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1.
mSphere ; 6(1)2021 02 17.
Article in English | MEDLINE | ID: covidwho-1088203

ABSTRACT

Many viruses, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and human immunodeficiency virus (HIV), have a structure consisting of spikes protruding from an underlying spherical surface. Research in biological and colloidal sciences has revealed secrets of why spikes exist on virus surfaces. Specifically, the spikes favor virus attachment on surfaces via receptor-specific interactions (RSIs), mediate the membrane fusion, and determine or change viral tropism. The spikes also facilitate viruses to approach surfaces before attachment and subsequently escape back to the environment if RSIs do not occur (i.e., easy come and easy go). Therefore, virus spikes create the paradox of having a large capacity for binding with cells (high infectivity) and meanwhile great mobility in the environment. Such structure-function relationships have important implications for the fabrication of virus-like particles and analogous colloids (e.g., hedgehog- and raspberry-like particles) for applications such as the development of antiviral vaccines and drug delivery.


Subject(s)
/transmission , /pathogenicity , Spike Glycoprotein, Coronavirus/metabolism , Animals , HIV/metabolism , HIV/pathogenicity , HIV Infections/transmission , Humans , Viral Proteins/metabolism , Viral Tropism/physiology , Virus Internalization
2.
Curr Opin Infect Dis ; 34(1): 56-61, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-1087868

ABSTRACT

PURPOSE OF REVIEW: This review considers the potential and demonstrated impacts of SARS-CoV-2 on the sexually transmissible infection (STI)/HIV transmission. RECENT FINDINGS: COVID-19 increases the vulnerability of those at highest risk of acquiring STI/HIV. Altered health-seeking behaviour, reductions in STI/HIV clinic capacity, service disruptions and redeployment of human resources to assist COVID-19 control efforts have impacted on STI/HIV control programmes. Reports of reduced STI incidence are emerging, but it is hard to determine whether this is real or due to decreased testing during COVID-19 lockdown periods. Fear of COVID-19 and implemented control measures have altered STI/HIV transmission dynamics. Sexual health services adapted to the pandemic by reducing face-to-face patient encounters in favour of telehealth and mail-based initiatives as well as more stringent triage practice. Many sexual health and HIV treatment services now operate at reduced capacity and experience ongoing service disruptions, which necessarily translates into poorer outcomes for patients and their communities. SUMMARY: In the short-term, COVID-19 related sexual behaviour change is driving STI/HIV transmission downwards. However, the impacts of the global COVID-19 response on sexual health-seeking behaviour and STI/HIV services threaten to drive STI/HIV transmission upwards. Ultimately, the expected rebound in STI/HIV incidence will require an appropriate and timely public health response. VIDEO ABSTRACT: http://links.lww.com/COID/A31.


Subject(s)
/epidemiology , HIV Infections/epidemiology , Sexually Transmitted Diseases/epidemiology , HIV Infections/transmission , Humans , Incidence , Sexual Behavior , Sexual Health , Sexual Partners , Sexually Transmitted Diseases/transmission
3.
Vet Res ; 52(1): 22, 2021 Feb 15.
Article in English | MEDLINE | ID: covidwho-1085161

ABSTRACT

COVID-19 is a zoonotic disease caused by SARS-CoV-2. Infections of animals with SARS-CoV-2 have recently been reported, and an increase of severe lung pathologies in domestic dogs has also been detected by veterinarians in Spain. Therefore, further descriptions of the pathological processes in those animals that show symptoms similar to those described in humans affected by COVID-19 would be highly valuable. The potential for companion animals to contribute to the continued transmission and community spread of this known human-to-human disease is an urgent issue to be considered. Forty animals with pulmonary pathologies were studied by chest X-ray, ultrasound analysis, and computed tomography. Nasopharyngeal and rectal swabs were analyzed to detect canine pathogens, including SARS-CoV-2. An additional twenty healthy dogs living in SARS-CoV-2-positive households were included. Immunoglobulin detection by several immunoassays was performed. Our findings show that sick dogs presented severe alveolar or interstitial patterns with pulmonary opacity, parenchymal abnormalities, and bilateral lesions. The forty sick dogs were negative for SARS-CoV-2 but Mycoplasma spp. was detected in 26 of 33 dogs. Five healthy and one pathological dog presented IgG against SARS-CoV-2. Here we report that despite detecting dogs with α-SARS-CoV-2 IgG, we never obtained a positive RT-qPCR for SARS-SoV-2, not even in dogs with severe pulmonary disease; suggesting that even in the case of canine infection, transmission would be unlikely. Moreover, dogs living in COVID-19-positive households could have been more highly exposed to infection with SARS-CoV-2.


Subject(s)
/veterinary , Dog Diseases/transmission , Immunoglobulins/blood , Zoonoses/transmission , Animals , /virology , Dog Diseases/virology , Dogs , Female , Immunity, Humoral , Male , Spain , Zoonoses/virology
4.
Obstet Gynecol Clin North Am ; 48(1): 53-74, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1083654

ABSTRACT

Viral infections are common complications of pregnancy. Although some infections have maternal sequelae, many viral infections can be perinatally transmitted to cause congenital or chronic infection in fetuses or infants. Treatments of such infections are geared toward reducing maternal symptoms and complications and toward preventing maternal-to-child transmission of viruses. The authors review updates in the treatment of herpes simplex virus, cytomegalovirus, hepatitis B and C viruses, human immunodeficiency virus, and COVID-19 during pregnancy.


Subject(s)
Infectious Disease Transmission, Vertical , Pregnancy Complications, Infectious/therapy , Virus Diseases/therapy , Virus Diseases/transmission , Adult , Antiviral Agents/therapeutic use , /transmission , Cytomegalovirus Infections/therapy , Cytomegalovirus Infections/transmission , Female , HIV Infections/therapy , HIV Infections/transmission , Hepatitis B/therapy , Hepatitis B/transmission , Hepatitis C/therapy , Hepatitis C/transmission , Herpes Simplex/therapy , Herpes Simplex/transmission , Humans , Infant , Pregnancy , Pregnancy Complications, Infectious/virology
5.
Front Immunol ; 11: 594572, 2020.
Article in English | MEDLINE | ID: covidwho-1083323

ABSTRACT

Mycobacterium tuberculosis (Mtb), the causative organism of pulmonary tuberculosis (PTB) now infects more than half of the world population. The efficient transmission strategy of the pathogen includes first remaining dormant inside the infected host, next undergoing reactivation to cause post-primary tuberculosis of the lungs (PPTBL) and then transmit via aerosol to the community. In this review, we are exploring recent findings on the role of bone marrow (BM) stem cell niche in Mtb dormancy and reactivation that may underlie the mechanisms of PPTBL development. We suggest that pathogen's interaction with the stem cell niche may be relevant in potential inflammation induced PPTBL reactivation, which need significant research attention for the future development of novel preventive and therapeutic strategies for PPTBL, especially in a post COVID-19 pandemic world. Finally, we put forward potential animal models to study the stem cell basis of Mtb dormancy and reactivation.


Subject(s)
Bone Marrow Cells/microbiology , Mycobacterium tuberculosis/physiology , Tuberculosis, Pulmonary , Virus Activation/physiology , Virus Latency/physiology , Humans , Mesenchymal Stem Cells/microbiology , Stem Cell Niche/physiology , Tuberculosis, Pulmonary/microbiology , Tuberculosis, Pulmonary/transmission
6.
N Z Med J ; 134(1529): 10-25, 2021 02 05.
Article in English | MEDLINE | ID: covidwho-1080064

ABSTRACT

AIMS: We developed a model, updated daily, to estimate undetected COVID-19 infections exiting quarantine following selectively opening New Zealand's borders to travellers from low-risk countries. METHODS: The prevalence of infectious COVID-19 cases by country was multiplied by expected monthly passenger volumes to predict the rate of arrivals. The rate of undetected infections entering the border following screening and quarantine was estimated. Level 1, Level 2 and Level 3 countries were defined as those with an active COVID-19 prevalence of up to 1/105, 10/105 and 100/105, respectively. RESULTS: With 65,272 travellers per month, the number of undetected COVID-19 infections exiting quarantine is 1 every 45, 15 and 31 months for Level 1, Level 2 and Level 3 countries, respectively. The overall rate of undetected active COVID-19 infections exiting quarantine is expected to increase from the current 0.40 to 0.50 per month, or an increase of one extra infection every 10 months. CONCLUSIONS: Loosening border restrictions results in a small increase in the rate of undetected COVID-19 infections exiting quarantine, which increases from the current baseline by one infection every 10 months. This information may be useful in guiding decision-making on selectively opening of borders in the COVID-19 era.


Subject(s)
Communicable Disease Control , Communicable Diseases, Imported , Disease Transmission, Infectious , International Health Regulations , Quarantine , /epidemiology , /transmission , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Diseases, Imported/epidemiology , Communicable Diseases, Imported/prevention & control , Communicable Diseases, Imported/transmission , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Forecasting , Global Health , Humans , International Health Regulations/organization & administration , International Health Regulations/trends , New Zealand/epidemiology , Prevalence , Public Policy , Quarantine/organization & administration , Quarantine/statistics & numerical data , Travel/legislation & jurisprudence , Travel/statistics & numerical data
7.
J Infect Dev Ctries ; 15(1): 22-31, 2021 Jan 31.
Article in English | MEDLINE | ID: covidwho-1079738

ABSTRACT

In late 2019 a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China and spread throughout the world over a short period of time causing a pandemic of a respiratory disease named coronavirus disease 2019 (COVID-19). SARS-CoV-2 is easily transmitted from person to person through respiratory droplets and direct contact. The scarce available data indicate that dental healthcare personnel are at increased risk for acquisition of infection. Following the lockdown lifting, dental schools should be prepared to refunction safely and provide essential educational and healthcare services while protecting their students, patients, and personnel. The generation of aerosols in dental practice, in association with the high-transmissibility of SARS-CoV-2 through aerosol-generation procedures, the simultaneous provision of dental services to patients in the same areas, and the fact that asymptomatic and pre-symptomatic infected persons may transmit the virus, render the implementation of specific infection prevention and control measures imperative for dental schools. Herein we review the few evidence-based data available to guide infection prevention and control measures for COVID-19 in dental schools.


Subject(s)
/prevention & control , Health Personnel , Infection Control/methods , Schools, Dental , Aerosols , Asymptomatic Infections , Carrier State/transmission , Carrier State/virology , Humans
8.
J Infect Dev Ctries ; 15(1): 58-68, 2021 Jan 31.
Article in English | MEDLINE | ID: covidwho-1079734

ABSTRACT

INTRODUCTION: SARS-CoV2 pandemic marks the need to pay attention to bacterial pathogens that can complicate the hospital stay of patients in the intensive care unit (ICU). ESKAPE bacteria which includes Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter cloacae are considered the most important, because of their close relationship with the development of ventilator-associated pneumonia (VAP). The aim of this work was to identify and characterize ESKAPE bacteria and to detect their possible clonal spread in medical devices, patients, and medical personnel of the ICU for COVID-19 patients of the Hospital Juarez de Mexico. METHODOLOGY: Genetic identification of ESKAPE bacteria was performed by analyzing the 16S rRNA gene. Resistance assays were performed according to the CLSI guidelines. Assembly of AdeABCRS operon and inhibition assays of pumps efflux in Acinetobacter baumannii isolates were performed. Associated gene involved in biofilm formation (icaA) was performed in isolates belonging to the Staphylococcus genus. Finally, typing by ERIC-PCR and characterization of mobile genetic element SCCmec were done. RESULTS: Heterogeneous distribution of ESKAPE and non-ESKAPE bacteria was detected in various medical devices, patients, and medical personnel. Acinetobacter baumannii and Staphylococcus aureus were the predominant ESKAPE members. The analysis of intergenic regions revealed an important clonal distribution of A. baumannii (AdeABCRS+). Genotyping of SCCmec mobile genetic elements and the icaA gene showed that there is no clonal distribution of S. aureus. CONCLUSIONS: Clonal spread of A. baumannii (AdeABCRS+) highlights the importance of adopting good practices for equipment disinfection, surfaces and management of COVID-19 patients.


Subject(s)
Acinetobacter Infections/transmission , Acinetobacter baumannii/isolation & purification , Cross Infection/prevention & control , Intensive Care Units , Acinetobacter baumannii/pathogenicity , Anti-Bacterial Agents/pharmacology , Biofilms/growth & development , Cross Infection/microbiology , Drug Resistance, Bacterial/genetics , Equipment and Supplies/microbiology , Genotype , Humans , Interspersed Repetitive Sequences , Mexico , Pneumonia, Ventilator-Associated/microbiology
10.
Onderstepoort J Vet Res ; 88(1): e1-e8, 2021 Feb 10.
Article in English | MEDLINE | ID: covidwho-1077469

ABSTRACT

Human coronaviruses are known respiratory pathogens associated with a range of respiratory illnesses, and there are considerable morbidity and hospitalisation amongst immune-compromised individuals of all age groups. The emergence of a highly pathogenic human coronavirus in China in 2019 has confirmed the long-held opinion that these viruses are important emerging and re-emerging pathogens. In this review article, we trace the discovery and emergence of coronaviruses (CoVs) over time since they were first reported. The review article will enrich our understanding on the host range, diversity and evolution, transmission of human CoVs and the threat posed by these viruses circulating in animal populations but overtime have spilled over to humans because of the increased proximity between humans and animals.


Subject(s)
Communicable Diseases, Emerging/virology , Coronavirus Infections/virology , Coronavirus/classification , Animals , Coronavirus/genetics , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Disease Outbreaks , Host Specificity , Humans
12.
Epidemiol Prev ; 44(5-6 Suppl 2): 152-159, 2020.
Article in English | MEDLINE | ID: covidwho-1068135

ABSTRACT

The determinants of the risk of becoming infected by SARS-CoV-2, contracting COVID-19, and being affected by the more serious forms of the disease have been generally explored in merely qualitative terms. It seems reasonable to argue that the risk patterns for COVID-19 have to be usefully studied in quantitative terms too, whenever possible applying the same approach to the relationship 'dose of the exposure vs pathological response' commonly used for chemicals and already followed for several biological agents to SARS-CoV-2, too. Such an approach is of particular relevance in the fields of both occupational epidemiology and occupational medicine, where the identification of the sources of a dangerous exposure and of the web of causation of a disease is often questionable and questioned: it is relevant when evaluating the population risk, too. Specific occupational scenarios, basically involving health workers, exhibit important proportions of both subjects simply infected by SARS-CoV-2 and of ill subjects with, respectively, mild, moderate, and severe disease. Similar patterns have been described referring to various circumstances of community exposure, e.g., standing in crowded public places, travelling on crowded means of transport, living in accommodation or care homes, living in the same household as a COVID-19 case. The hypothesis that these findings are a consequence not only of high probabilities of exposure, but also of high doses (as a product of both intensity and duration, with possible autonomous effects of peaks of exposure) deserves to be systematically tested, in order to reconstruct the web of causation of COVID-19 individual and clustered cases and to cope with situations at critical risk for SARS-CoV-2, needing to be identified, mapped, and dealt with at the right time. A limited but consistent set of papers supporting these assumptions has been traced in the literature. Under these premises, the creation of a structured inventory of both values of viral concentrations in the air (in case and if possible, of surface contaminations too) and of viral loads in biological matrixes is proposed, with the subsequent construction of a scenario-exposure matrix. A scenario-exposure matrix for SARS-CoV-2 may represent a useful tool for research and practical risk management purposes, helping to understand the possibly critical circumstances for which no direct exposure measure is available (this is an especially frequent case, in contexts of low socio-economic level) and providing guidance to determine evidence-based public health strategies.


Subject(s)
/virology , Environmental Exposure , Viral Load , Viremia/virology , Aerosols , Air Microbiology , Air Pollution, Indoor , /epidemiology , Cross Infection/epidemiology , Cross Infection/transmission , Cross Infection/virology , Crowding , Disease Transmission, Infectious , Environmental Monitoring , Family Characteristics , Fomites/virology , Humans , Infectious Disease Transmission, Patient-to-Professional , Institutionalization , Occupational Exposure , Risk , Risk Assessment , Time Factors , Transportation
13.
Hist Philos Life Sci ; 43(1): 7, 2021 Jan 13.
Article in English | MEDLINE | ID: covidwho-1064666

ABSTRACT

What should the best practices be for modeling zoonotic disease risks, e.g. to anticipate the next pandemic, when background assumptions are unsettled or evolving rapidly? This challenge runs deeper than one might expect, all the way into how we model the robustness of contemporary phylogenetic inference and taxonomic classifications. Different and legitimate taxonomic assumptions can destabilize the putative objectivity of zoonotic risk assessments, thus potentially supporting inconsistent and overconfident policy decisions.


Subject(s)
Chiroptera , Pandemics , Risk Assessment/methods , Zoonoses , Animals , Chiroptera/virology , Humans , Models, Theoretical , Pandemics/classification , Phylogeny , Zoonoses/epidemiology , Zoonoses/transmission , Zoonoses/virology
15.
Int J Mol Med ; 47(4): 1, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1067807

ABSTRACT

Nosocomial infections, also known as hospital-acquired infections, pose a serious challenge to healthcare professionals globally during the Coronavirus disease 2019 (COVID­19) pandemic. Nosocomial infection of COVID­19 directly impacts the quality of life of patients, as well as results in extra expenditure to hospitals. It has been shown that COVID­19 is more likely to transmit via close, unprotected contact with infected patients. Additionally, current preventative and containment measures tend to overlook asymptomatic individuals and superspreading events. Since the mode of transmission and real origin of COVID­19 in hospitals has not been fully elucidated yet, minimizing nosocomial infection in hospitals remains a difficult but urgent task for healthcare professionals. Healthcare professionals globally should form an alliance against nosocomial COVID­19 infections. The fight against COVID­19 may provide valuable lessons for the future prevention and control of nosocomial infections. The present review will discuss some of the key strategies to prevent and control hospital­based nosocomial COVID­19 infections.


Subject(s)
/epidemiology , Cross Infection/epidemiology , Cross Infection/prevention & control , Health Personnel , Asymptomatic Infections , China , Cross Infection/transmission , Disinfection , Hand Hygiene , Hospitals , Humans , Medical Waste Disposal , Personal Protective Equipment , Quality of Life
16.
Euro Surveill ; 26(5)2021 02.
Article in English | MEDLINE | ID: covidwho-1067624

ABSTRACT

In June-November 2020, SARS-CoV-2-infected mink were detected in 290 of 1,147 Danish mink farms. In North Denmark Region, 30% (324/1,092) of people found connected to mink farms tested SARS-CoV-2-PCR-positive and approximately 27% (95% confidence interval (CI): 25-30) of SARS-CoV-2-strains from humans in the community were mink-associated. Measures proved insufficient to mitigate spread. On 4 November, the government ordered culling of all Danish mink. Farmed mink constitute a potential virus reservoir challenging pandemic control.


Subject(s)
Animals, Wild/virology , /veterinary , Disease Outbreaks/veterinary , Disease Reservoirs/veterinary , Disease Transmission, Infectious/veterinary , Mink/virology , Pandemics/veterinary , /isolation & purification , /transmission , Animals , /virology , Denmark/epidemiology , Disease Outbreaks/statistics & numerical data , Disease Reservoirs/virology , Farms , Genes, Viral , Humans , Incidence , Polymerase Chain Reaction , Public Health , RNA, Viral/analysis , RNA, Viral/genetics , /virology , Whole Genome Sequencing , Zoonoses/transmission , Zoonoses/virology
17.
Ann Clin Microbiol Antimicrob ; 20(1): 8, 2021 Jan 18.
Article in English | MEDLINE | ID: covidwho-1067240

ABSTRACT

The Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has gained research attention worldwide, given the current pandemic. Nevertheless, a previous zoonotic and highly pathogenic coronavirus, the Middle East Respiratory Syndrome coronavirus (MERS-CoV), is still causing concern, especially in Saudi Arabia and neighbour countries. The MERS-CoV has been reported from respiratory samples in more than 27 countries, and around 2500 cases have been reported with an approximate fatality rate of 35%. After its emergence in 2012 intermittent, sporadic cases, nosocomial infections and many community clusters of MERS continued to occur in many countries. Human-to-human transmission resulted in the large outbreaks in Saudi Arabia. The inherent genetic variability among various clads of the MERS-CoV might have probably paved the events of cross-species transmission along with changes in the inter-species and intra-species tropism. The current review is drafted using an extensive review of literature on various databases, selecting of publications irrespective of favouring or opposing, assessing the merit of study, the abstraction of data and analysing data. The genome of MERS-CoV contains around thirty thousand nucleotides having seven predicted open reading frames. Spike (S), envelope (E), membrane (M), and nucleocapsid (N) proteins are the four main structural proteins. The surface located spike protein (S) of betacoronaviruses has been established to be one of the significant factors in their zoonotic transmission through virus-receptor recognition mediation and subsequent initiation of viral infection. Three regions in Saudi Arabia (KSA), Eastern Province, Riyadh and Makkah were affected severely. The epidemic progression had been the highest in 2014 in Makkah and Riyadh and Eastern Province in 2013. With a lurking epidemic scare, there is a crucial need for effective therapeutic and immunological remedies constructed on sound molecular investigations.


Subject(s)
Antiviral Agents/therapeutic use , Coronavirus Infections/drug therapy , /genetics , Middle East Respiratory Syndrome Coronavirus/genetics , Spike Glycoprotein, Coronavirus/genetics , /genetics , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Cross Infection/epidemiology , Cross Infection/virology , Disease Outbreaks , Humans , Middle East Respiratory Syndrome Coronavirus/isolation & purification , Phylogeny , RNA, Viral/genetics , Saudi Arabia/epidemiology
18.
Proc Natl Acad Sci U S A ; 118(1)2021 01 05.
Article in English | MEDLINE | ID: covidwho-1066035

ABSTRACT

Vaccination yields the direct individual benefit of protecting recipients from infectious diseases and also the indirect social benefit of reducing the transmission of infections to others, often referred to as herd immunity This research examines how prosocial concern for vaccination, defined as people's preoccupation with infecting others if they do not vaccinate themselves, motivates vaccination in more and less populated regions of the United States. A nationally representative, longitudinal survey of 2,490 Americans showed that prosocial concern had a larger positive influence on vaccination against influenza in sparser regions, as judged by a region's nonmetropolitan status, lesser population density, and lower proportion of urban land area. Two experiments (total n = 800), one preregistered, provide causal evidence that drawing attention to prosocial (vs. individual) concerns interacted with social density to affect vaccination intentions. Specifically, prosocial concern led to stronger intentions to vaccinate against influenza and COVID-19 but only when social density was low (vs. high). Moderated mediation analyses show that, in low-density conditions, the benefits of inducing prosocial concern were due to greater perceived impact of one's vaccination on others. In this light, public health communications may reap more benefits from emphasizing the prosocial aspects of vaccination in sparser environments.


Subject(s)
/administration & dosage , Influenza Vaccines/administration & dosage , Influenza, Human/epidemiology , Adolescent , Adult , /transmission , Female , Humans , Influenza, Human/prevention & control , Influenza, Human/transmission , Influenza, Human/virology , Longitudinal Studies , Male , Orthomyxoviridae/genetics , Orthomyxoviridae/immunology , Population Density , Probability , Public Health , /immunology , United States/epidemiology , Vaccination , Young Adult
19.
Nature ; 590(7844): 134-139, 2021 02.
Article in English | MEDLINE | ID: covidwho-1065896

ABSTRACT

As countries in Europe gradually relaxed lockdown restrictions after the first wave, test-trace-isolate strategies became critical to maintain the incidence of coronavirus disease 2019 (COVID-19) at low levels1,2. Reviewing their shortcomings can provide elements to consider in light of the second wave that is currently underway in Europe. Here we estimate the rate of detection of symptomatic cases of COVID-19 in France after lockdown through the use of virological3 and participatory syndromic4 surveillance data coupled with mathematical transmission models calibrated to regional hospitalizations2. Our findings indicate that around 90,000 symptomatic infections, corresponding to 9 out 10 cases, were not ascertained by the surveillance system in the first 7 weeks after lockdown from 11 May to 28 June 2020, although the test positivity rate did not exceed the 5% recommendation of the World Health Organization (WHO)5. The median detection rate increased from 7% (95% confidence interval, 6-8%) to 38% (35-44%) over time, with large regional variations, owing to a strengthening of the system as well as a decrease in epidemic activity. According to participatory surveillance data, only 31% of individuals with COVID-19-like symptoms consulted a doctor in the study period. This suggests that large numbers of symptomatic cases of COVID-19 did not seek medical advice despite recommendations, as confirmed by serological studies6,7. Encouraging awareness and same-day healthcare-seeking behaviour of suspected cases of COVID-19 is critical to improve detection. However, the capacity of the system remained insufficient even at the low epidemic activity achieved after lockdown, and was predicted to deteriorate rapidly with increasing incidence of COVID-19 cases. Substantially more aggressive, targeted and efficient testing with easier access is required to act as a tool to control the COVID-19 pandemic. The testing strategy will be critical to enable partial lifting of the current restrictive measures in Europe and to avoid a third wave.


Subject(s)
/statistics & numerical data , /prevention & control , Carrier State/epidemiology , Models, Biological , Age Distribution , /transmission , Carrier State/prevention & control , Carrier State/transmission , Female , France/epidemiology , Health Behavior , Hospitalization/statistics & numerical data , Humans , Incidence , Male , Pandemics/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Time Factors , Treatment Refusal/statistics & numerical data , World Health Organization
20.
Am J Primatol ; 83(2): e23228, 2021 02.
Article in English | MEDLINE | ID: covidwho-1060243

ABSTRACT

Respiratory illnesses, including COVID-19, present a serious threat to endangered wild chimpanzee (Pan troglodytes) populations. In some parts of sub-Saharan Africa, chimpanzee tracking is a popular tourism activity, offering visitors a chance to view apes in their natural habitats. Chimpanzee tourism is an important source of revenue and thus benefits conservation; however, chimpanzee tracking may also increase the risk of disease transmission from people to chimpanzees directly (e.g., via aerosol transmission) or indirectly (e.g., through the environment or via fomites). This study assessed how tourist behaviors might facilitate respiratory disease transmission at a chimpanzee tracking site in Kibale National Park, Uganda. We observed tourists, guides, and student interns from the time they entered the forest to view the chimpanzees until they left the forest and noted behaviors related to disease transmission. Common behaviors included coughing, sneezing, and urinating, which respectively occurred during 88.1%, 65.4%, and 36.6% of excursions. Per excursion, individuals touched their faces an average of 125.84 ± 34.45 times and touched large tree trunks or branches (which chimpanzees might subsequently touch) an average of 230.14 ± 108.66 times. These results show that many pathways exist by which pathogens might move from humans to chimpanzees in the context of tourism. Guidelines for minimizing the risk of such transmission should consider tourist behavior and the full range of modes by which pathogen transmission might occur between tourists and chimpanzees.


Subject(s)
Ape Diseases/etiology , Pan troglodytes , Respiratory Tract Diseases/veterinary , Tourism , Africa, Eastern , Animals , Ape Diseases/transmission , Ape Diseases/virology , Behavior , Behavior, Animal , /virology , Humans , Respiratory Tract Diseases/etiology , Respiratory Tract Diseases/virology , /pathogenicity
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