Pre-epidemic Period Research Articles

Population immunity in residents of the Kaliningrad region to current antigenic variants of influenza viruses over 2018-2021

The article presents the results of population immunity assessment in residents of the Kaliningrad region to current antigenic variants of influenza viruses over the period of 2018 to 2021. To assess spectrum of influenza types circulating in Kaliningrad region, the real-time PCR method was used using AmpliSense reagent kits. The biological material for the study was obtained from oropharyngeal swabs from the persons who applied to polyclinics with inflammatory diseases of upper respiratory tract, or underwent treatment at the out- or inpatient basis in a healthcare facilities of Kaliningrad region. Humoral immunity was assessed by testing blood sera obtained from healthy residents of Kaliningrad region during periodic prophylactic examinations at the city and regional polyclinics. The study of residents covered all age groups. For the period of 2018-2021, more than 14,000 studies have been carried out. Determination of specific serum antibody titers was carried out by staging the hemagglutination suppression reaction using local influenza antigens (LLC PPDP, St. Petersburg). Antibody titers of 1/40 and higher were considered sufficient to reduce the risk of disease by 50%. During the study period, 2165 cases of influenza were confirmed in the region by laboratory tests. Over the study period, the A(H1N1) pdm serotype proved to be the major strain causing influenza, its proportion reached 57.5%. However, along with A(H1N1) pdm, a significant contribution was also made the A(H3N2) strain to the epidemic process, being the etiological cause of influenza infection in 2019 (42.2%), type B influenza strains being actual in 2020 (42.5%). Over the period of 2018-2021, 420 samples of blood sera from vaccinated and non-vaccinated individuals were tested for specific antibodies. The sera were taken 1-2 months after vaccination and between epidemic rises of influenza (April-May). In vaccinated individuals, the antibody titer was protective in 58.3-64.5%. In this group of persons, the titer sufficient to produce immunity was maintained over the spring/summer period. Among those persons who refused vaccination, a protective antibody titer in the pre-epidemic period was noted in 41.2% of the examined, and during the off-season it was detected in 37.4% of the volunteers. Thus, the A(H1N1) pdm strain was the main etiological factor of influenza in Kaliningrad Region in 2018-2021. The protective level of antibodies in vaccinated population over the period preceding the epidemic peak, was observed 30% more often than in unvaccinated individuals. High incidence of influenza B strains noted in 2020 appears to require a change of specific vaccine preparation.

Trend of Academic Productivity in Plastic Surgery and the Impact of COVID-19: A Bibliometric Analysis.

Plastic surgery has grown rapidly over the past decade, with increasing scientific output. The emergence of coronavirus disease 2019 (COVID-19) has a considerable impact on plastic surgery. To identify trends in published literature in plastic surgery from 2011 to 2021. To explore the impact of COVID-19 on scientific research output through bibliometric analysis methods. Web of Science was searched by authors on December 23, 2021. Published papers about plastic surgery over the last decade were analyzed. The search output was imported into VOSviewer for science mapping. The actual number of papers related to plastic surgery during the COVID-19 period was higher than expected one. For scientific outputs in plastic surgery, keywords about surgical practice had a high frequency. "Reconstruction," "effect," "flap," "tissue," "defect," "model" maintained a high level of heat before and after COVID-19. The heat of "risk," "complication," "review," "infection," "cohort," and "meta-analysis" increased after the outbreak of COVID-19. The international collaboration showed an upward trend despite the impact of COVID-19. From the perspective of the volume of plastic surgery publications, some journals had a more positive performance compared to the pre-epidemic period. The proportion of original articles decreased after the spread of COVID-19 from 70.26% to 63.84%. Although the COVID-19 has a profound impact on the healthcare industry, the bibliographic data reveals an increasing scientific output in the field of plastic surgery over time. For plastic surgery, high-frequency terms, research hotspots, popular journals, article types, and international collaboration have changed under the influence of COVID-19.

Green recovery or pollution rebound? Evidence from air pollution of China in the post-COVID-19 era

Under the strict control measures, China has achieved phased victory in combating with the COVID-19, production activities have gradually returned to normal. This paper examined whether air pollution was rebounded or realized green recovery in the post-COVID-19 era with a dataset of weather normalized pollutant concentrations using difference-in-differences models. Results showed that air pollution experienced a significant decline due to the wide range of control measures. With entering the post-epidemic period, air pollution raised due to the orderly production resumption. Specifically, production resumption increased the PM2.5 concentrations of lockdown cities and non-lockdown cities by 43.2% (22.3 μg/m3) and 35.9% (17.3 μg/m3) compared with that in the period of COVID-19 breakout. Although the economic activities of China have been gradually recovered, PM2.5 concentrations were 8.8–11.2 μg/m3 lower than the level of pre-epidemic period. In addition, the environmental effects varied across cities. With the process of production resumption, the PM2.5 concentrations of cities with higher GDP, higher secondary industry output, more private cars and higher export volume rebounded less. Most developed cities realized green recovery by economy growth and air quality improvement, such as Beijing and Shanghai. While cities with heavy industry reflected pollution rebound with slow economy recovery, such as Shenyang and Harbin. Understanding the environmental effects of control measure and production resumption can provide crucial information for developing epidemic recovery policies and dealing with pollution issues for both China and other countries.

Influenza Vaccination and Risk of Ischemic Stroke: A Population-Based Case-Control Study.

To assess the relationship between influenza vaccination in the general population and risk of a first ischemic stroke (IS) during pre-epidemic, epidemic, and postepidemic periods. A nested case-control study was conducted in a Spanish primary care database over 2001-2015. Individuals aged 40-99 years with at least 1 year registry and no history of stroke or cancer were selected to conform the source cohort, from which incident IS cases were identified and classified as cardioembolic or noncardioembolic. Five controls per case were randomly selected, individually matched with cases for exact age, sex, and date of stroke diagnosis (index date). A patient was considered vaccinated when he/she had a recorded influenza vaccination at least 14 days before the index date within the same season. Adjusted odds ratios (aORs) and their respective 95% CIs were computed through a conditional logistic regression. Pneumococcal vaccination was used as a negative control. From a cohort of 3,757,621 patients, we selected 14,322 incident IS cases (9,542 noncardioembolic and 4,780 cardioembolic) and 71,610 matched controls. Of them, 41.4% and 40.5%, respectively, were vaccinated yielding a crude OR of 1.05 (95% CI 1.01-1.10). Vaccinated patients presented a higher prevalence of vascular risk factors, diseases, and comedication than those nonvaccinated, and after full adjustment, the association of influenza vaccination with IS yielded an aOR of 0.88 (95% CI 0.84-0.92), appearing early (aOR15-30 days 0.79; 95% CI 0.69-0.92) and slightly declining over time (aOR>150 days 0.92; 95% CI 0.87-0.98). A reduced risk of similar magnitude was observed with both types of IS, in the 3 epidemic periods, and in all subgroups analyzed (men, women, individuals younger and older than 65 years of age, and those with intermediate and high vascular risk). By contrast, pneumococcal vaccination was not associated with a reduced risk of IS (aOR 1.08; 95% CI 1.04-1.13). Results are compatible with a moderate protective effect of influenza vaccine on IS appearing early after vaccination. The finding that a reduced risk was also observed in pre-epidemic periods suggests that either the "protection" is not totally linked to prevention of influenza infection or it may be partly explained by unmeasured confounding factors.

A seroepidemiological study across age groups before and after the 2010-2011 mumps epidemic in Japan.

In Japan, large-scale mumps epidemics recur every 4-6 years because of low vaccination coverage. This study aimed to describe the seroprevalence of mumps in the Japanese population and identify the age groups most affected. The prevalence of anti-mumps antibodies was evaluated based on 1000 serum samples obtained from the Japanese National Serum Reference Bank. These samples consisted of 50 sera for each of 10 different age groups, collected during 2007-2008 (pre-epidemic period) and 2012-2013 (post-epidemic period). Seropositivity was lowest in the 6-11 months subgroup (3% and 0% in pre- and post-epidemic periods, respectively) and highest in the 10-14 years group (66% and 72% in pre- and post-epidemic periods, respectively). A comparison of anti-mumps antibody prevalence throughout the two periods considered revealed a large rise in seropositivity among the 2004-2008 birth cohort, using that of the 1-4 years group as representative in the pre-epidemic period (from 22% in pre- to 58% in post-epidemic periods;p = 0.0002). These results indicate that most people likely gain antibodies to the mumps virus during their childhood, especially during the first epidemic that they experience after their second year of life. Therefore, children should be vaccinated against mumps soon after their first birthday for effective prevention.

The impact of Covid-19 pandemic on Gastroenterology Department activity of Da Nang Hospital

Objective: Covid-19 is a global pandemic that severely affects healthcare systems around the world. The aim of this study was to evaluate the impact of Covid-19 in the treatment and operation of the Department of Gastroenterology, Da Nang Hospital. Materials and menthods: Retrospective descriptive study was conducted from January 1, 2019 to December 31, 2020 at the Department of Gastroenterology, Da Nang Hospital. Results: During the period of 02 years, a total of 12,282 patients were included to our analysis (in 2019: 7838 patients, with 54.4% male 45.6% female, mean age 51, 46 ± 18.87 years. In 2020: 4446 patients with 57.2% male and 42.8% female, mean age 52.05 ± 18.36 years). During the Covid-19 epidemic, the most common groups of hospitalized symptoms included melena (7.3%), Hematochezia (6.3%), Hematemesis (6.3%) and jaundice (8.3%). Similarly, the disease groups increased the rate of hospitalization such as gastric ulcer (15.6% compared to before the epidemic 11.9%, p < 0.001), combined gastro-duodenum ulcer (4.7% compared to 3.1%, p < 0.01), stomach cancer (5.1% vs 3.4%, p < 0.01), colorectal cancer (14.7% vs 10.3%, p < 0.01), cirrhosis (58% vs 54.4%, p < 0.05), acute hepatitis (9.7% vs 5.8%, p < 0.05), acute pancreatitis (70.7% versus 63.1%, p < 0.05). In particular, the number of gastrointestinal endoscopy decreased significantly during the Covid-19 epidemic compared with before the epidemic (17156 timescompared with 10880, p < 0.001), of which the number of gastroscopy and ERCP was mainly reduced. In contrast, the rate of emergency endoscopy increased significantly compared to the pre-epidemic period (6.69% vs 5.85%, p < 0.01), so the number of endoscopy intervention also increased significantly (5.29% vs 2.71%, p < 0.001) as well as the need for surgical intervention also increased (5.6% vs 4.2%, p < 0.001). The rate of patients with complications and death was also higher during the Covid-19 epidemic than before the epidemic, respectively (2.5% vs 1.7%, p < 0.01), mortality (1.4% vs 0.9%, p < 0.01) and duration of hospitalization were also longer (6.7 ± 4.54 vs 6.44 ± 4.68 days, p < 0.01). Conclusion: The Covid-19 pandemic has significantly reduced the number of patients at the Department of Gastroenterology, Da Nang Hospital. It is necessary to change the mode of operation to flexibly adapt to the current situation. Thereby helping to significantly reduce the impact on non-Covid-19 patients Key words: Covid-19 pandemic, Department of Gastroenterology, Da Nang Hospital

Hand, Foot and Mouth Disease: A Single Centre Retrospective Study of 403 New Cases and Brief Review of Relevant Indian Literature to Understand Clinical, Epidemiological, and Virological Attributes of a Long-Lasting Indian Epidemic.

Background:There have been sporadic and periodic large-scale epidemics of hand, foot, and mouth disease (HFMD) with cases at risk for significant morbidity and mortality particularly in Southeast Asia since 1997 and in India since early 2003.Method:We retrospectively studied 403 cases recorded from 2009 to 2019 and reviewed relevant Indian literature published between 2004 and 2019 to understand clinical, epidemiological, and virological attributes of this long-lasting Indian epidemic.Result:There were 96.8% children and adolescents (M:F 1.6:1) aged 2 months to 18 years and 84% were aged <5 years. Adult family contacts comprised 3.2%. Only 12 sporadic cases occurred during 2009-2011 followed by increased number from 2012 to 2015 peaking with 30.8% cases in 2013 and declining slowly until the year 2019 with small resurge in 2018. The major peaks occurred during summers with small peaks in autumns. Literature review showed 3332 cases presenting between 2004 and 2019 across Indian states with similar epidemiological trends whereas serotyping identified Coxsackievirus A16 (CV A16) in 83%, Coxsackievirus A6 (CV A6) in 17%, Enterovirus 71 in 4.1%, and multiple strains in 11.7% samples, respectively.Conclusion:The overall features of this long-lasting HFMD epidemic; affecting children aged <5 years more often than adults, none or minimum neurological or pulmonary complications in few patients, peaks occurring during summer and autumn months, and identity of the pathogenic virus coincide with global trends. However, the continuous spread of the disease across the country appears in sync with pre-epidemic periods of China and Taiwan. It calls for a continuous surveillance and making HFMD a notifiable disease in India.

As the virus sowed, the fungus reaped! A comparative analysis of the clinico-epidemiological characteristics of rhino-orbital mucormycosis before and during COVID-19 pandemic.

BackgroundThe sudden surge of mucormycosis cases which happened during the second wave of COVID‐19 pandemic was a significant public health problem in India.ObjectivesThe aim of this study was to analyse the clinico‐epidemicological characteristics of the mucormycosis cases to determine the changes that had occurred due to COVID‐19 pandemic.MethodologyA retrospective cross‐sectional study was conducted at the Department of Otolaryngology Head and Neck Surgery, PGIMER, Chandigarh, India. Patients diagnosed with rhino‐orbital mucormycosis were categorised into the following groups: Pre‐pandemic(May 2019 to April 2020), Pandemic Pre‐epidemic (May 2020 to April 2021) and Epidemic (1 May 2021 to 12 July 2021). The epidemiological, clinical and surgical data of all the patients were retrieved from the hospital records and analysed.ResultsThe epidemic period had 370 cases, compared with 65 during pandemic period and 42 in the pre‐pandemic period. Diabetes mellitus was seen in 87% of cases during epidemic period, 92.9% in the pre‐pandemic period and 90.8% in the pre‐pandemic pre‐epidemic period. The proportion of patients suffering from vision loss, restricted extra‐ocular movements, palatal ulcer and nasal obstruction was higher in the pre‐epidemic groups, and the difference was significant (p, <.01). There was no history of oxygen use in 85.9% of patients and no steroid use in 76.5%. The death rates were the lowest during epidemic (10%).ConclusionCOVID‐19 has caused a statistically significant increase in the number of mucormycosis infections. The mortality and morbidity which showed an increase during the first wave of COVID‐19 decreased significantly during the epidemic period.

Emerging infectious disease triggered a trophic cascade and enhanced recruitment of a masting tree.

There are several mechanisms that allow plants to temporarily escape from top-down control. One of them is trophic cascades triggered by top predators or pathogens. Another is satiation of consumers by mast seeding. These two mechanisms have traditionally been studied in separation. However, their combined action may have a greater effect on plant release than either process alone. In 2015, an outbreak of a disease (African swine fever, ASF) caused a crash in wild boar (Sus scrofa) abundance in Białowieża Primeval Forest. Wild boar are important consumers of acorns and are difficult to satiate relative to less mobile granivores. We hypothesized that the joint action of the ASF outbreak and masting would enhance regeneration of oaks (Quercus robur). Data from ungulate exclosures demonstrated that ASF led to reduction in acorn predation. Tree seedling data indicated that oak recruitment increased twofold relative to pre-epidemic period. Our results showed that perturbations caused by wildlife disease travel through food webs and influence forest dynamics. The outbreak of ASF acted synergistically with masting and removed herbivore top-down control of oaks by mobile consumers. This illustrates that the ASF epidemic that currently occurs across Europe can have broad effects on forest dynamics.

Anxiety, home blood pressure monitoring, and cardiovascular events among older hypertension patients during the COVID-19 pandemic

The global coronavirus disease 2019 (COVID-19) pandemic has led to a health crisis. It remains unclear how anxiety affects blood pressure (BP) and cardiovascular risk among older patients with hypertension. In this study, we extracted longitudinal data on home BP monitored via a smartphone-based application in 3724 elderly patients with hypertension from a clinical trial (60–80 years; 240 in Wuhan and 3484 in non-Wuhan areas) to examine changes in morning BP during the COVID-19 outbreak in China. Anxiety was evaluated using Generalized Anxiety Disorder-7 item scores. Changes in morning systolic BP (SBP) were analyzed for five 30-day periods during the pandemic (October 21, 2019 to March 21, 2020), including the pre-epidemic, incubation, developing, outbreak, and plateau periods. Data on cardiovascular events were prospectively collected for one year. A total of 262 individuals (7.0%) reported an increased level of anxiety, and 3462 individuals (93.0%) did not. Patients with anxiety showed higher morning SBP than patients without anxiety, and the between-group differences in SBP change were +1.2 mmHg and +1.7 mmHg during the outbreak and plateau periods (P < 0.05), respectively. The seasonal BP variation in winter among patients with anxiety was suppressed during the pandemic. Anxious patients had higher rates of uncontrolled BP. During the 1-year follow-up period, patients with anxiety had an increased risk of cardiovascular events with a hazard ratio of 2.47 (95% confidence interval, 1.10–5.58; P = 0.03). In summary, COVID-19-related anxiety was associated with a short-term increase in morning SBP among older patients and led to a greater risk of cardiovascular events. (ClinicalTrials. gov number, NCT03015311).

Influenza vaccination influencing level of specific humoral immunity in healthy individuals

To assess an effect of vaccination on the level of humoral anti-influenza herd immunity, 2955 sera were collected and analyzed by HIT in the 2019–2020 and 2020–2021 epidemiological seasons. All sera were obtained from healthy adult donors residing in various cities of the Russian Federation. Among them, 1057 volunteers were vaccinated with seasonal influenza trivalent inactivated vaccine. Characteristics of humoral anti-influenza immunity (average geometric antibody titers and the proportion of individuals seropositive for the vaccine viruses) obtained in autumn 2019 and 2020 (1–2 months after vaccination) in vaccinated individuals vs. unvaccinated subjects were found to be markedly higher evidencing about a positive vaccination-related contribution to developing herd immunity against influenza in the preepidemic periods. After the 2019–2020 influenza epidemic, in spring 2020 (6–7 months after vaccination), the levels of antibodies to all vaccine components decreased by 2.6–3.5-fold in vaccinated donors compared to the pre-epidemic period in 2019 autumn. Antibody titers became substantially lower than the protective level (titer by HIT 1/40). At the same time, no significant differences between the groups of vaccinated vs. unvaccinated individuals were observed afterwards. This indicates instability of post-vaccination anti-influenza humoral immunity. As a result, it may decrease an influenza-resistant population cohort of working age on the eve of new epidemic season. The immunogenicity of the inactivated trivalent seasonal influenza vaccine was estimated by HIT while analyzing paired sera obtained from 295 and 112 healthy individuals of various ages vaccinated in autumn 2019 and 2020, respectively. The response to the vaccine was found to be age-related. Children aged 3–14 years vs. older subjects showed a more efficient response. Insufficient immunogenicity of influenza B virus vaccine components was shown. In all age groups, average geometric titers for influenza B virus antibodies were lower (2–8-fold) than for current A(H1N1)pdm09-like strains and influenza A(H3N2) viruses 1–1.5 months post-vaccination. Analyzing vaccine immunogenicity showed a significant inverse relationship between the level of preexisting strain-specific serum antibodies before vaccination and formation of antibodies to the corresponding vaccine virus 1–1.5 months after vaccination. Seroconversion to each vaccine component was remarkably more frequent in individuals with a low preexisting level of antibodies specific to the corresponding virus.

Pediatric Training Crisis of Emergency Medicine Residency during the COVID-19 Pandemic.

Coronavirus disease 2019 (COVID-19) is an emerging viral disease that has caused a global pandemic. Among emergency department (ED) patients, pediatric patient volume mostly and continuously decreased during the pandemic period. Decreased pediatric patient volume in a prolonged period could results in inadequate pediatric training of Emergency Medicine (EM) residents. We collected data regarding pediatric patients who were first seen by EM resident physicians between 1 February 2019, and 31 January 2021, which was divided into pre-epidemic and epidemic periods by 1 February 2020. A significant reduction in pediatric patients per hour (PPH) of EM residents was noted in the epidemic period (from 1.55 to 0.81, p < 0.001). The average patient number was reduced significantly in the classification of infection (from 9.50 to 4.00, p < 0.001), respiratory system (from 84.00 to 22.00, p < 0.001), gastrointestinal system (from 52.00 to 34.00, p = 0.007), otolaryngology (from 4.00 to 2.00, p = 0.022). Among the diagnoses of infectious disease, the most obvious drop was noted in the diagnosis of influenza and enterovirus infection. Reduced pediatric patient volume affected clinical exposure to pediatric EM training of EM residency. Changes in the proportion of pediatric diseases presented in the ED may induce inadequate experience with common and specific pediatric diseases.

Effect of COVID-19 Closures and Distance-Learning on Biology Research Projects of High School Students in Israel

The COVID-19 pandemic has created a situation, the “anthropopause”, of lockdowns and distancing among individuals to reduce the spread of the disease. One of the major problems to surface is the inequality of the educational process in schools. We present a study of high school students who conduct a year-long research project with an academic. We hypothesized that the projects would not be impacted because of the individual manner of study involved. We analyzed the number of research proposals submitted in the years 2015–2021. We compared the data of the pre-epidemic period with the two pandemic years, 2020 and 2021. Our data show that in the years of the pandemic, significantly less research proposals were submitted, and the number of research proposals rejected was lower, but the total number of research proposals approved, or the number of theses submitted, was not significantly different. The research areas in which Israeli high school students conducted research were mostly in the laboratory (63.2%) and agriculture (27.5%), while ecology was relatively insignificant—whether in captivity (3.1%) or the field (5.1%). A new field that is fast becoming of interest is bioinformatics. Research in agriculture was significantly lower during the pandemic period, while there were no differences in the other subjects between the two periods. We conclude that the fewer research proposals submitted suggest that those that did not take the subject seriously enough did not begin the process. This resulted in a lower number of rejections and is substantiated by the fact that an equal number of students that submitted their final theses did not differ from the years before the pandemic. We are optimistic that the truly motivated students will continue to make the effort to be involved in biology science projects over and above their regular school curriculum and in spite of the COVID-19 restrictions and limitations.

Change in healthcare during Covid-19 pandemic was assessed through observational designs

ObjectiveMethodological challenges for investigating the changes in healthcare utilization during COVID-19 pandemic must be considered for obtaining unbiased estimates. Study design and settingA population-based study in the Lombardy region (Italy) measured the association between the level of epidemic restrictions (increasing exposure during pre-epidemic, post-lockdown, and lockdown periods) and the recommended healthcare (outcome) for patients with schizophrenia, heart failure, chronic obstructive pulmonary disease, breast cancer, and pregnancy women. Two designs are applied: the self-controlled case series (SCCS) and the usual cohort design. Adjustments for between-patients unmeasured confounders and seasonality of medical services delivering were performed. ResultsCompared with pre-epidemic, reductions in delivering recommended healthcare during lockdown up to 73% (95% confidence interval: 63%–80%) for timeliness of breast cancer surgery, and up to 20% (16%–23%) for appropriated gynecologic visit during pregnancy were obtained from SCCS and cohort design, respectively. Healthcare provision came back to pre-epidemic levels during the post-lockdown, with the exception of schizophrenic patients for whom the SCCS showed a reduction in continuity of care of 11% (11%–12%). ConclusionStrategies for investigating the changes in healthcare utilization during pandemic must be implemented. Recommendations for taking into account sources of systematic uncertainty are discussed and illustrated by using motivating examples.

Influenza vaccine and risk of acute myocardial infarction in a population-based case–control study

ObjectiveTo assess the relationship between influenza vaccination and risk of a first acute myocardial infarction (AMI) in the general population by different epidemic periods.MethodsThis is a population-based case–control study carried...

The impact of the COVID-19 epidemic on hospital admissions for alcohol-related liver disease and pancreatitis in Japan

During the coronavirus disease 2019 (COVID-19) pandemic, there have been health concerns related to alcohol use and misuse. We aimed to examine the population-level change in cases of alcohol-related liver disease and pancreatitis that required admission during the COVID-19 epidemic by interrupted time series (ITS) analysis using claims data. We defined the period from April 2020, when the Japanese government declared a state of emergency, as the beginning of the COVID-19 epidemic. This ITS analysis included 3,026,389 overall admissions and 10,242 admissions for alcohol-related liver disease or pancreatitis from 257 hospitals between July 2018 and June 2020. The rate of admissions per 1000 admissions during the COVID-19 epidemic period (April 2020–June 2020) was 1.2 times (rate ratio: 1.22, 95% confidence interval: 1.12–1.33) compared to the pre-epidemic period. Analyses stratified by sex revealed that the increases in admission rates of alcohol-related liver disease or pancreatitis for females were higher than for males during the COVID-19 epidemic period. The COVID-19 epidemic in Japan might associates an increase in hospital admissions for alcohol-related liver disease and pancreatitis. Our study could support the concern of alcohol consumption and health problems during the COVID-19 pandemic.

Smartphone use and addiction during the coronavirus disease 2019 (COVID-19) pandemic: cohort study on 184 Italian children and adolescents

BackgroundThe lives of many children and adolescents are today increasingly influenced by new technological devices, including smartphones. The coronavirus disease 2019 (COVID-19) pandemic occurred in a time of outstanding scientific progress and global digitalization. Young people had relevant adverse psychological and behavioral effects due to the COVID-19 pandemic, mainly related to infection control measures, which led them to spend more time at home and with major use of technological tools. The goal this study proposes is to evaluate health and social outcomes of smartphone overuse among Italian children and adolescents during the COVID-19 pandemic, analyzing patterns and aims of utilization, as well as the eventual presence and degree of addiction.MethodsThis study was based on a self-report and anonymous questionnaire, which was administered to 184 Italian school-age (6–18 years) children and adolescents during the second wave of the COVID-19 pandemic. The test was electronically (email, whatsapp) explained and sent by pediatricians either directly to older children (middle and high school), or indirectly, through the help of teachers, to younger ones (primary school). All participants spontaneously and voluntarily joined the present study. The survey was made by 4 sections, and designed to know and outline modalities (frequency, patterns and aims) of smartphone use, adverse outcomes, and related parental behaviors, also in order to reveal the eventual occurrence and degree of addiction. The same information, related to the pre-epidemic period, was also investigated and analyzed.ResultsThe data obtained revealed a significantly greater adhesion to the questionnaire by females, likely reflecting higher attention and interest than boys to initiatives relating to health education. Our study showed more frequent smartphone use among Italian children and adolescents during the COVID-19 pandemic, compared to the pre-epidemic period. This may be related to the social distancing measures adopted during the months under investigation. The present survey also outlined the changing patterns and aims in the use of smartphones among young people, which allowed to limit some effects of the crisis. Indeed, they were used for human connection, learning and entertainment, providing psychological and social support. Finally, it was observed a significant increase of overuse and addiction. This led to many clinical (sleep, ocular and musculoskeletal disorders), psychological (distraction, mood modification, loss of interest) and social (superficial approach to learning, isolation) unfavorable outcomes.ConclusionsPediatricians and health care professionals should be aware of the potential risks related to inappropriate use of smartphones. They should monitor, in cooperation with parents, possible associated adverse effects, in order to early recognize signs and symptoms suggestive, or at high risk, for addiction. They must carry out, as well, the necessary interventions to prevent and/or lower the detrimental impact of smartphone overuse on children and adolescents’ health, oriented to sustain adequate physical and psychological development as well as social relationships.

The Impact of COVID-19 on Dentistry in Yichang, China, and Protective Suggestions for Normalisation of Epidemic Prevention

BackgroundCoronavirus disease 2019 (COVID-19) has been identified as a pandemic by the World Health Organization in March 2020, and it affects all aspects of life, including dental care. ObjectivesThe purpose of this article is to explore the impact of COVID-19 on the daily operations of the stomatology department and provide some guidance for dental health care personnel around the world in continuing to provide exemplary care while limiting the spread of COVID-19. Materials and methodsRetrospective analyses were performed on dental patients’ medical records from the stomatology department of the First People's Hospital of Yichang, China, which were collected in the pre-epidemic, epidemic, and post-epidemic periods. Hospital-wide triage and stomatology department–specific protocols were established in the hospital to prevent cross-infection during the COVID-19 pandemic. ResultsThe number of patients decreased and proportion of emergency cases increased during the epidemic period. With prevention protocols in place, the number of dental patients returned to the normal range with a slight elevation during the post-epidemic period. Thus far, there has not been a single documented case of COVID-19 related to dental treatment in the hospital. ConclusionsCOVID-19 has a major impact on daily life, including dental care services. Effective prevention and control measures including 3 levels of protection—zoning, instrumentation, and environmental disinfection—are needed for dental settings to provide care.

Problems of assessing socio-economic damage due to epidemics

Relevance. The sudden epidemiological complications that have emerged in the current century have highlighted the serious difficulties on the part of medical services and States in general in responding to epidemiological emergencies of international significance, which required a comprehensive study of the scale of the problem of the negative socio-economic consequences of epidemics for the modern state. The aim of the work was to study the factors that determine the current configuration of medical and social risks in the pre-epidemic period and form the socio-economic significance of epidemics and pandemics in a developed postindustrial society. The results are based on the monitoring, analysis and aggregation of information from specialized national and international industry publications and online resources (medical, socio-economic), as well as materials from peer-reviewed periodicals, on the practical development of author's approaches and assessments of the functioning of the anti-epidemic preparedness system at the international and national levels. Modern factors that aggravate the negative consequences of the pandemic for demography and the state economy in the absence of immunoprophylaxis and specific therapy are identified. Conclusion. The socio-economic significance of epidemiological events in the modern post-industrial society is significantly higher than the predicted level, based on the calculations of the cost of a clinical case of an infectious disease used in the previous century, namely: without including the costs of sanitary and anti-epidemic measures in the foci of the disease, for the deployment of a hospital base; for ensuring a strict anti-epidemic regime of work in medical institutions, for the rehabilitation and restoration of health of persons who have suffered an infectious disease; for the organization of preventive measures in non-medical organizations and enterprises (including information and explanatory work among the population); for the organization of medical care for persons with somatic pathology.

An update on the epidemiology of hepatitis A in Italy 2015-2019. Data from the surveillance of acute viral hepatitis SEIEVA

hepatitis A is an infective disease whose global diffusion appears to be variable and strictly related to socioeconomic status, hygiene conditions, and access to potable water. During last twenty years, Italy registered a constant decrease of new cases with recurrent epidemic outbreaks. to outline the hepatitis A epidemiological situation in Italy in the five-year period 2015-2019. descriptive study based on cases reported to the National Surveillance System for Acute Viral Hepatitis (SEIEVA). hepatitis A cases reported to SEIEVA from 2015 to 2019. hepatitis A incidence, percentages of cases exposed to known risk factors, distribution of cases by vaccination status. during the whole observational period, SEIEVA registered 4,929 type A hepatitis cases. The epidemic curve initially showed a trend with a low incidence level interrupted in August 2016 with the onset of a large epidemic, in the period between August 2016 and December 2017, involving 3,428 cases mostly adult men exposed to homosexual intercourses (MSM). Since January 2018, the trend of the cases has been decreasing even though its level is still higher than the pre-epidemic period. Based on the analysis of the epidemic curve, three periods characterized by different trends in the monthly number of notified cases were identified: January 2015-July 2016 (pre-epidemic period), August 2016-December 2017 (epidemic period), January 2018-December 2019 (post-epidemic period). In the last observation period, cases show different characteristics compared to the previous periods. They are mainly males under 18 years (p=0.026), subjects travelling to Morocco (8.9% vs 15.9%; p< 0.001) or being in contact with an infected person (p< 0.001). The multivariate analysis confirmed a significantly higher probability for cases notified in the post-epidemic period, compared to the pre-epidemic, to be secondary cases or to have traveled to Morocco. Compared to the pre-epidemic period and the epidemic period, there was a higher percentage of subjects who received a single dose of anti-hepatitis A vaccine (p=0.001). Taking into account only secondary cases reported in the third period, the percentage of cases with incomplete vaccination rises to 31%; in this group, a single dose of the vaccine was administered at a median of 11.5 days before the onset of symptoms. vaccination is of paramount importance for the prevention of hepatitis A in all risk groups, including adult males exposed to same-sex sexual intercourse and travelers to areas at high-medium endemic level, especially children, as the timeliness in the vaccination of contacts is fundamental and crucial for interrupting the chains of infection. The observed increase in secondary cases and the delay in the administration of doses lead to a reflection on the need for greater promotion of vaccination, but also highlight the critical issues in the organization of vaccination services, mainly in the areas that have reported the greatest number of cases.