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.     

广西2008年一起甲型肝炎暴发流行株基因分型研究

目的了解2008年广西一起甲型肝炎暴发流行株基因型。方法采自甲型肝炎暴发流行中3所学校现症病人的血清。经RT-PCR对HAV-VP1区核苷酸进行扩增和序列分析。结果来自3所学校的HAV流行株VP1区核苷酸序列同源性为100％,与AH2株的同源性最高,为98．6％,同属于IA亚型;氨基酸水平上没有发生氨基酸的缺失、插入,未发生有意义的突变。结论IA亚型是导致此次甲肝暴发的流行株,3所学校具有相同的传染源和流行株。人群甲肝疫苗免疫水平低是甲肝流行的主要因素,应加强甲肝疫苗的免疫水平及甲肝分子流行病学监测。     

Tuberculosis outbreak in marijuana users, Seattle, Washington, 2004

Matching Mycobacterium tuberculosis isolates were noted among 11 young tuberculosis patients socially linked through illicit drug-related activities. A large proportion of their friends, 14 (64%) of 22, had positive tuberculin skin-test results. The behavior of "hotboxing" (smoking marijuana inside a closed car with friends to repeatedly inhale exhaled smoke) fueled transmission.     

Reemerging leptospirosis, California

Leptospirosis is a reemerging infectious disease in California. Leptospirosis is the most widespread zoonosis throughout the world, though it is infrequently diagnosed in the continental United States. From 1982 to 2001, most reported California cases occurred in previously healthy young adult white men after recreational exposures to contaminated freshwater. We report five recent cases of human leptospirosis acquired in California, including the first documented common-source outbreak of human leptospirosis acquired in this state, and describe the subsequent environmental investigation. Salient features in the California cases include high fever with uniform renal impairment and mild hepatitis. Because leptospirosis can progress rapidly if untreated, this reemerging infection deserves consideration in febrile patients with a history of recreational freshwater exposure, even in states with a low reported incidence of infection.     

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.     

2010-2016年广西报告的食源性疾病暴发事件分析

目的 分析2010-2016年广西食源性疾病暴发事件的流行病学特征,为政府决策提供依据。方法 对2010-2016年国家食源性疾病暴发监测系统和突发公共卫生信息报告管理系统上报的食源性疾病暴发事件进行描述性流行病学分析。结果 2010-2016年广西共报告食源性疾病暴发事件346起,累计发病5492人,死亡58人,年平均发病率为1.66/10万。微生物性因素导致的暴发事件数和发病数最多,分别占48.53%（132/272）、70.45%（3197/4538）, 以沙门菌为主（23.48%,31/132）;有毒植物导致死亡人数最多,占66.67%（36/54）,以钩吻碱（21人）和毒蘑菇（11人）死亡构成较大。。结论 加大对微生物污染和有毒植物中毒的科普宣传,加强对重点环节的监管,建立完善的食源性疾病报告机制,减少暴发事件的发生。     

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.     

凤阳县2005年伤寒暴发流行特征分析

目的研究凤阳县2005年伤寒暴发流行特征,为今后的防治工作提出科学依据。方法对2005年伤寒暴发资料进行统计分析。结果此次暴发主要集中在10～12月,11月达到最高峰,10～20岁病人为主（69.2%）,学生为主要人群（56.7%）。配对病例对照研究发现,在外就餐是发病主要原因（OR=5.71,P〈0.01）。结论加强餐饮业卫生的管理和监督、改变不良卫生习惯是防止伤寒暴发的关键措施;流行早期及时采取严格、有效的措施是短期内疫情得到有效控制的保证。     

Evaluation of the RIDAQuick norovirus immunochromatographic test kit

Background

Norovirus infections occur frequently and are widespread throughout the US population causing greater than half of all foodborne gastroenteritis cases. A rapid norovirus assay would be a useful clinical tool for identification of this common virus in gastroenteritis patient samples, thereby identifying outbreaks and facilitating rapid implementation of control measures.

Objectives

To determine the suitability of the RIDAQuick norovirus kit as a clinical tool by determining the specificity and sensitivity of the assay, and its cross-reactivity with other enteric viruses.

Study design

Archived stool specimens containing norovirus genogroup I or II or other viruses were tested using the RIDAQuick norovirus assay and results compared to those obtained with real-time RT-PCR.

Results

We tested 62 samples: 19 norovirus genogroup I, 25 genogroup II samples, and 18 norovirus negative samples. Compared to PCR results, RIDAQuick assay sensitivity was 61.4%, and specificity was 100%. The low sensitivity was mainly due to poor results with genogroup I specimens; only 11 of 19 were detected. Additionally, samples of four other common enteric viruses all tested negative with the RIDAQuick assay.

Conclusions

The RIDAQuick kit effectively detects norovirus genogroup II strains, but not genogroup I strains. We found no cross-reactivity with several common enteric viruses. As most norovirus cases are currently genogroup II strains, positive results with RIDAQuick can be used for rapid detection of norovirus in a large percentage of cases, thus also aiding in identification of outbreaks. However, final confirmation and negative results require further testing with more sensitive methods.     

Nosocomial Outbreak of Carbapenem-Resistant Acinetobacter baumannii in Intensive Care Units and Successful Outbreak Control Program

Acinetobacter baumannii has been increasingly reported as a significant causative organism of various nosocomial infections. Here we describe an outbreak of carbapenem-resistant A. baumannii (CRAB) in the ICUs of a Korean university hospital, along with a successful outbreak control program. From October 2007 through July 2008, CRAB was isolated from 57 ICU patients. Nineteen patients were diagnosed as being truly infected with CRAB, four of whom were presumed to have died due to CRAB infection, producing a case-fatality rate of 21.1%. In surveillance of the environment and the healthcare workers (HCWs), CRAB was isolated from 24 (17.9%) of 135 environmental samples and seven (10.9%) of 65 HCWs. The pulsed field gel electrophoresis patterns showed that the isolates from patients, HCWs, and the environment were genetically related. Control of the outbreak was achieved by enforcing contact precautions, reducing environmental contamination through massive cleaning, and use of a closed-suctioning system. By August 2008 there were no new cases of CRAB in the ICUs. This study shows that the extensive spread of CRAB can happen through HCWs and the environmental contamination, and that proper strategies including strict contact precautions, massive environmental decontamination, and a closed-suctioning system can be effective for controlling CRAB outbreaks.