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Al Gunaid M, Lami F, Jarour N. A Collaborative Initiative to Strengthen Sustainable Public Health Capacity for Polio Eradication and Routine Immunization Activities in the Eastern Mediterranean Region. JMIR Public Health Surveill 2019; 5:e14664. [PMID: 31663863 PMCID: PMC6913771 DOI: 10.2196/14664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 09/01/2019] [Accepted: 09/25/2019] [Indexed: 11/13/2022] Open
Abstract
The many challenges in the Eastern Mediterranean region put the involved countries at risk of polio transmission and affect their ability to meet progress targets in eliminating vaccine-preventable diseases. The Global Health Development (GHD) and Eastern Mediterranean Public Health Network (EMPHNET) are working together on the project "Strengthening sustainable public health capacity in the Eastern Mediterranean region for polio eradication and routine immunization activities" with an overall goal of improving routine immunization, eradicating poliovirus, and controlling/eliminating or eradicating other vaccine-preventable diseases in the Eastern Mediterranean region. The aim of this manuscript is to describe the project and the achievements of GHD/EMPHNET over the last 3 years (2016-2018) to build effective surveillance and immunization systems in the Eastern Mediterranean region through the development of a sustainable and competent public health system to eradicate polio and control/eliminate vaccine-preventable diseases. This project assists the targeted Eastern Mediterranean region countries to build effective surveillance and immunization systems in an effort to expand their capacities to eradicate polio and control/eliminate other vaccine-preventable diseases. The project is streamlined with the Global Polio Eradication Initiative, the Centers for Disease Control and Prevention's Strategic Framework for Global Immunization 2016-2020, and the Polio Eradication and Endgame Strategic Plan 2013-2018. The project also supports the Global Health Security Agenda by focusing on efforts to accelerate progress toward a world safe and secure from infectious disease threats. Project activities were designed to respond to countries' needs and assist them in building their institutional and workforce capacity to effectively plan, implement, and evaluate activities to eradicate polio and strengthen routine immunization activities. The project activities covered a set of areas including surveillance of acute flaccid paralysis and other vaccine-preventable diseases, family and community engagement, workforce capacity building, improvement of data quality, management and use of information systems, use of polio assets to control/eliminate other vaccine-preventable diseases, support of countries to develop national strategies, piloting of innovative initiatives, program evaluation and accountability, and immunization strengthening. The project adopts the Global Polio Eradication Initiative strategies for assisting countries to strengthen routine immunization services, maintain highly sensitive acute flaccid paralysis surveillance, and sustain polio eradication functions.
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Affiliation(s)
- Magid Al Gunaid
- Polio and Immunization Team, Global Health Development/Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Faris Lami
- Department of Community and Family Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Najwa Jarour
- Polio and Immunization Team, Global Health Development/Eastern Mediterranean Public Health Network, Amman, Jordan
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Al-Abdallat MM, Payne DC, Alqasrawi S, Rha B, Tohme RA, Abedi GR, Al Nsour M, Iblan I, Jarour N, Farag NH, Haddadin A, Al-Sanouri T, Tamin A, Harcourt JL, Kuhar DT, Swerdlow DL, Erdman DD, Pallansch MA, Haynes LM, Gerber SI. Hospital-associated outbreak of Middle East respiratory syndrome coronavirus: a serologic, epidemiologic, and clinical description. Clin Infect Dis 2014; 59:1225-33. [PMID: 24829216 PMCID: PMC4834865 DOI: 10.1093/cid/ciu359] [Citation(s) in RCA: 235] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 05/07/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In April 2012, the Jordan Ministry of Health investigated an outbreak of lower respiratory illnesses at a hospital in Jordan; 2 fatal cases were retrospectively confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) to be the first detected cases of Middle East respiratory syndrome (MERS-CoV). METHODS Epidemiologic and clinical characteristics of selected potential cases were assessed through serum blood specimens, medical record reviews, and interviews with surviving outbreak members, household contacts, and healthcare personnel. Cases of MERS-CoV infection were identified using 3 US Centers for Disease Control and Prevention serologic tests for detection of anti-MERS-CoV antibodies. RESULTS Specimens and interviews were obtained from 124 subjects. Seven previously unconfirmed individuals tested positive for anti-MERS-CoV antibodies by at least 2 of 3 serologic tests, in addition to 2 fatal cases identified by rRT-PCR. The case-fatality rate among the 9 total cases was 22%. Six subjects were healthcare workers at the outbreak hospital, yielding an attack rate of 10% among potentially exposed outbreak hospital personnel. There was no evidence of MERS-CoV transmission at 2 transfer hospitals having acceptable infection control practices. CONCLUSIONS Novel serologic tests allowed for the detection of otherwise unrecognized cases of MERS-CoV infection among contacts in a Jordanian hospital-associated respiratory illness outbreak in April 2012, resulting in a total of 9 test-positive cases. Serologic results suggest that further spread of this outbreak to transfer hospitals did not occur. Most subjects had no major, underlying medical conditions; none were on hemodialysis. Our observed case-fatality rate was lower than has been reported from outbreaks elsewhere.
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Affiliation(s)
| | - Daniel C. Payne
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Sultan Alqasrawi
- CommunicableDiseases Directorate, Jordan Ministry of Health, Amman
| | - Brian Rha
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
- Epidemic Intelligence Service
| | - Rania A. Tohme
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Glen R. Abedi
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | | | - Ibrahim Iblan
- Field Epidemiology Training Program, Jordan Ministry of Health, Amman
| | - Najwa Jarour
- CommunicableDiseases Directorate, Jordan Ministry of Health, Amman
| | - Noha H. Farag
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aktham Haddadin
- Directorate of Laboratories, Jordan Ministry of Health, Amman
| | | | - Azaibi Tamin
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Jennifer L. Harcourt
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - David T. Kuhar
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David L. Swerdlow
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Dean D. Erdman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Mark A. Pallansch
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Lia M. Haynes
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Susan I. Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
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Al-Abdallat MM, Payne DC, Alqasrawi S, Rha B, Tohme RA, Abedi GR, Al Nsour M, Iblan I, Jarour N, Farag NH, Haddadin A, Al-Sanouri T, Tamin A, Harcourt JL, Kuhar DT, Swerdlow DL, Erdman DD, Pallansch MA, Haynes LM, Gerber SI. Hospital-associated outbreak of Middle East respiratory syndrome coronavirus: a serologic, epidemiologic, and clinical description. Clin Infect Dis 2014. [PMID: 24829216 DOI: 10.1093/cid/ciu359.hospital-associated] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND In April 2012, the Jordan Ministry of Health investigated an outbreak of lower respiratory illnesses at a hospital in Jordan; 2 fatal cases were retrospectively confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) to be the first detected cases of Middle East respiratory syndrome (MERS-CoV). METHODS Epidemiologic and clinical characteristics of selected potential cases were assessed through serum blood specimens, medical record reviews, and interviews with surviving outbreak members, household contacts, and healthcare personnel. Cases of MERS-CoV infection were identified using 3 US Centers for Disease Control and Prevention serologic tests for detection of anti-MERS-CoV antibodies. RESULTS Specimens and interviews were obtained from 124 subjects. Seven previously unconfirmed individuals tested positive for anti-MERS-CoV antibodies by at least 2 of 3 serologic tests, in addition to 2 fatal cases identified by rRT-PCR. The case-fatality rate among the 9 total cases was 22%. Six subjects were healthcare workers at the outbreak hospital, yielding an attack rate of 10% among potentially exposed outbreak hospital personnel. There was no evidence of MERS-CoV transmission at 2 transfer hospitals having acceptable infection control practices. CONCLUSIONS Novel serologic tests allowed for the detection of otherwise unrecognized cases of MERS-CoV infection among contacts in a Jordanian hospital-associated respiratory illness outbreak in April 2012, resulting in a total of 9 test-positive cases. Serologic results suggest that further spread of this outbreak to transfer hospitals did not occur. Most subjects had no major, underlying medical conditions; none were on hemodialysis. Our observed case-fatality rate was lower than has been reported from outbreaks elsewhere.
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Affiliation(s)
| | - Daniel C Payne
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Sultan Alqasrawi
- Communicable Diseases Directorate, Jordan Ministry of Health, Amman
| | - Brian Rha
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases Epidemic Intelligence Service
| | - Rania A Tohme
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Glen R Abedi
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | | | - Ibrahim Iblan
- Field Epidemiology Training Program, Jordan Ministry of Health, Amman
| | - Najwa Jarour
- Communicable Diseases Directorate, Jordan Ministry of Health, Amman
| | - Noha H Farag
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aktham Haddadin
- Directorate of Laboratories, Jordan Ministry of Health, Amman
| | | | - Azaibi Tamin
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Jennifer L Harcourt
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - David T Kuhar
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David L Swerdlow
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Dean D Erdman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Mark A Pallansch
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Lia M Haynes
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Susan I Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
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Payne DC, Iblan I, Alqasrawi S, Al Nsour M, Rha B, Tohme RA, Abedi GR, Farag NH, Haddadin A, Al Sanhouri T, Jarour N, Swerdlow DL, Jamieson DJ, Pallansch MA, Haynes LM, Gerber SI, Al Abdallat MM. Stillbirth during infection with Middle East respiratory syndrome coronavirus. J Infect Dis 2014; 209:1870-2. [PMID: 24474813 PMCID: PMC4618552 DOI: 10.1093/infdis/jiu068] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We conducted an epidemiologic investigation among survivors of an outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Jordan. A second-trimester stillbirth occurred during the course of an acute respiratory illness that was attributed to MERS-CoV on the basis of exposure history and positive results of MERS-CoV serologic testing. This is the first occurrence of stillbirth during an infection with MERS-CoV and may have bearing upon the surveillance and management of pregnant women in settings of unexplained respiratory illness potentially due to MERS-CoV. Future prospective investigations of MERS-CoV should ascertain pregnancy status and obtain further pregnancy-related data, including biological specimens for confirmatory testing.
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Affiliation(s)
- Daniel C Payne
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | | | | | | | - Brian Rha
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases Epidemic Intelligence Service
| | - Rania A Tohme
- Global Immunization Division, Center for Global Health
| | - Glen R Abedi
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Noha H Farag
- Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases
| | | | | | | | - David L Swerdlow
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Denise J Jamieson
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mark A Pallansch
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Lia M Haynes
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Susan I Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
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Jarour N, Hayajneh WA, Balbeesi A, Otoom H, Al-Shurman A, Kharabsheh S. Seroprevalence of rubella among Jordanian women of childbearing age. Vaccine 2007; 25:3615-8. [PMID: 17280747 DOI: 10.1016/j.vaccine.2007.01.058] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2006] [Revised: 12/24/2006] [Accepted: 01/11/2007] [Indexed: 10/23/2022]
Abstract
This study was conducted to assess immunity (seroprevalence) to rubella among Jordanian women of childbearing age. A multistage cluster sampling was used to recruit 1125 women of childbearing age (15-49 year) from the 12 Governorates of Jordan. Anti-rubella antibody titers were measured using enzyme-linked immunoassays. The overall immunity rate to rubella among women in childbearing age was 90.9% (CI: 88.8-92.9). However, the immunity rate was significantly lower in younger women aged 15-19 years (83%) compared to the whole cohort (P</=0.001) which means potential increased risk for congenital rubella syndrome (CRS). Immunity rates did not differ between regions and between urban and rural areas. Since the main priority is to decrease CRS among relatively susceptible cohorts, we recommend modifying the existing Expanded Program on Immunization with inclusion of a second dose of rubella vaccine at school entry (6 years of age) to decrease circulation of the virus among susceptible young females. We also recommend yearly catch-up school vaccination of young females entering the 10th grade for the next 10 years. Strengthening of rubella and CRS surveillance programs is also recommended in parallel with pre-marriage counseling regarding rubella and CRS for young females.
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Affiliation(s)
- Najwa Jarour
- Directorate of Diseases Control and Prevention, Ministry of Health, Amman, Jordan.
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