surveillance

Protecting privacy in an age of surveillance

Is true privacy even possible in the internet age, and what is at stake if we don't protect what we have left?




surveillance

Surveillance of eagles




surveillance

Aged care royal commission told of need to install surveillance to stop elder abuse

A former ABC journalist, who pressed assault charges after her elderly mother was allegedly hit by a carer, urges Australians with family members in aged-care to install personal surveillance equipment.




surveillance

Mystery shopper surveillance ramped up to ensure consumers get what they pay for

Shopping these days is no private affair as shopper surveillance ramps up towards the Christmas period. What you might not be aware of is that traders and their employees are also being keenly observed.




surveillance

Police say the gunman was under electronic surveillance

The 45-year-old was on parole after over a year's imprisonment.




surveillance

Utah Pulls Plug On Surveillance Contractor After CEO's Past As A White Supremacist Surfaces

A couple of months ago, a records request revealed a private surveillance contractor had access to nearly every piece of surveillance equipment owned and operated by the state of Utah. Banjo was the company with its pens in all of the state's ink. Banjo's algorithm ran on top of Utah's surveillance gear: CCTV systems, 911 services, location data for government vehicles, and thousands of traffic cameras.

All of this was run through Banjo's servers, which are conveniently located in Utah government buildings. Banjo's offering is of the predictive policing variety. The CEO claims its software can "find crime" without any collateral damage to privacy. This claim is based on the "anonymization" of harvested data -- a term that is essentially meaningless once enough data is collected.

This partnership is now on the rocks, thanks to an investigation by Matt Stroud and OneZero. Banjo's CEO, Damien Patton, apparently spent a lot of his formative years hanging around with white supremacists while committing crimes.

In grand jury testimony that ultimately led to the conviction of two of his associates, Patton revealed that, as a 17-year-old, he was involved with the Dixie Knights of the Ku Klux Klan. On the evening of June 9, 1990 — a month before Patton turned 18 — Patton and a Klan leader took a semi-automatic TEC-9 pistol and drove to a synagogue in a Nashville suburb. With Patton at the wheel, the Ku Klux Klan member fired onto the synagogue, destroying a street-facing window and spraying bullets and shattered glass near the building’s administrative offices, which were next to that of the congregation’s rabbi. No one was struck or killed in the shooting. Afterward, Patton hid on the grounds of a white supremacist paramilitary training camp under construction before fleeing the state with the help of a second Klan member.

If you're wondering where the state of Utah's due diligence is in all of this, there's a partial explanation for this lapse: the feds, who brought Patton in, screwed up on their paperwork.

Because Patton’s name was misspelled in the initial affidavit of probable cause filed in Brown’s case — an FBI agent apparently spelled Damien with an “o” rather than an “e” — any search of a federal criminal court database for “Damien Patton” would not have surfaced the affidavit.

Now that his past has been exposed, the state of Utah has announced it won't be working with Banjo.

The Utah attorney general’s office will suspend use of a massive surveillance system after a news report showed that the founder of the company behind the effort was once an active participant in a white supremacist group and was involved in the shooting of a synagogue.

The AG's office can only shut down so much of Banjo's surveillance software. Other government agencies not directly controlled by the state AG are making their own judgment calls. The University of Utah is suspending its contract with Banjo, but the state's Department of Public Safety has only gone so far as to "launch a review" of its partnership with the company. City agencies and a number of police departments who have contracts with Banjo have yet to state whether they will be terminating theirs.

And the AG's reaction isn't a ban. The office appears to believe it might be able to work through this.

“While we believe Mr. Patton’s remorse is sincere and believe people can change, we feel it’s best to suspend use of Banjo technology by the Utah attorney general’s office while we implement a third-party audit and advisory committee to address issues like data privacy and possible bias,” Piatt said. “We recommend other state agencies do the same.

It's refreshing to hear a prosecutor state that it's possible for former criminals to turn their lives around and become positive additions to their communities, but one gets the feeling this sort of forgiveness is only extended to ex-cons who have something to offer law enforcement agencies. Everyone else is just their rap sheet for forever, no matter how many years it's been since their last arrest.

The other problem here is the DA's office's tacit admission it did not take data privacy or possible bias into account before granting Banjo access to the state's surveillance equipment, allowing it to set up servers in government buildings, and giving it free rein to dust everything with its unaudited AI pixie dust.

These are all steps that should have taken place before any of this was implemented, even if the state had chosen to do business with a company with a less controversial CEO. This immediate reaction is the right step to take, but a little proactivity now and then would be a welcome change.




surveillance

As More Students Sit Online Exams Under Lockdown Conditions, Remote Proctoring Services Carry Out Intrusive Surveillance

The coronavirus pandemic and its associated lockdown in most countries has forced major changes in the way people live, work and study. Online learning is now routine for many, and is largely unproblematic, not least because it has been used for many years. However, online testing is more tricky, since there is a concern by many teachers that students might use their isolated situation to cheat during exams. One person's problem is another person's opportunity, and there are a number of proctoring services that claim to stop or at least minimize cheating during online tests. One thing they have in common is that they tend to be intrusive, and show little respect for the privacy of the people they monitor.

As an article in The Verge explains, some employ humans to watch over students using Zoom video calls. That's reasonably close to a traditional setup, where a teacher or proctor watches students in an exam hall. But there are also webcam-based automated approaches, as explored by Vox:

For instance, Examity also uses AI to verify students' identities, analyze their keystrokes, and, of course, ensure they're not cheating. Proctorio uses artificial intelligence to conduct gaze detection, which tracks whether a student is looking away from their screens.

It's not just in the US that these extreme surveillance methods are being adopted. In France, the University of Rennes 1 is using a system called Managexam, which adds a few extra features: the ability to detect "inappropriate" Internet searches by the student, the use of a second screen, or the presence of another person in the room (original in French). The Vox articles notes that even when these systems are deployed, students still try to cheat using new tricks, and the anti-cheating services try to stop them doing so:

it's easy to find online tips and tricks for duping remote proctoring services. Some suggest hiding notes underneath the view of the camera or setting up a secret laptop. It's also easy for these remote proctoring services to find out about these cheating methods, so they're constantly coming up with countermeasures. On its website, Proctorio even has a job listing for a "professional cheater" to test its system. The contract position pays between $10,000 and $20,000 a year.

As the arms race between students and proctoring services escalates, it's surely time to ask whether the problem isn't people cheating, but the use of old-style, analog testing formats in a world that has been forced by the coronavirus pandemic to move to a completely digital approach. Rather than spending so much time, effort and money on trying to stop students from cheating, maybe we need to come up with new ways of measuring what they have learnt and understood -- ones that are not immune to cheating, but where cheating has no meaning. Obvious options include "open book" exams, where students can use whatever resources they like, or even abolishing formal exams completely, and opting for continuous assessment. Since the lockdown has forced educational establishments to re-invent teaching, isn't it time they re-invented exams too?

Follow me @glynmoody on Twitter, Diaspora, or Mastodon.




surveillance

Editorial: Can we still fight the coronavirus while holding the surveillance state at bay?

Some of the most effective strategies at containing the coronavirus are also the most intrusive. Can we adopt them without damaging our liberties?




surveillance

Lawmakers warn coronavirus contact-tracing is ripe for abusive surveillance

Silicon Valley can come up with apps that might free Americans from home confinement. But Washington fears creating an invasive surveillance system.




surveillance

Surveillance State: NSA Spying and more

At the start of June 2013, a large number of documents detailing surveillance by intelligence agencies such as the US’s NSA and UK’s GCHQ started to be revealed, based on information supplied by NSA whistle blower, Edward Snowden.

These leaks revealed a massive surveillance program that included interception of email and other Internet communications and phone call tapping. Some of it appears illegal, while other revelations show the US spying on friendly nations during various international summits.

Unsurprisingly, there has been a lot of furor. While some countries are no doubt using this to win some diplomatic points, there has been an increase in tension with the US and other regions around the world.

Much of the US surveillance programs came from the aftermath of the 9-11 terrorist attacks on the US in 2001. Concerns about a crackdown on civil rights in the wake of the so-called war on terror have been expressed for a long time, and these revelations seem to be confirming some of those fears.

Given the widespread collection of information, apparently from central servers of major Internet companies and from other core servers that form part of the Internet backbone, activities of millions (if not billions) of citizens have been caught up in a dragnet style surveillance problem called PRISM, even when the communication has nothing to do with terrorism.

What impacts would such secretive mass surveillance have on democracy?

Read full article: Surveillance State: NSA Spying and more




surveillance

After Paris Attacks, CIA Head Reignites Surveillance Debate

Just days after the attack in Paris, America’s top intelligence official suggested that recent leaks about classified surveillance programs were partially responsible.




surveillance

Employee-surveillance software is not welcome to integrate with Basecamp

We’ve been teaching people how to do remote work well for the better part of two decades. We wrote a whole book about the topic in 2013, called REMOTE: Office Not Required. Basecamp has been a remote company since day one, and our software is sold as an all-in-one toolkit for remote work. Yeah, we’re… keep reading




surveillance

CBD News: The World Health Organization's objective of scaling up the prevention, care, and surveillance of diabetes on World Health Day 2016 provides a timely opportunity to reflect upon the profound impacts of biodiversity loss and its consequences




surveillance

Infectious diseases in children and adolescents in China: analysis of national surveillance data from 2008 to 2017




surveillance

As Governments Build Advanced Surveillance Systems to Push Borders Out, Will Travel and Migration Become Unequal for Some Groups?

As governments seek to push their borders out by amassing ever more data on travelers and migrants, their creation of increasingly complex border surveillance systems and use of risk-assessment technologies could ease mobility for some while rendering other groups immobile based on hypothetical risk profiles and decisions that are not publicly known and cannot be challenged, as this article explores.




surveillance

How face surveillance threatens your privacy and freedom | Kade Crockford

Privacy isn't dead, but face surveillance technology might kill it, says civil rights advocate Kade Crockford. In an eye-opening talk, Kade outlines the startling reasons why this invasive technology -- powered by often-flawed facial recognition databases that track people without their knowledge -- poses unprecedented threats to your fundamental rights. Learn what can be done to ban government use before it's too late.




surveillance

Imputation and post-selection inference in models with missing data: An application to colorectal cancer surveillance guidelines

Lin Liu, Yuqi Qiu, Loki Natarajan, Karen Messer.

Source: The Annals of Applied Statistics, Volume 13, Number 3, 1370--1396.

Abstract:
It is common to encounter missing data among the potential predictor variables in the setting of model selection. For example, in a recent study we attempted to improve the US guidelines for risk stratification after screening colonoscopy ( Cancer Causes Control 27 (2016) 1175–1185), with the aim to help reduce both overuse and underuse of follow-on surveillance colonoscopy. The goal was to incorporate selected additional informative variables into a neoplasia risk-prediction model, going beyond the three currently established risk factors, using a large dataset pooled from seven different prospective studies in North America. Unfortunately, not all candidate variables were collected in all studies, so that one or more important potential predictors were missing on over half of the subjects. Thus, while variable selection was a main focus of the study, it was necessary to address the substantial amount of missing data. Multiple imputation can effectively address missing data, and there are also good approaches to incorporate the variable selection process into model-based confidence intervals. However, there is not consensus on appropriate methods of inference which address both issues simultaneously. Our goal here is to study the properties of model-based confidence intervals in the setting of imputation for missing data followed by variable selection. We use both simulation and theory to compare three approaches to such post-imputation-selection inference: a multiple-imputation approach based on Rubin’s Rules for variance estimation ( Comput. Statist. Data Anal. 71 (2014) 758–770); a single imputation-selection followed by bootstrap percentile confidence intervals; and a new bootstrap model-averaging approach presented here, following Efron ( J. Amer. Statist. Assoc. 109 (2014) 991–1007). We investigate relative strengths and weaknesses of each method. The “Rubin’s Rules” multiple imputation estimator can have severe undercoverage, and is not recommended. The imputation-selection estimator with bootstrap percentile confidence intervals works well. The bootstrap-model-averaged estimator, with the “Efron’s Rules” estimated variance, may be preferred if the true effect sizes are moderate. We apply these results to the colorectal neoplasia risk-prediction problem which motivated the present work.




surveillance

Obesity Disparities Among Elementary-Aged Children: Data From School-Based BMI Surveillance

Nationally representative surveys provide insight into overall childhood obesity trends and disparities but do not identify patterns specific to individual states. School-based surveillance is recommended, but it is unclear whether surveillance is helping to identify children at greatest risk.

This study includes 3 consecutive years of surveillance findings to describe within-state spatial and socioeconomic disparities in obesity among elementary-aged children. Implications for states using and considering school-based surveillance to plan preventive interventions are considered. (Read the full article)




surveillance

Clinical Characteristics of Pediatric Myasthenia: A Surveillance Study

Pediatric myasthenia encompasses a group of rare and underdiagnosed conditions affecting the neuromuscular junction. Symptoms include fluctuating skeletal muscle weakness, which can progress to respiratory failure if left untreated. The autoimmune form of this condition, in particular, is treatable.

This study describes the incidence, clinical features, diagnostic testing, and treatment trends of pediatric myasthenia in Canada, which have not been previously reported in the literature. (Read the full article)




surveillance

Using Electronic Health Records to Conduct Children's Health Insurance Surveillance

Stable health insurance coverage facilitates access to health care. Despite expanded coverage options for children, parents report barriers to accessing insurance programs for their children, including uncertainty about a child’s coverage status and eligibility.

Electronic health records can be used as an emerging data source for conducting health insurance surveillance to track trends in patients’ insurance coverage status, and to identify patients who may benefit from outreach and support to obtain and maintain coverage. (Read the full article)




surveillance

Genetic Mutations Associated with Isoniazid Resistance in Mycobacterium tuberculosis in Mongolia [Epidemiology and Surveillance]

Globally, mutations in the katG gene account for the majority of isoniazid-resistant strains of Mycobacterium tuberculosis. Buyankhishig et al analyzed a limited number of Mycobacterium tuberculosis strains in Mongolia and found that isoniazid resistance was mainly attributable to inhA mutations. The GenoType® MTBDRplus assay was performed for isolates collected in the First National Tuberculosis Prevalence Survey and the Third Anti-Tuberculosis Drug Resistance Survey to investigate genetic mutations associated with isoniazid resistance in Mycobacterium tuberculosis in Mongolia. Of the 409 isoniazid-resistant isolates detected by the GenoType® MTBDRplus assay, 127 (31.1%) were resistant to rifampicin, 294 (71.9%) had inhA mutations without katG mutations, 113 (27.6%) had katG mutations without inhA mutations, and two (0.5%) strains had mutations in both the inhA and katG genes. Of the 115 strains with any katG mutation, 114 (99.1%) had mutations in codon 315 (S315T). Of the 296 trains with any inhA mutation, 290 (98.0%) had a C–15T mutation. The proportion of isoniazid-resistant strains with katG mutations was 25.3% among new cases and 36.2% among retreatment cases (p=0.03), as well as 17.0% among rifampicin-susceptible strains and 52.8% among rifampicin-resistant strains (p<0.01). Rifampicin resistance was significantly associated with the katG mutation (adjusted odds ratio 5.36, 95% CI 3.3–8.67, p<0.001). Mutations in inhA predominated in isoniazid-resistant tuberculosis in Mongolia. However, the proportion of katG mutations in isolates from previously treated cases was higher than that among new cases, and that in cases with rifampicin resistance was higher than that in cases without rifampicin resistance.




surveillance

Prediction of antibiotic susceptibility for urinary tract infection in a hospital setting [Epidemiology and Surveillance]

Objectives: Empiric antibiotic prescribing can be supported by guidelines and/or local antibiograms, but these have limitations. We sought to use data from a comprehensive electronic health record to use statistical learning to develop predictive models for individual antibiotics that incorporate patient-, and hospital-specific factors. This paper reports on the development and validation of these models on a large retrospective cohort.

Methods: This is a retrospective cohort study including hospitalized patients with positive urine cultures in the first 48 hours of hospitalization at a 1500 bed, tertiary care hospital over a 4.5 year period. All first urine cultures with susceptibilities were included. Statistical learning techniques, including penalized logistic regression, were used to create predictive models for cefazolin, ceftriaxone, ciprofloxacin, cefepime, and piperacillin-tazobactam. These were validated on a held-out cohort.

Results: The final dataset used for analysis included 6,366 patients. Final model covariates included demographics, comorbidity score, recent antibiotic use, recent antimicrobial resistance, and antibiotic allergies. Models had acceptable to good discrimination in the training dataset and acceptable performance in the validation dataset, with a point estimate for area under the receiver operating characteristic curve (AUC) that ranged from 0.65 for ceftriaxone to 0.69 for cefazolin. All models had excellent calibration.

Conclusion: In this study we used electronic health record data to create predictive models to estimate antibiotic susceptibilities for UTIs in hospitalized patients. Our models had acceptable performance in a held-out validation cohort.




surveillance

Emergence of Mycobacterium leprae rifampicin resistance evaluated by whole-genome sequencing after 48 years of irregular treatment [Epidemiology and Surveillance]

A case of M. leprae rifampicin resistance after irregular anti-leprosy treatments since 1971 is reported. Whole-genome sequencing from four longitudinal samples indicated relapse due to acquired rifampicin resistance and not to reinfection with another strain. A putative compensatory mutation in rpoC was also detected. Clinical improvement was achieved using an alternative therapy.




surveillance

Impact of vanA-positive Enterococcus faecium exhibiting diverse susceptibility phenotypes to glycopeptides on 30-day mortality of patients with a bloodstream infection [Epidemiology and Surveillance]

Introduction: This study was performed to evaluate the impacts of vanA-positivity of Enterococcus faecium (EFM) exhibiting diverse susceptibility phenotypes to glycopeptides on clinical outcomes in patients with a bloodstream infection (BSI) through a prospective, multicenter, observational study.

Methods: A total of 509 patients with an EFM BSI from eight sentinel hospitals in South Korea during a two-year period were enrolled in this study. Risk factors of the hosts and causative EFM isolates were assessed to determine associations with the 30-day mortality of EFM BSI patients via multivariable logistic regression analyses.

Results: The vanA gene was detected in 35.2% (179/509) of EFM isolates; 131 EFM isolates exhibited typical VanA phenotypes (group vanA-VanA), while the remaining 48 EFM isolates exhibited atypical phenotypes (group vanA-Atypical), including VanD (n = 43) and vancomycin-variable phenotypes (n = 5). A multivariable logistic regression indicated that vanA-positivity of causative pathogens was independently associated with the increased 30-day mortality rate in the patients with an EFM BSI; however, there was no significant difference in the survival rates between the patients of the vanA-VanA and vanA-Atypical groups (log-rank test, P = 0.904).

Conclusions: A high 30-day mortality rate was observed in patients with vanA-positive EFM BSIs, and vanA-positivity of causative EFM was an independent risk factor for early mortality irrespective of the susceptibility phenotypes to glycopeptides; thus, intensified antimicrobial stewardship is needed to improve clinical outcome of patients with vanA-positive EFM BSI.




surveillance

Comparative Genomic Analysis of Third Generation Cephalosporin-Resistant Escherichia coli Harboring blaCMY-2-Positive IncI1 group, IncB/O/K/Z, and IncC Plasmids Isolated from Healthy Broilers in Japan. [Epidemiology and Surveillance]

The off-label use of third generation cephalosporin (3GC) during in ovo vaccination or vaccination of newly hatched chicks, was a common practice worldwide. CMY-2-producing Escherichia coli have been disseminated among broiler production. The objectives of this study were to determine the epidemiological linkage of blaCMY-2-positive plasmids among broilers both within and outside Japan because grandparent stock and parent stock were imported in Japan. We examined the whole genome sequences of 132 3GC-resistant E. coli isolates collected from healthy broilers during 2002-2014. The predominant 3GC-resistance gene was blaCMY-2, which was detected in the plasmids of 87 (65.9%) isolates. The main plasmid replicon types were IncI1-I (n=21; 24.1%), IncI (n=12; 13.8%), IncB/O/K/Z (n=28; 32.2%), and IncC (n=22; 25.3%). Those plasmids were subjected to gene clustering and network analyses and plasmid multi-locus sequence typing (pMLST). The chromosomal DNA of isolates was subjected to MLST and single nucleotide variant (SNV)-based phylogenetic analysis.

MLST and SNV-based phylogenetic analysis revealed high diversity of E. coli isolates. ST429 harboring blaCMY-2-positive IncB/O/K/Z was closely related to isolates from broiler in Germany harboring blaCMY-2-positive IncB/O/K/Z. pST55-IncI and pST12-IncI1-I and pST3-IncC were prevalent in western Japan. pST12-IncI1-I and pST3-IncC were closely related to those detected in E. coli isolates from chicken in American continent, whereas 26 IncB/O/K/Z were related to those in Europe. These data will be useful to reveal the whole picture of transmission of CMY-2-producing bacteria in and out of Japan.




surveillance

DDA begins annual surveillance for emerald ash borer (EAB)

With the arrival of summer, the Delaware Department of Agriculture (DDA) Forest Service and Plant Industries sections would like to alert homeowners, campers, and tree care professionals to look for signs or symptoms of emerald ash borer, otherwise known as EAB, a destructive wood-boring pest of ash trees. At the same time, DDA is beginning its own annual surveillance to look for EAB in the First State. EAB has been found in 25 states, including those in the Mid-Atlantic nearest to Delaware (Maryland, New Jersey, New York, Pennsylvania, and Virginia). The nearest known location of EAB to Delaware is in Montgomery County, Pennsylvania, just north of Philadelphia.



  • Department of Agriculture
  • Forest Service
  • ash trees
  • DDA Plant Industries
  • Delaware Department of Agriculture
  • Delaware Forest Service
  • emerald ash borer

surveillance

DPH Releases First Drug Overdose Mortality Surveillance Report

WILMINGTON  – For the first time, the Delaware Division of Public Health (DPH) through the integration of 12 multi-agency datasets, has developed a demographic picture of the Delawareans who died from drug overdoses in 2017. DPH released the Drug Overdose Mortality Surveillance Report, Delaware, 2017, in Wilmington on Wednesday, Aug. 14, 2019. In addition to […]




surveillance

How to setup a surveillance system for your business

  While the title might set off alarm bells for some of you folks it isn’t that bad an idea to have eyes on everything and everyone all the time. Surveillance is sometimes a necessity and sometime...




surveillance

India's Covid-19 app fuels worries over authoritarianism and surveillance

State-built Aarogya Setu has had record downloads but critics warn of civil liberties implications

Narendra Modi’s request was simple: to help combat the spread of coronavirus, people should download an Indian government-built smartphone app that helps identify their risk of catching and spreading the virus.

“As more and more people use it, its effectiveness will increase,” the prime minister said in a televised address last month.

Continue reading...



















surveillance

Countries must return to public health surveillance in COVID-19 fight -WHO

Countries must return to "basic principles" of public health surveillance if they are to bring the coronavirus outbreak under control, the World Health Organization's (WHO) top emergency health expert Mike Ryan said on Friday (May 8).




surveillance

Countries must return to public health surveillance in COVID-19 fight -WHO

Countries must return to "basic principles" of public health surveillance if they are to bring the coronavirus outbreak under control, the World Health Organization's (WHO) top emergency health expert Mike Ryan said on Friday (May 8).




surveillance

Nanopore Sequencing Reveals Novel Targets for Detection and Surveillance of Human and Avian Influenza A Viruses [Virology]

Accurate detection of influenza A virus (IAV) is crucial for patient management, infection control, and epidemiological surveillance. The World Health Organization and the Centers for Disease Control and Prevention have recommended using the M gene as the diagnostic gene target for reverse-transcription-PCR (RT-PCR). However, M gene RT-PCR has reduced sensitivity for recent IAV due to novel gene mutations. Here, we sought to identify novel diagnostic targets for the molecular detection of IAV using long-read third-generation sequencing. Direct nanopore sequencing from 18 nasopharyngeal specimens and one saliva specimen showed that the 5' and 3' ends of the PB2 gene and the entire NS gene were highly abundant. Primers selected for PB2 and NS genes were well matched with seasonal or avian IAV gene sequences. Our novel PB2 and NS gene real-time RT-PCR assays showed limits of detection similar to or lower than that of M gene RT-PCR and achieved 100% sensitivity and specificity in the detection of A(H1N1), A(H3N2), and A(H7N9) in nasopharyngeal and saliva specimens. For 10 patients with IAV detected by M gene RT-PCR conversion in sequentially collected specimens, NS and/or PB2 gene RT-PCR was positive in 2 (20%) of the initial specimens that were missed by M gene RT-PCR. In conclusion, we have shown that PB2 or NS gene RT-PCRs are suitable alternatives to the recommended M gene RT-PCR for diagnosis of IAV. Long-read nanopore sequencing facilitates the identification of novel diagnostic targets.




surveillance

Screening and surveillance in respiratory medicine

We are already a couple of months into 2020 and I hope you had a good start to the new year. I wish you, our readers, reviewers, authors and editors, happiness, success and health in this new decade.




surveillance

Respiratory surveillance in mineral dust-exposed workers

Recently, there has been a worldwide resurgence in pneumoconiosis, or pulmonary fibrosis due to occupational mineral dust exposure. In Queensland, Australia, there has been a re-emergence of coal workers' pneumoconiosis and silicosis. Some coal mining communities have experienced a resurgence of progressive massive fibrosis in the USA and a worldwide epidemic is occurring of accelerated silicosis due to exposure to artificial stone.

These diseases are all preventable and should not be occurring in the 21st century. Best practice prevention includes reduction of exposure to mineral dusts or, ideally, prevention of exposure altogether. However, where dust exposure has occurred, respiratory surveillance can provide a strategy for early disease detection. It is important to identify early signs of occupational lung disease at a stage where intervention may be beneficial, though it must be acknowledged that progression may occur even after cessation of exposure to dusts. Respiratory surveillance should be distinguished from population screening and case finding, which are different methods used for disease investigation and control. Designing an ideal respiratory surveillance programme is challenging, as there is no single test that accurately identifies early disease. Several different respiratory disorders may occur related to the same exposure(s). Physicians organising and interpreting tests used in respiratory surveillance must be aware of the broad range of potential work-related respiratory conditions, complexities in diagnosis, and appropriate interpretation of the exposure history, as well as current management options. A working knowledge of the compensation and medicolegal avenues available to workers in individual jurisdictions is also useful.

Key points

  • Mineral dust exposure causes a number of conditions, including those specific to dust exposures, such as the pneumoconioses (or pulmonary fibroses due to mineral dust exposure), and others that may additionally be related to other causes, such as COPD.

  • Identification of multiple conditions using respiratory investigations requires expert interpretation and understanding of the range of potential conditions.

  • The frequency and content of a respiratory surveillance programme will vary according to the relevant occupational exposures, and be affected by both medical and nonmedical factors, including the background prevalence of local diseases. A programme will also need to consider other factors such as local legislation, availability of resources, worker convenience and cost.

  • Educational aims

  • To identify the large range of respiratory diseases caused by exposure to mineral dusts and identify the range of tests that may be used in a surveillance programme for occupational respiratory disorders.

  • To highlight difficulties that might be experienced by medical practitioners in designing and operating an effective surveillance programme, while incorporating rapidly advancing medical technology and practice.




    surveillance

    Co-occurrence of Plasmid-Mediated Tigecycline and Carbapenem Resistance in Acinetobacter spp. from Waterfowls and Their Neighboring Environment [Epidemiology and Surveillance]

    Tigecycline serves as one of the antibiotics of last resort to treat multidrug-resistant (including carbapenem-resistant) pathogens. However, the recently emerged plasmid-mediated tigecycline resistance mechanism, Tet(X), challenges the clinical efficacy of this class of antibiotics. In this study, we detected 180 tet(X)-harboring Acinetobacter isolates (8.9%, n = 180) from 2,018 samples collected from avian farms and adjacent environments in China. Eighteen tet(X)-harboring isolates (10.0%) were found to cocarry the carbapenemase gene blaNDM-1, mostly from waterfowl samples (94.4%, 17/18). Interestingly, among six Acinetobacter strains, tet(X) and blaNDM-1 were found to colocalize on the same plasmids. Moreover, whole-genome sequencing (WGS) revealed a novel orthologue of tet(X) in the six isolates coharboring tet(X) and blaNDM-1. Inverse PCR suggested that the two tet(X) genes form a single transposable unit and may be cotransferred. Sequence comparison between six tet(X)- and blaNDM-1-coharboring plasmids showed that they shared a highly homologous plasmid backbone even though they were isolated from different Acinetobacter species (three from Acinetobacter indicus, two from Acinetobacter schindleri, and one from Acinetobacter lwoffii) from various sources and from different geological regions, suggesting the horizontal genetic transfer of a common tet(X)- and blaNDM-1-coharboring plasmid among Acinetobacter species in China. Emergence and spread of such plasmids and strains are of great clinical concern, and measures must be implemented to avoid their dissemination.