Public Health Control Research Articles

Analysis on the construction of intelligent public health prevention and control system of infectious diseases at ports based on SWOT-PEST analysis model

The most important thing in epidemic prevention and control is the port. The construction of intelligent prevention and control system of port public health cannot be ignored in maintaining national public health safety, and its development process is bound to be affected by political, economic, social and technical factors. Based on SWOT-PEST analysis model, this paper analyzes the internal and external factors of intelligent public health prevention and control system of port infectious diseases in Hubei Province, aiming at clarifying its own strengths and weaknesses, clarifying external opportunities and threats, and further putting forward corresponding development countermeasures, so as to promote the high-quality development of intelligent public health prevention and control system of port infectious diseases in China.

The changing epidemiology of shigellosis in Australia, 2001-2019.

Shigellosis is an increasing cause of gastroenteritis in Australia, with prolonged outbreaks reported in remote Aboriginal and Torres Strait Islander (hereafter "First Nations") communities and among men who have sex with men (MSM) in major cities. To determine associations between Shigella species and demographic and geographic factors, we used multivariate negative binomial regression to analyse national case notifications of shigellosis from 2001 to 2019. Between 2001 and 2019, Australian states and territories reported 18,363 shigellosis cases to the National Notifiable Diseases Surveillance System (NNDSS), of which age, sex and organism information were available for >99% (18,327/18,363) of cases. Of the cases included in our analysis, 42% (7,649/18,327) were S. sonnei, 29% (5,267/18,327) were S. flexneri, 1% (214/18,327) were S. boydii, less than 1% (87/18,327) were S. dysenteriae, and species information was unknown for 28% (5,110/18,327) of cases. Males accounted for 54% (9,843/18,327) of cases, and the highest proportion of cases were in children aged 0-4 years (19%; 3,562/18,327). Crude annual notification rates ranged from 2.2 cases per 100,000 in 2003 and 2011 to 12.4 cases per 100,000 in 2019. Nationally, notification rates increased from 2001 to 2019 with yearly notification rate ratios of 1.04 (95% CI 1.02-1.07) for S. boydii and 1.05 (95% CI 1.04-1.06) for S. sonnei. Children aged 0-4 years had the highest burden of infection for S. flexneri, S. sonnei and S. boydii; and males had a higher notification rate for S. sonnei (notification rate ratio 1.24, 95% CI 1.15-1.33). First Nations Australians were disproportionately affected by shigellosis, with the notification rate in this population peaking in 2018 at 92.1 cases per 100,000 population. Over the study period, we also observed a shift in the testing method used to diagnose shigellosis, with culture independent diagnostic testing (CIDT) increasing from 2014; this also coincided with an increase in notifications of untyped Shigella. This change in testing methodology may have contributed to the observed increase in shigellosis notifications since 2014, with CIDT being more sensitive than culture dependent testing methods. The findings of this study provide important insights into the epidemiological characteristics of shigellosis in Australia, including identification of high-risk groups. This can be used to inform public health prevention and control strategies, such as targeted communication programs in First Nations communities and places with high levels of interaction between young children, such as childcare centres. Our study findings also highlight the implications of culture independent testing on shigellosis surveillance, particularly a reduction in the availability of species level information. This emphasises the continued importance of culture dependant testing for national surveillance of shigellosis.

Tobacco—not for the body: epidemiologic understanding of tobacco use among members of the Church of Jesus Christ of Latter-day Saints from a Mormon perspective

: The role of religion as a factor affecting smoking has received very little attention in epidemiologic research despite other risk factors for smoking being well-documented and thoroughly researched. Previous research on the intersection of tobacco use and religion has focused primarily on the global faiths of Islam, Judaism, and Buddhism. This paper attempts to describe why members of the Church of Jesus Christ of Latter-day Saints abstain from tobacco use, by addressing the current state and landscape of epidemiologic literature from a Mormon perspective. The methodology to prepare this manuscript was a hand search performed in October 2021 using the Google Scholar portal for combinations of the terms “Mormon”, “health”, “public health”, “tobacco”, “nicotine”, and “addiction”. Inclusion criteria did not include any time limits, thus many of the identified articles were performed prior to the year 2000. Key informant interviews and personal experience with the subject matter also guided construction of the narrative. Latter-day Saint doctrine dictates the complete abstinence of tobacco along with abstinence from alcohol and certain other substances in a revelation known as the Word of Wisdom, which is recorded in one of the faiths standard works of scripture. While the Church focuses its attention on addiction recovery services, individual members of the Church participate in charitable organizations like the Church’s Relief Society and minister one-by-one to those in need. Beyond individual gains, community tobacco abstinence, as is practiced by Latter-day Saints, has notable and quantifiable advantages for population health. In large part due to the many social aspects of the Church of Jesus Christ of Latter-day Saints, as with other Christian denominations, tobacco use decreases with regular church attendance while tobacco cessation increases. Public health and tobacco control are intimately connected to faith and spirituality within the context of the Church of Jesus Christ.

Designing Digital COVID-19 Screening: Insights and Deliberations.

Due to the global COVID-19 pandemic, public health control and screening measures have been introduced at healthcare facilities, including those housing our most vulnerable populations. These warning measures situated at hospital entrances are presently labour-intensive, requiring additional staff to conduct manual temperature checks and risk-assessment questionnaires of every individual entering the premises. To make this process more efficient, we present eGate, a digital COVID-19 health-screening smart Internet of Things system deployed at multiple entry points around a children's hospital. This paper reports on design insights based on the experiences of concierge screening staff stationed alongside the eGate system. Our work contributes towards social-technical deliberations on how to improve design and deploy of digital health-screening systems in hospitals. It specifically outlines a series of design recommendations for future health screening interventions, key considerations relevant to digital screening control systems and their implementation, and the plausible effects on the staff who work alongside them.

Radionuclides: A synopsis of Distribution, Epidemiology, Importance, Public Health Significance and Control Measures

Associative Journal of Health Sciences Radionuclides: A synopsis of Distribution, Epidemiology, Importance, Public Health Significance and Control Measures Ochuko Orakpoghenor1*, Talatu Patience Markus2, Meshack Inotu Osagie3 and Paul Terkende Hambesha4 1Department of Veterinary Pathology, Ahmadu Bello University, Zaria, Nigeria 2Department of Veterinary Microbiology, Ahmadu Bello University, Zaria, Nigeria 3Department of Veterinary Public Health and Preventive Medicine, Ahmadu Bello University, Zaria, Nigeria 4Veterinary Teaching Hospital, Federal University of Agriculture, Makurdi, Nigeria *Corresponding author: Ochuko Orakpoghenor, Department of Veterinary Pathology, Ahmadu Bello University, Zaria, Nigeria Submission: January 18, 2023;Published: February 21, 2023 DOI: 10.31031/AJHS.2023.02.000537 ISSN:2690-9707 Volume2 Issue3

Exploring epidemic voluntary vaccinating behavior based on information-driven decisions and benefit-cost analysis

A complex dynamic interplay exists between epidemic transmission and vaccination, which is significantly influenced by human behavioral responses. We construct a research framework combining both the function modeling of the cumulative global COVID-19 information and limited individuals’ information processing capacity employing the Gompertz model for growing processes. Meanwhile, we built a function representing the decision to get vaccinated following benefit-cost analysis considered the choices made by people in each scenario have an influence from altruism, free-riding and immunity escaping capacity. Through the mean-field calculation analysis and using a fourth-order Runge-Kutta method with constant step size, we obtain plots from numerical simulations.We found that only when the total number of infectious individuals proves sufficient to reach and exceed a certain level will the individuals face a better trade-off in determining whether to get vaccinated against the diseases based on that information. Besides, authoritative media have a higher decisive influence and efforts should be focused on extending the duration of vaccine protection, which is beneficial to inhibit the outbreaks of epidemics. Our work elucidates that reducing the negative payoff brought about by the free-riding behavior for individuals or improving the positive payoff from the altruistic motivation helps to control the disease in cultures that value social benefits, vaccination willingness is generally stronger. We also note that at a high risk of infection, the decision of vaccination is highly correlated with global epidemic information concerning COVID-19 infection, while at times of lower risk, it depends on the game theoretic vaccine strategy. The findings demonstrate that improving health literacy, ensuring open and transparent information on vaccine safety and efficacy as a public health priority can be an effective strategy for mitigating inequalities in health education, as well as alleviating the phenomenon that immunity escaping abilities is more likely to panic by populations with high levels of education. In addition, prosocial nudges are great ways to bridge these immunity gaps that can contribute to implementing government public health control measures, creating a positive feedback loop.

Canada’s Cannabis Legalization with Strict Public Health Control

Abstract: Aims: To describe the impact of the legalization of cannabis for recreational use under strict public health control in 2018 on the following outcomes: cannabis use and use patterns, attributable harm, economic considerations. Methodology: Narrative review based on government documents, surveys, and published literature. Results: The 12-month prevalence increased after legalization and has decreased during the COVID-19 pandemic. Little change in prevalence for adolescents. Persons with daily use remained stable. No rigorous studies on changes in attributable health harm, but some indication that harm, as measured in prevalence of cannabis use disorders, treatment rate, and attributable traffic injury remained stable. No data yet available for cancer. Cannabis attributable emergency visits increased, including among children (poisoning). Cannabis-related offences decreased as biggest public health gain. Economic predictions were not realized, and there is some pressure from cannabis industry to loosen public health regulations in order to increase use. Conclusions: Overall, while not achieving its main objectives of more youth protection and decreases in cannabis-attributable health harm, legalization with strict public health control resulted in less cannabis-related offences and up to now did not seem to increase cannabis-attributable disease burden.

Foodborne and Waterborne Illness.

Safe water and food are impactful public health measures that improved significantly during the past century in the United States. But waterborne and foodborne illnesses continue to cause significant morbidity and mortality despite existing public health control measures and regulations. It was estimated that each year in the United States, 31 pathogens caused 37.2 million illnesses, with 36.4 million domestically acquired. Of those, 9.4 million were foodborne: 59% were caused by viruses, 39% by bacteria, and 2% by parasites. The pathogens that caused the most foodborne illnesses were norovirus (58%), nontyphoidal Salmonella species (11%), Clostridium perfringens (10%), and Campylobacter species (9%). Unspecified agents caused an estimated 38.4 million episodes of domestically acquired foodborne gastroenteritis, 258,033 hospitalizations, and 3,574 deaths. The estimate for illnesses caused by waterborne transmission was 7.15 million. The diseases that caused the greatest number were otitis externa (n = 4.67 million), norovirus (n = 1.33 million), giardiasis (n = 415,000), and cryptosporidiosis (n = 322,000). An important aspect of management and prevention is health-care provider reporting of foodborne and waterborne illnesses. Health-care provider reporting of reportable diseases has been inconsistent, infrequent, and delayed. Education efforts concerning reporting need to be enhanced, and physicians should report suspected cases before laboratory confirmation to enhance the timeliness of outbreak investigation and possibly prevent subsequent cases.

Evolutionary analysis of Omicron variant BF.7 and BA.5.2 pandemic in China

On December 7, 2022, China adjusted public health control measures, there have been widespread of SARS-CoV-2 infections in Chinese mainland. As the number of infected people increased, the mutation probability of SARS-CoV-2 is also raised. Therefore, it is of great importance to monitor SARS-CoV-2 variants and its mutations in China. In this current study, 665 SARS-CoV-2 genomes from China deposited in the public database were used to analyze the proportion of different variants; to determine the composition of variants in China across different provinces; and analyze specific mutation frequency, focusing on 12 immune escape residues. The results showed that no new mutations were generated on the 12 immune escape residues. The evolutionary analysis of the BF.7 variant circulating in China showed that there is an independent evolutionary branch with unique mutation sites, officially named BF.7.14 by PANGO. This variant may have been imported from Russia to Inner Mongolia at the end of September 2022 and continued its spread in China. The evolutionary analysis of BA.5.2 variant shows that the variant is composed of two sub-variants, named BA.5.2.48 and BA.5.2.49 by PANGO, respectively. This variant may have been imported from abroad to Beijing at the beginning of September 2022 and formed two sub-variants after domestic transmission. Finally, this study showed that current epidemic variants in China were already circulating in other countries, and there were no additional mutations on immune escape residues that could pose a threat to other countries.

Invasion of Toxoplasma gondii bradyzoites: Molecular dissection of the moving junction proteins and effective vaccination targets

Toxoplasmosis is a neglected parasitic disease necessitating public health control. Host cell invasion by Toxoplasma occurs at different stages of the parasite's life cycle and is crucial for survival and establishment of infection. In tachyzoites, which are responsible for acute toxoplasmosis, invasion involves the formation of a molecular bridge between the parasite and host cell membranes, referred to as the moving junction (MJ). The MJ is shaped by the assembly of AMA1 and RON2, as part of a complex involving additional RONs. While this essential process is well characterized in tachyzoites, the invasion process remains unexplored in bradyzoites, which form cysts and are responsible for chronic toxoplasmosis and contribute to the dissemination of the parasite between hosts. Here, we show that bradyzoites invade host cells in an MJ-dependent fashion but differ in protein composition from the tachyzoite MJ, relying instead on the paralogs AMA2 and AMA4. Functional characterization of AMA4 reveals its key role for cysts burden during the onset of chronic infection, while being dispensable for the acute phase. Immunizations with AMA1 and AMA4, alone or in complex with their rhoptry neck respective partners RON2 and RON2L1, showed that the AMA1-RON2 pair induces strong protection against acute and chronic infection, while the AMA4-RON2L1 complex targets more selectively the chronic form. Our study provides important insights into the molecular players of bradyzoite invasion and indicates that invasion of cyst-forming bradyzoites contributes to cyst burden. Furthermore, we validate AMA-RON complexes as potential vaccine candidates to protect against toxoplasmosis.

Impact of the V410L kdr mutation and co-occurring genotypes at kdr sites 1016 and 1534 in the VGSC on the probability of survival of the mosquito Aedes aegypti (L.) to Permanone in Harris County, TX, USA.

Harris County, TX, is the third most populous county in the USA and upon detection of arboviruses Harris County Public Health applies insecticides (e.g., pyrethroid-based Permanone 31-66) against adults of Culex quinquefasciatus to prevent disease transmission. Populations of Aedes aegypti, while not yet a target of public health control, are likely affected by pyrethroid exposure. As this species is a vector of emerging arboviruses, its resistance status to Permanone and the kdr mutations in the voltage-gated sodium channel (VGSC) associated with pyrethroid resistance were investigated. We examined females of known genotype at the V1016I and F1534C sites (N = 716) for their genotype at the 410 amino acid position in the VGSC, and for the influence of their kdr genotype on survival to Permanone at three different distances from the insecticide source in field tests. Most females (81.8%) had at least one resistant L allele at the 410 position, being the first report of the V410L mutation in Ae. aegypti for Texas. When only genotypes at the 410 position were analyzed, the LL genotype exhibited higher survivorship than VL or VV. Out of 27 possible tri-locus kdr genotypes only 23 were found. Analyses of the probability of survival of tri-locus genotypes and for the V410L genotype using a multivariate logistic regression model including area, distance, and genotype found significant interactions between distance and genotype. When only the most common tri-locus genotypes were analyzed (LL/II/CC, 48.2%; VL/II/CC, 19.1%; and VV/II/CC, 10.1%) genotype had no effect on survival, but significant interactions of distance and genotype were found. This indicated that the V410L kdr allele increased survival probability at certain distances. Genotypes did not differ in survivorship at 7.62-m, but LL/II/CC had higher survivorship than VL/II/CC at 15.24- and 22.86-m. The model also identified differences in survivorship among the operational areas investigated.

Influenza viral infection is a risk factor for severe illness in COVID-19 patients: a nationwide population-based cohort study

ABSTRACT In order to prepare for the twindemic of influenza and SARS-CoV-2 infection, we investigated the association between influenza infection and subsequent severity of SARS-CoV-2 infection. A population-based nationwide cohort study was performed using data from the National Health Insurance Service (NHIS) in the Republic of Korea. This study included 274,126 individuals who underwent SARS-CoV-2 PCR testing between 20 January 2020 and 1 October 2020. Among these patients, 28,338 tested positive for SARS-CoV-2, and 4,003 of these individuals had a history of influenza. The control group was selected through 1:1 propensity score matching. In the group of 4,003 COVID-19-positive individuals with no history of influenza, 192 (4.8%) experienced severe illness from COVID-19 infection. In the group of 4,003 COVID-19-positive individuals with a history of influenza, 260 (6.5%) had severe illness from COVID-19, and the overall adjusted odds ratio (aOR) was 1.29 (95% confidence interval 1.04–1.59). Among the 4,003 COVID-19-positive individuals with a history of influenza, severe COVID-19 infection was experienced by 143 of 1,760 (8.1%) with an influenza history within 1 year before the onset of COVID-19, 48 of 1,129 (4.3%) between 1 and 2 years, and 69 of 1,114 (6.2%) between 2 and 3 years before COVID-19 onset, and the aORs were 1.54 (1.20-1.98), 1.19 (0.84-1.70), and 1.00 (0.73-1.37), respectively. In conclusion, individuals who had an influenza infection less than 1 year before COVID-19 infection were at an increased risk of experiencing severe illness from the SARS-CoV-2 infection. To control the public health burden, it is essential that effective public health control measures, which include influenza vaccination, hand washing, cough etiquette, and mask use are in place.

Molecular detection of Escherichia coli isolated from human, animal and environmental samples targeting mdh gene: A simple one health approach

Background: Escherichia coli cause a wide range of infections in humans and animals in hospitals and community associated with multidrug-resistance, and serves as bioindicator of fecal contamination as well as AMR. Aim: Early detection of this bioindicator from humans, animals and environment facilitates characterization with respect to AMR and bacterial forensics for effective public health and infection control measurements. Method: We investigated a simple and rapid species-specific end-point and real-time PCR assays targeting malate dehydrogenase (mdh) gene to detect Escherichia coli isolated from livestock, human, and environmental water in Midnapore, West Bengal, India in a timely and cost-effective approach. Results: Of 126 E. coli isolates, 53, 41 and 32 were cultured from livestock, human and environmental water. The mdh gene was present in 120 (95.2%) isolates, including all environmental isolates. Two (3.8%) animal and four human (9.8%) isolates were discordant between culture and PCR results. The PCR assays produced results in about 90 min with a running cost of US$3-5 per sample. Conclusion: Both the PCR assays may be utilized in detection of Escherichia coli depending on the laboratory infrastructure.

Modelling the transmission and control of COVID-19 in Yangzhou city with the implementation of Zero-COVID policy.

In the fight against the COVID-19 pandemic, China has long adhered to the "Dynamic Zero COVID-19" strategy till the end of 2022. To understand the mechanism of this strategy, we used the case of the Yangzhou summer outbreak in 2021 and a multi-stage dynamical model incorporating city-wide and key area testing-trace-isolation (TTI) strategies. We defined two time-varying indexes for measuring the disease transmission risk and the public health prevention and control force, respectively, which allowed us to explore the mechanisms of TTI policies. Integrating with the historical data and literature parameter values, we first estimated the parameters and then quantified the relevant indexes over time. The findings showed that multiple rounds of rapid testing were one of the critical measures to overcome the outbreak in Yangzhou within one month. In addition, we compared the impact of the duration of the free transmission stage, tracking rate, testing interval and precise division of key areas on the epidemiological indicators, including the final sizes of infections and isolations, peak value, peak arrival time and epidemic duration and the minimum round of testing. Our results suggest that the early detection of the epidemic, an improved efficiency of tracking, and a reduced duration of each test play a positive role in restraining COVID-19; however, a considerable investment of resources was essential to achieve a significant effect quickly.

Monkeypox 2022

Introduction: Monkeypox is a rare zoonotic disease that is caused by a virus belonging to the Orthopoxvirus genus and is closely related to smallpox and cowpox viruses. The emerging epidemic amid the current COVID-19 pandemic is a matter of concern and warrants urgent public health attention with key issues discussed in the article. Aim: The aim of this study was to explore emerging zoonotic, epidemic threats, future implications, and the way ahead in respect of monkeypox. Methodology: Secondary data from official government sites, press information, latest articles, newspapers, and the WHO website were extracted and discussed in the article. The current epidemiology of monkeypox with the difference from the COVID-19 pandemic is highlighted in the study. The most probable factors for the emergence and recent outbreak are also discussed. The period of the study was from May 20, 2022, to May 27, 2022, and was conducted in the medical college of Western Maharashtra. Results and Discussion: Total number of 25 articles/government/international websites were assessed. While comparing the number of cases among different countries across the globe, the present outbreak has involved different countries with no geographical continuity, with a maximum number of cases from Portugal, Spain, and the United States of America. A comparison of epidemiological determinants of COVID-19 and monkeypox was done which reveals the lesser pandemic potential of monkeypox as compared to COVID-19. Conclusion: The present monkeypox outbreak scenario is different from the previous outbreaks, but with lesser pandemic potential as compared to COVID-19. However, with the increase in the incidence of monkeypox cases in different countries, the fear of cross-border transmission is real. Robust public health surveillance and control measures are vital to address this threat.

Influenza hospitalisations in Spain between the last influenza and COVID-19 pandemic (2009-2019).

Knowing the burden of severe disease caused by influenza is essential for disease risk communication, to understand the true impact of vaccination programmes and to guide public health and disease control measures. We estimated the number of influenza-attributable hospitalisations in Spain during the 2010-2011 to 2019-2020 seasons - based on the hospitalisations due to severe acute respiratory infection (SARI) in Spain using the hospital discharge database and virological influenza information from the Spanish Influenza Sentinel Surveillance System (SISSS). The weekly numbers of influenza-attributable hospitalisations were calculated by multiplying the weekly SARI hospitalisations by the weekly influenza virus positivity, obtained from the SISSS in each season, stratified by age group and sex. The influenza-related hospitalisation burden is age-specific and varies significantly by influenza season. People aged 65 and over yielded the highest average influenza-attributable hospitalisation rates per season (615.6 per 100,000), followed by children aged under 5 (251.2 per 100,000). These results provide an essential contribution to influenza control and to improving existing vaccination programmes, as well as to the optimisation and planning of health resources and policies.

Antifertility Potential of n-Butanol and Ethyl Acetate Extracts of Penicillium oxalicum OM282858 in Male Albino Rats as Biological Control Agents

Rodents cause significant damage to many crops, spread diseases, and pose a severe risk to public health. Several synthetic contraceptive agents are available for controlling rodents; however, their use is associated with toxic effects on non-target organisms. Penicillium oxalicum has several medical properties, but no reports were available on fertility. This study aimed to assess the antifertility potential of n-butanol and ethyl acetate extracts of P. oxalicum in adult male albino rats as biological control agents by lowering the population size of rodent pests. Rats were assigned into three groups (n = 36). The first control group (GI) was injected intraperitoneally with 0.5% dimethyl sulfoxide (DMSO). The second (GII) and third (GIII) groups were injected with a single dose of 200 mg/kg body weight (b.wt.) of n-butanol and ethyl acetate extracts of P. oxalicum intraperitoneally, respectively, after dissolving in 0.5% DMSO. Further, P. oxalicum was identified morphologically and molecularly and then submitted with accession number OM282858 to the National Center for Biotechnology Information (NCBI) GenBank. The antifertility potential of P. oxalicum was evaluated after 24 h (the injection period), 96 h, and 168 h (the recovery periods) of treatments. The effects of the treatments on organ weight, testicular histology, histomorphometry measurements, and sperm characteristics were assessed. Both P. oxalicum extracts caused changes in reproductive organ weights, testicular histology, histomorphometry measurements, and spermatogenic arrest accompanied by a significant decrease in the count of epididymal sperm and its motility and an increase in the percentage of sperm abnormalities during the injection and recovery periods. Thus, the results suggest that both P. oxalicum extract treatments cause suppression of fertility in adult male rats. Therefore, these outcomes are essential for public health, farming establishments, and vertebrate pest control managers.

Monkey Pox: Health Care System in Pakistan

The Zoonotic viruses have been a threat to the health care systems in all around the globe. The spread was pandemic with high mortality and morbidity rates [1]. The zoonotic viruses like small pox and monkey pox is included in orthopox genus of poxviridae family and is public health concern all around the world. The newly emerging zoonotic diseases have the potential to cause epidemics and have high mortality, have long been a threat to the security of global health [2, 3]. Prior to 2003, the first human monkey pox case around the Africa was identified and the monkey pox was endemic to nations such as western and central African. There has been a lot of upheaval recently because to the monkey pox outbreak that has affected 18 non-African nations, totaling 103 sure diseases cases and about 106 cases who had a little suspicion or early signs related [4, 5]. The worldwide epidemic of this illness has shown no fatalities have been recorded yet. Following a warning from the World Health Organization regarding an increase in cases of monkey pox in non-endemic nations, the National Institute of Health (NIH) Pakistan’s health authority, issued a warning to provincial and national health organizations advising them to intensify surveillance of the occurrence [3, 6]. Pakistan now is attempting to deal with the COVID-19 difficulties in this dire political and economic scenario. Another health and economic catastrophe rose in the next days as a result of the brittle healthcare system, inability to prevent fatal illnesses, and lack of resources [7]. A sensitive people are more vulnerable to subsequent epidemic cycles because of the ecological void left by the rising number of people lacking poxvirus protection after the smallpox vaccination programme was discontinued. In light of these challenges, Pakistan must make proactive plans in advance to prevent any disastrous events. The smallpox vaccine has historically demonstrated cross-protective immunity against monkey pox; however, Pakistan stopped administering the smallpox vaccine after the WHO proclaimed the globe free of the disease in 1980. Given that there are presently no monkey pox diagnostic tests accessible in Pakistan, the likelihood of an epidemic is even more concerning [8]. As a result, urgent action is required to stop the spread of the monkey pox virus [9]. The monkey pox infection spreads slowly as compared to Covid and requires the isolation and immunization to health care professionals before and after the exposure. No stigma should be attached to the distribution of health advice. The medical and allied professionals in the clinical practice may interact with suspected or confirmed case of monkey pox and advised to practice a maintained distance and limitation in contact, including proper maintained handling of all equipment and other things like contaminated syringes, garbage, and clothing. The disinfection of the surfaces of equipment and surrounding should be performed [10]. Public health emergency and control teams should be constituted as soon as the existence of a disease in the nation is confirmed in order to oversee and coordinate the response. Surveillance should involve an active search rather than depending on medical personnel's passive disease reporting. Monkey pox case identification and increased surveillance are crucial tools for comprehending the dynamic epidemiology of this emerging disease [11, 12].

On the lookout for influenza viruses in Italy during the 2021-2022 season: Along came A(H3N2) viruses with a new phylogenetic makeup of their hemagglutinin

AimsTo assess influenza viruses (IVs) circulation and to evaluate A(H3N2) molecular evolution during the 2021-2022 season in Italy. Materials and methods12,393 respiratory specimens (nasopharyngeal swabs or broncho-alveolar lavages) collected from in/outpatients with influenza illness in the period spanning from January 1, 2022 (week 2022-01) to May 31, 2022 (week 2022-22) were analysed to identify IV genome and were molecularly characterized by 12 laboratories throughout Italy. A(H3N2) evolution was studied by conducting an in-depth phylogenetic analysis of the hemagglutinin (HA) gene sequences. The predicted vaccine efficacy (pVE) of vaccine strain against circulating A(H3N2) viruses was estimated using the sequence-based Pepitope model. ResultsThe overall IV-positive rate was 7.2% (894/12,393), all were type A IVs. Almost all influenza A viruses (846/894; 94.6%) were H3N2 that circulated in Italy with a clear epidemic trend, with 10% positivity rate threshold crossed for six consecutive weeks from week 2022-11 to week 2022-16. According to the phylogenetic analysis of a subset of A(H3N2) strains (n=161), the study HA sequences were distributed into five different genetic clusters, all of them belonging to the clade 3C.2a, sub-clade 3C.2a1 and the genetic subgroup 3C.2a1b.2a.2. The selective pressure analysis of A(H3N2) sequences showed evidence of diversifying selection particularly in the amino acid position 156. The comparison between the predicted amino acid sequence of the 2021-2022 vaccine strain (A/Cambodia/e0826360/2020) and the study strains revealed 65 mutations in 59 HA amino acid positions, including the substitution H156S and Y159N in antigenic site B, within major antigenic sites adjacent to the receptor-binding site, suggesting the presence of drifted strains. According to the sequence-based Pepitope model, antigenic site B was the dominant antigenic site and the p(VE) against circulating A(H3N2) viruses was estimated to be -28.9%. Discussion and conclusionAfter a long period of very low IV activity since public health control measures have been introduced to face COVID-19 pandemic, along came A(H3N2) with a new phylogenetic makeup. Although the delayed 2021-2022 influenza season in Italy was characterized by a significant reduction of the width of the epidemic curve and in the intensity of the influenza activity compared to historical data, a marked genetic diversity of the HA of circulating A(H3N2) strains was observed. The identification of the H156S and Y159N substitutions within the main antigenic sites of most HA sequences also suggested the circulation of drifted variants with respect to the 2021-2022 vaccine strain. Molecular surveillance plays a critical role in the influenza surveillance architecture and it has to be strengthened also at local level to timely assess vaccine effectiveness and detect novel strains with potential impact on public health.

Hazardous drinking and alcohol use disorders.

Alcohol is one of the most widely consumed psychoactive drugs globally. Hazardous drinking, defined by quantity and frequency of consumption, is associated with acute and chronic morbidity. Alcohol use disorders (AUDs) are psychiatric syndromes characterized by impaired control over drinking and other symptoms. Contemporary aetiological perspectives on AUDs apply a biopsychosocial framework that emphasizes the interplay of genetics, neurobiology, psychology, and an individual's social and societal context. There is strong evidence that AUDs are genetically influenced, but with a complex polygenic architecture. Likewise, there is robust evidence for environmental influences, such as adverse childhood exposures and maladaptive developmental trajectories. Well-established biological and psychological determinants of AUDs include neuroadaptive changes following persistent use, differences in brain structure and function, and motivational determinants including overvaluation of alcohol reinforcement, acute effects of environmental triggers and stress, elevations in multiple facets of impulsivity, and lack of alternative reinforcers. Social factors include bidirectional roles of social networks and sociocultural influences, such as public health control strategies and social determinants of health. An array of evidence-based approaches for reducing alcohol harms are available, including screening, pharmacotherapies, psychological interventions and policy strategies, but are substantially underused. Priorities for the field include translating advances in basic biobehavioural research into novel clinical applications and, in turn, promoting widespread implementation of evidence-based clinical approaches in practice and health-care systems.