Re-emerging Disease Research Articles

Don’t pass me by: Tackling vaccine hesitancy among migrants via the RIVER-EU project

Abstract Literature research has suggested that vaccination hesitancy (VH) has been increasing in recent years across migrant populations. It poses various challenges, including risks of outbreaks, and re-emergence of diseases. Nevertheless, only few studies provide an insight of the interventions successful in tackling VH among these groups. This presentation will describe a multi-country research enterprise that aims to respond to these needs. The “RIVER-EU - Reducing Inequalities in Vaccine uptake in the European Region - Engaging Underserved communities” project (funding from EU’s Horizon 2020, Grant Agreement No. 964353) involves several underserved communities, such as Ukrainian migrants (UMs) in Poland, migrants and refugees in Greece, females with Turkish/Moroccan migration background in the Netherlands and the marginalized Roma communities in Slovakia. The project aims at improving child and adolescent HPV/MMR vaccination among these communities by implementing tailored interventions, suitable for each target country. The focus is on removing health system barriers to vaccination. The data regarding VH are an important by-product of the RIVER-EU project, and shows the connection between perceived access barriers and VH. A project-based approach to combat VH among UMs in Poland will serve as a case study to demonstrate the complex process of development of adequate interventions, that could be used to support this migrant group, with disturbingly low vaccination uptake. However, this presentation will go beyond this case study findings - a review of the existing evidence will help generalize our results. Overall, this presentation will show to how investigating various drivers of under-immunization helps to assess what approaches, strategies and interventions are effective to combat VH among marginalized migrant groups.

Climate change and emerging infections: Risks, adaptation and response

Abstract Background Weather and changing climate are key drivers of the emergence, re-emergence and spread of infectious diseases globally. However, approaches to emerging infections and climate strategies are still largely being developed separately missing the opportunities for integrated climate adaptation actions to address infectious diseases. Description To inform the development of the UK national emerging infectious diseases plan, a literature review of the current and projected risks from extreme weather events and climate change on emerging infections in the UK is currently underway. This will support further work examining and co-designing adaptation options in the context of preparedness and response to emerging infections. Results Key preliminary findings from the literature review have indicated risks predominantly from evolving patterns of vector borne diseases as climatic conditions and habitat suitability of pathogens change. Changing temperatures and hotter summer temperatures have been associated with changing food-borne infection patterns. Further risks driven by extreme weather, including flooding and droughts, could perpetuate changes in water-borne infection patterns. Adaptation actions focussed on these infectious disease groups are currently under review and will cover risk assessment, data and surveillance, preparedness and response. Lessons This work integrates climate action with action on emerging infectious diseases. By examining the evidence on climate sensitive infections and co-designing solutions across teams, awareness is being raised and relationships and infrastructures built to better prepare and respond to both fundamental global public health challenges.

A vaccine candidate based on baculovirus displaying chikungunya virus E1-E2 envelope confers protection against challenge in mice.

Chikungunya fever is a re-emerging mosquito-borne disease caused by the chikungunya virus (CHIKV) and produces acute arthritis that can progress to chronic disease with arthralgia. The first approved live-attenuated chikungunya vaccine has only recently become available for use in humans in the USA, but the access in endemic regions remains unmet. Here, we exploited the baculovirus display technology to develop a vectored vaccine candidate that exposes the CHIKV membrane proteins E1 and E2 on the baculovirus surface. Using recombinant baculovirus as vector vaccines has both productive and regulatory advantages: they are safe for handling and easy to produce in high titers and are non-pathogenic and non-replicative in mammals but have strong adjuvant properties by inducing humoral and cellular immune responses. CHIKV E1 and E2 envelope proteins with their own signal and transmembrane sequences were expressed on the surface of budded baculovirus virions. Immunization of C57BL/6 mice with non-adjuvanted recombinant baculovirus induced IgG antibodies against E2 with a predominant IgG2c subtype, neutralizing antibodies and a specific IFN-γ CD8+ T-cell response. Immunization with a second dose significantly boosted the antibody response, and mice immunized with two doses of the vaccine candidate were completely protected against challenge with CHIKV showing no detectable viremia or signs of disease. Altogether, baculovirus display of CHIKV envelope proteins served as an efficient vaccine platform against CHIKV.IMPORTANCEThe global spread of chikungunya virus (CHIKV) has disproportionately impacted the Americas that experienced a fourfold increase in 2023 in cases and deaths compared with the same period in 2022. The disease is characterized by acute fever and debilitating joint pain that can become chronic. Despite the socioeconomic burden related to the high morbidity rates of CHIKV infection, a vaccine for CHIKV is currently approved only in the USA. Vaccines are the most effective preventive measure against viral diseases, and advances in the development of different vaccine platforms such as nucleic acids and viral vectors have prompted the rapid deployment of vaccines to contain the COVID-19 pandemic. Here, we report the use of baculovirus display as a strategy for the design of a novel vaccine that provides sterilizing immunity in a mouse model of chikungunya disease. Our results encourage further research regarding the potential of baculovirus as platforms for human vaccine design.

Haemoprotozoan and haemorickettsial carrier status in pet and community owned dogs of south India

The increasing population of dogs and changes in the climatic conditions have resulted in the emergence and re-emergence of vector-borne diseases in canines. These vectors borne diseases in canines pose a diagnostic challenge to the field veterinarians because of co-infections with several pathogens. Comprehensive data on the prevalence of haemoparasites and haemorickettsiales in pet and community owned dogs from south India are scant. Hence, the present study aims to find and compare the prevalence of these infections in the pet and the community owned dogs of Kerala, a south Indian state. Two hundred and seventy-two pets and 150 community owned dogs were examined by microscopy and polymerase chain reaction (PCR) for infections with different heamoparasites and haemorickettsials from January 2018–November 2020 in the state of Kerala. A high prevalence of Babesia gibsoni infection (42.2–60.0 %) in pet and community owned dogs, followed by Babesia vogeli (5.8–39.3 %), Hepatozoon canis (0.7–28.0 %), Trypanosoma evansi (0.0–27.3 %), Ehrlichia canis (0.3–0.6 %) and Anaplasma platys (0.0–0.6 %) was observed in the present study. Eighty-eight per cent (132/150) of the community owned dogs and 49.2 % (134/272) of the pet dogs were positive for at least one pathogen. Phylogenetic analysis based on the partial nucleotide sequences of 18S rRNA and TRAP gene of B. gibsoni, 18S rRNA genes of B. vogeli and H. canis and RoTat, 1.2 virB9 and 16S rRNA genes of T. evansi, E. canis and A. platys, respectively was carried out. B. vogeli, H. canis, E. canis and A. platys revealed genetic relatedness between the Indian isolates and the isolates from other countries. However, B. gibsoni isolates from the Indian sub-continent were genetically unique compared to other Asian isolates. The clustering of T. evansi isolates from India in two clades viz., livestock origin (cattle, buffalo) and others indicated their genetic variability. The present study summarizes the prevalence of some of the haemoparasites and haemorickettsials in the dog populations of Kerala (south India) and also determined their genetic relationship with the isolates prevalent in dogs in other countries.

On Vegetal Geography: Perspectives on Critical Plant Studies, Placism, and Resilience

Abstract This study contributes to the emerging subdiscipline of geography, defined as vegetal geography, expanding beyond Critical Plant Studies’ focus on place-based interactions with and adaptations to human systems and ecologies. In this sense, vegetal geography covers political and cultural ecologies and psychogeography of events, highlighted by the recent pandemic, the ongoing threat of anthropogenic climate change, and the re-emergence of global diseases in recent years amid unrestrained consumerism and human niche constructions. These so-called Anthropocene proliferations tend to ramify the relation of place to organic entanglement with the non-organic, human with the nonhuman, which implicates species trade-offs, uncanny alliances, and affinities, via a series of differential synthesis, borrowing from Deleuze and Guattari, amid increasing climate anomalies. In the process, they engender emergent ecologies where vegetal life, a key Deleuzean concept, provides a critical pivot to interspecies relations in times of crisis and emergency.

Leptospira spp. Antibody Seroprevalence in Stray Dogs and Cats: A Study in Milan, Northern Italy

Leptospirosis is a widespread zoonosis recognised as a re-emerging infectious disease in both humans and dogs, yet the actual seroprevalence of Leptospira in pets in Italy is relatively unknown. The aim of this study was to evaluate Leptospira antibody prevalence in dogs and cats from a shelter by the microscopic agglutination test (MAT), the gold standard test in leptospiral serology, and to assess risk factors for Leptospira infection. This seroepidemiological study investigated the prevalence of leptospiral antibodies in a cohort of 106 dogs and 51 cats housed in a municipal shelter in Milan. Blood samples were collected from the animals during two sampling periods: spring/summer 2014 and autumn/winter 2016/2017. Eight serogroups were evaluated: L. Australis, L. Ballum, L. Canicola, L. Grippotyphosa, L. Icterohaemorrhagiae, L. Pomona, L. Sejroe, and L. Tarassovi. Antibody titres ranged from 1:100 to 1:6400. The results indicated that 21.7% of dogs had antibodies against serogroups L. Icterohaemorrhagiae and L. Australis, making them the most often found. Conversely, none of the cats showed any presence of antibodies. Seropositivity was higher in the spring/summer period (32.7%) than in autumn/winter (11.1%), and no statistically significant results were found regarding sex or age. These findings underscore the importance of ongoing serological surveillance and biosecurity measures in shelter environments to mitigate the zoonotic risk posed by leptospirosis.

Emergent and re-emergent zoonotic infectious diseases in Uruguay (2004-2024) and socio-environmental changes. a one health perspective

The One Health approach aims to operate at the intersection of human, animal, and environmental influence to prevent and control the scale of these shifts. In recent decades, Uruguay has experienced various productive and socio-environmental alterations. This communication presents some relationships between emerging and increasing zoonotic diseases and some socio-environmental-climatic determinant factors under the One Health framework. We identify emerging and re-emerging zoonotic diseases (e.g. rabies, Leishmaniasis, avian influenza, western equine encephalitis) based on Uruguayan WOAH and the zoonotic reports from the Ministry of Agriculture and Livestock and the Ministry of Public Health. We analyse the outbreaks, cases, deaths, distribution, and time progression. Finally, we compare the monitoring sources and reports and show their differences. There are some differences among them that need to be verified.

Association between domestic animal exposure and diarrhea prevalence in under- five children in low- and middle-income countries: a systematic review and meta-analysis

BackgroundDiarrheal disease is still the leading cause of morbidity and mortality in children, despite significant progress in diarrhea interventions. Zoonotic transmission is the main cause of the emergence and re-emergence of diseases. Domestic animals are often close to humans, particularly in resource-poor countries. Despite evidence of environmental contamination, there have been limited studies conducted to examine the association between domestic animal exposure and diarrheal disease in low- and middle-income countries (LMIC). Therefore, this systematic review and meta-analysis examines the association between domestic animal exposure and diarrheal disease in children under five years of age in LMIC.MethodsThe search strategy followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for the reporting of systematic reviews. All appropriate databases were searched to find relevant articles. Research studies were selected for review if they reported an outcome variable that measured diarrhea and exposure variables of any domestic animals. A data extraction form was used to extract information from each study. The quality of the individual articles was assessed using the Joanna Briggs Institute (JBI’s) critical appraisal tools. Publication bias was checked using a funnel plot, Egger’s regression test, and Begg’s test. The heterogeneity of studies was checked using the Galbraith plot and the I-squared test. A sensitivity analysis was conducted, and a meta-analysis was conducted using STATA 17.ResultsAfter reviewing 113 articles, 11 articles fulfilled the inclusion criteria hence considered for meta-analysis. The finding of these 11 studies revealed that study participants who had animal exposure had 1.95 higher odds of diarrhea as compared to participants who hadn’t animal exposure (OR: 1.95, 95%CI: 1.25, 2.66).Conclusions and recommendationsThis study reported that diarrheal disease was associated with study subjects who had domestic animal exposure. Therefore, more comprehensive research is needed on specific behaviors and interventions surrounding animal husbandry that may affect the transmission of pathogens between animals and humans; this would facilitate the design and implementation of measures to reduce animal exposure in the domestic environment.

Toxicogenomics of persistent organic pollutants: Potential impacts on biodiversity and infectious diseases

Pollution is recognized as one of the main causes of biodiversity loss. Growing evidence also points to pollution as an important risk factor for the emergence or reemergence of infectious diseases that affect humans and other animals. However, the mechanisms and pathways that explain how pollution erodes biodiversity and favors infectious diseases are poorly explored. Using the Dirty Dozen (aldrin, chlordane, dichlorodiphenyl trichloroethane - DDT, dieldrin, dioxins, endrin, furans, heptachlor, hexachlorobenzene, mirex, polychlorinated biphenyls - PCBs, and toxaphene) persistent organic pollutants (POPs) as a study model, in this article we demonstrate through toxicogenomic approaches that these POPs affect thousands of genes involved in the immune system and metabolic processes, among other biological pathways (n=19,086 genes from multiple organisms). One of the major findings indicate that POPs interact with hormone receptor genes prominently (i.e., Esr1, Nr1i2 and Ar genes). This finding highlights the activity of these pollutants as hormonal disruptors, with potentially deleterious consequences for the metabolism and reproduction of a wide range of species. These pollutants also have an important genotoxic activity, contributing to genomic instability and other related consequences. In summary, disturbances in the immune system can favor infection and the spread of pathogens, and changes in metabolism and genotoxic effects triggered by pollutants in multiple body systems can reduce fitness, harming the species’ survival in natural environments. The results of this exploratory toxicogenomic analysis represent a new piece in the puzzle that increasingly points to pollution as a major risk factor for both biodiversity loss and emerging infectious diseases.

Vaccinations for emerging and re-emerging viral diseases

Emerging or re-emerging viral diseases have apandemic potential and threaten global health. Vaccination is of crucial importance in the prevention of emerging and re-emerging viral diseases. Description of the current status of vaccine development against Filoviridae, highly pathogenic coronaviruses, smallpox viruses, influenza viruses and arboviruses. Focused literature search. The World Health Organization (WHO) regularly publishes alist of infectious diseases that are expected to pose amajor threat to humanity as they are could potentially trigger new pandemics; however, in addition to these human-to-human transmissible diseases, some arboviruses also have pandemic potential. In recent years numerous new vaccines, some of which are highly effective, have been licensed against new and re-emerging viral diseases and other promising vaccine candidates are currently in development. There are still gaps in the development of vaccines in the area of Filoviridae and highly pathogenic coronaviruses. Vaccinations against smallpox viruses have been available for a long time. Developing influenza vaccines against novel strains in atimely manner is achallenge and universal influenza vaccines could be apossible solution. Modern vaccines are available against the arboviruses dengue and Chikungunya fever.

Salsoline derivatives, genistein, semisynthetic derivative of kojic acid, and naringenin as inhibitors of A42R profilin-like protein of monkeypox virus: in silico studies.

Monkeypox virus (MPV) infection has developed into a re-emerging disease, and despite the potential of tecovirimat and cidofovir drugs, there is currently no conclusive treatment. The treatment's effectiveness and cost challenges motivate us to use In Silico approaches to seek natural compounds as candidate antiviral inhibitors. Using Maestro 11.5 in Schrodinger suite 2018, available natural molecules with validated chemical structures collected from Eximed Laboratory were subjected to molecular docking and ADMET analysis against the highly conserved A42R Profilin-like Protein of Monkeypox Virus Zaire-96-I-16 (PDB: 4QWO) with resolution of 1.52Å solved 3D structure. Compared to the FDA-approved Tecovirimat, molecular docking revealed that Salsoline derivatives, Genistein, Semisynthetic derivative of kojic acid, and Naringenin had strengthened affinity (-8.9 to -10kcal/mol) to 4QWO, and the molecular dynamic's simulation confirmed their high binding stability. In support of these results, the hydrogen bond analysis indicated that the Salsoline derivative had the most robust interaction with the binding pockets of 4QWO among the four molecules. Moreover, the comparative free energy analyses using MM-PBSA revealed an average binding free energy of the complexes of Salsoline derivative, Genistein, Semisynthetic derivative of kojic acid, Naringenin, of -106.418, -46.808, -50.770, and -63.319kJ/mol, respectively which are lower than -33.855kJ/mol of the Tecovirimat complex. Interestingly, these results and the ADMET predictions suggest that the four compounds are promising inhibitors of 4QWO, which agrees with previous results showing their antiviral activities against other viruses.

Identification of Salmonella enterica biovars Gallinarum and Pullorum and their antibiotic resistance pattern in integrated crop-livestock farms and poultry meats

Due to consumer demand, many conventional poultry farms are now growing poultry without antibiotics or synthetic chemicals. In addition to this, pasture/organic poultry farms have increased significantly in the USA, and they are also antibiotic- and chemical-free. According to recent reports, both antibiotic-free conventional and pasture poultry farmers are facing the re-emergence of bacterial diseases. Bacterial diseases cause higher mortality rates in birds and lead to non-profitable poultry farming. This study investigated the prevalence of Salmonella enterica subsp. enterica serovar Gallinarum biovars Gallinarum (S. Gallinarum), the causative agent of fowl typhoid, and Salmonella enterica subsp. enterica serovar Gallinarum biovars Pullorum (S. Pullorum), the causative agent of pullorum disease, within integrated crop-livestock/pasture farm environments and their processed products. Specifically, the study focused on both the pre-harvest period, which includes the conditions and practices on the farm before the crops and livestock are harvested, and the post-harvest period, which encompasses the handling, processing, and storage of the products after harvest. A total of 1286 samples were collected from six farms and adjacent 13 markets to determine the prevalence of S. Gallinarum and S. Pullorum by using both microbiological culture and molecular techniques, specifically PCR. Antimicrobial susceptibility testing was performed using the agar dilution method for the recommended antibiotics as described in the Clinical Laboratory Standards Institute (CLSI). S. Pullorum was detected in 11 samples (2.7%), while S. Gallinarum was found in six samples (1.5%) out of a total of 403 samples at the pre-harvest level. At the post-harvest level, only S. Gallinarum was identified in 14 meat samples out of 883(1.6%) recovered from samples collected from retail markets. Antibiogram showed S. Gallinarum and S. Pullorum to be highly resistant to cephradine, trimethoprim-sulfamethoxazole, amoxicillin, streptomycin, and ampicillin. This data demonstrates that both S. Pullorum and S. Gallinarum are commonly present in farm poultry environments as well as the products sold in the markets, which warrants implementation of regular surveillance and monitoring programmes, as well as potentially requiring future control strategies to reduce S. Pullorum and S. Gallinarum transmission.

Respiratory diphtheria in the time of Omicron.

Diphtheria is a potentially fatal bacterial infection caused by toxin-producing strains of corynebacteria, most often Corynebacterium diphtheriae and less commonly Corynebacterium ulcerans. Incidence of the disease has fallen significantly since the introduction of vaccination programs; it is now rare in countries with high vaccination coverage such as Australia. This article presents the most recent respiratory cases of diphtheria in two children in New South Wales-the first locally acquired childhood cases in Australia in 30 years-and discusses potential contributing factors. These encompass the lack of clinical awareness and the delays in laboratory diagnosis in regional laboratories. The cases also highlight the problem of vaccine hesitancy and the role that primary carers play in addressing these anxieties. While clinical management of the cases progressed well, factors in the public health responses were complicated by access to appropriate care and by delays in antibiotic sensitivity profiles. The public health response to these cases raises important considerations for clinicians and public health practitioners, including preparedness for rare and re-emerging diseases, the need for culturally safe environments and the importance of addressing vaccine hesitancy. Preparedness requires consideration of the capacity of regional health systems with fewer resources and of how public health departments can support response to multiple crises. Preparedness also relies on access to necessary diagnostic laboratory resources, on up-to-date guidelines, and on maintaining awareness among clinicians for these rare infections.

Prevalence and genetic diversity of Bartonella spp. in wild small mammals from South Africa.

Bartonella spp. are intracellular bacteria associated with several re-emerging human diseases. Small mammals play a significant role in the maintenance and spread of Bartonella spp. Despite the high small mammal biodiversity in South Africa, there is limited epidemiological information regarding Bartonella spp. in these mammals. The main aim of this study was to determine the prevalence and genetic diversity of Bartonella spp. from wild small mammals from 15 localities in 8 provinces of South Africa. Small mammals (n = 183) were trapped in the Eastern Cape, Free State, Gauteng, Limpopo, Mpumalanga, Northern Cape, North West, and Western Cape provinces of South Africa between 2010 and 2018. Heart, kidney, liver, lung, and spleen were harvested for Bartonella DNA screening, and prevalence was determined based on the PCR amplification of partial fragments of the 16S-23S rRNA intergenic spacer (ITS) region, gltA, and rpoB genes. Bartonella DNA was detected in Aethomys chrysophilus, Aethomys ineptus, Gerbillurus spp., Lemniscomys rosalia, Mastomys coucha, Micaelamys namaquensis, Rhabdomys pumilio, and Thallomys paedulcus. An overall prevalence of 16.9% (31/183, 95% CI: 12.2%-23%) was observed. Bartonella elizabethae, Bartonella grahamii, and Bartonella tribocorum were the zoonotic species identified, while the remaining sequences were aligned to uncultured Bartonella spp. with unknown zoonotic potential. Phylogenetic analyses confirmed five distinct Bartonella lineages (I-V), with lineage IV displaying strong M. coucha host specificity. Our results confirm that South African wild small mammals are natural reservoirs of a diverse assemblage of Bartonella spp., including some zoonotic species with high genetic diversity, although prevalence was relatively low.IMPORTANCESmall mammals play a significant role in the maintenance and spread of zoonotic pathogens such as Bartonella spp. Despite the high small mammal biodiversity in southern Africa including South Africa, there is limited epidemiological information regarding Bartonella spp. in these mammals across the country. Results from our study showed the liver and spleen had the highest positive cases for Bartonella spp. DNA among the tested organs. Bartonella elizabethae, B. grahamii, and B. tribocorum were the three zoonotic species identified and five distinct Bartonella lineages (I-V) were confirmed through phylogenetic analyses. To the best of our knowledge, this study presents the first extensive nuclear diversity investigation of Bartonella spp. in South African small mammals in South Africa.

Spatiotemporal analysis and clinico-epidemiological study for seroprevalence of canine leptospirosis.

Leptospirosis is a worldwide re-emerging zoonotic disease. The study was conducted to estimate the Seroprevalence of canine leptospirosis in a total of 450 dogs, from a total of 97 puppies and 353 adult dogs selected for examination Sampling, started from January to December 2023 in District Kasur in the province Punjab of the country Pakistan. Leptospira IgG ELISA kit manufactured by DRG Instruments GmbH, Germany was used for the screening of canine Leptospira antibodies. Out of 450 tested dogs, 183 dogs (40.67%) were tested positive for Leptospira antibody for the screening of Leptospira antibodies. The estimated Seroprevalence of leptospirosis in various age groups of dogs, were 23.7% (23/97) and 45.3% (160/353), in puppies and adults, respectively (P < 0.05). It was found that out of the sampled dogs, a total of 35/127 (27.6%), 29/100 (29%), 73/130 (56.2%), and 46/93 (49.5%) dogs were tested seropositive for Leptospira antibodies in winter, spring, summer and fall, respectively (P < 0.05).

Innovative advances for neglected tropical disease (NTD): A global perspective from intellectual property

This study examines innovative advances related to neglected tropical diseases (NTDs), which have severe health, social, and economic consequences that affect more than one billion people worldwide. It addresses the 2030 Agenda for the Sustainable Development Goals in tackling some of the “Grand Challenges,” such as dengue fever (DF), one of the primary and re-emerging diseases that have advanced worldwide in recent years. One of the challenges is the requirement that high investments in innovation can be rationalized by the potential returns sustained by the intellectual property protection system. This study answers the question: “How have dengue-related innovations been approached globally from an intellectual property perspective?” Seeking to shed light on innovative advances in NTD, this exploratory study adopted a (i) longitudinal approach, assessing the global impact of DF, and (ii) historical analysis from the intellectual property perspective, seeking the effectiveness of commercially viable solutions against the disease. An extensive search was conducted in international patent databases using Questel® Orbit Intelligence software to address the proposed objective. This study selected 2307 invention patent families (FamPat) from 1993 to 2023, of which nearly half have expired or been revoked. China is the largest jurisdiction, with 415 FamPat filings. However, many regions with a high global burden of DF lack intellectual protection for DF-related innovations. Although the number of Fampat is relatively high for DF, and the interaction between universities, government, and private companies shows the potential development of an innovation ecosystem, few technological solutions are available. This study concludes that the capacity to absorb knowledge influences the effectiveness of making a technology available as a commercial product.

Contexts and Priorities: Reflections on Developing a Master of Public Health Program in India

While the recent COVID-19 pandemic has accentuated attention to the public health challenges of our times, many of these concerns are certainly not new. There are multiple public health concerns including the rising burden of non-communicable diseases, health risks due to environmental degradation and climate change, and re-emergence of several communicable diseases. Responses to these challenges, including educational responses, have often been reductionist and hence found to be inadequate. There has been an increasing global recognition of the need for transformative education to address the complex health challenges of the 21st century. In this article, we discuss one such effort in designing a public health education program in India that echoes the sentiment of transformative learning that is contextual, competency-driven, transdisciplinary, reflective, and collaborative. We discuss how these aspects of learning were reflected and considered through a series of internal deliberations within the university and external consultations with different stakeholders. This process involved examining existing gaps in public health education, articulating the core competencies, developing the curriculum, and envisaging students’ contribution to public health practice in India.

Seroprevalence of anti-diphtheria toxoid antibody and implications for vaccination policy in Vietnam’s South-central coast: a cross-sectional study

BackgroundDiphtheria is a re-emerging infectious disease and public health concern worldwide and in Vietnam with increasing cases in recent years. This study aimed to assess the anti-diphtheria toxoid antibodies status in Khanh Hoa Province and identify factors contributing to the vaccination policy in the south-central coast of Vietnam.MethodsThis was a cross-sectional study to evaluate the seroprevalence of anti-diphtheria toxoid antibodies among 1,195 participants, aged 5 – 40 years in Khanh Hoa Province, Vietnam. Immunoglobulin G antibody levels against diphtheria were detected using a commercial anti-diphtheria toxoid enzyme-linked immunosorbent assay (SERION ELISA classic Diphtheria Immunoglobulin G) and were categorized following the World Health Organization guidelines.ResultsThe mean anti-diphtheria toxoid antibody levels were 0.07 IU/ml (95% Confidence Interval: 0.07–0.08). Anti-diphtheria toxoid antibody levels were found to be associated with age and history of diphtheria vaccination. The 5–15 years age group had the highest levels (0.09 IU/ml), while the older age group had the lowest antibody level (p < 0.001). Individuals who received three doses (adjusted Odds ratio: 2.34, 95%CI: 1.35 – 4.07) or 4+ doses (adjusted Odds ratio: 2.45, 95%CI: 1.29 – 4.64) had a higher antibody level compared to those who received only one dose regardless of age.ConclusionIt is crucial to promote routine vaccination coverage to over 95% for children under one year of age with three primary doses of the diphtheria-containing vaccine, including additional doses at 18 months and 7 years of age. Booster doses should be promoted and administered to adolescents and adults every 10 years.

Polio, public health memories and temporal dissonance of re-emerging infectious diseases in the global north

Social science research on polio has been centred in the global south, where countries that remain endemic or vulnerable to outbreaks are located. However, closely-related strains of poliovirus were detected in the sewage systems of several New York State counties and London boroughs in 2022. These detections constituted the first encounters with polio in the United States and United Kingdom for a generation – for both public health agencies and publics alike. This paper takes the transnational spread of poliovirus in 2022 as an opportunity to critique how public health memories of twentieth-century polio epidemics were mobilised to encourage vaccine uptake among groups considered vulnerable to transmission, notably Orthodox Jewish families. The study integrates data collected in London and New York as part of academic engagement with health protection responses to the spread of polio. Methods in both settings involved ethnographic research, and a total of 59 in-depth semi-structured interviews with public health professionals, healthcare providers, and Orthodox Jewish community partners and residents. Analysis of results demonstrate that narratives of epidemiological progress were deployed in public health responses in London and New York, often through references to sugar cubes, iron lungs, and timelines that narrate the impact of routine childhood immunisations. While memories of polio were deployed in both settings to provoke an urgency to vaccinate, vulnerable publics instead considered the more recent legacy of the COVID-19 pandemic when deciding whether to trust recommendations and responses. Critical attention to memory places analysis on the divergences between institutional (public health agencies) and peopled (publics) responses to disease events. Responses to re-emerging infectious disease outbreaks engender a temporal dissonance when historical narratives are evoked in ways that contrast with the contemporary dilemmas of people and parents.

The Impacts of Climate Change on the Emergence and Reemergence of Mosquito-Borne Diseases in Temperate Zones: An Umbrella Review Protocol.

Mosquito-borne diseases represent a global public health concern and are responsible for over 700 000 deaths globally every year. Additionally, many mosquito species have undergone a dramatic global expansion due to various factors, including climate change, and forecasts indicate that mosquito populations will persist in dispersing beyond their present geographic range, namely in temperate climates. The research literature on this topic has grown in recent years, including some systematic evidence synthesis. However, to provide a comprehensive overview of this growing literature needed for policy action, a summary of this evidence, including existing systematic reviews, is required. This study aims to undertake an umbrella review that explores the impacts of climate change on the emergence and reemergence of diseases transmitted by mosquitoes in temperate zones and the publication of the protocol is a fundamental step to ensure the credibility, transparency and reproducibility of this research. Studies published in scientific journals indexed by PubMed, EMBASE, Cochrane Library, Epistemonikos, and Web of Science Core Collection to be included in this umbrella review will meet the following criteria: the topic of study (climate change and mosquito-borne diseases), regions (temperate zones), study designs (systematic reviews and meta-analysis), language (any) and date (since inception until December 31st, 2023). Titles and abstracts from selected articles will be evaluated by two authors independently and any discrepancy will be resolved through consensus or, if not possible, through a third author. The data will be extracted, and the risk of bias will be evaluated. The quality of the methodology of the included reviews will be assessed using AMSTAR 2. A narrative synthesis will examine the included systematic reviews. The quality of evidence for all outcomes will be judged using the Grading of Recommendations Assessment, Development and Evaluation working group methodology.