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Abstract Background Contacts between people and free-ranging animals have a potential to cause viral disease epidemics when novel viruses are exchanged. The Netherlands has approximately 18 native bat species, of which some generally use buildings for roosting, and has a dense human population. Frequent indirect and direct contacts between bats and humans could thus be expected, however, this has hardly been studied. Methods To study human-bat contacts, people living in the Netherlands were questioned about the type and frequency of their bat contacts, their bat knowledge and perception of bats. For analyses respondents were grouped into (1) general population, (2) bat contact risk group, and (3) people that live in a house with a roost site for a Common Pipistrelle Bat maternity group. Associations between human-bat contacts and other variables were tested by an ordinal logistic regression model. Results We show that 85% (226/265) of group 1 reported no contacts, while 11% (28/265) reported indirect, and 4% (11/265) direct contacts with live bats, dead bats or bat products as their closest type of contacts. These contacts occurred mostly less than yearly. Somewhat similarly, the majority, 69% (9/13) of group 3 reported no contacts, and 15% (2/13) reported indirect contacts and 15% (2/13) reported direct contacts. These occurred monthly to less than yearly. In contrast, a minority, 5% (11/227) in group 2 reported no contacts, while 37% (85/227) reported direct bat contacts, mostly yearly, and 38% (86/227) reported bat-related injury, mostly less than yearly, as their closest type of contact. Overall, an increase in knowledge on bats and bat-related diseases was correlated with closer bat contacts. Conclusions We conclude that even though bats live close to people in the Netherlands, direct contacts between bats, or bat products, and humans are rare in people from the general population, while being common in people involved in bat-related work. Mitigation of human-bat contacts will be most efficient when targeted to specific groups that are likely to have contacts with bats.

Cruise ships have long been associated with an increased risk for outbreaks of infectious diseases, illustrated by transmissions of respiratory pathogens and pathogenic microorganisms spreading by the fecal-oral route (2-5). [...]

Abstract The inability of adult human cardiomyocytes to proliferate is an obstacle to efficient cardiac regeneration after injury. Understanding the mechanisms that drive postnatal cardiomyocytes to switch to a non-regenerative state is therefore of great significance. Here we show that Arid1a, a subunit of the switching defective/sucrose non-fermenting (SWI/SNF) chromatin remodeling complex, suppresses postnatal cardiomyocyte proliferation while enhancing maturation. Genome-wide transcriptome and epigenome analyses revealed that Arid1a is required for the activation of a cardiomyocyte maturation gene program by promoting DNA access to transcription factors that drive cardiomyocyte maturation. Furthermore, we show that ARID1A directly binds and inhibits the proliferation-promoting transcriptional coactivators YAP and TAZ, indicating ARID1A sequesters YAP/TAZ from their DNA-binding partner TEAD. In ischemic heart disease, Arid1a expression is enhanced in cardiomyocytes of the border zone region. Inactivation of Arid1a after ischemic injury enhanced proliferation of border zone cardiomyocytes. Our study illuminates the pivotal role of Arid1a in cardiomyocyte maturation, and uncovers Arid1a as a crucial suppressor of cardiomyocyte proliferation.

Background: Contacts between people and free-ranging animals have a potential to cause viral disease epidemics when novel viruses are exchanged. The Netherlands has approximately 18 native bat species, of which some generally use buildings for roosting, and has a dense human population. Frequent indirect and direct contacts between bats and humans could thus be expected, however, this has hardly been studied. Methods: To study human-bat contacts, people living in the Netherlands were questioned about the type and frequency of their bat contacts, their bat knowledge and perception of bats. For analyses respondents were grouped into (1) general population, (2) bat contact risk group, and (3) people that live in a house with a roost site for a Common Pipistrelle Bat maternity group. Associations between human-bat contacts and other variables were tested by an ordinal logistic regression model. Results: We show that 85% (226/265) of group 1 reported no contacts, while 11% (28/265) reported indirect, and 4% (11/265) direct contacts with live bats, dead bats or bat products as their closest type of contacts. These contacts occurred mostly less than yearly. Somewhat similarly, the majority, 69% (9/13) of group 3 reported no contacts, and 15% (2/13) reported indirect contacts and 15% (2/13) reported direct contacts. These occurred monthly to less than yearly. In contrast, a minority, 5% (11/227) in group 2 reported no contacts, while 37% (85/227) reported direct bat contacts, mostly yearly, and 38% (86/227) reported bat-related injury, mostly less than yearly, as their closest type of contact. Overall, an increase in knowledge on bats and bat-related diseases was correlated with closer bat contacts. Conclusions: We conclude that even though bats live close to people in the Netherlands, direct contacts between bats, or bat products, and humans are rare in people from the general population, while being common in people involved in bat-related work. Mitigation of human-bat contacts will be most efficient when targeted to specific groups that are likely to have contacts with bats. [ABSTRACT FROM AUTHOR]

We used national registry data on human cases of Francisella tularensis subspecies holarctica infection to assess transmission modes among all 26 autochthonous cases in the Netherlands since 2011. The results indicate predominance of terrestrial over aquatic animal transmission sources. We recommend targeting disease-risk communication toward hunters, recreationists, and outdoor professionals.

Purpose: To assess the safety and technical feasibility of in-vivo needle-based forward-looking confocal laser endomicroscopy in prostate tissue. Methods: For this feasibility study, 2 patients with a suspicion of prostate cancer underwent transperineal needle-based confocal laser endomicroscopy during ultrasound-guided transperineal template mapping biopsies. After intravenous administration of fluorescein, needle-based confocal laser endomicroscopy imaging was performed with a forward-looking probe (outer diameter 0.9 mm) in 2 trajectories during a manual push-forward and pullback motion. A biopsy was taken in a coregistered parallel adjacent trajectory to the confocal laser endomicroscopy trajectory for histopathologic comparison. Peri- and postprocedural adverse events, confocal laser endomicroscopy device malfunction and procedural failures were recorded. Needle-based confocal laser endomicroscopy image quality assessment, image interpretation, and histology were performed by an experienced confocal laser endomicroscopy rater and uro-pathologist, blinded to any additional information. Results: In both patients, no peri- and post-procedural adverse events were reported following needle-based confocal laser endomicroscopy. No confocal laser endomicroscopy device malfunction nor procedural failures were reported. Within 1.5 min after intravenous administration of fluorescein, needle-based confocal laser endomicroscopy image quality was sufficient for interpretation for at least 14 min, yielding more than 5000 confocal laser endomicroscopy frames per patient. The pullback confocal laser endomicroscopy recordings and most of the push-forward recordings almost only visualized erythrocytes, being classified as non-representative. During the push-forward recordings, prostate tissue was occasionally visualized in single frames, insufficient for histopathologic comparison. Prostate carcinoma was identified by biopsy in one patient (Gleason score 4 + 3 = 7, >50%), while the biopsy from the other patient showed no malignancy. Conclusion: Needle-based confocal laser endomicroscopy imaging of in-vivo prostate tissue with a forward-looking confocal laser endomicroscopy probe is safe without device malfunctions or procedural failures. Needle-based confocal laser endomicroscopy is technically feasible, but the acquired confocal laser endomicroscopy datasets are non-representative. The confocal laser endomicroscopy images’ non-representative nature is possibly caused by bleeding artifacts, movement artifacts and a lack of contact time with the tissue of interest. A different confocal laser endomicroscopy probe or procedure might yield representative images of prostatic tissue.

Abstract Background European Member States, the European Commission and its agencies work together to enhance preparedness and response for serious cross-border threats to health such as Ebola. Yet, common understanding of public health emergency preparedness across EU/EEA countries is challenging, because preparedness is a relatively new field of activity and is inherently fraught with uncertainty. A set of practical, widely accepted and easy to use recommendations for generic preparedness that bundles the activities described in separate guidance documents supports countries in preparing for any possible health threat. The aim of this consensus procedure was to identify and seek consensus from national-level preparedness experts from EU/EEA countries on key recommendations of public health emergency preparedness. Methods To identify key recommendations and to prioritize the recommendations we started with a literature consensus procedure, followed by a modified Delphi method for consultation of public health emergency preparedness leaders of EU/EEA countries. This consisted of six consecutive steps: a questionnaire to achieve consensus on a core set of recommendations, a face-to-face consultation, preselection of prioritized recommendations, a questionnaire to achieve consensus on the prioritized set and a face-to-face consensus meeting to further prioritize recommendations. Results As a result, EU/EEA experts selected 149 recommendations as core preparedness principles and prioritized 42. The recommendations were grouped in the seven domains: governance (57), capacity building and maintenance (11), surveillance (19), risk-assessment (16), risk- and crisis management (35), post-event evaluation (6) and implementation of lessons learned (5). Conclusions This prioritised set of consensus principles can provide a foundation for countries aiming to evaluate and improve their preparedness for public health emergencies. The recommendations are practical, support generic preparedness planning, and can be used by all countries irrespective of their current level of preparedness.

We report a case of Argentine hemorrhagic fever diagnosed in a woman in Belgium who traveled from a disease-endemic area. Patient management included supportive care and combination therapy with ribavirin and favipiravir. Of 137 potential contacts, including friends, relatives, and healthcare and laboratory workers, none showed development of clinical symptoms of this disease.

The joint action EU HEALTHY GATEWAYS (EUHG) aimed to support cooperation and coordinated action of MS to improve their preparedness and response capacities at PoE, for preventing and combating cross-border health threats from the transport sector. The aim of this study is to present how EUHG supported strengthening of core public health capacities at ports during routine operations and the COVID-19 pandemic. Methods used included surveys, literature reviews, in(tra)-action reviews, focus and expert working groups, site visits, exercises, inspection grading system methodology. In addition, the EU Common Ship Sanitation Database (EUSIS) was used as a tool to collect information on health conditions on board and to share information about public health events. EUHG network established the EUPOENET and implemented the European passenger ship inspections programme implementation where 558 inspectors in the EU SIS recorded 33,184 Ship Sanitation Certificates, followed up >80 public health events via the port communication form out of which 22 were COVID-19 related, and recorded > 4600 hygienic deficiencies. EUHG developed a web-based, searchable catalogue of best practices, SOPs for mosquito surveillance and control, a model MoU describing cooperation among authorities at ports, a tool was produced for development/assessment of contingency plans (ports), a tool serving group-based discussions about what defines risk at port level. EUHG conducted training courses and European level multi-sectorial TTE. The EUHG network of experts supported EU’s COVID-19 response by developing 16 technical guidance documents, provided >40 expert consultations and conducted three site visits and short seminars, two national level IAR and a European level meeting using IAR methodology and produced over five scientific publications. The JA’s network contribution to the pandemic has been globally acknowledged, recognized and demonstrated, with the network immediately activated to support EC and MS requests, and transport restart operations in 2020–2021.

To increase knowledge of tick-borne encephalitis virus (TBEV) circulation in the Netherlands, we conducted serosurveillance in roe deer (Capreolus capreolus) during 2017 and compared results with those obtained during 2010. Results corroborate a more widespread occurrence of the virus in 2017. Additional precautionary public health measures have been taken.