Pandemic Research Articles

Burden of viral respiratory infections in the pediatric intensive care unit: age, virus distribution, and the impact of the COVID-19 pandemic.

Viral respiratory infections can lead to severe complications. Their high prevalence in infants and young children highlights the need to extend vaccination age ranges for vaccine-preventable viral infections, monitor uptake in at-risk children, and implement public health interventions in daycare settings. •Viral respiratory infections in children are a significant cause of illness and mortality. •Severe infections in children beyond current vaccine eligibility suggest the need to expand vaccination to broaderage groups. •SARS-CoV-2 dominance during the COVID-19 pandemic altered disease characteristics of respiratory infections.

Modeling marburg virus control with limited hospital beds: a fractional approach

Abstract The Marburg virus is a serious global health threat due to its high mortality rate and rapid transmission. Effective control measures, such as hospital beds, are vital but often limited by inadequate healthcare resources. This study aims to address this challenge by developing a fractional-order epidemic model for Marburg virus, which considers the effects of limited hospital beds on transmission dynamics. We present a model to provide a more accurate understanding of Marburg virus transmission patterns and prevalence incorporating the memory effect through a fractional-order approach. The study explores the impact of constrained healthcare resources on virus progression and calculates the basic reproduction number using the next-generation matrix technique. Further analysis of the model’s global dynamics is conducted using reproduction numbers, the Lyapunov functional approach, and the Routh-Hurwitz criterion, shedding light on how hospital bed availability influences disease progression.We also apply Hyers-Ulam stability criterion to find the stability of the model and obtain numerical solutions through a fractional Lagrange two-step interpolation method. The fractional-order Marburg virus model, by accounting for memory effects, offers a more nuanced understanding of the disease dynamics compared to classical models. Our results demonstrate that increasing hospital bed availability significantly reduces Marburg virus infection rates. This approach highlights the value of fractional calculus in epidemiological modeling, offering significant insights into optimal control measures and strategies to improve public health outcomes during Marburg virus outbreaks.

Ivermectin Inhibits Zika Virus Replication in Vitro But Does Not Prevent Zika Virus Infection in Rhesus Macaques (Macaca mulatta).

Zika virus (ZIKV) outbreaks occur sporadically in tropical and subtropical regions. At present, there are no licensed vaccines or specific treatments available for ZIKV. Ivermectin is approved for use in humans as an antiparasitic drug. In this study, we conducted invitro cell culture and invivo experiments in rhesus macaque hosts and Aedes aegypti vectors to investigate the potential of ivermectin as an inhibitor of ZIKV infection. In LLC-MK2 mammalian cells, ivermectin inhibited ZIKV growth invitro with 50% inhibitory concentration (IC50) values in the ranges of 7.4-21.3 µM and 4.0-11.6 µM for African and Asian genotypes, respectively. In C6/36 mosquito cells, ivermectin inhibited ZIKV growth invitro with IC50 values in the ranges of 10.1-17.4 µM and 8.0-15.6 µM for the African and Asian genotypes, respectively. Despite these invitro results, high-dose ivermectin prophylaxis (1.2 mg/kg for 3 consecutive days) failed to prevent ZIKV infection in rhesus macaque and did not alter ZIKV IgM antibody production. The secondary transfer of ivermectin from nonhuman primate blood to mosquito vectors at 3 days post-ZIKV inoculation and after the last dose of ivermectin administration showed no reduction in ZIKV replication in mosquitoes. However, mosquito survival rates were significantly (P <0.0001) lower after exposure to ivermectin, thereby potentially impacting ZIKV transmission through increased vector mortality. However, further investigation is needed to determine dosing regimens that may realize these effects invivo.

Molecular genetic characterization of porcine reproductive and respiratory syndrome virus outbreak in Assam, India and neighbouring regions.

Porcine reproductive and respiratory syndrome (PRRS) is a significant swine disease with no effective vaccine due to high viral mutation rates. This study investigates a natural PRRS outbreak through molecular, pathological, and serological analyses. Nineteen affected pigs were clinically examined, and 10 underwent post-mortem examination. PRRS virus (PRRSV) presence was confirmed in all tissue samples by RT-PCR targeting open reading frame (ORF) 5 and ORF7 genes. Clinical signs, especially in boars and sows, included fever, appetite loss, movement reluctance, erythematous skin patches, vomiting, and abortions in sows. Post-mortem findings highlighted lung consolidation, severe lymph node enlargement, interstitial pneumonia with mononuclear cells, macrophage accumulation and necrotic cells in alveolar spaces. Multifocal myocarditis, lymphoid follicular degeneration, and follicular necrosis were observed in the tonsil, spleen, and lymph nodes. PRRSV-specific antibodies were detected in 32.75% of serum samples, confirming the outbreak. Phylogenetic analysis of the PRRSV-ORF5 and ORF7 genes revealed a close genetic relationship between the outbreak samples from Assam and recent outbreaks in Idukki, Kerala, India (2018), and neighbouring country China, indicating the circulation of Genotype 2 virus in Assam. However, the sequences showed some differences from the isolates of Mizoram, India. In conclusion, this study provides molecular and pathological evidence of a PRRSV outbreak, confirms the presence of PRRSV-specific antibodies and viral RNA, and shed light on the virus's genetic characteristics in India.

Perceived drivers of the Ebola virus disease outbreak in Mubende and Kassanda districts, Uganda: a qualitative study

IntroductionDuring the most recent Ebola virus disease (EVD) outbreak in Uganda, a cluster of community deaths with epidemiological linkages to the first reported case were identified to have occurred in...

Strategic vaccination responses to Chikungunya outbreaks in Rome: Insights from a dynamic transmission model.

Chikungunya virus (CHIKV) outbreaks, driven by the expanding habitat of the Aedes albopictus mosquito and global climate change, pose a significant threat to public health. Our study evaluates the effectiveness of emergency vaccination using a dynamic disease transmission model for a potential large-scale outbreak in Rome, Italy. The model incorporates a susceptible-exposed-infected-recovered (SEIR) framework for human and mosquito populations, taking into account temperature-dependent mosquito lifecycle dynamics, human-mosquito interactions, and various vaccination scenarios. Results indicate that emergency vaccination could significantly mitigate the impact of a CHIKV outbreak. Without vaccination, an outbreak is estimated to infect up to 6.21% of Rome's population, equating to approximately 170,762 individuals. Implementing rapid vaccination after detecting the virus in ten individuals and achieving 40% coverage could reduce infection rates by 82%, preventing 139,805 cases. Scenario and sensitivity analyses confirm that even with lower vaccination coverage rates, significant benefits are observed: at 10% coverage, the number of infections drops to 115,231, and at 20% coverage, it further reduces to 76,031. These scenarios indicate prevention of approximately 33% and 55% of infections, respectively. The findings highlight the critical role of timely vaccination interventions in outbreak settings, demonstrating that even modest coverage levels can markedly decrease the spread of CHIKV. This study underscores the importance of preparedness, early detection and adaptive response capabilities to manage emerging infectious diseases in urban centres, advocating for strategic vaccine stockpiling and rapid deployment mechanisms to enhance public health outcomes.

Sequence-based uniformity and mating type distribution of Berkeleyomyces rouxiae causing a pandemic black root rot disease in cotton in New South Wales, Australia

Sequence-based uniformity and mating type distribution of Berkeleyomyces rouxiae causing a pandemic black root rot disease in cotton in New South Wales, Australia

Chandipura Virus Outbreak in India: More Than Half-Century Old Mystery

Chandipura Virus Outbreak in India: More Than Half-Century Old Mystery

How does Agricultural Expansion Affect Nipah Virus Ecology?

In locations experiencing rapid agricultural expansion, the Nipah virus is an emerging zoonotic pathogen that brings about a serious threat to public health. This study looks at the effects that agricultural expansion has on the ecology of the Nipah virus. The study examines the consequences of habitat loss on fruit bat populations, the natural reservoir hosts for the Nipah virus, and how these changes influence bat foraging behaviour and interaction rates with other living organisms. Through reviews of outbreak data, the research identifies a link between agricultural activities and the increased risk of Nipah virus spillover into populations. The findings suggest that the expansion of agriculture disturbs the natural habitats of bats, forcing them to forage near humans and livestock which encourages the virus's spread. The results emphasize the importance of strategies for agricultural biosecurity, wildlife conservation, and land-use planning in order to minimize the potential for Nipah virus outbreaks.

Rapid virucidal activity of an air sanitizer against aerosolized MS2 and Phi6 phage surrogates for non-enveloped and enveloped vertebrate viruses, including SARS-CoV-2.

An air sanitizer was evaluated using an aerobiology protocol, compliant with the U.S. Environmental Protection Agency's Air Sanitizer Guidelines, for virucidal activity against bacteriophages Phi6 and MS2 (used as surrogates for enveloped and non-enveloped human pathogenic viruses). The phages were suspended in a medium containing a tripartite soil load simulating body fluids and aerosolized using a six-jet Collison nebulizer in an enclosed 25 m3 aerobiology chamber at 22 ± 2°C and 50 ± 10% relative humidity. The air sanitizer was sprayed into the chamber for 30 s. Viable phages in the air were captured directly, in real time, on host bacterial lawns using a slit-to-agar sampler. Reductions in viable phage concentration ≥3.0 log10 (99.9%) were observed after a mean exposure of 3.6 min for Phi6, suggesting efficacy against enveloped viruses (e.g., SARS-CoV-2, influenza, and RSV), and ~10.6 min for MS2, suggesting virucidal efficacy for non-enveloped viruses (e.g., noroviruses and rhinoviruses). This targeted air sanitization approach represents an important non-pharmaceutical public health intervention with virucidal efficacy against airborne viral pathogens.IMPORTANCEAirborne viruses are implicated in the transmission indoors of respiratory and enteric viral infections. Air sanitizers represent a non-pharmaceutical intervention to mitigate the risk of such viral transmission. We have developed a method that is now an ASTM International standard (ASTM E3273-21) as well as a test protocol approved by the U.S. EPA to evaluate the efficacy of air sanitizing sprays for inactivating airborne MS2 and Phi6 bacteriophage (used as surrogates for non-enveloped and enveloped human pathogenic viruses, respectively). The test phages were individually suspended in a soil load and aerosolized into a room-sized aerobiology chamber maintained at ambient temperature and relative humidity. Reductions in viable phage concentration ≥3.0 log10 (99.9%) were observed after a mean exposure of 3.6 min for Phi6, suggesting efficacy against enveloped viruses (e.g., SARS-CoV-2; influenza; RSV), and ~10.6 min for MS2, suggesting virucidal efficacy for non-enveloped viruses (e.g., noroviruses and rhinoviruses). The data suggest the utility of the air sanitizer for mitigating the risk of indoor viral transmission during viral pandemics and outbreaks.

Failed/difficult Intubation comparing between pre-COVID-19 and COVID-19 pandemic period using a national insurance claims database and information system of a university hospital

IntroductionEndotracheal intubation can be difficult or even fail under certain patient and anaesthesiologist conditions. During the COVID-19 pandemic a country-wide lockdown policy was enforced in Thailand which stipulated that anaesthesiologists wear personal protective equipment, powered air purifying respirator, or goggles and surgical/N95 mask during the intubation procedure. Thus, an anaesthesiologist’s vision is restricted and grip on the equipment less sure. Under these conditions, the incidence of difficult intubation was expected to increase.MethodsThis time-series study was based on the aggregated age- and sex-standardized monthly incidence of difficult intubation among all intubated patients whose data were recorded in the national insurance claims database and among patients recorded in the records of a university hospital from January 2018 to September 2022. Changes in incidence of difficult intubation following the implementation of a lockdown policy from 26 March 2020 during the COVID-19 pandemic were explored using negative binomial regression and interrupted linear regression time-series analysis.ResultsData of 922,274 individuals in the national database and 95,457 individuals in the university database were retrieved. The overall incidence of difficult intubation in both settings dropped by 25% following lockdown, significantly so in the national database (p < 0.001). At the point of interruption, a significant drop in level was evident in the national data (of 1.682 per thousand per month, P = 0.003) and a non-significant drop at the university level (of 1.118 per thousand per month, P = 0.304).DiscussionThe decreased incidence of difficult intubation during the lockdown period was contrary to expectation but might be related to the deployment solely of anaesthesiologists and more experienced anaesthetic staff using videolaryngoscopes during lockdown following the recommendation for intubation during respiratory disease pandemics.

Risk factors for SARS-CoV-2 pneumonia among renal transplant recipients in Omicron pandemic—a prospective cohort study

BackgroundThe coronavirus disease (COVID-19) pandemic is a global health emergency, and SARS-CoV-2 pneumonia poses significant challenges to health systems worldwide. Renal transplant recipients (RTRs) are a special group and are more vulnerable to viral pneumonia. However, few studies have elucidated the risk factors of SARS-CoV-2 pneumonia in RTRs infected with COVID-19. This study aimed to build a risk prediction model for SARS-CoV-2 pneumonia among RTRs based on demographic and clinical information.MethodsWe conducted a prospective cohort study among 383 RTRs (age ≥ 18 years) diagnosed with COVID-19 from December 21, 2022, to March 26, 2023. Patients’ demographic and clinical information was collected through a questionnaire survey combined with electronic medical records. A stepwise logistic regression model was established to test the predictors of SARS-CoV-2 pneumonia. We assessed the diagnostic performance of the model by calculating the area under the curve (AUC) of the receiver operating characteristic (ROC) and calibration using the Hosmer–Lemeshow (HL) goodness-of-fit test.ResultsOur study showed that the incidence of SARS-CoV-2 pneumonia among RTRs was 31.1%. Older age (OR = 2.08–3.37,95%CI:1.05–7.23), shorter post-transplantation duration (OR = 0.92,95% CI: 0.87,0.99), higher post-transplant Charlson Comorbidity Index (CCI) (OR = 1.84, 95%CI: 1.14,2.98), pulmonary infection history (OR = 3.44, 95%CI: 1.459, 8.099, P = 0.005), fatigue (OR = 2.11, 95%CI: 1.14, 3.90), cough (OR = 2.03, 95%CI: 1.08, 3.81), and lower estimated glomerular filtration rate (eGFR) at COVID-19 diagnosis (OR = 0.98, 95%CI:0.97,0.99) predicted a higher risk for SARS-CoV-2 pneumonia. The model showed good diagnostic performance with Chi-Square = 10.832 (P > 0.05) and AUC = 0.839 (P < 0.001).ConclusionsOur study showed a high incidence of SARS-CoV-2 pneumonia among RTRs, and we built a risk prediction model for SARS-CoV-2 pneumonia based on patients’ demographic and clinical characteristics. The model can help identify RTRs infected with COVID-19 at high risk of SARS-CoV-2 pneumonia to inform timely, targeted, and effective prevention and intervention efforts.

How fast are viruses spreading in the wild?

Genomic data collected from viral outbreaks can be exploited to reconstruct the dispersal history of viral lineages in a two-dimensional space using continuous phylogeographic inference. These spatially explicit reconstructions can subsequently be used to estimate dispersal metrics that can be informative of the dispersal dynamics and the capacity to spread among hosts. Heterogeneous sampling efforts of genomic sequences can however impact the accuracy of phylogeographic dispersal metrics. While the impact of spatial sampling bias on the outcomes of continuous phylogeographic inference has previously been explored, the impact of sampling intensity (i.e., sampling size) when aiming to characterise dispersal patterns through continuous phylogeographic reconstructions has not yet been thoroughly evaluated. In our study, we use simulations to evaluate the robustness of 3 dispersal metrics - a lineage dispersal velocity, a diffusion coefficient, and an isolation-by-distance (IBD) signal metric - to the sampling intensity. Our results reveal that both the diffusion coefficient and IBD signal metrics appear to be the most robust to the number of samples considered for the phylogeographic reconstruction. We then use these 2 dispersal metrics to compare the dispersal pattern and capacity of various viruses spreading in animal populations. Our comparative analysis reveals a broad range of IBD patterns and diffusion coefficients mostly reflecting the dispersal capacity of the main infected host species but also, in some cases, the likely signature of rapid and/or long-distance dispersal events driven by human-mediated movements through animal trade. Overall, our study provides key recommendations for the use of lineage dispersal metrics to consider in future studies and illustrates their application to compare the spread of viruses in various settings.

Comprehensive insight into recent algal enzymes production and purification advances: Toward effective commercial applications: A review.

Algal enzymes are essential catalysts in numerous biological reactions and industrial processes owing to their adaptability and potency. The marketing of algal enzymes has recently risen due to various reasons, including the cost-efficient manner of their cultivation in photobioreactors, the eco-friendly production of high biomass contents, sources of novel enzymes that used in many sectors (biofuel and bioremediation applications), sustainability, and more renewability. Oxidoreductases and hydrolytic enzymes are among the important applied algal enzymes in industrial applications, with annually growing demand. These algal enzymes have opened up new avenues for significant health advantages in reducing and treating oxidative stress, cardiovascular illness, tumors, microbial infections, and viral outbreaks. Despite their promising uses, commercial applications of algal enzymes face many difficulties, such as stability, toxicity, and lower data availability on specific and adequate catalytic mechanisms. Therefore, this review focuses on the algal enzyme types, their uses and advantages over other microbial enzymes, downstream and upstream processing, their commercial and marketing, and their challenges. With the constant development of novel enzymes and their uses, enzyme technology provides exciting options for several industrial sectors.

Oxymorphone and Oxycodone Pharmacy Purchases in US Counties: Prelude to the Largest Rural Human Immunodeficiency Virus Outbreak in US History.

The largest rural outbreak of human immunodeficiency virus (HIV) in the US was centered in Scott County, Indiana, and linked to injection practices involving the opioid Opana ER (oxymorphone extended release [ER] reformulated). We examined supply trends using pharmacy transactions of Opana ER in Scott and all US counties from January 2007 to December 2019. We calculated the monthly morphine milligram equivalents (MME) of Opana ER (and its competitor OxyContin) in pharmacies using the Automation of Reports and Consolidated Orders System (ARCOS) database from the Washington Post. We modeled the MME rate per capita in Scott County and five geographic comparators in seven distinct time periods including the market introduction of abuse deterrent formulations of both drugs and the HIV outbreak period (circa 2014). After Opana ER introduction, transaction rates surged in Scott County, where annual OxyContin MMEs were already seven-fold higher than Indiana overall (CY2009: 46.8 vs. 6.8 MME/pop., respectively). Immediately after OxyContin's reformulation, the Opana ER growth rate in Scott County surpassed all geographic comparators modeled (~27 times faster than the US, 1.28 vs. 0.047 MME/pop/month, respectively). By 2012, prior to the outbreak, MMEs from Opana ER almost perfectly replaced the diminishing OxyContin supply. When Opana ER with INTAC was subsequently introduced, pharmacy transactions declined precipitously by nearly 50%, persisting through the HIV outbreak period and market withdrawal. Opana ER rapidly supplanted OxyContin in a vulnerable population that was at heightened risk for HIV who subsequently faced an immediate supply shock after its reformulation. Pharmacy transactions are critical for suspicious order monitoring and pharmacovigilance by US and international agencies especially during deleterious supply shocks in legal and illicit drug markets.

Concurrent Rabies and Canine Distemper Outbreaks and Infection in Endangered Ethiopian Wolves.

Intensive disease surveillance in an endangered population of Ethiopian wolves provided evidence of concurrent outbreaks of rabies and canine distemper viruses in 2019, including co-infection in an individual animal. Disease surveillance and intensive monitoring of wolf packs in Ethiopia were essential in detecting the concurrent outbreaks and enabled accurate assessment of disease from both pathogens. The study highlights the risk posed to endangered populations that are susceptible to, or live in areas with, reservoir hosts for canine distemper and rabies viruses. Instances of concurrent distemper and rabies outbreaks appear unusual in the existing literature; modeling for one disease might underestimate the risk for extinction. Concurrent outbreaks may have a larger effect than single-disease outbreaks, even in a population that has partial vaccination coverage. Researchers studying wildlife populations from a conservation perspective should be aware that both diseases can strike at once where susceptible populations exist.

Development of Broad‐Spectrum β‐Cyclodextrins‐Based Nanomaterials Against Influenza Viruses

ABSTRACTIn recent decades, epidemics and pandemics have multiplied throughout the world, with viruses generally being the primary responsible agents. Among these, influenza viruses play a key role, as they potentially cause severe respiratory distress, representing a major threat to public health. Our study aims to develop new broad‐spectrum antivirals against influenza to improve the response to viral disease outbreaks. We engineered macromolecules (named CD‐SA) consisting of a β‐cyclodextrin scaffold modified with hydrophobic linkers in the primary face, onto which unitary sialic acid epitopes are covalently grafted to mimic influenza virus−host receptors. We assessed the antiviral efficacy, mechanism of action, and the genetic barrier to resistance of this compound against influenza in vitro, ex vivo, and in vivo. We demonstrated that CD‐SA, with a unitary SA, without extensive polysaccharides or specific connectivity, acts as a potent virucidal antiviral against several human influenza A and B viruses. Additionally, CD‐SA displayed antiviral activity against SARS‐CoV‐2, a virus that also relies on sialic acid for attachment. We then assessed the genetic barrier to resistance for CD‐SA. While resistance emerged after six passages with CD‐SA alone, the virus remained sensitive through eight passages when co‐treated with interferon‐λ1 (IFN λ1). Finally, we completed the characterization of the antiviral activity by conducting both ex vivo and in vivo studies, demonstrating a potent antiviral effect in human airway epithelia and in a mouse model of infection, higher than that of Oseltamivir, a currently approved anti‐influenza antiviral. The findings presented in this study support the potential therapeutic utility of a novel β‐cyclodextrin‐based nanomaterial for the treatment of influenza infections and potentially other sialic acid‐dependent viruses.

Herbal Remedies: An Emerging Alternative for the Treatment of Pandemic Diseases

Abstract: Pandemics are large-scale epidemics of infectious illness that may cause major economical, cultural, and political upheaval while also increasing illness and mortality across a huge geographic area. Evidence shows that pandemics have increased during the last century as a result of increasing international travel and connectivity, industrialization, agricultural expansion, and higher destruction of the natural environment. Over time, emerging pathogen strains cause pandemics that raise suffering, death, and instability in countries. Flu, plague, cholera, HIV, and the current COVID-19 pandemic caused by a novel coronavirus are just a few of the pathogen outbreaks. Unfortunately, given the lack of information and instruments to tackle the problem, managing new and developing infections is frequently challenging. Yet, the use of herbal remedies to treat new and developing infectious illnesses has received much interest. Until the invention of antibiotics, herbal plants, their preparations, and extracted phytoconstituents were reported to be efficient in reducing infectious diseases. Plants contain numerous complex metabolites, such as amino acids, alkaloids, tannins, flavonoids, terpenoids, and glycosides, that show different therapeutic activities. This review provides vital and useful information regarding herbal drugs and their effectiveness against various pathogens that cause major pandemics.

Pharmacological Provocation Test was Less Frequently Performed in Patients with Coronary Spastic Angina Onset during Coronavirus Disease Pandemic: A Multicenter Cross-sectional Study

Pharmacological Provocation Test was Less Frequently Performed in Patients with Coronary Spastic Angina Onset during Coronavirus Disease Pandemic: A Multicenter Cross-sectional Study

The COVID-19 Pandemic and the Proportion of People Diagnosed with Hypertension among Daegu Citizens

Objectives: Daegu Metropolitan City was a region that experienced the pandemic in the early stages of the COVID-19 outbreak, and the rate of physical activity practice decreased significantly compared with other metropolitan cities in 2020. In 2023, when it transitioned to an endemic, the proportion of people diagnosed with hypertension (standardized) increased the most among metropolitan cities. Methods: Using data from the Community Health Survey in Daegu, we examined changes in the proportion of people diagnosed with hypertension before and after the COVID-19 pandemic and changes according to sociodemographic characteristics. Results: The proportion of people diagnosed with hypertension, adjusted for gender, age, obesity, income, and occupation, was not different in 2019 and 2020 compared to 2018, and was likely to be higher in 2021, 2022, and 2023. The proportion of people diagnosed with hypertension was higher among men and women, ages in the 30s, 40s, and 50s, and income level in the 2 million won, 3 million won, and 4 million won and occupation in simple labor, others (students, housewives, unemployed) after the COVID-19 outbreak (2019-2023) than before the COVID-19 outbreak (2015-2019). In particular, there was a significant increase among women, 30s, 3 million won, and those in simple labor.Conclusions: In this study, the proportion of people diagnosed with hypertension increased significantly compared to before the outbreak of COVID-19, not only in vulnerable groups but also in younger age groups and high-income groups. In the physical activity aspect alone, the reason is interpreted as the result of the discontinuation of intense exercise, which can prevent hypertension by stimulating the cardiovascular system. Therefore, public health intervention is needed for vulnerable groups and maintain an intensity of exercise that can prevent hypertension. There is also a need to prepare to prevent a pandemic of chronic diseases from being caused by new infectious diseases.