Primary Outbreak Research Articles

Detection and Eradication of a Demodex Infestation in Specific Pathogen-free High-barrier Laboratory Mouse Facility Housing Immunocompromised Animals.

Demodex mites are a common ectoparasite in nonlaboratory Mus musculus (mouse) populations. While infrequently reported in laboratory research mice, the prevalence is thought to be as high as 35% of all colonies. Here, we discuss an outbreak of Demodex within an SPF high-barrier vivarium housing laboratory mice first identified through commercial sentinel-free PCR testing. Consequently, in-house PCR-mediated identification of individually infected cages was conducted, and a successful method for eradication of secondary reemergent infection was generated via recurrent testing and empirical 12-wk treatment with 3 mg/kg moxidectin and 13 mg/kg imidacloprid. While we were unable to determine the source of our primary outbreak, the secondary outbreak was traced to nongenetically modified C57B6/J immunocompetent mice, which were capable of harboring subclinical infection below our PCR threshold. Our eventual successful eradication of Demodex confirmed, first, that in-house PCR detection is a cost-effective means of monitoring an outbreak; second, that treatment with 3 mg/kg moxidectin and 13 mg/kg imidacloprid does kill Demodex mites in laboratory mice; and third, that treatment of only PCR-positive mice is an insufficient way to control an outbreak. Taken together, our methodological approach for infestations such as Demodex suggests it is possible to eradicate them but that it requires a thorough, systematic, and aggressive treatment regimen. Moreover, we recommend that all cages derived from infected animals be treated as positive, regardless of PCR positivity, to prevent recurrent and/or persistent infections within an animal colony.

Advancing projections of crown-of-thorns starfish to support management interventions

Outbreaks of corallivorous Crown of Thorns Starfish (Acanthaster spp.; CoTS) cause substantial coral mortality throughout the Indo-Pacific, particularly on the Great Barrier Reef (GBR). Refining CoTS population density modelling and understanding the disparities between real-world observations and model predictions is crucial for developing effective control strategies. Using a spatially explicit ecosystem model of the GBR, we compared CoTS density model predictions to observations and incorporated a new zone-specific mortality rate to account for differences in predation of CoTS between fished and protected reefs. We found high congruence between predictions and observations: ∼81 % of categorical reef level CoTS densities matched or only differed by one category. However, underpredictions increased with higher observed densities. Zone-specific CoTS mortality reduced severe underpredictions from 7.1 % to 5.6 %, which is critical for managers as underpredictions indicate missing outbreaks where targeted culling is necessary, but also lead to underestimated coral loss attributed to CoTS outbreaks. Reef protection status affected prediction accuracy, highlighting the importance of further research on in situ CoTS mortality rates. The location of a reef inside or outside the “initiation box”, a speculative area of primary outbreaks (i.e., initial abrupt population increases) on the GBR, also influenced accuracy, with exact predictions more likely outside. Accurately modelling initiation box dynamics is challenging due to limited empirical data on CoTS outbreaks, highlighting the need for focussed research on outbreak dynamics to enhance predictive accuracy. Spatial factors, such as region and shelf position, contributed to the variance between observations and predictions, underscoring the importance of the spatial-temporal context of each observation. Observations of CoTS can help refine model predictions, guide targeted control measures, and contribute to effective ecosystem management for the long-term resilience of the GBR and other reefs targeted by CoTS throughout the Indo-Pacific.

Avian influenza overview December 2023-March 2024.

Between 2 December 2023 and 15 March 2024, highly pathogenic avian influenza (HPAI) A(H5) outbreaks were reported in domestic (227) and wild (414) birds across 26 countries in Europe. Compared to previous years, although still widespread, the overall number of HPAI virus detections in birds was significantly lower, among other reasons, possibly due to some level of flock immunity in previously affected wild bird species, resulting in reduced contamination of the environment, and a different composition of circulating A(H5N1) genotypes. Most HPAI outbreaks reported in poultry were primary outbreaks following the introduction of the virus by wild birds. Outside Europe, the majority of outbreaks in poultry were still clustered in North America, while the spread of A(H5) to more naïve wild bird populations on mainland Antarctica is of particular concern. For mammals, A(H5N5) was reported for the first time in Europe, while goat kids in the United States of America represented the first natural A(H5N1) infection in ruminants. Since the last report and as of 12 March 2024, five human avian influenza A(H5N1) infections, including one death, three of which were clade 2.3.2.1c viruses, have been reported by Cambodia. China has reported two human infections, including one fatal case, with avian influenza A(H5N6), four human infections with avian influenza A(H9N2) and one fatal case with co-infection of seasonal influenza A(H3N2) and avian influenza A(H10N5). The latter case was the first documented human infection with avian influenza A(H10N5). Human infections with avian influenza remain rare and no sustained human-to-human infection has been observed. The risk of infection with currently circulating avian H5 influenza viruses of clade 2.3.4.4b in Europe remains low for the general population in the EU/EEA. The risk of infection remains low to moderate for those occupationally or otherwise exposed to infected animals.

The Effectiveness of Protection and Surveillance Zones in Detecting Further African Swine Fever Outbreaks in Domestic Pigs-Experience of the Baltic States.

In the event of an outbreak of African swine fever (ASF) in pig farms, the European Union (EU) legislation requires the establishment of a restricted zone, consisting of a protection zone with a radius of at least 3 km and a surveillance zone with a radius of at least 10 km around the outbreak. The main purpose of the restricted zone is to stop the spread of the disease by detecting further outbreaks. We evaluated the effectiveness and necessity of the restricted zone in the Baltic States by looking at how many secondary outbreaks were detected inside and outside the protection and surveillance zones and by what means. Secondary outbreaks are outbreaks with an epidemiological link to a primary outbreak while a primary outbreak is an outbreak that is not epidemiologically linked to any previous outbreak. From 2014 to 2023, a total of 272 outbreaks in domestic pigs were confirmed, where 263 (96.7%) were primary outbreaks and 9 (3.3%) were secondary outbreaks. Eight of the secondary outbreaks were detected by epidemiological enquiry and one by passive surveillance. Epidemiological enquiries are legally required investigations on an outbreak farm to find out when and how the virus entered the farm and to obtain information on contact farms where the ASF virus may have been spread. Of the eight secondary outbreaks detected by epidemiological investigations, six were within the protection zone, one was within the surveillance zone and one outside the restricted zone. Epidemiological investigations were therefore the most effective means of detecting secondary outbreaks, whether inside or outside the restricted zones, while active surveillance was not effective. Active surveillance are legally prescribed activities carried out by the competent authorities in the restricted zones. Furthermore, as ASF is no longer a rare and exotic disease in the EU, it could be listed as a "Category B" disease, which in turn would allow for more flexibility and "tailor-made" control measures, e.g., regarding the size of the restricted zone.

Role of exosomes in false-positive COVID-19 PCR tests: Non-specificity of SARS-CoV-2-RNA in vivo detection explains artificial post-pandemic peaks

Background: The COVID-19 pandemic priorities have focused on prevention by detection and response. National governments’ prevention response decisions are based upon detection statistics from PCR (polymerase chain reaction) tests that are used to define numbers of (i) COVID-19 infected persons, (ii) COVID-19 hospitalisations, and (iii) COVID-19 deaths. These statistics assume a priori that PCR tests are nigh 100% true detectors of COVID-19 infections. Here we will provide an alternative interpretation, along with the compelling evidence, that false positives have distorted to some degree the statistics of the primary outbreaks, and account for almost the whole of the 2nd and subsequent apparent COVID-19 outbreak peaks in various countries. Methods: We extract from the published literature on PCR-test outcomes graphical data that reveals the evidence for a very large percentage of false positive results. We review the role of exosomes in the immune response to all respiratory viral infections and its effect on PCR tests. We hypothesise that exosomes, triggered by all viral respiratory infections, are largely responsible for positive outcomes from PCR tests for COVID-19. We test our alternative interpretation for consistency with the empirical epidemiological trends as published by the World Health Organization (WHO). The Scientific Method is used to direct our research efforts. Findings: We find that PCR testing data for the second and following waves of the COVID-19 pandemic indicate that these waves are mainly artefacts of false-positive results. We find that this interpretation provides a more consistent explanation of the known epidemiology of COVID-19 than the hitherto consensus notion of extremely contagious and rapidly mutating viruses. Interpretation: The RNA (ribonucleic acid) code detected in PCR tests, previously attributed to SARS-CoV-2, belongs instead to a respiratory-virus-induced immune system response by human cells that liberate exosomes, and that vitiate PCR test results. PCR tests have zero specificity in vivo due to the exosome RNA. PCR tests exhibit excellent specificity in vitro on pure samples of other respiratory viruses. The low success rate of vaccines in preventing COVID-19 is explained by the inexact identification of the SARS-CoV-2 RNA.

The weak genetic structure of Melolontha melolontha (L.) and Melolontha hippocastani (Fabr.), two important forest pests, indicates their large population sizes and effective gene flow

Abstract Cockchafers Melolontha spp. are polyphagous root pests and outbreak species of considerable economic importance to forestry in Europe. Knowledge of genetic diversity within and between cockchafer populations is largely unexplored but could lead to more effective monitoring and management strategies of these pests. In this study, we fill several gaps in the knowledge of the genetic population structure of Melolontha melolontha and Melolontha hippocastani. Using microsatellite loci and over 200 individuals per species, we examined the genetic structure of Melolontha spp. populations collected from three primary outbreak areas in central and southeastern Poland. We demonstrated that our focal species share some common genetic patterns, such as considerable genetic diversity within subpopulations (within sampling sites) with minor effects of past bottlenecks possibly masked by current population sizes. The estimates of effective population sizes, although subject to wide credibility intervals, indicated a large number of individuals contributing to further generations of the population. The migration rates exceed the threshold of one per generation required for gene flow and maintenance of population equilibrium, indicating limited impact from forest management practices on either cockchafer species. While genetic differentiation was observed in M. melolontha populations, supported by various indices (fixation index, principal coordinate analysis, assignment tests), the M. hippocastani populations were genetically similar. This disparity may hint at the potential historical divergence between these species. In this aspect, more detailed phylogeographic and population genetic studies covering a large area of the Palaearctic distributions of both species are required. Our findings constitute one of the initial efforts aimed at delineating the genetic diversity, differentiation, population structure, gene flow, and migration patterns within Melolontha spp. This exploration is especially significant for M. hippocastani, given its completely unexplored genetic population structure.

Avian influenza overview September-December 2023.

Between 2 September and 1 December 2023, highly pathogenic avian influenza (HPAI) A(H5) outbreaks were reported in domestic (88) and wild (175) birds across 23 countries in Europe. Compared to previous years, the increase in the number of HPAI virus detections in waterfowl has been delayed, possibly due to a later start of the autumn migration of several wild bird species. Common cranes were the most frequently affected species during this reporting period with mortality events being described in several European countries. Most HPAI outbreaks reported in poultry were primary outbreaks following the introduction of the virus by wild birds, with the exception of Hungary, where two clusters involving secondary spread occurred. HPAI viruses identified in Europe belonged to eleven different genotypes, seven of which were new. With regard to mammals, the serological survey conducted in all fur farms in Finland revealed 29 additional serologically positive farms during this reporting period. Wild mammals continued to be affected mostly in the Americas, from where further spread into wild birds and mammals in the Antarctic region was described for the first time. Since the last report and as of 1 December 2023, three fatal and one severe human A(H5N1) infection with clade 2.3.2.1c viruses have been reported by Cambodia, and one A(H9N2) infection was reported from China. No human infections related to the avian influenza detections in animals in fur farms in Finland have been reported, and human infections with avian influenza remain a rare event. The risk of infection with currently circulating avian H5 influenza viruses of clade 2.3.4.4b in Europe remains low for the general population in the EU/EEA. The risk of infection remains low to moderate for occupationally or otherwise exposed people to infected birds or mammals (wild or domesticated); this assessment covers different situations that depend on the level of exposure.

Trend analysis of the current epidemic situation and analysis of factors underlying local uneven spread of covid cases

This research has been carried out by analyzing the specific processes of the local epidemic dynamics of COVID by comparing the qualitative differences in fluctuations in 2020 and 2023. Methods of nonlinear dynamics of the development of epidemic processes in a rapidly changing situation were used to identify and qualify trends and unique situations that sometimes changed extremely fast. A distinctive feature of the modern pandemic is a rather sharp change in local trends: the effect of the fading of the primary outbreak of the disease and the sudden sharp onset of a new epidemic wave after a long trend of decreasing daily infections. Minimization of the exposure to viral infections did not prevent spreading the virus but created the illusion of success. The existing experience in generating forecasts of epidemic outbreaks based on models of past epidemic processes could not help when faced with a new evolving virus. The previously obtained understanding of the development and completion of epidemic processes of influenza virus strains more likely hindered the prediction of the scenario for the completion of the spread of a new infection, which is also associated with the eventual nature of the process and a variety of dynamic situations. A victory over COVID in the phase of the minimum after the wave, which was announced by many countries, turned out to be premature. New Zealand and Japan, which opted for a strict lockdown strategy in 2020, had a surge of COVID cases in early 2023 because new strains came into circulation. Outbreaks of respiratory diseases known as the Spanish flu and swine flu pandemics, data from which were used by many countries to make predictions, had run their course naturally in two or three waves of illness. At the beginning of 2023, against the backdrop of a global positive trend, some countries have reported a record rise in both mortality and daily morbidity due to the emergence of locally circulating “alarm” strains. A current stage on isolation of stable regional strains substantiates the classification of a series of differentiated properties of the dynamics of regional epidemic situations. Among the observed epidemic effects, extreme phenomena in the form of instantaneous bifurcation destruction of established regimes such as a sharp transition from long-term damped oscillations to a new exponential outbreak in some infections are separately highlighted. The selected options for the development of epidemic transient oscillatory processes are separately introduced in equation forms with delay for local epidemic trends. Equations are proposed to describe three variants of development of the observed stages of local epidemics. The task of constructing a generalized predictive model of a pandemic to describe interrelated regional processes at this stage seems insoluble.

PESTE DES PETITS RUMINANTS: CHALLENGES AND CONTROL MEASURES IN TAJIKISTAN

The review presents information from the OIE, FAO and veterinary services on the current epizootic situation worldwide regarding Peste des Petits Ruminants (PPR). Literature analysis shows that PPR is a serious issue for small livestock farming globally, particularly in developing countries in Africa, the Middle East, and Asia. The disease is characterized by a high mortality rate, reaching 100% in primary outbreaks and up to 50% in secondary outbreaks. The analysis indicates that the greatest threat comes from diseases registered in neighboring countries and associated with animal migration and socio-economic connections. It is also important to expand vaccination coverage in border areas where PPR outbreaks have been registered. Immunizing all livestock in these zones will significantly reduce the risk of infection introduction and protect livestock from potential epizootics

Psychosocial status and risk perception among Iranian healthcare workers during the fifth wave of the COVID-19 pandemic

BackgroundHealthcare workers (HCWs) are essential resources, and their health and wellbeing are key not only for offering constant and useful care facilities to clients, but also for maintaining the safety of the workforce and patients. The risk of severe mental health problems among HCWs may have increased during large outbreaks of COVID-19. To evaluate the psychosocial status and risk perception of HCWs who participated in treating COVID-19 patients in Northern Iran, we performed a web-based cross-sectional study.MethodsThe web-based cross-sectional design was applied between June 27 and September 2, 2021. Using convenience sampling, 637 HCWs were recruited from hospitals in Northern Iran (Mazandaran). The HCWs completed self-report questionnaires that included a sociodemographic information form, the 12-item General Health Questionnaire, Impact of the Event Scale-Revised, Risk Perception Questionnaire, and Anxiety Stress Scale‐21. The data were analyzed via descriptive and inferential statistics and univariate/multivariate logistic regression to assess the risk factors linked to each psychosocial consequence.ResultsThe results reveal that the COVID-19 pandemic had an adverse psychosocial influence on HCWs, which was already apparent 1.5 years after the crisis began. Based on the results, 71.6%, 55.6%, and 32.3% of HCWs reported having anxiety, depression, and stress symptoms, respectively, since the outbreak of this disease. The logistic regression models displayed that marital status, having children, and working hours with patients were all risk factors of psychosocial impairment.ConclusionsThe outbreak of COVID-19 can be considered an important experience of a bio-disaster resulting in a significant rate of psychiatric problems in HCWs. There is a need for designing and promoting supportive programs to help HCWs cope and to improve their psychosocial state, and the present study has detected for whom psychosocial support may be effective and practical 1.5 years after the primary outbreak. Moreover, detecting and managing concerns and reducing infection-related embarrassment/stigma are essential for improving HCWs’ mental health.

Avian influenza overview March – April 2023

Between 2 March and 28 April 2023, highly pathogenic avian influenza (HPAI) A(H5Nx) virus, clade 2.3.4.4b, outbreaks were reported in domestic (106) and wild (610) birds across 24 countries in Europe. Poultry outbreaks occurred less frequently compared to the previous reporting period and compared to spring 2022. Most of these outbreaks were classified as primary outbreaks without secondary spread and some of them associated with atypical disease presentation, in particular low mortality. In wild birds, black-headed gulls continued to be heavily affected, while also other threatened wild bird species, such as the peregrine falcon, showed increased mortality. The ongoing epidemic in black-headed gulls, many of which breed inland, may increase the risk for poultry, especially in July-August, when first-year birds disperse from the breeding colonies. HPAI A(H5N1) virus also continued to expand in the Americas, including in mammalian species, and is expected to reach the Antarctic in the near future. HPAI virus infections were detected in six mammal species, particularly in marine mammals and mustelids, for the first time, while the viruses currently circulating in Europe retain a preferential binding for avian-like receptors. Since 13 March 2022 and as of 10 May 2023, two A(H5N1) clade 2.3.4.4b virus detections in humans were reported from China (1), and Chile (1), as well as three A(H9N2) and one A(H3N8) human infections in China. The risk of infection with currently circulating avian H5 influenza viruses of clade 2.3.4.4b in Europe remains low for the general population in the EU/EEA, and low to moderate for occupationally or otherwise exposed people.

Utility of prehospital call center ambulance dispatch data for COVID-19 cluster surveillance: A retrospective analysis.

Cluster surveillance, identification, and containment are primary outbreak management techniques; however, adapting these for low- and middle-income countries is an ongoing challenge. We aimed to evaluate the utility of prehospital call center ambulance dispatch (CCAD) data for surveillance by examining the correlation between influenza-like illness (ILI)-related dispatch calls and COVID-19 cases. We performed a retrospective analysis of state-level CCAD and COVID-19 data recorded between January 1 and April 30, 2020, in Telangana, India. The primary outcome was a time series correlation between ILI calls in CCAD and COVID-19 case counts. Secondarily, we looked for a year-to-year correlation of ILI calls in the same period over 2018, 2019, and 2020. On average, ILI calls comprised 12.9% (95% CI 11.7%-14.1%) of total daily calls in 2020, compared to 7.8% (95% CI 7.6%-8.0%) in 2018, and 7.7% (95% CI 7.5%-7.7%) in 2019. ILI call counts from 2018, 2019, and 2020 aligned closely until March 19, when 2020 ILI calls increased, representing 16% of all calls by March 23 and 27.5% by April 7. In contrast to the significant correlation observed between 2020 and previous years' January-February calls (2020 and 2019-Durbin-Watson test statistic [DW]=0.749, p < 0.001; 2020 and 2018-DW=1.232, p < 0.001), no correlation was observed for March-April calls (2020 and 2019-DW=2.012, p=0.476; 2020 and 2018-DW=1.820, p=0.208). In March-April 2020, the daily reported COVID-19 cases by time series significantly correlated with the ILI calls (DW=0.977, p < 0.001). The ILI calls on a specific day significantly correlated with the COVID-19 cases reported 6 days prior and up to 14 days after (cross-correlation > 0.251, the 95% upper confidence limit). The statistically significant time series correlation between ILI calls and COVID-19 cases suggests prehospital CCAD can be part of early warning systems aiding outbreak cluster surveillance, identification, and containment.

Population-based screening in a municipality after a primary school outbreak of the SARS-CoV-2 Alpha variant, the Netherlands, December 2020-February 2021.

An outbreak of SARS-CoV-2 Alpha variant (Pango lineage B.1.1.7) was detected at a primary school (School X) in Lansingerland, the Netherlands, in December 2020. The outbreak was studied retrospectively, and population-based screening was used to assess the extent of virus circulation and decelerate transmission. Cases were SARS-CoV-2 laboratory confirmed and were residents of Lansingerland (November 16th 2020 until February 22th 2021), or had an epidemiological link with School X or neighbouring schools. The SARS-CoV-2 variant was determined using variant PCR or whole genome sequencing. A questionnaire primarily assessed clinical symptoms. A total of 77 Alpha variant cases were found with an epidemiological link to School X, 16 Alpha variant cases linked to the neighbouring schools, and 146 Alpha variant cases among residents of Lansingerland without a link to the schools. The mean number of self-reported symptoms was not significantly different among Alpha variant infected individuals compared to non-Alpha infected individuals. The secondary attack rate (SAR) among Alpha variant exposed individuals in households was 52% higher compared to non-Alpha variant exposed individuals (p = 0.010), with the mean household age, and mean number of children and adults per household as confounders. Sequence analysis of 60 Alpha variant sequences obtained from cases confirmed virus transmission between School X and neighbouring schools, and showed that multiple introductions of the Alpha variant had already taken place in Lansingerland at the time of the study. The alpha variant caused a large outbreak at both locations of School X, and subsequently spread to neighbouring schools, and households. Population-based screening (together with other public health measures) nearly stopped transmission of the outbreak strain, but did not prevent variant replacement in the Lansingerland municipality.

Increased transmissibility of SARS-CoV-2 alpha variant (B.1.1.7) in children: three large primary school outbreaks revealed by whole genome sequencing in the Netherlands

BackgroundVariant of concern (VOC) SARS-CoV-2 alpha variant (B.1.1.7) was the dominant strain in the Netherlands between March 2021–June 2021. We describe three primary school outbreaks due to the alpha variant using whole genome sequencing with evidence of large-scale transmission among children, teachers and their household contacts.MethodAll outbreaks described were investigated by the South Limburg Public Health Service, the Netherlands. A case was defined as an individual with a real-time polymerase chain reaction test or antigen test positive for SARS-CoV-2. Whole genome sequencing was performed on random samples from at least one child and one teacher of each affected class.ResultsPeak attack rates in classes were 53%, 33% and 39%, respectively. Specific genotypes were identified for each school across a majority of affected classes. Attack rates were high among staff members, likely to promote staff-to-children transmission. Cases in some classes were limited to children, indicating child-to-child transmission. At 39%, the secondary attack rate (SAR) in household contacts of infected children was remarkably high, similar to SAR in household contacts of staff members (42%). SAR of household contacts of asymptomatic children was only 9%.ConclusionOur findings suggest increased transmissibility of the alpha variant in children compared to preceding non-VOC variants, consistent with a substantial rise in the incidence of cases observed in primary schools and children aged 5–12 since the alpha variant became dominant in March 2021. Lack of mandatory masking, insufficient ventilation and lack of physical distancing also probably contributed to the school outbreaks. The rise of the delta variant (B.1.617.2) since July 2021 which is estimated to be 55% more transmissible than the alpha variant, provides additional urgency to adequate infection prevention in school settings.

Triploid Atlantic salmon (Salmo salar) may have increased risk of primary field outbreaks of infectious salmon anaemia.

The impact that escaped farmed fish may have on wild populations is of major concern for Atlantic salmon (Salmo salar) farming. Triploid fish, being infertile, were originally introduced to mitigate the genetic impact of escaped fish. In the recent years, an increase in the number of infectious salmon anaemia (ISA) outbreaks in Norway has been observed, mainly in the northern parts, which is also where farming of triploid fish has been licensed. The present study investigated the susceptibility of triploid Atlantic salmon to ISA both by field observations and experimental infections. Based on field observations, we found an increased susceptibility, with 9.4 increased odds to primary ISA outbreaks in triploid fish versus diploid fish at production-site level, and a tendency of increased odds (3.4) of ISA in triploid fish at individual cage level at sited with primary outbreaks. At some sites, ISA outbreaks were only diagnosed in cages with triploid fish and not in cages with diploid fish. Primary ISA outbreaks are the source for further spread of the disease, and it is noteworthy that in an experimental trial we found significantly more viral RNA in non-ISA-vaccinated triploid than in non-ISA-vaccinated diploid fish at the peak of the infection. Interestingly, the notable differences of susceptibility to ISA for non-ISA vaccinated diploid and triploid fish observed in field were not repeated experimentally. The possible increased risk of ISA should be considered when evaluating the costs and benefits of triploid salmon in farming. It is recommended to keep triploid and diploid fish in biosecure separated sites, or that triploid fish are not farmed at all.

Effectiveness of case-area targeted interventions including vaccination on the control of epidemic cholera: protocol for a prospective observational study

IntroductionCholera outbreaks in fragile settings are prone to rapid expansion. Case-area targeted interventions (CATIs) have been proposed as a rapid and efficient response strategy to halt or substantially reduce the...

Risk factors associated with lumpy skin disease in cattle in West Kazakhstan

Lumpy skin disease is an important emerging disease posing a threat to the livestock industry worldwide. Moreover, factors involved in disease transmission in the field and at farm level remain unidentified. This research was based on a cross-sectional study using a questionnaire administered through face-to-face interviews with affected farmers. From January 2021 to July 2021, 543 households were visited in four provinces of the West Kazakhstan region to assess the prevalence of LSD and its associated risk factors. Animal and farm level risk factors were examined using univariable and multivariable mixed effect logistic regression. At animal level, the factors associated with LSD outbreaks include herd size Medium OR = 0.68, (95% CI: 0.54–0.84); large OR = 0.63, (95% CI: 0.49–0.81), purchasing animals OR = 11.67, (95% CI: 8.87–15.35), and selling animals during LSD outbreak OR = 1.24, (95% CI: 1.06–1.45). The overall animal level and herd level LSD prevalence were 10.2% (95% CI: 9.6 −0.10.9) and 49.2% (95% CI: 45.0 – 53.4) respectively. Our study demonstrates the dissemination of LSDV from primary outbreaks to new areas and risk factors associated with LSD in Kazakhstan. This finding will enhance knowledge on disease epidemiology and help develop coordinated actions in prevention and control of the possible LSD outbreaks.

Hemophagocytic Lymphohistiocytosis Associated With Endocarditis: A Case Years in the Making.

Hemophagocytic Lymphohistiocytosis Associated With Endocarditis: A Case Years in the Making.

Клінічні особливості перебігу локалізованих та генералізованих бактеріальних інфекцій у дітей

Актуальність. Cепсис і надалі залишається однією з найактуальніших проблем сучасності, оскільки зберігається тенденція до росту захворюваності та стабільно високої летальності. Мета: дослідити клінічні особливості перебігу бактеріальних інфекцій у дітей. Матеріали та методи. Досліджено 115 дітей із генералізованими та локалізованими формами бактеріальних інфекцій. Основна група (47 дітей) — діти із сепсисом, група порівняння (68 дітей) — діти з локалізованою бактеріальною інфекцією різної локалізації. Їх вік становив від 1 міс. до 18 років. Розподіл на групи проводився за наявності ознак синдрому системної запальної відповіді (ССЗВ) та органної дисфункції. Результати. Під час дослідження було виявлено, що рівень прояву та тривалість основних симптомів ССЗВ (гіпертермія, тахікардія та тахіпное) були статистично значимо вищими в групі сепсису. При збільшенні кількості ознак ССЗВ та розвитку септичного щоку прямо пропорційно зростали тривалість та вираженість клінічних ознак ССЗВ. Тахікардія практично завжди (93 %) супроводжує розвиток сепсису, тоді як при локалізованих бактеріальних інфекціях вона відмічається лише в третини дітей. 40 % дітей при сепсисі потребують оксигенотерапії. Ознаки ССЗВ тривають найдовше в дітей із локалізацією бактеріального вогнища в лор-огранах та грудній порожнині, тоді як при інфекції центральної нервової системи ці прояви минали найшвидше. Іонотропної підтримки найбільше потребували діти з первинним вогнищем у лор-органах — 44,4 % випадків, зовсім не потребували — з локалізацією первинного вогнища в черевній порожнині. Середній термін перебування у відділенні анестезіології та інтенсивної терапії в дітей групи порівняння становив 5,14 дня (ДІ 95% 4,42–5,87), а в дітей основної групи — 13,1 дня (ДІ 95% 9,16–17,00), що було в 2,5 раза більше (р &lt; 0,01). Висновки. Показник та тривалість основних проявів ССЗВ (гіпертермія, тахікардія, тахіпное) статистично значимо вищі в дітей із сепсисом, та вони пропорційно зростають із збільшенням кількості ознак ССЗВ. Основні симптоми ССЗВ у дітей із сепсисом із 2 ознаками ССЗВ спостерігаються тривалий час, та їх рівень статистично значимо менший порівняно з дітьми з 3 і більше ознаками ССЗВ. У 75 % дітей із локалізованою бактеріальною інфекцією відмічається задишка, хоча тривалість її незначна, і вони не потребують проведення оксигенотерапії, тоді як трохи менше половини дітей із сепсисом потребують проведення останньої.

Scabies in Spain? A comprehensive epidemiological picture.

IntroductionScabies is a neglected disease stablished worldwide with a fairy well determined incidence. In high-income countries, it often causes outbreaks affecting the residents and staff of institutions and long-term facilities, usually hard to detect and control due to the difficult diagnosis and notification delay. This study aim at characterizing the affected population, geographical distribution, and evolution of scabies in Spain from 1997–2019 as well as to describe the main environments of transmission using different data sources.MethodsWe carried out a nationwide retrospective study using four databases, which record data from different perspectives: hospital admissions, patients attended at primary healthcare services, outbreaks, and occupational diseases. We described the main characteristics from each database and calculated annual incidences in order to evaluate temporal and geographical patterns. We also analyzed outbreaks and occupational settings to characterize the main transmission foci and applied Joinpoint regression models to detect trend changes.ResultsThe elderly was the most frequent collective among the hospital admitted patients and notified cases in outbreaks, while children and young adults were the most affected according to primary care databases. The majority of the outbreaks occurred in homes and nursing homes; however, the facilities with more cases per outbreak were military barracks, healthcare settings and nursing homes. Most occupational cases occurred also in healthcare and social services settings, being healthcare workers the most common affected professional group. We detected a decreasing trend in scabies admissions from 1997 to 2014 (annual percentage change -APC- = -11.2%) and an increasing trend from 2014 to 2017 (APC = 23.6%). Wide geographical differences were observed depending on the database explored.DiscussionAn increasing trend in scabies admissions was observed in Spain since 2014, probably due to cutbacks in social services and healthcare in addition to worsen of living conditions as a result of the 2008 economic crisis, among other reasons. The main transmission foci were healthcare and social settings. Measures including enhancing epidemic studies and national registries, reinforcing clinical diagnosis and early detection of cases, hygiene improvements and training of the staff and wide implementation of scabies treatment (considering mass drug administration in institutions outbreaks) should be considered to reduce the impact of scabies among most vulnerable groups in Spain.