Emerging infectious diseases: threats to human health and global stability

Operationalisation of consensual One Health roadmaps in countries for improved IHR capacities and health security

The COVID-19 pandemic is a devastating reminder that mitigating the threat of emerging zoonotic outbreaks relies on our collective capacity to work across human health, animal health and environment sectors. Despite the critical need for shared approaches, collaborative benchmarks in the International Health Regulations (IHR) Monitoring and Evaluation Framework and more specifically the Joint External Evaluation (JEE) often reveal low levels of performance in collaborative technical areas (TAs), thus identifying a real need to work on the human-animal-environment interface to improve health security. The National Bridging Workshops (NBWs) proposed jointly by the World Organisation of Animal Health and World Health Organization (WHO) provide opportunity for national human health, animal health, environment and other relevant sectors in countries to explore the efficiency and gaps in their coordination for the management of zoonotic diseases. The results, gathered in a prioritised roadmap, support the operationalisation of the recommendations made during JEE for TAs where a multisectoral One Health approach is beneficial. For those collaborative TAs (12 out of 19 in the JEE), more than two-thirds of the recommendations can be implemented through one or multiple activities jointly agreed during NBW. Interestingly, when associated with the WHO Benchmark Tool for IHR, it appears that NBW activities are often associated with lower level of performance than anticipated during the JEE missions, revealing that countries often overestimate their capacities at the human-animal-environment interface. Deeper, more focused and more widely shared discussions between professionals highlight the need for concrete foundations of multisectoral coordination to meet goals for One Health and improved global health security through IHR.

Historical contingency, geography and anthropogenic patterns of exposure drive the evolution of host switching in the Blastocystis species-complex

Parasites have the power to impose significant regulatory pressures on host populations, making evolutionary patterns of host switching by parasites salient to a range of contemporary ecological issues. However, relatively little is known about the colonization of new hosts by parasitic, commensal and mutualistic eukaryotes of metazoans. As ubiquitous symbionts of coelomate animals, Blastocystis spp. represent excellent candidate organisms for the study of evolutionary patterns of host switching by protists. Here, we apply a big-data phylogenetic approach using archival sequence data to assess the relative roles of several host-associated traits in shaping the evolutionary history of the Blastocystis species-complex within an ecological framework. Patterns of host usage were principally determined by geographic location and shared environments of hosts, suggesting that weight of exposure (i.e. propagule pressure) represents the primary force for colonization of new hosts within the Blastocystis species-complex. While Blastocystis lineages showed a propensity to recolonize the same host taxa, these taxa were often evolutionarily unrelated, suggesting that historical contingency and retention of previous adaptions by the parasite were more important to host switching than host phylogeny. Ultimately, our findings highlight the ability of ecological theory (i.e. ‘ecological fitting’) to explain host switching and host specificity within the Blastocystis species-complex.

The Tragedy of Names

The naming of pathogens and their associated syndromes is a thorny process which unfolds in a complex geopolitical environment. This brief piece offers perspective on the multitude of forces that shape the name of a pathogen and summarizes the story of Sin Nombre Virus, with some reference to the ongoing saga of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A monopoly on names and circulating monikers rarely exists, and certain communities become disproportionately impacted by misunderstandings or stigmatization. By acknowledging these processes, we can better serve as allies to affected communities dealing with both pandemic and prejudice.

Sabiá Virus-Like Mammarenavirus in Patient with Fatal Hemorrhagic Fever, Brazil, 2020

New World arenaviruses can cause chronic infection in rodents and hemorrhagic fever in humans. We identified a Sabiá virus-like mammarenavirus in a patient with fatal hemorrhagic fever from São Paulo, Brazil. The virus was detected through virome enrichment and metagenomic next-generation sequencing technology.

Enlightenment on oscillatory properties of 23 class B notifiable infectious diseases in the mainland of China from 2004 to 2020

A variety of infectious diseases occur in mainland China every year. Cyclic oscillation is a widespread attribute of most viral human infections. Understanding the outbreak cycle of infectious diseases can be conducive for public health management and disease surveillance. In this study, we collected time-series data for 23 class B notifiable infectious diseases from 2004 to 2020 using public datasets from the National Health Commission of China. Oscillatory properties were explored using power spectrum analysis. We found that the 23 class B diseases from the dataset have obvious oscillatory patterns (seasonal or sporadic), which could be divided into three categories according to their oscillatory power in different frequencies each year. These diseases were found to have different preferred outbreak months and infection selectivity. Diseases that break out in autumn and winter are more selective. Furthermore, we calculated the oscillation power and the average number of infected cases of all 23 diseases in the first eight years (2004 to 2012) and the next eight years (2012 to 2020) since the update of the surveillance system. A strong positive correlation was found between the change of oscillation power and the change in the number of infected cases, which was consistent with the simulation results using a conceptual hybrid model. The establishment of reliable and effective analytical methods contributes to a better understanding of infectious diseases’ oscillation cycle characteristics. Our research has certain guiding significance for the effective prevention and control of class B infectious diseases.

Anxiety and associated factors among Ethiopian health professionals at early stage of COVID-19 pandemic in Ethiopia

Introduction

In late 2019, a new coronavirus disease known as COVID-19 (novel coronavirus disease 2019) was identified. As there is no any drug to treat this pandemic, the healthcare professionals are disproportionately at higher risk. The mental health outcome is expected to be high. Anxiety is expected to have a significant impact on health professionals, especially among those who work without adequate resources for self-protection.

Objectives

The objectives of this research was to assess self-reported anxiety symptoms and associated factors among Ethiopian healthcare professionals in the early stages of the pandemic.

Methods

We have conducted an online cross-sectional study to collect information from healthcare professionals in Ethiopia during the early stage of the outbreak from April 7, 2020 to May 19, 2020. GAD-7 was used for measurement of anxiety. We have used a cut of point of 10 and above to report anxiety symptoms. We have used Google Forms for online data collection and SPSS-22 for analysis. To determine associated factors for anxiety, a binary logistic regression model was used. Variables with p-value < 0.2 during the bivariable binary logistic regression were exported for further analysis in the multivariable binary logistic regression. Finally, variables with p-value <0.05 were considered as significantly associated with the outcomes.

Results

Three hundred and eighty-eight healthcare professionals filled the online questionnaire; Majority (71.1%) were males. Significant number of respondents (78.9%) reported lack of adequate personal protective equipment (PPE) at the work place. The prevalence of anxiety was 26.8%.

Being female (AOR: 1.88; 95% C.I:1.11, 3.19), visiting/treating 30–150 patients per day (AOR: 3.44; 95% C.I:1.51, 7.84), those employed at private healthcare institutions (AOR: 2.40; 95% C.I:1.17, 4.90), who do not believe that COVID-19 is preventable (AOR: 2.04; 95% C.I:1.04, 4.03) and those who reported lack of PPE (AOR: 1.98; 95% C.I:1.04, 3.79) were more likely to be anxious.

Conclusions

The anxiety prevalence among healthcare professionals in Ethiopia during early stage of COVID-19 pandemic was high. This study shows that lack of preventive equipment, being female, contact with many patients, low self-efficacy and working in private health facilities were risk factors for anxiety. Anxiety prevention among health professionals during COVID-19 pandemic requires a holistic approach including provision of sufficient PPE, improving self-efficacy and addressing problems both at public and private institutions and focusing more on female health professionals.

Sustainable Laboratory Capacity Building After the 2014 Ebola Outbreak in the Republic of Guinea

Background: The 2014–2016 West Africa Ebola virus disease outbreak heavily impacted the Republics of Guinea, Sierra Leone, and Liberia. The outbreak uncovered the weaknesses of the public health systems, including inadequately trained and insufficient health personnel as well as limited and poorly equipped health infrastructures. These weaknesses represent significant threats to global health security. In the wake of the outbreak, affected countries made urgent requests for international engagement to help strengthening the public health systems.

Methods: This work describes the successful multi-year implementation of a laboratory capacity building program in the Republic of Guinea. The program integrated biorisk and quality management systems training, infectious diseases diagnostic training, facility engineering and maintenance training, and mentorship to strengthen Guinea's bio-surveillance capacity.

Results: The major outcome of these efforts was an established and local staff-operated public health laboratory that performs disease surveillance and reporting and diagnostic of priority diseases and pathogens of security concerns.

Conclusions: This work has improved the Guinea country's capabilities to address country public health issues and preparedness to respond to future infectious disease threats.

Highly multiplexed oligonucleotide probe-ligation testing enables efficient extraction-free SARS-CoV-2 detection and viral genotyping

There is an urgent and unprecedented need for sensitive and high-throughput molecular diagnostic tests to combat the SARS-CoV-2 pandemic. Here we present a generalized version of the RNA-mediated oligonucleotide Annealing Selection and Ligation with next generation DNA sequencing (RASL-seq) assay, called "capture RASL-seq" (cRASL-seq), which enables highly sensitive (down to ~1-100 pfu/ml or cfu/ml) and highly multiplexed (up to ~10,000 target sequences) detection of pathogens. Importantly, cRASL-seq analysis of COVID-19 patient nasopharyngeal (NP) swab specimens does not involve nucleic acid purification or reverse transcription, steps that have introduced supply bottlenecks into standard assay workflows. Our simplified protocol additionally enables the direct and efficient genotyping of selected, informative SARS-CoV-2 polymorphisms across the entire genome, which can be used for enhanced characterization of transmission chains at population scale and detection of viral clades with higher or lower virulence. Given its extremely low per-sample cost, simple and automatable protocol and analytics, probe panel modularity, and massive scalability, we propose that cRASL-seq testing is a powerful new technology with the potential to help mitigate the current pandemic and prevent similar public health crises.

Depression, anxiety, stress and their associated factors among Ethiopian University students during an early stage of COVID-19 pandemic: An online-based cross-sectional survey

BACKGROUND

The occurrence of the Coronavirus Disease 2019 (COVID-19) affects the mental health situation of almost everyone, including University students who spent most of their time at home due to the closure of the Universities. Therefore, this study aimed at assessing depression, anxiety, stress and identifying their associated factors among university students in Ethiopia during the early stage of the COVID-19 pandemic.

METHODS

We invited students to complete an online survey using Google forms comprising consent, socio-demographic characteristics, and the standard validated depression, anxiety, and stress scale (DASS-21) questionnaire. After completion of the survey from June 30 to July 30, 2020, we exported the data into SPSS 22. Both descriptive and analytical statistics were computed. Associated factors were identified using binary logistic regression and variables with a p-value <0.05 were declared as statistically significant factors with the outcome variables.

RESULTS

A total of 423 students completed the online survey. The prevalence of depression, anxiety, and stress in this study was 46.3%, 52%, and 28.6%, respectively. In the multivariable model, female sex, poor self-efficacy to prevent COVID-19, those who do not read any material about COVID-19 prevention, lack of access to reading materials about their profession, and lack of access to uninterrupted internet access were significantly associated with depression. Female sex, lower ages, students with non-health-related departments, those who do not think that COVID-19 is preventable, and those who do not read any materials about COVID-19 prevention were significantly associated with anxiety. Whereas, being female, students attending 1st and 2nd years, those who do not think that COVID-19 is preventable, presence of confirmed COVID-19 patient at the town they are living in, and lack of access to reading materials about their profession were significantly associated with stress.

CONCLUSIONS

Depression, anxiety, and stress level among University students calls for addressing these problems by controlling the modifiable factors identified and promoting psychological wellbeing of students.

Effects of Propolis on Infectious Diseases of Medical Relevance

Infectious diseases are a significant problem affecting the public health and economic stability of societies all over the world. Treatment is available for most of these diseases; however, many pathogens have developed resistance to drugs, necessitating the development of new therapies with chemical agents, which can have serious side effects and high toxicity. In addition, the severity and aggressiveness of emerging and re-emerging diseases, such as pandemics caused by viral agents, have led to the priority of investigating new therapies to complement the treatment of different infectious diseases. Alternative and complementary medicine is widely used throughout the world due to its low cost and easy access and has been shown to provide a wide repertoire of options for the treatment of various conditions. In this work, we address the relevance of the effects of propolis on the causal pathogens of the main infectious diseases with medical relevance; the existing compiled information shows that propolis has effects on Gram-positive and Gram-negative bacteria, fungi, protozoan parasites and helminths, and viruses; however, challenges remain, such as the assessment of their effects in clinical studies for adequate and safe use.

Density or Connectivity: What Are the Main Causes of the Spatial Proliferation of COVID-19 in Korea?

COVID-19 has sparked a debate on the vulnerability of densely populated cities. Some studies argue that high-density urban centers are more vulnerable to infectious diseases due to a higher chance of infection in crowded urban environments. Other studies, however, argue that connectivity rather than population density plays a more significant role in the spread of COVID-19. While several studies have examined the role of urban density and connectivity in Europe and the U.S., few studies have been conducted in Asian countries. This study aims to investigate the role of urban spatial structure on COVID-19 by comparing different measures of urban density and connectivity during the first eight months of the outbreak in Korea. Two measures of density were derived from the Korean census, and four measures of connectivity were computed using social network analysis of the Origin-Destination data from the 2020 Korea Transport Database. We fitted both OLS and negative binomial models to the number of confirmed COVID-19 patients and its infection rates at the county level, collected individually from regional government websites in Korea. Results show that both density and connectivity play an important role in the proliferation of the COVID-19 outbreak in Korea. However, we found that the connectivity measure, particularly a measure of network centrality, was a better indicator of COVID-19 proliferation than the density measures. Our findings imply that policies that take into account different types of connectivity between cities might be necessary to contain the outbreak in the early phase.

Interventions targeting non-symptomatic cases can be important to prevent local outbreaks: SARS-CoV-2 as a case study

During infectious disease epidemics, an important question is whether cases travelling to new locations will trigger local outbreaks. The risk of this occurring depends on the transmissibility of the pathogen, the susceptibility of the host population and, crucially, the effectiveness of surveillance in detecting cases and preventing onward spread. For many pathogens, transmission from pre-symptomatic and/or asymptomatic (together referred to as non-symptomatic) infectious hosts can occur, making effective surveillance challenging. Here, by using SARS-CoV-2 as a case study, we show how the risk of local outbreaks can be assessed when non-symptomatic transmission can occur. We construct a branching process model that includes non-symptomatic transmission and explore the effects of interventions targeting non-symptomatic or symptomatic hosts when surveillance resources are limited. We consider whether the greatest reductions in local outbreak risks are achieved by increasing surveillance and control targeting non-symptomatic or symptomatic cases, or a combination of both. We find that seeking to increase surveillance of symptomatic hosts alone is typically not the optimal strategy for reducing outbreak risks. Adopting a strategy that combines an enhancement of surveillance of symptomatic cases with efforts to find and isolate non-symptomatic infected hosts leads to the largest reduction in the probability that imported cases will initiate a local outbreak.

Vaccine development for emerging infectious diseases

Examination of the vaccine strategies and technical platforms used for the COVID-19 pandemic in the context of those used for previous emerging and reemerging infectious diseases and pandemics may offer some mutually beneficial lessons. The unprecedented scale and rapidity of dissemination of recent emerging infectious diseases pose new challenges for vaccine developers, regulators, health authorities and political constituencies. Vaccine manufacturing and distribution are complex and challenging. While speed is essential, clinical development to emergency use authorization and licensure, pharmacovigilance of vaccine safety and surveillance of virus variants are also critical. Access to vaccines and vaccination needs to be prioritized in low- and middle-income countries. The combination of these factors will weigh heavily on the ultimate success of efforts to bring the current and any future emerging infectious disease pandemics to a close.

Covid-19 vs. Ebola: Impact on households and small businesses in North Kivu, Democratic Republic of Congo

In April 2020, the Eastern Democratic Republic of Congo was facing two major infectious disease outbreaks: Covid-19 and Ebola Virus Disease (EVD). We highlight large differences in the socioeconomic impact of these two outbreaks. The data come from a phone survey that we conducted in the period May-July 2020 with 637 households and 363 small firms from a megacity and two rural communes in the province of North Kivu. While 3,470 EVD cases and 2,287 EVD deaths were confirmed since August 2018, self-reported impacts of EVD on revenues, access to food and behavior were limited. In contrast, only 251 Covid-19 cases were reported as of July 22nd but respondents reported sizable effects on livelihoods, especially in the large urban hub, and in part driven by substantial job losses. Our results show that different infectious disease outbreaks can have very different effects, largely unrelated to case numbers of the disease. Moderately lethal but highly transmissible viruses such as Covid-19 can trigger a steep economic downturn, especially in areas with high economic interconnectedness, reflecting both national and international policies to contain the pandemic.

Risk and resilience of well-being in caregivers of young children in response to the COVID-19 pandemic

The COVID-19 pandemic is impacting communities worldwide, with direct effects of illness and mortality, and indirect effects on economies, workplaces, schools/daycares, and social life. However, we understand very little about the effects of this pandemic on families of young children. We used a risk and resilience model to evaluate the effects of the pandemic on mental health in diverse caregivers (N = 286) with children ages birth to 5. We evaluated the hypotheses that (a) pandemic stress and caregiver-reported child psychosocial concerns correlate with caregivers' mental health symptoms and (b) caregivers' pandemic-related self-efficacy and coping mediate these relationships. Caregivers completed surveys in April-May 2020 assessing pandemic stress (e.g., health, finances, and housing), child psychosocial problems, coping strategies, and self-efficacy to manage family needs. Our primary outcome was caregivers' self-reported changes in mental health symptoms since the outbreak. Path analysis revealed that higher pandemic stress was associated with caregivers' reduced confidence in meeting their family's needs related to COVID-19, which correlated with worse caregiver mental health symptoms. Greater child psychosocial problems also predicted worse caregiver mental health symptoms. Findings suggest that pandemic stress, child psychosocial problems, and caregiver self-efficacy are interrelated in their influence on caregivers' mental health. While further research is needed to examine strategies to foster resilience and buffer the pandemic's effects on caregiver mental health, this is a first step in evaluating the psychosocial effects of this pandemic in families of young children. Clinical implications are discussed for a tiered response to mitigate the pandemic's impacts on family functioning.

Antibacterial activity of selected invertebrate species

The evolution of multiple-drug resistant bacteria is contributing to the global antimicrobial crisis, hence driving us to search for novel antimicrobial(s). Among animals, invertebrates represent up to 80% of all known species suggesting their wide distribution. Despite their ubiquitous and plentiful nature, they have been largely unexplored as potential source of antibacterials. In this study, we selected a broad range of invertebrates from terrestrial and marine environments and tested their lysates for antibacterial activity against methicillin-resistant Staphylococcus aereus (MRSA) and neuropathogenic Escherichia coli K1. Cockroaches, centipedes, tarantulas, prawns, lobster, and mud crabs showed antibacterial activity with selected lysates exhibiting more than 90% bactericidal effects. The red-headed centipede's hemolymph showed 90% and 50% bacteriostatic activity against MRSA and E. coli K1, respectively. Tarantula's body extracts exhibited antibacterial activity against MRSA and E. coli K1. Gut extracts of tiger prawn exhibited more than 90% bacteriostatic activity against both bacteria. The selected lobster and mud crab extract exhibited up to 90% growth inhibitory activity against MRSA. Overall, these results showed that selected invertebrates are an untapped source of broad-spectrum antibacterial activity and suggest the presence of biologically active molecules.

Epidemic Propagation With Positive and Negative Preventive Information in Multiplex Networks

We propose a novel epidemic model based on two-layered multiplex networks to explore the influence of positive and negative preventive information on epidemic propagation. In the model, one layer represents a social network with positive and negative preventive information spreading competitively, while the other one denotes the physical contact network with epidemic propagation. The individuals who are aware of positive prevention will take more effective measures to avoid being infected than those who are aware of negative prevention. Taking the microscopic Markov chain (MMC) approach, we analytically derive the expression of the epidemic threshold for the proposed epidemic model, which indicates that the diffusion of positive and negative prevention information, as well as the topology of the physical contact network have a significant impact on the epidemic threshold. By comparing the results obtained with MMC and those with the Monte Carlo (MC) simulations, it is found that they are in good agreement, but MMC can well describe the dynamics of the proposed model. Meanwhile, through extensive simulations, we demonstrate the impact of positive and negative preventive information on the epidemic threshold, as well as the prevalence of infectious diseases. We also find that the epidemic prevalence and the epidemic outbreaks can be suppressed by the diffusion of positive preventive information and be promoted by the diffusion of negative preventive information.

A scientometric analysis on coronaviruses research (1900-2020): Time for a continuous, cooperative and global approach

Infectious diseases remain a complex, recurring, and challenging public health hazard. Coronaviruses have led to multidimensional consequences on health, mobility, and socio-economic conditions. Despite the significance and magnitude of impact from epidemics to the pandemic, literature is sparse on comprehensive coronaviruses related research performance over time. This study aimed at a scientometric evaluation of coronaviruses related literature including COVID-19. Data related to Coronavirus research was extracted from the Web of Science (WoS). All types of publications (28,846) were included and retrieved. To measure the quantity and quality of the publications, "R-Bibliometrix" package was used for detailed analysis exploring a wide range of indicators. Generally, an increasing trend was observed over time led by the USA and China followed by the United Kingdom, Europe, and few other developed countries. The last two decades contributed around 39.5% of documents while only 06 months of 2020 additionally contributed around 46.5% of total documents. Earlier shorter spikes of increased post epidemic publications followed by decreased productivity were detected in the last 2 decades and showed a lack of continuity-'a research epidemic following a disease epidemic'. Articles (53.4%) were the most common publication type. Journal of Virology, British Medical Journal (BMJ), and Virology were leading sources while BMJ, and Lancet showed increased contributions recently. Overall, similar trends of top authors were observed in terms of productivity, impact, collaborations, funding sources, and affiliations with few exceptions mainly from affected regions. Top 20 countries contributed >89% of documents suggesting a lack of global efforts. Networking was found to be mainly among developed nations with limited contributions from resource-limited countries perhaps requiring more cooperation. Recent post-COVID publications rise is highest, unprecedented, and rapidly growing. Authors strongly recommend recent COVID-19 pandemic as a call for continuous, more cooperative, and collective global research.

Efficient Microfluidic-Based Air Sampling/Monitoring Platform for Detection of Aerosol SARS-CoV-2 On-site

Airborne pathogens have been considered as highly infectious and transmittable between humans. With the pandemic outbreak of the coronavirus disease 2019 (COVID-19), an on-site diagnostic system-integrated airborne pathogen-monitoring machine is recommended by experts for preventing and controlling the early stage β-coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread. In this work, a small-volume rotating microfluidic fluorescence chip-integrated aerosol SARS-CoV-2 sampling system was constructed to satisfy the demand for rapid on-site sample collection and detection of SARS-CoV-2. The rotating microfluidic fluorescence system with small volume has very high sensitivity in the detection of SARS-CoV-2 (detection limit of 10 copies/μL with the shortest Ct value of 15 min), which is comparable to reverse transcription polymerase chain reaction (RT-PCR). The precision variation coefficients within/between batches are very low [coefficient of variation (CV) % ≤ 5.0%]. Our work has passed the comprehensive inspection of the microfluidic chip performance by the Shanghai Medical Device Testing Institute [National Medical Inspection (Design) no. 4408] and successfully tested 115 clinical samples. The integrated system exhibits 100% specificity, high sensitivity (10 copies/μL), and good precision (CV % ≤ 5.0%) in the rapid detection of SARS-CoV-2, thus realizing rapid monitoring and diagnostics of SARS-CoV-2 nucleic acid on-site.

Frequency-dependent transmission of Batrachochytrium salamandrivorans in eastern newts

Transmission is the fundamental process whereby pathogens infect their hosts and spread through populations, and can be characterized using mathematical functions. The functional form of transmission for emerging pathogens can determine pathogen impacts on host populations and can inform the efficacy of disease management strategies. By directly measuring transmission between infected and susceptible adult eastern newts (Notophthalmus viridescens) in aquatic mesocosms, we identified the most plausible transmission function for the emerging amphibian fungal pathogen Batrachochytrium salamandrivorans (Bsal). Although we considered a range of possible transmission functions, we found that Bsal transmission was best explained by pure frequency dependence. We observed that >90% of susceptible newts became infected within 17 days post‐exposure to an infected newt across a range of host densities and initial infection prevalence treatments. Under these conditions, we estimated R₀ = 4.9 for Bsal in an eastern newt population. Our results suggest that Bsal has the capability of driving eastern newt populations to extinction and that managing host density may not be an effective management strategy. Intervention strategies that prevent Bsal introduction or increase host resistance or tolerance to infection may be more effective. Our results add to the growing empirical evidence that transmission of wildlife pathogens can saturate and be functionally frequency‐dependent.

Climate change affected the spatio-temporal occurrence of disasters in China over the past five centuries

Climate change may contribute to the spatio-temporal occurrence of disasters. Long-term studies of either homogeneous or heterogeneous responses of historical disasters to climate change are, however, limited by the quality and quantity of the available proxy data. Here we reconstruct spatio-temporal patterns of five types of disasters in China during the period AD 1368-1911. Our analyses of these time series reveal that warmer temperatures decreased the occurrence of disasters in the monsoon-affected parts of central-east China, but it increased the frequency and intensity of disasters along the boundary of arid and humid conditions in parts of southwest and northeast China, probably driven by the interplay among monsoon, westerlies, polar vortex and variation of temperature. Moreover, we show that drought and flood events had cascading effects on the occurrences of locust outbreaks, famine and human epidemics. Our findings suggest that climate can contribute to the spatio-temporal occurrence of disasters, and therefore may contribute to an improvement of China's regional to national risk management of future climate and environmental change.

Lionfish envenomation in Caribbean and Atlantic waters: Climate change and invasive species

The concept of emerging diseases is well understood; however, the concept of emerging injuries is not. We describe the introduction of two species of lionfish, native to the Indian and Pacific Oceans, into the warm shallow coastal waters of the Western Atlantic Ocean and the Caribbean Sea. Lionfish thrive in the same coastal waters that attract recreational swimmers, snorkelers, and divers. Because lionfish have ornate colors, people often swim close to have a better look. Lionfish have venomous spines and, in a defensive reaction, frequently envenomate curious humans. The fish are voracious predators and disrupt the coral ecosystems of the Atlantic. Furthermore, their range is spreading through a combination of lack of natural predators and the expansion of hospitable warm waters into higher latitudes as part of climate change.

Megacities as drivers of national outbreaks: The 2017 chikungunya outbreak in Dhaka, Bangladesh

BACKGROUND

Several large outbreaks of chikungunya have been reported in the Indian Ocean region in the last decade. In 2017, an outbreak occurred in Dhaka, Bangladesh, one of the largest and densest megacities in the world. Population mobility and fluctuations in population density are important drivers of epidemics. Measuring population mobility during outbreaks is challenging but is a particularly important goal in the context of rapidly growing and highly connected cities in low- and middle-income countries, which can act to amplify and spread local epidemics nationally and internationally.

METHODS

We first describe the epidemiology of the 2017 chikungunya outbreak in Dhaka and estimate incidence using a mechanistic model of chikungunya transmission parametrized with epidemiological data from a household survey. We combine the modeled dynamics of chikungunya in Dhaka, with mobility estimates derived from mobile phone data for over 4 million subscribers, to understand the role of population mobility on the spatial spread of chikungunya within and outside Dhaka during the 2017 outbreak.

RESULTS

We estimate a much higher incidence of chikungunya in Dhaka than suggested by official case counts. Vector abundance, local demographics, and population mobility were associated with spatial heterogeneities in incidence in Dhaka. The peak of the outbreak in Dhaka coincided with the annual Eid holidays, during which large numbers of people traveled from Dhaka to other parts of the country. We show that travel during Eid likely resulted in the spread of the infection to the rest of the country.

CONCLUSIONS

Our results highlight the impact of large-scale population movements, for example during holidays, on the spread of infectious diseases. These dynamics are difficult to capture using traditional approaches, and we compare our results to a standard diffusion model, to highlight the value of real-time data from mobile phones for outbreak analysis, forecasting, and surveillance.

Emerging skin-targeted drug delivery strategies to engineer immunity: A focus on infectious diseases

INTRODUCTION

Infectious pathogens are global disrupters. Progress in biomedical science and technology has expanded the public health arsenal against infectious diseases. Specifically, vaccination has reduced the burden of infectious pathogens. Engineering systemic immunity by harnessing the cutaneous immune network has been particularly attractive since the skin is an easily accessible immune-responsive organ. Recent advances in skin-targeted drug delivery strategies have enabled safe, patient-friendly, and controlled deployment of vaccines to cutaneous microenvironments for inducing long-lived pathogen-specific immunity to mitigate infectious diseases, including COVID-19.

AREAS COVERED

This review briefly discusses the basics of cutaneous immunomodulation and provides a concise overview of emerging skin-targeted drug delivery systems that enable safe, minimally invasive, and effective intracutaneous administration of vaccines for engineering systemic immune responses to combat infectious diseases.

EXPERT OPINION

In-situ engineering of the cutaneous microenvironment using emerging skin-targeted vaccine delivery systems offers remarkable potential to develop diverse immunization strategies against pathogens. Mechanistic studies with standard correlates of vaccine efficacy will be important to compare innovative intracutaneous drug delivery strategies to each other and to existing clinical approaches. Cost-benefit analyses will be necessary for developing effective commercialization strategies. Significant involvement of industry and/or government will be imperative for successfully bringing novel skin-targeted vaccine delivery methods to market for their widespread use.

COVID-19 Isolation in Healthy Population in Israel: Challenges in Daily Life, Mental Health, Resilience, and Quality of Life

Background: Pandemics produce long-lasting secondary impacts on health, with a significant burden on people and society. Until now, the secondary impact of COVID-19 has been little estimated. Our aim was to investigate factors underlying quality of life (QOL) during COVID-19 lockdown among a healthy population, while QOL reduction expands vulnerability to the pandemic secondary impact. Methods: During the spring lockdown in Israel, 571 healthy adults completed a survey that included standard measurements for psychological distress, participation in daily life activities, a sense of social connectedness, resilience, and QOL. Results: We found a high level of psychological distress, significant reduction in participation dimensions, and in QOL (psychical, psychological, and social). These indices were even lower among women, younger adults, and the unemployed. Path analysis demonstrated that psychological distress, participation dimensions, social connectedness, and self-efficacy explained QOL, while participation dimensions were found to be the mediators. Conclusions: The COVID-19 has had a wide impact on the general population, with the potential for negative secondary impacts. Women, young adults, and the unemployed are at high risk for secondary effects. Public health strategies should address the reported factors and populations in order to improve QOL in a healthy population and limit the impact of the pandemic.

Exploring the druggable proteome of Candida species through comprehensive computational analysis

Candida albicans and non-albicans Candida spp. are major cause of systemic mycoses. Antifungal drugs such as azoles and polyenes are not efficient to successfully eradicate Candida infection owing to their fungistatic nature or low bioavailability. Here, we have adopted a comprehensive computational workflow for identification, prioritization and validation of targets from proteomes of Candida albicans and Candida tropicalis. The protocol involves identification of essential drug-target candidates using subtractive genomics, protein-protein interaction network properties and systems biology based methods. The essentiality of the novel metabolic and non-metabolic targets was established by performing in silico gene knockouts, under aerobic as well as anaerobic conditions, and in vitro drug inhibition assays respectively. Deletion of twelve genes that are involved in amino acid, secondary metabolite, and carbon metabolism showed zero growth in metabolic model under simulated conditions. The algorithm, used in this study, can be downloaded from http://pbit.bicnirrh.res.in/offline.php and executed locally.

Continuous Genomic Surveillance Monitored the In Vivo Evolutionary Trajectories of Vibrio parahaemolyticus and Identified a New Virulent Genotype

Our ability to predict evolutionary trajectories of pathogens is one of the promising leverages to fight against the pandemic disease, yet few studies have addressed this question in situ, due to the difficulty in monitoring the milestone evolutionary events for a given pathogen and in understanding the evolutionary strategies. In this study, we monitored the real-time evolution of Vibrio parahaemolyticus in response to successive antibiotic treatment in three shrimp farms in North China from 2011 to 2018 by whole-genome sequencing. Results showed that the stepwise emergence of resistance was associated with the antibiotic usage. Genomic analysis of resistant isolates showed that the acquisition of the resistant mobile genetic elements flanked by an insertion sequence (ISVal1) closely mirrored the antibiotics used in shrimp farms since 2014. Next, we also identified 50 insertion sites of ISVal1 in the chromosome, which facilitated the formation of pathogenicity islands (PAIs) and fitness islands in the following years. Further, horizontal transfers of a virulent trh-nik-ure genomic island (GI) and two GIs improving the fitness have been observed in two farms since 2016. In this case study, we proposed that the insertion sequence triggered four major evolutionary events during the outbreaks of shrimp disease in three farms, including horizontal transfer of transposon (HTT) (stage 1), the formation of resistance islands (stage 2) and the PAIs (stage 3), and horizontal transfer of the PAIs (stage 4). This study presented the first in vivo evolutionary trajectories for a given bacterial pathogen, which helps us to understand the emergence mechanisms of new genotypes.IMPORTANCE Most human infectious diseases originate from animals. Thus, how to reduce or prevent pandemic zoonoses before they emerge in people is becoming a critical issue. Continuous genomic surveillance of the evolutionary trajectories of potential human pathogens on farms is a promising strategy to realize early warning. Here, we conducted an 8-year surveillance of Vibrio parahaemolyticus in three shrimp farms. The results showed that the use of antibiotics and horizontal transfer of transposons (HTT) drove the evolution of V. parahaemolyticus, which could be divided into four stages: HTT, formation of resistance islands, formation of pathogenicity islands (PAIs), and horizontal transfer of PAIs. This study presented the first in vivo monitoring of evolutionary trajectories for a given bacterial pathogen, providing valuable information for the prevention of pandemic zoonoses.

Genome-wide comparison of four MRSA clinical isolates from Germany and Hungary

Staphylococcus aureus is a drug-resistant pathogen, capable of colonizing diverse ecological niches and causing a broad spectrum of infections related to a community and healthcare. In this study, we choose four methicillin-resistant S. aureus (MRSA) clinical isolates from Germany and Hungary based on our previous polyphasic characterization finding. We assumed that the selected strains have a different genetic background in terms of the presence of resistance and virulence genes, prophages, plasmids, and secondary metabolite biosynthesis genes that may play a crucial role in niche adaptation and pathogenesis. To clarify these assumptions, we performed a comparative genome analysis of these strains and observed many differences in their genomic compositions. The Hungarian isolates (SA H27 and SA H32) with ST22-SCCmec type IVa have fewer genes for multiple-drug resistance, virulence, and prophages reported in Germany isolates. Germany isolate, SA G6 acquires aminoglycoside (ant(6)-Ia and aph(3’)-III) and nucleoside (sat-4) resistance genes via phage transduction and may determine its pathogenic potential. The comparative genome study allowed the segregation of isolates of geographical origin and differentiation of the clinical isolates from the commensal isolates. This study suggested that Germany and Hungarian isolates are genetically diverse and showing variation among them due to the gain or loss of mobile genetic elements (MGEs). An interesting finding is the addition of SA G6 genome responsible for the drastic decline of the core/pan-genome ratio curve and causing the pan-genome to open wider. Functional characterizations revealed that S. aureus isolates survival are maintained by the amino acids catabolism and favor adaptation to growing in a protein-rich medium. The dispersible and singleton genes content of S. aureus genomes allows us to understand the genetic variation among the CC5 and CC22 groups. The strains with the same genetic background were clustered together, which suggests that these strains are highly alike; however, comparative genome analysis exposed that the acquisition of phage elements, and plasmids through the events of MGEs transfer contribute to differences in their phenotypic characters. This comparative genome analysis would improve the knowledge about the pathogenic S. aureus strain’s characterization, and responsible for clinically important phenotypic differences among the S. aureus strains.

Adaptive coping strategies used by people during coronavirus

BACKGROUND

Coronavirus (COVID-19) a worldwide pandemic has significantly affected life of people around the globe. It has also caused various psychological issues among public such as uncertainty, fear, anxiety, and of course stress. Globalization has facilitated it and has added greater complexity to the containment of infection leading to urgent call for public health challenge. Consequently, a multilevel stress coping adjustment process is going on. Hence, it is imperative to explore how people are affected psychologically and how they are coping with it. People are adopting different strategies for coping up from this challenging situation. In this sense, the present study intended to: explore which coping strategies were of relevance for people for adjusting in COVID-19 crises and were sociodemographic factors influencing the coping strategies.

MATERIALS AND METHODS

The research is descriptive study. For the present study, a sample of 475 participants was asked for coping strategies used by them using valid and reliable scales.

RESULTS

Results revealed that positive attitude and trust in God were the most used adaptive coping strategies and sociodemographic variables were playing a significant role in adaptive coping strategies.

CONCLUSION

Hence, understanding and identification of coping strategies and their relationship with demographic variables can help health professionals to direct interventions to control stressors related to the pandemics.

The Evolutionary Significance of Generalist Viruses with Special Emphasis on Plant Viruses and their Hosts

The host range of a virus is defined as the number of species a virus potentially infects. The specialist virus infects one or few related species while the generalist virus infects several different species, possibly in different families. Origin of generalist viruses from their specialist nature and the expansion of the host range of the generalist virus occur with the host shift event in which the virus encounters and adapts to a new host. Host shift events have resulted in the majority of the newly emerging viral diseases. This review discusses the advantages and disadvantages of generalist over specialist viruses and the unique features of plant viruses and their hosts that result in a higher incidence of generalist viruses in plants.

Biosensor and molecular-based methods for the detection of human coronaviruses: A review

The ongoing crisis due to the global pandemic caused by a highly contagious coronavirus (Coronavirus disease - 2019; COVID-19) and the lack of either proven effective therapy or a vaccine has made diagnostic a valuable tool in disease tracking and prevention. The complex nature of this newly emerging virus calls for scientists' attention to find the most reliable, highly sensitive, and selective detection techniques for better control or spread of the disease. Reverse transcriptase-polymerase chain reaction (RT-PCR) and serology-based tests are currently being used. However, the speed and accuracy of these tests may not meet the current demand; thus, alternative technology platforms are being developed. Nano biosensor technology platforms have been established as a promising diagnostic tool for rapid and accurate detection of viruses as well as other life-threatening diseases even in resource-limited settings. This review aims to provide a short overview of recent advancements in molecular and biosensor-based diagnosis of viruses, including the human coronaviruses, and highlight the challenges and future perspectives of these detection technologies.

Host-shift as the cause of emerging infectious diseases: Experimental approaches using Drosophila-virus interactions

Host shifts, when a cross-species transmission of a pathogen can lead to successful infections, are the main cause of emerging infectious diseases, such as COVID-19. A complex challenge faced by the scientific community is to address the factors that determine whether the cross-species transmissions will result in spillover or sustained onwards infections. Here we review recent literature and present a perspective on current approaches we are using to understand the mechanisms underlying host shifts. We highlight the usefulness of the interactions between Drosophila species and viruses as an ideal study model. Additionally, we discuss how cross-infection experiments - when pathogens from a natural reservoir are intentionally injected in novel host species- can test the effect cross-species transmissions may have on the fitness of virus and host, and how the host phylogeny may influence this response. We also discuss experiments evaluating how cooccurrence with other viruses or the presence of the endosymbiont bacteria Wolbachia may affect the performance of new viruses in a novel host. Finally, we discuss the need of surveys of virus diversity in natural populations using next-generation sequencing technologies. In the long term, these approaches can contribute to a better understanding of the basic biology of host shifts.

Rapid Differential Diagnosis of Seven Human Respiratory Coronaviruses Based on Centrifugal Microfluidic Nucleic Acid Assay

With the global outbreak of the coronavirus disease 2019 (COVID-19), the highly infective, highly pathogenic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has attracted great attention. Currently, a method to simultaneously diagnose the seven known types human coronaviruses remains lacking and is urgently needed. In this work, we successfully developed a portable microfluidic system for the rapid, accurate, and simultaneous detection of SARS-CoV, middle east respiratory syndrome coronavirus (MERS-CoV), SARS-CoV-2, and four other human coronaviruses (HCoVs) including HCoV-229E, HCoV-OC43, HCoV-NL63, and HCoV-HKU1. The disk-like microfluidic platform integrated with loop-mediated isothermal amplification provides highly accurate, sensitive, and specific results with a wide linear range within 40 min. The diagnostic tool achieved 100% consistency with the "gold standard" polymerase chain reaction in detecting 54 real clinical samples. The integrated system, with its simplicity, is urgently needed for the diagnosis of SARS-CoV-2 during the COVID-19 pandemic.

Addressing the illegal wildlife trade in the European Union as a public health issue to draw decision makers attention

The European Union is one of the most important markets for the trafficking of endangered species and a major transit point for illegal wildlife trade. The latter is not only one of the most important anthropogenic drivers of biodiversity loss, it also represents a growing risk for public health. Indeed, wildlife trade exposes humans to a plethora of severe emerging infectious diseases, some of which have contributed to the most dramatic global pandemics humankind has endured. Illegal wildlife trade is often considered as a problem of developing countries but it is first and foremost an international global business with a trade flow from developing to developed countries. The devastating effects of the ongoing SARS-CoV-2 outbreak should thus be an unassailable argument for European decision makers to change paradigm. Rather than deploying efforts and money to combat novel pathogens, mitigating the risk of spreading emerging infectious diseases should be addressed and be part of any sustainable socioeconomic development plan. Stricter control procedures at borders and policies should be enforced. Additionally, strengthening research in wildlife forensic science and developing a network of forensic laboratories should be the cornerstone of the European Union plan to tackle the illegal wildlife trade. Such proactive approach, that should further figure in the EU-Wildlife Action Plan, could produce a win-win situation: the curb of illegal wildlife trade would subsequently diminish the likelihood of importing new zoonotic diseases in the European Union.

Emerging Natural Focal Infectious Diseases in Russia: A Medical-Geographical Study

In Russia, as in other countries, the problem of emerging natural focal infectious diseases (EIDs) became more acute toward the end of the 20th century. However, the situation in Russia is unknown to foreign readers, while the prevention and control of these diseases require international collaboration. The aim of the study is to provide a medical–geographical assessment of the distribution of the main natural focal EIDs in Russia, as well as to present the approaches used in the country to create aggregate maps of risk assessment. To consider its current status, we determined the most important natural focal EIDs for Russia (tick-borne encephalitis, ixodid tick-borne borrelioses, hemorrhagic fever with renal syndrome, Crimean–Congo hemorrhagic fever, West Nile fever, Astrakhan spotted fever, leptospiroses, and tularemia) and analyzed the patterns of their epidemic manifestation. As a result, a working classification of such infections and a series of maps showing the current situation of EID morbidity in Russia were created. To design an aggregated risk map, we developed an original mapping methodology and recalculated the model disease incidence by taking data from administrative units and adjusting them for natural geographical boundaries (biomes) for European Russia, and then evaluated the risk of infection for separate model diseases and for a set of them. The highest risk rates are confined to the northwest regions of European Russia, the Cis-Urals and the Volga region, which are naturally related to forest biomes, as well as to the southern steppe regions of the interfluves between the Volga and the Don, and the foothills of the North Caucasus.

Efficient Plant Production of Recombinant NS1 Protein for Diagnosis of Dengue

Dengue fever is endemic in more than 120 countries, which account for 3.9 billion people at risk of infection worldwide. The absence of a vaccine with effective protection against the four serotypes of this virus makes differential molecular diagnosis the key step for the correct treatment of the disease. Rapid and efficient diagnosis prevents progression to a more severe stage of this disease. Currently, the limiting factor in the manufacture of dengue (DENV) diagnostic kits is the lack of large-scale production of the non-structural 1 (NS1) protein (antigen) to be used in the capture of antibodies from the blood serum of infected patients. In this work, we use plant biotechnology and genetic engineering as tools for the study of protein production for research and commercial purposes. Gene transfer, integration and expression in plants is a valid strategy for obtaining large-scale and low-cost heterologous protein production. The authors produced NS1 protein of the dengue virus serotype 2 (NS1DENV2) in the Arabidopsis thaliana plant. Transgenic plants obtained by genetic transformation expressed the recombinant protein that was purified and characterized for diagnostic use. The yield was 203 μg of the recombinant protein per gram of fresh leaf. By in situ immunolocalization, transgenic protein was observed within the plant tissue, located in aggregates bodies. These antigens showed high sensitivity and specificity to both IgM (84.29% and 91.43%, respectively) and IgG (83.08% and 87.69%, respectively). The study goes a step further to validate the use of plants as a strategy for obtaining large-scale and efficient protein production to be used in dengue virus diagnostic tests.

Impacts of social support on the treatment outcomes of drug-resistant tuberculosis: a systematic review and meta-analysis

OBJECTIVE

To assess the effectiveness of social support on treatment success promotion or lost to follow-up (LTFU) reduction for patients with drug-resistant tuberculosis (DR-TB).

DESIGN

We searched Pubmed, Web of Science, Embase, Scopus and Medline databases until 18 June 2020 for interventional or mixed-method studies which reported social support and treatment outcomes of DR-TB patients. Two independent reviewers extracted data and disagreements were resolved by consensus with a third reviewer. Random-effects meta-analysis was performed to calculate the OR and 95% CI for the effects of social support on the improvement of treatment outcomes and the heterogeneity and risk of bias were assessed.

SETTING

Low-income and middle-income countries.

PARTICIPANTS

DR-TB patients.

OUTCOMES

Treatment success is defined as the combination of the cured and treatment completion, and LTFU is measured as treatment being interrupted for two consecutive months or more.

RESULTS

Among 173 articles selected for full-text review, 162 were excluded through independent review (kappa=0.87) and 10 studies enrolling 1621 DR-TB patients in eight countries were included for qualitative analysis. In these studies, the most frequently introduced social support was material support (10 studies), followed by informational (eight studies), emotional (seven studies) and companionship support (four studies). Seven studies that reported treatment outcomes in both intervention arm and control arm are qualified for meta-analysis. An encouraging improvement on treatment success rate (OR: 2.58; 95% CI: 1.80 to 3.69) was found when material support was integrated into social support packages and no heterogeneity was observed (I1 of 0%, Q test p=0.72). Reduction on LTFU rate (OR: 0.17; 95% CI: 0.05 to 0.55) was also noted when material support was available but substantial heterogeneity was found (I² of 80%, Q test p=0.002).

CONCLUSION

Material support appeared feasible and effective to improve treatment success for DR-TB patients combined with other social support interventions.

PROSPERO REGISTRATION NUMBER

CRD42019140824.

Characterization of Emerging Swine Viral Diseases through Oxford Nanopore Sequencing Using Senecavirus A as a Model

Emerging viral infectious diseases present a major threat to the global swine industry. Since 2015, Senecavirus A (SVA) has been identified as a cause of vesicular disease in different countries and is considered an emerging disease. Despite the growing concern about SVA, there is a lack of preventive and diagnostic strategies, which is also a problem for all emerging infectious diseases. Using SVA as a model, we demonstrated that Oxford Nanopore MinION sequencing could be used as a robust tool for the investigation and surveillance of emerging viral diseases. Our results identified that MinION sequencing allowed for rapid, unbiased pathogen detection at the species and strain level for clinical cases. SVA whole genome sequences were generated using both direct RNA sequencing and PCR-cDNA sequencing methods, with an optimized consensus accuracy of 94% and 99%, respectively. The advantages of direct RNA sequencing lie in its shorter turnaround time, higher analytical sensitivity and its quantitative relationship between input RNA and output sequencing reads, while PCR-cDNA sequencing excelled at creating highly accurate sequences. This study developed whole genome sequencing methods to facilitate the control of SVA and provide a reference for the timely detection and prevention of other emerging infectious diseases.

COVID-19: urgent actions, critical reflections and future relevance of 'WaSH': lessons for the current and future pandemics

The COVID-19 pandemic placed hygiene at the centre of disease prevention. Yet, access to the levels of water supply that support good hand hygiene and institutional cleaning, our understanding of hygiene behaviours, and access to soap are deficient in low-, middle- and high-income countries. This paper reviews the role of water, sanitation and hygiene (WaSH) in disease emergence, previous outbreaks, combatting COVID-19 and in preparing for future pandemics. We consider settings where these factors are particularly important and identify key preventive contributions to disease control and gaps in the evidence base. Urgent substantial action is required to remedy deficiencies in WaSH, particularly the provision of reliable, continuous piped water on-premises for all households and settings. Hygiene promotion programmes, underpinned by behavioural science, must be adapted to high-risk populations (such as the elderly and marginalised) and settings (such as healthcare facilities, transport hubs and workplaces). WaSH must be better integrated into preparation plans and with other sectors in prevention efforts. More finance and better use of financing instruments would extend and improve WaSH services. The lessons outlined justify no-regrets investment by government in response to and recovery from the current pandemic; to improve day-to-day lives and as preparedness for future pandemics.

How to choose the best control strategy? Mathematical models as a tool for pre-intervention evaluation on a macroparasitic disease

During the last century, emerging diseases have increased in number, posing a severe threat for human health. Zoonoses, in particular, represent the 60% of emerging diseases, and are a big challenge for public health due to the complexity of their dynamics. Mathematical models, by allowing an a priori analysis of dynamic systems and the simulation of different scenarios at once, may represent an efficient tool for the determination of factors and phenomena involved in zoonotic infection cycles, but are often underexploited in public health. In this context, we developed a deterministic mathematical model to compare the efficacy of different intervention strategies aimed at reducing environmental contamination by macroparasites, using raccoons (Procyon lotor) and their zoonotic parasite Bayilsascaris procyonis as a model system. The three intervention strategies simulated are raccoon depopulation, anthelmintic treatment of raccoons and faeces removal. Our results show that all these strategies are able to eliminate the parasite egg population from the environment, but they are effective only above specific threshold coverages. Host removal and anthelmintic treatment showed the fastest results in eliminating the egg population, but anthelmintic treatment requires a higher effort to reach an effective result compared to host removal. Our simulations show that mathematical models can help to shed light on the dynamics of communicable infectious diseases, and give specific guidelines to contain B. procyonis environmental contamination in native, as well as in new, areas of parasite emergence. In particular, the present study highlights that identifying in advance the appropriate treatment coverage is fundamental to achieve the desired results, allowing for the implementation of cost- and time-effective intervention strategies.

How climate change can affect cholera incidence and prevalence? A systematic review

Although the number of cholera infection decreased universally, climate change can potentially affect both incidence and prevalence rates of disease in endemic regions. There is considerable consistent evidence, explaining the associations between cholera and climatic variables. However, it is essentially required to compare and interpret these relationships globally. The aim of the present study was to carry out a systematic review in order to identify and appraise the literature concerning the relationship between nonanthropogenic climatic variabilities such as extreme weather- and ocean-related variables and cholera infection rates. The systematic literature review of studies was conducted by using determined search terms via four major electronic databases (PubMed, Web of Science, Embase, and Scopus) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. This search focused on published articles in English-language up to December 31, 2018. A total of 43 full-text studies that met our criteria have been identified and included in our analysis. The reviewed studies demonstrated that cholera incidence is highly attributed to climatic variables, especially rainfall, temperature, sea surface temperature (SST) and El Niño Southern Oscillation (ENSO). The association between cholera incidence and climatic variables has been investigated by a variety of data analysis methodologies, most commonly time series analysis, generalized linear model (GLM), regression analysis, and spatial/GIS. The results of this study assist the policy-makers who provide the efforts for planning and prevention actions in the face of changing global climatic variables.

An open-source molecular diagnostic platform approach for outbreak and epidemic preparedness

Background

Diagnostic development for outbreak pathogens has typically followed a disease-specific reactive rather than proactive response. Given the diversity of outbreak pathogens, particularly those prioritised by the World Health Organization Research and Development Blueprint, a more flexible and proactive approach to epidemic preparedness is needed to expand access to critical molecular diagnostic tests in peripheral and resource-constrained deployment settings.

Objective

New and more sustainable directives are needed to spur the development of high-quality products, particularly for epidemics more often found in low- and middle-income countries. To leverage and de-risk the development process, we present the benefits and challenges of an open-source business model for co-development of molecular diagnostic tests for decentralised settings.

Methods

We identify key outbreak pathogens that are available only for testing in high infrastructure laboratories and compare in-country installed base platforms that could be leveraged for menu expansion. Key strengths and challenges for development are highlighted for both platform and assay developers, with discussion of how to leverage and de-risk the process through an open-source development model.

Results

Depending on the specific partner strengths, options for partnership roles are presented. The proposed open-source business model addresses the particular challenges in the detection of outbreak- and epidemic-prone pathogens in low- and middle-income countries, reduces development and deployment risks to support outbreak response, strengthens diagnostic capacity and creates a viable market for product developers.

Conclusion

We hope this model for a collaborative and open-source approach for molecular diagnostics serves to encourage stakeholders to consider co-development partnerships to improve outbreak preparedness and epidemic/pandemic response.

Implications of human activities for (re)emerging infectious diseases, including COVID-19

Since 1980, the world has been threatened by different waves of emerging disease epidemics. In the twenty-first century, these diseases have become an increasing global concern because of their health and economic impacts in both developed and resource-constrained countries. It is difficult to stop the occurrence of new pathogens in the future due to the interconnection among humans, animals, and the environment. However, it is possible to face a new disease or to reduce the risk of its spread by implementing better early warning systems and effective disease control and prevention, e.g., effective global surveillance, development of technology for better diagnostics, effective treatments, and vaccines, the global political will to respond to any threats and multidisciplinary collaboration involving all sectors in charge of good health maintenance. In this review, we generally describe some factors related to human activities and show how they can play a role in the transmission and spread of infectious diseases by using some diseases as examples. Additionally, we describe and discuss major factors that are facilitating the spread of the new pandemic known as COVID-19 worldwide.

Combating SARS-CoV-2: leveraging microbicidal experiences with other emerging/re-emerging viruses

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan City, China, late in December 2019 is an example of an emerging zoonotic virus that threatens public health and international travel and commerce. When such a virus emerges, there is often insufficient specific information available on mechanisms of virus dissemination from animal-to-human or from person-to-person, on the level or route of infection transmissibility or of viral release in body secretions/excretions, and on the survival of virus in aerosols or on surfaces. The effectiveness of available virucidal agents and hygiene practices as interventions for disrupting the spread of infection and the associated diseases may not be clear for the emerging virus. In the present review, we suggest that approaches for infection prevention and control (IPAC) for SARS-CoV-2 and future emerging/re-emerging viruses can be invoked based on pre-existing data on microbicidal and hygiene effectiveness for related and unrelated enveloped viruses.

Wall-Following Behavior for a Disinfection Robot Using Type 1 and Type 2 Fuzzy Logic Systems

Infectious diseases are caused by pathogenic microorganisms, whose transmission can lead to global pandemics like COVID-19. Contact with contaminated surfaces or objects is one of the major channels of spreading infectious diseases among the community. Therefore, the typical contaminable surfaces, such as walls and handrails, should often be cleaned using disinfectants. Nevertheless, safety and efficiency are the major concerns of the utilization of human labor in this process. Thereby, attention has drifted toward developing robotic solutions for the disinfection of contaminable surfaces. A robot intended for disinfecting walls should be capable of following the wall concerned, while maintaining a given distance, to be effective. The ability to operate in an unknown environment while coping with uncertainties is crucial for a wall disinfection robot intended for deployment in public spaces. Therefore, this paper contributes to the state-of-the-art by proposing a novel method of establishing the wall-following behavior for a wall disinfection robot using fuzzy logic. A non-singleton Type 1 Fuzzy Logic System (T1-FLS) and a non-singleton Interval Type 2 Fuzzy Logic System (IT2-FLS) are developed in this regard. The wall-following behavior of the two fuzzy systems was evaluated through simulations by considering heterogeneous wall arrangements. The simulation results validate the real-world applicability of the proposed FLSs for establishing the wall-following behavior for a wall disinfection robot. Furthermore, the statistical outcomes show that the IT2-FLS has significantly superior performance than the T1-FLS in this application.

Molecular biology of coronaviruses: current knowledge

The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) late December 2019 in Wuhan, China, marked the third introduction of a highly pathogenic coronavirus into the human population in the twenty-first century. The constant spillover of coronaviruses from natural hosts to humans has been linked to human activities and other factors. The seriousness of this infection and the lack of effective, licensed countermeasures clearly underscore the need of more detailed and comprehensive understanding of coronavirus molecular biology. Coronaviruses are large, enveloped viruses with a positive sense single-stranded RNA genome. Currently, coronaviruses are recognized as one of the most rapidly evolving viruses due to their high genomic nucleotide substitution rates and recombination. At the molecular level, the coronaviruses employ complex strategies to successfully accomplish genome expression, virus particle assembly and virion progeny release. As the health threats from coronaviruses are constant and long-term, understanding the molecular biology of coronaviruses and controlling their spread has significant implications for global health and economic stability. This review is intended to provide an overview of our current basic knowledge of the molecular biology of coronaviruses, which is important as basic knowledge for the development of coronavirus countermeasures.

From Ocean to Medicine: Pharmaceutical Applications of Metabolites from Marine Bacteria

Oceans cover seventy percent of the planet's surface and besides being an immense reservoir of biological life, they serve as vital sources for human sustenance, tourism, transport and commerce. Yet, it is estimated by the National Oceanic and Atmospheric Administration (NOAA) that eighty percent of the oceans remain unexplored. The untapped biological resources present in oceans may be fundamental in solving several of the world's public health crises of the 21st century, which span from the rise of antibiotic resistance in bacteria, pathogenic fungi and parasites, to the rise of cancer incidence and viral infection outbreaks. In this review, health risks as well as how marine bacterial derived natural products may be tools to fight them will be discussed. Moreover, an overview will be made of the research pipeline of novel molecules, from identification of bioactive bacterial crude extracts to the isolation and chemical characterization of the molecules within the framework of the One Health approach. This review highlights information that has been published since 2014, showing the current relevance of marine bacteria for the discovery of novel natural products.