Control and prevention of infectious diseases from a One Health perspective

Preferences for and drivers of adult vaccination clinic site selection: A cross-sectional study in 30 provinces in China

Focusing on vaccines available to adults and not in the immunization schedule, this study investigates the preferences and factors influencing adults in selecting vaccination clinic locations. It aims to provide strategic insights for boosting vaccination rates by analyzing adults' decision-making factors. This contributes to developing more efficient, patient-focused vaccination strategies that tackle vaccine hesitancy and improve access to vaccination sites. We conducted a cross-sectional study through the "YueMiao" platform from November 1 to December 10, 2023, using convenience and purposive sampling to engage 2014 participants. We collected data via online surveys that included questions about sociodemographic characteristics, sources of vaccination clinic information, clinic satisfaction, and the impact of site selection on vaccination decisions. Our findings reveal that adults' site preferences for vaccination are influenced by gender, age, income, and vaccination history. Participants showed a strong preference for locations that offer convenience, efficiency, transparent pricing, and a comfortable environment. Analysis of service satisfaction at these clinics indicates that vaccinated individuals report higher satisfaction with appointment systems, wait times, and service hours than those unvaccinated. Furthermore, the preference for vaccination sites consistently aligns with the vaccine type, with a majority opting for community health service centers. Our results suggest that public health strategies should concentrate on enhancing site convenience, service quality, and information transparency to elevate adult vaccination rates. Future initiatives should aim to increase public trust in vaccines, improve the selection and quality of vaccination sites, and effectively utilize digital technology for spreading vaccination information.

Human milk oligosaccharide secretion dynamics during breastfeeding and its antimicrobial role: A systematic review

BACKGROUND

Human milk oligosaccharides (HMOs) are bioactive components of breast milk with diverse health benefits, including shaping the gut microbiota, modulating the immune system, and protecting against infections. HMOs exhibit dynamic secretion patterns during lactation, influenced by maternal genetics and environmental factors. Their direct and indirect antimicrobial properties have garnered significant research interest. However, a comprehensive understanding of the secretion dynamics of HMOs and their correlation with antimicrobial efficacy remains underexplored.

AIM

To synthesize current evidence on the secretion dynamics of HMOs during lactation and evaluate their antimicrobial roles against bacterial, viral, and protozoal pathogens.

METHODS

A systematic search of PubMed, Scopus, Web of Science, and Cochrane Library focused on studies investigating natural and synthetic HMOs, their secretion dynamics, and antimicrobial properties. Studies involving human, animal, and in vitro models were included. Data on HMO composition, temporal secretion patterns, and mechanisms of antimicrobial action were extracted. Quality assessment was performed using validated tools appropriate for study design.

RESULTS

A total of 44 studies were included, encompassing human, animal, and in vitro research. HMOs exhibited dynamic secretion patterns, with 2′-fucosyllactose (2′-FL) and lacto-N-tetraose peaking in early lactation and declining over time, while 3-fucosyllactose (3-FL) increased during later stages. HMOs demonstrated significant antimicrobial properties through pathogen adhesion inhibition, biofilm disruption, and enzymatic activity impairment. Synthetic HMOs, including bioengineered 2′-FL and 3-FL, were structurally and functionally comparable to natural HMOs, effectively inhibiting pathogens such as Pseudomonas aeruginosa , Escherichia coli , and Campylobacter jejuni . Additionally, HMOs exhibited synergistic effects with antibiotics, enhancing their efficacy against resistant pathogens.

CONCLUSION

HMOs are vital in antimicrobial defense, supporting infant health by targeting various pathogens. Both natural and synthetic HMOs hold significant potential for therapeutic applications, particularly in infant nutrition and as adjuncts to antibiotics. Further research, including clinical trials, is essential to address gaps in knowledge, validate findings, and explore the broader applicability of HMOs in improving maternal and neonatal health.

The effect of deforestation on COVID-19 transmission to Indigenous peoples in Brazil: A panel fixed-effects analysis before and after vaccination

Brazil had the second-largest death toll during the COVID-19 pandemic, with indigenous peoples disproportionately affected among ethnic groups. Parallel to the pandemic, Brazil has recorded the highest rate of deforestation globally, with encroachments into Indigenous territories putting climate stabilization and biodiversity at risk. However, the effects of deforestation on COVID-19 transmission to Brazil's Indigenous peoples are unknown. This study shows that during the pre-vaccination period, deforestation partially explains COVID-19 transmission among Indigenous populations. Our main results for the pre-vaccination period indicate that a daily increase in deforestation per km2 is associated, on average, with the confirmation of 0.76 (p < 0.004, 95% CI: 0.240 - 1.276) new daily cases of COVID-19 among Indigenous peoples 14 days after deforestation warnings. Our estimates suggest deforestation explains at least 9.6% of all COVID-19 cases among indigenous populations. The association between the two variables disappears after the vaccination program. Our findings provide empirical evidence on the interplay between environmental degradation and negative health outcomes in a vulnerable segment of society in the context of a pandemic. Furthermore, these findings highlight the importance of the One Health approach to building preparedness for future pandemic threats.

Maternal Vaccination and Neonatal Feeding Strategies Among Polish Women

Background/Objectives: Maternal vaccination and breastfeeding are important aspects of public health that should be recommended by medical staff caring for pregnant and postpartum women. We aimed to analyze factors affecting women's likelihood of dual vaccination during pregnancy and their infant feeding strategies. Methods: A cross-sectional study was conducted with 953 Polish mothers. An online questionnaire was used and included questions on sociodemographic and obstetric variables, women's attitudes towards COVID-19 and influenza vaccination, and breastfeeding practices. Results: COVID-19 vaccination was reported by 66.0%, influenza vaccination by 18.2%, and dual vaccination by 15.6% of Polish mothers. Increasing willingness to receive vaccines was significantly associated with older maternal age, lower BMI, living in urban areas with >100,000 residents, and high levels of knowledge regarding vaccination. No significant association between dual vaccination and neonatal feeding strategy was detected. The group of exclusively breastfeeding mothers, in comparison to formula- and mixed-feeding women, was characterized by having lower pre-pregnancy BMI and previous maternal experience. Conclusions: Rates of vaccination against seasonal influenza and dual (influenza and COVID-19) vaccination remain low among Polish mothers. The promotion of antenatal vaccination and reliable information about short- and long-term advantages related to breastfeeding are crucial to perinatal health care for the mother-infant dyad. Young, primiparous women who are overweight or obese should be targets of preventive programs focused on the health of the mother-infant dyad.

mRNA vaccine platforms: linking infectious disease prevention and cancer immunotherapy

The advent of mRNA vaccines, accelerated by the global response to the COVID-19 pandemic, marks a transformative shift in vaccine technology. In this article, we discuss the development, current applications, and prospects of mRNA vaccines for both the prevention and treatment of infectious diseases and oncology. By leveraging the capacity to encode antigens within host cells directly, mRNA vaccines provide a versatile and scalable platform suitable for addressing a broad spectrum of pathogens and tumor-specific antigens. We highlight recent advancements in mRNA vaccine design, innovative delivery mechanisms, and ongoing clinical trials, with particular emphasis on their efficacy in combating infectious diseases, such as COVID-19, Zika, and influenza, as well as their emerging potential in cancer immunotherapy. We also address critical challenges, including vaccine stability, optimization of immune responses, and the broader issue of global accessibility. Finally, we review potential strategies for advancing next-generation mRNA vaccines, with the aim of overcoming current limitations in vaccine technology and enhancing both preventive and therapeutic approaches for infectious and oncological diseases.

Recent Progress in Developing Extracellular Vesicles as Nanovehicles to Deliver Carbohydrate-Based Therapeutics and Vaccines

Cell-derived, nanoscale extracellular vesicles (EVs) have emerged as promising tools in diagnostic, therapeutic, and vaccine applications. Their unique properties including the capability to encapsulate diverse molecular cargo as well as the versatility in surface functionalization make them ideal candidates for safe and effective vehicles to deliver a range of biomolecules including gene editing cassettes, therapeutic proteins, glycans, and glycoconjugate vaccines. In this review, we discuss recent advances in the development of EVs derived from mammalian and bacterial cells for use in a delivery of carbohydrate-based protein therapeutics and vaccines. We highlight key innovations in EVs' molecular design, characterization, and deployment for treating diseases including Alzheimer's disease, infectious diseases, and cancers. We discuss challenges for their clinical translation and provide perspectives for future development of EVs within biopharmaceutical research and the clinical translation landscape.

Advancing vaccine development in genomic era: a paradigm shift in vaccine discovery

The issue of antibiotic resistance is increasing with time because of the quick rise of microbial strains. Overuse of antibiotics has led to multidrug-resistant, pan-drug-resistant, and extensively drug-resistant bacterial strains, which have worsened the situation. Different techniques have been considered and applied to combat this issue, such as developing new antibiotics, practicing antibiotic stewardship, improving hygiene levels, and controlling antibiotic overuse. Vaccine development made a substantial contribution to overcoming this issue, although it has been underestimated. In the recent era, reverse vaccinology has contributed to developing different kinds of vaccines against pathogens, revolutionizing the vaccine development process. Reverse vaccinology helps to prioritize better vaccine candidates by using various tools to filter the pathogen's complete genome. In this review, we will shed light on computational vaccine designing, immunoinformatic tools, genomic and proteomic data, and the challenges and success stories of computational vaccine designing.

Addressing the emerging threat of Oropouche virus: implications and public health responses for healthcare systems

Oropouche fever is an increasingly significant health concern in tropical and subtropical areas of South and Central America, and is primarily spread by midge vectors. The Oropouche virus (OROV) was first identified in 1955 and has been responsible for numerous outbreaks, particularly in urban environments. Despite its prevalence, the disease is often under-reported, making it difficult to fully understand its impact. OROV typically causes febrile illness characterized by symptoms such as headaches, muscle pain, and, occasionally, neurological issues such as meningitis. The ability of the virus to thrive in both forested and urban areas has raised concerns regarding its potential spread to new regions, particularly in the context of climate change. This paper delves into the epidemiology, clinical features, and transmission patterns of OROV, shedding light on the difficulties in diagnosing and managing the disease. The absence of specific treatments and vaccines highlights the urgent need for continued research and development of targeted public health strategies. Advancements in molecular diagnostics and vector control strategies can mitigate Oropouche fever's impact. However, a comprehensive public health approach involving increased surveillance, public education, and cross-border collaboration is needed, especially as the global climate crisis may expand vector habitats, posing risks to previously unaffected regions.

Evaluation of oxidative stress biomarkers for differentiating bacterial and viral infections: a comparative study of glutathione disulfide (GSSG) and reduced glutathione (GSH)

Background and aims

This study evaluates the potential of oxidative stress biomarkers, specifically glutathione disulfide (GSSG) and reduced glutathione (GSH), for differentiating bacterial and viral infections. Oxidative stress plays a crucial role in the immune response, and glutathione is a key regulator of cellular redox balance. The aim was to assess whether differences in GSH and GSSG levels could be used as diagnostic markers for infection type.

Methods

A chemiluminescence-based method evaluated GSH and GSSG as potential biomarkers for distinguishing between bacterial and viral infections. The GSH and GSSG concentrations were analyzed across bacterial, viral, and control groups.

Results

Our data revealed significant differences in the GSH/GSSG ratio between the analyzed groups, with bacterial infections showing higher oxidative stress markers compared to viral infections. A combined analysis of GSH and GSSG concentrations, visualized through heatmaps and ROC curves, improved diagnostic accuracy, with clustering patterns distinguishing infection types.

Conclusions

These findings suggest that the GSH/GSSG ratio could be used as a biomarker in distinguishing between bacterial and viral infections, offering potential clinical applications for more accurate diagnosis. Further research is required to validate these results in larger cohorts and to explore the underlying mechanisms of oxidative stress in pathogen-specific immune responses.

First description of a mobatvirus (Hantaviridae) in the Amazon region

From 1988-2023, Pará accounted for the highest proportion of deforestation among all states in the Brazilian Amazon. Specifically, 57.20 % of the territory in the Santa Bárbara municipality was deforested as of 2023. Since 2017, the Hantaviridae family has included viruses identified in nonrodent vertebrates, such as mobatviruses (from moles and bats). In the current metagenomic analysis of a pool of multiple organs of a Carollia brevicauda bat, we obtained sequences for three segments of the previously described Buritiense virus (BURV); to date, only the L segment had been sequenced for this mobatvirus. This study provides the first description of BURV in the Amazon region and provides information on the S and M segments of the virus. These findings corroborate the presence of BURV in Brazil in an area far from the site of the first detection and in another bat species.

A Survey on Companion Animal Owners' Perception of Veterinarians' Communication About Zoonoses and Antimicrobial Resistance in Germany

The intimate bonds between humans and their pets create favourable conditions that support the mutual transmission of pathogens in either direction. In this context, veterinarians are essential in informing and educating pet owners about health risks linked to zoonotic pathogens and antimicrobial resistance (AMR). To effectively convey this information, veterinarians should have strong communication skills. To gather insights on pet ownership, veterinary consultations, and risk communication, an online questionnaire was used to survey dog and cat owners in Germany. The survey evaluated the frequency and perception of communication concerning zoonotic pathogens and AMR, deriving a communication score. The findings showed that pet owners rated veterinarian communication with a high average score, reflecting a high satisfaction level. The longer pet owners had been clients, the more frequently they received information on zoonoses and AMR, and the better they rated the communication. However, the results also indicated that the amount of information on zoonoses and/or AMR provided by veterinarians was still lower than desired by pet owners. Risk factors, including pathogen detection, vulnerable individuals, owning imported animals, and feeding them raw meat, fish, offal, or uncooked bones, were regularly present. These findings underscore the critical role of risk communication in preventing zoonoses and AMR.

Safety and efficacy of toll-like receptor agonists as therapeutic agents and vaccine adjuvants for infectious diseases in animals: a systematic review

Introduction

Strengthening global health security relies on adequate protection against infectious diseases through vaccination and treatment. Toll-like receptor (TLR) agonists exhibit properties that can enhance immune responses, making them potential therapeutic agents or vaccine adjuvants.

Methods

We conducted an extensive systematic review to assess the efficacy of TLR agonists as therapeutic agents or vaccine adjuvants for infectious diseases and their safety profile in animals, excluding rodents and cold-blooded animals. We collected qualitative and available quantitative data on the efficacy and safety outcomes of TLR agonists and employed descriptive analysis to summarize the outcomes.

Results

Among 653 screened studies, 51 met the inclusion criteria. In this review, 82% (42/51) of the studies used TLR agonists as adjuvants, while 18% (9/51) applied TLR agonist as therapeutic agents. The predominant TLR agonists utilized in animals against infectious diseases was CpG ODN, acting as a TLR9 agonist in mammals, and TLR21 agonists in chickens. In 90% (46/51) of the studies, TLR agonists were found effective in stimulating specific and robust humoral and cellular immune responses, thereby enhancing the efficacy of vaccines or therapeutics against infectious diseases in animals. Safety outcomes were assessed in 8% (4/51) of the studies, with one reporting adverse effects.

Discussion

Although TLR agonists are efficacious in enhancing immune responses and the protective efficacy of vaccines or therapeutic agents against infectious diseases in animals, a thorough evaluation of their safety is imperative to in-form future clinical applications in animal studies.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=323122.

Iranian experts' perspectives on facilitators and barriers influencing the infectious disease knowledge network: A qualitative study

BACKGROUND

Knowledge networks, such as Communities of Practice (CoP), are essential elements of knowledge management. They play a crucial role in assimilating various knowledge domains and converting individual knowledge into collective knowledge. This study aimed to assess the concept of knowledge networks and identify facilitators and barriers influencing knowledge sharing in infectious diseases, according to Iranian experts.

METHODS

This qualitative study employed content analysis and used purposive and snowball sampling. The data were collected via online or face-to-face interviews with 25 participants with diverse expertise in infectious diseases (both clinical and non-clinical), epidemiology, knowledge management, and knowledge-based business management in Iran. The thematic analysis technique was used to code the interviews, and the collected data were analyzed using MAXQDA 20 software.

RESULTS

Thematic analysis of the interviews led to 437 codes. These codes were categorized into two groups: facilitators and barriers. The facilitators shaping the knowledge network for infectious diseases were classified into three main categories: individual factors, organizational factors, and communication mechanisms. Individual factors involved two themes: strengthening knowledge exchange between experts in infectious diseases and personal characteristics such as the criteria for network membership. Organizational factors comprised three themes: organizational and trans-organizational factors, management strategies, and interactions with non-governmental sectors. Communication mechanisms included two themes: the use of information technology and knowledge brokers. In addition, three important challenges were identified as barriers influencing the knowledge network: administration and policy-making, organizational and trans-organizational, and personal challenges.

CONCLUSIONS

Several facilitators and barriers influence the formation of an infectious disease knowledge network, which must be addressed to ensure its effectiveness, development, and long-term sustainability. Addressing these factors will enable the network to effectively integrate diverse knowledge and contribute to advancing infectious disease management.

Impact of twelve immunization-preventable infectious diseases on population health using disability-adjusted life years (DALYs) in Spain

BACKGROUND

The objective of this study is to estimate the burden of selected immunization-preventable infectious diseases in Spain using the Burden of Communicable Diseases in Europe (BCoDE) methodology, as well as focusing on the national immunization programme and potential new inclusions.

METHODS

The BCoDE methodology relies on an incidence and pathogen-based approach to calculate disease burden via disability-adjusted life year (DALY) estimates. It considers short and long-term sequelae associated to an infection via outcome trees. The BCoDE toolkit was used to populate those trees with Spanish-specific incidence estimates, and de novo outcome trees were developed for four infections (herpes zoster, rotavirus, respiratory syncytial virus [RSV], and varicella) not covered by the toolkit. Age/sex specific incidences were estimated based on data from the Spanish Network of Epidemiological Surveillance; hospitalisation and mortality rates were collected from the Minimum Basic Data Set. A literature review was performed to design the de novo models and obtain the rest of the parameters. The methodology, assumptions, data inputs and results were validated by a group of experts in epidemiology and disease modelling, immunization and public health policy.

RESULTS

The total burden of disease amounted to 163.54 annual DALYs/100,000 population. Among the selected twelve diseases, respiratory infections represented around 90% of the total burden. Influenza exhibited the highest burden, with 110.00 DALYs/100,000 population, followed by invasive pneumococcal disease and RSV, with 25.20 and 10.57 DALYs/100,000 population, respectively. Herpes zoster, invasive meningococcal disease, invasive Haemophilus influenza infection and hepatitis B virus infection ranked lower with fewer than 10 DALYs/100,000 population each, while the rest of the infections had a limited burden (< 1 DALY/100,000 population). A higher burden of disease was observed in the elderly (≥ 60 years) and children < 5 years, with influenza being the main cause. In infants < 1 year, RSV represented the greatest burden.

CONCLUSIONS

Aligned with the BCoDE study, the results of this analysis show a persisting high burden of immunization-preventable respiratory infections in Spain and, for the first time, highlight a high number of DALYs due to RSV. These estimates provide a basis to guide prevention strategies and make public health decisions to prioritise interventions and allocate healthcare resources in Spain.

Willingness to receive mpox vaccine among men who have sex with men: a systematic review and meta-analysis

BACKGROUND

Since May 2022, mpox outbreaks have been occurring in non-mpox endemic areas, with the main population affected being men who have sex with men (MSM). Outbreak prevention and control depend not only on the effectiveness of vaccines but also on people's willingness to receive these vaccines. Currently, there is lack of synthesis on the overall rates and influence factors of MSMs' willingness to vaccinate against mpox. Therefore, we systematically reviewed studies that assessed the willingness of MSM to receive mpox vaccine.

METHODS

Studies reporting mpox vaccination intentions among MSM were included by searching five databases (PubMed, Web of Science, EMBASE, CINAHL, and SCOPUS) from inception to May 12, 2024. The quality of the included literature was assessed using Joanna Briggs Institute's critical appraisal tool. The data analysis software is Stata17. The systematic review has been registered with Prospero (registration ID: CRD42023452357).

RESULTS

Twenty cross-sectional studies were included in the review. Meta-analysis results showed that the pooled willingness rate of vaccinate against mpox was 77.0% (95% CI: 73-81%, I2 = 99.4%). According to subgroup analysis, study countries (P = 0.002), research sample size (P = 0.001), and whether participants were infected with HIV (P = 0.002) may be sources of heterogeneity. The results of the meta-analysis of influencing factors showed that more number of sexual partners (OR: 2.24, 95%CI: 1.86-2.69), pre-exposure prophylaxis use (OR: 6.04, 95%CI: 4.80-7.61), history of sexually transmitted infections (OR: 2.96, 95%CI: 2.33-3.76), confidence in the vaccine's effectiveness (OR: 2.79, 95%CI: 2.04-3.80) and safety (OR: 10.89, 95%CI: 5.22-22.72), fear of mpox infection (OR: 2.47, 95%CI: 2.11-2.89) and epidemics (OR: 2.87, 95%CI: 2.22-3.70), high mpox knowledge (OR: 2.35, 95%CI: 1.51-3.66), and the belief that people at high risk should be prioritized for vaccination (OR: 3.09, 95%CI: 1.40-6.84) were the facilitators of vaccine willingness. In addition, as a secondary outcome, meta-analysis results showed a pooled unwillingness rate of 16% (95% CI: 13-20%, I2 = 98.1%, 9 studies).

CONCLUSION

Willingness to vaccinate mpox was high among MSM, but some participants still had negative attitudes towards vaccination. Therefore, the Ministry of Public Health should develop targeted and effective strategies against those influencing factors to prevent and manage mpox outbreaks.

One World, One Health: Zoonotic Diseases, Parasitic Diseases, and Infectious Diseases

When we take into account how the boundaries between human, animal, and environmental health are inextricably linked and increasingly intertwined, it comes as no surprise that the One Health approach has assumed an unprecedented level of importance over the past decade [...].

Risk Assessment Tools from the One Health Perspective: A Narrative Review

Background

61% of the infections around the world that have emerged to date are zoonotic. Evidence warns that the threat posed by zoonoses is on the rise, and the risk of a new pandemic is higher now than ever. Early identification of risk, populations at risk, and risk of transmission are essential steps towards a prevention, preparation and response to outbreaks. This review aims to look at the tools available for identifying and estimating risks and threats from one health perspective and finally propose a list of indicators which could assess the risk of transmission of disease at the humans, animals and the environment intersection.

Methods

The databases like PubMed, google scholar, Embase and Scopus were used to extract the relevant articles. A search was carried out using a keyword. A total of 1311 articles were listed initially after the search and reviewed. Out of 1311, only 26 tools which assessed the risk of diseases mainly infectious or were relevant to risk of transmission of any infectious diseases were included in the review.

Results

The tools included in this review involve risk assessment at the environmental, animal and human dimensions. The tools are used to evaluate the contamination of the environment due to chemicals or toxins or the risk of transmission of infection due to environmental factors like air contamination, to identify the animal diseases like bovine respiratory disease and foot and mouth disease and to estimate the human health risk at the community or individual levels.

Conclusion

Risk assessment tools are an essential part of the prevention of pandemics. These tools are helpful in assessing the risk of transmission of infections either from human to human, between human and animals, between animals and animals and so on. Thus this review gives us an insight into the existing risk assessment tools and the need for a One Health risk assessment tools to prevent outbreaks in future. It also provides a list of factors that can be included in a one health risk assessment tool.

Holistic One Health Surveillance Framework: Synergizing Environmental, Animal, and Human Determinants for Enhanced Infectious Disease Management

Recent pandemics, including the COVID-19 outbreak, have brought up growing concerns about transmission of zoonotic diseases from animals to humans. This highlights the requirement for a novel approach to discern and address the escalating health threats. The One Health paradigm has been developed as a responsive strategy to confront forthcoming outbreaks through early warning, highlighting the interconnectedness of humans, animals, and their environment. The system employs several innovative methods such as the use of advanced technology, global collaboration, and data-driven decision-making to come up with an extraordinary solution for improving worldwide disease responses. This Review deliberates environmental, animal, and human factors that influence disease risk, analyzes the challenges and advantages inherent in using the One Health surveillance system, and demonstrates how these can be empowered by Big Data and Artificial Intelligence. The Holistic One Health Surveillance Framework presented herein holds the potential to revolutionize our capacity to monitor, understand, and mitigate the impact of infectious diseases on global populations.

Whole Genome Sequencing: Applications in Clinical Bacteriology

The success in determining the whole genome sequence of a bacterial pathogen was first achieved in 1995 by determining the complete nucleotide sequence of Haemophilus influenzae Rd using the chain-termination method established by Sanger et al. in 1977 and automated by Hood et al. in 1987. However, this technology was laborious, costly, and time-consuming. Since 2004, high-throughput next-generation sequencing technologies have been developed, which are highly efficient, require less time, and are cost-effective for whole genome sequencing (WGS) of all organisms, including bacterial pathogens. In recent years, the data obtained using WGS technologies coupled with bioinformatics analyses of the sequenced genomes have been projected to revolutionize clinical bacteriology. WGS technologies have been used in the identification of bacterial species, strains, and genotypes from cultured organisms and directly from clinical specimens. WGS has also helped in determining resistance to antibiotics by the detection of antimicrobial resistance genes and point mutations. Furthermore, WGS data have helped in the epidemiological tracking and surveillance of pathogenic bacteria in healthcare settings as well as in communities. This review focuses on the applications of WGS in clinical bacteriology.

Sustainable Dengue Prevention and Management: Integrating Dengue Vaccination Strategies with Population Perspectives

The GEMKAP study (2023) unveiled consistent knowledge, attitude, and practice (KAP) levels across Asia-Pacific (APAC) and Latin America (LATAM) countries regarding dengue, with variations in the willingness to vaccinate. Despite an overall KAP parity, the disparities within and between the countries indicated the need for both overarching and tailored strategies. Population-wide gaps in dengue awareness result in suboptimal vaccination priorities and preventive measures. This commentary delves into identifying the drivers and barriers for implementing a multi-pronged dengue prevention and management program, emphasizing the pivotal role of vaccination alongside education and vector control. Drawing on expert interviews in APAC and LATAM, informed by the Consolidated Framework for Implementation Research (CFIR), four key themes emerged: prioritizing and continuously advocating for dengue on national health agendas, fostering stakeholder collaboration, incorporating population perspectives for behavioral change, and designing sustainable dengue prevention and management programs. Successful implementation requires evidence-based decision making and a comprehensive understanding of population dynamics to design adaptive education tailored to diverse population views. This commentary provides actionable strategies for enhancing dengue prevention and management, with a pronounced emphasis on dengue vaccination, advocating for a holistic, population-centric approach for sustained effectiveness.

The Association between Term Chorioamnionitis during Labor and Long-Term Infectious Morbidity of the Offspring

Background: Chorioamnionitis during labor exposes the fetus to an intrauterine state that may alter the future immune response and may expose the offspring to future susceptibility to infectious disease. We evaluated the long-term pediatric infectious morbidity of children born at term to mothers who have chorioamnionitis during labor. Methods: This was a population-based cohort analysis including only term singleton deliveries at a regional tertiary hospital between the years 1991 and 2021. Offspring to mothers with and without a diagnosis of chorioamnionitis during labor were compared. Offspring hospitalizations up to the age of 18 years involving infectious morbidity were evaluated using the Kaplan-Meier survival curve and a Cox regression model to control possible confounders. Results: A total of 331,598 deliveries were included, 988 (0.3%) of which were of mothers diagnosed with chorioamnionitis during labor. All infectious morbidity rates included in the analysis were comparable between groups. The Kaplan-Meier survival curves were similar for both groups (log-rank = 0.881) and the multivariable analysis ascertained that chorioamnionitis during labor was not a risk factor for offspring's long-term infectious morbidity (HR 0.929, 95%CI 0.818-1.054, p = 0.254). Conclusions: In our cohort, term chorioamnionitis during labor was not associated with a higher risk of pediatric hospitalization due to infections. The infectious/inflammatory state during labor did not expose nor increase the susceptibility of the term offspring to future infectious morbidity.

Prevalence of intentions to receive monkeypox vaccine. A systematic review and meta-analysis

BACKGROUND

Immunization, as a preventive strategy against infectious diseases, has consolidated its position as a fundamental pillar in the field of public health. Therefore, the present study aimed to determine the prevalence of the intention to receive the monkeypox (Mpox) vaccine.

METHODS

A systematic review and meta-analysis of the available evidence was performed using five databases (PubMed, Scopus, Web of Science, Embase, and ScienceDirect) with a search strategy until July 24, 2023. Data analysis was performed in R software version 4.2.3. The quality of the included cross-sectional studies was assessed using the "JBI-MAStARI". In addition, a subgroup analysis by population and continent was developed.

RESULTS

Twenty-nine cross-sectional articles with a total sample of 52 658 participants were included. The pooled prevalence of intention to vaccinate against Mpox was 61% (95% CI: 53-69%; 52,658 participants; 29 studies; I2 = 100%). In the subgroup analysis, the intention to be vaccinated against Mpox according to continents was 64% (95% CI: 53-74%; 13,883 participants; 17 studies; I2 = 99%) in Asian countries, 43% (95% CI: 39-47%; 1538 participants; 3 studies; I2 = 53%) in African countries, 62% (95% CI: 45-78%; 35,811 participants; 6 studies; I2 = 99%) in European countries, and 63% (95% CI: 32-89%; 1426 participants; 3 studies; I2 = 99%) in American countries. In the subgroup analysis on the intention to be vaccinated against Mpox, according to study subjects, it was 54% (95% CI: 45-62%; 10,296 participants; 11 studies; I2 = 99%) in the general population, 57% (95% CI: 33-79%; 3333 participants; 10 studies; I2 = 99%) in health care workers, and 76% (95% CI: 70-82%; 39,029 participants; 8 studies; I2 = 98%) in the lesbian, gay, bisexual, transgender, and intersex (LGBTI) community. In addition, as a secondary outcome, a prevalence of refusal of Mpox vaccination was found to be 22% (95% CI: 16-30%; 45,577 participants; 21 studies; I2 = 99%).

CONCLUSION

The study highlights the importance of recognizing regional and subgroup disparities in Mpox vaccine willingness and refusal. It emphasizes the importance of employing strategies to achieve widespread vaccination coverage and safeguard public health worldwide.

TERMS USED

Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI), Prospective International Registry of Systematic Reviews (PROSPERO), and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

A Cross-Sectional Survey of Knowledge, Attitude, and Practices Regarding Influenza Vaccination Among Jordanians Aged 18-64 Years with Chronic Diseases

Objectives

Influenza is a frequent infectious disease that can be prevented and is associated with significant mortality and morbidity. The most economical way to prevent influenza is through vaccination, although this method is not widely used. This study aimed to assess the seasonal influenza vaccination rates and the knowledge and attitudes of Jordanian adults with chronic illnesses toward the influenza vaccine.

Materials and Methods

A cross-sectional design was employed. A 26-item online survey was used to gather data about patients' knowledge of and attitudes toward the influenza vaccine as well as their status as influenza vaccine recipients.

Results

A total of 19% of the 564 study participants received an influenza vaccination. Most (81%) of individuals reported inconsistent vaccination uptake. The most important factor affecting vaccination is the belief that the flu is not a threat (39%) and that their doctors did not advise them about the vaccination (32%). Participants with no health insurance and those with public insurance had a lower level of vaccination than those with private insurance (p= 0.008).

Conclusion

The adult population of Jordan with chronic diseases has subpar immunization rates. What is also revealed is a blatant misunderstanding about the value of routine influenza vaccination. These findings emphasize how urgently the public needs to be made aware of the effectiveness of the influenza vaccine.

Schistosoma transmission: scaling-up competence from hosts to ecosystems

In a One-Health context, it is urgent to establish the links between environmental degradation, biodiversity loss, and the circulation of pathogens. Here we review and literally draw a general vision of aquatic environmental factors that interface with Schistosoma species, agents of schistosomiasis, and ultimately modulate their transmission at the ecosystem scale. From this synthesis, we introduce the concept of ecosystem competence defined as 'the propensity of an ecosystem to amplify or mitigate an incoming quantity of a given pathogen that can be ultimately transmitted to their definitive hosts'. Ecosystem competence integrates all mechanisms at the ecosystem scale underlying the transmission risk of a given pathogen and offers a promising measure for operationalizing the One-Health concept.

Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis

AIMS

To summarise the evidence on barriers to and facilitators of population adherence to prevention and control measures for coronavirus disease 2019 (COVID-19) and other respiratory infectious diseases.

METHODS

A qualitative synthesis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and the Cochrane Effective Practice and Organization of Care: Qualitative Evidence Synthesis. We performed an electronic search on MEDLINE, Embase and PsycINFO from their inception to March 2023.

RESULTS

We included 71 studies regarding COVID-19, pneumonia, tuberculosis, influenza, pertussis and H1N1, representing 5966 participants. The measures reported were vaccinations, physical distancing, stay-at-home policy, quarantine, self-isolation, facemasks, hand hygiene, contact investigation, lockdown, infection prevention and control guidelines, and treatment. Tuberculosis-related measures were access to care, diagnosis and treatment completion. Analysis of the included studies yielded 37 barriers and 23 facilitators.

CONCLUSIONS

This review suggests that financial and social support, assertive communication, trust in political authorities and greater regulation of social media enhance adherence to prevention and control measures for COVID-19 and infectious respiratory diseases. Designing and implementing effective educational public health interventions targeting the findings of barriers and facilitators highlighted in this review are key to reducing the impact of infectious respiratory diseases at the population level.

Universal Tick Vaccines: Candidates and Remaining Challenges

Recent advancements in molecular biology, particularly regarding massively parallel sequencing technologies, have enabled scientists to gain more insight into the physiology of ticks. While there has been progress in identifying tick proteins and the pathways they are involved in, the specificities of tick-host interaction at the molecular level are not yet fully understood. Indeed, the development of effective commercial tick vaccines has been slower than expected. While omics studies have pointed to some potential vaccine immunogens, selecting suitable antigens for a multi-antigenic vaccine is very complex due to the participation of redundant molecules in biological pathways. The expansion of ticks and their pathogens into new territories and exposure to new hosts makes it necessary to evaluate vaccine efficacy in unusual and non-domestic host species. This situation makes ticks and tick-borne diseases an increasing threat to animal and human health globally, demanding an urgent availability of vaccines against multiple tick species and their pathogens. This review discusses the challenges and advancements in the search for universal tick vaccines, including promising new antigen candidates, and indicates future directions in this crucial research field.

Knowledge, Attitude and Conspiracy Beliefs of Healthcare Workers in Lebanon towards Monkeypox

The emergence of a monkeypox (MPOX) outbreak in 2022 represented the most recent recognizable public health emergency at a global level. Improving knowledge and attitude towards MPOX, particularly among healthcare workers (HCWs), can be a valuable approach in public health preventive efforts aiming to halt MPOX virus spread. The aim of the current study was to evaluate the knowledge and attitude of HCWs in Lebanon towards MPOX and to assess their conspiratorial attitude towards emerging virus infections (EVIs). The current study was based on a cross-sectional online survey distributed via Google Forms during September-December 2022 implementing a convenience sampling approach. The final study sample comprised a total of 646 HCWs: physicians (n = 171, 26.5%), pharmacists (n = 283, 43.8%), and nurses (n = 168, 26.0%), among others (n = 24, 3.7%). Variable defects in MPOX knowledge were detected, with a third of the participants having MPOX knowledge above the 75th percentile (n = 218, 33.7%). Satisfactory attitude towards MPOX (>75th percentile) was observed in less than a third of the participants (n = 198, 30.7%), while a quarter of the study sample endorsed conspiracy beliefs towards EVIs at a high level (>75th percentile, n = 164, 25.4%). Slightly more than two thirds of the participants agreed that MPOX vaccination should be used in disease prevention (n = 440, 68.1%). Better levels of MPOX knowledge and attitude were significantly associated with postgraduate education and older age. Physicians had significantly higher MPOX knowledge compared to other occupational categories. Less endorsement of conspiracies towards EVIs was significantly associated with male sex, occupation as a physician, and postgraduate education. Higher MPOX knowledge was associated with better attitude towards the disease. The current study showed unsatisfactory MPOX knowledge among Lebanese HCWs. Educational efforts can be valuable to improve the attitude towards the disease. Despite the relatively low level of embracing conspiracy beliefs regarding EVIs among HCWs in this study compared to previous studies, this area should be considered based on its potential impact on health-seeking behavior.

Soil-transmitted helminths detected from environmental samples in a campus of southern Brazil

Soil harbours enormous biodiversity, essential for maintaining environmental and human health. However, soil can also be a reservoir of various parasitic pathogens, such as soil-transmitted helminths (STH). We evaluated the presence of STH (e.g., hookworms, roundworms and whipworms) in soil samples collected at twenty points within the perimeter of Campus do Vale (a university campus belonging to the Federal University of Rio Grande do Sul - UFRGS), during 2022 winter season. Considering the One Health perspective, human, animal and environment-related data from each sampling point were collected. All soil samples showed nematode larvae, representing natural components of soil biodiversity. Considering STH eggs, 35% (n = 7) of soil samples showed hookworm eggs (e.g., from Necator americanus or Ancylostoma duodenale), 10% (n = 2) showed roundworm (Ascaris lumbricoides) eggs, and 5% (n = 1) showed whipworm (Trichuris trichiura-like) eggs. Of note, 10% of the sampling points showed the presence of rhabditiform hookworm larvae, 5% showed Strongyloides stercoralis rhabditiform larvae and 5% had the presence of filariform hookworm larvae, indicating a risk of human percutaneous infection. The significant people circulation in Campus do Vale, in association with other environment-related factors, help to explain the prevalence of STH observed in this study.

Iron deficiency and soil-transmitted helminth infection: classic and neglected connections

Beyond participating in the oxygen transport by red blood cells, iron is an essential micronutrient and contributes to different physiological pathways and processes, such as cell proliferation, DNA repair, and other homeostatic functions. Iron deficiency affects millions of people, especially children and pregnant women. The consequences of iron deficiency are diverse, including inadequate child development, impaired cognition, and reduced productivity. Several factors contribute to iron deficiency, such as iron-poor diet, genetic factors, and infection with soil-transmitted helminths (STHs), especially roundworms (Ascaris lumbricoides), hookworms (Necator americanus and Ancylostoma duodenale), and whipworms (Trichuris trichiura). This review updates and summarizes the role of STHs as drivers of iron deficiency. Also, the poorly explored connections between STH infection, geophagia (a pica manifestation), immune response, and iron deficiency are discussed, highlighting how iron deficiency may act as a risk factor for infections by STHs, in addition to being a consequence of intestinal parasitic infections. Finally, strategies for control and management of iron deficiency and STH infection are described.

Ingraining Polio Vaccine Acceptance through Public Service Advertisements in the Digital Era: The Moderating Role of Misinformation, Disinformation, Fake News, and Religious Fatalism

Recently, misinformation and disinformation, as well as fake news, have become global threats to public health owing to their role in spreading viral health hazard information. The growing explosive religious fatalistic views presented on social media and widespread misinformation, disinformation, and fake news can result in detrimental outcomes in adopting protective behavior. The moderating implications of misinformation and religious fatalism can be severe, leading to adverse effects on polio vaccine acceptance. Consequently, this research provides brief empirical evidence on the efficacy of risk communication strategies to address polio vaccine reluctance in a digital age landscape, an area that remains understudied. This research argues that the spread of misinformation, disinformation, fake news, and religious fatalism is not solely the bane of the polio vaccine, but rather represents the absence of risk communication strategies. The study opines that polio vaccine acceptance can be improved using risk communication strategies. Recognizing these risk factors and counter-risk communication strategies, this research tested a theoretical model using the cross-sectional survey design. Overall, data was collected from 2160 parents with children aged below five years. The results, based on structural equation modeling, revealed that public service advertisements are an effective tool to counter the inverse impacts of misinformation, disinformation, fake news, and religious fatalism. Furthermore, the inverse moderating role of misinformation, disinformation, fake news, and religious fatalism has been verified to potentially diminish polio vaccine acceptance. These results suggest that healthcare providers must identify and address all forms of digitally disseminated information that encumbers public health behaviors. Accordingly, this research recognized the utilization of evidence-based strategic communication campaigns to cultivate and encourage the literacy necessary to counter health hazard information, including misinformation. This study's findings will benefit health and other concerned authorities in utilizing strategic communication on different media platforms to reduce or eradicate the polio endemic.

Synthesizing the connections between environmental disturbances and zoonotic spillover

Zoonotic spillover is a phenomenon characterized by the transfer of pathogens between different animal species. Most human emerging infectious diseases originate from non-human animals, and human-related environmental disturbances are the driving forces of the emergence of new human pathogens. Synthesizing the sequence of basic events involved in the emergence of new human pathogens is important for guiding the understanding, identification, and description of key aspects of human activities that can be changed to prevent new outbreaks, epidemics, and pandemics. This review synthesizes the connections between environmental disturbances and increased risk of spillover events based on the One Health perspective. Anthropogenic disturbances in the environment (e.g., deforestation, habitat fragmentation, biodiversity loss, wildlife exploitation) lead to changes in ecological niches, reduction of the dilution effect, increased contact between humans and other animals, changes in the incidence and load of pathogens in animal populations, and alterations in the abiotic factors of landscapes. These phenomena can increase the risk of spillover events and, potentially, facilitate new infectious disease outbreaks. Using Brazil as a study model, this review brings a discussion concerning anthropogenic activities in the Amazon region and their potential impacts on spillover risk and spread of emerging diseases in this region.

Examining the paradox of urban disease ecology by linking the perspectives of Urban One Health and Ecology with Cities

The ecology of zoonotic, including vector-borne, diseases in urban social-ecological systems is influenced by complex interactions among human and environmental factors. Several characteristics contribute to the emergence and spread of infectious diseases in urban places, such as high human population densities, favorable habitat for vectors, and humans' close proximity to animals and their pathogens. On the other hand, urban living can contribute to the improvement of public health through better access to health services and creation of ecological and technological infrastructure that reduces disease burdens. Therefore, urbanization creates a disease ecology paradox through the interplay of urban health penalties and advantages for individual and community outcomes. To address this contradiction, we advocate a holistic Urban One Health perspective for managing urban systems, especially their green spaces and animal populations, in ways that more effectively control the spread of zoonotic diseases. This view should be coupled with an Ecology with Cities approach which emphasizes actionable science needed for urban planning, management and policymaking; developing disease and vector surveillance programs using citizen and community science methods; and improving education and communication actions that help diverse stakeholders understand the complexities of urban disease ecology. Such measures will enable scholars from many disciplines to collaborate with professionals, government officials, and others to tackle challenges of the urban disease paradox and create more sustainable, health-promoting environments.

Landscape Composition Affects Elements of Metacommunity Structure for Culicidae Across South-Eastern Illinois

The interplay among invasive alien vectors and the species assemblage of native potential vectors in areas of range expansion may affect the dynamics of pathogen transmission. In this study we investigate how Aedes albopictus, an invasive mosquito of considerable public health concern fits within mosquito communities at the edge of its range of distribution. This was addressed using a 2-year field survey of mosquitoes in south-eastern Illinois. We found that Ae. albopictus was more broadly distributed in this region than previously realized, with new occurrence records for nine counties. Abundance of this species varied strongly and peaked in locations of low-intermediate overall mosquito species richness. This differed from overall mosquito abundance, as well as abundance of another important vector, Cx. pipiens, for which the abundance-richness relationships were best described with power functions. Metacommunity analyses revealed that mosquito communities showed a non-random distribution with a Clementsian gradient, which suggests a pattern whereby distinct species assemblages are associated with specific habitats or environmental conditions. Land use was a significant underlying factor shaping mosquito community structure and species assemblages. Multivariate analyses showed that while Ae. canadensis and Cx. pipiens complex mosquitoes were associated with high and low proportions of wetlands in the environment, respectively, Ae. albopictus was most strongly associated with urban settlements. This work sheds light on landscape-level processes, such as niche differentiation driven by urban and agricultural development, structuring mosquito communities. We suggest that mosquito community assessments across habitats be incorporated as part of a One Health vector surveillance approach to aid in the goal of prediction and prevention of new and (re-)emerging vector-borne diseases.

Food security and emerging infectious disease: risk assessment and risk management

Climate change, emerging infectious diseases (EIDs) and food security create a dangerous nexus. Habitat interfaces, assumed to be efficient buffers, are being disrupted by human activities which in turn accelerate the movement of pathogens. EIDs threaten directly and indirectly availability and access to nutritious food, affecting global security and human health. In the next 70 years, food-secure and food-insecure countries will face EIDs driving increasingly unsustainable costs of production, predicted to exceed national and global gross domestic products. Our modern challenge is to transform this business as usual and embrace an alternative vision of the biosphere formalized in the Stockholm paradigm (SP). First, a pathogen-centric focus shifts our vision of risk space, determining how pathogens circulate in realized and potential fitness space. Risk space and pathogen exchange are always heightened at habitat interfaces. Second, apply the document-assess-monitor-act (DAMA) protocol developing strategic data for EID risk, to be translated, synthesized and broadcast as actionable information. Risk management is realized through targeted interventions focused around information exchanged among a community of scientists, policy practitioners of food and public health security and local populations. Ultimately, SP and DAMA protect human rights, supporting food security, access to nutritious food, health interventions and environmental integrity.

Perception, knowledge and attitude towards influenza vaccine during COVID-19 pandemic in Jordanian population

INTRODUCTION

Seasonal influenza is considered as one of the major causes of morbidity and mortality worldwide. This needs solutions to decrease burdens on the healthcare systems especially during the Coronavirus Disease (COVID-19) pandemic. Population knowledge, perception and attitude towards influenza vaccine during COVID-19 pandemic could have a positive impact to decrease mortality, morbidity and burdens on the healthcare system. This study focuses on investigating knowledge, attitude and practice (KAP) of Jordanian adults towards influenza vaccine during COVID-19 pandemic.

METHODS

This cross-sectional study recruited 1112 randomly selected Jordanian adults. A four-part questionnaire was designed and included questions about the demographic and clinical characteristics, perception about influenza, attitudes towards the role of influenza vaccine during COVID-19 pandemic and the factors that affect respondents' practice towards influenza vaccine.

RESULTS

73.1% population were not vaccinated, and most were not willing to be vaccinated during the COVID-19 pandemic. 55% of the population thought that influenza vaccine decreased the burden on the Jordanian healthcare system. The major refusal factor to be vaccinated was because influenza was not considered as a threat (41.3%). People mostly got their information about influenza vaccine from social media (64.3%). The role of the pharmacist and physician was neglected.

CONCLUSIONS

The reinforcement of the role of pharmacists, physician and media to educate people about the importance of influenza vaccine during the COVID-19 pandemic is needed. Furthermore, campaigns should be conducted to increase the population awareness towards the importance of influenza vaccine uptake and its importance.

Evidence of bovine leukemia virus circulating in sheep and buffaloes in Colombia: insights into multispecies infection

Bovine leukemia virus (BLV) is the causative agent of leukemia/lymphoma in cattle. However, previous evidence has shown its presence in other species of livestock as well as in humans, suggesting that other species can be accidental hosts of the virus. In viral infections, receptors that are common to different animal species are proposed to be involved in cross-species infections. For BLV, AP3D1 has been proposed to be its receptor, and this protein is conserved in most mammalian species. In Colombia, BLV has been reported in cattle with high prevalence rates, but there has been no evidence of BLV infections in other animal species. In this study, we tested for the virus in sheep (n = 44) and buffaloes (n = 61) from different regions of Colombia by nested PCR, using peripheral blood samples collected from the animals. BLV was found in 25.7% of the animals tested (12 buffaloes and 15 sheep), and the results were confirmed by Sanger sequencing. In addition, to gain more information about the capacity of the virus to infect these species, the predicted interactions of AP3D1 of sheep and buffaloes with the BLV-gp51 protein were analyzed in silico. Conserved amino acids in the binding domains of the proteins were identified. The detection of BLV in sheep and buffaloes suggests circulation of the virus in multiple species, which could be involved in dissemination of the virus in mixed livestock production settings. Due to the presence of the virus in multiple species and the high prevalence rates observed, integrated prevention and control strategies in the livestock industry should be considered to decrease the spread of BLV.

Progression of the Pathway for Public Health Care during the COVID-19 Outbreak at District Health Office

Public health activities under district health offices (DHOs) play a major role in Malaysia's fight against COVID-19. This article aims to describe and illustrate the public health activity pathway in combating the COVID-19 pandemic, and a team of public health workers who are familiar with DHO work settings was created in April 2020 for that purpose. Review of documents and the Ministry of Health's updates was carried out, followed by a series of discussions with stakeholders. Based on the steps in the outbreak investigation tasks, the flow of activities from January to May 2020 was listed in line with the phases of the country's National Movement Control Order 2020. Results show that the activities can be classified into three different sections-namely, the main action areas, category of cases, and level of care. The main process flow of activities comprised the case management and support activities. Case management flow was split into tasks for patients under investigation and persons under surveillance, while the support services existed throughout the phases. The pathways illustrate that the progression of the pandemic translated directly to changes in the pattern of activities, with additional subgroups of activities in accordance with all imposed guidelines.

Industrial Animal Farming and Zoonotic Risk: COVID-19 as a Gateway to Sustainable Change? A Scoping Study

The threat of zoonoses (i.e., human infectious diseases transmitted from animals) because of industrial animal farming may be receiving less attention in society due to the putative wildlife origin of COVID-19. To identify societal responses to COVID-19 that do address or affect the risk of future zoonoses associated with industrial animal farming, the literature was screened for measures, actions, proposals and attitudes following the guidelines of a scoping review. Forty-one articles with relevant information published between 1 January 2020 and 30 April 2021 were identified directly or indirectly via bibliographies from 138 records retrieved via Google Scholar. Analysis of relevant content revealed ten fields of policy action amongst which biosecurity and change in dietary habits were the dominant topics. Further searches for relevant records within each field of policy action retrieved another eight articles. Identified responses were furthermore classified and evaluated according to groups of societal actors, implying different modes of regulation and governance. Based on the results, a suggested policy strategy is presented for moving away from food production in factory farms and supporting sustainable farming, involving the introduction of a tax on the demand side and subsidies for the development and production of alternative meat.

The vaccine coverage and vaccine immunity status and risk factors of non-protective levels of antibodies against vaccines in children with juvenile idiopathic arthritis: cross-sectional Russian tertiary Centre study

BACKGROUND

Immunosuppressive drugs, incomplete vaccine coverage, immune system dysregulation might be factors of a low level of anti-vaccine antibodies in JIA patients. The study aimed to evaluate vaccine coverage, post-vaccine immunity, and risk factors of non-protective levels of antibodies against measles, mumps, rubella, hepatitis B, and diphtheria in JIA patients.

METHODS

A cross-sectional study included 170 children diagnosed with JIA aged 2 to 17 years who received routine vaccinations against measles, rubella, mumps (MMR), diphtheria, and hepatitis B national vaccine schedule. In all patients, the levels of post-vaccination antibodies (IgG) for measles, rubella, mumps, hepatitis B, and diphtheria were measured with ELISA.

RESULTS

Protective level of antibodies were 50% against hepatitis B, 52% - diphtheria, 58% - measles, 80% - mumps, 98% rubella. MMR's best coverage had patients with enthesitis-related arthritis-85%, compared to oligoarthritis-70%, polyarthritis-69%, systemic arthritis-63%. Diphtheria coverage was 50, 51, 46, 63%, respectively. Incomplete MMR vaccination had 39% patients, treated with biologics, 22% with methotrexate and 14% with NSAID (p = 0.025), and 61, 46, 36% for diphtheria (p = 0.021). Incomplete vaccination was a risk factor of non-protective level of antibodies against measles (HR = 2.03 [95%CI: 1.02; 4.0], p = 0.042), mumps (HR = 6.25 [95%CI: 2.13; 17.9], p = 0.0008) and diphtheria (HR = 2.39 [95%CI: 1.18; 4.85], p = 0.016) vaccines, as well as JIA category, biologics, corticosteroids and long-term methotrexate treatment for distinct vaccines. One-third part of JIA patients continued vaccination against MMR and diphtheria without serious adverse events and JIA flare. There were no differences between patients who continued MMR vaccination or denied in the means of JIA category and treatment options. Patients, continued diphtheria vaccination rare received methotrexate (p = 0.02), biologics (p = 0.004), but had higher levels of anti-diphtheria antibodies (p = 0.024) compare who omitted vaccination. Methotrexate (OR = 9.5 [95%CI: 1.004; 90.3]) and biologics (OR = 4.4 [95%CI: 1.6; 12.1]) were predictors of omitted diphtheria revaccination.

CONCLUSION

Children with JIA may have lower anti-vaccine antibody levels and required routine checks, especially in children with incomplete vaccination, biologics, systemic arthritis, and long-term methotrexate treatment. Revaccination of JIA patients was safe and effective.

Biothreat & One Health: Current scenario & way forward

There is an increased connectedness among humans, animals, and the environment and the current pandemic has taught the interlinking of the health of humans, animals and the planet. This inter-connectedness and factors like population growth, migration, urbanization, and climate change contribute significantly to the enhanced probability of emergence of previously unknown wildlife source pathogens at any place, any time, and without warning. Lurking in the background is the massive potential for the deliberate use of biological agents as weapons by State or non-State entities. Biological weapons have been used in wars since antiquity, however, newer research and techniques have led to these being real threats with a vast potential of harm to humans, animals, and crops. Over a period, it has become increasingly difficult to differentiate between deliberate and natural biothreat incidents. The response to both types is alike to safeguard lives, livestock, crops and the environment and reduce the consequent socio-economic ramifications. Biothreat may be targeted towards humans, animals, or crops, or all these concurrently. Every country including India is at risk of biothreat. The concept of one health is thus essential for responding to emerging infectious diseases or biothreats. Comprehensive surveillance for early detection, reporting and early concerted action is needed for prevention and blunting the effect of biothreats, which require close coordination and collaboration among various stakeholders within each country as well as globally.

Variability in human attractiveness to mosquitoes

Blood-feeding mosquitoes locate humans spatially by detecting a combination of human-derived chemical signals, including carbon dioxide, lactic acid, and other volatile organic compounds. Mosquitoes use these signals to differentiate humans from other animals. Spatial abiotic factors (e.g. humidity, heat) are also used by mosquitoes to find a host. Mosquitoes cause discomfort and harm to humans, being vectors of many pathogens. However, not all humans suffer from mosquito bites with the same frequency or intensity. Some individuals are more attractive to mosquitoes than others, and this has an important impact on the risk of infection by pathogens transmitted by these vectors, such as arboviruses and malaria parasites. Variability in human attractiveness to mosquitoes is partially due to individual characteristics in the composition and intensity in the release of mosquito attractants. The factors that determine these particularities are diverse, modestly understood and still quite controversial. Thus, this review discusses the role of pregnancy, infection with malaria parasites (Plasmodium spp.), skin microbiota, diet, and genetics in human attractiveness to mosquitoes. In brief, pregnancy and Plasmodium infection increase the host attractiveness to mosquitoes. Skin microbiota and human genetics (especially HLA alleles) modulate the production of mosquito attractants and therefore influence individual susceptibility to these insects. There is evidence pointing to a role of diet on human susceptibility to mosquitoes, with some dietary components having a bigger influence than others. In the last part of the review, other factors affecting human-mosquito interactions are debated, with a special focus on the role of mosquito genetics, pathogens and environmental factors (e.g. wind, environmental disturbances). This work highlights that individual susceptibility to mosquitoes is composed of interactions of different human-associated components, environmental factors, and mosquito characteristics. Understanding the importance of these factors, and how they interact with each other, is essential for the development of better mosquito control strategies and studies focused on infectious disease dynamics.

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Individual human attractiveness to mosquitoes is highly variable.

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Mosquito attractants released into the air vary from person to person.

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Variation in attractiveness to mosquitoes alters the risk of mosquito-borne infections.

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Pregnancy, malaria infection, skin microbiota and genetic factors alter the release of mosquito attractants.

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Environment and mosquito-related factors affect human–mosquito interactions.