Epidemiological Investigation Research Articles

Epidemiological investigation and diagnostic analysis of osteonecrosis of the femoral head in three northeastern provinces of China

BackgroundIn this retrospective case investigation, we analysed the data of patients with osteonecrosis of the femoral head (ONFH) to reveal demographic and clinical diagnostic features of ONFH in three northeastern provinces of China and provide a reference for its prevention, diagnosis, and treatment.MethodsWe collected data from patients in Beijing Orthopaedic Hospital of Liaoning, focusing on the aetiology and diagnosis of ONFH. Medical records and self-designed questionnaires were used to collect information for statistical analysis, including age, aetiology, reason for glucocorticoid use, hospital level at first visit, and diagnosis.ResultsIn total, 906 patients with complete medical records were included in the analysis. The mean patient age was 47.65 ± 12.12 years. The peak age distribution was in the 40s for men and the 50s for women. Among the total cohort, 72 patients (7.95%; 40 men and 32 women) had traumatic ONFH, 198 (21.85%; 131 men and 67 women) had steroid-induced ONFH, 230 (25.39%; 121 men and 109 women) had idiopathic ONFH, and 406 (44.81%; 397 men and 9 women) had alcohol-induced ONFH. Six hundred and twenty patients were diagnosed with ONFH at the first visit, while 286 patients were misdiagnosed, with a diagnosis rate of 68.43%. The diagnosis rate at the first visit in tertiary hospitals was 76.14%. The diagnosis rate at the first visit in second-class hospitals was 52.07%.ONFH was most likely to be misdiagnosed as lumbar disc herniation.ConclusionsMost patients with ONFH in three northeastern provinces of China were middle-aged, male, and had alcohol-induced ONFH. The misdiagnosis rate of ONFH at the first visit was very high, especially for misdiagnosis of lumbar disc herniation, indicating that the diagnosis of ONFH requires further improvement.

The incidence and risk factors of retinopathy of prematurity in South Korea: A nationwide cohort study.

Retinopathy of prematurity (ROP) is a major treatable cause of childhood blindness. Thus, epidemiological investigations are necessary for detecting and preventing ROP. Determining risk factors for ROP are also essential to improve screening methods. Therefore, we aimed to investigate the incidence and risk factors of ROP in Korea. The National Health Insurance Service (NHIS) covers almost all Koreans. Furthermore, the National Health Screening Program for Infants and Children (NHSPIC) is a government-run, health-screening program for children aged < 6 years. We used the NHIS-Infants and Children's Health Screening cohort database to evaluate the incidence of preterm infants and ROP. The database contains data on 84,005 participants, drawn from 5% of the NHSPIC survey on participants born annually during 2008 to 2012. Sociodemographic factors and systemic diseases were assessed as potential risk factors for ROP. We identified 2615 premature infants (3.11%); 846 of them had ROP (cumulative incidence: 32.4%). Although preterm births increased annually in 2008 to 2012, the ROP incidence in preterm infants did not increase by the birth year. Twenty patients (2.4%) with ROP underwent laser photocoagulation or surgery. Extremely low birth weight was a high risk factor (odds ratio [OR] = 49.86, P < .001). Moreover, chorioamnionitis (OR = 2.77, P = .028), respiratory distress syndrome (OR = 4.09, P < .001), apnea (OR = 1.59, P = .008), anemia (OR = 2.41, P < .001), and intraventricular hemorrhage (OR = 2.34, P < .001) were found to be risk factors for ROP. In conclusion, the incidence of premature babies increased between 2008 and 2012. However, the overall incidence of ROP among premature infants remained unchanged by birth year. Our findings revealed the roles of birth weight, respiratory conditions, anemia, and intraventricular hemorrhage in ROP.

An epidemiological investigation into Mycoplasma bovis infection in U.S. bison (Bison bison): A case-control survey

Mycoplasma bovis (M. bovis) is an emerging pathogen in North American Bison (Bison bison) characterized by significant mor­bidity and mortality. Herds are reported to experience case fa­tality rates from 10 to 45%, with mature animals being primar­ily affected. To date, there are no published reports regarding the epidemiology of M. bovis within U.S. bison herds; this study serves as the first in-depth analysis of the prevalence, clinical signs and potential risk factors for M. bovis-associated disease in the United States.

Development of a triplex quantitative reverse transcription-polymerase chain reaction for the detection of porcine epidemic diarrhea virus, porcine transmissible gastroenteritis virus, and porcine rotavirus A

Porcine viral diarrhea is caused by many pathogens and can result in watery diarrhea, dehydration and death. Various detection methods, such as polymerase chain reaction (PCR) and real-time quantitative PCR (qPCR), have been widely used for molecular diagnosis. We developed a triplex real-time quantitative reverse transcription PCR (qRT-PCR) for the simultaneous detection of three RNA viruses potentially associated with porcine viral diarrhea: porcine epidemic diarrhea virus (PEDV), porcine transmissible gastroenteritis virus (TGEV), and porcine rotavirus A (PoRVA). The triplex qRT-PCR had R2 values of 0.999 for the standard curves of PEDV, TGEV and PoRVA. Importantly, the limits of detection for PEDV, TGEV and PoRVA were 10 copies/μL. The specificity test showed that the triplex qRT-PCR detected these three pathogens specifically, without cross-reaction with other pathogens. In addition, the approach had good repeatability and reproducibility, with intra-and inter-assay coefficients of variation &amp;lt;1%. Finally, this approach was evaluated for its practicality in the field using 256 anal swab samples. The positive rates of PEDV, TGEV and PoRVA were 2.73% (7/256), 3.91% (10/256) and 19.14% (49/256), respectively. The co-infection rate of two or more pathogens was 2.73% (7/256). The new triplex qRT-PCR was compared with the triplex RT-PCR recommended by the Chinese national standard (GB/T 36871-2018) and showed 100% agreement for PEDV and TGEV and 95.70% for PoRVA. Therefore, the triplex qRT-PCR provided an accurate and sensitive method for identifying three potential RNA viruses for porcine viral diarrhea that could be applied to diagnosis, surveillance and epidemiological investigation.

Tracing the Untraceables: A Joint Outbreak Investigation With Law Enforcement Using a Geographic Information System.

The application of geospatial data often allows the tracing of people who are involved in activities of an illegal nature. In June 2021, we estimated the true magnitude of the spread of COVID-19 within the networks of escort-karaoke bars in Seoul, Republic of Korea, using geographic information system (GIS)-based contact tracing that was applied to our epidemiological investigation. Our joint rapid response team, composed of epidemic investigation officers and police personnel, identified 19 paper-traced cases and 158 GIS-traced cases from 5,692 confirmed cases in Seoul during the study period (June to July 2021). Our findings suggest that collaboration with law enforcement agencies and the use of overlaid satellite imagery in outbreak investigations enhances high vigilance and reduces the risk of potential breaches of human rights in the process.

Hearing loss prevalence and burden of disease in China: Findings from provincial-level analysis.

Without timely and effective rehabilitation, hearing loss may profoundly affect human life quality. China has a large population of hearing-impaired individuals, which imposes a heavy health burden on society. Moreover, this population is projected to increase rapidly owing to China's aging society. We used data from a population-representative epidemiological investigation of hearing loss and ear diseases in four Chinese provinces. We estimated the national prevalence using multiple linear regression of the age-group proportions and prevalence in 31 provinces with clustering analysis. We used years lived with disability (YLDs) to analyze the disease burden and forecasted the prevalence of hearing loss by 2060 in China. An estimated 115 million people had moderate-to-complete hearing loss in 2015 across the 31 provinces of China (8.4% of 1.37 billion people). Of these, 85.7% were older than age 50years (99 million people) and 2.4% were younger than 20years old (2.8 million people). Of all YLDs attributable to hearing loss, 68.9% were attributable to moderate-to-complete cases. By 2060, a projected 242 million people in China will have moderate-to-complete hearing loss, a 110.0% increase from 2015. The hearing loss prevalence in China is high. Population aging and socioeconomic factors substantially affect the prevalence and severity of hearing loss and the disease burden. The prevalence and severity of hearing loss are unevenly distributed across different provinces. Future public health policies should take these trends and regional variations into account.

Gaming disorder test: Assessing psychometric properties, prevalence, temporal stability, and invariance using a Czech two-time-point longitudinal sample

In 2019, Gaming Disorder (GD) was acknowledged as an official diagnosis by the World Health Organization. The Gaming Disorder Test (GDT) is the most widely used tool to measure GD; however, due to its novelty, various measurement properties are still unexplored, and the number of validated language variants is still limited. The present study is the first to assess the psychometric properties of the Czech version of the GDT. Further, it focuses on its temporal prevalence and stability, gaming genre invariance, and criterion validity. A large-scale sample of adult Czech gamers collected at two points within nine months was analysed – T1 N = 5356; T2 N = 6077; longitudinal sample N = 1430. Confirmatory factor analysis (CFA), structural equation modelling (SEM), and multigroup CFA were employed to assess the measurement invariance. The study confirmed the one-factor structure of the GDT and showed that it is invariant across preferred gaming genres and the time of data collection. It showed a negative relationship with life satisfaction and a positive relationship with anxiety, even when controlling for their mutual relationships. The prevalence in the longitudinal sample was equal to or below 1.9% in each wave, but only 0.5% in the longitudinal sample (hence n = 7 participants fulfilled in both waves the criteria for GD). The study suggests that the Czech version of the GDT has good psychometric properties, including temporal stability and invariance across gaming genres, so it is suitable for the survey type and epidemiological investigation of the ICD-11's Gaming Disorder.

A Duplex PCR Assay for Rapid Detection of Klebsiella pneumoniae and Chryseobacterium in Large Yellow Croaker Fish.

Both Klebsiella pneumoniae and Chryseobacterium cause an increasing number of diseases in fish, resulting in great economic losses in aquaculture. In addition, the disease infected with Klebsiella pneumoniae or Chryseobacterium exhibited the similar clinical symptoms in aquatic animals. However, there is no effective means for the simultaneous detection of co-infection and discrimination them for these two pathogens. Here, we developed a duplex polymerase chain reaction (PCR) method based on the outer membrane protein A (ompA) gene of Klebsiella pneumoniae and Chryseobacterium. The specificity and validity of the designed primers were confirmed experimentally using simplex PCR. The expected amplicons for Klebsiella pneumoniae and Chryseobacterium had a size of 663 and 1404 bp, respectively. The optimal condition for duplex PCR were determined to encompass a primer concentration of 0.5 μM and annealing temperature of 57°C. This method was analytical specific with no amplification being observed from the genomic DNA of Escherichia coli, Vibrio harveyi, Pseudomonas plecoglossicida, Aeromonas hydrophila and Acinetobacter johnsonii. The limit of detection was estimated to be 20 fg of genomic DNA for Chryseobacterium and 200 fg for Klebsiella pneumoniae, or 100 colony-forming units (CFU) of bacterial cells in both cases. The duplex PCR was capable of simultaneously amplifying target fragments from genomic DNA extracted from the bacteria and fish liver. For practical validation of the method, 20 diseased fish were collected from farms, among which 4 samples were PCR-positive for Klebsiella pneumoniae and Chryseobacterium. The duplex PCR method developed here is time-saving, specific, convenient, and may prove to be an invaluable tool for molecular detection and epidemiological investigation of Klebsiella pneumoniae and Chryseobacterium in the field of aquaculture.

Improvement the Monitoring System for Post-Injection Infectious Complications

Relevance. The high intensity of the therapeutic and diagnostic process in medical organizations is accompanied by an increase in the manipulation load on patients and, accordingly, an increase in the risk of post-injection infectious complications. In the Russian Federation, in the structure of infections associated with medical care, post-injection complications in the last ten years before the pandemic of a new coronavirus infection occupied 7.0–11.0% [1]. The question of the impact on the prevalence of post-injection complications of medical care conditions that changed during the COVID-19 pandemic remains open for discussion and study. The purpose of this study is to give an epidemiological characterization of post–injection infectious complications in medical organizations, to determine their place in the structure of patient health losses in order to improve the monitoring system for infections associated with medical care. Materials and methods. The forms of statistical observation No. 1, 2 «Information on infectious and parasitic morbidity», No. 30 «Information on medical organizations» for the period 1994–2022, 101 forms of epidemiological investigation of cases of post-injection complications for the period 2015–2022 are analyzed. Epidemiological and statistical research methods were used in the work. Conclusions. During the study period, the prevalence of post-injection complications in outpatient polyclinic organizations of the Khanty–Mansiysk autonomous okrug – Ugra was 0.10 per 100 thousand visits and 3.85 per 100 thousand treated in hospital. The risk groups for post–injection complications were persons of older age groups, and the place of risk was procedural, vaccination rooms, and neurological departments. Abscesses prevailed in the structure of post-injection complications (85.4%), with the most frequent localization of post-injection complications in the gluteal region (47.7%). During laboratory examination of the material, gram-positive microorganisms were isolated from the focus of infection in 72.9% of cases, the largest proportion of which was Staphylococcus aureus (74.3%), including MRSA. In 80.5% of cases of post-injection complications, surgical intervention was required, including 77.8% in a hospital setting. The prerequisites for the occurrence of post-injection complications were excessive manipulation load, prescribing more than 5 drugs to patients and non-compliance with the instructions for injections in 4.8%. The complexity of monitoring post-injection complications is due to the lack of a standard definition of the case in most nosological forms, deliberate concealment of cases of infectious complications and imperfection of laboratory diagnostics.

Prevalence, geographic distribution and risk factors of Eimeria species on commercial broiler farms in Guangdong, China

BackgroundCoccidiosis is one of the most frequently reported diseases in chickens, causing a significant economic impact on the poultry industry. However, there have been no previous studies evaluating the prevalence of this disease in broiler farms in Guangdong province. Therefore, this study aims to conduct an epidemiological investigation into the occurrence of Eimeria species and associated risk factors in intensive management conditions across four regions in Guangdong province, China. A total of 394 fecal samples were collected from 89 broiler farms in Guangdong province. The prevalence of Eimeria species infection was determined using PCR, and the occurrence of Clostridium perfringens type A was assessed using quantitative real-time PCR.ResultsThe results showed an overall prevalence of 98.88% (88/89) at the farm level and 87.06% (343/394) at the flock level. All seven Eimeria species were identified, with E. acervulina (72.53%; 64/89), E. tenella (68.54%; 61/89), and E. mitis (66.29%; 59/89) at the farm level, and E. acervulina (36.55%; 144/394), E. mitis (35.28%; 139/394), and E. tenella (34.01%; 134/394) at the flock level. The predominant species combination observed was a co-infection of all seven Eimeria species (6.74%; 6/89), followed by a combination of E. acervulina, E. tenella, E. mitis, E. necatrix, E. brunetti, and E. maxima (5.62%, 5/89). A combination of E. acervulina, E. tenella, E. mitis, E. necatrix, E. brunetti, and E. praecox (4.49%; 4/89) was also observed at the farm level. Furthermore, the study identified several potential risk factors associated with the prevalence of Eimeria species, including farm location, chicken age, drinking water source, control strategy, and the presence of C. perfringens type A were identified as potential risk factors associated with prevalence of Eimeria species. Univariate and multivariate analyses revealed a significant association between E. necatrix infection and both grower chickens (OR = 10.86; 95% CI: 1.92–61.36; p < 0.05) and adult chickens (OR = 24.97; 95% CI: 4.29–145.15; p < 0.001) compared to starter chickens at the farm level. Additionally, farms that used groundwater (OR = 0.27; 95% CI: 0.08–0.94; p < 0.05) were less likely to have E. maxima compared to those that used running water. At the flock level, the prevalence of E. tenella was significantly higher in the Pearl River Delta (OR = 2.48; 95% CI: 1.0–6.15; p = 0.05) compared to eastern Guangdong. Interestingly, flocks with indigenous birds were less likely to have E. brunetti (OR = 0.48; 95% CI: 0.26–0.89; p < 0.05) compared to flocks with indigenous crossbred birds. Furthermore, flocks that used anticoccidial drugs (OR = 0.09; 95% CI: 0.03–0.31; p < 0.001) or a combination of vaccines and anticoccidial drugs (OR = 0.06; 95% CI: 0.01–0.25; p < 0.001) were less likely to be positive for E. tenella compared to flocks that only used vaccines. Finally, flocks with C. perfringens type A infection were significantly more likely to have E. necatrix (OR = 3.26; 95% CI: 1.96–5.43; p < 0.001), E. tenella (OR = 2.14; 95% CI: 1.36–3.36; p < 0.001), E. brunetti (OR = 2.48; 95% CI: 1.45–4.23; p < 0.001), and E. acervulina (OR = 2.62; 95% CI: 1.69–4.06; p < 0.001) compared to flocks without C. perfringens type A.ConclusionsThis study conducted an investigation on the prevalence, distribution, and risk factors associated with Eimeria species infection in broiler chickens in Guangdong. The farm-level prevalence of Eimeria species was higher than the previous prevalence figures for other areas and countries. E. brunetti was identified at higher prevalence in Guangdong than previously survived prevalence in different regions in China. Farm location, chicken age, drinking water source, control strategy, and the presence of C. perfringens type A were considered as potential risk factors associated with prevalence of Eimeria species. It is imperative to underscore the necessity for further surveys to delve deeper into the occurrence of Eimeria species under intensive management conditions for different flock purposes.

Identification and phylogenetic analysis of Jingmen tick virus in Jiangxi Province, China

Jingmen tick virus (JMTV) is a newly identified segmented flavivirus that has been recognized in multiple hosts, such as humans, buffalos, bats, rodents, mosquitos and ticks. Various clinical cases and studies manifested that JMTV is a true arbovirus with wide host spectrum and showed potential threats toward public health. JMTV has been reported in multiple countries in Asia, Europe, Africa, and America. Moreover, wild boars serve as an important intermediary between humans and the wild ecological system. In China, it has been reported in nine provinces, while the prevalence and the distribution of JMTV in most regions including Jiangxi Province are still unknown. Thus, to profile the distribution of JMTV in Jiangxi Province, an epidemiological investigation was carried out from 2020 to 2022. In current study, 66 ticks were collected from 17 wild boars in Jiangxi Province. The results showed that 12 out of 66 ticks were JMTV positive, indicating JMTV is prevalent in ticks and boars in Jiangxi Province. The genome sequences of JMTV strain WY01 were sequenced to profile viral evolution of JMTV in China. Phylogenetic analysis divided JMTV strains into two genotypes, Group I and Group II. WY01 belongs to Group II and it shares the closest evolutionary relationship with the Japan strains rather than the strains from neighboring provinces in China suggesting that JMTV might have complex transmission routes. Overall, current study, for the first time, reported that JMTV is prevalent in Jiangxi Province and provided additional information concerning JMTV distribution and evolution in China.

Genetic Structure of Introduced Plasmodium vivax Malaria Isolates in Greece, 2015–2019

Greece has been malaria-free since 1974, after an intense malaria control program. However, as Greece hosts migrant populations from P. vivax malaria-endemic countries, there is a risk of introducing the disease to specific vulnerable and receptive areas of the country. Knowledge of the genetic diversity of P. vivax populations is essential for understanding the dynamics of malaria disease transmission in a given region. We used nine highly polymorphic markers to genotype 124 P. vivax-infected archived DNA samples from human blood specimens referred to the NMRL from all over Greece throughout 2015–2019. The genotypic variability of the samples studied was noted, as they comprised several unique haplotypes, indicative of the importation of a large number of different P. vivax strains in the country. However, only a few events of local transmission were recorded. Genotyping revealed and confirmed the same clusters as those identified through epidemiological investigation. In only one introduction event was the index case found. No sustained/ongoing malaria transmissions in/between the studied regions or during consecutive years or additional foci of local transmission were observed. Genotyping is an important component in assisting malaria surveillance, as it provides information concerning the patterns of introduction and the effectiveness of implemented malaria control and elimination measures.

Mycobacterium immunogenum acquisition from hospital tap water: a genomic and epidemiologic analysis.

We identified 23 cases of Mycobacterium immunogenum respiratory acquisition linked to a colonized plumbing system at a new hospital addition. We conducted a genomic and epidemiologic investigation to assess for clonal acquisition of M. immunogenum from hospital water sources and improve understanding of genetic distances between M. immunogenum isolates. We performed whole-genome sequencing on 28 M. immunogenum isolates obtained from August 2013 to July 2021 from patients and water sources on four intensive care and intermediate units at an academic hospital. Study hospital isolates were recovered from 23 patients who experienced de novo respiratory isolation of M. immunogenum and from biofilms obtained from five tap water outlets. We also analyzed 10 M. immunogenum genomes from previously sequenced clinical (n = 7) and environmental (n = 3) external control isolates. The 38-isolate cohort clustered into three clades with pairwise single-nucleotide polymorphism (SNP) distances ranging from 0 to 106,697 SNPs. We identified two clusters of study hospital isolates in Clade 1 and one cluster in Clade 2 for which clinical and environmental isolates differed by fewer than 10 SNPs and had less than 0.5% accessory genome variation. A less restrictive combined threshold of 40 SNPs and 5% accessory genes reliably captured additional isolates that met clinical criteria for hospital acquisition, but 12 (4%) of 310 epidemiologically unrelated isolate pairs also met this threshold. Core and accessory genome analyses confirmed respiratory acquisition of multiple clones of M. immunogenum from hospital water sources to patients. When combined with epidemiologic investigation, genomic thresholds accurately distinguished hospital acquisition.

Pathogen identification and epidemic factor analysis of yellow catfish, Pelteobagrus fulvidraco, red lower jaw disease

Since 2020, another type of epidemic disease, ‘red lower jaw disease’ (RLJD), has broken out in yellow catfish Pelteobagrus fulvidraco every spring in China, causing large-scale deaths and significant economic losses. This new disease has the characteristics of strong infectivity, high mortality and a single host. To prevent and control RLJD, epidemiological investigation, transmission electron microscopy (TEM), virome sequencing, Koch's rule verification and epidemic factor investigation were studied in this article. The clinical symptoms of diseased yellow catfish were pale gill filaments, hyperaemia and swelling of the spleen and kidney. TEM results revealed that a large number of 35–40 nm spherical virus particles without envelope structure were found in the cytoplasm of spleen cells. The liver, spleen and kidney of the diseased fish had serious lesions. After virome sequencing, the calicivirus reads in the unique virus reads accounted for 99.5% of the unique virus reads in the diseased fish, which provided a relevant reference value for identifying the pathogen of RLJD. The full-length sequence of yellow catfish calicivirus (YCCV) obtained at 7405 bp, including the RNA-helicase domain, RdRp-1 domain and d1iqqa domain. At the same time, both PCR and TaqMan fluorescence quantitative PCR detection method of YCCV were established. Through the artificial infection test, YCCV was verified as the pathogen for RLJD. It was also found that YCCV mainly harmed the fish within 1 year, whereas the fish above 2 years had good resistance. The water temperature of the RLJD outbreak was mainly concentrated at 18 °C–24 °C. In the current study, after YCCV was verified as the pathogen of RLJD, epidemic factors including fish age and water temperature were studied, to the best of our knowledge, for the first time to provide a relevant theoretical basis for the pathogenic mechanism and prevention and control measures of yellow catfish RLJD.

Epidemiological and etiological investigations of hand, foot, and mouth disease in Jiashan, northeastern Zhejiang Province, China, during 2016 to 2022

Epidemiological and etiological investigations of hand, foot, and mouth disease in Jiashan, northeastern Zhejiang Province, China, during 2016 to 2022

Epidemiological and molecular investigations of sequential outbreaks of Campylobacter jejuni infecting adults and schoolchildren in southeastern China, 2021-2022

To investigate cases of five Campylobacter jejuni outbreaks and describe laboratory characteristics of these infections. Whole genome sequencing and conventional methods were combined to thoroughly investigate the outbreaks, and data of contemporaneous sporadic cases was included for comparison. Seven sequence types (ST) of C. jejuni caused 83 cases, including ST9079 which recurred across two years. Trace-back investigation could not identify any food items of infection, but detected identical campylobacters from food contacts. Phylogenetic analysis unveiled genetic closeness between outbreak strains and some concurrent sporadic strains, indicating local campylobacteriosis may not be wholly sporadic but rather a series of linked cases. Virulence genes disclosed species/case-specific signatures to differentiate outbreak from truly non-outbreak strains. Resistance to fluoroquinolones and/or macrolides was prevalent (90.8%, 108/119), with a noteworthy portion exhibiting multidrug resistance (31.1%, 37/119). Five types of plasmids were harbored among outbreak isolates, which one plasmid harboring anti-stress and resistant genes was rarely found in C. jejuni. This is the first reported sequential outbreaks of C. jejuni in China. Our observations help to define the genomic landscape and antimicrobial resistance patterns of Campylobacter, emphasizing the need for a broader 'One Health' perspective to combat the threats posed by campylobacteriosis.

Unveiling genotypic diversity of Theileria orientalis in lethal outbreaks among bovines in Karnataka, India.

Theileria orientalis, the causal agent of oriental theileriosis, is known to cause mild disease in cattle and buffalo across the world. Recently, different genotypes of T. orientalis have emerged as pathogenic, causing high reported morbidity in cattle. This study focuses on investigating three suspected outbreaks of oriental theileriosis that resulted in fatalities among crossbred and indigenous bulls in Karnataka, India. Examination of blood smears revealed the presence of T. orientalis piroplasms within erythrocytes. The genetic characterization of T. orientalis was conducted by targeting specific markers, including the mpsp gene, p23 gene, and ribosomal DNA markers (18S rRNA gene, ITS-1, and ITS-2). Analysis based on the 18S rRNA gene unveiled the presence of both Type A and Type E genotypes of T. orientalis in the outbreaks. The mpsp gene-based analysis identified genotype 7 of T. orientalis in crossbred cows, whereas genotype 1 (Chitose B) was found to be present in indigenous bulls. Haplotype network analysis based on the mpsp gene revealed the presence of 39 distinct haplotypes within the 12 defined genotypes of T. orientalis with a high haplotype diversity of 0.9545 ± 0.017. Hematological and biochemical analysis revealed a decrease in calcium, hemoglobin levels, red blood cell counts, and phosphorus. This study constitutes the initial documentation of a clinical outbreak of oriental theileriosis in indigenous bulls with genotype 1 (Chitose 1B). Substantial epidemiological investigations are imperative to gain a comprehensive understanding of the geographical distribution of distinct genotypes and the diverse clinical manifestations of the disease across various hosts.

Development and utilization of a visual loop-mediated isothermal amplification coupled with a lateral flow dipstick (LAMP-LFD) assay for rapid detection of Echinostomatidae metacercaria in edible snail samples

Trematodes belonging to the family Echinostomatidae are food-borne parasites which cause echinostomiasis in animals and humans. This is a global public health issue, particularly in East and Southeast Asia. A method to detect the infective stage of Echinostomatidae species is required to prevent transmission to humans. In this study, a loop-mediated isothermal amplification coupled with a lateral flow dipstick (LAMP-LFD) assay was developed for visual detection of the metacercarial stage in edible snails of the genus Filopaludina from local markets in Thailand. The LAMP-LFD method can be performed within 70 min at a consistent temperature of 66 °C, and the results can be interpreted with the naked eye. The detection limits of the assay using Echinostoma mekongi, E. macrorchis, E. miyagawai and Hypoderaeum conoideum genomic DNA were equal between the four species at 50 pg/μL. A specificity evaluation demonstrated that the LAMP-LFD assay had no cross-reaction with another parasite (Thapariella species) or with the snail host species (Filopaludina martensi martensi, F. sumatrensis speciosa, and F. s. polygramma). Clinical test assessments were compared to microscopic examination in 110 edible snail samples. The clinical sensitivity and specificity of the tests were 84.62 % and 100 %, respectively, with a strong level of agreement based on the kappa statistic and the results of both methods were not significantly different (p > 0.05) per McNemar's test. The test successfully developed in this study may be useful for the detection of the metacercarial stage in edible snails for epidemiological investigations, control, surveillance, and to prevent future echinostomiasis health issues.

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

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

Molecular epidemiological investigation and recombination analysis of Cachavirus prevalent in China

Chaphamaparvovirus carnivoran1 (canine Chaphamaparvovirus, also known as Cachavirus [CachaV]) is a novel parvovirus first reported in dog feces collected from the United States in 2017 and China in 2019. To continuously track its infection and evolution status, 276 canine anal swabs were obtained from pet hospitals in central, northern, and eastern China between 2021 and 2023 and screened via polymerase chain reaction; subsequently, a systematic study was conducted. Of these samples, nine (3.3%) were positive for CachaV. Using polymerase chain reaction, whole genome sequences of the nine CachaV-positive strains were amplified. The NS1 amino acid sequence identity between CachaV strains from China and other countries was 96.23–99.85%, whereas the VP1 protein sequence identity was 95.83–100%. CHN230521 demonstrated the highest identity for NS1 amino acids (99.85%) and VP1 amino acids (100%) with NWT-W88 and CP-T015. According to the model prediction of CHN220916-VP1 protein, Met64Thr, Thr107Ala, and Phe131Ser mutations may cause tertiary structural changes in VP1 protein. Interestingly, each of the nine CachaV strains harbored the same site mutations in NS1 (Ser252Cys, Gly253Leu, and Gly254Thr). Although no explicit recombination events were predicted, the clustering and branching of the phylogenetic tree were complicated. Based on the evolution trees for VP1 and NS1, the nine CachaV strains identified from 2021 to 2023 were closely related to those identified in gray wolves and cats. This study may be beneficial for evaluating the prevalence of CachaVs in China, thereby understanding the evolution trend of CachaVs.