The findings of this study demonstrate that ethnicity and parasitemia are important independent risk factors for severe falciparum malaria in adults from malaria-nonendemic countries and that a history of previous clinical malaria significantly reduces the risk of WHO-defined severe falciparum malaria.
19 had tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by PCR. All 6 passengers had disembarked from cruise ships that had recently docked in Sydney. In the subsequent 2 weeks, several other cases of SARS-CoV-2 infection were identified among passengers on that flight. Although the role of cruise ships in SARS-CoV-2 transmission is well documented (1), information regarding potential flight-associated transmission of SARS-CoV-2 (2,3) is limited. We investigated SARS-CoV-2 transmission associated with a 5-hour domestic flight by analyzing epidemiologic and whole-genome sequencing (WGS) data. Ethics approval was not required for this investigation, conducted as part of the public health response to the SARS-CoV-2 outbreak under the Western Australia Public Health Act 2016. Methods Public Health Response to Coronavirus Disease in Australia In Australia, coronavirus disease (COVID-19) is an urgently notifiable disease (4); laboratory-confirmed cases and close contacts are investigated and managed according to national guidelines produced by the Communicable Disease Network of Australia (4). Details for flights with SARS-CoV-2 infectious persons on board are published at https://www. healthywa.wa.gov.au/coronavirus. Airlines are responsible for the management of crew and are notified of potential in-flight exposure by the National Incident Room (https://www.health.gov.au/initiatives-and-programs/national-incident-room).
Human papillomavirus (HPV) vaccines are now included in immunisation programmes in 71 countries. Unfortunately, uptake has been impacted in some countries by reduced confidence in the safety of the HPV vaccine. In 2013, we published an extensive review demonstrating a reassuring safety profile for bivalent (2vHPV) and quadrivalent (4vHPV) vaccines. A nonavalent (9vHPV) vaccine is now available and HPV immunisation programmes have been extended to males in 11 countries. The aim of this updated narrative review was to examine the evidence on HPV vaccine safety, focusing on the 9vHPV vaccine, special populations and adverse events of special interest (AESI). The previous searches were replicated to identify studies to August 2016, including additional search terms for AESI. We identified 109 studies, including 15 population-based studies in over 2.5 million vaccinated individuals across six countries. All vaccines demonstrated an acceptable safety profile; injection-site reactions were slightly more common for 9vHPV vaccine than for 4vHPV vaccine. There was no consistent evidence of an increased risk of any AESI, including demyelinating syndromes or neurological conditions such as complex regional pain or postural orthostatic tachycardia syndromes. The risk-benefit profile for HPV vaccines remains highly favourable.
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