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BACKGROUND: COVID‐19 screening testing (ST) can detect asymptomatic or pre‐symptomatic cases, allowing for prompt identification of cases and close contacts. This study examined parents' and school staffs' knowledge and attitudes toward to a pilot school‐based ST program in a school district in southern Arizona. METHODS: In May 2021, online surveys to parents and school staff were administered to examine attitudes toward ST and impacts of the COVID‐19 pandemic. Unweighted percent estimates were calculated, and bivariate differences were examined by demographics. Associations were assessed using chi‐square tests and logistic regression. RESULTS: The survey had response rates of 10% (606/6085) and 22% (187/849) among parents and staff, respectively. Approximately one‐third of responding parents (35%) would or already allow their child to participate in school‐based ST, 37% would not participate; 28% were unsure. Among responding staff, 46% would or already participate in ST, 33% would not; 21% were unsure. The top concern (38%) among responding staff was taking job‐related leave if testing positive. CONCLUSION: Schools work to balance the needs of students, families, and staff by implementing supportive and flexible policies and practices founded on buy‐in and acceptance from their communities [ABSTRACT FROM AUTHOR]

OBJECTIVE: Despite widespread availability of COVID‐19 vaccines, millions of Americans have not received the recommended vaccine doses. In the District of Columbia (DC), COVID‐19 vaccination rates are lowest among residents who are Non‐Hispanic (NH) Black and among school‐aged children. We assessed COVID‐19 vaccine hesitancy among staff and parents of students in DC K‐12 public and public charter schools. METHODS: We conducted a telephone‐based survey from February 6 to April 16, 2022 to staff, students, and parents of students who participated in school‐based COVID‐19 screening testing. COVID‐19‐related survey items included: vaccination status, reasons for not getting vaccinated, perceived vaccine access, and trusted COVID‐19 information sources. Utilizing time‐to‐event analyses, we evaluated differences across demographic groups. RESULTS: The interview response rate was 25.8% (308/1193). Most unvaccinated participants were NH Black and ages 5 to 11 years. Median time from vaccine eligibility to uptake was 236 days for NH Black participants vs. 10 days for NH White participants. Vaccine safety was the top concern among unvaccinated participants. Government and healthcare providers were the most trusted COVID‐19 information sources. CONCLUSIONS: Differences in timing of vaccine uptake among respondents and greater vaccine hesitancy among NH Black participants compared to other racial/ethnic groups highlight a need for continued tailored outreach and communication using trusted sources to convey the importance, benefits, and safety of COVID‐19 vaccination. [ABSTRACT FROM AUTHOR]

The article presents the discussion on improving ventilation being one of several COVID-19 prevention strategies implemented by kindergarten. Topics include transmission of SARS-CoV-2 occuring through inhalation of infectious viral particles being important for reducing the concentration and exposure time to infectious aerosols; and reporting replacement or upgrade of heating, ventilation, and air conditioning (HVAC) systems.

Background: The kala-azar elimination programme has resulted in a significant reduction in visceral leishmaniasis (VL) cases across the Indian Subcontinent. To detect any resurgence of transmission, a sensitive cost-effective surveillance system is required. Molecular xenomonitoring (MX), detection of pathogen DNA/RNA in vectors, provides a proxy of human infection in the lymphatic filariasis elimination programme. To determine whether MX can be used for VL surveillance in a low transmission setting, large numbers of the sand fly vector Phlebotomus argentipes are required. This study will determine the best method for capturing P. argentipes females for MX. Methodology/Principal findings: The field study was performed in two programmatic and two non-programmatic villages in Bihar, India. A total of 48 households (12/village) were recruited. Centers for Disease Control and Prevention light traps (CDC-LTs) were compared with Improved Prokopack (PKP) and mechanical vacuum aspirators (MVA) using standardised methods. Four 12x12 Latin squares, 576 collections, were attempted (12/house, 144/village,192/method). Molecular analyses of collections were conducted to confirm identification of P. argentipes and to detect human and Leishmania DNA. Operational factors, such as time burden, acceptance to householders and RNA preservation, were also considered. A total of 562 collections (97.7%) were completed with 6,809 sand flies captured. Females comprised 49.0% of captures, of which 1,934 (57.9%) were identified as P. argentipes. CDC-LTs collected 4.04 times more P. argentipes females than MVA and 3.62 times more than PKP (p<0.0001 for each). Of 21,735 mosquitoes in the same collections, no significant differences between collection methods were observed. CDC-LTs took less time to install and collect than to perform aspirations and their greater yield compensated for increased sorting time. No significant differences in Leishmania RNA detection and quantitation between methods were observed in experimentally infected sand flies maintained in conditions simulating field conditions. CDC-LTs were favoured by householders. Conclusions/Significance: CDC-LTs are the most useful collection tool of those tested for MX surveillance since they collected higher numbers of P. argentipes females without compromising mosquito captures or the preservation of RNA. However, capture rates are still low. Author summary: Molecular xenomonitoring, screening insects for pathogen DNA/RNA, may be used for surveillance of diseases transmitted by insects. Since the proportion of insects infected with pathogens is very low in areas targeted for disease elimination, large numbers of females need to be screened. We compared three different methods for collecting Phlebotomus argentipes sand fly females, the vector of parasites causing the disease visceral leishmaniasis in the Indian subcontinent, to determine which collected the largest number of females. Other factors that may also influence selection of a particular method of collection by a disease control programme, such as the time it takes to collect and sort samples, the acceptance of householders for a particular collection method and whether RNA degradation in insect samples differed between collection methods, were also considered. Centers for Disease Control and Prevention light traps (CDC-LTs) proved to be more useful than two types of aspiration methods for collecting higher numbers of sand fly females and RNA preservation was retained. Furthermore, they took less time to install than to perform aspirations and were favoured by householders. Therefore, CDC-LTs were considered to be the most suitable collection method for molecular xenomonitoring of sand flies in India. [ABSTRACT FROM AUTHOR]

Abstract: To our knowledge, the zoonotic potential of Giardia duodenalis has not been assessed in companion animals in Trinidad and Tobago. This report details the first attempt to evaluate the potential zoonotic risk of G. duodenalis in dogs and identify assemblages of G. duodenalis found in dog populations on both islands. Fecal samples were collected from free-roaming dogs and dogs at the Trinidad and Tobago Society for the Prevention of Cruelty to Animals from October 2010 to June 2011. A total of 168 samples were collected of which 104 samples were analyzed for the presence of G. duodenalis by PCR amplification of the ssu-rRNA gene with subsequent assemblage-typing. A subset of samples was also analyzed by ELISA. Twenty-six samples were positive for G. duodenalis by PCR for an overall prevalence of 25%. Four samples were identified as assemblage C (15.4%), 21 as assemblage D (80.8%), and one as assemblage E (3.8%). Puppies were four-times more likely to be infected with G. duodenalis than adult dogs (OR 4.61, 95% CI 1.73–12.2). There was a significant agreement between ELISA and PCR in the detection of the protozoa (κ =0.67). We infer from our results that while the prevalence of G. duodenalis is relatively high in Trinidad and Tobago, the zoonotic risk of infection in humans is low since neither assemblage A nor B was identified in the study population. [Copyright &y& Elsevier]

Abstract: A longitudinal herd-level study was carried out to determine the cumulative incidence of Giardia duodenalis infections in dairy cattle in the New York City Watershed. We also sought to assess the changes in infection pattern of animals diagnosed as shedding Giardia over time, determine risk factors that may be associated with G. duodenalis infections, and identify potentially zoonotic infections. A total of 2109 fecal samples were randomly collected from dairy cattle at 34 farms in the New York City Watershed on a seasonal basis. A total of 504 Giardia-positive samples were identified by zinc sulfate flotation. The overall cumulative incidence of G. duodenalis based on flotation results was 23.9% with 73.8% of all infections occurring in animals under 180 days of age (372/504). The intensity of infection ranged from 2 to 563,200 cysts/gram of feces. Cattle shedding Cryptosporidium spp. oocysts were twice as likely to shed G. duodenalis cysts in comparison to the animals that did not shed oocysts (1.81 95% CI 1.26–2.60 p =0.0012). In the multivariate analysis, only the age of the animal and the presence of dogs on the farm were significantly associated with the likelihood of shedding G. duodenalis. DNA was extracted from positive samples and analyzed by polymerase chain reaction (PCR) of the beta-giardin and triosephosphate isomerase genes of Giardia spp. 304 samples were analyzed by PCR of which 131 were sequenced. 22.1% of sequenced samples were identified as assemblage A and 77.9% were identified as assemblage E. Interestingly, 100% of specimens identified as assemblage A were from calves under 84 days of age indicating that younger cattle are important reservoirs for potentially zoonotic assemblages of G. duodenalis. [Copyright &y& Elsevier]

Background: The primary aims of this study were to determine the incidence of Giardia infections in dairy herds on farms in the New York City Watershed region and to evaluate risk factors associated with infections. Because coinfections of Giardia and Cryptosporidium spp. are common in this population, we also evaluated the effect of herd infection status on Giardia infections. Methods: Farms were grouped into three cohorts based on their prior infection status with Giardia and/or Cryptosporidium spp. The sampling plan included collecting fecal samples from all calves below 30 days of age and proportional sampling of calves, young stock, and adults. A total of 10,672 fecal samples were collected and analyzed for the presence of Giardia cysts using zinc sulfate flotation. Herds enrolled in the study were sampled seasonally for a study period of two years. The probability of shedding cysts past a certain age and the factors that influenced the likelihood of shedding were evaluated using survival analysis. Linear regression was used to evaluate factors that were associated with the intensity of shedding. Results: The majority of Giardia infections occurred in calves within their first 180 days of age, with the most number of calves shedding Giardia cysts between 11 and 20 days of age. The incidence of shedding of Giardia cysts ranged from 0.0004 per animal day for cattle in the low risk cohort to 0.0011 per animal day for cattle in the high risk cohort. The likelihood of shedding was influenced by the prior infection status of the herd and the season of collection. Infected animals shed on average 9,658 cysts/gram and the intensity of shedding Giardia cysts varied significantly with the age (p < 0.0001) and the season of collection (p = 0.0151 for Spring). Conclusion: Giardia infections are common in dairy herds in the New York City watershed, particularly in calves less than 6 months of age. Seasonality may be an important factor in the perpetuation of infections based on changes in management practices corresponding to weather patterns of a particular season. A dairy herd's prior infection status with Cryptosporidium influences the likelihood of infection with Giardia. [ABSTRACT FROM AUTHOR]

The highly transmissible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant led to increased hospitalizations, staffing shortages, and increased school closures. To reduce spread in school-aged children during the Omicron peak, the District of Columbia implemented a test-to-return strategy in public and public charter schools after a 2-week break from in-person learning. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Globally, coronavirus disease 2019 (COVID-19) has affected how children learn. We evaluated the impact of Test to Stay (TTS) on secondary and tertiary transmission of severe acute respiratory syndrome coronavirus 2 and potential impact on in-person learning in 4 school districts in the United States from September 13 to November 19, 2021. METHODS: Implementation of TTS varied across school districts. Data on index cases, schoolbased close contacts, TTS participation, and testing results were obtained from 4 school districts in diverse geographic regions. Descriptive statistics, secondary and tertiary attack risk, and a theoretical estimate of impact on in-person learning were calculated. RESULTS: Fifty-one schools in 4 school districts reported 374 coronavirus disease COVID-19 index cases and 2520 school-based close contacts eligible for TTS. The proportion participating in TTS ranged from 22% to 79%. By district, the secondary attack risk and tertiary attack risk among TTS participants ranged between 2.2% to 11.1% and 0% to 17.6%, respectively. Nine clusters were identified among secondary cases and 2 among tertiary cases. The theoretical maximum number of days of in-person learning saved by using TTS was 976 to 4650 days across jurisdictions. CONCLUSIONS: TTS preserves in-person learning. Decisions to participate in TTS may have been influenced by ease of access to testing, communication between schools and families, testing logistics, and school resources. Tertiary attack risk determination became more complicated when numbers of close contacts increased. Minimizing exposure through continued layered prevention strategies is imperative. To ensure adequate resources for TTS, community transmission levels should be considered. [ABSTRACT FROM AUTHOR]

Purpose: To investigate HIV transmission potential from a cluster of HIV infections among men who have sex with men to persons who inject drugs in 15 West Virginia counties. These counties were previously identified as highly vulnerable to rapid HIV dissemination through injection drug use (IDU) associated with high levels of opioid misuse.Methods: We interviewed persons with 2017 HIV diagnoses about past-year risk behaviors and elicited sexual, IDU, and social contacts. We tested contacts for HIV and assessed risk behaviors. To determine HIV transmission potential from persons with 2017 diagnoses to persons who inject drugs, we assessed viral suppression status, HIV status of contacts, and IDU risk behaviors of persons living with HIV and contacts.Results: We interviewed 78 persons: 39 with 2017 diagnoses and 39 contacts. Overall, 13/78 (17%) injected drugs in the past year. Of 19 persons with 2017 diagnoses and detectable virus, 9 (47%) had more than or equal to 1 sexual or IDU contacts of negative or unknown HIV status. During the past year, 2/9 had injected drugs and shared equipment, and 1/9 had more than or equal to 1 partner who did so.Conclusions: We identified IDU risk behavior among persons with 2017 diagnoses and their contacts. West Virginia HIV prevention programs should continue to give high priority to IDU harm reduction. [ABSTRACT FROM AUTHOR]

Objectives: In January 2014, 4-methylcyclohexanemethanol spilled into the Elk River near Charleston, West Virginia, contaminating the water supply for about 120000 households. The West Virginia American Water Company (WVAWC) issued a "do not use" water order for 9 counties. After the order was lifted (10 days after the spill), the communities' use of public water systems, information sources, alternative sources of water, and perceived impact of the spill on households were unclear to public health officials. To assist in recovery efforts, the West Virginia Bureau for Public Health and the Centers for Disease Control and Prevention conducted a Community Assessment for Public Health Emergency Response (CASPER). Methods: We used the CASPER 2-stage cluster sampling design to select a representative sample of households to interview, and we conducted interviews in 171 households in April 2014. We used a weighted cluster analysis to generate population estimates in the sampling frame. Results: Before the spill, 74.4% of households did not have a 3-day alternative water supply for each household member and pet. Although 83.6% of households obtained an alternative water source within 1 day of the "do not use" order, 37.4% of households reportedly used WVAWC water for any purpose. Nearly 3 months after the spill, 36.1% of households believed that their WVAWC water was safe, and 33.5% reported using their household water for drinking. Conclusions: CASPER results identified the need to focus on basic public health messaging and household preparedness efforts. Recommendations included (1) encouraging households to maintain a 3-day emergency water supply, (2) identifying additional alternative sources of water for future emergencies, and (3) increasing community education to address ongoing concerns about water. [ABSTRACT FROM AUTHOR]