OBJECTIVE: State and local public health departments (LHDs) are encouraged to collaborate with community-based organizations (CBOs) to enhance communication and promote protective practices with communities made vulnerable during emergencies, but there is little evidence-based understanding of practical approaches to fostering collaboration in this context. This research focuses on how collaboration enhances LHD capacity for effective communication for people with limited English proficiency (LEP) during infectious disease outbreaks specifically and strategies to facilitate productive LHD-CBO collaboration.
METHODS: Qualitative, telephone interviews, conducted March-October 2021.
METHODS: Rural and urban jurisdictions with Chinese-speaking or Spanish-speaking populations across the United States.
METHODS: 36 LHD and 31 CBO staff working on outreach to Chinese and Spanish speakers during COVID-19.
METHODS: Interviews were audio-recorded, transcribed verbatim, and analyzed using a team-based, codebook approach to thematic analysis.
RESULTS: During COVID-19, CBOs extended LHD capacity to develop and disseminate effective communication, meaning communication that is rapidly in-language, culturally resonant, locally relevant, and trusted. Practical strategies to enable and sustain effective collaboration were needed to address operational dimensions (eg, material and administrative) and relational dimensions (eg, promoting trust and respect).
CONCLUSIONS: Policies and financing to support LHD-CBO collaborations are critical to improving communication with people with LEP and addressing long-standing inequities in outcomes during outbreaks.

UNASSIGNED: Outbreaks are associated with increased risk of anxiety disorders, depression, and severe mental conditions. Integrating mental health and psychosocial support (MHPSS) into outbreak response facilitates the delivery of holistic care to the affected community. As there is an increasing incidence of outbreaks globally, integrating MHPSS into preparedness and response plans is paramount to strengthen the capacity of existing health systems and respond to mental health and psychosocial needs. However, the attention given to MHPSS during outbreak response is critically low. The objectives of this study were to identify areas of MHPSS integration and explore the challenges that hinder the delivery of an integrated care during outbreak response.
UNASSIGNED: A participatory qualitative study was conducted to explore how MHPSS can be incorporated into outbreak preparedness and response plans as a cross-cutting intervention in the context of low- and middle-income countries. We brought together civil society representatives, key stakeholders, and public health experts to explore areas of MHPSS integration during outbreak response.
UNASSIGNED: Systematic integration of MHPSS into outbreak response was perceived to be feasible. Study participants strongly agreed that MHPSS can be integrated into most of the outbreak response pillars including partner coordination, case management, infection prevention and control, staff health and well-being, and risk communication and community engagement. However, the effort requires multi-sectoral collaboration, political commitment, and adequate recognition in planning and financing.
UNASSIGNED: Despite complex challenges, integrating MHPSS into outbreak pillars is possible. Moreover, emphasis should be placed on cultural adaptation of MHPSS guidelines and strong leadership in coordinating MHPSS into outbreak planning and response.

BackgroundQ fever is a bacterial zoonosis caused by Coxiella burnetii. Spain has the highest number of notified human cases in Europe. Small ruminants are a key reservoir for the pathogen, transmission from animals to humans is usually airborne.AimWe aimed at exploring temporal and spatial epidemiological patterns of sporadic and outbreak cases of Q fever in four Spanish regions with the highest number of notified cases.MethodsWe extracted data on Q fever cases in the Canary Islands, Basque Country, La Rioja and Navarre between 2016 and 2022 from the Spanish National Epidemiological Surveillance Network. We calculated standardised incidence ratios (SIR), spatial relative risks (sRR) and posterior probabilities (PP) utilising Besag-York-Mollié models.ResultsThere were 1,059 notifications, with a predominance of males aged 30-60 years. In Basque Country, La Rioja and Navarre area, 11 outbreaks were reported, while no in the Canary Islands. A seasonal increase in incidence rates was observed between March and June. In the Canary Islands, elevated sRR was seen in La Palma, Gran Canaria, Lanzarote and Fuerteventura. In Basque Country, La Rioja and Navarre area, the highest sRR was identified in the south of Biscay province.ConclusionGoats were the main source for humans in outbreaks reported in the literature. Seasonal increase may be related to the parturition season of small ruminants and specific environmental conditions. Local variations in sRR within these regions likely result from diverse environmental factors. Future One Health-oriented studies are essential to deepen our understanding of Q fever epidemiology.

OBJECTIVE: To examine the perceptions of managers of elder care homes on the impact of facility and staff characteristics on infection control of COVID-19.
METHODS: Case study.
METHODS: Six purposively sampled care home managers in the city of Stockholm were interviewed. Through content analysis, three categories and nine subcategories were identified.
RESULTS: According to the interviewed care home managers, a home-like environment that allows for isolation of residents and possibilities for staff to get changed and store personal protective equipment outside each resident\'s room was considered ideal. Experienced employees were reported as invaluable when facing an infectious outbreak. A mix of permanent and temporary staff was considered essential although some thought that temporary staff who work in multiple care homes might negatively influence the spread of infection. Language barriers among staff were considered an obstacle when trying to disseminate information.

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The application of geospatial data often allows the tracing of people who are involved in activities of an illegal nature. In June 2021, we estimated the true magnitude of the spread of COVID-19 within the networks of escort-karaoke bars in Seoul, Republic of Korea, using geographic information system (GIS)-based contact tracing that was applied to our epidemiological investigation. Our joint rapid response team, composed of epidemic investigation officers and police personnel, identified 19 paper-traced cases and 158 GIS-traced cases from 5,692 confirmed cases in Seoul during the study period (June to July 2021). Our findings suggest that collaboration with law enforcement agencies and the use of overlaid satellite imagery in outbreak investigations enhances high vigilance and reduces the risk of potential breaches of human rights in the process.

Over the previous three decades, the incidence of infectious disease outbreaks has considerably increased and the trend is expected to increase further. Public health measures are essential for controlling and preventing emerging outbreaks of infectious illnesses. This study is aimed at evaluating the effectiveness of public health measures during infectious disease outbreaks by summarizing the outcomes from the available evidence in the literature. A systematic review was carried out through a detailed search strategy using specific keywords applied across different electronic databases, including the Science Direct, PubMed, and EMBASE databases. Studies published between 2015 and 2024 were included with a focus on cohorts, clinical trials, longitudinal studies, case-control, and quasi-experimental studies. Low-quality studies and those published before 2015 along with incorrect findings or measures were excluded. A standardized form was used for data extraction. The quality of included studies and the risk of bias were assessed through relevant techniques. The obtained data was narrative synthesized and findings were organized systematically. The reviewed studies revealed that public health measures are considerably effective against infectious disease outbreaks. The success of various measures such as social isolation, confinement measures, and public education on hygiene against different outbreaks of respiratory infectious diseases has been well-established in the literature. Moreover, the timing of intervention application plays a vital role in their success. The implementation in the early phase of an outbreak is highly effective, as it protects more people from infection and controls the overall burden of the disease. The systematic review provided valuable insights into the efficiency of public health measures in monitoring outbreaks of infectious illnesses. The main findings suggest that appropriate public health interventions are effective in controlling the incidence of contagious disease outbreaks. Ongoing research strives to investigate measures that are most effective from the perspective of public health against various transmittable diseases to prevent future outbreaks.

BACKGROUND: Serratia marcescens is a gram-negative bacterium that is widespread in the environment. S. marcescens bacteremia can be fatal during pregnancy and cause persistent chorioamnionitis. This study reports an outbreak of Serratia marcescens bloodstream infection (BSI) among high-risk pregnant women in an obstetric ward. The purpose of this study is to report our experience with the usefulness of the ATP test in hospital environmental management and to confirm that bloodstream infections of patients with the same strain were correlated by WGS testing.
METHODS: This retrospective study collected the data of inpatients with S. marcescens bacteremia in obstetric ward for high-risk pregnant women from August 22, 2021, to October 14, 2021. We performed: an adenosine triphosphate (ATP) bioluminescence test in the environment with a high-contact area; environmental culture; on-site monitoring and staff education; and whole-genome sequencing (WGS) to evaluate genetic relationships among S. marcescens isolates.
RESULTS: S. marcescens BSI occurred in four consecutive patients. None of the patients had central venous catheters. An ATP bioluminescence test revealed that high-contact areas and areas for injection preparation were not clean (≥ 1000 relative light units). However, S. marcescens was not identified in the environmental cultures, likely due to intensive environmental cleaning and discarding of potentially contaminated specimens before the culture test. On-site monitoring and education were conducted for 1 month. There were no further reports of BSI until 6 months after the last patient was discharged. WGS performed on three isolates from three patients indicated that the isolated S. marcescens was likely from the same strain.
CONCLUSIONS: We controlled an S. marcescens outbreak by improving environmental cleaning as well as education of and behavior changes in healthcare workers. Using the ATP bioluminescence test can provide feedback on environmental cleaning and education. WGS played a role in determining the spread of BSI caused by the same strain.

The speed of spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the coronavirus disease 2019 (COVID-19) pandemic highlights the importance of understanding how infections are transmitted in a highly connected world. Prior to vaccination, changes in human mobility patterns were used as non-pharmaceutical interventions to eliminate or suppress viral transmission. The rapid spread of respiratory viruses, various intervention approaches, and the global dissemination of SARS-CoV-2 underscore the necessity for epidemiological models that incorporate mobility to comprehend the spread of the virus. Here, we introduce a metapopulation susceptible-exposed-infectious-recovered model parametrized with human movement data from 340 cities in China. Our model replicates the early-case trajectory in the COVID-19 pandemic. We then use machine learning algorithms to determine which network properties best predict spread between cities and find travel time to be most important, followed by the human movement-weighted personalized PageRank. However, we show that travel time is most influential locally, after which the high connectivity between cities reduces the impact of travel time between individual cities on transmission speed. Additionally, we demonstrate that only significantly reduced movement substantially impacts infection spread times throughout the network.

There is a complex interplay between infectious disease outbreaks and the stigmatization of affected persons and communities. Outbreaks are prone to precipitating stigma due to the fear, uncertainty, moralisation, and abatement of freedoms associated with many infectious diseases. In turn, this stigma hampers outbreak control efforts. Understanding this relationship is crucial to improving coordinated outbreak response. This requires valid and reliable methods for assessing stigma towards and within impacted communities. We propose adopting a cross-outbreak model for developing the necessary assessment tools. A stigma-informed approach must then be integrated into outbreak preparedness and response efforts to safeguard public health and promote inclusivity and compassion in future outbreaks.