State. Only 5.6% and 4% of suspected and confirmed cases, respectively, had knowledge of contact with an infectious source. The study described the epidemiology of Mpox outbreaks between 2017 and 2023 and the findings have significant implications on detection and outbreak response activities.

Molecular Epidemiology and Clinical Characteristics of Hand, Foot and Mouth Disease in North Sichuan Region, China, 2018-2023: A Descriptive Study

Background: Hand, foot and mouth disease (HFMD) remains an important public health problem in China. Many studies on the epidemiological characteristics of HFMD have been reported, but studies in North Sichuan region have been neglected. Methods: HFMD-related enterovirus infected cases were clinically confirmed and underwent real-time RT-PCR (rRT-PCR) from May 2018 to October 2023 in Guangyuan Central Hospital. Results: During 2018-2023, other EV (437 cases, 81.08%) was the most predominant serotype followed by CV-A16 (94 cases, 17.44%), EV-A71 (8 cases, 1.48%) was the least predominant serotype. Peak infections occurred in July and October. There were no significant differences in gender, age and serotypes. HFMD was concentrated in children under 47 months of age, with the highest incidence in children aged 12 - 23 months and the highest proportion of other EV infections in the whole age group. COVID-19 did not cause significant changes in gender, age and serotype. Overall, there was a significant increase in the proportion of children aged 12 - 23 months infected with CV-A16, and an increase in the proportion of children aged over 36 months infected with other EVs. Conclusions: The incidence of HFMD caused by EV-A71 has decreased significantly, and other EVs have become the main pathogens of HFMD in North Sichuan region in recent years. In the prevention and control of CV-A16, more attention should be paid to children aged 12 - 23 months and the dominant serotype should be closely monitored. Our study highlights the importance of developing of new diagnostic reagents and vaccines for the prevention and control of enterovirus infection. This study for the first time provides insights into district interventions to local conditions.

Measurement,associations,patterns,and promotion:Unveiling vital areas in physical activity epidemiology

Physical activity(PA)epidemiology first emerged as a new field of study around the 1950s with publication of seminal investigations on London civil servants1 and has continued to evolve as a scientific discipline to present time.This subdiscipline of epidemiology studies the frequencies,distributions,and dynamics of PA and its impact on human health,morbidity,and mortality.Research over the past 75 years has demonstrated numerous health benefits of PA.Based on these research findings,the World Health Organization recommends adults aged 18-64 years engage in at least 150-300 min of moderate-intensity aerobic PA per week,or at least 75-150 min of vigorous-intensity aerobic PA per week,or a combination of both intensities.

Heart failure in China:epidemiology and current management

The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascularhealth in China.In connection with the previous section,this sixth section of the report offers a comprehensive analysis of heart failure(HF)in China.HF is one of the most important cardiovascular disease in the 21st century.Its mortality is equivalent to that of cancer.It is an important public health problem that seriously affects the health of Chinese residents.In recent years,with the deepeningof understanding,the change of treatment principles,the innovation of treatment methods and the update of treatment guidelines,the in-hospital mortality of HF patients has declined,and the long-term prognosis is also improving.However,there are stilldifferences in the management level of HF among different hospitals in China.How to improve the standardized diagnosis andtreatment level of HF in China remains an important challenge.

Epidemiology and current management of cardiovascular disease in China

The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China. This is the fourth section of the report with a specific focus on epidemiology and current management of cardiovascular disease(CVD) in China. This section of the report highlights the epidemiological trends of CVD in China. It reveal a concerning rise in prevalence, with approximately 330 million affected individuals, including significant numbers with stroke, coronary artery disease(CAD), heart failure, and other conditions. CVD stands as the primary cause of mortality among both urban and rural populations, accounting for nearly half of all deaths in 2020. Mortality rates are notably higher in rural areas compared to urban centers since 2009. While age-standardized mortality rates have decreased, the absolute number of CVD deaths has increased, primarily due to population aging. Ischemic heart disease, hemorrhagic and ischemic strokes are the leading causes of CVD-related deaths. Notably, the burden of atherosclerotic cardiovascular disease has risen substantially, with atherosclerotic cardiovascular disease-related deaths increasing from 1990 to 2016. The incidence of ischemic stroke and ischemic heart disease has shown similar increasing trends over the past three decades. CAD mortality, particularly acute myocardial infarction, has been on the rise, with higher mortality rates observed in rural areas since 2016. The prevalence of CAD has increased significantly, with over 11 million patients identified in 2013. Studies assessing hospital performance in managing acute coronary syndrome reveal gaps in adherence to guideline-recommended strategies, with disparities in care quality across hospitals. However, initiatives like the China Patient-centered Evaluative Assessment of Cardiac Events(PEACE)-Retrospective AMI Study and the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS) project aim to improve patient outcomes through enhanced care protocols. Moreover, advancements in medical technology, such as quantitative flow ratio-guided lesion selection during percutaneous coronary intervention, show promise in improving clinical outcomes for patients undergoing intervention.

Epidemiology of biliary tract cancer in China:A narrative review

Biliary tract cancer(BTC)is a group of rare malignancies that affect the gallbladder and bile ducts.Although rare,BTC is becoming a significant public health burden in China,particularly among males and older individuals.The increasing trends in BTC incidence and mortality in China are influenced by various demographic,environmental,and lifestyle factors.In this review,we examine available epidemiological data on the incidence,mortality,prognosis,and trends of different BTC subtypes in China.We also discuss the challenges and opportunities for improving the prevention,diagnosis,and management of BTC in China,and identify areas for further research and intervention.The article aims to provide a better understanding of the epidemiological features of BTC in China and to inform public health strategies and clinical practice.

Epidemiology of EGFR Mutation in Adenocarcinoma NSCLC Patients in India: A Systematic Review and Meta-Analysis

Studies reporting the Indian prevalence of Epidermal Growth Factor Receptor (EGFR) mutation are mostly single centers with small sample sizes. This systematic review and meta-analysis summarized the available evidence of EGFR mutation epidemiology in Indian patients with adenocarcinoma (ADC) Non-Small Cell Lung Cancer (NSCLC). We conducted a structured literature search in PubMed, and EMBASE databases from January 2004 through October 2019. The primary outcome of interest was prevalence of EGFR mutation by gender, smoking status, and mutation subtype. The review included 34 studies. EGFR mutation prevalence was 39.5% in patients with ADC, and significantly higher in females, non-smokers, and patients with exon 19 deletions. The EGFR mutation frequency in Indian patients with ADC was higher than reported in Caucasians but at a lower range of that reported in East Asians. These findings support the use of EGFR mutation testing to guide choice of treatment.

Effectiveness of Wastewater-Based Epidemiology as an Early Warning Tool to Detect SARS-CoV-2 (COVID-19)

Medical diagnostic tests to detect Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) for individuals in the United States were initially limited to people who were traveling or symptomatic to track disease incidence due to the cost of providing testing for all people in a community on a routine basis. As an alternative to randomly sampling large groups of people to track disease incidence at significant cost, wastewater-based epidemiology (WBE) is a well-established and cost-effective technique to passively measure the prevalence of disease in communities without requiring invasive testing. WBE can also be used as a forecasting tool since the virus is shed in individuals prior to developing symptoms that might otherwise prompt testing. This study applied the WBE approach to understand its effectiveness as a possible forecasting tool by monitoring the SARS-CoV-2 levels in raw wastewater sampled from sewer lift stations at a large public university campus setting including dormitories, academic buildings, and athletic facilities. The WBE analysis was conducted by sampling from building-specific lift stations and enumerating target viral copies using RT-qPCR analysis. The WBE results were compared with the 7-day rolling averages of confirmed infected individuals for the following week after the wastewater sample analysis. In most cases, changes in the WBE outcomes were followed by similar trends in the clinical data. The positive predictive value of the applied WBE approach was 86% for the following week of the sample collection. In contrast, positive correlations between the two data with Spearmen correlation (rs) ranged from 0.16 to 0.36. A stronger correlation (rs = 0.18 to 0.51) was observed when WBE results were compared with COVID-19 cases identified on the next day of the sampling events. The P value of 0.007 for Dorm A suggests high significance, while moderate significance was observed for the other dormitories (B, C, and D). The outcomes of this investigation demonstrate that WBE can be a valuable tool to track the progression of diseases like COVID-19 seven days before diagnostic cases are confirmed, allowing authorities to take necessary measures in advance and also enable authorities to decide to reopen a facility after a quarantine.

Uncovering the epidemiology of bladder cancer in the Arab world: A review of risk factors, molecular mechanisms, and clinical features

Objective:Bladder cancer(BC)is a significant public health concern in the Middle East and North Africa,but the epidemiology and clinicopathology of the disease and contributors to high mortality in this region remain poorly understood.The aim of this systematic review was to investigate the epidemiological features of BC in the Arab world and compare them to those in Western countries in order to improve the management of this disease.Methods:An extensive electronic search of the PubMed/PMC and Cochrane Library databases was conducted to identify all articles published until May 2022,following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.A total of 95 articles were included in the final analysis after title,abstract,and full-text screening,with additional data obtained from the GLOBOCAN and WHO 2020 databases.

Profiling of the Retrospective Epidemiology of the Human Papillomavirus and Related Cancers in the United Arab Emirates Population

The human papillomavirus (HPV) is a leading cause of infectious cancers, leading to a growing global interest on the profiling of HPV-related cancers. Therefore, the aim of the study was to determine the retrospective epidemiological profile of HPV-related cancer in the United Arab Emirates (UAE). The incidence profiling of HPV-related cancers in males and females of UAE of all ages ranged from a minimum of 0.6% to a maximum of 4.5% for testes cancer and colon cancer respectively in males;whilst in females it ranged from a minimum of 1.0% and a maximum of 34% for Hodgkin lymphoma, kidney, bladder, liver and pancreas cancer and breast cancer, respectively. The incidence profiling of HPV-related cancers in males and females of ages 15 - 44 years old ranged from a minimum of 0.1% to a maximum of 11.2% for pancreas cancer, and colon and rectum cancer respectively in males, whilst in females it ranged from a minimum of 0.1% and a maximum of 18% for pancreas and breast cancer, respectively. The mortality profiling of HPV-related cancers in males and females of all ages in the UAE ranged from a minimum of 0.1% for Hodgkin lymphoma and testicular cancer to a maximum of 4.5% for colon and rectum cancer respectively in males, whilst in females it ranged from a minimum of 0.2% and a maximum of 4.5% for pancreas and breast cancer, respectively. The mortality profiling of HPV-related cancers mortality in males and females of ages 15 - 44 years old in the UAE ranged from a minimum of 0.2% to a maximum of 4.3% for testicular cancer and colon cancer respectively in males, whilst in females it ranged from a minimum of 0.2% and a maximum of 7.2% for bladder and breast cancer respectively. In conclusion, the profiling of HPV-related cancers in UAE for both males and females of all ages is similar to that reported for other parts of the world.

Bidirectional relationship between diabetes mellitus and depression:Mechanisms and epidemiology

Diabetes mellitus and depression exhibit a complex bidirectional relationship that profoundly impacts patient health and quality of life.This review explores the physiological mechanisms,including inflammation,oxidative stress,and neu-roendocrine dysregulation,that link these conditions.Psychosocial factors such as social support and lifestyle choices also contribute significantly.Epidemiological insights reveal a higher prevalence of depression among diabetics and an in-creased risk of diabetes in depressed individuals,influenced by demographic variables.Integrated management strategies combining mental health asse-ssments and personalized treatments are essential.Future research should focus on longitudinal and multi-omics studies to deepen understanding and improve therapeutic outcomes.

Epidemiology of Maternal Deaths from 2017 to 2022 in the Obstetrics and Gynaecology Department of the University Hospital of Tengandogo, Burkina Faso

Background: Although maternal mortality is declining in most countries, it remains a significant public health problem worldwide, with high rates, particularly in developing and insecure countries like ours. Objective: To study the epidemiological factors and factors associated with the occurrence of maternal death in the Gynecology-Obstetrics Department of University Hospital of Tengandogo. Method: It was a retrospective case-control study with a descriptive and analytical purpose over a period of 6 years from January 1, 2017 to December 31, 2022. Cases were women with maternal deaths during the study period. Data processing and analysis were performed using Stata version 13 software. Univariate and multivariate analyses were performed with Stata version 13 software, and logistic regression modeling was used to estimate crude and adjusted odds ratios (OR), their 95% confidence intervals (CI), and the threshold for statistical significance was set at a p value < 0.05. Results: A total of 372 patients were included in the study, including 146 cases of maternal death. The in-hospital maternal mortality rate was 1933 deaths per 100,000 live births. The average age was 28.5 years. 58.9% of patients lived in rural areas. Married patients accounted for 88.7% of cases. The average parity was 3. Direct obstetrical causes were the main causes of death, accounting for 72.6%. They were dominated by post-partum hemorrhage (24.2%), puerperal infection (18.6%), pre-eclampsia/eclampsia (16.1%) and retroplacental hematoma (8.9%). Chronic anemia (12.9%) was the main indirect obstetric cause. Risk factors associated with maternal death were primiparity (OR for paucigravida and multigravida at 0.05;P = 0.001);ambulance transport (OR for patients referred and brought in by personal vehicle = 0.3, p < 0.001) and vaginal delivery (OR for cesarean deliveries = 0.4, p < 0.001). Conclusion: To reduce maternal mortality in Burkina Faso, strategies such as educating women about danger signs during pregnancy and promoting women’s education can be adopted.

A 10-year review and epidemiology of animal bite cases in Gerash city, south of Iran: A retrospective cross-sectional study

Objective:To determine the temporal trend and epidemiology of animal bite cases in Gerash City,Iran.Methods:This retrospective cross-sectional study analyzed 630 cases of people with animal bites between 2011 and 2021 in Gerash City.The collected data were analyzed using Chi-square test.Results:The mean age of victims was(30.9±17.5)years.80.54%Of victims were male,39.70%were self-employed,and 64.60%were adults(≥18 years).Most cases of bites occurred in 2019(91 cases),2020(74 cases)and 2021(87 cases),and most of the bites were related to the upper limbs(62.70%).Most of the wounds were superficial(78%),most of the biting animals were domestic animals(91.74%),and most of the victims had Iranian nationality(97.62%).Conclusions:Given the increasing trend of animal bites in Gerash City,health authorities should carry out basic measures such as education and awareness among the public,especially at-risk groups such as adult males.Additionally,since most cases of bites are due to dogs,it seems necessary to plan for vaccination of dogs,especially those with owners.

Seroepidemiology of hepatitis C and its risk factors in Khuzestan Province, South-West of Iran:A case-control study

AIM：To evaluate possible risk factors for the spread of hepatitis C infection and to analyze the characteristics of the epidemiological and clinical patterns among the patients with hepatitis C infection. METHODS： During a five-year period a cross-sectional study was conducted among HCV positive individuals referred to the Ahwaz JundiShapour University Hospitals （AJSUH） and Hepatitis Clinic from 1 Sept 1999 to 1 Sept 2003. The control group consisted of first time blood donors referred to the Regional Blood Transfusion organization. Enzyme-linked immunosorbent assay and recombinant immunoblot assay anti-hepatitis C virus （HCV） tests were performed for two groups. Positive serum specimens were retested using polymerase chain reaction （PCR） for HCV RNA. Risk factors were evaluated using a questionnaire. Reported risk factors among infected subjects （＂HCV-positive＂） were compared to those of subjects never exposed （＂HCV-negative＂） to HCV. RESULTS： A total of 514 subjects were studied for HCV, of which 254 were HCV-positive and 260 HCV- negative donors comprised the control group. Mean age of the patients was 28.4 （Std 15.22） years. HCV-positive subjects were more likely to be of male gender （63% versus 37%）. Transfusion 132 （52%）, non-intravenous （n-iv） drug abuse and iv drug abuse 37 （14.5%）, haemodialysis 25 （10%）, receiving wounds at war and extramarital sexual activities （2.4%）, tattooing （3.6%） were found to be independent risk factors of being HCV-positive. No apparent risk factors could be demonstrated in 29 （11.2%） of the positive cases. CONCLUSION： Our data indicate that a history of transfusion and iv drug abuse and haemodialysis are important risk factors for HCV infection in our area and that more careful pretransfusion screening of blood for anti- HCV must be introduced in our blood banks. Improvements in certain lifestyle patterns, and customs in this area may be essential to prevent transmission of the infection.