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Marc A. Strassburg

Bio: Marc A. Strassburg is an academic researcher from Los Angeles County Department of Health Services. The author has contributed to research in topics: Measles & Public health. The author has an hindex of 11, co-authored 23 publications receiving 726 citations.

Papers
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Journal ArticleDOI
17 Jan 1996-JAMA
TL;DR: The strategy currently used to control measles in most countries has been to immunize each successive birth cohort through the routine health services delivery system, while measles vaccine coverage has increased markedly, significant measles outbreaks have continued to recur.
Abstract: The strategy currently used to control measles in most countries has been to immunize each successive birth cohort through the routine health services delivery system. While measles vaccine coverage has increased markedly, significant measles outbreaks have continued to recur. During the past 5 years, experience in the Americas suggests that measles transmission has been interrupted in a number of countries (Cuba, Chile, and countries in the English-speaking Caribbean and successfully controlled in all remaining countries. Since 1991 these countries have implemented one-time "catch-up" vaccination campaigns (conducted during a short period, usually 1 week to 1 month, and targeting all children 9 months through 14 years of age, regardless of previous vaccination status or measles disease history). These campaigns have been followed by improvements in routine vaccination services and in surveillance systems, so that the progress of the measles elimination efforts can be sustained and monitored. Follow-up mass vaccination campaigns for children younger than 5 years are planned to take place every 3 to 5 years. ( JAMA . 1996;275:224-229)

250 citations

Journal ArticleDOI
TL;DR: The World Health Organization is currently supporting several control programs and has not singled out another disease for eradication and the lessons learned from the smallpox campaign can be readily applied to other public health programs.

138 citations

Journal ArticleDOI
TL;DR: An outbreak of pneumonia and febrile respiratory illness took place in a Los Angeles County nursing home for the elderly in February and March of 1979 andSerological evidence implicated respiratory syncytial virus (RSV) as the causative agent.

110 citations

Journal ArticleDOI
TL;DR: The association of high birth‐order with the birth defects was weakened greatly after simultaneous adjustment for age and ethnicity, and as in other studies in low‐risk areas, no increased risk was observed among teenage mothers.
Abstract: SUMMARY For the period 1973 to 1977, a total of 536 cases of anencephalus and spina bifida were ascertained in Los Angeles County, California, a low-risk area, and compared with a 2 per cent random sample of all live births in the county. Women with Spanish surnames had an elevated risk for anencephalus and to a lesser extent for spina bifida; Blacks were at lowest risk, especially for spina bifida. The occurrence of a previous fetal death was a strong risk factor for anencephalus but there was no association between socio-economic status and either of the defects. Advanced maternal age was a stronger risk factor for spina bifida than for anencephalus but, as in other studies in low-risk areas, no increased risk was observed among teenage mothers. Paternal age did not show any independent association after controlling for mother's age. Finally, the association of high birth-order with the birth defects was weakened greatly after simultaneous adjustment for age and ethnicity. RESUME Etude controle sur population d'anencephalie et de spina bifida dans une region a faible risque Durant la periode 1973 a 1977, 536 cas d'anencephalie et de spina bifida ont ete releves dans le comte de Los Angeles, Californie, region a faible risque. Ils ont ete compares avec un echantillon de 2 pour cent tire au hasard parmi toutes les naissances vivantes du comte. Le risque d'anencephalie et a un moindre degre de spina bifida s'est revele plus eleve chez les femmes a nom espagnol. Le risque, specialement en ce qui concernait le spina bifida, etait au minimum chez les noirs. L'existence d'une mort foetale anterieure constituait un facteur de risque eleve pour l'anencephalie mais il n'est pas apparu d'associations entre le statut socio-economique et l'une ou l'autre des anomalies. L'age maternel avance constituait un facteur de risque plus eleve pour le spina bifida que pour l'anencephalie mais comme dans les autres etudes en region de faible risque, le risque n'est pas apparu accru chez les meres de moins de 20 ans. Apres controle de l'âge de la mere, l'âge du pere n'est apparu avoir aucune influence. Enfin, l'association entre le rang eleve de naissance et les anomalies decrites est apparue grandement reduite apres ajustement pour l'âge et l'ethnie. ZUSAMMENFASSUNG Inzidenz von Anencephalus und Spina Bifida in einer risikoarmen Gegend In der Zeit von 1973 bis 1977 wurden 536 Falle mit Anencephalus und Spina bifida im Bezirk Los Angeles, California, einem risikoarmen Gebeit, gesichert und mit zwei Prozent aller Lebendgeburten in diesem Bezirk verglichen. Frauen mit spanischem Familiennamen hatten ein erhohtes Risiko fur Anencephalus und -etwas geringer- fur Spina bifida; Schwarze hatten das geringste Risiko, insbesondere fur Spina bifida. Das Vorkommen eines Fruchttodes war ein starker Risikofaktor fur Anencephalus, aber es gab keine Beziehung zwischen sozio-okonomischem Status und einem der Defekte. Zunehmendes mutterliches Alter war ein starkerer Risikofaktor fur Anencephalus, aber wie in anderen Studien in risikoarmen Gebieten gab es kein erhohtes Risiko bei Muttern im Teenageralter. Das Alter des Vaters zeigte keinen eigenen Zusammenhang, wenn das Alter der Mutter kontrolliert war. Die Beziehung zwischen hoher Geburtenzahl und den Geburtsdefekten wurde weitgehend relativiert, nachdem Alter und Ethnologie berucksichtigt worden waren. RESUMEN Un estudio de casos control en una poblacion de base de anencefalia y espina bifida en un area de bajo riesgo En el periodo de 1973 a 1977 fueron identificados 536 casos de anencefalia y espina bifida en el condado de Los Angeles, California, una area de bajo riesgo y se compararon con el 2 por ciento de una muestra al azar de todos los recien nacidos vivos del condado. Las mujeres con apellido castellano mostraban un elevado riesgo de anencefalias y en menor grado de espina bifida: las de raza negra tenian un riesgo menor especialmente para la espina bifida. El hecho de una muerte fetal previa constituia un fuerte riesgo para la anencefalia pero no habia ninguna asociacion entre la situacion socioeconomica y cualquiera de los defectos. La edad avanzada de la madre era un riesgo mas fuerte para la espina bifida que para la anencefalia, pero lo mismo quo lo ocurrido en otros estudios realizados en otras zonas de bajo riesgo no se obsservo aumento del riesgo en madres de menos de 20 anos. La edad del padre no mostro ninguna asociacion independiente en relacion con la edad de la madre. Finalmente, la asociacion entre el numero elevado en la fratria y los defectos de nacimientos disminuian grandemente despues de un ajuste simultaneo para la edad y la etnia.

57 citations

01 Jan 1992
TL;DR: It is clear that tremendous progress can be made in preventing death and disease from measles with existing knowledge about the disease, and by using the presently available vaccines and applying well-tried methods of treating cases.
Abstract: Measles is a highly infectious disease which has a major impact on child survival, particularly in developing countries. The importance of understanding the epidemiology of this disease is underlined by its ability to change rapidly in the face of increasing immunization coverage. Much is still to be learned about its epidemiology and the best strategies for administering measles vaccines. However, it is clear that tremendous progress can be made in preventing death and disease from measles with existing knowledge about the disease, and by using the presently available vaccines and applying well-tried methods of treating cases. Research in the coming decade may provide more effective vaccines for use in immunization programmes. An understanding of the basic epidemiology of measles is a prerequisite for effective control measures.

52 citations


Cited by
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Journal ArticleDOI
TL;DR: In this article, the authors evaluated all respiratory illnesses in prospective cohorts of healthy elderly patients (> or =65 years of age) and high-risk adults (those with chronic heart or lung disease) and in patients hospitalized with acute cardiopulmonary conditions.
Abstract: Background Respiratory syncytial virus (RSV) is an increasingly recognized cause of illness in adults. Data on the epidemiology and clinical effects in community-dwelling elderly persons and high-risk adults can help in assessing the need for vaccine development. Methods During four consecutive winters, we evaluated all respiratory illnesses in prospective cohorts of healthy elderly patients (> or =65 years of age) and high-risk adults (those with chronic heart or lung disease) and in patients hospitalized with acute cardiopulmonary conditions. RSV infection and influenza A were diagnosed on the basis of culture, reverse-transcriptase polymerase chain reaction, and serologic studies. Results A total of 608 healthy elderly patients and 540 high-risk adults were enrolled in prospective surveillance, and 1388 hospitalized patients were enrolled. A total of 2514 illnesses were evaluated. RSV infection was identified in 102 patients in the prospective cohorts and 142 hospitalized patients, and influenza A was diagnosed in 44 patients in the prospective cohorts and 154 hospitalized patients. RSV infection developed annually in 3 to 7 percent of healthy elderly patients and in 4 to 10 percent of high-risk adults. Among healthy elderly patients, RSV infection generated fewer office visits than influenza; however, the use of health care services by high-risk adults was similar in the two groups. In the hospitalized cohort, RSV infection and influenza A resulted in similar lengths of stay, rates of use of intensive care (15 percent and 12 percent, respectively), and mortality (8 percent and 7 percent, respectively). On the basis of the diagnostic codes of the International Classification of Diseases, 9th Revision, Clinical Modification at discharge, RSV infection accounted for 10.6 percent of hospitalizations for pneumonia, 11.4 percent for chronic obstructive pulmonary disease, 5.4 percent for congestive heart failure, and 7.2 percent for asthma. Conclusions RSV infection is an important illness in elderly and high-risk adults, with a disease burden similar to that of nonpandemic influenza A in a population in which the prevalence of vaccination for influenza is high. An effective RSV vaccine may offer benefits for these adults.

1,653 citations

01 Jan 2005

1,427 citations

Journal ArticleDOI
TL;DR: RSV and human parainfluenza virus types 1, 2, 3, and 4 have been known primarily as respiratory pathogens in young children but are now recognized as important pathogens in adults as well.
Abstract: Respiratory syncytial virus (RSV), originally recovered from a colony of chimpanzees with coryza and designated chimpanzee coryza agent,1,2 and human parainfluenza virus types 1, 2, 3, and 4 have been known primarily as respiratory pathogens in young children. They are now recognized as important pathogens in adults as well. Adults infected with these viruses tend to have more variable and less distinctive clinical findings than children, and the viral cause of the infection is often unsuspected. The consistency of the annual outbreaks of these agents and the frequency of reinfection suggest that they impose a considerable, but ill-defined, disease . . .

1,139 citations

Book ChapterDOI
01 Jan 2008
TL;DR: This article is reproduced from the previous edition, volume 3, pp. 59–71, of Elsevier Inc.
Abstract: Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries, and risk factors are generally incomplete, fragmented, and of uncertain reliability and comparability. The Global Burden of Disease (GBD) Study has provided a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability, the disability-adjusted life year (DALY). This article describes key features of the Global Burden of Disease analytic approach, the evolution of the GBD starting from the first study for the year 1990, and summarizes the methodological improvements incorporated into GBD revisions carried out by the World Health Organization. It also reviews controversies and criticisms, and examines priorities and issues for future GBD updates.

1,011 citations

Journal ArticleDOI
TL;DR: This report reviews the developmental arc of theoretical epidemiology with emphasis on vaccination, as it led from classical models assuming homogeneously mixing populations and ignoring human behavior, to recent models that account for behavioral feedback and/or population spatial/social structure.

789 citations