Tamie Sugawara

Bio: Tamie Sugawara is an academic researcher from National Institutes of Health. The author has contributed to research in topics: Outbreak & Population. The author has an hindex of 15, co-authored 114 publications receiving 776 citations.

Social contacts, vaccination decisions and influenza in Japan.

Abstract: Background Contact patterns and vaccination decisions are fundamental to transmission dynamics of infectious diseases. We report on age-specific contact patterns in Japan and their effect on influenza vaccination behaviour. Methods Japanese adults (N=3146) were surveyed in Spring 2011 to assess the number of their social contacts within a 24 h period, defined as face-to-face conversations within 2 m, and gain insight into their influenza-related behaviour. We analysed the duration and location of contacts according to age. Additionally, we analysed the probability of vaccination and influenza infection in relation to the number of contacts controlling for individual9s characteristics. Results The mean and median reported numbers of daily contacts were 15.3 and 12.0, respectively. School-aged children and young adults reported the greatest number of daily contacts, and individuals had the most contacts with those in the same age group. The age-specific contact patterns were different between men and women, and differed between weekdays and weekends. Children had fewer contacts between the same age groups during weekends than during weekdays, due to reduced contacts at school. The probability of vaccination increased with the number of contacts, controlling for age and household size. Influenza infection among unvaccinated individuals was higher than for those vaccinated, and increased with the number of contacts. Conclusions Contact patterns in Japan are age and gender specific. These contact patterns, as well as their interplay with vaccination decisions and infection risks, can help inform the parameterisation of mathematical models of disease transmission and the design of public health policies, to control disease transmission.

Research for Willingness to Pay for One QALY Gain

Abstract: 目 的：医療や公衆衛生における費用対効果分析における政策意思決定では，社会における１単位のQALYを獲得するためのWTPの情報が不可欠である。日本では先駆的な調査があるが，それは直接法でされており，問題が多い。本稿では先行研究と同じ目的を，コンジョイント分析を用いて行う。対象と方法：2005年度に全国において実施された調査における回答を分析した。調査は，772世帯から回収を得た（回収率88％）。分析対象者は20歳以上の成人1,297人である。質問では，経済社会的属性に加えて，仮想的な費用，期間，患者数，健康状態での医療を賛成するかどうかをコンジョイント分析で行う。また，推定式における説明変数，割引率，健康状態のQOL評価で感度分析を行う。結 果：全ての場合総費用は負で有意，獲得するQALYは正で有意である。QALYあたりWTPは，635～670万円である。所得によるQALYあたりWTPへの影響は確認されない。考 察：本稿で求められたQALYあたりのWTPは先行研究よりもやや高いが，大きく変わらなかったことは特筆に値する。これは，QALYあたりのWTPがほぼ600～700万円であるとする根拠が頑健であることが示唆される。

Real-time Prescription Surveillance and its Application to Monitoring Seasonal Influenza Activity in Japan

Abstract: Background: Real-time surveillance is fundamental for effective control of disease outbreaks, but the official sentinel surveillance in Japan collects information related to disease activity only weekly and updates it with a 1-week time lag. Objective: To report on a prescription surveillance system using electronic records related to prescription drugs that was started in 2008 in Japan, and to evaluate the surveillance system for monitoring influenza activity during the 2009–2010 and 2010–2011 influenza seasons. Methods: We developed an automatic surveillance system using electronic records of prescription drug purchases collected from 5275 pharmacies through the application service provider’s medical claims service. We then applied the system to monitoring influenza activity during the 2009–2010 and 2010–2011 influenza seasons. The surveillance system collected information related to drugs and patients directly and automatically from the electronic prescription record system, and estimated the number of influenza cases based on the number of prescriptions of anti-influenza virus medication. Then it shared the information related to influenza activity through the Internet with the public on a daily basis. Results: During the 2009–2010 influenza season, the number of influenza patients estimated by the prescription surveillance system between the 28th week of 2009 and the 12th week of 2010 was 9,234,289. In the 2010–2011 influenza season, the number of influenza patients between the 36th week of 2010 and the 12th week of 2011 was 7,153,437. The estimated number of influenza cases was highly correlated with that predicted by the official sentinel surveillance (r = .992, P < .001 for 2009–2010; r = .972, P < .001 for 2010–2011), indicating that the prescription surveillance system produced a good approximation of activity patterns. Conclusions: Our prescription surveillance system presents great potential for monitoring influenza activity and for providing early detection of infectious disease outbreaks. [J Med Internet Res 2012;14(1):e14]

The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries.

Abstract: The ongoing coronavirus disease 2019 (COVID-19) pandemic poses a severe threat to public health worldwide. We combine data on demography, contact patterns, disease severity, and health care capacity and quality to understand its impact and inform strategies for its control. Younger populations in lower-income countries may reduce overall risk, but limited health system capacity coupled with closer intergenerational contact largely negates this benefit. Mitigation strategies that slow but do not interrupt transmission will still lead to COVID-19 epidemics rapidly overwhelming health systems, with substantial excess deaths in lower-income countries resulting from the poorer health care available. Of countries that have undertaken suppression to date, lower-income countries have acted earlier. However, this will need to be maintained or triggered more frequently in these settings to keep below available health capacity, with associated detrimental consequences for the wider health, well-being, and economies of these countries.

Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa

Abstract: These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America (IDSA) in 2009, prior to the 2009 H1N1 influenza pandemic. This document addresses new information regarding diagnostic testing, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal influenza. It is intended for use by primary care clinicians, obstetricians, emergency medicine providers, hospitalists, laboratorians, and infectious disease specialists, as well as other clinicians managing patients with suspected or laboratory-confirmed influenza. The guidelines consider the care of children and adults, including special populations such as pregnant and postpartum women and immunocompromised patients.

Report 12: The global impact of COVID-19 and strategies for mitigation and suppression

Abstract: Patrick GT Walker*, Charles Whittaker*, Oliver Watson, Marc Baguelin, Kylie E C Ainslie, Sangeeta Bhatia, Samir Bhatt, Adhiratha Boonyasiri, Olivia Boyd, Lorenzo Cattarino, Zulma Cucunubá, Gina Cuomo-Dannenburg, Amy Dighe, Christl A Donnelly, Ilaria Dorigatti, Sabine van Elsland, Rich FitzJohn, Seth Flaxman, Han Fu, Katy Gaythorpe, Lily Geidelberg, Nicholas Grassly, Will Green, Arran Hamlet, Katharina Hauck, David Haw, Sarah Hayes, Wes Hinsley, Natsuko Imai, David Jorgensen, Edward Knock, Daniel Laydon, Swapnil Mishra, Gemma Nedjati-Gilani, Lucy C Okell, Steven Riley, Hayley Thompson, Juliette Unwin, Robert Verity, Michaela Vollmer, Caroline Walters, Hao Wei Wang, Yuanrong Wang, Peter Winskill, Xiaoyue Xi, Neil M Ferguson, Azra C Ghani

Adenovirus: Epidemiology, Global Spread of Novel Serotypes, and Advances in Treatment and Prevention

Abstract: Adenoviruses (AdVs) are DNA viruses that typically cause mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva. Rare manifestations of AdV infections include hemorrhagic cystitis, hepatitis, hemorrhagic colitis, pancreatitis, nephritis, or meningoencephalitis. AdV infections are more common in young children, due to lack of humoral immunity. Epidemics of AdV infection may occur in healthy children or adults in closed or crowded settings (particularly military recruits). The disease is more severe and dissemination is more likely in patients with impaired immunity (e.g., organ transplant recipients, human immunodeficiency virus infection). Fatality rates for untreated severe AdV pneumonia or disseminated disease may exceed 50%. More than 50 serotypes of AdV have been identified. Different serotypes display different tissue tropisms that correlate with clinical manifestations of infection. The predominant serotypes circulating at a given time differ among countries or regions, and change over time. Transmission of novel strains between countries or across continents and replacement of dominant viruses by new strains may occur. Treatment of AdV infections is controversial, as prospective, randomized therapeutic trials have not been conducted. Cidofovir is the drug of choice for severe AdV infections, but not all patients require treatment. Live oral vaccines are highly efficacious in reducing the risk of respiratory AdV infection and are in routine use in the military in the United States, but currently are not available to civilians.