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Spokespeople play a critical role during health emergencies in communicating credible, accurate, and actionable messages to the public. Effective spokespeople not only gain the public’s support during health emergencies but also personalize the health agency. Through professionalism, trustworthiness, authenticity, reliability, and clear communication, spokespeople build trust with the public each time they address the media or deliver a speech. This chapter describes the role of a spokesperson and why this role is critical to emergency response operations. It outlines ideal characteristics of a spokesperson including professionalism, experience working with the media, involvement with decision-making, trustworthiness, charisma, clarity of speech, and relatability. This chapter explains common spokesperson pitfalls and practical tips on how to avoid them. Media briefing and interview techniques on how to communicate effectively with the media are included. Agenda setting theory is described. A student case study uses the Crisis and Emergency Risk Communication framework to analyze the communication of Dr. Nirav D. Shah, director of Maine’s Centers for Disease Control and Pevention, during the COVID-19 outbreak. End-of-chapter reflection questions are included.
Health emergencies create unique information needs for different audience segments. This chapter outlines the differences in information needs between the general public and the medical community. Information needs of the medical community relate to scientific guidance, data reporting, health risks, personal protective equipment, interventions, and treatments. By analyzing communications used during a Centers for Disease Control and Prevention Clinical Outreach and Community Activity team webinar on COVID-19 vaccines, readers can identify the unique needs of the medical community. Epidemiologists and emergency risk communications can cocreate data-driven and actionable emergency messages when they collaborate. This chapter offers insights into how epidemiologists and emergency risk communicators can cocreate messages on health risks and interventions and leverage data graphics to help explain health risks to the public. The chapter also describes how health care practitioners can use and apply the Crisis and Emergency Risk Communication (CERC) framework within health care organizations to communicate to staff and patients. A student case study analyzes the US Ebola health emergency using the CERC framework. Reflection questions are included at the end of the chapter.
After the first 24–48 hours of a health emergency, the health emergency enters the maintenance phase. During the maintenance phase health officials provide maintenance messages that contain deeper risk explanations, promote interventions, continue to make commitments to the community, and address rumors and misinformation. Health emergencies often spend a lot of time in the maintenance phase, so it is imperative that emergency risk communicators provide clear, coordinated, and consistent messages about the health risks. By communicating credible, accurate, and actionable health information, a health agency can demonstrate the Crisis and Emergency Risk Communication (CERC) principles of Be First, Be Right, Be Credible, Show Respect, Express Empathy, and Promote Action. The chapter provides practical steps on how to write maintenance messages and provides quick response communication planning and implementation steps such as identifying communication objectives, audiences, key messages, and channels and developing communication products/materials. This chapter also includes key tips related to spokespeople, partner agencies, and call centers to ensure message consistency is achieved during the response. The rumor management framework is highlighted. A student case study analyzes the Mpox outbreak in Louisiana using the CERC framework. Reflection questions are included at the end of the chapter.
The COVID-19 pandemic impacted individuals worldwide, regardless of their geographic location, religious or political beliefs, occupation, or social standing. People’s experiences were directly impacted by lockdown measures, physical distancing, masks, vaccine recommendations, or illness of self or friend or family member, as well as by how their local and national elected officials and public health leaders managed and communicated about the pandemic. As people went into lockdown, they went online and found a proliferation of information both true and false about the pandemic. The constant deluge of online information, the new and evolving outbreak, and the worldwide impact created a complex health emergency. The COVID-19 pandemic brought emergency risk communication to the forefront of every health agency in the United States, from city to county to state to federal levels of government. This chapter provides an overview of public health preparedness; explains how Crisis and Emergency Risk Communication (CERC) is different from day-to-day public health communication; summarizes the CERC framework and phase-based messaging; and outlines how risk perception impacts the way people process information about health threats. A student case study analyzes a Legionnaires’ disease outbreak using the CERC framework. Reflection questions are included at the end of the chapter.
This chapter outlines practical ways emergency risk communicators can use evaluation throughout a health emergency to inform and improve emergency risk communication messaging strategies and activities. The chapter starts with a basic orientation on program evaluation and its relevance to emergency risk communication. Next, the chapter provides an in-depth look at 16 communication evaluation activities that emergency risk communications can use throughout a health emergency. Then the chapter describes how organizations learn after health emergencies and how organizational learning can inform community resilience and public education. Next, the chapter outlines current theoretical research approaches to evaluating emergency risk communication and practical ways to apply this research during a health emergency. The chapter highlights the ADKAR model for organizational change management, and a student case study uses the Crisis and Emergency Risk Communication framework to analyze how the Georgia Department of Health communicating during the e-cigarette or vaping product use-associated lung injury (EVALI) outbreak. End-of-chapter reflection questions are included.
Haemonchosis is a fatal disease of livestock caused by Haemonchus contortus (HC) – a blood-sucking parasite of the abomasum. This parasite is quite prevalent in sheep, causing mortality and production losses. The suppressor of cytokine signalling-2 (SOCS2) gene plays a vital role in sheep’s immune response against gastrointestinal parasites. This study aimed to estimate the parasitic load of HC in three sheep breeds (Balkhi, Ghalji, and Michni) through faecal egg count and to identify SNPs in the SOCS2 gene associated with the susceptibility of sheep against HC. The results showed that the mean number of HC eggs per gram (EPG) was higher in the faecal samples of Ghalji (4022 ± 1162 EPG), followed by Michni (1988 ± 367 EPG), while the HC EPG was the lowest in Balkhi sheep (1535 ± 552 eggs/gm). Sequencing results showed polymorphisms in the SOCS2 gene between the low-infection and high-infection categories of the three sheep breeds. A total number of six genic variants were observed, of which three were SNPs, one was insertion, and two were deletions. Polymorphisms were observed in the intronic and 3′ UTR regions of the SOCS2 gene. A deletion (c.1083delGCA) in intron 1 and an insertion (c.3304insT) in intron 2 showed positive correlations (0.833 and 0.889, respectively) with the HC infection, while one SNP in the 3′ UTR region showed negative correlation (–0.654). This study provides a basis for selecting resistant sheep against HC infection based on the SOCS2 gene molecular markers.
Previously, we reported the persistence of the bacterial pathogen Neisseria meningitidis on fomites, indicating a potential route for environmental transmission. The current goal was to identify proteins that vary among strains of meningococci that have differing environmental survival. We carried out a proteomic analysis of two strains that differ in their potential for survival outside the host. The Group B epidemic strain NZ98/254 and Group W carriage strain H34 were cultured either at 36 °C, 5% CO2, and 95% relative humidity (RH) corresponding to host conditions in the nasopharynx, or at lower humidities of 22% or 30% RH at 30 °C, for which there was greater survival on fomites. For NZ98/254, the shift to lower RH and temperature was associated with increased abundance of proteins involved in metabolism, stress responses, and outer membrane components, including pili and porins. In contrast, H34 responded to lower RH by decreasing the abundance of multiple proteins, indicating that the lower viability of H34 may be linked to decreased capacity to mount core protective responses. The results provide a snapshot of bacterial proteins and metabolism that may be related to normal fitness, to the greater environmental persistence of NZ98/254 compared to H34, and potentially to differences in transmission and pathogenicity.
Temporal variability and methodological differences in data normalization, among other factors, complicate effective trend analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wastewater surveillance data and its alignment with coronavirus disease 2019 (COVID-19) clinical outcomes. As there is no consensus approach for these analyses yet, this study explored the use of piecewise linear trend analysis (joinpoint regression) to identify significant trends and trend turning points in SARS-CoV-2 RNA wastewater concentrations (normalized and non-normalized) and corresponding COVID-19 case rates in the greater Las Vegas metropolitan area (Nevada, USA) from mid-2020 to April 2023. The analysis period was stratified into three distinct phases based on temporal changes in testing protocols, vaccination availability, SARS-CoV-2 variant prevalence, and public health interventions. While other statistical methodologies may require fewer parameter specifications, joinpoint regression provided an interpretable framework for characterization and comparison of trends and trend turning points, revealing sewershed-specific variations in trend magnitude and timing that also aligned with known variant-driven waves. Week-level trend agreement corroborated previous findings demonstrating a close relationship between SARS-CoV-2 wastewater surveillance data and COVID-19 outcomes. These findings guide future applications of advanced statistical methodologies and support the continued integration of wastewater-based epidemiology as a complementary approach to traditional COVID-19 surveillance systems.
Human toxocariasis is a worldwide parasitic disease caused by zoonotic roundworms of the genus Toxocara, which can cause blindness and epilepsy. The aim of this study was to estimate the risk of food-borne transmission of Toxocara spp. to humans in the UK by developing mathematical models created in a Bayesian framework. Parameter estimation was based on published experimental studies and field data from southern England, with qPCR Cq values used as a measure of eggs in spinach portions and ELISA optical density data as an indirect measure of larvae in meat portions. The average human risk of Toxocara spp. infection, per portion consumed, was estimated as 0.016% (95% CI: 0.000–0.100%) for unwashed leafy vegetables and 0.172% (95% CI: 0.000–0.400%) for undercooked meat. The average proportion of meat portions estimated positive for Toxocara spp. larvae was 0.841% (95% CI: 0.300–1.400%), compared to 0.036% (95% CI: 0.000–0.200%) of spinach portions containing larvated Toxocara spp. eggs. Overall, the models estimated a low risk of infection with Toxocara spp. by consuming these foods. However, given the potentially severe human health consequences of toxocariasis, intervention strategies to reduce environmental contamination with Toxocara spp. eggs and correct food preparation are advised.
This book clearly explains how public health officials plan, deliver, and evaluate crisis and emergency risk communication before, during, and after health emergencies. Organized into four parts - precrisis planning, communicating during a health emergency, communicating and evaluating after a health emergency, and crisis leadership - it offers practical information as well as the opportunity to reflect on emergency risk communication best practices and theories. Including information on precrisis planning, implications of public health law, developing communication plans, writing messages, evaluating emergency risk communication, and crisis leadership, this book brings together theory and practical application to provide working professionals with evidence-based research and practical knowledge to effectively communicate during health emergencies. Case studies of emergencies such as COVID-19, Zika, Ebola, Mpox, and water crises all use the US Centers for Disease Control and Prevention's Crisis and Emergency Risk Communication framework to analyze how health officials provided accurate and actionable health information to the public.
Leptospirosis in NZ has historically been associated with male workers in livestock industries; however, the disease epidemiology is changing. This study identified risk factors amid these shifts. Participants (95 cases:300 controls) were recruited nationwide between 22 July 2019 and 31 January 2022, and controls were frequency-matched by sex (90% male) and rurality (65% rural). Multivariable logistic regression models, adjusted for sex, rurality, age, and season—with one model additionally including occupational sector—identified risk factors including contact with dairy cattle (aOR 2.5; CI: 1.0–6.0), activities with beef cattle (aOR 3.0; 95% CI: 1.1–8.2), cleaning urine/faeces from yard surfaces (aOR 3.9; 95% CI: 1.5–10.3), uncovered cuts/scratches (aOR 4.6; 95% CI: 1.9–11.7), evidence of rodents (aOR 2.2; 95% CI: 1.0–5.0), and work water supply from multiple sources—especially creeks/streams (aOR 7.8; 95% CI: 1.5–45.1) or roof-collected rainwater (aOR 6.6; 95% CI: 1.4–33.7). When adjusted for occupational sector, risk factors remained significant except for contact with dairy cattle, and slaughter without gloves emerged as a risk (aOR 3.3; 95% CI: 0.9–12.9). This study highlights novel behavioural factors, such as uncovered cuts and inconsistent glove use, alongside environmental risks from rodents and natural water sources.
We describe an outbreak of Legionnaires’ disease linked to an exclusive cold-water source in a private residential setting in Yorkshire. The cold-water source was identified following microbiological testing of clinical and environmental samples. Legionella pneumophila was only detected in the cold-water system. Three cases were identified over the course of the outbreak: two confirmed and one probable. Conditions favourable to bacterial growth included system ‘dead legs’ and significant heat transfer to the cold-water system. We describe challenges in implementing control measures at the venue and highlight the importance of using enforcement powers, where necessary, to reduce risk.
Accacoeliid digeneans associated with fish of the family Molidae exhibit enigmatically high taxonomic diversity. However, the phylogenetic relationships between species within this digenean taxon are poorly understood. In the present study, the first nuclear 28S rRNA gene, ITS2 region of nuclear DNA, and mitochondrial cox1 gene sequence datasets were obtained for two members of the Accacoeliidae, a type and only species of the genus Odhnerium Yamaguti 1934 and an unidentified Accacladocoelium sp. collected from Mola mola (Linnaeus, 1758) off Iturup Island. Analyses of molecular differentiation and phylogenetic relationships indicate that Accacladocoelium sp. is a sister species to Accacladocoelium nigroflavum (Rudolphi, 1819). The genus Odhnerium is closely related to Tetrochetus Looss, 1912, on the 28S rRNA gene-based phylogenetic tree. Results of phylogenetic analysis based on both the mitochondrial cox1 gene and the concatenated ribosomal ITS2 region and cox1 gene of mtDNA show that the genus Odhnerium is close to the A. nigroflavum + Accacladocoelium sp. clade. In turn, the genus Accacladocoelium does not have monophyletic status in the trees reconstructed from these data.