Improving attribution of extreme heat deaths through interagency cooperation

Attributing individual deaths to extreme heat events (EHE) in Canada and elsewhere is important for understanding the risk factors, protective interventions, and burden of mortality associated with climate change. However, there is currently no single mechanism for identifying individual deaths due to EHE and different agencies have taken different approaches, including (1) vital statistics coding based on medical certificates of death, (2) probabilistic methods, and (3) enhanced surveillance. The 2018 EHE in Montréal provides an excellent case study to compare EHE deaths identified by these different approaches. There were 353 deaths recorded in the vital statistics data over an 8-day period, of which 102 were potentially attributed to the EHE by at least one approach and 251 were not attributed by any approach. Only nine of the 102 deaths were attributed to the EHE by all three approaches, 23 were attributed by two approaches, and 70 were attributed by only one approach. Given that there were approximately 50 excess deaths during the EHE, it remains unclear exactly which of the total 353 deaths should be attributed to the extreme temperatures. These results highlight the need for a more systematic and cooperative approach to EHE mortality in Canada, which will continue to increase as the climate changes.     

Outcomes of post-exposure vaccination by modified vaccinia Ankara to prevent mpox (formerly monkeypox): a retrospective observational study in Lyon,France, June to August 2022

Modified vaccinia virus Ankara vaccine (MVA-BN; Bavarian Nordic) is recommended to contacts of mpox cases up to 14 days post-exposure but the effectiveness of this strategy is unknown. Among 108 adults (≥ 18 years old) who received one dose of MVA-BN after exposure to mpox, 11 (10%) cases of breakthrough mpox were observed. Sexual exposure was associated with the risk of breakthrough mpox (p = 0.0179). Samples taken from vaccinated breakthrough mpox cases had similar rates of infectious virus isolation than unvaccinated mpox cases.     

Outbreak of OXA-48-producing Enterobacterales in a haematological ward associated with an uncommon environmental reservoir,France, 2016 to 2019

The hospital water environment, including the wastewater drainage system, is increasingly reported as a potential reservoir for carbapenemase-producing Enterobacterales (CPE). We investigated a persistent outbreak of OXA-48 CPE (primarily Citrobacter freundii) in a haematological ward of a French teaching hospital by epidemiological, microbiological and environmental methods. Between January 2016 and June 2019, we detected 37 new OXA-48 CPE-colonised and/or ‑infected patients in the haematological ward. In October 2017, a unit dedicated to CPE-colonised and/or ‑infected patients was created. Eleven additional sporadic acquisitions were identified after this date without any obvious epidemiological link between patients, except in one case. Environmental investigations of the haematological ward (June–August 2018) identified seven of 74 toilets and one of 39 drains positive for OXA-48 CPE (seven C. freundii, one Enterobacter sakazakii, one Escherichia coli). Whole genome comparisons identified a clonal dissemination of OXA-48-producing C. freundii from the hospital environment to patients. In addition to strict routine infection control measures, an intensive cleaning programme was performed (descaling and bleaching) and all toilet bowls and tanks were changed. These additional measures helped to contain the outbreak. This study highlights that toilets can be a possible source of transmission of OXA-48 CPE.     

Ein Fall von Anisometropie und allgemeine Beleuchtung dieses Gesichtsfehlers

Ohne Zusammenfassung     

Die Theorie des Astigmatismus

Ohne Zusammenfassung     

Ist die Schwingmühle geeignet zur Herstellung schlackenfreier Viruspräparate?

Ohne Zusammenfassung