Epidemiology and Infection最新文献

SARS-CoV-2 transmission dynamics within households involving children are complex. We examined the association between paediatric index case (PIC) age and subsequent household SARS-CoV-2 transmission among cases reported to the Minnesota Department of Health between March 2021 and February 2022. In our primary analysis, we used logistic regression to estimate odds ratios adjusted for race/ethnicity, sex, geographic region, and disease severity among households with an unvaccinated PIC. We performed a secondary analysis among households where the PIC was eligible for vaccination adjusting for the same covariates plus time since the last vaccination. Both analyses were stratified by variant wave. During the Alpha wave, PICs of all age groups had similar odds of subsequent transmission. During Delta and Omicron waves, PICs aged 16-17 had higher odds of subsequent transmission than PICs aged 0-4 (Delta OR, 1.32; [95% CI, 1.16-1.51], Omicron OR, 4.21; [95% CI, 3.25-5.45]). In the secondary analysis, unvaccinated PICs had higher odds of subsequent transmission than vaccinated PICs (Delta OR 2.89 [95% CI, 2.18-3.84], Omicron OR 1.35 [95% CI, 1.21-1.50]). Enhanced preventative measures, especially for 12-17-year-olds, may limit SARS-CoV-2 transmission within households involving children.

Residual blood specimens provide a sample repository that could be analyzed to estimate and track changes in seroprevalence with fewer resources than household-based surveys. We conducted parallel facility and community-based cross-sectional serological surveys in two districts in India, Kanpur Nagar District, Uttar Pradesh, and Palghar District, Maharashtra, before and after a measles-rubella supplemental immunization activity (MR-SIA) from 2018 to 2019. Anonymized residual specimens from children 9 months to younger than 15 years of age were collected from public and private diagnostic laboratories and public hospitals and tested for IgG antibodies to measles and rubella viruses. Significant increases in seroprevalence were observed following the MR SIA using the facility-based specimens. Younger children whose specimens were tested at a public facility in Kanpur Nagar District had significantly lower rubella seroprevalence prior to the SIA compared to those attending a private hospital, but this difference was not observed following the SIA. Similar increases in rubella seroprevalence were observed in facility-based and community-based serosurveys following the MR SIA, but trends in measles seroprevalence were inconsistent between the two specimen sources. Despite challenges with representativeness and limited metadata, residual specimens can be useful in estimating seroprevalence and assessing trends through facility-based sentinel surveillance.

By coupling long-range polymerase chain reaction, wastewater-based epidemiology, and pathogen sequencing, we show that adenovirus type 41 hexon-sequence lineages, described in children with hepatitis of unknown origin in the United States in 2021, were already circulating within the country in 2019. We also observed other lineages in the wastewater, whose complete genomes have yet to be documented from clinical samples.

We report a foodborne outbreak of the previously undetected Cryptosporidium parvum gp60 subtype IIγA11. In December 2023, notifications of cryptosporidiosis cases increased in Sweden, prompting the initiation of a national outbreak investigation, and a case-control study was performed to identify the source. We identified 60 cases between 15 December 2023 and 1 January 2024. The median age was 44 years (range: 16-81), and 73% were women. Controls were recruited from a national random pool; frequency was matched by age group and sex. Compared to controls, cases were more likely to have consumed items from salad bars in grocery stores (8% vs. 85%; adjusted odds ratios [aOR]: 58; 95% confidence interval [CI]: 22-186). In regards to food items from the salad bars, cases were more likely to have consumed kale mix salad compared to controls (62% vs. 32%; aOR: 3.6; 95%CI: 1.2-12). Trace-back investigations identified kale producers from Sweden, Belgium, and Spain, but no particular grower was identified, and no food samples were available for microbiological analysis. Our investigation indicates that leafy greens such as kale may contain Cryptosporidium spp. and cause outbreaks and it is important to understand how the contamination occurs to prevent future outbreaks and apply adequate preventive measures.

Since the beginning of mass vaccination campaign for COVID-19 in Italy (December 2020) and following the rapidly increasing vaccine administration, sex differences have been emphasized. Nevertheless, incomplete and frequently incoherent sex-disaggregated data for COVID-19 vaccinations are currently available, and vaccines clinical studies generally do not include sex-specific analyses for safety and efficacy. We looked at sex variations in the COVID-19 vaccine's effectiveness against infection and severe disease outcomes. We conducted a nationwide retrospective cohort study on Italian population, linking information on COVID-19 vaccine administrations obtained through the Italian National Vaccination Registry, with the COVID-19 integrated surveillance system, held by the Istituto Superiore di Sanità. The results showed that, in all age groups, vaccine effectiveness (VE) was higher in the time-interval ≤120 days post-vaccination. In terms of the sex difference in vaccination effectiveness, men and women were protected against serious illness by vaccination in a comparable way, while men were protected against infection to a somewhat greater extent than women. To fully understand the mechanisms underlying the sex difference in vaccine response and its consequences for vaccine effectiveness and development, further research is required. The sex-related analysis of vaccine response may contribute to adjust vaccination strategies, improving overall public health programmes.

Predicting epidemic trends of coronavirus disease 2019 (COVID-19) remains a key public health concern globally today. However, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection rate in previous studies of the transmission dynamics model was mostly a fixed value. Therefore, we proposed a meta-Susceptible-Exposed-Infectious-Recovered-Susceptible (SEIRS) model by adding a time-varying SARS-CoV-2 reinfection rate to the transmission dynamics model to more accurately characterize the changes in the number of infected persons. The time-varying reinfection rate was estimated using random-effect multivariate meta-regression based on published literature reports of SARS-CoV-2 reinfection rates. The meta-SEIRS model was constructed to predict the epidemic trend of COVID-19 from February to December 2023 in Sichuan province. Finally, according to the online questionnaire survey, the SARS-CoV-2 infection rate at the end of December 2022 in Sichuan province was 82.45%. The time-varying effective reproduction number in Sichuan province had two peaks from July to December 2022, with a maximum peak value of about 15. The prediction results based on the meta-SEIRS model showed that the highest peak of the second wave of COVID-19 in Sichuan province would be in late May 2023. The number of new infections per day at the peak would be up to 2.6 million. We constructed a meta-SEIRS model to predict the epidemic trend of COVID-19 in Sichuan province, which was consistent with the trend of SARS-CoV-2 positivity in China. Therefore, a meta-SEIRS model parameterized based on evidence-based data can be more relevant to the actual situation and thus more accurately predict future trends in the number of infections.

The extent to which the oro-faecal route contributes to the transmission of SARS-CoV-2 is not established.We systematically reviewed the evidence on the presence of infectious SARS-CoV-2 in faeces and other gastrointestinal sources by examining studies that used viral culture to investigate the presence of replication-competent virus in these samples. We conducted searches in the WHO COVID-19 Database, LitCovid, medRxiv, and Google Scholar for SARS-CoV-2 using keywords and associated synonyms, with a search date up to 28 November 2023.We included 13 studies involving 229 COVID-19 subjects - providing 308 faecal or rectal swab SARS-CoV2 reverse transcription-polymerase chain reaction (RT-PCR)-positive samples tested with viral culture. The methods used for viral culture across the studies were heterogeneous. Three studies (two cohorts and one case series) reported observing replication-competent SARS-CoV-2 confirmed by quantitative RT-PCR (qPCR) and whole-genome sequencing, and qPCR including appropriate cycle threshold changes. Overall, six (1.9%) of 308 faecal samples subjected to cell culture showed replication-competent virus. One study found replication-competent samples from one immunocompromised patient. No studies were identified demonstrating direct evidence of oro-faecal transmission to humans.Our review found a relatively low frequency of replication-competent SARS-CoV-2 in faecal and other gastrointestinal sources. Although it is biologically plausible, more research is needed using standardized cell culture methods, control groups, adequate follow-up, and robust epidemiologic methods, including whether secondary infections occurred, to determine the role of the oro-faecal route in the transmission of SARS-CoV-2.