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Colautti A, Civilini M, Franchi M, Felice A, De Martin S, De Paoli E, Vidotto M, Iacumin L. Draft genome sequences from 127 Legionella spp. strains isolated in water systems linked to legionellosis outbreaks. Microbiol Resour Announc 2024:e0115423. [PMID: 38690889 DOI: 10.1128/mra.01154-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/13/2024] [Indexed: 05/03/2024] Open
Abstract
Legionnaires' disease is a severe form of pneumonia caused by Legionella spp. bacteria. According to the European Centre for Disease Prevention and Control, problems related to this pathogen showed a significant surge in recent years, making its monitoring critical.
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Affiliation(s)
- Andrea Colautti
- Department of Agricultural, Food, Environmental and Animal Science (Di4A), University of Udine, Udine, Italy
| | - Marcello Civilini
- Department of Agricultural, Food, Environmental and Animal Science (Di4A), University of Udine, Udine, Italy
| | - Marinella Franchi
- Laboratory of Microbiology, ARPA-Regional Agency for Environmental Protection Friuli Venezia Giulia, Udine, Italy
| | - Antonella Felice
- Laboratory of Microbiology, ARPA-Regional Agency for Environmental Protection Friuli Venezia Giulia, Udine, Italy
| | - Stefano De Martin
- Laboratory of Microbiology, ARPA-Regional Agency for Environmental Protection Friuli Venezia Giulia, Udine, Italy
| | - Emanuele De Paoli
- Department of Agricultural, Food, Environmental and Animal Science (Di4A), University of Udine, Udine, Italy
| | | | - Lucilla Iacumin
- Department of Agricultural, Food, Environmental and Animal Science (Di4A), University of Udine, Udine, Italy
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Oerther S, Oerther DB. The Role of the School Nurse in Addressing Climate-Associated Illnesses: Water. NASN Sch Nurse 2024; 39:125-129. [PMID: 37968840 DOI: 10.1177/1942602x231208711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Climate change is having an unprecedented influence on human health. For example, increased frequency of storms with excessive precipitation may contribute to flooding, which contributes to increased water-related dermatological, gastrointestinal, and respiratory illnesses. Some of these water-related illnesses, which can be transmitted via recreational waterborne pathways, may be seen in school-age children. The purpose of this article is to raise awareness of the impact some recreational water-related illnesses have on school-age children's health and to provide school nurses with information on the signs and symptoms of these illnesses as well as prevention tips nurses may wish to share with parents. This is the third article in a series meant to inform school nurses about illnesses linked to local changes in weather that may be arising from global changes in climate and provide them with the tools they need to safeguard children's health.
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Affiliation(s)
- Sarah Oerther
- Trudy Busch Valentine School of Nursing, Saint Louis University, St. Louis, MO
| | - Daniel B Oerther
- Department of Civil, Architectural, and Environmental Engineering, Missouri University of Science and Technology, Rolla, MO
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Heilmann A, Rueda Z, Alexander D, Laupland KB, Keynan Y. Impact of climate change on amoeba and the bacteria they host. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2024; 9:1-5. [PMID: 38567368 PMCID: PMC10984314 DOI: 10.3138/jammi-2023-09-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Ashley Heilmann
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Zulma Rueda
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - David Alexander
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Cadham Provincial Lab, Winnipeg, Manitoba, Canada
| | - Kevin B Laupland
- Department of Intensive Care Services, Royal Brisbane and Women’s Hospital, Butterfield Street, Brisbane, Queensland, Australia
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Yoav Keynan
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Chung SJ, Jang SJ, Lee H. Eco-anxiety and environmental sustainability interest: A secondary data analysis. Int J Ment Health Nurs 2023; 32:1462-1472. [PMID: 37021349 DOI: 10.1111/inm.13150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 04/07/2023]
Abstract
Climate change is an increasingly important global concern, requiring urgent action. To achieve environmental sustainability, identifying the predictors influencing individuals' actions is necessary. Individuals with negative psychological responses to climate change, such as eco-anxiety, are more likely to engage in pro-environmental behaviour. However, eco-anxiety and other perceptions associated with climate change and sustainability can differ based on an individual's unique background. Therefore, this study aimed to identify potent predictors of individuals' environmental sustainability interest and examine the impact of eco-anxiety on environmental sustainability interest. Data from 459 South Korean adults (19-65 years) were included in this secondary analysis. Eco-anxiety, climate change risk perception and future event cognition were assessed by the Climate Change Anxiety Scale, the Climate Change Risk Perception Inventory and Future Event Questionnaires, respectively. Multiple linear regression analysis showed that eco-anxiety was the most potent predictor of environmental sustainability interest, followed by climate change risk perception, age 60-65 years, future event cognition and age under 30 years. Considering that eco-anxiety is the most potent predictor of environmental sustainability interest, mental health nurses should assess patients' eco-anxiety level and help them recognize and manage their anxiety levels appropriately. Age-specific approaches should be considered for interventions to enhance environmental sustainability interest. Further studies are needed to determine the cut-off anxiety level that influences the positive impact on environmental sustainability interest and to develop programmes to manage eco-anxiety.
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Affiliation(s)
- Sophia J Chung
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Sun Joo Jang
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Haeyoung Lee
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
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Fischer FB, Saucy A, Vienneau D, Hattendorf J, Fanderl J, de Hoogh K, Mäusezahl D. Impacts of weather and air pollution on Legionnaires' disease in Switzerland: A national case-crossover study. ENVIRONMENTAL RESEARCH 2023; 233:116327. [PMID: 37354934 DOI: 10.1016/j.envres.2023.116327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 05/03/2023] [Accepted: 06/02/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND The number of reported cases of Legionnaires' disease (LD) has risen markedly in Switzerland (6.5/100,000 inhabitants in 2021) and abroad over the last decade. Legionella, the causative agent of LD, are ubiquitous in the environment. Therefore, environmental changes can affect the incidence of LD, for example by increasing bacterial concentrations in the environment or by facilitating transmission. OBJECTIVES The aim of this study is to understand the environmental determinants, in particular weather conditions, for the regional and seasonal distribution of LD in Switzerland. METHODS We conducted a series of analyses based on the Swiss LD notification data from 2017 to 2021. First, we used a descriptive and hotspot analysis to map LD cases and identify regional clusters. Second, we applied an ecological model to identify environmental determinants on case frequency at the district level. Third, we applied a case-crossover design using distributed lag non-linear models to identify short-term associations between seven weather variables and LD occurrence. Lastly, we performed a sensitivity analysis for the case-crossover design including NO2 levels available for the year 2019. RESULTS Canton Ticino in southern Switzerland was identified as a hotspot in the cluster analysis, with a standardised notification rate of 14.3 cases/100,000 inhabitants (CI: 12.6, 16.0). The strongest association with LD frequency in the ecological model was found for large-scale factors such as weather and air pollution. The case-crossover study confirmed the strong association of elevated daily mean temperature (OR 2.83; CI: 1.70, 4.70) and mean daily vapour pressure (OR: 1.52, CI: 1.15, 2.01) 6-14 days before LD occurrence. DISCUSSION Our analyses showed an influence of weather with a specific temporal pattern before the onset of LD, which may provide insights into the effect mechanism. The relationship between air pollution and LD and the interplay with weather should be further investigated.
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Affiliation(s)
- Fabienne B Fischer
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Apolline Saucy
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Jan Hattendorf
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Julia Fanderl
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Daniel Mäusezahl
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
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Lee J, Lee S, Hu C, Marion JW. Beyond cyanotoxins: increased Legionella, antibiotic resistance genes in western Lake Erie water and disinfection-byproducts in their finished water. Front Microbiol 2023; 14:1233327. [PMID: 37700867 PMCID: PMC10493389 DOI: 10.3389/fmicb.2023.1233327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/15/2023] [Indexed: 09/14/2023] Open
Abstract
Background Western Lake Erie is suffering from harmful cyanobacterial blooms, primarily toxic Microcystis spp., affecting the ecosystem, water safety, and the regional economy. Continued bloom occurrence has raised concerns about public health implications. However, there has been no investigation regarding the potential increase of Legionella and antibiotic resistance genes in source water, and disinfection byproducts in municipal treated drinking water caused by these bloom events. Methods Over 2 years, source water (total n = 118) and finished water (total n = 118) samples were collected from drinking water plants situated in western Lake Erie (bloom site) and central Lake Erie (control site). Bloom-related parameters were determined, such as microcystin (MC), toxic Microcystis, total organic carbon, N, and P. Disinfection byproducts (DBPs) [total trihalomethanes (THMs) and haloacetic acids (HAAs)] were assessed in finished water. Genetic markers for Legionella, antibiotic resistance genes, and mobile genetic elements were quantified in source and finished waters. Results Significantly higher levels of MC-producing Microcystis were observed in the western Lake Erie site compared to the control site. Analysis of DBPs revealed significantly elevated THMs concentrations at the bloom site, while HAAs concentrations remained similar between the two sites. Legionella spp. levels were significantly higher in the bloom site, showing a significant relationship with total cyanobacteria. Abundance of ARGs (tetQ and sul1) and mobile genetic elements (MGEs) were also significantly higher at the bloom site. Discussion Although overall abundance decreased in finished water, relative abundance of ARGs and MGE among total bacteria increased after treatment, particularly at the bloom site. The findings underscore the need for ongoing efforts to mitigate bloom frequency and intensity in the lake. Moreover, optimizing water treatment processes during bloom episodes is crucial to maintain water quality. The associations observed between bloom conditions, ARGs, and Legionella, necessitate future investigations into the potential enhancement of antibiotic-resistant bacteria and Legionella spp. due to blooms, both in lake environments and drinking water distribution systems.
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Affiliation(s)
- Jiyoung Lee
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, United States
- Department of Food Science and Technology, The Ohio State University, Columbus, OH, United States
- Infectious Diseases Institute, The Ohio State University, Columbus, OH, United States
| | - Seungjun Lee
- Department of Food Science and Nutrition, Pukyong National University, Busan, Republic of Korea
| | - Chenlin Hu
- College of Pharmacy, University of Houston, Houston, TX, United States
| | - Jason W. Marion
- Department of Public Health and Clinical Sciences, Eastern Kentucky University, Richmond, KY, United States
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Riccò M, Ferraro P, Ranzieri S, Boldini G, Zanella I, Marchesi F. Legionnaires' Disease in Occupational Settings: A Cross-Sectional Study from Northeastern Italy (2019). Trop Med Infect Dis 2023; 8:364. [PMID: 37505660 PMCID: PMC10384770 DOI: 10.3390/tropicalmed8070364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/09/2023] [Accepted: 07/15/2023] [Indexed: 07/29/2023] Open
Abstract
In Italy, Legionnaires' Disease (LD) causes >1000 hospital admissions per year, with a lethality rate of 5 to 10%. Occupational exposures could reasonably explain a substantial share of total cases, but the role of Occupational Physicians (OPs) in management and prevention of LD has been scarcely investigated. The present survey therefore evaluates the knowledge, attitudes and practices (KAP) regarding LD from a convenience sample of Italian OPs, focusing on their participation in preventive interventions. A total of 165 OPs were recruited through a training event (Parma, Northeastern Italy, 2019), and completed a specifically designed structured questionnaire. The association between reported participation in preventive interventions and individual factors was analyzed using a binary logistic regression model, calculating corresponding multivariable Odds Ratio (aOR). Overall, participants exhibited satisfactory knowledge of the clinical and diagnostic aspects of LD, while substantial uncertainties were associated epidemiological factors (i.e., notification rate and lethality). Although the majority of participating OPs reportedly assisted at least one hospital (26.7%) and/or a nursing home (42.4%) and/or a wastewater treatment plant, only 41.8% reportedly contributed to the risk assessment for LD and 18.8% promoted specifically designed preventive measures. Working as OPs in nursing homes (aOR 8.732; 95% Confidence Intervals [95%CI] 2.991 to 25.487) and wastewater treatment plants (aOR 8.710; 95%CI 2.844 to 26.668) was associated with participation in the risk assessment for LD, while the promotion of preventive practice was associated with working as an OP in hospitals (aOR 6.792; 95%CI 2.026 to 22.764) and wastewater treatment plants (aOR 4.464, 95%CI 1.363 to 14.619). In other words, the effective participation of the OP in the implementation of preventive measures appears uncommon and is limited to certain occupational settings. Collectively, these results highlight the importance of tailoring specifically designed information campaigns aimed to raise the involvement of OPs in the prevention of LD in occupational settings other than healthcare.
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Affiliation(s)
- Matteo Riccò
- Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL-IRCCS di Reggio Emilia, Via Amendola n.2, I-42122 Reggio Emilia, Italy
| | - Pietro Ferraro
- Occupational Medicine Unit, Direzione Sanità, Italian Railways' Infrastructure Division, RFI SpA, I-00161 Rome, Italy
| | - Silvia Ranzieri
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy
| | - Giorgia Boldini
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy
- Servizio di Igiene Pubblica, AUSL di Parma, Via Vasari n.13/a, I-43123 Parma, Italy
| | - Ilaria Zanella
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy
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Gumá M, Drasar V, Santandreu B, Cano R, Afshar B, Nicolau A, Bennassar M, del Barrio J, Crespi P, Crespi S. A community outbreak of Legionnaires' disease caused by outdoor hot tubs for private use in a hotel. Front Microbiol 2023; 14:1137470. [PMID: 37180254 PMCID: PMC10167275 DOI: 10.3389/fmicb.2023.1137470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/30/2023] [Indexed: 05/16/2023] Open
Abstract
During the period October-November 2017, an outbreak of Legionnaires' disease involving 27 cases occurred in the tourist area of Palmanova (Mallorca, Spain). The majority of cases were reported by the European Centre of Disease Prevention and Control (ECDC) as travel associated cases of Legionnaires' disease (TALD). Most cases belonged to different hotel cluster alerts. No cases were reported among the local population residing in the area. All tourist establishments associated with one or more TALD cases were inspected and sampled by public health inspectors. All relevant sources of aerosol emission detected were investigated and sampled. The absence of active cooling towers in the affected area was verified, by documents and on-site. Samples from hot tubs for private use located on the terraces of the penthouse rooms of a hotel in the area were included in the study. Extremely high concentrations (> 106 CFU/l) of Legionella pneumophila, including the outbreak strain, were found in the hot tubs of vacant rooms of this hotel thus identifying the probable source of infection. Meteorological situation may have contributed to the geographical distribution pattern of this outbreak. In conclusion, hot tubs for private use located outdoors should be considered when investigating community outbreaks of Legionnaires' disease of unclear origin.
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Affiliation(s)
- Mercedes Gumá
- Conselleria de Salut i Consum, Govern Balear, Palma de Mallorca, Spain
| | - Vladimir Drasar
- Public Health Institute Ostrava, National Legionella Reference Laboratory, Ostrava, Czechia
| | - Beatriz Santandreu
- Environmental Health and Laboratory Services, Biolinea Int., Palma de Mallorca, Spain
| | - Rosa Cano
- Centro Nacional de Epidemiología and CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Baharak Afshar
- Respiratory and Vaccine Preventable Bacteria Reference Unit (RVPBRU), UK Health Security Agency (UKHSA), London, United Kingdom
| | - Antonio Nicolau
- Conselleria de Salut i Consum, Govern Balear, Palma de Mallorca, Spain
| | - Magdalena Bennassar
- Environmental Health and Laboratory Services, Biolinea Int., Palma de Mallorca, Spain
| | - Jorge del Barrio
- Environmental Health and Laboratory Services, Biolinea Int., Palma de Mallorca, Spain
| | - Pau Crespi
- Environmental Health and Laboratory Services, Biolinea Int., Palma de Mallorca, Spain
| | - Sebastian Crespi
- Environmental Health and Laboratory Services, Biolinea Int., Palma de Mallorca, Spain
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Lombardi A, Borriello T, De Rosa E, Di Duca F, Sorrentino M, Torre I, Montuori P, Trama U, Pennino F. Environmental Monitoring of Legionella in Hospitals in the Campania Region: A 5-Year Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085526. [PMID: 37107807 PMCID: PMC10138562 DOI: 10.3390/ijerph20085526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023]
Abstract
Legionella is a pathogen that colonizes soils, freshwater, and building water systems. People who are most affected are those with immunodeficiencies, so it is necessary to monitor its presence in hospitals. The purpose of this study was to evaluate the presence of Legionella in water samples collected from hospitals in the Campania region, Southern Italy. A total of 3365 water samples were collected from January 2018 to December 2022 twice a year in hospital wards from taps and showers, tank bottoms, and air-treatment units. Microbiological analysis was conducted in accordance with the UNI EN ISO 11731:2017, and the correlations between the presence of Legionella and water temperature and residual chlorine were investigated. In total, 708 samples (21.0%) tested positive. The most represented species was L. pneumophila 2-14 (70.9%). The serogroups isolated were 1 (27.7%), 6 (24.5%), 8 (23.3%), 3 (18.9%), 5 (3.1%), and 10 (1.1%). Non-pneumophila Legionella spp. represented 1.4% of the total. Regarding temperature, the majority of Legionella positive samples were found in the temperature range of 26.0-40.9 °C. An influence of residual chlorine on the presence of the bacterium was observed, confirming that chlorine disinfection is effective for controlling contamination. The positivity for serogroups other than serogroup 1 suggested the need to continue environmental monitoring of Legionella and to focus on the clinical diagnosis of other serogroups.
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Affiliation(s)
- Annalisa Lombardi
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Tonia Borriello
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Elvira De Rosa
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Fabiana Di Duca
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Ida Torre
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Paolo Montuori
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Ugo Trama
- General Directorate of Health, Campania Region, Centro Direzionale C3, 80143 Naples, Italy
| | - Francesca Pennino
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
- Correspondence:
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Jütte M, Abdighahroudi MS, Waldminghaus T, Lackner S, V Lutze H. Bacterial inactivation processes in water disinfection - mechanistic aspects of primary and secondary oxidants - A critical review. WATER RESEARCH 2023; 231:119626. [PMID: 36709565 DOI: 10.1016/j.watres.2023.119626] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/14/2022] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
Water disinfection during drinking water production is one of the most important processes to ensure safe drinking water, which is gaining even more importance due to the increasing impact of climate change. With specific reaction partners, chemical oxidants can form secondary oxidants, which can cause additional damage to bacteria. Cases in point are chlorine dioxide which forms free available chlorine (e.g., in the reaction with phenol) and ozone which can form hydroxyl radicals (e.g., during the reaction with natural organic matter). The present work reviews the complex interplay of all these reactive species which can occur in disinfection processes and their potential to affect disinfection processes. A quantitative overview of their disinfection strength based on inactivation kinetics and typical exposures is provided. By unifying the current data for different oxidants it was observable that cultivated wild strains (e.g., from wastewater treatment plants) are in general more resistant towards chemical oxidants compared to lab-cultivated strains from the same bacterium. Furthermore, it could be shown that for selective strains chlorine dioxide is the strongest disinfectant (highest maximum inactivation), however as a broadband disinfectant ozone showed the highest strength (highest average inactivation). Details in inactivation mechanisms regarding possible target structures and reaction mechanisms are provided. Thereby the formation of secondary oxidants and their role in inactivation of pathogens is decently discussed. Eventually, possible defense responses of bacteria and additional effects which can occur in vivo are discussed.
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Affiliation(s)
- Mischa Jütte
- Technical University of Darmstadt, Institute IWAR, Chair of environmental analytics and pollutants, Franziska-Braun-Straße 7, D-64287 Darmstadt, Germany
| | - Mohammad Sajjad Abdighahroudi
- Technical University of Darmstadt, Institute IWAR, Chair of environmental analytics and pollutants, Franziska-Braun-Straße 7, D-64287 Darmstadt, Germany
| | - Torsten Waldminghaus
- Technical University of Darmstadt, Centre for synthetic biology, Chair of molecular microbiology, Schnittspahnstraße 12, D-64287 Darmstadt, Germany
| | - Susanne Lackner
- Technical University of Darmstadt, Institute IWAR, Chair of water and environmental biotechnology, Franziska-Braun-Straße 7, D-64287 Darmstadt, Germany
| | - Holger V Lutze
- Technical University of Darmstadt, Institute IWAR, Chair of environmental analytics and pollutants, Franziska-Braun-Straße 7, D-64287 Darmstadt, Germany; IWW Water Centre, Moritzstraße 26, D-45476 Mülheim an der Ruhr, Germany; Centre for Water and Environmental Research (ZWU), Universitätsstraße 5, D-45141 Essen, Germany.
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Scheithauer L, Karagöz MS, Mayer BE, Steinert M. Protein sociology of ProA, Mip and other secreted virulence factors at the Legionella pneumophila surface. Front Cell Infect Microbiol 2023; 13:1140688. [PMID: 36936764 PMCID: PMC10017501 DOI: 10.3389/fcimb.2023.1140688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/17/2023] [Indexed: 03/06/2023] Open
Abstract
The pathogenicity of L. pneumophila, the causative agent of Legionnaires' disease, depends on an arsenal of interacting proteins. Here we describe how surface-associated and secreted virulence factors of this pathogen interact with each other or target extra- and intracellular host proteins resulting in host cell manipulation and tissue colonization. Since progress of computational methods like AlphaFold, molecular dynamics simulation, and docking allows to predict, analyze and evaluate experimental proteomic and interactomic data, we describe how the combination of these approaches generated new insights into the multifaceted "protein sociology" of the zinc metalloprotease ProA and the peptidyl-prolyl cis/trans isomerase Mip (macrophage infectivity potentiator). Both virulence factors of L. pneumophila interact with numerous proteins including bacterial flagellin (FlaA) and host collagen, and play important roles in virulence regulation, host tissue degradation and immune evasion. The recent progress in protein-ligand analyses of virulence factors suggests that machine learning will also have a beneficial impact in early stages of drug discovery.
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Affiliation(s)
- Lina Scheithauer
- Institut für Mikrobiologie, Technische Universität Braunschweig, Braunschweig, Germany
| | - Mustafa Safa Karagöz
- Institut für Mikrobiologie, Technische Universität Braunschweig, Braunschweig, Germany
| | - Benjamin E. Mayer
- Computational Biology & Simulation, Technische Universität Darmstadt, Darmstadt, Germany
| | - Michael Steinert
- Institut für Mikrobiologie, Technische Universität Braunschweig, Braunschweig, Germany
- *Correspondence: Michael Steinert,
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12
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Temporal trends in legionellosis national notification data and the effect of COVID-19, Switzerland, 2000-2020. Int J Hyg Environ Health 2023; 247:113970. [PMID: 35508422 DOI: 10.1016/j.ijheh.2022.113970] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 11/21/2022]
Abstract
The notification rate of legionellosis in Switzerland and other European countries has markedly increased over the last 20 years. Here, we investigated the Swiss notification data on legionellosis from 2000 to 2020 in regards of overall time trend, content and data quality. We further explored the impact of the COVID-19 pandemic on the reported case numbers using an interrupted time series approach. Between 2000 and 2020, 5980 cases were included in our analysis. The annual crude notification rate for legionellosis cases increased from 1.1/100,000 population (CI: 0.9-1.4) in 2000 to 5.6/100,000 population (CI: 5.1-6.1) in 2020. In recent years, the summer peaks have been more pronounced and some shifted earlier in the year. The highest notification rate was recorded in 2018 with 6.7/100,000 population (CI: 6.2-7.3). The hospitalisation rate for notified cases remained high across all study years (89.9%), while the case fatality rate slightly decreased (from 7.7% to 3.6%). COVID-19 containment measures, such as travel restrictions and/or related behavioural changes, are associated with a temporary decline in cases of 35%. Overall, the quality of the notification data was good. Clinical data were more susceptible to interferences than data from laboratory reporting, which could be observed most clearly in the decline of clinical reports by 4.3 percentage points in 2020. As the case classification for Legionnaires' disease includes pneumonia symptoms, this decline could lead to an underestimation of Legionnaires' disease cases, yet the continuous reporting though the diagnostic laboratories suggested a robust surveillance system for legionellosis in Switzerland.
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Robinson Y, Khorram-Manesh A, Arvidsson N, Sinai C, Taube F. Does climate change transform military medicine and defense medical support? Front Public Health 2023; 11:1099031. [PMID: 37213601 PMCID: PMC10194660 DOI: 10.3389/fpubh.2023.1099031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/11/2023] [Indexed: 05/23/2023] Open
Abstract
Background Climate change has effects on multiple aspects of human life, such as access to food and water, expansion of endemic diseases as well as an increase of natural disasters and related diseases. The objective of this review is to summarize the current knowledge on climate change effects on military occupational health, military healthcare in a deployed setting, and defense medical logistics. Methods Online databases and registers were searched on August 22nd, 2022 and 348 papers retrieved, published between 2000 and 2022, from which we selected 8 publications that described climate effects on military health. Papers were clustered according to a modified theoretical framework for climate change effects on health, and relevant items from each paper were summarized. Results During the last decades a growing body of climate change related publications was identified, which report that climate change has a significant impact on human physiology, mental health, water- and vector borne infectious diseases, as well as air pollution. However, regarding the specific climate effects on military health the level of evidence is low. The effects on defense medical logistics include vulnerabilities in the cold supply chain, in medical devices functioning, in need for air conditioning, and in fresh water supply. Conclusions Climate change may transform both the theoretical framework and practical implementations in military medicine and military healthcare systems. There are significant knowledge gaps on climate change effects on the health of military personnel in operations of both combat and non-combat nature, alerting the need for prevention and mitigation of climate-related health issues. Further research within the fields of disaster and military medicine is needed to explore this novel field. As climate effects on humans and the medical supply chain may degrade military capability, significant investments in military medical research and development are needed.
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Affiliation(s)
- Yohan Robinson
- Centre for Disaster Medicine, Gothenburg University, Gothenburg, Sweden
- Joint Centre for Defence Medicine, Swedish Armed Forces, Gothenburg, Sweden
- *Correspondence: Yohan Robinson
| | | | - Niclas Arvidsson
- Centre for Disaster Medicine, Gothenburg University, Gothenburg, Sweden
- Joint Centre for Defence Medicine, Swedish Armed Forces, Gothenburg, Sweden
| | - Cave Sinai
- Centre for Disaster Medicine, Gothenburg University, Gothenburg, Sweden
- Joint Centre for Defence Medicine, Swedish Armed Forces, Gothenburg, Sweden
| | - Fabian Taube
- Centre for Disaster Medicine, Gothenburg University, Gothenburg, Sweden
- Joint Centre for Defence Medicine, Swedish Armed Forces, Gothenburg, Sweden
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Global practices, geographic variation, and determinants of child feces disposal in 42 low- and middle-income countries: An analysis of standardized cross-sectional national surveys from 2016 - 2020. Int J Hyg Environ Health 2022; 245:114024. [PMID: 36029740 PMCID: PMC9489922 DOI: 10.1016/j.ijheh.2022.114024] [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: 05/16/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022]
Abstract
Background Despite considerable progress improving water and sanitation access globally, unsafe child feces disposal remains common in many low- and middle-income countries (LMICs), posing an important health risk. The present study characterizes the current prevalence of child feces disposal practices and child latrine use across low- and middle-income countries and investigates determinants associated with appropriate disposal practices. Methods Data for children ranging from 0 through 4 years of age were analyzed from standardized and nationally-representative surveys of 42 LMICs collected from 2016 to 2020 to assess child feces disposal practices. We report child feces disposal in three categories: disposal in any type of latrine, disposal in an improved latrine, and disposal through means other than in a latrine. Survey weighted multiple Poisson regression models were used to explore factors associated with these practices. Results Data on 403,036 children (weighted N = 191 million) demonstrated that a minority (40.3%) of children have their feces disposed of in a latrine of any kind, and just 29% have feces disposed of in an improved latrine. Prevalence varied considerably by country and region. In adjusted analyses, both child feces disposal in any latrine and disposal in an improved latrine increased with child age, higher intra-country relative wealth, and urban living, and decreased with breastfeeding and shared sanitation facilities. Disposal in improved latrines additionally increased with access to higher levels of service for drinking water and higher mother's education. Nevertheless, the role of facility access alone was insufficient, as only about half of children with household access to any latrine or improved latrines had their feces disposed of in these facilities. Child latrine use among households with latrine access was also low and highly variable across countries. Conclusions Children's feces in LMICs are infrequently disposed of in any latrine type, and even less frequently in improved latrines. In order to minimize health risks in LMICs, increased effort must be undertaken not just to increase sanitation coverage but to address these common barriers to safe child feces disposal and child latrine use. Global child feces disposal in latrines is low and variable between countries. Latrine access is insufficient to explain low use for child feces management. Household relative wealth is associated with increased disposal in latrines. Child latrine use increases with age but remains low and varied between countries.
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Wilson AM, Canter K, Abney SE, Gerba CP, Myers ER, Hanlin J, Reynolds KA. An application for relating Legionella shower water monitoring results to estimated health outcomes. WATER RESEARCH 2022; 221:118812. [PMID: 35816914 DOI: 10.1016/j.watres.2022.118812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Exposure models are useful tools for relating environmental monitoring data to expected health outcomes. The objective of this study was to (1) compare two Legionella shower exposure models, and (2) develop a risk calculator tool for relating environmental monitoring data to estimated Legionella infection risks and Legionnaires' Disease (LD) illness risks. Legionella infection risks for a single shower event were compared using two shower Legionella exposure models. These models varied in their description of partitioning of Legionella in aerosols and aerosol deposition in the lung, where Model 1 had larger and fewer aerosol ranges than Model 2. Model 2 described conventional vs. water efficient showers separately, while Model 1 described exposure for an unspecified shower type (did not describe it as conventional or water efficient). A Monte Carlo approach was used to account for variability and uncertainty in these aerosolization and deposition parameters, Legionella concentrations, and the dose-response parameter. Methods for relating infection risks to illness risks accounting for demographic differences were used to inform the risk calculator web application ("app"). Model 2 consistently estimated higher infection risks than Model 1 for the same Legionella concentration in water and estimated deposited doses with less variability. For a 7.8-min shower with a Legionella concentration of 0.1 CFU/mL, the average infection risks estimated using Model 2 were 4.8 × 10-6 (SD=3.0 × 10-6) (conventional shower) and 2.3 × 10-6 (SD=1.7 × 10-6) (water efficient). Average infection risk estimated by Model 1 was 1.1 × 10-6 (SD=9.7 × 10-7). Model 2 was used for app development due to more conservative risk estimates and less variability in estimated dose. While multiple Legionella shower models are available for quantitative microbial risk assessments (QMRAs), they may yield notably different infection risks for the same environmental microbial concentration. Model comparisons will inform decisions regarding their integration with risk assessment tools. The development of risk calculator tools for relating environmental microbiology data to infection risks will increase the impact of exposure models for informing water treatment decisions and achieving risk targets.
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Affiliation(s)
- Amanda M Wilson
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, Drachman Hall, PO Box: 245210, Tucson, AZ 85724, United States; Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, United States
| | - Kelly Canter
- Ecolab Research, Development & Engineering, Eagan, MN, United States
| | - Sarah E Abney
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, Drachman Hall, PO Box: 245210, Tucson, AZ 85724, United States; Department of Soil, Water, and Environmental Science, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Charles P Gerba
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, Drachman Hall, PO Box: 245210, Tucson, AZ 85724, United States; Department of Soil, Water, and Environmental Science, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Eric R Myers
- Nalco Water, An Ecolab Company, Naperville, IL, United States
| | - John Hanlin
- Ecolab Research, Development & Engineering, Eagan, MN, United States
| | - Kelly A Reynolds
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, Drachman Hall, PO Box: 245210, Tucson, AZ 85724, United States.
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Legionnaires' Disease: Update on Diagnosis and Treatment. Infect Dis Ther 2022; 11:973-986. [PMID: 35505000 PMCID: PMC9124264 DOI: 10.1007/s40121-022-00635-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
Legionellosis is the infection caused by bacteria of the genus Legionella, including a non-pneumonic influenza-like syndrome, and Legionnaires’ disease is a more serious illness characterized by pneumonia. Legionellosis is becoming increasingly important as a public health problem throughout the world; although it is an underreported disease, studies have consistently documented a high incidence. In addition, health costs associated with the disease are high. Diagnosis of Legionnaires’ disease is based mainly on the detection of Legionella pneumophila serogroup 1 antigen in urine. However, there have been advances in detection tests for patients with legionellosis. New methodologies show greater sensitivity and specificity, detect more species and serogroups of Legionella spp., and have the potential for use in epidemiological studies. Testing for Legionella spp. is recommended at hospital admission for severe community-acquired pneumonia, and antibiotics directed against Legionella spp. should be included early as empirical therapy. Inadequate or delayed antibiotic treatment in Legionella pneumonia has been associated with a worse prognosis. Either a fluoroquinolone (levofloxacin or moxifloxacin) or a macrolide (azithromycin preferred) is the recommended first-line therapy for Legionnaires’ disease; however, little information is available regarding adverse events or complications, or about the duration of antibiotic therapy and its association with clinical outcomes. Most published studies evaluating antibiotic treatment for Legionnaires’ disease are observational and consequently susceptible to bias and confounding. Well-designed studies are needed to assess the usefulness of diagnostic tests regarding clinical outcomes, as well as randomized trials comparing fluoroquinolones and macrolides or combination therapy that evaluate outcomes and adverse events.
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Guinto RR, Cahatol JJF, Lazaro KYMS, Salazar AFNC. Pathways linking climate change and HIV/AIDS: An updated conceptual framework and implications for the Philippines. THE JOURNAL OF CLIMATE CHANGE AND HEALTH 2022; 6:100106. [PMID: 35945919 PMCID: PMC9352190 DOI: 10.1016/j.joclim.2021.100106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/19/2021] [Indexed: 06/15/2023]
Abstract
As we commemorate the 40th anniversary of the discovery of Human Immunodeficiency Virus (HIV) while fighting the ongoing COVID-19 pandemic, another global crisis - climate change - is threatening the progress achieved so far in the global fight against HIV/AIDS. The climate emergency is anticipated to generate dire health consequences worldwide in the coming decades. While the pathways that link climate change and different disease areas are better understood, the connection between climate change and HIV/AIDS is still yet to be recognized both in research and practice. In this review, we update one of the frameworks on the HIV-climate nexus described in earlier literature. Four major pathways have been identified: extreme weather events; sea level rise; changes in precipitation and temperature; and increased air pollution. These pathways impact the spectrum of HIV/AIDS-related outcomes through changes in social systems, healthcare disruption, and other climate-sensitive diseases, influenced by the social determinants of health. We also reflect on the significance of this updated framework for the Philippines, a country that is both highly vulnerable to the climate crisis and facing a rising HIV/AIDS epidemic. The framework can aid countries like the Philippines in filling gaps in research, policy, and program design to mount climate-adaptive HIV/AIDS responses. The HIV/AIDS and climate justice movements must also join forces in calling for accelerated worldwide decline in greenhouse gas emissions from all sectors to stabilize the global climate - this will benefit not just people affected by HIV/AIDS but everyone.
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Affiliation(s)
- Renzo R Guinto
- St. Luke's Medical Center College of Medicine-William H. Quasha Memorial, Quezon City, Philippines
- Sunway Centre for Planetary Health, Sunway University, Selangor, Malaysia
- PH Lab, Manila, Philippines
- Planetary Health Philippines, Manila, Philippines
| | - Joshua Joel F Cahatol
- St. Luke's Medical Center College of Medicine-William H. Quasha Memorial, Quezon City, Philippines
| | - Kris Yvan Mari S Lazaro
- St. Luke's Medical Center College of Medicine-William H. Quasha Memorial, Quezon City, Philippines
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VanMensel D, Droppo IG, Weisener CG. Identifying chemolithotrophic and pathogenic-related gene expression within suspended sediment flocs in freshwater environments: A metatranscriptomic assessment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 807:150996. [PMID: 34656597 DOI: 10.1016/j.scitotenv.2021.150996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/27/2021] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
The introduction and proliferation of pathogenic organisms in aquatic systems is a serious global issue that consequently leads to economic, financial, and health concerns. Health and safety related to recreational water use is typically monitored through water quality assessments that are outdated and can be misleading. These traditional methods focus on broad taxa groups, provide no insight into the active community or source of contamination, and the sediment compartments (bed and suspended) are often overlooked. To bridge this knowledge gap, our study aimed to 1) examine the metatranscriptome of the microbial community associated with suspended sediment (SS) in freshwater systems; 2) explore the influence of SS in tributaries to the littoral zone of the receiving lake; and 3) compare the SS fraction with previously reported nearshore bed sediment data. Samples were collected seasonally from Lake St. Clair and Lake Erie. Beaches in this region are influenced by both agriculture runoff and continued urban expansion. Results show that both adjacent tributary and beach SS have similar microbial functional diversity and are strongly correlated by site and season. We identified expression of transcripts encoding sequences with similarities to genes involved in nine bacterial infectious disease pathways, including legionellosis (sdhA) and Vibrio cholerae pathogenesis. According to MG-RAST gene categories, lake samples typically showed higher overall expression (p < 0.05) of transcripts with similarities to genes involved in infectious disease pathways compared to the tributaries, with summer upregulated (p < 0.05) compared to fall. Our data suggests SS acts as a strong vector for pathogen transport, making this facet an important area for further research as it pertains to human health regarding recreational water use. To our knowledge, this work is the first to investigate SS in aquatic microbial communities using metatranscriptomic analyses and has significant potential to help address growing issues of microbial contamination impacting freshwater security.
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Affiliation(s)
- Danielle VanMensel
- Great Lakes Institute for Environmental Research, University of Windsor, 401 Sunset Ave, Windsor, Ontario N9B 3P4, Canada.
| | - Ian G Droppo
- Canada Centre for Inland Waters, Environment and Climate Change Canada, 867 Lakeshore Rd, Burlington, Ontario L7R 4A6, Canada
| | - Christopher G Weisener
- Great Lakes Institute for Environmental Research, University of Windsor, 401 Sunset Ave, Windsor, Ontario N9B 3P4, Canada
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Jiang L, Gu R, Li X, Song M, Huang X, Mu D. Multiple Cross Displacement Amplification Coupled with Lateral Flow Biosensor (MCDA-LFB) for rapid detection of Legionella pneumophila. BMC Microbiol 2022; 22:20. [PMID: 34996350 PMCID: PMC8742375 DOI: 10.1186/s12866-021-02363-3] [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: 12/15/2020] [Accepted: 10/15/2021] [Indexed: 08/30/2023] Open
Abstract
Background Legionella pneumophila is an opportunistic waterborne pathogen of significant public health problems, which can cause serious human respiratory diseases (Legionnaires’ disease). Multiple cross displacement amplification (MCDA), a isothermal nucleic acid amplification technique, has been applied in the rapid detection of several bacterial agents. In this report, we developed a MCDA coupled with Nanoparticles-based Lateral Flow Biosensor (MCDA-LFB) for the rapid detection of L. pneumophila. Results A set of 10 primers based on the L. pneumophila specific mip gene to specifically identify 10 different target sequence regions of L. pneumophila was designed. The optimal time and temperature for amplification are 57 min and 65 °C. The limit of detection (LoD) is 10 fg in pure cultures of L. pneumophila. No cross-reaction was obtained and the specificity of MCDA-LFB assay was 100%. The whole process of the assay, including 20 min of DNA preparation, 35 min of L. pneumophila-MCDA reaction, and 2 min of sensor strip reaction, took a total of 57 min (less than 1 h). Among 88 specimens for clinical evaluation, 5 (5.68%) samples were L. pneumophila-positive by MCDA-LFB and traditional culture method, while 4(4.55%) samples were L. pneumophila-positive by PCR method targeting mip gene. Compared with culture method, the diagnostic accuracy of MCDA-LFB method was higher. Conclusions In summary, the L. pneumophila-MCDA-LFB method we successfully developed is a simple, fast, reliable and sensitive diagnostic tool, which can be widely used in basic and clinical laboratories. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-021-02363-3.
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Affiliation(s)
- Luxi Jiang
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China
| | - Rumeng Gu
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China.,Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu, China
| | - Xiaomeng Li
- Department of Respiratory and Critical Care Medicine, Shanghai Fourth People's Hospital Affiliated to Tongji University, 1279 Sanmen Road, Shanghai, 200080, People's Republic of China
| | - Meijun Song
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China
| | - Xiaojun Huang
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China
| | - Deguang Mu
- Department of respiratory and critical care medicine, Xi'an Daxing Hospital, Xi'an, China.
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Fuller MG, Cavanaugh N, Green S, Duderstadt K. Climate Change and State of the Science for Children's Health and Environmental Health Equity. J Pediatr Health Care 2022; 36:20-26. [PMID: 34493406 DOI: 10.1016/j.pedhc.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/19/2021] [Accepted: 08/10/2021] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Climate change is impacting the physical and mental health of children and families. This is a state of the science update regarding the impacts of climate change for pediatric-focused health care providers and advanced practice registered nurses. METHOD Using an equity lens, the authors reviewed and synthesized current literature regarding the adverse impacts of climate change. RESULTS The poor and communities of color are disproportionately impacted by climate change. Physical health impacts include increased vector and water-born infectious diseases, increases in asthma and respiratory infections, and undernutrition. Social disruptions lead to human trafficking. Climate change is associated with mental health concerns, including anxiety and posttraumatic stress after natural disasters. DISCUSSION As clinicians, pediatric-focused providers, and advanced practice registered nurses should use multipronged and interdisciplinary approaches to address or prevent the adverse impacts of climate change. Advocacy at all government levels is necessary to safeguard children and vulnerable populations.
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Sevillano M, Vosloo S, Cotto I, Dai Z, Jiang T, Santiago Santana JM, Padilla IY, Rosario-Pabon Z, Velez Vega C, Cordero JF, Alshawabkeh A, Gu A, Pinto AJ. Spatial-temporal targeted and non-targeted surveys to assess microbiological composition of drinking water in Puerto Rico following Hurricane Maria. WATER RESEARCH X 2021; 13:100123. [PMID: 34704006 PMCID: PMC8524244 DOI: 10.1016/j.wroa.2021.100123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 05/05/2023]
Abstract
Loss of basic utilities, such as drinking water and electricity distribution, were sustained for months in the aftermath of Hurricane Maria's (HM) landfall in Puerto Rico (PR) in September 2017. The goal of this study was to assess if there was deterioration in biological quality of drinking water due to these disruptions. This study characterized the microbial composition of drinking water following HM across nine drinking water systems (DWSs) in PR and utilized an extended temporal sampling campaign to determine if changes in the drinking water microbiome were indicative of HM associated disturbance followed by recovery. In addition to monitoring water chemistry, the samples were subjected to culture independent targeted and non-targeted microbial analysis including quantitative PCR (qPCR) and genome-resolved metagenomics. The qPCR results showed that residual disinfectant was the major driver of bacterial concentrations in tap water with marked decrease in concentrations from early to late sampling timepoints. While Mycobacterium avium and Pseudomonas aeruginosa were not detected in any sampling locations and timepoints, genetic material from Leptospira and Legionella pneumophila were transiently detected in a few sampling locations. The majority of metagenome assembled genomes (MAGs) recovered from these samples were not associated with pathogens and were consistent with bacterial community members routinely detected in DWSs. Further, whole metagenome-level comparisons between drinking water samples collected in this study with samples from other full-scale DWS indicated no significant deviation from expected community membership of the drinking water microbiome. Overall, our results suggest that disruptions due to HM did not result in significant and sustained deterioration of biological quality of drinking water at our study sites.
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Affiliation(s)
- Maria Sevillano
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, United States of America
| | - Solize Vosloo
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Irmarie Cotto
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, United States of America
| | - Zihan Dai
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Tao Jiang
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, United States of America
| | - Jose M. Santiago Santana
- Department of Natural Sciences, University of Puerto Rico, Carolina, PR, United States of America
| | - Ingrid Y. Padilla
- Department of Civil Engineering and Surveying, University of Puerto Rico, Mayagüez, PR, United States of America
| | - Zaira Rosario-Pabon
- University of Puerto Rico—Medical Sciences Campus, San Juan, PR, United States of America
| | - Carmen Velez Vega
- University of Puerto Rico—Medical Sciences Campus, San Juan, PR, United States of America
| | - José F. Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia, United States of America
| | - Akram Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, United States of America
| | - April Gu
- School of Civil and Environmental Engineering, Cornell University, Ithaca, NY, United States of America
| | - Ameet J. Pinto
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
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Travel-related epidemiological studies of legionellosis in Federation of Bosnia and Herzegovina. HEALTH AND TECHNOLOGY 2021. [DOI: 10.1007/s12553-021-00584-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ângelo A, Barata J. Digital transformation of legionella-safe cooling towers: an ecosystem design approach. JOURNAL OF FACILITIES MANAGEMENT 2021. [DOI: 10.1108/jfm-12-2020-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Legionnaires’ disease is a major threat to public health. Solutions to deal with this problem are usually siloed and not entirely effective. This paper aims to model the information requirements of legionella-safe cooling towers in the era of Industry 4.0.
Design/methodology/approach
A year-long design science research was conducted in a cooling tower producer for heavy industries. The project started with a bibliometric analysis and literature review of legionella in cooling towers. Goal modeling techniques are then used to identify the requirements for digital transformation.
Findings
The improvement of legionella prevention, detection and outbreak response in digitally enabled cooling tower should involve different stakeholders. Digital twins and blockchain are disruptive technologies that can transform the cooling tower industry.
Originality/value
For theory, this study revises the most recent advances in legionella protection. Legionella-safe systems must be prepared to anticipate, monitor and immediate alert in case of an outbreak. For practice, this paper presents a distributed and digital architecture for cooling tower safety. However, technology is only a part of outbreak management solutions, requiring trustworthy conditions and real-time communication among stakeholders.
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Pereira A, Silva AR, Melo LF. Legionella and Biofilms-Integrated Surveillance to Bridge Science and Real-Field Demands. Microorganisms 2021; 9:microorganisms9061212. [PMID: 34205095 PMCID: PMC8228026 DOI: 10.3390/microorganisms9061212] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022] Open
Abstract
Legionella is responsible for the life-threatening pneumonia commonly known as Legionnaires’ disease or legionellosis. Legionellosis is known to be preventable if proper measures are put into practice. Despite the efforts to improve preventive approaches, Legionella control remains one of the most challenging issues in the water treatment industry. Legionellosis incidence is on the rise and is expected to keep increasing as global challenges become a reality. This puts great emphasis on prevention, which must be grounded in strengthened Legionella management practices. Herein, an overview of field-based studies (the system as a test rig) is provided to unravel the common roots of research and the main contributions to Legionella’s understanding. The perpetuation of a water-focused monitoring approach and the importance of protozoa and biofilms will then be discussed as bottom-line questions for reliable Legionella real-field surveillance. Finally, an integrated monitoring model is proposed to study and control Legionella in water systems by combining discrete and continuous information about water and biofilm. Although the successful implementation of such a model requires a broader discussion across the scientific community and practitioners, this might be a starting point to build more consistent Legionella management strategies that can effectively mitigate legionellosis risks by reinforcing a pro-active Legionella prevention philosophy.
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Cytotoxicity, Intracellular Replication, and Contact-Dependent Pore Formation of Genotyped Environmental Legionella pneumophila Isolates from Hospital Water Systems in the West Bank, Palestine. Pathogens 2021; 10:pathogens10040417. [PMID: 33915921 PMCID: PMC8066006 DOI: 10.3390/pathogens10040417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/15/2021] [Accepted: 03/28/2021] [Indexed: 12/02/2022] Open
Abstract
Legionella pneumophila is the causative agent of Legionnaires’ disease. Due to the hot climate and intermittent water supply, the West Bank, Palestine, can be considered a high-risk area for this often fatal atypical pneumonia. L. pneumophila occurs in biofilms of natural and man-made freshwater environments, where it infects and replicates intracellularly within protozoa. To correlate the genetic diversity of the bacteria in the environment with their virulence properties for protozoan and mammalian host cells, 60 genotyped isolates from hospital water systems in the West Bank were analyzed. The L. pneumophila isolates were previously genotyped by high resolution Multi Locus Variable Number of Tandem Repeat Analysis (MLVA-8(12)) and sorted according to their relationship in clonal complexes (VACC). Strains of relevant genotypes and VACCs were compared according to their capacity to infect Acanthamoeba castellanii and THP-1 macrophages, and to mediate pore-forming cytotoxicity in sheep red blood cells (sRBCs). Based on a previous detailed analysis of the biogeographic distribution and abundance of the MLVA-8(12)-genotypes, the focus of the study was on the most abundant L. pneumophila- genotypes Gt4(17), Gt6 (18) and Gt10(93) and the four relevant clonal complexes [VACC1, VACC2, VACC5 and VACC11]. The highly abundant genotypes Gt4(17) and Gt6(18) are affiliated with VACC1 and sequence type (ST)1 (comprising L. pneumophila str. Paris), and displayed seroroup (Sg)1. Isolates of these two genotypes exhibited significantly higher virulence potentials compared to other genotypes and clonal complexes in the West Bank. Endemic for the West Bank was the clonal complex VACC11 (affiliated with ST461) represented by three relevant genotypes that all displayed Sg6. These genotypes unique for the West Bank showed a lower infectivity and cytotoxicity compared to all other clonal complexes and their affiliated genotypes. Interestingly, the L. pneumophila serotypes ST1 and ST461 were previously identified by in situ-sequence based typing (SBT) as main causative agents of Legionnaires’ disease (LD) in the West Bank at a comparable level. Overall, this study demonstrates the site-specific regional diversity of L. pneumophila genotypes in the West Bank and suggests that a combination of MLVA, cellular infection assays and hierarchical agglomerative cluster analysis allows an improved genotype-based risk assessment.
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Gonçalves IG, Fernandes HS, Melo A, Sousa SF, Simões LC, Simões M. LegionellaDB - A Database on Legionella Outbreaks. Trends Microbiol 2021; 29:863-866. [PMID: 33612398 DOI: 10.1016/j.tim.2021.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
LegionellaDB is the first database on Legionella outbreaks; it is based on a metadata analysis of peer-reviewed manuscripts from PubMed and SCOPUS. LegionellaDB is dynamic and extensible, allowing users to search for specific outbreaks, suggest additional information to be included after curation, visualize statistical representations on specific outbreaks, and download selected data. The database is maintained online.
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Affiliation(s)
- Inês G Gonçalves
- Faculty of Engineering, Department of Chemical Engineering, University of Porto, Porto, Portugal; M2BE, Aragon Institute of Engineering Research, Mechanical Engineering Department, University of Zaragoza, Zaragoza, Spain
| | - Henrique S Fernandes
- UCIBIO/REQUIMTE, BioSIM, Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Ana Melo
- Faculty of Engineering, Department of Chemical Engineering, University of Porto, Porto, Portugal
| | - Sérgio F Sousa
- UCIBIO/REQUIMTE, BioSIM, Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - Lúcia C Simões
- CEB, Centre of Biological Engineering, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Manuel Simões
- LEPABE, Faculty of Engineering, Department of Chemical Engineering, University of Porto, Porto, Portugal.
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Ahmed T, Zounemat-Kermani M, Scholz M. Climate Change, Water Quality and Water-Related Challenges: A Review with Focus on Pakistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228518. [PMID: 33212957 PMCID: PMC7698392 DOI: 10.3390/ijerph17228518] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 01/06/2023]
Abstract
Climate variability is heavily impacting human health all around the globe, in particular, on residents of developing countries. Impacts on surface water and groundwater resources and water-related illnesses are increasing, especially under changing climate scenarios such as diversity in rainfall patterns, increasing temperature, flash floods, severe droughts, heatwaves and heavy precipitation. Emerging water-related diseases such as dengue fever and chikungunya are reappearing and impacting on the life of the deprived; as such, the provision of safe water and health care is in great demand in developing countries to combat the spread of infectious diseases. Government, academia and private water bodies are conducting water quality surveys and providing health care facilities, but there is still a need to improve the present strategies concerning water treatment and management, as well as governance. In this review paper, climate change pattern and risks associated with water-related diseases in developing countries, with particular focus on Pakistan, and novel methods for controlling both waterborne and water-related diseases are discussed. This study is important for public health care, particularly in developing countries, for policy makers, and researchers working in the area of climate change, water quality and risk assessment.
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Affiliation(s)
- Toqeer Ahmed
- Centre for Climate Research and Development, COMSATS University Islamabad, Park Road, Chak Shahzad, Islamabad 45550, Pakistan;
| | | | - Miklas Scholz
- Division of Water Resources Engineering, Faculty of Engineering, Lund University, PO Box 118, 22100 Lund, Sweden
- Department of Civil Engineering Science, School of Civil Engineering and the Built Environment, University of Johannesburg, Kingsway Campus, Aukland Park 2006, Johannesburg PO Box 524, South Africa
- Civil Engineering Research Group, School of Computing, Science and Engineering, The University of Salford, Newton Building, Peel Park Campus, Salford M5 4WT, UK
- Correspondence: ; Tel.: +46-46-222-8920
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The evolution of bacterial pathogens in the Anthropocene. INFECTION GENETICS AND EVOLUTION 2020; 86:104611. [PMID: 33130070 DOI: 10.1016/j.meegid.2020.104611] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022]
Abstract
Humankind has become a primary driver of global environmental and climate change. The extent of planetary change is such that it has been proposed to classify the current geological age as the 'Anthropocene'. Anthropogenic environmental degradation presents numerous threats to human health and wellbeing, including an increased risk of infectious disease. This review focuses on how processes such as pollution, climate change and human-mediated dispersal could affect the evolution of bacterial pathogens. Effects of environmental change on the 'big five' of evolution: mutation rate, recombination (horizontal gene transfer), migration, selection and drift are discussed. Microplastic pollution is used as a case study to highlight the combined effects of some of these processes on the evolutionary diversification of human pathogens. Although the evidence is still incomplete, a picture is emerging that environmental pathogens could evolve at increased rates in the Anthropocene, with potential consequences for human infection.
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Milanez GD, Masangkay FR, Scheid P, Dionisio JD, Somsak V, Kotepui M, Tangpong J, Karanis P. Acanthamoeba species isolated from Philippine freshwater systems: epidemiological and molecular aspects. Parasitol Res 2020; 119:3755-3761. [DOI: 10.1007/s00436-020-06874-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 09/01/2020] [Indexed: 12/19/2022]
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Kuhn KG, Nygård KM, Guzman-Herrador B, Sunde LS, Rimhanen-Finne R, Trönnberg L, Jepsen MR, Ruuhela R, Wong WK, Ethelberg S. Campylobacter infections expected to increase due to climate change in Northern Europe. Sci Rep 2020; 10:13874. [PMID: 32807810 PMCID: PMC7431569 DOI: 10.1038/s41598-020-70593-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/27/2020] [Indexed: 12/21/2022] Open
Abstract
Global climate change is predicted to alter precipitation and temperature patterns across the world, affecting a range of infectious diseases and particularly foodborne infections such as Campylobacter. In this study, we used national surveillance data to analyse the relationship between climate and campylobacteriosis in Denmark, Finland, Norway and Sweden and estimate the impact of climate changes on future disease patterns. We show that Campylobacter incidences are linked to increases in temperature and especially precipitation in the week before illness, suggesting a non-food transmission route. These four countries may experience a doubling of Campylobacter cases by the end of the 2080s, corresponding to around 6,000 excess cases per year caused only by climate changes. Considering the strong worldwide burden of campylobacteriosis, it is important to assess local and regional impacts of climate change in order to initiate timely public health management and adaptation strategies.
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Affiliation(s)
- Katrin Gaardbo Kuhn
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Artillerivej 5, Copenhagen, Denmark.
| | - Karin Maria Nygård
- Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Bernardo Guzman-Herrador
- Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Linda Selje Sunde
- Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Ruska Rimhanen-Finne
- Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland
| | - Linda Trönnberg
- Department of Monitoring and Evaluation, Public Health Agency of Sweden, Solna, Sweden
| | | | - Reija Ruuhela
- Weather and Climate Change Impact Research, Finnish Meteorological Institute, Helsinki, Finland
| | - Wai Kwok Wong
- Department of Hydrology, Norwegian Water Resources and Energy Directorate, Oslo, Norway
| | - Steen Ethelberg
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Artillerivej 5, Copenhagen, Denmark
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Laribi A, Allegra S, Souiri M, Mzoughi R, Othmane A, Girardot F. Legionella pneumophila sg1-sensing signal enhancement using a novel electrochemical immunosensor in dynamic detection mode. Talanta 2020; 215:120904. [PMID: 32312449 DOI: 10.1016/j.talanta.2020.120904] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 01/20/2023]
Abstract
This work presents a comparison between static and dynamic modes of biosensing using a novel microfluidic assay for continuous and quantitative detection of Legionella pneumophila sg1 in artificial water samples. A self-assembled monolayer of 16-amino-1-hexadecanethiol (16-AHT) was covalently linked to a gold substrate, and the resulting modified surface was used to immobilize an anti-Legionella pneumophila monoclonal antibody (mAb). The modified surfaces formed during the biosensor functionalization steps were characterized using electrochemical measurements and microscopic imaging techniques. Under static conditions, the biosensor exhibited a wide linear response range from 10 to 108 CFU/mL and a detection limit of 10 CFU/mL. Using a microfluidic system, the biosensor responses exhibited a linear relationship for low bacterial concentrations ranging from 10 to 103 CFU/mL under dynamic conditions and an enhancement of sensing signals by a factor of 4.5 compared to the sensing signals obtained under static conditions with the same biosensor for the detection of Legionella cells in artificially contaminated samples.
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Affiliation(s)
- Ahlem Laribi
- Environments, Territories, Societies (EVS) Lab, Mixed Research Unit (Jean Monnet University - French National Centre for Scientific Research) 5600, University of Lyon, F42023, France; Laboratory of Advanced Materials and Interfaces, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia.
| | - Séverine Allegra
- Environments, Territories, Societies (EVS) Lab, Mixed Research Unit (Jean Monnet University - French National Centre for Scientific Research) 5600, University of Lyon, F42023, France
| | - Mina Souiri
- Laboratory of Advanced Materials and Interfaces, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia
| | - Ridha Mzoughi
- Regional Laboratory of Hygiene, University Hospital Farhat Hached, 4000 Sousse, Tunisia and Laboratory of Analysis Treatment and Valorization of Pollutants and Products, Faculty of Pharmacy, 5000, Monastir, Tunisia
| | - Ali Othmane
- Laboratory of Advanced Materials and Interfaces, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia
| | - Françoise Girardot
- Environments, Territories, Societies (EVS) Lab, Mixed Research Unit (Jean Monnet University - French National Centre for Scientific Research) 5600, University of Lyon, F42023, France
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Faccini M, Russo AG, Bonini M, Tunesi S, Murtas R, Sandrini M, Senatore S, Lamberti A, Ciconali G, Cammarata S, Barrese E, Ceriotti V, Vitaliti S, Foti M, Gentili G, Graziano E, Panciroli E, Bosio M, Gramegna M, Cereda D, Perno CF, Mazzola E, Campisi D, Aulicino G, Castaldi S, Girolamo A, Caporali MG, Scaturro M, Rota MC, Ricci ML. Large community-acquired Legionnaires' disease outbreak caused by Legionella pneumophila serogroup 1, Italy, July to August 2018. Euro Surveill 2020; 25:1900523. [PMID: 32458793 PMCID: PMC7262491 DOI: 10.2807/1560-7917.es.2020.25.20.1900523] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 12/19/2019] [Indexed: 12/18/2022] Open
Abstract
In July 2018, a large outbreak of Legionnaires' disease (LD) caused by Legionella pneumophila serogroup 1 (Lp1) occurred in Bresso, Italy. Fifty-two cases were diagnosed, including five deaths. We performed an epidemiological investigation and prepared a map of the places cases visited during the incubation period. All sites identified as potential sources were investigated and sampled. Association between heavy rainfall and LD cases was evaluated in a case-crossover study. We also performed a case-control study and an aerosol dispersion investigation model. Lp1 was isolated from 22 of 598 analysed water samples; four clinical isolates were typed using monoclonal antibodies and sequence-based typing. Four Lp1 human strains were ST23, of which two were Philadelphia and two were France-Allentown subgroup. Lp1 ST23 France-Allentown was isolated only from a public fountain. In the case-crossover study, extreme precipitation 5-6 days before symptom onset was associated with increased LD risk. The aerosol dispersion model showed that the fountain matched the case distribution best. The case-control study demonstrated a significant eightfold increase in risk for cases residing near the public fountain. The three studies and the matching of clinical and environmental Lp1 strains identified the fountain as the source responsible for the epidemic.
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Affiliation(s)
- Marino Faccini
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
- These authors contributed equally to this article and share first authorship
| | - Antonio Giampiero Russo
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
- These authors contributed equally to this article and share first authorship
| | - Maira Bonini
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
- These authors contributed equally to this article and share first authorship
| | - Sara Tunesi
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Rossella Murtas
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Monica Sandrini
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Sabrina Senatore
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Anna Lamberti
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Giorgio Ciconali
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Serafina Cammarata
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Eros Barrese
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Valentina Ceriotti
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Sonia Vitaliti
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Marina Foti
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Gabriella Gentili
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Elisabetta Graziano
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Emerico Panciroli
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Marco Bosio
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Maria Gramegna
- Direzione Generale Welfare, Unità Organizzativa Prevenzione, Lombardy Region, Milan, Italy
| | - Danilo Cereda
- Direzione Generale Welfare, Unità Organizzativa Prevenzione, Lombardy Region, Milan, Italy
| | | | - Ester Mazzola
- Department of Laboratory Medicine, Hospital Niguarda, Milan, Italy
| | - Daniela Campisi
- Department of Laboratory Medicine, Hospital Niguarda, Milan, Italy
| | - Gianuario Aulicino
- Department of Biomedical Sciences for Health, Post Graduate School in Public Health, University of Milan, Milan, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, Post Graduate School in Public Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonietta Girolamo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Maria Scaturro
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Cristina Rota
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Luisa Ricci
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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The Impact of Climate Change on Cholera: A Review on the Global Status and Future Challenges. ATMOSPHERE 2020. [DOI: 10.3390/atmos11050449] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Water ecosystems can be rather sensitive to evolving or sudden changes in weather parameters. These changes can result in alterations in the natural habitat of pathogens, vectors, and human hosts, as well as in the transmission dynamics and geographic distribution of infectious agents. However, the interaction between climate change and infectious disease is rather complicated and not deeply understood. In this narrative review, we discuss climate-driven changes in the epidemiology of Vibrio species-associated diseases with an emphasis on cholera. Changes in environmental parameters do shape the epidemiology of Vibrio cholerae. Outbreaks of cholera cause significant disease burden, especially in developing countries. Improved sanitation systems, access to clean water, educational strategies, and vaccination campaigns can help control vibriosis. In addition, real-time assessment of climatic parameters with remote-sensing technologies in combination with robust surveillance systems could help detect environmental changes in high-risk areas and result in early public health interventions that can mitigate potential outbreaks.
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Mondino S, Schmidt S, Rolando M, Escoll P, Gomez-Valero L, Buchrieser C. Legionnaires’ Disease: State of the Art Knowledge of Pathogenesis Mechanisms of Legionella. ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE 2020; 15:439-466. [DOI: 10.1146/annurev-pathmechdis-012419-032742] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Legionella species are environmental gram-negative bacteria able to cause a severe form of pneumonia in humans known as Legionnaires’ disease. Since the identification of Legionella pneumophila in 1977, four decades of research on Legionella biology and Legionnaires’ disease have brought important insights into the biology of the bacteria and the molecular mechanisms that these intracellular pathogens use to cause disease in humans. Nowadays, Legionella species constitute a remarkable model of bacterial adaptation, with a genus genome shaped by their close coevolution with amoebae and an ability to exploit many hosts and signaling pathways through the secretion of a myriad of effector proteins, many of which have a eukaryotic origin. This review aims to discuss current knowledge of Legionella infection mechanisms and future research directions to be taken that might answer the many remaining open questions. This research will without a doubt be a terrific scientific journey worth taking.
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Affiliation(s)
- Sonia Mondino
- Institut Pasteur, Biologie des Bactéries Intracellulaires, CNRS UMR 3525, 75015 Paris, France;, , , , ,
| | - Silke Schmidt
- Institut Pasteur, Biologie des Bactéries Intracellulaires, CNRS UMR 3525, 75015 Paris, France;, , , , ,
- Sorbonne Université, Collège doctoral, 75005 Paris, France
| | - Monica Rolando
- Institut Pasteur, Biologie des Bactéries Intracellulaires, CNRS UMR 3525, 75015 Paris, France;, , , , ,
| | - Pedro Escoll
- Institut Pasteur, Biologie des Bactéries Intracellulaires, CNRS UMR 3525, 75015 Paris, France;, , , , ,
| | - Laura Gomez-Valero
- Institut Pasteur, Biologie des Bactéries Intracellulaires, CNRS UMR 3525, 75015 Paris, France;, , , , ,
| | - Carmen Buchrieser
- Institut Pasteur, Biologie des Bactéries Intracellulaires, CNRS UMR 3525, 75015 Paris, France;, , , , ,
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The relevance of molecular genotyping to allocate cases in a suspected outbreak of Legionella pneumonia in patients with prolonged immunosuppressive therapy. Int J Infect Dis 2019; 91:174-176. [PMID: 31707135 DOI: 10.1016/j.ijid.2019.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 10/25/2022] Open
Abstract
Three cases of pneumonia caused by Legionella pneumophila serogroup 1 (Lp1) in immunosuppressed patients with repeated hospitalization were suspected as a healthcare-associated cluster. The environmental investigation did not reveal the presence of legionellae in the hospital patient rooms. Water samples collected from the homes of two patients were also negative for Legionella spp. In the absence of environmental strains potentially involved in the infections, we proceeded to genotype environmental Lp1 strains isolated in the hospital during routine water sampling during the decade 2009-2019 and recovered after long-term storage at -20°C. These 'historical' strains exhibited a high grade of similarity and stability over time, regardless of the disinfection systems. The different molecular profiles shown among the clinical and environmental strains excluded a nosocomial outbreak. The study suggests that the application of molecular typing may be a useful tool to discriminate hospital vs community-acquired cases, mostly for severely immunosuppressed patients in whom the symptomatology could be insidious and the incubation period could be prolonged. Moreover, the genotyping allowed us to exclude any link between the cases.
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De Giglio O, Fasano F, Diella G, Lopuzzo M, Napoli C, Apollonio F, Brigida S, Calia C, Campanale C, Marzella A, Pousis C, Rutigliano S, Triggiano F, Caggiano G, Montagna MT. Legionella and legionellosis in touristic-recreational facilities: Influence of climate factors and geostatistical analysis in Southern Italy (2001-2017). ENVIRONMENTAL RESEARCH 2019; 178:108721. [PMID: 31541805 DOI: 10.1016/j.envres.2019.108721] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/02/2019] [Accepted: 09/03/2019] [Indexed: 06/10/2023]
Abstract
Legionella is the causative agent of Legionnaires' disease, a flu-like illness normally acquired following inhalation or aspiration of contaminated water aerosols. Our recent studies revealed that climatic parameters can increase the number of reported cases of community-acquired Legionnaires' disease. Here, we evaluated the presence of Legionella in water networks and the distribution of Legionnaires' disease cases associated with touristic-recreational facilities in the Apulia region (southern Italy) during the period 2001-2017 using geostatistical and climatic analyses. Geostatistical analysis data revealed that the area with the highest concentration of Legionella in water systems also had the greatest number of cases of Legionnaires' disease associated with touristic-recreational facilities. Climatic analysis showed that higher daily temperature excursion (difference between maximum and minimum temperature) on the day of sampling was more often associated with Legionella-positive samples than Legionella-negative samples. In addition, our data highlighted an increased risk of Legionnaires' disease with increases in precipitation and average temperature and with decreases in daily temperature excursion (difference between maximum and minimum temperature over the course of 24 h in the days of incubation period of disease) and minimum temperature. Healthcare professionals should be aware of this phenomenon and be particularly vigilant for cases of community-acquired pneumonia during such climatic conditions and among the tourist population. The innovative geo-statistical approach used in this study could be applied in other contexts when evaluating the effects of climatic conditions on the incidence of Legionella infections.
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Affiliation(s)
- Osvalda De Giglio
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Fabrizio Fasano
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Giusy Diella
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Marco Lopuzzo
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, 00189, Rome, Italy.
| | - Francesca Apollonio
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Silvia Brigida
- Water Research Institute-Italian National Research Council, Bari, Italy.
| | - Carla Calia
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Carmen Campanale
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Angelo Marzella
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Chrysovalentinos Pousis
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Serafina Rutigliano
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Francesco Triggiano
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Giuseppina Caggiano
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Maria Teresa Montagna
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124, Bari, Italy.
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Ruszkiewicz JA, Tinkov AA, Skalny AV, Siokas V, Dardiotis E, Tsatsakis A, Bowman AB, da Rocha JBT, Aschner M. Brain diseases in changing climate. ENVIRONMENTAL RESEARCH 2019; 177:108637. [PMID: 31416010 PMCID: PMC6717544 DOI: 10.1016/j.envres.2019.108637] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 05/12/2023]
Abstract
Climate change is one of the biggest and most urgent challenges for the 21st century. Rising average temperatures and ocean levels, altered precipitation patterns and increased occurrence of extreme weather events affect not only the global landscape and ecosystem, but also human health. Multiple environmental factors influence the onset and severity of human diseases and changing climate may have a great impact on these factors. Climate shifts disrupt the quantity and quality of water, increase environmental pollution, change the distribution of pathogens and severely impacts food production - all of which are important regarding public health. This paper focuses on brain health and provides an overview of climate change impacts on risk factors specific to brain diseases and disorders. We also discuss emerging hazards in brain health due to mitigation and adaptation strategies in response to climate changes.
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Affiliation(s)
- Joanna A Ruszkiewicz
- Molecular Toxicology Group, Department of Biology, University of Konstanz, Konstanz, Germany
| | - Alexey A Tinkov
- Yaroslavl State University, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University, Moscow, Russia; Institute of Cellular and Intracellular Symbiosis, Russian Academy of Sciences, Orenburg, Russia
| | - Anatoly V Skalny
- Yaroslavl State University, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University, Moscow, Russia; Trace Element Institute for UNESCO, Lyon, France
| | - Vasileios Siokas
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Aristidis Tsatsakis
- Laboratory of Toxicology, School of Medicine, University of Crete, 71003, Heraklion, Greece
| | - Aaron B Bowman
- School of Health Sciences, Purdue University, West Lafayette, IN, United States
| | - João B T da Rocha
- Department of Biochemistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, United States.
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Erickson TB, Brooks J, Nilles EJ, Pham PN, Vinck P. Environmental health effects attributed to toxic and infectious agents following hurricanes, cyclones, flash floods and major hydrometeorological events. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2019; 22:157-171. [PMID: 31437111 DOI: 10.1080/10937404.2019.1654422] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Extreme hydrometeorological events such as hurricanes and cyclones are increasing in frequency and intensity due to climate change and often associated with flash floods in coastal, urbanized and industrial areas. Preparedness and response measures need to concentrate on toxicological and infectious hazards, the potential impact on environmental health, and threat to human lives. The recognition of the danger of flood water after hurricanes is critical. Effective health management needs to consider the likelihood and specific risks of toxic agents present in waters contaminated by chemical spills, bio-toxins, waste, sewage, and water-borne pathogens. Despite significant progress in the ability to rapidly detect and test water for a wide range of chemicals and pathogens, there has been a lack of implementation to adapt toxicity measurements in the context of flash and hurricane-induced flooding. The aim of this review was to highlight the need to collect and analyze data on toxicity of flood waters to understand the risks and prepare vulnerable communities and first responders. It is proposed that new and routinely used technologies be employed during disaster response to rapidly assess toxicity and infectious disease threats, and subsequently take necessary remedial actions.
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Affiliation(s)
- Timothy B Erickson
- Department of Emergency Medicine, Brigham & Women's Hospital, Harvard Medical School, Harvard Humanitarian Initiative , Boston , MA , USA
| | - Julia Brooks
- Department of Emergency Medicine, Brigham & Women's Hospital, Harvard Medical School, Harvard Humanitarian Initiative , Boston , MA , USA
| | - Eric J Nilles
- Department of Emergency Medicine, Brigham & Women's Hospital, Harvard Medical School, Harvard Humanitarian Initiative , Boston , MA , USA
| | - Phuong N Pham
- Department of Emergency Medicine, Brigham & Women's Hospital, Harvard Medical School, Harvard Humanitarian Initiative , Boston , MA , USA
| | - Patrick Vinck
- Department of Emergency Medicine, Brigham & Women's Hospital, Harvard Medical School, Harvard Humanitarian Initiative , Boston , MA , USA
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Abstract
The consistent, sporadic transmission of shigellosis in Taiwan necessitates an exploration of risk factors for the occurrence of shigellosis. The purpose of this study was to study the epidemiologic characteristics and the relationship between climatic factors and the incidence of shigellosis in Taiwan. We collected data from cases of shigellosis reported to the Taiwan Centers for Disease Control (Taiwan CDC) from 2001 to 2016. Climatic data were obtained from the Taiwan Central Weather Bureau. The relationships between weather variability and the incidence of shigellosis in Taiwan were determined via Poisson regression analyses. During the 16-year study period, a total of 4171 clinical cases of shigellosis were reported to the Taiwan CDC. Among them, 1926 (46.2%) were classified as confirmed cases. The incidence of shigellosis showed significant seasonality, with the majority of cases occurring in summertime (for oscillation, P < .001). The number of shigellosis cases started to increase when temperatures reached 21°C (r = 0.88, P < .001). Similarly, the number of shigellosis cases began to increase at a relative humidity of 70-74% (r = 0.75, P < .005). The number of shigellosis cases was positively associated with the mean temperature and relative humidity in the period preceding the infection. In conclusion, the occurrence of shigellosis is significantly associated with increasing temperature and relative humidity in Taiwan. Therefore, these factors could be regarded as warning signals indicating the need to implement preventive measures.
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Affiliation(s)
- Chian-Ching Chen
- Department of Business Administration, National Taiwan University of Science and Technology
| | - Chuan-Yao Lin
- Research Center for Environmental Changes, Academia Sinica, Taipei
| | - Kow-Tong Chen
- Department of Occupational Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation)
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Semenza JC, Ebi KL. Climate change impact on migration, travel, travel destinations and the tourism industry. J Travel Med 2019; 26:5445924. [PMID: 30976790 PMCID: PMC7107585 DOI: 10.1093/jtm/taz026] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 12/19/2022]
Abstract
Background: Climate change is not only increasing ambient temperature but also accelerating the frequency, duration and intensity of extreme weather and climate events, such as heavy precipitation and droughts, and causing sea level rise, which can lead to population displacement. Climate change-related reductions in land productivity and habitability and in food and water security can also interact with demographic, economic and social factors to increase migration. In addition to migration, climate change has also implications for travel and the risk of disease. This article discusses the impact of climate change on migration and travel with implications for public health practice. Methods: Literature review. Results: Migrants may be at increased risk of communicable and non-communicable diseases, due to factors in their country of origin and their country of destination or conditions that they experience during migration. Although migration has not been a significant driver of communicable disease outbreaks to date, public health authorities need to ensure that effective screening and vaccination programmes for priority communicable diseases are in place.Population growth coupled with socio-economic development is increasing travel and tourism, and advances in technology have increased global connectivity and reduced the time required to cover long distances. At the same time, as a result of climate change, many temperate regions, including high-income countries, are now suitable for vector-borne disease transmission. This is providing opportunities for importation of vectors and pathogens from endemic areas that can lead to cases or outbreaks of communicable diseases with which health professionals may be unfamiliar. Conclusion: Health systems need to be prepared for the potential population health consequences of migration, travel and tourism and the impact of climate change on these. Integrated surveillance, early detection of cases and other public health interventions are critical to protect population health and prevent and control communicabledisease outbreaks.
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Affiliation(s)
- Jan C Semenza
- Scientific Assessment Section, European Centre for Disease Prevention and Control (ECDC), Gustav III:s boulevard 40, Solna, Sweden
| | - Kristie L Ebi
- Department of Global Health, University of Washington, PO Box 354695, Suite 2330, Seattle, WA, USA
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Cissé G. Food-borne and water-borne diseases under climate change in low- and middle-income countries: Further efforts needed for reducing environmental health exposure risks. Acta Trop 2019; 194:181-188. [PMID: 30946811 PMCID: PMC7172250 DOI: 10.1016/j.actatropica.2019.03.012] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 03/08/2019] [Accepted: 03/08/2019] [Indexed: 12/20/2022]
Abstract
Food- and water-borne diseases (FWBD) are a major cause of mortality and morbidity. Africa counts 91 million people falling ill and 137,000 dying per year by FWBD. Climate change could increase FWBD through bad water, sanitation and hygiene (WASH). Floods’ vulnerability maps of drinking water systems are important for prevention. Appropriate WASH interventions can significantly contribute in reducing FWBD under climate change.
This paper provides a view of the major facts and figures related to infectious diseases with a focus on food-borne and water-borne diseases and their link with environmental factors and climate change. The global burden of food-borne diseases for 31 selected hazards was estimated by the World Health Organization at 33 million disability-adjusted life years (DALYs) in 2010 with 40% of this burden concentrated among children under 5 years of age. The highest burden per population of food-borne diseases is found in Africa, followed by Southeast Asia and the Eastern Mediterranean sub-regions. Unsafe water used for the cleaning and processing of food is a key risk factors contributing to food-borne diseases. The role of quality and quantity of water to the general burden of infectious diseases deserves attention, particularly in low- and middle-income countries, as its effects go beyond the food chain. Water-related infectious diseases are a major cause of mortality and morbidity worldwide, and climate change effects will exacerbate the challenges for the public health sector for both food-borne and water-borne diseases. Selected case studies from Africa and Asia show that (i) climate change extreme events, such as floods, may exacerbate the risks for infectious diseases spreading through water systems, and (ii) improvements related to drinking water, sanitation and hygiene could result in a significant reduction of intestinal parasitic infections among school-aged children. There is a need to better anticipate the impacts of climate change on infectious diseases and fostering multi-stakeholder engagement and multi-sectoral collaborations for integrated interventions at schools, community and household levels. The paper calls for giving priority to improving the environmental conditions affecting food-borne and water-borne infectious diseases under climate change.
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Levy BS. Increasing Risks for Armed Conflict: Climate Change, Food and Water Insecurity, and Forced Displacement. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2019; 49:682-691. [PMID: 31027434 DOI: 10.1177/0020731419845249] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The interrelated factors of climate change, decreased access to freshwater, and forced displacement are heightening the risk of armed conflict. Higher temperatures and extremes of precipitation are contributing to food and water insecurity, forced displacement, and sociopolitical tensions. Health professionals can help to address these problems through education, advocacy, and other activities that aim to mitigate and adapt to climate change and minimize the risk of armed conflict.
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Affiliation(s)
- Barry S Levy
- 1 Department of Public Health and Community Medicine, Tufts University School of Medicine, Massachusetts, USA
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