RESUMEN
In response to the 1984 St. Louis encephalitis (SLE) epidemic in the Los Angeles Basin of southern California (USA), an investigative program was initiated to evaluate the interactive components of the SLE virus transmission cycle. From 1987 through 1996 (10 yr), 52,589 birds were bled and their sera tested for SLE and western equine encephalomyelitis (WEE) virus antibodies by the hemagglutination inhibition (HAI) test. Eighty-three percent of the birds tested were house finches (Carpodacus mexicanus) (48.7%) and house sparrows (Passer domesticus) (34.6%); 1.1% of these birds were positive for SLE antibodies. Prevalence of WEE antibodies was negligible. The analysis of 5,481 sera from rock doves (Columbia livia) yielded 3.6% SLE positives and 0.4% WEE positives. Collection sites were maintained as study sites when identified as positive bird, mosquito, and SLE virus activity localities; others were abandoned. Serial serum samples from 7,749 banded house sparrows and 9,428 banded house finches from these selected sites demonstrated year-round SLE virus transmission. One location exhibited significant numbers of house finches undergoing annual SLE seroconversion and a number of seroconversion-reversion-reconversion sequences suggesting either viral reinfection from mosquitoes or recrudescence by latent virus. A proportion of both bird species also lived for longer than 1 yr, thus, increasing the possibility of virus carry-over from autumn to spring. Assessment of concurrently collected mosquitoes indicated no correlative association between mosquito populations and SLE seroconversion and reconversion. European house sparrows introduced in the 1800's may have provided a supplemental link to the existing SLE virus enzootic cycle involving endemic house finches. Meteorological factors are reviewed as possible important correlates of SLE epidemics. The house finch/house sparrow serosurveillance system is also evaluated for use as an "Early Warning" indicator of SLE virus activity.
Asunto(s)
Enfermedades de las Aves/transmisión , Columbidae , Brotes de Enfermedades , Virus de la Encefalitis de San Luis/inmunología , Encefalitis de San Luis/transmisión , Pájaros Cantores , Animales , Anticuerpos Antivirales/sangre , Enfermedades de las Aves/epidemiología , California/epidemiología , Culex/virología , Virus de la Encefalitis Equina del Oeste/inmunología , Encefalitis de San Luis/epidemiología , Encefalomielitis Equina/epidemiología , Pruebas de Inhibición de Hemaglutinación/veterinaria , Humanos , Insectos Vectores/virología , Longevidad , Dinámica Poblacional , Estaciones del Año , Estudios SeroepidemiológicosRESUMEN
It is 9 months after reconfiguration, and it is safe to say that the operation is a success. The quality of distributive service provided by the department has improved. Pharmacists and technicians report a higher degree of job satisfaction, and the dimension and quality of the clinical programs now cannot be compared with before. Future plans are to evaluate technician order entry as a means of further increasing pharmacists' time for clinical activities. This must be accomplished in a manner that ensures appropriate concurrent monitoring and screening of orders with compromising patient therapy. The department also is planning follow-up surveys that address the staff's attitudes regarding the reconfiguration. Recognizing change as a dynamic process, we plan to continue involving the entire pharmacy staff in the planning and implementation of future change. While we as managers were able to recognize the need for global change, it is our staff who helped us identify specific changes that led us to the needed skill mix adjustment. It is also essential that the staff understand that resources are limited and that is why compromise is sometimes necessary.
Asunto(s)
Sistemas de Medicación en Hospital/organización & administración , Servicio de Farmacia en Hospital , Hospitales con más de 500 Camas , Illinois , Innovación Organizacional , Grupo de Atención al Paciente , Admisión y Programación de Personal , Competencia Profesional , Recursos HumanosRESUMEN
A study was conducted to determine the pattern of St. Louis encephalitis (SLE) virus activity in the avian populations of the Los Angeles metropolitan area in 1986. In total, 679 birds of 42 species were captured at 7 study sites. The overall prevalence of SLE neutralizing (N) antibody of 3% indicated enzootic transmission. Antibody prevalences were higher in birds sampled in the central part of the metropolitan area, which was consistent with other epidemiologic data. The use of specific avian species as sentinels for future surveillance of SLE virus activity was suggested.