Review of syndromic surveillance: implications for waterborne disease detection

Berger, M; Shiau, Rita; Weintraub, June M.

doi:10.1136/jech.2005.038539

Cited by 45 publications

(47 citation statements)

References 51 publications

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“…Presently, our understanding of bacterial enteric diseases in the community and of their virulence factors is based primarily on clinical disease reporting and examination of clinical pathogen isolates (27)(28)(29). This study aimed to investigate the feasibility of an alternative approach that monitors enteric disease prevalence and virulence factor diversity by directly quantifying and characterizing target virulence genes in the sanitary sewage of a human community.…”

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confidence: 99%

Estimating the Prevalence of Potential Enteropathogenic Escherichia coli and Intimin Gene Diversity in a Human Community by Monitoring Sanitary Sewage

Yang

Pagaling

Yan

2014

Appl Environ Microbiol

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Presently, the understanding of bacterial enteric diseases in the community and their virulence factors relies almost exclusively on clinical disease reporting and examination of clinical pathogen isolates. This study aimed to investigate the feasibility of an alternative approach that monitors potential enteropathogenic Escherichia coli (EPEC) and enterohemorrhagic E. coli (EHEC) prevalence and intimin gene (eae) diversity in a community by directly quantifying and characterizing target virulence genes in the sanitary sewage. The quantitative PCR (qPCR) quantification of the eae, stx 1 , and stx 2 genes in sanitary sewage samples collected over a 13-month period detected eae in all 13 monthly sewage samples at significantly higher abundance (93 to 7,240 calibrator cell equivalents [CCE]/100 ml) than stx 1 and stx 2 , which were detected sporadically. The prevalence level of potential EPEC in the sanitary sewage was estimated by calculating the ratio of eae to uidA, which averaged 1.0% ( ‫؍‬ 0.4%) over the 13-month period. Cloning and sequencing of the eae gene directly from the sewage samples covered the majority of the eae diversity in the sewage and detected 17 unique eae alleles belonging to 14 subtypes. Among them, eae-␤2 was identified to be the most prevalent subtype in the sewage, with the highest detection frequency in the clone libraries (41.2%) and within the different sampling months (85.7%). Additionally, sewage and environmental E. coli isolates were also obtained and used to determine the detection frequencies of the virulence genes as well as eae genetic diversity for comparison.A lthough the majority of Escherichia coli strains are harmless commensal microorganisms in human intestine, numerous pathotypes have been identified to cause severe human diseases, including enteropathogenic E. coli (EPEC) and enterohemorrhagic E. coli (EHEC) (1). EPEC is commonly associated with severe infant diarrhea; although large outbreaks of infant EPECcaused diarrhea are rare in the developed world, EPEC-related diarrhea is still one of the most important causes of infant mortality in developing countries (2). EHEC strains, on the other hand, are frequently associated with food-borne outbreaks in the developed world, which are characterized by bloody diarrhea and hemolytic uremic syndrome (HUS) (2, 3). For instance, the EHEC strain O157:H7 has caused numerous food-borne outbreaks and more than 73,000 cases of disease in the United States (4-6), and the recent outbreak of EHEC O104:H4 strains in Europe was the deadliest ever recorded, infecting more than 3,900 people and causing 46 deaths (7).As with many other pathogenic E. coli strains, the virulence factors of EPEC and EHEC are associated with mobile genetic elements (1). A common feature of EPEC and EHEC infection is the "attaching-and-effacing" (AE) histopathology, which is encoded by genes on a chromosomal pathogenicity island called the locus of enterocyte effacement (LEE) that was acquired through horizontal gene transfer (8-11). EHEC strains contain additi...

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confidence: 99%

Estimating the Prevalence of Potential Enteropathogenic Escherichia coli and Intimin Gene Diversity in a Human Community by Monitoring Sanitary Sewage

Yang

Pagaling

Yan

2014

Appl Environ Microbiol

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“…However, this approach should be associated with a public health surveillance system, such as the US Outbreak Surveillance System, for data collection and reporting of outbreaks of waterborne disease [21][22][23][24]. Moreover, sewage has to be treated to achieve efficient inactivation of the viral agents before it is poured in seawater, especially in tourist areas [10].…”

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confidence: 99%

Editorial Commentary:A Novel Mode of Transmission for Human Enterovirus Infection Is Swimming in Contaminated Seawater: Implications in Public Health and in Epidemiological Surveillance

Lévêque¹

2008

CLIN INFECT DIS

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“…The increasing availability of environmental data from the Sensorweb, sensor networks, and remote imaging technologies, coupled with data streams from over the counter and pharmacy purchases makes possible near real-time surveillance of population as well as individual-level exposures. When working with health data the identification of disease outbreaks using syndromic and health surveillance techniques for analyzing data streams from pharmacies, clinics and hospitals is an important research problem (Dembek, Carley et al 2005; Kaufmann, Pesik et al 2005; Lawson, Fitzhugh et al 2005; Ritzwoller, Kleinman et al 2005; Berger, Shiau et al 2006; Cooper, Verlander et al 2006; Hope, Durrheim et al 2006). …”

Section: Discussionmentioning

confidence: 99%

Geographic boundary analysis in spatial and spatio-temporal epidemiology: Perspective and prospects

Jacquez

2010

Spatial and Spatio-temporal Epidemiology

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Geographic boundary analysis is a relatively new approach that is just beginning to be applied in spatial and spatio-temporal epidemiology to quantify spatial variation in health outcomes, predictors and correlates; generate and test epidemiologic hypotheses; to evaluate health-environment relationships; and to guide sampling design. Geographic boundaries are zones of rapid change in the value of a spatially distributed variable, and mathematically may be defined as those locations with a large second derivative of the spatial response surface. Here we introduce a pattern analysis framework based on Value, Change and Association questions, and boundary analysis is shown to fit logically into Change and Association paradigms. This article addresses fundamental questions regarding what boundary analysis can tell us in public health and epidemiology. It explains why boundaries are of interest, illustrates analysis approaches and limitations, and concludes with prospects and future research directions.

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Review of syndromic surveillance: implications for waterborne disease detection

Cited by 45 publications

References 51 publications

Estimating the Prevalence of Potential Enteropathogenic Escherichia coli and Intimin Gene Diversity in a Human Community by Monitoring Sanitary Sewage

Estimating the Prevalence of Potential Enteropathogenic Escherichia coli and Intimin Gene Diversity in a Human Community by Monitoring Sanitary Sewage

Editorial Commentary:A Novel Mode of Transmission for Human Enterovirus Infection Is Swimming in Contaminated Seawater: Implications in Public Health and in Epidemiological Surveillance

Geographic boundary analysis in spatial and spatio-temporal epidemiology: Perspective and prospects

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