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RMSF is a public health problem in Sonora. Clinically, fatal cases differ from non-fatal cases in renal function and hemorrhagic manifestations, although these findings may occur too late for a timely intervention. First-line providers must be educated to harbor a timely suspicion of RMSF, and should provide empiric treatment with doxycycline when febrile patients first present for care.

Several studies suggest that the holiday season, starting from the last week of November to the first or second week of January, could be critical to gaining weight. This study aims to review the literature to determine the effects of the holidays on body weight. In studies of adults, a significant weight gain was consistently observed during this period (0.4 to 0.9 kg, p < 0.05). The only study in college students found an effect on body fat but not on weight (0.1 kg, p = 0.71). The only study found in children did not show an effect on BMI percentile (−0.4%, p > 0.05) during this period. Among individuals with obesity who attempt to lose weight, an increase in weight was observed (0.3 to 0.9 kg, significant in some but not in all studies), as well as increase in weight in motivated self-monitoring people (0.4 to 0.6%, p < 0.001). Programs focused on self-monitoring during the holidays (phone calls and daily mailing) appeared to prevent weight gain, but information is limited. The holiday season seems to increase body weight in adults, even in participants seeking to lose weight and in motivated self-monitoring people, whereas in children, adolescents, and college students, very few studies were found to make accurate conclusions.

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Background Rocky Mountain spotted fever (RMSF) is a significant public health problem in Sonora, Mexico, resulting in thousands of cases and hundreds of deaths. Outbreaks of RMSF are perpetuated by heavy brown dog tick infestations in and around homes. During 2009–2015, there were 61 RMSF cases and 23 deaths in a single community of Sonora (Community A). Methods An integrated intervention was carried out from March–November 2016 aimed at reducing tick populations with long-acting acaricidal collars on dogs, environmental acaricides applied to peri-domestic areas and RMSF education. Tick levels were measured by inspection of community dogs to monitor efficacy of the intervention. A similar neighborhood (Community B) was selected for comparison and received standard care (acaricide treatment and education). Results The prevalence of tick-infested dogs in Community A declined from 32.5% to 8.8% (p&lt;0.01). No new cases of RMSF were identified in this area during the subsequent 18 mo. By comparison, the percentage of tick-infested dogs in Community B decreased from 19% to 13.4% (p=0.36) and two cases were reported, including one death. Conclusions Community-based interventions using an integrated approach to control brown dog ticks can diminish the morbidity and mortality attributable to RMSF.

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several years after initial infection (1). Issues with primaquine (i.e., CYP2D6-poor metabolizers or hemolysis risk in patients with glucose-6-phosphate dehydrogenase deficiency) complicate treatment of dormant hypnozoites that cause relapse (1). A new treatment, tafenoquine, which still causes hemolysis in glucose-6-phosphate dehydrogenase deficiency, was recently approved in the United States as a single dose for prevention of P. vivax malaria relapse (10), although this medication might not reach at-risk groups in South America. Ecuador and Peru currently follow the Pan American Health Organization guidelines regarding primaquine use (https://www.paho.org/hq/dmdocuments/2011/ TreatmentGuidelines-2nd-ed-2010-eng.pdf). Local ministries of health responded quickly to these cases and implemented case surveillance. However, reductions in resources after elimination of local malaria transmission in 2011-2012 severely limited malaria control efforts in Ecuador and Peru. Imported cases of malaria at the Ecuador-Peru border region pose a serious threat of continued resurgence in local transmission. We urge international solutions for Venezuela's humanitarian crisis and augmentation of infectious disease surveillance and control along migration routes and in surrounding regions.

Objective. This paper explores the impact of contextual variables at the neighborhood level on a health marker in the city of Hermosillo, Mexico and discusses the importance of collaboration between planners and health professional to minimize the negative effect of contextual factors on urban health. Materials and methods. Few studies in Mexico have assessed health outcomes at the intra-urban scale and their interaction with neighborhood-level contextual variables. Using spatial analysis and geographical information systems, the paper explores the association between infant mortality and an index of socio-environmental vulnerability used to measure urban contextual factors. Results. Two high infant mortality clusters were detected within neighborhoods characterized by relatively good environmental conditions and one in a neighborhood with a poor environment. Conclusions. Our results show the clustering of high infant mortality areas and some association with built environment factors in Hermosillo. The results support the need to reconnect public health and urban planning as a way to create healthier environments in Mexican cities.