Risk Of Infectious Disease Transmission Research Articles

Managing risk of infectious disease transmission at religious mass gatherings: Insights from survey, COVID-19 PCR, and antibody tests from Arbaeen walkers in 2020.

Arbaeen in Iraq has been one of the largest mass gatherings during the COVID-19 pandemic with 14.5 million attendees in 2020. We set out to assess the prevalence of current or past COVID-19 among 2020 Arbaeen participants, and establish associations between COVID-19 test results, symptoms, and known recent exposure. This was a cross-sectional study involving participants who joined Arbaeen walk in Iraq in October 2020. COVID-19 PCR and/or rapid antibody test were conducted among consented participants. A short questionnaire was administered. Rapid antibody testing was done onsite. Nasal and throat swab samples were transferred to the laboratory for PCR testing. A total of 835 (88.3% male; 11.7% female) participants were recruited. The most common symptom overall was cough (9.6%) followed by sore throat, fever, and loss of taste/smell (6.6%, 5.5%, and 5.0%, respectively). One in five (20.3%) participants reported close contact with a confirmed COVID-19 case in the past 14 days. Of the 237 participants with a PCR test, 18 (7.6%) were positive. Of the 765 participants with rapid antibody test, 19.3% tested positive for IgM, 39.3% for IgG, and 16.4% for both. Approximately 40% of the participants had evidence of current or past COVID-19 infection based on antibody and PCR. The almost 1 in 10 COVID-19 cases within such a multimillion person gathering, illustrates the difficulty in limiting the participation of infectious individuals in religious mass gatherings. There is a pressing need to explore measures to reduce the risk of transmission of infectious diseases at major mass gathering events.

Challenges of Compliance with Infection Prevention and Control (IPC) Standard Procedures among Healthcare Workers: A Hospital-Based Cross-Sectional Study

Introduction: This hospital-based cross-sectional study aimed to assess the compliance of 251 healthcare workers (HCWs) with Infective Prevention and Control (IPC) standard procedures. The study addresses the critical issue of IPC compliance among HCWs, as it plays a pivotal role in reducing the risk of infectious disease transmission within healthcare settings. Methodology: Analytical cross-sectional study was conducted at St. Francis Referral Hospital, involving 251 healthcare workers from different departments including Internal medicine, Surgery, and Emergency. The Compliance with Standard Precautions Scale (CSPS) tool developed by WHO was used. Descriptive and regression analysis was done. A P-value of less than 0.05 indicated statistical significance. Results: Overall average compliance with IPCSPs was 54% whereby only 24.7% (62/251) of healthcare workers had a good compliance. The majority of HCWs (85.3%) reported highest compliance on proper disposal of used sharp items into sharp boxes and low compliance rate (11.6%) was on the disposal of the sharp box, sharp box is only disposed when it is full. Statistically significant were found between IPCSPs and number of years of working experience, level of education, profession, IPC training and IPC meeting attendance. Conclusion: This cross-sectional study has shed light on the critical challenges faced by healthcare workers in complying with IPCSPs. Findings revealed a concerning compliance with IPCSPs which is below the WHO standard and national level standard as well. We therefore recommend enhancement of IPC training program, IPC awareness campaign, and more implementational research for IPCSPs compliance.

Exploring the Effectiveness of Hydrophobic Glass Surface on Touch-Enabled Digital Device to Reduce Microbial Adhesion and Propagation

ABSTRACT This study investigates the effectiveness of hydrophobic glass surfaces in reducing microbial populations on touch-enabled digital devices. Hydrophobic coatings have been proposed as a potential solution to minimize microbial adhesion and growth on device surfaces. Here, we intended to investigate the effect of hydrophobic spray on microbial load. The results were quantitatively analyzed using microbiological techniques. the nonhydrophobic surface harbors gradual microbial buildup upon time, such as threefold increase from 2 to 4 h and fivefold increase to 6 h post initial sampling with 143.6 ± 33.89 cfu/ml increase up to 264.7 ± 28.53 cfu/ml, whereas the hydrophobic surface had an overall build-up from 16.6 ± 1.2 to 50.45 ± 11.12 cfu/ml with P < 0.0001 significance. This research provides valuable insights into the potential application of hydrophobic glass coatings to mitigate microbial contamination on touch-enabled digital devices, enhancing their hygienic properties and minimizing the risk of infectious disease transmission.

Case Management of Imported Crimean-Congo Hemorrhagic Fever, Senegal, July 2023.

We report an imported Crimean-Congo hemorrhagic fever case in Senegal. The patient received PCR confirmation of virus infection 10 days after symptom onset. We identified 46 patient contacts in Senegal; 87.7% were healthcare professionals. Strengthening border crossing and community surveillance systems can help reduce the risks of infectious disease transmission.

Quality of examination gloves in health facilities in Addis Ababa, Ethiopia

Background: Examination gloves are used in health facilities to protect health professionals and patients from the risk of infection and reduce opportunities for cross-transmission of infectious microorganisms. Poor-quality examination gloves can expose health professionals to infectious diseases such as Covid-19, Hepatitis, HIV/AIDS, and other contagious diseases. Hence, this study aimed to assess the quality of examination gloves in health facilities in Addis Ababa.
 Methods: A cross-sectional study design was employed. The examination gloves were collected from randomly selected health facilities in Addis Ababa. The gloves were examined following standard procedure in the Ethiopian Food and Drug Authority. Holes in the examination gloves were detected using the watertight (leakage test) and geometrical dimensions such as thickness, width, and length were measured.
 Results: A total of 2500 selected examination gloves were collected between Feb 10 and Feb 20, 2021. The gloves were sampled from health facilities in Addis Ababa. From the total samples collected, only 2280 examination gloves of five different brands were tested, which makes the response rate 91.2%. The proportion of gloves with holes detected ranged from 5.7% to 21.9%. Overall, only 0.17% and 3.2% of the gloves had width and length below standard, respectively. None of the gloves tested in this study had a thickness below the standard.
 Conclusions: All brands of examination gloves tested had a higher hole (leakage) rate than the acceptable quality limit. This implies there is a substantial risk of infectious disease transmission to health professionals and patients in healthcare settings. Hence, regulatory enforcements need to be strengthened across the life cycle of the product.

Infectious Disease Preparedness for Homeless Populations: Recommendations from a Community–Academic Partnership

Abstract: Background: People experiencing homelessness are at increased risk of infectious disease transmission due to congregate living conditions, barriers to healthcare, and excess burden of underlying chronic disease. Objectives: We are a multisectoral community–academic partnership working to address the intersecting crises of homelessness and health disparities in Tippecanoe County, Indiana. We offer key recommendations for infectious disease preparedness and risk mitigation for homeless populations based on our ongoing community-based participatory research and lessons learned through COVID-19 response and Monkeypox preparations. Lessons Learned: Infectious disease preparedness and response in homeless populations requires strong local partnerships; ongoing training and support for staff and volunteers of homeless shelters and service agencies; tailored outreach, education, and communication with people experiencing homelessness; and standardized processes for creating, disseminating, enforcing, and evaluating public health policies in homeless shelters. Consistency and open communication are key to a successful community-academic partnership. Conclusions: Community–academic partnerships are critical to effective infectious disease preparedness in homeless populations. The lessons learned from community-based participatory research with homeless communities and multisectoral partners on the frontline can improve future outbreak and pandemic response for people experiencing homelessness and other vulnerable communities in the United States.

Availability of basic infection control items and personal protection equipment in 7948 health facilities in eight low- and middle-income countries: Evidence from national health system surveys.

Hundreds of millions of people become infected globally every year while seeking care in health facilities that lack basic needs like infection control measures and personal protective equipment (PPE). We aimed to evaluate the availability of infection control items and PPE in eight low- and middle-income countries and identify disparities in the availability of those items. In this study, we combined publicly available nationally representative cross-sectional health system surveys (Service Provision Assessments by the Demographic and Health Survey Programme) conducted in eight countries between 2013 and 2018: Afghanistan, Bangladesh, the Democratic Republic of the Congo, Haiti, Malawi, Nepal, Senegal, and Tanzania. The availability of infection control items was evaluated using a list of six items (a waste receptacle, a sharps container, disinfectant, single-use disposable or auto-disposable syringes, soap and running water, or an alcohol-based hand rub, and guidelines for standard precautions). PPE includes four items: gloves, medical masks, gowns, and eye protection. We considered these items available in a facility if they were observed in general outpatient areas or any service-specific area (i.e. delivery room). We analysed data from 7948 health facilities (694 hospitals and 7254 health centres/clinics). Overall, among the infection control items and PPE, most surveyed facilities had high availability of single-use disposable or auto-disposable syringes (91.40%) and latex gloves (92.56%). Of infection control measures, guidelines for infection control were the least available during the survey, with the lowest (6.15%) in Nepal and the highest (68.18%) in Malawi. Of the PPE items, eye protection was the least available during the survey, with the lowest (5.4% in Senegal) and the highest (28.17%) in Haiti. Only 1567 (19.71%) facilities looked to have all the basic infection control materials, and 1023 (12.87%) of the analysed facilities possessed all of the PPE. Within the same country, the availability of items varied more between hospitals and health centres/clinics than between them. All eight of our study countries experience shortages of the most fundamental standard precaution items to avert infection. Steps must be taken in each of these countries to reduce inadequacies and disparities and enhance efficiency in the conversion of health-system inputs into the facility's availability of standard precaution items for infection control - to curb the risk of infectious disease transmission.

Ventilation shutdown and the breath-taking violence of infectious disease emergency management in industrial livestock production

Powerful ventilation systems are a crucial technology in industrial livestock production, mitigating the unhealthy ambient conditions that result from great densities of animal bodies, biowastes, and chemical agents, and enabling the rapid production of massive quantities of flesh and eggs in such crowded indoor spaces. But bad air is just one of many biophysical and technoscientific challenges managed in these spaces, chief among them the ever-present risks of infectious disease transmission and evolution that threaten animal health and productivity and pose untold risks for humans. This article examines the intersection of these two central problems, where ventilation systems that are normally used to manage bad air within enclosures have been repurposed in the context of disease outbreaks to quickly and cheaply kill infected populations by hyperthermia. An analysis of this nascent practice, euphemistically termed “ventilation shutdown,” shows how governments and publicly funded scientific institutions have worked with private industry to develop and systematize the use of this and other technologies of mass death to respond to infectious disease emergencies, a dynamic that, we argue, sheds new light on both the precarity and the violence of industrial livestock production.

Predicting COVID-19 Outbreaks in Correctional Facilities Using Machine Learning.

The risk of infectious disease transmission, including COVID-19, is disproportionately high in correctional facilities.We used machine learning methods with data collected from 24 prison facilities in the Pennsylvania Department of Corrections to determine which sources of data best predict a coming COVID-19 outbreak in a prison facility.Key predictors included county-level measures of COVID-19, facility population, and the test positivity rate in a facility.Fortifying correctional facilities with the ability to monitor local community rates of infection (e.g., though improved interagency collaboration and data sharing) along with continued testing of incarcerated people and staff can help correctional facilities better predict-and respond to-future infectious disease outbreaks.

Advancing indoor risk mapping for virus transmission of infectious diseases through geographic scenario simulation

ABSTRACT Close-range interpersonal interactions serve as a major channel for virus transmission, with higher infection risks indoors than outdoors. Thus, evaluating indoor infectious disease transmission risks is vital for effective epidemic prevention and control. However, collecting complete individual-level behavioral data faces challenges due to privacy concerns and data acquisition costs, impeding accurate indoor risk mapping. To address this, we propose an individual-centered, scenario-based simulation framework in this paper. This framework incorporates stepwise movement of agents to model crowd interactions in indoor spaces, enabling infection risk mapping through geographic scenario simulation. The simulation model’s core components encompass the generation of indoor environments, formulation of individual behavior rules, establishment of human-environment interaction logic, and simulation of virus transmission processes. Additionally, we outline the implementation algorithm for this simulation model. Lastly, we employ a high-risk university canteen as a case study to demonstrate the model’s capabilities in creating risk maps at different levels: spatial, spatiotemporal, and individual. The proposed framework achieves the construction and process simulation of multi-dimensional geographic scenarios at a microscale, introduces a behavior path model based on spatiotemporal cubes, and enhances the comprehensive analysis and mapping capabilities for indoor infectious disease risk, laying the foundation for precise prevention and control.

Airborne transmission risks of tuberculosis and COVID-19 in schools in South Africa, Switzerland, and Tanzania: Modeling of environmental data.

The COVID-19 pandemic renewed interest in airborne transmission of respiratory infections, particularly in congregate indoor settings, such as schools. We modeled transmission risks of tuberculosis (caused by Mycobacterium tuberculosis, Mtb) and COVID-19 (caused by SARS-CoV-2) in South African, Swiss and Tanzanian secondary schools. We estimated the risks of infection with the Wells-Riley equation, expressed as the median with 2.5% and 97.5% quantiles (credible interval [CrI]), based on the ventilation rate and the duration of exposure to infectious doses (so-called quanta). We computed the air change rate (ventilation) using carbon dioxide (CO2) as a tracer gas and modeled the quanta generation rate based on reported estimates from the literature. The share of infectious students in the classroom is determined by country-specific estimates of pulmonary TB. For SARS-CoV-2, the number of infectious students was estimated based on excess mortality to mitigate the bias from country-specific reporting and testing. Average CO2 concentration (parts per million [ppm]) was 1,610 ppm in South Africa, 1,757 ppm in Switzerland, and 648 ppm in Tanzania. The annual risk of infection for Mtb was 22.1% (interquartile range [IQR] 2.7%-89.5%) in South Africa, 0.7% (IQR 0.1%-6.4%) in Switzerland, and 0.5% (IQR 0.0%-3.9%) in Tanzania. For SARS-CoV-2, the monthly risk of infection was 6.8% (IQR 0.8%-43.8%) in South Africa, 1.2% (IQR 0.1%-8.8%) in Switzerland, and 0.9% (IQR 0.1%-6.6%) in Tanzania. The differences in transmission risks primarily reflect a higher incidence of SARS-CoV-2 and particularly prevalence of TB in South Africa, but also higher air change rates due to better natural ventilation of the classrooms in Tanzania. Global comparisons of the modeled risk of infectious disease transmission in classrooms can provide high-level information for policy-making regarding appropriate infection control strategies.

Injection Behaviors and Use of Syringe Service Programs over Time among People Who Inject Drugs in Baltimore, Maryland

Introduction: People who inject drugs (PWID) are at increased risk for infectious disease transmission, including hepatitis C and HIV. Understanding trends in injection risk behaviors and syringe service program (SSP) use over time can help improve infectious disease prevention and other harm reduction services. Methods: Using National HIV Behavioral Surveillance System data from Baltimore, Maryland, we examined changes in receptive sharing of (1) syringes, (2) injection equipment, (3) syringes to divide drugs; and (4) receipt of syringes from SSPs among PWID from 2009 to 2018 (n = 518 in 2009, n = 638 in 2012, n = 586 in 2015, and n = 575 in 2018) using unadjusted and adjusted logistic models calculated across time for the total sample. Results: The conditional probability of receptive sharing of syringes and receipt of syringes from SSPs remained relatively stable, while receptive sharing of injection equipment and receptive sharing of syringes to divide drugs dropped substantially after 2009. White race and daily injection frequency were positively associated with sharing syringes and injection equipment and negatively associated with SSP use over time. In 2015, there was a notable shift such that women were twice as likely as men to receive syringes from SSPs and less likely than men to report the use of shared syringes or equipment. Conclusion: Findings indicate overall steady or decreasing trends in injection risk and steady trends in SSP usage over time, with some notable improvements among women and indications of shifting drug market patterns. Injection-related risk behaviors remain high among White PWID and may require targeted outreach and interventions.

A statistical analysis of exhaled respiratory droplet trajectory distribution in view of assessing the risk of infectious disease transmission

In the present work an analytical model of exhaled droplet trajectory and evaporation is employed to perform a preliminary statistical analysis of the droplet spatial distribution. The analysis is carried out for a set of over twenty thousand droplets distributed in the range of diameters from 0.1 μm to 1 mm. The type of respiratory events modelled are mouth breathing and speaking. The analytical model employed has been recently developed by the authors. It implements the fundamental laws of fluid dynamics and convection-diffusion, and features a 2D empirical numerical model of buoyant intermittent jet modelling the exhaled breath cloud. A discrete random walk turbulent dispersion model is also included allowing statistical analysis of the droplet trajectory to be performed. With proper boundary conditions any type of respiratory event can be simulated making the model particularly versatile. From the analysis, spatial virus concentration maps are derived for the largest droplets falling to the ground, and for the smaller droplets remaining airborne in the area in front of an infected emitter and successively uniformly dispersed in the ambient. This allows to estimate the risk of infection by fomite, direct inhalation and indirect inhalation routes, and provide a better understanding of infectious disease transmission risks.

Cross-Sectional Survey of Horse Owners to Assess Their Knowledge and Use of Biosecurity Practices for Equine Infectious Diseases in the United States.

Horses are transported in the United States more than any other livestock species and co-mingle at various events; therefore, they are considered to be at an increased risk for infectious disease transmission. The fragmented movement of horses combined with numerous sites of co-mingling makes tracing the potential spread of a disease outbreak a necessary part of an infection control plan, both locally and nationally. The cross-movement of personnel with horses and the persistence of endemic diseases make biosecurity implementation an ongoing challenge. Although many of the risks for infection are known, there is limited documentation about the usefulness of prospective control measures. The objective of this survey was to determine horse owners' understanding and knowledge of biosecurity practices for preventing infectious diseases in the United States. Questions covered owner demographic information, including horse use which was divided into 10 categories as follows: Pleasure/Trail Riding, Lessons/School, Western Show, English Show, Breeding, Farm/Ranch, Retired, Racing, Driving and Other. The survey was distributed by sending requests to a list of horse owner organizations, which then sent emails to their members. The email request described the survey and provided a website link to start the survey. A total of 2413 responses were collected. Analysis of the results included cross-tabulation to identify significant differences in biosecurity knowledge and awareness by horse use. Significant differences by horse use were identified for vaccination, biosecurity planning, use of isolation, disease risk, monitoring for diseases, co-mingling of horses, sanitation, medical decision making and health record requirements for horse events. In summary, the results suggest that most owners are not highly concerned about the risk of disease or the use of biosecurity. There are several biosecurity applications and techniques which can be increased and will benefit horse health and welfare. These include reliance on temperature monitoring, isolation of new horses at facilities, risks of horse mingling, entry requirements such as vaccination and health certificates at events, and an emphasis on having biosecurity plans for facilities and events where horses co-mingle. The information from this study will be used to create tools and information that horse owners and veterinarians can use to implement appropriate biosecurity practices for different types of horse uses and events.

Infectious keratoconjunctivitis in semi-domesticated reindeer (Rangifer tarandus tarandus): a questionnaire-based study among reindeer herders in Norway and Sweden

BackgroundThe effects of climate change, loss of pastureland to other land usage and presence of large carnivores are the main reasons for the increase in supplementary feeding of semi-domesticated reindeer (Rangifer tarandus tarandus) in Fennoscandia over the last decades. Feeding might expose reindeer to stress and increased animal-to-animal contact, leading to an increased risk of infectious disease transmission, such as infectious keratoconjunctivitis (IKC). As it can develop rapidly and be very painful, IKC is described as an important animal welfare concern and a potential source of economic loss. The aim of this study was to investigate the current presence of IKC and potential associations between IKC and supplementary feeding through an online questionnaire survey, distributed among reindeer herders in Norway and Sweden in 2021.ResultsSeventy-six reindeer herders (33 from Norway and 43 from Sweden) responded to the questionnaire, representing 6% and 4% of the registered reindeer herding groups in Norway and Sweden, respectively. Infectious keratoconjunctivitis was common, with 54 (71%) of the 76 herders that responded having observed clinical signs during the past 10 years. These signs were mainly observed as increased lacrimation, causing “wet cheeks”, but also as keratitis and conjunctivitis. Autumn and winter were the seasons in which IKC was observed most. The herders reported several measures, such as slaughter and isolation of affected reindeer, to counteract the spread of disease. The herding year 2019/2020 was associated with reports of outbreaks of IKC in herds as well as being the herding year where most herders (80%) had performed supplementary feeding. A significant association was found between IKC and feeding performed in an enclosure (odds ratio = 15.20), while feeding on free-range areas had a non-significant, negative, relationship with the appearance of IKC outbreaks (odds ratio = 0.29). Finally, there was a trend in the data suggesting that IKC affected calves especially.ConclusionsInfectious keratoconjunctivitis is a common disease, mainly observed in winter and autumn. It usually has mild to moderately severe clinical signs. Our results imply that IKC is associated with stress and feeding situations and that calves might be more susceptible than adults, however, this needs to be confirmed with further studies, preferably at an individual animal level.

감염병 팬데믹 상황에서 항공 여행에 대한 위험지각이 항공사 선택속성과 만족에 미치는 영향

This study investigated the effect of risk perception on airline selection attributes and satisfaction in an infectious disease pandemic situation. As a result of the study, it was all adopted that risk perception for air travel would affect airline selection attributes. Among them, social and psychological risks had a negative (-) effect on airline selection attributes. H2. It was partially adopted that airline selection attributes would affect satisfaction. Infectious disease prevention measures, flight services, and economic feasibility affected satisfaction, but in-flight services did not affect satisfaction. The implications are as follows. In order to reduce the risk of infectious disease transmission, it will be necessary to provide in-flight meals in the form of a snack box that is packaged in-flight food and beverage. In order to reduce time and economic risk, it will be necessary to exempt or reduce fees when customers change or refund their flights due to uncertainties in the spread of infectious diseases. A back-to-front by-row boarding method will be needed to relieve congestion during boarding and doing during preventive measures for infectious diseases.

An investigation of the bio-medical waste produced in India during the COVID-19 pandemic and Maharashtra state (pre-COVID-19 and post-COVID-19) analysis: a GIS-based approach

BackgroundThe COVID-19 pandemic exerted substantial pressure on global healthcare systems and facilities, putting the lives of countless individuals at risk. In addition, the treatment of patients during the pandemic resulted in an unprecedented increase in the volume of medical waste generated, including biomedical waste (BMW) or healthcare waste (HCW), which poses a risk of infectious disease transmission. As the second most populous country in the world, India faced a severe challenge in managing its healthcare waste infrastructure during this time (2020–2021). Proper disposal of BMW was of utmost importance to prevent the spread of infectious agents and to safeguard public health.MethodsThe environmental monitoring and management framework of the country is well planned and governed by the Central Pollution Control Board (CPCB), which carefully handles the BMW across the states and union territory of the country. Through the execution of Android based application named ‘COVID19BMW’, India has laid the foundation of identification, classification, data collection, and management regarding the BMW. Further, the temporal scale of BMW generation tracking was further improved from a monthly to a daily basis by using the COVID19BMW tool. This data was used to map the change taken place across the India. Additionally, by using Geographical Information System the BMW is mapped using Choropleth method.ResultsThe current study conducted a national-level analysis of BMW generated during the COVID-19 pandemic in India. The results revealed that, in the year 2020, the seven states and the National Capital Territory (NCT) of Delhi generated the highest amounts of BMW, with Gujarat, Maharashtra, Kerala, Karnataka, Tamil Nadu, Uttar Pradesh, and West Bengal being the top BMW generating states. Additionally, the change detection equation was used to map the changes. The investigation analysed the daily changes in BMW generation between 2020 and 2021 at the national level. The results indicated a significant decreasing trend of -50.35% in BMW generation per day. In the case of Maharashtra state, the change detection analysis for the pre-COVID-19 and post-COVID-19 pandemic periods showed an increased trend of approximately 32%. However, in 2021, a decreasing trend was observed, with a -2.23% reduction in BMW generation compared to 2020 on the daily basis of BMW generation. These findings suggest that the COVID-19 pandemic has influenced BMW generation of waste, and the results can provide insights for improving waste management policies and practices.DiscussionIn this study, a Geographical Information System (GIS) was employed to create a mapped representation of the BMW data at national scale. Further, the study investigated changes in BMW generation in Maharashtra state during the COVID-19 pandemic. Analysis of changes in BMW generation revealed a pattern of BMW generation during the pandemic. The use of GIS technology to track these changes proved to be a valuable tool in providing a synoptic view of the overall BMW condition across India and identifying areas where infectious waste poses a significant threat. The visualisation of data using the GIS technique provided an easy means of identifying hotspots of BMW generation, which is more effective compared to a tabular format.

Assessment of aerosol persistence in ICUs via low-cost sensor network and zonal models

The COVID-19 pandemic raised public awareness about airborne particulate matter (PM) due to the spread of infectious diseases via the respiratory route. The persistence of potentially infectious aerosols in public spaces and the spread of nosocomial infections in medical settings deserve careful investigation; however, a systematic approach characterizing the fate of aerosols in clinical environments has not been reported. This paper presents a methodology for mapping aerosol propagation using a low-cost PM sensor network in ICU and adjacent environments and the subsequent development of the data-driven zonal model. Mimicking aerosol generation by a patient, we generated trace NaCl aerosols and monitored their propagation in the environment. In positive (closed door) and neutral-pressure (open door) ICUs, up to 6% or 19%, respectively, of all PM escaped through the door gaps; however, the outside sensors did not register an aerosol spike in negative-pressure ICUs. The K-means clustering analysis of temporospatial aerosol concentration data suggests that ICU can be represented by three distinct zones: (1) near the aerosol source, (2) room periphery, and (3) outside the room. The data suggests two-phase plume behavior: dispersion of the original aerosol spike throughout the room, followed by an evacuation phase where "well-mixed" aerosol concentration decayed uniformly. Decay rates were calculated for positive, neutral, and negative pressure operations, with negative-pressure rooms clearing out nearly twice as fast. These decay trends closely followed the air exchange rates. This research demonstrates the methodology for aerosol monitoring in medical settings. This study is limited by a relatively small data set and is specific to single-occupancy ICU rooms. Future work needs to evaluate medical settings with high risks of infectious disease transmission.

Corrections Officers' and Sheriffs' Perceptions of COVID-19 Vaccine Operationalization.

Justice-involved populations are at an elevated risk for infectious disease transmission and have been profoundly negatively impacted by the COVID-19 pandemic. Vaccination is being utilized as a primary tool for prevention and protection from serious infection in carceral settings. We examined the barriers and facilitators to vaccine distribution by surveying key stakeholders-sheriffs and corrections officers-in these settings. Most respondents felt prepared for rollout, although they still identified significant barriers to operationalization of vaccine distribution. Barriers ranked highest by stakeholders were vaccine hesitancy and problems related to deficits in communication and planning. There is enormous opportunity to install practices that will address the significant barriers being faced to efficient vaccine distribution and amplify existing facilitators. These could include, for example, the incorporation of in-person community communication models for discussion of the vaccine (and hesitancy) in carceral facilities.

Meta-Viromic Sequencing Reveals Virome Characteristics of Mosquitoes and Culicoides on Zhoushan Island, China.

Mosquitoes and biting Culicoides species are arbovirus vectors. Effective virome profile surveillance is essential for the prevention and control of insect-borne diseases. From June to September 2021, we collected eight species of female mosquito and Culicoides on Zhoushan Island, China, and used meta-viromic sequencing to analyze their virome compositions and characteristics. The classified virus reads were distributed in 191 genera in 66 families. The virus sequences in mosquitoes with the largest proportions were Iflaviridae (30.03%), Phasmaviridae (23.09%), Xinmoviridae (21.82%), Flaviviridae (13.44%), and Rhabdoviridae (8.40%). Single-strand RNA+ viruses formed the largest proportions of viruses in all samples. Blood meals indicated that blood-sucking mosquito hosts were mainly chicken, duck, pig, and human, broadly consistent with the habitats where the mosquitoes were collected. Novel viruses of the Orthobunyavirus, Narnavirus, and Iflavirus genera were found in Culicoides by de-novo assembly. The viruses with vertebrate hosts carried by mosquitoes and Culicoides also varied widely. The analysis of unclassified viruses and deep-learning analysis of the "dark matter" in the meta-viromic sequencing data revealed the presence of a large number of unknown viruses. IMPORTANCE The monitoring of the viromes of mosquitoes and Culicoides, widely distributed arbovirus transmission vectors, is crucial to evaluate the risk of infectious disease transmission. In this study, the compositions of the viromes of mosquitoes and Culicoides on Zhoushan Island varied widely and were related mainly to the host species, with different host species having different core viromes. and many unknown sequences in the Culicoides viromes remain to be annotated, suggesting the presence of a large number of unknown viruses.