Infectious Research Articles

Increased usage of doxycycline for young children with Lyme disease

BackgroundThe 2018 Infectious Disease Committee of the American Academy of Pediatrics stated that up to 3 weeks or less of doxycycline is safe in children of all ages. Our goal was to examine trends in doxycycline treatment for children with Lyme disease.MethodsWe assembled a prospective cohort of children aged 1 to 21 years with Lyme disease who presented to one of eight participating Pedi Lyme Net centers between 2015 and 2023. We defined a Lyme disease case with an erythema migrans (EM) lesion or positive two-tier Lyme disease serology categorized by stage: early-localized (single EM lesion), early-disseminated (multiple EM lesions, cranial neuropathy, meningitis, and carditis), and late (arthritis). We compared doxycycline treatment by age and disease stage and used logistic regression to examine treatment trends.ResultsOf the 1,154 children with Lyme disease, 94 (8.1%) had early-localized, 449 (38.9%) had early-disseminated, and 611 (53.0%) had late disease. Doxycycline treatment was more common for older children (83.3% ≥ 8 years vs. 47.1% < 8 years; p < 0.001) and with early-disseminated disease (77.2% early-disseminated vs. 52.1% early-localized or 62.1% late; p < 0.001). For children under 8 years, doxycycline use increased over the study period (6.9% 2015 to 67.9% 2023; odds ratio by year, 1.45; 95% confidence interval, 1.34–1.58).ConclusionYoung children with Lyme disease are frequently treated with doxycycline. Prospective studies are needed to confirm the safety and efficacy of doxycycline in children younger than 8 years, especially for those receiving courses longer than 3 weeks.

Fabrication of Ciprofloxacin-Loaded Sodium Alginate Nanobeads Coated with Thiol-Anchored Chitosan Using B-390 Encapsulator Following Optimization by DoE

Most infectious diseases of the gastrointestinal tract can easily be treated by exploiting the already available antibiotics with the change in administration approach and delivery system. Ciprofloxacin (CIP) is used as a drug of choice for many bacterial infections; however, long-term therapy and off-site drug accumulation lead to an increased risk of tendinitis and peripheral neuropathy. To overcome this issue, nanotechnology is being exploited to encapsulate antibiotics within polymeric structures, which not only facilitates dose maintenance at the infection site but also limits off-site side effects. Here, sodium alginate (SA) and thiol-anchored chitosan (TC) were used to encapsulate CIP via a calcium chloride (CaCl2) cross-linker. For this purpose, the B-390 encapsulator was employed in the preparation of nanobeads using a simple technique. The hydrogel-like sample was then freeze-dried, using trehalose or mannitol as a lyoprotectant, to obtain a fine dry powder. Design of Experiment (DoE) was utilized to optimize the nanobead production, in which the influence of different independent variables was studied for their outcome on the polydispersity index (PDI), particle size, zeta potential, and percentage encapsulation efficiency (% EE). In vitro dissolution studies were performed in simulated saliva fluid, simulated gastric fluid, and simulated intestinal fluid. Antibacterial and anti-inflammatory studies were also performed along with cytotoxicity profiling. By and large, the study presented positive outcomes, proving the advantage of using nanotechnology in fabricating new delivery approaches using already available antibiotics.

Sex-related immunity: could Toll-like receptors be the answer in acute inflammatory response?

An increasing number of studies have highlighted the existence of a sex-specific immune response, wherein men experience a worse prognosis in cases of acute inflammatory diseases. Initially, this sex-dependent inflammatory response was attributed to the influence of sex hormones. However, a growing body of evidence has shifted the focus toward the influence of chromosomes rather than sex hormones in shaping these inflammatory sex disparities. Notably, certain pattern recognition receptors, such as Toll-like receptors (TLRs), and their associated immune pathways have been implicated in driving the sex-specific immune response. These receptors are encoded by genes located on the X chromosome. TLRs are pivotal components of the innate immune system, playing crucial roles in responding to infectious diseases, including bacterial and viral pathogens, as well as trauma-related conditions. Importantly, the TLR-mediated inflammatory responses, as indicated by the production of specific proteins and cytokines, exhibit discernible sex-dependent patterns. In this review, we delve into the subject of sex bias in TLR activation and explore its clinical implications relatively to both the X chromosome and the hormonal environment. The overarching objective is to enhance our understanding of the fundamental mechanisms underlying these sex differences.

Modeling the Transmission Routes of Hepatitis E Virus as a Zoonotic Disease Using Fractional-Order Derivative

Hepatitis E virus (HEV) is one of the emerging zoonotic diseases in Sub-Saharan Africa. Domestic pigs are considered to be the main reservoir for this infectious disease. A third of the world’s population is thought to have been exposed to the virus. The zoonotic transmission of the HEV raises serious zoonotic and food safety concerns for the general public. This is a major public health issue in both developed and developing countries. The World Health Organization (WHO) estimated that 44,000 people died in 2015 as a result of HEV infection. East and South Asia have the highest prevalence of this disease overall. In this study, we proposed, developed, and analyzed the transmission routes of the infection using a fractional-order derivative approach. The existence, stability, and uniqueness of solutions were established using the approach and concept in Banach space. Local and global stability was determined using the Hyers–Ulam (HU) stability approach. Numerical simulation was conducted using existing parameter values, and it was established that, as the susceptible human population declines, the number of infected human populations rises with a change in fractional order θ^. When the susceptible pig population increases, the number of infected pig populations rises with a change in θ^. It was observed that a few variations in the fractional derivative order did not alter the function’s overall behavior with the results of numerical simulations. Moreover, as the number of recovered human populations increases, there is a corresponding increase in the population of recovered pigs with a change in θ^. The exponential increase in the infected pig population can be controlled by treatment of the infected pigs and prevention of the susceptible pigs. The authors recommend policymakers, and stakeholders prioritize the fight against the virus by enforcing the prevention of humans and treatment of infected pigs. The model can be extended to optimal control and cost-effectiveness analysis to determine the most effective control strategy that comes with less cost in the combat of the disease.

Species Composition and Feeding Behaviors of Vector Mosquitoes of Avian Infectious Diseases at a Wild Bird Rehabilitation Facility in Japan.

Although wild bird rehabilitation facilities are important for the conservation of wild species, individuals may be kept within the facilities for long periods, consequently posing a risk for the bird to be infected with pathogens to which they are not naturally exposed. In turn, novel pathogens may be introduced through rescued migratory species. Avian malaria and West Nile fever are important avian diseases transmitted by mosquitoes. To understand the transmission dynamics of such diseases at rehabilitation facilities, the ecology of vector mosquitoes, including species composition, seasonality, and feeding behaviors, were explored. Mosquitoes were collected at a wild bird rehabilitation facility and wildlife sanctuary in Japan from 2019 to 2020 using mouth aspirators, sweep nets, and light traps. A total of 2,819 mosquitoes of 6 species were captured, all of which are potential vectors of avian diseases. Culex pipiens pallens and Cx. pipiens form molestus were the dominant species (82.9% of all collected mosquitoes). Density and seasonality differed between sampling locations, presumably because of differences in mosquito behaviors including feeding preferences and responses to climatic factors. Blood-fed Culex mosquitoes fed solely on birds, and many mosquito species are thought to have fed on birds within the facility. Particularly, Cx. pipiens group probably fed on both rescued and free-living birds. The rehabilitation facility may be an important site for the introduction and spread of pathogens because 1) numerous mosquitoes inhabit the hospital and its surroundings; 2) blood-fed mosquitoes are caught within the hospital; 3) there is direct contact between birds and mosquitoes; 4) both birds within the hospital and wild birds are fed upon. Furthermore, blood-fed Cx. pipiens form molestus were observed in the winter, suggesting that pathogens might be transmitted even during the winter when other mosquito species are inactive.

A SAW-Based Programmable Controlled RNA Detecting Device: Rapid In Situ Cytolysis-RNA Capture-RNA Release-PCR in One Mini Chamber.

Viral RNA detection is crucial in preventing and treating early infectious diseases. Traditional methods of RNA detection require a large amount of equipment and technical personnel. In this study, proposed a programmable controlled surface acoustic wave (SAW)-based RNA detecting device has been proposed. The proposed device can perform the entire viral RNA detection process, including cell lysis by cell-microparticle collision through SAW-induced liquid whirling, RNA capture by SAW-suspended magnetic beads, RNA elution through SAW-induced high streaming force, and PCR thermal cycling through SAW-generated heat. The device has completed all RNA detection steps in one mini chamber, requiring only 489 µl reagents for RNA extraction, much smaller than the amount used in manual RNA extraction (2065 µl). The experimental results have shown that PCR results from the device are comparable to those achieved via commercial qPCR instrumental detection. This work has demonstrated the potential of SAW-based lab-on-a-chip devices for point-of-care testing and provided a novel approach for rapidly detecting infectiousdiseases.

Varroa destructor economic injury levels and pathogens associated with colony losses in Western Canada

IntroductionThe honey bee parasitic mite, Varroa destructor, is considered the main factor associated with winter colony losses. To control this mite, beekeepers must implement Integrated Pest Management (IPM) strategies. An effective IPM strategy is based on timely monitoring of mite levels to treat the colonies when the mites reach an economic threshold and before they grow to damaging levels (economic injury level). Additionally, concerns have been raised about the possible interaction between V. destructor and other stressors; stressors acting additively or synergistically may lead to high colony mortality.MethodologyVarroa destructor levels were recorded in colonies from five regions of British Columbia, Canada: Lower Mainland, Kootenay, Okanagan, Cariboo, and Peace. Mite levels were analyzed for associations with colony strength and mortality, as well as with other pathogens that were identified using total RNA sequencing.ResultsThe Kootenay and Lower Mainland regions had the highest V. destructor levels in the fall (3.38±0.65 and 2.51±0.57, respectively) followed by the Okanagan (1.54±0.36), Cariboo (1.31±0.39), and Peace (0.66±0.25) regions. The Peace region had a significantly lower proportion of dead colonies than the other regions. Varroa destructor levels in the fall significantly predicted odds of colony mortality in the spring. Colonies with ≥ 1% mite infestation in the fall (August) had a significantly higher mortality rate (p=0.005) compared to colonies with <1% mite levels. Therefore, treatment is recommended above that threshold. Also, deformed wing virus-B levels were 8.4 times higher than those of deformed wing virus-A variant in all the regions and were highest in the Kootenay region, which also had the highest rate of colony losses. Lastly, Malpighamoeba mellificae and Nosema (Vairimorpha) apis transcripts were identified along with other pathogens that deserve further investigation, including Apis mellifera filamentous virus, Apis rhabdovirus, Lake Sinai virus, Varroa tymo-like, and Apis mellifera solinvivirus 1.DiscussionThe dynamic nature of host-pathogen interactions requires frequent pathogen surveillance to determine the prevalence and levels of parasitic mites and associated infectious diseases, and their impact on honey bee health, not only in the regions of this study, but globally. Nevertheless, more studies are needed to determine the nature of the type of interaction between the identified pathogens and V. destructor. Also, more research is needed to evaluate their potential impact on colony survival, to provide accurate mite and disease control recommendations to beekeepers.

The Effect of Combinations of Antibiotics and Natural Products on the Antimicrobial Resistance of Staphylococcus aureus and Pseudomonas aeruginosa

Introduction/Background The steadily increasing bacterial resistance to existing antimicrobial drugs is a significant issue, hence, it is imperative to look out for new approaches to bacterial therapy Occasionally, effective inhibitory action is not produced when antibiotics are used alone. To overcome this problem, a combination of drugs is often used. One approach to treat infectious diseases is the use of a combination of antibiotics together with plant extracts or phytochemicals. For patients with serious infections caused by pathogens resistant to drugs, combination therapy is beneficial and useful. Materials and Methods Seven antibiotics were obtained from a local pharmacy (gentamicin, ceftazidime, ciprofloxacin, doxycycline, amoxicillin, ceftriaxone, and azithromycin). Minimum inhibitory concentrations (MIC) were determined by broth micro-dilution method, and different antimicrobial combinations were studied on 20 Multidrug-resistant (MDR) clinical isolates (10 S. aureus and 10 P. aeruginosa). Moreover, the antibacterial activity of some volatile oils (limonene, rosemary, salvia, thymus, and black pepper), plant extracts (moringa seed, curcumin, and capsicum), and phytochemicals (thymol, and chitosan) was detected against S. aureus and P. aeruginosa isolates using broth micro-dilution method. Results According to our findings, ceftriaxone and ciprofloxacin or gentamicin together exhibited a substantial synergistic effect against S. aureus. Moreover, the combination of amoxicillin with ceftazidime was synergistic to reduce MIC by five to six times. Regarding MDR clinical isolates of P. aeruginosa, the combination of azithromycin with doxycycline exhibited a decrease of MIC of azithromycin by about five to sixfold. The combination of gentamicin with ceftriaxone was significant. For natural compounds, thymol, rosemary oil, curcumin, capsicum, and moringa seed extract exhibited the highest synergistic activity with the tested antibiotics against S. aureus and P. aeruginosa. Conclusion In conclusion, the lack of new antibiotics necessitates the improvement of existing ones. Our study shows that antibiotic combinations and antibiotic-natural plant combinations are very promising strategies for combating complex bacterial resistance.

Infectious diseases in Poland in 2021.

OBJECTIVE OF THE WORK. As 2021 was the second year of COVID-19 pandemic we expect the continuous impact of the pandemic on other infectious diseases. We aimed at reviewing the national infectious surveillance data based on available surveillance reports (Epidemiological Chronicle) to summarize the infectious disease situation in 2021. MATERIAL AND METHODS. National infectious disease surveillance system collects mandatory notifications from physicians and laboratories as well as epidemiological investigation reports prepared by State Sanitary Inspection, where relevant. We also include mortality data based on the reports of Statistics Poland office. RESULTS AND DISCUSSION. In 2021, there were 2,852,789 cases of COVID-19 reported, corresponding to the incidence of 7475.4 per 100,000 and 90,126 deaths related to COVID-19. For most of diseases the incidence remained lower than before the pandemic. This included influenzea and influenzea-like illness incidence (- 5.4% vs 2020 and - 37.6% vs median 2015-2019) and tuberculosis incidence (+9.3% vs 2020 and -35.9% vs median 2015-2019). The incidence was lower than in 2020 for: pertussis (-75.7%), measles (-54.9%), rubella (48.7%), mumps (-16.4%), chickenpox (-19.0%) or H. influenzea invasive disease (-33.0%). A notable exception to these trends was Clostridium difficile intestinal infections incidence, which was higher by 88.2% from the 2015-2019 median with 21,157 case and 1,120 fatalities reported in 2021. There was also an almost 4-fold increase in norovirus infections incidence. The number of chronic hepatitis infections diagnoses were substantially lower than median for 2015-2019 (-53.7% for HBV and - 68.8% for HCV). The COVID-19 pandemic still played the crucial role as a public health problem, but its impact on other infectious diseases was less clear than in 2020. The reduction in the number of registered cases was with likely attributable to non-pharmaceutic interventions and to delays in registration due to reduced public health resources.

The exploration of cell population data in clinical use: Beyond infectious diseases

AbstractCell population data (CPD) is regarded as the fingerprint of a blood cell at a given moment. CPD parameters harbor information associated with cell morphology and can be automatically generated using modern hematological analyzers. Various studies have revealed many unique clinical applications for CPD, especially for infectious diseases, such as sepsis. For example, one monocyte‐related CPD parameter is the monocyte distribution width (MDW), which can be generated using a Beckman Coulter hematological analyzer. MDW has received FDA and CE approval for aiding in sepsis diagnosis in adult patients in the emergency department. Additionally, MDW can serve as a diagnostic biomarker in patients infected with SARS‐CoV‐2. CPD has also been widely explored for possible clinical applications beyond infectious diseases, such as for predicting myelodysplastic syndromes, screening for hematological malignancies, and detecting sterile inflammation. CPD parameter measurements are easily obtained and quite cost‐effective, making them practical for clinical use. However, there are some potential drawbacks of CPD parameters. Some pre‐analytical conditions can affect CPD values. Furthermore, CPD are specific to certain hematological analyzers and the result cannot be transferred between different analyzers. The practical usefulness of CPD reference intervals is also still questionable. In this review, wesummarize the current studies related to CPD and its clinical applications. Additional well‐designed clinical studies related to CPD are still expected.

Salmonellosis in Poland in 2021.

The aim of the article is to present and assess the epidemiological situation of salmonellosis in Poland in 2021, in relation to previous years. The assessment of the epidemiological situation of salmonellosis in Poland was made on the basis of individual data on salmonellosis cases, entered by sanitary-epidemiological stations into the EpiBaza System, data on outbreaks caused by Salmonella bacilli from the Registry of Epidemic Outbreaks System (ROE), as well as on the basis of aggregated data published in the annual bulletins "Infectious Diseases and Poisoning in Poland" (NIPH NIH - NRI, GIS, Warsaw), including information sent by laboratories of sanitary-epidemiological stations, data from the article on the epidemiological situation of salmonellosis in Poland in 2020 and data from the Demographic Research Department of the Central Statistical Office. In 2021, in Poland sanitary-epidemiological stations registered 8,294 cases of salmonellosis - 8,014 cases of intestinal salmonellosis and 280 extra-intestinal salmonellosis, including 190 cases of salmonellosis septicemia. The incidence rate for total salmonellosis was 21.7/100,000 population, for intestinal salmonellosis 21.0, for salmonellosis septicemia 0.50, and 0.23 per 100,000 population for other extra-intestinal infections of salmonellosis etiology. The reported 7,988 cases were classified as confirmed and 306 as probable. There were 5,127 hospitalizations due to salmonellosis, mainly children and the elderly. The peak of the incidence was registered in July. The highest incidence rate of salmonellosis in 2021 was recorded in the Podkarpackie voivodeship (39.8/100,000 population), the lowest in the Świętokrzyskie voivodeship (10.7/100,000 population). The highest incidence of intestinal salmonellosis was registered in the age group 0-4 years, accounting for 44.2% of the total number of cases. Among extra-intestinal infections, almost 62% of cases occurred in people aged 60+. In 2021, sanitary-epidemiological stations were detected and reported 229 outbreaks of food poisoning caused by Salmonella bacilli, 75% of them was Enteritidis serotype. In 2021, the most frequently isolated serotypes were S. Enteritidis 72%, S. Typhimurium (2%) and S. Infantis (0.5%). The serotype was not determined in 24.3% of cases. There were 24 imported cases of salmonellosis from different regions of the world. Due to Salmonella infection 11 people died in 2021. Laboratories of sanitary-epidemiological stations performed 438,183 tests for the presence of Salmonella and Shigella bacilli among humans, 92% of these tests concerned people working in contact with food. In 2021, there was an increase in the number of salmonellosis cases in Poland, compared to 2020. It can therefore be concluded that the COVID-19 pandemic did not have a long-term impact on reducing the number of Salmonella infections. At the same time, despite the increase, the situation of salmonellosis in Poland has not fully returned to the state before the COVID-19 pandemic.The area where we observe a significant difference, is the percentage of hospitalizations, which is the lowest in 2021 since 1998. It can be assumed, that one of the reasons for this, could be a stricter qualification of people with milder symptoms for hospital treatment, in favour of outpatient care.

Chickenpox in Poland in 2021.

Chickenpox is a highly contagious disease, but one that can be effectively prevented by vaccination. In Poland, vaccination against the disease is recommended, paid for, and chickenpox remains very common. In recent years, starting in 2002, the upward trend in the incidence of chickenpox has continued, except in 2020. In 2020, there was a decrease in incidence. The aim of this study was to evaluate epidemiological indicators of chickenpox in Poland in 2021 compared to previous years, taking into account the impact of the COVID-19 pandemic. The evaluation of the epidemiological situation of chickenpox in Poland in 2021 was carried out based on the results of the analysis of aggregate data published in the annual bulletins: "Infectious Diseases and Poisons in Poland in 2021" and "Immunization in Poland in 2021". In addition, recommendations from the 2021 Immunization Program are described. 57,669 cases of chickenpox were registered in Poland in 2021, 42% less than in the previous year. The incidence of chickenpox in 2021 was 151.1 per 100,000, which was lower than in 2020, as well as in 2019, when it was 470.6/100,000. The lowest incidence was registered in Lower Silesia Province - 99.2/100,000, while the highest in Silesia Province - 215.8/100,000. The highest incidence was in children aged 0-4 years (18,028). The incidence of chickenpox in males was higher than in females (159.5 vs. 143.3/100 thousand), and urban residents were higher than rural residents (152.1 vs. 149.6/100 thousand). Hospitalization due to chickenpox in 2021 included 210 people, which accounted for 0.36% of the total number of registered cases. In 2021, there was a decrease in the number of chickenpox cases compared to the previous year. The lower incidence may have been the result of a decrease in the transmission of the chickenpox virus, the decrease in the number of cases has to do with, among other things, the restrictions put in place in connection with the COVID-19 pandemic, which result in, among other things, reduced human contact, the wearing of masks and increased social distance.

Rubella in Poland in 2021.

Rubella is a viral infectious disease, and humans are the only reservoir of the virus. In 2020, all WHO member countries conducted epidemiological surveillance for rubella, and almost all (99%) had access to rubella testing at laboratories operating under the WHO Global Measles and Rubella Laboratory Network. The aim of this study was to evaluate epidemiological indicators of rubella in Poland in 2021 compared to previous years, taking into account the impact of the COVID-19 pandemic. The assessment of the epidemiological situation was based on a review of data from the bulletin , "Infectious Diseases and Poisons in Poland in 2021" (5), and the assessment of the immunization status of the population was based on data from the bulletin , "Immunization in Poland in 2021" (6). Classification of cases was made based on the definition used in the 2021 surveillance (7). Data from the epidemiological surveillance system "EpiBase" were also used. In 2021, 50 cases of rubella were registered, 48 fewer than in 2020 (98 cases). There was also a decrease in incidence to 0.13 per 100,000, compared to 0.26 per 100,000 in 2020. The highest incidence, regardless of gender and residential environment, was recorded in the 0-4 age group (1.23 per 100 thousand). No cases of congenital rubella syndrome were reported in 2021. In 2021, there was a decrease in the number of rubella cases in Poland, which could be a result of the COVID-19 pandemic and the introduced restrictions. In addition, rubella was registered 99% on the basis of clinical diagnoses, without the required laboratory confirmation, which means that other rash diseases could be registered as rubella.

Measles in Poland in 2021.

Measles is one of the most contagious childhood diseases, and the behavior also occurs in adults. This is a multi-year vaccination covered by an elimination program coordinated by the World Health Organization (WHO). Elimination of measles in the country is conditional on a 95% incidence of infection with two victims, monitoring the epidemiological situation, registering all suspected cases of measles, and monitoring by the WHO Reference Laboratory. In our country, the Department of Virology of the NIZP PZH-PIB in Warsaw serves as the head of the Department of Virology. The aim of this study was to evaluate epidemiological indicators of measles in Poland in 2021 compared to previous years, taking into account the impact of the COVID-19 pandemic. The assessment of the epidemiological situation was based on a review of data from the bulletin, "Infectious Diseases and Poisons in Poland in 2021" (5), and the assessment of the immunization status of the population was based on data from the bulletin, "Immunization in Poland in 2021" (6). Classification of cases was made based on the definition used in the 2021 surveillance (7). Data from the epidemiological surveillance system "EpiBase" were also used. In 2021, 13 measles cases were registered in Poland (incidence 0.03 per 100,000), 44.8% less than in 2020 and 80% less than the median in 2014-2018. In 2021, the highest incidence was recorded at 0.32 per 100,000 children aged 0-4 years. 6 patients (46.2%) were hospitalized; no deaths due to measles were reported. 32 suspected measles cases were recorded, with over a hundred cases expected. Vaccination status of children aged 3 with the first dose was 90.8%, and the second dose was given to children at the age of 9. - 84.6%. Epidemiological indicators of measles in 2021 in Poland compared to 2020 have decreased. A similar trend observed throughout Europe. This is related to the extinguishment of outbreaks that occurred before the pandemic, mainly in 2019.

Status of zoonotic disease research in refugees, asylum seekers and internally displaced people, globally: A scoping review of forty clinically important zoonotic pathogens.

At the end of 2022, there were over 108 million forcibly displaced people globally, including refugees, asylum seekers (AS) and internally displaced people (IDPs). Forced migration increases the risk of infectious disease transmission, and zoonotic pathogens account for 61% of emerging and re-emerging infectious diseases. Zoonoses create a high burden of disease and have the potential to cause large-scale outbreaks. This scoping review aimed to assess the state of research on a range of clinically relevant zoonotic pathogens in displaced populations in order to identify the gaps in literature and guide future research. Literature was systematically searched to identify original research related to 40 selected zoonotic pathogens of interest in refugees, AS and IDPs. We included only peer-reviewed original research in English, with no publication date restrictions. Demographic data, migration pathways, health factors, associated outbreaks, predictive factors and preventative measures were extracted and synthesized. We identified 4,295 articles, of which 347 were included; dates of publications ranged from 1937 to 2022. Refugees were the most common population investigated (75%). Migration pathways of displaced populations increased over time towards a more complex web, involving migration in dual directions. The most frequent pathogen investigated was Schistosoma spp. (n = 99 articles). Disease outbreaks were reported in 46 publications (13.3%), with viruses being the most commonly reported pathogen type. Limited access to hygiene/sanitation, crowding and refugee status were the most commonly discussed predictors of infection. Vaccination/prophylaxis drug administration, surveillance/screening and improved hygiene/sanitation were the most commonly discussed preventative measures. The current research on zoonoses in displaced populations displays gaps in the spectrum of pathogens studied, as well as in the (sub)populations investigated. Future studies should be more inclusive of One Health approaches to adequately investigate the impact of zoonotic pathogens and identify transmission pathways as a basis for designing interventions for displaced populations.

Design of SARS-CoV-2 protein S peptides recognized by the most frequent HLA alleles in the Moroccan population using an immunoinformatics approach

Background The coronavirus disease 2019 (COVID-19) is an infectious disease, caused by the new coronavirus known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and exhibits diverse clinical outcomes and symptoms in infected individuals, emphasizing the need to investigate how human genetic diversity influences the virus’s impact. This study aims to employ in silico methods to identify epitopes capable of eliciting an immune response, focusing on the most prevalent HLA-I and HLA-II alleles in the Moroccan population. Methods Our research consisted in predicting peptide-binding affinities between the most prevalent HLA Class I and Class II alleles in the Moroccan population and SARS-CoV-2 spike glycoprotein (S protein) peptides of variants isolated from strains of Moroccan patients. We performed the same analyses for SARS-CoV-2 wild type S protein to assess the ability of these HLA alleles to interact with peptides in the presence or absence of SARS-CoV-2 mutations. Results In a broader sense, 12 distinct HLA Class I and Class II alleles in the Moroccan population have been identified as possibly interacting with 19 epitopes in the SARS-CoV-2 S protein. Findings of this study must be validated in both in vitro and in vivo models. Conclusions These data may help clarify the issue of host cell susceptibility and the outcome of SARS-CoV-2 infection, and may guide further research to uncover potential targets for the vaccination strategy.

Giardioza (Lamblioza) w Polsce w 2021 roku.

Giardiosis is a parasitic disease caused by the protozoa Giardia lamblia (also known as Giardia intestinalis and Giardia duodenalis), which causes gastrointestinal symptoms. Infection usually occurs through the ingestion of contaminated water/food or through contact with an infected person. In Poland, giardiasis is notifiable disease, acoording to the EU deffinition implement in the polish surveillance system. The aim of this study is to asses epidemiological situation of giardiasis in Poland in 2021 and compare it to the previous years. The assessment of the epidemiological situation of giardiasis in Poland in 2021 was performed on the basis of data from the annual bulletins "Infectious diseases and poisoning in Poland" for the years 2008-2021, data on individual cases collected for the purposes of epidemiological surveillance in the EpiBaza system and data from food-born outbreak investigations recorded in the Registry of Epidemic Outbreaks (ROE). In 2021, 559 cases of giardiasis were reported in Poland (558 confirmed case, 1 probable case). There was an increase in the number of reported cases in comparision to 2020 by 56% and decrease to 2019 by 29%. Cases of giardiasis were reported in all voivodeships, with the highest incidence rate in Podlaskie voivodeship (9.1/100 000), incidence rate for Poland was 1.5/100 000. Giardiasis was diagnosed in patiens in all age group, the largest group of patiens were children (age groups 0-4 and 5-9). The hospitalization rate of patients diagnosed with giardiasis was 9.7% and was lower than in 2020, when it was 12.4%. As in previous years, no deaths from giardiasis were reported. The number of cases of giardiasis has increased compared to 2020, but has not reached pre-pandemic levels. As in previous years, differences in the incidence by age and sex of people with the disease were noted when comparing data reported from Poland and EU/EEA countries.

Matched vs Nonmatched Placebos in a Randomized Trial of COVID-19 Treatments

Matched placebo interventions are complex and resource intensive. Recent evidence suggests matched placebos may not always be necessary. Previous studies have predominantly evaluated potential bias of nonmatched placebos (ie, differing on dose, frequency of administration, or formulation) in pain and mental health, but to date no systematic examination has been conducted in infectious disease. To test for differences between nonmatched and matched placebo arms with respect to clinical outcome measures across multiple therapeutics for COVID-19. In a comparative effectiveness research study, a post hoc analysis was conducted of data on individual patients enrolled in a large, multiarm, platform randomized clinical trial in symptomatic adult outpatients with COVID-19 between January 15, 2021, to September 28, 2023, in which the outcomes of both matched and nonmatched placebo groups were reported. Bayesian and frequentist covariate-adjusted techniques were compared with 7 intervention-placebo pairs. Seven matched and nonmatched placebo pairs (for a total of 7 comparisons) were evaluated throughout the primary platform trial. Comparisons were made between treatment and its associated matched (concurrent) placebo, as well as with nonmatched placebo (alone and in combination) assessed at a similar time point. Outcomes assessed included hospitalizations, EuroQol 5-Dimension 5-level scores, and PROMIS Global-10 scores. A total of 7 intervention-control pairs (N = 2684) were assessed, including 1620 (60.4%) women, with mean (SD) age, 47 (15.2) years; the most common comorbidities were obesity (41.9%) and hypertension (37.9%). In a meta-analysis with decoupled SEs, accounting for overlapping placebo patients, the overall odds ratio (OR) of nonmatched compared with matched placebo was 1.01 (95% credible interval, 0.77-1.32), with posterior probability of equivalence, defined as 0.8 ≤ OR ≤ 1.2 (a deviation from perfect equivalence ie, OR = 1, by no more than 0.2) of 85.4%, implying no significant difference. Unadjusted analysis of the event rate difference between all nonmatched and matched placebo groups did not identify any notable differences across all 7 treatment-placebo combinations assessed. Similar analysis that was conducted for patient-reported quality of life outcomes did not yield statistically significant differences. In this post hoc study of a randomized clinical platform trial, pooling matched and nonmatched placebo patient data did not lead to inconsistencies in treatment effect estimation for any of the investigational drugs. These findings may have significant implications for future platform trials, as the use of nonmatched placebo may improve statistical power, or reduce barriers to placebo implementation.

Crack Cocaine Use and Mortality Risk: A Follow-Up Study on 178 Individuals in Drug Treatment for Crack Cocaine Problems

Background: In Europe, crack cocaine use is mainly observed in vulnerable and marginalized groups, many of whom have other substance use problems, including heroin-related problems. Objectives: To examine mortality risk and causes of death in a cohort of crack users.Methods: We performed a follow-up study to assess mortality in a cohort of patients who entered drug treatment for crack cocaine problems in the metropolitan area of Bologna (Northern Italy) from 1992 to 2020.Results: Most of participants were polydrug users, 75% reported concomitant heroin, 55% cocaine and 24% alcohol use; 43% have injected a substance. Mortality was six times higher than in the general population, and overdose and infectious diseases were among the leading causes of death.Conclusions: Longitudinal epidemiological studies are needed to systematically assess the health outcomes of crack cocaine use.

Molecular Identification of Ascomycetes from American Cranberry (Vaccinium macrocarpon Aiton) Grown in Plantation in Poland

The American cranberry is a perennial North American fruit plant that is grown successfully on commercial plantations in Poland. The purpose of this study was to recognize filamentous fungi that colonize roots, leaves, and fruits without visible disease symptoms. Pure fungal cultures were isolated from disinfected plant fragments in agar media and identified by sequencing common taxonomic DNA markers such as the ITS region, the TEF-1α, or RPB2 genes. Of the 141 isolates studied, 59% were identified as closely related to soil saprotrophs. They were classified primarily as showing the greatest similarity to type strains of Trichoderma amoenum, Trichoderma dorothopsis, Paraphaeosphaeria sporulosa, and Penicillium murcianum. Additionally, isolates that are most similar to strains of Penicillium crustosum, Aspergillus flavus, and Aspergillus versicolor that produced mycotoxins were detected. The fungi identified as closest to Alternaria geophila, Alternaria senecionicola, Paraphoma radicina, Pestalotiopsis unicolor, Pestalotiopsis scoparia, and Neopestalotiopsis spp., whose hosts are plants other than American cranberry, represented 33.81% of the isolates tested. Only 7.2% of the isolates corresponded to the species of Physalospora vaccinia, Diaporthe vaccinii, and Diaporthe eres, known cranberry pathogens. The results of this study can be used to identify latent plant infection and potential disease risks.