Journal of Infection and Public Health最新文献

{"title":"Circular genome of human bocavirus 1 associated with high load of viral DNA, positive antigen and increased risk of severe pneumonia in children","authors":"Kexiang Zhang ,&nbsp;Ri De ,&nbsp;Zeng Li ,&nbsp;Yanpeng Xu ,&nbsp;Zhenzhi Han ,&nbsp;Runan Zhu ,&nbsp;Yu Sun ,&nbsp;Liping Jia ,&nbsp;Dongmei Chen ,&nbsp;Yutong Zhou ,&nbsp;Qi Guo ,&nbsp;Yao Yao ,&nbsp;Xiaolin Ma ,&nbsp;Shuang Liu ,&nbsp;Chunmei Zhu ,&nbsp;Dong Qu ,&nbsp;Linqing Zhao","doi":"10.1016/j.jiph.2026.103156","DOIUrl":"10.1016/j.jiph.2026.103156","url":null,"abstract":"<div><h3>Background</h3><div>Human bocavirus 1 (HBoV1) causes acute respiratory infections (ARIs) in children, but its diagnosis is complicated by prolonged viral shedding. There are indications that the detection of a circular genome in a clinical specimens may be associated with acute infection.</div></div><div><h3>Methods</h3><div>Respiratory specimens collected from pediatric patients with ARIs during January 2021 to July 2024 were screened by a duplex qPCR, which was developed to distinguish circular genome from total viral genomes and evaluated by nested PCR and antigen test. Clinical data were collected from patients with single HBoV1 infection to reveal the association of circular genome with ARIs and the severity of pneumonia.</div></div><div><h3>Results</h3><div>Among 520 specimens positive for HBoV1 DNA, 206 (39.61 %) were positive for circular genomes as determined by duplex qPCR, with the median load of total genomes 10^10.08 (IQR 10^9.26, 10^10.62) copies/mL significantly higher than 10^7.81 (IQR 10^6.88, 10^8.60) copies/mL in the circular genome negative group (<em>p</em> &lt; 0.0001). In the antigen-positive group, the positive rate for circular genomes was 78.57 % (44/56), significantly higher than 34.29 % (108/315) observed in the antigen-negative group. Among patients single positive for HBoV1, the circular genome-positive group (n = 106) showed more severe clinical manifestations and required more intensive treatment. Logistic regression analysis identified the circular genome as a strong independent risk factor for severe pneumonia (OR = 6.38, AUC = 0.82).</div></div><div><h3>Conclusion</h3><div>Circular genome of HBoV1 associated with high load of viral DNA, positive antigen and severe pneumonia in children may serve as a biomarker for acute HBoV1 infection and severe pneumonia.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103156"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypervirulent and carbapenem-resistant Klebsiella pneumoniae: A call for global surveillance and coordinated action","authors":"Shital Ghogale,&nbsp;Ketaki Pathak","doi":"10.1016/j.jiph.2026.103141","DOIUrl":"10.1016/j.jiph.2026.103141","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103141"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering active surveillance of Carbapenem-resistant Enterobacterales: Insights from one year of genomic surveillance","authors":"Greta Petazzoni ,&nbsp;Stefano Gaiarsa ,&nbsp;Irene Mileto ,&nbsp;Angela Kuka ,&nbsp;Marta Corbella ,&nbsp;Cristina Merla ,&nbsp;Antonio Piralla ,&nbsp;Marina Ramus ,&nbsp;Aurora Piazza ,&nbsp;Vittoria Mattioni Marchetti ,&nbsp;Roberta Migliavacca ,&nbsp;Alba Muzzi ,&nbsp;Patrizia Cambieri ,&nbsp;Fausto Baldanti","doi":"10.1016/j.jiph.2026.103187","DOIUrl":"10.1016/j.jiph.2026.103187","url":null,"abstract":"<div><h3>Background</h3><div>Healthcare-associated infections (HAIs) in Europe affect millions of patients annually, driving antimicrobial resistance and imposing significant economic burdens. Carbapenem-resistant <em>Enterobacterales</em> (CRE) are particularly concerning due to their ability to spread, making genomic surveillance essential for tracking their transmission.</div></div><div><h3>Methods</h3><div>From October 2022 to September 2023, we sequenced and analysed the genome of 340 CRE obtained from patients admitted to Fondazione IRCCS Policlinico San Matteo ( Italy). Sequencing was performed using a short-read approach and genomes were <em>in-silico</em> characterized to identify Sequence Types (STs), antimicrobial resistance and virulence determinants, and plasmid content. Moreover, a core SNP-based phylogeny was performed to identify potential epidemic clusters within the same clone.</div></div><div><h3>Results</h3><div>Among the 340 CRE isolated from surveillance (N = 234) and other clinical specimens (N = 106), 87.7% belonged to the <em>Klebsiella</em> genus, primarily <em>K. pneumoniae</em> (CR-Kp, N = 284). <em>Escherichia coli</em> (CR-Ec) accounted for 8.5% (N = 29); while the remaining species were <em>Enterobacter spp.</em> (N = 13) and <em>Citrobacter spp.</em> (N = 9). <em>bla</em>_KPC and <em>bla</em>_NDM gene variants were detected in 55.9% and 25.6% of CRE, respectively. The most prevalent CR-Kp clones were ST307, ST6668, ST258, and ST512, whereas ST131 was dominant among CR-Ec. Large epidemic clusters (ECs; ≥ 5 strains in each clade) were mainly found in CR-Kp associated with ST307 and ST6668, with 80.63% of CR-Kp grouped into nine ECs. Conversely, other species were observed as sporadic cases or within transmission clusters with limited spread.</div></div><div><h3>Conclusion</h3><div>Our comprehensive analysis of CRE circulation at HSM revealed that their dissemination was largely driven by highly successful clones, shedding light on several of them.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103187"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors, clinical outcomes of patients with Ceftazidime/Avibactam-resistant carbapenem-Resistant Klebsiella pneumoniae infection and its potential resistant mechanisms","authors":"Zhenchao Wu ,&nbsp;Yanqiu Ma ,&nbsp;Jiajia Zheng ,&nbsp;Ping Yang ,&nbsp;Ming Lu ,&nbsp;Du Yipeng ,&nbsp;Ning Shen","doi":"10.1016/j.jiph.2026.103161","DOIUrl":"10.1016/j.jiph.2026.103161","url":null,"abstract":"<div><h3>Background</h3><div>Ceftazidime/avibactam (CZA) resistance (CZAr) poses critical challenges for the treatment of carbapenem-resistant <em>Klebsiella pneumoniae</em> (CRKP) infections. The early identification of high-risk populations is essential for controlling nosocomial transmission and guiding empirical therapy. This study aimed to systematically focus on the correlation between the clinical characteristics of patients and the microbial features of CZArCRKP.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study (January 2020-May 2023) of 97 patients with CRKP infection. Antimicrobial susceptibility testing and whole-genome sequencing (WGS) were used to analyze resistance phenotype-genotype correlations. Survival outcomes were evaluated using Kaplan–Meier analysis.</div></div><div><h3>Results</h3><div>CZArCRKP primarily caused lower respiratory (72.16 %) and urinary tract (16.49 %) infections, predominantly affecting elderly patients with comorbidities (81.4 %) or undergoing invasive procedures (63.9 %). Chronic renal failure combined with platelet counts &gt; 149× 10⁹/L post-infection strongly predicted patients with CZArCRKP in pulmonary infections. <em>NDM-1</em> gene carriage and <em>OmpK36</em> mutations were associated with CZA resistance. CZA-treated patients demonstrated lower 14-day mortality rates.</div></div><div><h3>Conclusion</h3><div>We established the first integrated host-pathogen risk model for CZArCRKP and identified chronic renal failure and platelet count as key clinical predictors. <em>NDM-1/OmpK36</em> mutations represents a clear mechanism of resistance. CZA use may improve the survival of selected patients with CRKP. These findings advance the surveillance and therapeutic strategies for multidrug-resistant infections.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103161"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calls for papers: Antimicrobial resistance and one health: interdisciplinary strategies to address a global challenge – Virtual special issue","authors":"","doi":"10.1016/j.jiph.2025.103122","DOIUrl":"10.1016/j.jiph.2025.103122","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103122"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-driven policy recommendations for dengue prevention and control in Thailand: A mixed-methods study","authors":"Chawarat Rotejanaprasert ,&nbsp;Ngamphol Soonthornworasiri ,&nbsp;Lokachet Tanasugarn ,&nbsp;Amorn Leelarasamee ,&nbsp;Kulkanya Chokephaibulkit ,&nbsp;Udomsak Narkkul ,&nbsp;Peeradone Srichan ,&nbsp;Khuanchai Koompapong ,&nbsp;Piroon Mootsikapun ,&nbsp;Winai Ratanasuwan ,&nbsp;Saranath Lawpoolsri","doi":"10.1016/j.jiph.2026.103166","DOIUrl":"10.1016/j.jiph.2026.103166","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization roadmap targets the eradication of dengue, a neglected tropical disease. Community participation is crucial for successful control efforts, which must transcend technical solutions to engage and motivate the public. This study examined the needs, perceptions, and emotional drivers underpinning dengue prevention efforts and recommended tailored policies to control dengue in varied settings.</div></div><div><h3>Methods</h3><div>This mixed-methods study, using a triangulation design, was conducted in four geographical regions of Thailand between November 2023 and April 2024. Quantitative surveys were administered to 664 community members and 430 public health personnel, complemented by 10 focus group discussions (FGDs) with community members, 16 FGDs, and 23 in-depth interviews (IDIs) with public health personnel. Logistic regression was used to examine factors associated with dengue control practices, while qualitative data were analyzed thematically. Findings from both components were integrated during interpretation to enhance the robustness of conclusions.</div></div><div><h3>Results</h3><div>Integrated quantitative and qualitative findings showed that most participants practiced active dengue prevention. Social support strongly influenced preventive behaviors (OR 19.81; 95 % CI 8.53–46.03), whereas demographic factors and perceived susceptibility or severity were not significant. Higher practice levels were observed among participants in the northeast and health personnel aged ≥ 50 years. Qualitative data reinforced these findings, emphasizing the vital role of village health volunteers and challenges such as limited participation, low risk perception, poor sanitation, and cultural barriers shaping vaccine hesitancy.</div></div><div><h3>Conclusion</h3><div>Effective dengue control requires context-specific, evidence-based strategies that strengthen community participation, empower village health volunteers, and enhance vector control. Early warning systems and intersectoral collaboration are vital in high-risk areas, while transparent, culturally tailored communication can improve vaccine acceptance. These findings provide evidence to guide policy toward sustainable, community-centered dengue prevention and control.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103166"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole blood gene expression to assess disease severity of omicron-associated acute encephalitis and croup in children: A transcriptomic and immune profiling study","authors":"Chong-Wei Huang ,&nbsp;Wei-Chao Liao ,&nbsp;Ian Yi-Feng Chang ,&nbsp;En-Wei Hsing ,&nbsp;Chung-Guei Huang ,&nbsp;Jainn-Jim Lin ,&nbsp;Kuang-Lin Lin ,&nbsp;Cheng-Hsun Chiu ,&nbsp;Chih-Ho Chen ,&nbsp;Jen-Han Chen ,&nbsp;Wen-I Lee ,&nbsp;Yu-Chia Hsieh","doi":"10.1016/j.jiph.2026.103181","DOIUrl":"10.1016/j.jiph.2026.103181","url":null,"abstract":"<div><h3>Background</h3><div>The Omicron variant of SARS-CoV-2 has caused severe complications in children, including encephalitis/encephalopathy and croup, yet the underlying pathogenic mechanisms remain unclear. Transcriptome analysis could provide insights into immune responses and guide clinical management strategies.</div></div><div><h3>Methods</h3><div>We conducted a case-control cohort study of COVID-19 patients across two medical centers in Taiwan from April 17 to November 7, 2022. Blood RNA sequencing was used to analyze differences in gene expression and functional pathways between cases of encephalitis/encephalopathy or croup of varying severity and controls with mild febrile disease. We applied computational analyses to identify transcriptomic signatures linked to COVID-19 associated encephalitis/encephalopathy.</div></div><div><h3>Results</h3><div>This study included 61 patients diagnosed with SARS-CoV-2 infection: 29 with mild febrile disease, 14 with croup, and 18 with encephalitis/encephalopathy. More differentially expressed genes were identified in encephalitis/encephalopathy (n = 834) than in croup (n = 185). Functional enrichment analysis revealed coordinated upregulation of myeloid leukocyte, neutrophil, and macrophage pathways in encephalitis/encephalopathy, accompanied by downregulation of HLA class II expression, antigen presentation, and T-cell activation, with changes tracking disease severity. CIBERSORT analysis revealed increased activated dendritic cells and reduced naïve CD4 T cells, CD8 T cells, naïve B cells, and NK cells. Croup patients showed reduced antigen presentation and low T cell receptor signaling. Gene expression profiles differentiated encephalitis/encephalopathy from mild febrile disease with a positive predictive value of 95.3 %.</div></div><div><h3>Conclusion</h3><div>Future interventions aiming at innate immune dysregulation, such as neutrophil inhibition, addressing macrophage activation, and enhancing T-cell responses, could play a promising role in improving outcomes for children infected with emerging, virulent SARS-CoV-2 variants.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103181"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive review of resistome profiles in ocular pathogens: Insights into Pseudomonas aeruginosa and emerging resistance trends","authors":"Raghav Krishnan Kulandaivelu ,&nbsp;Aditi Roy ,&nbsp;Soham Roy ,&nbsp;J.S. Amith Velavan ,&nbsp;Reddysai Amudala ,&nbsp;Debraj Joel Das Adhikari ,&nbsp;Karan S.V. ,&nbsp;Sudha Ramaiah ,&nbsp;Anand Anbarasu","doi":"10.1016/j.jiph.2026.103183","DOIUrl":"10.1016/j.jiph.2026.103183","url":null,"abstract":"<div><div>Eye infections are a significant area of microbial adaptation and therapeutic challenge, as antibiotic resistance threatens vision. In the last ten years, our knowledge of the ocular resistome has expanded through genomics and molecular epidemiology. An analysis of global evidence from 2015 to 2025 on the resistance architecture of major ocular pathogens will be presented, with a focus on <em>Pseudomonas aeruginosa</em> (<em>P. aeruginosa)</em>. The organism shows remarkable genomic flexibility by incorporating intrinsic resistance elements, biofilm-mediated tolerance, and by acquiring ARGs such as <em>bla</em>_VIM, <em>bla</em>_GES, QnrVC and RmtB by horizontal transfer. According to researchers, <em>Staphylococcus aureus</em> (<em>S. aureus</em>)<em>, Streptococcus pneumoniae</em> (<em>S. pneumoniae)</em>, and <em>Acinetobacter baumannii (A. baumannii)</em> have evolved mechanisms of drug resistance. Geographic analysis shows regional disparities, particularly in South Asia and North America, which are associated with antibiotic use and clinical exposure. To prevent the emergence of ocular antimicrobial resistance, there’s an urgent need for rapid molecular diagnostics, genomic-based surveillance, and responsible antimicrobial stewardship.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103183"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of changes in lactate dehydrogenase (LDH) levels in predicting COVID-19 severity and mortality: A biomarker analysis","authors":"Seyed Hassan Saadat ,&nbsp;Behzad Einollahi ,&nbsp;Hadi Norouzi ,&nbsp;Mohammad Farjami ,&nbsp;Nematollah Jonaidi Jafari ,&nbsp;Shahla Afsharpeyman ,&nbsp;Fahime Shahjooie ,&nbsp;Ali Bahrami Far ,&nbsp;Kiavash Hushmandi","doi":"10.1016/j.jiph.2026.103153","DOIUrl":"10.1016/j.jiph.2026.103153","url":null,"abstract":"<div><h3>Background</h3><div>Lactate dehydrogenase (LDH) has emerged as a potential biomarker for COVID-19 severity, but the diagnostic value of its dynamic changes (ΔLDH) remains unclear. This study aimed to determine the predictive value of ΔLDH for clinical outcomes in hospitalized patients with COVID-19.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of 5635 adults with confirmed COVID-19, analyzing LDH measurements. The patients were stratified by ΔLDH quartiles (Q1-Q4). Multivariable logistic regression was used to assess the associations with mortality and ICU admission, while ROC analysis was used to determine the predictive performance.</div></div><div><h3>Results</h3><div>A U-shaped relationship was observed, with both extreme reductions (Q1: ΔLDH ≤ -196 U/L) and elevations (Q4: ΔLDH ≥ 108 U/L) predicting adverse outcomes. Q4 patients had a higher risk of mortality (aOR = 6.72, 95 % CI: 5.31–8.51) and a higher risk of ICU admission (aOR = 6.63, 95 % CI: 5.26–8.36) compared to Q1. ΔLDH revealed excellent discrimination for mortality (AUC = 0.78) with an optimal cutoff at 181.5 U/L (sensitivity = 66.7 %, specificity = 88.9 %).</div></div><div><h3>Conclusion</h3><div>ΔLDH is a powerful, independent predictor of COVID-19 severity, revealing a novel U-shaped risk pattern. The 181.5 U/L threshold offers clinically actionable guidance for risk stratification. These findings support the incorporation of serial LDH monitoring into COVID-19 management protocols.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103153"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-exposure prophylaxis with favipiravir among household close contacts to confirmed COVID-19 cases: A cluster-randomized trial (PEPfavi)","authors":"Taweegrit Siripongboonsitti ,&nbsp;Teerapat Ungtrakul ,&nbsp;Kriangkrai Tawinprai ,&nbsp;Krongkwan Niemsorn ,&nbsp;Kunsuda Punjachaipornpol ,&nbsp;Worrawat Sangwipasnapaporn ,&nbsp;Natcha Wattanapokasilp ,&nbsp;Marisa Muadchimkaew ,&nbsp;Saowanee Wongpatcharawarakul ,&nbsp;Kamonwan Soonklang ,&nbsp;Nithi Mahanonda","doi":"10.1016/j.jiph.2026.103150","DOIUrl":"10.1016/j.jiph.2026.103150","url":null,"abstract":"<div><h3>Background</h3><div>Household transmission of SARS-CoV-2 remains a key driver of community spread, with secondary attack rates in Thai households reaching approximately 50 %. There is limited evidence supporting the efficacy of antiviral post-exposure prophylaxis (PEP) in this context.</div></div><div><h3>Methods</h3><div>The phase 2/3, open-label, (1:1) cluster-randomized controlled trial in Thailand, 168 household close contacts from 76 index cases were enrolled to receive either favipiravir-PEP (FPV-PEP) (1600–2000 mg/day for 7 days) or usual care. The efficacy of FPV-PEP was investigated in preventing SARS-CoV-2 infection after contact with index cases.</div></div><div><h3>Results</h3><div>The incidence of confirmed SARS-CoV-2 infection was lower in the FPV-PEP group than in the usual care group (7.32 % vs. 14.47 %), although the difference was not statistically significant. A trend toward fewer early positive rapid diagnostic test results on day 3 was observed in the FPV-PEP group. Symptom development was less frequent among FPV-PEP recipients, with fewer cases of fever, rhinorrhea, and myalgia. A significantly higher probability of remaining asymptomatic and delayed symptom onset was observed in the FPV-PEP group. No participants developed severe COVID-19 or required hospitalization.</div></div><div><h3>Conclusion</h3><div>FPV-PEP was associated with a lower incidence of fever, rhinorrhea, and myalgia among household contacts. While a reduction in secondary transmission was observed, it did not reach statistical significance. Further large-scale studies are warranted to clarify its role in preventing household transmission.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103150"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}