ABSTRACT
Wastewater surveillance has been a tool for public health officials throughout the COVID-19 pandemic. Universities established pandemic response committees to facilitate safe learning for students, faculty, and staff. These committees met to analyze both wastewater and clinical data to propose mitigation strategies to limit the spread of COVID-19. This paper reviews the initial efforts of utilizing campus data inclusive of wastewater surveillance for SARS-CoV-2 RNA concentrations, clinical case data from university response teams, and mitigation strategies from Grand Valley State University in West Michigan (population 21,648 students) and Oakland University in East Michigan (population 18,552 students) from November 2020 to April 2022. Wastewater positivity rates for both universities ranged from 32.8 to 46.8%. Peak viral signals for both universities directly corresponded to variant points of entry within the campus populations from 2021 to 2022. It was found that the organization of clinical case data and variability of wastewater testing data were large barriers for both universities to effectively understand disease dynamics within the university population. We review the initial efforts of onboarding wastewater surveillance and provide direction for structuring ongoing surveillance workflows and future epidemic response strategies based on those that led to reduced viral signals in campus wastewater.
Subject(s)
COVID-19 , SARS-CoV-2 , Wastewater , Universities , Wastewater/virology , Wastewater/analysis , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Michigan/epidemiology , Public HealthABSTRACT
Schistosoma mansoni worms cause a waterborne parasitic disease called schistosomiasis. It commonly affects individuals in lack of sanitation structure. In Brazil, Pará state has Belém as one of the worst sanitation-ranking places in 2023, where schistosomiasis transmission was already documented. This study reports the occurrence of schistosomiasis in residents of Ilha das Onças, an island next to Belém. Stool samples were obtained from participants over 2 years old, all residents from Furo do Rio Grande, one of the rivers on the island. The Kato-Katz technique was performed for parasite investigation in the stool samples. Each participant responded to a sociodemographic and clinical questionnaire. The residences were georeferenced for map designing. Three out of 263 participants were S. mansoni positive, all men, ages ranging from 19 to 41 years old, with low parasitic load. Malacological surveys were carried out, but no Biomphalaria snails were found. Risk factors for schistosomiasis establishment are present on the island, and the lack of sanitation makes it a potential risk area. Malacological surveys are highly encouraged as preventive measures, as well as health surveillance for riverside populations, generating data that will help health authorities in the management and planning of preventive control actions.
Subject(s)
Rivers , Schistosoma mansoni , Schistosomiasis mansoni , Humans , Brazil/epidemiology , Adult , Schistosomiasis mansoni/epidemiology , Male , Schistosoma mansoni/isolation & purification , Animals , Young Adult , Rivers/parasitology , Female , Feces/parasitology , Adolescent , Middle Aged , ChildABSTRACT
The health district of Sakassou is one of the 83 health districts in Côte d'Ivoire, located in a zone with very high malarial transmission rates, with an incidence rate of ≥40% Therefore, to guide vector control methods more effectively, it was crucial to have a good understanding of the vectors in the area. This study aimed to determine the level of malarial transmission during the dry season in Sakassou, Côte d'Ivoire. Female Anopheles mosquitoes were sampled using human landing catches (HLCs) and pyrethrum spraying catches (PSCs). The larvae were collected using the 'dipping' method. A total of 10,875 adult female mosquitoes of Anopheles gambiae were collected. The PCR analysis revealed that all individuals were Anopheles coluzzii. The geographical distribution of potential breeding sites of Anopheles showed the presence of An. coluzzii in all the wetlands of the city of Sakassou. During the dry season, the human-biting rate of An. coluzzii was 139.1 bites/person/night. An exophagic trend was displayed by an adult female of An. coluzzii. The entomological inoculation rate during the dry season was 1.49 infectious bites/person/night. This study demonstrated that An. coluzzii was the main vector of malarial transmission in Sakassou, and the intensity of transmission remains high throughout the dry season.
Subject(s)
Anopheles , Malaria , Mosquito Vectors , Seasons , Animals , Anopheles/physiology , Anopheles/parasitology , Cote d'Ivoire/epidemiology , Mosquito Vectors/physiology , Mosquito Vectors/parasitology , Malaria/transmission , Malaria/epidemiology , Female , Humans , Oryza/parasitology , Agricultural Irrigation , Mosquito ControlABSTRACT
The World Health Organization classifies leptospirosis as a significant public health concern, predominantly affecting impoverished and unsanitary regions. By using the Pensacola Bay System as a case study, this study examines the underappreciated susceptibility of developed subtropical coastal ecosystems such as the Pensacola Bay System to neglected zoonotic pathogens such as Leptospira. We analyzed 132 water samples collected over 12 months from 44 distinct locations with high levels of Escherichia coli (>410 most probable number/100 mL). Fecal indicator bacteria (FIB) concentrations were assessed using IDEXX Colilert-18 and Enterolert-18, and an analysis of water physiochemical characteristics and rainfall intensity was conducted. The LipL32 gene was used as a quantitative polymerase chain reaction (qPCR) indicator to identify the distribution of Leptospira interrogans. The results revealed 12 instances of the presence of L. interrogans at sites with high FIB over various land cover and aquatic ecosystem types. Independent of specific rainfall events, a seasonal relationship between precipitation and elevated rates of fecal bacteria and leptospirosis was found. These findings highlight qPCR's utility in identifying pathogens in aquatic environments and the widespread conditions where it can be found in natural and developed areas.
Subject(s)
Water Microbiology , Leptospirosis/microbiology , Leptospirosis/epidemiology , Leptospira/isolation & purification , Leptospira/genetics , Feces/microbiology , Leptospira interrogans/isolation & purification , Leptospira interrogans/genetics , Environmental Monitoring/methods , Rain , Seasons , Bays/microbiology , Spatio-Temporal AnalysisABSTRACT
Hospital wastewater has been identified as a hotspot for the emergence and transmission of multidrug-resistant (MDR) pathogens that present a serious threat to public health. Therefore, we investigated the current status of antibiotic resistance as well as the phenotypic and genotypic basis of biofilm formation in Pseudomonas aeruginosa from hospital wastewater in Dhaka, Bangladesh. The disc diffusion method and the crystal violet assay were performed to characterize antimicrobial resistance and biofilm formation, respectively. Biofilm and integron-associated genes were amplified by the polymerase chain reaction. Isolates exhibited varying degrees of resistance to different antibiotics, in which >80% of isolates showed sensitivity to meropenem, amikacin, and gentamicin. The results indicated that 93.82% of isolates were MDR and 71 out of 76 MDR isolates showed biofilm formation activities. We observed the high prevalence of biofilm-related genes, in which algD+pelF+pslD+ (82.7%) was found to be the prevalent biofilm genotypic pattern. Sixteen isolates (19.75%) possessed class 1 integron (int1) genes. However, statistical analysis revealed no significant association between biofilm formation and multidrug resistance (χ2 = 0.35, P = 0.55). Taken together, hospital wastewater in Dhaka city may act as a reservoir for MDR and biofilm-forming P. aeruginosa, and therefore, the adequate treatment of wastewater is recommended to reduce the occurrence of outbreaks.
Subject(s)
Anti-Bacterial Agents , Biofilms , Drug Resistance, Multiple, Bacterial , Hospitals , Pseudomonas aeruginosa , Wastewater , Biofilms/drug effects , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/physiology , Pseudomonas aeruginosa/isolation & purification , Pseudomonas aeruginosa/genetics , Wastewater/microbiology , Bangladesh/epidemiology , Anti-Bacterial Agents/pharmacology , Integrons , Microbial Sensitivity TestsABSTRACT
Subject(s)
Pleural Effusion , Polymerase Chain Reaction , Humans , Pleural Effusion/microbiology , Pleural Effusion/etiology , Pleural Effusion/diagnosis , Male , Female , Child, Preschool , Child , Cross-Sectional Studies , Infant , South Africa/epidemiology , Tuberculosis/diagnosis , Tuberculosis/complications , Tertiary Care Centers , Endemic DiseasesABSTRACT
Subject(s)
Antitubercular Agents , Humans , Male , Female , Retrospective Studies , Adult , Middle Aged , Incidence , Young Adult , Adolescent , New Mexico/epidemiology , Antitubercular Agents/therapeutic use , Tuberculosis/epidemiology , Aged , Child , Emigrants and Immigrants/statistics & numerical data , Transients and Migrants/statistics & numerical data , Tuberculosis, Multidrug-Resistant/epidemiology , Tuberculosis, Multidrug-Resistant/drug therapy , Child, PreschoolABSTRACT
Subject(s)
Asthma , Phenotype , Pulmonary Disease, Chronic Obstructive , Humans , Middle Aged , Male , Female , Prevalence , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/diagnosis , Adult , Asthma/epidemiology , Asthma/diagnosis , Vietnam/epidemiology , Aged , Skin Tests , Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome/epidemiology , Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome/diagnosisABSTRACT
Subject(s)
Tuberculin Test , Tuberculosis , Humans , Incidence , Male , Uganda/epidemiology , Adult , Female , Prospective Studies , Tuberculosis/epidemiology , Young Adult , Middle Aged , Adolescent , Mycobacterium tuberculosis/isolation & purification , Prevalence , Endemic Diseases , Cohort StudiesABSTRACT
The life expectancy and the risk of developing cardiovascular diseases in patients with inborn errors of immunity are systematically increasing. The aim of the study was to assess cardiovascular risk factors and to evaluate the heart in echocardiography in patients with primary antibody deficiency (PAD). Cardiac echography and selected cardiovascular risk factors, including body mass index, sedentary lifestyle, nicotine, glucose, C-reactive protein, lipid profile, uric acid level, certain chronic diseases, and glucocorticoid use, were analyzed in 94 patients >18 years of age with PAD. Of the patients,25.5% had a cardiovascular disease (mostly hypertension, 18%), 10.5% smoked, 17% were overweight, 14% were obese, and 15% were underweight. Abnormal blood pressure was found in 6.5% of the patients. Lipid metabolism disorders were found in 72.5% of in the studied cohort, increased total cholesterol (45.5%), non-high-density lipoprotein (HDL) (51%), low-density lipoprotein (LDL) (47%), and triglycerides (32%) were observed. Furthermore, 28.5% had a decrease in HDL and 9.5% had a history of hyperuricemia. The average number of risk factors was 5 ± 3 for the entire population and 4 ± 2 for those under 40 years of age. Elevated uric acid levels were found de novo in 4% of participants. In particular, 74.5% of the patients had never undergone an echocardiogram with a successful completion rate of 87% among those tested. Among them, 30% showed parameters within normal limits, primarily regurgitation (92.5%). New pathologies were identified in 28% of patients. Prevention in patients with PAD, aimed at reducing cardiovascular risk, should be a priority.
Subject(s)
Cardiovascular Diseases , Echocardiography , Heart Disease Risk Factors , Humans , Male , Female , Adult , Cardiovascular Diseases/etiology , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/diagnostic imaging , Middle Aged , Risk Factors , Young Adult , Risk AssessmentABSTRACT
The tragic COVID-19 pandemic affected many children worldwide. Among the factors that may influence the course of viral infections including COVID-19, it is still uncertain whether atopy has a protective or predisposing role. The study aims to address the knowledge gap by investigating the prevalence and severity of COVID-19 among atopic children in Kerman, in 2022. A descriptive-analytical cross-sectional study on children with a history of atopy was performed in Kerman Medical University. Demographic information, type of atopy (including allergic rhinitis, Hyper-Reactive Airway Disease (HRAD) or asthma, eczema, urticaria, anaphylaxis, and food allergy), history of COVID-19 infection, and disease severity were recorded. A total of 1007 children and adolescents, (boys: 56.4%, girls: 43.6%, age:5.61±2.64 years) were included in the study. History of COVID-19 infection was positive in 53.5%, with 75.9% of the cases exhibiting mild disease severity. The frequency of atopies was HRAD or asthma (67.2%), allergic rhinitis (42.6%), and food allergy (27.4%). The frequency of COVID-19 cases was significantly higher among patients with HRAD or asthma, whereas it was significantly lower among those with food allergies, anaphylaxis, and eczema. Among atopic individuals, COVID-19 severity was significantly lower in those with allergic rhinitis, while the opposite trend was observed among food-allergic individuals. This study sheds light on the relationship between atopy and COVID-19 among pediatric patients. It seems specific types of atopies may influence the risk and severity of COVID-19 infection differently. A better understanding of these associations can inform clinical management and preventive measures for vulnerable pediatric populations.
Subject(s)
COVID-19 , SARS-CoV-2 , Severity of Illness Index , Humans , COVID-19/epidemiology , COVID-19/immunology , Iran/epidemiology , Female , Male , Cross-Sectional Studies , Child , Prevalence , Child, Preschool , Adolescent , Asthma/epidemiology , Rhinitis, Allergic/epidemiology , Food Hypersensitivity/epidemiologyABSTRACT
BACKGROUND: There are limited data on severe cutaneous adverse reactions (SCARs) associated with antiepileptic medications. The current study aims to investigate the clinical and epidemiological characteristics of antiepileptic medication-induced SCARs in hospitalized children. MATERIALS AND METHODS: The current five-year retrospective study was conducted at Isfahan University of Medical Sciences, Iran. This study included all children with a definite diagnosis of SCARs secondary to the use of antiepileptic medications based on the world health organization (WHO) definition. In our study SCARs were categorized into three fields: Hypersensitivity syndrome, drug reaction with eosinophilia and systemic symptoms (DRESS), and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). RESULTS: Among 259 children with SCARs induced by antiepileptic medications, 199 (76.83%), 42 (16.22%), and 18 (6.95%) had hypersensitivity syndrome, DRESS, and SJS/TEN, respectively. Phenobarbital was the most common offending drug in all types of SCARs. The multinomial logistic regression model revealed that lymphadenopathy increased the occurrence of DRESS by 35 times compared to hypersensitivity syndrome (P < 0.001). Girls were at risk of SJS/TEN approximately 6 times more than boys (P = 0.027). Age (P = 0.021), weight (P = 0.036), and mucosal involvement (P < 0.001) affected the hospitalization duration in children with SCARs related to antiepileptic medication. CONCLUSION: There are some similarities and differences in the clinical and epidemiological features of Iranian children suffering from antiepileptic medication-induced SCARs.
Subject(s)
Anticonvulsants , Stevens-Johnson Syndrome , Humans , Anticonvulsants/adverse effects , Female , Male , Child , Retrospective Studies , Child, Preschool , Iran/epidemiology , Stevens-Johnson Syndrome/epidemiology , Stevens-Johnson Syndrome/etiology , Drug Hypersensitivity Syndrome/epidemiology , Drug Hypersensitivity Syndrome/etiology , Drug Hypersensitivity Syndrome/diagnosis , Adolescent , Infant , Child, Hospitalized , Hospitalization/statistics & numerical data , Risk FactorsABSTRACT
INTRODUCTION: Alcohol and substance use are increasing in older adults, many of whom have depression, and treatment in this context may be more hazardous. We assessed alcohol and other substance use patterns in older adults with treatment-resistant depression (TRD). We examined patient characteristics associated with higher alcohol consumption and examined the moderating effect of alcohol on the association between clinical variables and falls during antidepressant treatment. METHODS: This secondary and exploratory analysis used baseline clinical data and data on falls during treatment from a large randomized antidepressant trial in older adults with TRD (the OPTIMUM trial). Multivariable ordinal logistic regression was used to identify variables associated with higher alcohol use. An interaction model was used to evaluate the moderating effect of alcohol on falls during treatment. RESULTS: Of 687 participants, 51% acknowledged using alcohol: 10% were hazardous drinkers (AUDIT-10 score ≥5) and 41% were low-risk drinkers (score 1-4). Benzodiazepine use was seen in 24% of all participants and in 21% of drinkers. Use of other substances (mostly cannabis) was associated with alcohol consumption: it was seen in 5%, 9%, and 15% of abstainers, low-risk drinkers, and hazardous drinkers, respectively. Unexpectedly, use of other substances predicted increased risk of falls during antidepressant treatment only in abstainers. CONCLUSIONS: One-half of older adults with TRD in this study acknowledged using alcohol. Use of alcohol concurrent with benzodiazepine and other substances was common. Risks-such as falls-of using alcohol and other substances during antidepressant treatment needs further study.
Subject(s)
Accidental Falls , Alcohol Drinking , Antidepressive Agents , Depressive Disorder, Treatment-Resistant , Humans , Male , Female , Aged , Depressive Disorder, Treatment-Resistant/drug therapy , Accidental Falls/statistics & numerical data , Antidepressive Agents/therapeutic use , Middle Aged , Logistic Models , Aged, 80 and over , Substance-Related Disorders/epidemiology , Benzodiazepines/therapeutic use , Benzodiazepines/adverse effects , Risk FactorsABSTRACT
Highly pathogenic avian influenza (HPAI) virus subtypes have been increasingly identified in poultry and wild birds since 2021. Between 2020-2023, 26 countries have reported that the H5N1 virus had infected more than 48 mammalian species. On 1 April 2024, a public health alert was issued in Texas when the first confirmed case of human infection with the H5N1 influenza virus was reported in a dairy worker. Cases of H5N1, clade 2.3.4.4b in dairy cows have been reported in several states in the US but were unexpected, even though H5N1 was previously identified in mammalian species, including cats, dogs, bears, foxes, tigers, coyotes, goats, and seals. On 29 April 2024, almost one month after the first reported cases of H5N1 infection in dairy cows, measures were to be implemented by the US Department of Agriculture (USDA) to prevent the progression of H5N1 viral transmission. This editorial summarizes what is currently known about the epidemiology, transmission, and surveillance of the HPAI virus of the H5N1 subtype in birds, mammals, and dairy cows, and why there are concerns regarding transmission to humans.
Subject(s)
Influenza A Virus, H5N1 Subtype , Influenza in Birds , Influenza, Human , Animals , Cattle , Influenza A Virus, H5N1 Subtype/pathogenicity , Humans , Influenza in Birds/virology , Influenza in Birds/epidemiology , Influenza, Human/virology , Influenza, Human/epidemiology , Influenza, Human/transmission , Orthomyxoviridae Infections/virology , Orthomyxoviridae Infections/epidemiology , Birds/virology , Mammals/virology , DairyingSubject(s)
Psychiatry , Humans , Psychiatry/trends , COVID-19/epidemiology , Mental Disorders/therapyABSTRACT
BACKGROUND: There is increasing interest in elucidating the relationship between adenoid hypertrophy (AH) and allergic rhinitis (AR). However, the impact of aeroallergen sensitization patterns on children with AH and AR remains unclear. METHODS: Patients aged 2-8 years (recruited from January 2019 to December 2022) with nasal symptoms were assessed for allergies, adenoid size, and respiratory viral infection history. The serum total immunoglobulin E (IgE) and specific IgE levels were measured, and flexible nasal endoscopy was performed. The relationship between AH, aeroallergen sensitization patterns, and lymphocyte subpopulations in adenoid samples was analyzed using flow cytometry. RESULTS: In total, 5281 children were enrolled (56.5% with AR; and 48.6% with AH). AH was more prevalent in children with AR. Compared to nonsensitized individuals, those polysensitized to molds had a higher prevalence of AH (adjusted OR 1.61, 95% CI 1.32-1.96) and a greater occurrence of two or more respiratory viral infections, particularly in adenoidectomy patients. The percentages and corrected absolute counts of regulatory T (Treg) cells, activated Tregs, class-switched memory B cells (CSMBs), natural killer (NK) T cells, and NK cell subpopulations were reduced in the adenoid tissues of children with both AH and AR (AH-AR) compared to AH-nAR children. Polysensitization in AH-AR children correlated with lower CSMB percentages. CONCLUSION: Polysensitivity to molds is associated with an increased risk of AH in children with AR. Fewer B cells, NK cells, and Treg cells with an effector/memory phenotype were detected in the adenoids of AR children, and these lower percentages of immune cells, particularly CSMBs, were closely linked to aeroallergen sensitization models and respiratory viral infection.
Subject(s)
Adenoids , Hypertrophy , Immunoglobulin E , Rhinitis, Allergic , Humans , Adenoids/immunology , Adenoids/pathology , Child , Male , Female , Hypertrophy/immunology , Child, Preschool , Rhinitis, Allergic/immunology , Rhinitis, Allergic/epidemiology , Immunoglobulin E/blood , Phenotype , Allergens/immunology , T-Lymphocytes, Regulatory/immunology , Prevalence , AdenoidectomyABSTRACT
There is limited data assessing length of stay, cost of care, and differences in demographic data in hospitalized psoriasis patients with and without cardiovascular disease. Our study compares hospitalized psoriatic patients with and without comorbid cardiovascular disease for differences in length of stay and cost of care, as well as to assess differences in patient demographics. A cross-sectional study of hospital encounters of patients under the age of 60 with psoriasis in the National Inpatient Sample from 2016 to 2020 was performed using univariate analyses and a multivariable logistic regression model. A total of 2,485 psoriasis hospitalizations were included. 2,145 (86.3%) had psoriasis without cardiovascular disease and 340 (13.7%) had psoriasis with cardiovascular disease. Linear regression models identified significantly longer lengths of stay (Beta: 1.6; SE: 0.721; P = 0.030) and higher cost of care (Beta: 4,946; SE: 1,920; P = 0.011) in psoriasis patients with cardiovascular comorbidities.