Eliminating Viral Hepatitis in Turkey: Achievements and Challenges

After the declaration Global Health Sector Strategy on Viral Hepatitis by the World Health Organization in 2016, the Turkish Government defined a national strategy covering 2018-2023 to reach goals by 2030. Following a participatory decision process and a series of workshops, the strategy was built on eight separate subheadings. Apart from the official Prevention and Control Program, two separate road maps for hepatitis B and C were developed to obtain targets accessible with the cooperation of the Viral Hepatitis Society and the Turkish Association for the Study of the Liver in 2018 and 2020, respectively. Up to 2023, achievements and the current situation of the National Viral Hepatitis Prevention and Control Program and the hepatitis B virus and hepatitis C virus road maps were assessed in detail on June 28th, 2022, by the subject matter experts in Turkey. Besides the officially reported achievement rate (42%) of the Program in 2021, participants mentioned undesirable effects of the coronavirus disease-2019 pandemic, unregulated migration, low levels of professional and public awareness, and barriers to access to anti-viral treatment. Recommendations focused on increasing the efficiency of screening and surveillance by integrating the viral carrier identity of individuals into the national health information system, simplifying the drug supplement and treatment initiation process and insisting on education to raise awareness.

The Bad Bug is Back: Acinetobacter Baumannii Bacteremia Outbreak during the COVID-19 Pandemic in an Intensive Care Unit.

Background: Epidemiology of nosocomial infections may show variability because of under-estimation of infection control measures (ICMs) in coronavirus disease 19 (COVID-19) outbreak. Aim: To investigate the Acinetobacter bacteremia outbreak developed in an intensive care unit (ICU) between March 20 to May 15, 2020, examine the risk factors, and re-evaluate ICM retrospectively. Material and Methods: A retrospective cohort analysis was conducted to determine the risk factors, pulsed field gel electrophoresis (PFGE) was performed for analysis of the outbreak, ICM practices were observed by a team, and infection control interventions were undertaken. Results: Acinetobacter bacteremia developed in 17 patients (21.5%) within 79 COVID-19 patients included in the study. The mean age of the bacteremic patients was 67.3 (SD = 14.82) years, and 82.4% of them were male; of these, 15 died, leading to 88.2% mortality. The bacteremia rate was higher compared with a 14-month period preceding the COVID-19 pandemic (17/79 versus 12/580 patients, respectively). PFGE revealed that the outbreak was polyclonal. On multi-variate analysis, the bacteremia development rate was 13.7 and 5.06 times higher with central venous catheter (CVC) use and in patients with chronic obstructive pulmonary disease (COPD), respectively. The mortality rate was higher in bacteremic patients (p = 0.0016). It was observed that ICMs were not followed completely, especially change of gloves and hand hygiene. Contamination of A. baumannii was observed in 38% of the gloves. Conclusion: COPD and CVC use were determined as risk factors for Acinetobacter bacteremia development, and failures in ICM may have led to cross-contamination of endemic A. baumannii. The outbreak could be controlled within 3 weeks of interventions.

THE EFFICACY OF LUCILIA SERICATA LARVAE SECRETION AGAINST SARS-COV-2: A QUANTITATIVE PCR STUDY

Background: The lack of information about the novel coronavirus (SARS-CoV-2) makes it difficult to fight against it. The research about potential molecules that can be used to treat the SARS-CoV-2 continues all over the world. This study aimed to make a preliminary research on the possible effects of Lucilia sericata (L. sericata) larval secretion on the SARS-CoV-2, which has been used to treat chronic or infected wounds and shown to have antiviral effects. Methods: L. sericata larval secretion was applied to the pharyngeal swab samples of the SARS-CoV-2 positive patients, and the specimens were analyzed with the quantitative PCR method. The average Relative Fluorescence Unit (RFU) and Cycle Threshold (Ct) values were compared to the control group of positive specimens from the same patients without the application of larval secretion. Results: SARS-CoV-2 remained positive in the samples of the control group, while all samples in the experimental group were found to be negative. The difference between the average RFU and Ct values were found statistically significant (Control group: 752, Larvae group: 0) indicating that L. sericata larval secretion caused the lysis of SARS-CoV-2 and its RNA molecules. Conclusion: Revealing the antiviral effect of L. sericata larval secretion on SARS-CoV-2 can provide a basis for conducting further cell-culture studies, which might lead to developing an inexpensive substance that can help to fight against SARS-CoV-2.

Diagnosis of COVID-19

The pandemic that emerged at the beginning of this year spread rapidly all over the world. The most effective way to combat such a large-scale epidemic is to quickly diagnose infected individuals and take necessary isolation measures. Although rapid antigen tests used in the first stage in the diagnosis of COVID-19, they have quickly left their places to molecular-based real-time PCR tests due to sensitivity problems. Antibody response based diagnosis can be problematic because those found can become detectable as early as 2 weeks after the onset of infection, which is not a suitable acquisition for the diagnosis of acute infection. In this article, applications and methods used for the diagnosis of COVID-19, will be discussed. © 2021 Nova Science Publishers, Inc.

Clinical aspect of COVID-19

COVID-19, named by the World Health Organization in February 2020, is an infectious and fatal disease that first started in China in December 2019 by the determination of pneumonia cases secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been rapidly spreading all over the world since then. Although COVID-19 was first thought to be a disease manifested only by respiratory symptoms at the beginning of the outbreak, we learned in time that it is a disease that can develop symptoms in a wide spectrum from asymptomatic infection to cardiovascular complications. Experience in the diagnosis, clinical characteristics and treatment of COVID-19 has been accumulating in the time since it is a new disease. The severity of the disease might be variable according to the viral load received and the immune response of the individual. The frequency of asymptomatic disease is substantially high. The most commonly seen complaints in symptomatic disease are fever, cough, fatigue, and myalgia, while nausea, vomiting, and loss of taste and smell can also be seen. The longer the duration of the symptoms, the higher is the risk of developing a more severe disease necessitating hospital admission and intensive care, and invasive ventilation. Solid knowledge of clinical symptoms and diagnostic tests is important since early diagnosis may prevent the spread and intensification of the disease. © 2021 Nova Science Publishers, Inc.