Epidemiology and Infection最新文献

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.

The activity of respiratory viruses (RVs) displays large variability in tropical regions, posing challenges for public health response strategies. Data from most RVs in south-eastern Mexico remain limited, particularly in the Yucatan Peninsula, the largest tourism hub in the country. This retrospective study analyses the regional epidemiology of RVs in Merida, the largest city in the region, using laboratory test data from a local hospital (January 2018-April 2024). Test results of 143292 RVs were collected, including 121976 for SARS-CoV-2, 19355 for influenza A and B viruses, and 1961 for 17 distinct RVs. We found that non-SARS-CoV-2 RVs circulated year-round, with higher activity in autumn and spring, while SARS-CoV-2 peaked in summer and winter. Influenza A virus, respiratory syncytial virus, and influenza B virus reached their highest activity in autumn, earlier than in other regions of Mexico. Human metapneumovirus peaked during autumn-winter. Rhinovirus/enterovirus and parainfluenza showed year-round activity, with peaks in autumn and spring. Other coronaviruses were more frequent during winter-spring. In post-pandemic years (2022-2023), adenovirus outbreaks emerged, as well as an increased prevalence of non-SARS-CoV-2 RV co-infections. This study highlights the need for region-specific public health strategies, including optimized vaccination schedules, such as for influenza A virus, and enhanced diagnostic surveillance.

We aimed to describe the evolution of gonorrhea infection and its antimicrobial resistance patterns in the Prairie provinces compared to Canada between 1980 and 2022. Data was collected from publicly available sexually transmitted infection reports in Canada, Alberta, Saskatchewan, and Manitoba. We extracted the number and rates of gonorrhea cases; percentage of cases by sex, age, ethnicity, sexual orientation; and data on cases diagnosed by culture and antimicrobial resistance. Descriptive statistics and age-period-cohort effect analysis were used. Gonorrhea cases in Canada rose from 32.4 per 100 000 in 1992 to 92.3 in 2022. In 2020, 36.9% of gonorrhea cases in Canada were females, compared to 42.8% in Alberta, 55.3% in Saskatchewan and 56% in Manitoba. People aged ≥30 years represented 22.5% of cases in 1980, and 54.1% in 2022. By 2022, the proportion of Canadian cases detected by culture declined to less than 10%, and azithromycin resistance of N. gonorrhoeae isolates was 8.1%. Alberta, Manitoba, and Saskatchewan reported higher rates of gonorrhea compared to Canada, with a higher proportion of female cases in Manitoba and Saskatchewan. Rising antimicrobial resistance rates and decreased culture testing present significant concerns for gonorrhea control and surveillance.

This study examined whether coronavirus disease 2019 (COVID-19) infection experience enhances preventive behaviour (i.e., hand disinfection and mask-wearing), with risk perception acting as a mediating factor. The study included participants aged ≥18 years residing in Japan, enrolled in a 30-wave cohort study conducted from January 2020 to March 2024. Using propensity score matching, 135 pairs of participants with and without infection were extracted, adjusting for dread and unknown risk perception, preventive behaviours, sociopsychological variables, and individual attributes. Comparisons of risk perception and preventive behaviour were made between groups post-infection experience, and mediation analysis was conducted to test whether risk perception mediated the effect of infection experience on preventive behaviour. Following the infection experience, participants in the infection group reported significantly higher scores for one item of unknown risk perception and a greater proportion of mask-wearing. The indirect effect of infection experience on mask-wearing, mediated by the unknown risk perception item, was significant. COVID-19 infection experience increased perceptions of unknowable exposure, which in turn promoted mask-wearing behaviour. Incorporating insights from personal infection experiences into public health messaging may enhance risk perception and promote preventive behaviour among non-infected individuals, offering a novel approach to infection control at the population level.

Nationwide screening for parvovirus B19 among blood donors in Hungary has been conducted since 2019. Although B19 is primarily transmitted via the respiratory route, transfusion-related transmission also occurs. This study investigated the impact of COVID-19-related restrictions on B19 incidence. Between January 1 2019 and December 31 2024, a total of 2,043,119 blood donations were screened for B19 DNA using PCR, and the study period was divided into six epidemiological phases.During the pre-restriction period (Phase I), B19 incidence was relatively low (0.87/10,000 donations). Following the introduction of COVID-19 restrictions (Phase II), highly viremic donations were not detected. Incidence gradually returned in Phase III (0.22/10000) and increased in Phase IV (1.96/10000), suggesting a minor outbreak. A marked surge in December 2023 (23.03/10000) initiated a nationwide epidemic, peaking in March-April 2024 (46.01/10000), before declining by August (Phase VI; 0.54/10000).COVID-19 restrictions substantially reduced B19 transmission and may have led to increased population susceptibility. This likely contributed to the unusually intense B19 epidemic observed in 2024, which was considerably more severe than contemporaneous outbreaks reported in other countries.

Accidental escapes of pathogens from laboratories continue to cause outbreaks in the community today, posing significant risks to the general public, animal communities and the environment. These incidents, as well as the uncertainties surrounding the origins of the COVID-19 pandemic, highlight the need to consider unnatural origins as part of emerging outbreak surveillance and detection. Identifying recurring patterns and distinctive factors of laboratory-associated disease outbreaks can aid in successfully preventing and mitigating these occurrences. Seventy incidents of laboratory-associated leaks that led to outbreaks in the wider public have been reported (Supplementary Appendix S1). Seven renowned cases that have been comprehensively studied were selected for review: (i) 1955 Polio vaccine incident in western USA, (ii) 1977 H1N1 influenza virus re-emergence in China and the Soviet Union, (iii) 1979 Anthrax release in Sverdlovsk, Soviet Union, (iv) 1995 Venezuelan equine encephalitis epidemics in Venezuela and Colombia, (v) 2003-4 SARS-CoV-1 escapes from Singapore, Taiwan and China, (vi) 2007 Foot-and-Mouth disease virus outbreak in Pirbright, England and (vii) 2019 Brucella leak in Lanzhou, China. These outbreaks were selected because data on their geographical spread, genetics, phylogeny, epidemiological factors (including attack rates, infectious dose, time, location and season of spread) and governmental and institutional responses to the incidents had been previously analysed and published. Thematic analysis of these lines of evidence revealed seven recurring insights described in historically confirmed laboratory-associated outbreaks: unusual strain characteristics, peculiar clinical manifestations or affected demographics, unusual geographical features, atypical epidemiological patterns, delayed government action and communication to the public, misinformation and disinformation spread to the public and biosafety concerns/incidents predating the event. The outbreaks exhibited between 13 and 19 retrospectively identified indicators. These indicators were used to develop preliminary risk criteria intended to support structured, hypothesis-generating assessment of outbreaks, rather than to establish origin.