Abstract. Typhoid fever affects an estimated 22 million people annually and causes 216,000 deaths worldwide. We conducted an investigation in August and September 2010 to examine the acceptability of typhoid vaccine in Neno District, Malawi where a typhoid outbreak was ongoing. We used qualitative methods, including freelisting exercises, key informant and in-depth interviews, and group discussions. Respondents associated illness with exposure to "bad wind," and transmission was believed to be airborne. Typhoid was considered extremely dangerous because of its rapid spread, the debilitating conditions it produced, the number of related fatalities, and the perception that it was highly contagious. Respondents were skeptical about the effectiveness of water, sanitation, and hygiene (WaSH) interventions. The perceived severity of typhoid and fear of exposure, uncertainty about the effectiveness of WaSH measures, and widespread belief in the efficacy of vaccines in preventing disease resulted in an overwhelming interest in receiving typhoid vaccine during an outbreak.

Neonatal necrotizing fasciitis is rare and is predominantly associated with methicillin-susceptible Staphylococcus aureus (MSSA). Necrotizing fasciitis associated with community-associated methicillin-resistant S aureus (CA-MRSA) has only recently been reported in the literature, primarily among adults. We present a case of a previously healthy neonate with necrotizing fasciitis of the back caused by CA-MRSA, pulsed-field type USA-300. We describe a 5-day-old infant with necrotizing fasciitis of the back caused by CA-MRSA. Treatment of necrotizing fasciitis requires prompt medical evaluation, prompt surgical debridement, and appropriate antibiotic selection. The potential involvement of CA-MRSA in necrotizing fasciitis in children needs to be considered before institution of antibiotics.

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Building on experiences from earlier digital initiatives and partnerships, the University of Virginia has developed new services and forged new collaborations between traditional information technology and library units in support of changing approaches to science and engineering research and education. Over the past 4 years, the library has evolved through numerous service models, changes in institutional vision, and budgetary shortfalls and has emerged with a new understanding of where to invest resources and energy for coming challenges.

Although the Centers for Disease Control published infection control guidelines for tuberculosis in hospital and outpatient clinic settings, recommendations are not clearly established for protection of health care workers (HCWs) in the home and field, despite increased emphasis on directly observed therapy (DOT). HCWs visit clients with infectious tuberculosis (TB) in homes, homeless shelters, drug rehabilitation programs, and outdoor settings, and transport clients in cars. HCW exposure to airborne droplet nuclei is most significant during field visits made shortly after the client is diagnosed and for prolonged periods when the client is nonadherent to therapy or has a drug-resistant isolate. In the absence of formal guidelines to limit field HCWs' exposure to TB, we have proposed measures for their TB program that outline for HCWs recommended care of a patient with TB and appropriate HCW education to minimize TB transmission and exposure.