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The AstraZeneca ChAdOx1 nCoV-19 (AZD1222) vaccine is associated with Thrombosis with Thrombocytopenia Syndrome (TTS) in 3/100,000 vaccinations with high fatality rates reported in many countries. We conducted a risk–benefit analysis for Australians aged 18–59 years, comparing the risk of vaccination versus infection, and rate of TTS to other vaccines which prompted policy change following rare adverse events – rotavirus, smallpox and oral polio vaccines. COVID-19 deaths over 12 months range from 0 to 417 in current and future worst case scenarios. In the past 15 months 20 COVID-19 deaths occurred in people < 60 years compared to 890 deaths over 60 years. The estimated possible number of TTS cases is 347, with vaccine-related deaths ranging from 17 to 153 if 80% of adults 18–59 years are vaccinated. The reported rate of TTS is in the same range as rare but serious adverse events associated with other vaccines that have been subject to policy change. In Australia, the potential risks of the AZD1222 vaccine in younger adults, who are at low risk of dying from COVID-19, may outweigh the benefits. [ABSTRACT FROM AUTHOR]

• This was a cross-sectional survey in five cities without a culture of wearing masks. • Mask use decreased after the age of 50 years but this age effect was not seen in the US. • Risk perception and past experience affected mask use during the pandemic. • Mask use did not result in a net change in other risk-mitigation behaviours. • Pandemic fatigue was more common in young people and males in protracted outbreaks. To determine patterns of mask wearing and other infection prevention behaviours, over two time periods of the COVID-19 pandemic, in cities where mask wearing was not a cultural norm. A cross-sectional survey of masks and other preventive behaviours in adults aged ≥18 years was conducted in five cities: Sydney and Melbourne, Australia; London, UK; and Phoenix and New York, USA. Data were analysed according to the epidemiology of COVID-19, mask mandates and a range of predictors of mask wearing. The most common measures used were avoiding public areas (80.4%), hand hygiene (76.4%), wearing masks (71.8%) and distancing (67.6%). Over 40% of people avoided medical facilities. These measures decreased from March–July 2020. Pandemic fatigue was associated with younger age, low perceived severity of COVID-19 and declining COVID-19 prevalence. Predictors of mask wearing were location (US, UK), mandates, age <50 years, education, having symptoms and knowing someone with COVID-19. Negative experiences with mask wearing and low perceived severity of COVID-19 reduced mask wearing. Most respondents (98%) believed that hand washing and distancing were necessary, and 80% reported no change or stricter adherence to these measures when wearing masks. Pandemic mitigation measures were widely reported across all cities, but decreased between March and July 2020. Pandemic fatigue was more common in younger people. Cities with mandates had higher rates of mask wearing. Promotion of mask use for older people may be useful. Masks did not result in a reduction of other hygiene measures. [ABSTRACT FROM AUTHOR]

Graphene coated fabrics with incorporated nanoparticles can be smart textiles for multiple applications. The presence of an ample amount of oxygen-bearing functional groups on the surface can make the cotton fabric more suitable for modifications and functionalization. Here, we report the synthesis of reduced graphene oxide (RGO) coated-copper (Cu)/silver (Ag) nanoparticle incorporated cotton fabrics with excellent washing durability by ensuring strong bonding among graphene surface-cotton and nanoparticles. In our procedure, graphene oxide (GO) coating on the cotton fabric was followed by the incorporation of Cu/Ag nanoparticles via dip-coating approach using 3-glycidyloxypropyl trimethoxy silane as a coupling agent. Furthermore, the GO was reduced in the presence of sodium dithionite followed by heating at 180 °C under vacuum. The RGO coated and Cu/Ag incorporated cotton fabric samples exhibited improved hydrophobicity than pure cotton. Cotton-RGO-Cu showed remarkably lower surface resistance (6.42 KΩ/sq), better UV protection factor (46.45), and Joule heating capability as compared to Cotton-RGO-Ag and only Cotton-RGO. Moreover, the Cotton-RGO-Cu retained its resistance of 16.70 KΩ/sq after 20 wash cycles. Overall, the synergetic impact of enhanced hydrophobicity, high UV protectivity, low surface resistance, and thermal stability, have made the Cotton-RGO-Cu fabric suitable for smart textile and protective clothing. Image 1 [ABSTRACT FROM AUTHOR]

Highlights • Personal protective equipment (PPE) is commonly used to protect healthcare workers from becoming infected with communicable diseases. • PPE should be donned (put on) and doffed (removed) in the correct order. • Various PPE protocols were tested to estimate the risk of self-contamination during doffing of PPE. • Most problems during PPE use were related to doffing sequences. • Powered air-purifying respirator-containing protocols and assisted doffing are preferred whenever possible. Background The aim of this study was to describe the risk of self-contamination associated with doffing of personal protective equipment (PPE) and to compare self-contamination with various PPE protocols. Methods We tested 10 different PPE donning and doffing protocols, recommended by various health organizations for Ebola. Ten participants were recruited for this study and randomly assigned to use 3 different PPE protocols. After donning of PPE, fluorescent lotion and spray were applied on the external surface of the PPE to simulate contamination, and ultraviolet light was used to count fluorescent patches on the skin. Results After testing 30 PPE sequences, large fluorescent patches were recorded after using "WHO coverall and 95" and "North Carolina coverall and N95" sequences, and small patches were recorded after using "CDC coverall and N95" and "Health Canada gown and N95" sequences. Commonly reported problems with PPE use were breathing difficulty, suffocation, heat stress, and fogging-up glasses. Most participants rated PPE high (18/30) or medium (11/30) for ease of donning/doffing and comfort. PPE sequences with powered air-purifying respirators (PAPRs) and assisted doffing were generally associated with fewer problems and were rated the highest. Conclusion This study confirmed the risk of self-contamination associated with the doffing of PPE. PAPR-containing protocols and assisted doffing should be preferred whenever possible during the outbreak of highly infectious pathogens. [ABSTRACT FROM AUTHOR]

Abstract: Background: The aim of this study was to examine the rate of transmission of influenza and other respiratory viruses from children attending an Emergency Department to their family members in the household using active surveillance. Methods: A prospective hospital-based study was conducted over three consecutive winters (2006–2008) in children aged <1–15 years presenting with influenza-like illness (ILI). 168 children with ILI and their healthy families were recruited over three winter seasons. Results: Respiratory viruses were detected in 101 (60.8%) children with ILI; in 91/166 (54.8%) a single pathogen was detected, and in the remaining 10 children more than one virus was detected concurrently. Influenza was the most common virus detected (34/101), followed by rhinoviruses (22/101) and adenoviruses (14/101). Of influenza viruses, 21/34 were influenza A and 13/34 influenza B. Meeting the clinical definition of ILI did not differentiate between influenza and other viruses. Clinical ILI developed within one week of follow up in 12% (26/205) of the family members who were swabbed. Viral pathogens were detected in 42.3% (11/26) of the symptomatic family members. In 6/11 cases the same virus was detected in the adult and child. The lower estimate of the household risk of transmission of respiratory viruses, based on concordant proven infection in both child and adult, from a single sick child to adult household contacts is therefore 3% per week. Conclusion: This study provides quantitative, prospective data on rates of household transmission of infection from children to adults. [Copyright &y& Elsevier]

Cardiovascular diseases are the major cause of hospitalisation and death globally. Infections exacerbate cardiovascular events among cardiac patients, contributing to all-cause mortality. Vaccination is a cheap and effective intervention that can prevent infection. In Australia, influenza, pneumococcal and herpes zoster vaccines are recommended and funded for high-risk adults such as cardiac patients. There is high prevalence of high-risk adults in Western Sydney. This study investigates the uptake of influenza, pneumococcal and herpes zoster vaccines in patients admitted with heart failure and atrial fibrillation in a tertiary hospital in Western Sydney and factors associated with the uptake of the vaccines. Consecutive patients' hospitalised between 2014 and 2018 with heart failure or atrial fibrillation as principal diagnoses were identified. Information on patients' social demographic, clinical and vaccination status was collected and described using descriptive analysis. Univariate and multivariate analyses were conducted to determine factors associated with the uptake of the vaccines. Low uptake for pneumococcal (40–45 %) and herpes zoster (15 %) vaccines were found. Prevalence of influenza vaccination was lower among participants younger than 65 (51–72 %) than in older ones (78–96 %). Australia-born participants were more likely to receive pneumococcal vaccine than those born overseas (OR 2.02, 95 % CI 1.05–3.89). Participants 65 years or older and those with comorbidities such as hypertension, COPD and chronic renal impairment were more likely to receive the vaccines. Multidisciplinary strategies are needed to improve access to vaccination, community knowledge, community engagement, and healthcare provider support to provide appropriate care to migrants and younger cardiac patients and reduce morbidity and mortality in this high-risk group. [ABSTRACT FROM AUTHOR]

Influenza outbreaks in aged care facilities are a major public health concern. In response to the severe 2017 influenza season in Australia, enhanced influenza vaccines were introduced from 2018 onwards for those over 65 and more emphasis was placed on improving vaccination rates among aged care staff. During the COVID-19 pandemic, these efforts were then further escalated to reduce the additional burden that influenza could pose to facilities. An observational epidemiological study was conducted from 2018 to 2020 in nine Sydney (Australia) aged care facilities of the same provider. De-identified vaccination data and physical layout data were collected from participating facility managers from 2018 to 2020. Active surveillance of influenza-like illness was carried out from 2018 to 2020 influenza seasons. Correlation and Poisson regression analyses were carried out to explore the relationship between physical layout variables to occurrence of influenza cases. Influenza cases were low in 2018 and 2019, and there were no confirmed influenza cases identified in 2020. Vaccination rates increased among staff by 50.5% and residents by 16.8% over the three-year period of surveillance from 2018 to 2020. For each unit increase in total number of beds, common areas, single rooms, all types of rooms (including double occupancy rooms), the influenza cases increased by 1.02 (95% confidence interval:1.018–1.025), 1.04 (95% confidence interval: 1.019–1.073), 1.03 (95% confidence interval: 1.016–1 0.038) and 1.02 (95% confidence interval:1.005–1.026) times which were found to be statistically significant. For each unit increase in the proportion of shared rooms, influenza cases increased by 1.004 (95% confidence interval:1.0001–1.207) which was found to be statistically significant. There is a relationship between influenza case counts and aspects of the physical layout such as facility size, and this should be considered in assessing risk of outbreaks in aged care facilities. Increased vaccination rates in staff and COVID-19 prevention and control measures may have eliminated influenza in the studied facilities in 2020. [ABSTRACT FROM AUTHOR]

• A clinically matched dataset of rhinovirus (RV) isolates from children in Sydney, Australia • There were significantly more RV-C isolates from paediatric cases aged < 2 years • There were phylogenetic-trait associations between young age and VP4/VP2 capsid protein • There are possible age-specific variations in infectivity among subtypes Rhinoviruses (RV) represent the most common aetiological agent of all acute respiratory tract infections across all age groups and a significant burden of disease among children. Recent studies have shown that RV-A and RV-C species are associated with increased disease severity. In order to better understand the potential associations between RV species and clinical features among paediatric cases, this study aimed to integrate genetic and epidemiological data using Bayesian phylogenetic methods. Potential associations between RV species and subtypes, and clinical disease severity using a matched dataset of 52 RV isolates sampled from children (< 18 years) in Sydney, Australia, between 2006 and 2009 were uncovered using epidemiological and phylogenetic methods. It was found that RV-C was significantly more likely to be isolated from paediatric cases aged < 2 years compared with RV-A, although no significant differences in recorded symptoms were observed. Significant phylogenetic-trait associations between age and the VP4/VP2 capsid protein phylogeny suggest that age-specific variations in infectivity among subtypes may may be possible. This study adds to the growing body of epidemiological evidence concerning RV. Improving surveillance and testing for RV, including routine whole genome sequencing, may improve understanding of the varied disease outcomes of RV species and subtypes. Future studies could aim to identify specific genetic markers associated with age-specific infectivity of RV, which could inform treatment practices and public health surveillance of RV. [ABSTRACT FROM AUTHOR]