Novel vaccine acceptance in emerging infectious diseases: a case study of Hendra virus vaccine uptake in Australia

Background: The development of a horse vaccine against Hendra virus has been hailed as a good example of a One Health approach to the control of human disease. Although there is little doubt that this is true, it is clear from the underwhelming uptake of the vaccine by horse owners to date (approximately 10%) that realisation of a One Health approach requires more than just a scientific solution. As emerging infectious diseases may often be linked to the development and implementation of novel vaccines this presentation will discuss factors influencing their uptake; using Hendra virus in Australia as a case study. Methods: This presentation will draw on data collected from the Horse owners and Hendra virus: A Longitudinal cohort study To Evaluate Risk (HHALTER) study. The HHALTER study is a mixed methods research study comprising a two-year survey-based longitudinal cohort study and qualitative interview study with horse owners in Australia. The HHALTER study has investigated and tracked changes in a broad range of issues around early uptake of vaccination, horse owner uptake of other recommended disease risk mitigation strategies, and attitudes to government policy and disease response. Interviews provide further insights into attitudes towards risk and decision-making in relation to vaccine uptake. A combination of quantitative and qualitative data analysis will be reported. Results: Data collected from more than 1100 horse owners shortly after vaccine introduction indicated that vaccine uptake and intention to vaccinate was associated with a number of risk perception factors and financial cost factors. In addition, concerns about side effects and veterinarians refusing to treat unvaccinated horses were linked to uptake. Across the study period vaccine uptake in the study cohort increased to more than 50%, however, concerns around side effects, equine performance and breeding impacts, delays to full vaccine approvals, and attempts to mandate vaccination by horse associations and event organisers have all impacted acceptance. Conclusion: Despite being provided with a safe and effective vaccine for Hendra virus that can protect horses and break the transmission cycle of the virus to humans, Australian horse owners have been reluctant to commit to it. General issues pertinent to novel vaccines, combined with challenges in the implementation of the vaccine have led to issues of mistrust and misconception with some horse owners. Moreover, factors such as cost, booster dose schedules, complexities around perceived risk, and ulterior motives attributed to veterinarians have only served to polarise attitudes to vaccine acceptance.

A molecular survey of Eimeria in chickens across Australia

Coccidiosis is a costly enteric disease of chickens caused by protozoan parasites of the genus Eimeria. Disease diagnosis and management is complicated since there are multiple Eimeria species infecting chickens and mixed species infections are common. Current control measures are only partially effective and this, combined with concerns over vaccine efficacy and increasing drug resistance, demonstrates a need for improved coccidiosis diagnosis and control. Before improvements can be made, it is important to understand the species commonly infecting poultry flocks in both backyard and commercial enterprises. The aim of this project was to conduct a survey and assessment of poultry Eimeria across Australia using genetic markers, and create a collection of isolates for each Eimeria species. A total of 260 samples (faecal or caecal) was obtained, and survey results showed that Eimeria taxa were present in 98% of commercial and 81% of backyard flocks. The distribution of each Eimeria species was widespread across Australia, with representatives of all species being found in every state and territory, and the Eimeria species predominating in commercial flocks differed from those in backyard flocks. Three operational taxonomic units also occurred frequently in commercial flocks highlighting the need to understand the impact of these uncharacterised species on poultry production. As Eimeria infections were also frequent in backyard flocks, there is a potential for backyard flocks to act as reservoirs for disease, especially as the industry moves towards free range production systems. This Eimeria collection will be an important genetic resource which is the crucial first step in the development of more sophisticated diagnostic tools and the development of new live vaccines which ultimately will provide savings to the industry in terms of more efficient coccidiosis management.

Nationwide-US newspaper coverage of handling water contamination : a community structure approach

Resumen: Empleando la teoría de la “estructura comunitaria”, un muestreo de diarios principales en 28 ciudades grandes en Estados Unidos examina la cobertura del tema “El manejo de contaminación de agua y acceso a agua potable”. Mediante el análisis de todos los artículos de más de 250 palabras publicados a través de diez años entre 01/01/2001 y 01/01/2011 (339 artículos), se compararon sistemáticamente características comunitarias y el “Vector Mediático” de Pollock (combinando en un valor dos medidas de contenido: la “prominencia” de un artículo en un periódico con la orientación o tono). Cobertura “favorable”, que apoya la mayor ayuda gubernamental para mejorar el abastecimiento de agua potable, fue vinculada con medidas de “los interesados”, por ejemplo, con el porcentaje de hispanos (r de Pearson = .349, p = .04). El análisis de las medidas y su regresión reveló dos medidas significativas asociadas con apoyo para manejo gubernamental por agua potable: porcentaje de hispanos (12.2% de la varianza), y con porcentaje de ciudadanos de 18-24 años, 16.7%. Inesperadamente, la cobertura de manejo gubernamental para mejorar las existencias de agua potable no fue vinculado ni con medidas de “vulnerabilidad” (pobreza, desempleo) ni con medidas de “estabilidad” (educación, ingreso).

Use of aerial survey and aerophotogrammetry methods in monitoring manatee populations

We evaluated the use of strip-transect survey methods for manatees through a series of replicate aerial surveys in the Banana River, Brevard County, Florida, during summer 1993 and summer 1994. Transect methods sample a representative portion of the total study area, thus allowing for statistical extrapolation to the total area. Other advantages of transect methods are less flight time and less cost than total coverage, ease of navigation, and reduced likelihood of double-counting. Our objectives were: (1) to identify visibility biases associated with the transect survey method and to adjust the counts accordingly; (2) to derive a population estimate with known variance for the Banana River during summer; and (3) to evaluate the potential value of this survey method for monitoring trends in manatee population size over time. (51 page document)

Survey report of NOAA Ship McArthur II cruises AR-04-04, AR-05-05 and AR-06-03: Habitat classification of side scan sonar imagery in support of deep-sea coral/sponge explorations at the Olympic Coast National Marine Sanctuary

Habitat mapping and characterization has been defined as a high-priority management issue for the Olympic Coast National Marine Sanctuary (OCNMS), especially for poorly known deep-sea habitats that may be sensitive to anthropogenic disturbance. As a result, a team of scientists from OCNMS, National Centers for Coastal Ocean Science (NCCOS), and other partnering institutions initiated a series of surveys to assess the distribution of deep-sea coral/sponge assemblages within the sanctuary and to look for evidence of potential anthropogenic impacts in these critical habitats. Initial results indicated that remotely delineating areas of hard bottom substrate through acoustic sensing could be a useful tool to increase the efficiency and success of subsequent ROV-based surveys of the associated deep-sea fauna. Accordingly, side scan sonar surveys were conducted in May 2004, June 2005, and April 2006 aboard the NOAA Ship McArthur II to: (1) obtain additional imagery of the seafloor for broader habitat-mapping coverage of sanctuary waters, and (2) help delineate suitable deep-sea coral/sponge habitat, in areas of both high and low commercial-fishing activities, to serve as sites for surveying-in more detail using an ROV on subsequent cruises. Several regions of the sea floor throughout the OCNMS were surveyed and mosaicked at 1-meter pixel resolution. Imagery from the side scan sonar mapping efforts was integrated with other complementary data from a towed camera sled, ROVs, sedimentary samples, and bathymetry records to describe geological and biological (where possible) aspects of habitat. Using a hierarchical deep-water marine benthic classification scheme (Greene et al. 1999), we created a preliminary map of various habitat polygon features for use in a geographical information system (GIS). This report provides a description of the mapping and groundtruthing efforts as well as results of the image classification procedure for each of the areas surveyed. (PDF contains 60 pages.)

The nutritional status of pre-school children, Kainji Lake communities, Nigeria: a baseline survey

This survey was carried out to provide the Kainji Lake Fisheries Promotion Project (KLFPP), whose overall goal is the improvement of the standard of living of fishing communities around Kainji Lake, Nigeria, and an increase in the availability of fish to consumers, with nutritional status baseline data for long-term monitoring and evaluation of the overall project goal. In a cross-sectional survey, baseline anthropometric data was collected from 768 children, aged 3-60 months in 389 fisherfolk households around the southern sector of Kainji Lake, Nigeria. In addition, data was collected on the nutritional status and fertility of the mothers, vaccination coverage of children and child survival indicators. For control purposes, 576 children and 292 mothers from non-fishing households around Kainji Lake were likewise covered by the survey. A standardised questionnaire was used to collect relevant information, while anthropometric measurements were made using appropriate equipment. Data compilation and analysis was carried out with DATAEASE registered and EPI-INFO registered software, using NCHS reference data for the analysis of anthropometric measurements. The prevalence of stunted children in fishing households was high at 40%, while the prevalence of wasted and underweight children was likewise high at 10% and 29% respectively. Children from non-fishing households had a marginally lower prevalence of stunting, wasting and underweight with 37%, 7% and 25 % respectively, although these differences were not statistically significant. Considering the fact that the survey was carried out during a period of relative food abundance, the prevalence of wasting and underweight children is likely to be much higher during periods of food shortage. The prevalence of stunting, wasting and underweight was relatively high for children aged 3 to 23 months, suggesting an increased risk of malnutrition during this period, most likely associated with inadequate weaning practices. The prevalence of malnourishment amongst women of child-bearing age was relatively high, irrespective of occupation of the household, with an average of 11% undernourished and 6% wasted. Vaccination coverage was very low while infant and child mortality were extremely high with about 1 in 5 children dying before their fifth birthday. Based on the ethical obligation to maximise the potential benefits of the survey, recommendations for activities to improve community nutrition and health were made for communication to relevant authorities. (PDF contains 52 pages)

The nutritional status of pre-school children, Kainji Lake communities, Nigeria: a follow-up survey

This survey was carried out to provide the Kainji Lake Fisheries Promotion Project (KLFPP), whose overall goal is the improvement of the standard of living of fishing communities around Kainji Lake, Nigeria, managing the fisheries on a sustainable basis, with follow-up data for long-term monitoring and evaluation of the overall project goal. A similar survey, conducted in 1996, provided the baseline against which data from the current survey was evaluated. In a cross-sectional survey, anthropometric data was collected from 576 children aged 3-60 months in 282 fisherfolk households around the southern sector of Kainji Lake, Nigeria. In addition, data was collected on the nutritional status and fertility of the mothers, vaccination coverage of children and child survival indicators. For control purposes, 374 children and 181 mothers from non-fishing households around Kainji Lake were likewise covered by the survey. A standardised questionnaire was used to collect relevant data, while anthropometric measurements were made using appropriate equipment. Data compilation and analysis was carried out with a specially designed Microsoft Access application, using NCHS reference data for the analysis of anthropometric measurements. Statistical significance testing was done using EPI-INFO" software. The results of the follow-up survey indicate a slight increase in the percentage of stunted pre-school children in fishing households around Kainji Lake, from 40% in 1996 to 41% in 1999. This increase is however not statistically significant (p= 0.704). Over the same period, the percentage of stunted children in non-fishing households increased from 37% to 39% (p= 0.540), which is also not statistically significant. Likewise, there were no statistically significant differences between the 1996 and 1999 results for the prevalence of either wasted or underweight children in fishing households. The same applies to children from non-fishing households. In addition, vaccination coverage remains very low while infant and child mortality rates continue to be extremely high with about 1 in 5 children dying before their fifth birthday. There has been no perceptible and lasting improvement in the standard of living of fishing households over the course of the second project phase as indicated by the persistently high prevalence of stunting. The situation is the same for the control group, indicating that for the region as a whole, a number of factors beyond the immediate influence of the project continue to negatively impact on the standard of living. The results also show that the project activities have not had any negative long-term effect on the nutritional status of the beneficiaries. (PDF contains 44 pages)

A Survey of Brazil (1970-2010): o país nas páginas da The Economist

Esta dissertação analisa as diferentes imagens do Brasil construídas pela revista britânica The Economist, de forma a evidenciar como essas imagens forjaram o mito do Brasil como País do Futuro, contribuindo para a construção de uma identidade internacional do País. O marco cronológico desta pesquisa, 1970 a 2010, corresponde a uma longa curva que demonstra a gangorra de interesse e desinteresse da qual o Brasil foi objeto. Para a consecução dos objetivos desta dissertação foram analisadas as publicações editadas entre os anos mencionados. Dessa forma, a dissertação também demonstra que os debates sobre o posicionamento do Brasil na ordem econômica internacional e sobre as perspectivas de alteração nesta ordem são travados entre as elites político-econômicas que, por sua vez, são os segmentos preferenciais dos leitores da The Economist.

National report of the frame survey 2010 on the Uganda side of Lake Victoria

This is a report on the results of the Frame Survey conducted in the Uganda side of Lake Victoria during August 2010 by the LVFO Institutions, namely: the Department of Fisheries Resources (DFR) Uganda and the National Fisheries Resources Research Institute (NaFIRRI) in close collaboration with the District Fisheries offices of Busia, Bugiri, Mayuge, Jinja, Mukono, Kampala, Wakiso, Mpigi, Masaka, Kalangala and Rakai. The authors are grateful to the LVEMP II, for providing funds for the survey and the LVFO secretariat coordination. Fisheries Frame surveys have been carried out on Lake Victoria biannually since 2000 to determine the number of fishers, fish landing sites, and facilities at the landing sites, as well as the composition of fishing crafts, their mode of propulsion, fishing gears and the fish species they target. This information is used to guide development and management of the lake’s fisheries. Following the reorganisation of landing sites into Beach Management Units (BMUs), the number of landing sites decreased from 597 in 2000 to 435 in 2008. The survey in 2010 showed an increase to 503 landing sites, an indication that new landing sites are coming up. The fish landing sites continue to have inadequate facilities such as fish shades, cold rooms to service the fisheries industry and very few (5%) have access to electricity and 32% had access to all weather roads. There has been some progressive improvement in the landing site coverage of basic hygiene and sanitation facilities, especially public toilet facilities from 17% in 2000 to 39% in 2010; and portable water from 4% to 17% respectively. However more effort is required to cover all landing sites. Most landing sites (83%) have access to mobile phone networks which eases communication. 46% of landing sites had access to a Health clinic and 64% had a Primary school within a radius of 2 km.

Bacteremic pneumonia before and after withdrawal of 13-valent pneumococcal conjugate vaccine from a public vaccination program in Spain: a case-control study

The objective of this study is to compare the incidence and epidemiology of bacteremic community-acquired pneumonia (CAP) in the setting of changes in 13-valent pneumococcal conjugate vaccine (PCV13) coverage. In the region of Madrid, universal immunization with the PCV13 started in May 2010. In July 2012, public funding ceased. Vaccination coverage decreased from >95% to 82% in 2013 and to 67% in 2014. We performed a multicenter surveillance and case-control study from 2009-2014. Cases were hospitalized children with bacteremic CAP. Controls were children selected 1:1 from next-admitted with negative blood cultures and typical, presumed bacterial CAP. Annual incidence of bacteremic CAP declined from 7.9/100 000 children (95% CI 5.1-11.1) in 2009 to 2.1/100 000 children (95% CI 1.1-4.1) in 2012. In 2014, 2 years after PCV13 was withdrawn from the universal vaccination program, the incidence of bacteremic CAP increased to 5.4/100 000 children (95% CI 3.5-8.4). We enrolled 113 cases and 113 controls. Streptococcus pneumoniae caused most of bloodstream infections (78%). Empyema was associated with bacteremia (P = .003, OR 3.6; 95% CI 1.4-8.9). Simple parapneumonic effusion was not associated with bacteremia. Incomplete PCV immunization was not a risk factor for bacteremic pneumonia.

Impact of coverage-dependent marginal costs on optimal HPV vaccination strategies.

The effectiveness of vaccinating males against the human papillomavirus (HPV) remains a controversial subject. Many existing studies conclude that increasing female coverage is more effective than diverting resources into male vaccination. Recently, several empirical studies on HPV immunization have been published, providing evidence of the fact that marginal vaccination costs increase with coverage. In this study, we use a stochastic agent-based modeling framework to revisit the male vaccination debate in light of these new findings. Within this framework, we assess the impact of coverage-dependent marginal costs of vaccine distribution on optimal immunization strategies against HPV. Focusing on the two scenarios of ongoing and new vaccination programs, we analyze different resource allocation policies and their effects on overall disease burden. Our results suggest that if the costs associated with vaccinating males are relatively close to those associated with vaccinating females, then coverage-dependent, increasing marginal costs may favor vaccination strategies that entail immunization of both genders. In particular, this study emphasizes the necessity for further empirical research on the nature of coverage-dependent vaccination costs.

Blood-derived dermal langerin+ dendritic cells survey the skin in the steady state.

Langerin is a C-type lectin receptor that recognizes glycosylated patterns on pathogens. Langerin is used to identify human and mouse epidermal Langerhans cells (LCs), as well as migratory LCs in the dermis and the skin draining lymph nodes (DLNs). Using a mouse model that allows conditional ablation of langerin(+) cells in vivo, together with congenic bone marrow chimeras and parabiotic mice as tools to differentiate LC- and blood-derived dendritic cells (DCs), we have revisited the origin of langerin(+) DCs in the skin DLNs. Our results show that in contrast to the current view, langerin(+)CD8(-) DCs in the skin DLNs do not derive exclusively from migratory LCs, but also include blood-borne langerin(+) DCs that transit through the dermis before reaching the DLN. The recruitment of circulating langerin(+) DCs to the skin is dependent on endothelial selectins and CCR2, whereas their recruitment to the skin DLNs requires CCR7 and is independent of CD62L. We also show that circulating langerin(+) DCs patrol the dermis in the steady state and migrate to the skin DLNs charged with skin antigens. We propose that this is an important and previously unappreciated element of immunosurveillance that needs to be taken into account in the design of novel vaccine strategies.

Classical novae from the POINT-AGAPE microlensing survey of M31 - I. The nova catalogue

The POINT-AGAPE (Pixel-lensing Observations with the Isaac Newton Telescope-Andromeda Galaxy Amplified Pixels Experiment) survey is an optical search for gravitational microlensing events towards the Andromeda galaxy (M31). As well as microlensing, the survey is sensitive to many different classes of variable stars and transients. Here we describe the automated detection and selection pipeline used to identify M31 classical novae (CNe) and we present the resulting catalogue of 20 CN candidates observed over three seasons. CNe are observed both in the bulge region as well as over a wide area of the M31 disc. Nine of the CNe are caught during the final rise phase and all are well sampled in at least two colours. The excellent light-curve coverage has allowed us to detect and classify CNe over a wide range of speed class, from very fast to very slow. Among the light curves is a moderately fast CN exhibiting entry into a deep transition minimum, followed by its final decline. We have also observed in detail a very slow CN which faded by only 0.01 mag d(-1) over a 150-d period. We detect other interesting variable objects, including one of the longest period and most luminous Mira variables. The CN catalogue constitutes a uniquely well-sampled and objectively-selected data set with which to study the statistical properties of CNe in M31, such as the global nova rate, the reliability of novae as standard-candle distance indicators and the dependence of the nova population on stellar environment. The findings of this statistical study will be reported in a follow-up paper.

Vaccination and All Cause Child Mortality 1985-2011: Global Evidence from the Demographic and Health Surveys

Based on models with calibrated parameters for infection, case fatality rates, and vaccine efficacy, basic childhood vaccinations have been estimated to be highly cost effective. We estimate the association of vaccination with mortality directly from survey data. Using 149 cross-sectional Demographic and Health Surveys, we determine the relationship between vaccination coverage and under five mortality at the survey cluster level. Our data include approximately one million children in 68,490 clusters in 62 countries. We consider the childhood measles, Bacille Calmette-Guérin (BCG), Diphtheria-Pertussis-Tetanus (DPT), Polio, and maternal tetanus vaccinations. Using modified Poisson regression to estimate the relative risk of child mortality in each cluster, we also adjust for selection bias caused by the vaccination status of dead children not being reported. Childhood vaccination, and in particular measles and tetanus vaccination, is associated with substantial reductions in childhood mortality. We estimate that children in clusters with complete vaccination coverage have relative risk of mortality 0.73 (95% Confidence Interval: 0.68, 0.77) that of children in a cluster with no vaccination. While widely used, basic vaccines still have coverage rates well below 100% in many countries, and our results emphasize the effectiveness of increasing their coverage rates in order to reduce child mortality.

Accessibility Instrument Survey

This chapter presents the main results of the Accessibility Instrument Survey (AIS), collecting basic information on each of the accessibility instruments reviewed in this report (for more detail on these Instruments see Chapter 3). The aim of the survey was to enable quick, objective and comparable overviews of each of the reviewed accessibility instruments. The information collected will enable the categorization of accessibility instruments present in this research, aiming to be a reference for future categorization of accessibility instruments for planning practice. These categories will support the analysis of the coverage of accessibility instruments in this research, i.e., identify how representative this research is across different accessibility instrument types. In addition, these will be used to analyse the characteristics and concerns which most frequently underlie the development of accessibility instruments. Finally, the survey also collects developer’s perceptions on the usefulness of their accessibility instruments in planning practice, enabling the first insight into the main research question of this COST Action, although limited to the developer’s point of view. In summary, the results of the survey will be used for four purposes: Development of an accessibility instrument sheet for each accessibility instrument summarizing its main characteristics (Appendix A); Identify the coverage of accessibility instrument types present in this research (Section 4.3.1) discussing the representativeness of this Action; Provide a glimpse on the characteristics and concerns which most frequently underlie the development of accessibility instruments (Section 4.3.2); Provide a first insight into the perceived usefulness of accessibility instruments in planning practice from the point of view of the developer (Section 4.3.2 and Section 4.3.3). The next section provides an overview of the Survey describing the information collected. This section also describes the development process of this survey including data collection, dates and means. The results of the survey are analysed in the third section starting with a discussion on the coverage of accessibility instruments reviewed by this research (Section 4.3.1), identifying accessibility measure types which are represented and which are absent. This discussion is accompanied by the presentation of the main categories of accessibility instruments from the perspective of the end user. These categories try to summarize the main concerns planning practitioners are expected to have when searching for an accessibility instrument and is built upon some of the information collected by the survey. Following, the third section also presents a general analysis of the results (Section 4.3.2), focussing on the dominant characteristics of the accessibility instruments reviewed and on the developer’s perception of the usefulness their instrument will have for end users. The section ends with a brief cross analysis of results (Section 4.3.3) trying to identify relationships between accessibility instrument characteristics and perceptions of usefulness by developers. The fourth and last section presents the main conclusions of this study.