Infectious Disease Response Research Articles

Preparing Returning Workplaces for COVID-19: An Occupational Health Perspective

With the COVID-19 pandemic continuing and the resulting economic burden increasingly apparent, the Indonesian government began to prepare a "new normal" phase and make peace with COVID-19. From this new decision arises the question of the readiness of businesses and the industrial sector to resume operations amid COVID-19. This article aims to provide concise and precise information about the preparations that can be made by businesses to operate safely amid COVID-19 based on existing scientific studies and literatures. From the literature visits it can be concluded that transmission and danger of a COVID-19 pandemic can be prevented through: creation of infectious disease prevention and response plan, implementing basic infection prevention measures, policies and procedures for proper identification and isolation of sick people, applying flexibilities in policies, and protections in the workplace.

Emerging infectious disease preparedness and response in healthcare: perspectives from COVID-19 and the role of College-Learnt Microbiology

Coronavirus disease 2019 (COVID-19) pandemic began in December 2019 in Wuhan City China where it is believed to have been transmitted to humans from an unknown animal species. The public health, social and economic impact of the pandemic world over is detrimental. Health care providers at the frontline in the fight against COVID-19 are at the greatest risk of infection and so far, many have been infected and some have already died from the disease. Thus, it is imperative that healthcare providers have adequate knowledge of infectious diseases and microbial pathogens to comprehend the scale of risk for better recognition and response. Microbiological concepts of infection prevention and control, hand hygiene and aseptic techniques are essential in slowing down the spread of the virus. COVID-19 has proven that infectious agents can emerge from any region in the world and can spread rapidly with ominous consequences to all humanity. This narrative review discusses the role of college-learnt microbiology in health care provider preparedness for emerging infectious diseases in light of the current pandemic.
 Keywords: Emerging; Infections; Preparedness; Response; Microbiology; COVID-19; Training

The health response to the Rohingya refugee crisis post August 2017: Reflections from two years of health sector coordination in Cox's Bazar, Bangladesh.

On August 25 2017, an unprecedented influx of Rohingya refugees began from Rakhine State in Myanmar into Bangladesh’s district of Cox’s Bazar. The scale and acuteness of this humanitarian crisis was unprecedented and unique globally, requiring strong coordination of a multitude of actors. This paper reflects on the health sector coordination from August 2017 to October 2019, focusing on selected achievements and persisting challenges of the health sector strategic advisory group (HSSAG), and the health sector working groups including epidemiology and case management, sexual and reproductive health, community health, mental health and psychosocial support, and emergency preparedness. In the early days of the response, minimum service standards for primary health care were established, a fundamental initial step which enabled the standardization of services based on critical needs. Similarly, establishing standards for community health outreach was the backbone for capitalizing on this important health workforce. Novel approaches were adopted for infectious disease responses for acute watery diarrhoea and varicella, drawing on inter-sectoral collaborations. Sexual and reproductive health services were prioritized from the initial onset of the crisis and improvements in skilled delivery attendance, gender-based violence services, abortion care and family planning were recorded. Mental health service provision was strengthened through community-based approaches although integration of mental health programmes into primary health care has been limited by availability of specialist psychiatrists. Strong, collaborative and legitimate leadership by the health sector strategic advisory group, drawing on inter-sectoral collaborations and the technical expertise of the different technical working groups, were critical in the response and proved effective, despite the remaining challenges to be addressed. Anticipated reductions in funding as the crisis moves into protracted status threatens the achievements of the health sector in provision of health services to the Rohingya refugees.

Partisanship, policy options, and risk: Perceived influence of political partisanship on health emergency preparedness

AbstractThe 21st century has seen the emergence of two novel coronaviruses, severe acute respiratory syndrome (SARS) and COVID‐19 (coronavirus infectious disease of 2019). In the wake of the 9/11 attacks in 2001, Republicans and Democrats were united in their concerns regarding SARS and the potential threat of biological weapons. That united front was not to be seen during the 2016 debate over supplemental funding for Zika. The primary focus of this study is whether the perception of partisanship in the public health emergency preparedness (PHEP) area affects attitudes about policy options regarding PHEP. To investigate these issues, a Qualtrics online survey of members of hospital preparedness coalitions was conducted. The survey questions covered issues such as the level of governmental priority placed on fighting infectious disease, respondents' level of confidence that the essential functions of government are being managed, the role of partisanship in PHEP decision making, and support for proposals to reform the government's infectious disease response. A statistically significant association was found between respondents' reporting that partisanship in PHEP presents a risk of injury or death and support for all the proposed reforms, indicating a desire to decentralize PHEP activities and a need to reinvigorate PHEP bipartisanship.

Hypoalbuminemia on admission in COVID-19 infection: An early predictor of mortality and adverse events. A retrospective observational study

ObjectivesHypoalbuminemia is a negative acute phase reactant which has been associated with inflammatory response and poor outcome in infectious diseases. The aim of this study was to analyze the value of hypoalbuminemia on admission as a predictor of mortality and adverse events in COVID-19 patients. MethodsWe analyzed retrospective data from a cohort of 609 consecutive patients, with confirmed diagnosis of COVID-19, discharged from hospital (deceased or alive). Demographic characteristics, previous comorbidities, symptoms and laboratory findings on admission were collected. Comorbidities were assessed by Charlson-Age Comorbidity Index. ResultsHypoalbuminemia on admission (<34g/L) was more frequent in nonsurvivors than survivors (65.6% vs. 38%, p<0.001) and was significantly associated with the development of sepsis, macrophage activation syndrome, acute heart failure, acute respiratory distress syndrome and acute kidney injury, regardless of Charlson-Age Comorbidity Index. Hypoalbuminemia was a predictor of mortality in multivariable Cox regression analysis (HR 1.537, 95% CI 1.050–2.250, p=0.027), independently of Charlson-Age Index, gender, lymphocyte count <800/μL, creatinine, high-sensitivity C- reactive protein >8mg/L, lactate dehydrogenase >250U/L, bilateral infiltration on chest X-ray and q-SOFA ≥2. ConclusionsHypoalbuminemia was an early predictor of in-hospital mortality in COVID-19, regardless of age, comorbidity and inflammatory markers. It also had significant association with severe adverse events, independently of Charlson-Age Comorbidity Index. Our results suggest that serum albumin determination on admission may help to identify patients with SARS-CoV-2 infection at high risk of developing potential life-threatening conditions and death.

COVID-19 Pandemic Management: Best Practices and Lessons From China, Japan and South Korea

The management of COVID-19 pandemic is a reflection of how prepared states are when faced with a trans-boundary crisis. China, Japan and South Korea chose different strategies in containing the pandemic. All three were significantly successful in containing the pandemic in the initial stages. By using a qualitative approach, this article examines the timeline of events, measures are taken during the crisis to contain the coronavirus and the challenges faced in avoiding the further spread of the virus. The importance of early detection, defined procedures, the use of digital tools and possessing enough protective medical equipment and facilities are discussed at length. Since China, Japan and the Republic of Korea have been more successful in containing the virus compared to advanced economies, this research finds that the management practices of these East Asian countries inform policymakers in the future implementation of an infectious disease response strategy.

Macrophage migration inhibitory factor promotes the migration of dendritic cells through CD74 and the activation of the Src/PI3K/myosin II pathway

Constitutively expressed by innate immune cells, the cytokine macrophage migration inhibitory factor (MIF) initiates host immune responses and drives pathogenic responses in infectious, inflammatory, and autoimmune diseases. Dendritic cells (DCs) express high levels of MIF, but the role of MIF in DC function remains poorly characterized. As migration is critical for DC immune surveillance, we investigated whether MIF promoted the migration of DCs. In classical transwell experiments, MIF-/- bone marrow-derived DCs (BMDCs) or MIF+/+ BMDCs treated with ISO-1, an inhibitor of MIF, showed markedly reduced spontaneous migration and chemotaxis. CD74-/- BMDCs that are deficient in the ligand-binding component of the cognate MIF receptor exhibited a migration defect similar to that of MIF-/- BMDCs. Adoptive transfer experiments of LPS-matured MIF+/+ and MIF-/- and of CD74+/+ and CD74-/- BMDCs injected into the hind footpads of homologous or heterologous mice showed that the autocrine and paracrine MIF activity acting via CD74 contributed to the recruitment of DCs to the draining lymph nodes. Mechanistically, MIF activated the Src/PI3K signaling pathway and myosin II complexes, which were required for the migration of BMDCs. Altogether, these data show that the cytokine MIF exerts chemokine-like activity for DC motility and trafficking.

Establishing a Pre-COVID-19 Hospital Biopreparedness Initiative.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)/coronavirus disease 2019 (COVID-19) pandemic has amplified the role of hospitals in infectious disease response and capacity building. In efforts to respond to the growing volume of cases, hospitals have become a microcosm for US pandemic response. The COVID-19 outbreak has highlighted that hospital preparedness for biological events, such as a pandemic, are often inadequate and dependent on leadership investment in biopreparedness. This article discusses the proactive decision, before COVID-19, that a Phoenix-based hospital system made to invest in high-consequence disease (HCD) preparedness. Within these efforts, a gap analysis was performed, which led to creation of an HCD subcommittee and corresponding efforts to address vulnerabilities and opportunities for improvement. From establishing enhanced personal protective equipment (PPE) and infectious disease training for frontline staff, to building an outbreak tracking mechanism for travel alerts within the electronic medical record, the HCD efforts of this hospital system created a stronger foundation to respond to biological events like the COVID-19 pandemic.

COVID-19 measures and the Japanese Constitution

Since March 2020, the Act on Special Measures for Pandemic Influenza and New Infectious Diseases Preparedness and Response has been a significant statute in dealing with COVID-19 in Japan. The Act mandates requests and orders for business suspension and shortened business hours, as well as stay-at-home requests. Although there have been no penalties as of January 2021, these requests and orders limit freedom of movement and establishment, guaranteed rights under the Japanese Constitution. This article poses the following research question: “Does the Japanese Constitution allow measures against COVID-19 such as requests and orders for business suspension and shortened business hours, and stay-at-home requests?” It also asks: “Are measures with penalties allowed by the Constitution?” This paper introduces constitutional concepts that guarantee or limit individual freedom. Concepts that guarantee individual freedoms include freedom of establishment and movement. These freedoms derive from the constitutional values of freedom to choose one’s occupation and choose and change one’s residence (Art. 22) and the right to own or hold property (Art. 29). Concepts that limit individual freedom include the right to life (Art. 13), welfare rights and public health (Art. 25), and public welfare (Art. 13). Individual freedom that threatens right to life, welfare rights and public health, and public welfare may not be guaranteed. This paper argues that since measures against COVID-19 are considered public welfare, the Constitution allows the limiting of freedom of establishment and movement. Furthermore, from the perspectives of the right to life, welfare rights, and public health, the government is responsible for reducing the risk to life from COVID-19. It also argues that the Constitution permits measures with penalties, while proportionality needs to be considered.

Improving India’s Pandemic Response through a Health Information System Reform

Despite stringent lockdown measures to curb the spread of the 2019 Coronavirus disease (COVID-19), India remains vulnerable to an uncontrolled rise in the number of cases and deaths. Furthermore, in spite of the high number of recorded cases, the actual case counts may be much higher due to poor data reporting of probable and confirmed cases of COVID-19 from all of India’s states. Being a populous country with the potential to become the world’s COVID-19 epicenter, it should be the Indian government’s top priority to strengthen India’s health information system (HIS) to support their infectious disease response. To ensure that this paper is guided by current research on India’s HIS performance, a search strategy was developed on Ovid MEDLINE using database-specific subject headings and text words. The search terms used included: “health information systems” AND “India” AND “COVID-19” OR “Coronavirus.” Most district level COVID-19 information management is still paper-based, and with India’s vast terrain, this approach is prone to data compilation errors. Furthermore, India’s fragmented HIS has led to ineffective collaboration between COVID-19 response agencies at the central, state, and district levels, thereby creating barriers pertaining to the compilation and coordination of COVID-19 data. Investing in the use of technology is a viable approach to strengthen the country’s HIS performance during an infectious disease pandemic. To address the challenges associated with India’s fragmented HIS, the government is encouraged to implement a national regulatory body to monitor health information inputs and outputs.

China’s Response to the COVID-19 Pandemic: Surveillance and Autonomy

Pandemics bring the specter of death, disruption, and despair, but historically they have also been engines for social transformations visible at almost every level of society. For scholars interested in understanding contemporary surveillance dynamics, the COVID-19 pandemic encourages thinking about how different forms of monitoring have altered aspects of the global infectious disease response and what these developments might suggest about the evolving practices of surveillance and governance more generally. Here, Cassiano et al focus on China, where the virus is assumed to have originated and where--given China's population profile--rapidly spreading infections pose stark morbidity and mortality risks.

‘Choking the national demos’: research partnerships and the material constitution of global health

By foregrounding a widened view of the rule of law in transnational legal processes, the works under discussion in this symposium can support innovative critical perspectives on global health law –a field that has gained wide attention due to the spread of COVID-19 around the world (Lander, 2020; Bhatt, 2020). Legal and socio-legal scholars in the decade and a half before the pandemic worked on locating global health law and articulating its underlying principles. Lawrence Gostin's 2014 monograph offers a synoptic view centred on international institutions (e.g. the World Health Organization, World Trade Organization, UN Human Rights Council) and problems (e.g. infectious-disease response, tobacco control), along with an elaboration of its normative basis in universal moral principle and international human rights law (Gostin, 2014). Struggles over access to essential medicines and intellectual property in the early 2000s are, for example, represented in terms of the right to health constraining international trade law. Andreas Fischer-Lescano and Guenther Teubner's 2004 reading is oriented more by social theory than by doctrinal or ethical frames (Fischer-Lescano and Teubner, 2004, pp. 1006, 1008). A functional health regime has ‘differentiated out’, they observe, and operates as a discrete communication system across borders, albeit one that is threatened by the preponderant economic system. On this model, the battle for access to medicines amounts to ensuring, via human rights guarantees, that the rationality of the health system is not replaced by that of its economic rival in legal and policy communications (Fischer-Lescano and Teubner, 2004, pp. 1030, 1046).

Legend of the Sentinels: Development of Lung Resident Memory T Cells and Their Roles in Diseases.

SARS-CoV-2 is wreaking havoc around the world. To get the world back on track, hundreds of vaccines are under development. A deeper understanding of how the immune system responds to SARS-CoV-2 re-infection will certainly help. Studies have highlighted various aspects of T cell response in resolving acute infection and preventing re-infections. Lung resident memory T (TRM) cells are sentinels in the secondary immune response. They are mostly differentiated from effector T cells, construct specific niches and stay permanently in lung tissues. If the infection recurs, locally activated lung TRM cells can elicit rapid immune response against invading pathogens. In addition, they can significantly limit tumor growth or lead to pathologic immune responses. Vaccines targeting TRM cells are under development, with the hope to induce stable and highly reactive lung TRM cells through mucosal administration or “prime-and-pull” strategy. In this review, we will summarize recent advances in lung TRM cell generation and maintenance, explore their roles in different diseases and discuss how these cells may guide the development of future vaccines targeting infectious disease, cancer, and pathologic immune response.

Hypoalbuminemia on admission in COVID-19 infection: An early predictor of mortality and adverse events. A retrospective observational study

ObjectivesHypoalbuminemia is a negative acute phase reactant which has been associated with inflammatory response and poor outcome in infectious diseases. The aim of this study was to analyze the value of hypoalbuminemia on admission as a predictor of mortality and adverse events in COVID-19 patients. MethodsWe analyzed retrospective data from a cohort of 609 consecutive patients, with confirmed diagnosis of COVID-19, discharged from hospital (deceased or alive). Demographic characteristics, previous comorbidities, symptoms and laboratory findings on admission were collected. Comorbidities were assessed by Charlson-Age Comorbidity Index. ResultsHypoalbuminemia on admission (<34g/L) was more frequent in nonsurvivors than survivors (65.6% vs. 38%, p<0.001) and was significantly associated with the development of sepsis, macrophage activation syndrome, acute heart failure, acute respiratory distress syndrome and acute kidney injury, regardless of Charlson-Age Comorbidity Index. Hypoalbuminemia was a predictor of mortality in multivariable Cox regression analysis (HR 1.537, 95% CI 1.050–2.250, p=0.027), independently of Charlson-Age Index, gender, lymphocyte count <800/μL, creatinine, high-sensitivity C- reactive protein >8mg/L, lactate dehydrogenase >250U/L, bilateral infiltration on chest X-ray and q-SOFA ≥2. ConclusionsHypoalbuminemia was an early predictor of in-hospital mortality in COVID-19, regardless of age, comorbidity and inflammatory markers. It also had significant association with severe adverse events, independently of Charlson-Age Comorbidity Index. Our results suggest that serum albumin determination on admission may help to identify patients with SARS-CoV-2 infection at high risk of developing potential life-threatening conditions and death.

Моделирование дискретного управления противовирусным иммунным ответом в условиях неопределенности

In this paper is considered numerically solving a problem of discrete control with uncertainty of the immune response in infectious disease. The problem of discrete control is described by a nonlinear system of ordinary differential equations with a retarded argument. Control under conditions of uncertainty implies that the parameter values are unknown and parameter estimation is adjusted as new experimental values become available. In order to solve this problem, the algorithm that allows us to construct a control function and at the same time to identify parameters within mathematical model of the infectious disease is proposed. By means of the proposed algorithm, the treatment programs based on an immunotherapy are constructed and parameters of the mathematical model of antiviral immune response are identified. It is shown that immunotherapy allows us to effectively cure the acute form of a disease.

Big Data Analytics Framework for Childhood Infectious Disease Surveillance and Response System using Modified MapReduce Algorithm

Tanzania, like most East African countries, faces a great burden from the spread of preventable infectious childhood diseases. Diarrhea, acute respiratory infections (ARI), pneumonia, malnutrition, hepatitis, and measles are responsible for the majority of deaths amongst children aged 0-5 years. Infectious disease surveillance and response is the foundation of public healthcare practices, and it is increasingly being undertaken using information technology. Tanzania however, due to challenges in information technology infrastructure and public health resources, still relies on paper-based disease surveillance. Thus, only traditional clinical patient data is used. Nontraditional and pre-diagnostic infectious disease report case data are excluded. In this paper, the development of the Big Data Analytics Framework for Childhood Infectious Disease Surveillance and Response System is presented. The framework was designed to guide healthcare professionals to track, monitor, and analyze infectious disease report cases from sources such as social media for prevention and control of infectious diseases affecting children. The proposed framework was validated through use-cases scenario and performance-based comparison.

Virus-Dependent Immune Conditioning of Tissue Microenvironments

A thorough understanding of complex spatial host-disease interactions in situ is necessary in order to develop effective preventative measures and therapeutic strategies. Here, we developed Protein And Nucleic acid IN situ Imaging (PANINI) and coupled it with Multiplexed Ion Beam Imaging (MIBI) to sensitively and simultaneously quantify DNA, RNA, and protein levels within the microenvironments of tissue compartments. The PANINI-MIBI approach was used to measure over 30 parameters simultaneously across large sections of archival lymphoid tissues from non-human primates that were healthy or infected with simian immunodeficiency virus (SIV), a model that accurately recapitulates human immunodeficiency virus infection (HIV). This enabled multiplexed dissection of cellular phenotypes, functional markers, viral DNA integration events, and viral RNA transcripts as resulting from viral infection. The results demonstrated immune coordination from an unexpected upregulation of IL10 in B cells in response to SIV infection that correlated with macrophage M2 polarization, thus conditioning a potential immunosuppressive environment that allows for viral production. This multiplexed imaging strategy also allowed characterization of the coordinated microenvironment around latently or actively infected cells to provide mechanistic insights into the process of viral latency. The spatial multi-modal framework presented here is applicable to deciphering tissue responses in other infectious diseases and tumor biology.

The immune response in bacterial and viral infectious diseases

The actual medical situation, worrying for all humankind, induced by the COVID-19 pandemic, caused by a new type of coronavirus, SARS-CoV-2, mobilized the international medical research into knowing this type of virus and for finding the most appropriate solutions, as fast as pos­sible, in order to surrmount this global crisis. For a better un­der­standing of the immunological mechanisms which happen in human organisms in infectious diseases, in this article we tried to make a brief presentation of the immunological human response in case of bacterial and viral infections and, especially, of the immunological response in SARS-CoV-2 infection.

Covid‐19: Where We Are, What Got Us Here, and Where We Are Likely to Be Going—A Review Essay*

Covid‐19: Where We Are, What Got Us Here, and Where We Are Likely to Be Going—A Review Essay*

Early detection of COVID-19 in China and the USA: summary of the implementation of a digital decision-support and disease surveillance tool

ObjectivesRapid detection and surveillance of COVID-19 is essential to reducing spread of the virus. Inadequate screening capacity has hampered COVID-19 detection, while traditional infectious disease response has been delayed due...