Public Health Risk Research Articles

The trends of per-and polyfluoroalkyl substances (pfas) in drinking water systems in Maryland United States

Per- and polyfluoroalkyl substances (PFAS) have become a major concern in water quality management because of their persistence in the environment and associated health risks. In Maryland, the diverse water resources and densely populated areas, faces unique challenges culminating from PFAS contamination. This research paper presents a comprehensive overview of PFAS contamination trends in Maryland's drinking water systems across four distinct phases, spanning from 2019 to 2022, it highlights the trends of PFAS contamination, environmental and public health risks, and strategies for effective management. Utilizing data from extensive monitoring efforts conducted in the state, the study reveals a persistent and evolving environmental health challenge characterized by the dominance of different PFAS compounds, particularly PFOS and PFOA, found at concerning concentrations. Mean concentrations of total PFOA/PFOS across the sampling periods were at 18.78 ng/L, 7.28 ng/L, 14.60 ng/L, 12.46 ng/L, significantly surpassing the EPA's 2024 maximum contaminant levels of 4 ng/L for PFOA and PFOS. Despite fluctuations observed across sampling phases, PFAS levels consistently surpass EPA health advisory levels, indicating widespread contamination. Potential sources, such as industrial sites and wastewater treatment plants, underscore the need for robust regulatory enforcement and innovative remediation strategies to safeguard public health. The findings emphasize the necessity for continuous monitoring and multi-faceted mitigation approaches to address PFAS contamination effectively, ensuring the safety of Maryland's water resources and the health of its residents.

DAB-LSTMNN: A novel respiratory disease diagnosis deep CNN framework based on attention scheme and BLSTM neural networks

Respiratory diseases have a significant impact on modern society, posing considerable public health risks. With the emergence of the COVID-19 pandemic, addressing respiratory issues has become increasingly urgent and important. Recently, artificial intelligence-based methods utilizing the acoustic recordings of suspected patients have shown promise in the diagnosis of various respiratory diseases, enabling localized treatment and containment of their spread. As the existing methods cannot efficiently extract subtle differences between the sound samples, thereby limiting their generalization ability. To improve the diagnosis accuracy, this paper proposes a novel multi-channel, multi-modal deep learning architecture based on the attention mechanism. The proposed framework combines a deep convolutional neural network (DCNN) with a bidirectional long short-term memory (BLSTM) network, and also utilizes the attention scheme to extract temporal and spectral features from different modalities of speech data (e.g. coughs, counting sounds and sustained vowel articulation). The proposed method effectively classifies COVID-19 patients, asthma patients and healthy individuals, with a test accuracy of 89.27 ± 0.1%, and an F1 score of 85.42 ± 0.2%. The experimental results validate the feasibility of our method, and also indicate that it is competitive with the existing deep networks.

Deep Learning for Sustainable E-Waste Management: Leveraging Transfer Learning for Classification

The rapid rise of electronic waste (commonly referred to as "e-waste") has become a world's growing challenge which should be managed by creative approaches. The number of e-waste produced is estimated to be 53.6 million metric tons in 2019. From this we can see that the seriousness of the issue direly calls upon taking the measures to prevent the environmental and public health risks associated with this expanding crisis [1]. Since a lot of the e-waste may contain hazardous materials such as mercury, lead and cadmium, which can impact the health and the environment if not treated properly, the mismanagement of it increases the problem [2]. In the case of e-waste, there is wide assortment of the electronic devices and components hence, it becomes difficult to classify them into their product categories properly. Sorting processes can't keep up with the pace of production waste as a result of being tedious, error-prone, and slow. This research employs deep learning approaches to segregate E-waste items using images for automated category. Utilizing contemporary models like VGG16, DenseNet121, InceptionV3, MobileNetV3, and ResNet50, the research designs classification systems that have these great attributes. Dataset building (training and assessment) become easy when an extensive dataset of 3000 images from 10 different types of equipment is developed. This research study helps to offer useful implications for managing current methods of electronic waste disposal and developing sustainable circular economies with quantitative analyzing of model performance factors that include accuracy, precision, F1- score, mean squared error (MSE), and mean absolute error (MAE).

Prevalence and genetic diversity of Anaplasma phagocytophilum in wild small mammals from western Yunnan province, China.

Anaplasma phagocytophilum (A. phagocytophilum) is an emerging zoonotic pathogen causing human granulocytic anaplasmosis, linked to small mammal reservoirs that harbor various zoonotic pathogens, underscoring their importance in public health and ecology. This study seeks to determine the prevalence of A. phagocytophilum in small mammals using PCR, then sequence and genotype positive samples, and assess infection risk factors. Small mammals were seasonally captured and a nested polymerase chain reaction (nested-PCR) was conducted targeting the 16S rRNA gene on spleen samples to detect A. phagocytophilum infection from three counties in western Yunnan province, China. Positive samples were sequenced and genotyped, revealing genetic diversity and regional clustering of the pathogen. A total of 1,605 small mammals belonging to 30 species, 18 genera, 6 families, 3 orders were captured seasonally and screened in this region, yielding a 0.93% infection rate with A. phagocytophilum (15/1605). Significant variations in infection rates were observed across different species, counties, and habitats. The 16Sr RNA genes of A. phagocytophilum were categorized into two distinct clades, indicating notable genetic diversity. The identification of genetic variants in spleen samples underscores the potential public health risk and the critical importance of the One Health approach in disease surveillance. Our findings emphasize the necessity for continuous monitoring and highlight the value of nested-PCR testing on spleen samples for accurate prevalence assessment.

Rubbercrete as a sustainable solution for recycling waste tires in concrete: An overview

Due to the rapid growth of the automotive industry, the number of waste tires has been rising dramatically each year. This increase is causing a strain on landfills, as the bulky nature of waste tires, with about 75% of their volume being void, quickly depletes available space of landfills. Furthermore, waste tires are non-biodegradable and, due to their concave shape, provide an ideal breeding ground for insects and harmful rodents, posing a public health risk. Given the limited range of products that can be produced from recycled tires, it is crucial to find economically viable solutions to recycle these tires and use them in mass production of useful materials, such as concrete. Concrete has been chosen by researchers as it is the second most consumed material per capita, after water. Researchers have produced crumb rubber from recycled tires and used it to partially replace fine aggregates in concrete, creating a material known as rubbercrete. Compared to conventional concrete, rubbercrete has better thermal and acoustic properties, is lighter in weight, and more ductile. However, it also shows a reduction in mechanical strengths. This paper provides an overview of rubbercrete, highlighting its key challenges, advantages, and properties.

Assessment of medical doctors' knowledge of new psychoactive substances and their neurobehavioural effects

New Psychoacve Substances (NPS), also known as designer drugs, pose significant public health risks due to their potent psychoacve properes and potenal neurobehavioural effects. Medical doctors play a crucial role in idenfying and addressing the health risks associated with NPS use. This study assessed medical doctors' knowledge of NPS and their neurobehavioral effects. A cross-seconal online survey of licensed medical doctors was conducted, revealing varying levels of awareness and knowledge regarding NPS. While respondents showed familiarity with NPS terminology and street names, gaps existed, parcularly concerning specific NPS categories. This underscores the importance of enhancing medical professionals' understanding of NPS to ensure comprehensive paent care and informed treatment decisions.

The Economic Impact of Successful Businesspeople: The Dual Effect of Wealth Creation and Spending

This article explores the complex impact of successful businesspeople on others and society through wealth creation and spending in their economic lives. The article begins by defining the concept of a “successful businesspeople” and points out its diversity in different historical and political contexts. Then, from an economic perspective, this paper analyzes how successful businesspeople can positively impact society by promoting economic growth, improving production efficiency, creating jobs, and donating to philanthropy in their different roles as investors, producers, consumers, donors, and employers. However, the article also points out the negative externalities that can be brought about by successful businesspeople, such as environmental damage, labor problems, data privacy violations, and public health risks. By citing historical and modern examples, such as Andrew · Carnegie, Henry · Ford, Jeff · Bezos, and Elon · Musk, this article further elaborates on how the economic behavior of successful businessmen has both positive and negative effects, and emphasizes the importance of understanding these complex relationships.

Investigation of Various Toxigenic Genes and Antibiotic and Disinfectant Resistance Profiles of Staphylococcus aureus Originating from Raw Milk.

This study investigated the toxigenic genes and antimicrobial resistance profiles of Staphylococcus aureus strains isolated from 260 raw milk samples collected from dairy farms in Türkiye. The results indicated that 60.7% of staphylococcal enterotoxin genes (sea, seb, sed, seg, sei, sej, sek, seq, sem, seo, and seu) and 21.4% of the tst and eta genes were positive, with most enterotoxin-positive samples carrying more than one gene. The sec, see, seh, sel, sen, sep, and etb genes were not identified in any samples. The prevalence of antibiotic resistance genes (mecA, blaR, blaI, blaZ, vanA, ermT, tetK, aac/aph, ant, dfrA, tcaR, IS256, and IS257) was high at 89.2%, with bla being the most frequently detected gene (75%). The mecA gene was present in 14.2% of samples, while tcaR was detected in 78.5%. Nevertheless, the mecC was not identified. Disinfectant resistance genes (qacA/B, qacC, qacJ, smr) were detected in 21.4% of the samples. The results of the disk diffusion test showed that 64.2% of strains were resistant to penicillin G and ampicillin, with additional resistance found for cefoxitin, teicoplanin, levofloxacin, norfloxacin, and other antibiotics. These findings highlight a significant public health and food safety risk associated with raw milk due to the presence of S. aureus strains with toxigenic genes and high antimicrobial resistance.

Dengue Virus Serotypes 1 and 2 Responsible for Dengue Burden in Amazonas: Epidemiological and Clinical Features.

The increase in dengue cases in Amazonas poses a public health risk. This study aimed to examine the circulating serotypes in the region of Amazonas, Peru, from 2021 to 2023, along with the associated clinical and epidemiological characteristics. Serotype identification was determined for 420 serum samples using a multiplex real-time reverse transcription-polymerase chain reaction assay, revealing that 194 patients were infected by dengue virus (DENV)-1 and 226 by DENV-2. Both serotypes co-circulated in all affected provinces. Warning signs were more frequent in patients with DENV-2 (P = 0.004), and the manifestation of abdominal pain was correlated with this serotype (P = 0.004), highlighting its association with severe forms of the disease. In conclusion, this study emphasizes the widespread circulation of DENV-1 and DENV-2 in Amazonas. Furthermore, it underscores the importance of real-time molecular surveillance that could provide an early prognosis of disease severity.

Artificial intelligence – NPHIs’ role in utilizing its opportunities and addressing the risks

Abstract Issue & Problem National Public Health Institutes (NPHIs) in many countries are at the forefront of action to mitigate the impact of current and future threats to health as well as improving population health and wellbeing. Through research, collaboration, and support, NPHIs can approach these new realities together. One of the many emerging realities that NPHIs will need to engage in is how NPHIs best can utilise the powers of artificial intelligence and deal with the ethical and legal issues that come with it. Methods In preparation of IANPHI’s (International Association of National Public Health Institutes) Europe Regional network meeting in April 2024 a survey was conducted among the 42 members. 16 countries replied to questions, around e.g., 1) current applications of (generative) artificial intelligence (AI) in the work of institutes, 2) which experiences were made and 3) which measures NPHIs take to best utilize the possibilities and overcome challenges of AI technologies. Within four weeks 16 replies were shared. Lessons & Conclusions Some institutes have not yet adopted AI, while others report multiple applications but the primary areas of application vary considerably among Europe. Applications include summarizing and reformatting text; translation; transcribing and documenting meetings; search information in documents or databases; coding; creating visuals; literature review; surveillance of infectious diseases; disease forecasting; analysis of transmission dynamics; vaccine efficacy assessment and development; image recognition; diagnosis and prediction of diseases from medical datasets; text mining; symptom extraction; social listening; prediction of nitrate concentration in groundwater; drug analysis and measuring psychological resilience in social crisis. Key messages • AI poses opportunities and risks for public health and work of national public health institutes and capacity building initiatives are essential. • IANPHI decided to develop a joint framework for the use of AI in its member organisations with a focus on research and responsible use.

Antibiotic resistant Pseudomonas aeruginosa in dental unit waterline: a case study in Milan (Italy)

Abstract P.aeruginosa (Pa) is one of the most serious cause of healthcare-associated bacteremia, well-known for its antibiotic resistance (AR). Pa has often been found in dental unit water representing a great risk in public health. Aims are to evaluate the presence of Pa in dental unit (DU) water and its phenotypic and genotypic properties. Pa isolates derive from a monitoring of DU water in an Italian hospital (Milan). Samples were collected on Monday and on Friday, before the beginning and after the end of activities. Resistant PA strains were characterized by phenotypic method using E-test for 6 different classes of antibiotics, and by genotypic method with Whole-genome sequencing (WGS). Resistance genes were annotated with ResFinder v. 4.5 and Sequence Type (ST) was determined using the PA MLST database. 70/272 strains were identified as Pa and 21 of them were AR to one or more antibiotics. They were detected in 10/44 (22.7%) DUs and 2/4 (50%) control sinks (1-2000UFC/100mL). WGS was obtained for 18 strains. 17 belonged to serogroup O11 and ST667 was prevalent (8/18) followed by ST395 (4/18). At the ground floor ST395 was the most prevalent, followed by ST667 and 260, while, at the first floor, ST309 and 667 were in the two controls and ST667, 3245 and 260 in the other DUs. Resistant genes blaPAO, aph(3’)-IIb, catB7 conferring resistance to β-lactams, aminoglycosides and amphenicol, respectively, were observed in all isolates. Only ST3245 strain did not show resistance to Fosfomycin. Genotypic and phenotypic analyses present some discrepancies with the presence of AR genes and no antibiotic resistance detection (4/18) or resistance to other different classes of antibiotics (6/18). The MLST analyses showed a high diversity, with the presence of strains sharing different antibiotic resistance mechanisms in DU water. Detection and analyses by WGS can help to track dissemination of genetic resistance determinants and potential emergence of high-risk clones. Key messages • Phenotypic and genotypic analyses in DU water are needed to evaluate risk for human health, in addition to routine microbial monitoring. • WGS can help to track dissemination of genetic resistance determinants and potential emergence of high-risk clones.

Microbiome and Resistome Studies of the Lithuanian Baltic Sea Coast and the Curonian Lagoon Waters and Sediments

Background: the widespread use of antibiotics in human and veterinary medicine has contributed to the global challenge of antimicrobial resistance, posing significant environmental and public health risks. Objectives: this study aimed to examine the microbiome and resistome dynamics across a salinity gradient, analyzing water and sediment samples from the Baltic Sea coast and the Curonian Lagoon between 2017 and 2023. Methods: the composition of the water and sediment bacterial community was determined by Full-Length Amplicon Metagenomics Sequencing, while ARG detection and quantification were performed using the SmartChipTM Real-Time PCR system. Results: the observed differences in bacterial community composition between the Baltic Sea coast and the Curonian Lagoon were driven by variations in salinity and chlorophyll a (chl a) concentration. The genera associated with infectious potential were observed in higher abundances in sediment than in water samples. Over 300 genes encoding antibiotic resistance (ARGs), such as aminoglycosides, beta-lactams, and multidrug resistance genes, were identified. Of particular interest were those ARGs that have previously been detected in pathogens and those currently classified as a potential future threat. Furthermore, our findings reveal a higher abundance and a distinct profile of ARGs in sediment samples from the lagoon compared to water. Conclusions: these results suggest that transitional waters such as lagoons may serve as reservoirs for ARGs, and might be influenced by anthropogenic pressures and natural processes such as salinity fluctuation and nutrient cycling.

Monitoring the Public Health and Safety Impact of the Groningen Gas-Extraction Crisis

Abstract Background Gas extraction in the Dutch province of Groningen began in 1963 and was initially seen as an economic boon for the nation. Yet, it turned into a significant burden for the region, leading to earthquakes, damage to houses and property, complicated compensation processes, recovery, and reinforcement programs, as well as a lack of recognition. In 2016, the research group Gronings Perspectief (GP) was established with the objective of independently monitoring the public health and safety impact of the gas-extraction crisis from the residents’ perspective. Methods Monitoring activities take place in dialogue with sounding boards comprising residents, professionals, scientists, and local and national governments. GP employs a longitudinal mixed-methods approach, combining qualitative and quantitative research methods. Representative panel surveys are conducted yearly among residents in the provinces of Groningen (twice) and Drenthe (once). Additionally, 20 in-depth interviews are carried out each year, alongside a survey among households in the reinforcement program. GP analyses the periodic health monitors conducted by municipal health authorities. All reports are publicly accessible. Results Since 2016, monitoring consistently points to a profound and enduring effect of housing damage on health and well-being, subjective safety, risk perceptions, trust in governments and agencies among residents. The impact of the procedural burden imposed by governments and institutions, is as significant as the effects of earthquakes and housing damage. Conclusions GP’s findings were included in a parliamentary inquiry, which concluded in 2023 that the interests of residents were persistently neglected in favour of economic gain. New risk reduction and reconciliation programs are introduced. Despite the recent decision to end the gas extraction, continuation of GP is needed to monitor further developments. Key messages • GP’s stakeholder-driven monitoring approach made the impact of the gas-extraction crisis visible. • Enduring public health and safety risks, beyond the gas extraction, require continuing monitoring.

A Review of Wastewater-Based Epidemiology for the SARS-CoV-2 Virus in Rural, Remote, and Resource-Constrained Settings Internationally: Insights for Implementation, Research, and Policy for First Nations in Canada

Wastewater-based epidemiology (WBE) is regarded as a support tool for detecting and assessing the prevalence of infectious diseases at a population level. For rural, remote, and resource-constrained communities with little access to other public health monitoring tools, WBE can be a low-cost approach to filling gaps in population health knowledge to inform public health risk assessment and decision-making. This rapid review explores and discusses unique considerations of WBE in key settings, with a focus on the detection of the SARS-CoV-2 virus, which has rapidly expanded WBE infrastructure globally. To frame our understanding of possibilities for WBE with First Nations in Alberta, we address the following questions: What are the unique considerations and challenges for WBE under similar contexts in rural, remote, or resource-constrained settings? What are the resources and expertise required to support WBE? This review identifies several unique considerations for WBE in rural, remote, and resource-constrained communities, including costs, accessibility, operator capacity, wastewater infrastructure, and data mobilization—highlighting the need for equity in WBE. In summary, most resource-constrained communities require additional support from external research and/or governmental bodies to undertake WBE.

7.P. Skills building seminar: Using health impact assessment for assessing tobacco control policies

Abstract Tobacco use is the largest contributor to premature death and preventable disease in Europe. Despite decreasing tobacco use in recent years, the European Commission estimates that the number of smokers in Europe is 26% in the population, and 29% among 15-24 year olds. This persistent public health risk is amenable to policy, but targeted and effective strategies are needed. Health impact assessment (HIA) methods can aid decision-makers in exploring the consequences of policy actions on select outcomes, providing a platform for informed, evidence-based policy design. Routine data collection on risk factors including smoking and tobacco use behaviour is common and available in Europe. Analysing and valorising these data can provide a better picture of vulnerable and target groups for which tobacco use is a persistent problem, or where the attributable disease burden is particularly high. These data can form the basis for robust projections and the application of HIA methods. In addition, a number of policy strategies exist for tobacco control including changes in packaging, taxation, labelling, ingredients, creation of smoke-free environments, and restrictions on advertising. These policies have a common goal in improving tobacco control, but may lead to differential effects across age groups, populations, and different measures of tobacco use. It is thus necessary to use robust tools to understand these effects and better coordinate and plan policy. HIA methods, each with their own strengths and limitations, have been applied successfully to estimate the impact of different tobacco control measures. Novel methodologies that make use of available data, computational power, and provide a low-cost way to explore policy interventions can be an essential tool to policy planning and in particular to tackle the intractable areas of tobacco control. This skills building workshop will present two key approaches, each with their own strengths and weaknesses, that have been applied in HIA studies on tobacco control - i.e., a static approach based on the calculation of potential impact fraction, and a dynamic approach based on microsimulation models. Furthermore, the workshop will demonstrate, using two real-life examples, how policy measures can be translated into effect size estimates - which is one of the most crucial steps in any HIA. By providing a step-by-step presentation of how HIA has been applied in practice, attendees will gain unique insights in the different ways by which HIA can be used to gain insights into the relative impact of policy strategies for tobacco control. Key messages • Tobacco use remains the largest contributor to preventable disease burden in Europe; a key area for analysing policies using health impact assessment. • Attendees will gain unique insights in the different ways by which HIA can be used to gain insights into the relative impact of policy strategies for tobacco control.

Main challenges and measures taken by public health institutions in response to war in Kyiv Region

Abstract Background The establishment of martial law due to Russia’s military aggression against Ukraine led to specific adjustments in the functioning of the Centers for Diseases Control and Prevention (СDС). The negative impact of hostilities is determined by the increased morbidity rate of communicable and non-communicable diseases, insufficient supply of safe drinking water and food to damaged sites, inadequate living conditions, etc. Objectives The purpose of the work was to create an effective system for responding to biological, chemical and radiation hazards and eliminating the consequences of an emergency situation in the realities of martial law. Methods We used the most common methods, namely descriptive, statistical, microbiological and сhemical laboratory tests. Results The activities of the CDC under martial law include daily monitoring studies of environmental objects. The epidemic situation of acute intestinal infection (AII) and other communicable diseases (CD) is constantly analyzed. The Kyiv Oblast CDC became the basic institution for the implementation of the ‘pilot project’ in the direction of sanitary and epidemic assessment and monitoring of environmetal objects in 188 de-occupied areas. The main public health risks were identified: providing the population with high-quality drinking water; low immunization rate of the population; sites for the location of internally displaced persons; natural foci of especially dangerous diseases, such as tularemia, leptospirosis, infection fevers, etc. In 2022, the overall level of CD in the Kyiv region decreased by 44.0% from 2021. The most common nosologies were acute respiratory viral infections and influenza (98.9%), AII (42.4%), tuberculosis (15.3%), Lyme disease (15.3%), and viral hepatitis (14.2%). Conclusions Based on the research conducted, mechanisms have been developed for responding to hazards of various origins by public health institutions, including risk assessmant and laboratory studies. Key messages • The main focus of the Centers for Diseases Control and Prevention is aimed at effective response to hazards of various origins in order to ensure public health under martial law. • Risk assessment in de-occupied territories has become an important tool for identifying correct approaches to prevent negative consequences for public health.

Extended Spectrum β-Lactamase: Tackling Antibiotic Resistance and Overcoming Treatment Challenges

Antibiotics, also known as antibacterials, kill or inhibit bacterial growth but are ineffective against viruses, fungi, or parasites, often leading to misuse. They are categorized by molecular structure, mode of action, and spectrum of activity. Antimicrobial Resistance (AMR) occurs when pathogens no longer respond to antimicrobial drugs, arising naturally or through acquisition. Resistance mechanisms include enzymatic (most common), genetic and physical. Bacteria produce various β-lactamases, such as Extended Spectrum β-lactamases (ESBLs), AmpC enzymes, and carbapenemase to exert resistance to Beta-Lactam (βL) class of antibiotics. ESBL families include TEM, SHV, and CTX-M, with E. coli being the most prevalent host. Any Gram-Negative Bacteria (GNB) can be an ESBL producer, but most common ones are the Enterobacteriaceae including Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Proteus mirabilis. ESBL-producing Enterobacteriaceae (ESBL-E) resist penicillin, aztreonam, and cephalosporins except cephamycins and carbapenems, posing a significant public health risk. Genetic resistance mechanisms involve random mutations and horizontal gene transfer through either of the following processes namely conjugation, transformation, transduction. Physical mechanisms include efflux pump production and decreased porin channels. In some microbiological laboratories, ESBL production are often not determined, rather resistance based on MIC values to third generation Cephalosporins are considered as resistance due to ESBL production. Antibiotic use in agriculture and medicine has increased Multi-drug resistant (MDR) ESBL-producing E. coli and evidenced in retail meat and among meat shop employees. Community-acquired ESBL-E infections are a growing concern, with hospital transmission primarily occurring among patients sharing rooms with ESBL carriers. Empirical and definitive therapies for ESBL-E infections must be adjusted based on Antibiotic Susceptibility Testing (AST). The MERINO trial identified urinary tract infections as the most common source of ESBL-E bacteremia, with E. coli being predominant. For critically ill patients with non-urinary tract infections, Meropenem or Imipenem-cilastatin are recommended. For uncomplicated UTIs, Nitrofurantoin, Cotrimoxazole, and Piperacillin-Tazobactam (Pip-Taz) are effective, while Cotrimoxazole, Fluoroquinolones, and Ceftolozane-tazobactam are suitable for complicated UTIs. New β-lactamase inhibitors like avibactam, vaborbactam, and relebactam are promising for treatment. Misuse of antibiotics, such as inappropriate dosing and duration, contributes to AMR, a growing global challenge. Deaths from AMR, estimated at 1.27 million in 2019, could reach 10 million by 2050. ESBLs drive the use of broad-spectrum antibiotics, accelerating resistance development. Inadequate therapy exacerbates infections, leading to prolonged hospital stays, complications, and increased mortality. Balancing new drug development with resistance emergence is crucial to combat AMR.

Water Quality and Prevalence of Extended Spectrum Beta Lactamase Producing Escherichia coli (ESBL E. coli) in Sungai Terengganu, Malaysia

Antimicrobial resistance (AMR) is a significant global issue impacting human, animal, and environmental health, as well as economic security. Water bodies, especially, are now recognized for their role in the spread of antimicrobial-resistant pathogens, though standardized monitoring methods are lacking. This study investigates the presence of extended-spectrum beta-lactamase (ESBL) producing Escherichia coli in the Sungai Terengganu River in Malaysia, focusing on water quality and ESBL E. coli monitoring. Sampling was conducted twice in 2023 at 13 locations along the river. Overall, the water quality index (WQI) classified the river as Class II (WQI = 81), with upstream regions rated as Class I, indicating minimal anthropogenic impact. Higher Biological Oxygen Demand (BOD), Chemical Oxygen Demand (COD), and Total Suspended Solids (TSS) in downstream areas suggested organic pollution from anthropogenic activities. Four metal elements exceeded the National Water Quality Standards (NWQS): Al (0.88 mg/L), Fe (3.45 mg/L), Cu (0.102 mg/L), and Hg (2.525 mg/L). No Pb, Cr, Se, Sn, or As were detected. Statistical analysis showed better water quality correlates with lower microbial contamination. ESBL E. coli was found in 8 of 13 sampling sites (61.5%), with the highest concentration at 800 CFU/100 mL. From 40 presumptive ESBL isolates tested, 87.5% (35 isolates) were positive for ESBL and carried additional drug resistance genes, including mcr-1, tetW, sul-1, and sul-2. These findings indicate a concerning presence of multidrug-resistant E. coli in the river, representing a potential public health risk.

Combating Emerging Respiratory Viruses: Lessons and Future Antiviral Strategies

Emerging viral diseases, including seasonal illnesses and pandemics, pose significant global public health risks. Respiratory viruses, particularly coronaviruses and influenza viruses, are associated with high morbidity and mortality, imposing substantial socioeconomic burdens. This review focuses on the current landscape of respiratory viruses, particularly influenza and SARS-CoV-2, and their antiviral treatments. It also discusses the potential for pandemics and the development of new antiviral vaccines and therapies, drawing lessons from past outbreaks to inform future strategies for managing viral threats.

Global metagenomic survey identifies sewage-derived hgcAB+ microorganisms as key contributors to riverine methylmercury production

Methylmercury (MeHg) in aquatic systems poses a serious public health risk through bioaccumulation in the aquatic food web. In recent years, MeHg has been observed to increase to concerning levels globally in rivers near cities; however, the causes of this increase are not well understood. Here, we demonstrate the significant role of sewage contamination by analyzing over 1,300 publicly available metagenomes in urban rivers worldwide, and conducting experiments with water samples across China. We find that sewage contamination significantly increases the abundance of mercury (Hg)-methylating microorganisms in urban rivers globally. This increase is primarily attributed to the high abundance of active Hg-methylating microorganisms in sewage, which migrate to rivers via direct discharge or combined sewer overflows (CSOs), becoming key contributors to elevated riverine MeHg levels. Our findings underscore the importance of effectively eliminating Hg-methylating microorganisms from sewage to mitigate the public health risks associated with MeHg in urban rivers.