Epidemiological Information Research Articles

Molecular detection and characterization of Anaplasma spp. in cattle and sable antelope from Lusaka and North-Western provinces of Zambia

Rickettsiales of the genus Anaplasma are globally distributed tick-borne pathogens of animals and humans with complex epidemiological cycles. Anaplasmosis is an important livestock disease in Zambia but its epidemiological information is inadequate. This study aimed to detect and characterize the species of Anaplasma present in domestic and wild ruminants in Zambia with a focus on the infection risk posed by the translocation of sable antelope (Hippotragus niger) from North-Western Province to Lusaka Province. Archived DNA samples (n=100) extracted from whole blood (sable n=47, cattle n=53) were screened for Anaplasmataceae using 16S rRNA partial gene amplification followed by species confirmation using phylogenetic analysis. Out of the 100 samples, Anaplasma species were detected in 7% (4/57) of the cattle and 24% (10/43) of the sable antelope samples. Of the 14 positive samples, five were determined to be A. marginale (four from cattle and one from sable), seven were A. ovis (sable) and two were A. platys (sable). Phylogenetic analysis of the 16S rRNA partial gene sequences revealed genetic proximity between A. ovis and A. marginale, regardless of host. The detection of Anaplasma in wildlife in Zambia shows the risk of transmission of Anaplasma species associated with wildlife translocation.

Clinical and epidemiologic features of SARS-CoV-2 in dogs and cats compiled through national surveillance in the United States.

To characterize clinical and epidemiologic features of SARS-CoV-2 in companion animals detected through both passive and active surveillance in the US. 204 companion animals (109 cats, 95 dogs) across 33 states with confirmed SARS-CoV-2 infections between March 2020 and December 2021. Public health officials, animal health officials, and academic researchers investigating zoonotic SARS-CoV-2 transmission events reported clinical, laboratory, and epidemiologic information through a standardized One Health surveillance process developed by the CDC and partners. Among dogs and cats identified through passive surveillance, 94% (n = 87) had reported exposure to a person with COVID-19 before infection. Clinical signs of illness were present in 74% of pets identified through passive surveillance and 27% of pets identified through active surveillance. Duration of illness in pets averaged 15 days in cats and 12 days in dogs. The average time between human and pet onset of illness was 10 days. Viral nucleic acid was first detected at 3 days after exposure in both cats and dogs. Antibodies were detected starting 5 days after exposure, and titers were highest at 9 days in cats and 14 days in dogs. Results of the present study supported that cats and dogs primarily become infected with SARS-CoV-2 following exposure to a person with COVID-19, most often their owners. Case investigation and surveillance that include both people and animals are necessary to understand transmission dynamics and viral evolution of zoonotic diseases like SARS-CoV-2.

Lynch Syndrome Genetics and Clinical Implications

Lynch syndrome (LS) is one of the most prevalent hereditary cancer syndromes in humans and accounts for some 3% of unselected patients with colorectal or endometrial cancer and 10%-15% of those with DNA mismatch repair-deficient tumors. Previous studies have established the genetic basis of LS predisposition, but there have been significant advances recently in the understanding of the molecular pathogenesis of LS tumors, which has important implications in clinical management. At the same time, immunotherapy has revolutionized the treatment of advanced cancers with DNA mismatch repair defects. We aim to review the recent progress in the LS field and discuss how the accumulating epidemiologic, clinical, and molecular information has contributed to a more accurate and complete picture of LS, resulting in genotype- and immunologic subtype-specific strategies for surveillance, cancer prevention, and treatment.

Enhancing Epidemiology's Impact on Policy: Mediation by Expert Committees.

Epidemiologic evidence is often a key source of information used by expert committees to guide policy decisions, yet epidemiologists rarely consider this audience for their research. For a better understanding of the pipeline from epidemiologic research to expert committee assessment to policy, several reports from the National Academies of Sciences, Engineering, and Medicine were reviewed and discussed with staff and committee members. The topics of these consensus committee assessments included health behaviors, medical care, and military exposures. The focus was often on emerging issues of immediate concern for which there was little relevant research available but a need for prompt action. Committees generally sought a comprehensive assessment of potential health effects of a given product or exposure, which often included social and behavioral health outcomes that are rarely addressed by epidemiologists. To enhance epidemiology's contribution to societal decisions, the choice of research topics should expand to consider emerging societal concerns. Research funding agencies need to be engaged as mediators between committee needs and the research community to stimulate contributory research. Improved communication of research needs to the epidemiology community would be beneficial to researchers aspiring to have an impact and to those who use epidemiologic information to help guide policy decisions.

Epidemiology and healthcare utilization for rectal foreign bodies in United States adults, 2012–2021

IntroductionPresentations to the emergency department for rectal foreign bodies are common, but there is little epidemiologic information on this condition. This limits the ability to provide evidence-based education to trainees regarding the populations affected, the types and frequency of foreign bodies, and factors associated with hospitalization. To address this, we analyzed national estimates of emergency department presentations for rectal foreign bodies from 2012 to 2021 in the US. MethodsWe queried the National Electronic Injury Surveillance System for any injury to the ‘pubic region’ or ‘lower trunk’ with an accompanying diagnosis of foreign body, puncture, or laceration. Two authors manually reviewed all clinical narratives to identify cases of rectal foreign bodies. National estimates were determined using weighting and strata variables, incidence rates calculated using census data, trends assessed by linear regression, and factors associated with hospitalization identified by multivariable logistic regression. ResultsFrom 885 cases, there were an estimated 38,948 (95% CI, 32,040-45,856) emergency department visits for rectal foreign bodies among individuals ≥15 years from 2012 to 2021. The average age was 43, 77.8% were male, 55.4% of foreign bodies were sexual devices, and 40.8% required hospitalization. The annual incidence of presentations for rectal foreign bodies increased from 1.2 in 2012 to 1.9 per 100,000 persons in 2021 (R2 = 0.84, p < 0.01). Males have a bimodal age distribution peaking in the fifth decade, while females have a right-skewed age distribution peaking in the second decade. Female sex (odds ratio [OR] 0.4; 95% confidence interval [CI], 0.2–0.6) and, compared to sexual devices, balls/marbles (OR 0.2; 95% CI, 0.05–0.6) or drugs/paraphernalia (OR 0.1; 95% CI, 0.05–0.4) are associated with a reduced odds of hospitalization. ConclusionsPresentations to the emergency department for rectal foreign bodies increased for males and females from 2012 to 2021 in the United States. These epidemiologic estimates for a complex form of anorectal trauma provide preclinical information for emergency medicine, surgery, and radiology trainees.

Epidemiology and healthcare resource utilization in atopic dermatitis in Colombia: A retrospective analysis of data from the National Health Registry from 2015 to 2020

Introduction: Atopic dermatitis, also known as eczema or atopic eczema, is a chronic inflammatory skin disorder characterized by the presence of pruritus accompanied by itching. In Colombia, epidemiological and healthcare resource utilization information regarding this pathology is limited. Objective: To describe atopic dermatitis epidemiological characteristics and healthcare resource utilization patterns in Colombia. Material and methods: A retrospective database study using real-world data obtained from the national claims database SISPRO (Sistema de Información para la Protección Social) for the 2015-2020 period was carried out. Sociodemographic (age, and health services delivery), epidemiological (incidence, prevalence, and comorbidities), and healthcare resource utilization data were extracted from the SISPRO database. Results: The epidemiological results showed increased incidence and prevalence of atopic dermatitis in Colombia in the 2018-2019 period compared to 2015-2017. Accordingly, the number of medical consultations (particularly with specialists), the number of procedures, and the number of hospitalizations of patients with atopic dermatitis increased. Topic and systemic corticoids were the most frequently prescribed drugs. Conclusions: Diagnoses of atopic dermatitis in Colombia increased with a concomitant increase in healthcare resource utilization during 2015-2020, which was possibly slowed down by the arrival of the Covid-19. This study may help physicians gaining a better understanding of the disease, improving atopic dermatitis patient management.

Epidemiology and Molecular Characterizations of Coronavirus from Companion Animals Living in Chengdu, Southwest China

The recent COVID-19 pandemic has once again caught the attention of people on the probable zoonotic transmission from animals to humans, but the role of companion animals in the coronavirus (CoV) epidemiology still remains unknown. The present study was aimed to investigate epidemiology and molecular characterizations of CoVs from companion animals in Chengdu city, Southwest China. 523 clinical samples from 393 animals were collected from one veterinary hospital between 2020 and 2021, and the presence of CoVs was detected by end-point PCR using pan-CoV assay targeting the RdRp gene. Partial and complete S genes were sequenced for further genotyping and genetic diversity analysis. A total of 162 (31.0%, 162/523) samples and 146 (37.2%, 146/393) animals were tested positive for CoVs. The positive rate in rectal swabs was higher than that in eye/nose/mouth swabs and ascitic fluid but was not statistically different between clinically healthy and diseased ones. Genotyping identified twenty-two feline enteric coronavirus (FCoV) I, four canine enteric coronavirus (CECoV) I, fourteen CECoV IIa, and one CECoV IIb, respectively. Eight complete S genes, including one canine respiratory coronavirus (CRCoV) strain, were successfully obtained. FCoV strains (F21071412 and F21061627) were more closely related to CECoV strains than CRCoV, and C21041821-2 showed potential recombination event. In addition, furin cleavage site between S1 and S2 was identified in two strains. The study supplemented epidemiological information and natural gene pool of CoVs from companion animals. Further understanding of other functional units of CoVs is needed, so as to contribute to the prevention and control of emerging infectious diseases.

Fortify clinical advantages and promote innovative development: comparison of the Chinese Colorectal Cancer Surgery Database with foreign databases

With the continuous development of evidence-based medicine, increasing attention has been paid to the construction of a large medical database to ensure a source of high quality real-world data. The Chinese Medical Association Colorectal Surgery Group created the Chinese Colorectal Cancer Surgery Database (CCCD), whose objective is to promote the development of colorectal surgery and improve patient prognosis with evidence-based medicine theory. Compared to major databases around the world, CCCD contains more comprehensive information on colorectal cancer surgical cases, recording the main epidemiological characteristics and detailed surgical information, but perioperative treatment data still need to be strengthened. It is necessary to continuously expand the coverage, enrich perioperative data and strengthen data, quality control. In the future, CCCD is expected to play a role in promoting homogenization of medical services, promoting smooth and effective graded diagnosis and treatment, giving full role to the characteristics of each center to achieve integrated development, and connecting real-world data and artificial intelligence.

Truncal Acne in Adolescents and Young Adults: Self-reported Perception

No epidemiological information about truncal acne is available. This study assessed the self-reported impact of truncal acne in adolescents and young adults, using an internet survey in France in 1,001 adolescents and young adults with truncal acne. Participants' mean age was 18.6 ± 4.3 years, 75.7% were females, 52.9% reported severe and 16.0% very severe truncal acne; 90.0% of participants with truncal acne also reported past or ongoing facial acne. Stress (46.3%), a diet high in lipids (33.2%), and sleeplessness (27.0%) were considered to be triggers of truncal acne; 44.7% consulted at least 1 healthcare professional and 28.1% searched the internet or social network for information about truncal acne. Of subjects with truncal acne, 68.4% thought constantly about their condition. Overall, 79.9% of the participants with severe acne vs 41.8% with mild or moderate acne: 41.8% thought about their acne all the time (p < 0.0001). Truncal acne heavily or very heavily impacted quality of life of 38.7% of participants. It impacted females significantly more than males (p < 0.0001). Significantly (p < 0.001) more females than males reported facial acne. A significant (p = 0.0067) association was observed between the severities of facial and truncal acne. The self-perceived impact of truncal acne in adolescents and young adults highlights the need for information as well as reinforced medical and psychological care.

Epidemiology of COVID-19 in two cities in southern Brazil: a cross-sectional population-based study

The first recommendations to prevent coronavirus disease 2019 (COVID-19) were made without epidemiological information on what would be people’s behaviors in view of the biopsychosocial and physical effects of confinement because of a health emergency with great economic impact. Objective: To determine the incidence of COVID-19; analyze the associated behavioral and sociodemographic factors. Methods: Cross-sectional population-based study with a representative sample of two cities in southern Brazil. 2,170 individuals aged 18 years or over were interviewed from October 2020 to January 2021. Data were collected in person at the place of residence of the individuals using a questionnaire. Results: The incidence of COVID-19 was 6.8% (95% confidence interval, CI: 5.4; 8.4), and was significantly higher in white people, aged between 18 and 59 years, married, with higher education, higher family income, and who lived in an apartment. The incidence of COVID-19 was associated with diabetes. People who stayed less time at home has a higher incidence (3.7% versus 7.5%). The most reported symptoms were excessive tiredness, reduced smell and taste. Most of the individuals (85%) sought a health facility and less than 5% were hospitalized. Conclusion: Almost one in ten individuals was infected by COVID-19. The incidence was higher for adults (because of being more exposed), individuals from higher socioeconomic level (because of having tested more) and in diabetics. Almost everyone stayed home after being diagnosed with the virus, and the main risk factor was having contact with someone infected.

Assessment of bovine fasciolosis and the analytical test evaluation at Yirgalem municipal abattoir, Ethiopia

A cross-sectional study was conducted from November 2021 to April 2022 to estimate the prevalence of bovine fasciolosis, assess the risk factors, and estimate the direct financial loss due to liver condemnation in cattle slaughtered at Yirgalem municipal abattoir. Furthermore, the comparison of the diagnostic efficiency of fecal and postmortem examination was evaluated. The study was based on both postmortem inspection of the liver for liver fluke infection and coprological examination using the sedimentation technique. Thus, a total of 400 cattle were sampled using systemic random sampling techniques and the prevalence was 27.0% (108/400) and 20.8% (83/400), by postmortem and coprological examination, respectively. The prevalence of F. hepatica, F. gigantica, mixed infections, and unidentified species were 56.5%, 19.4%, 16.7%, and 7.4%, respectively. The difference between age groups was statically significant (p&lt;0.05). Coprological examination revealed the highest prevalence was recorded in the age group of &gt; 7 years old (34%, adjusted odds ratio [AOR]=4.2) followed by 4-6 years old adults (26.8%, AOR=4.2) and in young cattle of &lt;3 years old (6.7%). Prevalence by postmortem examination was 43.0% (AOR=4 0), 27.8% (AOR= 2.4), and 8.3%, for age groups &gt; 7 years old, 4-6 years old adults and in young cattle of &lt;3 years old, respectively. The body condition score result revealed a significant difference (p&lt;0.05) as a greater magnitude of infections were detected in poor body condition animals (AOR=7.7) than in medium and good body condition (p&lt;0.05). Considering the liver examination as a gold standard for diagnosis of fasciolosis, the sensitivity of the sedimentation technique was 76.8%, and the specificity of 100% with a very good agreement (kappa = 0.94) between the two methods. The total financial loss per annum due to the condemnation of infected liver was 945, 999 ETB (18,192.288 USD). Therefore, strategic control and prevention of the snail intermediate host should be implemented. Furthermore, upon diagnosis of fasciolosis, epidemiological information about the disease with suggestive clinical examination should be considered even in the absence of Fasciola eggs during coprological examinations and also other parasitological techniques such as the FLOTAC and FLUKE FINDER methods with high sensitivity and specificity should be employed.

Considerations and analysis of the implementation of oncogeriatrics in Chile and its importance: Review of current literature.

The Chilean census of 2017 reported that 11.4% of the local population are 65years or older, and according to the National Institute of Statistics (INE) the current expectancy of life in Chile is 76years for men and 81years for women respectively. Cancer in Chile is a major public health problem. Aging is a significant risk factor for cancer development which added to the improved life expectancy, it increases the incidence of cancer. In 2040, new cancer cases will increase from 19.3 to 30.2 million worldwide. Older people are a heterogeneous group requiring specialized and individualized management. Chronological age does not necessarily correlate with physiological age. More than half of the geriatric patients with cancer have at least one comorbidity which is relevant when defining a cancer treatment. Likewise, polypharmacy is frequent and is an important issue to consider in people with cancer due to the risk associated with drug interactions. Oncogeriatric assessment consists of a comprehensive multidimensional evaluation, including functional and biopsychosocial issues, addressing aspects of the neoplastic disease such as the risk of toxicities due to systemic therapy and life expectancy. This tool has proven to be helpful in the diagnosis of conditions that are not evident in a routine oncological evaluation, such as geriatric syndromes, frailty, functional dependence, and cognitive impairment among others, which have an impact when deciding on therapy, predicting risks of treatment toxicity and mortality. In this article we aim to describe the current situation of Oncogeriatrics and to provide epidemiological information about cancer in the elderly population in Chile attempting to highlight the importance of the Oncogeriatrics units, within cancer departments, for a better decision taking in the elderly cancer patient.

Analysis of risk factors of hepatocellular carcinoma and establishment of a clinical prognosis model.

Liver cancer is a common malignancy of the digestive system. Hepatocellular carcinoma (HCC) accounts for the most majority of these tumors and it has brought a heavy medical burden to underdeveloped countries and regions. Many factors affect the prognosis of HCC patients, however, there is no specific statistical model to predict the survival time of clinical patients. This study derived a risk factor signature of HCC and reliable clinical prediction model by statistically analyzing The Surveillance, Epidemiology, and End Results (SEER) database patient information using an open source package in the python environment.

Campylobacter spp. Prevalence in Santiago, Chile: A Study Based on Molecular Detection in Clinical Stool Samples from 2014 to 2019.

Campylobacter spp. is an emerging cause of infectious diarrhea worldwide. In South American countries such as Chile, its prevalence is underestimated due to inadequate detection methods. Gastrointestinal multiplex PCR panels (GMP) permit rapid and sensitive detection of bacterial pathogens and provide important epidemiological information. This study aimed to analyze Campylobacter epidemiology using the results of molecular methods and to compare molecular detection results to those of culture methods. We performed a retrospective, descriptive analysis of Campylobacter spp. detected in clinical stool samples between 2014-2019 by GMP and culture. Within 16,582 specimens examined by GMP, Campylobacter was the most prevalent enteropathogenic bacteria (8.5%), followed by Salmonella spp. (3.9%), Shigella spp./enteroinvasive Escherichia coli (EIEC) (1.9%), and Yersinia enterocolitica (0.8%). The highest Campylobacter prevalence occurred in 2014/2015. Campylobacteriosis affected more males (57.2%) and adults from 19-65 years (47.9%) and showed a bimodal seasonality with summer and winter peaks. In 11,251 routine stool cultures, Campylobacter spp. was detected in 4.6%, mostly C. jejuni (89.6%). Among 4533 samples tested by GMP and culture in parallel, GMP showed a superior sensitivity (99.1% versus 50%, respectively). The study suggests that Campylobacter spp. is the most frequent bacterial enteropathogen in Chile.

Maternal and congenital toxoplasmosis in Mayotte: Prevalence, incidence and management.

Toxoplasmosis is an infection caused by an intracellular protozoan, Toxoplasma gondii. It is usually asymptomatic, but toxoplasmosis acquired during pregnancy can cause congenital toxoplasmosis, potentially resulting in fetal damage. Epidemiological information is lacking for toxoplasmosis in Mayotte (a French overseas territory). We evaluated (1) the prevalence of maternal toxoplasmosis, (2) the incidence of maternal and congenital toxoplasmosis, and (3) the management of congenital toxoplasmosis in Mayotte. We collected all the available data for toxoplasmosis serological screening during pregnancy and maternal and congenital cases of toxoplasmosis obtained between January 2017 and August 2019 at the central public laboratory of Mayotte (Mamoudzou). Using toxoplasmosis serological data from samples collected from 16,952 pregnant women we estimated the prevalence of toxoplasmosis in Mayotte at 67.19%. Minimum maternal toxoplasmosis incidence was estimated at 0.29% (49/16,952, 95% CI (0.0022-0.0038)), based on confirmed cases of maternal primary infection only. The estimated incidence of congenital toxoplasmosis was 0.09% (16/16,952, 95% CI (0.0005-0.0015). Missing data made it difficult to evaluate management, but follow-up was better for mothers with confirmed primary infection and their infants. The seroprevalence of toxoplasmosis among pregnant women and the incidence of toxoplasmosis are higher in Mayotte than in mainland France. There is a need to improve the antenatal toxoplasmosis screening and prevention programme, providing better information to physicians and the population, to improve management and epidemiological monitoring.

АНАЛИЗ РАСПРОСТРАНЕННОСТИ ПАРАЗИТАРНЫХ ЗАБОЛЕВАНИЙ И МИКСТИНВАЗИЙ У ДЕТЕЙ В КЫРГЫЗСКОЙ РЕСПУБЛИКЕ

This article presents the results of a study of sanitary epidemiological surveillance (SES) among preschool and school-age children conducted in the pilot districts of Osh, Naryn, Jalal-Abad and Batken regions of the Kyrgyz Republic (KR) in the period from 2015 to 2021 and describes the relevance of combined parasitic diseases, in particular helminthiasis, the problematic issues of epidemiological features of the combination of helminthiasis with a large range of parasitic diseases to assess the true picture of the prevalence of parasitic diseases in children. SES for parasitic diseases is a system for collecting biomaterials (stool) of children using preservatives and taking scrapings from the anus, laboratory analysis to determine the types of parasites and the dissemination of epidemiological information on the prevalence of parasitic diseases and children with mixed infestations, necessary for planning, implementing and monitoring preventive programs. 39398 children of school and preschool age up to 14 years were examined. Preschool children accounted for 36.3 % and schoolchildren below 14 years years old 63.6 % of the total number of surveyed. During the analyzed period, the total infection rate of children below 14 in the republic amounted to 10.9 % of the total number of examined, of which 5.7 % are girls and 5.2 % are boys. Key words: parasites, mixed invasion, intestinal parasitocenosis, mixed invasion, invasion, SES.

Diversity and geographical distribution of Leishmania species and the emergence of Leishmania (Leishmania) infantum and L. (Viannia) panamensis in Central-Western Venezuela

Transmission of cutaneous leishmaniasis in Venezuela reveals diverse and changing epidemiological landscapes, as well as a spectrum of clinical phenotypes presumed to be linked to a variety of Leishmania species. Central-western Venezuela constitutes one of the highest endemic epicenters in the country, and updated molecular epidemiological information is still lacking. Therefore, in this study we aimed to characterize the landscape of circulating Leishmania species across central-western Venezuela through the last two decades, performed comparisons of haplotype and nucleotide diversity, and built a geospatial map of parasite species distribution. A total of 120 clinical samples were collected from patients across the cutaneous disease spectrum, retrieving parasitic DNA, and further characterizing by PCR and sequencing of the HSP70 gene fragment. This data was later collated with further genetic, geospatial and epidemiological analyses. A peculiar pattern of species occurrence including Leishmania (Leishmania) amazonensis (77.63% N=59), Leishmania (Leishmania) infantum (14.47% N=11), Leishmania (Viannia) panamensis (5.26% N=4) and Leishmania (Viannia) braziliensis (2.63% N=2) was revealed, also highlighting a very low genetic diversity amongst all analyzed sequences. Geographical distribution showed that most cases are widely distributed across the greater urban-sub urban area of the Irribaren municipality. L.(L.) amazonensis appears to be widely dispersed throughout Lara state. Statistical analyses failed to reveal significance for any comparisons, leading to conclude a lack of association between the infective Leishmania species and clinical phenotypes. To the best of our knowledge, this is an unprecedented study which addresses comprehensively the geographical distribution of Leishmania species in central-western Venezuela throughout the last two decades, and the first to incriminate L. (L.) infantum as an etiologic agent of cutaneous leishmaniasis in this region. Our findings support that Leishmania endemism in central-western Venezuela is caused mainly by L.(L.) amazonensis. Future studies are needed to unveil additional details on the ecological intricacies and transmission aspects of leishmaniasis (i.e. sampling phlebotomines and mammals) and to adopt adequate public health prevention and control strategies and mitigate disease impact in this endemic region.

Historical and modern views on the problem of prostatolithiasis

In the literature review the authors present data on the history of the development of diagnostics and treatment of patients with prostatolithiasis and basic information about the most effective methods of treatment of this urological nosology. Prostatolithiasis is one of the most common diseases of the prostate in which, due to various etiological factors, stones are formed in the parenchyma of the prostate gland. Due to the lack of a single diagnostic algorithm, there is no accurate epidemiological information on the prevalence of prostate stones. According to various authors, this figure starts from 7.35 % and reaches 88.6 %. Depending on the localization, prostate stones are divided into endogenous, exogenous and mixed. Asymptomatic course, polyetiological pathogenesis, frequent recurrences of the inflammatory process in the prostate gland with the subsequent appearance of symptoms of the lower urinary tract, sclerosis of the prostate and bladder neck determine the extremely important role of this pathology. Prostatolithiasis, due to its specific clinical course, continues to be one of the most poorly studied problems in men of active working age, as well as in elderly men.

A review and analysis of cryptosporidiosis outbreaks in New Zealand.

Cryptosporidium is a leading global cause of diarrhoea with many reported outbreaks related to water and zoonotic transmission. This study summarizes data from Public Health Surveillance reports since 2010 in New Zealand to describe exposures associated with human diarrhoea outbreaks caused by Cryptosporidium. We investigate the species and subtypes of cases involved in some of the outbreaks to elucidate transmission routes and the predominant aetiological agents of cryptosporidiosis. For the period 2010–2017, 318 cryptosporidiosis outbreaks were reported in New Zealand resulting in 1634 cases and 20 hospitalizations. The most important mode of transmission was person-to-person (primary infections and secondary or close contacts infections), relating to 260 outbreaks and 1320 cases, followed by 113 outbreaks associated with animals, resulting in 436 human cases. From 2018 to 2021, there were 37 cryptosporidiosis outbreaks associated with 324 cases. We identified the subtypes by using polymerase chain reaction targeting the gp60 gene and the likelihood of mixed subtype infections with the Tracking of Indels by DEcomposition (TIDE) algorithm. Subtype families Ib and Ig of Cryptosporidium hominis and IIa and IId of Cryptosporidium parvum were found among cases; however, C. hominis subtypes occurred in 8 of the 11 outbreaks reviewed where molecular data were available. Examination of the chromatograms showed no mixed subtype infections in the samples assessed. Subtyping data need to be routinely incorporated into national surveillance programmes to better understand the epidemiology, sources, transmission and extent of cryptosporidiosis outbreaks in New Zealand. Our study highlights the value of integrating epidemiological information and molecular typing to investigate and manage clusters of cryptosporidiosis cases.

Clarifying the clinical landscape of pediatric spinal arteriovenous shunts: an institutional experience and individual patient-data meta-analysis

BackgroundPediatric spinal arteriovenous shunts (SAVS) are rare lesions with heterogeneous pathogenesis and clinical manifestations.ObjectiveTo evaluate the clinical characteristics, angioarchitecture, and technical/clinical outcomes in SAVS through a large single-center cohort analysis...