ABSTRACT
Abstract: After four months of fighting the pandemic, the city of São Paulo, Brazil, entered a phase of relaxed social distancing measures in July 2020. Simultaneously, there was a decline in the social distancing rate and a reduction in the number of cases, fatalities, and hospital bed occupancy. To understand the pandemic dynamics in the city of São Paulo, we developed a multi-agent simulation model. Surprisingly, the counter-intuitive results of the model followed the city's reality. We argue that this phenomenon could be attributed to local bubbles of protection that emerged in the absence of contagion networks. These bubbles reduced the transmission rate of the virus, causing short and temporary reductions in the epidemic curve - but manifested as an unstable equilibrium. Our hypothesis aligns with the virus spread dynamics observed thus far, without the need for ad hoc assumptions regarding the natural thresholds of collective immunity or the heterogeneity of the population's transmission rate, which may lead to erroneous predictions. Our model was designed to be user-friendly and does not require any scientific or programming expertise to generate outcomes on virus transmission in a given location. Furthermore, as an input to start our simulation model, we developed the COVID-19 Protection Index as an alternative to the Human Development Index, which measures a given territory vulnerability to the coronavirus and includes characteristics of the health system and socioeconomic development, as well as the infrastructure of the city of São Paulo.
Resumo: Após quatro meses lutando contra a pandemia, a cidade de São Paulo, Brasil, entrou em uma fase de flexibilização das medidas de distanciamento social em julho de 2020. Simultaneamente, houve queda na taxa de distanciamento social e redução no número de casos, mortes e ocupação de leitos hospitalares. Um modelo de simulação multiagente foi desenvolvido para entender a dinâmica da pandemia na cidade de São Paulo. Ao contrário do esperado, os resultados contraintuitivos do modelo acompanharam a realidade da cidade. Argumentamos que este fenômeno pode ser atribuído às bolhas locais de proteção que surgiram na ausência de redes de contágio. Estas bolhas reduziram a taxa de transmissão do vírus, causando reduções curtas e temporárias na curva epidêmica - mas se manifestaram como um equilíbrio instável. Nossa hipótese está alinhada com a dinâmica da propagação do vírus observada até o momento, sem a necessidade de suposições ad hoc sobre limiares de imunidade coletiva natural ou heterogeneidade da taxa de transmissão da população, o que pode levar a previsões errôneas. Nosso modelo foi projetado para ser fácil de usar e não requer nenhum conhecimento científico ou de programação para gerar resultados sobre a transmissão do vírus em um determinado local. Além disso, como insumo para iniciar nosso modelo de simulação, desenvolvemos o Índice de Proteção contra a COVID-19 como alternativa ao Índice de Desenvolvimento Humano, que mede a vulnerabilidade de um determinado território ao coronavírus e inclui características do sistema de saúde e do desenvolvimento socioeconômico, além da infraestrutura da cidade de São Paulo.
Resumen: Tras cuatro meses luchando contra la pandemia, la ciudad de São Paulo, Brasil, empezó una fase de flexibilización de las medidas de alejamiento social en julio de 2020. A la vez, hubo una reducción en la tasa de alejamiento social y en el número de casos, muertes y ocupación de camas en los hospitales. Se desarrolló un modelo de simulación multiagente para entender la dinámica de la pandemia en la ciudad de São Paulo. Diferente de lo esperado, los resultados contradictorios del modelo reflejaron la realidad de la ciudad. Sostenemos que se puede atribuir este fenómeno a las burbujas locales de protección que surgieron durante la ausencia de redes de contagio. Estas burbujas redujeron la tasa de transmisión del virus, reduciendo de forma corta y temporal la curva epidémica -pero se manifestaron como un equilibrio inestable. Nuestra hipótesis se alinea con la dinámica de la propagación del virus observada hasta el momento, sin la necesidad de suposiciones ad hoc sobre umbrales de inmunidad colectiva natural o heterogeneidad de la tasa de transmisión de la población, lo que puede provocar previsiones equivocadas. Nuestro modelo se proyectó para ser fácil de usar y no necesita ningún conocimiento científico o de programación para generar resultados sobre la transmisión del virus en un determinado local. Además, como insumo para iniciar nuestro modelo de simulación, desarrollamos el Índice de Protección contra la COVID-19 como una alternativa al Índice de Desarrollo Humano, que mide la vulnerabilidad de un determinado territorio al coronavirus e incluye características del sistema de salud y del desarrollo socioeconómico, además de la infraestructura de la ciudad de São Paulo.
ABSTRACT
The present work recorded the impact of using Mycoplasma gallisepticum vaccines on post-vaccinal response and protection against challenge with Newcastle disease virus. Specific pathogen-free chickens were divided into eight groups of forty chickens each. Group G1 was vaccinated with Mycoplasma gallisepticum live attenuated and Mycoplasma gallisepticum inactivated vaccines. Group G2 was vaccinated with Mycoplasma gallisepticum live attenuated, Mycoplasma gallisepticum inactivated and Newcastle disease inactivated vaccines. Group G3 was vaccinated with Mycoplasma gallisepticum live attenuated vaccine. Group G4 was vaccinated with Mycoplasma gallisepticum live attenuated and Newcastle disease inactivated vaccines. Group G5 was vaccinated with Mycoplasma gallisepticum inactivated vaccine. Group G6 was vaccinated with Mycoplasma gallisepticum inactivated and Newcastle disease inactivated vaccines. Group G7 was vaccinated with Newcastle disease inactivated vaccine. Group G8 was kept as non-vaccinated control. The Newcastle disease hemagglutination inhibition antibodies and mortality percentages were measured. Group G7 recorded the best protective Newcastle disease hemagglutination inhibition antibody titer (7 log2). Group G2 recorded a marginal satisfactory antibody titer (6 log2) after vaccination by the three tested vaccines. The remaining groups revealed unsatisfactory titers ranged from 0-5. The protection levels for G2, G4, G6 and G7 ranged from 70percent to 100percent, but only G2 and G7 were considered protected. G1, G3, G5 and G8 showed typical clinical signs of Newcastle disease. The Mycoplasma gallisepticum vaccines couldn't improve the response to Newcastle disease inactivated vaccine. The results suggest that Mycoplasma gallisepticum vaccination is immunosuppressive rather than immunomodulatory in Newcastle disease vaccination(AU)
En el presente trabajo se registró el impacto de la utilización de vacunas contra Mycoplasma gallisepticum sobre la respuesta posvacunal y la protección frente al reto con el virus de la enfermedad de Newcastle. Pollos libres de patógenos específicos se distribuyeron en ocho grupos de cuarenta pollos cada uno. El grupo G1 se vacunó con vacunas vivas atenuadas e inactivadas contra Mycoplasma gallisepticum. Al grupo G2 se le aplicaron las vacunas: viva atenuada contra Mycoplasma gallisepticum, inactivada contra Mycoplasma gallisepticum e inactivada contra la enfermedad de Newcastle. El grupo G3 se inmunizó con la vacuna viva atenuada contra Mycoplasma gallisepticum; el G4, con las vivas atenuadas contra Mycoplasma gallisepticum e inactivada contra la enfermedad de Newcastle; el G5, con la vacuna inactivada contra Mycoplasma gallisepticum; el G6 con las vacunas inactivadas contra Mycoplasma gallisepticum y la enfermedad de Newcastle; el G7, con la vacuna inactivada contra la enfermedad de Newcastle y el G8 se mantuvo como control no vacunado. Se midieron los anticuerpos de inhibición de la hemaglutinación contra el virus de la enfermedad de Newcastle y los porcentajes de mortalidad. El grupo G7 registró el mejor título de anticuerpos inhibidores de la hemaglutinación contra la enfermedad de Newcastle (7 log2). El grupo G2 registró un título de anticuerpos marginalmente satisfactorio (6 log2) tras la vacunación con las tres vacunas ensayadas. Los demás grupos revelaron títulos insatisfactorios que oscilaban entre 0 y 5. Los niveles de protección de los grupos G2, G4, G6 y G7 oscilaron entre el 70 por ciento y el 100 por ciento, pero sólo G2 y G7 se consideraron protegidos. Los grupos G1, G3, G5 y G8 mostraron signos clínicos típicos de la enfermedad de Newcastle. Las vacunas contra Mycoplasma gallisepticum no pudieron mejorar la respuesta a la vacuna inactivada contra la enfermedad de Newcastle. Los resultados revelan que la vacunación con Mycoplasma gallisepticum es más inmunosupresora que inmunomoduladora en la vacunación contra la enfermedad de Newcastle(AU)
Subject(s)
Animals , Poultry Diseases , Chickens , Virus Shedding , Food Preservation/methods , Mycoplasma Infections/mortality , Newcastle Disease/mortality , EgyptABSTRACT
BACKGROUND@#We investigated factors associated with prolonged viral clearance of SARS-CoV-2 among non-severe adult patients in Osaka, Japan. A total of 706 laboratory-confirmed COVID-19 patients were enrolled in this longitudinal observational study between 29 January 2020 and 31 May 2020, across 62 hospitals and three non-hospital recuperation facilities.@*METHODS@#Logistic regression analysis was performed to investigate the factors associated with prolonged (29 days: upper 25% in duration) viral clearance of SARS-CoV-2. Linear regression analysis was conducted to assess these factors 14 days after symptom onset.@*RESULTS@#The median duration of viral clearance was 22 days from symptom onset. After adjustment for sex, age, symptoms, comorbidity, and location of recuperation, comorbidities were associated with prolonged duration: (OR, 1.77 [95% CI, 1.11-2.82]) for one, (OR, 2.47 [95% CI, 1.32-4.61]) for two or more comorbidities. Viral clearance 14 days after symptom onset was 3 days longer for one comorbidity and 4 days longer for two or more comorbidities compared to clearance when there was no comorbidity.@*CONCLUSION@#The presence of comorbidity was a robust factor associated with a longer duration of viral clearance, extending by 3 to 4 days compared to patients with no comorbidity.
Subject(s)
Adult , Humans , COVID-19 , Japan/epidemiology , RNA, Viral , SARS-CoV-2 , Virus SheddingABSTRACT
To prevent the spread of influenza among infants and adolescents attending kindergartens and schools, proper quarantining of those who are ill is necessary. In this study, the rapid antigen test (RAT) was performed in patients to investigate the factors affecting the duration of virus shedding. The study included pediatric patients who were diagnosed with influenza by RAT at Daedong Hospital between November 2016 and April 2019. We identified the influenza subtype, age, gender, fever duration, oseltamivir medications, and time gap between fever subsided and RAT examination through chart review. A total of 330 patients were examined at discharge. The average age for RAT positive and negative patients was 6.32 ± 4.26 years and 8.47 ± 4.54 years, respectively. The average duration of fever for the RAT positive patients was 3.84 ± 1.09 days, and for those who were RAT negative was 4.191 ± 1.39. The average number of doses oseltamivir for RAT positive and negative patients was 7.68 ± 1.57 and 8.72 ± 1.37, respectively. The RAT was performed 24 to 48 hours after fever subsided (TG 24–48H group). At this time, 60 patients were positive and the rate of positive expression was 55.56%. Of the TG 48–72H group, 36 patients (26.09%) were positive. Of the TG 72–96H group, 18 patients (21.43%) were positive. Age, fever duration, number of doses oseltamivir and time gap after fever subsided were the factors that influenced the duration of influenza virus shedding. These factors should be considered during the quarantining influenza patients.
Subject(s)
Adolescent , Animals , Child , Humans , Infant , Rats , Fever , Influenza, Human , Orthomyxoviridae , Oseltamivir , Pediatrics , Virus SheddingABSTRACT
Zika is a re-emerging, mosquito-borne viral infection, which has been recently shown to cause microcephaly and Guillain-Barré syndrome. Since 2015 the number of infected patients has increased significantly in South America. The purpose of this study was to identify the epidemiologic and clinical characteristics of patients with Zika virus (ZIKV) infections in Korea. Patients who had visited areas of risk and tested positive in the ZIKV reverse transcriptase polymerase chain reaction (RT-PCR) in blood, urine, or saliva specimens were included. The first Korean case of ZIKV infection was reported in March 2016, and 14 cases had been reported by October 2016. The median age of the patients was 34 years (19–64 years). Ten patients had been exposed in Southeast Asia and 4 in Latin America. Rash was the most common symptom (92.9%; 13/14), followed by myalgia (50.0%; 7/14), and arthralgia (28.6%, 4/14). There were no neurologic abnormalities and none of the patients was pregnant. Results of biochemical tests were normal. Positivity rates of RT-PCR for ZIKV in serum, urine, and saliva were 53.8%, 100.0%, and 83.3%, respectively in the first week of symptoms. In conclusion, 14 patients with ZIKV infections were reported in Korea by October 2016 and all of them had mild clinical symptoms.
Subject(s)
Humans , Arthralgia , Asia, Southeastern , Epidemiology , Exanthema , Guillain-Barre Syndrome , Korea , Latin America , Microcephaly , Myalgia , Reverse Transcriptase Polymerase Chain Reaction , Saliva , South America , Virus Shedding , Zika VirusABSTRACT
Since Zika virus has been spreading rapidly in the Americas from 2015, the outbreak of Zika virus infection becomes a global health emergency because it can cause neurological complications and adverse fetal outcome including microcephaly. Here, we report clinical manifestations and virus isolation findings from a case of Zika virus infection imported from Brazil. The patient, 43-year-old Korean man, developed fever, myalgia, eyeball pain, and maculopapular rash, but not neurological manifestations. Zika virus was isolated from his semen, and reverse-transcriptase PCR was positive for the virus in the blood, urine, and saliva on the 7th day of the illness but was negative on the 21st day. He recovered spontaneously without any neurological complications. He is the first case of Zika virus infection in Korea imported from Brazil.
Subject(s)
Adult , Humans , Male , Brazil , Microscopy, Electron, Transmission , RNA, Viral/analysis , Republic of Korea , Reverse Transcriptase Polymerase Chain Reaction , Saliva/virology , Semen/virology , Travel , Zika Virus/genetics , Zika Virus Infection/diagnosisABSTRACT
Viral shedding lasted 31 and 19 days from symptom onset in two patients with east respiratory syndrome coronavirus (MERS-CoV) pneumonia, respectively. Environmental real-time RT-PCR was weakly positive for bed guardrail and monitors. Even after cleaning the monitors with 70% alcohol-based disinfectant, RT-PCR was still weakly positive, and converted to negative only after wiping with diluted sodium chlorite. Further studies are required to clarify the appropriate methods to clean environments during and after treatment of patients with MERS-CoV infection.
Subject(s)
Humans , Coronavirus Infections , Coronavirus , Middle East , Pneumonia , Sodium , Virus SheddingABSTRACT
This retrospective study was conducted to estimate the shedding of 2009 H1N1 virus and the risk analysis by review of medical charts, laboratory and radiological findings of all inpatients with confirmed pandemic influenza A (H1N1) at a provincial pediatric hospital. A total of 41 cases attending the inpatient department between 15 November, 2009 to 14 December, 2009 were included. Prolonged and discontinuous shedding of 2009 H1N1 virus (median, 10days; range, 2 to 24 days) were detected by real-time RT-PCR. The interval from onset of symptom to the start of oseltamivir therapy was an independent risk factor for prolonged virus shedding.
ABSTRACT
Background: National Centre for Disease Control (NCDC), Delhi, is a national nodal centre for surveillance of pandemic Influenza A (H1N1) in India. The present study was undertaken to see the period of infectivity in positive cases undergoing antiviral therapy. Objective: To assess the duration of virus shedding by real-time polymerase chain reaction (real-time PCR) in some of the positive patients taking Oseltamivir treatment. Materials and Methods: Clinical samples (throat swabs, nasal swabs and nasopharyngeal swabs) collected by the clinicians from patients quarantined in government hospitals in different parts of India are being sent to the designated reference laboratory at Delhi for screening presence of pandemic Influenza virus. The samples are tested by Real-Time PCR using CDC recommended reagents and protocol for confirmation of the H1N1 novel influenza virus. In 150 of the positive cases, we requested the clinicians to send samples for 5 consecutive days after administration of antiviral therapy, to see the trend of therapy response on viral shedding. Samples for more than 5 days were received from patients till they showed no amplification for any of the three target genes (Influenza A, Swine Influenza A or Swine H1). Results and Conclusion: In 99.33% (149/150) cases, the influenza infection resolved within 10 days. Sixty-four percent (96/150) of the positive patients turned negative within 5 days of the start of antiviral treatment. Only one patient belonging to high risk group showed prolonged virus shedding (19 days).
Subject(s)
Adolescent , Adult , Antiviral Agents/administration & dosage , Child , Child, Preschool , Female , Humans , India , Infant , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/drug therapy , Male , Middle Aged , Oseltamivir/administration & dosage , Reverse Transcriptase Polymerase Chain Reaction/methods , Time Factors , Virology/methods , Virus Shedding , Young AdultABSTRACT
Despite the intensive vaccination policy that has been put in place to control Newcastle disease virus (NDV), the recent emergence of NDV genotype VII strains in Korea has led to significant economic losses in the poultry industry. We ssessed the ability of inactivated, oil-emulsion vaccines derived from La Sota or Ulster 2C NDV strains to protect chickens from challenge with Kr-005/00, which is a recently isolated Korean epizootic genotype VII strain. Six-week-old SPF chickens were vaccinated once and challenged three weeks later via the eye drop/intranasal route. All vaccinated birds were fully protected from disease, regardless of the vaccine strains used. All vaccinated and challenged groups showed significant sero-conversion 14 days after challenge. However, some vaccinated birds, despite being protected from disease, shed the challenge virus from their oro-pharynx and cloaca, albeit at significantly lower titers than the unvaccinated challenged control birds. The virological, serological, and epidemiological significance of our observations with regard to NDV disease eradication is discussed.