Ida Vangone, Cristina Arrigoni, Arianna Magon, Gianluca Conte, Sara Russo, Silvia Belloni, Alessandro Stievano, Celeste M Alfes, Rosario Caruso
The efficacy of high-fidelity simulation on knowledge and performance in undergraduate nursing students: An umbrella review of systematic reviews and meta-analysis
Nurse education today
dengue prevalent mosquitoborne viral illness worldwide endemic puerto rico dengues clinical spectrum range mild undifferentiated febrile illness hemorrhagic manifestations shock multiorgan failure death severe cases disease presentation nonspecific therefore various illnesses eg arboviral respiratory pathogens cause similar clinical symptoms enhanced surveillance necessary determine disease prevalence characterize epidemiology severe disease evaluate diagnostic treatment practices improve patient outcomes sentinel enhanced dengue surveillance system sedss established monitor trends dengue denguelike acute febrile illnesses afis characterize clinical course disease serve early warning system viral infections epidemic potential may 2012december 2022 sedss conducts enhanced surveillance dengue relevant afis puerto rico report includes aggregated data collected may 2012 december 2022 sedss launched may 2012 patients afis five health care facilities enrolled facilities included two emergency departments tertiary acute care hospitals san juancaguasguaynabo metropolitan area ponce two secondary acute care hospitals carolina guayama one outpatient acute care clinic ponce patients arriving sedss site eligible enrollment reported fever within past 7 days zika epidemic june 2016june 2018 patients eligible enrollment either rash conjunctivitis rash arthralgia fever eligibility expanded april 2020 include reported cough shortness breath within past 14 days blood urine nasopharyngeal oropharyngeal specimens collected enrollment participants consented diagnostic testing dengue virus denv serotypes 14 chikungunya virus zika virus influenza b viruses sarscov2 five respiratory viruses performed cdc laboratory san juan may 2012december 2022 total 43608 participants diagnosed afi enrolled sedss majority participants 450 ponce surveillance period 1432 confirmed probable cases dengue 2293 confirmed probable cases chikungunya 1918 confirmed probable cases zika epidemic curves three arboviruses indicate dengue endemic outbreaks chikungunya zika sporadic case counts peaking late 2014 2016 respectively majority commonly identified respiratory pathogens influenza virus 3756 sarscov2 1586 human adenovirus 1550 respiratory syncytial virus 1489 influenza b virus 1430 human parainfluenza virus type 1 3 1401 total 5502 participants confirmed probable arbovirus infection 11922 confirmed respiratory virus infection 26503 afi without arboviruses respiratory viruses examined dengue endemic puerto rico however incidence rates varied widely reporting period last notable outbreak occurring 20122013 denv1 predominant virus surveillance period sporadic cases denv4 also reported puerto rico experienced large outbreaks chikungunya peaked 2014 zika peaked 2016 cases viruses reported since influenza respiratory syncytial virus seasonality patterns distinct respiratory syncytial virus incidence typically reaching annual peak weeks influenza emergence sarscov2 led reduction circulation acute respiratory viruses sedss sitebased enhanced surveillance system designed gather information afi cases puerto rico report illustrates sedss adapted detect dengue zika chikungunya covid19 influenza outbreaks along seasonal acute respiratory viruses underscoring importance recognizing signs symptoms relevant diseases understanding transmission dynamics among viruses report also describes fluctuations disease incidence highlighting value active surveillance testing panel acute respiratory viruses importance flexible responsive surveillance systems addressing evolving public health challenges various vector control strategies vaccines considered implemented puerto rico data ongoing trials sedss might integrated better understand epidemiologic factors underlying transmission risk mitigation approaches data sedss might guide sampling strategies implementation future trials prevent arbovirus transmission particularly expansion sedss throughout island improve geographic representation