Contagion Rate Research Articles

COVID-19 en la República Dominicana: Declaramos la guerra, pero... ¿estamos ganando?

En este documento se presentan estimaciones de la tasa de contagio y el número reproductivo R0 del COVID-19 para la República Dominicana, contrastándolas con las identificadas para una selección de países. Las estimaciones se obtienen adaptando el enfoque estado-espacio al modelo canónico de epidemiología SIR. Con datos obtenidos al 16 de abril, los resultados indican una tendencia decreciente en los contagios secundarios (R0), sugiriendo que las políticas de distanciamiento han sido efectivas en disminuir la propagación del virus. Sin embargo, también sugieren que para reducirla a los niveles prevalecientes en los países que han sido más exitosos conteniendo la epidemia se deberían fortalecer y extender las medidas vigentes.

COVID-19 in pediatric cancer patients: risk of infection, surveillance and containment.

Coronavirus disease 2019 (COVID-19) continues to affect people throughout the planet due to its high contagion rate. Patients affected by the disease who received immunosuppressive treatments are at risk of developing the most serious aspects of COVID-19. So how does this new coronavirus affect pediatric cancer patients who are constantly immunosuppressed? How is it possible to reduce the risk of contagion in the oncology and hematology departments? We synthesized a couple of important articles on the subject.

In Response.

We thank Anile et al1 for their letter which expanded our concept of ultrasound (US)-guided triage for early detection of coronavirus disease 2019 (COVID-19) lung pneumonia. Moreover, we really appreciated the concept of a COVID alphabet as a multimodal approach to guide diagnosis and treatment in critical patients admitted in intensive care units (ICUs).2 Since its outbreak, COVID-19 pandemic created a never seen before connection between physicians from everywhere in the world, which resulted in sharing crucial information and data about early clinical experiences. Although many therapies have been suggested, at present, there are still no specific options capable of treating successfully severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease; by now, the only viable intervention which has proven to decrease the contagion rate seems to be preventive measures between general population, including quarantine, social distancing, and personal hygiene.3 In COVID-19 symptomatic patients, the disease stage and the extent of multiorganic involvement should be defined in order to plan the care process properly. In this regard, the COVID US alphabet could be universally spoken, across all medical specialties and the nationalities, giving accurate indications on the pathology stages and guiding clinicians through therapeutic interventions. US can graphically track the entire timeline of COVID-19 lung infection, recognizing typical signs from the initial stages to the advanced ones.4 US has a fundamental role in both prehospital and intrahospital care, but it should not be excluded as a useful application in posthospital follow-up as well. A summary of the potential role for US in both pandemic and postpandemic stages is shown in the Figure. Recent evidence, in fact, suggests possible long-term pulmonary lesions caused by COVID-19 disease.5Figure.: The evolution of US role in COVID-19 pandemic. COVID-19 indicates coronavirus disease 2019; US, ultrasound.US follow-up could be performed by clinicians with different skill sets, including general practitioners in outpatient medical settings, that is, clinics, medical offices, or even at patient’s home. Currently, the use of US has spread throughout medical disciplines, encouraged by the commercialization of portable probes, which have been proven effective in both diagnostic and interventional settings,6 and could be useful in environments beyond the ICU or the emergency department. Furthermore, a prehospital US assessment may contribute to early diagnosis in the event of a forthcoming new pandemic; US could be used as a screening test in combination with real time-polymerase chain reaction (PCR) and rapid serologic tests in patients who exhibit symptoms of respiratory tract infections. The use of US as a simple, noninvasive, and low-cost screening test for early detection of new clusters of SARS-CoV-2 contagions could be a key weapon to ward off the threat of a new world pandemic. Giuseppe Pascarella, MDAlessandro Strumia, MDUnit of Anaesthesia, Intensive Careand Pain ManagementDepartment of MedicineUniversità Campus Bio-Medico di RomaRome, ItalyMichael Benjamin Stone, MDDepartment of Emergency MedicineLegacy Emanuel Medical CenterPortland, OregonChiara Piliego, MDUnit of Anaesthesia, Intensive Careand Pain ManagementDepartment of MedicineUniversità Campus Bio-Medico di RomaRome, Italy[email protected]

Estudio comparativo entre el contagio durante la cuarentena obligada por el COVID-19 y el contagio durante la apertura gradual y controlada para algunos sectores de la economía en Colombia

Introducción: el nuevo coronavirus COVID-19 ha sido clasificado por la Organización Mundial de la Salud como una emergencia en salud pública de importancia internacional (ESPII). Se han reconocido casos en todos los continentes y el 6 de marzo se confirmó el primero en Colombia. La infección se evidencia cuando una persona enferma tose o estornuda y expulsa partículas del virus que entran en contacto con otras personas. Objetivo: presentar un estudio comparativo entre el promedio de contagio durante la cuarentena obligada por el COVID-19 y el promedio de contagio durante la apertura gradual y controlada para algunos sectores de la economía. Materiales y métodos: se utilizó la base de datos de las personas infectadas por el COVID-19 con la información correspondiente al período 25 de marzo 2020 a 26 de abril 2020 de cuarentena obligada entre 27 de abril a 29 de mayo 2020 con la apertura gradual y controlada para algunos sectores de la economía. En su análisis se utilizó la prueba t-student para muestras independientes, utilizando el paquete estadístico SPSS v.25. Resultados: se presentó mayor contagio de personas por COVID-19 con la apertura global y sistemática de varios sectores de la economía; a partir del análisis estadístico de los datos aplicando la prueba t-student se pudo observar que hay evidencia para rechazar la hipótesis nula; por consiguiente, las medias son diferentes. Conclusiones: la estrategia a seguir es sostener el aislamiento preventivo obligatorio para los grupos específicos y la cuarenta en toda la población.

Modelagem das mudanças comportamentais durante a propagação do sars-cov-2: um estudo de caso considerando o atraso nos testes

Este artigo apresenta uma modelagem epidêmico-comportamental da disseminação SARS-CoV-2 no Amapá em que foi empregada uma generalização do modelo SIR que captura a resposta comportamental da população no decorrer da evolução epidêmica através de um fator de redução δ na taxa de contágio. Os resultados da etapa de validação do modelo com os dados reais mostram que δ = [0.614.0.638] sinalizando que a resposta comportamental foi responsável por uma redução de ~[36,39]% na taxa de transmissibilidade epidêmica. Posteriormente, desenvolve-se uma análise dos cenários que podem emergir para um relaxamento das medidas de isolamento com tR dias após o primeiro pico considerando-se um novo fator de redução da transmissibilidade δR > δ. Os resultados indicam que a saída disciplinada (δR ≤0.80) do período de confinamento com 3 semanas (tR = 21) após o primeiro pico ainda pode desencadear um segundo pico, mas com um alcance menor que o primeiro.

A Simulation of a COVID-19 Epidemic Based on a Deterministic SEIR Model.

An epidemic disease caused by a new coronavirus has spread in Northern Italy with a strong contagion rate. We implement an SEIR model to compute the infected population and the number of casualties of this epidemic. The example may ideally regard the situation in the Italian Region of Lombardy, where the epidemic started on February 24, but by no means attempts to perform a rigorous case study in view of the lack of suitable data and the uncertainty of the different parameters, namely, the variation of the degree of home isolation and social distancing as a function of time, the initial number of exposed individuals and infected people, the incubation and infectious periods, and the fatality rate. First, we perform an analysis of the results of the model by varying the parameters and initial conditions (in order for the epidemic to start, there should be at least one exposed or one infectious human). Then, we consider the Lombardy case and calibrate the model with the number of dead individuals to date (May 5, 2020) and constrain the parameters on the basis of values reported in the literature. The peak occurs at day 37 (March 31) approximately, with a reproduction ratio R0 of 3 initially, 1.36 at day 22, and 0.8 after day 35, indicating different degrees of lockdown. The predicted death toll is approximately 15,600 casualties, with 2.7 million infected individuals at the end of the epidemic. The incubation period providing a better fit to the dead individuals is 4.25 days, and the infectious period is 4 days, with a fatality rate of 0.00144/day [values based on the reported (official) number of casualties]. The infection fatality rate (IFR) is 0.57%, and it is 2.37% if twice the reported number of casualties is assumed. However, these rates depend on the initial number of exposed individuals. If approximately nine times more individuals are exposed, there are three times more infected people at the end of the epidemic and IFR = 0.47%. If we relax these constraints and use a wider range of lower and upper bounds for the incubation and infectious periods, we observe that a higher incubation period (13 vs. 4.25 days) gives the same IFR (0.6 vs. 0.57%), but nine times more exposed individuals in the first case. Other choices of the set of parameters also provide a good fit to the data, but some of the results may not be realistic. Therefore, an accurate determination of the fatality rate and characteristics of the epidemic is subject to knowledge of the precise bounds of the parameters. Besides the specific example, the analysis proposed in this work shows how isolation measures, social distancing, and knowledge of the diffusion conditions help us to understand the dynamics of the epidemic. Hence, it is important to quantify the process to verify the effectiveness of the lockdown.

COVID-19 diagnosis and management: a comprehensive review.

Severe acute respiratory syndrome coronavirus (SARS‐CoV)‐2, a novel coronavirus from the same family as SARS‐CoV and Middle East respiratory syndrome coronavirus, has spread worldwide leading the World Health Organization to declare a pandemic. The disease caused by SARS‐CoV‐2, coronavirus disease 2019 (COVID‐19), presents flu‐like symptoms which can become serious in high‐risk individuals. Here, we provide an overview of the known clinical features and treatment options for COVID‐19. We carried out a systematic literature search using the main online databases (PubMed, Google Scholar, MEDLINE, UpToDate, Embase and Web of Science) with the following keywords: ‘COVID‐19’, ‘2019‐nCoV’, ‘coronavirus’ and ‘SARS‐CoV‐2’. We included publications from 1 January 2019 to 3 April 2020 which focused on clinical features and treatments. We found that infection is transmitted from human to human and through contact with contaminated environmental surfaces. Hand hygiene is fundamental to prevent contamination. Wearing personal protective equipment is recommended in specific environments. The main symptoms of COVID‐19 are fever, cough, fatigue, slight dyspnoea, sore throat, headache, conjunctivitis and gastrointestinal issues. Real‐time PCR is used as a diagnostic tool using nasal swab, tracheal aspirate or bronchoalveolar lavage samples. Computed tomography findings are important for both diagnosis and follow‐up. To date, there is no evidence of any effective treatment for COVID‐19. The main therapies being used to treat the disease are antiviral drugs, chloroquine/hydroxychloroquine and respiratory therapy. In conclusion, although many therapies have been proposed, quarantine is the only intervention that appears to be effective in decreasing the contagion rate. Specifically designed randomized clinical trials are needed to determine the most appropriate evidence‐based treatment modality.

Could BCG Vaccination Induce Protective Trained Immunity for SARS-CoV-2?

Trained immunity is a type of non-specific memory-like immune response induced by some pathogens and vaccines, such as BCG, which can confer antigen-independent protection against a wide variety of pathogens. The BCG vaccine has been extensively used to protect against tuberculosis for almost a 100 years. Interestingly, this vaccine reduces children's mortality caused by infections unrelated to Mycobacterium tuberculosis infection, a phenomenon thought to be due to the induction of trained immunity. The SARS-CoV-2 pandemic has infected, as of April 22, 2020, 2,623,231 people globally, causing a major public health problem worldwide. Currently, no vaccine or treatment is available to control this pandemic. We analyzed the number of positive cases and deaths in different countries and correlated them with the inclusion of BCG vaccination at birth in their national vaccination programs. Interestingly, those countries where BCG vaccination is given at birth have shown a lower contagion rate and fewer COVID-19-related deaths, suggesting that this vaccine may induce trained immunity that could confer some protection for SARS-CoV-2.

SARS-CoV-2: previous coronaviruses, immune response, and development of vaccines.

Since the emergence of the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China at the end of 2019, when its characteristics were practically unknown, one aspect was evident: its high contagion rate. This high infection rate resulted in the spread of the virus in China, Europe, and, eventually, the rest of the world, including Mexico. At present, around 9 million people are infected, and around 470,000 have died worldwide. In this context, the need to generate protective immunity, and especially the generation of a vaccine that can protect the world population against infection in the shortest possible time, is a challenge that is being addressed in different countries using different strategies in multiple clinical trials. This opinion article will present the evidence of the induction of immune response in some of the viruses of the coronavirus family before COVID-19, such as SARS-CoV and MERS-CoV (Middle East respiratory syndrome coronavirus). The information collected about the induction of an immune response by SARS-CoV-2 will be presented, as well as a description of the vaccine candidates reported to date in the various ongoing clinical trials. Finally, an opinion based on the evidence presented will be issued on the potential success of developing vaccine prototypes.

Book Review: Narrative Economics: How Stories Go Viral and Drive Major Economic Events

Much of Shiller's new book is about how economic narratives form, spread, and fade. Drawing on medical evidence about the spread of infectious disease, Shiller argues that "economic fluctuations are substantially driven by contagion of oversimplified and easily transmitted variants of economic narratives." But Shiller ignores the powerful role of monetary disorder, whether in forming the narrative or determining the contagion rate, or as a competitor to the narrative. Ignoring or downplaying money's role leaves _Narrative Economics_ a disappointment.

The epidemiological characteristics and spatio-temporal analysis of childhood hand, foot and mouth disease in Korea, 2011-2017.

ObjectivesHand-foot-mouth disease (HFMD) is a common viral infection in children, with a significant disease burden due to its high contagion rate. This report studied the epidemiological characteristics as well as the chronological and geographical distribution of HFMD in children younger than 6 years of age in Korea.MethodsThis report established a database by integrating population and geographical data from health insurance claims for HFMD between 2011 and 2017, with an age restriction of ≤6 years, and explored the epidemiological characteristics of both HFMD patients and hospitalized cases in Korea. The relative risk ratio and spatio-temporal scan statistics were calculated by administrative district, using SaTScan.ResultsOver a 7-year period, 1,879,342 children under the age of 6 were diagnosed with HFMD (8.4 of 100 persons younger than 6 years of age). Seasonal incidence tended to increase from week 17 (May) peak between weeks 29 (July) and 39 (September), and increase rapidly in 1- to 2-year cycles. HFMD primarily occurred in children younger than 4 years of age. Furthermore, the greatest proportion of cases occurred at ages 1 (39.2%) and 2 (25.7%). Overall, 92.6% of all cases occurred before the age of 6. The proportion of cases before the age of 6was slightly higher in males. The timing of HFMD epidemics differed over the years. In 2015, the HFMD cumulative incidence was the lowest (5.5/1,000), and the spatio-temporal cluster (RR 2.32) was predominantly located south-central Korea, covering 65 counties for twenty-two weeks. In 2016, however, its cumulative incidence was high (RR 6.34) over a short period (11 weeks) in specific areas such as Ulsan, Daegu, Busan, and Gyeongnam. Also, the southern parts of Korea were found to have a higher rate of hospitalization.ConclusionsHFMD in Korea is common in children younger than 6 years of age, and it tends to peak in the summer.

Family Ties and the Pandemic: Some Evidence from SARS-CoV-2

This paper provides an empirical analysis of the relationship between the strength of family ties and the spread of Sars-CoV-2. The dataset is constructed for a cross-section of 63 countries combining different data sources, to cover seven dimensions: the spread of the virus, family ties, trust and religion, policies implemented to stop the outbreak, status of the economy, geography, demography. We observe a robust positive relationship between family ties and the contagion rate across the world; in particular, the attitude of parents towards the wellbeing for their children is the main force that drives the positive correlation with the contagion. Instead, the respect toward parents (the variable love-parents) seems to be a component of the family ties which negatively correlates with the diffusion of Sars-CoV-2, leading to the final quadratic relationship between the overall family ties strength and the spread of the virus. Moreover, as expected, we find a significant negative correlation between religion and trust and the number of infected people. As conclusive evidence, we observe that the death rate, as well as the recovery rate, are not affected by the strength of family ties and other social capital variables. What matters, in this case, are structural variables like GPD, number of hospital beds per capita, life expectance, median age and geographical location.

COVID-19: IS IT A DISASTER FOR TOURISM IN TURKEY?

Covid-19, which started in China and spread to the rest of the world in a matter of months, is demanding us to keep distance with other people and not leave the region (or even home) because of its high contagion rate. The tourism sector, which is became helpless against Covid-19, like all economic sectors, collapsed in the first half of 2020. Turkey, which had 34.5 billion dollars tourism revenue from 52 million tourists in 2019, has also been negatively affected by the pandemic process as well as all over the world. In this study, in order to examine Turkey's dependence on tourism sector and to have knowledge about the possible impact of the Covid-19, an econometric analysis was conducted using the variables of GDP, tourism revenues, number of tourists and the ratio of tourism revenues to exports for the period of 2004:Q1-2019:Q4. According to unit root tests results, all variables were stationary at level except GDP and there were structural breaks in all variables. As a result of the Gregory-Hansen structural break cointegration test, it has been observed that tourism revenues have a positive effect on economic growth while the number of tourists has a negative effect. Therefore, in order to overcome the pandemic period with the least damage from tourism sector, the positive effects from the expected decrease of the number of tourists should be kept absolutely larger than the negative effects from the expected decrease of tourism revenues.

A case-based reasoning framework for early detection and diagnosis of novel coronavirus.

Coronavirus, also known as COVID-19, has been declared a pandemic by the World Health Organization (WHO). At the time of conducting this study, it had recorded over 11,301,850 confirmed cases while more than 531,806 have died due to it, with these figures rising daily across the globe. The burden of this highly contagious respiratory disease is that it presents itself in both symptomatic and asymptomatic patterns in those already infected, thereby leading to an exponential rise in the number of contractions of the disease and fatalities. It is, therefore, crucial to expedite the process of early detection and diagnosis of the disease across the world. The case-based reasoning (CBR) model is a compelling paradigm that allows for the utilization of case-specific knowledge previously experienced, concrete problem situations or specific patient cases for solving new cases. This study, therefore, aims to leverage the very rich database of cases of COVID-19 to solve new cases. The approach adopted in this study employs the use of an improved CBR model for state-of-the-art reasoning task in the classification of suspected cases of COVID-19. The CBR model leverages on a novel feature selection and the semantic-based mathematical model proposed in this study for case similarity computation. An initial population of the archive was achieved from 71 (67 adults and 4 pediatrics) cases obtained from the Italian Society of Medical and Interventional Radiology (SIRM) repository. Results obtained revealed that the proposed approach in this study successfully classified suspected cases into their categories with an accuracy of 94.54%. The study found that the proposed model can support physicians to easily diagnose suspected cases of COVID-19 based on their medical records without subjecting the specimen to laboratory tests. As a result, there will be a global minimization of contagion rate occasioned by slow testing and in addition, reduced false-positive rates of diagnosed cases as observed in some parts of the globe.

Yeni Koronavirüs (2019-nCoV/COVID-19) ve Vitamin C

For the first time in December 2019, a case of pneumonia of unknown etiology was reported in Wuhan, China. Then, in addition to China and on the basis of increasing incidence and mortality rates in other international countries, the global emergency health status was declared by the World Health Organization Emergency Committee, and a new coronavirus was reported.Due to the very high contagion rate of the new Coronavirus (COVID-19), it has affected and continues to affect quite a lot of people from all age groups in the world. General clinical signs of COVID-19 are high fever, cough, nasal congestion, dyspnea, myalgia, fatigue, upper and lower respiratory tract infection and diarrhea. The most important and fatal clinical sign of the virus has been described as pneumonia. Unfortunately, no vaccine or special antiviral drug has been developed against COVID-19 yet. Therefore, the purpose of this review is to examine whether intravenous vitamin C administration is a promising method for the COVID-19 pandemic in accordance with the most recent evidence. Using vitamin C to prevent or treat diseases is often classified in complementary and alternative medicine. For this reason, it should never prevent the actual treatment. Studies have found that high doses of vitamin C reduce lung damage in COVID-19 and other flu infections. Therefore, intravenous vitamin C administration may be useful in addition to COVID-19 treatment.There is a need for high-level clinical studies on the effect of Vitamin C administration on COVID-19.

Influence of Student Behavior on Hepatitis A Incidence and Prevalence in Islamic Boarding School “Sidogiri”

Islamic boarding school Sidogiri is one of the school which has 8.400 male students. The sanitary conditions of Islamic boarding school are closely related to the contagion rate of contagious environment-based diseases, one of which is Hepatitis A. Islamic boarding school Sidogiri experiencing Hepatitis A outbreak in 2014, attacked as many as 111 students. This research was conducted to find out the correlation between students behavior (knowledge, attitude, and action) with incident and prevalence of Hepatitis A. The type of research was analytic observational research by analyzing behavior with the occurrence of Hepatitis A (IgG and IgM). The study was conducted in Islamic boarding school Sidogiri Kraton subdistrict in Pasuruan district from July 2017 until March 2018. The population in this study were all students in Islamic boarding school Sidogiri. Sample selection was done randomly so that got sample amount 38 people. The result of this research mentioned that attitude and action factor have significant influence to the occurrence of hepatitis A (IgG) with p-value equal to 0.017. The lower the attitudes and actions, the higher the prevalence of IgG. While the action factor has a significant effect on the incidence of Hepatitis A (IgM) with p value of 0.001. The lower the action, the higher the prevalence of IgM. Socialization, promotion and health education needs to be done to reduce the risk of contracting hepatitis A.
 
 Keywords: Islamic boarding school; students behaviour; hepatistis A; IgG; IgM

Black Death—model and simulation

The Black Death analysis and data organizing have been performed in unifying manners, among others, by Byrne and Christakos. The mathematical modelling of Noble of 1974 did not originate full spatiotemporal 2D simulations. The present model incorporates a new term to calculate the effects of the interaction between contagion and short range dislocations. The contagion rate term is modified to account for saturation effects in the contact rate. The model and parameters used very nearly reproduce important features of the spatiotemporal evolution of the Black Death, the calculated global mortality attaining a very large fraction of the European population.

A comprehensive probabilistic solution of random SIS-type epidemiological models using the random variable transformation technique

This paper provides a complete probabilistic description of SIS-type epidemiological models where all the input parameters (contagion rate, recovery rate and initial conditions) are assumed to be random variables. By applying the Random Variable Transformation technique, the first probability density function, the mean and the variance functions, as well as confidence intervals associated with the solution of SIS-type epidemiological models, are determined. It is done under the general hypothesis that model random inputs have any joint probability density function. The distributions to describe the time until a given proportion of the population remains susceptible and infected are also determined. Finally, a probabilistic description of the so-called basic reproductive number is included. The theoretical results are applied to an illustrative example showing good fitting.

Abrupt transitions from reinfections in social contagions

The study of social contagion processes is of utmost importance for understanding the emergence of collective social states. Here we introduce reinfections in the Susceptible-Infected-Recovered (SIR) model so to incorporate the possibility that an individual that ceases its activity (recovered) can resume it due to secondary infections from its active (infected) peers. We show that, when primary infection is less frequent than secondary ones, a typical situation in many social contagion processes, the epidemic transition turns from smooth to abrupt. As a consequence, macroscopic collective states can be triggered from the inactive (healthy) regime by a small increment of the primary contagion rate.

Management of a caseous lymphadenitis outbreak in a new Iberian ibex (Capra pyrenaica) stock reservoir.

BackgroundIn 2010, an Iberian ibex (Capra pyrenaica hispanica) stock reservoir was established for conservation purposes in north-eastern Spain. Eighteen ibexes were captured in the wild and housed in a 17 hectare enclosure. Once in captivity, a caseous lymphadenitis (CLA) outbreak occurred and ibex handlings were carried out at six-month intervals between 2010 and 2013 to perform health examinations and sampling. Treatment with a bacterin-based autovaccine and penicillin G benzatine was added during the third and subsequent handlings, when infection by Corynebacterium pseudotuberculosis was confirmed. Changes in lesion score, serum anti-C. pseudotuberculosis antibodies and haematological parameters were analyzed to assess captivity effects, disease emergence and treatment efficacy. Serum acute phase proteins (APP) Haptoglobin (Hp), Amyloid A (SAA) and Acid Soluble Glycoprotein (ASG) concentrations were also determined to evaluate their usefulness as indicators of clinical status.Once in captivity, 12 out of 14 ibexes (85.7%) seroconverted, preceding the emergence of clinical signs; moreover, TP, WBC, eosinophil and platelet cell counts increased while monocyte and basophil cell counts decreased. After treatment, casualties and fistulas disappeared and both packed cell volume (PCV) and haemoglobin concentration significantly increased. Hp, SAA and ASG values were under the limit of detection or showed no significant differences.ConclusionsA role for captivity in contagion rate is suggested by the increase in antibody levels against C. pseudotuberculosis and the emergence of clinical signs. Although boosted by captivity, this is the first report of an outbreak of caseous lymphadenitis displaying high morbidity and mortality in wild ungulates. Treatment consisting of both vaccination and antibiotic therapy seemed to prevent mortality and alleviate disease severity, but was not reflected in the humoural response. Haematology and APP were not useful indicators in our study, perhaps due to the sampling frequency. Presumably endemic and irrelevant in the wild, this common disease of domestic small ruminants is complicating conservation efforts for the Iberian ibex in north-eastern Spain.