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Abstract Human cases of avian influenza virus (AIV) infections are associated with an age-specific disease burden. As the influenza virus N2 neuraminidase (NA) gene was introduced from avian sources during the 1957 pandemic, we investigate the reactivity of N2 antibodies against A(H9N2) AIVs. Serosurvey of healthy individuals reveal the highest rates of AIV N2 antibodies in individuals aged ≥65 years. Exposure to the 1968 pandemic N2, but not recent N2, protected against A(H9N2) AIV challenge in female mice. In some older adults, infection with contemporary A(H3N2) virus could recall cross-reactive AIV NA antibodies, showing discernable human- or avian-NA type reactivity. Individuals born before 1957 have higher anti-AIV N2 titers compared to those born between 1957 and 1968. The anti-AIV N2 antibodies titers correlate with antibody titers to the 1957 N2, suggesting that exposure to the A(H2N2) virus contribute to this reactivity. These findings underscore the critical role of neuraminidase immunity in zoonotic and pandemic influenza risk assessment.

Abstract Cross-reactive antibodies with Fc receptor (FcR) effector functions may mitigate pandemic virus impact in the absence of neutralizing antibodies. In this exploratory study, we use serum from a randomized placebo-controlled trial of seasonal trivalent influenza vaccination in children (NCT00792051) conducted at the onset of the 2009 H1N1 pandemic (pH1N1) and monitored for infection. We found that seasonal vaccination increases pH1N1 specific antibodies and FcR effector functions. Furthermore, prospective baseline antibody profiles after seasonal vaccination, prior to pH1N1 infection, show that unvaccinated uninfected children have elevated ADCC effector function, FcγR3a and FcγR2a binding antibodies to multiple pH1N1 proteins, past seasonal and avian (H5, H7 and H9) strains. Whereas, children that became pH1N1 infected after seasonal vaccination have antibodies focussed to seasonal strains without FcR functions, and greater aggregated HA-specific profiles for IgM and IgG3. Modeling to predict infection susceptibility, ranked baseline hemagglutination antibody inhibition as the highest contributor to lack of pH1N1 infection, in combination with features that include pH1-IgG1, H1-stem responses and FcR binding to seasonal vaccine and pH1 proteins. Thus, seasonal vaccination can have benefits against pandemic influenza viruses, and some children already have broadly reactive antibodies with Fc potential without vaccination and may be considered ‘elite influenza controllers’.

Background: Street foods are unique and convenient urban food supply meanwhile it lacks the food hygiene and safety posing major public health risk. Thus, the study aims to identify the food safety, sanitation and hygiene practices of street food vendors. Method: The study is cross sectional including 70 vending units selected conveniently. Structured interview schedule and observation checklist was used as data collection tool. Result: The mean age of the respondent was 38.06 (±10.417) years with >1/2 being females (61.4%). Majority (77.1%) had formal education, 37.1% earns>40,000/month and 86 % had not taken any food hygiene training. Eighty percent of the respondents had fixed stall with about 83% sell freshly cooked food and 75% prepare it in market place. About 84% of the respondent revealed diarrhea as the most prevalent disease caused by poor hygiene. Very less (27%) have their health check-up regularly and about 68.6% prepare food when they are ill. Almost 50% heat food before serving, 58% wash dishes with tap water, 98.6% wash raw food before preparation and all of them wash cooking dishes daily. About half (48.6%) of the respondents re-use oil while cooking. Approximately in 77% refrigeration facility was available. The food vending was found to be good (>50) in 54.3% and sanitation was good (>50%) in 60%. Conclusion: Overall sanitary conditions of the vending sites were good but instead needs improvement in most of the aspect of sanitary condition.

Purpose: This study aimed to identify the factors associated with depressive symptoms among postpartum mothers in Kathmandu, Nepal. Method: A hospital-based cross-sectional study that included 346 postpartum mothers at 4–14 weeks after delivery was carried out. Validated Nepalese version of Edinburgh Postnatal Depression Scale with cut-off value of ≥12 was used to screen depressive symptoms and structured questionnaires were used to identify the associated factors. Possible factors associated with depressive symptoms were identified by logistic regression analysis. Result: The mean age of the mothers was 22.75 (SD = 4.51). The prevalence of depressive symptoms among postpartum mothers was 17.1% (95% CI = 15.07–19.12). No significant association existed between postpartum depressive symptoms and socio demographic and economic characteristics. In multivariate analysis, risk factors for postpartum depressive symptoms were identified as follows: women without adequate rest during pregnancy (aOR = 4.023, 95% CI = 1.294–12.501), abortion history (aOR = 3.25, 95% CI = 1.208–9.065), poor relationship with husband (aOR = 1.67, 95% CI = 1.073–8.384), marital dissatisfaction (aOR = 4.053, 95% CI = 2.281–12.819) and stressful life events (aOR = 3.89, 95% CI = 1.504–9.810). Conclusions: This study aids to draw attention on the incorporation of routine screening for basic support and intervention for identified risk factors in postpartum period. Policies can be formulated to encourage postpartum women to obtain adequate rest during pregnancy, support women with poor partner relationship, reduce marital dissatisfaction, help women adjust with stressful life events, and prevent and manage abortion appropriately. These policies may reduce harmful consequences of postpartum depressive symptoms for women, newborn and their family. Keywords: Edinburgh postnatal depression scale (EPDS), Nepal, Postpartum depressive symptoms

Abstract Introduction Pseudomonas aeruginosa and Acinetobacter spp. are found to be associated with biofilm and metallo-β-lactamase production and are the common causes of serious infections mainly in hospitalized patients. So, the main aims of this study were to determine the rates of biofilm production and metallo beta-lactamase production (MBL) among the strains of Pseudomonas aeruginosa and Acinetobacter spp. isolated from hospitalized patients. Methods A total of 85 P. aeruginosa isolates and 50 Acinetobacter spp. isolates isolated from different clinical specimens from patients admitted to Shree Birendra Hospital, Kathmandu, Nepal from July 2013 to May 2014 were included in this study. The bacterial isolates were identified with the help of biochemical tests. Modified Kirby-Bauer disc diffusion technique was used for antimicrobial susceptibility testing. Combined disc diffusion technique was used for the detection of MBL production, while Congo red agar method and tube adherence method were used for detection of biofilm production. Results Around 16.4% of P. aeruginosa isolates and 22% of the strains of Acinetobacter spp. were metallo β-lactamase producers. Out of 85 P. aeruginosa isolates, 23 (27.05%) were biofilm producers according to tube adherence test while, only 13 (15.29%) were biofilm producers as per Congo red agar method. Similarly, out of 50 Acinetobacter spp. 7 (14%) isolates were biofilm producers on the basis of tube adherence test, while only 5 (10%) were positive for biofilm production by Congo red agar method. Highest rates of susceptibility of P. aeruginosa as well as Acinetobacter spp. were seen toward colistin. Conclusion In our study, biofilm production and metallo beta-lactamase production were observed among Pseudomonas aeruginosa and Acinetobacter spp. However, no statistically significant association could be established between biofilm production and metallo beta-lactamase production.

Objective: The study aims to describe Quality of Life of Patients with Hypertension and its predictors. Methods: The study was descriptive cross sectional involving 237 patients with hypertension attending outpatient department of Manmohan Cardiothoracic Vascular and Transplant Centre. Data was collected by interview technique using SF-36 questionnaire. The data was analyzed using SPSS version 16 and p values