Sera from different age cohorts in Belgium show limited cross-neutralization between the mumps vaccine and outbreak strains

ObjectivesMumps used to affect children between 2 and 15 years old. The mumps–measles–rubella (MMR) vaccine is available, with vaccine coverage rate of about 85% after two vaccine doses. Recently new mumps outbreaks have emerged in highly vaccinated populations; the causes for these new outbreaks are yet unknown. We tested if a difference in seroneutralizing capacity against the vaccine and wild-type viruses existed and if waning immunity could be detected.MethodsIn this study, 570 serum samples (age group 2–3 years (n = 96), 8–9 years (n = 95), 13–14 years (n = 94), 18–20 years (n = 96), 24–26 years (n = 92) and 50 + years (n = 97)) in Belgium were tested in the rapid fluorescent foci inhibition test for their neutralizing capacity against the vaccine and wild-type viruses.ResultsNeutralizing antibodies against the vaccine strain were present in 84% (81/97) of the 2–3-year, 74% (70/95) of the 8–9-year, 81% (76/94) of the 13–14-year, 76% (73/96) of the 18–20-year, 67% (62/92) of the 24–26-year and 77% (75/97) of the 50+-year age group serum samples. For all age groups, only about half of these serum samples were also positive for the wild-type virus. The geometric mean titres for the vaccine and wild-type virus for all younger age groups, except for 24–26 years, were significantly different, demonstrating poor in vitro cross-neutralization.ConclusionsA possible contribution of antigenic differences between the genotype A and G mumps virus as well as other immune factors, in addition to lower-than-optimal vaccination coverage and waning immunity, could explain the poor in vitro cross-neutralization and should be further studied.     

An insight into the mental health needs of the common public of Tamil Nadu,India, subjected to COVID-19 lockdown,a rare unprecedented crisis

PurposeCOVID-19, a major “Public Health Emergencies of International Concern”, had sought greater attention among researchers to study its pathogenesis, associated complications and management. However, there are only few studies that had studied its potential impact on mental health of general public, who are subjected to social distancing, community lockdown and restrictions in their routine activities.ObjectivesThe aim of this study is to assess the prevalence of psychological distress and mental health needs among general public in Tamil Nadu subjected to lockdown, social distancing amidst COVID-19 crisis. Tamil Nadu is one of the worst affected states of southern India.MethodsA self-administered, web-based application study using “WHO-Self Reported Questionnaire-20”, in bilingual version, both English and Tamil, is used to screen the public for the level of distress. The study is done while the state is under extended lockdown and restricted movement.Key findingsA total of 918 respondents participated in the survey and it is found that about more than one third of the respondents (～35%) are under psychological distress. A significant association between younger age group, female gender, unmarried, people with children are found to be under distress. The lockdown had increased the frequency of smoking and quantity of cigarettes among smokers, also has increased the frequency of drinking among alcohol consumers. Of the SRQ-20 items recorded, stress related neurotic symptoms (> 70%) was observed more than the depressive mood. About 33% of those scored > 7, had suicidal tendency. The districts declared red zones had significantly reported a greater number of respondents under distress.ConclusionBesides effectively mitigating the COVID-19 crisis, in terms of prevention, control and treatment strategies, it is prerogative to effectively manage fear, distress due to the COVID-19 and associated anxiety and depression among the public.     

Status of Foot‐and‐mouth Disease in India

Foot‐and‐mouth disease (FMD) is endemic in India and causes severe economic loss. Status of FMD in the country for five fiscal years is presented. Outbreaks were more in number in 2007–2008 than 2010–2011. Three serotypes of FMD virus (O, A and Asia1) are prevalent. Serotype O was responsible for 80% of the confirmed outbreaks/cases, whereas Asia1 and A caused 12% and 8%, respectively. Geographical region‐wise assessment indicated varying prevalence rate in different regions viz; 43% in Eastern region, 31.5% in Southern region, 11.6% in North‐eastern region, 5% Central region, 4.4% Western region and 4% in Northern region. Highest number of outbreaks/cases was recorded in the month of September and lowest in June. Emergence and re‐emergence of different genotypes/lineages within the serotypes were evident in real‐time investigation carried out from time to time. Continues antigenic divergence in serotype A resulted in change in the vaccine strain in 2009. As on date, all genetic diversity within the serotypes is well tolerated by the vaccine strains. Unrestricted animal movements in the country play a major role in the spread of FMD.     

贵州省某市X镇一起细菌性痢疾暴发的调查

目的 对2011年5月7日,贵州省毕节市X镇报告的一起菌痢暴发疫情展开调查,明确危险因素.方法 对所有的病例进行个案调查,用描述性流行病学方法分析病例分布情况,采用病例对照研究研究的方法,探讨本次暴发的危险因素.结果 从4月28日～17日共发生病例317例,总罹患率为0.63％.3个高发村寨中,使用镇自来水村寨的罹患率为3.3％,明显高于未使用镇自来水的村寨罹患率0.6％(RR=5.6,95％CI:2.9～11);80％ (110/137)的病例和46％(64/137)的对照使用镇自来水洗碗、刷牙(OR=4.6,95％ CI:2.7～8.0); 66％ (90/137)的病例和16％ (11/137)的对照生饮镇自来水(OR=9.8,95％ CI:5.3～18),且每天饮用镇自来水量越多,发病危险性越大(x趋势2=11,P=0.00).镇自来水水源上游有村民排污、农田污水等污染源存在,水厂未经任何消毒就直接将水供给村民使用;实验室检测镇自来水细菌总数＞3 100 cfu/ml,大肠杆菌＞1 600 MPN/ml.结论 生饮或使用未经消毒的镇自来水是引起本次菌痢暴发的可能原因.建议加强对农村集中供水的消毒和监管,保证农村的用水安全卫生.     

北京市2014－2018年诺如病毒急性胃肠炎暴发的影响因素分析

目的 分析2014－2018年北京市诺如病毒急性胃肠炎暴发的影响因素。方法 收集2014年4月至2018年3月北京市诺如病毒急性胃肠炎聚集性事件及暴发资料,应用非条件logistic回归模型分析诺如病毒急性胃肠炎暴发的影响因素。结果 北京市共报告由诺如病毒感染引起的急性胃肠炎事件765起,85.88%（657/765）为聚集性事件,14.12%（108/765）为暴发。在暴发中,70.37%（76/108）发生在2017年;84.26%（91/108）发生在冬、春季节;88.89%（96/108）发生在托幼机构及中小学;主要传播途径为人传人（81.48%,88/108）;93.52%（101/108）为GⅡ组诺如病毒感染引起。多因素logistic回归分析结果显示,在近郊区及远郊区发生的事件,出现暴发的风险分别是城区的1.84倍（95% CI：1.13～3.02）及3.78倍（95% CI：1.62～8.82）;在小学、中学及其他机构发生的事件,出现暴发的风险分别是幼儿园的6.26倍（95% CI：3.53～11.10）、14.98倍（95% CI：6.23～36.01）及8.71倍（95% CI：3.07～24.71）;就诊率低于全部事件就诊率中位数的,发生暴发的风险是就诊率高的2.29倍（95% CI：1.42～3.68）;传播途径为食源性的事件,发生暴发的风险为人传人传播的14.55倍（95% CI：3.15～67.07）。结论 加强郊区、中小学及其他机构诺如病毒暴发疫情的防控力度,急性胃肠炎患者积极就医,做好食源性疫情的防控及厨工的健康管理,有助于减少诺如病毒急性胃肠炎的暴发。     

Drainage systems,an occluded source of sanitation related outbreaks

Background

Drainage systems and its role in sanitation related outbreaks are evident but still occluded once it has been installed. This current review evaluates if drainage systems can cause infections and thus be of clinical concern.

Method

A review of the literature was analyzed. Papers, guidelines, and quality management systems have been considered.

Results

Adequate sanitation is fundamental and a prerequisite for safe life and productivity. In contrast, malfunctioning sanitation has been reported to cause outbreaks all over the world. In areas with no sanitation, diarrheal mortality is high and has been shown to decrease by 36% after interventions to improve sanitation. Often, infections are faeces associated and when present in wastewater and sewage sludge poses a high risk of infection upon exposure. Hence, there are working safety guidelines and in industries where infection reduction is essential strict quality assurance systems, i.e. HACCP (hazard analysis critical control points) and GMP (Good Manufacturing Practice) must be complied. Healthcare has recently taken interest in the HACCP system in their efforts to reduce healthcare associated infections as a response to increasing number of ineffective antibiotics and the threat of mortality rate like the pre-antibiotic era. The last few years have called for immediate action to contain the emergence of increasing resistant microorganisms. Resistance is obtained as a result of overuse and misuse of antibiotics in both healthcare and agriculture. Also, by the discharge of antibiotics from manufacturers, healthcare and society. One mechanism of development of novel resistant pathogens has been shown to be by effortless sharing of genetic mobile elements coding for resistance from microbes in the environment to human microbes. These pathogens have been sampled from the drainage systems. These were noticed owing to their possession of an unusual antibiotic resistance profile linking them to the outbreak. Often the cause of sanitation related outbreaks is due to inadequate sanitation and maintenance. However, in general these infections probably go unnoticed.

Conclusion

Drainage systems and its maintenance, if neglected, could pose a threat in both community and healthcare causing infections as well as emergence of multi-resistant bacteria that could cause unpredictable clinical manifestations.     

2006—2008年北京市海淀区中小学校及幼托园水痘暴发疫情分析

目的了解北京市海淀区中小学校和幼托园水痘暴发疫情的流行病学特征。方法利用描述流行病学方法,根据国家疾病监测报告管理系统,对海淀区2006—2008年报告的中小学校和幼托园水痘暴发疫情资料进行分析。结果海淀区2006—2008年中小学校和幼托园共报告水痘暴发疫情21起,累计发病317例,无死亡病例,小学水痘暴发疫情16起,占总数的76．2％;暴发疫情主要集中在3～6月、11月和12月;2006—06以后对疫情发生单位中年龄在15岁及以下易感者进行水痘疫苗的免费应急接种,接种率92．6％～100％;暴发疫情时间持续最长65d,最短5d,平均28d（中位数）;暴发病例中有水痘疫苗明确免疫史的占41．96％,无免疫史的占49．84％,免疫史不详的占8．20％。结论2006—2008年海淀区报告的中小学校和幼托园水痘暴发疫情逐年增多,小学的水痘暴发疫情比例较大,说明小学生是水痘暴发疫情控制的重点人群,需采取有针对性的控制措施。