Attack Rate Research Articles

A quantitative systems pharmacology model of plasma kallikrein-kinin system dysregulation in hereditary angioedema.

Hereditary angioedema (HAE) due to C1-inhibitor deficiency is a rare, debilitating, genetic disorder characterized by recurrent, unpredictable, attacks of edema. The clinical symptoms of HAE arise from excess bradykinin generation due to dysregulation of the plasma kallikrein-kinin system (KKS). A quantitative systems pharmacology (QSP) model that mechanistically describes the KKS and its role in HAE pathophysiology was developed based on HAE attacks being triggered by autoactivation of factor XII (FXII) to activated FXII (FXIIa), resulting in kallikrein production from prekallikrein. A base pharmacodynamic model was constructed and parameterized from literature data and ex vivo assays measuring inhibition of kallikrein activity in plasma of HAE patients or healthy volunteers who received lanadelumab. HAE attacks were simulated using a virtual patient population, with attacks recorded when systemic bradykinin levels exceeded 20pM. The model was validated by comparing the simulations to observations from lanadelumab and plasma-derived C1-inhibitor clinical trials. The model was then applied to analyze the impact of nonadherence to a daily oral preventive therapy; simulations showed a correlation between the number of missed doses per month and reduced drug effectiveness. The impact of reducing lanadelumab dosing frequency from 300mg every 2weeks (Q2W) to every 4weeks (Q4W) was also examined and showed that while attack rates with Q4W dosing were substantially reduced, the extent of reduction was greater with Q2W dosing. Overall, the QSP model showed good agreement with clinical data and could be used for hypothesis testing and outcome predictions.

The real life experience goes on: update after 4 years on the first cohort treated with lanadelumab at our center

IntroductionLanadelumab is a first-line long-term prophylaxis (LTP) in hereditary angioedema (HAE). Real-life data on its long-term efficacy and safety are limited. It is unknown whether patients using lanadelumab need short-term prophylaxis (STP).ObjectivesTo provide 4-year follow-up data for our first 34 patients treating with lanadelumab.MethodsPatients were assessed for their current injection interval, attacks, treatment satisfaction, disease control (AECT), quality of life impairment (AE-QoL), events that can induce attacks, and the use of STP since the start of their treatment with lanadelumab.ResultsOf 34 patients who started lanadelumab treatment, 32 were still using it after 4 years, with a median injection interval of 33 (range 14-90) days. HAE patients (n=28) reported longer intervals, i.e. 35 (14-90) days, than patients with angioedema due to acquired C1 inhibitor deficiency (n=4, 23 (14-31) days). With their current injection intervals, used for a mean duration of 29 ± 17 months, patients reported a yearly attack rate of 0.3 ± 0.1. More than 70% of patients were attack-free since starting their current injection interval. All patients reported well-controlled disease, i.e. ≥10 points in the AECT; 21 patients had complete control (16 points). AE-QoL scores improved further compared to our initial report, most prominently in the fears/shame domain (-6 points). Treatment satisfaction was very high. No angioedema occurred after 146 of 147 potentially attack-inducing medical procedures without STP.ConclusionsOur results demonstrate the long-term efficacy and safety of lanadelumab in real-life and question the need for STP in patients who use effective LTP.

The feeding and foraging behaviour of three ladybird beetles on Phenacoccus solenopsis (Hem.: Pseudococcidae) at different temperatures

ABSTRACT Ladybird beetles Scymnus nubilus Mulsant, Scymnus interruptus (Goeze), and Hippodamia convergens Guérin-Méneville are key contributors to biological control of some pests including Phenacoccus solenopsis Tinsley. This study explores their feeding preferences, functional response, and interference in controlled laboratory conditions. Feeding experiments, including both no-choice and free-choice tests, were conducted at temperatures ranging from 15 to 35°C fed on different developmental stages of P. solenopsis. The study analyzed the functional response with Holling's disc equation and assessed mutual interference among predators using the Hassell and Varley model. In the no-choice feeding tests, H. convergens adults exhibited the highest consumption at 26°C, with values of 46.0 1st instar nymphs, 40.9 2nd instar nymphs, and 34.9 adult females of P. solenopsis, followed by S. interruptus. Free-choice feeding tests also showed a preference for 26°C, with H. convergens consistently consuming the most prey at all stages, followed by S. interruptus. Functional response analysis revealed a type II functional response for three predators. Hippodamia convergens exhibited a significantly higher attack rate (1.0250 h−1) and a shorter handling time (0.0449 h) compared to the other species. Interference among predators was observed, with a progressive decline in prey consumption as predator density increased. Mutual interference constants (m) were calculated as 1.70, 1.74, and 1.77 for S. nubilus, S. interruptus, and H. convergens, respectively. As predator densities increased, searching efficiency declined. This suggest that H. convergens and S. interruptus adults at 26°C with a prey density of 40 can effectively contribute to sustainable P. solenopsis management.

High SARS-CoV-2 incidence and asymptomatic fraction during Delta and Omicron BA.1 waves in The Gambia

Little is known about SARS-CoV-2 infection risk in African countries with high levels of infection-driven immunity and low vaccine coverage. We conducted a prospective cohort study of 349 participants from 52 households in The Gambia between March 2021 and June 2022, with routine weekly SARS-CoV-2 RT-PCR and 6-monthly SARS-CoV-2 serology. Attack rates of 45% and 57% were seen during Delta and Omicron BA.1 waves respectively. Eighty-four percent of RT-PCR-positive infections were asymptomatic. Children under 5-years had a lower incidence of infection than 18-49-year-olds. One prior SARS-CoV-2 infection reduced infection risk during the Delta wave only, with immunity from ≥2 prior infections required to reduce the risk of infection with early Omicron lineage viruses. In an African population with high levels of infection-driven immunity and low vaccine coverage, we find high attack rates during SARS-CoV-2 waves, with a high proportion of asymptomatic infections and young children remaining relatively protected from infection.

Epidemiology of transient ischemic attack in the normandy stroke population-based study.

Transient ischemic attack (TIA) is a frequent neurological emergency which management and definition have changed radically over the last 15 years. However, recent epidemiological studies of TIA are scarce. We report here on the impact of the shift from a time-based to a tissue-based definition of TIA on its incidence and risk of recurrence in a new population-based cohort with a high rate of patients investigated by MRI. We prospectively included all TIAs that occurred between May 2017 and May 2021 from the Normandy Stroke Study, a population-based registry using multiple overlapping sources for exhaustive case identification in Caen la Mer area. TIAs were classified as either time-based (symptoms <24 h) or tissue-based (<24 h and no lesion on brain imaging). Attack and incidence rates were calculated, as was the 90-day ischemic stroke rate. Five hundred and sixty-seven TIAs (549 single patients) were included, with 80.6% having a brain MRI. Four hundred and ten (72.3%) met the definition of tissue-based TIA. The age standardized attack (to the 2013 European population) rate was 39.5 (95% CI 35.7-43.5) and the age-standardized incidence rate (first ever cerebrovascular event) was 29.7 (95% CI 27.3-34.2). The overall recurrent stroke rate at 90 days was 2.7%, with no difference between patients with or without ischemic lesions on MRI. We found that the use of the tissue-based definition of TIA resulted in a 27.5% reduction in incidence as compared to the time-based definition, but had no impact on the 90-day stroke rate. The burden of TIA remains high, and is likely to increase as the population ages.

Measles outbreak investigation in Berhet District, North Shewa, Ethiopia

IntroductionMeasles, though usually self-limiting, can have severe consequences influenced by factors such as vaccination and nutrition, notably vitamin A deficiency and malnutrition. Despite progress, contextual changes and implementation issues have hampered efforts, resulting in increased outbreaks and cases of measles. This study seeks to pinpoint outbreak features, risk factors, and strategies for preventing and controlling measles.MethodsA descriptive cross-sectional study and a 1:2 unmatched case-control study design were employed. All 101 suspected measles cases listed on the line-list were included in the descriptive research, with 60 measles patients and 120 controls included in the case-control investigation. Line-list data were cleaned and analyzed using a pivot table in Microsoft Excel 2016. Subsequently, the data were cleaned, entered into Epi Info 7.2, and exported to SPSS 26 for analysis.ResultsTwenty cases occurred per 10,000 individuals. Men accounted for 67.3% of cases, with ages ranging from 5 months to 45 years and mean and standard deviations of 9.6 and 7.6, respectively. Age group of 5–14 years comprised 57.4% of cases, followed by 1–4 years with 24.8%. Being unvaccinated against measles showed an adjusted odds ratio (AOR) of 12.06 (95% CI: 3.12–46.52). Travel history to regions with active cases had an AOR of 5.73 (95% CI: 1.78–18.38). Contact with a measles patient showed an AOR of 10.3 (95% CI: 3.48–30.5). Understanding the measles transmission mechanism had an AOR of 0.164 (95% CI: 0.049–0.55), and awareness of the disease's preventability had an AOR of 0.233 (95% CI: 0.67–0.811). All factors were independently associated with the illness.ConclusionThis outbreak affected a broader age range with a high attack rate, mainly in the age group of 5–14-years. Over 35% of cases lacked measles vaccination, indicating low administrative vaccine coverage. Factors contributing to the outbreak include lack of measles vaccination, travel to areas with active disease, contact with cases, and insufficient knowledge of measles transmission and prevention strategies among mothers and caregivers.

Garadacimab for hereditary angioedema attack prevention: long-term efficacy, quality of life, and safety data from a phase 2, randomised, open-label extension study

Garadacimab is a fully human immunoglobulin G4 monoclonal antibody targeting activated factor XII. This study evaluated long-term efficacy, health-related quality of life (HRQoL), and safety data for garadacimab in adults with hereditary angioedema. This global phase 2 study comprised a treatment period 1 (TP1: 12 weeks, double-blind, placebo-controlled) and a treatment period 2 (TP2: ≥44-week open-label extension). Patients aged 18-65 years with clinically confirmed hereditary angioedema were eligible. In TP1, 32 patients were randomly assigned (1:1:1:1) to receive subcutaneous garadacimab (75 mg, 200 mg, or 600 mg) or placebo every 4 weeks (once monthly). Randomisation was done using interactive response technology via block randomisation (block sizes 1-4). Subsequently, six additional patients in TP1 were assigned to open-label garadacimab 400 mg every 2 weeks. At the start of TP2, patients were re-randomised (if receiving placebo, garadacimab 75 mg, or garadacimab 400 mg) or continued to receive garadacimab 200 mg or garadacimab 600 mg once monthly. After a protocol amendment on March 20, 2020, patients originally assigned to the 600 mg dose were down-titrated to 200 mg at their next visit. The primary endpoint (published previously) was monthly attack rate for patients receiving 200 mg or 600 mg garadacimab in TP1 in the intention-to-treat population. Here, we assessed the impact of garadacimab on patient-reported and investigator-reported outcomes and HRQoL as well as long-term efficacy and safety. This trial is registered with ClinicalTrials.gov, NCT03712228, and is completed. Of 54 patients screened between Oct 29, 2018, and Aug 28, 2019, 32 randomised and six open-label patients completed TP1 and entered TP2 (20 in the garadacimab 200 mg group; 18 in the garadacimab 600 mg group; total 38 patients). Median age was 39·0 years (IQR 27·0-53·0), and 21 patients (55%) were female and 17 (45%) were male. In TP2, the median garadacimab exposure was 87·9 weeks (IQR 50·0-106·6) in the garadacimab 200 mg group and 44·1 weeks (24·1-56·1) in the garadacimab 600 mg group. Median monthly attack rates were 0·0 (IQR 0·0-0·1) in the garadacimab 200 mg group and 0·1 (0·0-0·4) in the garadacimb 600 mg group. Median reduction in monthly attack rate versus run-in was 100% (IQR 98-100) with garadacimab 200 mg. HRQoL improvements observed during TP1 with garadacimab were sustained throughout TP2. TP2 safety signals were consistent with TP1. Two patients experienced serious adverse events of diverticular perforation and asthma (not garadacimab-related). Treatment-emergent adverse events were mostly mild or moderate in severity. The most common adverse events were headache (nine of 38, 24%) and abdominal pain (seven of 38, 18%). There were no treatment-related deaths. Once-monthly garadacimab for more than 2 years in patients with hereditary angioedema was well tolerated and efficacious in reducing monthly attack rate and improving HRQoL. These results reveal the potential of long-term prophylactic treatment with 200 mg once-monthly garadacimab towards complete disease control of patients with hereditary angioedema. CSL Behring.

Epidemiology of SARS-CoV-2 in Kakuma Refugee Camp Complex, Kenya, 2020-20211.

Understanding SARS-CoV-2 infection in populations at increased risk for poor health is critical to reducing disease. We describe the epidemiology of SARS-CoV-2 infection in Kakuma Refugee Camp Complex, Kenya. We performed descriptive analyses of SARS-CoV-2 infection in the camp and surrounding community during March 16, 2020‒December 31, 2021. We identified cases in accordance with national guidelines.We estimated fatality ratios and attack rates over time using locally weighted scatterplot smoothing for refugees, host community members, and national population. Of the 18,864 SARS-CoV-2 tests performed, 1,024 were positive, collected from 664 refugees and 360 host community members. Attack rates were 325.0/100,000 population (CFR 2.9%) for refugees,150.2/100,000 population (CFR 1.11%) for community, and 628.8/100,000 population (CFR 1.83%) nationwide. During 2020-2021, refugees experienced a lower attack rate but higher CFR than the national population, underscoring the need to prioritize SARS-CoV-2 mitigation measures, including vaccination.

Real-time investigation of an influenza A(H3N2) virus outbreak in a refugee community, November 2022

ObjectivesTo report epidemiological and virological results of an outbreak investigation of influenza-like illness (ILI) among refugees in Northern Italy. Study designOutbreak investigation of ILI cases observed among nearly 100 refugees in Northern Italy unvaccinated for influenza. MethodsAn epidemiological investigation matched with a differential diagnosis was carried out for each sample collected from ILI cases to identify 10 viral pathogens (SARS-CoV-2, influenza virus type A and B, respiratory syncytial virus, metapneumovirus, parainfluenza viruses, rhinovirus, enterovirus, parechovirus, and adenovirus) by using specific real-time PCR assays according to the Centers for Disease Control and Prevention (CDC) protocols. In cases where the influenza virus type was identified, complete hemagglutinin (HA) gene sequencing and the related phylogenetic analysis were conducted. ResultsThe outbreak was caused by influenza A(H3N2): the attack rate was 83.3% in children aged 9–14 years, 84.6% in those aged 15–24 years, and 28.6% in adults ≥25 years. Phylogenetic analyses uncovered that A(H3N2) strains were closely related since they segregated in the same cluster, showing both a high mean nucleotide identity (100%), all belonging to the genetic sub-group 3C.2a1b.2a.2, as those mainly circulating into the general population in the same period. ConclusionsThe fact that influenza outbreak strains as well as the community strains were genetically related to the seasonal vaccine strain suggests that if an influenza prevention by vaccination strategy had been implemented, a lower attack rate of A(H3N2) and ILI cases might have been achieved.

Evaluating Seasonal Variations in Human Contact Patterns and Their Impact on the Transmission of Respiratory Infectious Diseases.

Human contact patterns are a key determinant driving the spread of respiratory infectious diseases. However, the relationship between contact patterns and seasonality as well as their possible association with the seasonality of respiratory diseases is yet to be clarified. We investigated the association between temperature and human contact patterns using data collected through a cross-sectional diary-based contact survey in Shanghai, China, between December 24, 2017, and May 30, 2018. We then developed a compartmental model of influenza transmission informed by the derived seasonal trends in the number of contacts and validated it against A(H1N1)pdm09 influenza data collected in Shanghai during the same period. We identified a significant inverse relationship between the number of contacts and the seasonal temperature trend defined as a spline interpolation of temperature data (p = 0.003). We estimated an average of 16.4 (95% PrI: 15.1-17.5) contacts per day in December 2017 that increased to an average of 17.6 contacts (95% PrI: 16.5-19.3) in January 2018 and then declined to an average of 10.3 (95% PrI: 9.4-10.8) in May 2018. Estimates of influenza incidence obtained by the compartmental model comply with the observed epidemiological data. The reproduction number was estimated to increase from 1.24 (95% CI: 1.21-1.27) in December to a peak of 1.34 (95% CI: 1.31-1.37) in January. The estimated median infection attack rate at the end of the season was 27.4% (95% CI: 23.7-30.5%). Our findings support a relationship between temperature and contact patterns, which can contribute to deepen the understanding of the relationship between social interactions and the epidemiology of respiratory infectious diseases.

Comparative Effectiveness of Baloxavir Marboxil and Oseltamivir Treatment in Reducing Household Transmission of Influenza: A Post Hoc Analysis of the BLOCKSTONE Trial.

The transmission of influenza virus in households, especially by children, is a major route of infection. Prior studies suggest that timely antiviral treatment of ill cases may reduce infection in household contacts. The aim of the study was to compare the effects of oseltamivir (OTV) and baloxavir marboxil (BXM) treatment of index cases on the secondary attack rate (SAR) of influenza within household. A post hoc analysis was done in BLOCKSTONE trial-a placebo-controlled, double-blinded post-exposure prophylaxis of BXM. Data were derived from the laboratory-confirmed index cases' household contacts who received placebo in the trial and also from household members who did not participate in the trial but completed illness questionnaires. To assess the SAR of household members, multivariate analyses adjusted for factors including age, vaccination status, and household size were performed and compared between contacts of index cases treated with BXM or OTV. In total, 185 index cases (116 treated with BXM and 69 treated with OTV) and 410 household contacts (201 from trial, 209 by questionnaire) were included. The Poisson regression modeling showed that the SAR in household contacts of index cases treated with BXM and OTV was 10.8% and 18.5%, respectively; the adjusted relative reduction in SAR was 41.8% (95% confidence interval: 1.0%-65.7%, p = 0.0456) greater with BXM than OTV. Similar reductions were found in contacts from the trial and those included by questionnaire. BXM treatment of index cases appeared to result in a greater reduction in secondary household transmission than OTV treatment.

Streptococcus pyogenes carriage and infection within households in The Gambia: a longitudinal cohort study.

Streptococcus pyogenes causes more than 500 000 deaths per year globally, which occur disproportionately in low-income and middle-income countries. The roles of S pyogenes skin and pharyngeal carriage in transmission are unclear. We aimed to investigate the clinical epidemiology and household transmission dynamics of both S pyogenes asymptomatic carriage and infection in a high-burden setting. We did a 1-year prospective, longitudinal, household cohort study, recruiting healthy participants from households in Sukuta, The Gambia. Households were eligible if they comprised at least three members, including one child younger than 18 years, and were excluded if more than half of household members declined to participate. Households were identified by random GPS coordinates derived from census data. At monthly visits, pharyngeal and normal skin swabs were collected for S pyogenes culture, and sociodemographic data were recorded by interview. Incident pharyngitis and pyoderma infections were captured. Cultured isolates underwent emm genotyping. The primary outcome measures were incidence of S pyogenes carriage and disease. Additional outcomes were prevalence of S pyogenes skin and pharyngeal carriage, S pyogenes skin and pharyngeal clearance time, S pyogenes emm type, risk factors for carriage and disease events, household secondary attack rate, and emm-linked household transmission events. The study is registered on ClinicalTrials.gov, NCT05117528. Between July 27, 2021, and Sept 28, 2022, 442 participants were enrolled from 44 households. The median age was 15 years (IQR 6-28) and 233 (53%) were female. We identified 17 pharyngitis and 99 pyoderma events and 49pharyngeal and 39 skin S pyogenes carriage acquisition events. Mean monthly prevalence was 1·4% (95% CI 1·1-1·9) for S pyogenes pharyngeal carriage and 1·2% (0·9-1·6) for S pyogenes skin carriage. Incidence was 120 per 1000 person-years (95% CI 87-166) for S pyogenes pharyngeal carriage, 124 per 1000 person-years (90-170) for S pyogenes skin carriage, 51 per 1000 person-years (31-84) for S pyogenes pharyngitis, and 263 per 1000 person-years (212-327) for S pyogenes pyoderma. Pharyngeal carriage risk was higher during the rainy season (HR 5·67, 95% CI 2·19-14·69) and in larger households (per additional person: 1·03, 1·00-1·05), as was pharyngitis risk (rainy season: 3·00, 1·10-8·22; household size: 1·04, 1·02-1·07). Skin carriage risk was not affected by season or household size, but was lower in female than in male participants (0·45, 0·22-0·92) and highest in children younger than 5 years compared with adults (22·69, 3·08-167·21), with similar findings for pyoderma (female sex: 0·34, 0·19-0·61; age <5 years: 7·00, 2·78-17·64). Median clearance time after carriage acquisition was 4·0 days for both skin (IQR 3·5-7·0) and pharynx (3·5-7·3). The mean household secondary attack rate was 4·9 (95% CI 3·5-6·3) for epidemiologically linked Spyogenes events and 0·74 (0·3-1·2) for emm-linked S pyogenes events. Of the 204 carriage and disease events, emm types were available for 179 (88%). Only 18 emm-linked between-visit household transmission events were identified. Pyoderma was the most common source of S pyogenes household transmissions in 11 (61%) of 18 emm-linked transmissions. Both pharynx to skin and skin to pharynx transmission events were observed. S pyogenes carriage and infection are common in The Gambia, particularly in children. Most events are non-household acquisitions, but skin carriage and pyoderma have an important role in S pyogenes household transmission and bidirectional transmission between skin and pharynx occurs. Wellcome Trust, Chadwick Trust, Fonds National de la Recherche Scientifique (Belgium), European Society for Paediatric Infectious Diseases, and Medical Research Council (UK).

Prevalence of African Mosaic and Morphological Characterization of Cassava (Manihot esculenta Cranz) Varieties in Two Agroecological Zones of Cameroon

The objective of this work is to conduct an epidemiological study of African cassava mosaic and to characterize the diversity of local cultivars in circulation in the monomodal and bimodal rainforest zones of Cameroon. Disease-related parameters (incidence and severity index) were studied as well as morphological parameters (plant height, leaflet color, petiole color, lobe length, number of lobes, number of branches, petiole length). The results show that 96 cassava varieties were identified with 89 local varieties and 07 improved varieties. Diseased plants showed a symptom severity index of 1 to 5, which could reduce production by half in the areas considered. The leaf color was dark green, the number of branches was 3, the lobe and petiole lengths were 16.46 and 22 cm respectively, while the number of lobes was 5 the disease incidence for the two agro-ecological zones as a whole is 57.58% for a symptom severity index of 3. The epidemiological study reveals that the desease incidence of both agro-ecological zones was 57.58 % for a symptom severity index of 2 corresponding to 40 %.  In the humid forest zone with monomodal spray the average incidence was 49.74% and a leaf attack rate was 29.03 % in the locality of Njombé (Cameroon's littoral region). At Ekona in southwestern Cameroon, the average incidence was 63% and leaf attack index was 1 corresponding to 20 %. In the bimodal rainforest zone (central Cameroon region), the average incidence was 60 % for a leaf attack rate was 37.11%. The expected results highlight a relatively worrying situation. Principal Component Analysis (PCA) confirms the convergence of tolerance towards the mosaic and grouped the different varieties into more or less homogeneous groups according to the morphological and epidemiological cassava descriptors. The results of the present work show that the introduction of cassava local varieties tolerant to mosaic disease in middling could be an alternative for the control of the cassava mosaic disease.

Spatiotemporal dynamics of prey-predator model incorporating Holling-type II functional response with fear and its carryover effects.

The recent focus in the fields of biology and ecology has centered on the significant attention given to the mathematical modeling and analyzing the spatiotemporal population distribution among species engaged in interactions. This paper explores the dynamics of the temporal and spatiotemporal delayed Bazykin-type prey-predator model, incorporating fear and its carryover effect. In our model, we incorporated a functional response of the Holling-type II. In the temporal model, a detailed dynamic analysis was carried out, investigating the positivity and boundedness of solutions, establishing the uniqueness and existence of positive interior equilibria, and examining both local and global stability. Additionally, we explored the presence of saddle-node, transcritical, and Hopf bifurcations varying attack rate parameter. The delayed system shows highly periodic behavior. Additionally, for the spatiotemporal model, we provide a complete analysis of local and global stability, and we derive the conditions for the existence of Turing instability for both self-diffusion and cross-diffusion, respectively. The two-dimensional diffusive model is further discussed, highlighting various Turing patterns, including holes, stripes, and hot and cold spots, along with their biological significance. Numerical simulations are executed to validate the analytical findings in both temporal and spatiotemporal models.

SARS-CoV-2 infection after COVID-19 vaccinations among vaccinated individuals, prevention rate of COVID-19 vaccination: A systematic review and meta-analysis

BackgroundThe global concern regarding protection against the COVID-19 variants through pre-existing antibodies from vaccination or previous infection is evident. Reports from around the world indicate that a considerable number of healthcare professionals/individuals experience re-infection despite being vaccinated. Moreover, several studies have highlighted cases of symptomatic SARS-CoV-2 re-infection, specifically among individuals who have been vaccinated. Understanding the factors that contribute to these re-infections is crucial for implementing effective public health measures and enhancing vaccination strategies. MethodA comprehensive search was conducted between January 1, 2021, and February 14, 2024, using various reputable sources such as PubMed, Google scholar, Medline, EMBASE, CINAHL, and others. The search aimed to retrieve relevant research on topics related to “world nations” and phrases like “COVID-19 vaccination breakthrough infection,” “SARS re-infection after COVID-19 vaccination,” “COVID-19 vaccine complication,” “post COVID-19 vaccination symptoms,” and specific nation names. The data obtained from the databases underwent extraction and quality assessment using the Newcastle-Ottawa Scale (NOS) and the Preferred Reporting Items for Systematic Review and Meta-Analyses. Data analysis was performed using STATA17MP software, and measures such as the I2 test statistic and Egger's test were used to assess heterogeneity and publication bias. The findings were presented using forest plots, displaying the odds ratio (OR) and 95 % confidence interval (CI). ResultThis review and meta-analysis comprised a total of 15 articles, or a total sample size of 342,598. The pooled prevalence of SARS-CoV-2 after vaccination of COVID-19 was 9 % (95CI 7%–11 %) of population globally. This implied that reduced the overall attack rate of COVID-19 by 91 % after vaccination. The highest pooled estimated of SARS-CoV-2 infection after COVID -19 Vaccinations was seen among developing nations, 20 % (95 % CI: 5%–36 %).The pooled odds ratio showed that a significant association was found between SARS-CoV-2 infection after COVID-19 vaccination and older age (OR = 2.04; 95%CI: 1.10–2.98) and comorbidity (OR = 3.25; 95%CI: 1.04–5.47). ConclusionIt is important for policymakers to prioritize continuous monitoring and surveillance of SARS-CoV-2 infection rates among vaccinated individuals globally, as there is a significant estimate of the combined prevalence of post-COVID-19 vaccine SARS-CoV-2 infections.

Relative effectiveness of a heterologous booster dose with adenovirus type 5 vectored COVID-19 vaccine versus three doses of inactivated COVID-19 vaccine in adults during a nationwide outbreak of omicron predominance, in China: a retrospective, individually matched cohort-control study

ABSTRACT Effectiveness of heterologous booster regimes with ad5 vectored COVID-19 vaccine in a large, diverse population during the national-scale outbreak of SARS-CoV-2 omicron predominance in China has not been reported, yet. We conducted a large-scale cohort-control study in six provinces in China, and did a retrospective survey on the COVID-19 attack risk during this outbreak. Participant aged ≥18 years in five previous trials who were primed with 1 to 3 doses of ICV received heterologous booster with either intramuscular or orally inhaled ad5 vectored COVID-19 vaccine were included in the heterologous-trial cohort. We performed propensity score-matching at a ratio of 1:4 to match participants in the heterologous-trial cohort individually with the community individuals who received three-dose of ICV as a control (ICV-community cohort). From February 4 to April 10, 2023, 41504 (74.5%) of 55710 individuals completed the survey. The median time since the most recent vaccination to the onset of the symptoms of COVID-19 was 303.0 days (IQR 293.0-322.0). The attack rate of COVID-19 in the heterologous-trial cohort was 55.8%, while that in the ICV-community cohort was 64.6%, resulting in a relative effectiveness of 13.7% (95% CI 11.9 to 15.3). In addition, a higher relative effectiveness against COVID-19 associated outpatient visits, and admission to hospital was demonstrated, which was 25.1% (95% CI 18.9 to 30.9), and 48.9% (95% CI 27.0 to 64.2), respectively. The heterologous booster with ad5 vectored COVID-19 vaccine still offered some additional protection in preventing COVID-19 breakthrough infection versus homologous three-dose regimen with ICV, 10 months after vaccination.

A SARS-CoV-2 outbreak investigation at a storage and distribution centre in England: an assessment of worker- and workplace-related risk factors

An outbreak of SARS-CoV-2 (1 March to 10 May 2021) with an attack rate of 26.5% among approximately 1150 workers at a storage and distribution centre in England prompted a multidisciplinary outbreak investigation (5 May to 6 August 2021), with the aim of better understanding worker- and workplace-related risk factors for viral transmission in the warehousing sector. Overall, environmental factors (e.g., ventilation, humidity and temperature) were assessed to be appropriate at the facility. Nevertheless, 39 (51.3%) surface samples from across the site tested positive for low/ very low levels of SARS-CoV-2 RNA (Ct value ≥ 32.0 for all). Among the study participants, of whom 35.6% were confirmed or suspected cases, 95.5% reported having received COVID-19 prevention training, 100.0% reported handwashing, and 80.0% reported use of face coverings at work. Notably, 43.9% and 19.0% reported working with a symptomatic and a positive contact respectively. Furthermore, 80.5% and 46.3% had concerns regarding reduction in their income and future unemployment, respectively, due to self-isolation. The findings of this study suggest that, in addition to targeted workplace infection control measures and tailored work area specific risk assessments, an enhanced and equitable sick leave policy may help limit presenteeism and viral transmission in large workplaces.

Epidemiology and risk factors of lumpy skin disease outbreak in cattle in the north-west area of Bangladesh

Lumpy skin disease (LSD) is an acute viral disease of cattle that recently emerged in Bangladesh that negatively impacts livestock by reducing animal production, increasing management costs, and death of infected animals. Recently, Bangladesh has faced the ominous effects of LSD, like other countries. Because of this pressing concern, the present cross-sectional study was undertaken to determine the infection status and risk factors of LSD outbreaks from January to December 2023 in Bangladesh’s northwest area. A total of 2858 cattle from various randomly selected farms were surveyed. The diagnosis was made on the basis of clinical inspection, clinical history, and owner complaints. The overall attack rate, mortality, and case fatality were 37.6%, 2.8%, and 7.5%, respectively, but in calves (≤1 month), the attack rate, mortality, and case fatality were 44.3%, 9.3%, and 21.3%, respectively. The infection status was discussed based on age, sex, breed, genotype, health status, immune status, coat color, farm size, farming system, separation of affected animals, separation place, use of common utensils, introduction of new cattle, use of vaccine and season of the year. Among them, age, sex, breed, health status, coat color, farm size, farming system, use of common utensils, and introduction of new cattle have no significant relationship with LSD outbreaks, but in calves (≤ 1 year), age has a significant association with the occurrence of LSD. The risk factor analysis revealed that the outbreaks of LSD were significantly (p&lt;0.05) associated with genotypes, immune status, separation place, vaccination status of farm, and season of the year. The findings of the present study could provide useful epidemiological data on risk factors associated with LSD to livestock owners, field veterinarians, and government-level livestock regulators, which will help formulate prevention and control strategies and minimize the negative impact of LSD on cattle farming.

Do Invasive Jorō Spiders (Trichonephila clavata) from Asia Avoid Eating Unpalatable Monarch Butterflies (Danaus plexippus) in North America?

An invasive spider from East Asia has established in the U.S. southeast (the “jorō spider,” Trichonephila clavata) and is rapidly expanding its range. Studies assessing the impact of this species are needed, including how expansive its diet is. An open question is whether monarch butterflies, Danaus plexippus, are a potential prey item for this spider, given that jorō spiders do not coexist with monarchs in their native range. Since monarch larvae feed on milkweed, they sequester cardiac glycosides into their adult tissues, rendering them unpalatable to many predators. At sites within northeast Georgia, we staged a series of trials (n = 61) where we tossed monarchs into jorō spider webs and, for comparison, performed similar trials with another aposematic species, gulf fritillary (Agraulis vanilla), and a palatable species, tiger swallowtail (Papilio glaucus). We recorded the outcome of the trials, which included whether the spider attacked or did not attack the prey. We also conducted a visual survey during the same fall season to look for evidence of jorō spiders consuming monarchs naturally. Our findings revealed that jorō spiders avoided eating monarchs; spiders only attacked monarchs 20% of the time, which was significantly less than the attack rates of similarly sized or larger butterflies: 86% for gulf fritillaries and 58% for tiger swallowtails. Some jorō spiders even removed monarchs from their webs. From our visual surveys of the surrounding area, we found no evidence of natural monarch consumption and, in general, butterflies made up only a fraction of the jorō spider diet. We conclude that jorō spiders appear to recognize monarch butterflies as being unpalatable, even without having a prior history with the species. This invokes questions about how these spiders can immediately recognize their unpalatability without touching the butterflies.

GSB: GNGS and SAG-BiGRU network for malware dynamic detection.

With the rapid development of the Internet, the continuous increase of malware and its variants have brought greatly challenges for cyber security. Due to the imbalance of the data distribution, the research on malware detection focuses on the accuracy of the whole data sample, while ignoring the detection rate of the minority categories' malware. In the dataset sample, the normal data samples account for the majority, while the attacks' malware accounts for the minority. However, the minority categories' attacks will bring great losses to countries, enterprises, or individuals. For solving the problem, this study proposed the GNGS algorithm to construct a new balance dataset for the model algorithm to pay more attention to the feature learning of the minority attacks' malware to improve the detection rate of attacks' malware. The traditional malware detection method is highly dependent on professional knowledge and static analysis, so we used the Self-Attention with Gate mechanism (SAG) based on the Transformer to carry out feature extraction between the local and global features and filter irrelevant noise information, then extracted the long-distance dependency temporal sequence features by the BiGRU network, and obtained the classification results through the SoftMax classifier. In the study, we used the Alibaba Cloud dataset for malware multi-classification. Compared the GSB deep learning network model with other current studies, the experimental results showed that the Gaussian noise generation strategy (GNGS) could solve the unbalanced distribution of minority categories' malware and the SAG-BiGRU algorithm obtained the accuracy rate of 88.7% on the eight-classification, which has better performance than other existing algorithms, and the GSB model also has a good effect on the NSL-KDD dataset, which showed the GSB model is effective for other network intrusion detection.