Disease Outbreaks

疾病爆发
  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    BACKGROUND: African swine fever (ASF) is a highly contagious and severe haemorrhagic disease of Suidae, with mortalities that approach 100 percent. Several studies suggested the potential implication of non-biting dipterans in the spread of ASFV in pig farms due to the identification of the ASFV DNA. However, to our knowledge, no study has evaluated the viral DNA load in non-biting dipterans collected in outbreak farms and no risk factors have been analysed. In this context, our study aimed to analyse the risk factors associated with the presence of non-biting dipterans collected from ASF outbreaks in relation to the presence and load of viral DNA.
    METHODS: Backyard farms (BF), type A farms (TAF), and commercial farms (CF), were targeted for sampling in 2020. In 2021, no BF were sampled. Each farm was sampled only once. The identification of the collected flies to family, genus, or species level was performed based on morphological characteristics using specific keys and descriptions. Pools were made prior to DNA extraction. All extracted DNA was tested for the presence of the ASFV using a real-time PCR protocol. For this study, we considered every sample with a CT value of 40 as positive. The statistical analysis was performed using Epi Info 7 software (CDC, USA).
    RESULTS: All collected non-biting flies belonged to five families: Calliphoridae, Sarcophagidae, Fanniidae, Drosophilidae, and Muscidae. Of the 361 pools, 201 were positive for the presence of ASFV DNA. The obtained CT values of the positive samples ranged from 21.54 to 39.63, with a median value of 33.59 and a mean value of 33.56. Significantly lower CT values (corresponding to higher viral DNA load) were obtained in Sarcophagidae, with a mean value of 32.56; a significantly higher number of positive pools were noticed in August, mean value = 33.12.
    CONCLUSIONS: Our study brings compelling evidence of the presence of the most common synanthropic flies near domestic pig farms carrying ASFV DNA, highlighting the importance of strengthening the biosecurity measures and protocols for prevention of the insect life cycle and distribution.
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  • 文章类型: Journal Article
    背景:奥杜氏小孢子菌最近又开始流行。皮肤癣菌感染很难治疗,这就提出了一个问题,如果我们用最有效的抗真菌(AF)药物治疗奥杜氏支原体感染。
    目的:本研究的目的是调查丹麦头癣(TC)的暴发,应对疫情管理中的挑战,并对以前的疫情和最低抑制浓度(MIC)进行两次审查。
    方法:我们使用Wood\的光,文化,直接显微镜,和PCR筛选和抗真菌药敏试验(AFST)的治疗优化。我们进行了两次评论,以使用肉汤微量稀释法探索奥杜尼氏分枝杆菌的暴发和MIC值。
    结果:在接受筛选的73个人中,10人确认了奥杜尼氏杆菌感染。在4例(66%)中观察到对灰黄霉素的临床抗性。虽然以前的疫情显示出很高的灰黄霉素疗效,我们的研究支持特比萘芬,氟康唑和伊曲康唑在我们难以治疗的病例中。AFST指导了AF的选择。通过文献检索,我们发现了五起奥杜尼氏杆菌爆发,其中管理的差异包括使用伍德光和预防性局部房颤治疗。来自文献的特比萘芬MIC值范围为0.002至0.125mg/L。
    结论:使用Wood的光照和预防措施对限制感染很重要。文献缺乏灰黄霉素对奥杜尼尼的MIC数据,但表明对特比萘芬敏感。奥杜尼分枝杆菌治疗的临床疗效是矛盾的,有利于特比萘芬和灰黄霉素。AFST可以在疑难病例的治疗中发挥关键作用,但是缺乏AAST和MIC断点的标准化限制了其实用性。
    BACKGROUND: Microsporum audouinii has resurged recently. Infections with the dermatophyte are difficult to treat, which raises the question if we treat M. audouinii infections with the most effective antifungal (AF) agent.
    OBJECTIVE: The aims of this study was to investigate an outbreak of tinea capitis (TC) in Denmark, address the challenges in outbreak management and to conduct two reviews regarding previous outbreaks and minimal inhibitory concentration (MIC).
    METHODS: We used Wood\'s light, culture, direct microscopy, and PCR for screening and antifungal susceptibility testing (AFST) for treatment optimization. We performed two reviews to explore M. audouinii outbreaks and MIC values using broth microdilution method.
    RESULTS: Of 73 screened individuals, 10 had confirmed M. audouinii infections. Clinical resistance to griseofulvin was observed in 4 (66%) cases. While previous outbreaks showed high griseofulvin efficacy, our study favoured terbinafine, fluconazole and itraconazole in our hard-to-treat cases. AFST guided the choice of AF. Through the literature search, we identified five M. audouinii outbreaks, where differences in management included the use of Wood\'s light and prophylactic topical AF therapy. Terbinafine MIC values from the literature ranged from 0.002 to 0.125 mg/L.
    CONCLUSIONS: Use of Wood\'s light and preventive measurements were important for limiting infection. The literature lacked MIC data for griseofulvin against M. audouinii, but indicated sensitivity for terbinafine. The clinical efficacy for M. audouinii treatment was contradictory favouring both terbinafine and griseofulvin. AFST could have a key role in the treatment of difficult cases, but lack of standardisation of AFST and MIC breakpoints limits its usefulness.
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  • 文章类型: News
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  • 文章类型: Journal Article
    2022年,匈牙利成人重症监护病房(ICU)爆发了由粘质沙雷氏菌引起的严重血流感染。八个案例,其中5人死亡,被检测到。最初的控制措施无法阻止疫情爆发。我们进行了匹配的病例对照研究。在单变量分析中,这些病例更有可能位于ICU的一个水槽周围,并且比对照组有更多的医疗程序和药物,然而,多变量分析尚无定论.通过全基因组测序,从病例的血培养物中分离出的细菌与ICU环境密切相关,并且对ICU中使用的季铵化合物表面消毒剂具有抗性或耐受性。因此,尽管有定期的清洁和消毒,但美国粘质抗生素还是能够在环境中生存。医院用另一种消毒剂代替了消毒剂,加强了清洁协议,并加强了医护人员的手部卫生依从性。一起,这些控制措施已被证明有效地防止了新病例。我们的研究结果突出了多学科暴发调查的重要性,包括环境采样,分子分型和消毒剂抗性测试。
    In 2022, an outbreak with severe bloodstream infections caused by Serratia marcescens occurred in an adult intensive care unit (ICU) in Hungary. Eight cases, five of whom died, were detected. Initial control measures could not stop the outbreak. We conducted a matched case-control study. In univariable analysis, the cases were more likely to be located around one sink in the ICU and had more medical procedures and medications than the controls, however, the multivariable analysis was not conclusive. Isolates from blood cultures of the cases and the ICU environment were closely related by whole genome sequencing and resistant or tolerant against the quaternary ammonium compound surface disinfectant used in the ICU. Thus, S. marcescens was able to survive in the environment despite regular cleaning and disinfection. The hospital replaced the disinfectant with another one, tightened the cleaning protocol and strengthened hand hygiene compliance among the healthcare workers. Together, these control measures have proved effective to prevent new cases. Our results highlight the importance of multidisciplinary outbreak investigations, including environmental sampling, molecular typing and testing for disinfectant resistance.
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  • 文章类型: Journal Article
    Oropouche发烧是由Oropouche病毒(OROV)引起的,主要通过被感染的mid虫的叮咬传播,特别是库利科雷氏属。该病毒主要在中美洲和南美洲传播,几个国家报告正在爆发。我们在这里报告了在意大利发现的两例输入性OROV感染病例,2024年5月下旬-6月初。这些病例表明,在美洲大规模登革热爆发的阴影下,Oropouche爆发可能比以前估计的更广泛。
    Oropouche fever is caused by Oropouche virus (OROV), transmitted primarily through the bite of infected midges, particularly of the genus Culicoides. The virus is mainly circulating in Central and South America where several countries reported an ongoing outbreak. We report here two imported cases of OROV infection identified in Italy, late May-early June 2024. These cases indicate that in the shadow of a massive dengue outbreak in the Americas, the Oropouche outbreak might be more widespread than previously estimated.
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  • 文章类型: News
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  • 文章类型: Journal Article
    世界卫生组织(WHO)于2022年制定了真菌优先病原体清单。耳念珠菌最终被列为关键的优先病原体。PubMed和WebofScience用于查找2011年1月1日至2021年2月18日发表的研究,报告了预定义的标准,包括:死亡率,发病率(即,住院和残疾),耐药性,可预防性,年发病率,和分布/出现。37项研究纳入最终分析。与金耳念珠菌血症相关的总体和30天死亡率从29%到62%和23%到67%不等。分别。住院时间中位数为46-68天,长达140天。C.auris念珠菌血症的迟发性并发症包括转移性脓毒症并发症。对氟康唑的耐药率高达87%-100%。对伊沙康康唑的敏感性,伊曲康唑,泊沙康唑的MIC90值为0.06-1.0mg/l。对伏立康唑的耐药率从28%到98%不等。两性霉素B的耐药率在8%至35%之间,棘白菌素的耐药率在0%-8%之间。在过去的十年里,世卫组织所有区域都报告了由C.auris引起的疫情。鉴于C.auris的爆发潜力,MDR菌株的出现和传播,以及与识别相关的挑战,以及在医疗机构中根除其环境来源,应根据已识别的风险因素评估预防和控制措施的有效性和可行性。全球监测研究可以更好地了解发病率和分布模式,以评估金黄色葡萄球菌感染的全球负担。
    The World Health Organization (WHO) in 2022 developed a fungal priority pathogen list. Candida auris was ultimately ranked as a critical priority pathogen. PubMed and Web of Science were used to find studies published from 1 January 2011 to 18 February 2021, reporting on predefined criteria including: mortality, morbidity (i.e., hospitalization and disability), drug resistance, preventability, yearly incidence, and distribution/emergence. Thirty-seven studies were included in the final analysis. The overall and 30-day mortality rates associated with C. auris candidaemia ranged from 29% to 62% and 23% to 67%, respectively. The median length of hospital stay was 46-68 days, ranging up to 140 days. Late-onset complications of C. auris candidaemia included metastatic septic complications. Resistance rates to fluconazole were as high as 87%-100%. Susceptibility to isavuconazole, itraconazole, and posaconazole varied with MIC90 values of 0.06-1.0 mg/l. Resistance rates to voriconazole ranged widely from 28% to 98%. Resistance rates ranged between 8% and 35% for amphotericin B and 0%-8% for echinocandins. Over the last ten years, outbreaks due to C. auris have been reported in in all WHO regions. Given the outbreak potential of C. auris, the emergence and spread of MDR strains, and the challenges associated with its identification, and eradication of its environmental sources in healthcare settings, prevention and control measures based on the identified risk factors should be evaluated for their effectiveness and feasibility. Global surveillance studies could better inform the incidence rates and distribution patterns to evaluate the global burden of C. auris infections.
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  • 文章类型: News
    科罗拉多队在反对派中继续前进,失去生态健康联盟伙伴关系。
    Colorado team presses on amid opposition, loss of EcoHealth Alliance partnership.
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  • 文章类型: Journal Article
    自1988年全球根除脊髓灰质炎倡议启动以来,在阻断野生脊髓灰质炎病毒(WPV)在全球范围内的传播方面取得了实质性进展:全球根除WPV2型和3型分别于2015年和2019年获得认证。WPV1型的地方性传播仅在阿富汗和巴基斯坦继续。在2016年全球同步退出所有2型血清口服脊髓灰质炎病毒疫苗(OPVs)后,流行疫苗衍生的2型脊髓灰质炎病毒(cVDPV2)已经广泛爆发,这与人群对脊髓灰质炎病毒免疫力低的地区有关。自2017年以来,索马里官员发现了正在进行的cVDPV2传播。审查了索马里的脊髓灰质炎疫苗接种覆盖率和监测数据,以评估这种持续传播。在2017年1月至2024年3月期间,索马里官员在20个地区中的14个地区发现了39例cVDPV2病例。并传播到邻国埃塞俄比亚和肯尼亚。自2021年1月以来,在索马里开展了28项针对cVDPV2的补充免疫活动。该国某些地区的安全受到威胁,无法进行疫苗接种运动。在1,921名非脊髓灰质炎急性弛缓性麻痹儿童中,231(12%)没有通过常规免疫接种或SIA接受OPV剂量,其中95%来自中南部地区,60%的人生活在交通不便的地区。加强索马里的人道主义谈判措施,使安全受损地区的儿童能够接种疫苗,并加强无障碍地区的运动质量,将有助于阻断cVDPV2传播。
    Since the launch of the Global Polio Eradication Initiative in 1988, substantial progress has been made in the interruption of wild poliovirus (WPV) transmission worldwide: global eradication of WPV types 2 and 3 were certified in 2015 and 2019, respectively, and endemic transmission of WPV type 1 continues only in Afghanistan and Pakistan. After the synchronized global withdrawal of all serotype 2 oral poliovirus vaccines (OPVs) in 2016, widespread outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) have occurred, which are linked to areas with low population immunity to poliovirus. Officials in Somalia have detected ongoing cVDPV2 transmission since 2017. Polio vaccination coverage and surveillance data for Somalia were reviewed to assess this persistent transmission. During January 2017-March 2024, officials in Somalia detected 39 cVDPV2 cases in 14 of 20 regions, and transmission has spread to neighboring Ethiopia and Kenya. Since January 2021, 28 supplementary immunization activities (SIAs) targeting cVDPV2 were conducted in Somalia. Some parts of the country are security-compromised and inaccessible for vaccination campaigns. Among 1,921 children with nonpolio acute flaccid paralysis, 231 (12%) had not received OPV doses through routine immunization or SIAs, 95% of whom were from the South-Central region, and 60% of whom lived in inaccessible districts. Enhancing humanitarian negotiation measures in Somalia to enable vaccination of children in security-compromised areas and strengthening campaign quality in accessible areas will help interrupt cVDPV2 transmission.
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