Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. We examined characteristics of HIV and viral hepatitis coinfections by using surveillance data from 15 US states and two cities. Each jurisdiction used an automated deterministic matching method to link surveillance data for persons with reported acute and chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, to persons reported with HIV infection. Of the 504 398 persons living with diagnosed HIV infection at the end of 2014, 2.0% were coinfected with HBV and 6.7% were coinfected with HCV. Of the 269 884 persons ever reported with HBV, 5.2% were reported with HIV. Of the 1 093 050 persons ever reported with HCV, 4.3% were reported with HIV. A greater proportion of persons coinfected with HIV and HBV were males and blacks/African Americans, compared with those with HIV monoinfection. Persons who inject drugs represented a greater proportion of those coinfected with HIV and HCV, compared with those with HIV monoinfection. Matching HIV and viral hepatitis surveillance data highlights epidemiological characteristics of persons coinfected and can be used to routinely monitor health status and guide state and national public health interventions.

As invasive species become increasingly abundant in forests, their presence may influence a number of key nutrient cycling processes. For example, Chinese privet has become well established in southeastern forests and continues to spread. Two studies, a multisite field investigation and a controlled approach on a single site, were conducted to examine the role of Chinese privet (Ligustrum sinense) on decomposition within riparian forests of the Georgia Piedmont. The field study also investigated the effects of privet presence on soil nitrogen (N) mineralization and microbial carbon and N immobilization. Both studies utilized a litterbag approach to examine how increasing proportions of privet in foliar litter influenced mass loss rates and nutrient dynamics. The field investigation included litterbags with representative proportions of the five dominant species from 16 sites. Litterbags in the controlled study were composed of specific levels of privet litter within bags (0, 10, 20, 30, 40, and 50% Chinese privet) as treatments. The litter quality of four native species was compared to Chinese privet in the controlled study. Both studies showed significant positive relationships between percentage of Chinese privet in litterbags and decomposition rates (2.6-fold rate increase with 30% privet in litterfall). Chinese privet leaf litter had lower lignin and cellulose concentrations, higher N concentrations, lower lignin : N ratios, and narrower C : N ratios than the native species. The positive relationship between mass loss rates and the proportion of Chinese privet in litter indicates that Chinese privet enhances decomposition rates as it becomes more abundant. During summer, N mineralization showed approximately a fivefold increase; during winter, microbial biomass N increased by approximately 30% on sites with the highest levels of privet in the understory. Consequently, C and N dynamics in Piedmont riparian forests were significantly influenced in direct proportion to the amount of privet present in the understory.

Objective: The objective is to describe by geographic proximity the extent to which the US pediatric population (aged 0-17 years) has access to pediatric and other specialized critical care facilities, and to highlight regional differences in population and critical resource distribution for preparedness planning and utilization during a mass public health disaster.

Methods: The analysis focused on pediatric hospitals and pediatric and general medical/surgical hospitals with specialized pediatric critical care capabilities, including pediatric intensive care units (PICU), pediatric cardiac ICUs (PCICU), level I and II trauma and pediatric trauma centers, and general and pediatric burn centers. The proximity analysis uses a geographic information system overlay function: spatial buffers or zones of a defined radius are superimposed on a dasymetric map of the pediatric population. By comparing the population living within the zones to the total population, the proportion of children with access to each type of specialized unit can be estimated. The project was conducted in three steps: preparation of the geospatial layer of the pediatric population using dasymetric mapping methods; preparation of the geospatial layer for each resource zone including the identification, verification, and location of hospital facilities with the target resources; and proximity analysis of the pediatric population within these zones.

Results: Nationally, 63.7% of the pediatric population lives within 50 miles of a pediatric hospital; 81.5% lives within 50 miles of a hospital with a PICU; 76.1% lives within 50 miles of a hospital with a PCICU; 80.2% lives within 50 miles of a level I or II trauma center; and 70.8% lives within 50 miles of a burn center. However, state-specific proportions vary from less than 10% to virtually 100%. Restricting the burn and trauma centers to pediatric units only decreases the national proportion to 26.3% for pediatric burn centers and 53.1% for pediatric trauma centers.

Conclusions: This geospatial analysis describes the current state of pediatric critical care hospital resources and provides a visual and analytic overview of existing gaps in local pediatric hospital coverage. It also highlights the use of dasymetric mapping as a tool for public health preparedness planning.

(Disaster Med Public Health Preparedness. 2012;6:117–125)