Introduction: On August 18, 2014, a case of food poisoning in San Vicente Village was reported to the Incident Surveillance and Response Unit of the Philippine Department of Health. Of the samples from cases, five (8%) were positive for Staphylococcus aureus, one (2%) for Aeromonas hydrophilia and one (2%) for Shigella boydii. One in seven (14%) rectal swab cultures from food handlers were positive for Aeromonas sobria.
The isolation of Aeromonas hydrophilia and Shigella boydii in one of the cases could have been a consequence of this outbreak. One in eight (13%) water samples collected were found to be positive for Aeromonas species. Information sources include international journals, World Health Organization guidelines, data from the Singapore Ministry of Health and the National Public Health Laboratory of the National Center for Infectious Diseases and the International Air Transport Association.
Assessing the risk to Singapore of the emergence of artemisinin-resistant malaria in the Greater Mekong Subregion. The epidemiology of malaria cases in Singapore was analyzed based on information released by the MOH.8 A qualitative review of the public health measures taken by Singapore in response to the emerging threat was conducted based on information released by the MOH and the Singapore National Environment Agency (NEA) .
Top 10 final destination cities outside the GMS for travellers originating from countries/areas with artemisinin- resistant malaria in the GMS, 2017
The risk posed to Singapore by the emergence of ART-R malaria was identified using the information gathered; key factors were considered to assess the likelihood of importation of cases to Singapore and the impact on public health (Table 3). Risk definition, presumably based on the likelihood of importation and corresponding minimal consequences, suggests that the overall risk of ART-R malaria in Singapore is low. Importance of ART-R case detection through blood and fever surveys in malaria.
To prevent the global spread of artemisinin resistance, containment efforts have been initiated in the GMS. In 2015, the WHO launched the Greater Mekong Subregion Malaria Eradication Strategy, which was endorsed by all GMS countries.31 All GMS countries have begun to implement national malaria eradication strategies that have resulted in a significant reduction in malaria cases and death; monitoring the effectiveness of.
Number of malaria cases imported into Singapore from 2013 to 2017 from GMS countries/areas in relation to travel volume
DISCUSSION
Identification of new molecular markers and improvements in laboratory capacity continue to impact disease surveillance, as illustrated by the significant progress in global surveillance of artemisinin resistance accelerated by the discovery of the molecular marker K13.12 Risk assessment will also change as new treatment options become available . Even though an assessment of the risks posed by resistance to partner drugs in the ACTs is beyond the scope of this paper, we recognize the risk of such resistance and the importance of monitoring all molecular markers of antimalarial drug resistance. Moreover, artemisinin resistance has also been observed in non-GMS countries, including countries in Africa, although the incidence is very rare.4 The risk of importation of ART-R malaria from these non-GMS countries is not discussed in this paper. of low connectivity of Singapore with these countries.
In conclusion, in view of the emergence of ART-R malaria in the GMS and its geographic expansion, this risk assessment emphasizes the need for a high degree of vigilance about the local and global situation to assess the risk and severity of the threat to the public health of ART-R malaria for Singapore. Origins of the current outbreak of multidrug-resistant malaria in Southeast Asia: a retrospective genetic study. The residents of one of the facilities who cleaned a particular toilet were 18.0 times more likely to be infected with EHEC (95% confidence interval) than those who did not.
Discussion: The source of the outbreak could not be determined; however, the infection may have spread through environmental sources contaminated with EHEC. The objectives of the study were to characterize the epidemiology of the cases and identify potential risk factors for EHEC infection in this outbreak.
RESULTS
The results of the primary univariate analyzes are shown in Table 2, and the stratified analyzes for the residents of Facilities A and B are shown in Table 3. Samples from the meals provided from May 23 to 30 were stored in a freezer, and all samples tested negative for EHEC. Chlorine levels of the tap water were checked and recorded every day and were consistently greater than 0.1 ppm.
Acknowledging the outbreak, facilities implemented additional disease prevention and control measures, including encouraging intensive hand washing. Objective: To document the development and optimization of the Zika virus (ZIKV) disease surveillance system in southern Vietnam in 2016 and to describe the characteristics of identified ZIKV-positive cases. As with any new control system, adjustments may be necessary as part of it.
As local and international situations evolved, Vietnam also adapted its surveillance approach and expanded the number of ZIKV disease surveillance sites in southern Vietnam, where most cases occurred. The objectives of this paper were to document the evolution and optimization of the ZIKV disease surveillance system in South Vietnam in 2016 and to describe the characteristics of the ZIKV positive cases identified through the surveillance system. MOH has released guidelines for treating pregnant women in the context of Vietnam's Zika outbreak.
In children and non-pregnant women, the Q4 positivity rate was more than double the year as a whole. Of the 145 children aged 5 to 9 who were tested, none tested positive for ZIKV. The characteristics of the persons tested for ZIKV and those who tested positive are summarized in Table 2.
The development of the surveillance system may have led to increased efficiency in detecting ZIKV-positive cases. In one of the sentinel districts (district 2), sample collection was experimentally decentralized to the municipal health station and private clinics in quarter 4. However, the increase may also be due to other contributing factors, including those that may have improved the ability of the surveillance system to more effectively detect ZIKV infections .
Green spots: cases of the current month; Red spots: cases from the start of the outbreak in February 2016 to the previous month. Therefore, it will be relevant to continue to strengthen the implementation of the guidelines.
CONCLUSIONS
We report a high incidence of dengue in major urban and suburban areas of Fiji. Mortality in the 2014 DENV-3 outbreak was higher than previously reported outbreaks in Fiji. The Malaysian healthcare system is a mix of public and private systems; the public and private sectors complement each other in the provision of health services.
Health facility use by dengue patients in the Klang Valley, Malaysia: a secondary analysis of dengue surveillance data. The background characteristics of all dengue patients in the Klang Valley and the pattern of health facility use were described through descriptive analyses. Therefore, this study aimed to analyze the pattern of health facility use among dengue patients in the Klang Valley using the data captured in the national dengue surveillance system, e-Dengue Registry.
The list of public health facilities in the Klang Valley was obtained from the Development Department of the Ministry of Health (MoH) Malaysia. The list of private health facilities was obtained from the Department of Medical Practice, MoH Malaysia. During the study period, there were 92 private hospitals and 2,205 private clinics in the Klang Valley.
We observed similar overall use of private and public healthcare facilities by dengue patients in the Klang Valley. Stratification by type of health care facility showed that dengue patients in the Klang Valley were used more up to 98 years. The use of private and public healthcare facilities by dengue patients in the Klang Valley was 51% and 49%, respectively.
At least 85% of the patients from these districts used public healthcare facilities instead of private healthcare facilities. Our finding shows that hospital utilization was almost five times higher than clinic utilization among dengue patients in the Klang Valley. This study shed light on the big picture of health facility utilization among dengue patients in the Klang Valley.
Our results showed that both public and private health institutions have important responsibilities in providing health care services to dengue patients in the Klang Valley. Middle East respiratory syndrome: what we learned from the 2015 outbreak in the Republic of Korea.
