Epidemiological Surveillance Programs Research Articles

Seroprevalence of leptospirosis in a Mexican military population working with animals

AbstractBackgroundLeptospirosis is a zoonotic disease and a challenge to global public health. There is an occupational risk, particularly in populations with direct contact with animals and in high‐humidity environments, which favors the survival of leptospires. This study aimed to determine the seroprevalence of leptospirosis in military personnel working in close contact with animals in México and to describe the available preventive measures and protection levels.MethodsA cross‐sectional study was conducted from March to October 2015. Information regarding protective factors in daily activities was gathered through a self‐evaluation questionnaire. The serum samples of participants were analyzed through enzyme‐linked immunoassay (ELISA) and microscopic agglutination test.ResultsSerums were obtained from 65 active military personnel, 56 males (86.2%) and 9 females (13.8%). Out of the total, 54 (83.1%) tested positive for infection by leptospirosis, 49 were males (87.5%) and 5 were females (55.6%). The highest seroprevalence age group was in the ≥45 years group (15, 23.07%), where all tested positive. Regarding military ranks, 100% of the highest hierarchy turned out positive: Officers (4 out of 4) and Chiefs (14 out of 14); and troops resulted in a seroprevalence of 76.5%. Protection equipment available during daily chores included: Overall, 64.6% had gloves and 53.8% had boots; the reported frequency for the use of gloves was 35.3% (46/65) if worn during more than half of the workday, yet 29.2% (19/65) reported never wearing them.ConclusionsThis study makes the petition to implement protocols of continuous training regarding labor risks and having an epidemiologic surveillance program for exposed personnel indispensable to improve the health and sanitary conditions of military personnel who work in direct contact with animals.

The state of cancer care in Russia: liver cancer - (From 22). Age-related features of the observed and relative one-year and five-year survival of patients. (clinical and population-based study). Part 2.

Survival rate calculations for liver cancer patients at the federal level in the Russian Federation are only conducted in the North-Western Federal District and a few other individual administrative territories. In the first part of our study, we presented a detailed analysis of the prevalence of liver cancer, noting that the levels of standardized incidence and mortality rates in Russia and the North-Western Federal District are virtually identical, allowing us to consider the results of our study as nationally representative. The conducted research confirmed the seriousness of the issue of liver cancer among the population. However, certain advancements in patient treatment were recorded, with a significant increase in survival rates, primarily for one-year survival. For example, in the North-Western Federal District, one-year survival increased from 13.6% in 2000 to 23.1% in 2022, representing a 69.8% increase. At the same time, five-year survival rates remained largely unchanged. Increases in survival rates were observed in most age groups. A significant deficiency in the initial patient record-keeping was identified - insufficiently accurate determination of the stage of liver cancer. One-year survival rates for male and female liver cancer patients (22.7% and 22.1%) were nearly equal, as were the survival rates for liver cancer patients residing in urban and rural areas. Therefore, further improvement in the outcomes of treatment for this complex patient group can only be achieved through the implementation of regional and federal screening and epidemiological surveillance programs among populations at high and extremely high risk of developing hepatocellular carcinoma.

Genomic Characterization of Two NDM-5-Producing Isolates of Klebsiella pneumoniae ST11 from a Single Patient.

Two metallo-β-lactamase-producing Klebsiella pneumoniae (HA30 and HA31) were isolated in a hospital in Argentina during 2018. K. pneumoniae HA30 was isolated from a rectal swab during the epidemiological surveillance for carbapenemase-producing strains, while K. pneumoniae HA31 was collected from the same patient 4days after hospitalization. The aim of the present study was to identify the clonal relationships and resistome of these two NDM-producing K. pneumoniae strains isolated from a patient with a fatal outcome. Whole-genome sequencing (WGS) was performed using Illumina MiSeq-I, and subsequent analysis involved genome assembly, annotation, antibiotic resistance gene identification, multilocus sequence typing (MLST), and plasmid characterization using bioinformatics tools. Conjugation assays to E. coli J53 was conducted as previously described. K. pneumoniae HA30 exhibited extensively drug-resistant phenotype, while HA31 was multidrug-resistant as defined by Magiorakos et al., including both resistance to carbapenems, aminoglycosides and ciprofloxacin with blaNDM-5, blaCTX-M-15 and rmtB genes found in both strains. MLST analysis showed that both strains belonged to ST11, differing by only 4 cgSNPs, indicating that K. pneumoniae HA30 and HA31 were the same strain. Conjugation assays revealed that K. pneumoniae HA31 strain possessed a transferable plasmid to E. coli J53. Bioinformatics studies identified that the same strain colonizing an inpatient during hospital admission subsequently caused the infection leading to a fatal outcome, being the first report of blaNDM-5, rmtB and blaCTX-M-15 genes in a K. pneumoniae ST11 strain from Latin America. Our results also highlighted the importance of focusing on epidemiological surveillance programs.

Pasteurella multocida ST20 is widespread in Australian poultry farms and may infect wild waterbirds

The bacterial agent that causes fowl cholera, Pasteurella multocida, was isolated from two deceased wild waterbirds in Victoria, Australia, in 2013. Whole genome sequence analysis placed the isolates into ST20, a subtype described in farmed chickens from Queensland, Australia and more recently in feedlot cattle and in pigs across a broader area of the continent. This study also found ST20 between 2009 and 2022 on three chicken farms and two turkey farms located in four Australian states. The sequences of 25 of these ST20 isolates were compared to 280 P. multocida genomes from 23 countries and to 94 ST20 Illumina datasets from Queensland that have been deposited in public databases. The ST20 isolates formed a single phylogenetic clade and were clustered into four sub-groups with highly similar genomes, possessing either LPS type 1 or type 3 loci. Various repertoires of mobile genetic elements were present in isolates from farmed, but not wild birds, suggesting complex histories of spill-over between avian populations and gene acquisition within farm environments. No major antimicrobial resistance was predicted in any of the ST20 isolates by the genomic analysis. The closest relative of these isolates was a ST394 bovine respiratory tract isolate from Queensland, which differed from ST20 by only one allele and carried beta-lactam and tetracycline resistance genes. These findings underline the importance of understanding the role of wild and commercial birds in the maintenance of fowl cholera, and of implementing regular epidemiological surveillance and biosecurity management programmes in wildlife, as well as free-range poultry farms.

Application of Geographic Information Systems in the Study of COVID-19 in Morocco

Introduction: The 2019 coronavirus disease (COVID-19) was first identified as a respiratory disease that originated in Wuhan, Hubei Province, China. The WHO declared the COVID-19 outbreak a public health emergency of international concern on 30 January 2020. Morocco reported its first coronavirus case on 2 March 2020. During the week of 9-15 March 2020, Morocco took steps to limit the spread of the epidemic. This article describes the use of spatial data applications in epidemiological research in Morocco, specifically its response to the COVID-19 epidemic. Methods: To conduct this study, we relied on the use and analysis of data provided by the Moroccan Ministry of Health for the study period from May to July 2021, as well as the geographical and administrative map of the Kingdom of Morocco. Spatial analysis of COVID-19 was performed using ArcGIS 10.8 and QGIS, a geographic information processing software. Health data for the 12 regions of the Moroccan territory were presented in the number of COVID-19 cases as a discrete quantitative variable and over time as a continuous time variable. Results: According to a map created using GIS, the concentration of COVID-19 cases appeared to be highest in the Casablanca Settat region. Depending on the number of documented COVID-19 cases, regions were ranked as follows: Casablanca-Settat> Rabat-Sale-Kenitra> Marrakech-Safi > Fes-Meknes > Tangier-Tetouan-Alhouceima>Oriental>Souss-Massa > Béni Mellal-Khenifra> Draa-Tafilalet> Laayoune-Sakia El Hamra >Guelmim-Oued Noun > Dakhla-Oued Eddahab. The increase in cases in major cities was due to several factors, including demographic, social and environmental factors. This demonstrated the need to consider demographic contributions to environmental health. Demographic factors helped us understand the health of our environment empirically. Geography improved health decision-making and accountability. Incorporating the geographic context of the spread of COVID-19 helped decision-makers understand the impact of location on strategies and goals to combat this pandemic. Conclusion: This study identified areas with high and low COVID-19 clusters and hotspots. The produced maps can serve as an excellent management tool to control and effectively eliminate the COVID-19 pandemic, contributing to investments in epidemiological surveillance programs.

Ciguatera poisoning in French Polynesia: A review of the distribution and toxicity of Gambierdiscus spp., and related impacts on food web components and human health

Ciguatera Poisoning (CP) is a seafood poisoning highly prevalent in French Polynesia. This illness results from the consumption of seafood contaminated with ciguatoxins (CTXs) produced by Gambierdiscus, a benthic dinoflagellate. Ciguatera significantly degrades the health and economic well-being of local communities largely dependent on reef fisheries for their subsistence. French Polynesia has been the site of rich and active CP research since the 1960′s. The environmental, toxicological, and epidemiological data obtained in the frame of large-scale field surveys and a country-wide CP case reporting program conducted over the past three decades in the five island groups of French Polynesia are reviewed. Results show toxin production in Gambierdiscus in the natural environment may vary considerably at a temporal and spatial scale, and that several locales clearly represent Gambierdiscus spp. “biodiversity hotspots”. Current data also suggest the “hot” species G. polynesiensis could be the primary source of CTXs in local ciguateric biotopes, pending formal confirmation. The prevalence of ciguatoxic fish and the CTX levels observed in several locales were remarkably high, with herbivores and omnivores often as toxic as carnivores. Results also confirm the strong local influence of Gambierdiscus spp. on the CTX toxin profiles characterized across multiple food web components including in CP-prone marine invertebrates. The statistics, obtained in the frame of a long-term epidemiological surveillance program established in 2007, point towards an apparent decline in the number of CP cases in French Polynesia as a whole; however, incidence rates remain dangerously high in some islands. Several of the challenges and opportunities, most notably those linked to the strong cultural ramifications of CP among local communities, that need to be considered to define effective risk management strategies are addressed.

Ergonomic Risk Analysis of Noise and its Effects on the Health of Operators in the Metal-Mechanical Sector.

The risk of developing an occupational pathology due to exposure to noise can cause occupational clinical symptoms with short, medium or long term health effects. The objective of the study is to identify the dysergonomic magnitude of oscillating acoustic comfort, approximately between 80 and 85 decibels, in MSMEs of the metal-mechanic sector and its effects on workers' exposure. The study population consisted of 1300 workers with a sample of 769 workers. The measurement was performed in different workstations with a sound level meter type 1, ISO 28803:2012 standard. Qualitative and quantitative data were obtained to analyze results related to occupational exposure. The sound pressure level was determined in each area of the plant during the different working days. This was done per worker according to their activity and tasks performed. In this way, it was possible to raise discussions about the improvement of the quality of life. The results of the study are satisfactory. Epidemiological surveillance programs (PVE) with an emphasis on audiometry are suggested.

Study of susceptibility to vancomycin from clinical isolates of Staphylococcus aureus

Vancomycin has been considered for over 40 years as the primary treatment option for Methicillin-Resistant Staphylococcus aureus (MRSA) strains. However, excessive, indiscriminate, or inappropriate use has led to the appearance of MRSA strains with intermediate resistance (VISA) and total resistance to vancomycin (VRSA) 1. In Central America, particularly in Honduras, no VRSA strains have been reported. However, it is vitally important to implement an epidemiological surveillance program where this isolation can be traced since its appearance has been considered a severe public health problem in the last two decades 2. By 2002, the first two VRSA strains were isolated, specifically in Michigan and Pennsylvania. Since then, a total of 52 VRSA isolates have been reported worldwide. The only country in Latin America that has reported VRSA strains is Brazil3. In this sense, we have carried out an assay to determine the MIC of the 96 clinical isolates of S.aureus obtained from patients who attended two of the essential hospital centers in Tegucigalpa, Honduras: the Hospital Escuela (HE) and the Honduran Institute of Social Security (IHSS). The samples were the same with which we studied resistance to methicillin, and it is a follow-up to the study that was previously published in this journal4. The MIC of S. aureus to vancomycin was determined using the E-test® strips (Solna, Sweden) under the same conditions reported in the previous study4 and based on what is recommended by the CLSI5 (figure 1). The cohort points to determine the susceptibility and resistance of S.aures to vancomycin can be seen in Table 1.

Proposal for an epidemiological surveillance program for the prevention of occupational accidents and diseases in workers exposed to carbon dioxide (CO2) at a Venezuelan brewing company

Introduction: In manufacturing companies, specifically in the brewery, there are processes that involve the handling and use of chemical agents, such as carbon dioxide (CO2), this is the reason why workers are exposed to this agent. In the studied company, an accident was caused by exposure to this substance. Objective: To propose an epidemiological surveillance program for the prevention of occupational accidents and diseases in workers exposed to carbon dioxide (CO2) in a Venezuelan brewery. Methods: A qualitative-quantitative, field, descriptive, feasible project-type research was carried out, with the epidemiological surveillance program as the unit of analysis. Documentary review, direct observation and the interview were used as data collection techniques, and the observation guide, the sociodemographic form and the field diary were used as instruments. Results: The machine room has 18 workers, which shows that the workforce is composed of men over 40 years of age. Among the main causes of consultation of workers to the medical service are headache with 24.1%, followed by fatigue with 20.6% and then dizziness with 13.7%. Conclusion: We propose an Epidemiological Surveillance Program aimed at machine room workers exposed to Carbon Dioxide (CO2), since there is no system that collects complete information on the working conditions and health of its workers, thus failing to comply with the legal framework governing the subject.

Socio-political and organizational influences on national infectious disease surveillance for refugees: A qualitative case study in Lebanon.

Infectious disease surveillance provides actionable information on displaced populations and helps identify outbreaks. Though not a signatory to the 1951 Refugee Convention, Lebanon has experienced large refugee influxes (e.g. Palestinians in 1948, Syrians in 2011), yet information on socio-political and organizational influences shaping surveillance targeting refugees is limited. We thus aimed to examine how Lebanese socio-politics affected infectious disease surveillance for refugees in Lebanon. We conducted a qualitative multimethod single case study of government engagement with refugee infectious disease surveillance (2011-2018) drawing from document analysis, semi-structured observations, and semi-structured key informant interviews at four surveillance sites in Lebanon. We analysed data thematically, using deductive and inductive coding. National politics delayed government and thus its epidemiological surveillance program's (ESU) engagement with refugee disease surveillance, largely due to Lebanon not being a 1951 Refugee Convention signatory and internal policy disagreements. Thus, it was initially difficult for the ESU to lead surveillance activities, though it later became more active. The ESU was limited by unclear reporting mechanisms and resources and its reliance on aggregated surveillance data prevented provision of data-informed responses. Though the ESU led surveillance nationally, and we identified positive provincial level collaborations due to individual efforts, some partners still conducted parallel surveillance. We found no systematic approach to infectious disease surveillance for refugees. The ESU could improve surveillance for refugees by collaborative strategic planning with partners for preparedness, surveillance, reporting, and sustainable resource allocation during refugee crises. Further suggestions include collecting disaggregated data, and piloting potentially more efficient syndromic surveillance, based on symptom clusters, for refugee populations.

Detection of Atypical Salmonella Infantis Phenotypes in Broiler Environmental Samples.

In numerous countries, strict and targeted measures concerning Salmonella monitoring and control are implemented and high quality of surveillance is ensured by obligatory investigation of samples from the primary production level of animals according to EN/ISO standards. Here, 2 phenotypic characteristics of Salmonella exhibited on compulsory media are crucial, namely, motility demonstrated on modified semisolid Rappaport Vassiliadis agar (MSRV), and production of hydrogen sulfide (H2S) on xylose lysine deoxycholate agar (XLD). In the present study, we describe the detection of Salmonella Infantis variants found in broiler environmental samples with major alterations in their growth characteristics on MSRV, XLD, and brilliant green-phenol red-agar (BPLS). The variants proved to be non-motile on MSRV and displayed non-confirming colony appearances on the previously mentioned selective agars. The growth spectrum comprised pinhead sized yellow colonies with small black centers, but also pinpoint sized colorless colonies, both colony types of regular shape. Our work contributes to highlight the finding of S. Infantis variants which possess more than one phenotypic deviation from the "typical" growth characteristics and by this limit the detection power of the actual obligatory used media. IMPORTANCE Salmonellosis caused by non-typhoidal Salmonella serovars is the second most frequently reported zoonotic disease in humans in the EU. The transmission of these agents is mainly via contaminated food of animal origin. In this context, poultry products are the main source of infection. Therefore, continuous and standardized surveillance of the prevalence of such Salmonella serovars at the primary production level is essential. Our findings show the phenotypic heterogeneity of the serovar Infantis and provide growth characteristics of atypical variants. Such variants pass unnoticed official screening methods, resulting in incorrect identification and being underrepresented in epidemiological surveillance programs.

Circulation of Pestiviruses in Small Ruminants from Greece: First Molecular Identification of Border Disease Virus.

The incidence of small ruminant pestivirus infections in Greece remains unknown as they have not been diagnosed in the country since 1974 when the most recent Border Disease Virus (BDV) outbreak was reported. The objective of our study was to explore the possible occurrence of pestiviral infections among sheep and goat farms in Greece and to further determine the variants of major concern. Thus, serum samples were collected from 470 randomly selected animals belonging to 28 different flocks/herds. ELISA on p80 antibody revealed the existence of seropositive animals in four out of the 24 studied sheep flocks, whereas all the goats in the four studied herds were seronegative. Viral RNA and antigens were detected in two sheep out of the four seropositive flocks by RT-PCR and ELISA, respectively. Sequencing and phylogenetic analysis showed that the newly identified Greek variants were closely related to the strains of the BDV-4 genotype. One of the BDV-positive sheep demonstrated the diagnostic profile of a persistently infected (PI) animal, providing additional information regarding the source of the infection. This is the first molecular identification of BDV isolates in Greece. Our findings indicate that BDV infections are likely to remain undiagnosed, highlighting the need for further epidemiological studies and active surveillance programs to determine the prevalence and impact of BDV infections on a countrywide level.

Heat Production Rate and Radiation Hazard Indices from Radioactive Elements in Different Types of Natural Water in Nineveh Governorate, Iraq.

The current study sheds light on the measurement and estimation of the radioactivity of radionuclides (238U, 226Ra, 232Th, and 40k) in natural waters of different regions of Nineveh Governorate in Iraq.15 samples were collected from different sources of natural waters, where gamma-ray spectroscopy was used using NaI)TI) sodium iodide detector to determine the concentration of radioactivity in the samples. According to the results, the radioactivity concentration in the tested water sample were ​​ranged from 0.36 ± 0.04-1.57 ± 0.09with an average value of 0.69 ± 0.06 Bq/l for 238U, and 2.9 ± 0.02-0.88 ± 0.03 with an average value of 0.65 ± 0.03 Bq/l for 226Ra Bq/l, and 0.48 ± 0.04-1.36 ± 0.06 with an average value of 0.88 ± 0.05 Bq/l for 232Th, while for 40K 13.00 ± 0.69-36.89 ± 1.12 with an average value of 25.1 ± 0.95 Bq/l, respectively. The results obtained from the water samples are below the safe and standard limits established by UNSCEAR. In addition to calculating the radiological hazard indicators that included Radium equivalent (Raeq), air absorbed dose rate (Dγ), effective annual equivalent dose rate (AEDE), indoor and outdoor radiation hazard (H) indices, lifetime cancer risk (ELCR), gonadotropin equivalent dose (AGDE), and ideal level index of gamma rays (Iγ) has been calculated. To verify its deleterious character. On the other hand, the results showed that the rate of heat production values ranged between 0.006-0.0015 µW/m3, which indicates a low rate of heat production and does not affect the temperature of the Earth's crust. Finally, In addition to physicochemical parameters such as PH, dissolved solids TDS, and electrical conductivity Ec. All tested data are within the permissible limit of WHO standards. The results of the current study can be used to provide essential baseline data for future epidemiological investigations and surveillance programs in the areas under study.

SENTIERI Project: a systematic review on the association between sources of environmental exposure in contaminated sites and health outcomes

the epidemiological surveillance programme carried out in the Italian Contaminated Sites (SENTIERI Project) is based on an a priori evaluation of the epidemiological evidence of a causal association between environmental exposures and health outcomes. to produce an updated review of the epidemiological evidence (January 2009-May 2020) on the association between environmental exposures and health outcomes predefined and published by the SENTIERI working group. a systematic review was conducted on MEDLINE, EMBASE, and Web of Science. Additional searches were conducted on the websites of relevant organizations. The sources of environmental exposure considered were the ones included in SENTIERI Projects (chemicals, petrochemicals and refineries, steel plants, power plants, port area, waste, mines and source of asbestos). a total of 16,817 records were identified and, after the screening process, 14 systematic reviews were identified: two IARC Monograph, two WHO Reports, one WHO/UNEP Report, and 15 observational studies. Living in proximity of contaminated sites was associated with specific diseases (mortality or incidence), with a high heterogeneity across environmental sources. For some exposures, data suggests a gender differential effect for some causes of disease. compared to a previous evidence evaluation, this systematic review shows a higher number of diseases associated with residential exposure to some contaminated sites (petrochemical facilities, waste, mines, and sources of asbestos). According to the results of this review, the a priori evidence evaluation was updated and used to interpret the epidemiological data of the Sixth SENTIERI Project Report.

Stroke in Africa: A systematic review and meta-analysis of the incidence and case-fatality rates.

The burden of stroke (a leading cause of disability and mortality) in Africa appears to be increasing, but a systematic review of the best available data to support or refute this observation is lacking. To determine the incidence and 1-month case-fatality rates from high-quality studies of stroke epidemiology among Africans. We searched and retrieved eligible articles on stroke epidemiology among indigenous Africans in bibliographic databases (MEDLINE, ScienceDirect, Google Scholar, and Cochrane library) using predefined search terms from the earliest records through January 2022. Methodological assessment of eligible studies was conducted using the Newcastle-Ottawa scale. Pooling of incidence and case-fatality rates was performed via generalized linear models (Poisson-Normal random-effects model). Of the 922 articles retrieved, 14 studies were eligible for inclusion. The total number of stroke cases was 2568, with a population denominator (total sample size included in population-based registries or those who agreed to participate in door-to-door community studies) of 3,384,102. The pooled crude incidence rate of stroke per 100,000 persons in Africa was 106.49 (95% confidence interval (CI) = 58.59-193.55), I2 = 99.6%. The point estimate of the crude incidence rate was higher among males, 111.33 (95% CI = 56.31-220.12), I2 = 99.2%, than females, 91.14 (95% CI = 47.09-176.37), I2 = 98.9%. One-month case-fatality rate was 24.45 (95% CI = 16.84-35.50), I2 = 96.8%, with lower estimates among males, 22.68 (95% CI = 18.62-27.63), I2 = 12.9%, than females, 27.57 (95% CI = 21.47-35.40), I2 = 51.6%. The burden of stroke in Africa remains very high. However, little is known about the dynamics of stroke epidemiology among Africans due to the dearth of high-quality evidence. Further continent-wide rigorous epidemiological studies and surveillance programs using the World Health Organization STEPwise approach to Surveillance (WHO STEPS) framework are needed.

How Does Hospital Microbiota Contribute to Healthcare-Associated Infections?

Healthcare-associated infections (HAIs) are still a global public health concern, associated with high mortality and increased by the phenomenon of antimicrobial resistance. Causative agents of HAIs are commonly found in the hospital environment and are monitored in epidemiological surveillance programs; however, the hospital environment is a potential reservoir for pathogenic microbial strains where microorganisms may persist on medical equipment surfaces, on the environment surrounding patients, and on corporal surfaces of patients and healthcare workers (HCWs). The characterization of hospital microbiota may provide knowledge regarding the relatedness between commensal and pathogenic microorganisms, their role in HAIs development, and the environmental conditions that favor its proliferation. This information may contribute to the effective control of the dissemination of pathogens and to improve infection control programs. In this review, we describe evidence of the contribution of hospital microbiota to HAI development and the role of environmental factors, antimicrobial resistance, and virulence factors of the microbial community in persistence on hospital surfaces.

Small Hive Beetle, Aethina tumida, in Africanized Honey Bees in Costa Rica: Sentinel Apiaries, Epidemiological Surveillance and Training Programs as Strategies for Early Detection or to Prevent Its Spread

Small Hive Beetle, Aethina tumida, in Africanized Honey Bees in Costa Rica: Sentinel Apiaries, Epidemiological Surveillance and Training Programs as Strategies for Early Detection or to Prevent Its Spread

Spatiotemporal monitoring of myxomatosis in European wild rabbit (Oryctolagus cuniculus) in Spanish Mediterranean ecosystems.

A long-term active epidemiological surveillance programme was conducted to determine seroprevalence to myxoma virus (MYXV), infection prevalence and spatiotemporal patterns and factors associated with MYXV circulation in wild rabbits (Oryctolagus cuniculus) in Spanish Mediterranean ecosystems. A total of 2376 animals were sampled over four study periods: 2009-2012 (P1), 2012-2015 (P2), 2015-2018 (P3) and 2018-2021 (P4). Antibodies against MYXV were detected by a commercial indirect ELISA in 59.9% (1424/2376; 95% CI: 58.0-61.9) of wild rabbits. At least one seropositive animal was detected on 131 (96.3%) of 136 game estates sampled. MYXV infection was confirmed by PCR in 94 of 1063 (8.8%; 95% CI: 7.3-10.7) wild rabbits. Circulation of the novel recombinant MYXV (ha-MYXV) was not found in wild rabbits analysed during P4. Five statistically significant spatiotemporal clusters of high MYXV seroprevalence were identified using a Bernoulli model: one in P2 and four in P3. A generalized linear mixed model (GLMM) analysis identified sampling season (autumn), age (adult and juvenile), outbreaks of myxomatosis in the month prior to sampling, mean annual temperature, humidity and seropositivity to rabbit haemorrhagic disease virus as factors potentially linked with MYXV seropositivity. GLMM analysis identified outbreaks of myxomatosis in the month prior to sampling, MYXV seropositivity and presence of lesions compatible with myxomatosis as factors associated with MYXV infection. The results indicate high exposure, widespread but non-homogeneous distribution, and endemic circulation of MYXV in wild rabbit populations in southern Spain during the last decade. Prevalence of antibodies against MYXV showed fluctuations both within the year and over the study periods, revealing variations in the immunity of wild rabbit populations in Mediterranean ecosystems that could increase the risk of MYXV re-emergence in immunologically naïve populations. The present study highlights the importance of long-term surveillance to better understand the epidemiology of MYXV in wild lagomorphs.

Phenotypic and genotypic antibiotic resistance patterns in Salmonella Typhimurium and its monophasic variant from pigs in southern Spain

The high incidence of human salmonellosis and multi-drug resistant (MDR) strains of Salmonella Typhimurium (ST) is of concern to global public and animal health. Our research, by means of the broth microdilution method, evaluated the Minimum Inhibitory Concentration (MIC) distribution of 12 antimicrobials against a collection of 73 ST and mST and S. typhimurium monophasic variant 4,[5],12:i:- (mST) isolates from slaughtered pigs reared in extensive systems in southern Spain, and also 12 resistance-associated genes or antimicrobial resistance (AMR) determinants using qPCR.Our data revealed that 98.6% of strains were MDR, with resistance to cephalothin/tetracycline/sulfamethoxazole-trimethoprim/ampicillin/chloramphenicol being the most common pattern (55.6%). Regarding AMR determinants, the most significantly (p < 0.05) genes detected by qPCR were sul1 and aadA2 (89% of strains positive), aadA1 and dfrA12 (87.7%), and blaTEM and tet(B) (86.3% and 84.9%, respectively).Up to date information on ST antimicrobial resistance patterns is essential for epidemiological surveillance programs to support animal and public health. The high number of MDR isolates and variability regarding resistance determinants revealed in this study highlights the role of animals reared in extensive systems as a source of resistant Salmonella strains.

COVID-19 mortality surveillance in Lebanon

Since the beginning of the COVID-19 pandemic, the Epidemiological surveillance program of the Lebanese Ministry of Public Health has launched a rapid surveillance system for collecting COVID-19-related mortality data. In this study, we document the Lebanese experience of COVID-19 mortality surveillance and provide an analysis of the epidemiological characteristics of confirmed deaths. The implementation of the rapid COVID-19 mortality surveillance system, data sources, and data collection were described. A retrospective descriptive analysis of the epidemiological characteristics of confirmed cases occurring in Lebanon between February 20, 2020, and September 15, 2021, was performed. Epidemiological curves of Covid-19 confirmed cases and deaths as well as the geographic distribution map of mortality rates were generated. Between February 21, 2020, and September 15, 2021, a total of 8163 COVID-19-related deaths were reported with a predominance of males (60.4%). More than 60% were aged 70 years or above. Of all deaths, 84% occurred at hospitals and 16% at home. The overall cumulative mortality rate was 119.6 per 100,000. The overall case fatality ratio (CRF) was 1.3%. Of the total deaths, 82.2% had at least one underlying medical condition. The top reported COVID-19 comorbidities associated with COVID-19-related deaths are cardiovascular diseases including hypertension (59.1%), diabetes (37.2%), kidney diseases including dialysis (11%), cancer (6.7%), and lung diseases (6.3%). The CFR was 30.9% for kidney diseases, 20.2% for cancer, 20.2% for lung diseases, 18.1% for liver diseases, 14% for diabetes, and 12.2% for cardiovascular diseases. Considering the limited human and financial resources in Lebanon due to the economic and political crisis, the rapid mortality surveillance system can be considered successful. Improving this system is important and would contribute to better detection of deaths from emerging and re-emerging diseases during health crises.