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Occupational hearing loss is one of the most prevalent occupational conditions; yet, there is no acknowledged international metric to allow comparisons of risk between different industries and regions. In order to make recommendations for an international standard of occupational hearing loss, members of an international industry group (the International Aluminium Association) submitted details of different hearing loss metrics currently in use by members. We compared the performance of these metrics using an audiometric data set for over 6000 individuals working in 10 locations of one member company. We calculated rates for each metric at each location from 2002 to 2006. For comparison, we calculated the difference of observed-expected (for age) binaural high-frequency hearing loss (in dB/year) for each location over the same time period. We performed linear regression to determine the correlation between each metric and the observed-expected rate of hearing loss. The different metrics produced discrepant results, with annual rates ranging from 0.0% for a less-sensitive metric to more than 10% for a highly sensitive metric. At least two metrics, a 10dB age-corrected threshold shift from baseline and a 15dB nonage-corrected shift metric, correlated well with the difference of observed-expected high-frequency hearing loss. This study suggests that it is feasible to develop an international standard for tracking occupational hearing loss in industrial working populations. [ABSTRACT FROM AUTHOR]

Background: Much of what is known about the exposure-response relationship between occupational noise exposures and hearing loss comes from cross-sectional studies conducted before the widespread implementation of workplace hearing conservation programmes. Little is known about the current relationship of ambient noise exposure measurements to hearing loss risk.Aim: To examine the relationship between rates of high frequency hearing loss and measured levels of noise exposure in a modern industrial workforce.Methods: Ten-year hearing loss rates were determined for 6217 employees of an aluminium manufacturing company. Industrial hygiene and human resources records allowed for reconstruction of individual noise exposures. Hearing loss rates were compared to ANSI 3.44 predictions based on age and noise exposure. Associations between hearing loss, noise exposure, and covariate risk factors were assessed using multivariate regression.Results: Workers in higher ambient noise jobs tended to experience less high frequency hearing loss than co-workers exposed at lower noise levels. This trend was also seen in stratified analyses of white males and non-hunters. At higher noise exposure levels, the magnitude of hearing loss was less than predicted by ANSI 3.44 formulae. There was no indication that a healthy worker effect could explain these findings. The majority of 10 dB standard threshold shifts (STS) occurred in workers whose calculated ambient noise exposures were less than or equal to 85 dBA.Conclusions: In this modern industrial cohort, hearing conservation efforts appear to be reducing hearing loss rates, especially at higher ambient noise levels. This could be related to differential use of hearing protection. The greatest burden of preventable occupational hearing loss was found in workers whose noise exposure averaged 85 dBA or less. To further reduce rates of occupational hearing loss, hearing conservation programmes may require innovative approaches targeting workers with noise exposures close to 85 dBA. [ABSTRACT FROM AUTHOR]

BACKGROUND: Farmers have high rates of hearing loss, yet little is known about the hearing status of migrant agricultural workers. We performed a cross-sectional survey to assess the prevalence and impact of hearing loss in this population. METHODS: One hundred fifty migrant and seasonal agricultural workers were surveyed at a series of health fairs held at migrant camps. A bilingual questionnaire included items related to hearing loss risk factors and subjective hearing difficulties. Pure tone audiometry and tympanometry were performed in a mobile testing van. RESULTS: More than half the subjects had some degree of hearing loss at audiometric frequencies between 500 and 6,000 Hz, especially in the higher frequencies. Hispanic males in the sample had significantly greater prevalence of high-frequency hearing loss compared to adults in the national Hispanic Health and Nutrition Examination Survey (HHANES). More than 35% of respondents complained of subjective difficulty hearing or understanding speech, yet no workers reported use of hearing aids. Even after adjusting for measured hearing loss, Hispanic farm workers were more likely than their English- speaking counterparts to complain of difficulty hearing or understanding speech, suggesting that language barriers could worsen the impact of hearing loss. Risk factors for hearing loss included age and abnormal tympanometry. Occupational exposures to noise from tractors and other machinery as well as pesticides were frequently reported, while use of hearing protection was rare. CONCLUSION: Hearing loss is a significant and under-recognized problem in the migrant worker population. Further preventive and treatment efforts are warranted. [ABSTRACT FROM AUTHOR]

Hearing loss caused by exposure to recreational and occupational noise results in devastating disability that is virtually 100 percent preventable. Noise-induced hearing loss is the second most common form of sensorineural hearing deficit, after presbycusis (age-related hearing loss). Shearing forces caused by any sound have an impact on the stereocilia of the hair cells of the basilar membrane of the cochlea; when excessive, these forces can cause cell death. Avoiding noise exposure stops further progression of the damage. Noise-induced hearing loss can be prevented by avoiding excessive noise and using hearing protection such as earplugs and earmuffs. Patients who have been exposed to excessive noise should be screened. When hearing loss is suspected, a thorough history, physical examination and audiometry should be performed. If these examinations disclose evidence of hearing loss, referral for full audiologic evaluation is recommended. [ABSTRACT FROM AUTHOR]

Escherichia coli ( E. coli ) is a predominant pathogen of urinary tract infections (UTIs) in the United States. We analyzed resistance patterns by geographic location in Washington State to assess the need for regional antibiograms. The study included urinary E. coli antibiotic susceptibility tests performed by Quest Diagnostics on Washington outpatient isolates from 2013 to 2019. We conducted logistic regressions with robust standard errors for five antibiotics (ceftriaxone, ciprofloxacin, gentamicin, trimethoprim-sulfamethoxazole), with isolates classified as "susceptible" or "resistant" for each antibiotic tested. Analyses were adjusted for sex, year of isolate collection, and age group (0-18, 19-50, >50). The state's nine Public Health Emergency Preparedness Regions (PHEPRs) were used as the geographic level for the analysis. The analysis included 40,217 isolates (93% from females, mean age 47 years). Compared to the Central PHEPR (containing Seattle), most other regions had significantly lower adjusted prevalence ratios (aPORs) of antimicrobial resistance (AMR), with aPORs as low as 0.20 (95% CI: 0.06-0.63) for ceftriaxone in the North Central region. Additionally, no regions had significantly higher aPOR of resistance for any antibiotic. Differences in resistance between the Central and other regions varied by antibiotic with the largest difference for ceftriaxone and smallest for ampicillin. The finding of regional variation of E. coli AMR calls for more specific community antibiograms to enable a precise approach to antibiotic prescribing and stewardship.

Background : The chikungunya virus (CHIKV), transmitted by infected Aedes mosquitoes, has caused a significant number of infections worldwide. In Brazil, the emergence of the CHIKV-ECSA genotype in 2014 posed a major public health challenge due to its association with more severe symptoms. Objectives/Methods : This study aimed to shed new light on the host immune response by examining the whole-blood transcriptomic profile of both CHIKV-acute and chronically infected individuals from Feira de Santana, Bahia, Brazil, a region heavily affected by CHIKV, Dengue, and Zika virus epidemics. Results : Our data reveal complex symptomatology characterized by arthralgia and post-chikungunya neuropathy in individuals with chronic sequelae, particularly affecting women living in socially vulnerable situations. Analysis of gene modules suggests heightened metabolic processes, represented by an increase in NADH, COX5A, COA3, CYC1, and cap methylation in patients with acute disease. In contrast, individuals with chronic manifestations exhibit a distinct pattern of histone methylation, probably mediated by NCOA3 in the coactivation of different nuclear receptors, KMT2 genes, KDM3B and TET2, and with alterations in the immunological response, majorly led by IL-17RA, IL-6R, and STAT3 Th17 genes. Conclusion : Our results emphasize the complexity of CHIKV disease progression, demonstrating the heterogeneous gene expression and symptomatologic scenario across both acute and chronic phases. Moreover, the identification of specific gene modules associated with viral pathogenesis provides critical insights into the molecular mechanisms underlying these distinct clinical manifestations.

Background: As a nexus of routine antibiotic use and zoonotic pathogen presence, the livestock farming environment is a potential hotspot for the emergence of zoonotic diseases and antibiotic resistant bacteria. Livestock can further facilitate disease transmission by serving as intermediary hosts for pathogens before a spillover event. In light of this, we aimed to characterize the microbiomes and resistomes of dairy workers, whose exposure to the livestock farming environment places them at risk for facilitating community transmission of antibiotic resistant genes and emerging zoonotic diseases., Results: Using shotgun sequencing, we investigated differences in the taxonomy, diversity and gene presence of 10 dairy farm workers and 6 community controls' gut metagenomes, contextualizing these samples with additional publicly available gut metagenomes. We found no significant differences in the prevalence of resistance genes, virulence factors, or taxonomic composition between the two groups. The lack of statistical significance may be attributed, in part, to the limited sample size of our study or the potential similarities in exposures between the dairy workers and community controls. We did, however, observe patterns warranting further investigation including greater abundance of tetracycline resistance genes and prevalence of cephamycin resistance genes as well as lower average gene diversity (even after accounting for differential sequencing depth) in dairy workers' metagenomes. We also found evidence of commensal organism association with tetracycline resistance genes in both groups (including Faecalibacterium prausnitzii, Ligilactobacillus animalis, and Simiaoa sunii)., Conclusions: This study highlights the utility of shotgun metagenomics in examining the microbiomes and resistomes of livestock workers, focusing on a cohort of dairy workers in the United States. While our study revealed no statistically significant differences between groups in taxonomy, diversity and gene presence, we observed patterns in antibiotic resistance gene abundance and prevalence that align with findings from previous studies of livestock workers in China and Europe. Our results lay the groundwork for future research involving larger cohorts of dairy and non-dairy workers to better understand the impact of occupational exposure to livestock farming on the microbiomes and resistomes of workers., (© 2024. The Author(s).)

We detected antibodies to H5 and N1 subtype influenza A viruses in 4/194 (2%) dogs from Washington, USA, that hunted or engaged in hunt tests and training with wild birds. Historical data provided by dog owners showed seropositive dogs had high levels of exposure to waterfowl.

Antimicrobial resistance (AMR) is a global health problem stemming from the use of antibiotics in humans, animals, and the environment. This study used whole-genome sequencing (WGS) of E. coli to explore patterns of AMR across sectors in Washington State, USA (WA). The WGS data from 1449 E. coli isolates were evaluated for isolation source (humans, animals, food, or the environment) and the presence of antibiotic resistance genes (ARGs). We performed sequence typing using PubMLST and used ResFinder to identify ARGs. We categorized isolates as being pan-susceptible, resistant, or multidrug-resistant (MDR), defined as carrying resistance genes for at least three or more antimicrobial drug classes. In total, 60% of isolates were pan-susceptible, while 18% were resistant, and 22% exhibited MDR. The proportion of resistant isolates varied significantly according to the source of the isolates ( p < 0.001). The greatest resistance was detected in isolates from humans and then animals, while environmental isolates showed the least resistance. This study demonstrates the feasibility of comparing AMR across various sectors in Washington using WGS and a One Health approach. Such analysis can complement other efforts for AMR surveillance and potentially lead to targeted interventions and monitoring activities to reduce the overall burden of AMR.

The One Health conceptual framework envisions human, animal, and environmental health as interconnected. This framework has achieved remarkable progress in the control of zoonotic diseases, but it commonly neglects the environmental domain, implicitly prioritizes human life over the life of other beings, and fails to consider the political, cultural, social, historical, and economic contexts that shape the health of multispecies collectives. We have developed a novel theoretical framework, Relational One Health, which expands the boundaries of One Health, clearly defines the environmental domain, and provides an avenue for engagement with critical theory. We present a systematic literature review of One Health frameworks to demonstrate the novelty of Relational One Health, and to orient it with respect to other critically-engaged frameworks for One Health. Our results indicate that while Relational One Health complements several earlier frameworks, these other frameworks are either not intended for research, or for narrow sets of research questions. We then demonstrate the utility of Relational One Health for One Health research through case studies in Brazil, Israel, and Ethiopia. Empirical research which is grounded in theory can speak collectively, increasing the impact of individual studies and the field as a whole. One Health is uniquely poised to address several wicked challenges facing the 21st century-climate change, pandemics, neglected zoonoses, and biodiversity collapse-and a unifying theoretical tradition is key to generating the evidence needed to meet these challenges., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

We analyzed whole genome sequences of 308 Escherichia coli isolates from a marine ecosystem to determine the prevalence and relationships of heavy metal resistance genes (HMRGs) and antibiotic resistance genes (ARGs), as well as the presence of plasmid sequences. We screened all genomes for presence of 18 functional HMRGs conferring resistance to arsenic, cadmium, copper, or cadmium/mercury. In subset analyses, we examined geographic variations of HMRG carriage patterns in 224 isolates from water sources, and sought genetic linkages between HMRGs and ARGs in 25 genomes of isolates resistant to antibiotics. We found high carriage rates of HMRGs in all genomes, with 100% carrying at least one copy of 11 out of 18 HMRGs. A total of 173 (56%) of the isolates carried both HMRGs and plasmid sequences. In the 25 genomes of antibiotic-resistant isolates, 80% (n = 20) carried HMRGs, ARGs, and plasmid sequences, while 40% (n = 10) had linked HMRGs and ARGs on their assembled genomes. We found no evidence of geographic variation in HMRG frequency, nor any association between locational proximity to Superfund sites and co-carriage of HMRGs and ARGs. Our study findings indicate that HMRGs are common among E. coli in marine ecosystems, suggesting widespread heavy metal presence in water sources of a region with history of environmental pollution. Further research is needed to determine the role HMRGs play in driving antimicrobial resistance in human pathogens through genetic linkage and the value their detection in environmental bacterial genomes may offer as an indicator of environmental heavy metal pollution., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Tseng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Livestock are important reservoirs for many zoonotic diseases, however the effects of livestock on human and environmental health extend well beyond direct disease transmission. In this retrospective ecological cohort study we use pre-existing data and the parametric g-formula, which imputes potential outcomes to quantify mediation, to estimate three hypothesized mechanisms by which livestock can influence human African trypanosomiasis (HAT) risk: the reservoir effect, where infected cattle and pigs are a source of infection to humans; the zooprophylactic effect, where preference for livestock hosts exhibited by the tsetse fly vector of HAT means that their presence protects humans from infection; and the environmental change effect, where livestock keeping activities modify the environment in such a way that habitat suitability for tsetse flies, and in turn human infection risk, is reduced. We conducted this study in four high burden countries: at the point level in Uganda, Malawi, and Democratic Republic of Congo (DRC), and at the county level in South Sudan. Our results indicate cattle and pigs play a reservoir role for the rhodesiense form (rHAT) in Uganda (rate ratio (RR) 1.68, 95% CI 0.84, 2.82 for cattle; RR 2.16, 95% CI 1.18, 3.05 for pigs), however zooprophylaxis outweighs this effect for rHAT in Malawi (RR 0.85, 95% CI 0.68, 1.00 for cattle, RR 0.38, 95% CI 0.21, 0.69 for pigs). For the gambiense form (gHAT) we found evidence that pigs may be a competent reservoir (RR 1.15, 95% CI 0.92, 1.72 in Uganda; RR 1.25, 95% CI 1.11, 1.42 in DRC). Statistical significance was reached for rHAT in Malawi (pigs and cattle) and Uganda (pigs only) and for gHAT in DRC (pigs and cattle). We did not find compelling evidence of an environmental change effect (all effect sizes close to 1)., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Meisner et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Since SARS-CoV-2 caused the COVID-19 pandemic, records have suggested the occurrence of reverse zoonosis of pets and farm animals in contact with SARS-CoV-2-positive humans in the Occident. However, there is little information on the spread of the virus among animals in contact with humans in Africa. Therefore, this study aimed to investigate the occurrence of SARS-CoV-2 in various animals in Nigeria. Overall, 791 animals from Ebonyi, Ogun, Ondo, and Oyo States, Nigeria were screened for SARS-CoV-2 using RT-qPCR ( n = 364) and IgG ELISA ( n = 654). SARS-CoV-2 positivity rates were 45.9% (RT-qPCR) and 1.4% (ELISA). SARS-CoV-2 RNA was detected in almost all animal taxa and sampling locations except Oyo State. SARS-CoV-2 IgGs were detected only in goats from Ebonyi and pigs from Ogun States. Overall, SARS-CoV-2 infectivity rates were higher in 2021 than in 2022. Our study highlights the ability of the virus to infect various animals. It presents the first report of natural SARS-CoV-2 infection in poultry, pigs, domestic ruminants, and lizards. The close human-animal interactions in these settings suggest ongoing reverse zoonosis, highlighting the role of behavioral factors of transmission and the potential for SARS-CoV-2 to spread among animals. These underscore the importance of continuous monitoring to detect and intervene in any eventual upsurge.

Background: As a nexus of routine antibiotic use and zoonotic pathogen presence, the livestock farming environment is a potential hotspot for the emergence of zoonotic diseases and antibiotic resistant bacteria. Livestock can further facilitate disease transmission by serving as intermediary hosts for pathogens as they undergo evolution prior to a spillover event. In light of this, we are interested in characterizing the microbiome and resistome of dairy workers, whose exposure to the livestock farming environment places them at risk for facilitating community transmission of antibiotic resistant genes and emerging zoonotic diseases., Results: Using shotgun sequencing, we investigated differences in the taxonomy, diversity and gene presence of the human gut microbiome of 10 dairy farm workers and 6 community controls, supplementing these samples with additional publicly available gut metagenomes. We observed greater abundance of tetracycline resistance genes and prevalence of cephamycin resistance genes in dairy workers' metagenomes, and lower average gene diversity. We also found evidence of commensal organism association with plasmid-mediated tetracycline resistance genes in both dairy workers and community controls (including Faecalibacterium prausnitzii , Ligilactobacillus animalis , and Simiaoa sunii ). However, we did not find significant differences in the prevalence of resistance genes or virulence factors overall, nor differences in the taxonomic composition of dairy worker and community control metagenomes., Conclusions: This study presents the first metagenomics analysis of United States dairy workers, providing insights into potential risks of exposure to antibiotics and pathogens in animal farming environments. Previous metagenomic studies of livestock workers in China and Europe have reported increased abundance and carriage of antibiotic resistance genes in livestock workers. While our investigation found no strong evidence for differences in the abundance or carriage of antibiotic resistance genes and virulence factors between dairy worker and community control gut metagenomes, we did observe patterns in the abundance of tetracycline resistance genes and the prevalence of cephamycin resistance genes that is consistent with previous work.

Background: . In response to large strides in the control of human African trypanosomiasis (HAT), in the early 2000s the WHO set targets for elimination of both the gambiense (gHAT) and rhodesiense (rHAT) forms as a public health (EPHP) problem by 2020, and elimination of gHAT transmisson (EOT) by 2030. While global EPHP targets have been met, and EOT appears within reach, current control strategies may fail to achieve gHAT EOT in the presence of animal reservoirs, the role of which is currently uncertain. Furthermore, rHAT is not targeted for EOT due to the known importance of animal reservoirs for this form., Methods: . To evaluate the utility of a One Health approach to gHAT and rHAT EOT, we built and parameterized a compartmental stochastic model, using the Institute for Disease Modeling's Compartmental Modeling Software, to six HAT epidemics: the national rHAT epidemics in Uganda and Malawi, the national gHAT epidemics in Uganda and South Sudan, and two separate gHAT epidemics in Democratic Republic of Congo distinguished by dominant vector species. In rHAT foci the reservoir animal sub-model was stratified on four species groups, while in gHAT foci domestic swine were assumed to be the only competent reservoir. The modeled time horizon was 2005-2045, with calibration performed using HAT surveillance data and Optuna. Interventions included insecticide and trypanocide treatment of domestic animal reservoirs at varying coverage levels., Results: . Validation against HAT surveillance data indicates favorable performance overall, with the possible exception of DRC. EOT was not observed in any modeled scenarios for rHAT, however insecticide treatment consistently performed better than trypanocide treatment in terms of rHAT control. EOT was not observed for gHAT at 0% coverage of domestic reservoirs with trypanocides or insecticides, but was observed by 2030 in all test scenarios; again, insecticides demonstrated superior performance to trypanocides., Conclusions: EOT likely cannot be achieved for rHAT without control of wildlife reservoirs, however insecticide treatment of domestic animals holds promise for improved control. In the presence of domestic animal reservoirs, gHAT EOT may not be achieved under current control strategies., (Copyright © 2022 Elsevier B.V. All rights reserved.)

SARS-CoV-2 likely emerged from an animal reservoir. However, the frequency of and risk factors for interspecies transmission remain unclear. We conducted a community-based study in Idaho, USA, of pets in households that had >1 confirmed SARS-CoV-2 infections in humans. Among 119 dogs and 57 cats, clinical signs consistent with SARS-CoV-2 were reported for 20 dogs (21%) and 19 cats (39%). Of 81 dogs and 32 cats sampled, 40% of dogs and 43% of cats were seropositive, and 5% of dogs and 8% of cats were PCR positive. This discordance might be caused by delays in sampling. Respondents commonly reported close human‒animal contact and willingness to take measures to prevent transmission to their pets. Reported preventive measures showed a slightly protective but nonsignificant trend for both illness and seropositivity in pets. Sharing of beds and bowls had slight harmful effects, reaching statistical significance for sharing bowls and seropositivity.

Domestic and wild animals are important reservoirs of the rhodesiense form of human African trypanosomiasis (rHAT), however quantification of this effect offers utility for deploying non-medical control activities, and anticipating their success when wildlife are excluded. Further, the uncertain role of animal reservoirs-particularly pigs-threatens elimination of transmission (EOT) targets set for the gambiense form (gHAT). Using a new time series of high-resolution cattle and pig density maps, HAT surveillance data collated by the WHO Atlas of HAT, and methods drawn from causal inference and spatial epidemiology, we conducted a retrospective ecological cohort study in Uganda, Malawi, Democratic Republic of the Congo (DRC) and South Sudan to estimate the effect of cattle and pig density on HAT risk. For rHAT, we found a positive effect for cattle (RR 1.61, 95% CI 0.90, 2.99) and pigs (RR 2.07, 95% CI 1.15, 2.75) in Uganda, and a negative effect for cattle (RR 0.88, 95% CI 0.71, 1.10) and pigs (RR 0.42, 95% CI 0.23, 0.67) in Malawi. For gHAT we found a negative effect for cattle in Uganda (RR 0.88, 95% CI 0.50, 1.77) and South Sudan (RR 0.63, 95% CI 0.54, 0.77) but a positive effect in DRC (1.17, 95% CI 1.04, 1.32). For pigs, we found a positive gHAT effect in both Uganda (RR 2.02, 95% CI 0.87, 3.94) and DRC (RR 1.23, 95% CI 1.10, 1.37), and a negative association in South Sudan (RR 0.66, 95% CI 0.50, 0.98). These effects did not reach significance for the cattle-rHAT effect in Uganda or Malawi, or the cattle-gHAT and pig-gHAT effects in Uganda. While ecological bias may drive the findings in South Sudan, estimated E-values and simulation studies suggest unmeasured confounding and underreporting are unlikely to explain our findings in Malawi, Uganda, and DRC. Our results suggest cattle and pigs may be important reservoirs of rHAT in Uganda but not Malawi, and that pigs-and possibly cattle-may be gHAT reservoirs., Competing Interests: The authors have declared that no competing interests exist.

Background: Dengue fever is the most common arboviral disease in humans, with an estimated 50-100 million annual infections worldwide. Dengue fever cases have increased substantially in the past four decades, driven largely by anthropogenic factors including climate change. More than half the population of Peru is at risk of dengue infection and due to its geography, Peru is also particularly sensitive to the effects of El Niño Southern Oscillation (ENSO). Determining the effect of ENSO on the risk for dengue outbreaks is of particular public health relevance and may also be applicable to other Aedes-vectored viruses., Methods: We conducted a time-series analysis at the level of the district-month, using surveillance data collected from January 2000 to September 2018 from all districts with a mean elevation suitable to survival of the mosquito vector (<2,500m), and ENSO and weather data from publicly-available datasets maintained by national and international agencies. We took a Bayesian hierarchical modeling approach to address correlation in space, and B-splines with four knots per year to address correlation in time. We furthermore conducted subgroup analyses by season and natural region., Results: We detected a positive and significant effect of temperature (°C, RR 1.14, 95% CI 1.13, 1.15, adjusted for precipitation) and ENSO (ICEN index: RR 1.17, 95% CI 1.15, 1.20; ONI index: RR 1.04, 95% CI 1.02, 1.07) on outbreak risk, but no evidence of a strong effect for precipitation after adjustment for temperature. Both natural region and season were found to be significant effect modifiers of the ENSO-dengue effect, with the effect of ENSO being stronger in the summer and the Selva Alta and Costa regions, compared with winter and Selva Baja and Sierra regions., Conclusions: Our results provide strong evidence that temperature and ENSO have significant effects on dengue outbreaks in Peru, however these results interact with region and season, and are stronger for local ENSO impacts than remote ENSO impacts. These findings support optimization of a dengue early warning system based on local weather and climate monitoring, including where and when to deploy such a system and parameterization of ENSO events, and provide high-precision effect estimates for future climate and dengue modeling efforts., Competing Interests: The authors have declared that no competing interests exist.

SARS-CoV-2 is believed to have emerged from an animal reservoir; however, the frequency of and risk factors for inter-species transmission remain unclear. We carried out a community-based study of pets in households with one or more confirmed SARS-CoV-2 infection in humans. Among 119 dogs and 57 cats with completed surveys, clinical signs consistent with SARS-CoV-2 were reported in 20 dogs (21%) and 19 cats (39%). Out of 81 dogs and 32 cats sampled for testing, 40% of dogs and 43% of cats were seropositive, and 5% of dogs and 8% of cats were PCR positive; this discordance may be due to delays in sampling. Respondents commonly reported close human-animal contact and willingness to take measures to prevent transmission to their pets. Reported preventative measures showed a slightly protective trend for both illness and seropositivity in pets, while sharing of beds and bowls had slight harmful effects.

Over the last several decades, feral cats have moved from the fringes to the mainstream in animal welfare and sheltering. Although many best practice guidelines have been published by national non-profits and veterinary bodies, little is known about how groups “in the trenches” actually operate. Our study sought to address that gap through an online survey of feral cat care and advocacy organizations based in the United States. Advertised as “The State of the Mewnion,” its topics included a range of issues spanning non-profit administration, public health, caretaking and trapping, adoptions of friendly kittens and cats, veterinary medical procedures and policies, data collection and program efficacy metrics, research engagement and interest, and relationships with wildlife advocates and animal control agencies. Respondents from 567 organizations participated, making this the largest and most comprehensive study on this topic to date. Respondents came primarily from grassroots organizations. A majority reported no paid employees (74.6%), served 499 or fewer feral cats per year (75.0%), engaged between 1 and 9 active volunteers (54.9%), and did not operate a brick and mortar facility (63.7%). Some of our findings demonstrate a shared community of practice, including the common use of a minimum weight of 2.0 pounds for spay/neuter eligibility, left side ear tip removals to indicate sterilization, recovery holding times after surgery commonly reported as 1 night for male cats and 1 or 2 nights for females, requiring or recommending to adopters of socialized kittens/cats that they be kept indoor-only, and less than a quarter still engaging in routine testing of cats for FIV and FeLV. Our survey also reveals areas for improvement, such as most organizations lacking a declared goal with a measurable value and a time frame, only sometimes scanning cats for microchips, and about a third not using a standardized injection site for vaccines. This study paints the clearest picture yet available of what constitutes the standard practices of organizations serving feral and community cats in the United States., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Aeluro, Buchanan, Boone and Rabinowitz.)

Purpose of Review: The purpose of the review is to summarize recent advances in understanding the origins, drivers and clinical context of zoonotic disease epidemics and pandemics. In addition, we aimed to highlight the role of clinicians in identifying sentinel cases of zoonotic disease outbreaks., Recent Findings: The majority of emerging infectious disease events over recent decades, including the COVID-19 pandemic, have been caused by zoonotic viruses and bacteria. In particular, coronaviruses, haemorrhagic fever viruses, arboviruses and influenza A viruses have caused significant epidemics globally. There have been recent advances in understanding the origins and drivers of zoonotic epidemics, yet there are gaps in diagnostic capacity and clinical training about zoonoses., Summary: Identifying the origins of zoonotic pathogens, understanding factors influencing disease transmission and improving the diagnostic capacity of clinicians will be crucial to early detection and prevention of further epidemics of zoonoses., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: A proactive approach to preventing and responding to emerging infectious diseases is critical to global health security. We present a three-stage approach to modeling the spatial distribution of outbreak vulnerability to Aedes aegypti-vectored diseases in Perú., Methods: Extending a framework developed for modeling hemorrhagic fever vulnerability in Africa, we modeled outbreak vulnerability in three stages: index case potential (stage 1), outbreak receptivity (stage 2), and epidemic potential (stage 3), stratifying scores on season and El Niño events. Subsequently, we evaluated the validity of these scores using dengue surveillance data and spatial models., Results: We found high validity for stage 1 and 2 scores, but not stage 3 scores. Vulnerability was highest in Selva Baja and Costa, and in summer and during El Niño events, with index case potential (stage 1) being high in both regions but outbreak receptivity (stage 2) being generally high in Selva Baja only., Conclusions: Stage 1 and 2 scores are well-suited to predicting outbreaks of Ae. aegypti-vectored diseases in this setting, however stage 3 scores appear better suited to diseases with direct human-to-human transmission. To prevent outbreaks, measures to detect index cases should be targeted to both Selva Baja and Costa, while Selva Baja should be prioritized for healthcare system strengthening. Successful extension of this framework from hemorrhagic fevers in Africa to an arbovirus in Latin America indicates its broad utility for outbreak and pandemic preparedness and response activities., (© 2021. The Author(s).)

Compassion fatigue (CF) has been described in various "caring professions," particularly the human medical field. Recently, CF has been identified as a concern in animal care professions, specifically veterinary medicine. Despite the perception that veterinary personnel in animal research are at increased risk of CF, few studies have assessed CF in this population. The current cross-sectional study aimed to describe the prevalence of both CF and compassion satisfaction (CS) among active-duty veterinary personnel in Department of Defense animal research environments, using the Professional Quality of Life Scale (ProQOL). The ProQOL measures burnout and secondary traumatic stress as representative of compassion fatigue, while also measuring the inverse of CF, or CS. The current study set out to identify factors associated with both CF and CS. Validated scales of measurement were used to assess the frequency of exposures and outcomes of interest, while associations were analyzed using linear regression models. The study found that most survey respondents reported high levels of CS and low levels of BO and STS. Factors associated with higher levels of CF and lower CS included working with NHPs, difficulty working with primary investigators, loneliness, and euthanasia distress. These findings can inform future studies of CF in animal research environments and bolster initiatives to reduce occupational stress by the preventing and mitigating CF.

The One Health approach recognizes the interconnectedness of human, animal, and ecosystem health and encourages collaboration between diverse disciplines to address complex health problems. In this paper, 3 academics, with diverse training, experience and backgrounds who each work on different pathogenic parasites, will share their stories of tackling parasitic challenges by applying a One Health approach. The pathogenic parasites to be discussed include the helminth Taenia solium and protozoans Giardia, Theileria, Babesia, Neospora and Toxoplasma species. The 3 narratives focus on research and clinical case-based challenges and illustrate where collaboration between human, animal, and environmental health scientists either has or could lead to improved control of human and animal health as well as important research discoveries. The need for better evaluation of interventions and scientific evidence to support changes in clinical practice and encourage enhanced collaboration between human and veterinary clinicians, as well as new governmental policies to improve public and wildlife health, are described. The need for a range of evidence-based metrics to monitor the success and impact of the One Health approach to veterinary parasitology is also discussed., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Escherichia coli O157:H7 is the predominant cause of diarrhea-associated hemolytic uremic syndrome (HUS) worldwide. Its cardinal virulence traits are Shiga toxins, which are encoded by stx genes, the most common of which are stx1a , stx2a , and stx2c. The toxins these genes encode differ in their in vitro and experimental phenotypes, but the human population-level impact of these differences is poorly understood. Using Shiga toxin-encoding bacteriophage insertion typing and real-time polymerase chain reaction, we genotyped isolates from 936 E. coli O157:H7 cases and verified HUS status via chart review. We compared the HUS risk between isolates with stx2a and those with stx2a and another gene and estimated additive interaction of the stx genes. Adjusted for age and symptoms, the HUS incidence of E. coli O157:H7 containing stx2a alone was 4.4% greater (95% confidence interval (CI) -0.3%, 9.1%) than when it occurred with stx1a . When stx1a and stx2a occur together, the risk of HUS was 27.1% lower (95% CI -87.8%, -2.3%) than would be expected if interaction were not present. At the population level, temporal or geographic shifts toward these genotypes should be monitored, and stx genotype may be an important consideration in clinically predicting HUS among E. coli O157:H7 cases.

Traditional zoonotic disease research focuses on detection of recognized pathogens and may miss opportunities to understand broader microbial transmission dynamics between humans, animals, and the environment. We studied human-macaque microbiome overlap in Kosum Phisai District, Maha Sarakham Province, Thailand, where a growing population of long-tailed macaques (Macaca fascicularis) in Kosumpee Forest Park interact with humans from an adjacent village. We surveyed workers in or near the park with elevated exposure to macaques to characterize tasks resulting in exposure to macaque feces in addition to dietary and lifestyle factors that influence gut microbiome composition. Fecal samples were collected from 12 exposed workers and 6 controls without macaque exposure, as well as 8 macaques from Kosumpee Forest Park and 4 from an isolated forest patch with minimal human contact. The V4 region of the 16S rRNA gene from fecal sample extracted DNA was amplified and sequenced using Illumina MiSeq to characterize the microbial community. A permuted betadisper test on the weighted UniFrac distances revealed significant differences in the dispersion patterns of gut microbiota from exposed and control macaques (p = 0.03). The high variance in gut microbiota composition of macaques in contact with humans has potential implications for gut microbiome stability and susceptibility to disease, described by the Anna Karenina principle (AKP). Human samples had homogenous variance in beta diversity but different spatial medians between groups (p = 0.02), indicating a shift in microbial composition that may be explained by fundamental lifestyle differences between the groups unrelated to exposure status. SourceTracker was used to estimate the percent of gut taxa in exposed humans that was contributed by macaques. While one worker showed evidence of elevated contribution, the overall trend was not significant. Task observations among workers revealed opportunities to employ protective measures or training to reduce exposure to occupational hazards. These results suggest the potential for hygiene measures to mitigate negative aspects of contact between humans and macaques in order to optimize the health of both populations., Competing Interests: The authors have declared that no competing interests exist.

Objectives: This study utilized personal noise measurements and fit-testing to evaluate the association between noise exposures and personal attenuation rating (PAR) values among participating workers, and second, to compare the attenuated exposure levels received by the workers and the British Standards Institute's recommended noise exposure range of 70 to 80 dBA., Design: We measured hearing protection device (HPD) attenuation among a sample of 91 workers at 2 US metal manufacturing facilities, through performance of personal noise dosimetry measurements and HPD fit-testing over multiple work shifts. We compared this testing with participant questionnaires and annual audiometric hearing threshold results., Results: The average 8-hr time-weighted average noise exposures for study participants was 79.8 dBA (SD = 7.0 dBA), and the average PAR from fit-testing was 20.1 dB (±6.7 dB). While differences existed between sites, 84% of the 251 PAR measurements resulted in effective protection levels below the recommended 70 dBA (indicating overprotection), while workers were underprotected (i.e., effective exposures >80 dBA) during <1% of monitored shifts. Our results also demonstrated a significant positive relationship between measured noise exposure and PAR among non-custom-molded plug users (p = 0.04). Non-custom-molded plug wearers also showed a significant increase in PAR by sequential fit-test interaction (p = 0.01), where on average, subsequent fit-testing resulted in increasingly higher HPD attenuation. Workers at site 1 showed higher PARs. PARs were significantly related to race, even when adjusting for site location. While age, hearing threshold level, task, and self-reported tinnitus showed no significant effect on individual PAR in an unadjusted model, site, race, and sand- or water-blasting activities were significant predictors in adjusted models. Within-worker variability in time-weighted averages and PARs across repeated measurements was substantially lower than variability between workers., Conclusions: Careful selection of HPDs is necessary to minimize instances of overprotection to workers in low and moderate occupational noise environments. The use of fit-testing in hearing conservation programs to evaluate PAR is recommended to avoid overprotection from noise exposure while also minimizing instances of under-attenuation.

Background: Pediatric diarrhea, a leading cause of under-five mortality, is predominantly infectious in etiology. As many putative causal agents are zoonotic, animal exposure is a likely risk factor. To evaluate the effect of animal-related factors on moderate to severe childhood diarrhea in rural Kenya, where animal contact is common, Conan et al. studied 73 matched case-control pairs from 2009-2011, collecting rich exposure data on many dimensions of animal contact. We review the challenges associated with analyzing moderately-sized datasets with a large number of predictors and present two alternative methodological approaches., Methodology/principal Findings: We conducted a simulation study to demonstrate that forward stepwise selection results in overfit models when data are high-dimensional, and that p values reported directly from the data used to train these models are misleading. We described how automated methods of variable selection, attractive when the number of predictors is large, can result in overadjustment bias. We proposed an alternative a priori regression approach not subject to this bias. Applied to Conan et al.'s data, this approach found a non-significant but positive trend for household's sharing of water sources with livestock or poultry, child's presence for poultry slaughter, and child's habit of playing where poultry sleep or defecate. For many predictors evaluated few pairs were discordant, suggesting matching compromised the power of this analysis. Finally, we proposed latent variable modeling as a complimentary approach and performed Item Response Theory modeling on Conan et al.'s data, with animal contact as the latent trait. We found a moderate but non-significant effect (OR 1.21, 95% CI 0.78, 1.87, unit = 1 standard deviation)., Conclusions/significance: Automated methods of model selection are appropriate for prediction models when fit and evaluated on separate samples. However when the goal is inference, these methods can produce misleading results. Furthermore, case-control matching should be done with caution., Competing Interests: The authors have declared that no competing interests exist.

Background: Human and animal African trypanosomiases impose a large economic and health burden in their endemic regions. Large strides have been made in the control of human African trypanosomiasis (HAT), yet these efforts have largely focused on the non-zoonotic form of the disease. Using a mathematical model with a 10 year time horizon, we demonstrate the role of the cattle treatment with trypanocides in the epidemiology of zoonotic and non-zoonotic HAT in Uganda, and its potential implications on elimination and eradication of the disease., Methodology/principal Findings: We created two compartmental, deterministic models, each comprised of three sub-models: humans, the tsetse fly vector ( Glossina fuscipes fuscipes ), and cattle. We applied these models to two HAT foci in Uganda: the gambiense (chronic, non-zoonotic) form in the Northern Region, and the rhodesiense (acute, zoonotic) form in the Eastern Region. Parameters were derived from prior literature or assumed. In both foci we assumed G. fuscipes fuscipes expresses zoophilic biting behavior.With trypanocide treatment of cattle administered every 3 months, treatment in stage I (representing engagement in active or passive surveillance) had a larger impact on HAT burden than cattle treatment coverage. However increasing cattle treatment coverage allowed for further reduction in prevalence in both foci. Using these model parameters, our estimated R 0 suggests humans cannot alone sustain the HAT epidemic in Uganda., Conclusions/significance: Even in the absence of zoonotic transmission, loss of a preferred tsetse host species can affect HAT risk. Thus One Health strategies which integrate HAT and animal African trypanosomiasis control may improve the timeliness and sustainability of gHAT and rHAT elimination and eradication in Uganda. Furthermore, such strategies reduce the burden of a high-morbidity livestock disease of economic importance.

Tuberculosis (TB) is a leading infectious cause of human death worldwide. In cattle, TB infection results in productivity losses, trade barriers and zoonotic transmission via milk, meat or direct contact. We conducted a cross-sectional study in rural communities in Uganda between 2014 and 2016 to evaluate the association between tuberculosis skin test (TST) positivity in humans and cattle-associated risk factors: household herd positivity and raw milk consumption. Human and cattle TSTs were performed in communities followed by a survey of household practices. TST data were available on 493 humans, 184 (37.3%) with positive results, and 1,441 cattle, 50 (3.5%) with positive results. We fit separate log binomial generalized estimating equation models for the herd positivity-human TST positivity association, stratified on sex; and for the raw milk consumption-human TST positivity association, stratified on frequency of milk consumption. Having at least one TST-positive bovid in the household's herd was significantly associated with lower risk of TB among men (prevalence ratio [PR] 0.66, 95% CI 0.49, 0.87) but was not significantly associated with TB among women (PR 1.21, 95% CI 0.76, 1.95). This apparent protective effect was contrary to our a priori hypothesis of higher exposure effect among men, the primary caretakers of cattle. This finding may be the result of residual confounding by socioeconomic status; wealthier individuals may be less likely to be TB positive, but more likely to have TST-positive herds by virtue of larger herd sizes, ability to purchase new and possibly infected stock, and propensity to keep more TB-susceptible European breeds. For raw milk consumption, effect estimates were close to one and not statistically significant. Thus, in settings where bovine TB prevalence is low, such as Uganda, cattle-associated zoonotic transmission may be rare, and cattle-associated risk factors may not be important drivers of human TB burden., (© 2018 Blackwell Verlag GmbH.)

Competing Interests: Competing interests: None declared.

Avian influenza virus (AIV) is a major health threat to both avian and human populations. The ecology of the virus is driven by numerous factors, including climate and avian migration patterns, yet relatively little is known about these drivers. Long-distance transport of the virus is tied to inter- and intra-continental bird migration, while enhanced viral reassortment is linked to breeding habitats in Beringia shared by migrant species from North America and Asia. Furthermore, water temperature, pH, salinity, and co-existing biota all impact the viability and persistence of the virus in the environment. Changes in climate can potentially alter the ecology of AIV through multiple pathways. Warming temperatures can change the timing and patterns of bird migration, creating novel assemblages of species and new opportunities for viral transport and reassortment. Water temperature and chemistry may also be altered, resulting in changes in virus survival. In this review, we explain how these shifts have the potential to increase viral persistence, pathogenicity, and transmissibility and amplify the threat of pandemic disease in animal and human hosts. Better understanding of climatic influences on viral ecology is essential to developing strategies to limit adverse health effects in humans and animals., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The One Health concept stresses the ecological relationships between human, animal, and environmental health. Much of the One Health literature to date has examined the transfer of pathogens from animals (e.g., emerging zoonoses) and the environment to humans. The recent rapid development of technology to perform high throughput DNA sequencing has expanded this view to include the study of entire microbial communities. Applying the One Health approach to the microbiome allows for consideration of both pathogenic and non-pathogenic microbial transfer between humans, animals, and the environment. We review recent research studies of such transmission, the molecular and statistical methods being used, and the implications of such microbiome relationships for human health. Our review identified evidence that the environmental microbiome as well as the microbiome of animals in close contact can affect both the human microbiome and human health outcomes. Such microbiome transfer can take place in the household as well as the workplace setting. Urbanization of built environments leads to changes in the environmental microbiome which could be a factor in human health. While affected by environmental exposures, the human microbiome also can modulate the response to environmental factors through effects on metabolic and immune function. Better understanding of these microbiome interactions between humans, animals, and the shared environment will require continued development of improved statistical and ecological modeling approaches. Such enhanced understanding could lead to innovative interventions to prevent and manage a variety of human health and disease states.

Dairy farming involves frequent contact among animals, workers and farm environments. To explore the Staphylococcus spp. diversity that occurs on dairy farms, a pilot study sampled dairy workers, cows and the farm environments from five farms, two organic and three conventional farms, in Washington State. Samples were taken from the nares and hands of consenting workers (n = 24), udders and nares of selected cows (n = 25) and representative environmental surfaces (n = 96) from each farm. To increase diversity of the Staphylococcus spp. characterized, five distinct colonies were selected from each sample for identification with 16S analysis. A total of 198 staphylococci were characterized representing 19 different Staphylococcus spp. The diversity of species ranged from 9-15 Staphylococcus spp./farm with no difference between conventional and organic farms. S. haemolyticus [n = 60 isolates] was the most common species and was isolated from all farms and from cows, humans and environmental samples. Whole genome sequencing of selected S. haemolyticus found no genetically related isolates among human, animal and environmental samples within the same farm. S. epidermidis, S. saprophyticus, S. sciuri and S. xylosus were also found in ≥1 farms from human, animal and environmental samples.

Objective: Women in veterinary occupations are routinely exposed to potential reproductive hazards, yet research into their birth outcomes is limited. We conducted a population-based retrospective cohort study of the association between maternal veterinary occupation and adverse birth outcomes., Methods: Using Washington State birth certificate, fetal death certificate and hospital discharge data from 1992 to 2014, we compared birth outcomes of mothers in veterinary professions (n=2662) with those in mothers in dental professions (n=10 653) and other employed mothers (n=8082). Relative risks (RRs) and 95% CIs were estimated using log binomial regression. Outcomes studied were premature birth (<37 weeks), small for gestational age (SGA), malformations and fetal death (death at ≥20 weeks gestation). Subgroup analyses evaluated risk of these outcomes among veterinarians and veterinary support staff separately., Results: While no statistically significant associations were found, we noted a trend for SGA births in all veterinary mothers compared with dental mothers (RR=1.16, 95% CI 0.99 to 1.36) and in veterinarians compared with other employed mothers (RR=1.37, 95% CI 0.96 to 1.96). Positive but non-significant association was found for malformations among children of veterinary support staff., Conclusions: These results support the need for further study of the association between veterinary occupation and adverse birth outcomes., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

[This corrects the article DOI: 10.1371/journal.pone.0194647.].

We report on a study conducted in Guangdong Province, China, to characterize behaviors and perceptions associated with transmission of pathogens with pandemic potential in highly exposed human populations at the animal-human interface. A risk factor/exposure survey was administered to individuals with high levels of exposure to wildlife. Serological testing was performed to evaluate prior infection with several wildlife viral pathogens. Follow up serology was performed on a subset of the cohort as well as close contacts of individuals. 1,312 individuals were enrolled in the study. Contact with a wide range of wildlife species was reported in both occupational and occasional contexts. The overall proportion of individuals seropositive to any of the tested wildlife pathogens was approximately 4.0%. However, persons employed as butchers demonstrated a seropositivity of 9.0% to at least one pathogen of interest. By contrast, individuals working as hunters had lower rates of seropositivity. Among the study population, a number of other behaviors showed correlation with seropositivity, including contact with particular wildlife species such as field rats. These results demonstrate the need to further explore zoonotic risks of particular activities regarding wildlife contact, and to better understand risks of persons working as butchers with wildlife species.

Objective: This study characterised overall and specific costs associated with hearing conservation programmes (HCPs) at US metal manufacturing sites, and examined the association between these costs and several noise-induced hearing loss (NIHL) outcomes., Design: We interviewed personnel and reviewed records at participating facilities. We also measured noise for comparison to the ten-year average of measurements made by each facility. NIHL outcomes assessed included rates of standard threshold shifts (STS) and high-frequency hearing loss, as well as prevalence of hearing impairment, for each participating facility. We used linear regression to identify per-person HCP costs that best predicted the NIHL outcomes., Study Sample: We evaluated 14 US metal manufacturing facilities operated by a single company., Results: Annual HCP costs ranged from roughly $67,000 to $397,000 (average $308 ± 80 per worker). Our full-shift noise measurements (mean 83.1 dBA) showed good agreement with the facilities' measurements (mean 82.6 dBA). Hearing impairment prevalence was about 15% overall. Higher expenditures for training and hearing protector fit-testing were significantly associated with reduced STS prevalence. Higher training expenditures were also related to lower hearing impairment prevalence and high-frequency hearing loss rates., Conclusions: HCP costs were substantial and variable. Increased workplace spending on training and fit-testing may help minimise NIHL.

Background: Community noise exposure has been shown to increase the risk of hypertension; however, the relationship between occupational noise exposure and hypertension is less clear., Methods: Using an inception cohort of workers in a specialty metals manufacturing company, we retrospectively assessed occupational noise exposure, hearing acuity, and incident hypertension diagnoses using administrative datasets. Time-weighted average noise exposure levels were assigned to employees based on their job histories. Cox proportional hazards models were performed to determine the association of noise exposure with risk of incident hypertension., Results: The adjusted hazard ratio (HR) of incident hypertension did not significantly differ between groups by cumulative continuous or categorized noise exposure metric., Conclusion: We found no increased risk of incident hypertension with exposure to occupational noise among workers. Further assessment examining workers' use of hearing protection devices is warranted., (© 2017 Wiley Periodicals, Inc.)

Patients receiving immunosuppressive cancer treatments in settings where there is a high degree of human-animal interaction may be at increased risk for opportunistic zoonotic infections or reactivation of latent infections. We sought to determine the seroprevalence of selected zoonotic pathogens among patients diagnosed with haematologic malignancies and undergoing chemotherapeutic treatments in Romania, where much of the general population lives and/or works in contact with livestock. A convenience sample of 51 patients with haematologic cancer undergoing chemotherapy at a referral clinic in Cluj-Napoca, Romania, was surveyed regarding animal exposures. Blood samples were obtained and tested for evidence of infection with Bartonella species, Coxiella burnetii and Toxoplasma gondii, which are important opportunistic zoonotic agents in immunocompromised individuals. 58.8% of participants reported living or working on a farm, and living or working on a farm was associated with contact with livestock and other animals. 37.5% of participants were IgG seroreactive against one or more of five Bartonella antigens, and seroreactivity was statistically associated with living on farms. Farm dwellers were 3.6 times more likely to test IgG seroreactive to Bartonella antibodies than non-farm dwellers. 47.1% of the participants tested T. gondii IgG positive and 13.7% tested C. burnetii IgG positive, indicating past or latent infection. C. burnetii IgM antibodies were detected in four participants (7.8%), indicating possible recent infection. These results indicate that a large proportion of patients with haematologic cancer in Romania may be at risk for zoonotic infections or for reactivation of latent zoonotic infections, particularly with respect to Bartonella species. Special attention should be paid to cancer patients' exposure to livestock and companion animals in areas where much of the population lives in rural settings., (© 2017 Blackwell Verlag GmbH.)

Most emerging infectious diseases are zoonotic in origin, with wildlife a frequent source of zoonotic disease events. Although individuals with extensive wildlife contact may be at the greatest risk of contracting novel infectious agents, the occupational risk of those working closely with wildlife has not been well studied. This study assessed the occupational exposures among wildlife health professionals working in multiple countries worldwide. An occupational risk survey of past and present exposures was developed and administered online in a confidential manner to wildlife workers recruited through an ongoing international wildlife pathogen surveillance project. Surveys were completed by 71 participants in 14 countries. Significant lifetime exposures reported included bites from bats and rodents and touching dead animals. Completion of training in occupational safety was reported by 75% of respondents. While gloves were used for most tasks, use of N95 respirators and other personal protective equipment varied by task. Eighty percent of workers reported rabies vaccination. Some respondents indicated interest in enhanced occupational health services targeting their unique needs. Wildlife workers represent an occupational population at risk of zoonotic infection and injury. Enhanced occupational health services targeting wildlife workers could reduce the risk and sequelae of zoonotic exposure and infection.