Outbreak In Belgium Research Articles

Attitudes toward mandatory vaccination and the COVID certificate as a function of vaccination status and risk perception: A vignette‐based study

AbstractIn January 2022, several vaccination policies were debated to address the Omicron outbreak in Belgium. Considering variability in risk perception and vaccine uptake, this study aimed to understand differences in support and expectations for four scenarios, ranging from relaxed to restrictive vaccination policies, to inform policymakers. Using an online survey, 12,670 participants (46% female; Mage = 45.9, SD = 13.38) reported their risk perception, number of vaccination doses (0/1, 2, 3 doses) as well as their support and several anticipated psychological outcomes for each scenario. Mixed model ANCOVA showed a pattern of preferential support for the relaxed scenario and more positive anticipated outcomes (general well‐being and government appraisals) compared to the restrictive policies, that were treated equivalently. An exception to this pattern was found when people were vaccinated with three doses and perceived high risk. Taken separately, risk perception and vaccination status were not sufficient to drive positive attitudes toward restrictive policies; only their interaction had an effect. Limitations include the self‐selected sample and the vignette methodology. The conjunct role of risk perception and vaccination status should be considered when discussing the introduction of restrictive vaccination policies. These findings inform vaccination strategies management during pandemics.

Understanding sexual transmission dynamics and transmission contexts of monkeypox virus: a mixed-methods study of the early outbreak in Belgium (May–June 2022)

ObjectiveThe available epidemiological and clinical evidence from the currently ongoing monkeypox (MPX) outbreak in non-endemic areas suggests an important factor of sexual transmission. However, limited information on the behaviour and...

Do pheromone traps help to reduce new attacks of Ips typographus at the local scale after a sanitary cut?

The spruce bark beetle, Ips typographus, is causing severe economic losses during epidemic phases triggered by droughts and/or windstorms. Sanitation felling and salvage logging are usually the most recommended strategies to limit the damages. However, any additional control method to limit the economic impact of an outbreak would be welcome. In this respect, the efficiency of pheromone trapping is still controversial or poorly documented. In this 2-year study (2020–2021), at the peak of a severe outbreak in Belgium, we quantified the wood volume and presence/absence of new attacks at 126 sites attacked during the previous year and within 100 m from the initial attack. Each site was randomly allocated to one of three treatments: (1) three crosstraps baited with pheromones, (2) one tree-trap baited with pheromones and treated with an insecticide and (3) control sites with no trapping device. The attacked trees of the previous year were all cut and removed before the start of the experiment and newly attacked trees were removed as they were detected. The trapping devices were only active during spring to target overwintering bark beetles that might have escaped the sanitation cuts and to limit the risk of attracting dispersing beetles from outside the patch during the summer. We found a strong decrease of the attacks relative to the previous year in all treatments, including the controls (more than 50% of the control sites had no new attacks). There was no relationship between the new attacks and the attacks of the previous year. In both years, new attacks were more frequent (presence/absence) in sites with crosstraps (95% Confidence Interval [56–84%] of the sites with new attacks) than in sites with a tree-trap (26–57% - p = 0.02) and to a lesser extent than in control sites (32–63%, p = 0.08). In 2020, the attacked volumes were slightly higher in sites with crosstraps (95% Confidence Interval [3.4–14.2 m³]) than in control sites (0.2–3.5 m³, p = 0.04) and no significant difference was found with tree-trap sites (1.1–6.2 m³, p = 0.38). In 2021, there were no significant differences between the volumes attacked in the control sites (1.8–9.4 m³), crosstraps sites (0.9–6.4 m³) and tree-trap sites (0–2.5 m³). Overall, we found no evidence in favor of the efficacy of pheromone trapping during spring to reduce economic damages at the local scale when combined with sanitation felling and during a severe outbreak. The use of baited crosstraps could even be hazardous as it seemed to increase the occurrence of new attacks probably by attracting bark beetles but failing to neutralize them.

Modified exponential time series model with prediction of total COVID-19 cases in Belgium, Czech Republic, Poland and Switzerland

Abstract The coronavirus (COVID-19) pandemic affected every country worldwide. In particular, outbreaks in Belgium, the Czech Republic, Poland and Switzerland entered the second wave and was exponentially increasing between July and November, 2020. The aims of the study are: to estimate the compound growth rate, to develop a modified exponential time-series model compared with the hyperbolic time-series model, and to estimate the optimal parameters for the models based on the exponential least-squares, three selected points, partial-sums methods, and the hyperbolic least-squares for the daily COVID-19 cases in Belgium, the Czech Republic, Poland and Switzerland. The speed and spreading power of COVID-19 infections were obtained by using derivative and root-mean-squared methods, respectively. The results show that the exponential least-squares method was the most suitable for the parameter estimation. The compound growth rate of COVID-19 infection was the highest in Switzerland, and the speed and spreading power of COVID-19 infection were the highest in Poland between July and November, 2020.

The well-being of physicians during the COVID-pandemic in a Belgian tertiary hospital

Background: COVID-19 has become the largest medical challenge worldwide, affecting the physical and mental well-being of physicians. The aim of this study was to explore the well-being of physicians during the second wave of the COVID-19 outbreak in a Belgian tertiary hospital, with special attention to anaesthesiologists. They were confronted with overcrowded intensive care units, were mentally challenged during several months by an overwhelming workload. Methods: All physicians of the Antwerp University Hospital (UZA) were invited to participate through an online anonymous questionnaire to objectively evaluate their well-being during the second wave of the COVID-19 outbreak in Belgium. Mental well-being was evaluated by the validated Warwick-Edinburgh Mental Well-being Scale (WEMWBS) summing 14 equally weighted questions (scoring range 1 to 5) about mental well-being. Demographic data such as age, gender, function, COVID exposure was collected. Results: Ninety physicians, 42 residents and 48 staff members, completed the questionnaire with an average WEMWBS of 50.6±8.0. Participating residents were deployed more on COVID-19 departments compared to participating staff members (p=0.02) and reported a higher workload (p=0.001). Residents scored significantly lower on the WEMBWS compared to staff members (48.1±8.2 vs. 52.8±7.3, p=0.01). Also, 15 female anaesthesiologists scored significantly lower in the WEMWBS compared to their 12 male colleagues (p=0.03). Conclusion: During the second wave of the COVID-19 outbreak in Belgium, residents reported a significantly higher workload due to COVID-19 and reported a significantly lower well-being compared to staff members.

Role of the Bronchoalveolar Lavage in Noncritically Ill Patients during the SARS-CoV-2 Epidemic.

Background Bronchoalveolar lavage (BAL) is currently not recommended in noncritically ill patients for the diagnosis of SARS-CoV-2 infection. Indeed, the diagnosis is based on the RT-PCR test on a nasopharyngeal swab (NPS) and abnormal findings on the chest CT scan. However, the sensitivity of the NPS and the specificity of the chest CT scan are low. Results of BAL in case of negative NPS testing are underreported, especially in the subgroup of immunocompromised patients. Objectives The added value of BAL in the management of unstable, but noncritically ill patients, suspected of having SARS-CoV-2 infection despite one previous negative NPS and the side effects of the procedure for the patients and the health-care providers, were assessed during the epidemic peak of the COVID-19 outbreak in Belgium. Methods This multicentric study included all consecutive noncritically ill patients hospitalized with a clinical and radiological suspicion of SARS-CoV-2 infection but with a negative NPS. BAL was performed according to a predefined decisional algorithm based on their state of immunocompetence, the chest CT scan features, and their respiratory status. Results Among the 55 patients included in the study, 14 patients were diagnosed with a SARS-CoV-2 infection. Interestingly, there was a relationship between the cycle threshold of the RT-PCR and the interval of time between the symptom onset and the BAL procedure (Pearson′s correlation coefficient = 0.8, p = 0.0004). Therapeutic management was changed in 33 patients because another infectious agent was identified in 23 patients or because an alternative diagnosis was made in 10 patients. In immunocompromised patients, the impact of BAL was even more marked (change in therapy for 13/17 patients). No significant adverse event was noted for patients or health-care staff. All health-care workers remained negative for SARS-CoV-2 NPS and serology at the end of the study. Conclusions In this real-life study, BAL can be performed safely in selected noncritically ill patients suspected of SARS-CoV-2 infection, providing significant clinical benefits that outweigh the risks.

1712P Risk of SARS-CoV-2 infection and outcome after infection: Experience from the day-care unit at CHU Liège in Belgium

No specific safety data concerning systemic oncological treatments were available at time of COVID-19 outbreak in Belgium. In our hospital we decided to maintain adjuvant and early line treatments for metastatic disease in patients under 65 and without specific comorbidities and to apply a shared decision approach in other patients while following closely the safety of these treatments.

Unravelling the dispersal dynamics and ecological drivers of the African swine fever outbreak in Belgium

Abstract African swine fever is a devastating disease of domestic pigs and wild boars caused by African swine fever virus (ASFV). ASFV originates from sub‐Saharan African countries. In the last 10 years, the virus left its endemic range to spread to eastern Europe and Russia. On September 2018, Belgian authorities reported that ASFV had been detected in two wild boars in a southern area of the country. One year later, no domestic pig has been infected, with the last ASFV‐positive wild boar being confirmed in mid‐August 2019, suggesting that the outbreak is now controlled. However, the dispersal dynamics as well as the specific impact of ecological factors and intervention measures on the outbreak remain unknown. In total, 827 positive cases have been reported in wild boar populations. In this study, we exploit the resulting spatio‐temporal distribution of occurrence data to investigate the wavefront progression. We first present the application of recently developed methods to quantify the local wavefront velocity of an invading epidemic. Second, we develop and apply a novel analytical framework that uses occurrence data to investigate the impact of ecological factors on the dispersal dynamics of a wavefront progression. Our analyses highlighted that the network of barriers, involving installed fences, had an impact on both the effective dispersal and the wavefront dispersal velocity. Furthermore, we also demonstrated that the wavefront progression was slower outside forest areas. Together, these results have concrete implications for potential future ASFV epidemics in similar regions. Synthesis and applications. We describe a novel analytical approach that exploits occurrence data to investigate the impact of ecological factors on the wavefront velocity and actual wavefront progression. This methodology has the potential to be quickly applied to outbreak datasets solely made of occurrence data, with key benefits for the epidemiological investigations of external spatial factors impacting pathogen dispersal across non‐endemic areas. Our analytical workflow could also be further applied to investigate the impact of ecological factors on any kind of biological dispersions (pathogen spreads, invasive species).

Genetic characterization of the spike gene of porcine epidemic diarrhea viruses (PEDVs) circulating in Vietnam from 2015 to 2016

BackgroundPorcine epidemic diarrhea (PED) is a highly contagious swine disease caused by the PED virus (PEDV), which is a member of the family Coronaviridae. Since the first outbreaks in Belgium and the United Kingdom were reported in 1971, PED has spread throughout many countries around the world and causing significant economic loss. This study was conducted to investigate the recent distribution of PEDV strains in Vietnam during the 2015–2016 seasons.MethodsA total of 30 PED‐specific PCR‐positive intestinal and faecal samples were collected from unvaccinated piglets in Vietnam during the 2015–2016 seasons. The full length of the spike (S) gene of these PEDV strains were analysed to determine their phylogeny and genetic relationship with other available PEDV strains globally.ResultsPhylogenetic analysis of the complete S gene sequences revealed that the 28 Vietnamese PEDV strains collected in the northern and central regions clustered in the G2 group (both G2a and G2b sub‐groups), while the other 2 PEDV strains (HUA‐PED176 and HUA‐PED254) collected in the southern region were clustered in the G1/G1b group/sub‐group. The nucleotide (nt) and deduced amino acid (aa) analyses based on the complete S gene sequences showed that the Vietnamese PEDV strains were closely related to each other, sharing nt and aa homology of 93.2%–99.9% and 92.6%–99.9%, respectively. The N‐glycosylation patterns and mutations in the antigenic region were observed in Vietnamese PEDV strains.ConclusionsThis study provides, for the first time, up‐to‐date information on viral circulation and genetic distribution, as well as evidence to assist in the development of effective PEDV vaccines in Vietnam.

Mycoplasma pneumoniae Infection in a 13-Year-Old Girl With Down’s Syndrome During the COVID-19 Pandemic

We report the case of a 13-year-old girl with Down’s syndrome who presented with cough, fever, and a rapidly evolving respiratory failure leading to intensive care unit transfer during coronavirus disease 2019 (COVID-19) outbreak in Belgium. COVID-19-related acute respiratory distress syndrome (ARDS) is rare in teenagers and its diagnosis remains challenging as reverse transcription-polymerase chain reaction (RT-PCR)-testing sensitivity and radiological criteria still have to be defined in that population. We finally concluded to severe Mycoplasma pneumoniae infection. This case report gives the opportunity to discuss the rare occurrence of that disease, and to review the radiological findings of M. pneumoniae - and COVID-19-related pneumonia in teenagers. Int J Clin Pediatr. 2020;9(3):77-81 doi: https://doi.org/10.14740/ijcp384

Real-time prediction of influenza outbreaks in Belgium

Seasonal influenza is a worldwide public health concern. Forecasting its dynamics can improve the management of public health regulations, resources and infrastructure, and eventually reduce mortality and the costs induced by influenza-related absenteism. In Belgium, a network of Sentinel General Practitioners (SGPs) is in place for the early detection of the seasonal influenza epidemic. This surveillance network reports the weekly incidence of influenza-like illness (ILI) cases, which makes it possible to detect the epidemic onset, as well as other characteristics of the epidemic season. In this paper, we present an approach for predicting the weekly ILI incidence in real-time by resorting to a dynamically calibrated compartmental model, which furthermore takes into account the dynamics of other influenza seasons. In order to validate the proposed approach, we used data collected by the Belgian SGPs for the influenza seasons 2010–2016. In spite of the great variability among different epidemic seasons, providing weekly predictions makes it possible to capture variations in the ILI incidence. The confidence region becomes more representative of the epidemic behavior as ILI data from more seasons become available. Since the SIR model is then calibrated dynamically every week, the predicted ILI curve gets rapidly tuned to the dynamics of the ongoing season. The results show that the proposed method can be used to characterize the overall behavior of an epidemic.

Usutu virus in wild birds: Lessons from the recent outbreak in Belgium

Usutu virus in wild birds: Lessons from the recent outbreak in Belgium

Outbreaks of canine distemper in Dutch and Belgian mink farms

Background: Vaccination of farmed minks against canine distemper virus (CDV) has proved to be very effective. In the Netherlands, vaccination of farmed minks against CDV was mandatory until the closure of the local agricultural product boards at the end of 2014.Objectives: To describe the first documented outbreaks of CD in Dutch mink farms since the closure of the agricultural product boards, as well as an outbreak in Belgium, with special attention to genotyping of the isolates.Methods: A full post-mortem was performed on three carcasses per submission from farms A–C and on two carcasses from farm D. Molecular detection with subsequent typing was performed on eleven samples originating from four different farms. To assess genetic diversity partial sequences of the H gene of CDV were compared based on phylogenetic analysis.Results: In 2017, there was a sudden series of CD outbreaks affecting four mink farms in the Netherlands (A–C) and Belgium (D). Gross, histologic and immunohistochemical findings were similar. There was a degree of genetic similarity between the viruses on farms A and D (98.5%) and between the viruses on farms B and C (97.3%), but the viruses from farms A and D belonged to a different clade than the viruses from farms B and C. Higher mortalities were reported in white and pastel minks.Conclusions: Findings indicated that the difference in severity of the outbreaks was partially related to the genetic composition of the farm populations. Vaccination against CDV on Dutch and Belgian mink farms seems warranted.

Identification of an enterovirus recombinant with a torovirus-like gene insertion during a diarrhea outbreak in fattening pigs.

Diarrhea outbreaks in pig farms have raised major concerns in Europe and USA, as they can lead to dramatic pig losses. During a suspected outbreak in Belgium of porcine epidemic diarrhea virus (PEDV), we performed viral metagenomics to assess other potential viral pathogens. Although PEDV was detected, its low abundance indicated that other viruses were involved in the outbreak. Interestingly, a porcine bocavirus and several enteroviruses were most abundant in the sample. We also observed the presence of a porcine enterovirus genome with a gene insertion, resembling a C28 peptidase gene found in toroviruses, which was confirmed using re-sequencing, bioinformatics, and proteomics approaches. Moreover, the predicted cleavage sites for the insertion suggest that this gene was being expressed as a single protein, rather than a fused protein. Recombination in enteroviruses has been reported as a major mechanism to generate genetic diversity, but gene insertions across viral families are rather uncommon. Although such inter-family recombinations are rare, our finding suggests that these events may significantly contribute to viral evolution.

Different measles outbreaks in Belgium, January to June 2016 – a challenge for public health

During the first half of 2016, several outbreaks of measles were reported in the three regions of Belgium. Main challenges for public health were severe complications occurring in adults, nosocomial transmission and infection in healthcare workers. Here, we describe those outbreaks and lessons learnt for public health.

Complete genome sequence of a porcine epidemic diarrhea virus from a novel outbreak in belgium, january 2015.

Porcine epidemic diarrhea virus (PEDV) is a member of the family Coronaviridae and can cause severe outbreaks of diarrhea in piglets from different age groups. Here, we report the complete genome sequence (28,028 nt) of a PEDV strain isolated during a novel outbreak in Belgium.

Complete Genome Sequences of Two Escherichia coli O145:H28 Outbreak Strains of Food Origin.

Escherichia coli O145:H28 strain RM12581 was isolated from bagged romaine lettuce during a 2010 U.S. lettuce-associated outbreak. E. coli O145:H28 strain RM12761 was isolated from ice cream during a 2007 ice cream-associated outbreak in Belgium. Here we report the complete genome sequences and annotation of both strains.

Eradication of bluetongue disease in Germany by vaccination

Bluetongue disease first broke out in Germany on 21 August 2006, almost simultaneously with the first outbreaks in Belgium and The Netherlands. More extensive tests showed that the serotype was serotype 8. Due to westerly winds the disease spread rapidly towards the East, with the result that in the year 2008 large parts of Germany were affected. The traditional methods of animal disease control were not of much help in view of the transmission of the disease by insects; the speed of the spread of the disease could only be slowed down by movement restrictions, but could not be influenced in a decisive manner. Authorised vaccines were not (yet) available. A large-scale field study based on three prototypes in bovine animals and sheep revealed that they were both effective and safe. Consequently, the Federal Ministry of Food, Agriculture and Consumer Protection issued an exceptional permission to administer these non-authorised vaccines. In May 2008, large-scale vaccination campaigns were launched (vaccination of all bovines, sheep and goats). As a consequence, the disease outbreak figures declined drastically. In 2009, the last blanket vaccinations were administered and from 2010 animal keepers were allowed to continue vaccinating their livestock on a voluntary basis. Intensive tests (serological, PCR) showed in the years 2010 and 2011 that BTV8 no longer circulated among the livestock population. Effective from 15.02.2012, Germany declared itself free from BTV8 in line with Article 8.3.3 of the OIE Animal Health Code.

Bluetongue surveillance system in Belgium: A stochastic evaluation of its risk-based approach effectiveness

BackgroundThe aim of this study was to assess the sensitivity of the four major bluetongue surveillance components implemented in Belgium in 2007 for farmed animals and prescribed by the European Union regulation; winter serological screening, sentinel system, passive clinical surveillance, export testing. Scenario tree methodology was used to evaluate the relative sensitivity of detection and targeted approach of each component in terms of early detection and freedom of infection substantiation. Field data collected from the previous year's outbreaks in Belgium were used to determine the risk groups to be considered. ResultsThe best sensitivities at herd level, taking into account the diagnostic test sensitivity, design prevalence and the number of animals tested within a herd were obtained with the winter screening and sentinel component. The sensitivities at risk group level, taking into account the obtained herd sensitivity, effective probabilities of infection and number of herds tested were high in all components, except for the export component. Component sensitivities ranged between 0.77 and 1 for all components except for the export component with a mean value of 0.22 (0.17–0.26). In terms of early detection, the probability of detection was best using the passive clinical component or the sentinel component. Sensitivity analysis showed that the passive clinical component sensitivity was mostly affected by the diagnostic process and the number of herds sampled. The sentinel and export components sensitivity were mainly affected by the relative risk estimates whereas the winter screening component was mainly affected by the assumptions about the design prevalence. ConclusionsThis study revealed interesting features regarding the sensitivity of detection and early detection of infection in the different surveillance components and their risk based approach as requested by the international standards.

Model‐Based Prediction of Nephropathia Epidemica Outbreaks Based on Climatological and Vegetation Data and Bank Vole Population Dynamics

Wildlife-originated zoonotic diseases in general are a major contributor to emerging infectious diseases. Hantaviruses more specifically cause thousands of human disease cases annually worldwide, while understanding and predicting human hantavirus epidemics pose numerous unsolved challenges. Nephropathia epidemica (NE) is a human infection caused by Puumala virus, which is naturally carried and shed by bank voles (Myodes glareolus). The objective of this study was to develop a method that allows model-based predicting 3 months ahead of the occurrence of NE epidemics. Two data sets were utilized to develop and test the models. These data sets were concerned with NE cases in Finland and Belgium. In this study, we selected the most relevant inputs from all the available data for use in a dynamic linear regression (DLR) model. The number of NE cases in Finland were modelled using data from 1996 to 2008. The NE cases were predicted based on the time series data of average monthly air temperature (°C) and bank voles' trapping index using a DLR model. The bank voles' trapping index data were interpolated using a related dynamic harmonic regression model (DHR). Here, the DLR and DHR models used time-varying parameters. Both the DHR and DLR models were based on a unified state-space estimation framework. For the Belgium case, no time series of the bank voles' population dynamics were available. Several studies, however, have suggested that the population of bank voles is related to the variation in seed production of beech and oak trees in Northern Europe. Therefore, the NE occurrence pattern in Belgium was predicted based on a DLR model by using remotely sensed phenology parameters of broad-leaved forests, together with the oak and beech seed categories and average monthly air temperature (°C) using data from 2001 to 2009. Our results suggest that even without any knowledge about hantavirus dynamics in the host population, the time variation in NE outbreaks in Finland could be predicted 3 months ahead with a 34% mean relative prediction error (MRPE). This took into account solely the population dynamics of the carrier species (bank voles). The time series analysis also revealed that climate change, as represented by the vegetation index, changes in forest phenology derived from satellite images and directly measured air temperature, may affect the mechanics of NE transmission. NE outbreaks in Belgium were predicted 3 months ahead with a 40% MRPE, based only on the climatological and vegetation data, in this case, without any knowledge of the bank vole's population dynamics. In this research, we demonstrated that NE outbreaks can be predicted using climate and vegetation data or the bank vole's population dynamics, by using dynamic data-based models with time-varying parameters. Such a predictive modelling approach might be used as a step towards the development of new tools for the prevention of future NE outbreaks.