Outbreak Of Illness Research Articles

Pediatric Rash Illness Outbreak with Initial Positive Measles Immunoglobulin M Antibody Test Results — American Samoa, March–July 2023

Pediatric Rash Illness Outbreak with Initial Positive Measles Immunoglobulin M Antibody Test Results — American Samoa, March–July 2023

FASTER AND COST-EFFECTIVE EXTRACTION FREE METHOD FOR SARS-COV2 DETECTION BY RT-PCR

Background: The World Health Organization (WHO) declared an outbreak of febrile respiratory illness caused by Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) in Wuhan City, China in December 2019. Within the immediate outbreak of three months, the global community was challenged with a devastating pandemic that caused heavy morbidities and mortalities around the globe. The expeditious spread of the virus, challenged the diagnostic laboratories to rapidly develop the accurate molecular diagnostic methods. As SARS CoV-2 assays became available for testing on existing molecular platforms, laboratories devoted unprecedented energy and resources to evaluating the analytical performance of the new tests and in some cases developed their diagnostic assays under FDA-EUA guidance. Aim: This study aims to compare the diagnostic efficacy of the extraction-free method of COVID-19 PCR and the conventional RT-PCR with extraction. Method: To get an accurate view of how an omission of RNA extraction step would perform in a real-world setting, a comparative study was performed using TATA MD CHECK RT-PCR DIRECT (Direct PCR) and LabGun Genomics for Conventional RT-PCR method. Result: From this study, direct RT-PCR correctly identified 92.3% of samples (n = 50) identified positive for SARS-CoV-2 RNA by conventional RT-PCR featuring an RNA extraction. Conclusion: Direct methods may represent a reasonable alternative to meet higher testing demands with low turnaround time as reverse transcription PCR includes traditionally time-consuming RNA extraction and purification procedures.

Epidemiological characteristics of influenza outbreaks in schools in Jiangsu Province, China, 2020–2023 post-COVID-19 pandemic

BackgroundThis study aimed to analyze the epidemic characteristics and influencing factors of school influenza outbreaks in Jiangsu Province, China from 2020 to 2023,following the COVID-19 pandemic, to inform prevention and control strategies.MethodsData on influenza-like illness(ILI) outbreaks from the Chinese Influenza Surveillance Information System and national-level influenza surveillance sentinel hospitals were analyzed. The temporal distribution, school type, virus strains, and outbreak scales were examined using descriptive statistics.ResultsFrom 2020 to 2023, 1142 influenza outbreaks occurred in schools, with primary schools(ages 6 to 12) accounting for 71.80%. Most large outbreaks were caused by A(H1N1) and A(H3N2), responsible for 8.99% of total outbreaks. Outbreaks were predominantly reported in the pre-peak periods of B(Victoria) and A(H1N1) circulation, accounting for 86.31% and 92.32% of their respective total outbreaks. No concurrent influenza and COVID-19 outbreaks were observed during the study period.ConclusionPrimary and secondary schools are high-risk settings for influenza outbreaks. A(H3N2) shows higher adaptability and is more likely to co-circulate with other subtypes/lineages, especially A(H1N1), leading to larger outbreaks. B(Victoria)-caused outbreaks are more frequent but smaller in scale. School influenza outbreaks are more likely to occur during the early stages of seasonal peaks, particularly for B(Victoria) and A(H1N1). This suggests that influenza outbreaks in schools may play a crucial role in seeding and accelerating the spread of the virus within the broader community.

MERS-CoV-nsp5 expression in human epithelial BEAS 2b cells attenuates type I interferon production by inhibiting IRF3 nuclear translocation

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is an enveloped, positive-sense RNA virus that emerged in 2012, causing sporadic cases and localized outbreaks of severe respiratory illness with high fatality rates. A characteristic feature of the immune response to MERS-CoV infection is low type I IFN induction, despite its importance in viral clearance. The non-structural proteins (nsps) of other coronaviruses have been shown to block IFN production. However, the role of nsp5 from MERS-CoV in IFN induction of human respiratory cells is unclear. In this study, we elucidated the role of MERS-CoV-nsp5, the viral main protease, in modulating the host’s antiviral responses in human bronchial epithelial BEAS 2b cells. We found that overexpression of MERS-CoV-nsp5 had a dose-dependent inhibitory effect on IFN-β promoter activation and cytokine production induced by HMW-poly(I:C). It also suppressed IFN-β promoter activation triggered by overexpression of key components in the RIG-I-like receptor (RLR) pathway, including RIG-I, MAVS, IKK-ε and IRF3. Moreover, the overexpression of MERS-CoV-nsp5 did not impair expression or phosphorylation of IRF3, but suppressed the nuclear translocation of IRF3. Further investigation revealed that MERS-CoV-nsp5 specifically interacted with IRF3. Using docking and molecular dynamic (MD) simulations, we also found that amino acids on MERS-CoV-nsp5, IRF3, and KPNA4 may participate in protein-protein interactions. Additionally, we uncovered protein conformations that mask the nuclear localization signal (NLS) regions of IRF3 and KPNA4 when interacting with MERS-CoV-nsp5, suggesting a mechanism by which this viral protein blocks IRF3 nuclear translocation. Of note, the IFN-β expression was restored after administration of protease inhibitors targeting nsp5, indicating this suppression of IFN-β production was dependent on the enzyme activity of nsp5. Collectively, our findings elucidate a mechanism by which MERS-CoV-nsp5 disrupts the host’s innate antiviral immunity and thus provides insights into viral pathogenesis.

Epidemiology of Ciguatoxin Poisoning Outbreaks in the United States Between 2001 and 2021.

This study examined data from the Centers for Disease Control and Prevention's National Outbreak Reporting System between 2001 and 2021 for confirmed outbreaks of foodborne illness due to Ciguatoxin in the United States. Previous research into Ciguatoxin illness in the United States has focused on specific states or territories-namely Hawaii, Florida, Puerto Rico, and the Virgin Islands-meaning the national distribution of outbreaks remains unclear. In addition, while specific categories of seafood (e.g., reef fish) are known to carry elevated risk of illness due to Ciguatoxin poisoning, it remains unclear the extent to which specific seafood items are associated with the odds of being hospitalized in an outbreak. This study calculated descriptive statistics for the distribution of outbreaks by state, season, site of exposure, and implicated seafood item. Then, binomial regression was used to assess the relationship between the implicated seafood item in an outbreak and hospitalization. Results provided evidence that knowing the implicated seafood item in an outbreak is associated with the odds of hospitalization (χ25 = 33.023, p < 0.0001). Even when a seafood item was found to be associated with elevated odds of hospitalization, not all cases involved hospitalization. This finding aligns with Ciguatoxin poisoning case reports, noting that key epidemiological factors include not just the seafood item consumed but also the quantity and the part consumed (e.g., the head). In conclusion, public health officials should consider Ciguatoxin poisoning outbreaks as multidimensional and utilize information about the seafood consumed as well as the quantity and parts of the seafood consumed.

Microbiological quality of vegan alternatives to dairy and meat products in England during 2022-3.

Plant-based alternatives to meat and dairy products have become increasingly popular in the UK. Despite a public perception that they have a relatively low microbiological risk, outbreaks of illness have been linked with these foods. This study aimed to assess the microbiological safety and quality of vegan alternatives to dairy and meat products available in England. Samples were collected between September 2022 and March 2023 from retail, production, and catering premises, and tested for a range of bacterial pathogens and hygiene indicators using standard procedures. A total of 937 samples were tested, of which 92% were of a satisfactory microbiological quality, 3% were borderline, and 5% were unsatisfactory. Those interpreted as unsatisfactory were due to elevated counts of Enterobacteriaceae and Escherichia coli (indicators of poor hygiene) rather than pathogenic microorganisms. Listeria monocytogenes was present in five samples of tofu, all from the same producer (all at counts of<100 CFU g-1), while other Listeria species were detected at counts of<20 CFU g-1 in two burgers and two 'vegan chicken' products. The majority of samples did not have pH and water activity values that would significantly contribute to preventing microbial growth: 62.4% had pH>5.0 and 82.4% had Aw>0.94. The majority of vegan products examined were of a satisfactory quality, but results demonstrate that microbiological control must be maintained using appropriate processing and storage temperatures, and application of a safe length of shelf life.

An overview of SARS-CoV-2 viral proteins with relevance to improved diagnostic and therapeutic platforms

In the past 25 years, the world has witnessed outbreaks of illnesses in humans from three different coronaviruses. Both the SARS-CoV outbreak of 2003 and the MERS-CoV outbreak of 2013 resulted in overall low fatalities in part due to inefficient human-to-human spread of each virus. In contrast, SARS-CoV-2, which emerged in 2019, was highly efficient at human-to-human spread and caused a global pandemic resulting in millions of casualties. Zoonotic transmission of viruses, including the three coronaviruses, poses an ongoing threat that cannot be ignored. In this review, we have focused on the diagnostics and therapeutics fronts using SARS-CoV-2 as a model. Specifically, we have selected proteins associated with the virus particles as targets and discussed various platform technologies. These insights hold the potential to inform the development of more effective therapeutics and vaccines not only for SARS-CoV-2 but also for future viral pandemics, thus contributing to global health on a broader scale.

Assessment of microbial contamination in various processing rooms using culture-dependent and 16S rRNA methods in a commercial kitchen in eastern China

Commercial kitchens, frequently implicated in foodborne illness outbreaks, underscore the importance of studying bacterial communities in these settings. This study analyzed bacterial communities of two cooked food samples and 49 food contact surface samples in a commercial kitchen in eastern China, utilizing traditional bacterial cultivation methods and 16S rRNA sequencing. The cutting room exhibited the highest microbial contamination, with elevated bacterial colony counts on cutting boards and containers, suggesting it as the primary site for potential cross-contamination risks between different foods. Regarding bacterial communities, Coliform levels in refrigerators ranged from 1.0 to 3.0 log10 CFU/cm2, which is below sanitary standards. However, E. coli levels on food contact surfaces and cooked foods exceeded microbial limits set by GB1903 and GB 2726 in China. Proteobacteria were predominant at the phylum level across processing rooms, with Moraxellaceae notably prevalent and Pseudomonadaceae dominant in cooked foods at the family level. Source tracking identified food contact surfaces, including countertops, containers in the cutting room, and refrigerators in the cooking room, as primary sources of bacterial contamination in the final cooked foods, contributing 61.62% of contamination. These findings suggest that effective measures should be developed to control bacterial contamination on kitchen food contact surfaces to prevent cross-contamination among different cooked foods.

Enumerating genotypic diversity and host specificity of Giardia in wild rodents around a New York watershed

Giardia is a genus of flagellated protozoans that parasitize the gastrointestinal tract of humans and wildlife worldwide. While G. duodenalis is well-studied due to its potential to cause outbreaks of diarrheal illness in humans, other Giardia species from wildlife have been largely understudied. This study examines the occurrence, host specificity, and genotypic diversity of Giardia in wild rodents living within the New York City water supply watershed. A novel nested PCR assay targeting the 18S ssu-rDNA gene is introduced, which captures nearly the entire gene for improved species-level determination versus existing molecular typing methods. Molecular characterization of 55 Giardia specimens reveals at least seven novel lineages. Phylogenetic analysis indicates a close relationship between the newly characterized Giardia lineages and rodent hosts, suggesting rodents as important reservoirs of Giardia and its close relatives. These findings provide insights into the diversity of Giardia species and their public health potential in localities with human-wildlife interaction and further emphasizes the need for continued efforts to improve the molecular tools used to study microbial eukaryotes, especially those with zoonotic potential.

A reporter Oropouche virus expressing ZsGreen from the M segment enables pathogenesis studies in mice.

Oropouche fever caused by Oropouche virus (OROV) is a significant zoonosis in Central and South America. Despite its public health significance, we lack high-throughput diagnostics, therapeutics, and a comprehensive knowledge of OROV biology. Reporter viruses are valuable tools to rapidly study virus dynamics and develop neutralization and antiviral screening assays. OROV is a tri-segmented bunyavirus, which makes generating a reporter virus challenging, as introducing foreign elements into the viral genome typically affects fitness. We previously demonstrated that the non-structural gene NSm on the OROV medium (M) segment is non-essential for replication in vitro. Taking advantage of this, we have now generated a recombinant OROV expressing fluorescent protein ZsGreen in place of NSm. This reporter OROV is both stable and pathogenic in IFNAR-/- mice and provides a powerful tool for OROV pathogenesis studies and assay development.IMPORTANCEEmerging and reemerging infectious agents such as zoonotic bunyaviruses are of global health concern. Oropouche virus (OROV) causes recurring outbreaks of acute febrile illness in the Central and South American human populations. Biting midges are the primary transmission vectors, whereas sloths and non-human primates are their reservoir hosts. As global temperatures increase, we will likely see an expansion in arthropod-borne pathogens such as OROV. Therefore, developing reagents to study pathogen biology to aid in identifying druggable targets is essential. Here, we demonstrate the feasibility and use of a fluorescent OROV reporter in mice to study viral dynamics and pathogenesis. We show that this reporter OROV maintains characteristics such as growth and pathogenicity similar to the wild-type virus. Using this reporter virus, we can now develop methods to assist OROV studies and establish various high-throughput assays.

Tracing wide-spread infectious contacts using GeoSpark in preventive medicine

A threat to governments and the medical community globally are infectious illness outbreaks such as COVID-19, Spanish flu, and Ebola, which kill millions of people. Furthermore, because people are afraid to go to their employment, infectious diseases hinder economic progress. Therefore, it is imperative to implement interventions to lessen the spread of infectious diseases. From this angle, the practice of tracking contacts might be viewed as a mitigation strategy to stop the spread of contagious diseases. As this is going on, users’ trace data sets are growing exponentially larger over time, making it difficult to conduct contact tracing queries over them. In this paper, a novel Spark contact-tracing query processing method is proposed. This method determines if users are suspected cases by analyzing their paths based on two variables: nearby social distance and exposure time. Additionally, the developed method makes full use of the Spark framework to address scalability issues and effectively respond to contact tracing inquiries over a wide range of trajectories.

Integrating lateral flow device with controllable gold in situ growth for sensitive detection of staphylococcal enterotoxin A in milk

Gold nanoparticle-based lateral flow immunoassays (AuNP-LFIA) are widely used for pathogen monitoring to prevent foodborne illness outbreaks. However, conventional AuNP-LFIA exhibits poor sensitivity and limited quantitative capacity due to the low colorimetric signal intensity of AuNPs. Herein, we introduced a low-background gold in situ growth (GISG) strategy by lowering the pH of the growth solution to weaken the reducibility of hydroxylamine, thereby enhancing the sensitivity of AuNP-LFIA. Additionally, we developed a universal and manufacturable lateral flow device to streamline the GISG process. We applied this device to detect staphylococcal enterotoxin A (SEA), an exotoxin produced by Staphylococcus aureus. Under optimal conditions, the proposed device demonstrated superior practicality and excellent sensitivity for SEA detection, achieving a detection limit of 0.061 ng/mL with the total detection time of 37 min, showing 311 times more sensitive than the unamplified AuNP-LFIA. Furthermore, SEA detection in milk samples showed a strong correlation (R2 = 0.8845) with results obtained from a conventional ELISA kit. Therefore, this promising LFIA device offers a novel strategy with high sensitivity and practicality for in-field detection of Staphylococcus aureus and can be easily adapted for screening other foodborne pathogens.

Ingestion of Bacillus cereus spores dampens the immune response to favor bacterial persistence

Strains of the Bacillus cereus (Bc) group are sporulating bacteria commonly associated with foodborne outbreaks. Spores are dormant cells highly resistant to extreme conditions. Nevertheless, the pathological processes associated with the ingestion of either vegetative cells or spores remain poorly understood. Here, we demonstrate that while ingestion of vegetative bacteria leads to their rapid elimination from the intestine of Drosophila melanogaster, a single ingestion of spores leads to the persistence of bacteria for at least 10 days. We show that spores do not germinate in the anterior part of the intestine which bears the innate immune defenses. Consequently, spores reach the posterior intestine where they germinate and activate both the Imd and Toll immune pathways. Unexpectedly, this leads to the induction of amidases, which are negative regulators of the immune response, but not to antimicrobial peptides. Thereby, the local germination of spores in the posterior intestine dampens the immune signaling that in turn fosters the persistence of Bc bacteria. This study provides evidence for how Bc spores hijack the intestinal immune defenses allowing the localized birth of vegetative bacteria responsible for the digestive symptoms associated with foodborne illness outbreaks.

Food Safety Knowledge, Attitudes, and Practices Among Food Handlers in Jeddah, Saudi Arabia

Background: Several outbreaks of foodborne illness have recently occurred in Saudi Arabia, posing a public health concern, especially considering the increasing trend of food consumption at restaurants. Objectives: This study evaluates the food safety knowledge, attitudes, and self-reported practices among food handlers in Jeddah, Saudi Arabia, and their association with the food handlers’ sociodemographic characteristics. Methods: A cross-sectional study was performed for a convenience sample of 80 food handlers (15–65 years old), followed by face-to-face interviews. A validated questionnaire with 65 questions across four sections (sociodemographic characteristics, knowledge, attitudes, and practice related to food safety) was utilized for data collection. Data entry and analysis were conducted using the SPSS version 26 software. Results: Most of the participants exhibited moderate levels of food safety knowledge and practices and a high level of food safety attitudes. Food safety knowledge was significantly greater among the oldest participants (&gt;45 years old), those holding valid health cards, and those who had attended training courses (p&lt;0.05). However, no significant differences in food safety attitudes and practices were found based on the sociodemographic characteristics of the participants (p&gt;0.05). Food safety knowledge was found to be significantly correlated with the food safety attitudes of the participants (r= 0.379, p= 0.001), and food safety attitudes were significantly correlated with practices (r= 0.264, p= 0.018). Conclusion: This study revealed that continuous implementation of food safety educational and training programs is necessary to improve the knowledge of food handlers and transform it into appropriate attitudes and practices.

Evaluating Multi-Jurisdictional Enteric Illness Outbreak Messaging in Canada: A Content Analysis of Public Health Notices

ABSTRACT Effective risk communication during enteric illness outbreaks requires the provision of clear and consistent information to diverse audiences to reduce risk of exposure, inform behavior changes, and prevent illness. Most enteric illnesses are caused by pathogens transmitted through consumption of contaminated food or water, contact with animals, or person-to-person contact. When multi-jurisdictional outbreaks occur, the Public Health Agency of Canada posts web-based Public Health Notices (PHNs) to inform Canadians. This study evaluated the comprehensibility of PHNs to optimize federal risk communication approaches. Publicly available web-based PHNs (n = 42) from 2014–2022 were obtained. A codebook was developed using the Centers for Disease Control and Prevention’s (CDC) Clear Communication Index (CCI) and Health Belief Model (HBM) and systematically applied. A SMOG readability calculator was used to determine reading grade level. Descriptive statistics were calculated to summarize coded data. The average reading grade level was above Grade 12 (13.9 ± 1.1). PHNs communicated the nature of the risk (100%) and behavioral recommendations (96.5%) clearly. An active voice was sometimes used (61.9%), but numerical information was less commonly presented using best practices (38.1%). The HBM was fully incorporated in seven PHNs, with most PHNs using five of six constructs (66.7%). PHNs shared similar information in a consistent order (75.0%). Aligning PHNs to best practices in risk communication is recommended, including writing content at a reading grade level that supports comprehension by diverse audiences, following the CCI to increase clarity, including all HBM constructs to promote behavior change, and maintaining message consistency.

Comparative growth kinetics of Listeria monocytogenes and Salmonella enterica on dehydrated enoki and wood ear mushrooms during rehydration and storage.

Specialty mushrooms have been implicated in foodborne illness outbreaks in the U.S. in recent years. These mushrooms are available to consumers in both their fresh and dried states. Dehydrating mushrooms is a convenient way to increase shelf life. The dehydration process results in a lowered water activity (aw) of the commodity, creating an environment where both spoilage and pathogenic bacteria cannot proliferate. Prior to food preparation and consumption, these mushrooms are typically rehydrated and possibly stored for later use which could lead to increased levels of pathogens. This study examined the survival and growth of Listeria monocytogenes and Salmonella enterica on dehydrated enoki and wood ear mushrooms during rehydration and subsequent storage. Mushrooms were heat dehydrated, inoculated at 3 log CFU/g, and rehydrated at either 5 or 25°C for 2 h. Rehydrated mushrooms were stored at 5, 10, or 25°C for up to 14 d. L. monocytogenes and S. enterica survived on enoki and wood ear mushroom types during rehydration at 5 and 25°C, with populations often <2.39 log CFU/g. During subsequent storage, no growth was observed on wood ear mushrooms, regardless of the rehydration or storage temperature, with populations remaining <2.39 log CFU/g for both pathogens. When stored at 5°C, no growth was observed for either pathogen on enoki mushrooms. During storage at 10 and 25°C, pathogen growth rates and populations after 14 d were generally significantly higher on the enoki mushrooms rehydrated at 25°C; the highest growth rate (3.56 ± 0.75 log CFU/g/d) and population (9.48 ± 0.62 log CFU/g) after 14 d for either pathogen was observed by S. enterica at 25°C storage temperature. Results indicate a marked difference in pathogen survival and proliferation on the two specialty mushrooms examined in this study and highlight the need for individual product assessments. Data can be used to assist in informing guidelines for time and temperature control for the safety of rehydrated mushrooms.

Inadequate food safety knowledge and hygiene practices among street food vendors in Dhaka, Bangladesh

Food safety remains a critical issue with outbreaks of foodborne illness. The knowledge gap of food safety and improper hygienic practices of food handlers are the key factors for the transmission of foodborne diseases. This study was conducted to investigate the level of food safety knowledge and practices among street food vendors in Dhaka City, Bangladesh, and its implications on consumers’ health. This cross-sectional study was conducted among 350 respondents in seven areas of Dhaka City. Trained data collectors gather data by interviewing street vendors using a pretested questionnaire. Most of the vendors (98%) were male, with 48% having secondary education and 85% having no food safety training. Although about 89% of the vendors were found to practice hand washing, only a small proportion of them practised using hand gloves while handling raw products (5.6%), cleaning tables (2.2%), preparing foods (1.3%) or handling garbage (0.9%). The education level of the vendors and their work experience were significantly correlated with their hand washing practice, wearing hand gloves and their knowledge about food-borne illnesses. The study demonstrated that formal education played a significant role in vendors’ knowledge and practice of health safety measures for food handlers to prevent foodborne illness. Effective food safety training and monitoring are needed to increase vendors' knowledge and practices, and in reducing foodborne diseases.

Modern biological methods of processing plant raw materials used to increase its storage capacity

Foodborne illnesses, mainly infectious, are a leading cause of morbidity and mortality worldwide. Pathogenic bacteria are present at virtually every stage of the food production chain, compromising company food safety programs and causing out-breaks of foodborne illnesses in various regions of the world. Finding new solutions that provide adequate microbiological stability to minimally processed foods is key to controlling bacterial pathogens that cause foodborne illnesses. The use of chemical and physical methods of food preservation often leads to a deterioration in their nutritional value, physical and organoleptic properties. Minimally processed foods produced without any radical preservation methods may be at particular risk of developing microorganisms, including pathogens. Low-temperature production processes and refrigerated storage promote the development of psychrophilic microorganisms; another threat is posed by high microbiological contamination of raw materials. To preserve the quality of food products, the most commonly used physicochemical methods include modified atmosphere packaging, membrane methods or ultrasound. Alternatively, biological methods can be used: bacteriophages and phage cocktails, bacteriocins, inactivation of plant tissue degradation enzymes, phytochemicals, edible coatings. Moreover, they can be used either individually to limit the growth of bacteria in the food environment, or in combination with other methods in order to achieve maximum effect. This article discusses the main biological methods of combating pathogenic bacteria most commonly found in the food environment. The purpose of this review was to consider existing biological methods for processing plant objects, as well as to identify the advantages and disadvantages of each method.

Assessment of bacterial and parasitic contamination of fruits gathered from specific local markets in Addis Ababa, Ethiopia

BackgroundAround the world, food-borne illnesses are still a frequent and significant hazard to public health. Human infection outbreaks brought on by eating raw fruits have happened more frequently. Fruits have been connected in recent years to a number of outbreaks of food-borne illness around the globe, including in Ethiopia.ObjectiveTo assess bacterial and parasitic contamination of fruits gathered from specific local markets in Addis Ababa, Ethiopia.MethodsA cross-sectional study was carried out using fruits gathered from Addis Ababa local marketplaces. Convenient sampling were applied. With the assumption that each vendor provided 30 samples, a total of 120 fruit samples were gathered. Fruit samples were gathered in a plastic bag that had been sanitized and then brought to the lab for bacterial and parasitological investigation. All of the samples were checked for intestinal parasites and bacterial contamination. SPSS software version 25 was used to analyze the data. The Pearson's Chi-square test was used to assess categorical variables. The student's t-test was utilized to compare continuous variables, which were represented as the mean ± standard deviation. Using both univariate and multivariate analysis, odds ratios (OR) with 95% confidence intervals (CI) were computed. Statistical significance was defined as a P &amp;lt; 0.05.ResultsThere was a 100 (83.3%) level of bacterial contamination. While Salmonella and Shigella species were not recovered, S. aureus isolates 16 (13.3%) were the most common bacterial contamination, followed by E. coli isolates 8 (6.7%). The samples of bananas, mangos, papayas, and avocados from all four sites had total coliform (TCC) bacteria ranging from 2.1 × 103 to 3.2 × 104, 8.3x 102 to 1.8x 105CFU/g, 1.6x 102 to 3.7 x 104, and 1.2x 102 to 3.8 x 104 CFU/g, in that order. No parasites were found in this investigation.Conclusion and recommendationIt is usually recommended that customers in this research region wash and handle infected fruits properly to prevent bacterial illnesses. In addition, fruit dealers should have their bacterial contaminations routinely inspected. Large-scale research is advised to support this discovery.

Prevalence of mass social media-induced illness presenting with Tourette-like behavior in Germany between 2019 and 2021

Starting in 2019, in Germany the first well documented outbreak of mass sociogenic illness induced by social media (mass social media-induced illness; MSMI) occurred presenting with functional Tourette-like behaviors (FTB). This study aimed to provide first data on the prevalence rate of MSMI-FTB in Germany between 2019 and 2021 in the general population. We conducted a large-scale representative population survey in cooperation with the USUMA market and social research institute. Between August and December 2021, n = 2.509 people (mean age: 49.5 years, range: 16–95 years, n = 1.276 females) were randomly selected, visited in their households, interviewed, and asked to answer for themselves, but also for close family members (n = 6.744). Thus, in total, we received answers for n = 9.253 people. Probable MSMI-FTB was found in n = 33 individuals (mean age at onset: 30.5 years, n = 8 females). Based on strict criteria, the diagnosis of MSMI-FTB was considered highly likely in 16/33 individuals (mean age at onset: 25.6 years, n = 2 females) corresponding to prevalence rates of 0.17% (CIlower = 0.10, CIupper = 0.28) and 0.36% (CIlower = 0.25, CIupper = 0.50), respectively. This is the first large-scale, population representative study investigating the prevalence of MSMI-FTB in the general population in Germany between 2019 and 2021. Based on the prevalence rates found, MSMI-FTB is highly relevant for health economy. Accordingly, we suggest educating healthcare professionals and the general public to avoid misdiagnosis and inefficient treatment.