Minimize Disease Transmission Research Articles

Exploring the influence of environmental indicators and forecasting influenza incidence using ARIMAX models.

Influenza is a respiratory infection that poses a significant health burden worldwide. Environmental indicators, such as air pollutants and meteorological factors, play a role in the onset and propagation of influenza. Accurate predictions of influenza incidence and understanding the factors influencing it are crucial for public health interventions. Our study aims to investigate the impact of various environmental indicators on influenza incidence and apply the ARIMAX model to integrate these exogenous variables to enhance the accuracy of influenza incidence predictions. Descriptive statistics and time series analysis were employed to illustrate changes in influenza incidence, air pollutants, and meteorological indicators. Cross correlation function (CCF) was used to evaluate the correlation between environmental indicators and the influenza incidence. We used ARIMA and ARIMAX models to perform predictive analysis of influenza incidence. From January 2014 to September 2023, a total of 21,573 cases of influenza were reported in Fuzhou, with a noticeable year-by-year increase in incidence. The peak of influenza typically occurred around January each year. The results of CCF analysis showed that all 10 environmental indicators had a significant impact on the incidence of influenza. The ARIMAX(0, 0, 1) (1, 0, 0)12 with PM10(lag5) model exhibited the best prediction performance, as indicated by the lowest AIC, AICc, and BIC values, which were 529.740, 530.360, and 542.910, respectively. The model achieved a fitting RMSE of 2.999 and a predicting RMSE of 12.033. This study provides insights into the impact of environmental indicators on influenza incidence in Fuzhou. The ARIMAX(0, 0, 1) (1, 0, 0)12 with PM10(lag5) model could provide a scientific basis for formulating influenza control policies and public health interventions. Timely prediction of influenza incidence is essential for effective epidemic control strategies and minimizing disease transmission risks.

Experiences of Midwestern obstetric clinicians during the Coronavirus disease 2019 pandemic

BackgroundThe Coronavirus disease 2019 (COVID-19) pandemic led to healthcare system changes aimed at minimizing disease transmission that impacted experiences with obstetric healthcare. ObjectiveTo explore experiences of clinicians providing obstetric care during the COVID-19 pandemic. Study DesignQualitative, in-depth, semi-structured interviews were conducted with five nurse practitioners and 16 obstetrical physicians providing a mix of outpatient and inpatient obstetric care during the COVID-19 pandemic in a mid-sized, Midwestern city in the United States. Interviews elucidated challenges and facilitators of obstetric care provision and vaccination of pregnant patients against COVID-19 during the pandemic. Transcripts were coded inductively then deductively using the Health Equity Implementation Framework (HEIF), which integrates a disparities framework and implementation framework to highlight multilevel factors that influence obstetric care. Thematic analysis was conducted, and thematic saturation was reached. ResultsWe interviewed 21 clinicians. Clinicians recounted personal challenges such as social isolation and burnout that could be countered by social support. Challenges within the clinical encounter included implementation of infection mitigation efforts, vaccine counseling, and limitations of telehealth. However, when successfully implemented, telehealth facilitated care and circumvented barriers. Clinicians cited challenges at the healthcare system level such as rapidly evolving knowledge and recommendations, restrictive visitor policies, personnel shortage, and inadequate institutional resources to support pandemic-related stressors. However, interdisciplinary care and guidelines available for clinicians facilitated care. Clinicians reported that challenges at the societal level included financial strain, lack of childcare, medical mistrust, politicization of medicine, misinformation, and racism. Societal-level facilitators included insurance access, community outreach, positive policy changes, and fostering trust in medicine. ConclusionThe pandemic produced unique stressors and exacerbated existing challenges for clinicians providing obstetric care. Applying the HEIF to the findings emphasizes the influence of societal factors on all other levels. Identified facilitators can inform interventions to address stressors in obstetric care that have resulted from the changed sociopolitical landscape of the pandemic.

A Risk-Structured Model for the Transmission Dynamics of Anthrax Disease

Anthrax, a zoonotic disease with serious public health consequences, has been the subject of rigorous mathematical and statistical modeling to better understand its dynamics and to devise effective control techniques. In this study, we propose a novel mathematical risk-structured model for anthrax disease spread that includes both qualitative and quantitative evaluations. Our research focuses on the complex interplay between host–anthrax interactions and zoonotic transmission. Our mathematical approach incorporates bifurcation analysis and stability considerations. We investigate the dynamic behavior of the proposed model under various settings, shedding light on the important parameters that determine anthrax transmission and persistence. The normalized forward sensitivity analysis method is used to determine the parameters that are relevant to reducing Rc and, by extension, disease spread. Through scenario simulation of our model, we identify intervention techniques, such as enlightenment of the populace, that will effectively minimize disease transmission. Our findings provide insights into anthrax epidemiology and emphasize the importance of effective disease management. Bifurcation investigations reveal the existence and stability of numerous equilibria, allowing for a better understanding of the behavior of the system under various scenarios. This study adds to the field of anthrax modeling by providing a foundation for informed decision-making regarding public health measures. The use of a mathematical modeling approach improves our ability to anticipate and control anthrax epidemics, ultimately helping to protect both human and animal populations.

Pragmatic Return to Effective Dental Infection Control through Triage and Testing (PREDICT): an observational, feasibility study to improve dental office safety

BackgroundDuring the COVID-19 pandemic, there was a substantial interruption of care, with patients and workers fearful to return to the dental office. As dental practice creates a highly aerosolized environment, the potential for spread of airborne illness is magnified. As a means to increase safety and mitigate risk, pre-visit testing for SARS-CoV-2 has the potential to minimize disease transmission in dental offices. The Pragmatic Return to Effective Dental Infection Control through Testing (PREDICT) Feasibility Study examined the logistics and impact of two different testing mechanisms (laboratory-based PCR viral testing and point-of-care antigen testing) in dental offices.MethodsDental healthcare workers (DHCWs) and patients in four dental offices within the National Dental Practice-based Research Network participated in this prospective study. In addition to electronic surveys, participants in two offices completed POC testing, while participants in two offices used lab-based PCR methods to detect SARS-CoV-2 infection. Analysis was limited to descriptive measures, with median and interquartile ranges reported for Likert scale responses and mean and standard deviation for continuous variables.ResultsOf the total 72 enrolled, 28 DHCWs and 41 patients completed the protocol. Two patients (4.9%) tested positive prior to their visit, while 2 DHCWs (12.5%) tested positive for SARS-CoV-2 infection at the start of the study. DHCWs and patients shared similar degree of concern (69% and 63%, respectively) for contracting COVID-19 from patients, while patients feared contracting COVID-19 from DHCWs less (49%). Descriptive statistics calculations revealed that saliva, tongue epithelial cells, and nasal swabs were the most desirable specimen collection method; both testing (LAB and POC) protocols took similar amounts of total time to complete; and DHCWs and patients reported feeling more comfortable when both groups were tested.ConclusionsWhile a larger-scale, network study is necessary for generalizability of results, this feasibility study suggests that SARS-CoV-2 testing can be effectively implemented into dental practice workflows and positively impact perception of safety for DHCWs and patients. As new virulent infectious diseases emerge, preparing dental personnel to employ an entire toolbox of risk mitigation strategies, including testing, may have the potential to decrease dental practice closure time, maintaining continuity of dental care services for patients.Trial registrationClinicalTrials.gov: NCT05123742.

Disaster-Related Health Impacts and Endemic Disease among Middle-Aged Adults in India: Evidence from Longitudinal Ageing Survey of India (LASI), 2017-18

AimThis study aims to identify the disaster-related health impact on endemic diseases among middle-aged individuals in India.Data & Methods: This study utilizes data from the first wave of the Longitudinal Ageing Survey of India, 2017-18 with an eligible sample of 66,606 individuals aged 45 years and above. Binary logistic regression analysis and the Fairlie decomposition technique were used to understand the factors affecting endemic disease and to predict the factors contributing to rural-urban inequality in endemic disease prevalence. ResultsThe prevalence of endemic disease was 48 % among individuals whose health was affected by the disaster and 25 % among those whose health was not affected by the disaster. The Odds Ratio (ORs) of having endemic disease among disaster-affected individuals was found to be uniformly higher in rural areas [OR: 2.6 (95% CI: 2.2,3.0)] than in urban areas [OR: 1.84 (95% CI: 1.4,2.5)]. In the adjusted model, the risk of endemic disease among disaster-affected individuals was 2.17 times and 1.42 times higher in rural and urban areas respectively in comparison to individuals without any health impact from a disaster. ConclusionEfforts aimed at education on hygiene, and provisions of safe water and sanitation will significantly reduce the burden. Preparedness in disaster-prone areas, training the health and local community, efficient resource allocation, and identifying and managing the particular disease will help to minimize disease transmission.

Efficacy of Neem Leaves Extract and Aloe Vera as Antimicrobial in Hand Sanitizer

Since the coronavirus disease pandemic of 2019 (COVID-19) is spreading quickly around the world, 99% alcohol-based hand sanitizer (ABHS) is utilized to minimize disease transmission. During the COVID-19 outbreak, isopropyl supply becomes limited. Herbal based hand sanitizers were used as an alternative way during pandemic to reduce the spreading of COVID-19. This study aimed to evaluate the efficacy of neem leaves extract and aloe vera as antimicrobials for Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) bacteria which can readily be found on the hands. Moreover, 30% isopropyl alcohol, citrus lemon oil, essential oil and vitamin E oil were also added in the formulations. Four different hand sanitizers were formulated which labelled as A1, A2, A3 and A4. The initial formulation, A1, is said to be the most effective because it contains the highest amount of neem leaf extract and aloe vera, and it is followed by A2, which contains less neem leaf extract and aloe vera. A3 does not contain neem leaf extract, while A4 does not contain aloe vera. All formulations contained the same amount of isopropyl alcohol, essential oil, vitamin E oil, and citrus lemon. Streaking methods on Tryptic Soy Agar plate and nutrient agar plate were used to evaluate the effectiveness of hand sanitizer against S. aureus and E. coli bacteria. The total colony forming unit (CFU) and percentage of effectiveness were calculated to compare the antimicrobial activity of all the formulations. The results revealed that a significant reduction in total bacterial colony counts of microbes after treatment with the formulations. Besides, pH value for A1, A2, A3 and A4 were also evaluated, and the results were 5.2, 5.3, 4.8, and 5.5 respectively. Among all four formulations, A1 showed the highest efficiency of microbial disinfectant for both S. aureus and E. coli bacteria by showing the reduction of microbes for 94.55% and 97.27% respectively since A1 contains the highest amount of neem leaves extract and aloe vera. It also has a skin-friendly pH value of 5.2 which is slightly acidic to control the bacterial infection and applicable since it is within the pH range of 4.5 to 6.5 found in human skin.

A Digital Mask-Voiceprint System for Postpandemic Surveillance and Tracing Based on the STRONG Strategy.

Lockdowns and border closures due to COVID-19 imposed mental, social, and financial hardships in many societies. Living with the virus and resuming normal life are increasingly being advocated due to decreasing virus severity and widespread vaccine coverage. However, current trends indicate a continued absence of effective contingency plans to stop the next more virulent variant of the pandemic. The COVID-19-related mask waste crisis has also caused serious environmental problems and virus spreads. It is timely and important to consider how to precisely implement surveillance for the dynamic clearance of COVID-19 and how to efficiently manage discarded masks to minimize disease transmission and environmental hazards. In this viewpoint, we sought to address this issue by proposing an appropriate strategy for intelligent surveillance of infected cases and centralized management of mask waste. Such an intelligent strategy against COVID-19, consisting of wearable mask sample collectors (masklect) and voiceprints and based on the STRONG (Spatiotemporal Reporting Over Network and GPS) strategy, could enable the resumption of social activities and economic recovery and ensure a safe public health environment sustainably.

The optimum concentration of soya-lecithin for replacing egg yolk in INRA-82-modified semen extenders improved the cryopreserved semen quality and DNA integrity of Arabian stallions

The cryopreservation of stallion spermatozoa varies greatly between animals. Different equine semen extender supplements were invented to maximize the post-thaw semen quality. Soy lecithin is one of those additives that contain plant origin phospholipids used to replace egg yolk to minimize disease transmission. This study aimed to determine which concentrations of soy lecithin can replace egg-yolk in modified INRA-82 semen extenders for the cryopreservation of horse semen. Semen was collected from six Arabian stallions and extended with modified INRA-82 semen extender supplemented with 0.0, 1.25, 2.50, and 5.0% soya lecithin. Frozen-thawed sperm motility was measured at 0, 1, 2, and 3 h. Viability index, sperm plasma membrane integrity (SPMI), and acrosome integrity in addition to the comet assay non-fragmented DNA, head DNA, tail DNA, tail length, and tail moment were statistically analyzed. The addition of 2.5% soya lecithin had the highest post-thaw sperm motility at 0, 1, 2 h (P < 0.001) and 3 h (P < 0.0001), the optimum viability index (P < 0.0001), SPMI (P < 0.05), acrosome integrity (P < 0.0001), non-fragmented DNA (P < 0.01), DNA in the comet head (P < 0.05), minimum DNA in the comet tail (P < 0.05), shortest comet tail length (P < 0.0001), and lowest comet tail moment (P < 0.01). Soy lecithin at concentrations other than 2.5% deteriorated all post-thaw semen parameters. Soy lecithin (2.5%) can replace egg yolk in the modified INRA-82 semen extender for the cryopreservation of good-quality stallion semen.

DECIPHERING DYNAMICS OF COVID-19 OUTBREAK IN INDIA: AN AGE-STRUCTURED MODEL

The dynamics of infectious disease transmission depends on social contact patterns and the precautions people take to minimize disease transmission. The social contact pattern varies depending on the community at large age distribution at work, school, and recreation. Consequently, knowing the age-specific prevalence and incidence of infectious diseases is critical for predicting future disease burden and the efficacy of interventions like vaccination. In this study, we use an SEIR age-structured multi-group epidemic model to understand how social contact affects disease control. We construct location-specific social contact matrices to observe that how social mixing affects disease spread. For mathematical analysis, we compute the basic reproduction number [Formula: see text] and exhibit the global behavior of the system in terms of [Formula: see text]. We also estimate the transmission rate using the empirical data of COVID-19 for India from 1 September 2020, to 31 December 2020. We simulate the lifting of non-pharmaceutical interventions by allowing people to return to work in phases and investigate its impact. Our findings imply that raising awareness in symptomatic infected individuals aged 20–49 years can help in reducing the number of infected individuals. When some schools are partially open, awareness in symptomatic infected individuals in school-age groups also plays a significant role in reducing disease cases. The simulation results also suggest that limiting contact at school and other gathering places could significantly lower the number of instances. Using the least square approach, we show that the time-dependent transmission rate is more realistic than the constant spread rate for COVID-19 in India. To reduce the COVID-19 burden, we obtain that gradually loosening control measures could flatten and lower other peaks. Our findings may help health policymakers to decide on timely age-based vaccination distribution strategies and control measures.

The effectiveness of disinfection protocols in osteopathic family medicine offices.

Healthcare-associated infections (HAIs) pose a substantial public health threat. Despite significant strides tocurb HAIs in hospital environments, outpatient settings have not received the same degree of attention. Given their emphasis on holistic, patient-centered care, osteopathic family medicine offices are pivotal in both disease prevention and comprehensive patient treatment. The importance of simple yet effective disinfection protocols, such as thorough cleaning between patient appointments, cannot be overstated in these settings because they are integral to minimizing disease transmission. This study aims to assess the effectiveness of the current disinfection protocols in osteopathic family medicine offices. A cross-sectional study evaluating disinfection practices on 18 examination tables in an osteopathic family medicine office was conducted. Two high-touch surfaces (midtorso region and table edge) were examined. Initial swab samples were collected after morning disinfection by Environmental Services, and terminal swab samples were gathered after day's-end disinfection by the medical staff. Adenosine triphosphate (ATP) bioluminescence assays were performed utilizing AccuPoint Advanced HC Reader, which quantified ATP, indicating contamination levels in the samples. The higher the ATP levels found in a sample, the greater the amount of biological contamination. All samplers were handled and tested as per manufacturer's instructions. Apreliminary trial was conducted to confirm the internal validity of ATP bioluminescence measurements. The statistical analysis involved Shapiro-Wilk and Wilcoxon signed-rank tests, with significance set at p<0.05. Cohen's d test was utilized to calculate the effect size, identifying meaningful differences in initial and terminal swab sample relative light units (RLUs). The midtorso region demonstrated an 11.1 % increase in failure rate after terminal disinfection when compared to initial disinfection. A Wilcoxon signed-rank testrevealed a median estimated pathogen level forthemidtorso region that was higher after terminal disinfection (median, 193 RLUs; range, 1-690 RLUs; n=18) compared to initial disinfection (median, 134 RLUs; range,4-946 RLUs; n=18). However, this increase was not statistically significant, p=0.9124, with a small effect size, d=0.04. The edge showed no change in failure rate after terminal disinfection, maintaining a 100 % failure rate both before and after disinfection. However, the Wilcoxon signed-rank test revealed a slight reduction in the median estimated pathogen levels after terminal disinfection (median, 2095 RLUs; range, 891-5,540 RLUs; n=18) compared to before disinfection (median, 2,257 RLUs; range, 932-5,825 RLUs; n=18). However, this reduction wasnot statistically significant, p=0.61, with a small effect size, d=0.12. The findings from this study reveal a substantial disparity in outcomes between the two sample locations, midtorso and edge. The midtorso demonstrated arelatively low failure rate in both initial and terminal swab samples, indicating successful outcomes. In contrast, the edge consistently displayed a 100 % failure rate, emphasizing the need for more care and attention when cleaning the edge of the examination to ensure better outcomes. By prioritizing adequate disinfection protocols, including thorough cleaning between patients, osteopathic family medicine offices can more effectively prevent disease transmission and promote patient safety.

"Our interventions are still here to support communities during the pandemic": Resuming mass drug administration for neglected tropical diseases after COVID-19 implementation delays.

The COVID-19 pandemic disrupted essential health services, including those provided by national neglected tropical disease (NTD) programs. Most mass drug administration (MDA) programs were postponed for 6-12 months following World Health Organization guidance released in April 2020 to temporarily halt NTD programs and launch necessary COVID-19 precautions. While NTD-endemic countries have since resumed MDA activities, it is critical to understand implementers' perspectives on the key challenges and opportunities for program relaunch, as these insights are critical for maximizing gains towards disease control and elimination during public health emergencies. Using data from using online surveys and focus group discussions, this mixed-methods study sought perspectives from Ministry of Health NTD Program Managers and implementing partners from non-governmental organizations working in sub-Saharan Africa. Data analysis revealed that findings converged around several main themes: disruptions for MDA programs included resource shortages due to prioritization of pandemic response, challenges adhering to COVID-19 safety protocols, and community hesitancy due to coronavirus transmission fears. Identified solutions for restarting MDA programs focused on adapting intervention delivery and packaging to minimize disease transmission, embracing technology to optimize intervention planning and delivery, and identifying opportunities to promote program integration between pandemic response strategies and NTD campaign delivery. Findings identifies key challenges due to disruptions to NTD program delivery and provide strategic recommendations for endemic countries to build resilient programs that can continue to perform during and beyond global pandemics.

Essential Service Products as Channels for COVID-19 Awareness and Behavior Change: A Narrative Review

Coronavirus disease 2019 (COVID-19) is here to stay. Nonpharmacological interventions such as hand hygiene, social distancing, and respiratory hygiene have remained the mainstay to curb the spread of the virus, and these are sustainable. To understand the information, education, and communication (IEC) efforts undertaken during previous pandemics and successful behavior change strategies that may be applicable to ongoing COVID-19 pandemic, we conducted a narrative review of articles using PubMed search on September 11, 2022. The results highlighted that reinforced IEC is the need of the hour in efforts against COVID-19 pandemic. The communication strategy during a pandemic should be of three stages aligned to the objectives of building a basic understanding and knowledge in the target population: building an awareness of the threat; personal actions to minimize the impact; and reinforcing the need for appropriate actions to minimize disease transmission, in that order. An innovative strategy of displaying IEC on the daily essential products can result in a sustainable solution that might result in a “felt need” in the community to follow COVID-19 appropriate behavior. A broad base of stakeholders' engagement with civil bodies, nongovernmental organizations, private sectors with well-defined responsibilities and accountability would offer an enabling environment for these efforts in ultimately curbing the COVID-19 pandemic.

Investigating Ontario dairy farmers motivations and barriers to the adoption of biosecurity and Johne's control practices

For the control of Johne's disease (JD), management practices to minimize disease transmission must be implemented and maintained. Once infected, animals will enter a latent phase and will typically only manifest clinical symptoms years later. As young calves are the main susceptible group on farm, the observed effects of management practices geared toward minimizing their exposure to infective material may not be realized until years later. This delayed feedback limits the sustained implementation of JD control practices. Although quantitative research methods have demonstrated changes to management practices as well as their association with changes to JD prevalence, dairy farmers can offer insights into the current challenges relating to JD implementation and control. Thus, this study aims to use qualitative methods and in-depth interviews (n = 20) with Ontario dairy farmers who had previously been engaged in a Johne's control program to explore their motivations and barriers to the implementation of JD control practices and general herd biosecurity. A thematic analysis using inductive coding was completed generated the following 4 overarching themes: (1) the hows and whys of Johne's control, (2) barriers to general herd biosecurity, (3) barriers to Johne's control, and (4) overcoming barriers. Farmers no longer believed JD was an issue on their farm. Johne's was low on their list of concerns due to little public discourse, absence of animals displaying clinical signs, and no financial support for diagnostic testing. Producers who were still actively engaged in JD control cited animal and human health as their primary motivations. Financial support, targeted education, and promoting engagement through discourse may help encourage producers to reconsider their participation in JD control. Government and industry collaboration with producers may help to develop more effective biosecurity and disease control programs.

2020년 국내 양식 흰다리새우(Litopenaeus vannamei)의 TS, IMN, NHP 및 DIV1 모니터링

Disease monitoring in aquatic animals is important to minimize disease transmission and provide important information for effective quarantine measures. In this study, Taura syndrome (TS), infectious myonecrosis (IMN), necrotizing hepatopancreatitis (NHP), and decapod iridescent virus 1 (DIV1) were monitored in 2,592 whiteleg shrimp (Litopenaeus vannamei) collected from 108 shrimp farms in Korea from September to October 2020. A disease detection and monitoring experiment was conducted according to the WOAH

Analysis of Factors Affecting the Improvement of Open Defecation Free (ODF) behavior in Communities in Kerta Timur Village, Dasuk District, Sumenep Regency

Various problems experienced by the community related to not maintaining environmental hygiene, basically related to low hygiene and sanitation of water used for daily needs, human waste/feces, waste water, garbage, and public places.. The purpose of this study is to analyzethe influence of attitude, support from health workers and social support on increasing Open Defecation Free (ODF) behavior in the community in Kerta Timur Village, Dasuk District, Sumenep Regency. The design of this research is an observational quantitative research with a cross sectional approach with the focus of the research being directed at analyzingthe influence of attitude, support from health workers and social support to increase Open Defecation Free (ODF) behavior in the community in Kerta Timur Village, Dasuk District, Sumenep Regency. The total population is 173 respondents and a sample of 121 respondents is taken by using Simple Random Sampling technique. In the study, it was found that almost half of the respondents had a sufficient category attitude as many as 55 respondents (45%). Almost half of the respondents have sufficient support from officers in the category of 43 respondents (36%). Almost half of the respondents have social support in the sufficient category as many as 52 respondents (43%). Most of the respondents have behavior in the sufficient category as many as 51 respondents (42%).Based on the results of Multiple Linear Regression analysis shows that with a p-value of 0.000 &lt;0.05 then H1 is accepted so it can be concluded that simultaneously there is the influence of attitude, support from officers and social support to increase Open Defecation Free (ODF) behavior in the community in Kerta Timur Village, Dasuk District, Sumensep Regency with an influence magnitude of 89.1%. Respondents are expected to defecate in latrines in order to minimize disease transmission due to fecal contamination. To create a clean and healthy environment from all kinds of dirt and disease.

Telegenetics and COVID 19: Through the Pandemic and Beyond

Introduction - The COVID 19 pandemic led to restrictions on the conventional ways of healthcare delivery. Telemedicine provided a viable solution that was in line with the social distancing policies imposed to minimize disease transmission. This demanded physicians adapt to new ways of healthcare delivery. We surveyed geneticists across the country to determine their experience and to ascertain if telegenetics will be a lasting change.&#x0D; Materials and Methods - A 23 item standardized survey was distributed to various US-based geneticists via email and other social media platforms focusing on their experience of providing care via telemedicine.&#x0D; Results - We received 69 responses from physicians across 26 states. Of these, 91% practiced in academia. 70% responded that pediatric genetics takes up more than 50% of their practice. 68% had over 50% of their practice switch to telemedicine. 77% felt they could provide adequate care via telemedicine and 94% of providers would like to continue telemedicine post-pandemic.&#x0D; Conclusion - The future of telemedicine looks promising as the majority of clinicians would like to routinely use telemedicine post-pandemic. Uniform guidelines for use of telemedicine in genetics may need to be proposed by professional societies and supported by federal laws.

Rapid transmission of respiratory infections within but not between mountain gorilla groups

Minimizing disease transmission between humans and wild apes and controlling outbreaks in ape populations is vital to both ape conservation and human health, but information on the transmission of real infections in wild populations is rare. We analyzed respiratory outbreaks in a subpopulation of wild mountain gorillas (Gorilla beringei beringei) between 2004 and 2020. We investigated transmission within groups during 7 outbreaks using social networks based on contact and proximity, and transmission between groups during 15 outbreaks using inter-group encounters, transfers and home range overlap. Patterns of contact and proximity within groups were highly predictable based on gorillas’ age and sex. Disease transmission within groups was rapid with a median estimated basic reproductive number (R0) of 4.18 (min = 1.74, max = 9.42), and transmission was not predicted by the social network. Between groups, encounters and transfers did not appear to have enabled disease transmission and the overlap of groups’ ranges did not predict concurrent outbreaks. Our findings suggest that gorilla social structure, with many strong connections within groups and weak ties between groups, may enable rapid transmission within a group once an infection is present, but limit the transmission of infections between groups.

MA12.05 The Impact of the COVID-19 Pandemic on Post-Operative Outcomes of Thoracic Cancer Surgery in Canada

During the COVID-19 pandemic, surgical services had to adapt their priority of operations to ensure an optimal and safe delivery of care. To minimize disease transmission and create surge capacity, elective and non-emergent procedures, including cancer operations, were initially delayed or cancelled. Studies have described an increase in post-operative complications during the pandemic for cancer patients undergoing surgery, while others have shown that thoracic surgery can be conducted safely despite this global health crisis.

The importance of message framing in rule compliance by visitors during wildlife tourism

AbstractA conundrum of wildlife tourism is balancing wildlife conservation and tourist satisfaction. Mountain gorillas (Gorilla beringei) are a flagship species for biodiversity and there is worldwide interest in gorilla trekking safaris. This tourism provides substantial revenue to the government and local communities for gorilla protection, but puts them in danger of zoonotic diseases. To minimize disease transmission, health guidelines are in place for visitors whereby they are asked to remain 7 m from the endangered apes and stay in a cohesive group. Unfortunately, tourists often do not follow these rules and consequently their behavior puts gorillas at risk. The pre‐trekking messages presented to tourists in Bwindi Impenetrable National Park, Uganda were changed to determine if the way messages are stated affects visitor adherence to rules. Tourists (n = 389) either received strategic messages that were positively or negatively framed in relation to expectations to follow specific rules to adhere to health guidelines, and tourist behavior was measured, such as the nearest distance they were to gorillas, and their cohesiveness. Using generalized linear mixed models, it was found that framing messages affected tourist behavior. Tourists who received a negatively framed message had a higher adherence to rules than those who received a positive or control message. They were 75% further from the gorillas (7.26 vs. 4.52 m), more cohesive (0.40 vs. 0.81 m to each other), and approached the gorillas less (0.34 vs. 1.32 times) than the control message. These findings demonstrate that communicating in different ways promotes changes in behavior by tourists, which reduces the chances of epizootic respiratory infections being passed to vulnerable animals. Strategic message framing should be widely considered as a cost‐effective mechanism to promote behavior change during ecotourism.

Potential for community based surveillance of febrile diseases: Feasibility of self-administered rapid diagnostic tests in Iquitos, Peru and Phnom Penh, Cambodia.

Rapid diagnostic tests (RDTs) have the potential to identify infectious diseases quickly, minimize disease transmission, and could complement and improve surveillance and control of infectious and vector-borne diseases during outbreaks. The U.S. Defense Threat Reduction Agency’s Joint Science and Technology Office (DTRA-JSTO) program set out to develop novel point-of-need RDTs for infectious diseases and deploy them for home use with no training. The aim of this formative study was to address two questions: 1) could community members in Iquitos, Peru and Phnom Penh, Cambodia competently use RDTs of different levels of complexity at home with visually based instructions provided, and 2) if an RDT were provided at no cost, would it be used at home if family members displayed febrile symptoms? Test kits with written and video (Peru only) instructions were provided to community members (Peru [n = 202]; Cambodia [n = 50]) or community health workers (Cambodia [n = 45]), and trained observers evaluated the competency level for each of the several steps required to successfully operate one of two multiplex RDTs on themselves or other consenting participant (i.e., family member). In Iquitos, >80% of residents were able to perform 11/12 steps and 7/15 steps for the two- and five-pathogen test, respectively. Competency in Phnom Penh never reached 80% for any of the 12 or 15 steps for either test; the percentage of participants able to perform a step ranged from 26–76% and 23–72%, for the two- and five-pathogen tests, respectively. Commercially available NS1 dengue rapid tests were distributed, at no cost, to households with confirmed exposure to dengue or Zika virus; of 14 febrile cases reported, six used the provided RDT. Our findings support the need for further implementation research on the appropriate level of instructions or training needed for diverse devices in different settings, as well as how to best integrate RDTs into existing local public health and disease surveillance programs at a large scale.