Infectious Disease Reports最新文献

Background/Objectives: During the pandemic, client-facing workers were perceived to be at greater risk of SARS-CoV-2 infection. This study investigated the risk factors for SARS-CoV-2 infection among a cohort of 304 retail workers in the Quebec City metropolitan area. Methods: After providing consent, participants were interviewed to gather information on demographic, socioeconomic, behavioural, and occupational variables. They were subsequently followed for up to five visits, scheduled every 12 ± 4 weeks. The study covered critical periods before and during the emergence of the Omicron variants and included retrospective reporting of COVID-19 symptoms and virus detection tests to capture the pandemic's early stages. Results: During the observation period, 173 (57%) participants experienced a first episode of COVID-19. Serological evidence of recent infection was detected in 160 participants (53%), while 117 (38%) reported a positive virus detection test. In adjusted analyses, risk factors for infection included younger age, a diagnosis of lung disease, longer weekly working hours, more frequent social gatherings, and having received fewer than three doses of vaccine. Notably, the increased risk associated with younger age and longer working hours was observed only after the relaxation of public health measures in the spring of 2022. Conclusions: These data suggest that during the early years of the pandemic when strict public health measures were in place, retail work was not a significant risk factor for SARS-CoV-2 infection in Quebec City metropolitan area. These findings highlight the complex dynamics of COVID-19 transmission and the effectiveness of workplace protective measures.

Background: The global push to eliminate tuberculosis (TB) as a public health threat is increasingly urgent, particularly in high-burden areas like the Oliver Reginald Tambo District Municipality, South Africa. Drug-resistant TB (DR-TB) poses a significant challenge to TB control efforts and is a leading cause of TB-related deaths. This study aimed to assess DR-TB transmission patterns and predict future cases using geospatial and predictive modeling techniques.

Methods: A retrospective cross-sectional study was conducted across five decentralized DR-TB facilities in the O.R. Tambo District Municipality from January 2018 to December 2020. Data were obtained from Statistics South Africa, and patient GPS coordinates were used to identify clusters of DR-TB cases via DBSCAN clustering. Hotspot analysis (Getis-Ord Gi) was performed, and two predictive models (Linear Regression and Random Forest) were developed to estimate future DR-TB cases. Analyses were conducted using Python 3.8 and R 4.1.1, with significance set at p < 0.05.

Results: A total of 456 patients with DR-TB were enrolled, with 56.1% males and 43.9% females. The mean age was 37.5 (±14.9) years. The incidence of DR-TB was 11.89 cases per 100,000 population, with males being disproportionately affected. Key risk factors included poverty, lack of education, and occupational exposure. The DR-TB types included RR-TB (60%), MDR-TB (30%), Pre-XDR-TB (5%), XDR-TB (3%), and INHR-TB (2%). Spatial analysis revealed significant clustering in socio-economically disadvantaged areas. A major cluster was identified, along with a distinct outlier. The analyses of DR-TB case trends using historical data (2018-2021) and projections (2022-2026) from Linear Regression and Random Forest models reveal historical data with a sharp decline in DR-TB case, from 186 in 2018 to 15 in 2021, highlighting substantial progress. The Linear Regression model predicts a continued decline to zero cases by 2026, with an R² = 0.865, a mean squared error (MSE) of 507.175, and a mean absolute error (MAE) of 18.65. Conversely, the Random Forest model forecasts stabilization to around 30-50 cases annually after 2021, achieving an R² = 0.882, an MSE of 443.226, and an MAE of 19.03. These models underscore the importance of adaptive strategies to sustain progress and avoid plateauing in DR-TB reduction efforts.

Conclusions: This study highlights the need for targeted interventions in vulnerable populations to curb DR-TB transmission and improve treatment outcomes.

Background:Salmonella enterica serovar Hvittingfoss, a member of the non-typhoidal Salmonella group, is an important foodborne serovar most frequently identified in regions (Australia, Belgium, and the United States) with active surveillance systems. This serovar has been implicated in outbreaks of foodborne illness. Soft cheese, crab cocktail, beef, and rock melon are commonly involved in these outbreaks. Although the definitive host of this serovar is not yet established, Salmonella Hvittingfoss can be found in wild animals (Feral pigs), bird populations (Bar-tailed godwit, Plumed whistling ducks, White-naped crane, and Sharp-tailed sandpiper), and domestic birds like chickens. Case presentation: We report the first case of Salmonella enterica serovar Hvittingfoss causing acute gastroenteritis in a 52-year-old male labourer and agriculturist from a rural area of Mysuru, South India. This is the first documented case of Salmonella Hvittingfoss causing acute gastroenteritis in India. Conclusions: While non-typhoidal Salmonella infections typically resolve on their own, they can be particularly dangerous for certain demographics, such as children, the elderly, and those with compromised immune systems. Therefore, studying the different serotypes of these infections in both clinical and subclinical cases is crucial for targeting effective surveillance, hygiene practises, and food safety measures that can mitigate their impact on public health.

Introduction: Invasive aspergillosis (IA) is an opportunistic fungal infection that typically occurs in the immunocompromised host and is associated with severe morbidity and mortality. Myocardial abscess formation is seldomly described. Detailed Case Description: We present a case of IA with purulent myocarditis. The patient was on long-term high-dose corticosteroid and mycophenolate mofetil therapy for severe lupus nephritis. After multiple visits to his general practitioner and nephrologist for general malaise, he was admitted to our hospital with visual complaints. Within several days, he developed atrial fibrillation, respiratory insufficiency, and, finally, a decreased level of consciousness. After admission to the intensive care unit, the broncho alveolar lavage (BAL) fluid galactomannan (GM) index was normal, but the serum GM index was severely elevated. Despite initiation of antifungal therapy, the patient passed away shortly thereafter. Autopsy revealed massive intracranial hemorrhage and disseminated IA affecting the lungs, brain, and myocardium, with macroscopic myocardial abscess formation. Discussion: This classic case of diagnostic uncertainty illustrates how invasive fungal infections can progress to disseminated disease while showing nonspecific symptoms only. It emphasizes the importance of vigilance for opportunistic fungal infections in a growing category of immunocompromised patients. Conclusion: Clinicians should have a low threshold of suspicion for fungal infections in patients on combination immunosuppressive medication, such as high-dose corticosteroid therapy in combination with T-cell inhibitors like MMF.

Background: The current economic and social crisis in Latin America has caused migration to the USA, bringing with it Public Health challenges due to the importation of various infectious diseases. Migrants, particularly those with chronic conditions, such as HIV infection and other sexually transmitted infections (STI), are at greater risk due to pharmacological interruption and access to medical care, so the timely detection of diseases acquired during their migration, such as malaria, is crucial to avoid health complications.

Objective: To outline by a multidisciplinary approach (Infectology, Parasitology, Epidemiology, molecular Biology, Venereology, and Public Health) the diagnosis and management of a male case with malaria imported to Mexican territory, HIV chronic infection, and latent syphilis.

Methods: A male migrant of Venezuelan nationality attended the Clínica Especializada Condesa Iztapalapa in Mexico City for health complications. A comprehensive analysis of laboratory and molecular tests was performed to confirm HIV infection. During the STI diagnostic algorithm, latent syphilis was detected and microscopic observation of blood smears revealed parasitic forms compatible with malaria. Standard and molecular tests were applied under the operational definition for malaria cases for identification, diagnosis, and treatment. Finally, study of clinical history and migration route by questioning for the investigation of the imported case was performed.

Results: The immigrant was diagnosed with HIV chronic-stage infection with interrupted antiretroviral therapy (ART), latent syphilis, and malaria by Plasmodium vivax. The ART administered was chosen based on the possible drug interaction with antimalarials and genetic barrier to the HLA-B* allele. Finally, antimicrobial therapy against syphilis was penicillin. From the analysis of the migratory route, incubation time of imported malaria, and questioning, we speculated that the migrant acquired the P. vivax infection in Panama.

Conclusions: This case highlights the complex health problems faced by migrants with HIV infection, particularly when they contract additional infections such as malaria during migration and highlights the need for comprehensive access to healthcare and ART, antimalarial and antimicrobial treatments to mitigate the health risks of this vulnerable population.

Background: Plantar warts, caused by human papillomavirus (HPV), are a common condition that can be painful and resistant to treatment. There are various therapeutic options for managing them, but it is not always clear which are the most effective and tolerated by patients. Among the most commonly used treatments are a zinc and nitric complex (nitrizinc complex), cantharidin, and bleomycin, each with different mechanisms of action and profiles in terms of pain and patient satisfaction. Objectives: We aimed to evaluate and compare the clinical efficacy, post-treatment pain, and patient satisfaction among three common treatments (zinc and nitric complex, cantharidin, and bleomycin) in subjects with plantar warts, as well as identify the most effective and best-tolerated treatment. Materials and Methods: This is a retrospective case series study analyzing 60 records of subjects aged 18 to 40 years diagnosed with plantar warts without systemic diseases or allergies and without any prior treatment. Complete records from 2020 to 2023 were selected. Subjects were divided into three groups according to the treatment received (zinc and nitric complex, cantharidin, bleomycin), and demographic variables, post-treatment pain (measured using the visual analog scale), the number of sessions required, and satisfaction after discharge (evaluated with the Likert scale) were analyzed. Results: Of the 60 subjects included, the group treated with bleomycin experienced higher levels of pain after the first session (mean of 7.1 points on the VAS) compared to the cantharidin group (2.7 points) and the zinc and nitric complex group (1.1 points). However, the bleomycin group required fewer sessions for complete healing (an average of 1.8 sessions), while the nitric acid group needed more (3.4 sessions), with cantharidin falling in between (2.5 sessions). Regarding post-discharge satisfaction, all groups showed comparable scores (between 7.9 and 8.5 points), although cantharidin demonstrated slightly higher satisfaction. A statistical analysis showed significant differences in the number of sessions and post-treatment pain between treatments (p < 0.05) but not in final satisfaction. Conclusions: Although bleomycin treatment is more painful, it is the most effective in terms of reducing the number of sessions required for complete healing. Cantharidin offers a good balance between efficacy and patient satisfaction, while a zinc and nitric complex, although less painful, requires more sessions for complete treatment. Each treatment has specific advantages, suggesting that therapeutic choices should be personalized according to the patient's needs and preferences.

Background: Leprosy control remains challenging in Brazil and has been aggravated by the COVID-19 pandemic.

Objective: To analyze the impact of the COVID-19 pandemic on the epidemiological scenario of leprosy through the detection rate of new cases, the risk of illness, and the hidden prevalence of leprosy according to high-risk micro-region in Minas Gerais, Brazil.

Methods: An ecological study conducted in the health micro-regions of Minas Gerais, using data on new leprosy cases diagnosed between 2015 and 2023. The annual detection rate of new cases, the risk of illness index and the hidden prevalence of leprosy were evaluated. The time trend was evaluated by calculating the annual percentage change (APC) of the detection rate, based on segmented linear regression, considered significant when it showed p < 0.05.

Results: The state of Minas Gerais showed a significant negative annual increase between 2015 and 2020 (APC = -7.91; 95%CI -21.76--1.72), and in 2020 it showed an inflection point, with an annual increase of 9.91 in the period from 2020 to 2023. When evaluating the hidden prevalence of leprosy in Minas Gerais, we observed a reduction in the estimates' average from 2015-2019 (2.78) to 2020-2023 (2.00). The state as a whole showed an upward trend in the risk of illness, with the average index varying from 0.28 (medium risk) to 0.55 (high risk).

Conclusions: The pandemic has had a considerable and heterogeneous impact on the detection of new cases, as well as on the risk of becoming ill and the hidden prevalence of leprosy, with repercussions for the control of the endemic in populations. There is a need to implement public health policies that prioritize the early identification of cases and ensure that vulnerable populations are monitored.

Background/objectives: The COVID-19 pandemic has revolutionized vaccine production and compelled a massive global vaccination campaign. This study aimed to estimate the positivity and levels of SARS-CoV-2 IgG antibodies acquired due to vaccination and infection in the academic population of a Portuguese university.

Methods: Blood samples were collected and analyzed through the ELISA methodology, and statistical analysis was performed.

Results: A total of 529 volunteers with at least one dose of the vaccine were enrolled in this study. Individuals without a prior COVID-19 diagnosis were divided into two groups: 350, who received a full vaccination, and 114, who received a full vaccination and a booster dose of the same vaccine (81) and mixed vaccines (33). Regarding the individuals who reported a prior SARS-CoV-2 infection, 31 received a full vaccination, and 34 received only one vaccination dose. Data analysis showed a higher level of IgG against SARS-CoV-2 in individuals who were younger, female, who received the Moderna vaccine, with recent post-vaccine administration, a mixed booster dose, and prior SARS-CoV-2 infection.

Conclusions: Assessing vaccination's effectiveness and group immunity is crucial for pandemic management, particularly in academic environments with high individual mobility, in order to define groups at risk and redirect infection control strategies.