Cross-border Spread Research Articles

Application of GIS and Earth Remote Sensing Data for the Evaluation of the Spatiotemporal Spread of Rabies in Eastern Trans-Baikal Region

The aim of the study was to improve monitoring of natural foci of rabies based on the use of modern technologies of cartographic analysis.Materials and methods. A retrospective study was carried out on the data of official registration of rabies in the Trans-Baikal Territory (Eastern Trans-Baikal Region) for 1950–2020. The spatial spread of rabies among animals was compared for two time periods: 1972–1978 (n=157 cases) and 2014–2020 (n=61 cases). Software packages QGIS 3.16.0, ArcMap 10.8.1, ArcScene 10.8.1 and electronic landscape-geographical maps of the world “Natural Earth”, “OpenStreetMap” were used for the mapping. Analyzed territorial units (ATUs) tied to a degree grid (0,5º × 0,5º) were marked on the cartograms. The interdependence between the localization of rabies cases and landscape elements was assessed statistically, comparing between the rabies free and the rabies affected ATUs.Results and discussion. Differences in the landscape confinedness of rabies epizootics in Eastern Trans-Baikal Region at different periods of time have been established. Until 1983, dog rabies prevailed, and epizootics spread beyond the forest-steppe zone. In 1984–2013 rabies among animals was not recorded. In 2014–2020 red foxes (Vulpes vulpes) were the main source of the rabies virus. The area of the epizootic has more than halved in comparison with 1972–1978. The main manifestations of rabies were observed at the junction of lowland and mountainous, steppe and forest areas. The rabies affected ATUs were characterized by more pronounced landscape variables. Possible routes of cross-border spread of the rabies virus have been identified. The connection between the features of the spatiotemporal spread of rabies and genetic variants of the virus, climate change, animal migrations and anthropogenic factors in Eastern Trans-Baikal Region in 1950–2020 is discussed. The results of the study are proposed to be used to adjust the programs for barrier oral vaccination of the foxes.

Does high COVID-19 spread impact neighbouring countries? Evidence from Ireland.

Background : Coronavirus disease 2019 (COVID-19) has necessitated public health responses on an unprecedented scale. Controlling infectious diseases requires understanding of the conditions that increase spread. Prior studies have identified sociodemographic, epidemiological and geographic associations. Ireland offers an unusual opportunity to quantify how high infection rates in one country impacted cases in a neighbouring country. Methods : We analysed official statistics on confirmed COVID-19 cases on the island of Ireland for 52 weeks from March 2020. Our main research question was: Did higher cases in Northern Ireland (NI) impact the number of cases in the Republic of Ireland (ROI)? We used least squares regression to compare confirmed cases in ROI counties that border NI with the rest of the state. We included in our model sociodemographic, epidemiological and geographic factors. We employed the latitude of each county town as an instrumental variable to isolate a quasi-experimental estimate of the cross-border spread. Results : In the quasi-experimental framework, and controlling for population density, age distribution and circulatory disease prevalence, border counties had an extra 21.0 (95%CI: 8.4-33.6) confirmed COVID-19 cases per 1000 people. This equates to an estimated 9,611 additional cases in ROI, or 4% of the national total in the first year of the pandemic. Our results were substantively similar in non-experimental frameworks, with alternative additional predictors, and in sensitivity analyses. Additionally, population density in ROI counties was positively associated with confirmed cases and higher proportions of residents in the professional classes was negatively associated. Conclusion : On the island of Ireland during the first year of the COVID-19 pandemic, high infection rates in NI increased cases in the neighbouring ROI. Maximising co-ordination of pandemic responses among neighbouring countries is essential to minimising disease spread, and its associated disruptions to society and the economy. Socioeconomic disadvantage appeared to confer significant additional risk of spread.

Multidrug-resistant tuberculosis imported into low-incidence countries-a GeoSentinel analysis, 2008-2020.

Early detection of imported multidrug-resistant tuberculosis (MDR-TB) is crucial, but knowledge gaps remain about migration- and travel-associated MDR-TB epidemiology. The aim was to describe epidemiologic characteristics among international travellers and migrants with MDR-TB. Clinician-determined and microbiologically confirmed MDR-TB diagnoses deemed to be related to travel or migration were extracted from GeoSentinel, a global surveillance network of travel and tropical medicine clinics, from January 2008 through December 2020. MDR-TB was defined as resistance to both isoniazid and rifampicin. Additional resistance to either a fluoroquinolone or a second-line injectable drug was categorized as pre-extensively drug-resistant (pre-XDR) TB, and as extensively drug-resistant (XDR) TB when resistance was detected for both. Sub-analyses were performed based on degree of resistance and country of origin. Of 201 patients, 136 had MDR-TB (67.7%), 25 had XDR-TB (12.4%), 23 had pre-XDR TB (11.4%) and 17 had unspecified MDR- or XDR-TB (8.5%); 196 (97.5%) were immigrants, of which 92 (45.8%) originated from the former Soviet Union. The median interval from arrival to presentation was 154days (interquartile range [IQR]: 10-751days); 34.3% of patients presented within 1month after immigration, 30.9% between 1 and 12months and 34.9% after ≥1year. Pre-XDR- and XDR-TB patients from the former Soviet Union other than Georgia presented earlier than those with MDR-TB (26days [IQR: 8-522] vs. 369days [IQR: 84-827]), while patients from Georgia presented very early, irrespective of the level of resistance (8days [IQR: 2-18] vs. 2days [IQR: 1-17]). MDR-TB is uncommon in traditional travellers. Purposeful medical migration may partly explain differences in time to presentation among different groups. Public health resources are needed to better understand factors contributing to cross-border MDR-TB spread and to develop strategies to optimize care of TB-infected patients in their home countries before migration.

African swine fever virus genotype II in Mongolia, 2019.

African swine fever (ASF) is a severe haemorrhagic disease of domestic and wild pigs caused by the African swine fever virus (ASFV). In recent years, ASF has steadily spread towards new geographical areas, reaching Europe and Asia. On January 15th, 2019, Mongolia reported its first ASF outbreak to the World Organization for Animal Health (OIE), becoming, after China, the second country in the region affected by the disease. Following an event of unusual mortality in domestic pigs in Bulgan Province, a field team visited four farms and a meat market in the region to conduct an outbreak investigation and collect samples for laboratory analysis. Different organs were examined for ASF associated lesions, and total nucleic acid was extracted for real-time PCR, virus isolation and molecular characterization. The real-time PCR results confirmed ASFV DNA in 10 out of 10 samples and ASFV was isolated. Phylogenetic analysis established that ASFVs from Mongolia belong to genotype II and serogroup 8. The viruses were identical to each other, and to domestic pig isolates identified in China and Russia, based on the comparison of five genomic targets. Our results suggest a cross-border spread of ASFV, without indicating the source of infection.

Lessons learned from implementation of a national hotline for Ebola virus disease emergency preparedness in South Sudan

BackgroundThe world’s second largest Ebola outbreak occurred in the Democratic Republic of Congo from 2018 to 2020. At the time, risk of cross-border spread into South Sudan was very high. Thus, the South Sudan Ministry of Health scaled up Ebola preparedness activities in August 2018, including implementation of a 24-h, toll-free Ebola virus disease (EVD) hotline. The primary purpose was the hotline was to receive EVD alerts and the secondary goal was to provide evidence-based EVD messages to the public.MethodsTo assess whether the hotline augmented Ebola preparedness activities in a protracted humanitarian emergency context, we reviewed 22 weeks of call logs from January to June 2019. Counts and percentages were calculated for all available data.ResultsThe hotline received 2114 calls during the analysis period, and an additional 1835 missed calls were documented. Callers used the hotline throughout 24-h of the day and were most often men and individuals living in Jubek state, where the national capital is located. The leading reasons for calling were to learn more about EVD (68%) or to report clinical signs or symptoms (16%). Common EVD-related questions included EVD signs and symptoms, transmission, and prevention. Only one call was documented as an EVD alert, and there was no documentation of reported symptoms or whether the person met the EVD case definition.ConclusionsBasic surveillance information was not collected from callers. To trigger effective outbreak investigation from hotline calls, the hotline should capture who is reporting and from where, symptoms and travel history, and whether this information should be further investigated. Electronic data capture will enhance data quality and availability of information for review. Additionally, the magnitude of missed calls presents a major challenge. When calls are answered, there is potential to provide health communication, so risk communication needs should be considered. However, prior to hotline implementation, governments should critically assess whether their hotline would yield actionable data and if other data sources for surveillance or community concerns are available.

African Swine Fever Virus Circulation between Tanzania and Neighboring Countries: A Systematic Review and Meta-Analysis.

For over 100 years after the description of the first case of African swine fever (ASF) in Kenya, ASF virus (ASFV) cross-border spread in eastern and southern Africa has not been fully investigated. In this manuscript, we reviewed systematically the available literature on molecular epidemiology of ASF in Tanzania and its eight neighboring countries in order to establish the transmission dynamics of ASFV between these countries. Data were retrieved from World Animal Health Information System (WAHIS), Google Scholar, PubMed, Scopus, and CrossRef databases, using the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and reviewed to document ASF outbreaks and ASFV genotypes distribution. Using phylogeographic approach applied to ASFV p72 sequence dataset, the evolutionary history and the dispersal pattern of the ASFV strains were assessed. From 2005 to 2019, a total of 1588 ASF outbreaks affecting 341,742 cases that led to 302,739 domestic pig deaths were reported. The case fatality rates (CFR) varied from 15.41% to 98.95% with an overall CFR of 88.58%. Fifteen different p72 ASFV genotypes were reported and the time to the most recent common ancestor (TMRCA) for ASFV strains dated back to 1652.233 (1626.473, 1667.735) with an evolutionary rate of 4.805 × 10−5 (2.5857 × 10−5, 9.7789 × 10−5). Phylogeographic dispersal analysis revealed several transboundary spread events of ASFV strains between these countries. These results suggest persistent circulation of ASFV in these countries and advocate for more research to improve our understanding of the transmission dynamics of the virus and for a regional approach to mitigate the spread of ASFV.

Use of US Public Health Travel Restrictions during COVID-19 Outbreak on Diamond Princess Ship, Japan, February-April 2020.

Public health travel restrictions (PHTR) are crucial measures during communicable disease outbreaks to prevent transmission during commercial airline travel and mitigate cross-border importation and spread. We evaluated PHTR implementation for US citizens on the Diamond Princess during its coronavirus disease (COVID-19) outbreak in Japan in February 2020 to explore how PHTR reduced importation of COVID-19 to the United States during the early phase of disease containment. Using PHTR required substantial collaboration among the US Centers for Disease Control and Prevention, other US government agencies, the cruise line, and public health authorities in Japan. Original US PHTR removal criteria were modified to reflect international testing protocols and enable removal of PHTR for persons who recovered from illness. The impact of PHTR on epidemic trajectory depends on the risk for transmission during travel and geographic spread of disease. Lessons learned from the Diamond Princess outbreak provide critical information for future PHTR use.

The Law of the WHO and COVID-19 Pandemic Reformism

In the wake of the COVID-19 pandemic, international law norms on the cross-border spread of disease are under a reformist spotlight. Multiple perspectives have emerged on what the best course of action for better pandemic preparedness is. The legally binding and non-binding instruments from the World Health Organization (WHO) lie at the centre of these reformist debates. Against this backdrop, the current article explores past and current iterations of law-making and reform within the WHO. Currently, a three-pronged legal juncture is in place: creating a new instrument, amending existing rules, or issuing recommendations. The article concludes with a cautionary note regarding the overreliance on legally binding norms as the only worthwhile outcome of pandemic reformism. The prevalent geopolitical setting, always susceptible to major divides, is an inescapable determinant of success.

Analysis and modelling of territorial vulnerability to epidemiological diseases in the Wilaya of Batna (Algeria) – case of tuberculosis

Some epidemiological situations, because of their magnitude and their propagation dynamics, can escape local or national control. For example, the world is currently experiencing an uncontrollable cross-border spread of the corona virus (Covid-19). The Wilaya of Batna is among the most affected in Algeria by many epidemiological diseases, including tuberculosis, which raises questions about possible causal links between this contagious and often fatal disease and the environmental and socio-economic reality of this territory. We based our study on a number of factors, covering economic, societal and health aspects, which constitute indicators of the standard of living in each of the 61 communes of the Wilaya of Batna. The relationship between the epidemiological status of tuberculosis in these communes and these indicators showed significant correlations and thus confirmed the reliability of the choice of parameters of vulnerability to tuberculosis. To understand their interaction and impact on the disease and its spatial distribution, we used the hierarchical multicriteria analysis (AHP) method, the results of which were implemented in a GIS database. The aim was to provide health and territorial decision makers with a decision support tool. The results show that the spatial distribution of tuberculosis cases which reappeared in the Wilaya of Batna after its eradication since years is in good correlation with the socio-economic situation of each commune of the territory and confirm that this scourge of tuberculosis is closely linked to the degradation of the living conditions of the inhabitants.

COVID ‐19 transmission in cold chain: A safe and green new‐generation cold chain is demanded

<scp>COVID</scp> ‐19 transmission in cold chain: A safe and green new‐generation cold chain is demanded

COVID-19 does not stop at open borders: Spatial contagion among local authority districts during England's first wave.

Infectious diseases generate spatial dependence or contagion not only between individuals but also between geographical units. New infections in one local district do not just depend on properties of the district, but also on the strength of social ties of its population with populations in other districts and their own degree of infectiousness. We show that SARS-CoV-2 infections during the first wave of the pandemic spread across district borders in England as a function of pre-crisis commute to work streams between districts. Crucially, the strength of this spatial contagion depends on the phase of the epidemic. In the first pre-lockdown phase, the spread of the virus across district borders is high. During the lockdown period, the cross-border spread of new infections slows down significantly. Spatial contagion increases again after the lockdown is eased but not statistically significantly so.

Dengue fever as an emerging disease in Afghanistan: Epidemiology of the first reported cases

ObjectiveThis paper aims to describe the epidemiological characteristics and clinical manifestations of the first 15 dengue fever cases reported in Afghanistan. MethodsA retrospective descriptive analysis of the data on confirmed dengue cases detected by the national disease surveillance system was conducted. Epidemiological, socio-demographic, clinical, laboratory and outcome data from the cases were analyzed. ResultsBetween May and December 2019, 62 samples were tested for DENV, among which 15 (24.2%) were positive. Seven of the cases were probable autochthonous with no travel history, the other seven cases had a travel history to dengue-endemic countries (five Pakistan, two India) and the travel history for one of the cases was not known. The 15 confirmed cases were reported from six provinces, seven cases (46.7%) were reported from Nangarhar Province, two (13%) from Paktya, and one (6.7%) from Paktika province, bordering with Pakistan, three (20%) were reported from Kabul, and one each (each 6.7%) from Faryab and Laghman provinces. All of the cases manifested fever, headache, myalgia, and arthralgia. Other clinical features were low platelet count (50%), pain behind eyes (36%), rash, and nausea/vomiting (each 21%). ConclusionFor the first time, the surveillance system detected and reported locally acquired DENV cases in Afghanistan, mostly in provinces bordering with Pakistan. Population movements between Afghanistan and Pakistan facilitate the cross-border spread of DENV between two countries.

What are acute NHS trusts in England doing to prevent the cross-border spread of carbapenem-resistant Enterobacteriaceae?

Carbapenem-resistant Enterobacteriaceae (CRE) pose a significant threat to global public health as these organisms have the potential to cause infections which are easily spread and are associated with high mortality rates. The aim of this study was to establish which screening strategies acute NHS trusts in England have chosen to adopt and whether or not that strategy has prevented or is likely to prevent the cross-border spread of CRE. All acute NHS trusts in England were invited to participate in a multicentre quantitative study. Participants were asked to complete a questionnaire relating to their local CRE screening protocol. Of the 91 participating trusts, 83 (91.2%) adhere to Public Health England (2013) guidance. However, only 22 (24.2%) trusts have adopted the European Centre for Disease Prevention and Control (2016) recommendations. In total, 31 (34.1%) trusts reported incidences of person-to-person transmission, of which 45.2% were related to foreign travel. Furthermore, 31 (34.1%) trusts reported that patients who have had an admission to a hospital in the UK not known to have a high prevalence of healthcare-associated CRE in the last 12 months had screened positive. This study has demonstrated that inter-hospital transmission is as much of a concern as cross-border spread. Mandatory participation in enhanced surveillance could provide PHE with the epidemiological evidence required to support this stance and help to develop new national guidance.

Molecular epidemiology of multidrug resistant tuberculosis in Mongolia and Eastern Siberia: two independent dissemination processes for dominant strains

Mongolia and Russia are among the countries with the high tuberculosis (TB) burden. The prevalence of tuberculosis, including multidrug-resistant tuberculosis (MDR), in Eastern Siberia bordering Mongolia is significantly higher than in the European part of Russia. In addition, unlike Mongolia, Eastern Siberia is characterized by a high prevalence of HIV infection. The cross-border spread of socially significant infections in these countries seems to occur due to their wide-range cooperation and cultural exchange. Whereas the HIV infection has no epidemiological significance for Mongolia at the moment, tuberculosis, however, has a similar prevalence on both sides of the border. The aim was to evaluate the cross-border MDR M. tuberculosis distribution in Mongolia and Eastern Siberia by using molecular genetic data. Materials and methods. A total of 1045 M. tuberculosis strains isolated in Mongolia (291) and the three regions of Eastern Siberia (754) were studied by using the MIRU-VNTR-24 loci genotyping. The CC2/W148 and CC1 subtypes were identified by the specific deletion in the kdpD gene and SNP in the pks17 gene at position 1887060, respectively. Phylogenetic analysis of MIRU-VNTR patterns was carried out by generating UPGMA tree and maximum likelihood tree. Results. The Beijing genotype was found in 75.3% (219/291) and 69.0% (520/754) from Mongolian and East Siberian collection, respectively. Common minor genotypes were LAM (11.0% and 15.1%), T (10.3% and 4.5%), and Haarlem (1.4% and 2.4%) found in Mongolia and Eastern Siberia, respectively. The genotypes S (1.3%) and Ural (5.0%) were found solely in the Russia-derived samples. The main epidemic Beijing subtypes in each country belonged to different clonal complexes (CC): the majority of Mongolian Beijing strains displayed profiles 342-32, 3819-32, 1773-32 MLVA types and belonged to the CC4 subtype; Russian Beijing strains mainly belonged to the CC1 (43.7% — 227/520) and CC2/W148 (34.8% — 181/520) subtypes. The MDR level and distribution patterns differed significantly between Mongolia and Eastern Siberia. Modeling of Beijing strain expansion evidences about extremely subtle contribution of the M. tuberculosis cross-border transmission between Mongolia and Russia. The phylogenetic reconstruction of Beijing CC4 subtype evolution in Mongolia suggests that its distribution is primarily associated with China and other countries of the Western Pacific Region. Three main phylogenetic branches of CC4 subtype were traced, which probably spread throughout Mongolia in the 11—12th centuries. It may be assumed that spreading of the epidemic Beijing CC4 subtype might occur in two stages: early period — emergence of ancestral CC4 variants in Mongolia or their introduction from China (they are homologous to the strains preserved in the Chinese population), later period — dissemination due to the active exchange of M. tuberculosis with countries of Southeast Asia, but not Russia. Conclusion. Using MIRU-VNTR-24 genotyping as well as classification according to specific single nucleotide polymorphisms specific to certain Beijing subtypes, it allowed to describe separate patterns of the epidemic variants spread in Mongolia and Russia. It has been demonstrated that emergence and spread of MDR-TB in Mongolia are entirely iatrogenic in nature, while the epidemic subtypes of the Beijing genotype (subtypes CC1 and CC2/W148) contribute markedly into the MDR-TB spreading in Eastern Siberia.

Do Walls Work? The Effectiveness of Border Barriers in Containing the Cross-Border Spread of Violent Militancy

AbstractSince the end of the Cold War, walls, fences, and fortifications have been constructed on interstate borders at a rapid rate. It remains unclear, however, whether these fortifications provide effective security. We explore whether border fortifications provide security against the international spread of violent militancy. Although barriers can reduce the likelihood that militant activity diffuses across international borders, their effectiveness is conditional upon the roughness of the terrain on which they are built and the level of infrastructure development in their proximity. Barriers require intensive manpower to monitor and patrol, and so conditions like rough terrain and poor infrastructure render security activity more difficult. However, rebels and other militants prefer to operate in such difficult areas, ultimately reducing the effectiveness of barriers in containing the international spread of violent militancy. Analyses on newly collated data on interstate border fortifications within a global sample of contiguous-state directed-dyad-years show that border fortifications are only effective in limiting the diffusion of militancy in contexts in which states can plausibly monitor and police their borders. This paper has significant implications for the academic literatures on national security and intrastate conflict, and it also speaks to the broader policy debate over border walls and fences.

Cross-border spread of blaNDM-1- and blaOXA-48-positive Klebsiella pneumoniae: a European collaborative analysis of whole genome sequencing and epidemiological data, 2014 to 2019.

Analysis of sequencing data for 143 blaNDM-1- and blaOXA-48-positive Klebsiella pneumoniae isolates from 13 European national collections and the public domain resulted in the identification of 15 previously undetected multi-country transmission clusters. For 10 clusters, cases had prior travel/hospitalisation history in countries outside of the European Union including Egypt, Iran, Morocco, Russia, Serbia, Tunisia and Turkey. These findings highlight the benefit of European whole genome sequencing-based surveillance and data sharing for control of antimicrobial resistance.

Governmental Public Health Powers During the COVID-19 Pandemic

The president and all 50 governors have declared health emergencies to combat the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). While researchers race for vaccines, officials are implementing physical distancing, including orders to stay at home, restrict travel, and close non-essential businesses. To limit cross-border spread, a few states have issued mandatory quarantines for interstate travelers. Models suggest physical distancing would have to persist for 3 months to mitigate peak impacts on health systems and could continue on an intermittent basis for 12-18 months. What legal powers do governments have? What is the role of the courts? How can we balance public health with personal and economic rights?

A long-distance translocation initiated an outbreak of raccoon rabies in Hamilton, Ontario, Canada.

Despite proactive measures to prevent raccoon rabies entering Canada from the United States, several incursions of this disease have occurred. The largest outbreak, first reported in December 2015 in the city of Hamilton, Ontario, has resulted in the reporting of 449 animal cases as of December 31, 2018. Initial phylogenetic studies on the index case suggested that this outbreak was not due to local cross-border spread from the Niagara region of the United States where raccoon rabies has persisted for several years. Phylogenetic analysis of whole genome sequences of a viral collection from the Hamilton area and several US states indicates that a long-distance translocation of a diseased animal from southeastern New York State was responsible for this incursion. The role of the skunk as a potential secondary host supporting persistence and / or spread of the virus is also examined.

Intervention To Stop Transmission of Imported Pneumonic Plague - Uganda, 2019.

Plague, an acute zoonosis caused by Yersinia pestis, is endemic in the West Nile region of northwestern Uganda and neighboring northeastern Democratic Republic of the Congo (DRC) (1-4). The illness manifests in multiple clinical forms, including bubonic and pneumonic plague. Pneumonic plague is rare, rapidly fatal, and transmissible from person to person via respiratory droplets. On March 4, 2019, a patient with suspected pneumonic plague was hospitalized in West Nile, Uganda, 4 days after caring for her sister, who had come to Uganda from DRC and died shortly thereafter, and 2 days after area officials received a message from a clinic in DRC warning of possible plague. The West Nile-based Uganda Virus Research Institute (UVRI) plague program, together with local health officials, commenced a multipronged response to suspected person-to-person transmission of pneumonic plague, including contact tracing, prophylaxis, and education. Plague was laboratory-confirmed, and no additional transmission occurred in Uganda. This event transpired in the context of heightened awareness of cross-border disease spread caused by ongoing Ebola virus disease transmission in DRC, approximately 400 km to the south. Building expertise in areas of plague endemicity can provide the rapid detection and effective response needed to mitigate epidemic spread and minimize mortality. Cross-border agreements can improve ability to respond effectively.

Pandemic response and international law: The case of COVID-19

The coronavirus pandemic is currently raging throughout the world. The ensuing crisis has acquired a multidimensional nature, affecting all levels of society, including international health legal order. For international health law, the World Health Organization (WHO) is the international institution with a core mandate in issues of global health. Moreover, the International Health Regulations (IHR) is the main legally binding instrument laying down rules for the cross-border spread of contagious diseases. Against this backdrop, this paper evaluates the issues and disputes under the current regimes of international health law. The paper then offers some thoughts by way of answers to the research questions.