Strict Isolation Measures Research Articles

COVID-19 Serological Tests: How Well Do They Actually Perform?

In only a few months after initial discovery in Wuhan, China, SARS-CoV-2 and the associated coronavirus disease 2019 (COVID-19) have become a global pandemic causing significant mortality and morbidity and implementation of strict isolation measures. In the absence of vaccines and effective therapeutics, reliable serological testing must be a key element of public health policy to control further spread of the disease and gradually remove quarantine measures. Serological diagnostic tests are being increasingly used to provide a broader understanding of COVID-19 incidence and to assess immunity status in the population. However, there are discrepancies between claimed and actual performance data for serological diagnostic tests on the market. In this study, we conducted a review of independent studies evaluating the performance of SARS-CoV-2 serological tests. We found significant variability in the accuracy of marketed tests and highlight several lab-based and point-of-care rapid serological tests with high levels of performance. The findings of this review highlight the need for ongoing independent evaluations of commercialized COVID-19 diagnostic tests.

COVID-19: In the Absence of Vaccination – ‘Mask the Nation’

COVID-19: In the Absence of Vaccination – ‘Mask the Nation’

Literacy in the new norm: stay-home game plan for parents

Purpose The purpose of this study is twofold. Firstly, this research aims at helping countries implement an equitable, innovative and context-appropriate stay-home game plan for the millions of disadvantaged and under-privileged students severely affected by the forfeiture of school closures; and secondly, this study proclaims that the burgeoning popularity of gamification has the potential to lay the bedrock foundation for ‘Literacy in the New Norm’. Design/methodology/approach The temporal closure of schools around the world to limit the spread of the COVID-19 has resulted in massive educational disruptions triggering adverse effects and bringing much of education under grave threat. Through a review of the current empirical and conceptual literature, this study proposes a new gamification concept in a non-technology environment. Findings Well underway are global dialogues that hold conversations on implementing mitigation strategies to counter the looming global health crisis. This has generated the impetus for a more concerted effort by concerned governments and international organizations to identify appropriate solutions for the continuity of learning so that the learning never stops. While educators and learners plunge further into the core of reconstructing education, the authors recognize that the fundamentals of technology and virtual connectivity have all along contributed to the multi-faceted e-learning stage set. However, concerns regarding the paradigm shift to remote online learning would certainly exacerbate inequalities cardinally felt across disadvantaged communities around the globe. Originality/value As the world is currently bound by strict isolation measures, learners of all ages have been relegated to the confines of their homes. For the most part, the stark realities of technological mishaps that have befallen underprivileged school children, serve as a reminder to help target children all over the world who are in most peril of losing ground in terms of continued education. It is on these grounds that the criterion set out in this article elucidates the nature and scope of a supplementary stay-home game plan detailing the use of game affordances that bear intelligently in the creation of home-based activities for parents to give it their best effort in fostering a collaborative and meaningful parent-child relationship that spawns the new language of literacy in the new norm.

La vacunación: estrategia fundamental en la eliminación de la viruela en Cuba (1804-1923)

Las epidemias de viruela azotaron a Cuba desde 1522, produciendo elevada morbilidad y mortalidad. En 1804, se inició la estrategia de vacunación contra esta enfermedad que, con distintos avatares y fases en su desarrollo, tuvo como figura central a Tomas Romay. El objetivo del trabajo fue analizar los resultados de la estrategia de vacunación llevada a cabo en la eliminación de la viruela en Cuba y como se transformaron las instituciones en relación a los avances y producción de la vacuna en función del contexto científico, social y político del periodo estudiado. Las fuentes primarias utilizadas han sido diversas: fuentes de tipo epidemiológico y estadístico, documentos relacionados con los organismos puestos en marcha para la propagación y producción de la vacuna, informes institucionales y periodismo científico local. El trabajo reconstruye el papel jugado por la Junta Central de la Vacuna (1804), para planificar, ejecutar y expandir esta estrategia en el territorio, el Instituto de Vacunación Animal (1873) y el Centro General de la Vacuna (1883) en la producción de la misma. En el siglo XX, se convirtió en obligatoria por ley y junto a las estrictas medidas de aislamiento tomadas sobre los casos y los controles de focos, llevaron a la eliminación de la enfermedad a partir de 1923.

Mental Health Effects of COVID-19 Pandemia: A Review of Clinical and Psychological Traits.

Objective As the coronavirus (COVID-19) pandemic sweeps across the world, it is causing widespread concern, fear and stress, all of which are natural and normal reactions to the changing and uncertain situation that everyone finds themselves in. Methods In this general review, we examined the literature about the psychological effects of COVID-19 pandemia. In total 65 papers were reviewed using the Medline computer database. Only publications in English were selected. Results Children are likely to be experiencing worry, anxiety and fear and older people are also those with underlying health conditions, having been identified as more vulnerable to COVID-19, can be extremely frightening and very fear-inducing. China and several other countries took strict isolation measures. Medical staff and affiliated healthcare workers (staff) are under both physical and psychological pressure. Conclusion The COVID-19 pandemic is exceptional. Its effect will likely be imprinted on each individual involved. Extensive stressors will emerge or become worsened. Many medical staff workers will be harmfully psychologically affected.

A Study of Breastfeeding Practices, SARS-CoV-2 and Its Antibodies in the Breast Milk of Mothers Confirmed with COVID-19

Background: There have been no confirmed cases of vertical transmission of the 2019 novel coronavirus disease (COVID-19) from mother to child through breastfeeding, but the possibility of COVID-19 transmission to neonates through breast milk has been postulated. Studies on the presence of the ribonucleic acid (RNA) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in breast milk have shown inconsistent results, and the risk of transmission through breast milk remains unverified. Furthermore, the presence of SARS-CoV-2 antibodies in breast milk, as well as the impacts of prolonged mother-child separation and the cessation of breastfeeding practices due to quarantine control measures have not been reported. Methods: This paper presents the interim results of a multi-center longitudinal study being carried out in Wuhan City of Hubei Province in China. The study began on 10 February 2020, with the aim to describe the short- and medium-term health and developmental outcomes of neonates born to mothers with confirmed/suspected COVID-19. As of 1 April 2020, 24 pairs of pregnant women confirmed with COVID-19 and their neonates (including one pair of twins), 19 pairs of pregnant women suspected with COVID-19 but found to be Polymerase chain reaction (PCR) negative and their neonates, and 21 pairs of pregnant women who were not confirmed with or suspected of COVID-19 and their neonates (control group admitted to hospital due to non-COVID-19 related pregnancy/neonatal complications, including one pair of twins) have been recruited for the study. Telephone follow-up was conducted until 30 April 2020 to collect information on breastfeeding practices, and the length of mother-child separation. Fortyfour breast milk samples were collected from 16 of the 24 mothers with confirmed COVID-19 and tested for the SARS-CoV-2 nucleic acid and antibodies (IgM and IgG). Findings: Among the 24 mothers confirmed with COVID-19, 12 cases presented with symptoms predelivery and 12 cases presented with symptoms during the delivery or post-delivery. The average number of days from the onset of symptoms until recovery with negative PCR testing was 16·4 ± 15·6 days (range 3–62 days). The average mother-child separation time was 36·7 ± 21·1 days, significantly longer than that of the suspected/PCR negative group (16·6 ± 13·1 days) and control group (10·5 ± 8·2 days). Both the COVID-19 confirmed (58·3%) and suspected (52·6%) groups presented significantly lower rates of breastfeeding as compared with the control group (95·2%). Ten out of 14 confirmed mothers who fed their babies with expressed breast milk began expressing breast milk after delivery, but did not initiate feeding breast milk to their baby until between 22–29 days after delivery, primarily due to strict isolation and quarantine measures. Forty-four breast milk samples were collected from 16 of the 24 confirmed mothers. All breast milk samples tested negative for the SARS-CoV-2 nucleic acid. Samples were collected from mothers between 3–79 days from the onset of COVID-19 symptoms. Thirty-eight breast milk samples underwent antibody testing and all tested negative for IgG. Twenty-one breast milk samples from 8 women tested positive for IgM, while the remaining 17 samples from 11 women tested negative. The IgM positive samples were collected on average 30·8 ± 19·4 days from the onset of COVID-19 symptoms, while IgM negative samples were collected on average 43·4 ± 21·3 days after the onset of symptoms. Interpretation: There was no evidence of SARS-CoV-2 in any collected samples of the breast milk. While the IgM antibody was detected in the breast milk of some mothers with confirmed COVID-19, IgG was not detected in the breast milk of any mothers. A longer follow-up period is likely needed to detect IgG antibody. Breastfeeding practices were severely impacted during the COVID-19 epidemic, as the Chinese national guidelines called for suspension of breastfeeding among both confirmed and suspected/PCR negative mothers. Our study also found late initiation of breastfeeding or feeding expressed breast milk to infants even among mothers who were not confirmed with or suspected of COVID-19. Considering the lack of evidence for transmission of SARS-CoV-2 through breast milk, health care workers should provide adequate breastfeeding counseling and support along with appropriate hygiene precautions to all pregnant women and their families. Funding Statement: The study was funded by the Hong Kong Committee for UNICEF. Declaration of Interests: The authors of this paper have no conflict of interest. Ethics Approval Statement: All procedures performed in the study involving the collection of human samples were in accordance with the ethical standards approved by the Ethical Committee of Hubei Provincial Maternal and Child Health Hospital (NO. 2020–IEC–XM010). All participants gave their written permission for both their own and their children’s involvement in the study.

What We Need to Consider During and After the SARS-CoV-2 Pandemic.

Even though extreme containment and mitigation strategies were implemented by numerous governments around the world to slow down the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the number of critically ill patients and fatalities keeps rising. This crisis has highlighted the socioeconomic disparities of health care systems within and among countries. As new CoVID policies and responses are implemented to lessen the impact of the virus, it is imperative (1) to consider additional mitigation strategies critical for the development of effective countermeasures, (2) to promote long-term policies and strict regulations of the trade of wildlife and live animal markets, and (3) to advocate for necessary funding and investments in global health, specifically for the prevention of and response to natural and manmade pandemics. This document considers some of these challenges.

How Did Chinese Government Implement Unconventional Measures Against COVID-19 Pneumonia.

In recent years, respiratory infectious diseases had continued to attack China, the recent outbreak of COVID-19 pneumonia had attracted worldwide attention. Through studying the literature, interpreting official documents, analyzing medical and social management data, we summarized and compared some powerful measures taken by the Chinese government, such as declaring emergency state, blocking down the epidemic center, prohibiting crowd gathering activities, forcing residents to wear masks, and mobilizing medical staff and products. We found that these unconventional measures, on the one hand, controlled the spread of the epidemic in China, and on the other hand, exposed some of China’s shortcomings in biosafety, food safety, public health input, and emergency system construction. This paper also recommends that other countries should take strict isolation measures as early as possible when fighting COVID-19 epidemics, and also mobilize citizens to strengthen self-protection.

Nosocomial cross-infection of hypervirulent Listeria monocytogenes sequence type 87 in China.

BackgroundTo investigate the epidemiological and phenotypic characteristics and molecular relatedness of L. monocytogenes, which were cultured from the blood and cerebrospinal fluid (CSF) samples isolated from two neonates.MethodsIn the present case study, two infected neonates were interviewed and epidemiological investigation performed. The phenotypic characteristics and molecular relatedness of L. monocytogenes was characterized by serotyping, pulsed-field gel electrophoresis and whole-genome sequencing (WGS).ResultsThe field investigation found that the two neonates were born in the same hospital (Hospital B) and admitted to the neonatal department through different channels within half an hour by different nurses, where they were weighed and placed in different but adjacent incubators. Then they were cared for by the same group of nurses that evening. It is worth noting that there was no record of sanitation of the neonatal incubator of neonate-1. The serotype of the two isolated L. monocytogenes were 1/2b, with an indistinguishable pulsotypes and were sequence type (ST) 87. WGS showed that there were no core SNP differences identified. In order to explore the genomic traits associated with L. monocytogenes virulence genes, we identified the Listeria pathogenicity island 4 and found that the genome was devoid of any stress islands. There are no positive results from the environmental samples. Considering the genomic data together with epidemiological evidence and clinical symptoms, insufficient surface cleaning along with the nursing staff caring for these neonates was considered as cross-infection factors.ConclusionsTo our knowledge, this is the first report of a nosocomial cross-infection of L. monocytogenes ST87 between two neonates, which carries the recently identified gene cluster expressing the cellobiose-family phosphotransferase system (PTS-LIPI-4) between two neonates. The test results of environmental samples in the hospital indicate that strict sterilization and patient isolation measures cannot be emphasized enough in neonatal nursing.

A nosocomial scabies outbreak originating from immunocompromised transplant patients in Turkey: Upholstery as a possible cause.

Inpatients with crusted scabies represent an important source of nosocomial transmission with consequent outbreaks among patients and healthcare workers. This study aimed to report the course of an institutional scabies outbreak, which progressed with infestation of immunosuppressed transplant patients, health care workers, and caregivers. Patients diagnosed with scabies in a nosocomial outbreak in a 200-bed, tertiary hospital were included. Following a diagnosis of scabies in the index patient, strict contact isolation measures were implemented. During the outbreak, a root cause analysis (RCA) was carried out by an infection prevention and control team. Forty-two individuals were affected (7 patients, 25 health care workers, and 10 family members of the patients) during the outbreak consisting of three attacks. Index case was a multiple myeloma patient who received hematopoietic stem cell transplantation and presented with crusted scabies. A RCA suggested that upholstery could serve as a means of reservoir. All upholstery of the sofa and armchairs in patient rooms as well as in lounge areas were replaced by wipeable leather material. After the 19-week course of the outbreak, no additional cases of scabies have been observed until now. A high index of suspicion should be maintained, particularly in immunocompromised patients, in order to achieve rapid diagnosis of scabies and to implement institutional infection control measures. It should also be borne in mind that the transmission may occur through direct contact as well as fomites, such as upholstery.

Statistical analysis and autoregressive modeling of confirmed coronavirus disease 2019 epidemic cases

Based on the information about more than 800 cases reported by Anhui provincial health commission on February 19 2020, the directional transmission relationship between the confirmed patients is constructed according to the contact history published in the cases, and it is found that the majority of the patients who can infect others are male and most of the patients who are infected are female. According to the analysis of case information, the early confirmed coronavirus disease 2019 (COVID-19) cases in Anhui province had the history of residence or exposure in Wuhan. In the later stage, the cases spread in small communities mainly by local transmission, and the strict prevention and control measures can effectively cut off further transmission in the communities. The time interval between diagnosing the source-infected patients and infected patients is fitted by <i>Γ</i> distribution, with a median of 2 days and an average of 2.67 days. Based on the statistical characteristics of directional transmission relationship, an autoregressive transmission model is constructed in the late stage of epidemic development in Anhui province, and the simulation results are consistent with the epidemic development data. Autoregressive model and simulation are also used for predicting the data of confirmed cases in the whole country except for Hubei province. This discovery can be referenced by regional epidemic prevention and control except for where it originated. Through strict protection measures and isolation measures, the spread of the epidemic outside the original place is highly viscous. It usually spreads by close contact between family members, and the local spread of COVID-19 can be effectively controlled.

AOU Policlinico di Bari - West China Hospital of Sichuan University. Global experience of medical profession, battle, health, friendship against COVID -19.

Background:The global context we are experiencing, characterized by the pandemic spread of SARS-CoV2, imposes strict containment, isolation and physical distance measures, necessary to control and contain the risk of contagion. Despite social distances and isolation in this context of threat to Global Health, the sharing of experiences, professionalism, scientific research and Public Health strategies is fundamental. Never before has telemedicine played a decisive role in supporting the healthcare organization, The University Hospital Consortium Policlinico of Bari has launched an experimental partnership project with West China Hospital of Sichuan University through periodic and scheduled video conferences.Materials and Methods:The Company Strategic Management, the Dean of the Faculty of Medicine and Surgery of the University of Bari, Medical Executives of the Health Department, of the U.O of Infectious Diseases, Anesthesia and Resuscitation, Pulmonology, Emergency, Hygiene, Occupational Medicine, Psychiatry and Doctors Resident operating in the COVID Area. are involved in the Experimental Project., all adequately trained and instructed on the operating protocol.Results:From the preliminary data of this study, it appears that the Bari Polyclinic has adopted the same therapeutic strategies started in China in the previous months, believing early diagnosis and treatment to be a strength in the battle against COVID-19. The project makes it possible to make the management of COVID-19 patients optimal, safe and better, using the experience acquired in the field by Chinese doctors who, first caught by this health emergency, have obtained positive results. (www.actabiomedica.it)

Effective management of an outbreak with multiresistent Klebsiella pneumoniae in aneurorehabilitation unit

In addition to acute care hospitals, rehabilitation centres are increasingly confronted with multi-resistant pathogens. Long durations of stay and intensive treatments impose special hygienic challenges. We investigated an extended spectrum beta-lactamase-Klebsiella pneumoniae (ESBL-K.pneumoniae) outbreak in aneurorehabilitation centre. We defined confirmed cases as patients who stayed in the centre during the outbreak period and from whom ESBL-K.pneumoniae was isolated with the outbreak sequence type. Probable cases had an epidemiological link to at least one confirmed case but no isolate for typing. Next generation sequencing (NGS) was performed on 53isolates from patients. Environmental sampling was performed. Systematic microbiological screening was implemented and ESBL-K.pneumoniae-positive patients were cohorted in adesignated ward. We identified 30confirmed and 6probable cases. NGS revealed three genetic clusters: Cluster1 - the outbreak cluster - with isolates of 30cases (sequence type ST15), Cluster2 with 7patients (ST405) and Cluster3 with 8patients (ST414). In two patients, the outbreak strain developed further antibiotic resistance, one with colistin resistance and the other carbapenem resistance. The outbreak ceased after strict isolation measures. Epidemiology and NGS results paired with the effectiveness of cohorting suggest that transmission occurred mainly from person to person in this outbreak. There was an apparent association of the probability to acquire ESBL-K.pneumoniae and treatment intensity, whereas infection rate was related to morbidity. The identification of the outbreak clone and additional clusters plus the development of additional antibiotic resistance shows the relevance of NGS and highlights the need for timely and efficient outbreak management.

An Itchy Problem: A Clinical Case of Crusted Scabies.

Scabies is an infestation of the skin by the mite Sarcoptes scabiei. A more severe form called crusted or Norwegian scabies may occur in immunosuppressed patients and the elderly. Crusted scabies mostly differs from normal scabies by the exuberance of its lesions, body distribution and high contagiousness, and requires different and more prolonged treatment. Early recognition of the lesions and isolation precautions are crucial for disease control and prevention of transmission. The authors describe a clinical case of crusted scabies with pruritus and exuberant cutaneous lesions.LEARNING POINTSCrusted scabies is an infestation of the skin by the mite Sarcoptes scabiei that is highly contagious and results in an intensely pruritic eruption with exuberant cutaneous lesions.Crusted scabies occurs in patients with AIDS, lymphoma or compromised cellular immunity, and sometimes in older patients. It is characterized by an elevated burden of mites and does not have a characteristic distribution pattern.This disease requires strict isolation measures and treatment which differs from and is more prolonged than for scabies.

Tuberculosis and Migration: A Challenge for Medical Staff and Public Health.

A high number of asylum seekers enter Switzerland every year. They often originate from countries with a high TB prevalence. Our patient from Somalia presented with 2 lipoma-like tumors with pain on palpation on his left chest wall but no symptoms including coughing, fever, night-sweats, or loss of weight. CT scan then showed diffuse infiltrations of his lung and multiple abscesses on his left chest wall. Therefore contagious tuberculosis (TB) was suspected and the patient was put in isolation. In the follow-up the diagnosis of open TB was proofed with bronchial secretion and EBUS-guided biopsy that showed acid-fast rods. This particular case shows how difficult the identification of patients with open TB can be, especially if there are no respiratory or systemic symptoms. Therefore awareness of possible infectious disease is paramount for ED Doctors treating patients from countries with high prevalence. Early and strict isolation measures can help to reduce risk of contagion among staff and patients.

Strukturelle Erfordernisse für das Management von Patienten mit hochkontagiösen, lebensbedrohlichen Erkrankungen – Update 2015

ZusammenfassungDie Versorgung von Patienten mit hochkontagiösen, lebensbedrohlichen Erkrankungen (HKLE) erfordert spezialisierte Behandlungseinrichtungen, die neben einer strikten Isolierung der Erkrankten gleichzeitig eine adäquate medizinische Betreuung ermöglichen. Das in Deutschland bestehende nationale Konzept zum Management dieser hochkontagiösen, lebensbedrohlichen Erkrankungen, das durch die Zentren des „Ständigen Arbeitskreises der Kompetenz- und Behandlungszentren für hochkontagiöse und lebensbedrohliche Erkrankungen“ (STAKOB) am Robert Koch-Institut gewährleistet wird, soll durch die vorliegende Publikation, die sich auf die rezenten Erfahrungen in der Versorgung solcher Erkrankungen bezieht, an neue und kommende Erfordernisse angepasst werden. Synergien im Sinne einer systematischen Verbesserung der Infrastrukturen und einer Bündelung von Ressourcen haben zu vergleichbaren Anstrengungen auf europäischer Ebene geführt. So hat das von den Mitgliedern des STAKOB getragene Konzept eine Vorreiterfunktion. Die hier vorliegende Aktualisierung soll der verbesserten professionellen Versorgung von Patienten mit HKLE dienen und das Risiko einer Krankheitsübertragung auf Dritte weiter minimieren.

Effects of Carbapenem consumption on the prevalence of Acinetobacter infection in intensive care unit patients

BackgroundThe consumption of carbapenems has increased worldwide, together with the increase in resistant gram negative bacilli. Subsequently, the prevalence of carbapenem-resistant Acinetobacter infections has increased rapidly and become a significant problem particularly in intensive care unit patients. The aim of the present study was to evaluate the changes in the prevalence of Acinetobacter infection by restricting the consumption of carbapenems in intensive care unit patients.MethodsThis study was conducted between May 1, 2011 and February 28, 2013. The amount of carbapenem consumption and the number of patients with multi-drug resistant Acinetobacter baumannii (MDRAB) isolates during the study period were retrospectively obtained from the records of the patients, who were hospitalized in the intensive care unit. The study period was divided into two periods named as: Carbapenem non-restricted period (CNRP) and carbapenem-restricted period (CRP). During CNRP, no restrictions were made on the use of carbapenems. During CRP, the use of carbapenems was not allowed if there was an alternative to carbapenems. Primary Endpoint: MDRAB infection after ICU admission. The definition of nosocomial infections related to Acinetobacter spp. was based on the criteria of the Center for Disease Control (CDC). The correlation between the amount of carbapenem consumption and the number of infections with MDRAB strains between the two periods were evaluated.ResultsDuring the study period, a total of 1822 patients’ (1053 patients in CNRP and 769 patients in CRP) records were evaluated retrospectively. A total of 10.82 defined daily dose (DDD/100 ICU days) of anti-pseudomonal carbapenem were used in CNRP, and this figure decreased to 6.95 DDD/100 ICU days in CRP. In the 8-month CNRP, 42 (3.98%) MDRAB-related nosocomial infections were detected, and 14 (1.82%) infections were detected in CRP (p = 0.012).ConclusionThe prevalence of MDRAB strains isolated in the CNRP was 2.24-fold higher than the prevalence in the CRP. The prevalence of Acinetobacter infections can be reduced by taking strict isolation measures as well as by implementing good antibiotics usage policy.

Aeromedical Evacuation Using an Aircraft Transit Isolator of a Patient with Lassa Fever

Lassa fever is a viral hemorrhagic fever only present in West Africa. The mortality rate is 1% and may reach 15% among hospitalized patients. Transmission between humans is mostly due to direct contact with infected body fluids. Aeromedical evacuation of patients with viral hemorrhagic fevers (such as Lassa fever) demands strict isolation measures. Only a few cases of such evacuations have been reported in the literature during the last 40 yr. The use of an aircraft transit isolator device could be helpful. We report the aeromedical evacuation of a confirmed Lassa fever patient from Sierra Leone to Sweden with a dedicated air ambulance using an aircraft transit isolator. The patient was a 30-yr-old physician working for a nonprofit organization. The patient contracted the disease working with infected hospitalized patients. The duration of the mission between activation and arrival at the Swedish hospital was 36 h, which is within the World Health Organization recommendations. Evacuation of patients with potentially lethal contagious infections is possible, but only with strict isolation measures. Specific protective equipment and isolator are mandatory. Medical and technical crews performing such evacuations should be trained in proper equipment use and the isolator should first be used with a low-risk patient to create minimal risk transport conditions.

Imported Dengue Hemorrhagic Fever, Europe

Imported Dengue Hemorrhagic Fever, Europe

Imported Dengue Hemorrhagic Fever, Europe

To determine the presence of European bat lyssavirus type 1 in southern Spain, we studied 19 colonies of serotine bats (Eptesicus isabellinus), its main reservoir, during 1998-2003. Viral genome and antibodies were detected in healthy bats, which suggests subclinical infection. The different temporal patterns of circulation found in each colony indicate independent endemic circulation.