Persons In Close Contact Research Articles

Assessing effective half-life of I-131 in 39 thyroid cancer patients at Dong Nai General Hospital

Radioiodine therapy to kill the residual cells after surgery in thyroid cancer patients is a widespread treatment method nowadays. Despite the therapeutic benefits, the amount of I-131 that remains in the patient's body also causes radiation risks to caregivers and persons in close contact. This study assesses the effective half-life () of I-131 in 39 patients underwent thyroid cancer treatment at Dong Nai General Hospital. Radioactive activity on the patient's body was measured by survey meter GAL20-C (ELSE SOLUTIONS), placed 1.0 meters away from the patient, at 0.5; 2.0; 4.0; 6.0; 24.0 hours; and 7 days after administration. The measurement data was fitted by a mono-exponential function respecting time by the least squares method to figure out the effective half-life. The result function has a good coefficient of determination, R2 ~ 1, Te was 7.89 +- 1.55 h (high-activity group), and 5.83+-1.76 h (low-activity group). The effective half-life was proved to be different between these two groups of patients.

The Pattern of Tuberculosis in Iran: A National Cross-Sectional Study.

Despite of the remarkable achievement in control of tuberculosis, it is still a challenging health problem in Iran. Success in any health program depends on monitor the diseases epidemiology and finding the gaps. We aimed to describe the epidemiological profile of TB patients in Iran to find the gaps in the TB program and using the finding to set the program activities. This cross-sectional study was performed based on the data of tuberculosis patients registered in Iran in 2016-2017. The information of all TB patients is registered in the TB registry software. The patients were followed during the treatment phase. The data were analyzed by SPSS 23 software using Chi-Square test. Overall 12% of cases were Afghans and 72.3% of patients had pulmonary tuberculosis. There was a significant difference in the success rate of treatment in smear-positive pulmonary patients by gender, HIV status, marital status, history of hospitalization and incarceration (P <0.01). The highest prevalence of antibiotic resistance was related to isoniazid (9.9%). In close contact persons who requiring prophylaxis, 65.3% of adults and 73.6% of children received full period of prophylaxis. Despite of the TB treatment success and low prevalence of MDR cases, TB incidence has not been decreased significantly in Iran. Delay in diagnosis, high TB burden in refugees and close contact investigation and prophylaxis are important issues in the TB control program in Iran to be considered in the control planning.

Public health responses to COVID-19 in Japan.

Two years have passed since the confirmation of the first case of coronavirus disease (COVID-19) in Japan. The aim of this article was to review the public health responses to COVID-19 in Japan. As of January 31, 2022, COVID-19-positive cases have cumulatively totaled 2,669,638 and deaths cases have cumulatively totaled 18,784. To deter COVID-19 transmission in the community, the government declared a state of emergency to minimize the impact on people's livelihoods and the economy. The prefectural (province) governor of an area under a "State of Emergency" may request special action to prevent the spread of infection among residents. A nationwide campaign, Avoid the "3 Cs" (Closed spaces, Crowded spaces, and Close-contact settings), has been widely acknowledged to have controlled infection in high-risk areas. In Japan, COVID-19 vaccines were supplied by Pfizer, Moderna, and AstraZeneca. Pfizer's vaccine received regulatory approval in Japan in February 2021, and Moderna and AstraZeneca's did so in May 2021. Public health centers (PHCs) under the jurisdiction of local governments are responsible for conducting Polymerase Chain Reaction (PCR) testing, coordinating the treatment of COVID-19-positive patients, and identifying persons in close contact with COVID-19 patients through an epidemiological study of each positive case. These public health responses have been implemented based on the assessment of the impact of each variant and support from a government panel of experts. Further studies may be need to be conducted develop more flexible and efficient public health responses.

Few SARS-CoV-2 infections detected in Newfoundland and Labrador in the absence of Public Health Laboratory-based confirmation.

To assess the incidence of COVID-19 infection in the absence of a confirmatory test in persons suspecting they contracted COVID-19 and elucidate reasons for their belief. We recruited persons with a confirmed COVID-19 diagnosis and persons who believed they may have contracted COVID-19 between December, 2019 and April, 2021 into a study of immunity against SARS-CoV-2. An intake questionnaire captured their perceived risk factors for exposure and symptoms experienced, including symptom duration and severity. ELISA testing against multiple SARS-CoV-2 antigens was done to detect antibodies against SARS-CoV-2. No participant had received COVID-19 vaccination prior to the time of testing. The vast majority of study subjects without Public Health confirmation of infection had no detectable antibodies against SARS-CoV-2. Suspected infection with SARS-CoV-2 generally involved experiencing symptoms common to many other respiratory infections. Unusually severe or persistent symptoms often supported suspicion of infection with SARS-CoV-2 as did travel or contact with travelers from outside Newfoundland and Labrador. Rare cases in which antibodies against SARS-CoV-2 were detected despite negative results of Public Health testing for SARS-CoV-2 RNA involved persons in close contact with confirmed cases. Broad public awareness and declaration of pandemic status in March, 2020 contributed to the perceived risk of contracting COVID-19 in Newfoundland and Labrador from late 2019 to April 2021 and raised expectation of its severity. Serological testing is useful to diagnose past infection with SARS-CoV-2 to accurately estimate population exposure rates.

Multi-household social gatherings contribute to the second SARS-CoV-2 wave in Rhineland-Palatinate, Germany, August to November 2020

BackgroundAlthough the private household setting is considered a major driver of viral spread, only little is known about the contextual details of SARS-CoV-2 household transmission, thus hampering political decision-making. Materials and methodsWe analyzed individual case and cluster data from statutory notifications from August to November 2020 in Rhineland-Palatinate - the period preceding the second SARS-CoV-2 wave. We also conducted an into-depth survey on contextual details of household transmission in a representative sample of 149 private household clusters that had occurred during this period. ResultsDuring the study period, 18,695 PCR-confirmed SARS-CoV-2 cases were notified, 3,642 of which occurred in 911 clusters (private households (67.3%), the workplace (7.8%), elderly homes (1.8%), others (23.2%). Demographically, clustered cases were representative of all notified cases. Two-thirds (77/113, 68%) of sample response clusters involved more than one private household. These caused on average more close contact persons (mean 13.5, ±SD 15.8) and secondary cases (3.9, ±SD 0.4) than clusters involving one household only (5.1 ± 13.8 and 2.9 ± 0.2). About one in six multi-household clusters in the private setting (13/77) followed a social gathering (e.g. birthday party). Breaches of one or more of the three major barrier concepts (mask, ventilation, and distance) were identified in most (10/13) of these social gatherings. SARS-CoV-2 clusters following social gatherings were overrepresented during the second half of the study period. ConclusionIn times of increasing infectious pressure in a given population, multi-household social gatherings appear to be an important target for reducing SARS-CoV-2 transmission.

Transmission of SARS-CoV-2 among children and staff in German daycare centres.

In daycare centres, the close contact of children with other children and employees favours the transmission of infections. The majority of children <6 years attend daycare programmes in Germany, but the role of daycare centres in the SARS-CoV-2 pandemic is unclear. We investigated the transmission risk in daycare centres and the spread of SARS-CoV-2 to associated households. 30 daycare groups with at least one recent laboratory-confirmed SARS-CoV-2 case were enrolled in the study (10/2020-06/2021). Close contact persons within daycare and households were examined over a 12-day period (repeated SARS-CoV-2 PCR tests, genetic sequencing of viruses, symptom diary). Households were interviewed to gain comprehensive information on each outbreak. We determined primary cases for all daycare groups. The number of secondary cases varied considerably between daycare groups. The pooled secondary attack rate (SAR) across all 30 daycare centres was 9.6%. The SAR tended to be higher when the Alpha variant was detected (15.9% vs. 5.1% with evidence of wild type). The household SAR was 53.3%. Exposed daycare children were less likely to get infected with SARS-CoV-2 than employees (7.7% vs. 15.5%). Containment measures in daycare programmes are critical to reduce SARS-CoV-2 transmission, especially to avoid spread to associated households.

Vaccination during pregnancy

HintergrundSchwangere, Feten und Säuglinge weisen aufgrund von Besonderheiten ihres Immunsystems eine erhöhte infektionsbedingte Morbidität und Mortalität auf, die durch den Einsatz von Impfungen während der Schwangerschaft reduziert werden kann.ZielIn diesem Beitrag werden die Wirkungsweise, die Evidenz der zu erwartenden Effekte, Kontraindikationen und mögliche Nebenwirkungen von Impfungen in der Schwangerschaft erläutert.MethodeEs wurde eine selektive Literaturrecherche unter besonderer Berücksichtigung der Empfehlungen der Ständigen Impfkommission am Robert Koch-Institut (STIKO) und einschlägiger Leitlinien durchgeführt.ErgebnisseImpfungen in der Schwangerschaft schützen die werdende Mutter vor schweren Verläufen einzelner Infektionskrankheiten und damit verbundenen Schwangerschaftskomplikationen. Zudem vermitteln sie dem Neugeborenen durch die vertikale Übertragung mütterlicher Antikörper einen passiven Immunschutz vor lebensbedrohlichen Infektionen. Für die Impfung mit inaktivierten Impfstoffen gegen Tetanus, Influenza und Pertussis sind Wirksamkeit und Sicherheit gut belegt. Impfungen mit Lebendvakzinen sind wegen ihres theoretischen Risikos für den Fetus kontraindiziert. Die Datenlage zur Anwendung der Impfstoffe gegen die „coronavirus disease 2019“ (COVID 19) ist noch limitiert.DiskussionImpfungen in der Schwangerschaft zielen auf den direkten Schutz der Schwangeren durch aktive Immunisierung und/oder des Kindes durch natürliche passive Immunisierung. Schwangere sollten von einer indizierten Impfung zum eigenen Schutz und dem des Kindes nicht ausgeschlossen werden. Zusätzliche sinnvolle Maßnahmen zum Schutz der Gesundheit von Mutter und Kind sind die Impfung enger Kontaktpersonen sowie das Schließen relevanter Impflücken junger Erwachsener, insbesondere bei Frauen im gebärfähigen Alter.

Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in day care centres – Lessons learned from a prospective analysis of outbreaks in Germany

Abstract Background The role of children for the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still unclear. The aim of our case-ascertained study is to examine transmission dynamics of SARS-CoV-2 among children and staff based on outbreaks in day care centres in Germany. Methods Based on day care centres with at least one reported case of SARS-CoV-2 we include 1-6-year-old children and staff of the affected group in the day care centre as well as their respective households. We test each study participant on acute and past SARS-CoV-2 infection with innovative child friendly tests and collect data on sociodemographics and symptoms. At four further measurement points within 12 days, the participants carry out the tests on SARS-CoV-2 by themselves. From October 2020 to May 2021, 25 day care centres with SARS-CoV-2 outbreaks participated and we included n = 244 children 1-6 years and n = 72 staff members in the study. Results First analyses from 25 outbreaks showed that the observed infection events in the examined day care centres were very different. Often, no or only few transmissions were found among the participants in the day care group, but in one day care centre, 13 people were infected: Between 0% and 81% of close contact persons in the day care centres were tested positive for SARS-CoV-2 in the study period. Children showed a similar percentage of secondary SARS-CoV-2 infections compared to adults (both 11%). Conclusions The study has been successful in detecting previously undetected infections of SARS-CoV-2 in day care centres. Results of these outbreaks examinations are presented regularly in public reports to inform public health decision-makers. By studying individual day care centre-related infection dynamics the data supplement the information from national reporting data.

Vaccination in Pregnancy.

Vaccination during pregnancy can protect both the expecting mother and the unborn and newborn child from infectious diseases. This review is based on publications retrieved by a selective literature search on the immunological particularities of infectious diseases affecting pregnant women, unborn children, and neonates, with particular attention to the guidelines of the German Standing Committee on Vaccinations (Ständige Impfkommission, STIKO) and the pertinent guidelines. Vaccination during pregnancy protects the expecting mother from a severe course of a number of different infectious diseases. Vaccination with inactivated vaccines against influenza, tetanus, and pertussis is effective, safe, and well tolerated. Women who are pregnant or of child-bearing age should be immunized against tetanus according to the STIKO recommendations. All pregnant women from the second trimester onward should receive an inactivated quadrivalent influenza vaccine. The immunity acquired after vaccination with an acellular pertussis vaccine is present only for a limited time. In a cohort study involving 72,781 pregnant women, pertussis vaccination during pregnancy was found to yield 91% protection against pertussis for their subsequently born children in the first three months of life. Further types of vaccine can also be given during pregnancy if indicated. Additional reasonable measures to protect the health of mother and child include the vaccination of other persons in close contact as well as the closure of relevant vaccination gaps among young adults, particularly women of child-bearing age. Treating physicians play a crucial role in encouraging vaccine acceptance by their patients. Maternal immunization is a safe and effective strategy for giving neo - nates passive immune protection against life-threatening infections by the vertical transmission of maternal antibodies until they are able to build up their own adaptive immunity.

An institutional approach to governance and corruption in Kosovo

The main purpose of this paper is to analyze the activity of various state bodies which by implementing the law and bylaws protect the rule of law, democracy and human rights, honesty and social justice, and how these bodies are influenced by factors of various aspects of corruption, such as incompatibility between holding public office and carrying out profitable activities for officials, restrictions on the acceptance of gifts related to the performance of official duties, supervision of their assets and persons in close contact with them. Although corruption is widely and publicly discussed, the clearest definition is that corruption constitutes an abuse of office for private gain (The World Bank Group, 1997). To analyze this phenomenon, we will analyze the data published by the Anti-Corruption Agency (ACA), the data published by the Kosovo Special Prosecution Office, the data published by the EU progress report on Kosovo, as well as the published data by the Courts. Data analysis concludes on descriptive statistics, tables, and graphs of criminal reports, processed cases, and court decisions. Given that, corruption is severely damaging the country, we believe that corruption is the main obstacle for Kosovo to move forward in the dialogue on visa liberalization and get a positive response regarding the Stabilization and Association Agreement (SAA) (Transparency International, n.d.). The study concludes that corruption is widespread in the main institutions of the country and its high presence in the judiciary is a very worrying issue. This paper is of great importance for policymakers, officials, scholars as to the processing, publication, and sanctioning will enable this phenomenon that has become a new way of governing to be stopped and the state to be built for society and to belong to society (Bekim, 2017).

Epidemiological characteristics of COVID-19 in Wuchang district of Wuhan

Objective: To analyzes epidemiological characteristics of COVID-19 and provide evidence for adjustment for COVID-19 prevention and control strategies. Methods: The data of COVID-19 cases in Wuchang district reported as of 19 March, 2020 were obtained from National Notifiable Disease Report System of Chinese Disease Prevention and Control Information System. The software's of Excel 2010, SPSSS 22.0, Arc GIS10.2 and Joinpoint regression program 4.8.0.0 were used for statistical analysis. Results: A total of 7547 COVID-19 cases had been reported as of 19 March, 2020 in Wuchang district, including 5 448 confirmed cases (72.19%), 2009 clinical diagnosed cases (26.62%) and 90 asymptomatic cases case (1.19%). The age of the cases was (56.65±16.25) years and age ranged from 2 days to 105 years among confirmed cases, 2634 were males (48.35%) and 2814 were females (51.65%), 2 492 were retirees (45.74%). A total of 545 health workers were infected with SARS-CoV-2 (7.22% of all cases) including 365 confirmed cases and 5 cases have died. A total of 430 cases of death were reported with case fatality rate of 7.89% (430/5 448), case fatality rate of males (10.9%, 266/2 634) was higher than that of females (5.82%, 164/2 814). The first phase of epidemic peak was from January 24 to January 26, the second phase of epidemic peak was from February 1 to February 5 and there was no one of new confirmed case in one day for the first time on March 18. The first four Streets with the highest incidence rates of confirmed cases were Huanghelou Street (1 043.77/100 000), Ziyang Street (627.97/100 000), Yangyuan Street (503.67/100 000) and Shuiguohu Street (486.02/100 000). Compared with females, aged ≤50 years and mild cases of clinical classification respectively, males (RR=0.690, 95%CI: 0.322-1.478), aged >50 years (RR=11.745, 95%CI: 6.878-20.058), severe cases (RR=2.317, 95%CI: 1.789-3.000) and critical cases of clinical classification (RR=10.794, 95%CI: 7.997-14.569), and gender time-dependent covariate (RR=1.392, 95%CI: 1.053-1.840) were major influencing factors of prognosis of COVID-19 confirmed cases. Conclusions: The gender, ages and occupation of distribution were wide among COVID-19 cases in Wuchang district. Males, aged >50 years, severe cases and critical cases of clinical classification were influencing factors of prognosis of COVID-19 confirmed cases. The standardized management of discharged cases, asymptomatic infected cases and close contact persons were main measures to reduce incidence rates of COVID-19 cases.

COVID-19 and Educational Engagement

COVID-19 and Educational Engagement

Prevalence of ticks on indigenous breed of hunting dogs in Ogun State, Nigeria

Ticks are haematophagous arthropods that are important vectors of diseases of animals and humans, many of which are zoonotic, thus predisposing humans, including hunters to risk. The present study was conducted to assess the prevalence of tick infestation among hunting dogs with the aim of determining the danger which the presence of ticks portends, bearing in mind that hunting dogs are kept by the duo of rural and urban dwellers. A total of one hundred and nine (109) hunting dogs were sampled from nineteen (19) different locations in the State. The age, weight and sex of the dogs were noted and recorded as variables. The dogs were thoroughly examined for ticks and other ectoparasites which were collected into properly labelled plastic containers and were transported to the laboratory for identification. Chi-square test was used to compare the prevalence of tick infestation between recorded variables. Significance level was set at p = 0.05 or less. The overall prevalence of tick infestation in the 109 hunting dogs was 56%. The tick prevalence in the male dogs (66.7%) and that in the female dogs (51.9%) was not significantly (p&gt; 0.05) different. Also, tick prevalence in young dogs (53.8%) and adult dogs (62.1%) was not significantly (p&gt;0.05) different. There was a significant difference in the prevalence of tick infestation from urban and rural locations (p&lt;0.05). Of the 352 ticks harvested from the hunting dogs, Rhipicepalus sanguineus constituted 68.2%, Haemaphysalis leachi leachi, 30.6%; and Ambylomma variegatum, 1.21%. The education of the hunters and other persons in close contact with dogs is required for the control of ectoparasites.Keywords: Hunting dogs, Indigenous, Nigeria, Prevalence, Ticks

Surveys and Proposals of the Infectious Disease Home Isolation through Middle East Respiratory Syndrome (MERS) Transmission

Background The purpose of this study was to identify the degree of home isolation and to determine what is needed for an effective home isolation through experience with home isolation that has been found to be in close contact persons with MERS-confirmed patient. Methods We conducted a questionnaire survey of employees at a university hospital in Seoul, Korea, which were classified as close contact with the MERS patient who visited the emergency room in June 2015. The questionnaire items were prepared by referring to the MERS response guideline, 3-3 edition. Results There were 81respondents in total. At the time of home isolation notification, 74 (91.4%) were guided by the instructions. At the time of home isolation notification, 42 (51.9%) persons were out of the home. When they comed back home, 7 (16.7%) persons were ambulanced-supported, but 14 (33.3%) used public transportation. the performance of “keeping inside home” was 4.51 out of 5, and the perfomance of “twice daily monitoring” was 3.68 out of 5. Conclusion As the result of survey suggests, overall isolation practices were satisfactory, but there were difficulties in home isolation practices such as the supply of daily necessities, monitoring of symptom manifestations, and worries about family infections. Therefore, it is advisable to fix the home isolation problems in tandem with the isolation of facilities.

Occurrence and molecular characteristics of ESBL/AmpC-producing Escherichia coli in faecal samples from horses in an equine clinic.

To investigate the occurrence and characteristics of ESBL/AmpC-producing Escherichia coli in faecal samples from horses at one equine clinic in the Netherlands. A total of 91 horses, including residents and patients, were sampled. ESBL/AmpC-producing E. coli were identified by a combination disc diffusion test. Phylogenetic groups and MLST were determined. ESBL/AmpC genes were analysed using PCR and sequencing. Plasmids were characterized by transformation and PCR-based replicon typing. Subtyping of plasmids was done by plasmid MLST. At least one E. coli isolate with a confirmed ESBL/AmpC gene was found in samples from 76 horses (84%). Although phylogenetic group B1 E. coli bla CTX-M-1 predominated, a diverse E. coli population was found, indicating that clonal nosocomial spread was not the only reason for the high occurrence found. MLST analysis revealed the presence of 47 E. coli STs, organized in four clusters of genetically related strains. ST10, ST641, ST1079 and ST1250 were most commonly found. With regard to the genes, bla CTX-M-1 was most prevalent ( n = 91), followed by bla CTX-M-2 ( n = 26). The most frequently found plasmid type was IncHI1, but plasmids belonging to the IncF, IncI1 and IncN groups were also identified. A high occurrence of ESBL-producing E. coli in faecal samples was found among horses in an equine clinic and the variety of STs, ESBL genes and plasmid types suggests nosocomial transmission. ESBL E. coli can cause difficult-to-treat infections in horses and prudent use of antimicrobials is warranted. A further assessment of the risks of transmission to persons in close contact with horses, such as caretakers or veterinarians, is crucial.

Rediscovering Pertussis.

Pertussis, caused by Bordetella (B.) pertussis, a Gram-negative bacterium, is a highly contagious airway infection. Especially in infants, pertussis remains a major health concern. Acute infection with B. pertussis can cause severe illness characterized by severe respiratory failure, pulmonary hypertension, leucocytosis, and death. Over the past years, rising incidence rates of intensive care treatment in young infants were described. Due to several virulence factors (pertussis toxin, tracheal cytotoxin, adenylate cyclase toxin, filamentous hemagglutinin, and lipooligosaccharide) that promote bacterial adhesion and invasion, B. pertussis creates a unique niche for colonization within the human respiratory tract. The resulting long-term infection is mainly caused by the ability of B. pertussis to interfere with the host’s innate and adaptive immune system. Although pertussis is a vaccine-preventable disease, it has persisted in vaccinated populations. Epidemiological data reported a worldwide increase in pertussis incidence among children during the past years. Either acellular pertussis (aP) vaccines or whole-cell vaccines are worldwide used. Recent studies did not detect any differences according to pertussis incidence when comparing the different vaccines used. Most of the currently used aP vaccines protect against acute infections for a period of 6–8 years. The resurgence of pertussis may be due to the lack of herd immunity caused by missing booster immunizations among adolescents and adults, low vaccine coverages in some geographic areas, and genetic changes of different B. pertussis strains. Due to the rising incidence of pertussis, probable solution strategies are discussed. Cocooning strategies (vaccination of close contact persons) and immunizations during pregnancy appear to be an approach to reduce neonatal contagiousness. During the past years, studies focused on the pathway of the immune modulation done by B. pertussis to provide a basis for the identification of new therapeutic targets to enhance the host’s immune response and to probably modulate certain virulence factors.

Pertussis: Where did we go wrong and what can we do about it?

Pertussis or whooping cough, mainly caused by the Gram-negative coccobacillus Bordetella pertussis, is a severe respiratory disease that can by life-threatening especially in young infants. It has recently made a spectacular come-back in high vaccination-coverage countries, such as the US, Australia and many European countries. Although a trend towards increased pertussis incidence was already visible before the switch from whole-cell to acellular vaccines, it was really since the introduction of the acellular vaccines that the number of cases reached record highs. Several hypotheses have been proposed to explain these observations. Unexpectedly fast waning of acellular vaccine-induced protection may be one of the major reasons. Furthermore, evidence from a recent non-human primate model suggests that acellular vaccines, although protective against pertussis disease, do not protect against B. pertussis infection, which may explain many of the current observations on the resurgence of pertussis. Optimized use of current vaccines has been explored, including cocoon vaccination of persons in close contact with newborn infants, neonatal vaccination and maternal immunization during pregnancy. All have their inherent limitations. New vaccines are therefore desperately needed, and current efforts have been geared towards the identification of novel antigens and adjuvants to prolong immunity and ameliorate protection. The most advanced vaccine candidate is live attenuated nasal BPZE1, a genetically modified B. pertussis derivative that has recently completed a first-in-man phase I trial and was shown to be safe in young male volunteers, able to transiently colonize the naso-pharynx and to induce antibody responses to B. pertussis antigens. This vaccine candidate is designed to protect against both pertussis disease and B. pertussis infection and may therefore be useful for long-term control of pertussis.

Risk factors for latent tuberculosis infection in close contacts of active tuberculosis patients in South Korea: a prospective cohort study.

BackgroundThe diagnosis and treatment of latent tuberculosis infection (LTBI) have become mandatory to reduce the burden of tuberculosis worldwide. Close contacts of active TB patients are at high risk of both active and LTBI. The aim of this study is to identify the predominant risk factors of contracting LTBI, persons in close contact with TB patients were recruited. This study also aimed to compare the efficacy of the tuberculin skin test (TST) and QuantiFERON®-TB GOLD (QFT-G) to diagnose LTBI.MethodsClose contacts of active pulmonary TB patients visiting a hospital in South Korea were diagnosed for LTBI using TST and/or QFT-G. The association of positive TST and/or QFT-G with the following factors was estimated: age, gender, history of Bacillius Calmette-Guerin (BCG) vaccination, history of pulmonary TB, cohabitation status, the acid-fast bacilli smear status, and presence of cough in source cases.ResultsOf 308 subjects, 38.0% (116/305) were TST positive and 28.6% (59/206) were QFT-G positive. TST positivity was significantly associated with male gender (OR: 1.734; 95% CI: 1.001-3.003, p =0.049), history of pulmonary TB (OR: 4.130; 95% CI: 1.441-11.835, p =0.008) and household contact (OR: 2.130; 95% CI: 1.198-3.786, p =0.01) after adjustment for confounding variables. The degree of concordance between TST and QFT-G was fair (70.4%, κ =0.392).ConclusionsA prevalence of LTBI among close contacts of active pulmonary TB patients was high, and prior TB history and being a household contact were risk factors of LTBI in the study population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0566-4) contains supplementary material, which is available to authorized users.

Protecting newborns from pertussis - the challenge of complete cocooning.

BackgroundAn increase of pertussis cases, especially in young infants and adolescents, has been noted in various countries. Whooping cough is most serious in neonates and young infants in whom it may cause serious complications such as cyanosis, apnoea, pneumonia, encephalopathy and death. To protect newborns and infants too young to be fully immunized, immunization of close contact persons has been proposed (“cocoon strategy”) and implemented in several countries, including Switzerland in 2011. The goal of this study was to assess knowledge about pertussis among parents of newborns and acceptance, practicability and implementation of the recently recommended pertussis cocoon strategy in Switzerland.MethodsWe performed a cross sectional survey among all parents of newborns born between May and September 2012 and 2013 in Basel city and country. Regional statistical offices provided family addresses after approval by the ethical and data protection committees. A standardized questionnaire with detailed instructions was sent to all eligible families. For statistical analyses, independent proportions were compared by Pearson’s chi-squared test.ResultsOf 3546 eligible parents, 884 (25%) participated. All three questions exploring pertussis knowledge were answered correctly by 37% of parents; 25% gave two correct answers, 22% gave one correct answer and in the remaining 16% no answer was correct. Pertussis immunization as part of cocooning was recommended to 20% and 37% of mothers and 14% and 32% of fathers in the 2012 and 2013 study cohorts, respectively. Principal advisors for cocooning were pediatricians (66%) followed by gynecologists/obstetricians (12%) and general practitioners (5%). When recommended, 64% of mothers and 59% of fathers accepted pertussis immunization. The majority of vaccinations were administered in the perinatal period and within 2 months of the child’s birth. However, cocooning remained incomplete in 93% of families and in most families <50% of close contacts received pertussis vaccination.ConclusionsImplementation of cocooning for protecting newborns from pertussis is challenging and usually remains incomplete. Pertussis immunization rates among close contacts of newborns need to be improved. Ideally, all healthcare providers involved in family planning, pregnancy and child birth should recommend cocooning. Pertussis immunization of pregnant women is an additional measure for optimal protection of newborns and should be promoted.

Epidemiological investigation of hand-foot-and-mouth disease in children and exposed population in Hangzhou city

To investigate the epidemic characteristics of hand-foot-and-mouth disease (HFMD) in children and exposed population in Hangzhou city. The throat swab or stool samples from children with HFMD admitted in Hangzhou Children's Hospital were collected. The HFMD pathogens were detected by real-time fluorescent quantitative PCR. The distribution of different HFMD pathogens in HFMD patients was subsequently determined. Human enteric virus type-71 (HEV71) in stool samples from subjects, who had close or general contact to 54 severe HFMD children with positive HEV71, was detected, and these contact persons were followed-up for one month. The diversity of predominant pathogens of HFMD in the area during 2011-2013 was investigated. In 641 HFMD children, the male/female ratio was 1.4:1 and 80.3% was 1-3 years old. HEV71 was detected in 24.3% HFMD children (156/641), while coxsackievirus group-A type-16 (CVA16) and other enteroviruses were detected in 4.7% (30/641) and 71.0% (455/641) of the cases, respectively. 75.6% (118/156) of HEV71-infected cases were diagnosed as severe HFMD cases, while those for CVA16-infected and other HFMD viruses-infected were 13.3% (4/30) and 6.2% (28/455) respectively (Χ(2)=43.28, P<0.05). HEV71 was the predominant HFMD pathogens during 2011-2012, while the predominant HFMD pathogens in 2013 were the other HFMD viruses. In the 54 close contact persons or 54 general contact persons, 9 or 10 persons were detectable for HEV71, but no clinical symptoms of HFMD were presented. There are no marked changes of epidemic seasons, favorable age and gender ratio of HFMD in Hangzhou area in 2013. The infection of HEV71 tends to cause the severe HFMD but the other enteroviruses have substituted HEV71 as the predominant pathogens of HFMD.