Mpox outbreak 2022: an overview of all cases reported to the Cologne Health Department.

PURPOSE: The worldwide mpox outbreak starting in May 2022 marks the occurrence of another previously atypical infectious disease in Europe. This study's objective was to present a comprehensive overview based on the gathered data and to illustrate the approach of the Cologne Health Department to contain the mpox outbreak. METHODS: In this retrospective observational study, 368 individuals reported to the Cologne Health Department as PCR-positive for mpox were included. Data were collected in structured telephone interviews and digitally processed. RESULTS: The first mpox case in Cologne was recorded on May 24, 2022. The local outbreak lasted approximately 4 months and reached its peak in July. The last reported case in Cologne occurred on September 17. Transmissions mostly occurred through sexual contacts (67.4%) or other close physical contacts (4.6%) between men, but also through fomites, in the context of events or occasionally in the work environment. In 21.5% of cases, no route of infection could be determined. The mean incubation period was 8.2 days. Clinically, mpox infections usually presented with skin and/or mucosal lesions accompanied by general symptoms. In 74.8% of cases, a prodromal stage was absent. Initially, the rash often had an unspecific appearance, but in the further clinical course, it usually passed through the typical stages. Most infections resolved spontaneously under home care. In 3.5% of cases, however, inpatient hospitalisation was required. Infected persons with a previous smallpox vaccination had 0.43 times the odds of unvaccinated persons to be affected by lesions in 3 or more body regions and 0.30 times the odds to develop lesions in all 5 body regions. Previous vaccination statistically reduced the total duration of symptoms by 2.0 days. CONCLUSIONS: The mpox outbreak 2022 in Cologne primarily affected men who have sex with men and have reported recent sexual encounters. The observed average incubation period was shorter than initially assumed. Mucosal involvement and associated symptoms occur in a relevant number of cases and can lead to more severe clinical courses. Previous smallpox vaccination was statistically significantly associated with milder courses of mpox. In the case of an unclear rash or symptoms suggesting mucosal involvement, mpox should be considered as a differential diagnosis. An equally rapid and well-orchestrated public health response are crucial for infection control.

Symptom diaries as a digital tool to detect SARS-CoV-2 infections and differentiate between prevalent variants.

The COVID-19 pandemic and the high numbers of infected individuals pose major challenges for public health departments. To overcome these challenges, the health department in Cologne has developed a software called DiKoMa. This software offers the possibility to track contact and index persons, but also provides a digital symptom diary. In this work, the question of whether these can also be used for diagnostic purposes will be investigated. Machine learning makes it possible to identify infections based on early symptom profiles and to distinguish between the predominant dominant variants. Focusing on the occurrence of the symptoms in the first week, a decision tree is trained for the differentiation between contact and index persons and the prevailing dominant variants (Wildtype, Alpha, Delta, and Omicron). The model is evaluated, using sex- and age-stratified cross-validation and validated by symptom profiles of the first 6 days. The variants achieve an AUC-ROC from 0.89 for Omicron and 0.6 for Alpha. No significant differences are observed for the results of the validation set (Alpha 0.63 and Omicron 0.87). The evaluation of symptom combinations using artificial intelligence can determine the individual risk for the presence of a COVID-19 infection, allows assignment to virus variants, and can contribute to the management of epidemics and pandemics on a national and international level. It can help to reduce the number of specific tests in times of low labor capacity and could help to early identify new virus variants.

DNA methylation associated with persistent ADHD suggests TARBP1 as novel candidate.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by age-inappropriate symptoms of inattention and/or hyperactivity and impulsivity. ADHD is highly prevalent in childhood and often persists into adulthood. Both genetic variants and environmental factors play a role in the onset and persistence of ADHD, and epigenetic changes, such as DNA methylation are considered as a link for their interplay. To investigate this, we studied DNA methylation in 37 candidate genes by performing targeted bisulfite sequencing of DNA isolated from whole blood of N = 88 individuals diagnosed with adult ADHD and N = 91 unaffected individuals (mean age 34.2 years). Differentially methylated sites were assessed by generalized linear models testing ADHD status and ADHD symptoms, accounting for a methylation-based smoking score, age, sex, and blood cell count. DNA methylation of single sites within DRD4 and KLDR1 was associated with adult ADHD status, and multiple DNA methylation sites within TARBP1 were associated with ADHD symptoms in adulthood and childhood. Awaiting replication, findings of this pilot study point to TARBP1 as a new candidate gene for ADHD symptoms. Our work also stresses the need for research to further examine the effects of environmental factors, such as nicotine exposure, on epigenetic modifications associated with psychiatric traits.

Biodegradable capsules as non-viral vectors for in vitro delivery of PEI/siRNA polyplexes for efficient gene silencing.

The efficiency of siRNA delivery is demonstrated to be improved by encapsulating the siRNA within a non-viral carrier based on layer-by-layer assembly of oppositely charged biodegradable and biocompatible polyelectrolytes. In comparison to other non-viral delivery vehicles such as polycation-based complexes, a smaller amount of siRNA was necessary to produce in vitro gene silencing as early as 20-30 h after incubation. Colloidal carriers based on assembled biodegradable polyelectrolytes offer several advantages, such as efficient intracellular delivery after endocytosis followed by release to the cytosol, as well as protection of the siRNA, which is crucial for its therapeutic activity.

Isolation of bacteria from remote high altitude Andean lakes able to grow in the presence of antibiotics.

High altitude Andean lakes are placed in Puna desert over 4400 above sea level. Completely isolated, they are exposed to extreme environmental factors like high levels of salinity, UV radiation and heavy metals and low concentrations of phosphorus. Nevertheless, they are the habitat of enormous populations of three flamingo species that migrate among these Lakes. Previous reports have determined that bacteria isolated from these environments present high levels of resistance to antibiotics. The aim of this work was to determine the diversity of antibiotic resistant bacteria in water from Andean Lakes and their connection with flamingo enteric biota. Bacteria from water and birds faeces from high altitude Lakes: Laguna (L.) Aparejos, L. Negra, L. Vilama and L. Azul (all are located between 4,200 and 4,600 m altitude) were isolated by plating in five different Antibiotics (ampicillin, 100 microg ml(-1); chloramphenicol, 170 microg ml(-1); colistin , 20 microg ml(-1); erythromycin, 50 microg ml(-1) and tetracycline 50 microg ml(-1)). 56 bacteria were isolated and identified by 16 S rDNA sequencing. Antibiotic resistance profiles of isolated bacteria were determined for 22 different antibiotics. All identified bacteria were able to growth in multiple ATBs. Colistin, ceftazidime, ampicillin/sulbactam, cefotaxime, cefepime, cefalotin, ampicillin and erythromycin were the most distributed resistances among the 56 tested bacteria. The current results demonstrated that antibiotic resistance was abundant and diverse in high altitude Lakes. Also the present article indicates some useful patents regarding the isolation of bacteria able to grow in the present of antibiotics.