Potential Transmission Routes Research Articles

Migration of Grey Heron from the Peter the Great Bay and the potential transmission routes of avian influenza

Eight nestlings of Grey Heron were captured in the Peter the Great Bay, Primorskii Territory, Russia and were deployed with trackers supporting GPS and Mobile Phone in May 2017. In total, 35,166 records on the locations of the birds were obtained over the study period until November 18, 2019. The tracking data were available for seven birds in autumn 2017, three birds from spring to autumn 2018, two birds in spring 2019, and only a single bird in autumn 2019. We could trace the migration routes accurately and locate the places for feeding and resting of the Grey Heron during the post-nesting period and seasonal migrations. The direction of the migration of the Grey Herons in autumn was southwest, and it was northeast in spring without exception. With tracking data, we found that there were two main patterns of migration of the Grey Heron: fast and delayed migration. The Grey Heron has been frequently reported to be affected by highly pathogenic avian influenza, and thus, a possibility that infected Grey Heron delivers avian influenza virus in East Asia had been discussed.

Microbial Community Analysis and Food Safety Practice Survey-Based Hazard Identification and Risk Assessment for Controlled Environment Hydroponic/Aquaponic Farming Systems.

Hydroponic and aquaponic farming is becoming increasingly popular as a solution to address global food security. Plants in hydroponic systems are grown hydroponically under controlled environments and are considered to have fewer food safety concerns than traditional field farming. However, hydroponics and aquaponics might have very different sources of microbial food safety risks that remain under-examined. In this study, we investigated the microbiomes, microbial hazards, and potential bacterial transmission routes inside two commercial hydroponic and aquaponic farming systems using 16S-ITS-23S rRNA sequencing and a hydroponic food safety practice survey. The hydroponic farming system microbiome was analyzed from the fresh produce, nutrient solution, tools, and farmworkers. Proteobacteria, Actinobacteria, Cyanobacteria, Bacteroidetes, and Firmicutes were the main components of hydroponic/aquaponic farming systems, with Pseudomonas being the most abundant genus in fresh produce samples. We further identified the presence of multiple spoilage bacteria and potential human, plant, and fish pathogens at the subspecies level. Spoilage Pseudomonas spp. and spoilage Clostridium spp. were abundant in the hydroponic microgreen farm and aquaponic lettuce farm, respectively. Moreover, we demonstrated the mapping of Escherichia coli 16s-ITS-23s rRNA sequence reads (∼2,500 bp) to small or large subunit rRNA databases and whole-genome databases to confirm pathogenicity and showed the potential of using 16s-ITS-23s rRNA sequencing for pathogen identification. With the SourceTracker and overlapping amplicon sequence variants, we predicted the bidirectional transmission route between plants and the surrounding environment and constructed the bacteria transmission map, which can be implemented in future food safety risk control plans.

The hospital environment versus carriage: transmission pathways for third-generation cephalosporin-resistant bacteria in blood in neonates in a low-resource country healthcare setting

Neonatal bloodstream infections (BSI) can lead to sepsis, with high morbidity and mortality, particularly in low-income settings. The high prevalence of third-generation cephalosporin-resistant organisms (3GC-RO) complicates the management of BSI. Whether BSI is linked to carriage of 3GC-RO, or to acquisition from the hospital environment is important for infection prevention and control, but the relationship remains unclear, especially in low-income settings. At a tertiary hospital in Mwanza, Tanzania, we screened neonatal blood and rectal samples from 200 neonates, and 400 (hospital) environmental samples. We used logistic regression to identify risk factors, and Kolmogorov–Smirnov tests and randomisation analyses to compare distributions of species and resistance patterns to assess potential routes of transmission. We found that BSIs caused by 3GC-RO were frequent (of 59 cases of BSI, 55 were caused by 3GC-RO), as was carriage of 3GC-RO, particularly Escherichia coli, Klebsiella pneumoniae, and Acinetobacter species. In the 28 infants with both a carriage and blood isolate, there were more (4 of 28) isolate pairs of the same species and susceptibility profile than expected by chance (p < 0.05), but most pairs were discordant (24 of 28). Logistic regression models found no association between BSI and carriage with either 3GC-RO or only 3GC-R K. pneumoniae. These analyses suggest that carriage of 3GC-RO is not a major driver of BSI caused by 3GC-RO in this setting. Comparison with environmental isolates showed very similar distributions of species and resistance patterns in the carriage, BSI, and the environment. These similar distributions, a high frequency of Acinetobacter spp. isolations, the lack of strong association between carriage and BSI, together with the high proportion of 3GC-RO in BSI all suggest that these neonates acquire multidrug-resistant carriage and blood isolates directly from the hospital environment.

Microbial activity and community structure in PM2 .5 at different heights in ground boundary layer of Beijing atmosphere under various air quality levels.

The outbreak of the COVID-19 epidemic is a reminder that aerosols have important health effects as a potential route for disease transmission. Biological components in aerosols (especially PM2.5 ) may pose potential threats to humans as pathogens and allergens. Research on PM2.5 and biological components currently focuses mainly on polluted conditions, with less emphasis on clean environments. Sampling has also been primarily based on a single point with a lack of data at different positions. In this study, a modified fluorescein diacetate hydrolysis method was used to measure microbial activity in PM2.5 at different altitudes over a year in Beijing, China. A high-throughput sequencing method was used to study the microbial community. Results showed that microbial activity 1.5m (0.0465 ng m-3 ) above the ground was higher than 31.5m (0.0348 ng m-3 ). There was higher microbial activity at both heights during spring. Furthermore, a positive correlation was observed between microbial activity and relative abundance of dominant species. Microbial activity increased during autumn and winter increased alongside the pollution level, but in spring higher levels of microbial activity were observed in excellent or good weather conditions. The results from this study are valuable for further research regarding the biological components of atmospheric PM, the prevention of biological pollution, and establishing a comprehensive air quality evaluation system.

Invasive Group A Streptococcus Outbreaks Associated with Home Healthcare, England, 2018-2019.

Healthcare-associated invasive group A Streptococcus (iGAS) outbreaks are common worldwide, but only England has reported outbreaks associated with home healthcare (HHC). We describe 10 outbreaks during 2018-2019 in England. A total of 96 iGAS cases (range 2-39 per outbreak) and 28 deaths (case-fatality rate 29%) occurred. Outbreak duration ranged from 3-517 days; median time between sequential cases was 20.5 days (range 1-225 days). Outbreak identification was difficult, but emm typing and whole-genome sequencing improved detection. Network analyses indicated multiple potential transmission routes. Screening of 366 HHC workers from 9 outbreaks identified group A Streptococcus carriage in just 1 worker. Outbreak control required multiple interventions, including improved infection control, equipment decontamination, and antimicrobial prophylaxis for staff. Transmission routes and effective interventions are not yet clear, and iGAS outbreaks likely are underrecognized. To improve patient safety and reduce deaths, public health agencies should be aware of HHC-associated iGAS.

Orf Virus Detection in the Saliva and Milk of Dairy Goats.

Orf is a zoonotic and highly contagious disease caused by Orf virus (ORFV) infection. Orf outbreaks in sheep and goats usually lead to high culling rate and mortality in newborn kids and lambs, posing a great threat to the development of goat and sheep industry. Human Orf occurs via direct contact with infected animals or fomites. While this disease is traditionally thought to spread through direct contact, whether other transmission routes exist remains unclear. Herein, we report the detection of ORFV in the saliva and milk of dairy goats without clinical Orf symptoms. Further analyses showed that these ORFV are infectious, as they can induce characteristic cytopathic changes in primary mammary and lip cells. Importantly, these ORFV can induce typical Orf lesions after inoculation in ORFV-free dairy goats. This is the first study showing that live, infectious ORFV can be isolated from the saliva and milk of asymptomatic goats, highlighting novel potential transmission routes of ORFV. These findings provide a novel idea for the prevention and control of Orf spread.

Uncovering antimicrobial resistance in three agricultural biogas plants using plant-based substrates

Antimicrobial resistance (AMR) is becoming an increasing global concern and the anaerobic digestion (AD) process represents a potential transmission route when digestates are used as fertilizing agents. AMR contaminants, e.g. antibiotic-resistant bacteria (ARB) and plasmid-mediated antibiotic resistance genes (ARGs) have been found in different substrates and AD systems, but not yet been investigated in plant-based substrates. AMR transfer from soils to vegetable microbiomes has been observed, and thus crop material potentially represents a so far neglected AMR load in agricultural AD processes, contributing to AMR spread. In order to test this hypothesis, this study examined the AMR situation throughout the process of three biogas plants using plant-based substrates only, or a mixture of plant-based and manure substrates. The evaluation included a combination of culture-independent and –dependent methods, i.e., identification of ARGs, plasmids, and pathogenic bacteria by DNA arrays, and phylogenetic classification of bacterial isolates and their phenotypic resistance pattern. To our knowledge, this is the first study on AMR in plant-based substrates and the corresponding biogas plant. The results showed that the bacterial community isolated from the investigated substrates and the AD processing facilities were mainly Gram-positive Bacillus spp. Apart from Pantoea agglomerans, no other Gram-negative species were found, either by bacteria culturing or by DNA typing array. In contrast, the presence of ARGs and plasmids clearly indicated the existence of Gram-negative pathogenic bacteria, in both substrate and AD process. Compared with substrates, digestates had lower levels of ARGs, plasmids, and culturable ARB. Thus, digestate could pose a lower risk of spreading AMR than substrates per se. In conclusion, plant-based substrates are associated with AMR, including culturable Gram-positive ARB and Gram-negative pathogenic bacteria-associated ARGs and plasmids. Thus, the AMR load from plant-based substrates should be taken into consideration in agricultural biogas processing.

Detection of Coxiella burnetii DNA in sheep and goat milk and dairy products by droplet digital PCR in south Italy

Coxiella burnetii is a Gram-negative obligate intracellular bacterium that is responsible for Q fever, a common zoonosis which is present virtually worldwide. This microorganism infects a wide range of wild and domestic mammals, but the main reservoirs are cattle, goats and sheep, which also represent sources of human infection. A potential route of transmission of this pathogen to humans is the consumption of C. burnetii-contaminated raw milk or dairy products derived from contaminated raw milk, although the role of these foods as possible infection sources is controversial. The aims of this study were (i) to apply two ddPCR based assays targeting the C. burnetii IS1111 and icd genes for the detection and quantification of C. burnetii DNA, and (ii) to evaluate the occurrence of C. burnetii DNA in raw milk and raw milk products from sheep and goats in Apulia and Basilicata regions of Southern Italy.Of 413 milk and cheese samples tested, 78 were positive for the presence of C. burnetii DNA (18.9%), specifically, 68 of 285 milk samples (23.9%) and 10 of 128 cheese samples (7.8%) The presence of both IS1111 and icd genes was detected in only 2 (2.6%) of the 78 positive samples, while the remaining 76 (97.4%) were positive only for IS1111. C. burnetii DNA was specifically detected by the ddPCR method, whereas no cross-amplification was observed with the DNA of other foodborne bacterial pathogens. The sensitivity of the ddPCR method was determined as 0.35 and 0.56 copies/μL for IS1111 and icd genes, respectively.The findings of this study demonstrate the presence of C. burnetii DNA in a significant proportion of raw milk and dairy products. Although there is no conclusive epidemiological evidence that C. burnetii infection occurs via food, the presence of this organism in raw milk and dairy products made of raw milk should be considered a potential hazard. ddPCR is a useful tool to investigate the quality and safety of food products due to its sensitivity and precision, and could be applied to routine testing.

Sofosbuvir/velpatasvir or glecaprevir/pibrentasvir for treating patients with hepatitis C virus reinfection following direct‐acting antiviral‐induced sustained virologic response

AbstractData regarding the patient characteristics of hepatitis C virus (HCV) reinfection following viral eradication by a prior course of direct‐acting antivirals (DAAs) and the clinical performance of pangenotypic DAAs to retreat such patients are lacking. The demographics and potential routes of transmission were shown in 22 patients with confirmed reinfection following HCV clearance by a prior course of DAAs. Twenty patients received retreatment with pangenotypic sofosbuvir/velpatasvir (SOF/VEL) or glecaprevir/pibrentasvir (GLE/PIB) according to label recommendations. The sustained virologic response (SVR12) rates and the tolerance following treatment were reported. The incidence rates of reinfection among human immunodeficiency virus (HIV)‐positive and HIV‐negative patients were 8.33 per 100 person‐years (95% CI: 5.33‐12.78) and 0.30 per 100 person‐years (95% CI: 0.12‐0.77), respectively. Eighteen (81.8%) patients had HIV coinfection. The elapsed time between SVR12 and reinfection ranged from 3 to 36 months. Twenty (90.9%) patients had different viral genotypes/subtypes before and after HCV reinfection. Prior to reinfection, 15 (68.2%) patients achieved SVR12 using SOF/VEL or GLE/PIB. Twelve and eight patients were retreated with SOF/VEL for 12 weeks and GLE/PIB for 8 weeks, respectively, in whom SVR12 was all achieved. All patients completed the assigned course of retreatment without interruption and all had excellent tolerance. The risk of HCV reinfection is higher in HIV‐positive patients than HIV‐negative patients following DAA‐induced SVR. Treating reinfected patients with SOF/VEL or GLE/PIB as DAA‐naïve patients has excellent effectiveness and tolerance, irrespective of the type of prior DAA exposure or viral genotypes/subtypes.

Molecular and pathological characterization of natural co-infection of poultry farms with the recently emerged Leucocytozoon caulleryi and chicken anemia virus in Egypt.

In the summers of 2018 and 2019, a disease outbreak stroke 25 broiler chicken farms and 3 broiler breeder farms in different Governorates in Egypt. The disease caused a mortality rate ranging from 3.2 to 9%. Postmortem examination showed petechial hemorrhage in the breast and thigh muscles, thymus gland, and peritoneal cavity and extensive hemorrhages in the kidneys. A total of 140 liver, kidney, lung, skeletal muscles, thymus, and spleen samples were collected. Twenty-eight pooled samples were created and examined by PCR and histopathological examination to identify the causative pathogens. All collected samples were PCR-negative to Newcastle disease virus (NDV), avian influenza viruses (H5, H9, and H7), infectious bursal disease virus (IBDV), infectious bronchitis virus (IBV), and fowl adenovirus (FadV). Leucocytozoon caulleryi (L. caulleryi) genetic material was identified by PCR in 17 out of the 28 collected samples (61%). Five chicken farms (18%) showed positive PCR results for both L. caulleryi and chicken anemia virus (CAV). Histopathological examination revealed unilocular megaloschizonts in thymus, skeletal muscle, and lung as well as massive hemorrhages in parenchymatous organs. Nucleotide sequences of the identified pathogens were compared with other reference sequences available in the GenBank. The identified L. caulleryi has a close relationship with those previously detected in Asia, indicating potential transmission route of the parasite. The CAV has a close genetic relation with CAVs previously identified in Egypt. Furthermore, a real-time PCR for rapid, specific, and quasiquantitative detection of L. caulleryi was developed with a detection limit of 100 genome copies per reaction.

Aerosol transmission in passenger car cabins: Effects of ventilation configuration and driving speed.

Identifying the potential routes of airborne transmission during transportation is of critical importance to limit the spread of the SARS-CoV-2 virus. Here, we numerically solve the Reynolds-averaged Navier–Stokes equations along with the transport equation for a passive scalar in order to study aerosol transmission inside the passenger cabin of an automobile. Extending the previous work on this topic, we explore several driving scenarios including the effects of having the windows fully open, half-open, and one-quarter open, the effect of opening a moon roof, and the scaling of the aerosol transport as a function of vehicle speed. The flow in the passenger cabin is largely driven by the external surface pressure distribution on the vehicle, and the relative concentration of aerosols in the cabin scales inversely with vehicle speed. For the simplified geometry studied here, we find that the half-open windows configuration has almost the same ventilation effectively as the one with the windows fully open. The utility of the moonroof as an effective exit vent for removing the aerosols generated within the cabin space is discussed. Using our results, we propose a “speed–time” map, which gives guidance regarding the relative risk of transmission between driver and passenger as a function of trip duration and vehicle speed. A few strategies for the removal of airborne contaminants during low-speed driving, or in a situation where the vehicle is stuck in traffic, are suggested.

Neurobehavioral abnormalities following prenatal psychosocial stress are differentially modulated by maternal environment

Prenatal stress (PS) is associated with increased vulnerability to affective disorders. Transplacental glucocorticoid passage and stress-induced maternal environment alterations are recognized as potential routes of transmission that can fundamentally alter neurodevelopment. However, molecular mechanisms underlying aberrant emotional outcomes or the individual contributions intrauterine stress versus maternal environment play in shaping these mechanisms remain unknown. Here, we report anxiogenic behaviors, anhedonia, and female hypothalamic-pituitary-adrenal axis hyperactivity as a consequence of psychosocial PS in mice. Evidence of fetal amygdala programming precedes these abnormalities. In adult offspring, we observe amygdalar transcriptional changes demonstrating sex-specific dysfunction in synaptic transmission and neurotransmitter systems. We find these abnormalities are primarily driven by in-utero stress exposure. Importantly, maternal care changes postnatally reverse anxiety-related behaviors and partially rescue gene alterations associated with neurotransmission. Our data demonstrate the influence maternal environment exerts in shaping offspring emotional development despite deleterious effects of intrauterine stress.

The Prevalence and Clinical Implications of Rectal SARS-CoV-2 Shedding in Danish COVID-19 Patients and the General Population.

Background: SARS-CoV-2 has resulted in a global pandemic since its outbreak in Wuhan, 2019. Virus transmission primarily occurs through close contact, respiratory droplets, and aerosol particles. However, since SARS-CoV-2 has been detected in fecal and rectal samples from infected individuals, the fecal-oral route has been suggested as another potential route of transmission. This study aimed to investigate the prevalence and clinical implications of rectal SARS-CoV-2 shedding in Danish COVID-19 patients.Methods: Hospitalized and non-hospitalized adults and children who were recently tested with a pharyngeal COVID-19 test, were included in the study. A rectal swab was collected from all participants. Hospitalized adults and COVID-19 positive children were followed with both pharyngeal and rectal swabs until two consecutive negative results were obtained. RT-qPCR targeting the envelope gene was used to detect SARS-CoV-2 in the samples. Demographic, medical, and biochemical information was obtained through questionnaires and medical records.Results: Twenty-eight of 52 (53.8%) COVID-19 positive adults and children were positive for SARS-CoV-2 in rectal swabs. Seven of the rectal positive participants were followed for more than 6 days. Two of these (28.6%) continued to test positive in their rectal swabs for up to 29 days after the pharyngeal swabs had turned negative. Hospitalized rectal positive and rectal negative adults were comparable regarding demographic, medical, and biochemical information. Furthermore, no difference was observed in the severity of the disease among the two groups.Conclusions: We provided evidence of rectal SARS-CoV-2 shedding in Danish COVID-19 patients. The clinical importance of rectal SARS-CoV-2 shedding appears to be minimal.

Silica nanoparticles with encapsulated DNA (SPED) to trace the spread of pathogens in healthcare

BackgroundTo establish effective infection control protocols, understanding pathogen transmission pathways is essential. Non-infectious surrogate tracers may safely explore these pathways and challenge pre-existing assumptions. We used silica nanoparticles with encapsulated DNA (SPED) for the first time in a real-life hospital setting to investigate potential transmission routes of vancomycin-resistant enterococci in the context of a prolonged outbreak.MethodsThe two study experiments took place in the 900-bed University Hospital Zurich, Switzerland. A three-run ‘Patient experiment’ investigated pathogen transmission via toilet seats in a two-patient room with shared bathroom. First, various predetermined body and fomite sites in a two-bed patient room were probed at baseline. Then, after the first patient was contaminated with SPED at the subgluteal region, both patients sequentially performed a toilet routine. All sites were consequently swabbed again for SPED contamination. Eight hours later, further spread was tested at predefined sites in the patient room and throughout the ward. A two-run ‘Mobile device experiment’ explored the potential transmission by mobile phones and stethoscopes in a quasi-realistic setting. All SPED contamination statuses and levels were determined by real-time qPCR.ResultsOver all three runs, the ‘Patient experiment’ yielded SPED in 59 of 73 (80.8%) predefined body and environmental sites. Specifically, positivity rates were 100% on subgluteal skin, toilet seats, tap handles, and entertainment devices, the initially contaminated patients’ hands; 83.3% on patient phones and bed controls; 80% on intravenous pumps; 75% on toilet flush plates and door handles, and 0% on the initially not contaminated patients’ hands. SPED spread as far as doctor’s keyboards (66.6%), staff mobile phones (33.3%) and nurses’ keyboards (33.3%) after eight hours. The ‘Mobile device experiment’ resulted in 16 of 22 (72.7%) positive follow-up samples, and transmission to the second patient occurred in one of the two runs.ConclusionsFor the first time SPED were used to investigate potential transmission pathways in a real hospital setting. The results suggest that, in the absence of targeted cleaning, toilet seats and mobile devices may result in widespread transmission of pathogens departing from one contaminated patient skin region.

Whole-Genome Sequencing of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli From Human Infections in Finland Revealed Isolates Belonging to Internationally Successful ST131-C1-M27 Subclade but Distinct From Non-human Sources.

Antimicrobial resistance (AMR) is a growing concern in public health, particularly for the clinically relevant extended-spectrum beta-lactamase (ESBL) and AmpC-producing Enterobacteriaceae. Studies describing ESBL-producing Escherichia coli clinical samples from Finland to the genomic level and investigation of possible zoonotic transmission routes are scarce. This study characterizes ESBL-producing E. coli from clinical samples in Finland using whole genome sequencing (WGS). Comparison is made between animal, food, and environmental sources in Finland to gain insight into potential zoonotic transmission routes and to recognize successful AMR genes, bacterial sequence types (STs), and plasmids. ESBL-producing E. coli isolates (n = 30) obtained from the Eastern Finland healthcare district between 2018 and 2020 underwent WGS and were compared to sequences from non-human and healthy human sources (n = 67) isolated in Finland between 2012 and 2018. A majority of the clinical isolates belonged to ST131 (n = 21; 70%), of which 19 represented O25:H4 and fimH30 allele, and 2 O16:H5 and fimH41 allele. Multidrug resistance was common, and the most common bla gene identified was blaCTX–M–27 (n = 14; 47%) followed by blaCTX–M–15 (n = 10; 33%). blaCTX–M–27 was identified in 13 out of 21 isolates representing ST131, with 12 isolates belonging to a recently discovered international E. coli ST131 C1-M27 subclade. Isolates were found to be genetically distinct from non-human sources with core genome multilocus sequence typing based analysis. Most isolates (n = 26; 87%) possessed multiple replicons, with IncF family plasmids appearing in 27 (90%) and IncI1 in 5 (17%) isolates. IncF[F1:A2:B20] replicon was identified in 11, and IncF[F-:A2:B20] in 4 isolates. The results indicate the ST131-C1-M27 clade gaining prevalence in Europe and provide further evidence of the concerning spread of this globally successful pathogenic clonal group. This study is the first to describe ESBL-producing E. coli in human infections with WGS in Finland and provides important information on global level of the spread of ESBL-producing E. coli belonging to the C1-M27 subclade. The results will help guide public health actions and guide future research.

Ornithodoros turicata (Dugès) on a Feral Hog in Real County, Texas, USA.

The potential introduction of African swine fever virus (ASFV) into the US has researchers evaluating routes of potential transmission and the establishment of sylvatic cycles. To help document vector-host associations related to ASFV transmission, the finding of O. turicata on a feral hog in Real County, Texas is reported.

Clinical features of endophthalmitis clusters after cataract surgery and practical recommendations to mitigate risk: systematic review.

Intraocular transmission of exogenous pathogens in cataract surgery can lead to endophthalmitis. This review evaluates the features of endophthalmitis clusters secondary to pathogen transmission in cataract surgery. Articles reporting on pathogen transmission in cataract surgery were identified via searches of Ovid MEDLINE, EMBASE, and Cochrane CENTRAL, and a total of 268 eyes from 24 studies were included. The most common source of infectious transmission was attributed to a contaminated intraocular solution (ie, irrigation solution, viscoelastic, or diluted antibiotic; n = 10). Visual acuity at presentation with infectious features was 1.89 logMAR (range: 1.35 to 2.58; ∼counting fingers) and 1.33 logMAR (range: 0.04 to 3.00; Snellen: ∼20/430) at last follow-up. Patients with diabetes had worse outcomes compared with patients without diabetes. The most frequently isolated pathogen from the infectious sources was Pseudomonas sp. (50.0%). This review highlights the various routes of pathogen transmission during cataract surgery and summarizes recommendations for the detection, prevention, and management of endophthalmitis clusters.

Minimizing Risks of Antimicrobial Resistance Development in the Environment from a Public One Health Perspective.

Antimicrobial resistance (AMR) is a globally recognized crisis with meaningful engagement across humans, animals, and the environment as in the One Health approach. The environment is the potential source, reservoir, and transmission route of AMR, and it plays a key role in AMR development from the One Health perspective. Animal farming, hospitals, and the pharmaceutical industry are identified as the main emission sources in the environment. Minimizing emissions and determining antimicrobial emission limits are priorities in the containment of environmental AMR development. From the perspectives of environmental management and environmental engineering, some important actions to minimize risks of AMR development are summarized, including the recent progress in enhanced hydrolysis pre-treatment technology to control the development of antibiotic resistance genes (ARGs) during biological wastewater treatment. It is desirable to establish a holistic framework to coordinate international actions on the containment of environmental AMR development. To establish a community with a shared future for humanity, China should and could play an important role in international cooperation to cope with AMR challenges.

The First Detection of Echinococcus Granulosus DNA in Residents' Hands, Dogs' Hair, and Soil in Highly Endemic Region of Echinococcosis - Naqu City, Xizang Autonomous Region, China, 2020.

Echinococcosis is a serious zoonotic parasitic disease that predominantly infects humans; domestic animals like cattle or sheep; as well as wild animals such as small rodents. To date, there is a lack of comprehensive information about all potential environmental transmission routes for Echinococcus. This study assesses the importance of under-researched environmental factors for the transmission of Echinococcus. It concludes that hand hygiene is an important factor in the robust environmental transmission of Echinococcus granulosus. This study suggests that residents are at risk of catching echinococcosis through hand-oral transmission routes. Health education given to local residents is thus a key intervention, as well as avoiding close contact with dogs and ensuring proper hand-washing practices are followed.

Estimating the Level of Asymptomatic COVID-19 Infections in Northern Ireland in 2020

The identification and understanding of COVID-19 potential routes of transmission are fundamental to informing policies and strategies to successfully control the outbreak. Various studies highlighted asymptomatic infections as one of the silent drivers of the epidemic. An accurate estimation of the asymptomatic cases and the understanding of their contribution to the spread of the disease could enhance the effectiveness of current control strategies, mainly based on the symptom onset, to curb transmission. We investigate the dynamics of the COVID-19 epidemic in Northern Ireland during the period 1st March 25th to December 2020 to estimate the proportion of the asymptomatic infections in the country. We extended our previous model to include the stage of the asymptomatic infection, and we implement the corresponding deterministic model using a publicly available dataset. We partition the data into 11 sets over the period of study and fit the model parameters on the consecutive intervals using the cumulative number of confirmed positive cases for each interval. Moreover, we assess numerically the impacts of uncertainty in testing and we provide estimates of the reproduction numbers using the fitted parameters. We found that the proportion of asymptomatically infectious subpopulations, in Northern Ireland during the period of study, ranged between 5% and 25% of exposed individuals. Also, the estimate of the basic reproduction number, R0, is 3.3089. The lower and upper estimates for herd immunity are (0.6181, 0.7243) suggesting that around 70% of the population of Northern Ireland should acquire immunity via infection or vaccination, which is in line with estimates reported in other studies.