Lessons from the re-emergence of imported measles cases following the COVID-19 pandemic in Victoria, Australia.

Introduction: Australia was declared to have eliminated endemic measles in 2014; however, imported cases continue to pose a threat of outbreaks. International travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic led to a rapid decline in measles cases. The re-opening of the Australian international border to measles endemic regions returns the threat of outbreaks, which may be further compounded by disruptions in routine vaccinations during the COVID-19 pandemic. We consider lessons learned from the public health response to recent measles cases. Methods: This case series includes all confirmed measles cases meeting the national case definition reported to the Victorian Government Department of Health (the Department) between 1 January and 31 December 2022. The Department conducted active case finding and contact tracing of all cases in line with national guidelines. Cases were descriptively analysed. Results: In 2022, six of the seven measles cases reported in Australia occurred in Victoria, all of whom resided in Australia and acquired their infection overseas. Three cases were unlinked, and three formed an epidemiologically-linked household cluster. One case was partially vaccinated, one was not eligible for vaccination, one had unknown vaccination status, and three were unvaccinated, one of whom was under 12 months old but would have been eligible for vaccination prior to travel to endemic regions. None of the cases led to secondary transmission within Australia. Discussion: Following the COVID-19 pandemic, measles importations have re-commenced in Victoria. Although few measles cases occurred in 2022 and none resulted in onwards transmission, imported measles cases remain complex and require substantial public health follow-up. Delays in case diagnosis and flight contact tracing pose a significant risk for outbreaks of measles. Public health interventions are needed to maintain high vaccination rates, improve contact tracing, and ensure public health authorities and healthcare providers can rapidly identify and respond to imported measles cases.

[Care of infectious diseases in underage refugees exemplified by Ukraine]. / Infektiologische Versorgung minderjähriger Flüchtlinge am Beispiel der Ukraine: Vorgehen in Deutschland gemäß der S1-Leitlinine (AWMF-Register Nr. 048-017).

Background: By early June 2022, around 300,000 children and adolescents from Ukraine were registered in the German central registry for foreigners.The updated recommendations for action should provide the foundations for an evidence-based and targeted care for the diagnosis and prevention of infectious diseases in underage refugees and asylum seekers, exemplified by Ukraine. Objective: The recommendations for action are intended to support medical personnel in the care of minor refugees in order to1) ensure early recognition and completion of an incomplete vaccination status,2) diagnose and treat common infectious diseases,3) ensure early recognition and treatment of infectious diseases that are rare in the German healthcare system. Material and methods: The recommendations for action were drafted as level 1 (S1) guidelines coordinated by the Association of the Scientific Medical Societies in Germany (AWMF) and were adapted to the situation of refugees from Ukraine.The recommendations were compiled by a representative expert panel appointed by the participating professional societies in an informal consensus and finally officially adopted by the board of directors of all societies concerned. Results: Recommendations are given for the extent of the medical evaluation of minor refugees, including the medical history and physical examination, adapted to the situation of refugees from Ukraine. A blood count and screening for tuberculosis, hepatitis B and C as well as human immunodeficiency virus (HIV) infections are recommended for all minor refugees.For a rapid completion of the vaccination status, an age-related and indications-related prioritization of individual vaccinations will be undertaken. Conclusion: In view of the continuing high numbers of refugees not only from Ukraine, a further professionalization of medical health care is necessary. For this purpose, the necessary structural and personnel framework conditions need to be accomplished.

Caracterización de viajeros confirmados a la COVID-19, según número reproductivo básico, provincia Camagüey

Introducción: Las enfermedades importadas constituyen un problema de salud para el individuo y para la población general. Debido al peligro sanitario que conlleva los viajes internacionales y el riesgo de introducción de enfermedades en la provincia. Objetivo: Caracterizar los viajeros notificados a la COVID-19 con fuente de infección en el extranjero según número reproductivo básico en la provincia Camagüey. Métodos: Se realizó un estudio observacional, descriptivo, transversal. El universo de estudio estuvo constituido por todos los viajeros notificados con la COVID-19 en la provincia que cumplieron con los criterios de inclusión y exclusión. Resultados: El escenario de intervención del 70 % de los notificados fue los centros de aislamiento para viajeros, predominaron los procedentes de Venezuela y el mes de marzo fue el de mayor incidencia, el 100 % procedían de áreas de transmisión de la enfermedad, el 55 % se encontraban asintomáticos en el momento del diagnóstico y el número reproductivo básico fue menor que uno en los municipios de destino y a nivel provincial. Conclusiones: Los centros de aislamientos para viajeros disminuyó el riesgo de dispersión de la enfermedad en los municipios de destino, los viajeros notificados tenían alta probabilidad de enfermar por proceder de países con transmisión de la enfermedad y los asintomáticos complejizaron el escenario de actuación.

Introduction: The cared illnesses constitute an important problem of health for the individual and for the general population. Due to the sanitary danger that bears the international trips and the risk of introduction of illnesses cared in the county, an investigation was carried out. Objective: To characterize the travelers notified to the COVID-19 with infection source abroad according to basic reproductive number in Camagüey's province. Methods: A observational, descriptive, traverse study was carried out. The study universe was constituted by all the travelers notified with the COVID-19 in the county that fulfilled the inclusion approaches and exclusion. Results: The scenario of intervention of 70% of those notified was the isolation centers for travelers, prevailing those coming from Venezuela and the month of March was that of more incidence, 100% came from areas of transmission of the illness, 55% was asymptomatic in the moment of the diagnosis and the basic reproductive number was smaller than one in the destination municipalities and at provincial level. Conclusions: The centers of isolations for travelers diminished the risk of dispersion of the illness in the destination municipalities, the notified travelers had high probability of making sick to come from countries with transmission of the illness and the asymptomatic ones worsen the performance scenario.

Association between treatment with colchicine and improved survival in a single-centre cohort of adult hospitalised patients with COVID-19 pneumonia and acute respiratory distress syndrome.

OBJECTIVES: The outbreak of COVID-19 posed the issue of urgently identifying treatment strategies. Colchicine was considered for this purpose based on well-recognised anti-inflammatory effects and potential antiviral properties. In the present study, colchicine was proposed to patients with COVID-19, and its effects compared with 'standard-of-care' (SoC). METHODS: In the public hospital of Esine, northern Italy, 140 consecutive inpatients, with virologically and radiographically confirmed COVID-19 admitted in the period 5-19 March 2020, were treated with 'SoC' (hydroxychloroquine and/or intravenous dexamethasone; and/or lopinavir/ritonavir). They were compared with 122 consecutive inpatients, admitted between 19 March and 5 April 2020, treated with colchicine (1 mg/day) and SoC (antiviral drugs were stopped before colchicine, due to potential interaction). RESULTS: Patients treated with colchicine had a better survival rate as compared with SoC at 21 days of follow-up (84.2% (SE=3.3%) vs 63.6% (SE=4.1%), p=0.001). Cox proportional hazards regression survival analysis showed that a lower risk of death was independently associated with colchicine treatment (HR=0.151 (95% CI 0.062 to 0.368), p<0.0001), whereas older age, worse PaO2/FiO2, and higher serum levels of ferritin at entry were associated with a higher risk. CONCLUSION: This proof-of-concept study may support the rationale of use of colchicine for the treatment of COVID-19. Efficacy and safety must be determined in controlled clinical trials.