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Samkange A, Mbiri P, Matomola OC, Zaire G, Homateni A, Junias E, Kaatura I, Khaiseb S, Ekandjo S, Shoopala J, Hausiku M, Shilongo A, Mujiwa ML, Dietze K, Busch F, Winter C, Matos C, Weiss S, Chitanga S. Serological Evidence of Crimean-Congo Haemorrhagic Fever in Livestock in the Omaheke Region of Namibia. Microorganisms 2024; 12:838. [PMID: 38674782 PMCID: PMC11051821 DOI: 10.3390/microorganisms12040838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/10/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
This research examined the positivity ratio of Crimean-Congo haemorrhagic fever (CCHF) antibodies in cattle and sheep within Namibia's Omaheke region after a human disease outbreak in the same geographical area. A total of 200 samples (100 cattle and 100 sheep) were randomly collected from animals brought to two regional auction sites, and then tested using the ID Screen® CCHF Double Antigen Multi-Species Enzyme-Linked Immunosorbent Assay kit. Of the cattle samples, 36% tested positive, while 22% of the sheep samples were seropositive. The cattle had a significantly higher positivity ratio than sheep at the individual animal level (p = 0.0291). At the herd level, 62.5% of cattle herds and 45.5% of sheep flocks had at least one positive animal, but this difference was statistically insignificant (p = 0.2475). The fourteen cattle farms with at least one seropositive animal were dispersed across the Omaheke region. In contrast, the ten sheep farms with seropositive cases were predominantly situated in the southern half of the region. The study concluded that the CCHF is endemic in the Omaheke region and likely in most of Namibia, underscoring the importance of continued surveillance and preventive measures to mitigate the impact of CCHFV on animal health and potential spillover into human populations.
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Affiliation(s)
- Alaster Samkange
- School of Veterinary Medicine, Faculty of Health Sciences & Veterinary Medicine, University of Namibia, Private Bag 13301, Windhoek 10005, Namibia; (A.S.); (P.M.); (O.C.M.); (I.K.); (S.K.); (M.L.M.)
| | - Pricilla Mbiri
- School of Veterinary Medicine, Faculty of Health Sciences & Veterinary Medicine, University of Namibia, Private Bag 13301, Windhoek 10005, Namibia; (A.S.); (P.M.); (O.C.M.); (I.K.); (S.K.); (M.L.M.)
| | - Ophelia Chuma Matomola
- School of Veterinary Medicine, Faculty of Health Sciences & Veterinary Medicine, University of Namibia, Private Bag 13301, Windhoek 10005, Namibia; (A.S.); (P.M.); (O.C.M.); (I.K.); (S.K.); (M.L.M.)
| | - Georgina Zaire
- Directorate of Veterinary Services, Ministry of Agriculture, Water and Land Reform, Private Bag 13184, Windhoek 10005, Namibia; (G.Z.); (A.H.); (E.J.); (S.E.); (J.S.); (M.H.); (A.S.)
| | - Anna Homateni
- Directorate of Veterinary Services, Ministry of Agriculture, Water and Land Reform, Private Bag 13184, Windhoek 10005, Namibia; (G.Z.); (A.H.); (E.J.); (S.E.); (J.S.); (M.H.); (A.S.)
| | - Elifas Junias
- Directorate of Veterinary Services, Ministry of Agriculture, Water and Land Reform, Private Bag 13184, Windhoek 10005, Namibia; (G.Z.); (A.H.); (E.J.); (S.E.); (J.S.); (M.H.); (A.S.)
| | - Israel Kaatura
- School of Veterinary Medicine, Faculty of Health Sciences & Veterinary Medicine, University of Namibia, Private Bag 13301, Windhoek 10005, Namibia; (A.S.); (P.M.); (O.C.M.); (I.K.); (S.K.); (M.L.M.)
| | - Siegfried Khaiseb
- School of Veterinary Medicine, Faculty of Health Sciences & Veterinary Medicine, University of Namibia, Private Bag 13301, Windhoek 10005, Namibia; (A.S.); (P.M.); (O.C.M.); (I.K.); (S.K.); (M.L.M.)
- Directorate of Veterinary Services, Ministry of Agriculture, Water and Land Reform, Private Bag 13184, Windhoek 10005, Namibia; (G.Z.); (A.H.); (E.J.); (S.E.); (J.S.); (M.H.); (A.S.)
| | - Simson Ekandjo
- Directorate of Veterinary Services, Ministry of Agriculture, Water and Land Reform, Private Bag 13184, Windhoek 10005, Namibia; (G.Z.); (A.H.); (E.J.); (S.E.); (J.S.); (M.H.); (A.S.)
| | - Johannes Shoopala
- Directorate of Veterinary Services, Ministry of Agriculture, Water and Land Reform, Private Bag 13184, Windhoek 10005, Namibia; (G.Z.); (A.H.); (E.J.); (S.E.); (J.S.); (M.H.); (A.S.)
| | - Magrecia Hausiku
- Directorate of Veterinary Services, Ministry of Agriculture, Water and Land Reform, Private Bag 13184, Windhoek 10005, Namibia; (G.Z.); (A.H.); (E.J.); (S.E.); (J.S.); (M.H.); (A.S.)
| | - Albertina Shilongo
- Directorate of Veterinary Services, Ministry of Agriculture, Water and Land Reform, Private Bag 13184, Windhoek 10005, Namibia; (G.Z.); (A.H.); (E.J.); (S.E.); (J.S.); (M.H.); (A.S.)
| | - Mushabati Linus Mujiwa
- School of Veterinary Medicine, Faculty of Health Sciences & Veterinary Medicine, University of Namibia, Private Bag 13301, Windhoek 10005, Namibia; (A.S.); (P.M.); (O.C.M.); (I.K.); (S.K.); (M.L.M.)
| | - Klaas Dietze
- Institute of International Animal Health/One Health, Friedrich-Loeffler Institute, 17489 Greifswald, Germany; (K.D.); (F.B.)
| | - Frank Busch
- Institute of International Animal Health/One Health, Friedrich-Loeffler Institute, 17489 Greifswald, Germany; (K.D.); (F.B.)
| | - Christian Winter
- Centre for International Health Protection, Robert Koch Institute, 13353 Berlin, Germany; (C.W.); (C.M.); (S.W.)
| | - Carolina Matos
- Centre for International Health Protection, Robert Koch Institute, 13353 Berlin, Germany; (C.W.); (C.M.); (S.W.)
| | - Sabrina Weiss
- Centre for International Health Protection, Robert Koch Institute, 13353 Berlin, Germany; (C.W.); (C.M.); (S.W.)
| | - Simbarashe Chitanga
- School of Veterinary Medicine, Faculty of Health Sciences & Veterinary Medicine, University of Namibia, Private Bag 13301, Windhoek 10005, Namibia; (A.S.); (P.M.); (O.C.M.); (I.K.); (S.K.); (M.L.M.)
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, P.O. Box 50110, Lusaka 10101, Zambia
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Schädler J, Azeke AT, Ondruschka B, Steurer S, Lütgehetmann M, Fitzek A, Möbius D. Concordance between MITS and conventional autopsies for pathological and virological diagnoses. Int J Legal Med 2024; 138:431-442. [PMID: 37837537 PMCID: PMC10861633 DOI: 10.1007/s00414-023-03088-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/04/2023] [Indexed: 10/16/2023]
Abstract
In pandemics or to further study highly contagious infectious diseases, new strategies are needed for the collection of post-mortem tissue samples to identify the pathogen as well as its morphological impact. In this study, an ultrasound-guided minimally invasive tissue sampling (MITS) protocol was developed and validated for post-mortem use. The histological and microbiological qualities of post-mortem specimens were evaluated and compared between MITS and conventional autopsy (CA) in a series of COVID-19 deaths. Thirty-six ultrasound-guided MITS were performed. In five cases more, specimens for histological and virological examination were also obtained and compared during the subsequently performed CA. Summary statistics and qualitative interpretations (positive, negative) were calculated for each organ tissue sample from MITS and CA, and target genes were determined for both human cell count (beta-globin) and virus (SARS-CoV-2 specific E gene). There are no significant differences between MITS and CA with respect to the detectability of viral load in individual organs, which is why MITS can be of utmost importance and an useful alternative, especially during outbreaks of infectious diseases.
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Affiliation(s)
- Julia Schädler
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Akhator Terence Azeke
- Department of Anatomic Pathology, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marc Lütgehetmann
- Institute of Medical Microbiology, Virology, and Hygiene, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Antonia Fitzek
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dustin Möbius
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Adamu AM, Onoja AB, Ugbodu VE, Bala RS, Maina M, Salisu US, Pewan SB, David E, Malgwi A, Adamu C, Adeiza A, Herbert M, Horwood P, Adegboye O. Investigating Crimean-Congo haemorrhagic fever virus seropositivity in camels and human behavioural risks in an abattoir in Nigeria. Epidemiol Infect 2024; 152:e29. [PMID: 38299329 PMCID: PMC10894886 DOI: 10.1017/s0950268824000189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/15/2023] [Accepted: 01/07/2024] [Indexed: 02/02/2024] Open
Abstract
Crimean-Congo haemorrhagic fever virus (CCHFV) is an emerging viral pathogen with pandemic potential that is often misdiagnosed. Case fatality in low-resource settings could be up to 40% due to close contact between animals and humans. A two-year cross-sectional study was conducted in Fagge abattoir, Kano State, Nigeria, to estimate the seropositivity of CCHFV in camels using a commercial multi-species competitive enzyme-linked immunosorbent assay (ELISA). A closed-ended questionnaire was administered to the abattoir workers to assess their awareness, mitigation, and behavioural practices associated with CCHF. Of the 184 camels tested, 179 (97%) were seropositive for CCHFV (95% confidence interval (CI): 93.77, 99.11). The median (interquartile range (IQR)) age of respondents was 41 (35-52), with 62% having no education. Respondents had little knowledge about CCHFV and the concept of zoonotic disease. In this study, the high estimated prevalence of antibodies to CCHFV in camels highlights the heightened risk of transmission of CCHFV in Nigeria. Similarly, a concerning lack of knowledge and inadequate preventive practices, alongside a prevalence of high-risk behaviours associated with CCHF among abattoir workers, were noted in this study. Thus, there is an urgent need for comprehensive public health education and collaborative One Health strategies to avert the threats of spillover events.
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Affiliation(s)
- Andrew Musa Adamu
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Department of Veterinary Public Health and Preventive Medicine, University of Abuja, Abuja, Nigeria
| | | | - Victoria Ehinor Ugbodu
- Department of Veterinary Public Health and Preventive Medicine, University of Abuja, Abuja, Nigeria
| | | | - Meshach Maina
- Department of Veterinary Microbiology, University of Maiduguri, Borno, Nigeria
| | - Usman Shehu Salisu
- Department of Animal Science, Federal University Dutsin-Ma, Katsina State, Nigeria
| | | | - Emmanuel David
- Nigerian Field and Laboratory Training Programme, Abuja, Nigeria
| | - Arhyel Malgwi
- Nigerian Field and Laboratory Training Programme, Abuja, Nigeria
| | - Cornelius Adamu
- One Health (Man-Imal) Nantes College of Veterinary Medicine, Food Science and Engineering, University of Nantes, Nantes, France
| | - Abdulrahman Adeiza
- Department of Veterinary Public Health and Preventive Medicine, University of Abuja, Abuja, Nigeria
| | - Megan Herbert
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Paul Horwood
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Oyelola Adegboye
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory Australia
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Mumin FI, Fenton A, Osman AY, Mor SM. Zoonoses research in Somalia: A scoping review using a One Health approach. One Health 2023; 17:100626. [PMID: 38024257 PMCID: PMC10665144 DOI: 10.1016/j.onehlt.2023.100626] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/31/2023] [Indexed: 12/01/2023] Open
Abstract
Zoonoses are likely to cause a substantial burden on both human and animal health systems in Somalia, given the close proximity between the pastoralist majority and their livestock. However, decades of instability leading to weak disease surveillance have meant that data on the burden of zoonoses is lacking. The aim of this scoping review was to assess and synthesize the available literature on the presence and burden of zoonoses in Somalia. We used keywords to search Web of Science for relevant publications. Studies were included if they contained relevant data on a zoonosis and were undertaken in Somalia or were undertaken in another country where exposure could reasonably be assumed to have occurred in Somalia (e.g., migrants/refugees, returning soldiers, exported animals). Studies were not included if they focused on Somali ethnic communities permanently living elsewhere or if zoonotic aspects were not considered. We extracted data on disease(s) reported, geographic focus, data reported (human, animal, environment), study design and author affiliation. A total of 22 zoonotic infections were documented in 76 publications. The most frequently studied diseases were Rift Valley Fever (n = 15, 17%), brucellosis (n = 13, 14%) and hepatitis E (n = 10, 11%). Around 30% of papers reported data from relevant populations outside Somalia. Only 18 papers undertook laboratory analysis within Somalia. Most papers reported data on humans (45%) and animals (36%) with limited research on the environmental domain. Descriptive studies (47%) dominated and most were led by non-Somali researchers (89% in first authors and 95% of last authors). This study highlights the need for well-designed zoonoses research in Somalia supported by capacity building of local researchers and investments in diagnostic laboratories.
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Affiliation(s)
- Farah I. Mumin
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
- International Livestock Research Institute, Addis Ababa, Ethiopia
- Faculty of Veterinary Medicine, Red Sea University, Bosaso, Puntland State, Somalia
| | - Andy Fenton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
| | - Abdinasir Yusuf Osman
- Royal Veterinary College, University of London, London, United Kingdom
- National Institute of Health, Ministry of Health, Mogadishu, Somalia
| | - Siobhan M. Mor
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
- International Livestock Research Institute, Addis Ababa, Ethiopia
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Bao M, Waitkus J, Liu L, Chang Y, Xu Z, Qin P, Chen J, Du K. Micro- and nanosystems for the detection of hemorrhagic fever viruses. Lab Chip 2023; 23:4173-4200. [PMID: 37675935 DOI: 10.1039/d3lc00482a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Hemorrhagic fever viruses (HFVs) are virulent pathogens that can cause severe and often fatal illnesses in humans. Timely and accurate detection of HFVs is critical for effective disease management and prevention. In recent years, micro- and nano-technologies have emerged as promising approaches for the detection of HFVs. This paper provides an overview of the current state-of-the-art systems for micro- and nano-scale approaches to detect HFVs. It covers various aspects of these technologies, including the principles behind their sensing assays, as well as the different types of diagnostic strategies that have been developed. This paper also explores future possibilities of employing micro- and nano-systems for the development of HFV diagnostic tools that meet the practical demands of clinical settings.
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Affiliation(s)
- Mengdi Bao
- Department of Chemical and Environmental Engineering, University of California, Riverside, CA, USA.
| | - Jacob Waitkus
- Department of Chemical and Environmental Engineering, University of California, Riverside, CA, USA.
| | - Li Liu
- Department of Chemical and Environmental Engineering, University of California, Riverside, CA, USA.
| | - Yu Chang
- Department of Chemical and Environmental Engineering, University of California, Riverside, CA, USA.
| | - Zhiheng Xu
- Department of Industrial Engineering, Rochester Institute of Technology, Rochester, NY, USA
| | - Peiwu Qin
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
| | - Juhong Chen
- Department of Biological Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Ke Du
- Department of Chemical and Environmental Engineering, University of California, Riverside, CA, USA.
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Fereidouni M, Apanaskevich DA, Pecor DB, Pshenichnaya NY, Abuova GN, Tishkova FH, Bumburidi Y, Zeng X, Kuhn JH, Keshtkar-Jahromi M. Crimean-Congo hemorrhagic fever virus in Central, Eastern, and South-eastern Asia. Virol Sin 2023; 38:171-183. [PMID: 36669701 PMCID: PMC10926685 DOI: 10.1016/j.virs.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/03/2023] [Indexed: 01/19/2023] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF), caused by Crimean-Congo hemorrhagic fever virus (CCHFV), is endemic in Africa, Asia, and Europe, but CCHF epidemiology and epizootiology is only rudimentarily defined for most regions. Here we summarize what is known about CCHF in Central, Eastern, and South-eastern Asia. Searching multiple international and country-specific databases using a One Health approach, we defined disease risk and burden through identification of CCHF cases, anti-CCHFV antibody prevalence, and CCHFV isolation from vector ticks. We identified 2313 CCHF cases that occurred in 1944-2021 in the three examined regions. Central Asian countries reported the majority of cases (2,026). In Eastern Asia, China was the only country that reported CCHF cases (287). In South-eastern Asia, no cases were reported. Next, we leveraged our previously established classification scheme to assign countries to five CCHF evidence levels. Six countries (China, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan) were assigned to level 1 or level 2 based on CCHF case reports and the maturity of the countries' surveillance systems. Two countries (Mongolia and Myanmar) were assigned to level 3 due to evidence of CCHFV circulation in the absence of reported CCHF cases. Thirteen countries in Eastern and South-eastern Asia were categorized in levels 4 and 5 based on prevalence of CCHFV vector ticks. Collectively, this paper describes the past and present status of CCHF reporting to inform international and local public-health agencies to strengthen or establish CCHFV surveillance systems and address shortcomings.
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Affiliation(s)
- Mohammad Fereidouni
- Jahrom University of Medical Sciences (دانشگاه علوم پزشكي خدمات بهداشتی درمانی جهرم), Jahrom, Fars Province, 74148-46199, Iran
| | - Dmitry A Apanaskevich
- U.S. National Tick Collection, The James H. Oliver Jr. Institute for Coastal Plain Science, Georgia Southern University, Statesboro, GA 30458, USA; Zoological Institute of Russian Academy of Sciences (Зоологический институт Российской академии наук), 199034, St. Petersburg, Russia
| | - David B Pecor
- Walter Reed Biosystematics Unit, Department of Entomology, Smithsonian Institution, Suitland, MD 20746-2863, USA; One Health Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Natalia Yu Pshenichnaya
- Central Research Institute of Epidemiology (Центральный научно-исследовательский институт эпидемиологии), 111123, Moscow, Russia
| | - Gulzhan N Abuova
- South Kazakhstan Medical Academy (Оңтүстік Қазақстан медицина академиясы), Shymkent, 160016, Kazakhstan
| | - Farida H Tishkova
- Tajik Science and Research Institute of Preventive Medicine (Институти илмй-тадкикотии тибби профилактикии Тоцикистон), 734025 Dushanbe, Tajikistan
| | - Yekaterina Bumburidi
- Central Asian Office, Centers for Disease Control and Prevention, Almaty, 050010, Kazakhstan
| | - Xiankun Zeng
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD 21702, USA.
| | - Maryam Keshtkar-Jahromi
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
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Ahmed A, Abubakr M, Sami H, Mahdi I, Mohamed NS, Zinsstag J. The First Molecular Detection of Aedes albopictus in Sudan Associates with Increased Outbreaks of Chikungunya and Dengue. Int J Mol Sci 2022; 23:ijms231911802. [PMID: 36233103 PMCID: PMC9570206 DOI: 10.3390/ijms231911802] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 12/28/2022] Open
Abstract
As part of our surveys of the invasive malaria vector Anopheles stephensi in four Sudanese states, including North and South Kordofan, Sennar, and White Nile, we collected 166 larvae. Our morphological identification confirmed that 30% of the collected mosquito samples were Anopheles species, namely An. gambiae s.l. and An. stephensi, while the 117 Aedes specimens were Ae. luteocephalus (39%), Ae. aegypti (32%), Ae. vexans (9%), Ae. vittatus (9%), Ae. africanus (6%), Ae. metalicus (3%), and Ae. albopictus (3%). Considering the serious threat of Ae. albopictus emergence for the public health in the area and our limited resources, we prioritized Ae. albopictus samples for further genomic analysis. We extracted the DNA from the three specimens and subsequently sequenced the cytochrome oxidase 1 (CO1) gene and confirmed their identity as Aedes albopictus and their potential origin by phylogenetic and haplotype analyses. Aedes albopictus, originating from Southeast Asia, is an invasive key vector of chikungunya and dengue. This is the first report and molecular characterization of Ae. albopictus from Sudan. Our sequences cluster with populations from the Central African Republic and La Réunion. Worryingly, this finding associates with a major increase in chikungunya and dengue outbreaks in rural areas of the study region and might be linked to the mosquito’s spread across the region. The emergence of Ae. albopictus in Sudan is of serious public health concern and urges for the improvement of the vector surveillance and control system through the implementation of an integrated molecular xenosurveillance. The threat of major arboviral diseases in the region underlines the need for the institutionalization of the One Health strategy for the prevention and control of future pandemics.
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Affiliation(s)
- Ayman Ahmed
- Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
- Molecular Biology Unit, Sirius Training and Research Centre, Khartoum 11111, Sudan
- Correspondence: ; Tel.: +249-123997091
| | - Mustafa Abubakr
- Directorate of Environmental Health, Federal Ministry of Health, Khartoum 11111, Sudan
| | - Hamza Sami
- Directorate of the Integrated Vector Management (IVM), Federal Ministry of Health, Khartoum 11111, Sudan
| | - Isam Mahdi
- Directorate of the Integrated Vector Management (IVM), Federal Ministry of Health, Khartoum 11111, Sudan
| | - Nouh S. Mohamed
- Molecular Biology Unit, Sirius Training and Research Centre, Khartoum 11111, Sudan
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
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Klitting R, Kafetzopoulou LE, Thiery W, Dudas G, Gryseels S, Kotamarthi A, Vrancken B, Gangavarapu K, Momoh M, Sandi JD, Goba A, Alhasan F, Grant DS, Okogbenin S, Ogbaini-Emovo E, Garry RF, Smither AR, Zeller M, Pauthner MG, McGraw M, Hughes LD, Duraffour S, Günther S, Suchard MA, Lemey P, Andersen KG, Dellicour S. Predicting the evolution of the Lassa virus endemic area and population at risk over the next decades. Nat Commun 2022; 13:5596. [PMID: 36167835 PMCID: PMC9515147 DOI: 10.1038/s41467-022-33112-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 09/02/2022] [Indexed: 01/27/2023] Open
Abstract
Lassa fever is a severe viral hemorrhagic fever caused by a zoonotic virus that repeatedly spills over to humans from its rodent reservoirs. It is currently not known how climate and land use changes could affect the endemic area of this virus, currently limited to parts of West Africa. By exploring the environmental data associated with virus occurrence using ecological niche modelling, we show how temperature, precipitation and the presence of pastures determine ecological suitability for virus circulation. Based on projections of climate, land use, and population changes, we find that regions in Central and East Africa will likely become suitable for Lassa virus over the next decades and estimate that the total population living in ecological conditions that are suitable for Lassa virus circulation may drastically increase by 2070. By analysing geotagged viral genomes using spatially-explicit phylogeography and simulating virus dispersal, we find that in the event of Lassa virus being introduced into a new suitable region, its spread might remain spatially limited over the first decades.
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Affiliation(s)
- Raphaëlle Klitting
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, 92037, USA.
| | - Liana E. Kafetzopoulou
- grid.5596.f0000 0001 0668 7884Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory for Clinical and Epidemiological Virology, KU Leuven - University of Leuven, Leuven, Belgium ,grid.424065.10000 0001 0701 3136Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Wim Thiery
- grid.8767.e0000 0001 2290 8069Department of Hydrology and Hydraulic Engineering, Vrije Universiteit Brussel, Brussels, Belgium
| | - Gytis Dudas
- grid.6441.70000 0001 2243 2806Institute of Biotechnology, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Sophie Gryseels
- grid.5284.b0000 0001 0790 3681Evolutionary Ecology group, Department of Biology, University of Antwerp, 2610 Antwerp, Belgium ,grid.20478.390000 0001 2171 9581Vertebrate group, Directorate Taxonomy and Phylogeny, Royal Belgian Institute of Natural Sciences, 1000 Brussels, Belgium
| | - Anjali Kotamarthi
- grid.214007.00000000122199231Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037 USA
| | - Bram Vrancken
- grid.5596.f0000 0001 0668 7884Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory for Clinical and Epidemiological Virology, KU Leuven - University of Leuven, Leuven, Belgium
| | - Karthik Gangavarapu
- grid.214007.00000000122199231Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037 USA
| | - Mambu Momoh
- grid.442296.f0000 0001 2290 9707Eastern Technical University of Sierra Leone, Kenema, Sierra Leone ,grid.463455.50000 0004 1799 2069Viral Hemorrhagic Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - John Demby Sandi
- grid.463455.50000 0004 1799 2069Viral Hemorrhagic Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Augustine Goba
- grid.463455.50000 0004 1799 2069Viral Hemorrhagic Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Foday Alhasan
- grid.463455.50000 0004 1799 2069Viral Hemorrhagic Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Donald S. Grant
- grid.463455.50000 0004 1799 2069Viral Hemorrhagic Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone ,grid.442296.f0000 0001 2290 9707College of Medicine and Allied Health Sciences, University of Sierra Leone, Kenema, Sierra Leone
| | - Sylvanus Okogbenin
- grid.508091.5Irrua Specialist Teaching Hospital, Irrua, Nigeria ,grid.411357.50000 0000 9018 355XFaculty of Clinical Sciences, College of Medicine, Ambrose Alli University, Ekpoma, Nigeria
| | | | - Robert F. Garry
- grid.265219.b0000 0001 2217 8588Department of Microbiology and Immunology, Tulane University, School of Medicine, New Orleans, LA 70112 USA ,grid.505518.c0000 0004 5901 1919Zalgen Labs, LCC, Frederick, MD 21703 USA ,grid.475149.aGlobal Virus Network (GVN), Baltimore, MD 21201 USA
| | - Allison R. Smither
- grid.265219.b0000 0001 2217 8588Department of Microbiology and Immunology, Tulane University, School of Medicine, New Orleans, LA 70112 USA
| | - Mark Zeller
- grid.214007.00000000122199231Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037 USA
| | - Matthias G. Pauthner
- grid.214007.00000000122199231Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037 USA
| | - Michelle McGraw
- grid.214007.00000000122199231Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037 USA
| | - Laura D. Hughes
- grid.214007.00000000122199231Department of Integrative, Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037 USA
| | - Sophie Duraffour
- grid.424065.10000 0001 0701 3136Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany ,grid.452463.2German Center for Infection Research (DZIF), Partner site Hamburg–Lübeck–Borstel–Riems, Hamburg, Germany
| | - Stephan Günther
- grid.424065.10000 0001 0701 3136Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany ,grid.452463.2German Center for Infection Research (DZIF), Partner site Hamburg–Lübeck–Borstel–Riems, Hamburg, Germany
| | - Marc A. Suchard
- grid.19006.3e0000 0000 9632 6718Department of Biomathematics, David Geffen School of Medicine, University of California, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Philippe Lemey
- grid.5596.f0000 0001 0668 7884Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory for Clinical and Epidemiological Virology, KU Leuven - University of Leuven, Leuven, Belgium
| | - Kristian G. Andersen
- grid.214007.00000000122199231Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037 USA ,grid.214007.00000000122199231Scripps Research Translational Institute, La Jolla, CA 92037 USA
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory for Clinical and Epidemiological Virology, KU Leuven - University of Leuven, Leuven, Belgium. .,Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, CP160/12 50, av. FD Roosevelt, 1050, Bruxelles, Belgium.
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9
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Guenin M, De Nys HM, Peyre M, Loire E, Thongyuan S, Diallo A, Zogbelemou L, Goutard FL. A participatory epidemiological and One Health approach to explore the community’s capacity to detect emerging zoonoses and surveillance network opportunities in the forest region of Guinea. PLoS Negl Trop Dis 2022; 16:e0010462. [PMID: 35816491 PMCID: PMC9273079 DOI: 10.1371/journal.pntd.0010462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/02/2022] [Indexed: 12/01/2022] Open
Abstract
The Ebola virus disease epidemic that threatened West Africa between 2013 and 2016 was of unprecedented health magnitude. After this health crisis, studies highlighted the need to introduce community-based surveillance systems and to adopt a One Health approach. This study aimed to provide preparatory insights for the definition of a community-based surveillance system for emerging zoonoses such as viral hemorrhagic fevers in Guinea. The objective was to explore the disease detection capacity and the surveillance network opportunities at the community level in two pilot areas in the forest region of Guinea, where the epidemic emerged. Based on a participatory epidemiological and One Health approach, we conducted Focus Group Discussions with human, animal and ecosystem health actors. We used a range of participatory tools, included semi-structured interviews, ranking, scoring and flow diagram, to estimate the local knowledge and perception of diseases and clinical signs and to investigate the existing health information exchange network and its related strengths and weaknesses. The results showed that there is heterogeneity in knowledge of diseases and perception of the clinical signs among actors and that there are preferred and more effective health communication channels opportunities. This preparatory study suggests that it is necessary to adapt the case definitions and the health communication channels to the different actors who can play a role in a future community-based surveillance system and provides recommendations for future surveillance activities to be carried out in West Africa. Viral hemorrhagic diseases have a high risk of emergence in tropical regions. The consequences on public health are often disastrous in the low- and middle-income countries that face difficulties to control epidemics. This scenario has unfortunately occurred in West Africa between 2013 and 2016 with the Ebola virus disease epidemic. There is an urgent need to increase the capacity for rapid detection of the emergence of such diseases and adopting a One Health approach since most of them are zoonotic. Community-based surveillance seems appropriate to address this issue in the context of these countries. We collected preparatory data through semi-structured interviews of community actors in human health, animal health and ecosystem health in Guinea. We used participatory epidemiology that appears to be a consistent method to assess local knowledge and perceptions of diseases and clinical signs and to identify health information exchange network opportunities. We aimed to provide relevant recommendations for the design of adapted case definitions and surveillance network in the prospect of implementing a community-based surveillance system of viral hemorrhagic fevers in Guinea and future surveillance activities to be carried out in West Africa.
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10
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Ahmed A, Ali Y, Salim B, Dietrich I, Zinsstag J. Epidemics of Crimean-Congo Hemorrhagic Fever (CCHF) in Sudan between 2010 and 2020. Microorganisms 2022; 10:928. [PMID: 35630372 PMCID: PMC9147186 DOI: 10.3390/microorganisms10050928] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/12/2022] [Accepted: 04/25/2022] [Indexed: 02/05/2023] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic arboviral disease that poses a great threat to global health in the Old World, and it is endemic in Europe, Asia, and Africa, including Sudan. In this retrospective study, we reviewed previous epidemiological reports about the major epidemics of CCHF throughout Sudan between 2010 and 2020. During these epidemics, the infection of humans with Crimean-Congo hemorrhagic fever virus (CCHFV), the causative agent of CCHF, was diagnosed using qRT-PCR. We have identified 88 cases of CCHF, including 13 fatalities reported during five epidemics that occurred in 2010, 2011, 2015, 2019, and 2020. The two epidemics in 2010 and 2011 were by far the largest, with 51 and 27 cases reported, respectively. The majority of cases (78%) were reported in the endemic region of Kordofan. Here, we document that the first emergence of CCHFV in the Darfur region, West Sudan, occurred in 2010. We were not able to investigate outbreak dynamics through phylogenetic analysis due to the limited diagnostic capacity and the lack of sequencing services in the country. These findings call for establishing a genomic-based integrated One Health surveillance and response system for the early preparedness, prevention, and control of CCHF in the country.
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Affiliation(s)
- Ayman Ahmed
- Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4123 Allschwil, Switzerland;
- Faculty of Science, University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
- Sudanese National Academy of Sciences, Khartoum 11111, Sudan
| | - Yousif Ali
- Health Emergencies and Epidemics Control General Directorate, Sudan Federal Ministry of Health, Khartoum 11111, Sudan;
| | - Bashir Salim
- Faculty of Veterinary Medicine, University of Khartoum, Khartoum 11111, Sudan;
| | | | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4123 Allschwil, Switzerland;
- Faculty of Science, University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
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11
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Papa A, Marklewitz M, Paraskevopoulou S, Garrison AR, Alkhovsky SV, Avšič-Županc T, Bente DA, Bergeron É, Burt F, Di Paola N, Ergünay K, Hewson R, Mirazimi A, Sall AA, Spengler JR, Postler TS, Palacios G, Kuhn JH. History and classification of Aigai virus (formerly Crimean-Congo haemorrhagic fever virus genotype VI). J Gen Virol 2022; 103. [PMID: 35412967 PMCID: PMC10026732 DOI: 10.1099/jgv.0.001734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Crimean-Congo haemorrhagic fever virus (CCHFV) is the medically most important member of the rapidly expanding bunyaviral family Nairoviridae. Traditionally, CCHFV isolates have been assigned to six distinct genotypes. Here, the International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group outlines the reasons for the recent decision to re-classify genogroup VI (aka Europe-2 or AP-92-like) as a distinct virus, Aigai virus (AIGV).
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Affiliation(s)
- Anna Papa
- National Reference Centre for Arboviruses and Haemorrhagic Fever Viruses (Εθνικό Κέντρο Αναφοράς Αρμποϊών και Αιμορραγικών πυρετών, 1st Laboratory of Microbiology (Α' Εργαστήριο Μικροβιολογίας), School of Medicine (Τμήμα Ιατρικής), Aristotle University of Thessaloniki (Αριστοτέλειο Πανεπιστήμιο Θεσσαλονίκης), Thessaloniki, Greece
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
| | - Marco Marklewitz
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sofia Paraskevopoulou
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Aura R Garrison
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland, USA
- The members of the 2020-2023 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Groups
| | - Sergey V Alkhovsky
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- D. I. Ivanovsky Institute of Virology of the N. F. Gamaleya National Center on Epidemiology and Microbiology of Ministry of Health of Russian Federation (Институт вирусологии им. Д. И. Ивановского, входящий в состав ФГБУ «НИЦЭМ им. Н. Ф. Гамалеи» Минздрава России), Moscow, Russia
| | - Tatjana Avšič-Županc
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- The members of the 2020-2023 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Groups
- University of Ljubljana (Univerza v Ljubljani), Faculty of Medicine (Medicinska fakulteta), Slovenia
| | - Dennis A Bente
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- University of Texas Medical Branch, Galveston, Texas, USA
| | - Éric Bergeron
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- The members of the 2020-2023 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Groups
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Felicity Burt
- Division of Virology, National Health Laboratory Service and Division of Virology, University of the Free State, Bloemfontein, South Africa
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- The members of the 2020-2023 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Groups
| | - Nicholas Di Paola
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland, USA
- The members of the 2020-2023 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Groups
| | - Koray Ergünay
- Virology Unit (Viroloji Birimi), Department of Medical Microbiology (Tıbbi Mikrobiyoloji Anabilim Dalı), Faulty of Medicine (Tıp Fakültesi), Hacettepe University (Hacettepe Üniversitesi), Ankara, Turkey
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- The members of the 2020-2023 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Groups
| | - Roger Hewson
- Public Health England, Porton Down, Wiltshire, Salisbury, UK
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- The members of the 2020-2023 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Groups
| | - Ali Mirazimi
- Folkhalsomyndigheten, Stockholm, Sweden
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- The members of the 2020-2023 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Groups
| | - Amadou Alpha Sall
- Institut Pasteur de Dakar, Dakar, Senegal
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
| | - Jessica R Spengler
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Thomas S Postler
- Department of Microbiology & Immunology, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Gustavo Palacios
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland, USA
- The members of the 2020-2023 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Groups
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick. National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
- The members of the 2017-2020 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Group
- The members of the 2020-2023 International Committee on Taxonomy of Viruses (ICTV) Nairoviridae Study Groups
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12
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Mukhtar MM, Ibrahim SS. Temporal Evaluation of Insecticide Resistance in Populations of the Major Arboviral Vector Aedes Aegypti from Northern Nigeria. Insects 2022; 13:187. [PMID: 35206760 PMCID: PMC8876019 DOI: 10.3390/insects13020187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/02/2022] [Accepted: 02/08/2022] [Indexed: 11/24/2022]
Abstract
To support evidence-based control measures, two Nigerian Aedes populations (BUK and Pantami) were characterised. Larval bioassay using temephos and deltamethrin revealed a significant increase in deltamethrin resistance, with LC50 of 0.018mg/L (resistance ratio compared to New Orleans, RR = 2.250) in 2018 increasing ~6-fold, by 2019 (LC50 = 0.100mg/L, RR = 12.5), and ~11-fold in 2020 (LC50 = 0.198mg/L, RR = 24.750). For the median deltamethrin concentration (0.05mg/L), a gradual decrease in mortality was observed, from 50.6% in 2018, to 44.9% in 2019, and 34.2% in 2020. Extremely high DDT resistance was observed, with <3% mortalities and LT50s of 352.87 min, 369.19 min and 406.94 min in 2018, 2019 and 2020, respectively. Significant temporal increase in resistance was observed towards ƛ-cyhalothrin (a type II pyrethroid) over three years. Synergist bioassays with diethylmaleate and piperonylbutoxide significantly recovered DDT and ƛ-cyhalothrin susceptibility respectively, implicating glutathione S-transferases and CYP450s. Cone bioassays revealed increased resistance to the PermaNet® 3.0, side panels (mortalities of 94% in 2018, 66.4% in 2019, and 73.6% in 2020), while full susceptibility was obtained with the roof of PermaNet® 3.0. The F1534C kdr mutation occurred in low frequency, with significant correlation between heterozygote genotypes and DDT resistance. This temporal increase in resistance is a major challenge for control of this vector of public health importance.
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13
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Raab M, Pfadenhauer LM, Doumbouya D, Froeschl G. Clinical presentations, diagnostics, treatments and treatment costs of children and adults with febrile illness in a tertiary referral hospital in south-eastern Guinea: A retrospective longitudinal cohort study. PLoS One 2022; 17:e0262084. [PMID: 35007283 PMCID: PMC8746772 DOI: 10.1371/journal.pone.0262084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 12/18/2021] [Indexed: 12/04/2022] Open
Abstract
Background Febrile illness is frequent among patients in the tropics. It is caused by a wide variety of common diseases such as malaria or gastrointestinal infections but also by less common but highly contagious pathogens with epidemic potential. This study describes the clinical features of adult and paediatric patients with febrile illness in in the largest tertiary referral hospital in south-eastern Guinea, a region at high risk for viral haemorrhagic fever outbreaks. The study further compares their diagnostic characteristics, treatments and outcomes with non-febrile patients in order to contribute to the local epidemiology of febrile illness. Methods We used retrospective data collection to record demographic and clinical data of all incoming patients during a study period of three months. For the follow-up study of inpatients, we retrospectively reviewed patient charts for diagnostic characteristics, diagnoses and outcomes. Results Of the 4317 incoming patients during the study period, 9.5% had a febrile illness. The most used diagnostic measures to identify causative agents in febrile patients were point-of-care tests and most treatments relied on antibiotics. Most common discharge diagnoses for febrile inpatients were malaria (9.6% adults, 56.7% children), salmonella gastroenteritis/typhoid (10.6% adults, 7.8% children) and respiratory infection/pneumonia (5.3% adults, 18.7% children). Inpatient mortality for children was significantly higher in febrile than non-febrile children (18.5% vs. 5.1%, p<0.001) and considerably higher in febrile than non-febrile adults (29.8% vs. 25.0%, p = 0.404). Conclusions Malaria, respiratory infection and gastroenteritis are considered the main causes for febrile illness. The wide reliance on rapid diagnostic tests to diagnose febrile patients not only risks to over- or under-diagnose certain diseases but also leaves the possibility of highly infectious diseases in febrile patients unexplored. Furthermore, the heavy reliance on antibiotics risks to cause antimicrobial resistance. High mortality rates in febrile patients, especially children, should be of concern to public health authorities.
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Affiliation(s)
- Manuel Raab
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), Munich, Germany
- * E-mail:
| | - Lisa M. Pfadenhauer
- Institute of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig Maximilian University Munich, Munich, Germany
| | - Dansira Doumbouya
- Paediatric Service, Hôpital Régional de Nzérékoré, Nzérékoré, Guinea
| | - Guenter Froeschl
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), Munich, Germany
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14
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Phonera MC, Simuunza MC, Kainga H, Ndebe J, Chembensofu M, Chatanga E, Kanyanda S, Changula K, Muleya W, Mubemba B, Chitanga S, Kajihara M, Sawa H, Njunga G, Takada A, Simulundu E. Seroprevalence and Risk Factors of Crimean-Congo Hemorrhagic Fever in Cattle of Smallholder Farmers in Central Malawi. Pathogens 2021; 10:1613. [PMID: 34959568 DOI: 10.3390/pathogens10121613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Africa, Asia, and Eastern Europe where it circulates among animals and ticks causing sporadic outbreaks in humans. Although CCHF is endemic in sub-Saharan Africa, epidemiological information is lacking in many countries, including Malawi. To assess the risk of CCHF in Malawi, we conducted an epidemiological study in cattle reared by smallholder livestock farmers in central Malawi. A cross-sectional study was conducted in April 2020 involving seven districts, four from Kasungu and three from Lilongwe Agriculture Development Divisions. A structured questionnaire was administered to farmers to obtain demographic, animal management, and ecological risk factors data. Sera were collected from randomly selected cattle and screened for CCHF virus (CCHFV) specific antibodies using a commercial ELISA kit. Ticks were collected from cattle and classified morphologically to species level. An overall CCHFV seropositivity rate of 46.9% (n = 416; 95% CI: 42.0–51.8%) was observed. The seropositivity was significantly associated with the age of cattle (p < 0.001), sex (p < 0.001), presence of ticks in herds (p = 0.01), district (p = 0.025), and type of grazing lands (p = 0.013). Five species of ticks were identified, including Hyalomma truncatum, a known vector of CCHFV. Ticks of the species Hyalomma truncatum were not detected in two districts with the highest seroprevalence for CCHF and vector competency must be further explored in the study area. To our knowledge, this is the first report of serologic evidence of the presence of CCHV among smallholder cattle in central Malawi. This study emphasizes the need for continued monitoring of CCHFV infection among livestock, ticks, and humans for the development of data-based risk mitigation strategies.
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15
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Albery GF, Becker DJ, Brierley L, Brook CE, Christofferson RC, Cohen LE, Dallas TA, Eskew EA, Fagre A, Farrell MJ, Glennon E, Guth S, Joseph MB, Mollentze N, Neely BA, Poisot T, Rasmussen AL, Ryan SJ, Seifert S, Sjodin AR, Sorrell EM, Carlson CJ. The science of the host-virus network. Nat Microbiol 2021; 6:1483-1492. [PMID: 34819645 DOI: 10.1038/s41564-021-00999-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/18/2021] [Indexed: 01/21/2023]
Abstract
Better methods to predict and prevent the emergence of zoonotic viruses could support future efforts to reduce the risk of epidemics. We propose a network science framework for understanding and predicting human and animal susceptibility to viral infections. Related approaches have so far helped to identify basic biological rules that govern cross-species transmission and structure the global virome. We highlight ways to make modelling both accurate and actionable, and discuss the barriers that prevent researchers from translating viral ecology into public health policies that could prevent future pandemics.
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Affiliation(s)
- Gregory F Albery
- Department of Biology, Georgetown University, Washington DC, USA.
| | - Daniel J Becker
- Department of Biology, University of Oklahoma, Norman, OK, USA
| | - Liam Brierley
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Cara E Brook
- Department of Integrative Biology, University of California, Berkeley, Berkeley, CA, USA
| | | | - Lily E Cohen
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tad A Dallas
- Department of Biological Sciences, University of South Carolina, Columbia, SC, USA
| | - Evan A Eskew
- Department of Biology, Pacific Lutheran University, Tacoma, WA, USA
| | - Anna Fagre
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Maxwell J Farrell
- Department of Ecology and Evolutionary Biology, University of Toronto, Toronto, Ontario, Canada
| | - Emma Glennon
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Sarah Guth
- Department of Integrative Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Maxwell B Joseph
- Earth Lab, Cooperative Institute for Research in Environmental Science, University of Colorado Boulder, Boulder, CO, USA
| | - Nardus Mollentze
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK.,MRC - University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Benjamin A Neely
- National Institute of Standards and Technology, Charleston, SC, USA
| | - Timothée Poisot
- Québec Centre for Biodiversity Sciences, Montréal, Québec, Canada.,Département de Sciences Biologiques, Université de Montréal, Montréal, Québec, Canada
| | - Angela L Rasmussen
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Biochemistry, Microbiology, and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sadie J Ryan
- Department of Geography, University of Florida, Gainesville, FL, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.,School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Stephanie Seifert
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, USA
| | - Anna R Sjodin
- Department of Biological Sciences, University of Idaho, Moscow, ID, USA
| | - Erin M Sorrell
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, USA.,Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, USA
| | - Colin J Carlson
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, USA. .,Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, USA.
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16
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Goniewicz K, Burkle FM, Horne S, Borowska-stefańska M, Wiśniewski S, Khorram-manesh A. The Influence of War and Conflict on Infectious Disease: A Rapid Review of Historical Lessons We Have Yet to Learn. Sustainability 2021; 13:10783. [DOI: 10.3390/su131910783] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Armed conflicts degrade established healthcare systems, which typically manifests as a resurgence of preventable infectious diseases. While 70% of deaths globally are now from non-communicable disease; in low-income countries, respiratory infections, diarrheal illness, malaria, tuberculosis, and HIV/AIDs are all in the top 10 causes of death. The burden of these infectious diseases is exacerbated by armed conflict, translating into even more dramatic long-term consequences. This rapid evidence review searched electronic databases in PubMed, Scopus, and Web of Science. Of 381 identified publications, 73 were included in this review. Several authors indicate that the impact of infectious diseases increases in wars and armed conflicts due to disruption to surveillance and response systems that were often poorly developed to begin with. Although the true impact of conflict on infectious disease spread is not known and requires further research, the link between them is indisputable. Current decision-making management systems are insufficient and only pass the baton to the next unwary generation.
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17
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Jonkmans N, D'Acremont V, Flahault A. Scoping future outbreaks: a scoping review on the outbreak prediction of the WHO Blueprint list of priority diseases. BMJ Glob Health 2021; 6:e006623. [PMID: 34531189 PMCID: PMC8449939 DOI: 10.1136/bmjgh-2021-006623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/01/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The WHO's Research and Development Blueprint priority list designates emerging diseases with the potential to generate public health emergencies for which insufficient preventive solutions exist. The list aims to reduce the time to the availability of resources that can avert public health crises. The current SARS-CoV-2 pandemic illustrates that an effective method of mitigating such crises is the pre-emptive prediction of outbreaks. This scoping review thus aimed to map and identify the evidence available to predict future outbreaks of the Blueprint diseases. METHODS We conducted a scoping review of PubMed, Embase and Web of Science related to the evidence predicting future outbreaks of Ebola and Marburg virus, Zika virus, Lassa fever, Nipah and Henipaviral disease, Rift Valley fever, Crimean-Congo haemorrhagic fever, Severe acute respiratory syndrome, Middle East respiratory syndrome and Disease X. Prediction methods, outbreak features predicted and implementation of predictions were evaluated. We conducted a narrative and quantitative evidence synthesis to highlight prediction methods that could be further investigated for the prevention of Blueprint diseases and COVID-19 outbreaks. RESULTS Out of 3959 articles identified, we included 58 articles based on inclusion criteria. 5 major prediction methods emerged; the most frequent being spatio-temporal risk maps predicting outbreak risk periods and locations through vector and climate data. Stochastic models were predominant. Rift Valley fever was the most predicted disease. Diseases with complex sociocultural factors such as Ebola were often predicted through multifactorial risk-based estimations. 10% of models were implemented by health authorities. No article predicted Disease X outbreaks. CONCLUSIONS Spatiotemporal models for diseases with strong climatic and vectorial components, as in River Valley fever prediction, may currently best reduce the time to the availability of resources. A wide literature gap exists in the prediction of zoonoses with complex sociocultural and ecological dynamics such as Ebola, COVID-19 and especially Disease X.
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Affiliation(s)
- Nils Jonkmans
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Valérie D'Acremont
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, Université de Genève, Geneva, Switzerland
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18
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Meisner J, Frisbie LA, Munayco CV, García PJ, Cárcamo CP, Morin CW, Pigott DM, Rabinowitz PM. A novel approach to modeling epidemic vulnerability, applied to Aedes aegypti-vectored diseases in Perú. BMC Infect Dis 2021; 21:846. [PMID: 34418974 PMCID: PMC8379593 DOI: 10.1186/s12879-021-06530-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/20/2021] [Indexed: 11/25/2022] Open
Abstract
Background A proactive approach to preventing and responding to emerging infectious diseases is critical to global health security. We present a three-stage approach to modeling the spatial distribution of outbreak vulnerability to Aedes aegypti-vectored diseases in Perú. Methods Extending a framework developed for modeling hemorrhagic fever vulnerability in Africa, we modeled outbreak vulnerability in three stages: index case potential (stage 1), outbreak receptivity (stage 2), and epidemic potential (stage 3), stratifying scores on season and El Niño events. Subsequently, we evaluated the validity of these scores using dengue surveillance data and spatial models. Results We found high validity for stage 1 and 2 scores, but not stage 3 scores. Vulnerability was highest in Selva Baja and Costa, and in summer and during El Niño events, with index case potential (stage 1) being high in both regions but outbreak receptivity (stage 2) being generally high in Selva Baja only. Conclusions Stage 1 and 2 scores are well-suited to predicting outbreaks of Ae. aegypti-vectored diseases in this setting, however stage 3 scores appear better suited to diseases with direct human-to-human transmission. To prevent outbreaks, measures to detect index cases should be targeted to both Selva Baja and Costa, while Selva Baja should be prioritized for healthcare system strengthening. Successful extension of this framework from hemorrhagic fevers in Africa to an arbovirus in Latin America indicates its broad utility for outbreak and pandemic preparedness and response activities. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06530-9.
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Affiliation(s)
- Julianne Meisner
- Department of Epidemiology, University of Washington, Seattle, WA, USA. .,Center for One Health Research, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
| | - Lauren A Frisbie
- Center for One Health Research, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - César V Munayco
- Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, Peruvian Ministry of Health, Lima, Peru
| | - Patricia J García
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - César P Cárcamo
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cory W Morin
- Center for Health and the Global Environment, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Peter M Rabinowitz
- Center for One Health Research, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
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19
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Ahmed A, Mahmoud I, Eldigail M, Elhassan RM, Weaver SC. The Emergence of Rift Valley Fever in Gedaref State Urges the Need for a Cross-Border One Health Strategy and Enforcement of the International Health Regulations. Pathogens 2021; 10:pathogens10070885. [PMID: 34358035 PMCID: PMC8308630 DOI: 10.3390/pathogens10070885] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
This study investigated the causative agent of a haemorrhagic fever epidemic in Gedaref state, south-east Sudan. Six cases of febrile illness with haemorrhagic manifestations presented at outpatient health-clinics. Blood samples were collected from the patients and shipped to Khartoum where they were tested for dengue virus (DENV), chikungunya virus (CHIKV), and Rift Valley fever virus (RVFV) using real-time qPCR. Fifty percent (3/6) of them tested positive for RVFV and neither DENV or CHIKV was detected. All patients were males between 20 and 48 years old who had no history of recent travel. This finding describes the first emergence of RVFV in Gedaref state. Considering that the state hosts a major market of livestock, and it has one of the largest-seasonal open pastures in the country that is usually flooded with herds from the neighbouring states and countries during the rainy season, this emergence could represent a major threat to public health in the region and countries importing animals and/or animal products from east Africa. Therefore, we urge the policymakers of the health and animal resources sectors to implement a one health strategy with a well-established early warning surveillance and response system to prevent the establishment of the disease in the area.
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Affiliation(s)
- Ayman Ahmed
- Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX 77550, USA;
- Institute for Human Infections and Immunity, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77550, USA
- Correspondence: ; Tel.: +249-123997091
| | - Iman Mahmoud
- National Public Health Laboratory, Sudan Federal Ministry of Health, Khartoum 11111, Sudan; (I.M.); (M.E.); (R.M.E.)
| | - Mawahib Eldigail
- National Public Health Laboratory, Sudan Federal Ministry of Health, Khartoum 11111, Sudan; (I.M.); (M.E.); (R.M.E.)
| | - Rehab M. Elhassan
- National Public Health Laboratory, Sudan Federal Ministry of Health, Khartoum 11111, Sudan; (I.M.); (M.E.); (R.M.E.)
| | - Scott C. Weaver
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX 77550, USA;
- Institute for Human Infections and Immunity, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77550, USA
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20
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Raab M, Roth E, Nguyen VK, Froeschl G. The 2021 Ebola virus outbreak in Guinea: Mistrust and the shortcomings of outbreak surveillance. PLoS Negl Trop Dis 2021; 15:e0009487. [PMID: 34166374 DOI: 10.1371/journal.pntd.0009487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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21
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Dedkov VG, Magassouba N, Stukolova OA, Savina VA, Camara J, Soropogui B, Safonova MV, Semizhon P, Platonov AE. Differential Laboratory Diagnosis of Acute Fever in Guinea: Preparedness for the Threat of Hemorrhagic Fevers. Int J Environ Res Public Health 2021; 18:6022. [PMID: 34205104 PMCID: PMC8199941 DOI: 10.3390/ijerph18116022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/30/2021] [Accepted: 05/31/2021] [Indexed: 11/29/2022]
Abstract
Acute febrile illnesses occur frequently in Guinea. Acute fever itself is not a unique, hallmark indication (pathognomonic sign) of any one illness or disease. In the infectious disease context, fever's underlying cause can be a wide range of viral or bacterial pathogens, including the Ebola virus. In this study, molecular and serological methods were used to analyze samples from patients hospitalized with acute febrile illness in various regions of Guinea. This analysis was undertaken with the goal of accomplishing differential diagnosis (determination of causative pathogen) in such cases. As a result, a number of pathogens, both viral and bacterial, were identified in Guinea as causative agents behind acute febrile illness. In approximately 60% of the studied samples, however, a definitive determination could not be made.
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Affiliation(s)
- Vladimir G. Dedkov
- Pasteur Institute, Federal Service on Consumers’ Rights Protection and Human Well-Being Surveillance, 197101 Saint Petersburg, Russia; (V.A.S.); (A.E.P.)
- Martsinovsky Institute of Medical Parasitology, Tropical and Vector Borne Diseases, Sechenov First Moscow State Medical University, 119435 Moscow, Russia
| | - N’Faly Magassouba
- Laboratoire de Virologie, Université Gamal Abdel Nasser de Conakry, Projet de Recherche sur les Fièvres Hémorragiques en Guinée, 001 B1568 Conakry, Guinea; (N.M.); (J.C.); (B.S.)
| | - Olga A. Stukolova
- Central Research Institute for Epidemiology, Federal Service on Consumers’ Rights Protection and Human Well-Being Surveillance, 111123 Moscow, Russia;
| | - Victoria A. Savina
- Pasteur Institute, Federal Service on Consumers’ Rights Protection and Human Well-Being Surveillance, 197101 Saint Petersburg, Russia; (V.A.S.); (A.E.P.)
| | - Jakob Camara
- Laboratoire de Virologie, Université Gamal Abdel Nasser de Conakry, Projet de Recherche sur les Fièvres Hémorragiques en Guinée, 001 B1568 Conakry, Guinea; (N.M.); (J.C.); (B.S.)
| | - Barrè Soropogui
- Laboratoire de Virologie, Université Gamal Abdel Nasser de Conakry, Projet de Recherche sur les Fièvres Hémorragiques en Guinée, 001 B1568 Conakry, Guinea; (N.M.); (J.C.); (B.S.)
| | - Marina V. Safonova
- Anti-Plague Center, Federal Service on Consumers’ Rights Protection and Human Well-Being Surveillance, 119121 Moscow, Russia;
| | - Pavel Semizhon
- The Republican Research and Practical Center for Epidemiology and Microbiology, 220114 Minsk, Belarus;
| | - Alexander E. Platonov
- Pasteur Institute, Federal Service on Consumers’ Rights Protection and Human Well-Being Surveillance, 197101 Saint Petersburg, Russia; (V.A.S.); (A.E.P.)
- Central Research Institute for Epidemiology, Federal Service on Consumers’ Rights Protection and Human Well-Being Surveillance, 111123 Moscow, Russia;
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22
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Temur AI, Kuhn JH, Pecor DB, Apanaskevich DA, Keshtkar-Jahromi M. Epidemiology of Crimean-Congo Hemorrhagic Fever (CCHF) in Africa-Underestimated for Decades. Am J Trop Med Hyg 2021; 104:1978-1990. [PMID: 33900999 PMCID: PMC8176481 DOI: 10.4269/ajtmh.20-1413] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/09/2021] [Indexed: 01/15/2023] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is endemic in Africa, but the epidemiology remains to be defined. Using a broad database search, we reviewed the literature to better define CCHF evidence in Africa. We used a One Health approach to define the impact of CCHF by reviewing case reports, human and animal serology, and records of CCHF virus (CCHFV) isolations (1956-mid-2020). In addition, published and unpublished collection data were used to estimate the geographic distribution of Hyalomma ticks and infection vectors. We implemented a previously proposed classification scheme for organizing countries into five categories by the level of evidence. From January 1, 1956 to July 25, 2020, 494 CCHF cases (115 lethal) were reported in Africa. Since 2000, nine countries (Kenya, Mali, Mozambique, Nigeria, Senegal, Sierra Leone, South Sudan, Sudan, and Tunisia) have reported their first CCHF cases. Nineteen countries reported CCHF cases and were assigned level 1 or level 2 based on maturity of their surveillance system. Thirty countries with evidence of CCHFV circulation in the absence of CCHF cases were assigned level 3 or level 4. Twelve countries for which no data were available were assigned level 5. The goal of this review is to inform international organizations, local governments, and healthcare professionals about shortcomings in CCHF surveillance in Africa to assist in a movement toward strengthening policy to improve CCHF surveillance.
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Affiliation(s)
- Ahmet Irfan Temur
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Bezmialem Vakif University, Istanbul, Turkey
| | - Jens H. Kuhn
- Integrated Research Facility, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland
| | - David B. Pecor
- Department of Entomology, Walter Reed Biosystematics Unit, Smithsonian Institution, Suitland, Maryland
- Department of Entomology, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Dmitry A. Apanaskevich
- US National Tick Collection, The James H. Oliver Jr. Institute for Coastal Plain Science, Georgia Southern University, Statesboro, Georgia
| | - Maryam Keshtkar-Jahromi
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
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23
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Yadouleton A, Picard C, Rieger T, Loko F, Cadar D, Kouthon EC, Job EO, Bankolé H, Oestereich L, Gbaguidi F, Pahlman M, Becker-Ziaja B, Journeaux A, Pannetier D, Mély S, Mundweiler S, Thomas D, Kohossi L, Saizonou R, Kakaï CG, Da Silva M, Kossoubedie S, Kakonku AL, M'Pelé P, Gunther S, Baize S, Fichet-Calvet E. Lassa fever in Benin: description of the 2014 and 2016 epidemics and genetic characterization of a new Lassa virus. Emerg Microbes Infect 2021; 9:1761-1770. [PMID: 32723007 PMCID: PMC7473144 DOI: 10.1080/22221751.2020.1796528] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
We report two outbreaks of Lassa fever that occurred in Benin in 2014 and 2016 with 20 confirmed cases and 50% (10/20) mortality. Benin was not previously considered to be an endemic country for Lassa fever, resulting in a delay to diagnose the disease and its human transmission. Molecular investigations showed the viral genomes to be similar to that of the Togo strain, which is genetically very different from other known strains and confirms the existence of a new lineage. Endemic circulation of Lassa virus in a new territory and the genetic diversity thus confirm that this virus represents a growing threat for West African people. Given the divergence of the Benin strain from the prototypic Josiah Sierra Leone strain frequently used to generate vaccine candidates, the efficacy of vaccine candidates should also be demonstrated with this strain.
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Affiliation(s)
| | - Caroline Picard
- Virology Department, Institut Pasteur CNR des fièvres hémorragiques virales (CNR FHV), Lyon, France
| | - Toni Rieger
- Virology Department, Bernhard-Nocht Institute for Tropical Medicine, Hamburg, Germany
| | | | - Daniel Cadar
- Virology Department, Bernhard-Nocht Institute for Tropical Medicine, Hamburg, Germany
| | | | | | | | - Lisa Oestereich
- Virology Department, Bernhard-Nocht Institute for Tropical Medicine, Hamburg, Germany
| | | | - Meike Pahlman
- Virology Department, Bernhard-Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Beate Becker-Ziaja
- Virology Department, Bernhard-Nocht Institute for Tropical Medicine, Hamburg, Germany
| | | | | | - Stéphane Mély
- INSERM - Jean Mérieux BSL4Laboratory, CNR FHV, Lyon, France
| | | | - Damien Thomas
- INSERM - Jean Mérieux BSL4Laboratory, CNR FHV, Lyon, France
| | | | | | | | | | | | | | | | - Stephan Gunther
- Virology Department, Bernhard-Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Sylvain Baize
- Laboratoire des Fièvres Hémorragiques Virales, Cotonou, Benin
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24
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Basinski AJ, Fichet-Calvet E, Sjodin AR, Varrelman TJ, Remien CH, Layman NC, Bird BH, Wolking DJ, Monagin C, Ghersi BM, Barry PA, Jarvis MA, Gessler PE, Nuismer SL. Bridging the gap: Using reservoir ecology and human serosurveys to estimate Lassa virus spillover in West Africa. PLoS Comput Biol 2021; 17:e1008811. [PMID: 33657095 PMCID: PMC7959400 DOI: 10.1371/journal.pcbi.1008811] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 03/15/2021] [Accepted: 02/17/2021] [Indexed: 01/07/2023] Open
Abstract
Forecasting the risk of pathogen spillover from reservoir populations of wild or domestic animals is essential for the effective deployment of interventions such as wildlife vaccination or culling. Due to the sporadic nature of spillover events and limited availability of data, developing and validating robust, spatially explicit, predictions is challenging. Recent efforts have begun to make progress in this direction by capitalizing on machine learning methodologies. An important weakness of existing approaches, however, is that they generally rely on combining human and reservoir infection data during the training process and thus conflate risk attributable to the prevalence of the pathogen in the reservoir population with the risk attributed to the realized rate of spillover into the human population. Because effective planning of interventions requires that these components of risk be disentangled, we developed a multi-layer machine learning framework that separates these processes. Our approach begins by training models to predict the geographic range of the primary reservoir and the subset of this range in which the pathogen occurs. The spillover risk predicted by the product of these reservoir specific models is then fit to data on realized patterns of historical spillover into the human population. The result is a geographically specific spillover risk forecast that can be easily decomposed and used to guide effective intervention. Applying our method to Lassa virus, a zoonotic pathogen that regularly spills over into the human population across West Africa, results in a model that explains a modest but statistically significant portion of geographic variation in historical patterns of spillover. When combined with a mechanistic mathematical model of infection dynamics, our spillover risk model predicts that 897,700 humans are infected by Lassa virus each year across West Africa, with Nigeria accounting for more than half of these human infections. The 2019 emergence of SARS-CoV-2 is a grim reminder of the threat animal-borne pathogens pose to human health. Even prior to SARS-CoV-2, the spillover of pathogens from animal reservoirs was a persistent problem, with pathogens such as Ebola, Nipah, and Lassa regularly but unpredictably causing outbreaks. Machine-learning models that anticipate when and where pathogen transmission from animals to humans is likely to occur would help guide surveillance efforts and preemptive countermeasures like information campaigns or vaccination programs. We develop a novel machine learning framework that uses datasets describing the distribution of a virus within its host and the range of its animal host, along with data on spatial patterns of human immunity, to infer rates of animal-to-human transmission across a region. By training the model on data from the animal host alone, our framework allows rigorous validation of spillover predictions using human data. We apply our framework to Lassa fever, a viral disease of West Africa that is spread to humans by rodents, and use the predictions to update estimates of Lassa virus infections in humans. Our results suggest that Nigeria is most at risk for the emergence of Lassa virus, and should be prioritized for outbreak-surveillance.
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Affiliation(s)
- Andrew J. Basinski
- Department of Mathematics, University of Idaho, Moscow, Idaho, United States of America
- * E-mail:
| | | | - Anna R. Sjodin
- Department of Biological Sciences, University of Idaho, Moscow, Idaho, United States of America
| | - Tanner J. Varrelman
- Bioinformatics and Computational Biology, University of Idaho, Moscow, Idaho, United States of America
| | - Christopher H. Remien
- Department of Mathematics, University of Idaho, Moscow, Idaho, United States of America
| | - Nathan C. Layman
- Department of Biological Sciences, University of Idaho, Moscow, Idaho, United States of America
| | - Brian H. Bird
- One Health Institute, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - David J. Wolking
- One Health Institute, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Corina Monagin
- One Health Institute, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Bruno M. Ghersi
- One Health Institute, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Peter A. Barry
- Center for Comparative Medicine, California National Primate Research Center, Department of Pathology and Laboratory Medicine, University of California, Davis, California, United States of America
| | - Michael A. Jarvis
- School of Biomedical and Healthcare Sciences, University of Plymouth, Plymouth, United Kingdom
| | - Paul E. Gessler
- College of Natural Resources, University of Idaho, Moscow, Idaho, United States of America
| | - Scott L. Nuismer
- Department of Biological Sciences, University of Idaho, Moscow, Idaho, United States of America
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25
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Balinandi S, von Brömssen C, Tumusiime A, Kyondo J, Kwon H, Monteil VM, Mirazimi A, Lutwama J, Mugisha L, Malmberg M. Serological and molecular study of Crimean-Congo Hemorrhagic Fever Virus in cattle from selected districts in Uganda. J Virol Methods 2021; 290:114075. [PMID: 33515661 DOI: 10.1016/j.jviromet.2021.114075] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Crimean-Congo Hemorrhagic Fever (CCHF) is a severe tick-borne viral hemorrhagic disease caused by Crimean-Congo Hemorrhagic Fever Virus (CCHFV) that poses serious public health challenges in many parts of Africa, Europe and Asia. METHODS We examined 500 cattle sera samples from five districts for CCHFV antibodies using in-house and commercially available (IDVet) ELISA, Immunofluorescent assay (IFA) and Real-time polymerase chain reaction (RT-PCR). RESULTS 500 cattle (73.8 % females) were analyzed; CCHFV seropositivity was 12.6 % (n = 63) and 75.0 % (n = 375) with the in-house and IDVet ELISAs, respectively. Seropositivity was associated with geographical location, increasing age, being female, and having a higher tick burden. Twenty four out of the 37 (64.8 %) were seropositive for CCHFV using IFA and all were negative for virus on RT-PCR. The IFA results were more comparable to IDVet (κcoefficient = 0.88, p = <0.01) than to in-house (κcoefficient = 0.32, p = 0.02). CONCLUSIONS Our study confirmed the presence and high prevalence of anti-CCHF antibodies in cattle based on three methods from all the five study districts, confirming presence and exposure of CCHFV. Given the zoonotic potential for CCHFV, we recommend a multidisciplinary public health surveillance and epidemiology of CCHFV in both animals and humans throughout the country.
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Affiliation(s)
- Stephen Balinandi
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda; College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda.
| | - Claudia von Brömssen
- Division of Applied Statistics and Mathematics, Department of Engergy and Technology, Swedish University of Agricultural Sciences, Box 7013, Uppsala, 750 07, Sweden.
| | - Alex Tumusiime
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.
| | - Jackson Kyondo
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.
| | - Hyesoo Kwon
- National Veterinary Institute, Uppsala, 751 89, Sweden.
| | - Vanessa M Monteil
- Department of Laboratory Medicine, Karolinska Institute and Karolinska Hospital University, Stockholm, 171 77, Sweden.
| | - Ali Mirazimi
- National Veterinary Institute, Uppsala, 751 89, Sweden; Department of Laboratory Medicine, Karolinska Institute and Karolinska Hospital University, Stockholm, 171 77, Sweden; Public Health Agency of Sweden, Stockholm, 171 82, Sweden.
| | - Julius Lutwama
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.
| | - Lawrence Mugisha
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda; Ecohealth Research Group, Conservation & Ecosystem Health Alliance (CEHA), Box 34153, Kampala, Uganda.
| | - Maja Malmberg
- Section of Virology, Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Box 7028, Uppsala, 750 07, Sweden; SLU Global Bioinformatics Centre, Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Box 7023, Uppsala, 750 07, Sweden.
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Raab M, Pfadenhauer LM, Nguyen VK, Doumbouya D, Hoelscher M, Froeschl G. Period prevalence and identification challenges of viral haemorrhagic fever suspect cases in a tertiary referral hospital in Guinea: a cross-sectional, retrospective study of triage and emergency room patient profiles. BMC Infect Dis 2020; 20:838. [PMID: 33183252 PMCID: PMC7663860 DOI: 10.1186/s12879-020-05573-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 10/31/2020] [Indexed: 11/22/2022] Open
Abstract
Background A functioning Viral Haemorrhagic Fever (VHF) surveillance system in countries at risk for outbreaks can reduce early transmission in case of an outbreak. Surveillance performance depends on the application of suspect case definitions in daily clinical practice. Recommended suspect case criteria during outbreaks are designed for high sensitivity and include general symptoms, pyrexia, haemorrhage, epidemiological link and unexplained death in patients. Non-outbreak criteria are narrower, relying on the persistence of fever and the presence of haemorrhagic signs. Methods This study ascertains VHF suspect case prevalence based on outbreak and non-outbreak criteria in a Guinean regional hospital for a period of three months. The study further describes clinical trajectories of patients who meet non-outbreak VHF suspect case criteria in order to discuss challenges in their identification. We used cross-sectional data collection at triage and emergency room to record demographic and clinical data of all admitted patients during the study period. For the follow-up study with description of diagnostic trajectories of VHF suspect cases, we used retrospective chart review. Results The most common symptoms of all patients upon admission were fever, tiredness/weakness and abdominal pain. 686 patients met EVD outbreak criteria, ten adult patients and two paediatric patients met study-specific non-outbreak VHF suspect case criteria. None of the suspect cases was treated as VHF suspect case and none tested positive for malaria upon admission. Their most frequent discharge diagnosis was unspecific gastrointestinal infection. The most common diagnostic measures were haemoglobin level and glycaemia for both adults and for children; of the requested examinations for hospitalized suspect cases, 36% were not executed or obtained. Half of those patients self-discharged against medical advice. Conclusions Our study shows that the number of VHF suspect cases may vary greatly depending on which suspect case criteria are applied. Identification of VHF suspect cases seems challenging in clinical practice. We suggest that this may be due to the low use of laboratory diagnostics to support certain diagnoses and the non-application of VHF suspect case definitions in clinical practice. Future VHF suspect case management should aim to tackle such challenges in comparable hospital settings.
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Affiliation(s)
- Manuel Raab
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), Leopoldstr. 5, 80802, Munich, Germany.
| | - Lisa M Pfadenhauer
- Institute of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig Maximilian University Munich, Marchioninistr, 15, 81377, Munich, Germany
| | - Vinh-Kim Nguyen
- Department of Anthropology and Sociology, The Graduate Institute (IHEID), Rue Eugene-Rigot 2, Case postale 1672, 1211, Geneva 1, Switzerland
| | - Dansira Doumbouya
- Paediatric Service, Hôpital Régional de N'zérékoré, Nzérékoré, Guinea
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), Leopoldstr. 5, 80802, Munich, Germany
| | - Guenter Froeschl
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), Leopoldstr. 5, 80802, Munich, Germany
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27
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Hemingway-Foday JJ, Ngoyi BF, Tunda C, Stolka KB, Grimes KEL, Lubula L, Mossoko M, Kebela BI, Brown LM, MacDonald PDM. Lessons Learned from Reinforcing Epidemiologic Surveillance During the 2017 Ebola Outbreak in the Likati District, Democratic Republic of the Congo. Health Secur 2020; 18:S81-S91. [PMID: 32004132 DOI: 10.1089/hs.2019.0065] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
On May 12, 2017, the Democratic Republic of Congo (DRC) publicly declared an outbreak of Ebola virus disease (EVD) in the Likati District of the Bas-Uélé Province, 46 days after the index case became symptomatic. The delayed EVD case detection and reporting highlights the importance of establishing real-time surveillance, consistent with the Global Health Security Agenda. We describe lessons learned from implementing improved EVD case detection and reporting strategies at the outbreak epicenter and make recommendations for future response efforts. The strategies included daily coordination meetings to enhance effective and efficient outbreak response activities, assessment and adaptation of case definitions and reporting tools, establishment of a community alert system using context-appropriate technology, training facility and community health workers on adapted case definitions and reporting procedures, development of context-specific plans for outbreak data management, and strengthened operational support for communications and information-sharing networks. Post-outbreak, surveillance officials should preemptively plan for the next outbreak by developing emergency response plans, evaluating the case definitions and reporting tools used, retraining on revised case definitions, and developing responsive strategies for overcoming telecommunications and technology challenges. The ongoing EVD outbreak in the North Kivu and Ituri provinces of DRC, currently the second largest EVD outbreak in history, demonstrates that documentation of successful context-specific strategies and tools are needed to combat the next outbreak. The lessons learned from the rapid containment of the EVD outbreak in Likati can be applied to the DRC and other rural low-resource settings to ensure readiness for future zoonotic disease outbreaks.
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Affiliation(s)
- Jennifer J Hemingway-Foday
- Jennifer J. Hemingway-Foday, MPH, MSW, is a Research Epidemiologist, and Kristen B. Stolka, MPH, and Kathryn E. L. Grimes, MPH, are Research Public Health Analysts; all at RTI International, Research Triangle Park, NC. Bonaventure Fuamba Ngoyi, MD, is a Field Epidemiologist, and Christian Tunda, ME, is an Information Communication Technology Specialist, working as a consultant; both at RTI International, Kinshasa, Democratic Republic of Congo. Léopold Lubula, MD, MPH, is Surveillance Manager; Mathias Mossoko, MSc, is Data Manager; and Benoit Ilunga Kebela, MD, is Director; all at the Ministry of Public Health, Kinshasa, Democratic Republic of Congo. Linda M. Brown, PhD, is Senior Research Epidemiologist, RTI International, Rockville, MD. Pia D. M. MacDonald, PhD, is Senior Director/Senior Epidemiologist, RTI International, Berkeley, CA
| | - Bonaventure Fuamba Ngoyi
- Jennifer J. Hemingway-Foday, MPH, MSW, is a Research Epidemiologist, and Kristen B. Stolka, MPH, and Kathryn E. L. Grimes, MPH, are Research Public Health Analysts; all at RTI International, Research Triangle Park, NC. Bonaventure Fuamba Ngoyi, MD, is a Field Epidemiologist, and Christian Tunda, ME, is an Information Communication Technology Specialist, working as a consultant; both at RTI International, Kinshasa, Democratic Republic of Congo. Léopold Lubula, MD, MPH, is Surveillance Manager; Mathias Mossoko, MSc, is Data Manager; and Benoit Ilunga Kebela, MD, is Director; all at the Ministry of Public Health, Kinshasa, Democratic Republic of Congo. Linda M. Brown, PhD, is Senior Research Epidemiologist, RTI International, Rockville, MD. Pia D. M. MacDonald, PhD, is Senior Director/Senior Epidemiologist, RTI International, Berkeley, CA
| | - Christian Tunda
- Jennifer J. Hemingway-Foday, MPH, MSW, is a Research Epidemiologist, and Kristen B. Stolka, MPH, and Kathryn E. L. Grimes, MPH, are Research Public Health Analysts; all at RTI International, Research Triangle Park, NC. Bonaventure Fuamba Ngoyi, MD, is a Field Epidemiologist, and Christian Tunda, ME, is an Information Communication Technology Specialist, working as a consultant; both at RTI International, Kinshasa, Democratic Republic of Congo. Léopold Lubula, MD, MPH, is Surveillance Manager; Mathias Mossoko, MSc, is Data Manager; and Benoit Ilunga Kebela, MD, is Director; all at the Ministry of Public Health, Kinshasa, Democratic Republic of Congo. Linda M. Brown, PhD, is Senior Research Epidemiologist, RTI International, Rockville, MD. Pia D. M. MacDonald, PhD, is Senior Director/Senior Epidemiologist, RTI International, Berkeley, CA
| | - Kristen B Stolka
- Jennifer J. Hemingway-Foday, MPH, MSW, is a Research Epidemiologist, and Kristen B. Stolka, MPH, and Kathryn E. L. Grimes, MPH, are Research Public Health Analysts; all at RTI International, Research Triangle Park, NC. Bonaventure Fuamba Ngoyi, MD, is a Field Epidemiologist, and Christian Tunda, ME, is an Information Communication Technology Specialist, working as a consultant; both at RTI International, Kinshasa, Democratic Republic of Congo. Léopold Lubula, MD, MPH, is Surveillance Manager; Mathias Mossoko, MSc, is Data Manager; and Benoit Ilunga Kebela, MD, is Director; all at the Ministry of Public Health, Kinshasa, Democratic Republic of Congo. Linda M. Brown, PhD, is Senior Research Epidemiologist, RTI International, Rockville, MD. Pia D. M. MacDonald, PhD, is Senior Director/Senior Epidemiologist, RTI International, Berkeley, CA
| | - Kathryn E L Grimes
- Jennifer J. Hemingway-Foday, MPH, MSW, is a Research Epidemiologist, and Kristen B. Stolka, MPH, and Kathryn E. L. Grimes, MPH, are Research Public Health Analysts; all at RTI International, Research Triangle Park, NC. Bonaventure Fuamba Ngoyi, MD, is a Field Epidemiologist, and Christian Tunda, ME, is an Information Communication Technology Specialist, working as a consultant; both at RTI International, Kinshasa, Democratic Republic of Congo. Léopold Lubula, MD, MPH, is Surveillance Manager; Mathias Mossoko, MSc, is Data Manager; and Benoit Ilunga Kebela, MD, is Director; all at the Ministry of Public Health, Kinshasa, Democratic Republic of Congo. Linda M. Brown, PhD, is Senior Research Epidemiologist, RTI International, Rockville, MD. Pia D. M. MacDonald, PhD, is Senior Director/Senior Epidemiologist, RTI International, Berkeley, CA
| | - Léopold Lubula
- Jennifer J. Hemingway-Foday, MPH, MSW, is a Research Epidemiologist, and Kristen B. Stolka, MPH, and Kathryn E. L. Grimes, MPH, are Research Public Health Analysts; all at RTI International, Research Triangle Park, NC. Bonaventure Fuamba Ngoyi, MD, is a Field Epidemiologist, and Christian Tunda, ME, is an Information Communication Technology Specialist, working as a consultant; both at RTI International, Kinshasa, Democratic Republic of Congo. Léopold Lubula, MD, MPH, is Surveillance Manager; Mathias Mossoko, MSc, is Data Manager; and Benoit Ilunga Kebela, MD, is Director; all at the Ministry of Public Health, Kinshasa, Democratic Republic of Congo. Linda M. Brown, PhD, is Senior Research Epidemiologist, RTI International, Rockville, MD. Pia D. M. MacDonald, PhD, is Senior Director/Senior Epidemiologist, RTI International, Berkeley, CA
| | - Mathias Mossoko
- Jennifer J. Hemingway-Foday, MPH, MSW, is a Research Epidemiologist, and Kristen B. Stolka, MPH, and Kathryn E. L. Grimes, MPH, are Research Public Health Analysts; all at RTI International, Research Triangle Park, NC. Bonaventure Fuamba Ngoyi, MD, is a Field Epidemiologist, and Christian Tunda, ME, is an Information Communication Technology Specialist, working as a consultant; both at RTI International, Kinshasa, Democratic Republic of Congo. Léopold Lubula, MD, MPH, is Surveillance Manager; Mathias Mossoko, MSc, is Data Manager; and Benoit Ilunga Kebela, MD, is Director; all at the Ministry of Public Health, Kinshasa, Democratic Republic of Congo. Linda M. Brown, PhD, is Senior Research Epidemiologist, RTI International, Rockville, MD. Pia D. M. MacDonald, PhD, is Senior Director/Senior Epidemiologist, RTI International, Berkeley, CA
| | - Benoit Ilunga Kebela
- Jennifer J. Hemingway-Foday, MPH, MSW, is a Research Epidemiologist, and Kristen B. Stolka, MPH, and Kathryn E. L. Grimes, MPH, are Research Public Health Analysts; all at RTI International, Research Triangle Park, NC. Bonaventure Fuamba Ngoyi, MD, is a Field Epidemiologist, and Christian Tunda, ME, is an Information Communication Technology Specialist, working as a consultant; both at RTI International, Kinshasa, Democratic Republic of Congo. Léopold Lubula, MD, MPH, is Surveillance Manager; Mathias Mossoko, MSc, is Data Manager; and Benoit Ilunga Kebela, MD, is Director; all at the Ministry of Public Health, Kinshasa, Democratic Republic of Congo. Linda M. Brown, PhD, is Senior Research Epidemiologist, RTI International, Rockville, MD. Pia D. M. MacDonald, PhD, is Senior Director/Senior Epidemiologist, RTI International, Berkeley, CA
| | - Linda M Brown
- Jennifer J. Hemingway-Foday, MPH, MSW, is a Research Epidemiologist, and Kristen B. Stolka, MPH, and Kathryn E. L. Grimes, MPH, are Research Public Health Analysts; all at RTI International, Research Triangle Park, NC. Bonaventure Fuamba Ngoyi, MD, is a Field Epidemiologist, and Christian Tunda, ME, is an Information Communication Technology Specialist, working as a consultant; both at RTI International, Kinshasa, Democratic Republic of Congo. Léopold Lubula, MD, MPH, is Surveillance Manager; Mathias Mossoko, MSc, is Data Manager; and Benoit Ilunga Kebela, MD, is Director; all at the Ministry of Public Health, Kinshasa, Democratic Republic of Congo. Linda M. Brown, PhD, is Senior Research Epidemiologist, RTI International, Rockville, MD. Pia D. M. MacDonald, PhD, is Senior Director/Senior Epidemiologist, RTI International, Berkeley, CA
| | - Pia D M MacDonald
- Jennifer J. Hemingway-Foday, MPH, MSW, is a Research Epidemiologist, and Kristen B. Stolka, MPH, and Kathryn E. L. Grimes, MPH, are Research Public Health Analysts; all at RTI International, Research Triangle Park, NC. Bonaventure Fuamba Ngoyi, MD, is a Field Epidemiologist, and Christian Tunda, ME, is an Information Communication Technology Specialist, working as a consultant; both at RTI International, Kinshasa, Democratic Republic of Congo. Léopold Lubula, MD, MPH, is Surveillance Manager; Mathias Mossoko, MSc, is Data Manager; and Benoit Ilunga Kebela, MD, is Director; all at the Ministry of Public Health, Kinshasa, Democratic Republic of Congo. Linda M. Brown, PhD, is Senior Research Epidemiologist, RTI International, Rockville, MD. Pia D. M. MacDonald, PhD, is Senior Director/Senior Epidemiologist, RTI International, Berkeley, CA
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Hardcastle AN, Osborne JCP, Ramshaw RE, Hulland EN, Morgan JD, Miller-Petrie MK, Hon J, Earl L, Rabinowitz P, Wasserheit JN, Gilbert M, Robinson TP, Wint GRW, Shirude S, Hay SI, Pigott DM. Informing Rift Valley Fever preparedness by mapping seasonally varying environmental suitability. Int J Infect Dis 2020; 99:362-372. [PMID: 32738486 PMCID: PMC7562817 DOI: 10.1016/j.ijid.2020.07.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/09/2020] [Accepted: 07/24/2020] [Indexed: 01/29/2023] Open
Abstract
Database of Rift Valley Fever occurrences from 46 countries over 22 years. Predictions of Rift Valley Fever suitability for every month over 1995–2016. Identifies areas at-risk by synthesizing time-series of environmental predictions. We use human and livestock data to identify possible hotspots of disease spillover. We identify places where long-term and routine preparation efforts should be focused.
Background Rift Valley Fever (RVF) poses a threat to human and animal health throughout much of Africa and the Middle East and has been recognized as a global health security priority and a key preparedness target. Methods We combined RVF occurrence data from a systematic literature review with animal notification data from an online database. Using boosted regression trees, we made monthly environmental suitability predictions from January 1995 to December 2016 at a 5 × 5-km resolution throughout regions of Africa, Europe, and the Middle East. We calculated the average number of months per year suitable for transmission, the mean suitability for each calendar month, and the “spillover potential,” a measure incorporating suitability with human and livestock populations. Results Several countries where cases have not yet been reported are suitable for RVF. Areas across the region of interest are suitable for transmission at different times of the year, and some areas are suitable for multiple seasons each year. Spillover potential results show areas within countries where high populations of humans and livestock are at risk for much of the year. Conclusions The widespread environmental suitability of RVF highlights the need for increased preparedness, even in countries that have not previously experienced cases. These maps can aid in prioritizing long-term RVF preparedness activities and determining optimal times for recurring preparedness activities. Given an outbreak, our results can highlight areas often at risk for subsequent transmission that month, enabling decision-makers to target responses effectively.
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Affiliation(s)
- Austin N Hardcastle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Joshua C P Osborne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Rebecca E Ramshaw
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin N Hulland
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Julia D Morgan
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Molly K Miller-Petrie
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Julia Hon
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Lucas Earl
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Peter Rabinowitz
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | - Marius Gilbert
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, Brussels, Belgium; Fonds National de la Recherche Scientifique (FNRS), Brussels, Belgium
| | - Timothy P Robinson
- Animal Production and Health Division (AGA), Food and Agriculture Organization of the United Nations, Italy
| | - G R William Wint
- Environmental Research Group Oxford (ERGO), c/o Department of Zoology, Oxford, UK
| | - Shreya Shirude
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
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Rang C, Cheng A, Kelly P, Kotsimbos T. COVID-19 from the land "Down Under" in an upside-down world: an Australian perspective. Eur Respir J 2020; 56:2001844. [PMID: 32586884 PMCID: PMC7315813 DOI: 10.1183/13993003.01844-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/11/2020] [Indexed: 11/05/2022]
Abstract
We frame the world, which then frames all our seeing, thinking and doing [1]. This is true individually, professionally and at the level of all our institutions. It is a perpetual work in progress that occasionally undergoes a single seismic shift. This is the situation that the world is currently experiencing with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), notwithstanding prior warnings [2, 3]. Australia's approach to the current COVID-19 pandemic has resulted in relative containment of the disease. However, it must be remembered that any defence is only as strong as its weakest link. https://bit.ly/2N2hHy1
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Affiliation(s)
- Catherine Rang
- Dept of Respiratory Medicine, Alfred Health, Melbourne, Australia
| | - Allen Cheng
- Dept of Infectious Diseases, Alfred Health, Melbourne, Australia
- Dept of Medicine, Monash University, Alfred Campus, Melbourne, Australia
| | - Paul Kelly
- Australian National University Medical School, Canberra, Australia
| | - Tom Kotsimbos
- Dept of Respiratory Medicine, Alfred Health, Melbourne, Australia
- Dept of Medicine, Monash University, Alfred Campus, Melbourne, Australia
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30
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Polonsky JA, Baidjoe A, Kamvar ZN, Cori A, Durski K, Edmunds WJ, Eggo RM, Funk S, Kaiser L, Keating P, de Waroux OLP, Marks M, Moraga P, Morgan O, Nouvellet P, Ratnayake R, Roberts CH, Whitworth J, Jombart T. Outbreak analytics: a developing data science for informing the response to emerging pathogens. Philos Trans R Soc Lond B Biol Sci 2020; 374:20180276. [PMID: 31104603 PMCID: PMC6558557 DOI: 10.1098/rstb.2018.0276] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Despite continued efforts to improve health systems worldwide, emerging pathogen epidemics remain a major public health concern. Effective response to such outbreaks relies on timely intervention, ideally informed by all available sources of data. The collection, visualization and analysis of outbreak data are becoming increasingly complex, owing to the diversity in types of data, questions and available methods to address them. Recent advances have led to the rise of outbreak analytics, an emerging data science focused on the technological and methodological aspects of the outbreak data pipeline, from collection to analysis, modelling and reporting to inform outbreak response. In this article, we assess the current state of the field. After laying out the context of outbreak response, we critically review the most common analytics components, their inter-dependencies, data requirements and the type of information they can provide to inform operations in real time. We discuss some challenges and opportunities and conclude on the potential role of outbreak analytics for improving our understanding of, and response to outbreaks of emerging pathogens. This article is part of the theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control‘. This theme issue is linked with the earlier issue ‘Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes’.
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Affiliation(s)
- Jonathan A Polonsky
- 1 Department of Health Emergency Information and Risk Assessment, World Health Organization , Avenue Appia 20, 1211 Geneva , Switzerland.,3 Faculty of Medicine, University of Geneva , 1 rue Michel-Servet, 1211 Geneva , Switzerland
| | - Amrish Baidjoe
- 4 Department of Infectious Disease Epidemiology, School of Public Health, MRC Centre for Global Infectious Disease Analysis, Imperial College London , Medical School Building, St Mary's Campus, Norfolk Place London W2 1PG , UK
| | - Zhian N Kamvar
- 4 Department of Infectious Disease Epidemiology, School of Public Health, MRC Centre for Global Infectious Disease Analysis, Imperial College London , Medical School Building, St Mary's Campus, Norfolk Place London W2 1PG , UK
| | - Anne Cori
- 4 Department of Infectious Disease Epidemiology, School of Public Health, MRC Centre for Global Infectious Disease Analysis, Imperial College London , Medical School Building, St Mary's Campus, Norfolk Place London W2 1PG , UK
| | - Kara Durski
- 2 Department of Infectious Hazard Management, World Health Organization , Avenue Appia 20, 1211 Geneva , Switzerland
| | - W John Edmunds
- 5 Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK.,6 Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK
| | - Rosalind M Eggo
- 5 Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK.,6 Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK
| | - Sebastian Funk
- 5 Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK.,6 Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK
| | - Laurent Kaiser
- 3 Faculty of Medicine, University of Geneva , 1 rue Michel-Servet, 1211 Geneva , Switzerland
| | - Patrick Keating
- 5 Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK.,8 UK Public Health Rapid Support Team , London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT , UK
| | - Olivier le Polain de Waroux
- 5 Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK.,8 UK Public Health Rapid Support Team , London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT , UK.,9 Public Health England , Wellington House, 133-155 Waterloo Road, London SE1 8UG , UK
| | - Michael Marks
- 7 Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK
| | - Paula Moraga
- 10 Centre for Health Informatics, Computing and Statistics (CHICAS), Lancaster Medical School, Lancaster University , Lancaster LA1 4YW , UK
| | - Oliver Morgan
- 1 Department of Health Emergency Information and Risk Assessment, World Health Organization , Avenue Appia 20, 1211 Geneva , Switzerland
| | - Pierre Nouvellet
- 4 Department of Infectious Disease Epidemiology, School of Public Health, MRC Centre for Global Infectious Disease Analysis, Imperial College London , Medical School Building, St Mary's Campus, Norfolk Place London W2 1PG , UK.,11 School of Life Sciences, University of Sussex , Sussex House, Brighton BN1 9RH , UK
| | - Ruwan Ratnayake
- 5 Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK.,6 Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK
| | - Chrissy H Roberts
- 7 Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK
| | - Jimmy Whitworth
- 5 Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK.,8 UK Public Health Rapid Support Team , London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT , UK
| | - Thibaut Jombart
- 4 Department of Infectious Disease Epidemiology, School of Public Health, MRC Centre for Global Infectious Disease Analysis, Imperial College London , Medical School Building, St Mary's Campus, Norfolk Place London W2 1PG , UK.,5 Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK.,8 UK Public Health Rapid Support Team , London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT , UK
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Kraemer MUG, Pigott DM, Hill SC, Vanderslott S, Reiner RC, Stasse S, Brownstein JS, Gutierrez B, Dennig F, Hay SI, Wint GRW, Pybus OG, Castro MC, Vinck P, Pham PN, Nilles EJ, Cauchemez S. Dynamics of conflict during the Ebola outbreak in the Democratic Republic of the Congo 2018-2019. BMC Med 2020; 18:113. [PMID: 32336281 PMCID: PMC7184697 DOI: 10.1186/s12916-020-01574-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/24/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The 2018-2019 Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo (DRC) is the largest ever recorded in the DRC. It has been declared a Public Health Emergency of International Concern. The outbreak emerged in a region of chronic conflict and insecurity, and directed attacks against health care workers may have interfered with disease response activities. Our study characterizes and quantifies the broader conflict dynamics over the course of the outbreak by pairing epidemiological and all available spatial conflict data. METHODS We build a set of conflict variables by mapping the spatial locations of all conflict events and their associated deaths in each of the affected health zones in North Kivu and Ituri, eastern DRC, before and during the outbreak. Using these data, we compare patterns of conflict before and during the outbreak in affected health zones and those not affected. We then test whether conflict is correlated with increased EVD transmission at the health zone level. FINDINGS The incidence of conflict events per capita is ~ 600 times more likely in Ituri and North Kivu than for the rest of the DRC. We identified 15 time periods of substantial uninterrupted transmission across 11 health zones and a total of 120 bi-weeks. We do not find significant short-term associations between the bi-week reproduction numbers and the number of conflicts. However, we do find that the incidence of conflict per capita was correlated with the incidence of EVD per capita at the health zone level for the entire outbreak (Pearson's r = 0.33, 95% CI 0.05-0.57). In the two provinces, the monthly number of conflict events also increased by a factor of 2.7 in Ebola-affected health zones (p value < 0.05) compared to 2.0 where no transmission was reported and 1.3 in the rest of the DRC, in the period between February 2019 and July 2019. CONCLUSION We characterized the association between variables documenting broad conflict levels and EVD transmission. Such assessment is important to understand if and how such conflict variables could be used to inform the outbreak response. We found that while these variables can help characterize long-term challenges and susceptibilities of the different regions they provide little insight on the short-term dynamics of EVD transmission.
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Affiliation(s)
- Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK. .,Harvard Medical School, Harvard University, Boston, USA. .,Computational Epidemiology Group, Boston Children's Hospital, Boston, USA.
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Sarah C Hill
- Department of Zoology, University of Oxford, Oxford, UK
| | | | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Stephanie Stasse
- European Union Delegation to the Democratic Republic of the Congo, Kinshasa, Democratic Republic of the Congo
| | - John S Brownstein
- Harvard Medical School, Harvard University, Boston, USA.,Computational Epidemiology Group, Boston Children's Hospital, Boston, USA
| | - Bernardo Gutierrez
- Department of Zoology, University of Oxford, Oxford, UK.,School of Biological and Environmental Sciences, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | | | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - G R William Wint
- Environmental Research Group Oxford, Department of Zoology, University of Oxford, Oxford, UK
| | | | - Marcia C Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Patrick Vinck
- Harvard Medical School, Harvard University, Boston, USA.,Program on Infectious Diseases and Emergencies, Harvard Humanitarian Initiative, Harvard University, Cambridge, USA.,Brigham and Women's Hospital, Boston, USA
| | - Phuong N Pham
- Harvard Medical School, Harvard University, Boston, USA.,Program on Infectious Diseases and Emergencies, Harvard Humanitarian Initiative, Harvard University, Cambridge, USA.,Brigham and Women's Hospital, Boston, USA
| | - Eric J Nilles
- Harvard Medical School, Harvard University, Boston, USA.,Program on Infectious Diseases and Emergencies, Harvard Humanitarian Initiative, Harvard University, Cambridge, USA.,Brigham and Women's Hospital, Boston, USA
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, CNRS, UMR2000, Paris, France.
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Kayem ND, Rojek A, Denis E, Salam A, Reis A, Olliaro P, Horby P. Clinical REsearch During Outbreaks (CREDO) Training for Low- and Middle-Income Countries. Emerg Infect Dis 2020; 25:2084-2087. [PMID: 31625845 PMCID: PMC6810185 DOI: 10.3201/eid2511.180628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
We describe a pilot of the Clinical REsearch During Outbreaks (CREDO) initiative, a training curriculum for researchers in epidemic-prone low- and middle-income countries who may respond to disease outbreaks. Participants reported improved confidence in their ability to conduct such research and overall satisfaction with the course structure, content, and training.
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Olayemi A, Fichet-Calvet E. Systematics, Ecology, and Host Switching: Attributes Affecting Emergence of the Lassa Virus in Rodents across Western Africa. Viruses 2020; 12:E312. [PMID: 32183319 PMCID: PMC7150792 DOI: 10.3390/v12030312] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 12/18/2022] Open
Abstract
Ever since it was established that rodents serve as reservoirs of the zoonotic Lassa virus (LASV), scientists have sought to answer the questions: which populations of rodents carry the virus? How do fluctuations in LASV prevalence and rodent abundance influence Lassa fever outbreaks in humans? What does it take for the virus to adopt additional rodent hosts, proliferating what already are devastating cycles of rodent-to-human transmission? In this review, we examine key aspects of research involving the biology of rodents that affect their role as LASV reservoirs, including phylogeography, demography, virus evolution, and host switching. We discuss how this knowledge can help control Lassa fever and suggest further areas for investigation.
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Affiliation(s)
- Ayodeji Olayemi
- Natural History Museum, Obafemi Awolowo University, Ile Ife HO220005, Nigeria;
| | - Elisabeth Fichet-Calvet
- Department of Virology, Bernhard Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany
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Raab M, Pfadenhauer LM, Millimouno TJ, Hoelscher M, Froeschl G. Knowledge, attitudes and practices towards viral haemorrhagic fevers amongst healthcare workers in urban and rural public healthcare facilities in the N'zérékoré prefecture, Guinea: a cross-sectional study. BMC Public Health 2020; 20:296. [PMID: 32138720 PMCID: PMC7059383 DOI: 10.1186/s12889-020-8433-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/28/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The 2013-2016 Ebola epidemic in West Africa began in Guinea's Forest region, a region now considered to be at high risk for future epidemics of viral haemorrhagic fevers (VHF). Good knowledge, attitudes and practices towards VHF amongst healthcare workers in such regions are a central pillar of infection prevention and control (IPC). To inform future training in IPC, this study assesses the knowledge, attitudes and practices (KAP) towards VHF amongst healthcare workers in public healthcare facilities in the most populated prefecture in Forest Guinea, and compares results from urban and rural areas. METHODS In June and July 2019, we interviewed 102 healthcare workers in the main urban and rural public healthcare facilities in the N'zérékoré prefecture in Forest Guinea. We used an interviewer-administered questionnaire adapted from validated KAP surveys. RESULTS The great majority of respondents demonstrated good knowledge and favourable attitudes towards VHF. However, respondents reported some gaps in preventive practices such as VHF suspect case detection. They also reported a shortage of protective medical equipment used in everyday clinical work in both urban and rural healthcare facilities and a lack of training in IPC, especially in rural healthcare facilities. However, whether or not healthcare workers had been trained in IPC did not seem to influence their level of KAP towards VHF. CONCLUSIONS Three years after the end of the Ebola epidemic, our findings suggest that public healthcare facilities in the N'zérékoré prefecture in Forest Guinea still lack essential protective equipment and some practical training in VHF suspect case detection. To minimize the risk of future VHF epidemics and improve management of outbreaks of infectious diseases in the region, current efforts to strengthen the public healthcare system in Guinea should encompass questions of supply and IPC training.
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Affiliation(s)
- Manuel Raab
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), Leopoldstr. 5, 80802 Munich, Germany
| | - Lisa M. Pfadenhauer
- Institute of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig Maximilian University Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Tamba Jacques Millimouno
- Department of Disease Surveillance, Agence Nationale de Sécurité Sanitaire (ANSS), Conakry, Guinea
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), Leopoldstr. 5, 80802 Munich, Germany
| | - Guenter Froeschl
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), Leopoldstr. 5, 80802 Munich, Germany
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35
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Jacob ST, Crozier I, Fischer WA, Hewlett A, Kraft CS, Vega MADL, Soka MJ, Wahl V, Griffiths A, Bollinger L, Kuhn JH. Ebola virus disease. Nat Rev Dis Primers 2020; 6:13. [PMID: 32080199 PMCID: PMC7223853 DOI: 10.1038/s41572-020-0147-3] [Citation(s) in RCA: 267] [Impact Index Per Article: 66.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2020] [Indexed: 12/16/2022]
Abstract
Ebola virus disease (EVD) is a severe and frequently lethal disease caused by Ebola virus (EBOV). EVD outbreaks typically start from a single case of probable zoonotic transmission, followed by human-to-human transmission via direct contact or contact with infected bodily fluids or contaminated fomites. EVD has a high case-fatality rate; it is characterized by fever, gastrointestinal signs and multiple organ dysfunction syndrome. Diagnosis requires a combination of case definition and laboratory tests, typically real-time reverse transcription PCR to detect viral RNA or rapid diagnostic tests based on immunoassays to detect EBOV antigens. Recent advances in medical countermeasure research resulted in the recent approval of an EBOV-targeted vaccine by European and US regulatory agencies. The results of a randomized clinical trial of investigational therapeutics for EVD demonstrated survival benefits from two monoclonal antibody products targeting the EBOV membrane glycoprotein. New observations emerging from the unprecedented 2013-2016 Western African EVD outbreak (the largest in history) and the ongoing EVD outbreak in the Democratic Republic of the Congo have substantially improved the understanding of EVD and viral persistence in survivors of EVD, resulting in new strategies toward prevention of infection and optimization of clinical management, acute illness outcomes and attendance to the clinical care needs of patients.
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Affiliation(s)
- Shevin T Jacob
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Global Health Security Department, Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Ian Crozier
- Integrated Research Facility at Fort Detrick, Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research supported by the National Cancer Institute, Frederick, MD, USA
| | - William A Fischer
- Department of Medicine, Division of Pulmonary Disease and Critical Care Medicine, Chapel Hill, NC, USA
| | - Angela Hewlett
- Nebraska Biocontainment Unit, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - Colleen S Kraft
- Microbiology Section, Emory Medical Laboratory, Emory University School of Medicine, Atlanta, GA, USA
| | - Marc-Antoine de La Vega
- Department of Microbiology, Immunology & Infectious Diseases, Université Laval, Quebec City, QC, Canada
| | - Moses J Soka
- Partnership for Ebola Virus Disease Research in Liberia, Monrovia Medical Units ELWA-2 Hospital, Monrovia, Liberia
| | - Victoria Wahl
- National Biodefense Analysis and Countermeasures Center, Fort Detrick, Frederick, MD, USA
| | - Anthony Griffiths
- Department of Microbiology and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA, USA
| | - Laura Bollinger
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, MD, USA
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, MD, USA.
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36
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Cheshmehzangi A. How Cities Cope in Outbreak Events? The City in Need 2020. [DOI: 10.1007/978-981-15-5487-2_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
An outbreak can cause more problems than just the spread of disease. It can be an antagonistic nemesis to our cities and communities, particularly if we lack preparedness and resilience. Its progress is usually unclear as it can be completely different from case to case, and can react differently in different contexts and with different groups of people. Such reactions may purely relate to climatic conditions, hygienic status, and environmental attributes of the context. Those reactions can also differ from one group of people to another, while the disease has to find its correct host as well the way it can transmit and evolve. Consequently, the magnitude of impacts would depend on many factors, of which the nature of the disease is very important during the whole outbreak progress.
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37
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Egeru A, Dejene SW, Siya A. Short report on implications of Covid-19 and emerging zoonotic infectious diseases for pastoralists and Africa. Pastoralism 2020; 10:12. [PMID: 32537120 PMCID: PMC7281698 DOI: 10.1186/s13570-020-00173-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/18/2020] [Indexed: 04/17/2023]
Abstract
Many emerging and re-emerging zoonotic infectious diseases occur in Africa. These are projected to increase as human-animal host contact increases owing to increasing environmental degradation that shrinks nature habitats for wildlife over the continent. The current outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) responsible for causing coronavirus disease in 2019 (COVID-19) has reinvigorated discourse on the disruptiveness of the zoonotic emerging infectious diseases, owing to their transboundary character. Even as the world focuses on the COVID-19 sweeping pandemic, the Middle East respiratory syndrome coronavirus (MERS)-CoV re-emerged in Saudi Arabia infecting 18 people with five deaths; this has barely received any attention. This outbreak is particularly of concern to the pastoralists in the Horn of Africa, a region that has in recent past seen an increase in camel trade with the Gulf States, especially Yemen and Saudi Arabia. Emerging and re-emerging zoonotic infectious diseases are complex, depend on human-animal-environment interaction and pose a strain on public health systems. There is a need to address these diseases dynamically through a synergistic approach, drawing on expertise from diverse sectors. One Health approach has distinguished itself as an integrative action able to bring together multiple actors on a global, national and local scale to advance the attainment of optimal health outcomes for people, animals and the environment. One Health works by strengthening the preparedness, response, mitigation and monitoring of zoonotic infectious disease risks collaboratively. We opine that as zoonotic emerging and re-emerging infectious diseases continue to rise over pastoral Africa, comprehensive implementation of the One Health approach will be urgently required.
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Affiliation(s)
- Anthony Egeru
- Department of Environmental Management, College of Agricultural and Environmental Science, Makerere University, P.O. Box 7062, Kampala, Uganda
- Training and Community Development, Regional Universities Forum for Capacity Building in Agriculture, P.O. Box 16811, Wandegeya, Kampala, Uganda
| | - Sintayehu W. Dejene
- College of Agriculture and Environmental Sciences, Haramaya University, P.O. Box 282, Dire Dawa, Ethiopia
| | - Aggrey Siya
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda
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38
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Hulland EN, Wiens KE, Shirude S, Morgan JD, Bertozzi-Villa A, Farag TH, Fullman N, Kraemer MUG, Miller-Petrie MK, Gupta V, Reiner RC, Rabinowitz P, Wasserheit JN, Bell BP, Hay SI, Weiss DJ, Pigott DM. Travel time to health facilities in areas of outbreak potential: maps for guiding local preparedness and response. BMC Med 2019; 17:232. [PMID: 31888667 PMCID: PMC6937971 DOI: 10.1186/s12916-019-1459-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/05/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Repeated outbreaks of emerging pathogens underscore the need for preparedness plans to prevent, detect, and respond. As countries develop and improve National Action Plans for Health Security, addressing subnational variation in preparedness is increasingly important. One facet of preparedness and mitigating disease transmission is health facility accessibility, linking infected persons with health systems and vice versa. Where potential patients can access care, local facilities must ensure they can appropriately diagnose, treat, and contain disease spread to prevent secondary transmission; where patients cannot readily access facilities, alternate plans must be developed. Here, we use travel time to link facilities and populations at risk of viral hemorrhagic fevers (VHFs) and identify spatial variation in these respective preparedness demands. METHODS AND FINDINGS We used geospatial resources of travel friction, pathogen environmental suitability, and health facilities to determine facility accessibility of any at-risk location within a country. We considered in-country and cross-border movements of exposed populations and highlighted vulnerable populations where current facilities are inaccessible and new infrastructure would reduce travel times. We developed profiles for 43 African countries. Resulting maps demonstrate gaps in health facility accessibility and highlight facilities closest to areas at risk for VHF spillover. For instance, in the Central African Republic, we identified travel times of over 24 h to access a health facility. Some countries had more uniformly short travel times, such as Nigeria, although regional disparities exist. For some populations, including many in Botswana, access to areas at risk for VHF nationally was low but proximity to suitable spillover areas in bordering countries was high. Additional analyses provide insights for considering future resource allocation. We provide a contemporary use case for these analyses for the ongoing Ebola outbreak. CONCLUSIONS These maps demonstrate the use of geospatial analytics for subnational preparedness, identifying facilities close to at-risk populations for prioritizing readiness to detect, treat, and respond to cases and highlighting where gaps in health facility accessibility exist. We identified cross-border threats for VHF exposure and demonstrate an opportunity to improve preparedness activities through the use of precision public health methods and data-driven insights for resource allocation as part of a country's preparedness plans.
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Affiliation(s)
- E N Hulland
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA, 98121, USA
| | - K E Wiens
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA, 98121, USA
| | - S Shirude
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA, 98121, USA
| | - J D Morgan
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA, 98121, USA
| | - A Bertozzi-Villa
- Malaria Atlas Project, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, UK
- Institute for Disease Modeling, Bellevue, WA, 98005, USA
| | - T H Farag
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA, 98121, USA
| | - N Fullman
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA, 98121, USA
| | - M U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK
| | - M K Miller-Petrie
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA, 98121, USA
| | - V Gupta
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA, 98121, USA
| | - R C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA, 98121, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, 98121, USA
| | - P Rabinowitz
- Department of Global Health, University of Washington, Seattle, WA, 98195, USA
| | - J N Wasserheit
- Department of Global Health, University of Washington, Seattle, WA, 98195, USA
| | - B P Bell
- Department of Global Health, University of Washington, Seattle, WA, 98195, USA
| | - S I Hay
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA, 98121, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, 98121, USA
| | - D J Weiss
- Malaria Atlas Project, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, UK
| | - D M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA, 98121, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, 98121, USA.
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Krubiner CB, Schwartz DA. Viral Hemorrhagic Fevers in Pregnant Women and the Vaccine Landscape: Comparisons Between Yellow Fever, Ebola, and Lassa Fever. Curr Trop Med Rep 2019. [DOI: 10.1007/s40475-019-00194-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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40
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Dallas TA, Carlson CJ, Poisot T. Testing predictability of disease outbreaks with a simple model of pathogen biogeography. R Soc Open Sci 2019; 6:190883. [PMID: 31827836 PMCID: PMC6894608 DOI: 10.1098/rsos.190883] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/08/2019] [Indexed: 05/15/2023]
Abstract
Predicting disease emergence and outbreak events is a critical task for public health professionals and epidemiologists. Advances in global disease surveillance are increasingly generating datasets that are worth more than their component parts for prediction-oriented work. Here, we use a trait-free approach which leverages information on the global community of human infectious diseases to predict the biogeography of pathogens through time. Our approach takes pairwise dissimilarities between countries' pathogen communities and pathogens' geographical distributions and uses these to predict country-pathogen associations. We compare the success rates of our model for predicting pathogen outbreak, emergence and re-emergence potential as a function of time (e.g. number of years between training and prediction), pathogen type (e.g. virus) and transmission mode (e.g. vector-borne). With only these simple predictors, our model successfully predicts basic network structure up to a decade into the future. We find that while outbreak and re-emergence potential are especially well captured by our simple model, prediction of emergence events remains more elusive, and sudden global emergences like an influenza pandemic are beyond the predictive capacity of the model. However, these stochastic pandemic events are unlikely to be predictable from such coarse data. Together, our model is able to use the information on the existing country-pathogen network to predict pathogen outbreaks fairly well, suggesting the importance in considering information on co-occurring pathogens in a more global view even to estimate outbreak events in a single location or for a single pathogen.
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Affiliation(s)
- Tad A. Dallas
- Research Centre for Ecological Change, University of Helsinki, 00840 Helsinki, Finland
- Department of Biology, Louisiana State University, Baton Rouge, LA 70803, USA
- Author for correspondence: Tad A. Dallas e-mail:
| | - Colin J. Carlson
- Department of Biology, Georgetown University, Washington, DC 20057, USA
| | - Timothée Poisot
- Dépt de Sciences Biologiques, Univ. de Montréal, Montréal, Canada
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Ellenberg SS, Keusch GT, Babiker AG, Edwards KM, Lewis RJ, Lundgren JD, Wells CD, Wabwire-Mangen F, McAdam KPWJ. Rigorous Clinical Trial Design in Public Health Emergencies Is Essential. Clin Infect Dis 2019; 66:1467-1469. [PMID: 29177461 DOI: 10.1093/cid/cix1032] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/18/2017] [Indexed: 12/18/2022] Open
Abstract
Randomized clinical trials are the most reliable approaches to evaluating the effects of new treatments and vaccines. During the 2014-2015 West African Ebola epidemic, many argued that such trials were neither ethical nor feasible in an environment of limited health infrastructure and severe disease with a high fatality rate. Consensus among the numerous organizations providing help to the affected areas was never achieved, resulting in fragmented collaboration, delayed study initiation, and ultimately failure to provide definitive evidence on the efficacy of treatments and vaccines. Randomized trials were in fact approved by local ethics boards and initiated, demonstrating that randomized trials, even in such difficult circumstances, are feasible. Improved planning and collaboration among research and humanitarian organizations, and affected communities, in the interepidemic periods are needed to ensure that questions regarding the efficacy of vaccines and treatments can be definitively answered during future public health emergencies.
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Affiliation(s)
- Susan S Ellenberg
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Gerald T Keusch
- Departments of Medicine and Global Health, Boston University Schools of Medicine and Public Health, Massachusetts
| | - Abdel G Babiker
- Medical Research Council Clinical Trials Unit, University College London, United Kingdom
| | - Kathryn M Edwards
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Roger J Lewis
- Department of Emergency Medicine, Harbor-UCLA Medical Center, University of California, Los Angeles, California
| | - Jens D Lundgren
- Department of Infectious Diseases, University of Copenhagen, Denmark
| | - Charles D Wells
- Infectious Diseases Unit, Sanofi-US, Bridgewater, New Jersey
| | - Fred Wabwire-Mangen
- Department of Epidemiology, Makerere University School of Public Health, Kampala, Uganda
| | - Keith P W J McAdam
- Department of Clinical and Tropical Medicine, London School of Hygiene and Tropical Medicine, United Kingdom
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42
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Redding DW, Atkinson PM, Cunningham AA, Lo Iacono G, Moses LM, Wood JLN, Jones KE. Impacts of environmental and socio-economic factors on emergence and epidemic potential of Ebola in Africa. Nat Commun 2019; 10:4531. [PMID: 31615986 PMCID: PMC6794280 DOI: 10.1038/s41467-019-12499-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/13/2019] [Indexed: 12/15/2022] Open
Abstract
Recent outbreaks of animal-borne emerging infectious diseases have likely been precipitated by a complex interplay of changing ecological, epidemiological and socio-economic factors. Here, we develop modelling methods that capture elements of each of these factors, to predict the risk of Ebola virus disease (EVD) across time and space. Our modelling results match previously-observed outbreak patterns with high accuracy, and suggest further outbreaks could occur across most of West and Central Africa. Trends in the underlying drivers of EVD risk suggest a 1.75 to 3.2-fold increase in the endemic rate of animal-human viral spill-overs in Africa by 2070, given current modes of healthcare intervention. Future global change scenarios with higher human population growth and lower rates of socio-economic development yield a fourfold higher likelihood of epidemics occurring as a result of spill-over events. Our modelling framework can be used to target interventions designed to reduce epidemic risk for many zoonotic diseases.
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Affiliation(s)
- David W Redding
- Centre for Biodiversity and Environment Research, Department of Genetics, Evolution and Environment, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Peter M Atkinson
- Lancaster Environment Centre, Lancaster University, Bailrigg, Lancaster LA4 1YW, UK
| | - Andrew A Cunningham
- Institute of Zoology, Zoological Society of London, Regent's Park, London, NW1 4RY, UK
| | - Gianni Lo Iacono
- School of Veterinary Medicine, University of Surrey, Guildford, UK
| | - Lina M Moses
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA
| | - James L N Wood
- Department of Veterinary Medicine, Disease Dynamics Unit, University of Cambridge, Cambridge, UK
| | - Kate E Jones
- Centre for Biodiversity and Environment Research, Department of Genetics, Evolution and Environment, University College London, Gower Street, London, WC1E 6BT, UK. .,Institute of Zoology, Zoological Society of London, Regent's Park, London, NW1 4RY, UK.
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43
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Abstract
BACKGROUND In 2015, the Zika virus spread from Brazil throughout the Americas, posing an unprecedented challenge to the public health community. During the epidemic, international public health officials lacked reliable predictions of the outbreak's expected geographic scale and prevalence of cases, and were therefore unable to plan and allocate surveillance resources in a timely and effective manner. METHODS In this work, we present a dynamic neural network model to predict the geographic spread of outbreaks in real time. The modeling framework is flexible in three main dimensions (i) selection of the chosen risk indicator, i.e., case counts or incidence rate; (ii) risk classification scheme, which defines the high-risk group based on a relative or absolute threshold; and (iii) prediction forecast window (1 up to 12 weeks). The proposed model can be applied dynamically throughout the course of an outbreak to identify the regions expected to be at greatest risk in the future. RESULTS The model is applied to the recent Zika epidemic in the Americas at a weekly temporal resolution and country spatial resolution, using epidemiological data, passenger air travel volumes, and vector habitat suitability, socioeconomic, and population data for all affected countries and territories in the Americas. The model performance is quantitatively evaluated based on the predictive accuracy of the model. We show that the model can accurately predict the geographic expansion of Zika in the Americas with the overall average accuracy remaining above 85% even for prediction windows of up to 12 weeks. CONCLUSIONS Sensitivity analysis illustrated the model performance to be robust across a range of features. Critically, the model performed consistently well at various stages throughout the course of the outbreak, indicating its potential value at any time during an epidemic. The predictive capability was superior for shorter forecast windows and geographically isolated locations that are predominantly connected via air travel. The highly flexible nature of the proposed modeling framework enables policy makers to develop and plan vector control programs and case surveillance strategies which can be tailored to a range of objectives and resource constraints.
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Affiliation(s)
- Mahmood Akhtar
- School of Civil and Environment Engineering, UNSW Sydney, Sydney, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Sydney, NSW, Australia
| | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK
- Computational Epidemiology Group, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lauren M Gardner
- School of Civil and Environment Engineering, UNSW Sydney, Sydney, NSW, Australia.
- Department of Civil Engineering, Johns Hopkins University, Baltimore, MD, USA.
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44
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Duarte-Neto AN, Monteiro RAA, Johnsson J, Cunha MDP, Pour SZ, Saraiva AC, Ho YL, da Silva LFF, Mauad T, Zanotto PMA, Saldiva PHN, de Oliveira IRS, Dolhnikoff M. Ultrasound-guided minimally invasive autopsy as a tool for rapid post-mortem diagnosis in the 2018 Sao Paulo yellow fever epidemic: Correlation with conventional autopsy. PLoS Negl Trop Dis 2019; 13:e0007625. [PMID: 31329590 DOI: 10.1371/journal.pntd.0007625] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 08/01/2019] [Accepted: 07/10/2019] [Indexed: 12/22/2022] Open
Abstract
Background New strategies for collecting post-mortem tissue are necessary, particularly in areas with emerging infections. Minimally invasive autopsy (MIA) has been proposed as an alternative to conventional autopsy (CA), with promising results. Previous studies using MIA addressed the cause of death in adults and children in developing countries. However, none of these studies was conducted in areas with an undergoing infectious disease epidemic. We have recently experienced an epidemic of yellow fever (YF) in Brazil. Aiming to provide new information on low-cost post-mortem techniques that could be applied in regions at risk for infectious outbreaks, we tested the efficacy of ultrasound-guided MIA (MIA-US) in the diagnosis of patients who died during the epidemic. Methodology/principal findings In this observational study, we performed MIA-US in 20 patients with suspected or confirmed YF and compared the results with those obtained in subsequent CAs. Ultrasound-guided biopsies were used for tissue sampling of liver, kidneys, lungs, spleen, and heart. Liver samples from MIA-US and CA were submitted for RT-PCR and immunohistochemistry for detection of YF virus antigen. Of the 20 patients, 17 had YF diagnosis confirmed after autopsy by histopathological and molecular analysis. There was 100% agreement between MIA-US and CA in determining the cause of death (panlobular hepatitis with hepatic failure) and main disease (yellow fever). Further, MIA-US obtained samples with good quality for molecular studies and for the assessment of the systemic involvement of the disease. Main extrahepatic findings were pulmonary hemorrhage, pneumonia, acute tubular necrosis, and glomerulonephritis. One patient was a 24-year-old, 27-week pregnant woman; MIA-US assessed the placenta and provided adequate placental tissue for analysis. Conclusions MIA-US is a reliable tool for rapid post-mortem diagnosis of yellow fever and can be used as an alternative to conventional autopsy in regions at risk for hemorrhagic fever outbreaks with limited resources to perform complete diagnostic autopsy. Reliable mortality information is of paramount importance to establish sound public health policies. Autopsy is an important tool not only for determining the cause of death, but also for the detection of novel diseases. In the last decades, we have been globally identifying an unprecedented number of emerging infections. Therefore, there is great interest in the development of less invasive and low-cost tools for the accurate post-mortem diagnosis in fatal cases. Minimally invasive autopsy (MIA), conceived as targeting diagnostic biopsies of key organs by needle puncture, has been proposed as an alternative to conventional autopsy (CA) for the determination of cause of death in developing countries. In this research, we tested the efficacy of MIA in the post-mortem diagnosis of 20 patients with suspected or confirmed yellow fever who died during the recent epidemic of yellow fever that occurred in Brazil. There was a perfect agreement between MIA and CA in determining the cause of death (hepatic failure) and main disease (yellow fever) in all patients with confirmed yellow fever. This finding indicates that MIA can be used as an alternative to CA in regions at risk for infectious disease outbreaks with limited resources to perform conventional autopsies.
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45
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Messina JP, Brady OJ, Golding N, Kraemer MUG, Wint GRW, Ray SE, Pigott DM, Shearer FM, Johnson K, Earl L, Marczak LB, Shirude S, Davis Weaver N, Gilbert M, Velayudhan R, Jones P, Jaenisch T, Scott TW, Reiner RC, Hay SI. The current and future global distribution and population at risk of dengue. Nat Microbiol 2019; 4:1508-1515. [PMID: 31182801 PMCID: PMC6784886 DOI: 10.1038/s41564-019-0476-8] [Citation(s) in RCA: 471] [Impact Index Per Article: 94.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/01/2019] [Indexed: 01/17/2023]
Abstract
Dengue is a mosquito-borne viral infection that has spread throughout the tropical world over the past 60 years and now affects over half the world’s population. The geographical range of dengue is expected to further expand due to ongoing global phenomena including climate change and urbanization. We applied statistical mapping techniques to the most extensive database of case locations to date to predict global environmental suitability for the virus as of 2015. We then made use of climate, population and socioeconomic projections for the years 2020, 2050 and 2080 to project future changes in virus suitability and human population at risk. This study is the first to consider the spread of Aedes mosquito vectors to project dengue suitability. Our projections provide a key missing piece of evidence for the changing global threat of vector-borne disease and will help decision-makers worldwide to better prepare for and respond to future changes in dengue risk. Statistical mapping techniques provide insights into the current geographical spread of the mosquito-borne dengue virus infection and predict changes in the areas that will be environmentally suitable to the virus for the years 2020, 2050 and 2080.
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Affiliation(s)
- Jane P Messina
- School of Geography and the Environment, University of Oxford, Oxford, UK. .,School of Interdisciplinary Area Studies, University of Oxford, Oxford, UK.
| | - Oliver J Brady
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Nick Golding
- School of BioSciences, University of Melbourne, Parkville, VIC, Australia
| | - Moritz U G Kraemer
- Harvard Medical School, Harvard University, Boston, MA, USA.,Boston Children's Hospital, Boston, MA, USA.,Department of Zoology, University of Oxford, Oxford, UK
| | - G R William Wint
- Environmental Research Group Oxford, c/o Department of Zoology, University of Oxford, Oxford, UK
| | - Sarah E Ray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Freya M Shearer
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Kimberly Johnson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Lucas Earl
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Laurie B Marczak
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Shreya Shirude
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nicole Davis Weaver
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | | | - Peter Jones
- Waen Associates Ltd, Y Waen, Islaw'r Dref, Dolgellau, Gwynedd, UK
| | - Thomas Jaenisch
- Department of Infectious Diseases, Section Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas W Scott
- Department of Entomology and Nematology, University of California, Davis, USA
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
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46
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Abstract
Geographic mapping of pathogen emergence risk, as recently done for viral haemorrhagic fever in Africa, provides an important tool for targeting interventions. More comprehensive preparedness and prediction systems that increase surveillance and forecast infectious disease outbreak growth and spread in real time are also needed.
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Affiliation(s)
- Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
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47
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Shan X, Lai S, Liao H, Li Z, Lan Y, Yang W. The epidemic potential of avian influenza A (H7N9) virus in humans in mainland China: A two-stage risk analysis. PLoS One 2019; 14:e0215857. [PMID: 31002703 PMCID: PMC6474630 DOI: 10.1371/journal.pone.0215857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 04/09/2019] [Indexed: 11/18/2022] Open
Abstract
Background From 2013 to 2017, more than one thousand avian influenza A (H7N9) confirmed cases with hundreds of deaths were reported in mainland China. To identify priorities for epidemic prevention and control, a risk assessing framework for subnational variations is needed to define the epidemic potential of A (H7N9). Methods We established a consolidated two-stage framework that outlined the potential epidemic of H7N9 in humans: The Stage 1, index-case potential, used a Boosted Regression Trees model to assess population at risk due to spillover from poultry; the Stage 2, epidemic potential, synthesized the variables upon a framework of the Index for Risk Management to measure epidemic potential based on the probability of hazards and exposure, the vulnerability and coping capacity. Results Provinces in southern and eastern China, especially Jiangsu, Zhejiang, Guangzhou, have high index-case potential of human infected with A (H7N9), while northern coastal provinces and municipalities with low morbidity, i.e. Tianjin and Liaoning, have an increasing risk of A (H7N9) infection. Provinces in central China are likely to have high potential of epidemic due to the high vulnerability and the lack of coping capacity. Conclusions This study provides a unified risk assessment of A (H7N9) to detect the two-stage heterogeneity of epidemic potential among different provinces in mainland China, allowing proactively evaluate health preparedness at subnational levels to improve surveillance, diagnostic capabilities, and health promotion.
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Affiliation(s)
- Xuzheng Shan
- Department of Epidemiology and Biostatistics, School of Public Health, Sichuan University, Chengdu, Sichuan, China
- Prevention and Health Section, Affiliated Hospital, Chengdu University, Chengdu, Sichuan, China
| | - Shengjie Lai
- WorldPop, School of Geography and Environment, University of Southampton, Southampton, United Kingdom
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Flowminder Foundation, Stockholm, Sweden
| | - Hongxiu Liao
- Department of Epidemiology and Biostatistics, School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Zhongjie Li
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yajia Lan
- Department of Environmental Health and Occupational Medicine, School of Public Health, Sichuan University, Chengdu, Sichuan, China
- * E-mail: (WY); (YL)
| | - Weizhong Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Sichuan University, Chengdu, Sichuan, China
- Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: (WY); (YL)
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48
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Abstract
Hemorrhagic fevers (HF) resulting from pathogenic arenaviral infections have traditionally been neglected as tropical diseases primarily affecting African and South American regions. There are currently no FDA-approved vaccines for arenaviruses, and treatments have been limited to supportive therapy and use of non-specific nucleoside analogs, such as Ribavirin. Outbreaks of arenaviral infections have been limited to certain geographic areas that are endemic but known cases of exportation of arenaviruses from endemic regions and socioeconomic challenges for local control of rodent reservoirs raise serious concerns about the potential for larger outbreaks in the future. This review synthesizes current knowledge about arenaviral evolution, ecology, transmission patterns, life cycle, modulation of host immunity, disease pathogenesis, as well as discusses recent development of preventative and therapeutic pursuits against this group of deadly viral pathogens.
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Affiliation(s)
- Morgan E Brisse
- Biochemistry, Molecular Biology, and Biophysics Graduate Program, University of Minnesota, St. Paul, MN, United States.,Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
| | - Hinh Ly
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
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49
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Mokdad AH, Mensah GA, Krish V, Glenn SD, Miller-Petrie MK, Lopez AD, Murray CJL. Global, Regional, National, and Subnational Big Data to Inform Health Equity Research: Perspectives from the Global Burden of Disease Study 2017. Ethn Dis 2019; 29:159-172. [PMID: 30906165 DOI: 10.18865/ed.29.s1.159] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objectives Everyone deserves a long and healthy life, but in reality, health outcomes differ across populations. We use results from the Global Burden of Disease Study 2017 (GBD 2017) to report patterns in the burden of diseases, injuries, and risks at the global, regional, national, and subnational level, and by sociodemographic index (SDI), from 1990 to 2017. Design GBD 2017 undertook a systematic analysis of published studies and available data providing information on prevalence, incidence, remission, and excess mortality. We computed prevalence, incidence, mortality, life expectancy, healthy life expectancy, years of life lost due to premature mortality, years lived with disability, and disability-adjusted life years with 95% uncertainty intervals for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries from 1990 to 2017. We also computed SDI, a summary indicator combining measures of income, education, and fertility. Results There were wide disparities in the burden of disease by SDI, with smaller burdens in affluent countries and in specific regions within countries. Select diseases and risks, such as drug use disorders, high blood pressure, high body mass index, diet, high fasting plasma glucose, smoking, and alcohol use disorders warrant increased global attention and indicate a need for greater investment in prevention and treatment across the life course. Conclusions Policymakers need a comprehensive picture of what risks and causes result in disability and death. The GBD provides the means to quantify health loss: these findings can be used to examine root causes of disparities and develop programs to improve health and health equity.
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Affiliation(s)
- Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington and the Department of Health Metrics Sciences, University of Washington, Seattle, WA
| | - George A Mensah
- Center for Translation Research and Implementation Science, National Institutes of Health, Bethesda, MD, USA; Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Varsha Krish
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Scott D Glenn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Molly K Miller-Petrie
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Alan D Lopez
- University of Melbourne, Melbourne, VIC, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington and the Department of Health Metrics Sciences, University of Washington, Seattle, WA
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50
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Marais BJ, Williams S, Li A, Ofrin R, Merianos A, Negin J, Firman J, Davies R, Sorrell T. Improving emergency preparedness and response in the Asia-Pacific. BMJ Glob Health 2019; 4:e001271. [PMID: 30775010 PMCID: PMC6352770 DOI: 10.1136/bmjgh-2018-001271] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 01/08/2023] Open
Affiliation(s)
- Ben J Marais
- Centre for Research Excellence in Emerging Infectious Diseases (CREID) and the Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie Williams
- Department of Foreign Affairs and Trade, Indo-Pacific Centre for Health Security, Canberra, Australia
| | - Ailan Li
- Division of Health Security and Emergencies, WHO Health Emergencies Programme, WHO Western Pacific Regional Office, Manila, Philippines
| | - Roderico Ofrin
- WHO Health Emergencies Programme, WHO South-East Asia Regional Office, New Delhi, India
| | - Angela Merianos
- Pacific Health Security, WHO Communicable Disease and Climate Change Division, Suva, Fiji
| | - Joel Negin
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jenny Firman
- Department of Health, Office of Health Protection, Canberra, Australia
| | - Robin Davies
- Department of Foreign Affairs and Trade, Indo-Pacific Centre for Health Security, Canberra, Australia
| | - Tania Sorrell
- Centre for Research Excellence in Emerging Infectious Diseases (CREID) and the Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, New South Wales, Australia
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