Transmissible Infectious Diseases Research Articles

NEW SPHERE OF INTERDISCIPLINARY KNOWLEDGE "ONE HEALTH": SCIENTIFIC ORIENTATION AND EDUCATIONAL CONTENT

The aim of the study. Based on the analysis of the sources of scientific information, scientific and methodical approaches of the "One Health" concept, justify and develop the "One Health" certificate program for training and continuous professional development of specialists in the field of public health in order to solve complex interdisciplinary problems in the health care field. Materials and methods. The methods of system approach and system analysis, bibliosemantic, historical method, comparative analysis and conceptual modelling were used. Research results and discussion. Taking into account world experience, the joint efforts of the leading scientific and pedagogical staff of the departments of the Bogomolets National Medical University, certificate program "One Health" was created for the training and re-training of public health specialists, which consists of 5 interrelated content modules: Zooanthroponous and transmissible infectious diseases: new, traditional, imported; Food safety and one health in the "human-animal-plant-environment" system; Contribution to changes in the one health by industrial activity and environmental pollution; Climate changes on planet Earth in the context of impact on one health; The problem of resistance to antimicrobial drugs in the treatment of humans and animals and its consequences. The new educational program is aimed at preserving and strengthening the health of the population (with the joint efforts of health care systems, veterinary medicine, the State Service of Ukraine On Food Safety And Consumer Protection (SSUFSCP), the phytosanitary service and the State Environmental inspectorate of Ukraine). Conclusions. Training under the certificate program will allow students to learn the concept of "One Health", to form an understanding of the cooperation of WHO, FAO, UNEP and WOAH in the context of "human-animal-plant-environment", aimed at the integration and practical implementation of "One Health" concept on a global, regional and national levels.

Investigating socio-ecological factors influencing implementation of tuberculosis infection prevention and control in rural Papua New Guinea.

Tuberculosis (TB) is a highly transmissible infectious disease killing millions of people yearly, particularly in low-income countries. TB is most likely to be transmitted in healthcare settings with poor infection control practices. Implementing TB infection prevention and control (TB-IPC) is pivotal to preventing TB transmission in healthcare settings. This study investigated diverse stakeholders' perspectives relating to barriers and strategies for TB-IPC in rural hospitals in Papua New Guinea. Multiple qualitative case studies were conducted with 32 key stakeholders with experience in TB services. Data collection drew on three primary sources to triangulate data: semi-structured interviews, document reviews and field notes. The data were analyzed using hybrid deductive-inductive thematic analysis. Our results reveal that key stakeholders perceive multiple interdependent factors that affect TB-IPC practice. The key emerging themes include strategic planning for and prioritizing TB-IPC guidelines; governance, leadership and accountability at the provincial level; community attitudes towards TB control; institutional capacity to deliver TB care, healthcare workers' safety, and long-term partnership and integration of TB-IPC programmes into the broad IPC programme. The evidence suggests that a multi-perspective approach is crucial for TB-IPC guidelines in healthcare institutions. Interventions focusing on addressing health systems strengthening may improve the implementation of TB-IPC guidelines.

Relationship between the salivary concentrations of proteinase-3 and interleukin-8 and severe early childhood caries.

Severe early childhood caries (S-ECC) is a multifactorial transmissible infectious disease continuing to affect infants and toddlers worldwide. Saliva plays a modulatory role in the pathogenesis of dental caries. The present study aimed to assess the salivary levels of proteinase-3 (PR3) and interleukin-8 (IL-8) as pro-inflammatory cytokines related to the function of neutrophils in association with S-ECC and its treatment. Fifty children aged 36-60 months were recruited (25 caries-free controls and 25 S-ECC patients). Saliva sampling was performed in all participants. In the S-ECC group, sampling was repeated 6-8 weeks after restorative treatment. The salivary concentrations of PR3 and IL-8 were determined using the enzyme-linked immunosorbent assay (ELISA). The χ2 test, Fisher's exact test, the independent t test, and the paired t test were applied at p < 0.05. The baseline salivary concentrations of PR3 and IL-8 in the S-ECC group were significantly higher than in the caries-free group (p < 0.001). A significant reduction occurred in the levels of these cytokines following restorative treatment in the S-ECC group (p < 0.001), although they were still significantly higher than in the caries-free group (p < 0.05). The salivary levels of PR3 and IL-8 were significantly affected by the presence of dental caries in children, implying their potential efficiency as non-invasive indicators in the determination of the caries risk and treatment effectiveness.

881. Saliva-Based, Extraction-Free PCR Testing For The Detection Of Key Respiratory Pathogens

Abstract Background Efforts to control and monitor transmissible infectious diseases rely on large-scale screening often impaired by logistically difficult or invasive sample collection. The use of saliva as a non-invasive sample type could alleviate bottlenecks encountered in mass testing strategies. Having extensively demonstrated saliva as a sensitive sample type for SARS-CoV-2 detection, we sought to validate the approach for other common upper respiratory tract pathogens. Methods We modified our RNA-extraction-free SARS-CoV-2 PCR test for multiplexed detection of four additional respiratory viruses (“SalivaDirect+”): influenza A/B, RSV, and hMPV, and singleplex detection of pneumococcus. Stability of detection was tested after storage of saliva from pathogen-positive patients at +4°C, room temperature (∼19°C) and 30°C for 72 hours. De-identified saliva samples were collected from consenting adults ≥ 18 years of age with respiratory symptoms, requiring nasopharyngeal-swab based SARS-CoV-2 testing at Yale Health, New Haven, CT, USA. Saliva samples from individuals testing nasopharyngeal-swab negative for SARS-CoV-2 at the clinical laboratory were stored at -80°C until further processing in the research laboratory. Results We confirmed the limit of assay detection at 4 copies/µl for each target. We confirmed pathogen detection remained stable at +4°C, room temperature and 30°C for up to 72 hours. From the symptomatic testing site, 804 nasopharyngeal swabs tested negative for SARS-CoV-2; their paired saliva samples were tested with the SalivaDirect+ assay. Of those, 17 (2.1%) tested positive for one of the viruses targeted (influenza A, n=7; RSV, n=4; hMPV, n=6). No samples tested positive for influenza B. For influenza A and RSV, detection by SalivaDirect+ was comparable to testing following RNA extraction but detection of hMPV was less sensitive, even following assay modifications. In singleplex testing, 87 (10.8%) samples tested positive for pneumococcus. Conclusion We expanded a low-cost, open-source saliva-based PCR test for detection of other common respiratory pathogens. By testing saliva samples from symptomatic, SARS-CoV-2-negative adults, we detected common respiratory viruses which were otherwise missed in testing focused solely on SARS-CoV-2. Disclosures Anne L. Wyllie, PhD, Co-Diagnostics: Board Member|Merck: Grant/Research Support|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support

Features of the immune response in early period of ixodid tick-borne borreliosis

Lyme borreliosis is a group of transmissible infectious diseases that are similar in etiology, but diverse in clinical manifestations. The development of Lyme disease symptoms is due not only to the activity of the pathogen itself, but also to the result of its interaction with immune system of macroorganism. The first line of defense, represented by a variety of cellular and humoral components of innate immunity, is most rapidly involved in immune response, and it is it that seeks to limit dissemination of the causative agent from the initial site of infection. However, a wide range of protective surface proteins of Borrelia and a number of other structures aimed at avoiding immune mechanisms prevent the destruction of the pathogen. Not the last place in this dynamic process is occupied by ixodid ticks themselves, since the secret of their salivary glands has an inhibitory effect on a number of cells and complement system. In parallel with innate immunity, adaptive immune response factors are activated, serving as a second line of defense. The synthesis of specific antibodies in the early period of Lyme disease has its own ambiguous features, but this does not exclude their importance in fight against borreliosis infection. To date, the issues of interaction with dendritic cells and cytotoxic T-lymphocytes remain less studied. Research of all aspects, including little-studied ones, is extremely important for both practical healthcare and fundamental medicine.

Mitigating the effects of climate change on human health with vaccines and vaccinations.

Climate change represents an unprecedented threat to humanity and will be the ultimate challenge of the 21st century. As a public health consequence, the World Health Organization estimates an additional 250,000 deaths annually by 2030, with resource-poor countries being predominantly affected. Although climate change's direct and indirect consequences on human health are manifold and far from fully explored, a growing body of evidence demonstrates its potential to exacerbate the frequency and spread of transmissible infectious diseases. Effective, high-impact mitigation measures are critical in combating this global crisis. While vaccines and vaccination are among the most cost-effective public health interventions, they have yet to be established as a major strategy in climate change-related health effect mitigation. In this narrative review, we synthesize the available evidence on the effect of climate change on vaccine-preventable diseases. This review examines the direct effect of climate change on water-related diseases such as cholera and other enteropathogens, helminthic infections and leptospirosis. It also explores the effects of rising temperatures on vector-borne diseases like dengue, chikungunya, and malaria, as well as the impact of temperature and humidity on airborne diseases like influenza and respiratory syncytial virus infection. Recent advances in global vaccine development facilitate the use of vaccines and vaccination as a mitigation strategy in the agenda against climate change consequences. A focused evaluation of vaccine research and development, funding, and distribution related to climate change is required.

Practical Considerations in Hospital Infection Prevention

Inpatient infection prevention practices vary widely between health care institutions, on a national and international scale. Transmissible infectious diseases pose a risk to vulnerable inpatient populations as well as hospital staff and visitors. Maintaining a high index of suspicion, along with early identification and prompt isolation procedures of patients with these conditions can greatly reduce the likelihood of transmission. We review the presenting features and recommended infection prevention practices for six transmissible infectious diseases known to pose risks to patients, staff and visitors: scabies, tuberculosis, respiratory viruses, varicella zoster virus, Clostridioides difficile, and syphilis.

Transmission and lesion progression of treponeme-associated hoof disease in captive elk (Cervus canadensis).

Treponeme-associated hoof disease (TAHD) is a debilitating disease of free-ranging elk (Cervus canadensis) in the northwestern U.S. While treponemes are associated with lesions, the etiology and transmissibility between elk are unknown. Our objective was to determine whether the disease can be environmentally transmitted to captive elk. Four individually housed treatment elk and 2 control elk were challenged with soil mixed with inoculum prepared from free-ranging elk hooves from TAHD-positive elk or autoclaved hooves from normal elk, respectively. The inoculum for each group was applied to the interdigital space and added to pre-existing soil in each pen. Eight challenges were conducted at 1-4-week intervals and lesion development was assessed during a 138-day challenge period that was followed by a 170-day monitoring period to document lesion progression. All treatment elk, but no control elk, developed gross and histologic lesions consistent with TAHD. Treponema phylotypes similar to those in bovine digital dermatitis in cattle were detected using 16S rRNA gene amplicon sequencing from lesions in all treatment elk, but no control elk, during the challenge period. Lesions progressed from ulcerations in the interdigital space to extensive ulceration and underrunning of the hoof capsule by 35 and 173 days following the initial inoculation, respectively. Lameness in treatment elk was correlated with lesion development (R = 0.702, p≤0.001), and activity of infected elk was reduced during the challenge (p≤0.001) and monitoring periods (p = 0.004). Body condition was significantly lower in treatment than control elk 168 days following the initial inoculation (p = 0.05) and at each individual elk's study endpoint (p = 0.006). Three of 4 treatment elk were euthanized when they reached humane endpoints, and one elk recovered. These results provide direct evidence that TAHD is a transmissible infectious disease in elk. As such, actions that reduce transmission risk can support disease management and prevention.

Classification of COVID-19 X-ray images using transfer learning with visual geometrical groups and novel sequential convolutional neural networks

COVID-19 is a highly transmissible infectious disease that remains a substantial challenge. The utilization of chest radiology, particularly X-ray imaging, has proven to be highly effective, easily accessible, and cost-efficient in detecting COVID-19. A dataset named COVID-Xray-5k, consisting of imbalanced X-ray images of COVID-19-positive and normal subjects, is employed for investigation. The research introduces a novel methodology that utilizes conventional machine learning (ML), such as local binary patterns (LBP) for feature extraction and support vector machines (SVM) for classification. In addition, transfer learning is employed with the Visual Geometry Group 16-layer (VGG16) and 19-layer (VGG19) models. Besides, novel sequential convolutional neural network (CNN) architectures are presented to develop an autonomous system for classifying COVID-19. One of the proposed CNN architectures classifies the test dataset with an F1 score of 91.00% and an accuracy of 99.45% based on an empirical investigation to determine optimal hyper-parameters. The methods presented in the research show promising potential for COVID-19 classification, irrespective of class imbalance.•Employment of ML models to investigate subjective feature engineering and classification.•Transfer learning was employed for VGG16 and VGG19 with eight distinct models.•Illustration of two novel CNN sequential architectures; all the investigation is performed with and without weighted sampling.

Mumps epidemic dynamics in the United States before vaccination (1923–1932)

Mumps is a vaccine-preventable, reemerging, and highly transmissible infectious disease. Widespread vaccination dramatically reduced cases; however, case counts have been increasing over the past 20 years. To provide a quantitative overview of historical mumps dynamics that can act as baseline information to help identify causes of mumps reemergence, we analyzed timeseries of cases reported from 1923 to 1932 in the United States. During that time, 239,230 mumps cases were reported in 70 cities. Larger cities reported annual epidemics and smaller cities reported intermittent, sporadic outbreaks. The critical community size above which transmission continuously occurred was likely between 365,583 and 781,188 individuals but could range as high as 3,376,438 individuals. Mumps cases increased as city size increased, suggesting density-dependent transmission. Using a density-dependent SEIR model, we calculated a mean effective reproductive number (Re) of 1.2. Re varied by city and over time, with periodic high values that could characterize short periods of very high transmission known as superspreading events. Case counts most often peaked in March, with higher-than-average transmission from December through April and showed a correlation with weekly births. While certain city pairs in Midwestern states had synchronous outbreaks, most outbreaks were less synchronous and not driven by distance between cities. This work demonstrates the importance of long-term infectious disease surveillance data and will inform future studies on mumps reemergence and control.

Impact of the First Year of the COVID-19 Pandemic on Pediatric Emergency Department Attendance in a Tertiary Center in South Italy: An Interrupted Time-Series Analysis.

The evidence shows a reduction in pediatric emergency department (PED) flows during the early stages of the COVID-19 pandemic. Using interrupted time-series analysis, we evaluated the impact of different stages of the pandemic response on overall and cause-specific PED attendance at a tertiary hospital in south Italy. Our methods included evaluations of total visits, hospitalizations, accesses for critical illnesses and four etiological categories (transmissible and non-transmissible infectious diseases, trauma and mental-health) during March-December 2020, which were compared with analogous intervals from 2016 to 2019; the pandemic period was divided into three segments: the "first lockdown" (FL, 9 March-3 May), the "post-lockdown" (PL, 4 May-6 November) and the "second lockdown" (SL, 7 November-31 December). Our results showed that attendance dropped by a mean of 50.09% during the pandemic stages, while hospitalizations increased. Critical illnesses decreased during FL (incidence rate ratio -IRR- 0.37, 95% CI 0.13, 0.88) e SL (IRR 0.09, 95% CI 0.01, 0.74) and transmissible disease related visits reduced more markedly and persistently (FL: IRR 0.18, 95% CI 0.14, 0.24; PL: IRR 0.20, 95% CI 0.13, 0.31, SL: IRR 0.17, 95% CI 0.10, 0.29). Non-infectious diseases returned to pre-COVID-19 pandemic levels by PL. We concluded that that the results highlight the specific effect of the late 2020 containment measures on transmissible infectious diseases and their burden on pediatric emergency resources. This evidence can inform resource allocation and interventions to mitigate the impact of infectious diseases on pediatric populations and the health-care system.

Prevalence of Transmissible Infectious Diseases among Healthy Blood Donors in Faisalabad, Pakistan

Blood transfusions are necessary due to the increased incidence of blood diseases and an increase in automobile accidents. In healthcare systems with limited resources, the provision of safe blood products is hampered by transfusion-transmitted diseases (TTIs), such as the hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), syphilis, and malaria. Objective: To determine how common TTIs are among blood donors in Faisalabad. Methods: Immuno-chromatographic technique (ICT) kits and thick film (malaria) screening were used to test donors for HBV, HCV, HIV, syphilis, and malaria. Results: Among 1500 donors, prevalence of HCV was highest (n=106), followed by HBV (n=42), syphilis (n=11), and malaria (n=3). One positive case was reported as HIV. Between the ages of 21 and 40, donors who tested positive were more prevalent. Conclusions: By more carefully evaluating and screening each donor before selecting them for blood donation, safe blood transfusions can both increase recipient safety and reduce the spread of TTIs.

Epidemiological and Clinical Features of Leprosy Reactions and Associated Risk Factors in Malagasy People from 2012 to 2021

<i>Introduction</i>: Leprosy is a transmissible infectious disease while cutaneous and neurological manifestations vary according to the patient's immunity. It is a chronic disease with acute immunological complication called leprosy reactions. Leprosy remains endemic in Madagascar. The objective of this study is to characterize the epidemiological and clinical profile of leprosy and leprosy reactions and to determine the risk factors for leprosy reactions. <i>Methods</i>: This was a retrospective, case-control study over a period of 10 years from January 2012 to December 2021 conducted among leprosy patients of the University Hospital Joseph Raseta Befelatanana. Univariate and multivariate logistic regression was used to determine the risk factors for leprosy reactions. <i>Results:</i> Of the 161 patients selected, 53 patients had a leprosy reaction. There were 91 males and 70 females with a mean age of 35.8 years (±15,47). The borderline lepromatous type was the most common clinical form. The prevalence of lepromatous reaction was 33%. Type 1 and type 2 reactions were found in 41.50% and 45.28% of cases respectively. The average time to develop leprosy reactions after the initiation of multidrug therapy was 5.80 months (±3.91). From multivariate analysis, the risk factors identified were: male gender [OR=2.64 (95% CI: 1.80-9.57), p=0.02], positive BI [OR=3.53 (95% CI: 2.41-48.98), p=0.02], MB treatment regimen [OR=8.87 (95% CI: 1.23-3.57), p=0.008)], and poor adherence to treatment [OR=1.97 (95% CI: 1.34-12.95), p=0.0354]. <i>Conclusion: </i>The knowledge of these risk factors allows for early diagnosis and treatment of leprosy reactions to prevent the morbidities due to leprae disease such as amputations and disabilities that are a source of stigma.

Science-Informed Health Policies for Oral and Systemic Health.

Oral, dental and craniofacial (ODC) health has a profound impact on general health and welfare throughout life, yet US dentists and physicians operate across misaligned silos. This protracted division limits access to optimal health, supports fee for services, and exacerbates health disparities. Early in the 20th century, the most frequent dental therapy was tooth extraction: removed infected teeth were substituted by prosthetic appliances - commonly, dentures or nothing. Most adults assumed becoming edentulous was a normal corollary of aging. With the discovery of penicillin and other antibiotics, healthcare professionals and policy makers predicted infectious diseases would become irrelevant. However, given numerous health threats, including SARS-CoV-2, HIV, multidrug-resistant bacteria, Zika virus, Ebola virus, and now monkeypox, public and professional awareness of transmissible infectious diseases has never been more evident. Ironically, little attention has been paid to unmet transmissible, infectious, common oral diseases - dental caries and periodontal diseases. Therefore, these persist within "the silent and invisible epidemic". The preventable death of a young boy in 2007 from an infected untreated tooth that produced bacterial meningitis is a profound reminder that our nation has vast inequities in education, health, and welfare. The impact of oral infections on hospital-acquired pneumonia, post-operative infection in cardiac valve surgery, and even academic performances of disadvantaged children displayed through sociodemographic characteristics and access to care determinants also are profound! This paper asserts that current and emerging ODC health knowledge and science will inform health policies and advance equity in access to care, affordable costs, and optimal healthcare outcomes. We recommend that legal and regulatory systems and public health programs be required to ensure health equity. A fair healthcare system that addresses holistic healthcare must be transparent, accessible, integrated and provide a standard of oral healthcare based upon scientific evidence for all people across the lifespan.

FREQUENCY OF TRANSFUSION-TRANSMISSIBLE INFECTIOUS DISEASES AMONG BLOOD DONORS AT AKHTER SAEED TRUST HOSPITAL LAHORE, PAKISTAN

Background: Blood transfusion is an essential lifesaving treatment. The unsafe blood transfusion practices are one of the reasons of spreading transfusion-transmissible infections among individuals. It is necessary to screen the all donated blood units for HBV, HCV, HIV, VDRL, and MP.&#x0D; Aims: This aim of this study was to evaluate the burden of transfusion-transmissible infectious diseases caused by blood transfusions among donors.&#x0D; Materials &amp; Methodology: It was a prospective observational study which included the 9114 blood donors who attended the Akhtar Saeed Trust Hospital Lahore from January 2020 to September 2022. The informed consent was taken from all blood donors. 3-5 ml of venous sample was drawn by using aseptic technique from blood donors on enrollment. Screening of blood donors was done by Chemiluminescence immunoassay (Maglumi-800) for HBV, HCV, HIV and VDRL. The MP was confirmed by peripheral blood picture on slide. According to the automation kit manufacturer’s guidelines, cut-off value for reporting positive results of HBV, HCV, HIV and VDRL was calculated. Data was analyzed by using SPSS version 25.0.&#x0D; Results: The mean age was 27.79 + 12.1 years. The numbers of volunteer and replacement donors were 961 (10.54%) and 8153 (89.45%) respectively. The total numbers of positive donors for transfusion transmissible infectious diseases were 591/9114 (6.49%). The seropositivity was found to be 170/9114 (1.86%) for HBV, 324/9114 (3.55%) for HCV, 33/9114 (0.36%) for HIV, 64/9114 (0.70%) for VDRL, and 0/9114 (0.0%) for MP respectively.&#x0D; Conclusion: There is currently a low risk of transfusion transmissible infectious diseases but the availability of safe blood is contingent on screening tests and appropriate donor selection.&#x0D; &#x0D;

Análisis de la salud de la población sin hogar de un distrito desfavorecido de Barcelona. Estudio ESSELLA

ObjectiveTo assess the health status of the homeless population. DesignCross-sectional descriptive study. SettingRaval Sud Primary Care Health Center (Barcelona). ParticipantsHomeless legal age people who have slept rough at some point in their lives. Main measurementsSociodemographic data and time in a situation of homelessness. Chronic pathologies, transmissible infectious diseases, mental illnesses and substance use disorders. HAD questionnaire on anxiety and depression. CVRS EQ-5D-3L questionnaire. Descriptive statistics. ResultsThe information of 146 patients with a mean age of 51.6 years (SD=12.8), 87% male and a mean of 12 years (SD=11.9) in a situation of homelessness was analyzed. The burden of disease was compared between the CAS profile (Drug addiction center – Baluard) and the socio-sanitary profile (Arrels Foundation). CAS users presented higher percentages of substance use disorders, mental illnesses and transmissible infectious diseases. People with a socio-health profile presented a higher percentage of chronic diseases (respiratory, cardiovascular and oncological) and more than half presented an alcohol use disorder and a higher percentage of disease associated with its consumption. ConclusionsThe homeless population presents a high burden of disease, especially for mental illness, addictions and transmissible infectious diseases. We believe that studies are necessary to evaluate the disease excess compared to the general population with its derived costs and to design new strategies to address this burden of disease and its specificity.

Bilateral Orbital Tuberculosis with Unilateral Severe Irrversible Vision Loss in Children: A Case Report

Introduction: Tuberculosis is a transmissible infectious disease caused by mycobacterium tuberculosis. Ocular tuberculosis is rare representing between 1% to 18% of all forms of tuberculosis and only 0.3% of patients develop the orbital form. The focus is usually unilateral, we report through this observation a case of bilateral orbital tuberculosis in a 12 year old girl. Observation: A 12-year-old girl was admitted to the department of infectious and tropical diseases of the National Hospital of Zinder for long term fever and violent headache. The ophthalmological examination revealed a visual acuity of 1/10 on the right, absence of light perception on the left and bilateral exophthalmos. Biomicroscopic examination showed superficial punctate keratitis bilaterally, a normal fundus on the right and left atrophy. In view of the long-lasting fever and the biological inflammatory syndrome, the diagnosis of tuberculosis was evoked. The tuberculin intradermal test (IDR) was positive and the search for BK in the bronchial lavage revealed BAARs. HIV serology was negative. The standard chest X-ray was normal but the CT scan of the orbito- cerebral cavity showed two cystic foci with grade III exophthalmos. After 3 months of anticillary treatment the evolution was considered satisfactory. Conclusion: The orbital involvement of tuberculosis was generally unilateral, its bilateral localization is unusual. It must be systematically evoked in front of any case of bilateral exophthalmos especially in an infectious context in order to avoid irrevesible vsion loss.

Identifying spatiotemporal patterns of COVID-19 transmissions and the drivers of the patterns in Toronto: a Bayesian hierarchical spatiotemporal modelling

Spatiotemporal patterns and trends of COVID-19 at a local spatial scale using Bayesian approaches are hardly observed in literature. Also, studies rarely use satellite-derived long time-series data on the environment to predict COVID-19 risk at a spatial scale. In this study, we modelled the COVID-19 pandemic risk using a Bayesian hierarchical spatiotemporal model that incorporates satellite-derived remote sensing data on land surface temperature (LST) from January 2020 to October 2021 (89 weeks) and several socioeconomic covariates of the 140 neighbourhoods in Toronto. The spatial patterns of risk were heterogeneous in space with multiple high-risk neighbourhoods in Western and Southern Toronto. Higher risk was observed during Spring 2021. The spatiotemporal risk patterns identified 60% of neighbourhoods had a stable, 37% had an increasing, and 2% had a decreasing trend over the study period. LST was positively, and higher education was negatively associated with the COVID-19 incidence. We believe the use of Bayesian spatial modelling and the remote sensing technologies in this study provided a strong versatility and strengthened our analysis in identifying the spatial risk of COVID-19. The findings would help in prevention planning, and the framework of this study may be replicated in other highly transmissible infectious diseases.

How do I implement an outpatient program for the administration of convalescent plasma for COVID-19?

Convalescent plasma, collected from donors who have recovered from a pathogen of interest, has been used to treat infectious diseases, particularly in times of outbreak, when alternative therapies were unavailable. The COVID‐19 pandemic revived interest in the use of convalescent plasma. Large observational studies and clinical trials that were executed during the pandemic provided insight into how to use convalescent plasma, whereby high levels of antibodies against the pathogen of interest and administration early within the time course of the disease are critical for optimal therapeutic effect. Several studies have shown outpatient administration of COVID‐19 convalescent plasma (CCP) to be both safe and effective, preventing clinical progression in patients when administered within the first week of COVID‐19. The United States Food and Drug Administration expanded its emergency use authorization (EUA) to allow for the administration of CCP in an outpatient setting in December 2021, at least for immunocompromised patients or those on immunosuppressive therapy. Outpatient transfusion of CCP and infusion of monoclonal antibody therapies for a highly transmissible infectious disease introduces nuanced challenges related to infection prevention. Drawing on our experiences with the clinical and research use of CCP, we describe the logistical considerations and workflow spanning procurement of qualified products, infrastructure, staffing, transfusion, and associated management of adverse events. The purpose of this description is to facilitate the efforts of others intent on establishing outpatient transfusion programs for CCP and other antibody‐based therapies.

Vestibular Cochlear Manifestations in COVID-19 Cases.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a high transmissible infectious disease that primarily impacts the respiratory system and leads to death as it worsens. Ever since the World Health Organization declared the disease as a global pandemic, the pathophysiology, clinical manifestations, and disease prognosis has been discussed in various literature. In addition to impaired respiratory health, the symptoms also indicated the involvement of the cardiovascular and neurological system after SARS-CoV-2 infection. Despite the pulmonary, cardiovascular, and neurological complications, many reports also revealed the prevalence of vestibulocochlear symptoms like dizziness, vertigo, vestibular neuritis, sudden sensorineural hearing loss, and tinnitus. Though many clinical reports and scientific reviews reported the vestibular and cochlear impairments associated with coronavirus disease 2019 (COVID-19) infection, the underlying pathological mechanisms are still unclear and unexplored. In this review, we discussed the published clinical reports, research articles, and literature reviews related to vestibulocochlear manifestations following SARS-CoV-2 infections. We also summarized the current knowledge about the prevalence, epidemiological and clinical features, and potential pathological mechanisms related to vestibular and cochlear manifestations resulting from COVID-19 infections.