PCR-positive Cases Research Articles

Preliminary Study of Cutaneous Leishmaniasis (CL) in Zinder

Introduction: Cutaneous leishmaniasis (CL) is the most common clinical manifestation of leishmaniasis, a neglected tropical disease (NTD). It is caused by Leishmania transmitted to humans by the bite of a small infested sandfly: the female sandfly. The objective of our study is to determine the epidemiological, clinical profile and the nature of the parasite responsible for LC in Zinder. Materials and Method: This is a cross-sectional descriptive study. Retrospective data was collected from patients registered at the laboratory level of the district hospital and the Kara-kara health center from January 2017 to May 2021. This study helped determine the frequency of CL in the Zinder region as well as the socio-demographic characteristics of the cases. The prospective collection carried out at the HNZ over a period of seven (7) months from June 01, 2021 to December 31, 2021, made it possible to determine the nature of the parasite responsible for CL in Zinder as well as the management practices. Discussion/Conclusion: This study is the first to identify in molecular biology the parasite responsible for CL in Niger. The parasitic species identified in circulation in the city of Zinder was L. major for all PCR positive cases. Metronidazole was the reference treatment; administered orally. The evolution was favorable with a cure rate of 66% and 44% of sight loss.

P-130. A Case-Control Study of Post-Infectious Sequelae Following a Shiga Toxin-Producing Escherichia coli (STEC) Outbreak at a U.S. Marine Corps Recruit Depot

Abstract Background In November 2017, an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 and O26 occurred among male recruits at a United States Marine Corps Recruit Depot, San Diego, CA. We sought to evaluate the 6-year risk of hypertension (HTN), chronic kidney disease (CKD), and irritable bowel syndrome (IBS) following STEC infection by conducting a retrospective, case-control study utilizing medical record data.Table 1.Proportion of STEC cases and matched asymptomatic controls with post-infectious sequelae following November 2017 outbreak Methods Data from the outbreak investigation were used to identify cases and asymptomatic controls. Asymptomatic controls were recruits who were in the exposure area during the outbreak but remained asymptomatic and were negative for STEC by stool PCR. Cases were matched 1:4 with asymptomatic controls based on the duration of follow-up available in the Military Health System Data Repository (MDR). Controls could be matched to > 1 case. Post-infectious outcomes were assessed using ICD-10 diagnostic codes in the MDR. Results 239 cases were identified of whom 192 (80%) developed bloody diarrhea, 30 (13%) were hospitalized, and 17 (7%) developed hemolytic uremic syndrome (HUS). The stx-2 gene was detected in 39% of PCR positive cases. The median age of recruits was 19 years, and the median duration of MDR follow-up for cases and controls was 3.7 years (IQR: 2.9-5.4). There was no significant difference in the proportion of cases and controls with post-infectious sequelae (Table 1). Resolution of renal dysfunction was noted within 3 months after discharge for all HUS cases, and only 1 case remained hypertensive following discharge. There was no significant difference in the proportion of bloody diarrhea and HUS cases that developed IBS compared to controls. A limitation of the analyses was the short duration of MDR follow-up available for 6/30 hospitalized cases due to military separation after hospital discharge. Conclusion STEC infection in this cohort of young military recruits was associated with a good prognosis, even among cases of STEC-associated HUS, with resolution of renal dysfunction and no increase in incidence of IBS or HTN compared with asymptomatic controls. The findings suggest that STEC infection in young adults who recover from acute illness is not associated with a higher likelihood of post-infectious sequelae. Disclosures Ryan C. Maves, MD, AiCuris: Grant/Research Support|Biotest: Grant/Research Support|GeoVax: Grant/Research Support|Shionogi: Advisor/Consultant|Shionogi: Honoraria|Sound Pharmaceuticals: Grant/Research Support

P-644. Clinical and Sociodemographic Changes in Reported Pertussis Cases, Los Angeles County, 2014-2023

Abstract Background In 2020, the pertussis national case definition was revised to classify any symptomatic PCR-positive case as confirmed, no longer requiring a cough illness of at least 14 days. The revision intended to improve case ascertainment, but the annual number of pertussis cases reported to Los Angeles County (LAC) Department of Public Health (DPH) has decreased since 2020 due to the pandemic. We sought to describe demographic and clinical differences among pertussis cases reported to LAC before 2020 versus 2020 onwards. Methods All confirmed, probable, and suspect pertussis cases reported to LAC DPH from 2014 through 2023 were analyzed. Cases were categorized as pre-2020 (reported 1/1/2014 to 12/31/2019) or post-2020 (reported 1/1/2020 to 12/31/2023). Pearson’s chi-square test was used to assess bivariate associations between report period and case demographics and reported symptoms (paroxysms of coughing, inspiratory whoop, post-tussive vomiting, apnea with or without cyanosis, and cough illness lasting ≥14 days). A logistic regression model was built with report period as the outcome and symptoms and demographics as model covariates. Event modeled is post-2020 with pre-2020 as reference group. Results Of 6,594 cases reported, 391 (5.9%) cases were reported post-2020. Post-2020, the average annual case count decreased 91% from 1,034 to 98. Between time periods, case populations differed with respect to age and ethnicity (p< .001); sex remained similar (p=0.39). Post-2020, median case age decreased from 11 (interquartile range (IQR): 4-16) to 5 (IQR: 2-13). The prevalence of all symptoms decreased post-2020 (p< .001) (Figure 1). In the multivariable model, the association remained significant for cough illness lasting ≥14 days) (odds ratio (OR): 0.47 95% confidence interval (CI): 0.36-0.61) (Figure 2). This finding suggests that among those reporting cough illness lasting ≥14 days, the odds of diagnosis post-2020 versus pre-2020 were lower, after adjustment for age, sex, ethnicity, and other symptoms. Conclusion The revised 2020 case definition may have increased case sensitivity in certain populations and among pertussis cases with less severe symptomology. Clinicians may consider PCR testing as soon as pertussis illness is suspected, which could enable sooner public health intervention and prevention of secondary transmission. Disclosures Chelsea Foo, MPH, Assertio Holdings: Stocks/Bonds (Public Company)|Bionano Genomics: Stocks/Bonds (Public Company)|eHealth, Inc.: Stocks/Bonds (Public Company)|Johnson & Johnson: Stocks/Bonds (Public Company)

Molecular diagnosis and phylogenetic analysis of a Middle East respiratory syndrome coronavirus human case in Jordan.

Middle East respiratory syndrome coronavirus (MERS-CoV) is an important zoonotic pathogen. The aim of this paper is to report one polymerase chain reaction (PCR)-positive case of MERS-CoV in a 27-year-old man who was involved in a nationwide longitudinal surveillance study of certain zoonotic diseases in Jordan including MERS-CoV. Whole-blood and nasal swab samples were collected from the man and five camels in the vicinity of his living area. The samples were subjected to enzyme-linked immunosorbent assay (ELISA) and real-time reverse-transcription PCR (RT-PCR) to detect MERS-CoV-specific antibodies and MERS-CoV genetic material, respectively. Genomic sequencing and phylogenetic analysis were also performed to detect similarities with known strains of the virus in the region. In January 2021, an ongoing surveillance study detected a MERS-CoV-positive nasal swab sample from an asymptomatic male and camels using RT-PCR. Phylogenetically, the MERS-CoV isolated in this case belonged to clade B and is clustered with other strains originating in the Arabian Peninsula. The case report represents the first PCR-positive case of MERS-CoV in an asymptomatic individual in Jordan, indicating active circulation of the virus within the population.

Overview of COVID-19 Test Results (2021–2022) at the Laboratory of the Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia

Background: COVID-19 (Coronavirus Disease-19) is a respiratory infection caused by the SARS-CoV-2 virus. In 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic due to the rapid rise in cases and mortality rates worldwide. The pandemic has impacted millions of people and continues to pose a significant global public health threat. Accurate diagnosis of the disease depends on laboratory testing, with RT-PCR widely recognized as the gold standard for confirming COVID-19. Aims: To describe an overview of COVID-19 test results at Laboratory Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia, from 2021-2022. Methods: This study used a descriptive observational method. The sample was collected in July 2024 using a total sampling technique. The sample includes all 135,713 patients who had COVID-19 tests at Laboratory Faculty of Medicine Swadaya Gunung Jati Univesity between 2021 and 2022. Data were collected from medical records of COVID-19 test. The variables of this study include gender, age, and COVID-19 test results. A statistical analysis was used to determine frequency distribution. Results: The results of the study showed that among the sample who tested for COVID-19, the majority are male (50.9%) and early adolescent age group (23.9%). RT-PCR test findings were positive in 16.3% of patients and negative in 83.7% of patients. Among PCR positive cases, the majority are female (17.4%), with seniors age groups >65 years accounting for 39.0%. Conclusion: Most of the tested samples are males and early adolescent age groups, with more negative PCR results than positive ones. Among positive cases, the highest number was found in females and seniors age group. It is recommended that females and seniors age groups keep protected during COVID-19 outbreaks. Received: 25 September 2024 | Reviewed: 22 October 2024 | Revised: 30 November 2024 | Accepted: 11 December 2024.

Seroprevalence and Molecular Detection of Toxoplasma gondii in Wild Boars (Sus scrofa) in Khuzestan Province, Iran.

Toxoplasma gondii is a parasitic protozoan capable of infecting warm-blooded animals, including humans, and is the causative agent of toxoplasmosis. Wild boars (Sus scrofa) serve as reservoirs for zoonotic pathogens like T. gondii, which can cause disease in humans if transmitted. This study aimed to assess the seroprevalence and molecular prevalence of T. gondii in wild boars in Khuzestan Province, Iran. Seroprevalence of T. gondii antibodies was assessed using enzyme-linked immunosorbent assay (ELISA), employing a commercial kit (Calbiotech), whereas molecular detection was carried out through polymerase chain reaction (PCR) targeting the B1 gene of T. gondii on tissue samples (tongue, muscle, diaphragm and heart). Thirty wild boars were sampled from the regions of Shush, Shushtar, Dezful and Abadan, and both blood and tissue samples were analysed. In this study, the seroprevalence of T. gondii antibodies was found to be 83.3% (25/30) among wild boar serum samples using ELISA. Molecular detection through PCR identified T. gondii DNA in 46.7% (14/30) of tissue samples, with the highest detection rates in tongue tissues (64%), followed by muscle (21%) and diaphragm (14%). No positive results were found in heart samples, and no animal had multiple tissues testing positive. All PCR-positive cases corresponded with positive ELISA results, and a statistically significant difference was observed in parasite prevalence across different tissues (p = 0.002). Although consumption of wild boar meat is banned in Iran, illegal hunting and consumption remain a concern. The high prevalence of T. gondii in wild boars poses a potential risk for transmission through the illegal consumption of undercooked or raw meat. This study highlights the need for public health interventions to control the illegal trade of wild boar meat and reduce the risk of toxoplasmosis transmission. Further research is recommended to investigate T. gondii distribution in other tissues, including the brain, and to better understand the parasite's epidemiology in this region.

Antibodies to Anaplasma phagocytophilum in Patients with Human Granulocytic Anaplasmosis Confirmed by Both Polymerase Chain Reaction and Culture

Background/AimsSera from patients from a single medical institution in New York State with human granulocytic anaplasmosis established by a positive polymerase chain reaction test (PCR) for Anaplasma phagocytophilum were used to assess the performance of serologic testing. All cases were also confirmed by culture in order to eliminate any false positive PCR samples. MethodsA nested PCR was performed targeting the heat shock operon of A. phagocytophilum. Culture was done using the HL-60 promyelocytic cell line. Serologic testing was performed to detect IgG/A/M using an indirect immunofluorescence assay that incorporated a human isolate of A. phagocytophilum as the source of the antigen. ResultsFrom 1997-2009, 38 human granulocytic anaplasmosis patients were evaluated. On the baseline serum sample 21 (55.3%; 95% CI: 38.3% to 71.4%) had a positive serologic test; 7 samples (33.1%) were positive at a titer of 80-320 and 14 samples (66.7%) at a titer of at least 640. Sixteen (94.1%) of the 17 with a negative baseline test had follow-up testing performed. All 16 tested positive on a convalescent phase serum sample obtained from 6 to 45 days later. ConclusionPCR testing is the most commonly used direct diagnostic test to diagnose human granulocytic anaplasmosis. Our findings demonstrate that only approximately 55% of the PCR and culture positive cases were also seropositive on blood samples obtained at the same time point, indicating that serologic testing performed at the time of presentation has limited sensitivity. However, all of the 16 evaluable seronegative patients developed antibodies to A. phagocytophilum during convalescence.

Influenza Vaccine Effectiveness Against Symptomatic Influenza in Primary Care: A Test Negative Case Control Study Over Two Influenza Seasons 2022/2023 and 2023/2024 in Ireland.

Live attenuated influenza vaccine (LAIV) is recommended in Ireland for all children aged 2-17 years. Quadrivalent influenza vaccine (QIV) is recommended for all others eligible for vaccination, including those ≥ 18 years with underlying medical conditions and all aged ≥ 65 years. We aimed to estimate influenza vaccine effectiveness (IVE) against acute respiratory infection (ARI) presentations to primary care due to influenza over two influenza seasons in Ireland, to inform vaccination recommendations and communication campaigns. We undertook a test-negative case control study within the Irish sentinel general practice surveillance network as part of the Vaccine Effectiveness Burden and Impact Studies (VEBIS) network. We compared influenza vaccination status among influenza PCR positive cases with influenza PCR negative controls, both with ARI presentations, of all ages. We estimated IVE using logistic regression adjusting for age, onset time, medical conditions and sex. In 2022/2023, there were 288 cases and 765 controls. In 2023/2024, there were 567 cases and 1832 controls. In 2022/2023, overall IVE was 42% (95% CI 9 to 64) and 50% (95% CI -30 to 83) in 2- to 17-year-olds. Overall IVE in 2023/2024 was 35% (95% CI 15 to 51) and 68% (95% CI 30 to 87) in 2- to 17-year-olds. Influenza vaccination reduced the risk of influenza among ARI patients presenting to general practice, demonstrating the benefits of vaccination, particularly among children. Promotion of the seasonal influenza vaccine to recommended groups, should remain a public health priority. Targeted vaccination campaigns for children promoting LAIV should emphasise the effectiveness of LAIV in children.

Evaluating Senegal's COVID-19 surveillance system for early detection and response: lessons from the Keur Massar district, March 03, 2020 to May 31, 2022

BackgroundThe COVID-19 pandemic highlights the importance of strong surveillance systems in detecting and responding to public health threats. We sought to evaluate attributes of Keur Massar district's existing COVID-19 surveillance system.MethodA descriptive, cross-sectional study was conducted in June 2022; desk review covered data collected from March 03, 2020 to May 31, 2022 in 18 health posts. Data were collected using a standardized questionnaire completed during a face-to-face interview and a desk review of surveillance data gathered from different notification platforms (Excel, ODK, DHIS2 aggregated, and tracker). Study was conducted in Keur Massar department, in the Dakar region. We conducted face-to-face interviews with 18 nurses in June 2022. We utilized a standardized, semi-structured questionnaire adapted from CDC guidelines for surveillance evaluation.ResultsAll 18 head nurses targeted, responded to the questionnaire, with an average age of 41.5 years and 63% aged between 30 and 44. The sex ratio (M/F) was 0.6, and respondents had an average of 15.1 years of experience. All nurses were involved in COVID-19 surveillance and had notified at least one suspected case.While 39% conducted COVID-19 data analysis, 55.6% received feedback from the national level. The usefulness score for the surveillance system was 77.7, with the lowest score (72.9) related to describing the pandemic’s magnitude. Simplicity scored 63.3, with low scores for the availability of guidelines (0) but high scores for training and equipment (94.4). Acceptability scored 76.6, with strong support for COVID-19 surveillance but weak community involvement (48.6).While no cases were reported through the DHIS2 aggregated platform, 1327 PCR-positive SARS-CoV-2 cases were reported through the national Excel sheet and 278 PCR-positive cases were reported through the COVID-19 DHIS2 tracker during the same period. Timeliness varied, averaging 3 days using ODK and 7 days with the national Excel sheet, with a combined average of 5 days across both systems.ConclusionThe study highlights challenges in COVID-19 surveillance due to limited human resources, multiple data systems, and delays in notification. While most nurses were trained and equipped, gaps in data quality, timeliness, and community support emphasize the need for streamlined processes and increased workforce capacity.

Evaluation of Altered Oral Changes in Covid-19 PCR Positive Cases- A Cross Sectional Study

Background: The Coronavirus Disease caused by SARS-CoV-2 had rapid and worldwide transmission, which resulted in a significant number of fatalities. The virus is known to spread through close contact via exposure to infected droplets and aerosols, and it can infect cells in the upper respiratory tract. However, it was unclear whether the virus directly infects the tissues of the oral cavity and alter oral physiology, resulting in oral symptoms in many COVID-19 patients. Objective: The present study was performed to evaluate the altered oral changes in covid-19 PCR positive cases.Materials and Methods: The cross-sectional study was carried out in 211 PCR confirmed patients of SARS-CoV-2. Data was collected using a digital questionnaire for each patient. Saliva was collected through “passive drool” procedure. Both direct samples and extracted RNA were used for qRT-PCR targeting the conserved region of the SARS-CoV-2 genome, the N and ORF1ab genes. Descriptive statistics were computedResults: There were 211 confirmed patients of COVID-19, out of which 146 (69%) were male and 65 (31%) were female. Regarding oral symptoms in COVID-19 positive patients, Xerostomia and Amblygeustia were commonly reported, with 87% and 90.5% of patients experiencing these symptoms, respectively. Acute parotitis was also reported by 49(23%) patients, indicating that it may be a potential oral symptom of COVID-19. Conclusion: This study concludes that xerostomia (87%) and amblygeustia(90.5%) are common oral symptoms in SARS-CoV-2 positive patients, and acute parotitis(23%) is also a potential oral symptom. Keywords: Amblygeustia, COVID-19, Oral, Parotitis, Xerostomia.

Severe Acute Respiratory Syndrome Coronavirus 2 Household Transmission During the Omicron Era in Massachusetts: A Prospective, Case-Ascertained Study Using Genomic Epidemiology.

Households are a major setting for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, but there remains a lack of knowledge regarding the dynamics of viral transmission, particularly in the setting of preexisting SARS-CoV-2 immunity and evolving variants. We conducted a prospective, case-ascertained household transmission study in the greater Boston area in March-July 2022. Anterior nasal swabs, along with clinical and demographic data, were collected for 14 days. Nasal swabs were tested for SARS-CoV-2 by polymerase chain reaction (PCR). Whole genome sequencing was performed on high-titer samples. We enrolled 33 households in a primary analysis set, with a median participant age of 25 years (range, 2-66 years), 98% of whom had received at least 2 doses of a coronavirus disease 2019 (COVID-19) vaccine. Fifty-eight percent of households had a secondary case during follow-up and the secondary attack rate (SAR) for contacts was 39%. We further examined a strict analysis set of 21 households that had only 1 PCR-positive case at baseline, finding an SAR of 22.5%. Genomic epidemiology further determined that there were multiple sources of infection for household contacts, including the index case and outside introductions. When limiting estimates to only highly probable transmissions given epidemiologic and genomic data, the SAR was 18.4%. Household contacts of a person newly diagnosed with COVID-19 are at high risk for SARS-CoV-2 infection in the following 2 weeks. This is, however, not only due to infection from the household index case, but also because the presence of an infected household member implies increased SARS-CoV-2 community transmission.

Antibiogram and Salmonella typhi detection in suspected patients using advanced PCR technique, serology, and conventional blood culture

Background & Objectives: Salmonella enterica serovar Typhi is a diverse gram-negative bacillus that causes life-threatening invasive bloodstream infection and remains a public health burden in developing countries. The antimicrobial resistance in Salmonella typhi has led to widespread multidrug resistance strains making complication in the treatment and demanding alternative therapies. Various diagnostics test such as blood culture, serological assay, and molecular assay are available. PCR is a newer gold standard method, but blood culture is still considered a definitive diagnosis of typhoid fever. Materials and Methods: A cross-sectional study was conducted. Venous blood was collected, and a widal test was performed to detect antibodies against O and H antigens in serum. Blood culture, isolation, and identification were performed using the standard techniques. The antibiogram of isolates was performed by the Kirby Bauer method. Amplification of the hilA gene through PCR was used for the molecular diagnosis. Results: Out of 141 suspected typhoid patients, 78 were males, and 63 were females. PCR detected maximum positivity rate (70%) followed by Widal test (43.26%) and blood culture (16.25%). PCR positive cases were highly prevalent in the male in less than 15 years of age group (14.8%), followed by 15-30 (12.7%) and 30-45 (9.1%). The isolated organism was found to be 100% sensitive to most antibiotics studied, except ofloxacin, which showed 71.4% sensitivity. In contrast, all the isolates were 100% resistant to nalidixic acid. None of the isolates showed multi-drug resistance. Conclusion: PCR is a sensitive, rapid, and better alternative than conventional methods that can be used in clinical diagnosis for early detection of the Salmonella typhi.

Impact of the 2022 African Cup of Nations mass-gathering event on the COVID-19 epidemic in Garoua, Cameroon.

The 2022 African Cup of Nations (AFCON) took place in Cameroon from January 9th to February 5th, 2022, including Garoua in the north. We aimed to measure the impact of this event on the local COVID-19 epidemic given the implementation of a preventive strategy based on a health pass. All players, staff and fans involved in the AFCON event were screened with PCR tests. Symptomatic cases were also continuously monitored in the general population and screened for variants of concern. Daily numbers of confirmed cases were compared to neighboring countries numbers retrieved from a public domain source. In total, 1479 and 2481 tests were performed in the general population and on asymptomatic AFCON attendees, respectively. From the latter, 12.5% were PCR-positive; 97% were infected with Omicron, with no significant difference compared to the passive program (G-test, P value=0.162). Surveillance indicated the AFCON did not increase the number of symptomatic PCR-positive cases in the general population compared to neighboring countries. Though the COVID-19 epidemic was fueled by asymptomatic cases infected with the Omicron variant at the time, the non-therapeutic preventive measures implemented for AFCON mitigated an increase in the epidemic in the local population.

Do patients infected with human coronavirus before the COVID-19 pandemic have less risk of being infected with COVID-19?

Although seasonal human coronaviruses (HCoVs) have long been recognized as respiratory tract viruses, the newly identified SARS-CoV-2 caused a pandemic associated with severe respiratory failure. We aimed to evaluate the incidence of COVID-19 infection in patients diagnosed in three tertiary teaching hospitals, both with and without prior confirmed HCoV infection, and to compare these cohorts in terms of COVID-19 contraction. In our study, we examined HCoV PCR-positive cases obtained retrospectively between January 2014 and March 2020 from three University Hospital Microbiology Laboratories (Cohort 1), as well as PCR-negative patients detected in the same PCR cycle as the positive cases (Cohort 2). We also evaluated subgroups of HCoV-positive cases. There was no difference in COVID-19 contraction rates between Cohort 1 and Cohort 2 (p = 0.724). When previous HCoV subgroups of COVID-19-positive patients were examined, no significant difference was found between the betacoronavirus and alphacoronavirus subgroups (p = 0.822), among the four groups (NL63, 229E, OC43, HKU-1) (p = 0.207), or between the OC43 subgroup and the other groups (p = 0.295). Being previously infected with HCoV did not provide protection against COVID-19 in our study group. We suggest evaluating the possible effect of previous OC43 infection on COVID-19 contraction in larger cohorts.

Evidence of Orientia spp. Endemicity among Severe Infectious Disease Cohorts, Uganda.

At 3 severe infection cohort sites in Uganda, Orientia seropositivity was common. We identified 4 seroconversion cases and 1 PCR-positive case. These results provide serologic and molecular support for Orientia spp. circulating in sub-Saharan Africa, possibly expanding its endemic range. Orientia infections could cause severe illness and hospitalizations in this region.

Efficacy and safety of Chinese herbal medicine to prevent and treat COVID-19 household close contacts in Hong Kong: an open-label, randomized controlled trial.

To evaluate the efficacy and safety of CHM in the prevention of COVID-19 infection and treatment for COVID-19 related symptoms. Prospective open-label randomized controlled trial. Participants' home in Hong Kong. Participants who had household close contact with COVID-19-infected family members. Close contacts were stratified into 4 groups (cohort A, B, C, D) based on symptoms and infection status and were randomized in 4:1 ratio to receive CHM granules (9g/sachet, two times daily) or blank control for 7 days with 2 weeks of follow-up. The primary outcome measure was the rate of positive nucleic acid tests. Secondary outcomes were the proportion of developed COVID-19 related symptoms and adverse events during the whole 3-week study period. Subgroup analysis was used to evaluate demographic factors associated with positive infection rates. A total of 2163 contacts were enrolled and randomly assigned to the CHM group (1720 contacts) and blank control (443 contacts) group. During the 21 days, the rate of PCR-positive cases in cohort A was markedly lower in the CHM group (3.6%) compared to the control group (7.0%) (P=0.036). Overall, the rate of infection in the CHM group was significantly lower than that in the control group (10.69% vs. 6.03%; RR 0.56, 95% CI 0.39-0.82) after 7-day treatment. No serious adverse events were reported during the medication period. The preliminary findings indicate that CHM may be effective and safe in preventing COVID-19. Future double-blind, randomized controlled trials and long-term follow-up are needed to fully evaluate the efficacy of CHM in a larger contact population. ClinicalTrials.gov, identifier NCT05269511.

Assessing the Impact of the 2020 Council of State and Territorial Epidemiologists Case Definition for Pertussis on Reported Pertussis Cases.

In 2020, the Council of State and Territorial Epidemiologists (CSTE) pertussis case definition was modified; the main change was classifying polymerase chain reaction (PCR)-positive cases as confirmed, regardless of cough duration. Pertussis data reported through Enhanced Pertussis Surveillance (EPS) in 7 sites and the National Notifiable Diseases Surveillance System (NNDSS) were used to evaluate the impact of the new case definition. We compared the number of EPS cases with cough onset in 2020 to the number that would have been reported based on the prior (2014) CSTE case definition. To assess the impact of the change nationally, the proportion of EPS cases newly reportable under the 2020 CSTE case definition was applied to 2020 NNDSS data to estimate how many additional cases were captured nationally. Among 442 confirmed and probable cases reported to EPS states in 2020, 42 (9.5%) were newly reportable according to the 2020 case definition. Applying this proportion to the 6124 confirmed and probable cases reported nationally in 2020, we estimated that the new definition added 582 cases. Had the case definition not changed, reported cases in 2020 would have decreased by 70% from 2019; the observed decrease was 67%. Despite a substantial decrease in reported pertussis cases in the setting of coronavirus disease 2019 (COVID-19), our data show that the 2020 pertussis case definition change resulted in additional case reporting compared with the previous case definition, providing greater opportunities for public health interventions such as prophylaxis of close contacts.

Cytopathological study of pleural effusion in SARS-CoV2 RTPCR positive subjects during pandemic at tertiary care hospital

Introduction and Aim: Respiratory system is the most common system affected by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Review of literature reveals that pleural effusion were seen in one third of cases with Middle East Respiratory Syndrome(MERS) but were rarely reported in SARS –CoV2.This study aims to study the cytomorphological changes in Pleural effusion seen in SARS CoV-2 positive cases, to correlate the cytological findings with radiological CT COVID-19 Reporting and Data System(CORADS)scorings and to categorize pleural effusion as isolated cause of SARS CoV-2 or aggravation of underlying other etiologies. Materials and Methods: Pleural fluid samples of SARS CoV-2 RT PCR positive cases, obtained from patients of all age groups were included in the study. The samples were predominantly from Covid19 wave 1 (March 2020- February 2021) and few from Covid wave 2(March 2021-April 2021). Biochemical analysis, hematological parameters, cytomorphology and associated comorbidity was recorded, and analysis done. Results: Male predominance was observed. Most common cytological and biochemical finding in pleural fluid analysis was Exudative pleural effusion. Predominant cytological features showed lymphocytic effusion. Radiology showed maximum left sided pleural effusion (42%). CORADS score was 6 in majority of cases and effusion as an isolated cause was seen in few cases. Conclusion: Pleural effusion is a rare finding in SARS COV-2 induced bronchopneumonia. Effusion is seen with a high CORADS score, and they carry a high risk of mortality. This study suggests having SARS CoV-2 infection as a differential diagnostic entity when we find the mentioned morphological and biochemical findings as discussed in the present study.

The Prognosis of Crimean-congo Hemorrhagic Fever in Thiqar City, South of Iraq, in 100 Cases over 2022

Background:: The study of Crimean-Congo hemorrhagic fever (CCHF) worldwide is of low rate as it is an uncommon disease. The outbreak in Iraq in 2022 is high. Aim:: To study the prognosis of hemorrhagic fever patients in Thi-Qar governorate, where the highest rate of the disease is, so that we might expect the fat of the disease. : Patients and Methods: A descriptive cases series of cross-section studies that included all patients with severe or life-threatening Crimean-Congo hemorrhagic fever(CCHF) PCR-positive cases (out of the total 100) admitted and followed up in AL-Hussain Teaching Hospital in 2022. To study patients' features that indicate the prognostic factors of the disease. Results:: All cases proved to be CCHF by PCR were 100 patients of variable severity, 14 cases were admitted to intensive care units (ICU), 13 patients died, 2 pregnant ladies were infected with CCHF unfortunately died, 16 children admitted to hospital 2 of them died and 14 cases completely cured. The most serious cases are intrapulmonary hemorrhage and neuropsychiatric presentation. Conclusion:: There are many clinical and laboratory prognostic markers. The riskiest clinical bad prognostic factor is the neuropsychiatric and pulmonary hemorrhage and CCHF in pregnant ladies.

Risk factors for SARS-CoV-2 infection: a test-negative case–control study with additional population controls in Norway

ObjectivesThis study aims to assess risk factors for SARS-CoV-2 infection by combined design; first comparing positive cases to negative controls as determined by PCR testing and then comparing these two...