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Kakoullis L, Steffen R, Osterhaus A, Goeijenbier M, Rao SR, Koiso S, Hyle EP, Ryan ET, LaRocque RC, Chen LH. Influenza: seasonality and travel-related considerations. J Travel Med 2023; 30:taad102. [PMID: 37535890 DOI: 10.1093/jtm/taad102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/08/2023] [Accepted: 07/27/2023] [Indexed: 08/05/2023]
Abstract
RATIONALE FOR REVIEW This review aims to summarize the transmission patterns of influenza, its seasonality in different parts of the globe, air travel- and cruise ship-related influenza infections and interventions to reduce transmission. KEY FINDINGS The seasonality of influenza varies globally, with peak periods occurring mainly between October and April in the northern hemisphere (NH) and between April and October in the southern hemisphere (SH) in temperate climate zones. However, influenza seasonality is significantly more variable in the tropics. Influenza is one of the most common travel-related, vaccine-preventable diseases and can be contracted during travel, such as during a cruise or through air travel. Additionally, travellers can come into contact with people from regions with ongoing influenza transmission. Current influenza immunization schedules in the NH and SH leave individuals susceptible during their respective spring and summer months if they travel to the other hemisphere during that time. CONCLUSIONS/RECOMMENDATIONS The differences in influenza seasonality between hemispheres have substantial implications for the effectiveness of influenza vaccination of travellers. Health care providers should be aware of influenza activity when patients report travel plans, and they should provide alerts and advise on prevention, diagnostic and treatment options. To mitigate the risk of travel-related influenza, interventions include antivirals for self-treatment (in combination with the use of rapid self-tests), extending the shelf life of influenza vaccines to enable immunization during the summer months for international travellers and allowing access to the influenza vaccine used in the opposite hemisphere as a travel-related vaccine. With the currently available vaccines, the most important preventive measure involves optimizing the seasonal influenza vaccination. It is also imperative that influenza is recognized as a travel-related illness among both travellers and health care professionals.
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Affiliation(s)
- Loukas Kakoullis
- Department of Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, 8001, Switzerland
- Division of Epidemiology, Human Genetics & Environmental Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - Albert Osterhaus
- Research Center Emerging Infections and Zoonoses, University of Veterinary Medicine, Hannover, 30559, Germany
| | - Marco Goeijenbier
- Department of Intensive Care, Spaarne Gasthuis, Haarlem, 2035, Netherlands
- Department of Intensive Care, Erasmus Medical Center, Rotterdam, 3015, Netherlands
| | - Sowmya R Rao
- Department of Global Health, Boston University, Boston, MA 02118, USA
| | - Satoshi Koiso
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Emily P Hyle
- Harvard Medical School, Boston, MA 02115, USA
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA 02114, USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, 02114, USA
| | - Edward T Ryan
- Harvard Medical School, Boston, MA 02115, USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, 02114, USA
| | - Regina C LaRocque
- Harvard Medical School, Boston, MA 02115, USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, 02114, USA
| | - Lin H Chen
- Department of Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA
- Harvard Medical School, Boston, MA 02115, USA
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA
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Transmission of SARS-CoV-2 Associated with Cruise Ship Travel: A Systematic Review. Trop Med Infect Dis 2022; 7:tropicalmed7100290. [PMID: 36288031 PMCID: PMC9610645 DOI: 10.3390/tropicalmed7100290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Maritime and river travel may be associated with respiratory viral spread via infected passengers and/or crew and potentially through other transmission routes. The transmission models of SARS-CoV-2 associated with cruise ship travel are based on transmission dynamics of other respiratory viruses. We aimed to provide a summary and evaluation of relevant data on SARS-CoV-2 transmission aboard cruise ships, report policy implications, and highlight research gaps. Methods: We searched four electronic databases (up to 26 May 2022) and included studies on SARS-CoV-2 transmission aboard cruise ships. The quality of the studies was assessed based on five criteria, and relevant findings were reported. Results: We included 23 papers on onboard SARS-CoV-2 transmission (with 15 reports on different aspects of the outbreak on Diamond Princess and nine reports on other international cruises), 2 environmental studies, and 1 systematic review. Three articles presented data on both international cruises and the Diamond Princess. The quality of evidence from most studies was low to very low. Index case definitions were heterogeneous. The proportion of traced contacts ranged from 0.19 to 100%. Studies that followed up >80% of passengers and crew reported attack rates (AR) up to 59%. The presence of a distinct dose−response relationship was demonstrated by findings of increased ARs in multi-person cabins. Two studies performed viral cultures with eight positive results. Genomic sequencing and phylogenetic analyses were performed in individuals from three cruises. Two environmental studies reported PCR-positive samples (cycle threshold range 26.21−39.00). In one study, no infectious virus was isolated from any of the 76 environmental samples. Conclusion: Our review suggests that crowding and multiple persons per cabin were associated with an increased risk of transmission on cruise ships. Variations in design, methodology, and case ascertainment limit comparisons across studies and quantification of transmission risk. Standardized guidelines for conducting and reporting studies on cruise ships of acute respiratory infection transmission should be developed.
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Lloret J, Carreño A, Carić H, San J, Fleming LE. Environmental and human health impacts of cruise tourism: A review. MARINE POLLUTION BULLETIN 2021; 173:112979. [PMID: 34598093 DOI: 10.1016/j.marpolbul.2021.112979] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 06/13/2023]
Abstract
The intensive growth of cruise tourism worldwide during recent decades is leading to growing concerns over the sector's global environmental and health impacts. This review combines for the first time various sources of information to estimate the magnitude of the cruise industry's environmental and public health footprints. This research shows that cruising, despite technical advances and some surveillance programmes, remains a major source of air, water (fresh and marine) and land pollution affecting fragile habitats, areas and species, and a potential source of physical and mental human health risks. Health risks impact both the people on board (crew and passengers) and on land (workers of shipyards where cruise ships are dismantled and citizens inhabiting cities with cruise ports and shipyards). In this context, we argue that the cruise industry should be held accountable with more monitoring and regulation to prevent or minimize the growing negative environmental and human health impacts.
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Affiliation(s)
- Josep Lloret
- Oceans & Human Health Chair, Institute of Aquatic Ecology, Faculty of Science, University of Girona, C/ Maria Aurèlia Capmany 69, 17003 Girona, Spain.
| | - Arnau Carreño
- Oceans & Human Health Chair, Institute of Aquatic Ecology, Faculty of Science, University of Girona, C/ Maria Aurèlia Capmany 69, 17003 Girona, Spain
| | - Hrvoje Carić
- Institute for Tourism, Vrhovec 5, 10000 Zagreb, Croatia
| | - Joan San
- Faculty of Medicine, University of Girona, c/ Emili Grahit, 77, 17003 Girona, Catalonia, Spain
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Cornwall TR1 3HD, UK.
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Aoki Y, Amaya Dimas LDC, Kitazawa K, Mizushiro N. Reconstitution of Oseltamivir Capsules for Pediatric Use on a Long-Term Cruise: A Treatment Option. Wilderness Environ Med 2021; 32:74-77. [PMID: 33431303 DOI: 10.1016/j.wem.2020.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 08/15/2020] [Accepted: 09/17/2020] [Indexed: 11/16/2022]
Abstract
Influenza is a concerning disease in terms of risk management for cruise passengers during a voyage. Currently, cruise passengers include children in addition to elderly people. Oral oseltamivir can be used to treat pediatric influenza. In addition, early antiviral treatment may reduce the spread of influenza on board. However, the capsule form of oseltamivir is not of the recommended dosage for children. In this report, we describe 2 siblings who acquired influenza during travel on a world cruise ship and were treated with decapsulated oseltamivir. The siblings' mother was instructed to decapsulate a 75 mg oseltamivir capsule, suspend the powder in 15 mL of water (5 mg·mL-1), stir well, and administer the required amount of medicine orally to each patient using a syringe. Both patients recovered successfully with no complications. The presented case suggests that suspending decapsulated oseltamivir in water and measuring the required amount with a syringe for orally administration to children with influenza can be a safe treatment strategy in resource-limited settings.
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Affiliation(s)
- Yoshihiro Aoki
- Department of Emergency and Critical Care Medicine, Aizawa Hospital, Nagano, Japan; Department of Pediatrics, Aizawa Hospital, Nagano, Japan.
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Ahmed W, Bertsch PM, Angel N, Bibby K, Bivins A, Dierens L, Edson J, Ehret J, Gyawali P, Hamilton KA, Hosegood I, Hugenholtz P, Jiang G, Kitajima M, Sichani HT, Shi J, Shimko KM, Simpson SL, Smith WJM, Symonds EM, Thomas KV, Verhagen R, Zaugg J, Mueller JF. Detection of SARS-CoV-2 RNA in commercial passenger aircraft and cruise ship wastewater: a surveillance tool for assessing the presence of COVID-19 infected travellers. J Travel Med 2020; 27:taaa116. [PMID: 32662867 PMCID: PMC7454825 DOI: 10.1093/jtm/taaa116] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 06/30/2020] [Accepted: 07/06/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Wastewater-based epidemiology (WBE) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be an important source of information for coronavirus disease 2019 (COVID-19) management during and after the pandemic. Currently, governments and transportation industries around the world are developing strategies to minimize SARS-CoV-2 transmission associated with resuming activity. This study investigated the possible use of SARS-CoV-2 RNA wastewater surveillance from airline and cruise ship sanitation systems and its potential use as a COVID-19 public health management tool. METHODS Aircraft and cruise ship wastewater samples (n = 21) were tested for SARS-CoV-2 using two virus concentration methods, adsorption-extraction by electronegative membrane (n = 13) and ultrafiltration by Amicon (n = 8), and five assays using reverse-transcription quantitative polymerase chain reaction (RT-qPCR) and RT-droplet digital PCR (RT-ddPCR). Representative qPCR amplicons from positive samples were sequenced to confirm assay specificity. RESULTS SARS-CoV-2 RNA was detected in samples from both aircraft and cruise ship wastewater; however concentrations were near the assay limit of detection. The analysis of multiple replicate samples and use of multiple RT-qPCR and/or RT-ddPCR assays increased detection sensitivity and minimized false-negative results. Representative qPCR amplicons were confirmed for the correct PCR product by sequencing. However, differences in sensitivity were observed among molecular assays and concentration methods. CONCLUSIONS The study indicates that surveillance of wastewater from large transport vessels with their own sanitation systems has potential as a complementary data source to prioritize clinical testing and contact tracing among disembarking passengers. Importantly, sampling methods and molecular assays must be further optimized to maximize detection sensitivity. The potential for false negatives by both wastewater testing and clinical swab testing suggests that the two strategies could be employed together to maximize the probability of detecting SARS-CoV-2 infections amongst passengers.
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Affiliation(s)
- Warish Ahmed
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Qld 4102, Australia
| | - Paul M Bertsch
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Qld 4102, Australia
| | - Nicola Angel
- Australian Centre for Ecogenomics, School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD 4072, Australia
| | - Kyle Bibby
- Department of Civil & Environmental Engineering & Earth Science, University of Notre Dame, 156 Fitzpatrick Hall, Notre Dame, IN 46556, USA
| | - Aaron Bivins
- Department of Civil & Environmental Engineering & Earth Science, University of Notre Dame, 156 Fitzpatrick Hall, Notre Dame, IN 46556, USA
| | - Leanne Dierens
- Australian Centre for Ecogenomics, School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD 4072, Australia
| | - Janette Edson
- Australian Centre for Ecogenomics, School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD 4072, Australia
| | - John Ehret
- Qantas Airways Limited, 10 Bourke Rd Mascot, 2020, NSW, Australia
| | - Pradip Gyawali
- Institute of Environmental Science and Research Ltd (ESR), Porirua, 5240, New Zealand
| | - Kerry A Hamilton
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Temple, AZ 85287, USA
| | - Ian Hosegood
- Qantas Airways Limited, 10 Bourke Rd Mascot, 2020, NSW, Australia
| | - Philip Hugenholtz
- Australian Centre for Ecogenomics, School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD 4072, Australia
| | - Guangming Jiang
- School of Civil, Mining and Environmental Engineering, University of Wollongong, NSW 2522, Australia
| | - Masaaki Kitajima
- Division of Environmental Engineering, Faculty of Engineering, Hokkaido University, North 13 West 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
| | - Homa T Sichani
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4103, Australia
| | - Jiahua Shi
- School of Civil, Mining and Environmental Engineering, University of Wollongong, NSW 2522, Australia
| | - Katja M Shimko
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4103, Australia
| | | | - Wendy J M Smith
- CSIRO Agriculture and Food, Bioscience Precinct, St Lucia QLD 4067, Australia
| | - Erin M Symonds
- College of Marine Science, University of South Florida, 140 Seventh Avenue South, St. Petersburg, Florida 33701 USA
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4103, Australia
| | - Rory Verhagen
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4103, Australia
| | - Julian Zaugg
- Australian Centre for Ecogenomics, School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD 4072, Australia
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4103, Australia
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Niu T, Zhao X, Jiang J, Yan H, Li Y, Tang S, Li Y, Song D. Evolution and Biological Evaluation of Matrinic Derivatives with Amantadine Fragments As New Anti-Influenza Virus Agents. Molecules 2019; 24:molecules24050921. [PMID: 30845734 PMCID: PMC6429159 DOI: 10.3390/molecules24050921] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 11/17/2022] Open
Abstract
A series of novel tricyclic matrinic derivatives with 11-adamantyl substitution were designed, synthesized, and evaluated for their activities against Influenza A H3N2 virus, based on the privileged structure strategy. Structure-activity relationship (SAR) analysis indicated that the introduction of an 11-adamantyl might be helpful for the potency. Among them, compounds 9f and 9j exhibited the promising anti-H3N2 activities with IC50 values of 7.2 μM and 10.2 μM, respectively, better than that of lead 1. Their activities were further confirmed at the protein level. Moreover, compound 9f displayed a high pharmacokinetic (PK) stability profile in whole blood and a safety profile in vivo. In primary mechanism, compound 9f could inhibit the virus replication cycle at early stage by targeting M2 protein, consistent with that of the parent amantadine. This study provided powerful information for further strategic optimization to develop these compounds into a new class of anti-influenza agents.
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Affiliation(s)
- Tianyu Niu
- Beijing Key Laboratory of Anti-infective Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 10005, China.
| | - Xiaoqiang Zhao
- Beijing Key Laboratory of Anti-infective Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 10005, China.
| | - Jing Jiang
- Beijing Key Laboratory of Anti-infective Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 10005, China.
| | - Haiyan Yan
- Beijing Key Laboratory of Anti-infective Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 10005, China.
| | - Yinghong Li
- Beijing Key Laboratory of Anti-infective Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 10005, China.
| | - Sheng Tang
- Beijing Key Laboratory of Anti-infective Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 10005, China.
| | - Yuhuan Li
- Beijing Key Laboratory of Anti-infective Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 10005, China.
| | - Danqing Song
- Beijing Key Laboratory of Anti-infective Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 10005, China.
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Liu T, Liu M, Chen F, Chen F, Tian Y, Huang Q, Liu S, Yang J. A Small-Molecule Compound Has Anti-influenza A Virus Activity by Acting as a ‘‘PB2 Inhibitor”. Mol Pharm 2018; 15:4110-4120. [DOI: 10.1021/acs.molpharmaceut.8b00531] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Teng Liu
- Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Miaomiao Liu
- Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Feimin Chen
- Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Fangzhao Chen
- Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Yuanxin Tian
- Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Qi Huang
- Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Shuwen Liu
- Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Jie Yang
- Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
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8
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Young BE, Wilder-Smith A. Influenza on cruise ships. J Travel Med 2018; 25:5238721. [PMID: 30649459 DOI: 10.1093/jtm/tay146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/11/2018] [Indexed: 11/14/2022]
Affiliation(s)
- Barnaby E Young
- National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore
| | - Annelies Wilder-Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore.,Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, UK
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