Re-emerging Infectious Disease Research Articles

"Monkeypox: Re-Emerging Infectious Disease and One Health Strategy"

"Monkeypox: Re-Emerging Infectious Disease and One Health Strategy"

Tips and tools to obtain and assess mosquito viromes.

Due to their vectorial capacity, mosquitoes (Diptera: Culicidae) receive special attention from health authorities and entomologists. These cosmopolitan insects are responsible for the transmission of many viral diseases, such as dengue and yellow fever, causing huge impacts on human health and justifying the intensification of research focused on mosquito-borne diseases. In this context, the study of the virome of mosquitoes can contribute to anticipate the emergence and/or the reemergence of infectious diseases. The assessment of mosquito viromes also contributes to the surveillance of a wide variety of viruses found in these insects, allowing the early detection of pathogens with public health importance. However, the study of mosquito viromes can be challenging due to the number and complexities of steps involved in this type of research. Therefore, this article aims to describe, in a straightforward and simplified way, the steps necessary for obtention and assessment of mosquito viromes. In brief, this article explores: the capture and preservation of specimens; sampling strategies; treatment of samples before DNA/RNA extraction; extraction methodologies; enrichment and purification processes; sequencing choices; and bioinformatics analysis.

Climate drivers of migration and neglected tropical disease burden in Latin American and Caribbean immigrants: A pilot study in Atlanta, Georgia

IntroductionClimate change has negatively impacted the agricultural and socioeconomic infrastructure of Latin American and Caribbean (LAC) countries leading to conditions that promote human migration. It has also led to emergence and reemergence of infectious diseases. This pilot study aimed to identify climate-related drivers of migration and to describe the burden of climate-sensitive neglected tropical diseases (NTD) in immigrants living in Atlanta, Georgia, USA. MethodsFirst generation immigrants from LAC countries living in the Atlanta-metro area were recruited between May and December 2021. Participants completed a survey concerning demographics, socioeconomics, living conditions in their country of origin and living conditions in Atlanta, and motivations for migration. Blood and stool samples were collected to identify Chagas disease and soil-transmitted helminths, and skin exams screened for leprosy and leishmaniasis. Descriptive, univariate, and multivariable analyses of this dataset looked at the association between a climate-driven motivation to migrate and geographic and socioeconomic factors. ResultsFifty-seven individuals were recruited representing 11 LAC countries of origin. Most originated from Central America (n = 32; 56 %) and Mexico (n = 13; 23%). Forty-two participants reported a change in climate or weather in their country of origin prior to moving and direct climate drivers of migration (e.g., floods, drought, etc.) were identified by 12 participants (21.1%). Infectious diseases screening found one definitive case of Chagas (2.5%) out of 40 blood samples screened. Food insecurity was significantly associated with a climate-related factor for migrating: aOR = 6.3 (95 % CI 1.1, 35.5). ConclusionsWhile most participants did not directly identify “climate change” as a reason for migration, our study reveals many factors such as food insecurity, agricultural occupations, and region of origin that may underlie climate-motivated migration. Finding one case of Chagas was also noteworthy and shows the need for improved surveillance for this important NTD.

Grasping knowledge, attitude, and perception towards monkeypox among healthcare workers and medical students: an Egyptian cross-sectional study.

Monkeypox (Mpox) is a re-emerging infectious disease representing a new global challenge. It poses a substantial threat to countries, particularly those with a low number of cases. Due to its popularity as a tourist destination and its proximity to many African refugees, Egypt is potentially at risk of Mpox importation. Therefore, effective disease management necessitates healthcare workers (HCWs) to possess adept knowledge, along with a positive attitude and behavior. The study aimed to assess the knowledge, attitude, and perception of Egyptian HCWs and medical students towards human Mpox. The present cross-sectional study data was collected from participants between October and December 2022 via a questionnaire. The questionnaire comprised 31 questions in the knowledge section, 11 questions in the attitude section, and 14 in the perception section. The present study involved a total of 1,034 HCWs and medical students. It was found that 55.3% of the participants demonstrated adequate knowledge about Mpox, whereas 44.5% and 39.8% of the respondents exhibited favorable attitudes and perceptions towards the disease, respectively. Binary logistic regression analysis revealed that adequate knowledge was significantly observed in ages older than 40 years (p < 0.001), married participants (p < 0.001), and doctors (p < 0.001). The positive attitude was significantly observed among the male sex (p = 0.045), urban residents (p = 0.002), and nurses (p = 0.002). Conversely, married participants (p = 0.013), doctors (p < 0.001), and individuals employed in pharmacy and laboratory departments (p < 0.001) experienced an increase in positive perception. Knowledge, attitude, and perception towards Mpox among Egyptian HCWs and medical students exhibit suboptimal levels. Addressing these gaps is crucial to controlling and effectively preventing disease transmission.

Hemophagocytic lymphohistiocytosis-a rare life threatening association with scrub typhus: case report

Scrub typhus is an important cause of acute febrile illness and one of the re-emerging infectious diseases in India particularly in southern Rajasthan. Hemophagocytic lympho-histiocytosis (HLH) results from an uncontrolled and ineffective hyperinflammatory response to a variety of triggers. HLH is further subdivided into primary and secondary type. We present a case of Scrub typhus which presented with multiple organ dysfunction syndrome (MODS) and secondary HLH which is a rare entity. A 9-month-old male child presented with high grade fever with encephalopathy. Examination showed hepatosplenomegaly, cervical Lymph adenopathy with eschar mark visible on abdomen. Scrub typhus was suspected on clinical grounds and further investigations were done. Serological diagnosis was strongly positive for scrub typhus. Initially, child did not respond to doxycycline, so further investigations were done to rule out HLH which fits into criteria of secondary HLH as per the revised HLH 2004 protocol. In view of secondary HLH and MODS methylprednisolone was added to treatment. Child responded to steroids and there was complete recovery. Scrub typhus patient with progressive MODS, in spite of appropriate antimicrobial therapy should raise the suspicion of secondary HLH which is rare but life-threatening condition and steroids plays an important role in the management of this condition.

Effects of Experiential Learning Program of Community Health Workers on Health Literacy and Preventive Behaviors of Emerging Infectious Diseases and Re-Emerging Infectious Diseases of Respiratory System.

Community health workers (CHWs) can be extremely important in many facets of healthcare, especially for marginalized communities. Health Literacy and Preventive Behaviors of Emerging Infectious Diseases and Re-emerging Infectious Diseases of the Respiratory System were important for CHWs in Preventing and Control Diseases. This quasi-experimental research; a 2 pretest-post group design, aimed to investigate the result of the experiential learning program of the CHWs toward health literacy and preventive behaviors of the infection of emerging and re-emerging diseases of the respiratory system. The samples are 66 CHWs working in Ngao District, Lampang Province which were divided into 2 groups; the experimental and control groups, 33 subjects for each group. The tools used in this research consisted of an experiential learning program for 6 weeks and a questionnaire concerning health literacy and preventive behaviors of emerging and re-emerging diseases in the respiratory system. The experimental group had the mean score of health literacy regarding the prevention of emerging and re-emerging diseases of the respiratory system at the highest level ( = 4.52, SD = 0.16) which was higher than before receiving the program which was a high level ( = 3.61, SD = 0.32) at the significant level of P < .001 while the preventive behavior concerning the emerging and re-emerging diseases in the respiratory system was at the highest level ( = 4.63, SD = 0.41)and higher than the control group which was at a high level ( = 4.36, SD = 0.50) at the significant level of P < .001. The research results could be a guideline for developing the CHW's potential effectively and proficiently.

Impact of wars and natural disasters on emerging and re-emerging infectious diseases.

Emerging Infectious Diseases (EIDs) and Re-Emerging Infectious Diseases (REIDs) constitute significant health problems and are becoming of major importance. Up to 75% of EIDs and REIDs have zoonotic origin. Several factors such as the destruction of natural habitats leading humans and animals to live in close proximity, ecological changes due to natural disasters, population migration resulting from war or conflict, interruption or decrease in disease prevention programs, and insufficient vector control applications and sanitation are involved in disease emergence and distribution. War and natural disasters have a great impact on the emergence/re-emergence of diseases in the population. According to a World Bank estimation, two billion people are living in poverty and fragility situations. Wars destroy health systems and infrastructure, curtail existing disease control programs, and cause population movement leading to an increase in exposure to health risks and favor the emergence of infectious diseases. A total of 432 catastrophic cases associated with natural disasters were recorded globally in 2021. Natural disasters increase the risk of EID and REID outbreaks by damaging infrastructure and leading to displacement of populations. A Generic National Action Plan covering risk assessment, mechanism for action, determination of roles and responsibilities of each sector, the establishment of a coordination mechanism, etc. should be developed.

Genomic Surveillance of Rabies Virus in Georgian Canines.

Rabies is a fatal zoonosis that is considered a re-emerging infectious disease. Although rabies remains endemic in canines throughout much of the world, vaccination programs have essentially eliminated dog rabies in the Americas and much of Europe. However, despite the goal of eliminating dog rabies in the European Union by 2020, sporadic cases of dog rabies still occur in Eastern Europe, including Georgia. To assess the genetic diversity of the strains recently circulating in Georgia, we sequenced seventy-eight RABV-positive samples from the brain tissues of rabid dogs and jackals using Illumina short-read sequencing of total RNA shotgun libraries. Seventy-seven RABV genomes were successfully assembled and annotated, with seventy-four of them reaching the coding-complete status. Phylogenetic analyses of the nucleoprotein (N) and attachment glycoprotein (G) genes placed all the assembled genomes into the Cosmopolitan clade, consistent with the Georgian origin of the samples. An amino acid alignment of the G glycoprotein ectodomain identified twelve different sequences for this domain among the samples. Only one of the ectodomain groups contained a residue change in an antigenic site, an R264H change in the G5 antigenic site. Three isolates were cultured, and these were found to be efficiently neutralized by the human monoclonal antibody A6. Overall, our data show that recently circulating RABV isolates from Georgian canines are predominantly closely related phylogroup I viruses of the Cosmopolitan clade. Current human rabies vaccines should offer protection against infection by Georgian canine RABVs. The genomes have been deposited in GenBank (accessions: OQ603609-OQ603685).

The Effectiveness of Improving Infectious Disease-Specific Health Literacy Among Residents: WeChat-Based Health Education Intervention Program.

Infectious disease-specific health literacy (IDSHL) has become an important determinant of infectious disease incidence. It can not only reduce the incidence of re-emerging infectious diseases, but also effectively prevent the emergence of new infectious diseases such as COVID-19. WeChat, as a new media, has been proven to greatly reduce the chance of infectious diseases spreading from person to person, especially in case of respiratory infections. However, there is currently no concrete health education invention program to improve IDSHL using a WeChat public account. The aims of this study were as follows: (1) to determine the IDSHL of the population in Zhejiang, China; (2) to develop a health education program for the improvement of IDSHL using a WeChat public account; and (3) to evaluate the effectiveness of the health education program that was implemented in the prevention of infectious disease outbreaks. We used a standardized questionnaire, which consisted of 28 closed-ended questions, to measure the level and score of IDSHL before and after intervention. A multiple-stage stratified random sampling technique was used to select study participants from Zhejiang province in China, who were further divided randomly into 2 groups: the intervention and control groups. From July 2014 to January 2015, a WeChat-based health education intervention program was carried out on the intervention group. Standard descriptive statistics and chi-square and t tests were conducted to analyze the data. A total of 3001 residents participated in the baseline survey of this study. At baseline, participant IDSHL rates were 73.29% and 72.12% for the intervention and control groups, respectively (Χ21=0.5; P=.50). After 7 months of intervention, 9.90% (297/3001) of participants dropped out of the study. Of the lost participants, 119 were from the intervention group and 178 were from the control group. There were significant differences between follow-up and lost participants with respect to age (P=.04), marital status (P=.02) and occupations (P=.002). After intervention, the intervention group scores in the different domains were higher than those in the control group (infectious disease-related knowledge, prevention, management, or treatment, identification of pathogens and infection sources, and cognitive ability). There were significant improvements in the IDSHL of participants in both the intervention and control groups (Χ21=135.9; P<.001 vs Χ21=9.1; P=.003), and there was a greater change in the IDSHL among the intervention group participants than among the control group participants (1230/1359, 90.51% vs 1038/1359, 77.17%). The health education intervention program using a WeChat public account proved to be an effective, feasible, and well-accepted means to improve the IDSHL of the general population. In the future, this health education intervention program can be used as a reference for prevention and treatment of infectious diseases.

Current status of infectious diseases among migrants and non-citizens in Malaysia.

The mass movement of migrants to Malaysia for employment is one of the factors contributing to the emergence and re-emergence of infectious diseases in this country. Despite mandatory health screening for migrants seeking employment, prevalence records of infectious diseases amongst migrant populations in Malaysia are still within negligible proportions. Therefore, the present review highlights the incidence, mortality and overall status of infectious diseases amongst migrants' populations in Malaysia, which maybe be useful for impeding exacerbation of inequalities among them and improving our national health system thru robust and effective emergency responses in controlling the prevalent diseases found among these populations and maybe, Malaysian citizens too. Peer-reviewed articles from January 2016 to December 2020 were searched through online platform including SCOPUS, PubMed, Science Direct, and Google Scholar. Non-peer-reviewed reports and publications from ministry and government websites including data from related agencies were also scoured from in order to ensure that there are no cases being overlooked, as most published articles did not have migrants as the research subjects. A total of 29 studies had been selected in the final analysis. Migrants in Malaysia were at higher risk for tuberculosis, malaria, lymphatic filariasis, cholera, leprosy and leptospirosis. Lymphatic filariasis was still endemic among this population while thousand cases of TB and cholera had been reported among them due to cramp living conditions and poor sanitation in their settlements respectively. While malaria had gradually decreased and become sporadic, the influx of migrant workers had led to the rising of imported malaria cases. Low cases of leprosy had been recorded in Malaysia but a significant proportion of it was contributed by migrant workers. As for leptospirosis, studies found that there are prominent cases among migrant workers, which particularly highest within workers with lower educational attainment. Infectious diseases are still prevalent among migrants in Malaysia due to various interplay factors including their working sectors, country of origin, immunization status, type of settlement, impoverished living conditions, and language and cultural barriers that impeding access to health facilities.

Multi-patch epidemic models with partial mobility, residency, and demography

The emergence and re-emergence of infectious diseases has been a global cause of concern in the past few decades. Previous research in the field has revealed that human connectivity and mobility behavior play a major role in the spreading of an infectious disease. In this work, we propose multi-patch models that take into account the effects of human mobility on the evolution of disease dynamics in a multi-population environment. In particular, we develop SEIRS multi-patch and multi-group epidemic models, extending the work of Bichara et al. (2015) and Bichara and Abderrahman (2018) to practically account for distinct epidemiological-status-dependent mobilities in each patch. We rigorously show that the disease free equilibria (DFE) for both models are stable when R0≤1. We also prove that the models have a unique endemic asymptotically stable equilibrium when R0>1. In addition, we introduce new local reproduction numbers from the point of view of the sub-populations, and establish some important relation between them and the global reproduction number. Various numerical simulations are conducted to study the effects of mobility and the residence time matrix on the evolution of the disease in individual patches and the overall environment.

An Updated Review on Monkeypox Viral Disease: Emphasis on Genomic Diversity.

Monkeypox virus has remained the most virulent poxvirus since the elimination of smallpox approximately 41 years ago, with distribution mostly in Central and West Africa. Monkeypox (Mpox) in humans is a zoonotically transferred disease that results in a smallpox-like disease. It was first diagnosed in 1970 in the Democratic Republic of the Congo (DRC), and the disease has spread over West and Central Africa. The purpose of this review was to give an up-to-date, thorough, and timely overview on the genomic diversity and evolution of a re-emerging infectious disease. The genetic profile of Mpox may also be helpful in targeting new therapeutic options based on genes, mutations, and phylogeny. Mpox has become a major threat to global health security, necessitating a quick response by virologists, veterinarians, public health professionals, doctors, and researchers to create high-efficiency diagnostic tests, vaccinations, antivirals, and other infection control techniques. The emergence of epidemics outside of Africa emphasizes the disease's global significance. Increased monitoring and identification of Mpox cases are critical tools for obtaining a better knowledge of the ever-changing epidemiology of this disease.

COMPARATIVE PROTEIN PROFILE ANALYSIS OF DIFFERENTIALLY EXTRACTED WHOLE CELL BACTERIAL PROTEIN DERIVED FROM SALMONELLA TYPHI AND INVASIVE NON-TYPHOIDAL SALMONELLA

Typhoid fever is an endemic disease that has been acknowledged as a major global health burden. Typhoid fever is a neglected re-emerging infectious disease that is transmitted through fecal oral route. Nevertheless, non-typhoidal Salmonella outbreak has been increasing globally with large number of cases involving immunocompromised individuals. The clinical diagnosis of typhoid is difficult due to the overlapping symptoms of typhoid fever, non-typhoidal Salmonella, and other associated febrile diseases, which causes to delayed treatment. Herein, this study aims to provide a reproducible, discriminative protein fingerprint of two different Salmonella serovars using a differential extraction procedure comprising of whole cell protein (WCP), cell surface protein (CSP) and surface-depleted whole cell protein (sdWCP) derived from whole cell bacterial protein of Salmonella Typhi (S.Typhi) and Salmonella spp (S.spp). In the present research, we perform comparative analysis to characterize protein profiles of two differentially extracted Salmonella serovars by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and dendrogram analysis. The findings showed that the proteins were reproducible in optimized concentration. Separation of protein into three different extractions revealed discriminative protein profiles with major and micro-heterogenicity. We observed the diverseness of differentially extracted proteins between two strains which provided an effective adjunct that can be used in identification of Salmonella strains. The results achieved when differential extraction procedure was applied, provides a promising, future opportunity for further immunoproteomic classifications.

Lessons that can be learned from the SARS-CoV-2 pandemic and their impact on the prophylaxis and treatment development for neglected tropical arboviruses

In the 21st Century, emergence and re-emergence of infectious diseases is significant and has an increasing importance in global concern of public health. Based on the COVID-19 pandemic and recently reported epidemics, most human pathogens originate in zoonosis. Many of such pathogens are related to viruses that have RNA genomes, which can be presented structurally as a single-strand or double-strand. During the last two decades, a timeline of major RNA viruses emergencies can be exemplified, such as Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) in 2003, influenza A virus (H1N1) pdm09 in 2009, Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, Ebola virus (EBOV) in 2013–2016, Zika virus (ZIKV) in 2015 and the SARS-CoV-2 pdm19 in 2019. Even so, prophylactic or therapeutic drugs are unavailable for many RNA viruses circulating. Nonetheless, the COVID-19 pandemic brought considerable scientific advances in accelerating progress regarding prophylaxis, antiviral and drug development, and novel treatments. Regarding RNA virus diseases for humans, arboviruses play an essential and neglected role, constantly reemerging and affecting almost half of the human population, for which no drug has been licensed. Here we review the consolidated RNA viruses’ emergence and re-emergence in the 21st Century through available data. Then, we explored valuable lessons gained during the SARS-CoV-2 pandemic and focused on potential epidemiologic updates, prophylaxis, available treatments, and viral drug inhibitors. Finally, we explore arbovirus’s significance and the ongoing development of effective vaccines, antiviral drugs, and novel therapeutic approaches as strategies to control these neglected tropical diseases (NTD).

Phylogenetic analysis of the origin and spread of plague in Madagascar

Plague is a zoonotic disease caused by the bacterium Yersinia pestis, highly prevalent in the Central Highlands, a mountainous region in the center of Madagascar. After a plague-free period of over 60 years in the northwestern coast city of Mahajanga, the disease reappeared in 1991 and caused several outbreaks until 1999. Previous research indicates that the disease was reintroduced to the city of Mahajanga from the Central Highlands instead of reemerging from a local reservoir. However, it is not clear how many reintroductions occurred and when they took place. In this study we applied a Bayesian phylogeographic model to detect and date migrations of Y. pestis between the two locations that could be linked to the re-emergence of plague in Mahajanga. Genome sequences of 300 Y. pestis strains sampled between 1964 and 2012 were analyzed. Four migrations from the Central Highlands to Mahajanga were detected. Two resulted in persistent transmission in humans, one was responsible for most of the human cases recorded between 1995 and 1999, while the other produced plague cases in 1991 and 1992. We dated the emergence of the Y. pestis sub-branch 1.ORI3, which is only present in Madagascar and Turkey, to the beginning of the 20th century, using a Bayesian molecular dating analysis. The split between 1.ORI3 and its ancestor lineage 1.ORI2 was dated to the second half of the 19th century. Our results indicate that two independent migrations from the Central Highlands caused the plague outbreaks in Mahajanga during the 1990s, with both introductions occurring during the early 1980s. They happened over a decade before the detection of human cases, thus the pathogen likely survived in wild reservoirs until the spillover to humans was possible. This study demonstrates the value of Bayesian phylogenetics in elucidating the re-emergence of infectious diseases.

The Reemergence of Monkeypox in Nigeria

The emergence and reemergence of infectious diseases caused by viruses continue to be a major public health concern globally, affecting both humans and animals. One such disease is monkeypox, a zoonotic infection caused by the monkeypox virus (MPXV) that has recurred in sub-Saharan Africa over several decades. Notably, the 2022 outbreak of monkeypox in Nigeria follows a deadly outbreak in 2017, which was preceded by the disease’s first recorded outbreak in 1978. Epidemiological investigations in 2017 showed no apparent link between human monkeypox cases and the outbreak that year, indicating the potential existence of multiple sources of the virus and limited human-to-human transmission. This underscores the presence of an alternative ecological niche in humans. Furthermore, in some communities in Nigeria, monkeys are regarded as sacred and not hunted or consumed, leading to their proliferation and increased likelihood of MPXV transmission. This mini-review focuses on the occurrence, epidemiological distribution, geographical distribution, endemicity, and possible solutions to reduce the spread of human monkeypox in Nigeria. The implications of this reemergence and the need for effective public health measures to prevent and control outbreaks of monkeypox are also discussed.

Quality, reliability and content evaluation of YouTube videos associated monkeypox

Aim :Human monkeypox (HMPX) is a re-emerging infectious disease. YouTube is an effective tool for disseminating health-related information. Considering that dissemination of information about the ways of transmission and prevention of infectious diseases in public is very important. The aim of this study is to evaluate the information content and reliability of the videos about MPX on the popular and widely used video-sharing platform YouTube.&#x0D; Material and Method: YouTube (http://www.youtube.com) was searched using the keyword ‘monkeypox’. The number of views, likes, comments, and duration of the videos were recorded. The videos were analyzed blindly by an infectious diseases and microbiology (virology) specialist. The content was rated out of 10 points. The videos are grouped according to the uploaded source by the news agency and Physicians /Public coorperation.A DISCERN tool and the Global Quality Scale (GQS) were used to evaluate the reliability and quality of the videos.&#x0D; Results: Of the 100 videos screened, 44 that met the inclusion criteria were included in the study.Our study shows that video reliability (DISCERN) and Quality Scale (GQS) of YouTube videos related to MPX uploaded by physicians and health institutions were statistically significantly higher than news agencies. In terms of content, we are on the aspect that all videos contain useful information. Cohen Kappa scores indicating inter-observer agreement were 0.802, 0.827, and 0.858 for the Content , DISCERN and the GQS scores, respectively (95% confidence interval (CI).&#x0D; Conclusion: HMPX, especially during the global disease epidemic, the quality and reliable publication of useful YouTube content by Physicians /Public cooperation can help reduce and control the spread of the disease.

EDITORIAL. Las enfermedades tropicales desatendidas en Venezuela en la era de COVID-19.

Neglected tropical diseases (NTDs) remain a public health problem among vulnerable, marginalized populations. The crisis in Venezuela has caused poverty, malnutrition, the collapse of the health system and public services that have determined the emergence and re-emergence of infectious diseases that exacerbate the problem of NTDs. Due to its economic impact, the COVID-19 pandemic could lead to greater poverty and aggravate the situation. The WHO aims to eliminate 20 NTDs, including geohelminthiasis, as a public health problem by 2030, which is an ambitious plan for Venezuela. To eliminate NTDs as a public health problem, it is necessary to maximize the efforts of the different health disciplines and the application by governments of environmental sanitation measures and the improvement of the standard of living of the affected populations. However, these measures are complex and take time to implement.

COVID-19 Mass Vaccination and Flu Season: Concern for Decreased Public Health Measures and Worsening the Influenza Situation.

Reports show that other ordinary childhood infections like measles or influenza are likely to reemerge. The re-emergence of infectious diseases may happen due to the direct impact of the pandemic on the community because of decreased access to health and medical services, interrupted transport systems, weaknesses in the supply chain, flight restrictions, closings of the border, and international trade problems. The most prevalent cause (60.9%) for low vaccine uptake and coverage during the current pandemic was fear of exposure to the COVID-19 virus outside the home. The expectation and hope that the pattern of reduction in transmission and number of influenza cases will continue over the next flu season depend on continued adherence to nonpharmaceutical interventions and their long-term application. But there is always the fear and threat of increasing the spread of influenza by reducing the movement restrictions and low adherence to protective health measures due to vaccination. So far, not much information has been published about the interaction between different infectious diseases in the background of the coronavirus pandemic and related interventions. The purpose of this article is to examine the general effects of the COVID-19 vaccination on the spread of influenza in the coming seasons.

SG-APSIC1155: Drug susceptibility patterns of fulminant group G Streptococcus (GGS) infection as a re-emerging infectious disease in Japan

Objectives: Severe streptococcal infections are invasive, re-emerging infections that rapidly worsen and lead to death. Not only group A Streptococcus (GAS) but also group g Streptococcus (GGS) are the causative agents of this infection. Moreover, GGS produces hemolytic toxins, proteolytic toxins, and other toxins like GAS. Furthermore, drug-resistant Streptococcus spp, like other pathogenic bacteria, are on the rise worldwide. However, drug resistance has not been studied extensively in invasive GGS. Therefore, we investigated the drug susceptibility of GGS clinical isolates that are closely related to fulminant streptococcal infections. Methods: We used GGS strains isolated from sterile sites of invasive infections at a hospital in Nagoya City, Japan, from 2017 to 2021. Bacterial identification and drug-susceptibility testing were performed using a VITEK-2 system. Results: Overall, 53 strains were included in the study. The GGS strains examined in this study were resistant to 3 different antibiotics (erythromycin, clindamycin, and minocycline). Also, 18 strains (34%) were resistant to erythromycin, 9 (17%) were resistant to clindamycin, and 18 (34%) were resistant to minocycline. Moreover, there were 5 strains (9.4%) of 2-drug–resistant bacteria and 8 strains (15.1%) of 3-drug–resistant bacteria. Conclusions: Acquired resistance not only to individual antibiotics but also to multiple antibiotics suggests that GGS tends to become multidrug resistant. Continued surveillance of the drug susceptibility of GGS as a potential cause of fulminant streptococcal infections will be necessary in the future.