Measuring Pandemic Impact: Vital Signs From Vital Statistics.

Kiang and colleagues' study emphasizes that deaths directly related to SARS-CoV-2 infection tell only part of the story. Many deaths are likely to be attributable to indirect consequences of the pandemic, including those associated with disruptions in health care systems and the economic and social hardships endured by many people. The editorial discusses the importance of national vital statistics to health and emergency preparedness systems in the United States.

The new vaccine frontier.

Vaccines are one of the greatest public health achievements and have had a tremendous impact on people's health and survival around the world. Nevertheless, highly prevalent infectious disease threats unresponsive to traditional immunization strategies, emerging and re-emerging threats, and non-communicable diseases amenable to immunization remain critical global health challenges. Scientific advances will reveal solutions, but it will take political, social and economic commitment from all stakeholders for these solutions to achieve their health protection benefit among the people who need them most.

Healthcare epidemiology: past and future.

Healthcare epidemiology is a robust and adaptable profession with the noble mission of protecting patients and their healthcare providers from infectious diseases and other threats. Change is the constant that links the successes of our field in each decade of our history. Although it is not possible to predict what specific challenges the next decade will bring, the themes of the Sixth Decennial International Conference in 2020 are likely to reflect the most prominent drivers of change that are affecting our profession, including globalization, sustainability, and consumer empowerment.

Management of occupational and nonoccupational postexposure HIV prophylaxis.

The principles of managing patients with recent HIV exposures are similar whether the exposure occurs in an occupational or nonoccupational setting. For both settings, clinicians should 1) assess the likelihood that HIV and other bloodborne viruses will be transmitted as a consequence of the exposure; 2) advise the patient about the risks and benefits of treatment; 3) choose an appropriate antiretroviral treatment regimen (if the decision is made to treat); 4) screen for other illnesses that may complicate treatment or follow-up; 5) counsel patients about the importance of adhering to treatment; 6) promote safe-sex practices and methods to avoid future exposures; 7) follow the patient for potential side effects of treatment; 8) provide follow-up care including repeat HIV testing for seroconversion, surveillance for primary HIV infection, and reinforcement of counseling messages.

Medicine. The need for a global HIV vaccine enterprise.

A new collaborative model of research is needed to increase resources, to prioritize the R (ii) to increase the pace, reduce the overlap, and more systematically explore the elements of and delivery systems for vaccines; (iii) to use common standards for the prompt comparative testing of vaccine candidates; (iv) to expand resources for manufacturing vaccine candidates to speed their use in human trials; and (v) to increase the capacity for international clinical trials and to focus this effort toward quickly measuring the effectiveness of vaccine protection as prototype vaccine candidates are identified.

Management of Occupational and Nonoccupational Postexposure HIV Prophylaxis.

The principles of managing patients with recent HIV exposure are similar whether the exposure occurs in an occupational or nonoccupational setting. For both settings, clinicians should assess the likelihood that HIV and other bloodborne viruses will be transmitted as a consequence of the exposure; advise the patient about the risks and benefits of treatment; choose an appropriate antiretroviral treatment regimen (if the decision is made to treat); screen for other illnesses that may complicate treatment or follow-up; counsel patients about the importance of adhering to treatment; promote safe-sex practices and methods to avoid future exposures; follow the patient for potential side effects of treatment; and provide follow-up care including repeat HIV testing for seroconversion, surveillance for primary HIV infection, and reinforcement of counseling messages.

Epidemiology of vancomycin-resistant Enterococcus faecium under a selective isolation policy at an urban county hospital.

Background: We report our experience in a county hospital with the use of selective contact isolation for patients with vancomycin-resistant Enterococcus faecium (VREF). About 12% of patients with VREF are isolated for reasons such as draining wounds and uncontrolled diarrhea.

Methods: Passive surveillance identified all inpatients (181) from 1995 to 1999 with cultures positive for VREF.

Hospital-onset infections: a patient safety issue.

Hospital-onset infections, particularly those involving the urinary tract, lung, and bloodstream, are common and costly and cause substantial morbidity. This article analyzes the case of a 78-year-old man with lung cancer who died after developing hospital-onset pneumonia and urinary catheter-related infection during hospitalization for elective removal of a cerebellar metastasis. The field of infection control could benefit by adopting several approaches advocated by patient safety adherents, such as root-cause analysis.