Background: We sought to determine the knowledge of, perception, attitudes, and behaviors toward influenza virus and immunization, and the determinants of vaccination among students, patients, and Healthcare Workers (HCWs) at the American University of Beirut and its affiliated Medical Center. Methods: We conducted a cross-sectional study between October 2016 and January 2017 utilizing a self-administered questionnaire that was provided to 247 randomly selected adult participants. Data collected included socio-demographic characteristics, prior vaccination against influenza, knowledge, perception, attitudes, and behaviors toward influenza and influenza immunization. A multivariable regression model was used to evaluate for independent associations between the different variables and regular or yearly vaccination as a primary outcome. Results: The overall survey response rate was 77%. A substantial proportion of respondents (47.4%) had never received the influenza vaccine. Only 10.2% of students, 19.1% of patients, and 35.6% of HCWs reported regular or yearly influenza vaccine uptake. HCWs had the lowest knowledge score about influenza and its vaccine despite high self-reported levels of knowledge. Barriers to vaccinations included lack of information (31%), fear of adverse effects (29%), and a perception of not being at risk (23%). Several factors were independently associated with regular or yearly vaccination uptake including having children (adjusted OR = 3.8; 95% CI 1.2–12.5), a “very good” self-reported level of knowledge (OR = 16.3; 95% CI 1.4–194.2) and being afraid of the consequences of influenza (OR = 0.2; 95% CI 0.1–0.6). Conclusion: Adherence rates with regular or yearly vaccination against influenza remain low across all study groups. We were able to identify predictors as well as barriers to vaccination. Future awareness and vaccination campaigns should specifically aim at correcting misconceptions about vaccination, particularly among HCWs, along with addressing the barriers to vaccination. Predictors of vaccination should be integrated in the design of future campaigns.
Acute transverse myelitis is a neurological syndrome resulting from inflammation of the spinal cord [1]. it is characterized by a variety of presentations depending on the level at which the spinal cord is involved, the location of the lesions, and the affected tracts. Signs and symptoms are commensurate with motor, sensory, or autonomic dysfunction, including paraparesis, flaccidity, spasticity, sensory impairment, bladder, bowel, and sexual dysfunction [2]. the clinical course may be monophasic or recurrent with variable remission rates depending on the underlying etiology [3]. while the exact trigger for this inflammatory process is yet to be identified, several conditions seem to be associated with the occurrence of transverse myelitis. Among the infectious etiologies, Mycoplasma pneumoniae, Borrelia burgdorferi, Treponema pallidum, and various viral pathogens have been implicated, including hiV, influenza, rubella, mumps, and all herpes viruses [4-8]. the diagnosis is suspected based on clinical signs and symptoms and is usually confirmed with Mri signal abnormality in the spinal cord, cereobrospinal fluid (CSf) pleocytosis, or both [9]. transverse myelitis caused by herpes simplex virus-2 (hSV-2) is rare, and only a small number of cases have been reported in adults. herein, we report a case of transverse myelitis due to hSV-2, with persistent viral replication in the CSf despite complete neurological recovery. CASe repOrt An 85-year-old man with an unremarkable medical history presented to the emergency unit with bilateral lower extremity weakness of five days duration. the patient was unable to stand from a sitting position without help but did not complain of any pain. he denied headaches, neck pain, visual disturbances, facial asymmetry, upper extremity weakness, or paresthesias. he had normal bowel and bladder control but reported urinary frequency. he did not report a recent febrile illness and his family verified normal cognitive and mental function. upon review of systems, he described a history of a recurrent rash on the back and buttocks for the past 20 years, with a recent flare two weeks prior to presentation.
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