Risk Of Further Transmission Research Articles

Vector bionomic of Culex species in possible Japanese Encephalitis Transmitted areas of Ein-me Township, Ayayawady Region in Myanmar

Japanese encephalitis is a public health problem in many parts of Myanmar. The diseases are transmitted to human by the biting of vector mosquitoes. The study was conducted in JE suspected cases occurred villages ThaPhan Pinseit and ThaPyu Pinseit villages in ThaPhan Pinseit RHC and PaukGone and SarPhyusu villages in PaukGone village in PaukGone RHC from Ayeyawady Region were selected for JE vector surveillance from December 2023 to March 2024. 50 houses from the pigs were randomly selected from each village. Mosquitoes were collected in all selected houses and pig farms using WHO sucking tubes. Larvae were collected in and around 1 Kilometer radius from study sites. Result found that JE main vector Cx. tritaeniorhynchus was abundantly collected in all study village and the highest number of vectors Cx. tritaeniorhynchus was collected from SarPhyusu village 2284 followed by ThaPyu Pinseit 1890 and lowest number of main vectors was collected in ThaPhan Pinseit village (1268). In overall collected mosquitoes, the highest density was found 74.18% of main vector Cx. tritaeniorhynchus followed by suspected vector Cx. vishnui 10.04%, and lowest density was observed Mansonia and An. vagus 0.33% each. Peak biting time of main vector Cx. tritaeniorhynchus was found 9-10 pm. Suspected vector Cx. vishnui was also collected in high number in all villages. Nine species of mosquitoes were collected from the study villages. Of this only four species of An. hyrcanus, An. barbirostris, An. vagus and An. tesellatus were collected. These Anopheles species were available in PaukGone and SarPhyusu villages. Anopheles hyrcanus was collected from all villages. Culex tritaeniorhynchus larvae were abundantly collected from rice fields, polluted water pools and stagnant water pools with plenty of hyacinth plants and also larvae were collected in concrete jars, Bago jars and metal drums water which water was stored for fire water. High density of main vector and suspected vector were collected in all JE suspected villages, pig farms, pigs, and breeding sources of vectors mosquitoes were available in the villages and also JE suspected cases are available in the all villages. This study provides information of high collection of main vector adult and larvae on risk of further transmission in the study areas. Environmental and ecological factors are responsible for the spread of JE virus. Therefore, awareness of community to vector borne diseases control activities and health education to all family members should be strengthened to prevent JE transmission in the villages.

Transmission of SARS-CoV-2 among recruits in a US Army training environment: a brief report.

In 2020, preventive measures were implemented to mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among 600-700 recruits arriving weekly at a basic combat training (BCT) facility in the southern United States. Trainees were sorted into companies and platoons (cocoons) at arrival, tested, quarantined for 14days with daily temperature and respiratory-symptom monitoring and retested before release into larger groups for training where symptomatic testing was conducted. Nonpharmaceutical measures, such as masking, and social distancing, were maintained throughout quarantine and BCT. We assessed for SARS-CoV-2 transmission in the quarantine milieu. Nasopharyngeal (NP) swabs were collected at arrival and at the end of quarantine and blood specimens at both timepoints and at the end of BCT. Epidemiological characteristics were analyzed for transmission clusters identified from whole-genome sequencing of NP samples. Among 1403 trainees enrolled from 25 August to 7 October 2020, epidemiological analysis identified three transmission clusters (n=20 SARS-CoV-2 genomes) during quarantine, which spanned five different cocoons. However, SARS-CoV-2 incidence decreased from 2.7% during quarantine to 1.5% at the end of BCT; prevalence at arrival was 3.3%. These findings suggest layered SARS-CoV-2 mitigation measures implemented during quarantine minimized the risk of further transmission in BCT.

Ophthalmic manifestations of Covid-19 and Mpox - potentially dangerous complications, and underdiagnosis by researchers and clinicians

Introduction: The Covid-19 pandemic and the increase in monkeypox (Mpox) infections that have been with us for the past two years have forced scientists and doctors to intensify their efforts to understand them. They mainly affect the respiratory, circulatory and immune systems and cause skin lesions. They can lead to death from lung disease, so complications such as ophthalmic ones are not often described in scientific studies, but doctors report that Covid-19 and Mpox patients not infrequently show symptoms such as inflammation, conjunctival congestion, corneal ulceration, swelling of the eye area and others. Aim of the study: The aim of this study was to review scientific articles with a view to presenting the problem of ocular complications following SARS-CoV-2 infection and ways to prevent them. Methods and materials: a literature review was conducted using the PubMed database, using the keywords: “ocular complications”, “ophthalmic complications” “ocular manifestations”, “eye complications”, “monkeypox”, “Mpox”, “Covid-19” “SARS-CoV-2”. Results: PCR studies from conjunctival swabs have confirmed the presence of SARS-COV-2 and MPXV genetic materials in ocular secretions, so they are a reservoir of viruses and pose a risk of further transmission. In the case of Covid-19, the eye can act as a host for infection. Humidification and preventive antibiotic therapy have been shown to prevent bacterial superinfection and avoid serious ocular complications, including loss of vision. Conclusions: Patients with Covid-19 and Mpox should be diagnosed ophthalmologically, as neglect can lead to deterioration and even loss of vision, reducing their quality of life. Eye care treatments and pharmacotherapy prevent future complications. It is also important to use personal protective equipment, take care of hygiene and disinfect equipment used for ophthalmic examinations to prevent the spread of infections to other patients as well as to medical staff.

Detection of 10 cases of ceftriaxone-resistant Neisseria gonorrhoeae in the United Kingdom, December 2021 to June 2022.

Between December 2021 and June 2022, 10 cases of ceftriaxone-resistant Neisseria gonorrhoeae (ST8123; n = 8) were detected in the United Kingdom, compared with nine cases during the previous 6 years. Most of these cases were associated with travel from the Asia-Pacific region; all were heterosexual people, with most in their 20s. Although all cases were successfully treated, not all partners of cases could be traced, and there is a risk of further transmission of ceftriaxone-resistant gonococcal infection within the UK.

Mass Screening of SARS-CoV-2 With Rapid Antigen Tests in a Receding Omicron Wave: Population-Based Survey for Epidemiologic Evaluation.

The COVID-19 Omicron BA.2 epidemic wave in Hong Kong peaked in the first quarter of 2022. Following the implementation of stringent public health measures, the daily number of reported cases fell from over 50,000 to below 2000. Although outbreaks steadily receded, the government rolled out a 3-day "voluntary universal rapid testing" campaign to invite all citizens to self-perform a rapid antigen test (RAT) daily to identify undetected prevalent infections. This study aimed to evaluate the uptake and results of RAT mass screening to estimate the population's residual epidemic burden and assess the risk of further transmission. A cross-sectional study comprising an open web-based population-based survey was conducted a week after the RAT campaign. Participants were asked to report their COVID-19 vaccination and infection history and the RAT performance and test result during the period. They were also invited to report their coliving individuals' test performance and results. Reasons for nonuptake were enquired. Testing and positive rates were age-adjusted. Determinants of undergoing RAT were identified using univariable and multivariable logistic regression models. In total, particulars from 21,769 individuals were reported by 8338 participants. The overall age-adjusted testing rate was 74.94% (95% CI 73.71%-76.18%), with over 80% of participants in the age groups between 45-84 years having self-performed RAT during the campaign period. After age-adjustment, 1.03% (95% CI 0.86%-1.21%) of participants tested positive. The positive rates in the age groups between 20-29 years and >84 years exceeded 2%. Taking into account the positive rate and 5819 reported cases during the period, the cases identified in the campaign might account for 7.65% (95% CI 6.47%-9.14%) of all infections. Testers were more likely to be female, older, not previously diagnosed with COVID-19, and have received COVID-19 vaccination. Adjusting for the number of household members, those living with a child aged <12 years and whose household members were also tested were more likely to have self-performed an RAT. Main reasons for not performing an RAT included the absence of symptoms (598/1108, 53.97%), disbelief of the appropriateness of the campaign as an antiepidemic measure (355/1108, 32.04%), and a recent COVID-19 diagnosis (332/1108, 29.96%). The residual population burden remained substantial in spite of the clear evidence of a receding epidemic wave. Despite caution in generalization to the Hong Kong population, the high participation rate in mass screening indicated that the voluntary RAT was well accepted, making it a feasible option for implementation as a complementary means of public health surveillance.

Monkeypox outbreak in a piercing and tattoo establishment in Spain

Monkeypox outbreak in a piercing and tattoo establishment in Spain

Enterobacterales high-risk clones and plasmids spreading blaESBL/AmpC and blaOXA-48 genes within and between hospitalized dogs and their environment.

Compared with healthcare settings, the role of veterinary hospitals in the spread of extended-spectrum cephalosporin- and carbapenem-resistant (ESC-R/CP-R) bacteria has been overlooked. To investigate using genome-based approaches the dynamics of ESC-R and CP-R Enterobacterales among 125 dogs admitted to the same veterinary hospital over a 4 month period. Dogs (n = 125) were sampled within 48 h of admission and at discharge. ESC-R/CP-R were phenotypically characterized and whole-genome sequenced using short- and long-read technologies. Phylogenetic analyses were performed using appropriate pipelines. ESC-R/CP-R prevalence in dogs was 4.8% (6/125) upon admission and reached 24.8% (31/125) at discharge, reflecting multiple acquisitions of ESBL/AmpC and OXA-48-positive Enterobacterales during hospitalization. Indistinguishable or closely related isolates were found within dogs, shared between dogs, and shared between dogs and their environment, suggesting numerous clonal and plasmid spreads. Even though carbapenems are not licensed for use in companion animals, a wide distribution of the blaOXA-48/IncL plasmid was evidenced across different bacterial species and dogs. This study highlights nosocomial acquisitions of ESBL/AmpC and carbapenemase-producing Enterobacterales by companion animals and the risk of further transmission within the community in a One Health perspective. Reinforced infection prevention and control measures and screening procedures are urgently needed in small animal veterinary settings where advanced therapeutics and intensive care is provided.

Contact tracing of COVID-19 in Karnataka, India: Superspreading and determinants of infectiousness and symptomatic infection.

BackgroundIndia has experienced the second largest outbreak of COVID-19 globally, yet there is a paucity of studies analysing contact tracing data in the region which can optimise public health interventions (PHI’s).MethodsWe analysed contact tracing data from Karnataka, India between 9 March and 21 July 2020. We estimated metrics of transmission including the reproduction number (R), overdispersion (k), secondary attack rate (SAR), and serial interval. R and k were jointly estimated using a Bayesian Markov Chain Monte Carlo approach. We studied determinants of risk of further transmission and risk of being symptomatic using Poisson regression models.FindingsUp to 21 July 2020, we found 111 index cases that crossed the super-spreading threshold of ≥8 secondary cases. Among 956 confirmed traced cases, 8.7% of index cases had 14.4% of contacts but caused 80% of all secondary cases. Among 16715 contacts, overall SAR was 3.6% [95% CI, 3.4–3.9] and symptomatic cases were more infectious than asymptomatic cases (SAR 7.7% vs 2.0%; aRR 3.63 [3.04–4.34]). As compared to infectors aged 19–44 years, children were less infectious (aRR 0.21 [0.07–0.66] for 0–5 years and 0.47 [0.32–0.68] for 6–18 years). Infectors who were confirmed ≥4 days after symptom onset were associated with higher infectiousness (aRR 3.01 [2.11–4.31]). As compared to asymptomatic cases, symptomatic cases were 8.16 [3.29–20.24] times more likely to cause symptomatic infection in their secondary cases. Serial interval had a mean of 5.4 [4.4–6.4] days, and case fatality rate was 2.5% [2.4–2.7] which increased with age.ConclusionWe found significant heterogeneity in the individual-level transmissibility of SARS-CoV-2 which could not be explained by the degree of heterogeneity in the underlying number of contacts. To strengthen contact tracing in over-dispersed outbreaks, testing and tracing delays should be minimised and retrospective contact tracing should be implemented. Targeted measures to reduce potential superspreading events should be implemented. Interventions aimed at children might have a relatively small impact on reducing transmission owing to their low symptomaticity and infectivity. We propose that symptomatic cases could cause a snowballing effect on clinical severity and infectiousness across transmission generations; further studies are needed to confirm this finding.

Performance evaluation of four rapid antibody tests for the detection of severe acute respiratory syndrome coronavirus 2.

BackgroundThe prompt detection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is important in the therapeutic management of infected patients. Rapid diagnostic tests are widely used for this purpose. This study aimed to evaluate the clinical performance of four SARS‐CoV‐2 immunoglobulin IgG/IgM rapid diagnostic tests in the detection of SARS‐CoV‐2.MethodsNasopharyngeal and oropharyngeal swabs and/or sputum were collected from 30 patients infected with SARS‐CoV‐2 and 30 healthy volunteers. All specimens were tested using four SARS‐CoV‐2 IgG/IgM rapid diagnostic tests and real‐time polymerase chain reaction. We assessed the clinical sensitivity and specificity of the tests.ResultsThe clinical sensitivity of FREND™, SsmarTest™, BIOCREDIT™, and IVDLAB™ was 96.67%, 100.00%, 100.00%, and 96.67%, respectively, compared to real‐time polymerase chain reaction. The clinical specificity was 96.67%, 100.00%, 86.67%, and 96.67%, respectively.ConclusionThese findings could expedite the detection of SARS‐CoV‐2 and thus reduce the risk of further transmission of the virus.

Association among CO-RADS score, co-morbid diseases, and short-term prognosis in COVID-19 infection.

CO-RADS scoring system is used as a diagnostic tool. However, the data about its association with co-morbid diseases and effectiveness in predicting intensive care need and short-term mortality are lacking. In our study, we aimed to investigate the association among CO-RADS score, co-morbid diseases, intensive care need, and 28-day-mortality. The study included 665 patients with COVID-19 infection suspicion between 30 May 2020 and 30 October 2020. The sensitivity of CT was 77%, and specificity was 52%. A higher CT score was associated with the rate of positive PCR test results (p<0.001), and older patients had higher CO-RADS scores than younger patients (p<0.001). Hypertension (OR: 7.956; p=0.005) and diabetes mellitus (OR: 5.902; p=0.015) were associated with significantly higher CO-RADS scores. Most patients treated in the intensive care unit (ICU) had a CO-RADS score of 5. The CO-RADS score was 4 and above in 115 (89.2%) patients who were transferred to the intensive care unit due to worsening of clinical condition (p<0.001). The 28-day mortality was significantly higher in patients with a CO-RADS score of 4 and above than in patients with a score of 3 and below (97.3% vs. 2.7%) (p<0.001). Irrespective of PCR results, a higher CO-RADS score gives us useful information about ICU need or mortality risk and alerts us for early treatment to reduce the risk of further transmission, intensive care need, and mortality particularly in patients with co-morbid diseases.

Risk assessment of airborne COVID-19 exposure in social settings.

The COVID-19 pandemic has led to many countries oscillating between various states of lock-down as they seek to balance keeping the economy and essential services running and minimizing the risk of further transmission. Decisions are made about which activities to keep open across a range of social settings and venues guided only by ad hoc heuristics regarding social distancing and personal hygiene. Hence, we propose the dual use of computational fluid dynamic simulations and surrogate aerosol measurements for location-specific assessment of risk of infection across different real-world settings. We propose a 3-tiered risk assessment scheme to facilitate classification of scenarios into risk levels based on simulations and experiments. Threshold values of <54 and >840 viral copies and <5% and >40% of original aerosol concentration are chosen to stratify low, medium, and high risk. This can help prioritize allowable activities and guide implementation of phased lockdowns or re-opening. Using a public bus in Singapore as a case study, we evaluate the relative risk of infection across scenarios such as different activities and passenger positions and demonstrate the effectiveness of our risk assessment methodology as a simple and easily interpretable framework. For example, this study revealed that the bus's air-conditioning greatly influences dispersion and increases the risk of certain seats and that talking can result in similar relative risk to coughing for passengers around an infected person. Both numerical and experimental approaches show similar relative risk levels with a Spearman's correlation coefficient of 0.74 despite differing observables, demonstrating applicability of this risk assessment methodology to other scenarios.

Saliva as a gold-standard sample for SARS-CoV-2 detection

Saliva as a gold-standard sample for SARS-CoV-2 detection

Factors affecting SARS-CoV-2 (COVID-19) Pandemic, including Zoonotic, Human Transmission and Chain of Infection. Reducing Public health Risk by Serum Antibody Testing, Avoiding Screening in Unhygienic Places and False PCR Reporting. A Scientific Review

During December 2019, a rapid increase in the number of SARS-CoV-2 (COVID-19) cases was reported worldwide. We investigated several factors for rapid increase in SARS-COV-2. Genomic sequence reveals that domestic and wild animals were likely ancestors and zoonotic source for SARS-CoVs, MERS-CoVs, and SARS-CoV-2; these viruses replicated in animals and humans during past several decades, exhibiting diverse mutations and self-limiting diseases except during outbreaks. SARS-CoV-2 has been retrospectively isolated in different studies in August 2019, several months before Wuhan reported. Hence, there is a possibility that viruses went undetected and infecting sub-clinically, in past several years, and SARS-CoV-2 antigens and neutralizing antibodies may have been present in humans since years. All SARS-CoVs are basically respiratory viruses, spread by droplets, hence droplet precautions are essential. Furthermore, silent phase of transmission (asymptomatic/subclinical) can be beneficial for humans. Lack of symptoms eventually lessen virus transmission and reduce the pathogen's long-term survival and provide strong humoral herd immunity (with sropositivity and diverse antibodies) up to several years and during epidemics. RT-PCR has low sensitivity and specificity, carries a high risk of handling live virus antigens, and requires difficult protocols. As viral load also sharply declines after few days of onset of infection, this technique might overlook infection. Furthermore, SARS-CoV-2 infection may be present in blood when oropharyngeal swabs are negative by RT-PCR. Conversely, antibodies against SARS-CoVs develop robustly in by reduced amount of antigens and ELISA for diagnosing antibodies demonstrates 100% specificity and 100% sensitivity, even in clinically asymptomatic individuals. These antibodies can be used for serologic surveys, monitoring and screening. Furthermore, screening tests for SARS-COV-2 should be avoided in unhygienic public places by nasopharyngeal swabs, which carry a high risk of further transmission, co-infection or super-infection. If above mentioned factors and Infection control policy is followed, SARS-CoV-2 pandemic can be controlled effectively.

Keeping in-school adolescents safe from COVID-19 sequelae to the suspension of school lockdown restriction

Rapid transmission of the Coronavirus disease (COVID-19) and resulting fatalities necessitated the closure of educational institutions in March 2020, and affected nearly 1.6 billion learners globally. However, presently lockdown measures have been lifted, and resumption of physical learning in schools has commenced. At this notable period, it is pertinent to ensure the safety of in-school adolescents from COVID-19 while preventing the risk of further transmission of COVID-19 in school settings. Therefore, we recommend adherence to the reduction of contact between in-school adolescents during school hours. The provision of handwashing equipment such as soap, clean water, bucket(s), and disposable tissue papers positioned at different points should be ensured in schools, with the modalities for such practice exemplified on information, education, and communication materials. Also, maintaining a minimal physical distance of 1m, use of face masks, regular hand washing and disinfection of classrooms, toilet facilities, and surfaces must be ensured among teachers and other school personnel would contribute effectively to the safety of in-school adolescents while schools have reopened amid the COVID-19 pandemic.

Psychosocial Safety Climate of Employees During the COVID-19 Pandemic in Iran: A Policy Analysis.

Iran is among the top 15 countries in the world in terms of coronavirus disease (COVID-19) infection rates. The numbers of infections and deaths are still increasing in September 2020. This study aims to investigate the impact of the policies on terminating the quarantine period on the perception of psychosocial safety by employees and workers in Iran. In this study, policy announcements and regulations, media reports, and the results were collected from 2 previously published population surveys that collected employees' views of the government approach to quarantine. The information thus collected was then analyzed using the "What is the Problem Represented (WPR)" approach for data analysis introduced by Carol Bacchi, and focuses on the question, "What effects are produced by the representation of the problem?" The Iranian Government decided to quarantine people and close most sectors during the New Year holidays in Iran in March 2020. The duration of quarantine was only 2 weeks, and the government then ordered government organizations and industrial companies to reopen. The advantage of a short quarantine period is assumed to be the reinstatement of productivity while the disadvantage is the likely risk of further transmission of the virus. The government approach to and communication about the quarantine period has neglected to consider the psychosocial safety climate of employees, who have to go to their workplaces using buses, subways, or other vehicles, and who are under pressure mentally because of fear of infection, dismissal for non-attendance, and the consequent economic problems. The government approach necessarily impacts on the perceived psychosocial safety climate of employees, and hence influences the causes of work stress. If the psychosocial safety climate is not considered and improved, it may reduce the quality of services and products, and increase accidents.

Three-chamber chest drain system in the COVID-19 era: is there a risk of further transmission?

We discuss the hypothesis that common Chest Drain Systems collected to a COVID-19 patient, could be a possible source of contamination for health care staff in a Thoracic Surgery ward and we propose an alternative way to minimize this further risk of transmission.

Prevalence of Covid-19 Infection and Subsequent Cohorting in a Residential Substance Use Treatment Program in Boston, MA.

The global pandemic of coronavirus disease 2019 (Covid-19) may disproportionately affect persons in congregate settings, including those in residential substance use treatment facilities. To limit the spread of SARS-CoV-2 through congregate settings, universal testing may be necessary. We aimed to determine the point prevalence of SARS-CoV-2 in a residential treatment program setting and to understand the unique challenges of Covid-19 transmission in this setting. We performed a case series of SARS-CoV-2 rT-PCR testing via nasopharyngeal in a residential substance use treatment program for women in Boston. Staff and residents of the treatment program were tested for SARS-CoV-2. The primary outcome was SARS-CoV-2 test result. A total of 31 residents and staff were tested. Twenty-seven percent (6/22) of the residents and 44% (4/9) of staff tested positive for SARS-CoV-2. All of the SARS-CoV-2 positive residents resided in the same residential unit. Two positive cases resided together with 2 negative cases in a 4-person room. Two other positive cases resided together in a 2-person room. One positive case resided with 2 negative cases in a 3-person room. One positive case resided with a negative case in a 2-person room. Based on test results, residents were cohorted by infection status and continued to participate in addiction treatment on-site. SARS-CoV-2 infection was common among staff and residents within a residential substance use treatment program for women in Boston. Universal SARS-CoV-2 testing in residential substance use programs can be instituted to reduce the risk of further transmission and continue addiction treatment programming when accompanied by adequate space, supplies, and staffing.

Regional Transmission and Reassortment of 2.3.4.4b Highly Pathogenic Avian Influenza (HPAI) Viruses in Bulgarian Poultry 2017/18.

Between 2017 and 2018, several farms across Bulgaria reported outbreaks of H5 highly-pathogenic avian influenza (HPAI) viruses. In this study we used genomic and traditional epidemiological analyses to trace the origin and subsequent spread of these outbreaks within Bulgaria. Both methods indicate two separate incursions, one restricted to the northeastern region of Dobrich, and another largely restricted to Central and Eastern Bulgaria including places such as Plovdiv, Sliven and Stara Zagora, as well as one virus from the Western region of Vidin. Both outbreaks likely originate from different European 2.3.4.4b virus ancestors circulating in 2017. The viruses were likely introduced by wild birds or poultry trade links in 2017 and have continued to circulate, but due to lack of contemporaneous sampling and sequences from wild bird viruses in Bulgaria, the precise route and timing of introduction cannot be determined. Analysis of whole genomes indicates a complete lack of reassortment in all segments but the matrix protein gene (MP), which presents as multiple smaller clusters associated with different European 2.3.4.4b viruses. Ancestral reconstruction of host states of the hemagglutinin (HA) gene of viruses involved in the outbreaks suggests that transmission is driven by domestic ducks into galliform poultry. Thus, according to present evidence, we suggest the surveillance of domestic ducks as they are an epidemiologically relevant species for subclinical infection. Monitoring the spread due to movement between farms within regions and links to poultry production systems in European countries can help to predict and prevent future outbreaks. The 2.3.4.4b lineage which caused the largest recorded poultry epidemic in Europe continues to circulate, and the risk of further transmission by wild birds during migration remains.

Scope of international traffic restrictions in the containment of the coronavirus disease 2019 pandemic: World Health Organization

The Corona Virus Disease-2019 (COVID-19) pandemic has been declared as a Public Health Emergency of International Concern and its overall risk of transmission at global level has also been increased to very high based on the recent trends of the disease. It is the need of the hour to strengthen international traffic regulations, if we really want to limit the onward spread of the infection to other nations. The recent recommendations released by the World Health Organization does not support travel or trade restrictions in nations which are reporting cases. Acknowledging all these facts and understanding about the disease as it continues to evolve, the best approach for the containment of the infection is to increase the awareness level of travellers about the preventive measures and to obtain the health declaration from travellers at the time of arrival. In conclusion, for the containment of COVID-19 outbreak and for minimizing the risk of further transmission, strengthening of the international traffic regulations will play a critical role.

Respiratory Illness in a Piggery Associated with the First Identified Outbreak of Swine Influenza in Australia: Assessing the Risk to Human Health and Zoonotic Potential.

Australia was previously believed to be free of enzootic swine influenza viruses due strict quarantine practices and use of biosecure breeding facilities. The first proven Australian outbreak of swine influenza occurred in Western Australian in 2012, revealing an unrecognized zoonotic risk, and a potential future pandemic threat. A public health investigation was undertaken to determine whether zoonotic infections had occurred and to reduce the risk of further transmission between humans and swine. A program of monitoring, testing, treatment, and vaccination was commenced, and a serosurvey of workers was also undertaken. No acute infections with the swine influenza viruses were detected. Serosurvey results were difficult to interpret due to previous influenza infections and past and current vaccinations. However, several workers had elevated haemagglutination inhibition (HI) antibody levels to the swine influenza viruses that could not be attributed to vaccination or infection with contemporaneous seasonal influenza A viruses. However, we lacked a suitable control population, so this was inconclusive. The experience was valuable in developing better protocols for managing outbreaks at the human–animal interface. Strict adherence to biosecurity practices, and ongoing monitoring of swine and their human contacts is important to mitigate pandemic risk. Strain specific serological assays would greatly assist in identifying zoonotic transmission.