Epidemiology and Infection最新文献

West Nile virus (WNV) is a zoonotic mosquito-borne Flavivirus, with bird populations reservoirs. Although often asymptomatic, infection in humans can cause febrile symptoms and, more rarely, severe neurological symptoms. Previous studies assessed environmental drivers of WNV infections, but most overlooked areas with potential WNV circulation despite no reported human case, and mixed mechanisms affecting hosts vs. vectors. Our objective was to generate a WNV Bird Risk Index (BRI) mapping the potential of WNV circulation in bird communities across Europe. We first used a bird traits-based model to estimate WNV seroprevalence in European wild bird species and identify eco-ethological characteristics associated with it. This allowed us to build a map of the WNV BRI that showed a strong spatial heterogeneity across Europe. To validate this metric, using a Besag-York-Mollie 2 spatial model in a Bayesian framework, we showed a positive association between the BRI and the number of years with notified WNV human cases between 2016 and 2023, at the NUTS administrative region scale. To conclude, we provide a map quantifying the suitability for WNV to circulate in the bird reservoir. This allows to target surveillance efforts in areas at risk for WNV zoonotic infections in the future.

We analysed weekly influenza A intensive care unit (ICU) or high dependency unit (HDU) admissions reported by age group and subtype by NHS trusts in England through mandatory surveillance during the 2023-2024 influenza season. We investigated whether subtype reporting varied with patient age group, NHS trust type and region. We estimated the subtype ratio and explored whether this estimate varied among subsets of trusts grouped by the regularity of subtype reporting. Our aim was to explore factors relating to subtype reporting and investigate how these affect subtype ratio estimates. 112 NHS trusts reported data, with 86 trusts reporting influenza A cases and 28 trusts reporting subtyped influenza A cases. The proportion of subtype reporting trusts varied with region and trust type, but not patient age group. The estimated ratio of influenza A(H1N1)pdm09 to influenza A(H3N2) was 3.13 (95% CI: 2.17, 4.51), indicating that influenza A(H1N1)pdm09 was dominant; this was approximately similar across levels of regularity of trust subtype reporting. The accuracy of subtype ratio estimates depends on the availability of influenza A subtype information and data representativeness. We identified low levels of subtype reporting, which likely limits early recognition of new influenza strains and informing of the prescription of antivirals in influenza outbreaks.

Shiga toxin-producing Escherichia coli (STEC) are zoonotic, foodborne pathogens that cause outbreaks of infectious gastrointestinal disease, including haemolytic uraemic syndrome (HUS) which can be fatal. In November 2023, a foodborne outbreak of STEC serotype O26:H11 stx2a/eae, involving 40 cases (54% female and 76% aged 0-9 years old), including 19 children with HUS. Whole-genome sequencing analysis revealed the outbreak strain was multidrug resistant and likely originated from outside the United Kingdom. Epidemiological analysis showed greatest odds of exposure among cases for consumption of a dried fruit product, predominantly in multi-packs. Batch numbers of the packs consumed by cases were rarely available, and where recorded, other packs in the same the batch were unavailable for testing; therefore, targeted microbiological testing was not possible. Fruit for drying can become contaminated when the crop is exposed to irrigation water or rainwater run off containing animal faeces. For STEC, where detection of the causative agent in food is challenging, we recommend establishing multi-source weight of evidence frameworks that promote the application of epidemiological and food chain evidence for public health action and the expansion of global surveillance networks to enhance the detection of foodborne threats at home and abroad.

In France, HIV prevention measures including HIV testing, treatment, and uptake of pre-exposure prophylaxis (PrEP), have increased throughout the last decade. To analyse their impact, we performed a time series analysis of monthly HIV diagnoses reported via the national HIV surveillance database. In addition, we compared the timing of HIV promotional campaigns with monthly trends in HIV testing and PrEP initiation. From January 2012 to December 2022, new HIV diagnoses steadily decreased among men who have sex with men (MSM) born in France and heterosexuals born in France, whereas HIV diagnoses increased among MSM born abroad. HIV testing activity and PrEP use in France both steadily increased from 2014 to 2020, during which multiple campaigns targeting HIV testing and prevention occurred. The decline in HIV diagnoses among MSM born in France preceded the introduction of PrEP in 2016 and continued post-2016 without any acceleration in the rate of decline. Increased awareness of, access to and uptake of HIV prevention measures remain essential to progress towards HIV elimination in France, especially among MSM born abroad.

Orientia tsutsugamushi, the causative agent of scrub typhus, is endemic to the Asia-Pacific region. In South Korea, the Boryong strain is considered dominant; however, nationwide phylogeographic distribution and genetic diversity based on clinical isolates remain incompletely characterized. In this study, 121 O. tsutsugamushi clinical isolates were collected from scrub typhus patients at 11 hospitals across South Korea between 2015 and 2024. Isolates were genotyped using 56-kDa gene sequencing and multilocus sequence typing (MLST) of seven housekeeping genes. Sequence analysis and phylogenetic reconstruction were performed using BLAST, PubMLST, BURST, MEGA11, DnaSP6, and R-based tools. Five 56-kDa genotypes were identified: Boryong (93.4%), Ikeda, Je-cheon, Young-worl, and Yeo-joo. MLST revealed 11 sequence types (STs), including five novel STs. While the Boryong strain and related STs were distributed nationwide, minor strains showed restricted distribution in northern regions. Several isolates sharing the same 56-kDa genotype exhibited different MLST STs, indicating possible recombination or local microevolution. This study provides the first nationwide MLST-based characterization of O. tsutsugamushi in South Korea and demonstrates the dominance of the Boryong strain alongside localized diversity. Our findings underscore the utility of MLST for higher-resolution typing and support the need for continued molecular surveillance to inform regional epidemiology and disease management.

Community-acquired pneumonia (CAP) remains an important public-health problem, and the COVID-19 pandemic and non-pharmaceutical interventions (NPIs) may have altered its burden. This study aimed to provide updated CAP burden among adults in Shanghai from 2016-2023.We analysed 61,230 participants aged 20-74 years from the Shanghai Suburban Adult Cohort and Biobank. CAP episodes were ascertained via ICD codes and clinical diagnoses. We calculated incidence rates before, during, and after NPIs, conducted subgroup analyses by age, sex, comorbidity and lifestyle. We used Poisson regression to compare stages, and Cox models to identify risk factors. The Overall CAP incidence was 42.1 per 1,000 person-years (95% CI 41.3-42.8). Incidence declined during NPIs (24.2/1,000 py) and rose after NPIs (95.9/1,000 py). The inpatient-to-outpatient ratio increased to 10.1% during NPIs and fell to 5.7% post-NPI. Among those without underlying conditions, rates were 40.1, 20.1 and 73.6/1,000 py before, during and after NPIs. Incidence was higher in participants ≥60 years and in those with multiple comorbidities, especially respiratory diseases. CAP burden temporarily fell during NPIs but resurged post-NPI, notably among high-risk groups. These findings highlight the need for targeted preventive strategies and continued CAP surveillance in the post-pandemic era.

Hyderabad, the fourth-most populous city in India, accounts for the majority of people living with human immunodeficiency virus (HIV) (PLWH) in Telangana, likely comprised of two populations with a disproportionately high national HIV prevalence: gay, bisexual, and other men who have sex with men (MSM) and those who engage in sex work (SW). Research has shown that engaging in SW increases vulnerability to HIV transmission risk for both women and MSM, but less is known about contributors to non-optimal (ART) adherence. We analyzed data from 45 MSM and 49 women living with HIV who were enrolled in the first year of data collection from an mHealth education study in Hyderabad. Modified Poisson regression was used to measure factors associated with ART adherence measured with a visual analogue scale (VAS) (model 1) and pill count (model 2). Less than half (40.9%) reported ever engaging in SW, including 13 women and 25 MSM. The prevalence of non-optimal ART adherence was 14.9% with VAS and 42.4% with pill count. Engaging in SW was not associated with non-optimal ART adherence. Differences in non-optimal ART adherence measured by VAS and pill count suggest that future studies should utilize both methods to better distinguish the measures.