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Contagious diseases in the United States from 1888 to the present.

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      Travelling waves and spatial hierarchies in measles epidemics.

      Spatio-temporal travelling waves are striking manifestations of predator-prey and host-parasite dynamics. However, few systems are well enough documented both to detect repeated waves and to explain their interaction with spatio-temporal variations in population structure and demography. Here, we demonstrate recurrent epidemic travelling waves in an exhaustive spatio-temporal data set for measles in England and Wales. We use wavelet phase analysis, which allows for dynamical non-stationarity--a complication in interpreting spatio-temporal patterns in these and many other ecological time series. In the pre-vaccination era, conspicuous hierarchical waves of infection moved regionally from large cities to small towns; the introduction of measles vaccination restricted but did not eliminate this hierarchical contagion. A mechanistic stochastic model suggests a dynamical explanation for the waves-spread via infective 'sparks' from large 'core' cities to smaller 'satellite' towns. Thus, the spatial hierarchy of host population structure is a prerequisite for these infection waves.
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        Travelling waves in the occurrence of dengue haemorrhagic fever in Thailand.

        Dengue fever is a mosquito-borne virus that infects 50-100 million people each year. Of these infections, 200,000-500,000 occur as the severe, life-threatening form of the disease, dengue haemorrhagic fever (DHF). Large, unanticipated epidemics of DHF often overwhelm health systems. An understanding of the spatial-temporal pattern of DHF incidence would aid the allocation of resources to combat these epidemics. Here we examine the spatial-temporal dynamics of DHF incidence in a data set describing 850,000 infections occurring in 72 provinces of Thailand during the period 1983 to 1997. We use the method of empirical mode decomposition to show the existence of a spatial-temporal travelling wave in the incidence of DHF. We observe this wave in a three-year periodic component of variance, which is thought to reflect host-pathogen population dynamics. The wave emanates from Bangkok, the largest city in Thailand, moving radially at a speed of 148 km per month. This finding provides an important starting point for detecting and characterizing the key processes that contribute to the spatial-temporal dynamics of DHF in Thailand.
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          Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases.

          Vaccines are among the most effective prevention tools available to clinicians. However, the success of an immunization program depends on high rates of acceptance and coverage. There is evidence of an increase in vaccine refusal in the United States and of geographic clustering of refusals that results in outbreaks. Children with exemptions from school immunization requirements (a measure of vaccine refusal) are at increased risk for measles and pertussis and can infect others who are too young to be vaccinated, cannot be vaccinated for medical reasons, or were vaccinated but did not have a sufficient immunologic response. Clinicians can play a crucial role in parental decision making. Health care providers are cited as the most frequent source of immunization information by parents, including parents of unvaccinated children. Although some clinicians have discontinued or have considered discontinuing their provider relationship with patients who refuse vaccines, the American Academy of Pediatrics Committee on Bioethics advises against this and recommends that clinicians address vaccine refusal by respectfully listening to parental concerns and discussing the risks of nonvaccination. 2009 Massachusetts Medical Society
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            Author and article information

            Affiliations
            [1 ] From the Departments of Epidemiology (W.G.P., S.Y.J., N.S.C., H.E., D.S.B.) and Biostatistics (J.G., A.C., S.B.), Graduate School of Public Health, the Department of Medicine, School of Medicine (B.Y.L.), and the Graduate Information Science and Technology Program, School of Information Sciences (V.Z.), University of Pittsburgh, Pittsburgh; and the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore (D.C.).
            Journal
            N. Engl. J. Med.
            The New England journal of medicine
            1533-4406
            0028-4793
            Nov 28 2013
            : 369
            : 22
            10.1056/NEJMms1215400
            24283231
            4175560
            NIHMS628018

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