Pub Date : 2024-10-05DOI: 10.1016/j.jiph.2024.102560
Nan-Chang Chiu , Daniel Tsung-Ning Huang , Shun-Long Weng , Hsin Chi , Yu-Lin Tai , Ya-Ning Huang , Hsiang Huang , Wei-Te Lei , Lung Chang , Chien-Yu Lin
Background
The global impact of COVID-19 has prompted profound shifts in public health policies. The epidemiology of respiratory infectious disease may change in the post-covid era. This study investigates the repercussions of these policies on respiratory infectious diseases, specifically the resurgence of severe influenza and enterovirus infections in the post-COVID-19 era.
Methods
Examining the period from January 2020 to December 2023, our nationwide study analyzes data from the Taiwan Centers for Disease Control and Our World in Data. Two distinct phases, containing (Week 1, 2020, to Week 43, 2022) and coexisting (Week 44, 2022, to Week 50, 2023), are scrutinized, emphasizing policy changes and their potential impact on epidemiology.
Results
Epidemiological trends reveal a decline in COVID-19 and all-cause pneumonia during the co-existing period but a notable rise in severe influenza and enterovirus infections. Interrupted time series analysis confirms the surge in severe influenza and enterovirus cases post-restriction ease.
Conclusion
The post-COVID-19 era introduces challenges with the resurgence of traditional respiratory diseases, necessitating continuous surveillance, timely non-pharmaceutical interventions, and vaccination as crucial strategies. Vigilance and targeted measures by policymakers and healthcare providers are imperative to navigate the evolving landscape of respiratory infectious diseases in the aftermath of the pandemic.
{"title":"Resurgence of influenza and enterovirus infections in Taiwan post-COVID-19: A nationwide surveillance study","authors":"Nan-Chang Chiu , Daniel Tsung-Ning Huang , Shun-Long Weng , Hsin Chi , Yu-Lin Tai , Ya-Ning Huang , Hsiang Huang , Wei-Te Lei , Lung Chang , Chien-Yu Lin","doi":"10.1016/j.jiph.2024.102560","DOIUrl":"10.1016/j.jiph.2024.102560","url":null,"abstract":"<div><h3>Background</h3><div>The global impact of COVID-19 has prompted profound shifts in public health policies. The epidemiology of respiratory infectious disease may change in the post-covid era. This study investigates the repercussions of these policies on respiratory infectious diseases, specifically the resurgence of severe influenza and enterovirus infections in the post-COVID-19 era.</div></div><div><h3>Methods</h3><div>Examining the period from January 2020 to December 2023, our nationwide study analyzes data from the Taiwan Centers for Disease Control and Our World in Data. Two distinct phases, containing (Week 1, 2020, to Week 43, 2022) and coexisting (Week 44, 2022, to Week 50, 2023), are scrutinized, emphasizing policy changes and their potential impact on epidemiology.</div></div><div><h3>Results</h3><div>Epidemiological trends reveal a decline in COVID-19 and all-cause pneumonia during the co-existing period but a notable rise in severe influenza and enterovirus infections. Interrupted time series analysis confirms the surge in severe influenza and enterovirus cases post-restriction ease.</div></div><div><h3>Conclusion</h3><div>The post-COVID-19 era introduces challenges with the resurgence of traditional respiratory diseases, necessitating continuous surveillance, timely non-pharmaceutical interventions, and vaccination as crucial strategies. Vigilance and targeted measures by policymakers and healthcare providers are imperative to navigate the evolving landscape of respiratory infectious diseases in the aftermath of the pandemic.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 11","pages":"Article 102560"},"PeriodicalIF":4.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-03DOI: 10.1016/j.jiph.2024.102559
Chih-Wei Chen , Hsun-Hua Lee , Shu-Hao Chang , Yi-Ling Chen , Yu-Hsun Wang , Pui-Ying Leong , James Cheng-Chung Wei
Background
Many patients who recovered from COVID-19 still suffer from chronic fatigue syndrome (CFS). It was observed that patients with comorbidities were more prone to developing CFS. This research investigates the risk of post-COVID-19 CFS to assist healthcare professionals in reducing the risk of CFS.
Methods
A retrospective cohort study is conducted to investigate the risk of post-COVID-19 CFS based on the TriNetX-sourced electronic health records. Factors including age, sex, race, vaccination, and severity of COVID-19 are analysed. Propensity score matching was applied to balance COVID-19 and non-COVID-19 cohorts. Kaplan-Meier analysis and Cox proportional hazard model were used to perform the relationship between COVID-19 and CFS risk.
Results
This research involved 3227281 patients with COVID-19 and 3227281 with non-COVID-19 between 1st January 2020 and 31st December 2023. The incidence of CFS was higher in the COVID-19 group compared to the non-COVID-19 group at 1 follow-up intervals (HR 1.59, 95 % CI = 1.54–1.63). Subgroup analysis revealed increased CFS risk across different age groups (>18), sexes, races, and comorbid conditions, with notable variations.
Conclusions
COVID-19 patients have a higher risk of developing CFS compared to individuals without COVID-19. The increased risk is particularly significant in adults aged 18 years and older.
{"title":"Risk of chronic fatigue syndrome after COVID-19: A retrospective cohort study of 3227281 patients","authors":"Chih-Wei Chen , Hsun-Hua Lee , Shu-Hao Chang , Yi-Ling Chen , Yu-Hsun Wang , Pui-Ying Leong , James Cheng-Chung Wei","doi":"10.1016/j.jiph.2024.102559","DOIUrl":"10.1016/j.jiph.2024.102559","url":null,"abstract":"<div><h3>Background</h3><div>Many patients who recovered from COVID-19 still suffer from chronic fatigue syndrome (CFS). It was observed that patients with comorbidities were more prone to developing CFS. This research investigates the risk of post-COVID-19 CFS to assist healthcare professionals in reducing the risk of CFS.</div></div><div><h3>Methods</h3><div>A retrospective cohort study is conducted to investigate the risk of post-COVID-19 CFS based on the TriNetX-sourced electronic health records. Factors including age, sex, race, vaccination, and severity of COVID-19 are analysed. Propensity score matching was applied to balance COVID-19 and non-COVID-19 cohorts. Kaplan-Meier analysis and Cox proportional hazard model were used to perform the relationship between COVID-19 and CFS risk.</div></div><div><h3>Results</h3><div>This research involved 3227281 patients with COVID-19 and 3227281 with non-COVID-19 between 1st January 2020 and 31st December 2023. The incidence of CFS was higher in the COVID-19 group compared to the non-COVID-19 group at 1 follow-up intervals (HR 1.59, 95 % CI = 1.54–1.63). Subgroup analysis revealed increased CFS risk across different age groups (>18), sexes, races, and comorbid conditions, with notable variations.</div></div><div><h3>Conclusions</h3><div>COVID-19 patients have a higher risk of developing CFS compared to individuals without COVID-19. The increased risk is particularly significant in adults aged 18 years and older.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 11","pages":"Article 102559"},"PeriodicalIF":4.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Omicron, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, entered Taiwan at the end of 2021. The Taiwanese government ended its "zero-COVID" policy in March 2022. Multiple coronavirus disease 2019 (COVID-19) outbreaks began in April 2022. We monitored the replacement of Omicron subvariants after BA.1/BA.2 and analyzed their correlation with COVID-19 outbreaks.
Methods
We collected SARS-CoV-2 real-time qRTPCR-positive nasopharyngeal swabs from Kaohsiung Medical University Hospital (KMUH), Kaohsiung City, Taiwan, and performed sequencing for specimens exhibiting a cytopathic effect in Vero E6 cells to determine their clades and lineages. We analyzed the medical records of COVID-19 patients and identified hospitalization risk factor(s). We retrieved SARS-CoV-2 sequences identified in Taiwan from GISAID and analyzed their correlation with COVID-19 data from the Taiwan Centers for Disease Control.
Results
We analyzed the phylogenesis of KMUH-47 to KMUH-104 (SARS-CoV-2 isolates identified herein) and all of the Omicron subvariants from BA.5 to XBB.1 (n = 1930). Age and comorbidities were hospitalization risk factors. Men generally exhibited a greater fatality rate than women. COVID-19-related deaths predominantly occurred in individuals over 70 years old. The COVID-19-related case fatality rate increased as nucleotide (NT) and amino acid (AA) substitutions increased. The number of COVID-19-related cases and deaths progressively decreased with each outbreak between August 2022 and October 2023.
Conclusion
Hospitalization was associated with age and the presence of comorbidities. COVID-19-related fatality was linked to sex, age, and the accumulation of NT and AA substitutions in emerging Omicron subvariants.
{"title":"The epidemiology and phylogenetic trends of Omicron subvariants from BA.5 to XBB.1 in Taiwan","authors":"Jih-Jin Tsai , Shyh-Shin Chiou , Po-Chih Chen , Chun-Hong Chen , Ping-Chang Lin , Ching-Yi Tsai , Wan-Long Chuang , Shang-Jyh Hwang , Inn-Wen Chong , Li-Teh Liu","doi":"10.1016/j.jiph.2024.102556","DOIUrl":"10.1016/j.jiph.2024.102556","url":null,"abstract":"<div><h3>Background</h3><div>Omicron, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, entered Taiwan at the end of 2021. The Taiwanese government ended its \"zero-COVID\" policy in March 2022. Multiple coronavirus disease 2019 (COVID-19) outbreaks began in April 2022. We monitored the replacement of Omicron subvariants after BA.1/BA.2 and analyzed their correlation with COVID-19 outbreaks.</div></div><div><h3>Methods</h3><div>We collected SARS-CoV-2 real-time qRT<img>PCR-positive nasopharyngeal swabs from Kaohsiung Medical University Hospital (KMUH), Kaohsiung City, Taiwan, and performed sequencing for specimens exhibiting a cytopathic effect in Vero E6 cells to determine their clades and lineages. We analyzed the medical records of COVID-19 patients and identified hospitalization risk factor(s). We retrieved SARS-CoV-2 sequences identified in Taiwan from GISAID and analyzed their correlation with COVID-19 data from the Taiwan Centers for Disease Control.</div></div><div><h3>Results</h3><div>We analyzed the phylogenesis of KMUH-47 to KMUH-104 (SARS-CoV-2 isolates identified herein) and all of the Omicron subvariants from BA.5 to XBB.1 (n = 1930). Age and comorbidities were hospitalization risk factors. Men generally exhibited a greater fatality rate than women. COVID-19-related deaths predominantly occurred in individuals over 70 years old. The COVID-19-related case fatality rate increased as nucleotide (NT) and amino acid (AA) substitutions increased. The number of COVID-19-related cases and deaths progressively decreased with each outbreak between August 2022 and October 2023.</div></div><div><h3>Conclusion</h3><div>Hospitalization was associated with age and the presence of comorbidities. COVID-19-related fatality was linked to sex, age, and the accumulation of NT and AA substitutions in emerging Omicron subvariants.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 11","pages":"Article 102556"},"PeriodicalIF":4.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-27DOI: 10.1016/j.jiph.2024.102557
Chenyuan Qin , Yaping Wang , Min Liu , Jue Liu
Background
Zika virus (ZIKV) infection during pregnancy presents a significant health risk in women of reproductive age and their offspring due to severe neurological complications. It is meaningful to assess its global burden and temporal trends.
Methods
This study extracted annual incidence cases and rates of ZIKV among women of reproductive age (15–49 years) between 2011 and 2021 from Global Burden of Diseases (GBD) 2021, including global level, 21 GBD regions, 5 socio-demographic index (SDI) regions, 7 age groups, and 204 countries and territories. Relative percent change in cases and estimated annual percentage change (EAPC) of incidence rates were used to quantify the temporal trends.
Results
The incidence rate of ZIKV infection exhibited a pronounced peak in 2016 at 174.27 per 100,000 population, with an EAPC of 158.30 % from 2011 to 2016 and −51.86 % from 2016 to 2021 at 3.06 per 100,000 population. And only 5 out of the 21 GBD regions reported ZIKV infection in 2021, predominantly concentrated in Latin America and Caribbean. The outbreaks were primarily concentrated in low-middle and middle SDI regions. In 2021, at the global level, the incidence rates of ZIKV infection among women of reproductive age were similar across different age groups, ranging from 2.41 to 3.39 per 100,000 population. The proportion of ZIKV infection cases was slightly higher in women aged 25–29 and 30–34 years compared to other age groups in 2021, whereas a higher proportion of cases were observed in younger age groups in 2011 and 2016.
Conclusions
Women of reproductive age in Latin America and Caribbean continue to face the threat of ZIKV. Regions with lower SDI had a disproportionately severe burden. Future public health strategies should focus on high-risk areas and populations of reproductive age, enhancing surveillance, prevention, and education efforts to further mitigate the public health threat posed by ZIKV.
{"title":"Global burden and incidence trends of zika virus infection among women aged 15–49 years from 2011 to 2021: A systematic analysis","authors":"Chenyuan Qin , Yaping Wang , Min Liu , Jue Liu","doi":"10.1016/j.jiph.2024.102557","DOIUrl":"10.1016/j.jiph.2024.102557","url":null,"abstract":"<div><h3>Background</h3><div>Zika virus (ZIKV) infection during pregnancy presents a significant health risk in women of reproductive age and their offspring due to severe neurological complications. It is meaningful to assess its global burden and temporal trends.</div></div><div><h3>Methods</h3><div>This study extracted annual incidence cases and rates of ZIKV among women of reproductive age (15–49 years) between 2011 and 2021 from Global Burden of Diseases (GBD) 2021, including global level, 21 GBD regions, 5 socio-demographic index (SDI) regions, 7 age groups, and 204 countries and territories. Relative percent change in cases and estimated annual percentage change (EAPC) of incidence rates were used to quantify the temporal trends.</div></div><div><h3>Results</h3><div>The incidence rate of ZIKV infection exhibited a pronounced peak in 2016 at 174.27 per 100,000 population, with an EAPC of 158.30 % from 2011 to 2016 and −51.86 % from 2016 to 2021 at 3.06 per 100,000 population. And only 5 out of the 21 GBD regions reported ZIKV infection in 2021, predominantly concentrated in Latin America and Caribbean. The outbreaks were primarily concentrated in low-middle and middle SDI regions. In 2021, at the global level, the incidence rates of ZIKV infection among women of reproductive age were similar across different age groups, ranging from 2.41 to 3.39 per 100,000 population. The proportion of ZIKV infection cases was slightly higher in women aged 25–29 and 30–34 years compared to other age groups in 2021, whereas a higher proportion of cases were observed in younger age groups in 2011 and 2016.</div></div><div><h3>Conclusions</h3><div>Women of reproductive age in Latin America and Caribbean continue to face the threat of ZIKV. Regions with lower SDI had a disproportionately severe burden. Future public health strategies should focus on high-risk areas and populations of reproductive age, enhancing surveillance, prevention, and education efforts to further mitigate the public health threat posed by ZIKV.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 11","pages":"Article 102557"},"PeriodicalIF":4.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-27DOI: 10.1016/j.jiph.2024.102558
Engku Nur Syafirah Engku Abd Rahman , Ahmad Adebayo Irekeola , Abdirahman Hussein Elmi , Wei Chuan Chua , Yean Yean Chan
This global systematic review and meta-analysis of Vibrio cholerae prevalence, covering environmental, food, animal, and human samples, analysed 111 studies from five databases. The meta-analysis, adhering to standard reporting guidelines, revealed a pooled prevalence of 10.6 % (95 % CI; 8.2 – 13.5; I2 = 99.595 %, p < 0.001) from 176,740 samples, including 27,219 cholera cases. Despite significant publication bias (Egger’s test, p = 0.00018), prevalence estimate remained stable in leave-one-out analysis. Subgroup analysis showed prevalence varied by region, with Indonesia highest (55.2 %) and Jordan lowest (0.2 %). Asia continent had the highest prevalence (13.9 %), followed by South America (12.1 %), and lowest in Europe (3.8 %). Environmental samples exhibited the highest prevalence (24.9 %), while human samples had the lowest (7.1 %). The pervasive presence of V. cholerae in environmental resources highlights the persistent risk of global cholera outbreaks, necessitating urgent proactive measures and ongoing surveillance for effective cholera control.
{"title":"Global prevalence patterns and distribution of Vibrio cholerae: A systematic review and meta-analysis of 176,740 samples","authors":"Engku Nur Syafirah Engku Abd Rahman , Ahmad Adebayo Irekeola , Abdirahman Hussein Elmi , Wei Chuan Chua , Yean Yean Chan","doi":"10.1016/j.jiph.2024.102558","DOIUrl":"10.1016/j.jiph.2024.102558","url":null,"abstract":"<div><div>This global systematic review and meta-analysis of <em>Vibrio cholerae</em> prevalence, covering environmental, food, animal, and human samples, analysed 111 studies from five databases. The meta-analysis, adhering to standard reporting guidelines, revealed a pooled prevalence of 10.6 % (95 % CI; 8.2 – 13.5; <em>I</em><sup><em>2</em></sup> = 99.595 %, <em>p</em> < 0.001) from 176,740 samples, including 27,219 cholera cases. Despite significant publication bias (Egger’s test, <em>p</em> = 0.00018), prevalence estimate remained stable in leave-one-out analysis. Subgroup analysis showed prevalence varied by region, with Indonesia highest (55.2 %) and Jordan lowest (0.2 %). Asia continent had the highest prevalence (13.9 %), followed by South America (12.1 %), and lowest in Europe (3.8 %). Environmental samples exhibited the highest prevalence (24.9 %), while human samples had the lowest (7.1 %). The pervasive presence of <em>V. cholerae</em> in environmental resources highlights the persistent risk of global cholera outbreaks, necessitating urgent proactive measures and ongoing surveillance for effective cholera control.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 11","pages":"Article 102558"},"PeriodicalIF":4.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-20DOI: 10.1016/j.jiph.2024.102546
Alexandra Roth , Lena Gehre , Jonas Gerke , Maja Lutz , Georgianna Manafa , Tillman Schmitz , Christoph Lambio , Sida Zhuang , Jeffrey Butler , Tobia Lakes , Nicolai Savaskan
Background
The COVID-19 pandemic has affected various urban population groups in different ways. Earlier studies have shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disproportionally impacts nursing home residents by increasing morbidity and mortality following viral exposure. However, little is known about the epidemiology of this disease in detail. Therefore, the objective of this study is to analyze the development of the COVID-19 pandemic in 14 nursing homes across Berlin-Neukölln, Germany, during pandemic waves 1 to 5 (Feb 2020 - May 2022).
Methods
Reporting data to the Neukölln Department of Public Health on COVID-19 cases in connection with nursing homes were extracted from the SORMAS database. The case fatality rates (CFRs) and odds ratios (ORs) of demographic parameters, prevalent variants of concern (VOCs) and vaccine availability were calculated. In addition, the temporal course in waves 1–5 in Neukölln and the relevant government measures were examined.
Results
Data collected from nursing homes providing age-dependent physical care revealed that 1.9 % of the total 108,600 cases registered in Berlin-Neukölln during the study period were related one of the 14 facilities. Compared to the general population in Neukölln, nursing homes exhibited a 20-fold increase in the CFR. Notably, nursing homes with higher bed capacities displayed a greater CFR than did smaller nursing homes. Similarly, elderly residents living in nursing homes faced a much greater mortality rate than did their counterparts living outside of medical settings (OR = 3.5). The original wild-type SARS-CoV-2 strain had the most severe direct impact, with a CFR of 16.7 %, compared to the alpha (CFR = 6.9 %), delta (CFR = 10.2 %) and omicron (CFR = 2.8 %) variants in nursing homes. Interestingly, the number of infections increased following vaccination campaigns, but this trend was accompanied by a decrease in the number of deaths from 2.6 to 1.1 per week. As a result, the CFR significantly decreased from 18.4 to 5.5, while still exceeding the mean CFR compared to that of the general population of Neukölln.
Conclusions
Our findings reveal the changing patterns of outbreak frequency and severity across the five pandemic waves. They highlight the crucial role of rapid vaccination programs for residents, staff, visitors, and third-party services in safeguarding nursing homes. Additionally, improvements in containment and cluster strategies are essential in prevaccination scenarios to prevent future infection traps for elderly individuals in long-term care facilities. The presented data highlight the importance of tailored protection measures for one of the most vulnerable populations in our society.
{"title":"Epidemiology of COVID-19 in Berlin-Neukölln nursing homes","authors":"Alexandra Roth , Lena Gehre , Jonas Gerke , Maja Lutz , Georgianna Manafa , Tillman Schmitz , Christoph Lambio , Sida Zhuang , Jeffrey Butler , Tobia Lakes , Nicolai Savaskan","doi":"10.1016/j.jiph.2024.102546","DOIUrl":"10.1016/j.jiph.2024.102546","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic has affected various urban population groups in different ways. Earlier studies have shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disproportionally impacts nursing home residents by increasing morbidity and mortality following viral exposure. However, little is known about the epidemiology of this disease in detail. Therefore, the objective of this study is to analyze the development of the COVID-19 pandemic in 14 nursing homes across Berlin-Neukölln, Germany, during pandemic waves 1 to 5 (Feb 2020 - May 2022).</div></div><div><h3>Methods</h3><div>Reporting data to the Neukölln Department of Public Health on COVID-19 cases in connection with nursing homes were extracted from the SORMAS database. The case fatality rates (CFRs) and odds ratios (ORs) of demographic parameters, prevalent variants of concern (VOCs) and vaccine availability were calculated. In addition, the temporal course in waves 1–5 in Neukölln and the relevant government measures were examined.</div></div><div><h3>Results</h3><div>Data collected from nursing homes providing age-dependent physical care revealed that 1.9 % of the total 108,600 cases registered in Berlin-Neukölln during the study period were related one of the 14 facilities. Compared to the general population in Neukölln, nursing homes exhibited a 20-fold increase in the CFR. Notably, nursing homes with higher bed capacities displayed a greater CFR than did smaller nursing homes. Similarly, elderly residents living in nursing homes faced a much greater mortality rate than did their counterparts living outside of medical settings (OR = 3.5). The original wild-type SARS-CoV-2 strain had the most severe direct impact, with a CFR of 16.7 %, compared to the alpha (CFR = 6.9 %), delta (CFR = 10.2 %) and omicron (CFR = 2.8 %) variants in nursing homes. Interestingly, the number of infections increased following vaccination campaigns, but this trend was accompanied by a decrease in the number of deaths from 2.6 to 1.1 per week. As a result, the CFR significantly decreased from 18.4 to 5.5, while still exceeding the mean CFR compared to that of the general population of Neukölln.</div></div><div><h3>Conclusions</h3><div>Our findings reveal the changing patterns of outbreak frequency and severity across the five pandemic waves. They highlight the crucial role of rapid vaccination programs for residents, staff, visitors, and third-party services in safeguarding nursing homes. Additionally, improvements in containment and cluster strategies are essential in prevaccination scenarios to prevent future infection traps for elderly individuals in long-term care facilities. The presented data highlight the importance of tailored protection measures for one of the most vulnerable populations in our society.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 11","pages":"Article 102546"},"PeriodicalIF":4.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1876034124002806/pdfft?md5=2fd2b50a7d987eabd696e9b151fb0d8f&pid=1-s2.0-S1876034124002806-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-17DOI: 10.1016/j.jiph.2024.102547
Majid Alshamrani , Fayssal Farahat , Mohammed Alzunitan , Musallam Abu Hasan , Nisreen Alsherbini , Ali Albarrak , Sameera M Al Johani , Atef shibl , Jaffar A. Al-Tawfiq , Alimuddin Zumla , Ziad A. Memish
Millions of pilgrims travel annually to Makkah and Madinah, Saudi Arabia, for the Hajj, posing unique challenges for public health management and disease control. The large influx of pilgrims from diverse backgrounds traveling to a confined geographic area, coupled with the close proximity and interactions among them, create significant pressure on the healthcare system and heighten the potential for the spread of communicable diseases. This review examines current trends in communicable diseases and their impact, drawing insights from expert perspectives on the required (i.e., meningococcal meningitis, polio, and yellow fever) and recommended vaccinations (influenza, COVID-19) for Hajj participants. The updated COVID-19 vaccine is mandatory for local pilgrims and is strongly recommended for international visitors, with ongoing discussions on adapting protocols to address emerging variants. The timing and strain coverage of influenza vaccination, along with quadrivalent meningococcal vaccination, are also emphasized as critical preventive measures. Diseases such as cholera and yellow fever are addressed underscoring the need for rigorous surveillance and targeted vaccination strategies to mitigate the risk of transmission during the Hajj. By providing up-to-date information on mandated and recommended vaccinations, this review aims to empower pilgrims and healthcare professionals to make informed decisions regarding public health and disease prevention during this significant event.
{"title":"Hajj vaccination strategies: Preparedness for risk mitigation","authors":"Majid Alshamrani , Fayssal Farahat , Mohammed Alzunitan , Musallam Abu Hasan , Nisreen Alsherbini , Ali Albarrak , Sameera M Al Johani , Atef shibl , Jaffar A. Al-Tawfiq , Alimuddin Zumla , Ziad A. Memish","doi":"10.1016/j.jiph.2024.102547","DOIUrl":"10.1016/j.jiph.2024.102547","url":null,"abstract":"<div><div>Millions of pilgrims travel annually to Makkah and Madinah, Saudi Arabia, for the Hajj, posing unique challenges for public health management and disease control. The large influx of pilgrims from diverse backgrounds traveling to a confined geographic area, coupled with the close proximity and interactions among them, create significant pressure on the healthcare system and heighten the potential for the spread of communicable diseases. This review examines current trends in communicable diseases and their impact, drawing insights from expert perspectives on the required (i.e., meningococcal meningitis, polio, and yellow fever) and recommended vaccinations (influenza, COVID-19) for Hajj participants. The updated COVID-19 vaccine is mandatory for local pilgrims and is strongly recommended for international visitors, with ongoing discussions on adapting protocols to address emerging variants. The timing and strain coverage of influenza vaccination, along with quadrivalent meningococcal vaccination, are also emphasized as critical preventive measures. Diseases such as cholera and yellow fever are addressed underscoring the need for rigorous surveillance and targeted vaccination strategies to mitigate the risk of transmission during the Hajj. By providing up-to-date information on mandated and recommended vaccinations, this review aims to empower pilgrims and healthcare professionals to make informed decisions regarding public health and disease prevention during this significant event.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 11","pages":"Article 102547"},"PeriodicalIF":4.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-17DOI: 10.1016/j.jiph.2024.102545
Sherif Ammar , Andrew Anglemyer , Julie Bennett , Julianna Lees , Michael Addidle , Julie Morgan , Kara DuBray , Yvonne Galloway , Corina Grey , Putu Duff
Background
Since October 2022, multiple high-income countries have reported an increase in invasive group A streptococcal (iGAS) infections. This study describes trends in iGAS infections in Aotearoa New Zealand (NZ) between 2017 and 2023, and examines associations of iGAS incidence, COVID-19 eras, and acute respiratory infections (ARI).
Methods
Analyses include national-level surveillance data on iGAS and ARI. Multivariable Poisson regression was used to examine relationships between COVID-19 era and iGAS incidence, and Pearson pairwise correlations were calculated to examine trends between ARI and iGAS.
Findings
A sharp increase in iGAS was observed in 2023, with notable increases among children aged under ten years. Indigenous Māori and Pacific peoples were disproportionately affected. emm1 and emm12 were commonly reported in 2022–2023. Compared to pre-pandemic, iGAS decreased significantly during the COVID-19 restrictions era and increased once COVID-19 restrictions were relaxed, after adjusting for ethnicity, sex, and age. ARI was moderately correlated with iGAS (r = 0∙55) in 2022–2023.
Interpretation
Though delayed, NZ’s recent iGAS trends mirror those seen in the 2022/2023 multi-country iGAS surge. These findings expand existing research, suggesting a link between the easing of COVID-19 measures, increased ARI circulation, and the rise in iGAS. Continued and improved iGAS surveillance, is needed to better understand iGAS epidemiology and support public health response. iGAS in NZ will become notifiable in late 2024, which should help improve iGAS monitoring and support public health response.
Funding
This research received no specific funding, though iGAS surveillance and typing in NZ is funded by the Ministry of Health, which was not involved in the analysis, interpretation, design, or any aspect of this study. No authors were paid to write this manuscript.
背景自 2022 年 10 月以来，多个高收入国家报告侵袭性 A 组链球菌（iGAS）感染增加。本研究描述了2017年至2023年期间新西兰奥特亚罗瓦（NZ）的iGAS感染趋势，并研究了iGAS发病率、COVID-19时代和急性呼吸道感染（ARI）之间的关联。研究结果2023年iGAS急剧增加，10岁以下儿童的iGAS显著增加。原住民毛利人和太平洋岛屿族裔受到的影响尤为严重。与大流行前相比，在 COVID-19 限制期间，iGAS 显著下降，而在 COVID-19 限制放宽后，经种族、性别和年龄调整后，iGAS 有所上升。2022-2023年，ARI与iGAS呈中度相关（r = 0∙55）。解释虽然新西兰最近的iGAS趋势有所延迟，但它反映了2022/2023年多国iGAS激增的趋势。这些发现扩展了现有的研究，表明 COVID-19 措施的放松、ARI 传播的增加和 iGAS 的上升之间存在联系。为更好地了解 iGAS 流行病学并支持公共卫生应对措施，需要继续开展并改进 iGAS 监测工作。新西兰的 iGAS 将于 2024 年末成为可通报的疾病，这将有助于改进 iGAS 监测工作并支持公共卫生应对措施。撰写本手稿的作者未获得任何报酬。
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Pub Date : 2024-09-16DOI: 10.1016/j.jiph.2024.102544
Rawaa A. Hussein , Shaymaa H. AL-Kubaisy , Mushtak T.S. Al-Ouqaili
Background
An important chance of nosocomial acquired infections are caused by the opportunistic bacterium Klebsiella pneumoniae. Urine, wound, sputum, and blood samples were collected from all patients. This study aimed to detect the antibiotic resistance profile, the frequency of MDR, XDR, PDR, and detection of efflux pump and outer membrane permeability genes in K. pneumoniae isolates.
Methods
One hundred twenty samples were collected from patients who were admitted to the Ramadi Teaching Hospitals in Al-Anbar Governorate. Fifty five of K. pneumoniae strains were collected from patients. The VITEK®2 Compact B System was used to detect the antibiotic resistance pattern of studied bacteria. The isolates were classified as MDR, XDR, or PDR based on established guidelines. The data were analyzed using Clinical and Laboratory Standards Institute (CLSI) breakpoints. PCR was used to detect the efflux pumps and porins genes.
Results
Out of the 120 samples studied, 45.83 % (55) tested positive for K. pneumoniae. The isolates displayed the greatest amount of resistance to cefazolin, ceftriaxone (98.2 %), ampicillin (100 %), and ceftazidime, cefepime (90.9 %). 20 % of the isolates were found to produce metallo-lactamases, and 41.81 % tested positive for extended-spectrum beta-lactamases. Overall, the rates of multi-drug resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) isolates were 57.2 %, 10.9 %, and 9.09 %, respectively. Additionally, the prevalence of efflux pump genes acrAB, mdtK, and tolC were 94.54 %, 14.54 %, and 89.09 %, respectively, while the porin-encoding genes ompK35 and ompK36 were found in 96.36 % and 98.18 % of the isolates.
Conclusion
This investigation concluded that the study isolates had a high degree of antibiotic resistance heterogenicity. High frequencies of resistance to ampicillin, cefazolin, and ceftriaxone are present in study isolates. Most strains were categorized as MDR strains, with six being XDR strains and five being PDR strains. One of the main routes of antibiotic resistance in multidrug-resistant K. pneumoniae strains is through the acrAB efflux system. The high prevalence of the acrAB, tolC, ompk35, and ompK36 genes were increases the ability of these isolates combat antimicrobial treatments.
{"title":"The influence of efflux pump, outer membrane permeability and β-lactamase production on the resistance profile of multi, extensively and pandrug resistant Klebsiella pneumoniae","authors":"Rawaa A. Hussein , Shaymaa H. AL-Kubaisy , Mushtak T.S. Al-Ouqaili","doi":"10.1016/j.jiph.2024.102544","DOIUrl":"10.1016/j.jiph.2024.102544","url":null,"abstract":"<div><h3>Background</h3><div>An important chance of nosocomial acquired infections are caused by the opportunistic bacterium <em>Klebsiella pneumoniae</em>. Urine, wound, sputum, and blood samples were collected from all patients. This study aimed to detect the antibiotic resistance profile, the frequency of MDR, XDR, PDR, and detection of efflux pump and outer membrane permeability genes in <em>K. pneumoniae</em> isolates.</div></div><div><h3>Methods</h3><div>One hundred twenty samples were collected from patients who were admitted to the Ramadi Teaching Hospitals in Al-Anbar Governorate. Fifty five of <em>K. pneumoniae</em> strains were collected from patients. The VITEK®2 Compact B System was used to detect the antibiotic resistance pattern of studied bacteria. The isolates were classified as MDR, XDR, or PDR based on established guidelines. The data were analyzed using Clinical and Laboratory Standards Institute (CLSI) breakpoints. PCR was used to detect the efflux pumps and porins genes.</div></div><div><h3>Results</h3><div>Out of the 120 samples studied, 45.83 % (55) tested positive for <em>K. pneumoniae</em>. The isolates displayed the greatest amount of resistance to cefazolin, ceftriaxone (98.2 %), ampicillin (100 %), and ceftazidime, cefepime (90.9 %). 20 % of the isolates were found to produce metallo-lactamases, and 41.81 % tested positive for extended-spectrum beta-lactamases. Overall, the rates of multi-drug resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) isolates were 57.2 %, 10.9 %, and 9.09 %, respectively. Additionally, the prevalence of efflux pump genes <em>acrAB, mdtK</em>, and <em>tolC</em> were 94.54 %, 14.54 %, and 89.09 %, respectively, while the porin-encoding genes <em>ompK35</em> and <em>ompK36</em> were found in 96.36 % and 98.18 % of the isolates.</div></div><div><h3>Conclusion</h3><div>This investigation concluded that the study isolates had a high degree of antibiotic resistance heterogenicity. High frequencies of resistance to ampicillin, cefazolin, and ceftriaxone are present in study isolates. Most strains were categorized as MDR strains, with six being XDR strains and five being PDR strains. One of the main routes of antibiotic resistance in multidrug-resistant <em>K. pneumoniae</em> strains is through the acrAB efflux system. The high prevalence of the <em>acrAB</em>, <em>tolC</em>, <em>ompk35</em>, and <em>ompK36</em> genes were increases the ability of these isolates combat antimicrobial treatments.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 11","pages":"Article 102544"},"PeriodicalIF":4.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1876034124002788/pdfft?md5=81d9063f3372e07a0582f9cc8b5d1e8a&pid=1-s2.0-S1876034124002788-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-16DOI: 10.1016/j.jiph.2024.102542
Cheon-Hoo Jun , Si-Ho Kim , Junyoung Kim , Kwang Min Kim , Jung Won Lee , Sung Min Kong , Jiyeong Kwak , Byung Soo Kwan , Hyun Kyu Cho , Kyoung-Jin Park , Hyoung Tae Kim , Yu Mi Wi
Background
Tissue-invasive end-organ disease (EOD) caused by cytomegalovirus (CMV) is less frequently reported in immunocompetent patients compared to immunocompromised patients. In this study, we investigated the association between CMV viremia and CMV end-organ disease in immunocompetent patients.
Methods
Adult patients (≥18 years old) with CMV viremia were screened from January 2010 to June 2022. The primary outcome was the presence of CMV EOD. Risk factors associated with CMV EOD were analyzed, and a receiver operating characteristic curve was plotted to determine the most accurate cutoff value of the CMV titer for the prediction of CMV EOD.
Results
Among the 106 immunocompetent patients with CMV viremia, 31 exhibited CMV EOD. Gastrointestinal tract disease was the most common. The log10 value of the CMV titer was significantly associated with the occurrence of CMV EOD in immunocompetent patients with CMV viremia. The optimal cut-off CMV titer for the prediction of CMV EOD was 749 IU/mL.
Conclusions
Our study suggests the potential association between high CMV titers and the development of CMV end-organ diseases and describes the diagnostic performance and utility of quantitative PCR as a surrogate marker for predicting the occurrence of CMV EOD in immunocompetent patients.
{"title":"Quantitative PCR for early detection of human cytomegalovirus end-organ disease in immunocompetent host: A retrospective single-center study","authors":"Cheon-Hoo Jun , Si-Ho Kim , Junyoung Kim , Kwang Min Kim , Jung Won Lee , Sung Min Kong , Jiyeong Kwak , Byung Soo Kwan , Hyun Kyu Cho , Kyoung-Jin Park , Hyoung Tae Kim , Yu Mi Wi","doi":"10.1016/j.jiph.2024.102542","DOIUrl":"10.1016/j.jiph.2024.102542","url":null,"abstract":"<div><h3>Background</h3><p>Tissue-invasive end-organ disease (EOD) caused by cytomegalovirus (CMV) is less frequently reported in immunocompetent patients compared to immunocompromised patients. In this study, we investigated the association between CMV viremia and CMV end-organ disease in immunocompetent patients.</p></div><div><h3>Methods</h3><p>Adult patients (≥18 years old) with CMV viremia were screened from January 2010 to June 2022. The primary outcome was the presence of CMV EOD. Risk factors associated with CMV EOD were analyzed, and a receiver operating characteristic curve was plotted to determine the most accurate cutoff value of the CMV titer for the prediction of CMV EOD.</p></div><div><h3>Results</h3><p>Among the 106 immunocompetent patients with CMV viremia, 31 exhibited CMV EOD. Gastrointestinal tract disease was the most common. The log10 value of the CMV titer was significantly associated with the occurrence of CMV EOD in immunocompetent patients with CMV viremia. The optimal cut-off CMV titer for the prediction of CMV EOD was 749 IU/mL.</p></div><div><h3>Conclusions</h3><p>Our study suggests the potential association between high CMV titers and the development of CMV end-organ diseases and describes the diagnostic performance and utility of quantitative PCR as a surrogate marker for predicting the occurrence of CMV EOD in immunocompetent patients.</p></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 11","pages":"Article 102542"},"PeriodicalIF":4.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1876034124002764/pdfft?md5=19e0047364d59e996ff8af9abf9da42e&pid=1-s2.0-S1876034124002764-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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