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In this study, the Quantitative Microbial Risk Assessment (QMRA) methodology was applied to estimate the annual risk of Giardia and Cryptosporidium infection associated with a water treatment plant in southern Brazil. The efficiency of the treatment plant in removing protozoa and the effectiveness of the Brazilian legislation on microbiological protection were evaluated, emphasizing the relevance of implementing the QMRA in this context. Two distinct approaches were employed to estimate the mechanical removal of protozoa: The definitions provided by the United States Environmental Protection Agency (USEPA), and the model proposed by Neminski and Ongerth. Although the raw water collected had a higher concentration of Giardia cysts than Cryptosporidium oocysts, the estimated values for the annual risk of infection were significantly higher for Cryptosporidium than for Giardia. From a general perspective, the risk values of protozoa infection were either below or very near the limit set by the World Health Organization (WHO). In contrast, all the risk values of Cryptosporidium infection exceeded the threshold established by the USEPA. Ultimately, it was concluded that the implementation of the QMRA methodology should be considered by the Brazilian authorities, as the requirements and guidelines provided by the Brazilian legislation proved to be insufficient to guarantee the microbiological safety of drinking water. In this context, the QMRA application can effectively contribute to the prevention and investigation of outbreaks of waterborne disease. [ABSTRACT FROM AUTHOR]

Eye infections from bacterial contamination of bulk-refillable liquid soap dispensers and artificial tear eye drops continue to occur, resulting in adverse health outcomes that include impaired vision or eye enucleation. Pseudomonas aeruginosa (P. aeruginosa), a common cause of eye infections, can grow in eye drop containers and refillable soap dispensers to high numbers. To assess the risk of eye infection, a quantitative microbial risk assessment for P. aeruginosa was conducted to predict the probability of an eye infection for two potential exposure scenarios: (i) individuals using bacteria-contaminated eye drops and (ii) contact lens wearers washing their hands with bacteria-contaminated liquid soap prior to placing the lens. The median risk of an eye infection using contaminated eye drops and hand soap for both single and multiple exposure events (per day) ranged from 10-1 to 10-4, with contaminated eye drops having the greater risk. The concentration of P. aeruginosa was identified as the parameter contributing the greatest variance on eye infection risk; therefore, the prevalence and level of bacterial contamination of the product would have the greatest influence on health risk. Using eye drops in a single-use container or with preservatives can mitigate bacterial growth, and using non-refillable soap dispensers is recommended to reduce contamination of hand soap. Given the opportunistic nature of P. aeruginosa and its ability to thrive in unique environments, additional safeguards to mitigate bacterial growth and exposure are warranted. IMPORTANCE Pseudomonas aeruginosa (P. aeruginosa) is a pathogen that can persist in a variety of unusual environments and continues to pose a significant risk for public health. This quantitative microbial risk assessment (QMRA) estimates the potential human health risks, specifically for eye infections, associated with exposure to P. aeruginosa in bacteria-contaminated artificial tear eye drops and hand soap. This study applies the risk assessment framework of QMRA to evaluate eye infection risks through both consumer products. The study examines the prevalence of this pathogen in eye drops and soap, as well as the critical need to implement measures that will mitigate bacterial exposure (e.g., single-use soap dispensers and eye drops with preservatives). Additionally, limitations and challenges are discussed, including the need to incorporate data regarding consumer practices, which may improve exposure assessments and health risk estimates. [ABSTRACT FROM AUTHOR]

Hepatitis E virus (HEV) is a major cause of acute jaundice in South Asia. Gaps in our understanding of transmission are driven by non-specific symptoms and scarcity of diagnostics, impeding rational control strategies. In this context, serological data can provide important proxy measures of infection. We enrolled a population-representative serological cohort of 2,337 individuals in Sitakunda, Bangladesh. We estimated the annual risks of HEV infection and seroreversion both using serostatus changes between paired serum samples collected 9 months apart, and by fitting catalytic models to the age-stratified cross-sectional seroprevalence. At baseline, 15% (95 CI: 14–17%) of people were seropositive, with seroprevalence highest in the relatively urban south. During the study, 27 individuals seroreverted (annual seroreversion risk: 15%, 95 CI: 10–21%), and 38 seroconverted (annual infection risk: 3%, 95CI: 2–5%). Relying on cross-sectional seroprevalence data alone, and ignoring seroreversion, underestimated the annual infection risk five-fold (0.6%, 95 CrI: 0.5–0.6%). When we accounted for the observed seroreversion in a reversible catalytic model, infection risk was more consistent with measured seroincidence. Our results quantify HEV infection risk in Sitakunda and highlight the importance of accounting for seroreversion when estimating infection incidence from cross-sectional seroprevalence data. [ABSTRACT FROM AUTHOR]

Abstract Background Despite being at higher risk of severe disease and pregnancy complications, evidence on susceptibility to SARS-CoV-2 infection in pregnancy is still limited. The aim of the study is to compare the likelihood of undergoing a SARS-CoV-2 test and testing positive for COVID-19 in pregnancy and puerperium with that of the general female population of reproductive age. Methods This is a retrospective population-based cohort study including 117,606 women of reproductive age (March 2020-September 2021) with 6608 (5.6%) women having ≥ 1 pregnancy. Women were linked to the pregnancy registry to be classified as “non-pregnant”, “pregnant”, and “puerperium”; then, according to the national case-based integrated COVID-19 surveillance system, all women undergoing a SARS-CoV-2 test during the study period were identified. The Incidence Rate Ratio was calculated to compare the likelihood of being tested for SARS-CoV-2 in pregnant, puerperium and non-pregnant women among all women included. The likelihood of having a COVID-19 diagnosis was calculated using two comparators (not-pregnant women and the person-time before/after pregnancy) by means of Cox proportional hazards models, adjusting for age and with the cluster option to control standard error calculation in repeated pregnancies. Only first infection and swabs before the first one positive were included. Results The probability of being tested for SARS-CoV-2 was 4.9 (95% CI: 4.8–5.1) and 3.6 times higher (95%CI: 3.4–3.9) in pregnancy (including spontaneous miscarriages) and in the puerperium, respectively. The Hazard Ratio (HR) of covid-19 diagnosis during pregnancy vs. non-pregnancy was 1.17 (95% CI 1.03–1.33) with similar results when comparing the risk during pregnancy with that of the same women outside pregnancy (puerperium excluded), with an HR of 1.13 (95% CI 0.96–1.33); the excess decreased when excluding the test performed at admission for delivery (HR 1.08 (95%CI 0.90–1.30). In the puerperium, the HR was 0.62 (95% CI 0.41–0.92) comparing women with ≥ 1childbirth with all other women and excluding the first two weeks of puerperium. Conclusions Women during pregnancy showed a small increase in the risk of infection, compatible with a higher likelihood of being tested. A lower probability of infection during the puerperium was observed during the entire pandemic period, suggesting likely protective behaviors which were effective in reducing their probability of infection.

Features of the landscape and geographical conditions of the Samara region, the rich world of flora and fauna create favorable conditions for the existence of natural foci of infectious and parasitic diseases. The high population density, the presence of megacities (Samara, Togliatti), the passion of the inhabitants of the region for country recreation, together with developed agriculture, determine a high risk of infection of people with pathogens of natural focal infections.Objectives: to analyze the manifestations of the epidemic and epizootic processes of natural focal infections in the Samara region for its zoning according to the degree of danger of infection of the population with actual zoonoses.Methods. We used information on the incidence of the population (form No. 2 "Information on infectious and parasitic diseases") for the period from 2019 to 2021, data from an immunological examination of residents of municipalities using enzyme immunoassay, results of examination of environmental objects in natural foci (indication of genomes and antigens of viruses and bacteria) in vertebrates and their pellets (litter), arthropods using polymerase chain reaction and enzyme immunoassay. Cluster analysis was performed using the Statgraphics plus for Windows application program for a personal computer.Results. Territories with high, moderate and low risk of infection of the population of the Samara region with hemorrhagic fever with renal syndrome, viral tick-borne encephalitis, tularemia, leptospirosis, Q fever and West Nile fever were identified. It is shown that the most relevant zoonosis is hemorrhagic fever with renal syndrome.Discussion. Compiled cartographic mapping of the administrative formations of the Samara region with different risks of infection and disease of people with natural focal infections is relevant for planning preventive measures.

Objectives: The health emergency following the COVID-19 pandemic has seen hospital structures collapse and put in crisis nursing homes and other long-term care facilities worldwide. Our study aims to analyze and comparing the data relating to the infection rate and mortality for COVID-19 in the elderly over 75 living in the long-term care facilities and in the home-dwelling population. Study design: The study adopts a retrospective cohort design and was conducted in Italy, in the Lazio region, in the area of the Local Health Authority (LHA) named “Azienda Sanitaria Locale Roma 6”. Methods: Data were extracted from the COVID-19 surveillance system of the Lazio region. The primary outcome is the SARS-CoV-2 incidence rate in the period between 1st September 2020 and 31st May 2021. The secondary outcome is the mortality rate. Results: Living in a residential versus a home-dwelling setting was associated with a higher infection rate (OR 5.03, CI 4.67–5.43; p

Background There is no immunization campaign that currently exist for respiratory syncytial virus (RSV). Seroprevalence studies are critical for assessing epidemiological dynamics before and during an immunization program. A systematic literature review was conducted to summarize the evidence from seroprevalence studies on RSV. Methods A systematic search of age-dependent RSV seroprevalence was conducted using the PubMed database and EMBASE. Age-dependent force of infections (FoI) and the decay rate of immunity were estimated. A mixture finite model was used, estimating the age-dependent disease state and the antibody concentrations in susceptible and infected or recovered populations. Results Twenty-one studies were identified from 15 countries, with studies using enzyme-linked immunosorbent assay being the most represented. Using a catalytic model, the age-dependent force of infection was estimated to be the lowest in infants aged 6 months to 1 year and increased in older age groups. The proportion ever-infected/recovered was estimated to be above 90% by 3 years of age. Conclusions The number of seroprevalence studies covering a broad range of ages are limited. The age-dependent FoI indicated that the risk of infection was greatest among those aged >5 years. Additional data using valid assays are required to describe the transmission dynamics of RSV infection. [ABSTRACT FROM AUTHOR]

Background: One of today's most significant organizational priorities, including healthcare organizations, is to improve the quality of work-life (QoWL), which leads to offering high-quality services to patients. Aim: The study aimed to explore the effect of the perceived risk of infection and its impact on the quality of work-life (QoWL) on HCWs during the COVID-19 pandemic. Methods: A cross-sectional survey was conducted on 484 healthcare workers. Respondents were recruited using convenience sampling methods. Results: : The study findings revealed a better QoWL with a decreased perceived risk of COVID-19 infection. Conclusion: Increasing the quality of work life will be reflected in adherence to health protocols, which creates a work environment capable of dealing with challenges, including the risk of infection such as COVID-19. [ABSTRACT FROM AUTHOR]

High-risk single nucleotide polymorphisms (SNPs) in nucleotide-binding oligomerization domain-2 (NOD2) gene are associated with high susceptibility for infections and inflammation due to risk of inappropriate cytokine production and NF- κ B activation. We studied the incidence of three high-risk NOD2 gene SNPs (8, 12 and 13) among BM-transplant (BMT) recipients. Sequential patients undergoing BMT over 1-year period were prospectively studied. Patients were tested with MspI/HhaI or NlaIV restriction-endonucleases (Euryx, Gdansk, Poland) for NOD2 gene SNPs 8, 12, and 13, respectively. Regimen-related organ toxicity was graded using the Seattle-Bearman criteria. Forty patients were enrolled, their median age was 38 years (range 3–64), and 52.5% were males. Twenty patients each (50%) underwent autologous and allogeneic BMT. Majority of the patients (n = 38, 95%) developed febrile-neutropenia in the post-transplant period and 4 patients died due to overwhelming sepsis within day +100. Acute graft-versus-host disease (GVHD) [grade I–II (n = 3) and grade III-IV (n = 6)] was observed in 9/20 allogeneic HSCT recipients. None of our 40 patients showed presence of any of the three NOD2 gene SNPs. The 3 commonly observed high risk SNPs (8,12, and 13) of NOD2 genes were not present in study population. It is quite likely that due to geographical and racial variations these polymorphisms are completely absent in North India. NOD2 gene is highly diverse and polymorphic variants can be absolutely different in various populations. Larger studies targeting sequencing of the whole NOD2 gene can convincingly rule out or confirm the role of NOD2 gene variants in Indian population. [ABSTRACT FROM AUTHOR]

Background: Despite being at higher risk of severe disease and pregnancy complications, evidence on susceptibility to SARS-CoV-2 infection in pregnancy is still limited. The aim of the study is to compare the likelihood of undergoing a SARS-CoV-2 test and testing positive for COVID-19 in pregnancy and puerperium with that of the general female population of reproductive age. Methods: This is a retrospective population-based cohort study including 117,606 women of reproductive age (March 2020-September 2021) with 6608 (5.6%) women having ≥ 1 pregnancy. Women were linked to the pregnancy registry to be classified as "non-pregnant", "pregnant", and "puerperium"; then, according to the national case-based integrated COVID-19 surveillance system, all women undergoing a SARS-CoV-2 test during the study period were identified. The Incidence Rate Ratio was calculated to compare the likelihood of being tested for SARS-CoV-2 in pregnant, puerperium and non-pregnant women among all women included. The likelihood of having a COVID-19 diagnosis was calculated using two comparators (not-pregnant women and the person-time before/after pregnancy) by means of Cox proportional hazards models, adjusting for age and with the cluster option to control standard error calculation in repeated pregnancies. Only first infection and swabs before the first one positive were included. Results: The probability of being tested for SARS-CoV-2 was 4.9 (95% CI: 4.8–5.1) and 3.6 times higher (95%CI: 3.4–3.9) in pregnancy (including spontaneous miscarriages) and in the puerperium, respectively. The Hazard Ratio (HR) of covid-19 diagnosis during pregnancy vs. non-pregnancy was 1.17 (95% CI 1.03–1.33) with similar results when comparing the risk during pregnancy with that of the same women outside pregnancy (puerperium excluded), with an HR of 1.13 (95% CI 0.96–1.33); the excess decreased when excluding the test performed at admission for delivery (HR 1.08 (95%CI 0.90–1.30). In the puerperium, the HR was 0.62 (95% CI 0.41–0.92) comparing women with ≥ 1childbirth with all other women and excluding the first two weeks of puerperium. Conclusions: Women during pregnancy showed a small increase in the risk of infection, compatible with a higher likelihood of being tested. A lower probability of infection during the puerperium was observed during the entire pandemic period, suggesting likely protective behaviors which were effective in reducing their probability of infection. [ABSTRACT FROM AUTHOR]

Introduction: Characteristics of exposure and infection risk, are important in strategy development for infection control among healthcare workers (HCWs). Our objective was to investigate the characteristics of exposure of HCWs to SARS-CoV-2 and determine the risk of COVID-19 development. Methodology: This is a retrospective single-center cohort study, conducted between March and December 2020. Unvaccinated and exposed HCWs were asked to complete a standard form, including demographic data and characteristics of exposure(s). Exposures were stratified according to national guidelines. STROBE checklist was used. Results: Among a total of 4,385 healthcare workers, 1,483 HCWs (33.8%) with a total of 1,903 exposures to SARS-CoV-2 were identified. Median age was 31 (IQR: 26-40) years and 45.4% were male (N = 673). Following exposure, 78 HCWs became SARS-CoV-2-positive (attack rate: 3.9%) and secondary attack rate was 4/16. In terms of infection, exposure to SARS-CoV-2-positive HCWs posed a greater risk compared to contact with patients (8.9%, [n = 66] vs. 3.8% [n = 12], respectively, p = 0.003). PCR positivity rates were 11.5%, 6.3%, and 8.4% for low, medium, and high-risk contacts (p = 0.152). Median time to infection post-exposure was 7 (IQR: 4-13) days. Conclusions: Given the attack rates, there was no correlation between risk levels and PCR test positivity rates. There was no difference between HCWs with or without work restrictions, in terms of PCR positivity. Due to feasibility issues, prioritizing universally applied symptom screening and resource control strategies and suspending contact tracing and work restrictions, appear to be safe during high prevalence period. [ABSTRACT FROM AUTHOR]

Aim: The coronavirus disease (COVID)‐19 incidence was higher in diabetes mellitus (DM), although several differences should be considered on the basis of characteristics of cohorts evaluated. This study was designed to evaluate the prevalence and potential consequences of COVID-19 in a large diabetic population in Northern Italy. Design: Observational, longitudinal, retrospective, clinical study. Methods: Subjects with both type 1 and type 2 DM living in the Province of Modena and submitted to at least one SARS-CoV-2 swab between March 2020 and March 2021 were included. Data were extracted from the Hospital data warehouse. Results: 9553 diabetic subjects were enrolled (age 68.8 ± 14.1 years, diabetes duration 11.0 ± 6.9 years, glycated hemoglobin 57.2 ± 16.2 mmol/mol). COVID-19 was detected in 2302 patients (24.1%) with a death rate of 8.9%. The mean age and diabetes duration were significantly lower in infected versus non-infected patients. SARS-CoV-2 infection was more frequent in youngest people, according to quartile of age and retirement pension age of 65 years. No differences were detected considering sex. Higher HbA1c was detected in infected compared to non-infected patient. Death was predicted by diabetes duration and HbA1c. ROC analyses for death risk showed significant threshold for diabetes duration (10.9 years) and age (74.4 years). Conclusion: In our cohort, SARS-CoV-2 infection correlates with age, diabetes duration and disease control. Diabetic patients with COVID-19 should be carefully followed when older than 74 years and with more than 10 years of DM duration. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is a critical public health concern that has disproportionately affected the Black community in the United States. The purpose of this study was to examine the risk and protective factors faced by residents in the City of Miami Gardens during the COVID-19 pandemic, with emphases placed on racial health disparities and Black heterogeneity. Using convenience and snowball sampling, quantitative and qualitative data for this study were collected via an anonymous online questionnaire using QuestionPro. Survey links were distributed by e-mail invitations with assistance from city officials to the residents of this predominantly Black city in Florida (n = 83). Descriptive statistics and relevant qualitative responses are presented. Furthermore, a machine learning (ML) approach was used to select the most critical variables that characterized the two racial groups (Black versus non-Black participants) based on four ML feature selectors. Study findings offered important and interesting insights. Specifically, despite the greater prevalence of adopting measures to protect themselves and others from COVID-19, Black participants were more susceptible to activities that increased their COVID-19 risk levels. In addition, their rate of infection, particularly among the Afro-Caribbean ethnic group, was reported to be higher, indicating the need to further investigate the underlying conditions and root causes (including vaccine hesitancy and refusal) that contribute to their greater health disparities. [ABSTRACT FROM AUTHOR]

We investigate the impact that disparities in regional vaccine coverage have on the risk of infection for an unvaccinated individual. To address this issue, we develop an agent-based computational model of epidemics with two features: 1) a population divided among multiple regions with heterogeneous vaccine coverage; 2) contact networks for individuals that allow for both intra-regional interactions and inter-regional interactions. The benchmark version of the model is specified using county-level flu vaccination claims rates from California. We isolate the effects of heterogeneity by holding overall vaccination levels constant, while changing the variance in the distribution of regional vaccine coverage. We find that an increase in spatial heterogeneity leads to larger epidemics on average. This effect is magnified when more connections that are inter-regional exist in the contact structure of the networks. The central result in the paper is that there is a non-monotonic relationship between the infection risk and the geographic resolution of vaccination rate measurement. Infection risk of an unvaccinated individual decreases in both the global rate of vaccinations and the rate of vaccination of the individual’s specific contacts. Surprisingly, we find that the vaccination rate in an individual’s home region does not have a significant impact on an individual’s infection risk in our model. This has significant implications for an individual’s vaccine choices. Global and local (network specific) vaccination rates are highly correlated with infection risk and thus should be prioritized as information sources for rational decision-making. Using the region-specific information, however, is likely to lead to non-optimal decisions. [ABSTRACT FROM AUTHOR]

Introduction: Injecting drug use is a public health concern due to its clinical, social, economic, and legal consequences. Objective: (1) To evaluate the prevalence of infections associated with injecting drug use; and (2) To assess the social profile of substance users and high-risk behaviors among people who inject drugs (PWID) receiving opioid substitution therapy (OST). Materials and Methods: A cross-sectional study was conducted among 100 PWID who were deemed eligible using inclusion and exclusion criteria. Data were collected through an interviewer-administered structured questionnaire after obtaining informed written consent. Results: The results revealed that 14% of PWID had human immunodeficiency virus (HIV), 7% had tuberculosis, and 2% had hepatitis B virus (HBV). None of the PWID self-reported hepatitis C virus (HCV) infection. Importantly, 71% of PWID were living on the streets (i.e. homeless), and 41% of PWID had a history of sharing needles with other users in the preceding 3 months. Unmarried or single PWID had significantly increased risk of homelessness (χ2 = 4.570; P = 0.032) and reported high-risk sexual practices with commercial sexual partners in the preceding 3 months (χ2 = 4.163; P = 0.041). Homeless PWID had significantly increased frequency of injecting practices (P = 0.020). Conclusion: Despite the higher global prevalence of HCV compared with HBV and HIV among PWID, HCV testing is not currently conducted at most OST centers in India. Access to free needles and syringes should be enhanced to reduce the morbidity associated with injecting drug use.

Purpose: To examine the acute effects of concurrent muscle power and sport-specific endurance exercises order on immunological stress responses, muscular-fitness, and rating-of-perceived-exertion (RPE) in highly trained youth male judo athletes. Methods: Twenty male participants randomly performed two concurrent training (CT) sessions; power-endurance and endurance-power. Measures of immune response (e.g., white blood cells), muscular-fitness (i.e., counter-movement-jump [CMJ]), RPE, blood-lactate, and -glucose were taken at different time-point (i.e., pre, mid, post, and post6h). Results: There were significant time*order interactions for white blood cells, lymphocytes, granulocytes, granulocyte-lymphocyte-ratio, and systemic-inflammation-index. Power-endurance resulted in significantly larger pre-to-post increases in white blood cells and lymphocytes while endurance-power resulted in significantly larger pre-to-post increases in the granulocyte-lymphocyte-ratio and systemic-inflammation-index. Likewise, significantly larger pre-to-post6h white blood cells and granulocytes increases were observed following power-endurance compared to endurance-power. Moreover, there was a significant time*order interaction for blood-glucose and -lactate. Following endurance-power, blood-lactate and -glucose increased from pre-to-mid but not from pre-to-post. Meanwhile, in power-endurance blood-lactate and -glucose increased from pre-to-post but not from pre-to-mid. A significant time*order interaction was observed for CMJ-force with larger pre-to-post decreases in endurance-power compared to power-endurance. Further, CMJ-power showed larger pre-to-mid performance decreases following power-endurance, compared to endurance-power. Regarding RPE, significant time*order interactions were noted with larger pre-to-mid values following endurance-power and larger pre-to-post values following power-endurance. Conclusion: CT induced acute and delayed order-dependent immune cell count alterations in highly trained youth male judo athletes. In general, power-endurance induced higher acute and delayed immunological stress responses compared to endurance-power. CMJ-force and RPE fluctuated during both CT sessions but went back to baseline 6 h post-exercise. [ABSTRACT FROM AUTHOR]

Background & objectives: Research studies in the 1970s reported that in pre-school children, undernutrition increased the risk of infections and infections aggravated undernutrition. Over decades, there has been a reduction in prevalence of undernutrition and improvement in access to healthcare for treatment of infections. A mixed longitudinal study was undertaken to assess whether over time there were any changes from the earlier reported effect of undernutrition prior to infection on the risk of morbidity and effect of morbidity on nutritional status in pre-school children. Methods: Pre-school (0-59 months of age) children from urban low- and middle-income families whose parents were willing to allow their participation in the study were enrolled. Information on sociodemographic profile of the families was collected at enrolment. Weight of all children and length in infants were recorded every month; length/height in children 12-59 months of age was recorded once in three months. Morbidity information was collected through fortnightly visits. Results: 3888 pre-school children were followed up in 74636 home visits. Among these children, underweight and wasting were associated with a small increase in risk of infections. The odds ratio for risk of infection for underweight children was 1.09 (95% CI: 1.02 to 1.16) and for wasting was 1.18 (95% CI: 1.08 to 1.29). The deterioration in Z scores for weight-for-age and body mass index-for-age in children during illness and convalescence was small but significant (P<0.001). Interpretation & conclusions: The increased risk of infections in undernourished children living in overcrowded tenements in areas with poor environmental hygiene was not significant, perhaps because the risk of infection in normally nourished children was also high. The deterioration in nutritional status following infection was small because of the ready access to and utilization of health and nutrition care. [ABSTRACT FROM AUTHOR]

COVID-19 may accelerate the automation of jobs as employers invest in technology to safeguard against pandemics. We identify occupations that have high automation potential and also exhibit a high risk of viral infection. We examine regional variation in terms of which U.S. local labour markets are most at risk. Next, we outline the differential impacts COVID-19 may have on different demographic groups. We find that the highest-risk occupations in the U.S. are those held by females with mid- to low-wage and education levels. Using comparable data for 25 other countries, we also find that women in this demographic are at the highest risk internationally. [ABSTRACT FROM AUTHOR]

Despite the fact that COVID is today not a life-threat for the general population, recipients of solid organ transplantation should be viewed as a high risk group for severe COVID. Repetitive doses of SARS-CoV-2 vaccine still fail to protect SOT recipients from infection, disease or even death caused by COVID. A more frequent need for medical care may initially place these patients at greater chances of SARS-CoV-2 infection. Immunosuppression after engrafting and underlying medical conditions that led to the practice of SOT contribute to more risk of severe infection. Immunosuppression also blunts the intensity of humoral and cellular responses after vaccination, even when several booster doses have been administered. Still, vaccination is the best strategy to prevent a fatal outcome in case of SARS-CoV-2 infection, with a particular reduction in mortality. SOT recipients should be considered a high-risk population that need yearly SARS-CoV-2 vaccination. [ABSTRACT FROM AUTHOR]

Microbiological monitoring after infectious diseases in the system of epidemiological surveillance implies simultaneous pathogen identification both among patients and in hospital environment. Our aim is to assess potential hospital environmental hazard for the two in-patient infectious disease hospitals of the Khabarovsk city by using bacteriological and epidemiological analysis during new coronavirus disease pandemic. Materials and methods. Bacteriological assessment of nasopharyngeal microflora in 241 patients suffering from community-acquired pneumonia that were hospitalized in the two prevention and treatment facilities of the Khabarovsk city was performed. Sanitary-bacteriological control of hospital environment (428 hospital environment samples and 91 air samples) was carried out in parallel. Bacteriological assessment was performed with classical methods. Identification of isolated bacteriological pathogens and evaluation of drug-resistant strains were carried out by utilizing bacteriological analyzer Vitek 2 Compact. Results. Nine different pathogens (Pseudomonas aeruginosa, Pseudomonas stutzeri, Acinetobacter baumannii, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, Pantoea, Enterococcus faecium, Staphylococcus haemolyticus) were isolated in 20 out of 428 samples 4.7% [2.76.7]. Half of isolated agents 2.3% [0.93.8] were represented by drug-resistant isolates (10 out of 20 isolates) including 5 carbapenem-resistant isolates (Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae) and 5 isolates with multiple drug resistance (Enterobacter cloacae, Pantoea, Enterococcus faecium, Staphylococcus haemolyticus). Air samples contained pathogenic biological agents found in 6 out of 91 samples 6.6% [1.511.7], and half of them 3.3% [0.67.9] were identified as drug-resistant variants, including S. aureus и S. haemolyticus. One of the surveyed hospitals was recognized as more hazardous due to microflora isolated from intensive care unit (A. baumannii and P. aeruginosa were resistant to 3rd4th generation cephalosporins and carbapenems). Conclusion. Revealed circulation of wide range of microorganisms isolated from environment of two in-patient hospitals indicates high risk of healthcare-associated infections formation. Intensive care units can serve as a reservoir of healthcare-associated infections due to high percentage of patients with severe disease cases (main reservoir of drug-resistant strains).

Background: Covid-19 disease was first reported in December 2019 in Wuhan, China. Inflammatory connective tissue diseases include rheumatoid arthritis and lupus, and non-inflammatory types include osteoarthritis and discopathy. This study was performed to compare the severity and risk of COVID-19 in patients with inflammatory and non-inflammatory connective tissue diseases. Materials and Methods: This cross-sectional study was performed on patients with COVID-19 with positive PCR in a population of 2370 patients with inflammatory connective tissue (1030 cases) and non-inflammatory patients (1340 cases). Sampling was performed by convenience method. The collected data were analyzed by SPSS software version 16. Results: In this study, 190 patients (including 142 cases of inflammatory and 48 cases of non-inflammatory connective tissue disorders) with COVID-19. The risk of COVID-19 was estimated 8.01% in connective tissue cases, 13.8% in inflammatory connective tissue patients and 3.6% in cases with non-inflammatory types. Another finding of our study was a significant difference between the two groups of inflammatory and non-inflammatory connective tissue patients in terms of the severity of COVID-19, so that the severity of the infection was higher in the inflammatory group. Conclusion: The results of the present study show that the risk of COVID-19 is 3.8 times higher in patients with inflammatory connective tissue disorders than in patients with non-inflammatory connective tissue disorders.

Introduction: Injecting drug use is a public health concern due to its clinical, social, economic, and legal consequences. Objective: (1) To evaluate the prevalence of infections associated with injecting drug use; and (2) To assess the social profile of substance users and high-risk behaviors among people who inject drugs (PWID) receiving opioid substitution therapy (OST). Materials and Methods: A cross-sectional study was conducted among 100 PWID who were deemed eligible using inclusion and exclusion criteria. Data were collected through an interviewer-administered structured questionnaire after obtaining informed written consent. Results: The results revealed that 14% of PWID had human immunodeficiency virus (HIV), 7% had tuberculosis, and 2% had hepatitis B virus (HBV). None of the PWID self-reported hepatitis C virus (HCV) infection. Importantly, 71% of PWID were living on the streets (i.e. homeless), and 41% of PWID had a history of sharing needles with other users in the preceding 3 months. Unmarried or single PWID had significantly increased risk of homelessness (X2 = 4.570; P = 0.032) and reported high-risk sexual practices with commercial sexual partners in the preceding 3 months (X2 = 4.163; P = 0.041). Homeless PWID had significantly increased frequency of injecting practices (P = 0.020). Conclusion: Despite the higher global prevalence of HCV compared with HBV and HIV among PWID, HCV testing is not currently conducted at most OST centers in India. Access to free needles and syringes should be enhanced to reduce the morbidity associated with injecting drug use. [ABSTRACT FROM AUTHOR]

Cryptosporidium and Giardia are pathogenic agents which cause risk to public health. The goal of this research was to evaluate the risk of infection by cryptosporidiosis and giardiasis in a population of the Cerrado biome and its relation to land use. Raw water samples were collected from 41 different surface sources of the state of Goiás (Brazil). The parasites were quantified via the membrane filtration method. The probability of an individual contracting an infection after consuming contaminated water was estimated using the quantitative microbial risk assessment. Generally, the analyzed watersheds (WS) presented Giardia cysts in 63.4% of the samples (

Abstract Background The COVID-19 pandemic has disproportionately impacted economically-disadvantaged populations in the United States (US). Precarious employment conditions may contribute to these disparities by impeding workers in such conditions from adopting COVID-19 mitigation measures to reduce infection risk. This study investigated the relationship between employment and economic conditions and the adoption of COVID-19 protective behaviors among US workers during the initial phase of the COVID-19 pandemic. Methods Employing a social media advertisement campaign, an online, self-administered survey was used to collect data from 2,845 working adults in April 2020. Hierarchical generalized linear models were performed to assess the differences in engagement with recommended protective behaviors based on employment and economic conditions, while controlling for knowledge and perceived threat of COVID-19, as would be predicted by the Health Belief Model (HBM). Results Essential workers had more precarious employment and economic conditions than non-essential workers: 67% had variable income; 30% did not have paid sick leave; 42% had lost income due to COVID-19, and 15% were food insecure. The adoption of protective behaviors was high in the sample: 77% of participants avoided leaving home, and 93% increased hand hygiene. Consistent with the HBM, COVID-19 knowledge scores and perceived threat were positively associated with engaging in all protective behaviors. However, after controlling for these, essential workers were 60% and 70% less likely than non-essential workers, who by the nature of their jobs cannot stay at home, to stay at home and increase hand hygiene, respectively. Similarly, participants who could not afford to quarantine were 50% less likely to avoid leaving home (AOR: 0.5; 95% CI: 0.4, 0.6) than those who could, whereas there were no significant differences concerning hand hygiene. Conclusions Our findings are consistent with the accumulating evidence that the employment conditions of essential workers and other low-income earners are precarious, that they have experienced disproportionately higher rates of income loss during the initial phase of the COVID-19 pandemic and face significant barriers to adopting protective measures. Our findings underscore the importance and need of policy responses focusing on expanding social protection and benefits to prevent the further deepening of existing health disparities in the US.

Free-living amoebae (FLA) are cosmopolitan microorganisms known to be pathogenic to humans who often have a history of contact with contaminated water. Swimming pools and recreational waters are among the environments where the greatest human exposure to FLA occurs. This study aimed to determine the prevalence of FLA in swimming pools and recreational waters, through a systematic review and meta-analysis that included studies published between 1977 and 2022. A total of 106 studies were included and an overall prevalence of FLA in swimming pools and recreational waters of 44.34% (95% CI = 38.57–50.18) was found. Considering the studies published up to 2010 (1977–2010), between 2010 and 2015, and those published after 2010 (> 2010–2022), the prevalence was 53.09% (95% CI = 43.33–62.73) and 37.07% (95% CI = 28.87–45.66) and 45.40% (95% CI = 35.48–55.51), respectively. The highest prevalence was found in the American continent (63.99%), in Mexico (98.35%), and in indoor hot swimming pools (52.27%). The prevalence varied with the variation of FLA detection methods, morphology (57.21%), PCR (25.78%), and simultaneously morphology and PCR (43.16%). The global prevalence by genera was Vahlkampfia spp. (54.20%), Acanthamoeba spp. (33.47%), Naegleria spp. (30.95%), Hartmannella spp./Vermamoeba spp. (20.73%), Stenamoeba spp. (12.05%), and Vannella spp. (10.75%). There is considerable risk of FLA infection in swimming pools and recreational waters. Recreational water safety needs to be routinely monitored and, in case of risk, locations need to be identified with warning signs and users need to be educated. Swimming pools and artificial recreational water should be properly disinfected. Photolysis of NaOCl or NaCl in water by UV-C radiation is a promising alternative to disinfect swimming pools and artificial recreational waters. [ABSTRACT FROM AUTHOR]

To investigate the motion of virus‐laden droplets between moving passengers in line, we performed numerical simulations of the distribution of airborne droplets within a geometrically detailed model similar to an actual escalator. The left and right sides and the ceiling of the escalator model were surrounded by walls, assuming a subway used by many people every day with concern to virus‐laden droplets. Steps and handrails were incorporated in the model to faithfully compute the escalator‐specific flow field. The ascending and descending movements of the escalator were performed with 10 or 5 passengers standing at different boarding intervals. To resolve the unsteady airflow that is excited by a moving boundary consisting of passengers, steps, and handrails, the moving computational domain method based on the moving‐grid finite‐volume method was applied. On the basis of the consideration that the droplets were small enough, droplet dispersion was computed by solving the equation of virus‐laden droplet motion using a pre‐computed velocity field, in which the flow rate of a cough, diameter distribution, and evaporation of droplets are incorporated. The simulation resolved the detailed motion of droplets in flow, and therefore, we were able to evaluate the risk of viral adhesion to following passengers. As a result, we found that the ascending escalator had a higher risk of being exposed to virus‐laden droplets than the descending escalator. We also reported that the chance of viral droplet adhesion decreases as the distance from the infected person increases, emphasizing the importance of social distancing. [ABSTRACT FROM AUTHOR]

The present study aimed to explore the opportunities for the sustainable development of professional sports enterprises and events from the perspective of the public's awareness, attitude, and behavior, as well as the physical and mental health of the spectators of professional events in Taiwan. First, 1,129 valid questionnaires were collected and analyzed by statistical, t test, and ANOVA methods. In addition, 9 respondents were interviewed to provide their personal opinions on the questionnaire results, and finally, multivariate analysis was conducted. Sports entrepreneurs must follow the decision to prevent the epidemic, make good use of Internet technology, plan a complete process, and use accurate testing facilities to grasp the movements of participants. They will win public recognition to maintain professional sports companies and events in COVID-19 and normal operation under the epidemic and create a sustainable environment for professional sports companies and events. [ABSTRACT FROM AUTHOR]

• Crude risk of COVID-19 infection is similar in HCWs in ICU and non-ICU settings • The risk becomes higher in ICU after adjusting for professional categories of HCWs • Nurses had higher ICU risk than other professional categories • Support staff had the highest risk irrespective of ICU working status • The differential risk is determined by both exposure level and protection practices The higher risk of COVID-19 in health care workers (HCWs) is well-known. However, the risk within HCWs is not fully understood. The objective was to compare the COVID-19 risk in intensive care unit (ICU) vs non-ICU locations. A prospective surveillance study was conducted among HCWs at a large tertiary care facility in Riyadh between March 1st to November 30th, 2020. HCWs included both clinical (provide direct patient care) and nonclinical positions (do not provide direct patient care). A total 1,594 HCWs with COVID-19 were included; 103 (6.5%) working in ICU and 1,491 (93.5%) working in non-ICU locations. Compared with non-ICU locations, ICU had more nurses (54.4% vs 22.1%, P <.001) and less support staff (2.9% vs 53.1%, P <.001). COVID-19 infection was similar in ICU and non-ICU locations (9.0% vs 9.8%, P =.374). However, it was significantly higher in ICU nurses (12.3% vs 6.5%, P <.001). Support staff had higher risk than other HCWs, irrespective of ICU working status (15.1% vs 7.2%, P < 0.001). The crude relative risk of COVID-19 in ICU vs non-ICU locations was 0.92, 95% confidence interval (was 0.76-1.11 (P =.374). However, relative risk adjusted for professional category was significantly increased to 1.23, 95% confidence interval 1.01-1.50 (P =.036). ICU had a significantly higher risk of COVID-19 infection only after adjusting for the distribution and risk of different professional categories. The latter is probably determined by both exposure level and protection practices. The finding underscores the importance of strict implementation of preventive measures among all HCWs, including those performing nonclinical services. [ABSTRACT FROM AUTHOR]

Background. Medical workers are a group that is particularly vulnerable to infection during the coronavirus disease 2019 (COVID-19) pandemic. Objectives. The study aimed to assess the risk of COVID-19 infection and its course in the medical staff of a COVID-only and a non-COVID hospital. Materials and methods. The observational study included 732 participants who were medical workers. The study was conducted between June 2020 and December 2020, before widespread COVID-19 immunization was introduced. Results. Of the 732 employees of the hospitals, 377 had a history of COVID-19. The risk of disease was twice as high in the medical staff of the COVID-only hospital compared to the medical staff of the non-COVID hospital (odds ratio (OR) = 2.0; p < 0.001). Among medical personnel, 20.6% of the participants were asymptomatic and 6.4% required hospitalization. For the non-COVID hospital, the employees who were most frequently infected with COVID-19 were nurses/paramedics/medical caretakers. The factor influencing the risk of infection was body mass index (BMI; OR = 1.05; p = 0.004). The risk of COVID-19 infection was lower in the influenza vaccine group (OR = 2.23, p < 0.001). Conclusions. The study results indicate that employees of the hospital treating only COVID patients have a higher risk of infection. Previous observations on factors predisposing to COVID-19 infection like gender and BMI were confirmed. However, the observations carried out on the studied population did not confirm the influence of other factors, such as the coexistence of chronic diseases (apart from diabetes) on the risk of developing COVID-19. In addition, we noticed that seasonal influenza vaccination has a beneficial effect in patients with COVID-19 infection. [ABSTRACT FROM AUTHOR]

Key learnings from some landmark studies that the author has been associated with and their implications on program strategies are highlighted. Learnings from prevalence surveys provide justification for active TB Case finding (ACF), role of Chest X-ray screening, justification of the elderly as a key vulnerable population and suggest re-think of the methods of sub-national certification for progress towards tuberculosis free status. Risk of infection studies suggest 14 million people acquiring new tuberculous infection each year in India suggesting a re-think on the targets for TB elimination. Justification is given for 'TB deaths averted' as a parameter for monitoring program impact, reviving risk of infection surveys using CyTB and higher emphasis on careful analysis of routine surveillance data for monitoring epidemiological trends rather than oft-repeated surveys. The modelling outputs suggest higher focus on reducing transmission of infection in urban and reducing treatment delay in rural areas and the need to scale up active case finding and TB preventive treatment in order to achieve End TB targets. Case finding studies justify upfront molecular diagnostics, need to confirm a single sputum result by another specimen or radiology during ACF and futility of X-ray based diagnosis during ACF. High rates of recurrence with intermittent treatment regimen providing evidence in favor of daily regimen, role of family centric approach to nutritional supplementation to prevent TB mortality and reduce TB incidence among household contacts are highlighted besides the need to address high proportion of families suffering catastrophic expenses during pre-treatment period., Competing Interests: Declaration of competing interest 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., (Copyright © 2024 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

Background: The COVID-19 pandemic has disproportionately impacted economically-disadvantaged populations in the United States (US). Precarious employment conditions may contribute to these disparities by impeding workers in such conditions from adopting COVID-19 mitigation measures to reduce infection risk. This study investigated the relationship between employment and economic conditions and the adoption of COVID-19 protective behaviors among US workers during the initial phase of the COVID-19 pandemic.Methods: Employing a social media advertisement campaign, an online, self-administered survey was used to collect data from 2,845 working adults in April 2020. Hierarchical generalized linear models were performed to assess the differences in engagement with recommended protective behaviors based on employment and economic conditions, while controlling for knowledge and perceived threat of COVID-19, as would be predicted by the Health Belief Model (HBM).Results: Essential workers had more precarious employment and economic conditions than non-essential workers: 67% had variable income; 30% did not have paid sick leave; 42% had lost income due to COVID-19, and 15% were food insecure. The adoption of protective behaviors was high in the sample: 77% of participants avoided leaving home, and 93% increased hand hygiene. Consistent with the HBM, COVID-19 knowledge scores and perceived threat were positively associated with engaging in all protective behaviors. However, after controlling for these, essential workers were 60% and 70% less likely than non-essential workers, who by the nature of their jobs cannot stay at home, to stay at home and increase hand hygiene, respectively. Similarly, participants who could not afford to quarantine were 50% less likely to avoid leaving home (AOR: 0.5; 95% CI: 0.4, 0.6) than those who could, whereas there were no significant differences concerning hand hygiene.Conclusions: Our findings are consistent with the accumulating evidence that the employment conditions of essential workers and other low-income earners are precarious, that they have experienced disproportionately higher rates of income loss during the initial phase of the COVID-19 pandemic and face significant barriers to adopting protective measures. Our findings underscore the importance and need of policy responses focusing on expanding social protection and benefits to prevent the further deepening of existing health disparities in the US. [ABSTRACT FROM AUTHOR]

This study assessed solid healthcare (SHC) waste management practices and levels of heavy metals in soils within four public healthcare facilities in Abeokuta, Nigeria. Walkthrough observation and one-on-one interviews were used to elicit information on waste management practices. Topsoils of waste storage areas were collected and analyzed for heavy metals using Atomic Absorption Spectrometry. SHC general waste is often burnt and buried at the general hospitals while licensed private operators collect it at the Clinics and Specialist hospitals. The Specialist Hospitals generate the highest weight of all the waste categories and in the order; general > infectious > sharps > pathological > pharmaceutical, with the clinic having the highest rate of waste generated/patient (0.8kg/day). Heavy metal concentration (mg/kg) ranges are 5321.46 -- 9356.49 (Fe), 96.72 -- 314.49 (Zn) and 8.58 - 20.77 (Cr), with an indication of potential non-carcinogenic risks for all exposure routes for both adults and children. Mixed storage of all waste types is still being practised in some healthcare facilities, which portends the risk of infection transmission and environmental pollution. Hence, there is a need to improve the segregation and special handling of SHCW to avoid environmental contamination and negative health-related impacts. [ABSTRACT FROM AUTHOR]

Background: Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a pandemic threat to global health. We are now in the fourth wave of this pandemic. As the pandemic developed, the requirements and therapeutic endoscopic procedures for SARS-CoV-2-positive patients underwent changes. Methods: Analysis of implications for an endoscopy unit during the first and second/third waves of the COVID-19 pandemic with a focus on COVID-19-related process changing. Addressed are number of SARS-CoV-2-positive patients and endoscopic examinations performed in patients who tested positive for SARS-CoV-2 during the various waves, adherence to scheduled examinations, rotation of staff to COVID-dedicated structures and, finally, impact of vaccination on infection rate among endoscopic staff. Results: During the first wave, 10 SARS-CoV-2-positive in-house patients underwent a total of 22 gastrointestinal (GI) endoscopic procedures. During the second and third waves, 59 GI endoscopies were performed in 38 patients. While in the first wave, GI bleeding was the main indication for endoscopy (82%), in the second and third waves the main indication for endoscopy was endoscopic insertion of deep feeding tubes (78%; p < 0.001). During the first wave, 5 (17%) of 29 Interdisciplinary Endoscopy Unit (IEU) staff members were moved to designated COVID wards, which was not necessary during the following waves. Lack of protective clothing was critical during the first wave, but not in the later waves. Screening tests for patients and staff were widely available after the first wave, and IEU staff was vaccinated during the second wave. Conclusion: Strategies to ensure safe endoscopies with respect to preventing transmission of SARS-CoV-2 from patients to staff were effective. Organizational adjustments allowed the routine program to continue unaffected. Indications for GI endoscopies changed over time: during the first wave, GI endoscopies were performed for life-threatening indications, whereas later supportive procedures were the main indication. [ABSTRACT FROM AUTHOR]

In this study, the risk of infection from SARS‐CoV‐2 Delta variant of passengers sharing a car cabin with an infected subject for a 30‐min journey is estimated through an integrated approach combining a recently developed predictive emission‐to‐risk approach and a validated CFD numerical model numerically solved using the open‐source OpenFOAM software. Different scenarios were investigated to evaluate the effect of the infected subject position within the car cabin, the airflow rate of the HVAC system, the HVAC ventilation mode, and the expiratory activity (breathing vs. speaking). The numerical simulations here performed reveal that the risk of infection is strongly influenced by several key parameters: As an example, under the same ventilation mode and emitting scenario, the risk of infection ranges from zero to roughly 50% as a function of the HVAC flow rate. The results obtained also demonstrate that (i) simplified zero‐dimensional approaches limit proper evaluation of the risk in such confined spaces, conversely, (ii) CFD approaches are needed to investigate the complex fluid dynamics in similar indoor environments, and, thus, (iii) the risk of infection in indoor environments characterized by fixed seats can be in principle controlled by properly designing the flow patterns of the environment. [ABSTRACT FROM AUTHOR]

ABSTRACT Colonization by KPC-producing Klebsiella pneumoniae (KPC-Kp) is associated with the risk of developing KPC-Kp infection. The impact of the time elapsed since a patient becomes colonized on this risk is not well known. An observational, prospective, longitudinal cohort study of colonized patients undergoing active rectal culture screening to rule out KPC-Kp colonization (July 2012 to November 2017). Patients with a positive culture at inclusion (colonized at start of follow-up) and those with a negative culture at inclusion who became colonized within 90 days (colonized during follow-up) were included in the analysis. CART analysis was used to dichotomize variables according to their association with infection. Kaplan–Meier infection-free survival curves and the log-rank test were used for group comparisons. Logistic regression was used to identify variables associated with KPC-Kp infection. Among 1310 patients included, 166 were colonized at the end of follow-up. Forty-seven out of 118 patients colonized at start of follow-up developed infection (39.8%) versus 31 out of 48 patients colonized during follow-up (64.6%; P = 0.006). Variables associated with KPC-Kp infection in the logistic regression analysis were: colonization detection during follow-up (OR, 2.74; 95% CI, 1.07 to 7.04; P = 0.03), Giannella risk score (OR, 1.51; 95% CI, 1.32 to 1.73; P < 0.001), high-risk ward (OR, 4.77; 95% CI, 1.61 to 14.10; P = 0.005) and urological manipulation after admission (OR, 3.69; 95% CI, 1.08 to 12.60; P = 0.04). In 25 out of 31 patients (80.6%) colonized during follow-up who developed KPC-Kp infection, infection appeared within 15 days after colonization. The risk of KPC-Kp infection was higher when colonization is recently acquired during hospitalization. In this prospective study, we concluded that the timing of colonization was a factor to assess when considering empirical treatment for suspected KPC-Kp infection and prophylaxis or infection control. IMPORTANCE In this study, it was confirmed that patients who became colonized during hospitalization had a higher risk of developing KPC-Kp infection than hospitalized patients who were already colonized at the start of follow-up. Besides, the risk of infection in the group of patients who became colonized during follow-up was greater in the first weeks immediately after colonization was confirmed. Our findings support the need for designing preventive strategies for patients at the highest risk of infection development, including those admitted in high-risk hospital wards and those undergoing urological procedures.

ObjectivesGiven the high occurrence of asymptomatic subsets, the true prevalence of SARS-CoV-2 infection in rheumatic patients is still underestimated. This study aims to evaluate the seroprevalence of SARS-CoV-2 antibodies in rheumatic musculoskeletal diseases (RMD) patients receiving immunomodulatory drugs.MethodsAll consecutive patients with rheumatoid arthritis or spondyloarthritis receiving disease-modifying antirheumatic drugs (DMARDs) evaluated between 4th May and 16th June 2020 were included. All participants were tested for anti-SARS-CoV-2 antibodies (IgG, IgM, IgA) by ELISA and were questioned about previous COVID-19 symptoms and clinical course. Results were compared with healthy population from the same region and with a control group of healthy subjects diagnosed with confirmed COVID-19.ResultsThe study population includes 358 patients. The overall prevalence of anti-SARS-CoV-2 antibodies (18.4%) was higher than prevalence rate based on swab-positivity (1.12%) or clinically suspected cases (10.6%), but consistent with seroprevalence observed in the healthy population. Among seropositive patients 58% were asymptomatic. Mean anti-SARS-CoV-2 titer was comparable with the control group. No differences in seroprevalence were observed according to age, sex, rheumatic disease and treatment with conventional, biologic or targeted synthetic DMARDs, whereas glucocorticoids and comorbidities resulted in higher seroprevalence rate.ConclusionsThe results of this study are reassuring about the low impact of RMDs and immunomodulatory therapies on the risk and clinical course of COVID-19 and on humoral immune response to SARS-CoV-2 infection.

Introduction: There are concerns about pulmonary function tests (PFTs) being associated with aerosol generation and enhanced virus transmission. As a consequence, the number of PFTs was reduced significantly during the coronavirus disease 2019 pandemic. However, there are no robust data supporting this fear.Objectives: To perform real-life measurement of aerosol concentrations in a PFT laboratory to monitor the concentration of particles near the patient, and to model the associated potential viral load.Methods: Two optical particle counters were used to sample the background concentration and the concentration of particles near the patient's mouth in a whole-body plethysmography box. Statistical evaluation of the measured particle concentration time series was completed. The particle exhalation rate was assessed based on the measured particle concentration data by applying the near-field/far-field theory. The number of exhaled viruses by an infected patient during the test was compared with the emission of viruses during quiet breathing and speaking.Results: Twenty-five patients were included in the study. Eighteen patients showed a significant increase in aerosol concentration [mean 1910 (standard deviation 593) particles/L]. Submicron particles dominated the number size distribution of the generated particles, but large particles represented a higher volume fraction in the generated particles compared with background. An average gene exhalation rate of 0.2/min was estimated from this data. This is one order of magnitude higher than the release rate for the same infected person during quiet breathing, and of the same order of magnitude as the release rate during normal speaking.Conclusions: This study demonstrated that PFTs are aerosol-generating procedures. Based on these results, the moderate increase in viral load does not underpin stopping such examinations. [ABSTRACT FROM AUTHOR]

Cryptosporidium and Giardia are pathogenic agents which cause risk to public health. The goal of this research was to evaluate the risk of infection by cryptosporidiosis and giardiasis in a population of the Cerrado biome and its relation to land use. Raw water samples were collected from 41 different surface sources of the state of Goiás (Brazil). The parasites were quantified via the membrane filtration method. The probability of an individual contracting an infection after consuming contaminated water was estimated using the quantitative microbial risk assessment. Generally, the analyzed watersheds (WS) presented Giardia cysts in 63.4% of the samples (Cryptosporidium oocysts in 87.8% of the samples (Cryptosporidium, in which the possible contamination source is the excrements of animals. There is a greater risk of giardiasis. It is concluded that there is a need to implement improvement actions regarding environmental quality and the management of the use and occupation of surface sources in the Cerrado Biome, in order to reduce the spreading of diseases and negative impacts to the local population.

The risk of viral transmission of SARS-CoV-2 associated with football (soccer) training and match play is unknown. Therefore, studies on infection-relevant contacts in football are of utmost importance. A retrospective video-based analysis was performed over 3 matches with 18 SARS-CoV-2 positive players (age: 17.6 ± 3.1 years; 2 professional, 2 semi-professional and 14 youth academy players) during the pre-season in August and September 2020 in Germany. Repeated RT-PCR tests were performed in 5 of 6 teams and pre-match RT-PCR tests in 4 of 6 teams. The last RT-PCR test ranged between 5 − 14 days post-match. The most important result was that no case of virus transmission was found as documented by RT-PCR tests (and symptom monitoring up to 14 days post-match). Physical contact between contagious and non-infected players never lasted longer than 3 seconds each and the position of players during duels was almost exclusively laterally or behind each other. In conclusion, very low risk of SARS-CoV-2 transmission during football match play has been documented. Nevertheless, due to the observational retrospective design of the study, which was based on ethical reasons, inconsistent RT-PCR testing should be regarded as limitation and larger studies are needed to confirm a low probability of virus transmission. [ABSTRACT FROM AUTHOR]

Introduction: Since the Covid-19 pandemic, research has focused on identifying people at risk and preventing its spread. The aim of this study was to investigate the relationship between blood groups (ABO) and the risk of COVID-19 infection in Shahroud. Methods: This study is an analytical cross-sectional study. Data from suspected cases of Covid-19 were collected in Shahroud by the Corona Registration System from the beginning of the epidemic in February 2020. In this study, confirmed cases of Covid-19 were defined as those that had a positive RT-PCR test. Logistic regression was used in order to investigate the relationship between ABO and COVID-19 infection, and other variables, such as co-morbidities, age, and gender also were adjusted. Results: In this study, the highest percentage of positive PCR was for B type (49.6%) and then AB (43.1%), but this difference was not significant. In the modeling, a significant relationship was observed between B type and Covid-19 infection, so that the risk is 56% higher. Also, in the study of the relationship between non-O blood groups and adjusted for the variables of age, gender, and comorbidities, it was shown that non-O blood type compared to O blood type increased the odds of infection by35% significantly. Rh did not show a significant association with infection. Conclusion: This study showed that non-O blood types have higher odds of developing Covid-19 compared to the O blood type. Among the various blood types, type B increases the odds of infection by 56%. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak caused major disruptions on individuals’ out-of-home activities. Worldwide mandates to slow down the spread of the disease resulted in significant reductions in travel. This study analyzes the changes in individuals’ travel outcomes and their risk perceptions related to exposure and specific travel modes during the COVID-19 pandemic. We use data collected through an online survey with residents of Columbus, OH from April 30 to May 7, 2020. Employing multiple generalized estimating equations (GEEs) with a logit link function, we analyze the perceived risk of infection while traveling with different modes controlling for socio-demographics. The findings show that on average individuals are more likely to find shared modes (i.e., transit, ride-hailing, carsharing) riskier as compared to individual ones (i.e., walking, autos) when it comes to COVID-19 exposure. This study also suggests that the associations between perceptions related to exposure and various travel modes vary across groups with (1) different primary mode preferences (auto users vs non-auto users (e.g., transit users, bicyclists, etc.)), and (2) different socio-demographics. For example, auto users are more likely to find shared modes such as ride-hailing or transit riskier as compared to personal car. The conclusions present recommendations for future transportation policies in the post-COVID era. These include building upon the emerging positive perceptions towards non-motorized modes as an opportunity to promote sustainable transportation as well as formulating viable solutions to address the high-risk perceptions associated with transit.

Securing healthcare workers and patients against the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection/transmission, require the development of new tools and methods. Several laboratories have started recently clinical trials to develop vaccines and drugs, however these solutions require more time to evaluate and validate them. As an alternative and in order to stop the spread of SARS-CoV-2 infection, our objective is to implement preventive and corrective actions to reduce the infectious/transmission risk of SARS-COV-2 during hospital retrocession, using the failure mode effect analysis (FMEA) method. The criticality of each failure mode was assessed by calculating the criticality index (CI). The obtained data showed 12 fault modes with a total criticality index (CI) of 480, two acceptable risks, four significant risks and six critical risks. Ten risks were identified as priorities (CI > 15): four related to patient reception, two related to personnel, two during dispensation, one related to the end of dispensation and the last related to traceability. These risks were corrected by improvement actions proposed by FMEA and then re-evaluated effectively. This study assessed the feasibility and relevance of the use ofFMEA in the hospital retrocession dispensing process related to the infectious/transmission risk of SARS-CoV-2. Finally, FMEA seems to be an effective method to reduce the infectious/transmission risk of SARS-COV-2 during hospital retrocession. [ABSTRACT FROM AUTHOR]

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Almost every year in Kazakhstan, cases of diseases of animals and people with anthrax are recorded. The incidence rate of people with anthrax in the period from 2000 to 2018 ranged from 0.01 to 0.24 per 100 thousand people. In the territory of the East Kazakhstan region, the incidence rate is higher than in the republic.Objective: a retrospective analysis of anthrax outbreaks in the East Kazakhstan region from 2000 to 2018.Methods: a retrospective analysis using statistical, cadastral data, archival funds, the results of participation in the investigation of outbreaks of infection.Results. Since 1938, cases of animal and human disease of anthrax have been recorded in East Kazakhstan. Infection of humans occurs during the slaughter of animals. In Zharma, Urjar, and Ayagozskiy areas most of all are anthrax foci of soil. In 67 % of cases, outbreaks of anthrax were recorded in these areas.Conclusion. The relative incidence rate of anthrax in people in East Kazakhstan is from 0.07 to 0.27, since 2001 it is higher than the republican indicator.In the East Kazakhstan region from 1997 to 2018, 37 people fell ill with anthrax. The form of the disease is skin, in 8.1 % secondary sepsis. In the remaining patients, the diseases were mild (70.3 %), ended in recovery. The source of human infection is mainly cattle. The isolated strains of B. anthracis have typical properties, they are included in cluster A1a, A3b (MLVA-8). The strains isolated in 2016 are similar to the strains isolated in the Almaty region (MLVA-25). Grouped with a number of European, Asian and African strains from France, Germany, Italy, Tajikistan, Pakistan, Korea and Namibia. The presence of a significant number of soil foci of anthrax in the territory of the East Kazakhstan region, not fully the implementation of veterinary and sanitary preventive measures leads to an exacerbation of the situation for anthrax.

The purpose of the research: to evaluate the sanitary-parasitological status of urban waste water and the effectiveness of its disinvasion at the station of biological elimination of Yakutsk. Materials and methods. Taking of water samples and their sanitary-parasitological research have run in compliance to generally accepted in parasitology methods and confirmed statutory documents. For evaluation of the epidemical situation on tapeworm disease morbidity parameters were used, long-time average annual morbidity parameter. Results and discussion. Evaluation of parasitological pollution of sewer waste water in Yakutsk has shown that in water samples taken before clean-up as well as dregs from degritter ascaride and difillobotriida eggs were registered in 100 % cases. Ascaride and difillobotriida eggs were educed after mechanical treatment and in dregs from n-filter in 100% and 80% respectively, and also after repeated mechanical treatment and bio-treatment of water by active sludge in 33% and 17% specimens respectively. Sound eggs of ascariasis and diphyllobothriasis germs were founded in 18% and 9% water specimens respectively post-run ultraviolet irradiation. Eggs of enterobiasis germ were founded in 17% specimens of waste water. Mechanical treatment and bio-treatment cut a share of positive specimen to 8%. Seat worm’s eggs haven’t found in water samples after ultraviolet irradiation of drains. During all period of research taeniidae’s hexacanths and whipworm’s eggs haven’t found. Disinvasion methods, applied at sewage treatment facilities of Yakutsk, don’t guarantee the germs eradication of parasitic disease and don’t warrant epidemiological water safety as for ascaride and difillobotriida germs. Public utility drains, polluted by propagative forms of bio- and soil-transmitted helminth, are among of factors conditioning negative sanitary-parasitological situation of Lena river, having detrimental effect on ecological and epidemiological situation upon parasitic disease in the region.