Control Of Infectious Diseases Research Articles

On Basic Reproduction Number R0 : Derivation and Application

The basic reproductive number (R0 ) is a threshold parameter for a population-level model of infectious disease control. The basic reproduction number is derived by epidemiologists using different techniques. It is used to estimate the basic reproductive rates of infected and susceptible hosts and to guide intervention strategies. In this paper, we give an overview of the methods used in the derivation of R0 and assess the use of R0 in the literature. Finally, we discuss some of the limitations and alternatives to the basic reproduction number that have been identified in the literature. The main contribution of this paper is to provide a guideline and shed light on the basic reproduction number to mathematical modellers and policy makers in order to prevent the possible blown out of the epidemic in the susceptible population.

Bcl-6 expression by CD4+ T cells determines concomitant immunity and host resistance across distinct parasitic infections

Cluster of differentiation (CD4+) T cells consist of multiple subtypes, defined by expression of lineage-specific transcription factors, that contribute to the control of infectious diseases by providing help to immune and nonimmune target cells. In the current study, we examined the role of B cell lymphoma (Bcl)-6, a transcriptional repressor and master regulator of T follicular helper cell differentiation, in T cell-mediated host defense against intestinal and systemic parasitic infections. We demonstrate that while Bcl-6 expression by CD4+ T cells is critical for antibody-mediated protective immunity against secondary infection with the nematode Heligmosoides polygyrus bakeri, it paradoxically compromises worm expulsion during primary infection by limiting the generation of interleukin-10 (IL-10)-producing Gata3+ T helper 2 cells. Enhanced worm expulsion in the absence of Bcl-6 expressing T cells was associated with amplified intestinal goblet cell differentiation and increased generation of alternatively activated macrophages, effects that were reversed by neutralization of IL-10 signals. An increase in IL-10 production by Bcl-6-deficient CD4+ T cells was also evident in the context of systemic Leishmania donovani infection, but in contrast to Heligmosoides polygyrus bakeri infection, compromised T helper 1-mediated liver macrophage activation and increased susceptibility to this distinct parasitic challenge. Collectively, our studies suggest that host defense pathways that protect against parasite superinfection and lethal systemic protozoal infections can be engaged at the cost of compromised primary resistance to well-tolerated helminths.

Control of emerging and re-emerging zoonotic and vector-borne diseases in countries of the Eastern Mediterranean Region

Despite improvements in the detection and control of infectious diseases, many new pathogens are emerging and re-emerging in various parts of the world. Most of these emerging and re-emerging infections are of zoonotic origin, which highlights the importance of the human–animal interface. Similarly, the rate of vector-borne diseases has increased recently due to changes in human habitats, climate change, deforestation, changes in food production practices, and increased population movement. The risk of spread of these zoonotic and vector-borne diseases is higher in the Eastern Mediterranean Region (EMR) of the World Health Organization due to its topography and geopolitical situation, fragile health systems, complex humanitarian emergencies, and, in some countries, other socioeconomic risk factors. Many countries in the region have reported outbreaks of zoonotic and vector-borne diseases over the last few decades, and some of these diseases have spread to other WHO regions as well. Avian influenza A (H5N1) and Middle East respiratory syndrome coronavirus (MERS-CoV) are among the greatest threats to global health security and both viruses are endemic in the EMR. Countries in the EMR have made significant progress toward the control of zoonotic and vector-borne diseases in recent years, and prevention, preparedness, and response capacities have been improved. However, there are still many challenges associated with the control of these diseases in the EMR, particularly in countries facing humanitarian emergencies. In this paper, we present the current situation of emerging and re-emerging infections in the EMR and discuss progress, challenges, and ways forward.

Role of Geographers in the Analysis and Modeling of the Spread of Communicable Diseases (Malaria & COVID-19) in Ambon City: A Spatial Approach for Epidemiological Analysis

This study explores the role of geographers in analyzing the distribution of infectious diseases (malaria and COVID-19) in Ambon City with a spatial approach in epidemiological analysis. The method used in this review is a comparative descriptive study with a qualitative approach using secondary data from relevant sources. This research will review the role of geographers in analyzing and modeling the distribution of infectious diseases (malaria & COVID-19) in Ambon City from previous research. This research integrates geographic and health data to understand the pattern of spread and environmental factors that influence disease. Through case mapping, environmental factor analysis, and modeling of future trends, this research illustrates the important contribution of geographers in infectious disease control and prevention efforts at the local level. Interdisciplinary collaboration plays a key role in this approach, which ultimately supports more informed and effective decision-making in addressing these health challenges.

Analyzing the Costs and Benefits of Utilizing a Mixed-Strategy Approach in Infectious Disease Control under a Voluntary Vaccination Policy.

Infectious diseases pose significant public health risks, necessitating effective control strategies. One such strategy is implementing a voluntary vaccination policy, which grants individuals the autonomy to make their own decisions regarding vaccination. However, exploring different approaches to optimize disease control outcomes is imperative, and involves assessing their associated costs and benefits. This study analyzes the advantages and disadvantages of employing a mixed-strategy approach under a voluntary vaccination policy in infectious disease control. We examine the potential benefits of such an approach by utilizing a vaccination game model that incorporates cost and benefit factors, where lower costs and higher benefits lead to reduced infection rates. Here, we introduce a mixed-strategy framework that combines individual-based risk assessment (IB-RA) and society-based risk assessment (SB-RA) strategies. A novel dynamical equation is proposed that captures the decision-making process of individuals as they choose their strategy based on personal or communal considerations. In addition, we explore the implications of the mixed-strategy approach within the context of social dilemmas. We examine deviations from expected behavior and the concept of social efficiency deficit (SED) by allowing for the evolution of vaccine strategy preferences alongside risk perception. By comprehensively evaluating the financial implications and societal advantages associated with the mixed-strategy approach, decision-makers can allocate resources and implement measures to combat infectious diseases within the framework of a voluntary vaccination policy.

Progress and challenge in intelligent syndromic surveillance for infectious diseases

Intelligent syndromic surveillance is an important part of multi-point triggering and multi-channel surveillance system of intelligent early warning of infectious diseases in China, and an inevitable development process of traditional syndromic surveillance as the constant emergence of new technologies. Intelligent syndromic surveillance collects not only the medical data of patients seeking medical care in hospitals but also massive non-medical information. However, along with its rapid development, challenges in intelligent syndromic surveillance have emerged, such as information explosion, cost-effective balance, information sharing, data security and privacy. This paper summarizes the concept and development of intelligent syndromic surveillance to provide references for the method and technique development of intelligent early warning of infectious diseases and new thought for the prevention and control of infectious diseases in China and in the world.

Spatial Approach in Health Predicting the Spread of Infectious Disease Incidence Rates (Malaria & COVID-19) in Ambon City, Indonesia, A Review

This study explores the role of geographers in analyzing the distribution of infectious diseases (malaria and COVID-19) in Ambon City with a spatial approach in epidemiological analysis. The method used in this review is a comparative descriptive study with a qualitative approach using secondary data from relevant sources. This research will review the role of geographers in analyzing and modeling the distribution of infectious diseases (malaria & COVID-19) in Ambon City from previous research. This research integrates geographic and health data to understand the pattern of spread and environmental factors that influence disease. Through case mapping, environmental factor analysis, and modeling of future trends, this research illustrates the important contribution of geographers in infectious disease control and prevention efforts at the local level. Interdisciplinary collaboration plays a key role in this approach, which ultimately supports more informed and effective decision-making in addressing these health challenges.

Prime editor-mediated functional reshaping of ACE2 prevents the entry of multiple human coronaviruses, including SARS-CoV-2 variants.

The spike protein of SARS-CoV-2 hijacks the host angiotensin converting enzyme 2 (ACE2) to meditate its entry and is the primary target for vaccine development. Nevertheless, SARS-CoV-2 keeps evolving and the latest Omicron subvariants BQ.1 and XBB have gained exceptional immune evasion potential through mutations in their spike proteins, leading to sharply reduced efficacy of current spike-focused vaccines and therapeutics. Compared with the fast-evolving spike protein, targeting host ACE2 offers an alternative antiviral strategy that is more resistant to viral evolution and can even provide broad prevention against SARS-CoV and HCoV-NL63. Here, we use prime editor (PE) to precisely edit ACE2 at structurally selected sites. We demonstrated that residue changes at Q24/D30/K31 and/or K353 of ACE2 could completely ablate the binding of tested viruses while maintaining its physiological role in host angiotensin II conversion. PE-mediated ACE2 editing at these sites suppressed the entry of pseudotyped SARS-CoV-2 major variants of concern and even SARS-CoV or HCoV-NL63. Moreover, it significantly inhibited the replication of the Delta variant live virus. Our work investigated the unexplored application potential of prime editing in high-risk infectious disease control and demonstrated that such gene editing-based host factor reshaping strategy can provide broad-spectrum antiviral activity and a high barrier to viral escape or resistance.

Annual incidence and fatality rates of notifiable infectious diseases in southeast China from 1950 to 2022 and relationship to socioeconomic development.

Over the past 70 years, China has advanced significantly in the prevention and treatment of infectious diseases while simultaneously undergoing a socioeconomic transformation, making it a useful source of data for analysing relationships between public health policy and the control of infectious diseases. We collected data on the incidence of notifiable infectious diseases and associated fatalities in Jiangsu province in southeast China from the Provincial Center for Disease Control and Prevention, Provincial Institute of Parasitic Diseases, and the Nationwide Notifiable Infectious Diseases Reporting Information System. We compared data from different historical periods using descriptive statistical methods, joinpoint regression, and correlation analysis. During 1950-2022, 75 754 008 cases of 46 notifiable infectious diseases were reported in Jiangsu, with an average annual incidence was 1679.49 per 100 000 population and a fatality rate of 1.82 per 1000 persons. The incidence of classes A-B decreased (average annual percent change (AAPC) = -2.1) during the entire study period, while the incidence of class C increased (AAPC = 10.8) after 2004. The incidence of intestinal diseases (AAPC = -4.4) and vector-borne and zoonotic diseases (AAPC = -8.1) decreased rapidly, while the incidence of sexually transmitted and blood-borne diseases (AAPC = 1.8) increased. The number of medical and health institutions and the per capita gross domestic product correlated negatively with the annual incidence of diseases in classes A-B, but not with fatality rates. Although the annual incidence of many severe infectious diseases has decreased in Jiangsu since 1950, the incidence of sexually transmitted and blood-borne diseases increased. Socioeconomic growth and sustainable investment in health systems are associated with better control of infectious diseases.

Methods on COVID-19 Epidemic Curve Estimation During Emergency Based on Baidu Search Engine and ILI Traditional Surveillance in Beijing, China

Surveillance is an essential work on infectious diseases prevention and control. When the pandemic occurred, the inadequacy of traditional surveillance was exposed, but it also provided a valuable opportunity to explore new surveillance methods. This study aimed to estimate the transmission dynamics and epidemic curve of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron BF.7 in Beijing under the emergent situation using Baidu index and influenza-like illness (ILI) surveillance. A novel hybrid model (multiattention bidirectional gated recurrent unit (MABG)–susceptible–exposed–infected–removed (SEIR)) was developed, which leveraged a deep learning algorithm (MABG) to scrutinize the past records of ILI occurrences and the Baidu index of diverse symptoms such as fever, pyrexia, cough, sore throat, anti-fever medicine, and runny nose. By considering the current Baidu index and the correlation between ILI cases and coronavirus disease 2019 (COVID-19) cases, a transmission dynamics model (SEIR) was formulated to estimate the transmission dynamics and epidemic curve of SARS-CoV-2. During the COVID-19 pandemic, when conventional surveillance measures have been suspended temporarily, cases of ILI can serve as a useful indicator for estimating the epidemiological trends of COVID-19. In the specific case of Beijing, it has been ascertained that cumulative infection attack rate surpass 80.25% (95% confidence interval (95% CI): 77.51%–82.99%) since December 17, 2022, with the apex of the outbreak projected to transpire on December 12. The culmination of existing patients is expected to occur three days subsequent to this peak. Effective reproduction number (Rt) represents the average number of secondary infections generated from a single infected individual at a specific point in time during an epidemic, remained below 1 since December 17, 2022. The traditional disease surveillance systems should be complemented with information from modern surveillance data such as online data sources with advanced technical support. Modern surveillance channels should be used primarily in emerging infectious and disease outbreaks. Syndrome surveillance on COVID-19 should be established to following on the epidemic, clinical severity, and medical resource demand.

Infectious disease control: from health security strengthening to health systems improvement at global level

Since the twenty first century, the outbreaks of global infectious diseases have caused several public health emergencies of international concern, imposing an enormous impact on population health, the economy, and social development. The COVID-19 pandemic has once again exposed deficiencies in existing global health systems, emergency management, and disease surveillance, and highlighted the importance of developing effective evaluation tools. This article outlines current challenges emerging from infectious disease control from the perspective of global health, elucidated through influenza, malaria, tuberculosis, and neglected tropical diseases. The discordance among government actors and absent data sharing platforms or tools has led to unfulfilled targets in health system resilience and a capacity gap in infectious disease response. The current situation calls for urgent action to tackle these threats of global infectious diseases with joined forces through more in-depth international cooperation and breaking governance barriers from the purview of global health. Overall, a systematic redesign should be considered to enhance the resilience of health systems, which warrants a great need to sustain capacity-building efforts in emergency preparedness and response and raises an emerging concern of data integration in the concept of One Health that aims to address shared health threats at the human-animal-environment interface.

"Dramatic Growth" of Microbial Aerosols for Visualization and Accurate Counting of Bioaerosols.

While the global COVID-19 pandemic has subsided, microbial aerosol detection has become of high concern. Timely, accurate, and highly sensitive monitoring of microbial aerosols in indoor air is the basis for effective prevention and control of infectious diseases. At present, no commercial equipment or reliable technology can simultaneously control the detection time and limit at 6 h and 102 CFU/mL, respectively. Based on the "safety size range" of particulate matter in the air, we propose a new method of microbial dilation detection, which enables the pathogen to grow rapidly and dramatically into a polymeric microsphere, larger in size than the coexisting aerosol particles. "Like a crane standing among chickens", the microorganism can be easily visualized and counted. Different from routine chemical and biological sensing technologies, this method can achieve absolute counting of microbial particles, and the simple principles can be developed into devices for different life scenarios.

A Neglected Narrative in the COVID-19 Pandemic: Epidemiological and Clinical Impacts of the COVID-19 Outbreak on Syphilis.

The COVID-19 pandemic has profoundly changed our lives. While healthcare resources were redistributed and mobilized to focus on dealing with the COVID-19 crisis, there have been unmet medical needs of patients with other diseases such as syphilis, weaving an integral but neglected component of the pandemic story. In different countries, the epidemiology of newly reported syphilis underwent diverse changes during the COVID-19 pandemic. Asymptomatic cases experienced the largest decline in number. From the perspective of transmission, on one hand, the implementation of lockdown measures led to a higher degree of abstinence and sex distancing in many countries, thereby reducing the transmission of syphilis. On the other hand, vertical transmission was reported to have increased significantly during COVID-19. Meanwhile, the volume of STI clinic capacity declined, and STI staff were redeployed to facilitate the contact tracing of COVID-19. As a result, many STI centers converted traditional in-person clinical services to telemedicine and self-testing. However, syphilis testing and clinical treatment cannot fully adapt to this conversion. In syphilis diagnosis, COVID-19 infection and vaccination were reported to cause false positivity in syphilis serological tests. Diverse cutaneous manifestations of COVID-19 could resemble the skin lesions in syphilis patients, requiring differential diagnosis from clinicians. As for the post-pandemic years, consequent to service interruptions and diagnosis delays, a surge in the number of confirmed cases of syphilis is expected. The COVID-19 pandemic has also been a meaningful lesson for the control and prevention of infectious diseases. The experience in combating COVID-19 has underscored the importance of maintaining a robust and well-supported medical system for the provision of sexual health services and better healthcare equality even during eras of crisis, not least for syphilis patients.

Genomic epidemiology unveils the dynamics and spatial corridor behind the Yellow Fever virus outbreak in Southern Brazil.

Despite the considerable morbidity and mortality of yellow fever virus (YFV) infections in Brazil, our understanding of disease outbreaks is hampered by limited viral genomic data. Here, through a combination of phylogenetic and epidemiological models, we reconstructed the recent transmission history of YFV within different epidemic seasons in Brazil. A suitability index based on the highly domesticated Aedes aegypti was able to capture the seasonality of reported human infections. Spatial modeling revealed spatial hotspots with both past reporting and low vaccination coverage, which coincided with many of the largest urban centers in the Southeast. Phylodynamic analysis unraveled the circulation of three distinct lineages and provided proof of the directionality of a known spatial corridor that connects the endemic North with the extra-Amazonian basin. This study illustrates that genomics linked with eco-epidemiology can provide new insights into the landscape of YFV transmission, augmenting traditional approaches to infectious disease surveillance and control.

Heterogeneous-Nucleation Biosensor for Long-Term Collection and Mask-Based Self-Detection of SARS-CoV-2.

The effective control of infectious diseases, including Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, depends on the availability of rapid and accurate monitoring techniques. However, conventional SARS-CoV-2 detection technologies do not support continuous self-detection and may lead to cross-infection when utilized in medical institutions. In this study, we introduce a prototype of a mask biosensor designed for the long-term collection and self-detection of SARS-CoV-2. The biosensor utilizes the average resonance Rayleigh scattering intensity of Au nanocluster-aptamers. The inter-mask surface serves as a medium for the long-term collection and concentration enhancement of SARS-CoV-2, while the heterogeneous-nucleation nanoclusters (NCs) contribute to the exceptional stability of Au NCs for up to 48 h, facilitated by the adhesion of Ti NCs. Additionally, the biosensors based on Au NC-aptamers exhibited high sensitivity for up to 1 h. Moreover, through the implementation of a support vector machine classifier, a significant number of point signals can be collected and differentiated, leading to improved biosensor accuracy. These biosensors offer a complementary wearable device-based method for diagnosing SARS-CoV-2, with a limit of detection of 103 copies. Given their flexibility, the proposed biosensors possess tremendous potential for the continuous collection and sensitive self-detection of SARS-CoV-2 variants and other infectious pathogens.

A novel ruthenium-silver based antimicrobial potentiates aminoglycoside activity against Pseudomonas aeruginosa.

The rapid dissemination of antibiotic resistance combined with the decline in the discovery of novel antibiotics represents a major challenge for infectious disease control that can only be mitigated by investments in novel treatment strategies. Alternative antimicrobials, including silver, have regained interest due to their diverse mechanisms of inhibiting microbial growth. One such example is AGXX, a broad-spectrum antimicrobial that produces highly cytotoxic reactive oxygen species (ROS) to inflict extensive macromolecular damage. Due to the connections identified between ROS production and antibiotic lethality, we hypothesized that AGXX could potentially increase the activity of conventional antibiotics. Using the gram-negative pathogen Pseudomonas aeruginosa, we screened possible synergistic effects of AGXX on several antibiotic classes. We found that the combination of AGXX and aminoglycosides tested at sublethal concentrations led to a rapid exponential decrease in bacterial survival and restored the sensitivity of a kanamycin-resistant strain. ROS production contributes significantly to the bactericidal effects of AGXX/aminoglycoside treatments, which is dependent on oxygen availability and can be reduced by the addition of ROS scavengers. Additionally, P. aeruginosa strains deficient in ROS detoxifying/repair genes were more susceptible to AGXX/aminoglycoside treatment. We further demonstrate that this synergistic interaction was associated with a significant increase in outer and inner membrane permeability, resulting in increased antibiotic influx. Our study also revealed that AGXX/aminoglycoside-mediated killing requires an active proton motive force across the bacterial membrane. Overall, our findings provide an understanding of cellular targets that could be inhibited to increase the activity of conventional antimicrobials. IMPORTANCE The emergence of drug-resistant bacteria coupled with the decline in antibiotic development highlights the need for novel alternatives. Thus, new strategies aimed at repurposing conventional antibiotics have gained significant interest. The necessity of these interventions is evident especially in gram-negative pathogens as they are particularly difficult to treat due to their outer membrane. This study highlights the effectiveness of the antimicrobial AGXX in potentiating aminoglycoside activities against P. aeruginosa. The combination of AGXX and aminoglycosides not only reduces bacterial survival rapidly but also significantly re-sensitizes aminoglycoside-resistant P. aeruginosa strains. In combination with gentamicin, AGXX induces increased endogenous oxidative stress, membrane damage, and iron-sulfur cluster disruption. These findings emphasize AGXX's potential as a route of antibiotic adjuvant development and shed light on potential targets to enhance aminoglycoside activity.

Small ruminant drug use for the cow vet

With the rapid increase in numbers and popularity of small ru­minants in North America, there is a need for ambulatory prac­titioners to provide for their care. With the economics of small ruminant practice not being near those of bovine practice, combined with extremely limited drugs for sheep and goats, there is an opportunity for creative solutions regarding bovine therapies for caprine and ovine patients. In this review the role of the small ruminant as a food animal will be discussed along with extralabel drug usage for food animal species. Analgesic drugs will be discussed for utility in ambulatory practice set­tings. Use of approved and extralabel antimicrobials will be investigated for control and prevention of infectious disease. Sedation practices will be mentioned, along with additional re­sources to guide the bovine veterinarian with small ruminant treatment decisions.

Movement Control Order (MCO) - A Viable Legal Mechanism in the Management of COVID-19 Pandemic in Malaysia?

COVID-19 has caused a global health disaster accompanied by economic and social unpredictability. This study evaluates the legislative measures implemented in Malaysia throughout Phases 1 through 7 of the Movement Control Order in an effort to battle the pandemic and stem its spread. The narrative review applies a socio-legal analysis with reference to primary sources, including Malaysian legal documents and legislation. Findings suggest that the law complements other preventive efforts implemented by the government to break the chain of virus transmission, especially the Prevention and Control of Infectious Diseases Act of 1988. This study illustrates that the public interest must trump individual rights in order to not only respond to this crisis, but also recover and prosper in the fight against the pandemic. In addition, it is recommended that enforcing a clearer set of international MCO laws within regional security cooperation will contribute to the development of a stronger global community with a shared future, as well as promote international law and neighborhood diplomacy.

Investigations of indoor environment of high level biosafety laboratory in China based on field measurements

The high-level biosafety laboratory is not only the basic support for infectious disease prevention and control, but also interrelated with key areas such as environmental security and social security, which has attracted increasing attention. A good indoor environment is the premise to ensure the smooth progress of the experiment and biological risk prevention and control. In order to better understand the indoor environment of high-level biosafety laboratories, 19 high-level biosafety laboratories in China (with a total of 65 main rooms) were carefully selected as the test objects from December 2020 to December 2022. According to the test methods specified in the Chinese standard GB 50346, the air change, cleanliness, static pressure difference, temperature, relative humidity, and illumination were tested and analyzed. The results showed that all the measured parameters met the requirements of the Chinese standard GB 50346, and the bio-safety performance was completely satisfactory. However, individual parameters showed some overlarge values: the proportion of main rooms with cleanliness levels of 7 and 8 exceeding 50% of the lower limit for air changes was 54.5% and 69.8%, respectively; the proportion of main rooms in BSL-3-b1 laboratories with atmospheric pressure differentials exceeding 50% of the standard lower limit was 94.7%; and the atmospheric pressure differential in the main rooms of BSL-3-b2 laboratories reached a maximum of nearly -160 Pa. On the premise of ensuring the cleanliness and pressure gradient of the main room, it may be possible to reduce the air change. This study, for the first time, reveals the environmental parameters of various types and levels of biosafety laboratories, which can provide reference for the design and operation of such facilities.

Understanding the Impact of Vaccination and Self-Defense Measures on Epidemic Dynamics Using an Embedded Optimization and Evolutionary Game Theory Methodology.

Explaining how individual choice and government policy can appear in the same context in real society is one of the most challenging scientific problems. Controlling infectious diseases requires effective prevention and control measures, including vaccination and self-defense measures. In this context, optimal control strategies incorporating vaccination and self-defense measures have been proposed using the framework of evolutionary game theory. This approach accounts for individuals' behavior and interactions in a population. It can provide insights into the effectiveness of different strategies for controlling the spread of infectious diseases. The optimal control strategy involves balancing the costs and benefits of vaccination, considering the dynamic interplay between the infected and susceptible populations. By combining evolutionary game theory with optimal control theory, we can identify the optimal allocation of resources for vaccination and self-defense measures, which can maximize the control of infectious diseases while minimizing costs. The model is utilized to analyze public health policies diseases, such as vaccination and self-defense strategies, to mitigate the spread of infectious in the context of delayed decision-making.