Higher Probability Of Infection Research Articles

Can the infection risk in elevators be negligible? A comparative study of airborne infection probability in elevators and conference rooms

People in crowded and poorly ventilated elevators are at risk of respiratory infection. However, due to the short duration of the elevator ride, the transmission of respiratory diseases in elevators does not get enough attention. To evaluate the infection risk, this study investigated the airborne transmission of respiratory diseases in the hospital elevator by comparison to the conference room. A validated computational fluid dynamics (CFD) model was adopted to simulate airflow, temperature and tracer gas dispersion in the elevator and conference room. We used Wells-Riley model to evaluate the infection probability of the susceptible persons. In addition, the influences of source patient posture and ventilation strategy on the transmission of tracer gas were analyzed. The results showed that the infection probability in the elevator with 5 min (average 2.70%) was higher than that in the conference room with 50 min (average 1.77%). The effects of source patient posture and ventilation strategy on the infection probability in the elevator were more significant than those in the conference room. Local air circulation could gather the tracer gas inside a confined space in the elevator and led to a high infection probability. The infection risk of respiratory diseases in the elevator was non-negligible.

Association between non-injection drug use and hepatitis C infection among HIV-negative men who have sex with men

BackgroundPrior research predominantly examined the association between HIV-positive men who have sex with men (MSM) or those using injection drugs and hepatitis C virus (HCV) infection. However, limited attention has been given to understanding the association among HIV-negative MSM who do not inject drugs. This gap leaves apportion of the population unexamined, potentially overlooking important factor that may contribute to the transmission and prevalence of HCV. This study aims to investigate the relationship between non-injection drug use and HCV infection in this population.MethodsIn this cross-sectional study, we analyzed data on 118 MSM who reported use of non-injection drugs. The participants were recruited from two inner-city communities in Houston, TX, between 2004 and 2007 and were negative for both HIV and hepatitis B virus infection. Latent class analysis (LCA) was used to identify drug use latent classes. Multinomial logistic regression analysis was used to evaluate the association between drug use latent class and HCV infection.ResultsFour distinct latent classes of drug use were identified: class 1, persons ≥ 42 years of age who used only crack cocaine; class 2, persons approximately 42 years of age who used > 2 drugs; class 3, persons < 42 years of age who used > 5 drugs; and class 4, persons ≥ 42 years of age who used > 6 drugs. Class 4 was significantly associated with HCV infection. The odds of HCV infection in members of class 4 was 17 times higher than in class 2 members (adjusted odds ratio [aOR] = 16.9, 95% confidence interval [CI]: 1.4–205.4) and almost 22 times higher than in class 3 members (aOR = 21.8, 95% CI: 1.5–322.8).ConclusionsAmong MSM with non-injection drug use, the subgroup of individuals who were ≥ 42 years of age and used multiple drugs (including heroin, speedball, methamphetamine, crack cocaine, and marijuana) had a high probability of HCV infection. Public health and education programs, as well as drug treatment and rehabilitation programs, should be developed for this high-risk subgroup of individuals to prevent HCV acquisition and transmission.

Quantitative microbial risk assessment (QMRA) of the work of manual pit emptiers, commonly known as bayakous.

In Haiti, manual pit emptiers, known as bayakous, face significant health risks. They work by descending naked into latrine pits, exposing themselves to pathogens and contributing to environmental contamination. This study employs the quantitative microbial risk assessment (QMRA) method to evaluate the microbial risks associated with this practice, considering nine prevalent pathogens in Haiti. Three ingestion scenarios were developed: hand-to-mouth contact, ingestion while immersed in excreta, and a combination of both. A sensitivity analysis assessed the impact of input data on study outcomes. The results indicate a high probability of infection and illness during pit emptying operations annually for all scenarios and pathogens. Recommendations include adopting personal protective equipment (PPE) and using a manual Gulper waste pump to eliminate the need to descend directly into the pits, thereby reducing the risk of injury from sharp objects. The study proposes the establishment of intermediate disposal points approximately 5 km from collection sites to deter illegal dumping. National regulations and professionalization of the bayakou profession are suggested, along with awareness campaigns to promote PPE and Gulper pump usage. Addressing these issues is crucial for safeguarding the health of bayakou and public health in Haiti.

Integrated assessment of bioaerosol dispersion patterns and infection risk in a typical urban environment: Implications for urban biosecurity management

Exposure to bioaerosols in high-density urban environments will pose a severe threat to human life and health and present significant challenges to the sustainability and resilience of cities. In this study, the aerodynamic dispersion patterns of bioaerosols at two release locations (open and dense areas) under both thermal conditions in Zhongguancun, Beijing, are investigated. By coupling a dose-response model and an improved cellular automaton, the infection risk within exposed populations was assessed, and emergency evacuation strategies for distinct populations in high-risk areas were devised. This study reveals that bioaerosol distribution is notably influenced by factors such as thermal conditions, release locations and pedestrian height. Bioaerosol concentration above the release source decreases with increasing pedestrian height at two release locations. Under the same exposure time, the infection probability of different groups in this area declines with pedestrian height increases, with adult males having the highest and elderly females having the lowest probability. Thermal conditions and building layout near the release source were second only to exposure time in influencing infection probability and evacuation path. Proximity to the release source indicates a high infection probability but a short evacuation distance to safe areas, while downstream areas exhibit lower infection probability but require longer evacuation distances. The layout of buildings near the release source has the most significant effect on evacuation time. Evacuation for high-risk populations should be prioritized upstream or either side of the mainstream. This study aims to mitigate potential biological threats, address challenges in enhancing urban biosecurity management, and enable sustainable urban development.

The straight and narrow: A game theory model of broad- and narrow-spectrum empiric antibiotic therapy

Physicians prescribe empiric antibiotic treatment when definitive knowledge of the pathogen causing an infection is lacking. The options of empiric treatment can be largely divided into broad- and narrow-spectrum antibiotics. Prescribing a broad-spectrum antibiotic increases the chances of covering the causative pathogen, and hence benefits the current patient’s recovery. However, prescription of broad-spectrum antibiotics also accelerates the expansion of antibiotic resistance, potentially harming future patients. We analyse the social dilemma using game theory. In our game model, physicians choose between prescribing broad and narrow-spectrum antibiotics to their patients. Their decisions rely on the probability of an infection by a resistant pathogen before definitive laboratory results are available. We prove that whenever the equilibrium strategies differ from the socially optimal policy, the deviation is always towards a more excessive use of the broad-spectrum antibiotic. We further show that if prescribing broad-spectrum antibiotics only to patients with a high probability of resistant infection is the socially optimal policy, then decentralization of the decision making may make this policy individually irrational, and thus sabotage its implementation. We discuss the importance of improving the probabilistic information available to the physician and promoting centralized decision making.

Prediction and validation of potential transmission risk of Dirofilaria spp. infection in Serbia and its projection to 2080.

Animal and human dirofilariosis is a vector-borne zoonotic disease, being one of the most important diseases in Europe. In Serbia, there are extensive studies reporting the presence of Dirofilaria immitis and D. repens, mainly in the north of the country, where the human population is concentrated and where there is a presence of culicid mosquitoes that transmit the disease. Ecological niche modeling (ENM) has proven to be a very good tool to predict the appearance of parasitosis in very diverse areas, with distant orography and climatologies at a local, continental, and global level. Taking these factors into account, the objective of this study was to develop an environmental model for Serbia that reflects the suitability of the ecological niche for the risk of infection with Dirofilaria spp. with which the predictive power of existing studies is improved. A wide set of variables related to the transmission of the parasite were used. The potential number of generations of D. immitis and the ecological niche modeling method (ENM) were used to estimate the potential distribution of suitable habitats for Culex pipiens. The highest probability of infection risk was located in the north of the country, and the lowest in the southern regions, where there is more orographic relief and less human activity. The model was corroborated with the location of D. immitis-infected dogs, with 89.28% of the country having a high probability of infection. In addition, it was observed that the percentage of territory with optimal habitat for Culex spp. will increase significantly between now and 2080. This new model can be used as a tool in the control and prevention of heartworm disease in Serbia, due to its high predictive power, and will serve to alert veterinary and health personnel of the presence of the disease in the animal and human population, respectively.

Detection of antibodies against Ornithodoros moubata salivary antigens and their association with detection of African swine fever virus in pigs slaughtered in central Uganda.

African swine fever (ASF) is an important disease of pigs in sub-Saharan Africa and Uganda and is threatening the pig population and agricultural economy of other continents. ASF virus (ASFV) can be transmitted from wild suids to domestic pigs through soft ticks of the Ornithodoros species. The aim of this study was to understand the relationship between domestic pigs' O. moubata tick exposure and ASFV status. Pigs were sampled from six abattoirs in the Kampala metropolitan area of Uganda from May 2021 through June 2022. Blood, serum, and tissue samples were collected. Serum was tested for antibodies against the rtTSGP1 salivary antigens of O. moubata ticks using an indirect ELISA assay. Blood and tissue samples from pigs were tested to detect ASFV using qPCR. Probability of tick exposure was categorized based on sample-to-positive ratio cut-off points. Out of 1,328 serum samples tested, there were 828 (62.3%) samples with a negligible probability; 369 (27.8%) with a medium probability; 90 (6.8%) with a high probability, and 41 (3.1%) with a very high probability of exposure to the O. moubata salivary antigen. There was a statistically significant association between the pigs' O. moubata exposure and ASFV status with a higher proportion of pigs having a very high probability of infection if they were ASFV positive by blood, tonsil, and lymph nodes. These results suggested that tick exposure was associated with ASFV transmission in Uganda. There were ASFV qPCR positive pigs that had no O. moubata exposure as well, which highlights that pig-to-pig and indirect contact transmission still play a significant role. This work highlights the need for further work in Uganda to investigate these transmission factors related to the O. moubata tick and ASFV transmission.

Proportion of Low Birth weight and Associated Maternal Risk Factors in a Developing Country, Bangladesh

Introduction: Though the health situation of Bangladesh has been improved substantially over the years, the low birth weight (LBW) rate is still pretty high. LBW has been associated with high probability of infection, malnutrition, mental deficiencies and behavioural and learning problem in later life. The principle focus of this study was to ascertain the proportion of LBW and its associated maternal risk factors identification. Materials &amp; methods: It was a cross-sectional type of descriptive study done at two tertiary level hospitals – Rajshahi Medical College Hospital and Islami Bank Medical College Hospital. A total of 270 mothers were interviewed within 1 month of their delivery. The purposively selected participants were asked about their socio-demographic characters and other associated factors related to birth of the babies. Weights of the babies at birth were documented from hospital records. Result: Proportion of LBW was found 28.1% with no significant sex variation. Majority of the LBW babies were found in mothers of 15-20 years of age group. Mothers’ educational qualifications, occupations, early age pregnancy and type of pregnancy were associated significantly for LBW. Less than 37 weeks of gestational age of baby, home delivery, NVD were also significant risk factors of LBW. Residence and sex of neonate were not significantly associated with LBW. Conclusion: Proportion of LBW in tertiary care hospitals were found 28.1%. Early maternal pregnancy, lower gestational age, higher parity, NVD and home delivery played an important role in the incidence of LBW. TAJ 2023; 36: No-2: 207-214

Bayesian hierarchical modelling of the geospatial distribution of fasciolosis in dairy cattle and the impact on production: Application to the main milk-producing region (Galicia) in Spain

Fasciolosis caused by Fasciola hepatica is a common parasitic infection among cattle in many countries. Although infected adult cows rarely show overt clinical signs, milk production may be impaired. Thus, significant production losses may occur in dairy herds with a high prevalence of fasciolosis. In this study, Bayesian hierarchical modelling was used to estimate the geospatial distribution of dairy cattle fasciolosis and its impact on milk production. The study was conducted in Galicia, the main milk producing region in Spain and a geographically heterogeneous area. The aims were: 1) to model the geospatial distribution of fasciolosis in dairy herds in the study area, 2) to identify clusters of herds with a high prevalence of fasciolosis, and 3) to assess the effect of fasciolosis on milk yield and quality. A large number of dairy cattle farms (n = 4907), of which 1660 provided production records, were surveyed. Fasciola infection status was determined by applying the MM3-SERO ELISA test to bulk tank milk samples. A high probability of infection was predicted in several zones, particularly in the centre, northeast and southeast of Galicia. Conversely, the predicted probability was very low in some parts of the northwest of the region. Infections with high within-herd prevalence (> 25% lactating cows infected) predominated. High within-herd prevalence was associated with loss of milk production (−1.387 kg/cow/ day, on average). No association between Fasciola infection and either milk fat or protein content was observed. This study has generated the first maps of the spatial distribution of the probability of Fasciola infection in dairy cattle herds in Galicia. The maps presented here can be used for reference purposes, enabling the design of better targeted fasciolosis control programmes in the region. Use of Bayesian hierarchical statistical analysis enabled us to ascertain the uncertainty of the predictions and to account for the spatial autocorrelation in the data. It also enabled us to generate maps showing the residual spatial variation in milk production, a topic that may deserve more detailed study.

A cohort study on the biochemical and haematological parameters of Italian blood donors as possible risk factors of COVID-19 infection and severe disease in the pre- and post-Omicron period.

To investigate the association between biochemical and blood parameters collected before the pandemic in a large cohort of Italian blood donors with the risk of infection and severe disease. We also focused on the differences between the pre- and post-Omicron spread in Italy (i.e., pre- and post-January 01, 2022) on the observed associations. We conducted an observational cohort study on 13750 blood donors was conducted using data archived up to 5 years before the pandemic. A t-test or chi-squared test was used to compare differences between groups. Hazard ratios with 95% confidence intervals for SARS-CoV-2 infection and severe disease were estimated using Cox proportional hazards models. Subgroup analyses stratified by sex, age and epidemic phase of first infection (pre- and post-Omicron spread) were examined. We confirmed a protective effect of groups B and O, while groups A and AB had a higher likelihood of infection and severe disease. However, these associations were only significant in the pre-Omicron period. We found an opposite behavior after Omicron spread, with the O phenotype having a higher probability of infection. When stratified by variant, A antigen appeared to protect against Omicron infection, whereas it was associated with an increased risk of infection by earlier variants. We were able to stratify for the SARS CoV-2 dominant variant, which revealed a causal association between blood group and probability of infection, as evidenced by the strong effect modification observed between the pre- and post-Omicron spread. The mechanism by which group A acts on the probability of infection should consider this strong effect modification.

Risk assessment of respiratory droplet infections caused by coughing in various indoor dynamic environments

Since most respiratory infections occur in confined spaces, it is necessary to further investigate the effect of wake caused by human movement on droplet dispersion. This paper investigates the effects of droplet dispersion in dynamic indoor environment by using computational fluid dynamics when the infected person remained stationary, and the susceptible person moved at different speeds and at different distances from the infected person. The modified Wells-Riley model, which introduced the concept of local quantum concentration, was used to estimate the transient infection probability of a virtual person inhaling droplets at 1 m distance from an infected person. The results show that the human motion speed has a stronger effect on the diffusion of 1 μm droplets. The distance between people had a more significant effect on the resuspension and diffusion of 34 μm droplets. The effect of both is very small for droplets above 67 μm. The higher human movement speed results in much higher probability of infection within 40 s–55 s, and has the highest probability about 96.2 × 10−6. The distance between people mainly affects the probability of infection at the beginning of the cough (10s). When the distance is 0.1 m, the infection probability is highest at 10 s with a value of 232.1 × 10−6. In addition, it was found that when one person passes another, a distance of at least 1 m is maintained between them. In this paper, this study provides greater insight into the impact of human activities on infection risk in indoor environments.

Co-ERA-Net: Co-Supervision and Enhanced Region Attention for Accurate Segmentation in COVID-19 Chest Infection Images.

Accurate segmentation of infected lesions in chest images remains a challenging task due to the lack of utilization of lung region information, which could serve as a strong location hint for infection. In this paper, we propose a novel segmentation network Co-ERA-Net for infections in chest images that leverages lung region information by enhancing supervised information and fusing multi-scale lung region and infection information at different levels. To achieve this, we introduce a Co-supervision scheme incorporating lung region information to guide the network to accurately locate infections within the lung region. Furthermore, we design an Enhanced Region Attention Module (ERAM) to highlight regions with a high probability of infection by incorporating infection information into the lung region information. The effectiveness of the proposed scheme is demonstrated using COVID-19 CT and X-ray datasets, with the results showing that the proposed schemes and modules are promising. Based on the baseline, the Co-supervision scheme, when integrated with lung region information, improves the Dice coefficient by 7.41% and 2.22%, and the IoU by 8.20% and 3.00% in CT and X-ray datasets respectively. Moreover, when this scheme is combined with the Enhanced Region Attention Module, the Dice coefficient sees further improvement of 14.24% and 2.97%, with the IoU increasing by 28.64% and 4.49% for the same datasets. In comparison with existing approaches across various datasets, our proposed method achieves better segmentation performance in all main metrics and exhibits the best generalization and comprehensive performance.

Health Outcomes and Cost-effectiveness of Monoclonal SARS-CoV-2 Antibodies as Pre-exposure Prophylaxis

Pre-exposure prophylaxis with neutralizing SARS-CoV-2 monoclonal antibodies (mAbs PrEP) prevents infection and reduces hospitalizations and the duration thereof for COVID-19 and death among high-risk individuals. However, reduced effectiveness due to a changing SARS-CoV-2 viral landscape and high drug prices remain substantial implementation barriers. To assess the cost-effectiveness of mAbs PrEP as COVID-19 PrEP. For this economic evaluation, a decision analytic model was developed and parameterized with health care outcome and utilization data from individuals with high risk for COVID-19. The SARS-CoV-2 infection probability, mAbs PrEP effectiveness, and drug pricing were varied. All costs were collected from a third-party payer perspective. Data were analyzed from September 2021 to December 2022. Health care outcomes including new SARS-CoV-2 infections, hospitalization, and deaths. The cost per death averted and cost-effectiveness ratios using a threshold for prevention interventions of $22 000 or less per quality-adjusted life year (QALY) gained. The clinical cohort consisted of 636 individuals with COVID-19 (mean [SD] age 63 [18] years; 341 [54%] male). Most individuals were at high risk for severe COVID-19, including 137 (21%) with a body mass index of 30 or higher, 60 (9.4%) with hematological malignant neoplasm, 108 (17%) post-transplantation, and 152 (23.9%) who used immunosuppressive medication before COVID-19. Within the context of a high (18%) SARS-CoV-2 infection probability and low (25%) effectiveness the model calculated a short-term reduction of 42% ward admissions, 31% intensive care unit (ICU) admissions, and 34% deaths. Cost-saving scenarios were obtained with drug prices of $275 and 75% or higher effectiveness. With a 100% effectiveness mAbs PrEP can reduce ward admissions by 70%, ICU admissions by 97%, and deaths by 92%. Drug prices, however, need to reduce to $550 for cost-effectiveness ratios less than $22 000 per QALY gained per death averted and to $2200 for ratios between $22 000 and $88 000. In this study, use of mAbs PrEP for preventing SARS-CoV-2 infections was cost-saving at the beginning of an epidemic wave (high infection probability) with 75% or higher effectiveness and drug price of $275. These results are timely and relevant for decision-makers involved in mAbs PrEP implementation. When newer mAbs PrEP combinations become available, guidance on implementation should be formulated ensuring a fast rollout. Nevertheless, advocacy for mAbs PrEP use and critical discussion on drug prices are necessary to ensuring cost-effectiveness for different epidemic settings.

Bacterial hazard identification and exposure assessment of raw milk consumption in Jimma zone, South West Ethiopia

BackgroundRaw milk may contain pathogenic microorganism that can sometimes fatally affect the health of consumers. However, risks related to raw milk consumption in Southwest Ethiopia are not well studied. The aim of this study was to evaluate the presence of five target pathogenic bacteria including Escherichia coli O157:H7, Salmonella enterica Typhimurium, Staphylococcus aureus, Listeria monocytogenes, and Campylobacter jejuni in raw milk and to assess exposure associated with the consumption of raw milk.MethodA cross-sectional study was carried out between November 2019 and June 2020 to in Jimma zone, Southwest Ethiopia. Laboratory analysis was conducted on milk samples collected from Seven Woreda towns, including, Agaro, Yebu, Sekoru, Serbo, Shebe, Seka, Sheki and Jimma town administration. Semi-structured interview questions were administered to collect data on the amount and frequency of consumption. Descriptive statistics were used to summarize laboratory results and questionnaire survey data.ResultAmong 150 total raw milk samples, about 61.3% were found contaminated by one or more types of pathogens along the dairy value chain. The highest and the least bacterial counts recorded were 4.88 log10cfu/ml and 3.45 log10cfu/ml from E. coli and L. monocytogenes respectively. The mean concentrations of pathogens demonstrated significant statistical difference (p < 0.05) using 95% confidence interval where the prevalence percentage of isolates increased as the milk was transported from farms to the retail outlets. Except for C. jejuni; all other pathogens were detected in the range of unsatisfactory level of milk microbiological quality along the chain. The estimated mean annual risk of acquiring intoxication of E. coli across retailer outlets is 100% whereas salmonellosis, S. aureus intoxication, and listeriosis are 84%, 65% and 63% respectively.ConclusionThe study highlights the significant health risks associated with the consumption of raw milk due to its unacceptable microbiological quality. The traditional production and consumption patterns of raw milk are the primary reasons for the high annual probability of infection. Therefore, regular monitoring and implementation of hazard identification and critical control point principles are necessary from raw milk production to retail points to ensure the safety of consumers.

Drivers behind co-occurrence patterns between pathogenic bacteria, protozoa, and helminths in populations of the multimammate mouse, Mastomys natalensis

Advances in experimental and theoretical work increasingly suggest that parasite interactions within a single host can affect the spread and severity of wildlife diseases. Yet empirical data to support predicted co-infection patterns are limited due to the practical challenges of gathering convincing data from animal populations and the stochastic nature of parasite transmission. Here, we investigated co-infection patterns between micro- (bacteria and protozoa) and macroparasites (gastro-intestinal helminths) in natural populations of the multimammate mouse (Mastomys natalensis). Fieldwork was performed in Morogoro (Tanzania), where we trapped 211 M. natalensis and tested their behaviour using a modified open-field arena. All animals were checked for the presence of helminths in their gastro-intestinal tract, three bacteria (Anaplasma, Bartonella, and Borrelia) and two protozoan genera (Babesia and Hepatozoon). Besides the presence of eight different helminth genera (reported earlier), we found that 19% of M. natalensis were positive for Anaplasma, 10% for Bartonella, and 2% for Hepatozoon species. Hierarchical modelling of species communities was used to investigate the effect of the different host-related factors on these parasites’ infection probability and community structure. Our results show that the infection probability of Bartonella increased with the host's age, while the infection probability of Anaplasma peaked when individuals reached adulthood. We also observed that less explorative and stress-sensitive individuals had a higher infection probability with Bartonella. Finally, we found limited support for within-host interactions between micro-and macroparasites, as most co-infection patterns could be attributed to host exposure time.

Main factors associated with foot-and-mouth disease virus infection during the 2001 FMD epidemic in Uruguay.

Large epidemics provide the opportunity to understand the epidemiology of diseases under the specific conditions of the affected population. Whilst foot-and-mouth disease (FMD) epidemics have been extensively studied in developed countries, epidemics in developing countries have been sparsely studied. Here we address this limitation by systematically studying the 2001 epidemic in Uruguay where a total of 2,057 farms were affected. The objective of this study was to identify the risk factors (RF) associated with infection and spread of the virus within the country. The epidemic was divided into four periods: (1) the high-risk period (HRP) which was the period between the FMD virus introduction and detection of the index case; (2) the local control measures period (LCM) which encompassed the first control measures implemented before mass vaccination was adopted; (3) the first mass vaccination, and (4) the second mass vaccination round. A stochastic model was developed to estimate the time of initial infection for each of the affected farms. Our analyses indicated that during the HRP around 242 farms were probably already infected. In this period, a higher probability of infection was associated with: (1) animal movements [OR: 1.57 (95% CI: 1.19-2.06)]; (2) farms that combined livestock with crop production [OR: 1.93 (95% CI: 1.43-2.60)]; (3) large and medium farms compared to small farms (this difference was dependent on regional herd density); (4) the geographical location. Keeping cattle only (vs farms that kept also sheep) was a significant RF during the subsequent epidemic period (LCM), and remained as RF, together with large farms, for the entire epidemic. We further explored the RF associated with FMDV infection in farms that raised cattle by fitting another model to a data subset. We found that dairy farms had a higher probability of FMDV infection than beef farms during the HRP [OR: 1.81 (95% CI: 1.12-2.83)], and remained as RF until the end of the first round of vaccination. The delay in the detection of the index case associated with unrestricted animal movements during the HRP may have contributed to this large epidemic. This study contributes to the knowledge of FMD epidemiology in extensive production systems.

COVID 19: impactos na saúde mental dos profissionais de saúde

Health professionals are the public who are dealing directly with COVID-19 and with high probability of infection, since they are on the front line. This exposure and the extensive work hours, physical, emotional and psychological overload experienced by these professionals, which has affected mental health and the occurrence of stress, anxiety, anguish, fear, discouragement and possible evolution to disorders such as depression and Burnout. Based on this, the objective of the present study is to investigate the impacts of COVID-19 on the mental health of health professionals. This research consisted of a literature review, for which the quality approach was used and was devel-oped from elaborate materials available in the full text. The data collection was carried out with arti-cles found in the BVS and ScIELO, from the year 2020. The results revealed that the professionals experienced high stress loads and work overload, which intensified during the pandemic period, in addition to the fear of infection and contamination of family members, friends and patients, which increased the stress factors in the daily work. Thus, it was necessary to use support resources for interventions with professionals, aiming to alleviate the suffering caused, the main resources used were online psychotherapy, online conversation wheels, empathic listening and integrative practic-es, in order to ensure the best performance of physical and mental well-being of professionals.

Strain-stream model of epidemic spread in application to COVID-19.

The recently developed model of the epidemic spread of two virus strains in a closed population is generalized to the situation typical for the couple of strains delta and omicron, when there is a high probability of omicron infection soon enough after recovering from delta infection. This model can be considered as a kind of combination of SIR and SIS models for the case of competition of two strains of the same virus with different contagiousness in a population. The obtained equations and results can be directly implemented for practical calculations of the replacement of strains of the SARS-CoV-2 virus. A comparison between the estimated replacement time and the corresponding statistics shows reasonable agreement.

“COVID-19 - POSTCOVID SYNDROME” Pandemic: How to Protect Doctors and Nurses in the “Red Zone” of the Hospital?

WHO Director-General Tedros Adan Ghebreyesus announced on May 21, 2021, at the 74th World Health Assembly, that at least 115,000 health workers had died during the novel coronavirus pandemic. Analysis of literary sources showed that significant losses are borne by the doctors of the “Red Zones” of hospitals: doctors, nurses, as well as doctors, paramedics, ambulance drivers. The most likely cause of such losses is considered by health experts from different countries: an increased load on staff, which leads to early “Professional burnout” and “Emotional fatigue”, a higher probability of infection with the virus. This does not take into account other, probable causes, for example, distant interactions or the “Kaznacheev effect”.

Laporan Kasus : Neonatal Dengue

Background : Dengue fever in late pregnancy puts the fetus at great risk because fewer maternal-specific antibodies cross the placenta, leading to a high probability of neonatal dengue infection. We followed a patient in the pediatric health department of the Bali Mandara Hospital. &#x0D; Case Persentation : A 9-day-old baby boy complained of fever for 3 days up to a temperature of 39℃; the fever rose up and fell, but the fever did not go down to normal temperature. On physical examination, the baby was found to be less active, crying enough, suction reflex (+), pulse 135x/minute, breathing: 44 x/minute, temperature: 38.8 (axillary), SpO2: 93%, jaundice (+), lower extremities: warm acral (+), left petechiae (+), CRT &lt;2'', jaundice skin of Kramer 2-3. Laboratory test result’s showed the platelets (69.000), hematocrit(52.2), positive dengue NS1 antigen, and positive dengue IgG and IgM. The patient was diagnosed with neonatal dengue and admitted to Perinatology. Optimal management is needed to treat neonatal dengue.&#x0D; Conclussion : It is Importance to know the transmission of dengue infection to infants, especially in endemic areas. Considering the complication that may occur, early recognition of dengue will significantly reduce infant mortality. Careful monitoring and proper laboratory tests can lead to a smooth recovery.&#x0D; Key word : Neonatal dengue, Platelets, Placenta