Pub Date : 2026-04-01Epub Date: 2026-02-11DOI: 10.1016/j.jiph.2026.103180
Wen Wang , Xinyuan Chen , Wei Cui
Dermatopathic lymphadenopathy (DL) is a reactive lymphadenopathy typically associated with chronic dermatoses. However, DL presenting with isolated fever and no cutaneous manifestations is exceptionally rare and diagnostically challenging. We report a 73-year-old male with a history of hepatitis B virus-related cirrhosis, diabetes mellitus, and prior eczema who presented with recurrent high-grade fever (39–39.5 ℃) unresponsive to empiric antibiotics and antifungals. Extensive workup, including negative infectious and autoimmune serologies, elevated inflammatory markers (ESR 73 mm/h, CRP 42.4 mg/L), and positron emission tomography/computed tomography (PET-CT) findings of hypermetabolic lymphadenopathy, initially obscured the diagnosis. The diagnosis was ultimately confirmed by lymph node biopsy, which showed the characteristic histopathological features of DL, including pigment-laden histiocytes and polyclonal plasma cell proliferation. Fever resolved spontaneously one month post-biopsy, with no recurrence during one-year follow-up. Our experience reinforces that DL must be considered in the differential diagnosis of Fever of unknown origin (FUO), and biopsy is key to its identification.
{"title":"Dermatopathic lymphadenopathy without cutaneous manifestations presenting as fever of unknown origin: A rare case report","authors":"Wen Wang , Xinyuan Chen , Wei Cui","doi":"10.1016/j.jiph.2026.103180","DOIUrl":"10.1016/j.jiph.2026.103180","url":null,"abstract":"<div><div>Dermatopathic lymphadenopathy (DL) is a reactive lymphadenopathy typically associated with chronic dermatoses. However, DL presenting with isolated fever and no cutaneous manifestations is exceptionally rare and diagnostically challenging. We report a 73-year-old male with a history of hepatitis B virus-related cirrhosis, diabetes mellitus, and prior eczema who presented with recurrent high-grade fever (39–39.5 ℃) unresponsive to empiric antibiotics and antifungals. Extensive workup, including negative infectious and autoimmune serologies, elevated inflammatory markers (ESR 73 mm/h, CRP 42.4 mg/L), and positron emission tomography/computed tomography (PET-CT) findings of hypermetabolic lymphadenopathy, initially obscured the diagnosis. The diagnosis was ultimately confirmed by lymph node biopsy, which showed the characteristic histopathological features of DL, including pigment-laden histiocytes and polyclonal plasma cell proliferation. Fever resolved spontaneously one month post-biopsy, with no recurrence during one-year follow-up. Our experience reinforces that DL must be considered in the differential diagnosis of Fever of unknown origin (FUO), and biopsy is key to its identification.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103180"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172211","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}
Dengue fever has become a significant public health issue worldwide, especially in tropical and subtropical regions. In 2000, 505,430 cases of dengue were reported worldwide, and by 2023, the number of cases had increased to nearly 6.5 million. The present study aims to examine the temporal trends in dengue incidence and disability-adjusted life years from 1990 to 2021 using Global Burden of Disease 2021 data across South Asian countries while identifying geographic, gender, and age-related disparities with a specific focus on trends and spatial variations in India.
Methods
The GBD 2021 database was used to extract data on age-standardized incidence rates, DALYs, and ASDRs. Joinpoint regression was used to examine the trends and annual and average annual percentage changes. We also performed spatial and age-group analyses to explore the differences in disease burden across different geographical and demographic groups.
Findings
In 2021, 32.3 million cases of dengue were reported in South Asia, indicating a 152.9 % increase from 1990. With an estimated annual percentage change of 1.5 %, the ASIR increased from 1141.7 to 1704.9 per 100,000 people. At 944,761, DALYs almost doubled, whereas ASDRs increased at a rate of 1.87 % each year. A total of 28.2 million of these cases were in India, followed by Pakistan and Bangladesh. The increase in dengue cases in India has been reported as 11.2 million in 1990–28.2 million in 2021, with DALYs increasing by 2.86 % annually and an increase in the ASIR of 1.55 %.
Conclusion
The findings highlight a substantial increase in dengue burden across South Asia. The rising burden of incidence and disability requires public health initiatives, such as robust surveillance, targeted vector control, and improved treatment strategies, to reduce its impact effectively.
{"title":"Trends in dengue incidence and disease burden in South Asia with special reference to India: Insights from the global burden of disease data, 1990–2021","authors":"Ravichandiran Velayutham , Sheetal Kalra , Sheetal Yadav , Abhishek Dadhich , Prabodh Chander Sharma , Sapna Yadav , Palka Mittal , Aditya Kukreti , Priyansh Ajmera , Puneeta Ajmera , Mohammad Miraj , Riyaz Ahamed Shaik , Abeer Al-Maamari","doi":"10.1016/j.jiph.2026.103142","DOIUrl":"10.1016/j.jiph.2026.103142","url":null,"abstract":"<div><h3>Background</h3><div>Dengue fever has become a significant public health issue worldwide, especially in tropical and subtropical regions. In 2000, 505,430 cases of dengue were reported worldwide, and by 2023, the number of cases had increased to nearly 6.5 million. The present study aims to examine the temporal trends in dengue incidence and disability-adjusted life years from 1990 to 2021 using Global Burden of Disease 2021 data across South Asian countries while identifying geographic, gender, and age-related disparities with a specific focus on trends and spatial variations in India.</div></div><div><h3>Methods</h3><div>The GBD 2021 database was used to extract data on age-standardized incidence rates, DALYs, and ASDRs. Joinpoint regression was used to examine the trends and annual and average annual percentage changes. We also performed spatial and age-group analyses to explore the differences in disease burden across different geographical and demographic groups.</div></div><div><h3>Findings</h3><div>In 2021, 32.3 million cases of dengue were reported in South Asia, indicating a 152.9 % increase from 1990. With an estimated annual percentage change of 1.5 %, the ASIR increased from 1141.7 to 1704.9 per 100,000 people. At 944,761, DALYs almost doubled, whereas ASDRs increased at a rate of 1.87 % each year. A total of 28.2 million of these cases were in India, followed by Pakistan and Bangladesh. The increase in dengue cases in India has been reported as 11.2 million in 1990–28.2 million in 2021, with DALYs increasing by 2.86 % annually and an increase in the ASIR of 1.55 %.</div></div><div><h3>Conclusion</h3><div>The findings highlight a substantial increase in dengue burden across South Asia. The rising burden of incidence and disability requires public health initiatives, such as robust surveillance, targeted vector control, and improved treatment strategies, to reduce its impact effectively.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103142"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156991","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}
Pub Date : 2026-04-01Epub Date: 2026-02-06DOI: 10.1016/j.jiph.2026.103170
Carolina Hincapié-Osorno , Tamar J. van der Aart , Raymond J. van Wijk , Konstantin Föhse , Jacobien J. Hoogerwerf , Fabián Jaimes , Jacqueline Koeze , Adam Linder , Marco van Londen , Jan C. ter Maaten , Lisa Mellhammar , Renée A.M. Tuinte , Jaap ten Oever , Carlos E. Vallejo , Douwe F. Postma , Hjalmar R. Bouma
Background
Early identification of patients with suspected infection who are at risk of clinical deterioration in the Emergency Department (ED) is challenging, yet crucial for timely initiation of appropriate care and prevention of clinical deterioration. This multicenter international study evaluates the performance of established scores (SIRS, LODS, qSOFA, SOFA, NEWS) in predicting severe outcomes in ED patients with suspected infection.
Methods
We combined data from five different ED cohort studies (n = 4044 adult patients) from the Netherlands and Sweden. Suspected infection was defined as obtaining a microbiological culture combined with starting antibiotics. The scores were evaluated for their accuracy in predicting the composite outcome of intensive care unit (ICU) admission and in-hospital mortality.
Findings
Of 4044 patients, 655 (16 %) experienced a severe outcome, defined as ICU admission (n = 429, 11 %) or in-hospital mortality (n = 327, 8 %). SOFA (AUC 0.75 [95 %CI:0.73–0.77]) and LODS (AUC 0.73 [95 %CI:0.71–0.75]) showed the highest predictive accuracy. NEWS ≥ 5 yielded fair sensitivity (78 %) but low specificity (40 %), whereas NEWS ≥ 7 (sensitivity 71 %, specificity 59 %) performed similarly to SOFA ≥ 2 (69 %, 68 %) and LODS ≥ 2 (70 %, 66 %). In contrast, qSOFA (AUC 0.66 [95 %CI:0.64–0.69]) and SIRS (AUC 0.54 [95 %CI:0.52–0.57]) performed poorly for ED risk stratification.
Interpretation
SOFA and LODS showed the highest accuracy but are limited by their complexity and the requirement for laboratory data. The NEWS score, simpler and more accessible, is a practical tool for rapid ED screening with comparable accuracy as SOFA and LODS.
{"title":"Early risk assessment of severe outcomes in patients with suspected infection in the emergency department using clinical scores in a multicenter international validation","authors":"Carolina Hincapié-Osorno , Tamar J. van der Aart , Raymond J. van Wijk , Konstantin Föhse , Jacobien J. Hoogerwerf , Fabián Jaimes , Jacqueline Koeze , Adam Linder , Marco van Londen , Jan C. ter Maaten , Lisa Mellhammar , Renée A.M. Tuinte , Jaap ten Oever , Carlos E. Vallejo , Douwe F. Postma , Hjalmar R. Bouma","doi":"10.1016/j.jiph.2026.103170","DOIUrl":"10.1016/j.jiph.2026.103170","url":null,"abstract":"<div><h3>Background</h3><div>Early identification of patients with suspected infection who are at risk of clinical deterioration in the Emergency Department (ED) is challenging, yet crucial for timely initiation of appropriate care and prevention of clinical deterioration. This multicenter international study evaluates the performance of established scores (SIRS, LODS, qSOFA, SOFA, NEWS) in predicting severe outcomes in ED patients with suspected infection.</div></div><div><h3>Methods</h3><div>We combined data from five different ED cohort studies (n = 4044 adult patients) from the Netherlands and Sweden. Suspected infection was defined as obtaining a microbiological culture combined with starting antibiotics. The scores were evaluated for their accuracy in predicting the composite outcome of intensive care unit (ICU) admission and in-hospital mortality.</div></div><div><h3>Findings</h3><div>Of 4044 patients, 655 (16 %) experienced a severe outcome, defined as ICU admission (n = 429, 11 %) or in-hospital mortality (n = 327, 8 %). SOFA (AUC 0.75 [95 %CI:0.73–0.77]) and LODS (AUC 0.73 [95 %CI:0.71–0.75]) showed the highest predictive accuracy. NEWS ≥ 5 yielded fair sensitivity (78 %) but low specificity (40 %), whereas NEWS ≥ 7 (sensitivity 71 %, specificity 59 %) performed similarly to SOFA ≥ 2 (69 %, 68 %) and LODS ≥ 2 (70 %, 66 %). In contrast, qSOFA (AUC 0.66 [95 %CI:0.64–0.69]) and SIRS (AUC 0.54 [95 %CI:0.52–0.57]) performed poorly for ED risk stratification.</div></div><div><h3>Interpretation</h3><div>SOFA and LODS showed the highest accuracy but are limited by their complexity and the requirement for laboratory data. The NEWS score, simpler and more accessible, is a practical tool for rapid ED screening with comparable accuracy as SOFA and LODS.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103170"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213374","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}
Pub Date : 2026-03-13DOI: 10.1016/j.jiph.2026.103193
Tiantian Xu, Lu Kuang, Yi Chen, Jiamin Zhang, Yihong Zhou, Xiangyuan Hou, Changbing Wang, Yuqing Yan, Misi Xiao, Yingying Zhang, Xiaomin Liu, Jiahui Xie, Bing Zhu
Background: Community-acquired pneumonia (CAP) in children is a major public health issue due to its morbidity and economic impact, primarily caused by viral pathogens, highlighting the need to understand their prevalence and patterns for effective management and strategies.
Methods: This study analyzed 14,442 pediatric CAP patients in Guangzhou from 2023 to 2024 to evaluate viral prevalence, demographics, and seasonal trends, and their association with disease severity to elucidate their impact on children's health outcomes.
Results: Our analysis found 5610 positive viral cases, with a 38.85% positivity rate; RSV was the most common at 26.58%, followed by ADV (18.42%) and RHV (15.67%). Infection rates for ADV and RHV rose in 2024. Children aged 0-3 made up 68.2% of cases, with severe CAP mainly affecting males (62.4%) and infants (57.3%). RSV peaked in winter, while ADV and RHV peaked in spring.
Conclusions: The study highlights the dynamic viral epidemiology in pediatric CAP, emphasizing RSV's threat and emerging risks from RHV and ADV, advocating for better diagnostics and targeted vaccinations for vulnerable groups to improve clinical management and reduce the misuse of antibiotics.
{"title":"Epidemiological characteristics of respiratory viruses in children with community-acquired pneumonia in Guangzhou, 2023-2024.","authors":"Tiantian Xu, Lu Kuang, Yi Chen, Jiamin Zhang, Yihong Zhou, Xiangyuan Hou, Changbing Wang, Yuqing Yan, Misi Xiao, Yingying Zhang, Xiaomin Liu, Jiahui Xie, Bing Zhu","doi":"10.1016/j.jiph.2026.103193","DOIUrl":"https://doi.org/10.1016/j.jiph.2026.103193","url":null,"abstract":"<p><strong>Background: </strong>Community-acquired pneumonia (CAP) in children is a major public health issue due to its morbidity and economic impact, primarily caused by viral pathogens, highlighting the need to understand their prevalence and patterns for effective management and strategies.</p><p><strong>Methods: </strong>This study analyzed 14,442 pediatric CAP patients in Guangzhou from 2023 to 2024 to evaluate viral prevalence, demographics, and seasonal trends, and their association with disease severity to elucidate their impact on children's health outcomes.</p><p><strong>Results: </strong>Our analysis found 5610 positive viral cases, with a 38.85% positivity rate; RSV was the most common at 26.58%, followed by ADV (18.42%) and RHV (15.67%). Infection rates for ADV and RHV rose in 2024. Children aged 0-3 made up 68.2% of cases, with severe CAP mainly affecting males (62.4%) and infants (57.3%). RSV peaked in winter, while ADV and RHV peaked in spring.</p><p><strong>Conclusions: </strong>The study highlights the dynamic viral epidemiology in pediatric CAP, emphasizing RSV's threat and emerging risks from RHV and ADV, advocating for better diagnostics and targeted vaccinations for vulnerable groups to improve clinical management and reduce the misuse of antibiotics.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 5","pages":"103193"},"PeriodicalIF":4.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494095","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}
Pub Date : 2026-03-12DOI: 10.1016/j.jiph.2026.103207
Beatriz Lazaro-Martin, Laura Tarancon-Diez, Joaquín Burgos, Beatriz Álvarez Vallejo, Sofía Ibarra, Elisa Garrote, Cristina Epalza, Laura Bermejo, Sergio Reus, Maria Del Carmen Vicent Castelló, José Antonio Iribarren, Eider Oñate Vergara, Miguel Torralba, Javier García-Abellán, María José Galindo, José Rafael Bretón-Martínez, Dolores Merino, José Tomás Ramos, Maria Luisa Navarro Gómez
Introduction: Adolescents and young adults living with HIV (AYHIV) face complex psychosocial and adherence challenges that compromise long-term treatment success. Long-acting injectable therapies (LA-ART), such as cabotegravir and rilpivirine, may improve adherence, reduce stigma, and facilitate treatment retention.
Methods: We conducted a retrospective, multicenter study of AYHIV enrolled in the Spanish pediatric HIV cohort (CoRISpe) and its adult extension (CoRISpe-FARO), who initiated LA-ART. Demographic, clinical, virological, immunological and biochemical data were analyzed up to March 2025. Outcomes before and after LA-ART initiation were analyzed, including CD4/CD8 ratio, viral suppression, and body mass index (BMI).
Results: Among 681 individuals in active follow-up, 26 AYHIV (65.4% women, median age 28) initiated LA-ART, primarily for treatment simplification. Most had acquired HIV perinatally and had extensive ART histories; 30% had received more than ten different ART regimens. Twenty-one patients had documented virological failures prior to LA-ART. Despite this, all patients achieved or maintained virological suppression after a median follow-up of 11 months. This included three individuals who initiated LA-ART with detectable viral load. CD4 and CD8 counts remained stable; the CD4/CD8 ratio showed an upward trend (p = 0.057), suggesting improved immune balance. Notably, AYHIV with BMI < 30 kg/m² showed significant increases in CD4 count, CD4%, and CD4/CD8 ratio. Overall BMI increased post-LA-ART (p = 0.036), especially in women. Treatment was well tolerated, with only one discontinuation due to injection site pain.
Conclusions: LA-ART was safe, well tolerated, and effective in maintaining virological suppression, and showed positive immunological trends in AYHIV, including those with prior adherence issues or detectable viral load at baseline. These results support the potential of LA-ART as a valuable therapeutic strategy in AYHIV, especially in those with complex treatment histories and adherence challenges. Further prospective studies are warranted to confirm long-term outcomes.
{"title":"Use of long-acting therapies for the HIV treatment in the Spanish pediatric cohort (CoRISpe).","authors":"Beatriz Lazaro-Martin, Laura Tarancon-Diez, Joaquín Burgos, Beatriz Álvarez Vallejo, Sofía Ibarra, Elisa Garrote, Cristina Epalza, Laura Bermejo, Sergio Reus, Maria Del Carmen Vicent Castelló, José Antonio Iribarren, Eider Oñate Vergara, Miguel Torralba, Javier García-Abellán, María José Galindo, José Rafael Bretón-Martínez, Dolores Merino, José Tomás Ramos, Maria Luisa Navarro Gómez","doi":"10.1016/j.jiph.2026.103207","DOIUrl":"https://doi.org/10.1016/j.jiph.2026.103207","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents and young adults living with HIV (AYHIV) face complex psychosocial and adherence challenges that compromise long-term treatment success. Long-acting injectable therapies (LA-ART), such as cabotegravir and rilpivirine, may improve adherence, reduce stigma, and facilitate treatment retention.</p><p><strong>Methods: </strong>We conducted a retrospective, multicenter study of AYHIV enrolled in the Spanish pediatric HIV cohort (CoRISpe) and its adult extension (CoRISpe-FARO), who initiated LA-ART. Demographic, clinical, virological, immunological and biochemical data were analyzed up to March 2025. Outcomes before and after LA-ART initiation were analyzed, including CD4/CD8 ratio, viral suppression, and body mass index (BMI).</p><p><strong>Results: </strong>Among 681 individuals in active follow-up, 26 AYHIV (65.4% women, median age 28) initiated LA-ART, primarily for treatment simplification. Most had acquired HIV perinatally and had extensive ART histories; 30% had received more than ten different ART regimens. Twenty-one patients had documented virological failures prior to LA-ART. Despite this, all patients achieved or maintained virological suppression after a median follow-up of 11 months. This included three individuals who initiated LA-ART with detectable viral load. CD4 and CD8 counts remained stable; the CD4/CD8 ratio showed an upward trend (p = 0.057), suggesting improved immune balance. Notably, AYHIV with BMI < 30 kg/m² showed significant increases in CD4 count, CD4%, and CD4/CD8 ratio. Overall BMI increased post-LA-ART (p = 0.036), especially in women. Treatment was well tolerated, with only one discontinuation due to injection site pain.</p><p><strong>Conclusions: </strong>LA-ART was safe, well tolerated, and effective in maintaining virological suppression, and showed positive immunological trends in AYHIV, including those with prior adherence issues or detectable viral load at baseline. These results support the potential of LA-ART as a valuable therapeutic strategy in AYHIV, especially in those with complex treatment histories and adherence challenges. Further prospective studies are warranted to confirm long-term outcomes.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 5","pages":"103207"},"PeriodicalIF":4.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491042","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}
Pub Date : 2026-03-07DOI: 10.1016/j.jiph.2026.103194
Yu Mi Wi, Jong Hyun Shin, Ji Young Choi, Jung Min Shin, Cheon Hoo Jeon, Si-Ho Kim, Young-Sun Kim, Kwan Soo Ko
Enterotoxigenic Escherichia coli (ETEC) commonly causes diarrheal disease, but little is known about the contribution of asymptomatic carriers to foodborne outbreaks. We investigated an ETEC outbreak at a 760-bed hospital in South Korea in June 2024. A confirmed cases were defined as an individual with ETEC detection by PCR and gastrointestinal symptoms or fever. We screened all 61 food handlers for ETEC regardless of whether they had symptoms, and we sampled environmental surfaces and preserved food items. Of 1606 employees, 77 met the symptomatic case definition. The most frequent symptoms were diarrhoea (98.7%), abdominal pain (87.0%), and fever (28.6%). Cold buckwheat noodles were identified as the probable vehicle in multivariable analysis (adjusted OR=3.00, 95% CI 1.34-6.55, p = 0.006). ETEC was not recovered from any environmental or food samples. Among 61 food handlers, 13 asymptomatic cases were identified. (21.3%, 13/61) and only two of them had eaten cold buckwheat noodles. Kitchen inspection revealed inadequate handwashing station capacity. A 21.3% asymptomatic carriage rate among food handlers point to a contamination route that symptom-based screening would miss. Strict hand hygiene is especially important when handling cold dishes without further heat treatment.
产肠毒素大肠杆菌（ETEC）通常引起腹泻疾病，但对无症状携带者对食源性暴发的贡献知之甚少。我们调查了韩国一家拥有760个床位的医院于2024年6月爆发的ETEC疫情。确诊病例定义为PCR检测出ETEC并出现胃肠道症状或发热的个体。我们对所有61名食品处理人员进行了ETEC筛查，无论他们是否有症状，我们对环境表面和保存的食品进行了采样。在1606名员工中，有77人符合症状病例定义。最常见的症状是腹泻（98.7%）、腹痛（87.0%）和发烧（28.6%）。在多变量分析中，冷荞麦面被确定为可能的载体（调整OR=3.00, 95% CI 1.34-6.55, p = 0.006）。没有从任何环境或食品样品中回收ETEC。在61名食品处理人员中，发现13例无症状病例。（21.3%, 13/61），其中只有2人吃过冷荞麦面。厨房检查发现洗手站容量不足。食品处理人员中21.3%的无症状携带率表明了一种基于症状的筛查可能错过的污染途径，在处理未经进一步热处理的冷菜时，严格的手部卫生尤为重要。
{"title":"High prevalence of asymptomatic Enterotoxigenic Escherichia coli carriers among food handlers in a hospital foodborne outbreak.","authors":"Yu Mi Wi, Jong Hyun Shin, Ji Young Choi, Jung Min Shin, Cheon Hoo Jeon, Si-Ho Kim, Young-Sun Kim, Kwan Soo Ko","doi":"10.1016/j.jiph.2026.103194","DOIUrl":"https://doi.org/10.1016/j.jiph.2026.103194","url":null,"abstract":"<p><p>Enterotoxigenic Escherichia coli (ETEC) commonly causes diarrheal disease, but little is known about the contribution of asymptomatic carriers to foodborne outbreaks. We investigated an ETEC outbreak at a 760-bed hospital in South Korea in June 2024. A confirmed cases were defined as an individual with ETEC detection by PCR and gastrointestinal symptoms or fever. We screened all 61 food handlers for ETEC regardless of whether they had symptoms, and we sampled environmental surfaces and preserved food items. Of 1606 employees, 77 met the symptomatic case definition. The most frequent symptoms were diarrhoea (98.7%), abdominal pain (87.0%), and fever (28.6%). Cold buckwheat noodles were identified as the probable vehicle in multivariable analysis (adjusted OR=3.00, 95% CI 1.34-6.55, p = 0.006). ETEC was not recovered from any environmental or food samples. Among 61 food handlers, 13 asymptomatic cases were identified. (21.3%, 13/61) and only two of them had eaten cold buckwheat noodles. Kitchen inspection revealed inadequate handwashing station capacity. A 21.3% asymptomatic carriage rate among food handlers point to a contamination route that symptom-based screening would miss. Strict hand hygiene is especially important when handling cold dishes without further heat treatment.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 5","pages":"103194"},"PeriodicalIF":4.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491063","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}
Pub Date : 2026-03-01Epub Date: 2025-12-17DOI: 10.1016/j.jiph.2025.103114
Shangyang Jiang , Leying Wang , Zijun Zhang, Zhenyu Wei, Kai Cao, Qingfeng Liang
Acanthamoeba keratitis (AK) is an uncommon yet vision-threatening corneal infection, and the lack of an international consensus on its surgical management often complicates clinical decision-making. To address this gap, a comprehensive literature review was conducted across PubMed, EMBASE, Web of Science, and the Cochrane Library from database inception to July 1, 2025, focusing on clinical studies that reported outcomes of keratoplasty. The analysis included 24 studies encompassing 487 eyes and compared different keratoplasty techniques, specifically therapeutic penetrating keratoplasty (TPK), optical penetrating keratoplasty (OPK), and therapeutic deep anterior lamellar keratoplasty (TDALK). The data indicated that Acanthamoeba infection control sufficient to permit OPK was associated with the most favorable results. In eyes with infection confined to the anterior stroma and thus eligible for TDALK, graft survival was higher and postoperative complications were fewer. In cases with persistent full-thickness infection, TPK was required and was associated with poorer visual recovery and higher rates of graft failure, recurrent infection, and regrafting.
棘阿米巴角膜炎（AK）是一种罕见但威胁视力的角膜感染，其手术治疗缺乏国际共识，往往使临床决策复杂化。为了解决这一差距，我们对PubMed、EMBASE、Web of Science和Cochrane图书馆从数据库建立到2025年7月1日进行了全面的文献综述，重点关注报道角膜移植结果的临床研究。该分析包括24项研究，涵盖487只眼睛，并比较了不同的角膜移植技术，特别是治疗性穿透性角膜移植（TPK）、光学穿透性角膜移植（OPK）和治疗性深前板层角膜移植（TDALK）。数据表明，棘阿米巴感染控制足以允许OPK与最有利的结果相关。在感染局限于前基质的眼睛中，适合进行TDALK，移植物存活率较高，术后并发症较少。在持续性全层感染的病例中，TPK是必需的，并且与较差的视力恢复和较高的移植物失败、复发感染和再移植率相关。
{"title":"Corneal transplantation strategies for Acanthamoeba Keratitis: A systematic review and meta-analysis","authors":"Shangyang Jiang , Leying Wang , Zijun Zhang, Zhenyu Wei, Kai Cao, Qingfeng Liang","doi":"10.1016/j.jiph.2025.103114","DOIUrl":"10.1016/j.jiph.2025.103114","url":null,"abstract":"<div><div><em>Acanthamoeba</em> keratitis (AK) is an uncommon yet vision-threatening corneal infection, and the lack of an international consensus on its surgical management often complicates clinical decision-making. To address this gap, a comprehensive literature review was conducted across PubMed, EMBASE, Web of Science, and the Cochrane Library from database inception to July 1, 2025, focusing on clinical studies that reported outcomes of keratoplasty. The analysis included 24 studies encompassing 487 eyes and compared different keratoplasty techniques, specifically therapeutic penetrating keratoplasty (TPK), optical penetrating keratoplasty (OPK), and therapeutic deep anterior lamellar keratoplasty (TDALK). The data indicated that <em>Acanthamoeba</em> infection control sufficient to permit OPK was associated with the most favorable results. In eyes with infection confined to the anterior stroma and thus eligible for TDALK, graft survival was higher and postoperative complications were fewer. In cases with persistent full-thickness infection, TPK was required and was associated with poorer visual recovery and higher rates of graft failure, recurrent infection, and regrafting.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103114"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802170","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}
Pub Date : 2026-03-01Epub Date: 2026-01-09DOI: 10.1016/j.jiph.2026.103149
Jeongmin Moon , Youn Young Choi , Hye Sook Min , Ho Kyung Sung , Kyung-Shin Lee
Objective
To evaluate the performance and limitations of an emergency department (ED)-based syndromic surveillance (SyS) model for detecting respiratory infection outbreaks in Korea, across distinct age groups and epidemiological contexts before and during the COVID-19 pandemic.
Methods
We conducted a retrospective time-series analysis using nationwide data from Level 1 and 2 EDs between January 2017 and December 2022. Syndromic visits were defined as those with fever (≥38.0 °C) or respiratory symptoms. Age-stratified autoregressive integrated moving average (ARIMA) models were trained on data from January 2017–December 2018 and January 2020–December 2021 to forecast syndromic ED visits in January–December 2019 and January–December 2022, respectively. Alarms were triggered when observed visit counts exceeded both the model’s 95th percentile prediction interval and historical day-of-week thresholds. Alarm performance was assessed against ED discharge diagnoses of respiratory infectious diseases.
Results
The system performed well under stable pre-pandemic conditions, particularly among children aged 0–4 years (3-day alarm sensitivity: 1.000; specificity: 0.964), and moderately among adults aged 65 years and older. In contrast, model performance deteriorated in 2022 under pandemic conditions, especially among adults aged 20–64 years, with alarm sensitivity dropping below 0.300. The decline was driven by persistently elevated syndromic activity during the Omicron wave, which overwhelmed the static thresholds of the ARIMA models.
Conclusion
ED-based SyS can offer timely and specific early warning for seasonal respiratory outbreaks, particularly in pediatric populations. However, its utility is limited during sustained pandemic waves. Future surveillance systems must incorporate adaptive models, dynamic thresholds, and multiple data streams to remain effective under evolving epidemiological baselines.
{"title":"Time-series evaluation of an ED-based syndromic alarm system before and during the COVID-19 pandemic","authors":"Jeongmin Moon , Youn Young Choi , Hye Sook Min , Ho Kyung Sung , Kyung-Shin Lee","doi":"10.1016/j.jiph.2026.103149","DOIUrl":"10.1016/j.jiph.2026.103149","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the performance and limitations of an emergency department (ED)-based syndromic surveillance (SyS) model for detecting respiratory infection outbreaks in Korea, across distinct age groups and epidemiological contexts before and during the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>We conducted a retrospective time-series analysis using nationwide data from Level 1 and 2 EDs between January 2017 and December 2022. Syndromic visits were defined as those with fever (≥38.0 °C) or respiratory symptoms. Age-stratified autoregressive integrated moving average (ARIMA) models were trained on data from January 2017–December 2018 and January 2020–December 2021 to forecast syndromic ED visits in January–December 2019 and January–December 2022, respectively. Alarms were triggered when observed visit counts exceeded both the model’s 95th percentile prediction interval and historical day-of-week thresholds. Alarm performance was assessed against ED discharge diagnoses of respiratory infectious diseases.</div></div><div><h3>Results</h3><div>The system performed well under stable pre-pandemic conditions, particularly among children aged 0–4 years (3-day alarm sensitivity: 1.000; specificity: 0.964), and moderately among adults aged 65 years and older. In contrast, model performance deteriorated in 2022 under pandemic conditions, especially among adults aged 20–64 years, with alarm sensitivity dropping below 0.300. The decline was driven by persistently elevated syndromic activity during the Omicron wave, which overwhelmed the static thresholds of the ARIMA models.</div></div><div><h3>Conclusion</h3><div>ED-based SyS can offer timely and specific early warning for seasonal respiratory outbreaks, particularly in pediatric populations. However, its utility is limited during sustained pandemic waves. Future surveillance systems must incorporate adaptive models, dynamic thresholds, and multiple data streams to remain effective under evolving epidemiological baselines.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103149"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977900","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}
Pub Date : 2026-03-01Epub Date: 2025-12-05DOI: 10.1016/j.jiph.2025.103090
Kai-Yang Chen , Hoi-Chun Chan , Chi-Ming Chan
Background
Klebsiella pneumoniae pyogenic liver abscess (KP-PLA) is increasingly recognized as a cause of endogenous endophthalmitis (EE), particularly in East and Southeast Asia. Hypervirulent K. pneumoniae (hvKP) strains have been implicated in severe ocular complications, yet comprehensive data on incidence, risk factors, and visual outcomes are limited.
Methods
A systematic review and meta-analysis were conducted following PRISMA guidelines. We searched PubMed, Google Scholar, Cochrane Library, Science Direct for studies reporting KP-PLA-associated EE up to March 2025. Data on patient demographics, comorbidities, microbiological features, treatments, and visual outcomes were extracted. Pooled event rates and odds ratios (OR) with 95 % confidence intervals (CI) were calculated using random-effects models.
Results
Seventeen studies encompassing 219 patients met inclusion criteria. Diabetes mellitus was common among KP PLA associated EE cases (pooled event rate 0.674; 95 % CI: 0.585–0.751; p < 0.001). hvKP strains, identified by positive string tests and virulence genes including rmpA, magA, and aerobactin, predominated in EE cases. Regional differences were observed, with higher prevalence in East and Southeast Asia. Despite aggressive systemic and ocular treatment, visual prognosis was poor: 77.9 % of patients had final visual acuity worse than 3/60. Early pars plana vitrectomy with silicone oil tamponade was associated with fewer postoperative interventions (p < 0.05).
Conclusions
EE is a devastating complication of KP-PLA, particularly in diabetic patients infected with hvKP. Early recognition of at-risk patients and prompt intervention, including early vitrectomy, are crucial to improve visual outcomes. These findings highlight the clinical importance of hvKP in the pathogenesis of EE and reinforce the need for vigilant ophthalmic monitoring in KP-PLA cases.
{"title":"How does hypervirulent Klebsiella pneumoniae influence the risk and visual outcomes of endogenous endophthalmitis in Klebsiella pneumoniae pyogenic liver abscess? A systematic review and meta analysis","authors":"Kai-Yang Chen , Hoi-Chun Chan , Chi-Ming Chan","doi":"10.1016/j.jiph.2025.103090","DOIUrl":"10.1016/j.jiph.2025.103090","url":null,"abstract":"<div><h3>Background</h3><div>Klebsiella pneumoniae pyogenic liver abscess (KP-PLA) is increasingly recognized as a cause of endogenous endophthalmitis (EE), particularly in East and Southeast Asia. Hypervirulent K. pneumoniae (hvKP) strains have been implicated in severe ocular complications, yet comprehensive data on incidence, risk factors, and visual outcomes are limited.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following PRISMA guidelines. We searched PubMed, Google Scholar, Cochrane Library, Science Direct for studies reporting KP-PLA-associated EE up to March 2025. Data on patient demographics, comorbidities, microbiological features, treatments, and visual outcomes were extracted. Pooled event rates and odds ratios (OR) with 95 % confidence intervals (CI) were calculated using random-effects models.</div></div><div><h3>Results</h3><div>Seventeen studies encompassing 219 patients met inclusion criteria. Diabetes mellitus was common among KP PLA associated EE cases (pooled event rate 0.674; 95 % CI: 0.585–0.751; p < 0.001). hvKP strains, identified by positive string tests and virulence genes including rmpA, magA, and aerobactin, predominated in EE cases. Regional differences were observed, with higher prevalence in East and Southeast Asia. Despite aggressive systemic and ocular treatment, visual prognosis was poor: 77.9 % of patients had final visual acuity worse than 3/60. Early pars plana vitrectomy with silicone oil tamponade was associated with fewer postoperative interventions (p < 0.05).</div></div><div><h3>Conclusions</h3><div>EE is a devastating complication of KP-PLA, particularly in diabetic patients infected with hvKP. Early recognition of at-risk patients and prompt intervention, including early vitrectomy, are crucial to improve visual outcomes. These findings highlight the clinical importance of hvKP in the pathogenesis of EE and reinforce the need for vigilant ophthalmic monitoring in KP-PLA cases.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103090"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882189","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}
Pub Date : 2026-03-01Epub Date: 2025-12-16DOI: 10.1016/j.jiph.2025.103112
BongGyun Kim , Okyu Kwon , Jae-Suk Yang
Background
Despite widespread adoption of contact tracing during the COVID-19 pandemic, countries exhibited marked differences in tracing performance. Existing studies have documented policy variation but lack standardized, comparable outcome indicators of tracing effectiveness. Recent reviews emphasize the need for quantitative, cross-national, outcome-based measures and broader frameworks that account for contextual factors such as governance, education, and culture. To address this gap, this study aims to validate the time lag (τ) between peaks in confirmed cases and testing as a proxy for tracing responsiveness and examines how government policies, socioeconomic conditions, and cultural dimensions jointly shape τ across OECD countries.
Methods
Panel data for 38 OECD countries (Jan 2020–Jun 2022) were analyzed. τ was computed through rolling cross-correlation between daily cases and tests. We estimated fixed-effects and pooled OLS models to identify policy and contextual effects and ran mixed-effects models as a robustness extension. Additional robustness tests included two-way fixed effects, exclusion of high-incidence periods, and winsorization of τ, alongside variance-inflation and residual diagnostics, to ensure results were not driven by outliers or specification bias.
Results
Stricter containment and stronger tracing policies were associated with longer τ, while broader testing and higher epidemic severity shortened it. Among contextual variables, higher education lengthened τ, whereas greater urbanization reduced it. Cultural dimensions showed smaller, less stable effects. Despite modest explanatory power (R² ≈ 0.08–0.11), results were consistent across alternative specifications and model types.
Conclusion
The case–test peak lag (τ) provides a practical, comparable metric of tracing performance across countries. However, our findings suggest that its utility as an indicator of tracing responsiveness is context-dependent and should be interpreted with caution. Effective tracing depends on coherent policy coordination supported by socioeconomic and institutional environments that foster technological participation and compliance. Limitations include τ’s indirect nature and remaining unobserved heterogeneity.
{"title":"What makes contact tracing successful? An empirical analysis of COVID-19 data from 38 OECD countries","authors":"BongGyun Kim , Okyu Kwon , Jae-Suk Yang","doi":"10.1016/j.jiph.2025.103112","DOIUrl":"10.1016/j.jiph.2025.103112","url":null,"abstract":"<div><h3>Background</h3><div>Despite widespread adoption of contact tracing during the COVID-19 pandemic, countries exhibited marked differences in tracing performance. Existing studies have documented policy variation but lack standardized, comparable outcome indicators of tracing effectiveness. Recent reviews emphasize the need for quantitative, cross-national, outcome-based measures and broader frameworks that account for contextual factors such as governance, education, and culture. To address this gap, this study aims to validate the time lag (τ) between peaks in confirmed cases and testing as a proxy for tracing responsiveness and examines how government policies, socioeconomic conditions, and cultural dimensions jointly shape τ across OECD countries.</div></div><div><h3>Methods</h3><div>Panel data for 38 OECD countries (Jan 2020–Jun 2022) were analyzed. τ was computed through rolling cross-correlation between daily cases and tests. We estimated fixed-effects and pooled OLS models to identify policy and contextual effects and ran mixed-effects models as a robustness extension. Additional robustness tests included two-way fixed effects, exclusion of high-incidence periods, and winsorization of τ, alongside variance-inflation and residual diagnostics, to ensure results were not driven by outliers or specification bias.</div></div><div><h3>Results</h3><div>Stricter containment and stronger tracing policies were associated with longer τ, while broader testing and higher epidemic severity shortened it. Among contextual variables, higher education lengthened τ, whereas greater urbanization reduced it. Cultural dimensions showed smaller, less stable effects. Despite modest explanatory power (R² ≈ 0.08–0.11), results were consistent across alternative specifications and model types.</div></div><div><h3>Conclusion</h3><div>The case–test peak lag (τ) provides a practical, comparable metric of tracing performance across countries. However, our findings suggest that its utility as an indicator of tracing responsiveness is context-dependent and should be interpreted with caution. Effective tracing depends on coherent policy coordination supported by socioeconomic and institutional environments that foster technological participation and compliance. Limitations include τ’s indirect nature and remaining unobserved heterogeneity.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103112"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802169","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}
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