COVID-19 vaccination coverage among travellers at Lomé International airport (Togo), in 2022

Introduction: COVID-19 pandemic management leads to new health policies including the requirement of a vaccination pass or a negative Polymerase Chain Reaction(PCR)test for cross-border flights. The objective of this study was to estimate COVID-19 vaccination coverage among travelers, as well as factors associated with a full vaccination. Materials and Methods: A cross sectional study was conducted in July 2022 at the Gnassingbé Eyadema International Airport (LFW) in Lomé. Travellers met at LFW, aged 12 years or above, and who agreed to participate in the study have been submitted a questionnaire. Logistic regression analysis was performed to identify factors associated with full vaccination defined as having received at least two doses of COVID-19 vaccine according to a validated vaccine schedule. Results: A total of847travellerswere included. 67% were menThe median age was 40 years, Interquartile Range [31-48]. The main health document presented by travellers was the vaccination pass(69.1%). The majority (84.4%) of travellershad received at least one dose of COVID-19 vaccine and 63.9% had received at least two doses. Being 40 years of age or above(aOR=1.42;p=0.046), and travellingfrom a country outside Africa (aOR=2.18, p=0.003), were positively associated with full vaccination. Conclusion: Vaccination coverage among travellers at the LFWwas relatively high. Travellersfrom a region outside Africa and aged40 years or above were more likely to be full vaccinated. Better communication and strengthening of the vaccination strategiesin Africa could help reduce these gaps.

Attitudes and practices of travelers regarding COVID-19 vaccine and adverse reactions

Objective.In the context of the global COVID-19 pandemic, COVID-19 vaccines were made available to different countries. This study aimed to assess travelers' attitudes and practices toward the COVID vaccine and adverse events. Methods. A survey was conducted using a questionnaire from April 1 to June 30, 2021, among travelers who came for their COVID-19 test at the Institut Pasteur of Côte d'Ivoire.Results. A total of 527 travelers agreed to participate in this study, including 336 men and 161 women. Overall, 26% of respondents had already received their COVID-19 vaccine, while 76% of respondents responded they did not want to be vaccinated. The age of those most vaccinated (116) ranged from 25 to 64 years with a small proportion for those over 65 years (0.8%). Travelers (41) to France were the most vaccinated. All vaccinated persons (135) had a high level of education and were either Christian (89 persons), Muslim (45 persons) or animist (1 person). Adverse events related to the COVID vaccination were reported in seven individuals. These included muscle pain, fever and nausea. Conclusion.Negative attitudes towards vaccines are a major public health concern. In view of these results, for awareness raising, vaccination campaign may be focused on youthand people over 65 years of age. Public health messages containing information about vaccine safety should be tailored to address this vaccine hesitancy

First importations of SARS-CoV-2 P.1 and P.2 variants from Brazil to Spain and early community transmission / Primeras importaciones de las variantes SARS-CoV-2 P.1 y P.2 de Brasil a Madrid y transmisión comunitaria

Introduction: SARS-CoV-2variants of concern (VOC) have been described in the UK (B.1.1.7), South Africa (B.1.351) and Brazil (P.1). Among them, the most scarce information has been obtained from the P.1 variant and more data on its global presence and about its spreading dynamics are needed.Methods: Whole genome sequencing was performed prospectively on travellers arriving from Brazil and on a random selection of SARS-CoV-2 positive cases from our population.Results: In this study we report the first SARS-CoV-2 P.1 and P.2 variants exported from Brazil to Spain. The case infected with the P.1 variant, who had only stayed in Rio de Janeiro, required hospitalisation. The two P.2 cases remained asymptomatic. A wider distribution for P.1 variant beyond the Brazilian Amazonia should be considered. The exportation of the P.2 variant, carrying the E484K mutation, deserves attention. One month after the first description of P.1 and P.2 importations from Brazil to Madrid, these variants were identified circulating in the community, in cases without a travel history, and involved in household transmissionsConclusion: Whole genome sequencing of SARS-CoV-2 positive travellers arriving from Brazil allowed us to identify the first importations of P.1 and P.2 variants to Spain and their early community transmission.

Introducción: Se han descrito «variantes de preocupación» (VOC) de SARS-CoV-2 en el Reino Unido (B.1.1.7), Sudáfrica (B.1.351) y Brasil (P.1). Entre ellas, se dispone de información más escasa para la variante P.1 y se necesitan más datos sobre su presencia global y sobre su dinámica de expansión.Métodos: Se realizó secuenciación del genoma completo de forma prospectiva de SARS-CoV-2 en viajeros procedentes de Brasil y en una selección aleatoria de casos positivos de SARS-CoV-2 de nuestra población.Resultados: En este estudio reportamos las primeras variantes de SARS-CoV-2 P.1 y P.2 exportadas desde Brasil a España. El caso infectado por la variante P.1, que solo había permanecido en Río de Janeiro, requirió hospitalización. Los 2 casos de la variante P.2 permanecieron asintomáticos. Se debe considerar una distribución más amplia para la variante P.1 más allá de la Amazonía brasileña. La exportación de la variante P.2, que porta la mutación E484K, merece asimismo atención adicional. Un mes después de la primera descripción de las importaciones de P.1 y P.2 de Brasil a Madrid, se identificaron estas variantes circulando en la comunidad, en casos sin antecedentes de viaje, e implicadas en transmisiones domiciliarias.Conclusión: La secuenciación de genoma completo de viajeros positivos para SARS-CoV-2 procedentes de Brasil nos permitió identificar las primeras importaciones de variantes P.1 y P.2 a España y su transmisión comunitaria precoz.

Una propuesta desde el centro de Cuba sobre la cuarentena turística en la nueva normalidad / A proposal from the center of Cuba on the tourist quarantine in the New Normality Phase

RESUMEN Una vez emitidas las alertas tempranas sobre la COVID-19, Cuba comenzó a revisar todos los protocolos de actuación en frontera y las tareas del Control Sanitario Internacional que estarían contenidas en el Plan para el control y la prevención del nuevo coronavirus; se reforzaron las tres líneas de vigilancia epidemiológica, el plan con nuevas medidas y los protocolos de actuación. Se establecieron los Protocolos de Control Sanitario Internacional en la atención primaria de salud y en las instalaciones turísticas. Implementar la cuarentena con características turísticas para los viajeros que arriben a Cuba, en Fase Epidémica, de Recuperación o en Fase de Nueva Normalidad, en hoteles o instalaciones destinadas al turismo de salud, es una propuesta organizativa que fortalece el Programa Nacional de Control Sanitario Internacional para la prevención del SARS-COV-2. Estas acciones contribuirán a controlar la pandemia, evitar los rebrotes, y mantener el turismo con ingresos a la economía nacional.

ABSTRACT Once the early warnings on COVID-19 were issued, Cuba began to review all action protocols at the border and International Sanitary Control tasks that would be contained in the Plan for the control and prevention of the new coronavirus; three lines of epidemiological surveillance, the plan with new measures and the action protocols were reinforced. International Health Control Protocols were established in primary health care and in tourist facilities. Implementing the quarantine with tourist characteristics for travelers arriving in Cuba, in the Epidemic, Recovery or New Normality Phase, in hotels or facilities for health tourism, is an organizational proposal that strengthens the National Program for International Sanitary Control to prevent SARS-COV-2. These actions will help to control the pandemic, prevent outbreaks, and maintain tourism with incomes to the national economy.

Considerações para quarentena dos contatos de casos de COVID-19. Orientação provisória de 25 de junho de 2021

Este documento é uma atualização da orientação provisória intitulada Considerations for quarantine of contacts of COVID-19 cases [Considerações para quarentena dos contatos de casos de COVID-19], publicada em 19 de agosto de 2020. O escopo desta quarta versão limita-se ao uso de quarentena para contatos de casos confirmados ou prováveis de infecção por SARS-CoV-2. As considerações sobre as restrições à circulação dos viajantes (geralmente denominada “quarentena” de viajantes) foram abordadas em outras orientações da OMS. Esta versão fornece orientações atualizadas para a implementação da quarentena, incluindo considerações para as autoridades de saúde que consideram a redução do período de quarentena e atualizações sobre o cuidado de crianças cumprindo quarentena. Esta atualização baseia-se no feedback dos estados-membros sobre a experiência de implementação de quarentena para contatos da COVID-19, e está fundamentada em evidências sobre o controle da propagação do SARSCoV-2, o vírus que causa a COVID-19, e no conhecimento científico sobre o vírus.

Guía Técnica para la prevención y control de la COVID-19 en viajeros que ingresan y salen del país durante la Emergencia Sanitaria. Incluye modificatoria. / Technical Guide for the prevention and control of COVID-19 in travelers entering and leaving the country during the health emergency. includes modifier

La guía contiene los procedimientos sanitarios para la prevención y control de la COVID-19 en los viajeros que ingresan y salen del país por vía aérea, terrestre y fluvial en el contexto de la Emergencia Sanitaria por la pandemia de la COVID-19. Incluye modificatorio con R.M. N° 831-2021.

Lineamientos para el abordaje de casos positivos para SARS-COV-2 de viajeros que ingresan al país por el aeropuerto internacional "La Aurora" (AILA) / Guidelines for addressing positive cases for SARS-COV-2 of travelers entering the country through the international airport "La Aurora" (AILA)

En los antecedentes se presentan estadísticas del COVID-19 a la fecha en la que se elaboró el documento (enero 2021) y aborda las tres mutaciones del virus conocidas hasta la fecha del documento. Así mismo, menciona el tema de las mutaciones y las tres variantes conocidas hasta ese momento: Reino Unido e Irlanda del Norte, República de Sudáfrica y Brasil, siendo la de mayor transmisibilidad, según el documento, la del Reino Unido En relación a ello y enfocado en el tema principal, menciona que: "La enfermedad por el coronavirus 2019 (COVID-19) se ha propagado a través de varias fronteras, lo que ha dado lugar a la demanda de medidas de detección y gestión de los casos sospechosos en los puntos de entrada, en particular los puertos, aeropuertos y pasos fronterizos" Por lo que los objetivos del documento son: "1. Generar información genética mediante la vigilancia genómica de casos confirmados de COVID-19 en el Aeropuerto Internacional "La Aurora". 2. Determinar las variantes genéticas del SARS-CoV-2 de casos confirmados para COVID-19 de pasajeros que ingresan al país. 3. Detectar oportunamente las variantes genómicas del SARS-CoV-2 de interés nacional e internacional." En el anexo 1 incluye: Escenarios para la realización de prueba diagnóstica de COVID-19 y referencia para secuenciación y en el 2: Solicitud de Análisis, Secuenciación SARS-CoV-2

Protocolo provisional para la vigilancia genómica de SARS-CoV-2 / Interim Protocol for SARS-CoV-2 Genomic Surveillance

En los antecedentes se presentan estadísticas del COVID-19 a la fecha en la que se elaboró el documento (enero 2021) y aborda las tres mutaciones del virus conocidas hasta la fecha del documento: Reino Unido e Irlanda del Norte, República de Sudáfrica y Brasil, siendo la de mayor transmisibilidad, según el documento, la del Reino Unido Destaca la importancia de los protocolos, puesto que ellos han sido parte primordial en la lucha contra la pandemia: "Asimismo, la secuenciación genómica del SARS-CoV-2 y la liberación oportuna de la información no solo permitió la caracterización del agente etiológico involucrado en el brote inicial, sino también el desarrollo oportuno de protocolos de diagnóstico y seguimiento a la evolución de la pandemia de COVID-19. Así, la secuenciación genómica se ha convertido en una herramienta esencial para generar datos virológicos de SARS-CoV-2, para impulsar la respuesta de laboratorio, y entender mejor los patrones de dispersión y evolución de SARS-CoV-2 " Por ello, el objetivo general del documento es: "Contribuir a la generación de datos de las variantes genómicas del virus SARS-CoV-2 para establecer patrones de dispersión y evolución." Así como: "Establecer y actualizar protocolos de detección y tratamiento de COVID-19 utilizando la información generada a partir de la secuenciación de las muestras" (objetivo específico 1).

O viajante como agente ativo na transmissibilidade do SARS-CoV-2: uma revisão sistemática / The traveler as an active agent of SARS-CoV-2 transmission: a systematic review

O objetivo deste trabalho foi evidenciar o papel dos viajantes na transmissão e na disseminação do novo coronavírus. A busca pelos artigos foi realizada nas bases de dados PubMed®, SciELO, MEDLINE®, Cochrane, Center for Disease Control and Prevention e UpToDate. Foram incluídos artigos relacionados à transmissibilidade, principalmente aqueles associados à disseminação realizada por viajantes, do novo coronavírus. Excluíram-se artigos relacionados a outros surtos de coronavírus. Todos os estudos foram lidos e analisados integralmente. Onze artigos foram selecionados e tabulados, dos quais se pôde desenvolver uma fundamentação teórica, que expõe o grande impacto dos viajantes perante o crescimento da pandemia relacionada ao SARS-CoV-2, levando em consideração as diversas formas com que esse vírus pode se propagar, sendo elas por contato com superfícies contaminadas ou pessoa a pessoa, visto que a infecção pode ser decorrente de gotículas, aerossóis, fômites e, possivelmente, contato sexual, estando os indivíduos sintomáticos ou não.

The objective of this study was to highlight the travelers role in the transmission and dissemination of new coronavirus. The search for the articles was carried out in PubMed®, SciELO, MEDLINE®, Cochrane, Centers for Disease Control and Prevention, and UpToDate databases. Articles related with transmissibility of the new coronavirus were included, mainly those linked with the dissemination from travelers. Articles related with other coronavirus outbreaks were excluded. All of the studies were read and analyzed in their entirety. Eleven articles were selected and tabulated, from which a theoretical framework was developed, which exposes the great impact of travelers in the face of the growth of the pandemic related to the SARS-CoV-2, considering the several ways in which this virus can spread, either through contact with contaminated surfaces or person-to-person, since the infection may occur through droplets, aerosols, fomites, and possibly sexual contact, whether individuals are symptomatic or not.

Retomada das viagens internacionais não essenciais no contexto da pandemia de COVID-19: orientação sobre o uso de testes para a COVID-19. 9 de outubro de 2020 / Reanudación de los viajes internacionales no esenciales en el contexto de la pandemia de COVID-19: orientación sobre el uso de pruebas para la COVID-19

Este documento foi elaborado pela Repartição Sanitária Pan-Americana em cumprimento da resolução sobre A Pandemia de COVID-19 na Região das Américas, aprovada pelo 58º Conselho Diretor da OPAS em setembro de 2020. No documento são resumidas as considerações relativas ao processo de decisão para a retomada das viagens internacionais não essenciais no contexto da pandemia de COVID-19 e, considerando que esse risco não pode ser eliminado, são incluídas as principais medidas que devem ser implementadas para aceitar e mitigar o risco de propagação internacional do SARS-CoV-2. Também são fornecidos mais detalhes sobre o possível uso de testes para a COVID-19, destacando os desafios primários (biológicos, técnicos e epidemiológicos) e as limitações secundárias (legais, operacionais e de recursos).

Protocolo sanitario para la atención de viajeros de vuelos internacionales comerciales: Guía técnica / Health protocol for the care of travelers on commercial international flights: Technical guide

El documento contiene los procedimientos para los viajeros que ingresan y salen del país en vuelos comerciales en el contexto de la emergencia sanitaria por COVID-19 a nivel nacional.

Entrada de viajeros y densidad poblacional en la propagación de la COVID-19 en Cuba / Arrival of travelers and population density in the spread of COVID-19 in Cuba

Introducción: El comportamiento no homogéneo de la cantidad de casos confirmados con COVID-19 en diferentes regiones de Cuba aún no se ha esclarecido, lo cual resultaría de utilidad para la toma de decisiones en futuras epidemias en el país. Objetivo: Determinar la influencia de la entrada de viajeros y la densidad poblacional sobre la distribución no homogénea de la cantidad de casos con COVID-19 por provincias en Cuba. Métodos: Se desarrolló un estudio ecológico, exploratorio, de grupos múltiples, comparando las provincias cubanas según variables del nivel global y agregado, relacionadas con la cantidad de casos con COVID-19, confirmados durante la epidemia en Cuba. Se aplicó el análisis de regresión lineal múltiple para seleccionar el modelo que mejor describe el comportamiento de los datos y el análisis de clúster para visualizar la agrupación de las provincias. Resultados: Se evidenció una correlación significativa entre la cantidad de casos con COVID-19 y la cantidad de viajeros con COVID-19, la cantidad total de viajeros que arribaron al país en marzo y los eventos de trasmisión. En el modelo de regresión resultaron significativas la densidad poblacional y las cantidades de viajeros total y con COVID-19. El análisis de clúster reveló la formación de cuatro grupos de provincias. Conclusiones: La cantidad de casos con COVID-19 por provincia se relaciona con la cantidad de viajeros que entraron al país, con y sin COVID-19, y la densidad poblacional. Se forman cuatro grupos de provincias por su similitud en los aspectos identificados en la regresión(AU)

Introduction: The non-homogeneous behavior of the number of COVID-19 confirmed cases in different regions of Cuba has not yet been clarified, which would be useful for decision-making in future epidemics in the country. Objective: To determine the influence of the arrival of travelers and the population density on the non-homogeneous distribution of the number of COVID-19 cases by provinces in Cuba. Methods: An ecological, exploratory, multiple group study was carried out, comparing Cuban provinces according to variables of the global and aggregate levels, related to the number of COVID-19 cases, confirmed during the epidemic in Cuba. Multiple linear regression analysis was applied to select the model that best describes the behavior of the data and cluster analysis to visualize the grouping of the provinces. Results: A significant correlation was proved between the number of COVID-19 cases and the number of travelers with COVID-19, the total number of travelers who arrived in Cuba in March, and transmission events. In the regression model, the population density and the total number of travelers and those with COVID-19 were significant. The cluster analysis revealed the formation of four groups of provinces. Conclusions: The number of cases with COVID-19 by province is related to the number of travelers who arrived in the country, with and with no COVID-19, and the population density. Four groups of provinces are formed by their similarity in the aspects identified at regression(AU)

Consideraciones sobre medidas de distanciamiento social y medidas relacionadas con los viajes en el contexto de la respuesta a la pandemia de COVID-19, 27 de abril del 2020

Las medidas no farmacéuticas incluyen medidas de protección personal, medidas ambientales, medidas de distanciamiento social y medidas relacionadas con los desplazamientos. Estas consideraciones detallan la implementación de medidas de distanciamiento social y medidas relacionadas con los desplazamientos. Este documento está sujeto a revisión a medida que evoluciona la pandemia y se dispone de nueva información.

Considerations on Social Distancing and Travel-Related Measures in the Context of the Response to COVID-19 Pandemic, 27 April 2020

Non-pharmaceutical measures include personal protective measures, environmental measures, social distancing measures, and travel-related measures. These considerations elaborate upon the implementation of social distancing measures and travel-related measures outlined in the WHO interim guidance documents "Critical preparedness, readiness and response actions for COVID-19" and "Responding to community spread of COVID-19," and takes in to account the WHO document "Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza." At the time of this writing, countries and territories in the Region of the Americas are broadly experiencing the same transmission scenario.

An Overview of Current Social Distancing Measures and Required Evidence for Determining Optimal Time for Relaxing Such Measures, 10 April 2020

In the context of an unprecedented event such as the COVID-19 pandemic, at present, the effectiveness of stringent social distancing and international traffic-related measures in decreasing the rate of spread of SARS-CoV-2, and related mortality, is inferred from empiric observations of their application in countries experiencing different transmission scenarios (e.g., Australia, China, Germany, Italy, New Zealand, and Spain). Such observations are consistent with and corroborated by mathematical models.

Considerations on the Adjustments of Social Distancing and Travel-Related Measures in the Context of the Response to COVID-19 Pandemic, 24 April 2020

As the COVID-19 pandemic evolves, this document was developed to complement the PAHO document Considerations on social distancing and travel related measures in the context of the response to COVID-19 pandemic, distributed to the PAHO/WHO Country Offices on 3 April 2020 and now available on the PAHO COVID-19 web page.

Consideraciones sobre los ajustes de las medidas de distanciamiento social y las medidas relacionadas con los viajes en el contexto de la respuesta a la pandemia de COVID-19, 24 de abril del 2020

El impacto socioeconómico negativo real o potencial, determinado por la adopción de medidas estrictas de distanciamiento social y relacionadas con los desplazamientos, se está traduciendo en una creciente presión sobre los dirigentes nacionales para pedir una transición a medidas menos estrictas que permitan a la economía recuperar algo de impulso, sin precipitar una dramática evolución de la pandemia. Conscientes de eso, este documento tiene como objetivo proporcionar a las autoridades nacionales, en todos los sectores públicos, un marco para orientar el proceso de toma de decisiones en los próximos meses sobre el ajuste del distanciamiento social y las medidas relacionadas con los desplazamientos, que están estrictamente entrelazadas, sin anular los esfuerzos y sacrificios realizados hasta ahora.

Manejo de viajantes doentes nos pontos de entrada (aeroportos, portos marítimos e passagens de fronteira internacionais) no contexto da COVID-19. Orientação provisória, 19 de março de 2020 / Management of ill travellers at Points of Entry (international airports, seaports, and ground crossings) in the context of COVID-19: Interim guidance, 19 March 2020

[Introdução]: Segundo o Regulamento Sanitário Internacional (RSI), as autoridades sanitárias nos pontos de entrada – portos, aeroportos e passagens de fronteira internacionais - devem estabelecer planos de contingência e ações efetivos em resposta a uma Emergência de Saúde Pública de Importância Internacional, e comunicar com o Ponto Focal Nacional do RSI no tocante a medidas relevantes de saúde pública. O atual surto do vírus COVID-19 atravessou diversas fronteiras, levando à necessidade de detecção e manejo de casos suspeitos nos pontos de entrada. Este documento fornece orientações sobre a detecção e manejo dos viajantes doentes com suspeita de COVID-19 nos pontos de entrada e em meios de transporte de qualquer natureza.

Guía técnica de atención de viajeros que ingresan y salen del país con sospecha de infección por COVID-19 / Technical guide of care of travelers entering and leaving the country with suspected COVID-19 infection

El documento contiene los procedimientos para la atención a los viajeros que llegan del extranjero con sospecha de COVID-19