Incidence Of Human Cases Research Articles

Mpox – Clado 1B: Uma revisão e avanços do novo alerta global de saúde pública

Scientific interest in mpox has grown significantly in recent decades, especially due to the increase in the incidence of human cases and the potential threat that the virus poses to global public health. This article aims to increase access to information about this disease and the behavior of the Clade 1B mutation in affecting the immune system and representing a first-degree threat to carriers of the Human Immunodeficiency Virus (HIV) in Portuguese, since the main information is still are published in a foreign language. The information is recent and so is the global alert issued by the World Health Organization. It is necessary to democratize access to scientific information about a possible second global pandemic in the making.

Can risk area designation help increase vaccination coverage for Tick-Borne Encephalitis? Evidence from German claims data

Background and objectivesAlthough vaccine preventable, the incidence of tick-borne encephalitis (TBE) increased in Germany from 2001 to 2021 by on average 2% each year, with a peak of more than 700 TBE infections documented in 2020. TBE-risk areas, as designated by district based on incidence of human cases, expanded north- and northeastward, present in 11 of the 16 Federal States as of 2022. Using claims data from a German statutory health insurance in the Federal States of Saxony and Thuringia (AOK PLUS), we aimed to assess whether official assignment of a district to a risk area had an impact on vaccination rates in Germany. MethodsThe data covered the period from 01/01/2010 to 31/12/2018 and included information on vaccine administrations from outpatient physicians. Yearly incident vaccination rates were reported overall and by district. To investigate the association between a new designation of an incident TBE-risk area and vaccination rates, a difference-in-difference analysis was conducted. ResultsOverall, the incident vaccination rates increased from 6.2 to 9.5 per 1,000 person-years between 2012 and 2018, with a peak of 12.2 in 2015. While districts that had been risk-areas for the whole study period had always a higher vaccination rate compared to districts that were never categorized as risk areas, the increase between 2012 and 2018 was comparable in the two groups (3.0 and 3.2 per 1,000 person-years, respectively). In contrast, districts that were newly designated risk districts during the study period experienced a significantly larger increase in vaccination rates, going from 5.8 to 14.7 per 1,000 person-years between 2012 and 2018, with a peak of 19.6 in 2015. ConclusionThe results suggest that the new designation of a district as risk area has a significant positive impact on vaccination rates, which is strongest immediately after designation of risk area.

Comparison of Three Serological Methods for the Epidemiological Investigation of TBE in Dogs.

Tick-borne encephalitis (TBE) virus is an emerging pathogen that causes severe infections in humans. Infection risk areas are mostly defined based on the incidence of human cases, a method which does not work well in areas with sporadic TBE cases. Thus, sentinel animals may help to better estimate the existing risk. Serological tests should be thoroughly evaluated for this purpose. Here, we tested three test formats to assess the use of dogs as sentinel animals. A total of 208 dog sera from a known endemic area in Southern Germany were tested in an All-Species-ELISA and indirect immunofluorescence assays (IIFA), according to the manufacturer’s instructions. Sensitivity and specificity for both were determined in comparison to the micro-neutralization test (NT) results. Of all 208 samples, 22.1% tested positive in the micro-NT. A total of 18.3% of the samples showed characteristic fluorescence in the IIFA and were, thus, judged positive. In comparison to the micro-NT, a sensitivity of 78.3% and a specificity of 98.8% was obtained. In the ELISA, 19.2% of samples tested positive, with a sensitivity of 84.8% and a specificity of 99.4%. The ELISA is a highly specific test for TBE-antibody detection in dogs and should be well suited for acute diagnostics. However, due to deficits in sensitivity, it cannot replace the NT, at least for epidemiological studies. With even lower specificity and sensitivity, the same applies to IIFA.

Avian influenza H5N1: still a pandemic threat?

Highly pathogenic avian influenza H5N1 viruses have become endemic in global poultry populations over the past 25 years and pose an ongoing public health threat. Although the incidence of human cases has declined, viruses from the H5N1 lineage can now be found in poultry throughout Asia, the Middle East and Africa, in addition to causing outbreaks in Europe and the Americas. The recent emergence and spread of reassortant H5Nx viruses, resulting in regional poultry outbreaks, has increased the risk for further evolution of these viruses and possible avian-to-human transmission. Ongoing surveillance and pandemic preparedness for H5N1 and other avian influenza viruses of public health concern are warranted.

Spatial distribution of Haemaphysalis species ticks and human Kyasanur Forest Disease cases along the Western Ghats of India, 2017-2018.

Kyasanur Forest Disease (KFD) is a viral haemorrhagic fever, transmitted to humans and other hosts by a tick vector of genus Haemaphysalis. It affects 400-500 people annually in the Western Ghats region of India through spring to summer season. To understand the species composition, distribution, and abundance of Haemaphysalis ticks in endemic taluks (sub-districts) of India, a surveillance for ticks was conducted between October 2017 and January 2018. In total 105 sites were selected based on grid sampling from five taluks representing five KFD endemic states in south India. A sum of 8373 ticks were collected by using standard flagging method. The study showed a wide distribution of host seeking tick species among the selected taluks, wherein Haemaphysalis spinigera was predominant in 3/5 taluks, Haemaphysalis bispinosa in 1/5 taluks, and both the species in 1/5 taluks. Further, the H. spinigera abundance was categorised and compared with the incidence of human cases during the same season. The grids with very high and high H. spinigera abundance had 70% of the 205 human cases reported. This method of tick surveillance could be efficiently used as a standard model for KFD transmission risk assessment and prediction of impending outbreaks.

One Health approach to controlling a Q fever outbreak on an Australian goat farm.

A recent outbreak of Q fever was linked to an intensive goat and sheep dairy farm in Victoria, Australia, 2012-2014. Seventeen employees and one family member were confirmed with Q fever over a 28-month period, including two culture-positive cases. The outbreak investigation and management involved a One Health approach with representation from human, animal, environmental and public health. Seroprevalence in non-pregnant milking goats was 15% [95% confidence interval (CI) 7-27]; active infection was confirmed by positive quantitative PCR on several animal specimens. Genotyping of Coxiella burnetii DNA obtained from goat and human specimens was identical by two typing methods. A number of farming practices probably contributed to the outbreak, with similar precipitating factors to the Netherlands outbreak, 2007-2012. Compared to workers in a high-efficiency particulate arrestance (HEPA) filtered factory, administrative staff in an unfiltered adjoining office and those regularly handling goats and kids had 5·49 (95% CI 1·29-23·4) and 5·65 (95% CI 1·09-29·3) times the risk of infection, respectively; suggesting factory workers were protected from windborne spread of organisms. Reduction in the incidence of human cases was achieved through an intensive human vaccination programme plus environmental and biosecurity interventions. Subsequent non-occupational acquisition of Q fever in the spouse of an employee, indicates that infection remains endemic in the goat herd, and remains a challenge to manage without source control.

How Effective are Federal Food Safety Regulations? The Case of Eggs and Salmonella Enteritidis

In 2009 the Food and Drug Administration (FDA) estimated that its shell egg rule would reduce illness from Salmonella Enteritidis (SE) by about 79,000 cases annually (37%), with a range from about 30,000 to 191,000 cases avoided. I assess the effectiveness of this rule, which requires farmers who sell eggs to adopt SE control measures, by comparing illness from SE with illness from other Salmonella serotypes, using a differences-in-differences approach. The data reject the hypothesis that the rule reduced illnesses by FDA’s best 2009 estimate, but do not reject a hypothesis of no effect. The percentage of young broilers that test positive for SE has a modest effect on the incidence of human cases of salmonellosis caused by SE. Recent literature offers two other reasons to adjust FDA’s prospective 2009 calculations. One adjustment would follow the Centers for Disease Control’s use of a lower multiplier to infer the total number of (unobserved) cases of illness from those confirmed by positive lab tests. A second adjustment would lower the average cost of Salmonella cases, by recognizing lower risk of severe sequelae. These adjustments and the new retrospective assessment of the effectiveness of the rule together suggest that the benefits of FDA’s egg rule may be a small fraction of the prospective estimate of benefits, and less than the prospective estimate of costs. I conclude with some policy recommendations to make food safety regulations more effective.

Rickettsia raoultii, the predominant Rickettsia found in Dermacentor silvarum ticks in China–Russia border areas

Since the year 2000, clinical patterns resembling tick-borne rickettsioses have been noticed in China-Russia border areas. Epidemiological data regarding species of the aetiological agent, tick vector prevalence and distribution as well as incidence of human cases in the areas are still sparse to date. In order to identify Rickettsia species occurring in the areas, we investigated Dermacentor silvarum collected in the selected areas. Rickettsia raoultii was the predominant Rickettsia found in D. silvarum evident with ompA, ompB, gltA and 17 kDa protein genes. The Rickettsia prevalence in D. silvarum appeared to be 32.25 % with no sex difference. The results extend the common knowledge about the geographic distribution of R. raoultii and its candidate vector tick species, which suggest an emerged potential threat of human health in the areas.

Rickettsia raoultii, the predominant Rickettsia found in Mongolian Dermacentor nuttalli

Since the year 2005, clinical patterns resembling tick-borne rickettsioses have been noticed in Mongolia. Epidemiological data regarding species of the aetiological agent, tick vector, prevalence, and distribution as well as incidence of human cases throughout Mongolia are still sparse to date. In order to identify Rickettsia species occurring in Mongolia, we investigated Dermacentor nuttalli (n=179) and Ixodes persulcatus (n=374) collected in 4 selected provinces. Rickettsia raoultii was the predominant Rickettsia (82% prevalence) found in D. nuttalli and was also detected in I. persulcatus (0.8%). The Rickettsia prevalence in D. nuttalli from different provinces varied between 70% and 97%. In addition, R. sibirica was identified in approximately 4% of D. nuttalli, but solely from Arkhanghai province. The results of this study extend the common knowledge about the geographic distribution of R. raoultii and its high prevalence in D. nuttalli. Although the pathogenicity of this Rickettsia is still unclear, it should be considered in Mongolian patients suspected of having tick-borne rickettsiosis.

“Body bags ready”: Print media coverage of avian influenza in Australia

In 2006 the avian influenza A (H5N1) virus received considerable media coverage in Australia, as it did in many other countries. It is often argued that the media sensationalizes health crises, and experts cautioned about the risk of panic as a result of fear of avian influenza. The purpose of the present study was to systematically analyze Australian print media coverage of avian influenza in 2006 and to examine whether this coverage served the purpose of informing, rather than alarming, the general public. For the period January 1, 2006 to December 31, 2006, 20 Australian newspaper titles were monitored for coverage of avian influenza. The identified articles were analyzed using aspects of protection motivation theory for theoretical direction to determine whether there were any consistent themes or perspectives in the coverage. A total of 850 articles were identified for analysis. Concerning vulnerability, 46% of articles reported the incidence of human cases, with 24% noting that avian influenza was a potential threat to Australia. The most common severity theme was “deadly” with over 50% of mentions, followed by “pandemic” with 35%. Only 11% of articles referred to any form of self-protection. We found that a considerable proportion of the articles reporting on avian influenza were framed in a way that had the potential to incite fear and panic amongst the public; the intensity of media coverage reduced over time; and, of particular concern, that there was little media coverage that focused on protective or preventative issues. Whether an influenza pandemic eventuates or not, it is prudent for governments and health authorities to continually develop appropriate resources and strategies to prepare the health system and the general public to respond to current, and future, infectious disease risks.

Relationship between rainfall and temperature: observations on the cases of visceral leishmaniasis in São Luis Island, State of Maranhão, Brazil

Visceral leishmaniasis is a serious public health problem that requires global control strategies, especially with respect to factors that may intervene in reducing the incidence of endemicity. In this work, rainfall density and temperature were correlated with the incidence of human cases in an area endemic for leishmaniasis in São Luis do Maranhão, Northeastern Brazil. Notification of human cases by the National Health Foundation/Regional Coordination of Maranhão (FUNASA/COREMA) from 2002 to 2010 was used. Ecological data (mean temperature and rainfall density) were provided by the Meteorological Office of State. A significant association was verified between the number of VL cases and rainfall rate but not in the analysis concerning mean temperatures. These data suggest that the control actions in visceral leishmaniasis should be performed during rainy season in the State of Maranhão, which is in the first half of the year.

Rodents as Sentinels for the Prevalence of Tick-Borne Encephalitis Virus

Tick-borne encephalitis virus (TBEV) causes one of the most important flavivirus infections of the central nervous system, affecting humans in Europe and Asia. It is mainly transmitted by the bite of an infected tick and circulates among them and their vertebrate hosts. Until now, TBE risk analysis in Germany has been based on the incidence of human cases. Because of an increasing vaccination rate, this approach might be misleading, especially in regions of low virus circulation. To test the suitability of rodents as a surrogate marker for virus spread, laboratory-bred Microtus arvalis voles were experimentally infected with TBEV and analyzed over a period of 100 days by real-time (RT)-quantitative polymerase chain reaction. Further, the prevalence of TBEV in rodents trapped in Brandenburg, a rural federal state in northeastern Germany with autochthonous TBE cases, was determined and compared with that in rodents from German TBE risk areas as well as TBE nonrisk areas. In experimentally infected M. arvalis voles, TBEV was detectable in different organs for at least 3 months and in blood for 1 month. Ten percent of all rodents investigated were positive for TBEV. However, in TBE risk areas, the infection rate was higher compared with that of areas with only single human cases or of nonrisk areas. TBEV was detected in six rodent species: Apodemus agrarius, Apodemus flavicollis, Apodemus sylvaticus, Microtus agrestis, Microtus arvalis, and Myodes glareolus. M. glareolus showed a high infection rate in all areas investigated. The infection experiments proved that TBEV can be reliably detected in infected M. arvalis voles. These voles developed a persistent TBE infection without clinical symptoms. Further, the study showed that rodents, especially M. glareolus, are promising sentinels particularly in areas of low TBEV circulation.

Echinococcus spp. and echinococcosis

Echinococcus spp. are cestode parasites commonly known as small tapeworms of carnivorous animals. Their medical importance lies in the infection of humans by the larval stage of the parasites, predominantly including Echinococcus granulosus, which is the causative agent of cystic echinococcosis (CE) and Echinococcus multilocularis, which causes alveolar echinococcosis (AE). A few other species or genotypes are only very rarely or not at all found in humans. Due to the emerging situation in many parts of Europe, the present article will predominantly focus on E. multilocularis . The natural life cycle of E. multilocularis involves predominantly red and arctic foxes as definitive hosts, but domestic dogs can also become infected and represent an important infection source for humans in highly endemic areas. In the definitive host, egg production starts as early as 28 days after infection. After egg ingestion by a rodent or a human, larval maturation will occur practically exclusively within the liver tissue. The geographic distribution of E. multilocularis is restricted to the northern hemisphere. In Europe, relatively frequent reports of AE in humans occur in central and eastern France, Switzerland, Austria and Germany. Within the past ten years, the endemic area of Europe now includes many more countries such as Belgium, The Netherlands, Italy, and most former Eastern countries as far as up to Estonia. The Asian areas where E. multilocularis occurs include the whole zone from the White Sea eastward to the Bering Strait, covering large parts of Siberia, western and central parts of China and northern Japan. Worldwide there are scant data on the overall prevalence of human AE. Some well-documented studies demonstrate a generally low prevalence among affected human populations. The annual mean incidence of new cases in different areas including Switzerland, France, Germany and Japan has therefore been reported to vary between 0.1 and 1.2/ 100,000 inhabitants. The incidence of human cases correlates with the prevalence in foxes and the fox population density. Recently, a study documented that a fourfold increase of the fox population in Switzerland resulted in a statistically significant increase of the annual incidence of AE cases [1] (Schweiger et al., 2007). This dramatic increase in red fox populations has also been reported throughout Europe, especially in urban areas. The so-called city-fox phenomenon and, thereafter, the increased proximity of foxes with humans and an urban domestic dog – rodent cycle may, therefore, have significant public health implications [1-3]. In infected humans the E. multilocularis metacestode (larva) develops primarily in the liver. Occasionally, secondary lesions form metastases in the lungs, brain and other organs. The typical lesion appears macroscopically as a dispersed mass of fibrous tissue with a conglomerate of scattered vesiculated cavities with diameters ranging from a few millimeters to centimeters in size. In advanced chronic cases, a central necrotic cavity containing a viscous fluid may form, and rarely there is a bacterial superinfection. The lesion often contains focal zones of calcification, typically within the metacestode tissue. Histologically, the hepatic lesion is characterized by a conglomerate of small vesicles and cysts demarcated by a thin PAS-positive laminated layer with or without an inner germinative layer [4]. Parasite proliferation is usually accompanied by a granulomatous host reaction, including vigorous synthesis of fibrous and germinative tissue in the periphery of the metacestode, but also necrotic changes centrally. In contrast to lesions in susceptible rodent hosts, lesions from infected human patients rarely show protoscolex formation within Correspondence: bruno.gottstein@ipa.unibe.ch Faculty of Medicine, Institute of Parasitology, University of Bern, Bern, Switzerland Gottstein Acta Veterinaria Scandinavica 2010, 52(Suppl 1):S5 http://www.actavetscand.com/content/52/S1/S5

大阪府における日本脳炎の生態学的研究 : 1. 水田面積, 家畜飼育農家戸数の減少と患者の発生状況(1965-1986年)

大阪府における日本脳炎の生態学的研究 : 1. 水田面積, 家畜飼育農家戸数の減少と患者の発生状況(1965-1986年)

Effect of Eradicating Brucellosis in Cattle on Incidence of Human Cases

Effect of Eradicating Brucellosis in Cattle on Incidence of Human Cases