Disease Transmission, Infectious

疾病传播,传染性
  • 文章类型: Journal Article
    我们在非免疫抑制的MSM(与男性发生性关系的男性)患者中提出了明显的第二次水痘(猴痘)生殖器溃疡性疾病发作,该患者在4个月前从原发性水痘感染中完全康复。在两次演示之间,患者还接受了完整的两剂量天花疫苗接种。该病例强调了在生殖器或粘膜溃疡患者的鉴别诊断中继续包括痘的重要性,无论先前感染或疫苗接种产生的假定免疫力。
    We present an apparent second episode of mpox (monkeypox) genital ulcerative disease in a non-immunosuppressed MSM (man who has sex with men) patient who had completely recovered from a primary mpox infection 4 months previously. The patient had also received a complete two-dose course of smallpox vaccination between the two presentations. This case highlights the importance of continuing to include mpox in the differential diagnoses for individuals presenting with genital or mucosal ulceration, regardless of assumed immunity derived from prior infection or vaccination.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    卫生保健工作者(HCWs)特别暴露于COVID-19,因此研究该人群的预防措施非常重要。
    为了调查诺曼底卫生机构中与COVID-19风险相关的社会人口统计学因素和专业实践,法国。
    为了探索导致SARS-CoV2在HCW内传播的可能危险因素,进行了使用Bootstrap方法的横断面和3个病例对照研究。病例对照研究侧重于与(A)COVID-19患者护理相关的危险因素,(b)对非COVID-19患者的护理和(c)同事之间的接触。
    2,058名受访者,医疗和医疗社会机构分别为1363家(66.2%)和695家(33.8%),包括与患者接触和不接触的HCW。
    301名参与者(14.6%)报告感染了SARS-CoV2。在照顾COVID-19患者时,声明佩戴呼吸器的医护人员,对于所有患者护理(ORa0.39;95%CI:0.29-0.51)或仅在暴露于气溶胶生成程序时(ORa0.56;95%CI:0.43-0.70),与宣布主要佩戴外科口罩的医护人员相比,感染风险较低。在非COVID-19患者的护理期间,主要佩戴呼吸器与较高的感染风险相关(ORa1.84;95%CI:1.06-3.37).在工作场所更衣室更换制服的医护人员的风险也增加(ORa1.93;95%CI:1.63-2.29)。
    正确使用适应情况和风险水平的PPE对于保护HCWs免受感染至关重要。
    Health care workers (HCWs) are particularly exposed to COVID-19 and therefore it is important to study preventive measures in this population.
    To investigate socio-demographic factors and professional practice associated with the risk of COVID-19 among HCWs in health establishments in Normandy, France.
    A cross-sectional and 3 case-control studies using bootstrap methods were conducted in order to explore the possible risk factors that lead to SARS-CoV2 transmission within HCWs. Case-control studies focused on risk factors associated with (a) care of COVID-19 patients, (b) care of non COVID-19 patients and (c) contacts between colleagues.
    2,058 respondents, respectively 1,363 (66.2%) and 695 (33.8%) in medical and medico-social establishments, including HCW with and without contact with patients.
    301 participants (14.6%) reported having been infected by SARS-CoV2. When caring for COVID-19 patients, HCWs who declared wearing respirators, either for all patient care (ORa 0.39; 95% CI: 0.29-0.51) or only when exposed to aerosol-generating procedures (ORa 0.56; 95% CI: 0.43-0.70), had a lower risk of infection compared with HCWs who declared wearing mainly surgical masks. During care of non COVID-19 patients, wearing mainly a respirator was associated with a higher risk of infection (ORa 1.84; 95% CI: 1.06-3.37). An increased risk was also found for HCWs who changed uniform in workplace changing rooms (ORa 1.93; 95% CI: 1.63-2.29).
    Correct use of PPE adapted to the situation and risk level is essential in protecting HCWs against infection.
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  • 文章类型: Journal Article
    印度尼西亚是全球第二大结核病(TB)负担。扩大结核病控制工作的尝试集中在结核病家庭。然而,在大多数高负担环境中,大量的结核分枝杆菌(Mtb)传播发生在结核病家庭之外。更好地了解印度尼西亚城市环境中的传播动态对于结核病控制计划以更有针对性的方式扩大消除结核病的努力至关重要。因此,该研究旨在测量已知结核病例附近家庭接触者和社区的结核病患病率和发病率,并评估其基因组和流行病学相关性.
    将对与诊断为肺结核患者(n=250)或邻近家庭(约4500人)生活在同一家庭中的个体(约1000人)进行TB症状筛查和胸部X光检查。将从任何患有生产性咳嗽的人收集两个痰样本用于微生物学分析。任何被发现患有结核病的人都将接受国家结核病控制计划的治疗。所有没有结核病证据的人将在12个月时进行重复筛查。全基因组测序(WGS)和社会网络分析(SNA)将对诊断为结核病的索引病例和接触者进行。
    Indonesia has the second largest tuberculosis (TB) burden globally. Attempts to scale-up TB control efforts have focused on TB households. However, in most high burden settings, considerable Mycobacterium tuberculosis (Mtb) transmission occurs outside TB households. A better understanding of transmission dynamics in an urban setting in Indonesia will be crucial for the TB Control Program in scaling up efforts towards elimination of TB in a more targeted way. Therefore, the study aims to measure TB prevalence and incidence in household contacts and neighbourhoods in the vicinity of known TB cases and to assess their genomic and epidemiological relatedness.
    Individuals (~1000) living in the same household as a case diagnosed with pulmonary TB (n = 250) or in a neighbouring household (~4500 individuals) will be screened for TB symptoms and by chest x-ray. Two sputum samples will be collected for microbiological analysis from anyone with a productive cough. Any person found to have TB will be treated by the National TB Control Program. All those with no evidence of TB disease will have a repeat screen at 12 months. Whole-genome sequencing (WGS) and social network analysis (SNA) will be conducted on Index cases and contacts diagnosed with TB.
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  • 文章类型: Journal Article
    世界卫生组织建议应用大规模药物管理(MDA)治疗高患病率被忽视的热带疾病,如土壤传播的蠕虫(STHs),血吸虫病,淋巴丝虫病,盘尾丝虫病和沙眼。MDA-这是安全的,有效且廉价-已广泛应用于消除或中断特别是STH的传播,并已提供给流行地区的人们,而无需单独诊断。我们提出了两个数学模型来研究MDA对处理和未处理的人类亚群中蠕虫平均数量的影响。通过改变药物的功效,模型的初始条件,MDA的覆盖率和频率(每年和每年两次),我们检查了两个模型的动态行为和传输中断的可能性。两种模型都预测,如果药物疗效足够高,传播的中断是可能的,但如果药物疗效足够低,STH感染仍然是地方性的。在这两个临界值之间,这两个模型产生不同的预测。通过再应用一轮每半年和每年的MDA,我们发现,在两种药物疗效较低的情况下,传播中断都可能发生。为了有效地阻断STH的传播或消除感染,确定药物的适当功效至关重要,覆盖范围,频率,MDA的时间和轮数。
    The World Health Organization has recommended the application of mass drug administration (MDA) in treating high prevalence neglected tropical diseases such as soil-transmitted helminths (STHs), schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. MDA-which is safe, effective and inexpensive-has been widely applied to eliminate or interrupt the transmission of STHs in particular and has been offered to people in endemic regions without requiring individual diagnosis. We propose two mathematical models to investigate the impact of MDA on the mean number of worms in both treated and untreated human subpopulations. By varying the efficay of drugs, initial conditions of the models, coverage and frequency of MDA (both annual and biannual), we examine the dynamic behaviour of both models and the possibility of interruption of transmission. Both models predict that the interruption of transmission is possible if the drug efficacy is sufficiently high, but STH infection remains endemic if the drug efficacy is sufficiently low. In between these two critical values, the two models produce different predictions. By applying an additional round of biannual and annual MDA, we find that interruption of transmission is likely to happen in both cases with lower drug efficacy. In order to interrupt the transmission of STH or eliminate the infection efficiently and effectively, it is crucial to identify the appropriate efficacy of drug, coverage, frequency, timing and number of rounds of MDA.
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  • 文章类型: Case Reports
    During the COVID19 pandemic, a range of vaccines displayed high efficacy in preventing disease, severe outcomes of infection, and mortality. However, the immunological correlates of protection, the duration of immune response, the transmission risk over time from vaccinated individuals are currently under active investigation. In this brief report, we describe the case of a vaccinated Healthcare Professional infected with a variant of Sars-CoV-2, who has been extensively investigated in order to draw a complete trajectory of infection. The patient has been monitored for the whole length of infection, assessing the temporal viral load decay, the quantification of viral RNA and subgenomic mRNA, antibodies (anti Sars-CoV-2, IgA, IgG, IgM) and cell-mediated (cytokine, B- and T-cell profiles) responses. Overall, this brief report highlights the efficacy of vaccine in preventing COVID19 disease, accelerating the recovery from infection, reducing the transmission risk, although the use of precautionary measures against Sars-CoV-2 spreading still remain critical.
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  • 文章类型: Journal Article
    在全球范围内,COVID-19大流行的爆发正在给各国政府造成困扰,各国政府竭尽全力控制新型冠状病毒(SARS-CoV-2)的传播,以防止发病率和死亡率。正在采取行动,以防止医疗保健系统过度紧张并遏制疫情。任何旨在减缓病毒传播和减轻其对医疗保健系统的直接影响的政策反应都需要关于目前受感染人数绝对数量的坚实基础信息,增长率,以及感染的地点/热点。获得这种信息库的唯一方法是有针对性地进行大量测试。目前,在加纳,有一个集中的测试方法,需要4-5天的时间才能将样品运送到中央参考实验室进行测试,并将结果传达给该地区,区域和国家利益相关者。这种诊断延迟增加了社区和脆弱机构持续传播的风险。我们已经验证了,在移动实验室平台上评估并部署了创新的诊断工具,以加速COVID-19测试。对COVID-19疑似病例的74份样本的初步结果,阳性率为12%,从取样到报告结果的周转时间不到3小时,将等待时间从几天缩短到几小时,使卫生系统能够对接触者追踪做出权宜之计,以减少传播,并进一步改善病例管理。
    测试套件由AngloGoldAshantiObuasi矿山(AngloGoldAshantiHealthFoundation)提供。美国麻风研究团捐赠了PCR仪,和流动实验室面包车由荷兰王国大使馆(EKN)资助。AAS,YAA由(PANDORA-ID-NETRIA2016E-1609)支持,ROP由EDCTP高级研究员(TMA2016SF)支持,两者均由欧洲和发展中国家临床试验伙伴关系(EDCTP2)计划资助,该计划由欧盟Horizon2020支持。
    Across the globe, the outbreak of the COVID-19 pandemic is causing distress with governments doing everything in their power to contain the spread of the novel coronavirus (SARS-CoV-2) to prevent morbidity and mortality. Actions are being implemented to keep health care systems from being overstretched and to curb the outbreak. Any policy responses aimed at slowing down the spread of the virus and mitigating its immediate effects on health care systems require a firm basis of information about the absolute number of currently infected people, growth rates, and locations/hotspots of infections. The only way to obtain this base of information is by conducting numerous tests in a targeted way. Currently, in Ghana, there is a centralized testing approach, that takes 4-5 days for samples to be shipped and tested at central reference laboratories with results communicated to the district, regional and national stakeholders. This delay in diagnosis increases the risk of ongoing transmission in communities and vulnerable institutions. We have validated, evaluated and deployed an innovative diagnostic tool on a mobile laboratory platform to accelerate the COVID-19 testing. A preliminary result of 74 samples from COVID-19 suspected cases has a positivity rate of 12% with a turn-around time of fewer than 3 hours from sample taking to reporting of results, significantly reducing the waiting time from days to hours, enabling expedient response by the health system for contact tracing to reduce transmission and additionally improving case management.
    UNASSIGNED: Test kits were provided by AngloGold Ashanti Obuasi Mine (AngloGold Ashanti Health Foundation). The American Leprosy Mission donated the PCR machine, and the mobile laboratory van was funded by the Embassy of the Kingdom of the Netherlands (EKN). AAS, YAA was supported by (PANDORA-ID-NET RIA2016E-1609) and ROP supported by EDCTP Senior Fellowship (TMA2016SF), both funded by the European and Developing Countries Clinical Trials Partnership (EDCTP2) programme which is supported under Horizon 2020, the European Union.
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  • 文章类型: Journal Article
    To estimate the prevalence of symptoms and signs related to a COVID-19 case series confirmed by polymerase chain reaction (PCR) for SARS-CoV-2. Risk factors and the associated use of health services will also be analysed.
    Observational, descriptive, retrospective case series study. The study was performed at two Primary Care Health Centres located in Madrid, Spain. The subjects studied were all PCR SARS-CoV-2 confirmed cases older than 18 years, diagnosed from the beginning of the community transmission (March 13) until April 15, 2020. We collected sociodemographic, clinical, health service utilization and clinical course variables during the following months. All data was gathered by their own attending physician, and electronic medical records were reviewed individually.
    A descriptive analysis was carried out and a Poisson regression model was adjusted to study associated factors to Health Services use.
    Out of the 499 patients studied from two health centres, 55.1% were women and mean age was 58.2 (17.3). 25.1% were healthcare professionals. The most frequent symptoms recorded related to COVID-19 were cough (77.9%; CI 95% 46.5-93.4), fever (77.7%; CI95% 46.5-93.4) and dyspnoea (54.1%, CI95% 46.6-61.4). 60.7% were admitted to hospital. 64.5% first established contact with their primary care provider before going to the hospital, with a mean number of 11.4 Healthcare Providers Encounters with primary care during all the follow-up period. The number of visit-encounters with primary care was associated with being male [IRR 1.072 (1.013, 1.134)], disease severity {from mild respiratory infection [IRR 1.404 (1.095, 1.801)], up to bilateral pneumonia [IRR 1.852 (1.437,2.386)]}, and the need of a work leave [IRR 1.326 (1.244, 1.413].
    Symptoms and risk factors in our case series are similar to those in other studies. There was a high number of patients with atypical unilateral or bilateral pneumonia. Care for COVID has required a high use of healthcare resources such as clinical encounters and work leaves.
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  • 文章类型: Journal Article
    2019年出现的冠状病毒病(COVID-19)具有高度传染性,已经让位于全球大流行。目前的COVID-19在全球范围内具有很高的传播率,包括在巴西的小城市,如Ijuí。Ijuí位于南里奥格兰德州(RS)的西北部,人口83,475,被选为基于人口的调查地点,涉及2,222名受试者,2020年4月至6月。测试受试者是否存在抗冠状病毒(SARS-CoV-2)的抗体,并回答有关社交距离依从性(SDA)的问题。日常预防程序(DPR),合并症,和社会人口特征。并行,当地政府在伊朱伊登记了官方的COVID-19病例,以及移动社交距离指数(MSDI)。在这项研究中,我们证明SDA水平有所下降,在伊朱伊开始COVID-19社区传播之前,DPR和MSDI。此外,我们提供了对COVID-19病例数的预测,住院治疗,和城市中的死亡。我们得出结论,社会距离不足,不同的方法证明了这一点,可能与伊朱伊的COVID-19病例迅速增加有关。我们的研究预测,伊朱伊将通过社区传播爆发COVID-19,随着人口之间社会距离的增加,这种情况可以避免或减弱。
    The coronavirus disease that emerged in 2019 (COVID-19) is highly contagious and has given way to a global pandemic. A present COVID-19 has high transmission rates worldwide, including in small Brazilian cities such as Ijuí. Located in the northwest part of the state of Rio Grande do Sul (RS) and with a population of 83,475, Ijuí was selected as the site of a population-based survey involving 2,222 subjects, from April to June 2020. Subjects were tested for the presence of antibodies against coronavirus (SARS-CoV-2) and answered questions regarding social distance adherence (SDA), daily preventive routines (DPR), comorbidities, and sociodemographic characteristics. In parallel, the local government registered the official COVID-19 cases in Ijuí, as well as the mobile social distancing index (MSDI). In this study, we demonstrate that there was a decrease in the levels of SDA, DPR and MSDI before the beginning of COVID-19 community transmission in Ijuí. Furthermore, we provide predictions for the number of COVID-19 cases, hospitalizations, and deaths in the city. We conclude that insufficient social distancing, as evidenced by different methods, may be related to the rapid increase of COVID-19 cases in Ijuí. Our study predicts an approaching outbreak of COVID-19 in Ijuí through community spread, which could be avoided or attenuated with increased levels of social distancing among the population.
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  • 文章类型: Case Reports
    Thelazia callipaeda is a vector-borne nematode transmitted by Phortica spp. (fruit flies) and one of the causes of mild to severe conjunctivitis and keratitis in dogs, cats, rabbits and humans. It has been formerly known as the oriental eye worm based on its geographic occurrence. By now, it has been shown to be endemic in several southern and eastern European countries as well as extending its geographic distribution further throughout Europe. In the present case report, T. callipaeda infection was diagnosed in a female dog from Germany. The dog was referred by a local veterinarian due to a treatment-resistant conjunctivitis. A comprehensive ophthalmologic examination revealed 3 adult eye worms in the conjunctival sac as well as on the bulbar side of the nictitating membrane of the left eye. These were identified by morphological features and molecular techniques as T. callipaeda and represented the primary cause of the dog\'s unilateral blepharospasm, hyperemic conjunctiva and epiphora. Treatment consisted of manual collection of the adult worms and the administration of moxidectin/imidacloprid as spot on (Advocate®, Bayer). All clinical signs resolved within one week after treatment. In Germany, ocular thelaziosis still represents a rare disease. Usually, it is diagnosed in cats and dogs either imported from abroad or accompanying the owners on holiday travels to endemic countries. The dog presented in this case report was born in Germany. Except for a one-week stay in the Netherlands 11 months before the symptoms began, it had never traveled abroad. Considering the prepatency of T. callipaeda, an autochthonous transmission in this case is highly probable.
    Thelazia callipaeda, ein von Phortica spp. (Fruchtfliegen) übertragener Nematode, verursacht bei Hunden, Katzen, Hasenartigen und Menschen eine milde bis schwere Konjunktivitis und Keratitis. Er war aufgrund seines Vorkommens lange Zeit als orientalischer Augenwurm bekannt, ist aber inzwischen in vielen süd- und osteuropäischen Ländern endemisch und breitet sich zunehmend in Europa aus. Bei einer aufgrund von therapieresistenter Konjunktivitis überwiesenen Hündin wurden bei der ophthalmologischen Untersuchung 3 adulte Augenwürmer im Konjunktivalsack und auf der bulbären Seite der Nickhaut des linken Auges gefunden. Diese ließen sich mittels morphologischer Merkmale und molekulargenetischer Techniken als T. callipaeda identifizieren und stellten die Ursache für unilateralen Blepharospasmus, hyperämische Konjunktiven und Epiphora dar. Die Therapie erfolgte durch Absammeln der Würmer und Applikation von Moxidectin/Imidacloprid als Spot-on-Präparat (Advocate®, Bayer). Sämtliche klinischen Symptome verschwanden innerhalb 1 Woche nach Therapiebeginn. In Deutschland ist die okuläre Thelaziose immer noch eine selten auftretende Erkrankung. Bei den meisten Patienten handelt es sich um Hunde und Katzen, die entweder aus dem Ausland importiert wurden oder sich auf Auslandsreisen infiziert haben. Die hier vorgestellte Hündin wurde dagegen in Deutschland geboren und hatte außer 1 Woche Auslandsaufenthalt in den Niederlanden, 15 Monate vor Beginn der Symptome, Deutschland nie verlassen. Aufgrund der Präpatenz von T. callipaeda handelt es sich daher höchstwahrscheinlich um eine autochthone Infektion.
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