Intensity Of Outbreaks Research Articles

A deep dive into chickenpox epidemiology and outbreaks: A retrospective study in a tribal-dominated district of Western India

Objectives: This retrospective observational study conducted in the district of Dadra and Nagar Haveli, Western India, over the past 9 years aimed to comprehensively investigate the epidemiology of chickenpox. The objectives were to analyze demographic and clinical characteristics, examine temporal trends, identify outbreak locations, assess outbreak intensity and duration, determine laboratory-confirmed cases, and provide insights for public health interventions. Materials and Methods: The study employed a retrospective approach, gathering data on chickenpox cases in the region. Demographic information, clinical profiles, and outbreak details were analyzed. Temporal variations and seasonal trends were assessed. Laboratory confirmation was achieved through serology and molecular methods. Locations of outbreaks were identified, and their characteristics were evaluated. Results: The study revealed that the 6–10 age groups were most vulnerable, with mild-to-moderate symptoms predominantly observed. Significant variations in cases occurred year round, with peaks between November and February. Out of 25 recorded outbreaks and three early warning signals, Aganwadis, play schools, and schools were common outbreak locations. Most outbreaks were low intensity, and laboratory confirmation identified Clade-1 Varicella-Zoster virus as the causative agent. Conclusion: These findings provide essential insights for public health officials. Identifying the vulnerable age group and high-risk locations allows for targeted vaccination campaigns. Moreover, the study underscores the need for continuous monitoring and surveillance to detect outbreaks early and mitigate their spread effectively, emphasizing the importance of proactive prevention and control measures for chickenpox in the region.

Modeling the impact of COVID-19 nonpharmaceutical interventions on respiratory syncytial virus transmission in South Africa.

The South African government employed various nonpharmaceutical interventions (NPIs) to reduce the spread of SARS-CoV-2. Surveillance data from South Africa indicates reduced circulation of respiratory syncytial virus (RSV) throughout the 2020-2021 seasons. Here, we use a mechanistic transmission model to project the rebound of RSV in the two subsequent seasons. We fit an age-structured epidemiological model to hospitalization data from national RSV surveillance in South Africa, allowing for time-varying reduction in RSV transmission during periods of COVID-19 circulation. We apply the model to project the rebound of RSV in the 2022 and 2023 seasons. We projected an early and intense outbreak of RSV in April 2022, with an age shift to older infants (6-23 months old) experiencing a larger portion of severe disease burden than typical. In March 2022, government alerts were issued to prepare the hospital system for this potentially intense outbreak. We then assess the 2022 predictions and project the 2023 season. Model predictions for 2023 indicate that RSV activity has not fully returned to normal, with a projected early and moderately intense wave. We estimate that NPIs reduced RSV transmission between 15% and 50% during periods of COVID-19 circulation. A wide range of NPIs impacted the dynamics of the RSV outbreaks throughout 2020-2023 in regard to timing, magnitude, and age structure, with important implications in a low- and middle-income countries (LMICs) setting where RSV interventions remain limited. More efforts should focus on adapting RSV models to LMIC data to project the impact of upcoming medical interventions for this disease.

Grasshopper Species Composition and Severe Attack in the Semi-Arid Region of Rajasthan, India

Adequate knowledge is needed to know when grasshopper species abundance shifts and to follow severe outbreaks during microclimatic variations. Grasshoppers regularly cause enormous harm to a wide variety of crops and grazing lands; sometimes they show a potential attack on particular crops. A study was carried out in the southern region of Jaipur, Rajasthan, where 11 sites were weekly sampled to monitor grasshopper population dynamics, grasshopper densities, species composition, and vegetation loss from July 2021 to December 2022. A serious grasshopper attack was reported in 2021, with the highest grasshopper densities ranging from 5 to 17.5 per m2, whereas grasshopper densities dropped in 2022 from 4 to 14.5 per m2. In the survey area, the acridid grasshopper Hieroglyphus banian (Acrididae:Orthoptera) was reported as the most abundant species that was accountable for the majority of the crop damage in agricultural fields, followed by Spathosternum praciniferaum and Acrida turrita, respectively. The grasshopper population density was revealed to be significantly different in 2021 and 2022 (t = 1.568, df = 20, P = 2.086). Severe infestation was observed in all of the pearl millet fields and also in seasonal crops and vegetables, where H. banian caused 91% infestation, followed by S. praciniferaum with 7% and A. turrita with 2%, respectively. The study confirmed that climatic factors were significantly related to outbreaks and assessed their effect, which revealed a rare population in the summer season and peaked in the monsoon season. The finding provides important information for grasshopper risk forecasting, which is advantageous for preparing grasshopper risk maps, predicting the intensity of outbreaks, and developing an integrated pest management plan.

Confronting the cycle synchronisation paradigm of defoliator outbreaks in space and time—Evidence from two systems in a mixed‐species forest landscape

Abstract Defoliators cause extensive damage in boreal and temperate forests of the world. Considerable effort has been invested to understand their individual population dynamics, and despite ample theorising, there is little empirical evidence on factors causing spatial synchrony of pest eruptions at landscape scales. We report on the landscape‐level effect of forest configuration and composition on the intensity of outbreaks of spruce budworm and forest tent caterpillar in a mixedwood boreal forest in northern Minnesota (USA) and adjacent Ontario (Canada), and how this is related to the degree of spatial synchrony in each species' outbreak cycling. Using a large spatiotemporal tree‐ring reconstruction of outbreak impacts across these two systems, we evaluate two contrasting theories governing defoliator outbreaks: harmonic oscillation (a.k.a. ‘clockwork’) and relaxation oscillation (a.k.a. ‘catastrophe’), each with consequences linked to top‐down versus bottom‐up influences on outbreak behaviour in time and space. We find synchrony varies temporally, among outbreak cycles and in direct proportion to cycle peak intensity; however, cycle peak intensities are distributed bimodally in time, and so, therefore, are synchrony coefficients. Spatially, the area where each pest species currently cycles with the greatest peak intensity and synchrony is where their preferred host trees are currently found in greatest proportion. Despite overall synchrony in cycling, we found, in both systems, a persistent negative spatial correlation among successive eruptive pulses of defoliation. Many of these eruptions failed to spread spatially and to coalesce with other spot eruptions to form extensive area‐wide outbreaks. Eruptions often fail to spread at the hardwood‐conifer interface, resulting in outbreak pulses that systematically bounce back and forth between landscape types, particularly when systems were cycling at low amplitude. These over‐dispersed spatial patterns of pulse impact are consistent with a contagious theory of eruption and outbreak spread. They could be considered consistent with harmonic oscillation theory only for populations cycling at different frequencies, with cycling frequency determined by host forest landscape structure. Synthesis. We find that defoliator outbreak dynamics across systems include spatiotemporal signatures of each theoretical paradigm—suggesting a hybrid approach will better characterise outbreak behaviour. Host concentration influences which paradigm dominates the spatial dynamics in any given forest landscape context. Because of the synchronising effect of host concentration on forest insect spatial dynamics, mixedwoods appear to be less prone to intense, synchronised defoliator attack than forests of pure hardwood or pure conifer.

Institutional outbreaks of influenza-like illnesses in the state of São Paulo: an analysis of the epidemiological profile during the COVID-19 pandemic

ObjectivesThis study aimed to spatiotemporally analyze the profile of influenza-like illness (ILI) outbreaks in the state of São Paulo, Brazil, between 2020 and 2022. Study designThis was a cross-sectional retrospective study. MethodsOutbreaks of ILI with final diagnoses of COVID-19, influenza, or other respiratory viruses (ORVs) recorded between January 2020 and November 2022, obtained from the Notifiable Diseases Information System (SINAN NET) Outbreak module, were analyzed. Kernel density estimates and Getis-Ord Gi∗ statistics were performed to identify spatial clusters. ResultsA total of 13,314 ILI outbreaks were identified, involving 130,568 cases and 2649 deaths. Of these, 104,399 (80%) were confirmed as COVID-19, 15,861 (12%) were confirmed as ORV, and 10,308 (8%) were confirmed as influenza. The year 2021 had the highest number of outbreaks and cases. Schools recorded the most outbreaks and cases, followed by long-term care facilities for older adults (LTCs). The highest average number of cases per outbreak and the highest attack rates occurred at social gatherings and prisons. Prisoners were three times more likely to contract COVID-19 during outbreaks than people in other institutions. The highest hospitalization and mortality rates for all virus types occurred in the LTC group. The occurrence and intensity of outbreaks were highly heterogeneous among the different institutions after the introduction of new SARS-CoV-2 variants in the state. ConclusionsILI outbreaks were not randomly distributed; they clustered in specific areas. Transmissibility varied among different institutions with different responses to the COVID-19 pandemic. These results can be used as a basis for prioritizing actions and allocating resources during future pandemics.

Comprehensive bibliometric research in neuroscience: focusing on ophthalmology.

This study aimed to comprehensively summarize the knowledge structure and research hotspots of ophthalmology in the field of neuroscience through bibliometric and visual analysis. We searched the Web of Science Core Collection database for articles from 2002 to 2021 related to ophthalmology in the field of neuroscience. Using VOSviewer and CiteSpace, bibliometric analysis was conducted on the number of annual ophthalmology publications, authors, organizations, countries, journals, cited references, keywords, and burst keywords. A total of 9,179 articles were published from 34,073 authors, 4,987 organizations, and 87 countries. The cited references in these articles were published in 23,054 journals. Moreover, there were 30,864 keywords among the 9,179 articles. Notably, scholars have increasingly begun paying attention to ophthalmology in the field of neuroscience in the past 20 years. Claudio Babiloni published the most articles. The University of Washington had the greatest number of articles. The United States, Germany, and England led in the number of articles published. The Journal of Neuroscience was the most cited. The article with the highest outbreak intensity was an article published by Maurizio Corbetta in Nature Reviews Neuroscience in 2002 entitled "Control of goal-directed and stimulus-driven attention in the brain." The most important keyword was the brain, and the top burst keyword was functional connectivity. This study visualized ophthalmology research in the field of neuroscience through bibliometric analysis and predicted potential research trends in future to help clinicians and basic researchers provide diversified perspectives and further carry out in-depth research on ophthalmology.

Enterovirus D68 Outbreak in Children, Finland, August–September 2022

We observed an intense enterovirus D68 outbreak in children in southwest Finland in August-September 2022. We confirmed enterovirus D68 infection in 56 children hospitalized for respiratory illnesses and in 1 child with encephalitis but were not able to test all suspected patients. Continuing surveillance for enterovirus D68 is needed.

Time-dependent vaccine efficacy estimation quantified by a mathematical model.

In this paper we calculate the variation of the estimated vaccine efficacy (VE) due to the time-dependent force of infection resulting from the difference between the moment the Clinical Trial (CT) begins and the peak in the outbreak intensity. Using a simple mathematical model we tested the hypothesis that the time difference between the moment the CT begins and the peak in the outbreak intensity determines substantially different values for VE. We exemplify the method with the case of the VE efficacy estimation for one of the vaccines against the new coronavirus SARS-CoV-2.

Spatial and temporal distribution of emerging airborne viral infectious diseases outbreaks on a global scale.

This study aimed to explore the spatial and temporal characteristics of emerging airborne viral infectious diseases outbreaks worldwide. We conducted a systematic literature review on outbreaks of emerging airborne viral infectious diseases and calculated outbreak number and intensity at the country level. Fisher's exact test was used to compare the viral infectious diseases outbreaks in different income-level regions. To identify the major airborne viral infectious diseases outbreaks, we ranked and extracted the leading viral infectious diseases in outbreak number and intensity in each country by year. A total of 2505 outbreaks were reported from 1873 to 2021 across 2010 studies. There were 47 countries (47/130, 36.15%) with more frequent emerging airborne viral infectious disease outbreaks (more than nine outbreaks), and these countries mainly distributed in high-income regions (22/47 countries, 46.81%, p < 0.05), especially in Western Europe (14/47 countries, 29.79%, p < 0.05). The number of overall outbreaks was more in the United States and China than in other countries in different years. Outbreaks of measles and influenza are always frequent and intense. Highly pathogenic human coronaviruses infection caused short-term pandemics during which their outbreak number and intensity exceeded other viruses. Rift valley fever outbreaks in the human population are spreading outside of Africa through the flow of goods and travelers. Countries in high-income regions reported more emerging airborne viral infectious diseases outbreaks, especially in the Western European region, the United States, and China. It is urgent to strengthen collaborative surveillance of emerging airborne viruses, cross-border flow of goods and travelers, and ecological environment to avoid the spread of viral infectious diseases outbreaks worldwide. The online version contains supplementary material available at 10.1007/s10389-023-01850-3.

Putative chemical cue from Gyrodactylus-infected guppies subtly alters behaviour but prior exposure decreases parasite intensity.

The reliance on chemical communication is well established for evading predation in aquatic systems. Only a few studies have found evidence that chemical cues released from aquatic animals infected with parasites alter behaviour. Furthermore, the link between putative chemical cues and susceptibility to infection has not been studied. The objectives of this study were to determine if exposure to chemical cues from Gyrodactylus turnbulli-infected guppies (Poecilia reticulata) at various times post-infection resulted in altered behaviour of uninfected conspecifics, and if prior exposure to this putative infection cue reduced transmission. Guppies responded to this chemical cue. Those exposed for 10 min to cues released from fish that had been infected for 8 or 16 days spent less time in the centre half of the tank. Continuous exposure to infection cues for 16 days did not alter guppy shoal behaviour but provided partial protection against infection when the parasite was introduced. Shoals exposed to these putative infection cues became infected, but infection intensity increased more slowly and to a lower peak compared with shoals exposed to the control cue. These results indicate that guppies show subtle behavioural responses to infection cues, and that exposure to infection cues reduces the intensity of outbreaks.

Application of geospatial and remote sensing data to support locust management

Negative impacts on agricultural activities by different locust species are well documented and have always been one of the major threats to food security and livelihoods, especially for local communities. Locust management and control have led to less frequent and intense plagues and outbreaks worldwide. However, political insecurity and armed conflicts affect locust management, and can as well as changing climate, and land use management contribute to new outbreaks. In the context of the increasing world population and higher demand for agricultural production, locust pests will remain of high concern. Geospatial and remote sensing data have become an important source of information for different applications within locust research and management. However, there is still a gap between available information and actual practical usage. In this study, we demonstrate the importance of geospatial and remote sensing data and how this information can be prepared for a straightforward application for stakeholders. For this purpose, we use the h3-hexagonal hierarchical geospatial indexing system to simplify and structure spatial information into standardized hexagon units. The presented concept provides decision makers and ground teams with a simplified information database that contains area-wide information over time and space and can be used without detailed geospatial knowledge and background. The concept is designed for the use case of Italian locust management in the Pavlodar region (Kazakhstan) and based on actual practices. It can be extrapolated to any other study area or species of interest. Our results underline the importance of actual land management on locust presence. Up-to-date land management information can be derived from time-series analyses of remote sensing data. Furthermore, essential meteorological data are used to generate locust-specific climatic characteristics within the h3-system. Within this system, areal prioritizing for locust management can be achieved based on the included spatial information and experience from ongoing practices.

Vertical characterization of fine and coarse dust particles during an intense Saharan dust outbreak over the Iberian Peninsula in springtime 2021

Abstract. An intense and long-lasting Saharan dust outbreak crossed the Iberian Peninsula (IP) from the southwest (SW) to the northeast (NE) from 25 March until 7 April 2021. This work aims to assess the optical and mass contribution of both fine and coarse dust particles along their transport. Five Iberian lidar stations were monitoring the transport and evolution of the Saharan dust particles, i.e. El Arenosillo/Huelva, Granada, Torrejón/Madrid and Barcelona in Spain, and Évora in Portugal. The particular meteorological conditions determined the aerosol scenario along the overall dust event, differing in the first part of the event (25–31 March), in which the strongest dust incidence occurred on 29–31 March at the south and central stations and 1 April at Barcelona, from the second one (1–7 April). The use of the two-step POLIPHON algorithm showed the relevance of using polarized lidar measurements for separating the aerosol properties of dust fine and coarse particles as an added value. Both the fine dust (Df) and coarse dust (Dc) components of the total particle backscatter coefficient (total dust, DD = Dc + Df) were separately derived. The dust plume was well-mixed with height and no significant differences were found in the vertical structure of both the Dc and Df particle backscatter coefficients. From the beginning of the dust outbreak until 1 April, the vertical Df / DD mass ratio was nearly constant in time at each station and also in altitude with values of ∼ 10 %. Moreover, the mean dust optical depth at 532 nm was decreasing along that dust pathway, reporting values from SW to NE stations of 0.34 at El Arenosillo/Huelva, 0.28 at Granada, 0.20 at Évora, 0.28 at Torrejón/Madrid, and 0.14 at Barcelona, although its Df / DD ratio remained almost constant (28 %–30 %). A similar pattern was found for the total dust mass loading and its Df / DD ratio, i.e. mostly decreasing mean mass values were reported, being constant in its Df / DD ratio (∼ 10 %) along the SW–NE dust pathway. In addition, the episode-mean centre-of-mass height increased with latitude overall, showing a high variability, being greater than 0.5 km at the southern sites (El Arenosillo/Huelva, Granada, Évora) and ∼ 1.0 km at Torrejón/Madrid and Barcelona. However, despite the relatively high intensity of the dust intrusion, the expected ageing of the dust particles was hardly observed, by taking into account the minor changes found in the contribution and properties of the coarse and fine dust particles. This is on the basis that the IP is relatively close to the Saharan dust sources and then, under certain dust transport conditions, any potential ageing processes in the dust particles remained unappreciated. The following must be highlighted: the different relative contribution of the fine dust particles to the total dust found for their optical properties (∼ 30 %) associated with the radiative effect of dust, with respect to that for the mass features (∼ 10 %) linked to air quality issues, along the overall dust event by crossing the IP.

Phagocytotic activity and gene expression of leukocytes isolated from Astyanax lacustris.

The constant intensification of aquaculture has considerable increased the stress levels of farmed fish and, consequently, the number and intensity of diseases outbreaks. Thus, studies on fish immune response, especially regarding the interaction of fish leukocytes with potential pathogens and xenobiotics are of great importance in order to develop new prophylactic and curative strategies. We isolated leukocytes from the head kidney of Astyanax lacustris-an important Neotropical fish species for aquaculture and a potential model for Neotropical aquaculture research-using a Percoll centrifugation protocol. The isolated leukocytes were incubated with lipopolysaccharide (LPS), and the expression of genes IL-1β, IL-8, LysC, and LysG were measured. We assessed the phagocytotic activity of leukocytes using Congo red-dyed yeast, a novel and cost-effective protocol that has been developed in this study. The isolated leukocytes responded to LPS induction, exhibiting strong IL-1β and IL-8 upregulation, two of the most important pro-inflammatory interleukins for vertebrates immune reponse. The optimal concentration of yeast for the phagocytic assay was 106 cells mL-1, resulting in acceptable phagocytic capacity (PC) but without excess of yeasts during the counting process, ensuring a high precision and accuracy of the method. To the best of our knowledge, the present study is the first to investigate the in vitro gene expression and phagocytic activity of leukocytes isolated from A. lacustris. Our findings will serve as a reference for future studies on the immunology and toxicology of Neotropical fish.

Transmission of monkeypox virus through the saliva and air that need careful management.

Transmission of monkeypox virus through the saliva and air that need careful management.

Anthrax hotspot mapping in Kenya support establishing a sustainable two-phase elimination program targeting less than 6% of the country landmass

Using data collected from previous (n = 86) and prospective (n = 132) anthrax outbreaks, we enhanced prior ecological niche models (ENM) and added kernel density estimation (KDE) approaches to identify anthrax hotspots in Kenya. Local indicators of spatial autocorrelation (LISA) identified clusters of administrative wards with a relatively high or low anthrax reporting rate to determine areas of greatest outbreak intensity. Subsequently, we modeled the impact of vaccinating livestock in the identified hotspots as a national control measure. Anthrax suitable areas included high agriculture zones concentrated in the western, southwestern and central highland regions, consisting of 1043 of 1450 administrative wards, covering 18.5% country landmass, and hosting 30% of the approximately 13 million cattle population in the country. Of these, 79 wards covering 5.5% landmass and hosting 9% of the cattle population fell in identified anthrax hotspots. The rest of the 407 administrative wards covering 81.5% of the country landmass, were classified as low anthrax risk areas and consisted of the expansive low agricultural arid and semi-arid regions of the country that hosted 70% of the cattle population, reared under the nomadic pastoralism. Modelling targeted annual vaccination of 90% cattle population in hotspot administrative wards reduced > 23,000 human exposures. These findings support an economically viable first phase of anthrax control program in low-income countries where the disease is endemic, that is focused on enhanced animal and human surveillance in burden hotspots, followed by rapid response to outbreaks anchored on public education, detection and treatment of infected humans, and ring vaccination of livestock. Subsequently, the global anthrax elimination program focused on sustained vaccination and surveillance in livestock in the remaining few hotspots for a prolonged period (> 10 years) may be implemented.

Associations Between Mobility Indices and the COVID-19 Pandemic in Thailand

This study aims to examine the associations between the Coronavirus disease 2019 (COVID-19) pandemic and alternative indicators. Specifically, Apple mobility index, Google community mobility index, and Nighttime-light (NTL) data are used for empirical analyses using ordinary least squares (OLS) and panel regressions as research methods. Results produced by OLS models show that Apple’s subcategory of driving activity and Google’s subcategory of visiting transit places are negatively associated with the number of COVID-19 cases. To extend the spatiotemporal details of this analysis, we formulate the panel data by integrating the monthly provincial indicators of Apple mobility index, NTL index, and the COVID-19 infected cases. Both fixed- and random-effects panel regression models indicate that Apple’s driving and walking mobility subcategories are negatively associated with the COVID-19 infected cases. By contrast, the relationship between the NTL index and the intensity of the COVID-19 outbreak is inconclusive. These findings suggest that Apple's mobility index can be applied as an alternative and timely indicator of economic activity, particularly for observing the near real-time intensity of mobility and transportation volume. In addition, these findings can serve as a resource for developing spatial models for urban planning and geographical impacts.

A curated DNA barcode reference library for parasitoids of northern European cyclically outbreaking geometrid moths.

Large areas of forests are annually damaged or destroyed by outbreaking insect pests. Understanding the factors that trigger and terminate such population eruptions has become crucially important, as plants, plant-feeding insects, and their natural enemies may respond differentially to the ongoing changes in the global climate. In northernmost Europe, climate-driven range expansions of the geometrid moths Epirrita autumnata and Operophtera brumata have resulted in overlapping and increasingly severe outbreaks. Delayed density-dependent responses of parasitoids are a plausible explanation for the 10-year population cycles of these moth species, but the impact of parasitoids on geometrid outbreak dynamics is unclear due to a lack of knowledge on the host ranges and prevalences of parasitoids attacking the moths in nature. To overcome these problems, we reviewed the literature on parasitism in the focal geometrid species in their outbreak range and then constructed a DNA barcode reference library for all relevant parasitoid species based on reared specimens and sequences obtained from public databases. The combined recorded parasitoid community of E. autumnata and O. brumata consists of 32 hymenopteran species, all of which can be reliably identified based on their barcode sequences. The curated barcode library presented here opens up new opportunities for estimating the abundance and community composition of parasitoids across populations and ecosystems based on mass barcoding and metabarcoding approaches. Such information can be used for elucidating the role of parasitoids in moth population control, possibly also for devising methods for reducing the extent, intensity, and duration of outbreaks.

Advances in coral immunity ‘omics in response to disease outbreaks

Coral disease has progressively become one of the most pressing issues affecting coral reef survival. In the last 50 years, several reefs throughout the Caribbean have been severely impacted by increased frequency and intensity of disease outbreaks leading to coral death. A recent example of this is stony coral tissue loss disease which has quickly spread throughout the Caribbean, devastating coral reef ecosystems. Emerging from these disease outbreaks has been a coordinated research response that often integrates ‘omics techniques to better understand the coral immune system. ‘Omics techniques encompass a wide range of technologies used to identify large scale gene, DNA, metabolite, and protein expression. In this review, we discuss what is known about coral immunity and coral disease from an ‘omics perspective. We reflect on the development of biomarkers and discuss ways in which coral disease experiments to test immunity can be improved. Lastly, we consider how existing data can be better leveraged to combat future coral disease outbreaks.

Lifting non-pharmaceutical interventions following the COVID-19 pandemic – the quiet before the storm?

ABSTRACT Introduction In the first months of the novel coronavirus (COVID-19) pandemic that begun in 2020, non-pharmaceutical interventions (NPIs) have been adopted worldwide. However, the effects of NPI implementation go beyond slowing the spread of COVID-19. Here, we review the non-intended effects that may have arisen from prolonged application of NPIs. Areas covered NPIs also affected the epidemiology of other infectious diseases, with unprecedentedly low circulation of several respiratory and gastrointestinal viruses being observed worldwide in 2020. While this was a welcome effect for already strained health-care systems, prolonged low exposure to pathogens may result in an increased pool of individuals susceptible to certain diseases. Out-of-season or unusually intense outbreaks of non-vaccine preventable diseases have already been documented as NPIs were gradually eased. In the context of widespread and important disruptions in national vaccination programs during the early phase of the pandemic, the risk of vaccine-preventable disease resurgence after NPIs are lifted cannot be excluded either. Expert opinion Awareness must be raised of the risk of vaccine-preventable disease resurgence, and efforts need to be made to mitigate this risk, where possible, by increasing vaccination coverage. Research and regulatory opportunities brought on by the COVID-19 pandemic should be seized.

Outbreak of Middle East Respiratory Syndrome Coronavirus in Camels and Probable Spillover Infection to Humans in Kenya.

The majority of Kenya’s > 3 million camels have antibodies against Middle East respiratory syndrome coronavirus (MERS-CoV), although human infection in Africa is rare. We enrolled 243 camels aged 0–24 months from 33 homesteads in Northern Kenya and followed them between April 2018 to March 2020. We collected and tested camel nasal swabs for MERS-CoV RNA by RT-PCR followed by virus isolation and whole genome sequencing of positive samples. We also documented illnesses (respiratory or other) among the camels. Human camel handlers were also swabbed, screened for respiratory signs, and samples were tested for MERS-CoV by RT-PCR. We recorded 68 illnesses among 58 camels, of which 76.5% (52/68) were respiratory signs and the majority of illnesses (73.5% or 50/68) were recorded in 2019. Overall, 124/4692 (2.6%) camel swabs collected from 83 (34.2%) calves in 15 (45.5%) homesteads between April–September 2019 screened positive, while 22 calves (26.5%) recorded reinfections (second positive swab following ≥ 2 consecutive negative tests). Sequencing revealed a distinct Clade C2 virus that lacked the signature ORF4b deletions of other Clade C viruses. Three previously reported human PCR positive cases clustered with the camel infections in time and place, strongly suggesting sporadic transmission to humans during intense camel outbreaks in Northern Kenya.