Eran Kopel

• M.D., MPH, B.Med.Sc.
• Ministry of Health (Israel)

Background: In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past....

Background In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. T...

Prior studies have shown that an acute coronary syndrome (ACS) may be triggered by external activities, however their frequency, predictors and significance are uncertain. We evaluated data from The National Israel Survey of Acute Coronary Syndromes, which was conducted in 2004 (February-March) in all 25 coronary care units and cardiac wards in Isr...

Background: Limited information exists on whether changes in medical practices over the study decades have affected the outcomes of acute coronary syndrome (ACS) patients who undergo early coronary artery bypass surgery (CABG) during index hospitalisation. Methods: Data on trends for early CABG referral and associated outcomes were obtained amon...

Background: Utilization of cardiac rehabilitation is suboptimal. The aim of the study was to assess referral trends over the past decade, to identify predictors for referral to a cardiac rehabilitation program, and to evaluate the association with one-year mortality in a large national registry of acute coronary syndrome patients. Design and meth...

Background Polio eradication is an extraordinary globally coordinated health program in terms of its magnitude and reach, leading to the elimination of wild poliovirus (WPV) in most parts of the world. In 2013, a silent outbreak of WPV was detected in Israel, a country using an inactivated polio vaccine (IPV) exclusively since 2005. The outbreak wa...

Objectives: To enhance timely surveillance of bacterial enteric pathogens, space-time cluster analysis was introduced in Israel in May 2013. Methods: Stool isolation data of Salmonella, Shigella, and Campylobacter from patients of a large Health Maintenance Organization were analyzed weekly by ArcGIS and SaTScan, and cluster results were sent pr...

Background: The independent association between elevated triglycerides and all-cause mortality among patients with established coronary heart disease is controversial. The aim of this study was to investigate this association in a large cohort of patients with proven coronary heart disease. Methods and results: The study cohort comprised 15 355...

Introduction: Heart failure is a major cause of death and disability and poses a significant public health concern. Approximately half of the patients admitted with heart failure, have preserved left ventricular ejection fraction. The association between systolic blood pressure (SBP) and long-term outcome in this group has not been well establishe...

In 2013, a silent wild poliovirus type 1 importation and sustained transmission event occurred in southern Israel. With the aim of preventing clinical poliomyelitis and ensuring virus re-elimination, the public health response to the importation event included intensification of clinical and environmental surveillance activities, enhancement of vac...

Data on long-term impact of universal national vaccination programmes against hepatitis A are lacking. We aimed at evaluating the impact on hepatitis A incidence of the Israeli toddlers-only universal routine two-dose vaccination programme against hepatitis A initiated in 1999. All hepatitis A episodes reported to the national surveillance system f...

In patients with acute coronary syndrome (ACS), the predictive potential of admission systolic blood pressure (SBP) on early and late outcomes is not entirely clear. We investigated the association between admission SBP in patients hospitalized for ACS and subsequent morbidity and mortality in a real world setting. The study population comprised 76...

The Syntax score (SS) is a helpful tool for determining the optimal revascularization strategy regarding coronary artery bypass surgery (CABG) vs. percutaneous coronary intervention (PCI) in patients with complex coronary disease. While an association between higher SS and mortality was found for PCI patients, no such association was found for CABG...

During 2002 to 2011, 275 of 6828 children with giardiasis in Israel were reported with recurrent, over 6 months apart, episodes. The only significant multivariable-adjusted risk predictor of a recurrent episode was non-Jewish ethnicity (hazard ratio, 4.61 [95% confidence interval, 3.32–6.40]; P < .001), also accompanied by significant interaction w...

Atovaquone-proguanil (AP) and artemether-lumefantrine (AL) are both treatments for uncomplicated Plasmodium falciparum malaria, but comparative clinical trials are lacking. We performed a retrospective analysis, comparing treatment failure and fever clearance time in non-immune travelers with uncomplicated P. falciparum malaria, treated with AP or...

Wild poliovirus type 1 (WPV1) introduction into southern Israel in early 2013 was detected by routine environmental surveillance. The virus was identified genetically as related to the South Asian (SOAS) R3A lineage endemic to Pakistan in 2012. Intensified, high-throughput environmental surveillance using advanced molecular methods played a critica...

Background: Data regarding travelers with chronic illnesses (TCI) traveling to developing countries is limited. Methods: A retrospective cohort study of travelers. We analyzed demographics, travel destinations, travel dates and duration, as well as the medical history (chronic illnesses, chronic medications, and allergies) of the travelers. Res...

In 2013, samples from routine environmental surveillance at a sewage-treatment plant in Israel tested positive for wild-type poliovirus. In response, Israeli health policymakers ramped up environmental surveillance and launched supplementary immunization activities.

Background/objectives: Over the past decade, the development of novel management strategies has resulted in improved outcomes among patients hospitalized with ST-segment myocardial infarction (STEMI). The aim of the present study was to compare temporal trends in the mortality of smokers versus non-smokers admitted with STEMI in a real world setti...

Objectives: This study aimed to evaluate factors associated with the prescription of high-dose potent statin (HDPS) therapy following hospitalization for acute coronary events. Study design: Sub-analysis was made using the data of 3,525 patients enrolled in the 2008 and 2010 Acute Coronary Syndrome Israeli Surveys (ACSIS). Methods: Analyses we...

High-density lipoprotein cholesterol (HDL-C) is a strong inverse predictor of cardiovascular events. The aim of the current study was to evaluate the correlation between changes in HDL-C and subsequent cardiovascular events. Study population comprised 13,037 subjects free of cardiovascular disease with a mean follow up of 6±3years. Low HDL-C was de...

Influenza vaccine is a well-recommended secondary prevention measure for improving survival in patients with coronary artery disease, but it has generally been less studied in heart failure. We ask whether having influenza vaccination is associated with survival among patients with acute heart failure (HF). This was a prospective population-based c...

Israel has been certified as polio-free by the World Health Organization and its routine immunisation schedule consists of inactivated poliovirus vaccine (IPV) only. At the end of May 2013, the Israeli Ministry of Health (MOH) has confirmed the reintroduction of wild-type poliovirus 1 into the country. Documented ongoing human-to-human transmission...

Current data on the influence of gender on the prognosis of heart failure (HF) are conflicting, possibly due to usage of different endpoints and a heterogeneous heart failure population in prior studies. We sought to evaluate the effect of gender on the risk of early and late mortality outcomes following hospitalization for acute heart failure (HF)...

Current guidelines recommend continuation of atovaquone-proguanil (AP) malaria prophylaxis for 7 days after leaving Plasmodium falciparum endemic areas. Evidence from clinical studies suggests that discontinuation of AP 1 day after exposure ends may be safe and effective. Our objective was to assess the effectiveness of short-course AP prophylaxis...

Objective: Four drug classes, platelet inhibitors, β-blockers, statins, and angiotensin-converting enzyme inhibitors (or angiotensin receptor blockers), have been shown to reduce mortality in clinical trials. We sought to evaluate whether the simple number of secondary prevention drugs at discharge is independently associated with 1-year mortality...

Our aim was to evaluate trends in blood pressure (BP) management and BP levels among patients admitted with acute coronary syndromes (ACS) over the past decade. The study population comprised 7658 ACS patients enrolled in the Acute Coronary Syndromes Israeli Survey (ACSIS) between 2002 and 2010. We compared patients' characteristics, admission syst...

Israel was certified as polio-free country in June 2002, along with the rest of the World Health Organization European Region. Some 11 years later, wild-type polio virus 1 (WPV1) was isolated initially from routine sewage samples collected between 7 and 13 April 2013 in two cities in the Southern district. WPV1-specific analysis of samples indicate...

To the Editor: The interventional nutritional study by Estruch et al. (April 4 issue)(1) is limited by low primary composite cardiovascular outcome rates (3.8% and 3.4% in the intervention groups vs. 4.4% in the control group) with minor absolute risk differences (range, 0.6 to 1%). Given these small margins of risk, there were at least four statis...

Background: Contemporary heart failure (HF) therapies have not resulted in improved outcome among HF patients with preserved left ventricular (LV) function. We sought to evaluate the differential effect of LV function on long term mortality following hospitalization for acute HF patients in a real world setting. Methods: All-cause mortality at 4 ye...

Background: Following the EPHESUS trial, published in 2003, mineralocorticoid receptor antagonist (MRA) therapy among acute MI patients with left ventricular dysfunction and heart failure or diabetes mellitus received a class I indication in this high risk population. We sought to assess predictors for the implementation of this indication in a rea...

Background: High-density lipoprotein (HDL) cholesterol is a strong inverse predictor of cardiovascular events. However, it is not clear whether changes in HDL levels during follow-up in apparently healthy individuals affect subsequent cardiovascular outcomes. Methods: The study population comprised 10,067 healthy subjects without known cardiovascul...

Objective: Previous studies have demonstrated an association between increased serum uric acid (SUA) levels and incident diabetes. Most clinical and epidemiological investigations, however, focused solely on male populations or did not analyze men and women separately. We assessed the association between SUA levels and diabetes incidence in a larg...

Background: Clinical thyroid disease is associated with changes in the cardiovascular system, including changes in heart rate during exercise. However, data on the relation between subclinical thyroid disease (SCTD) and heart rate during exercise are limited. Methods: We investigated 3799 apparently healthy subjects who were evaluated in the Ins...

It is well known that quality of life is an integral part in the outcome evaluation process of psoriasis treatment. Very few studies, however, examined the effect of climatotherapy at the Dead Sea on quality of life of such chronically ill patients. To determine the effect of the Dead Sea climatotherapy on the quality of life of patients with psori...

A measles outbreak is affecting the Tel Aviv district, Israel, since April 2012. As of 10 September, 99 cases were confirmed, including 63 (64%) migrants of Eritrean and Sudanese origin. All genotyped cases had the African B3 genotype*. The mean age of migrant and non-migrant cases was 6.0±9.6 and 30.2±24.2 years, respectively (p<0.001). The majori...

Serum lactate dehydrogenase (LDH) is known pathologic marker for a diversity of diseases, including myocardial ischemia. Strenuous and enduring physical activity can transiently induce a greater total LDH level, still within its normal range. To date, however, it has not been determined whether normal-range LDH might be inversely associated with co...

We describe an inadequate antibody response to rabies vaccine in an immunocompromised patient. A literature search revealed 15 additional immunocompromised patients, of whom 7 did not exhibit the minimum acceptable level of antibodies after a complete postexposure prophylaxis regimen. An international rabies registry is needed to provide a basis fo...

Introduction: Ultra-orthodox Jews compose a segregated group that struggles to preserve its centuries-old way of life by strictly adhering to the Jewish religious law in every aspect of life. Their health habits were infrequently studied to date. We sought to determine the smoking prevalence and to find its significant correlates in the ultra-orth...

We report a successful treatment of severe falciparum malaria in a non-immune adult patient with 30% parasitemia treated with the 6-dose oral regimen of artemether plus lumefantrine combination therapy alone. We have also retrospectively searched our tertiary center's database for similar cases and we have found two additional severe malaria cases,...

We present the findings of a six-year surveillance period (2005–2010) of human West Nile virus (WNV) infection in Tel Aviv district, Israel. Initial notifications of positively identified patients received from the Central Virology Laboratory were followed by epidemiological investigations of the local district health office. During 2005–2010, 104...

We report on a cluster of relapsing vivax malaria among Eritrean refugees residing in Israel. Since the beginning of 2010, 15 cases have been identified. Five of the six patients who had complete medical and epidemiological histories, reported Sudan as the place of primary infection during their journey to Israel, and having had the first relapse i...

To the Editor: We report results of an active surveillance system established by the Tel Aviv District Health Office in Israel. This surveillance system monitors the daily status of patients with laboratory-confirmed pandemic (H1N1) 2009 virus infection in each of the district's intensive care units (ICUs), including pediatric ICUs.