Pertussis outbreak in an Amish Community: Kent County, Delaware, 2018.

The Amish lead a very simplistic lifestyle free of modern conveniences. They have unique perceptions and beliefs regarding health and illness and generally do not adhere to conventional preventive measures such as immunizations, which can result in un- or under-immunized populations. Populations with low vaccination coverage are at greater risk of outbreaks compared to vaccinated populations as a result of low herd immunity.

Health data for Delaware:: The path towards creating Delaware's Environmental Public Health Tracking Network.

The environment impacts health and contributes to factors that not only protect us from disease but also increase our risk for certain negative health outcomes. The Delaware Division of Public Health (DPH) embarked on an endeavor in 2014 to provide its communities with timely, high-quality data on the environment, risk and protective factors, and health outcomes through a data sharing platform. Through strong partnerships with the Department of Natural Resources and Environmental Control and key opportunities, these efforts coalesced into the development of Delaware's Environmental Public Health Tracking Network.

The Impact of Vaccine Concerns on Racial/Ethnic Disparities in Influenza Vaccine Uptake Among Health Care Workers.

Objectives: We explored whether collective concerns about the safety, effectiveness, and necessity of influenza vaccines mediate racial/ethnic disparities in vaccine uptake among health care workers (HCWs).

Methods: We used a self-administered Web-based survey to assess race/ethnicity (exposure), concerns about influenza vaccination (mediator; categorized through latent class analysis), and influenza vaccine uptake (outcome) for the 2012 to 2013 influenza season among HCWs at St. Jude Children's Research Hospital in Memphis, Tennessee.

Inequalities in vaccination coverage for young females whose parents are informal caregivers.

The effects of caregiver strain and stress on preventive health service utilization among adult family members are well-established, but the effects of informal caregiving on children of caregivers are unknown. We aimed to assess whether inequalities in vaccination coverage (specifically human papillomavirus [HPV] and influenza) exist for females aged 9 to 17 years whose parents are informal caregivers (i.e.

Younger age distribution of cervical cancer incidence among survivors of pediatric and young adult cancers.

Background: Pediatric and young adult (PAYA) cancer survivors may have an earlier onset of chronic diseases compared with the general population. We compared the age at cervical cancer diagnosis between PAYA cancer survivors and females in the general US population.

Methods: We used longitudinal data from 9 population-based registries of the Surveillance, Epidemiology, and End Results program collected between 1973 and 2010.

Influenza vaccination coverage among adult survivors of pediatric cancer.

Background: A large proportion of long-term survivors of childhood cancer have treatment-related adverse cardiac and pulmonary late-effects, with related mortality. Consequently, this population of approximately 379,000 individuals in the U.S.

The incidence of human papillomavirus infection following treatment for cervical neoplasia: a systematic review.

Objective: To systematically review the published literature in order to estimate the incidence and describe the variability of human papillomavirus (HPV) infection in women following treatment for cervical neoplasia.

Methods: Several scientific literature databases (e.g.

Guillain-Barre syndrome following quadrivalent human papillomavirus vaccination among vaccine-eligible individuals in the United States.

Post-marketing surveillance studies provide conflicting evidence about whether Guillain-Barre syndrome occurs more frequently following quadrivalent human papillomavirus (HPV4) vaccination. We aimed to assess whether Guillain-Barre syndrome is reported more frequently following HPV4 vaccination than other vaccinations among females and males aged 9 to 26 y in the United States. We used adverse event reports received by the United States Vaccine Adverse Event Reporting System (VAERS) between January 1, 2010 and December 31, 2012 to estimate overall, age-, and sex-specific proportional reporting ratios (PRRs) and corresponding Χ2 values for reports of Guillain-Barre syndrome between 5 and 42 d following HPV vaccination.

Human papillomavirus-associated subsequent malignancies among long-term survivors of pediatric and young adult cancers.

Long-term survivors of pediatric and young adult (PAYA) cancers have a high incidence of subsequent neoplasms, but few risk factors other than cancer treatment have been identified. We aimed to describe the burden of human papillomavirus (HPV)-associated malignancies among survivors of PAYA cancers to assess whether HPV infections might be a reasonable area of future etiologic research on subsequent malignancies in this population. We used longitudinal data from 9 population-based registries of the Surveillance, Epidemiology, and End Results program collected between 1973 and 2010 to assemble a cohort of individuals who were diagnosed with any cancer between the ages of 0 and 29 years and survived at least 5 years post-diagnosis.

The accuracy of human papillomavirus vaccination status based on adult proxy recall or household immunization records for adolescent females in the United States: results from the National Immunization Survey-Teen.

Purpose: We assessed the accuracy of human papillomavirus (HPV) vaccination status based on adult proxy recall and household immunization records for adolescent females in the United States.

Methods: We used data from the 2010 National Immunization Survey-Teen for females aged 13 to 17 years. The accuracy of HPV vaccination status (≥1 dose) based on adult proxy recall (unweighted n = 6868) and household immunization records (unweighted n = 2216) was assessed by estimating the sensitivity, specificity, and corresponding 95% confidence limits (CL) of these measures with provider-reported HPV vaccination status as the reference standard.

Epidemiology, policy, and racial/ethnic minority health disparities.

Purpose: Epidemiologists have long contributed to policy efforts to address health disparities. Three examples illustrate how epidemiologists have addressed health disparities in the United States and abroad through a "social determinants of health" lens.

Methods: To identify examples of how epidemiologic research has been applied to reduce health disparities, we queried epidemiologists engaged in disparities research in the United States, Canada, and New Zealand, and drew upon the scientific literature.

Correlation coefficients in ecologic studies of environment and cancer.

The objective of this study was to determine the proportion of ecologic studies published during a 20-year period regarding environmental exposures and cancer in which correlation coefficients or coefficients of determination were used as a measure of association. The authors performed a descriptive analysis of published literature by conducting a systematic review of PubMed to identify eligible ecologic studies published between 1991 and 2010. The reported measure of association was extracted for all eligible studies.