Pathogens and Global Health最新文献

Nipah virus (NiV) outbreak was declared in Kozhikode district, Kerala state, India, on 12 September 2023. The local, state, and national authorities worked in an integrated way to tackle and control the outbreak. Indian Council of Medical Research (ICMR) deployed a team from the ICMR-National Institute of Virology (NIV), Pune, India, along with an indigenously developed and validated Mobile BSL-3 (MBSL-3) laboratory for providing onsite NiV diagnosis. The Kozhikode district of Kerala state was the epicenter of three NiV outbreaks on May 2018, August 2021, and most recently in September 2023. The Ernakulam district of Kerala also reported a NiV outbreak in June 2019. In the 2023 outbreak, six confirmed NiV cases were detected, with two deaths. During previous outbreaks in 2019 and 2021, the team from ICMR-NIV, Pune, had successfully established a field laboratory utilizing the BSL-2 facility for NiV onsite diagnosis. BSL-3 personnel protective equipment and standard operative procedures were used to handle clinical specimens. Post COVID-19 pandemic, under the pioneering initiative of the Government of India, ICMR, and Klenzaids Contamination Control Pvt. Ltd, Mumbai developed a rapidly deployable, pragmatic, access control, and containment laboratory on bus chassis. The MBSL-3 laboratory was utilized for the NiV onsite diagnosis for early containment of outbreaks, reducing the turnaround time for diagnosis to just 4 hrs. The MBSL-3 laboratory plays a significant role in NiV outbreak response and could be utilized in the future also reaching the remotest areas of the country.

Background: Clostridioides difficile infection (CDI) is a significant contributor to healthcare-associated infections worldwide, with an increasing incidence in Europe. It has significant morbidity in high-risk, hospitalized patients. Despite previous studies in Spain, there have been no updates to nationwide data since 2015.

Aim: To provide an updated epidemiological overview of CDI in Spain, focusing on incidence, recurrence, mortality, and regional variability in hospitalized patients between 2016 and 2022.

Methods: A nationwide, retrospective study was carried out using a Spanish national health system registry including data from hospitalization discharge reports. Data from 66,864 hospitalizations with a CDI diagnosis were analyzed and descriptive analyses and Poisson regression models were performed to assess trends in CDI incidence, recurrence, and mortality over time.

Results: CDI incidence increased from 30 to 43 cases per 100,000 hospitalizations between 2016 and 2022. Recurrence was observed in 15-16% of cases from 2020 to 2022. All-cause, in-hospital mortality remained steady at 11-13% over the observation period. There was regional variability, with some regions showing the highest incidences and other regions having the lowest. The median age of patients was 75 years, and women accounted for 53% of cases.

Conclusion: The results highlight a steady increase in CDI incidence in Spain over the last two decades, particularly since 2020, probably influenced by the widespread antibiotic use during the COVID-19 pandemic. Recurrence and mortality rates remain significant challenges. These findings highlight the need for national surveillance programs, improved diagnostic protocols, and targeted interventions to mitigate the impact of CDI.

The seasonality of influenza still poses a significant challenge to public health today, with different dynamics between the southern and northern hemispheres. In Europe and Italy, the arrival of winter is often accompanied by alarmist media reports about the so-called 'Australian flu', a term that has no scientific basis and is potentially misleading. This study systematically compares the most recent epidemiological and virological data from Australia and Italy, analyzing laboratory-confirmed cases, the distribution of viral subtypes, and vaccination coverage. The results show that, although Australia is a useful sentinel system for identifying circulating strains and validating vaccine composition, the trend of its flu season is not a direct predictor of the subsequent European season. Demographic differences, vaccination coverage, mobility, and co-circulation of other respiratory viruses (RSV, SARS-CoV-2) determine distinct epidemiological scenarios. The implications for public health indicate the need to move beyond alarmist communication approaches in favor of a scientifically based interpretation of data, promoting integrated surveillance systems, targeted vaccination campaigns, and updated clinical strategies for multi-pathogen management. An evidence-based approach and clear, contextualized communication are essential to effectively address the challenges posed by seasonal respiratory diseases in an increasingly complex global context.

Influenza virus and its various strains are a significant risk for the global health; influenza and its various strains have caused various periodic outbreaks and pandemics. As we delve into this review, it studies the history and the threat possessed by the four prominent strains of influenza H1N1, H3N2, H7N9, and H9N2. It also examines some of recent and notable outbreaks posed by these influenza strains. In 2009, the H1N1 pandemic was originated in the swine and was spread worldwide rapidly. This outbreak highlighted the gaps in the preparations and response in global healthcare system. The other strain H3N2 with a long history of frequent outbreaks distresses the public health and the health care sectors due to its evolution and the ability to adapt. In 2013 China, a novel strain was identified with a high mortality rate and the potential for human-to-human transmission remains a concern to the public health. Another strain H9N2 though less infectious is being monitored for its ability to cause pandemics in the future, and its distinct genetic makeup and sporadic human infections are causes for worry. This review outlines their differences and similarities, the importance of vigilant surveillance, effective treatment strategies, and the preparedness measures to mitigate any future influenza outbreaks.

The mortality trends associated with the mpox virus (MPXV) are not well defined. This study aims to systematically assess the mortality rate of mpox and its stratification across different geographical locations. Comprehensive review of articles from the PubMed, Embase, Scopus, and Web of Science databases up to June 2025, focusing on studies reporting mortality rates among patients diagnosed with mpox. A random-effects proportional meta-analysis assessed global and regional mpox mortality rates and their geographical variations. Sensitivity analysis using one-study removal method and meta-regression analyses were conducted. Out of 4,098 records, 30 articles met the selection criteria, comprising a total of 47,311 patients diagnosed with mpox. The pooled global mpox mortality rate was 3.1% (95% CI: 1.6%-5.9%). Mortality was significantly higher before 2016 at 11.4% (95% CI: 5.8%-21.1%), compared to 2.4% (95% CI: 1.2%-4.7%) during 2016-2025, and declined further in the post-COVID era to 1.5% (95% CI: 0.7%-3.4%). Mortality was markedly elevated among individuals with HIV co-infection (83.8%; 95% CI: 74.0%-90.5%). Regionally, mortality was highest in Africa (6.3%) and lowest in Europe (0.1%). Among studies conducted in endemic regions, a notable temporal decline was also observed, with mortality decreasing from 11.4% before 2016 to 4.1% during 2016-2025. Meta-regression identified year of publication as a significant predictor of mortality (p = 0.028), indicating improved outcomes over time. Global mpox mortality has declined over time, particularly in endemic regions and the post-COVID era. However, individuals with HIV remain at exceptionally high risk, underscoring the need for targeted interventions.

Despite the effectiveness of vaccination in preventing severe COVID-19, some individuals remain at risk. The study goal was to determine risk factors for COVID-19 requiring hospital admission. A case-control study was conducted in Porto Alegre, Brazil. Vaccinated adults with confirmed SARS-CoV-2 infection from February 2021 to March 2023 were eligible. Hospitalized patients (cases) and outpatients with non-severe infections (control group) were time-matched in a 1:1 ratio. Moreover, we followed hospitalized patients (cases) to evaluate factors related to 30-day mortality and/or ventilation support. We included 364 patients: 182 cases and 182 controls. Age > 60 years (odds ratio [OR] 3.98 [95% confidence interval{CI} 2.23-7.19]), male sex (OR 3.07 [95%CI 1.78-5.40]), diabetes mellitus (OR 4.61 [95% CI 2.08-11.08]), cardiovascular disease (OR 4.07 [95%CI 1.73-10.64]), lung disease (OR 3.06 [95%CI 1.39-6.94]), obesity (OR 3.39 [95%CI 1.29-9.73]), and previous infection (OR 0.19 [95%CI 0.06-0.51]) were independently related to COVID-19 hospital admission. In the arm of hospitalized patients, the number of vaccine doses (OR 0.53 [95%CI 0.39-0.73]) was a protective factor against 30-day mortality and/or ventilation support, whereas obesity (OR1.62 [95%CI 1.19-2.20]) was a risk factor. Health policies should consider focusing on these risk populations for targeted interventions, such as additional boosters, early treatment and prophylaxis.

Vector-borne pathogens like West Nile virus (WNV), an emerging zoonotic arbovirus, are strongly influenced by mosquito community dynamics. WNV is maintained between birds and mosquitoes, with humans and other mammal species (such as equids) as dead-end hosts. In Spain, the role of Culex perexiguus as main vector of WNV is gaining significance over Cx. pipiens due to differences in feeding behavior, and vector competence, and ecological preferences that affect WNV transmission. Using a SEIR (Susceptible-Exposed-Infectious-Recovered) model, we examined how mosquito abundance and feeding preferences impact WNV spread in a Mediterranean region. Our results suggest that, under the conditions simulated, Cx. pipiens alone is unlikely to sustain WNV transmission in the study area, whereas Cx. perexiguus may contribute more substantially to outbreak dynamics. Increased avian-feeding preferences were associated with higher outbreak intensity, although the basic reproduction number (R₀) remained below one in all scenarios. Sensitivity analyses highlighted that bite rates and abundance of Cx. perexiguus are key drivers of WNV spread in our model. Furthermore, a dilution effect was observed when Cx. pipiens fed more frequently on dead-end hosts, which contributed to lowering R₀. Our findings underscore the need for species-specific vector surveillance to inform public health interventions and control strategies for WNV and other mosquito-borne diseases.

This meta-analysis aimed to provide pooled overall prevalence estimates of oral human papillomavirus (HPV) infection in Africa. A literature search for cross-sectional studies was conducted until January 2025. The Newcastle-Ottawa Scale assessed the methodological quality. Random-effects model estimated the pooled prevalence of oral HPV infection. Sub-group analyses were conducted using study characteristics as covariates. Thirty-three studies involving 4.607 participants from 9 countries were included. Prevalence of oral HPV infection ranged between 0% to 95.1%, with a pooled overall estimate of 15.8%. The studies exhibited considerable heterogeneity (I2 = 99.3%). Subgroup analyses revealed the highest prevalence among participants with head and neck cancer (19.9%), from sub-Saharan area (19.2%), female (17.3%), moderate-low-quality studies (16.7%), and in HIV-positive (5.8%). High-quality studies with an accurate collection of the risk factors are needed for tailoring programs and health-care policies to prevent and control oral HPV infection and associated diseases.