Lassa fever (LF) virus (LASV) is endemic in Sierra Leone (SL) and poses a significant public health threat to the region; however, no risk factors for clinical LF have been reported in SL. The objective of this study was to identify the risk factors for clinical LF in an endemic community in SL. We conducted a case–control study by enrolling 37 laboratory-confirmed LF cases identified through the national LF surveillance system in SL and 140 controls resided within a one-kilometre radius of the case household. We performed a conditional multiple logistic regression analysis to identify the risk factors for clinical LF. Of the 37 cases enrolled, 23 died (62% case fatality rate). Cases were younger than controls (19.5 years vs 28.9 years, p < 0.05) and more frequently female (64.8% vs 52.8%). Compared to the controls, clinical LF cases had higher contact with rodents (rats or mice) in their households in the preceding three weeks (83.8% vs 47.8%). Households with a cat reported a lower presence of rodents (73% vs 38%, p < 0.01) and contributed to a lower rate of clinical LF (48.6% vs 55.7%) although not statistically significant (p = 0.56). The presence of rodents in the households (matched adjusted odds ratio (mAOR): 11.1) and younger age (mAOR: 0.99) were independently associated with clinical LF.

Rodent access to households and younger age were independently associated with clinical LF. Rodent access to households is likely a key risk factor for clinical LF in rural SL and potentially in other countries within the West African region. Implementing measures to control rodents and their access to households could potentially decrease the number of clinical LF cases in rural SL and West Africa.

In 2022, the largest ever virgin soil outbreak of Japanese encephalitis (JE) occurred in Australia resulting in 45 reported human cases of JE, with seven fatalities. Japanese encephalitis virus (JEV) was detected in 84 piggeries across Australia. In response, states implemented targeted vaccination programs for those individuals at the highest risk of JEV exposure. A mixed methods approach, including geospatial mapping of JEV vaccine distribution in Queensland, a case series of Queensland human cases and interviews with Queensland Health staff, assessed the JEV vaccination response program. Five notified human cases were reviewed, with three having occupational outdoor risk and local travel-related exposure. Vaccine coverage ranged from 0 to 7.4 doses per 100 people after 12 months of the program. The highest uptake was in southern Queensland, where 95% of the state’s commercial pig population is located. The vaccination program was limited by a heavy reliance on general practitioners, vast geographical distribution of eligible populations, difficulties mobilising and engaging eligible cohorts, and suboptimal One Health collaboration. Population and climate factors make it possible for the virus to become endemic. Targeted vaccination programs remain an important strategy to protect people at the highest risk of exposure, however, program improvements are required to optimize vaccine accessibility.

Our study aims to enhance future pandemic preparedness by leveraging insights from historical pandemics, focusing on the multidimensional analysis of past outbreaks. In this study, we digitised and analysed for the first time aggregated mortality and morbidity data series from the Russian flu in Switzerland in 1889/1890 and subsequent years to assess its comprehensive impact. The strongest effects were observed in January 1890, showing significant monthly excess mortality from all causes compared to the preceding five years (58.9%, 95% CI 36.6 to 81.0). Even though the whole of Switzerland was affected, the impact varied regionally due to ecological variations. Deaths from other conditions such as tuberculosis and heart disease also increased during this period. A significant drop in birth occurred 9 months later, in the autumn of 1890. Morbidity estimates by physicians suggest that around 60% of the Swiss population fell ill, with regional discrepancies and earlier outbreaks among postal workers (1–2 weeks earlier than the rest of the population). A subsequent spike in all-cause excess and influenza mortality was recorded in January 1894 but more localized than in 1890. Our findings show no cross-protection between the 1890 and 1894 outbreaks.

Foodborne diseases are ongoing and significant public health concerns. This study analysed data obtained from the Foodborne Outbreaks Surveillance System of Wenzhou to comprehensively summarise the characteristics of foodborne outbreaks from 2012 to 2022. A total of 198 outbreaks were reported, resulting in 2,216 cases, 208 hospitalisations, and eight deaths over 11 years. The findings suggested that foodborne outbreaks were more prevalent in the third quarter, with most cases occurring in households (30.8%). Outbreaks were primarily associated with aquatic products (17.7%) as sources of contamination. The primary transmission pathways were accidental ingestion (20.2%) and multi-pathway transmission (12.1%). Microbiological aetiologies (46.0%), including Vibrio parahaemolyticus, Salmonella ssp., and Staphylococcus aureus, were identified as the main causes of foodborne outbreaks. Furthermore, mushroom toxins (75.0%), poisonous animals (12.5%), and poisonous plants (12.5%) were responsible for deaths from accidental ingestion. This study identified crucial settings and aetiologies that require the attention of both individuals and governments, thereby enabling the development of effective preventive measures to mitigate foodborne outbreaks, particularly in coastal cities.

Abortion is one of the major threats to the livestock industry, and it also poses significant threats to public health since some of the abortifacient agents are considered zoonotic. Chlamydia abortus (C. abortus), Coxiella burnetii (C. burnetii), Listeria monocytogenes (L. monocytogenes), and Cache Valley virus (CVV) are recognized as important zoonotic and abortifacient agents of reproductive failure in small ruminants. This study determined the prevalence of these agents in ovine and caprine foetuses in Türkiye. A total of 1 226 foetuses were collected from the sheep (n = 1 144) and goats (n = 82) from different flocks between 2012 and 2017. Molecular detection methods were used to detect C. abortus, C. burnetii, and L. monocytogenes DNA and CVV RNA in aborted foetuses. In this study, C. abortus was the most prevalent abortifacient agent among the investigated ovine (264/1144) and caprine (12/82) foetuses, followed by C. burnetii with a frequency of 2.8% (32/1144) and 8.5% (7/82) in ovine and caprine foetuses, respectively. L. monocytogenes DNA was detected in 28 (2.4%) and 2 (2.4%) of the ovine and caprine foetuses, respectively. However, CVV RNA was not detected. Although the predominant mixed infection was C. abortus and C. burnetii, mixed infection of C. abortus and L. monocytogenes, and C. burnetii and L. monocytogenes were also found. The information presented in this study contributes to the understanding of the roles of C. abortus, C. burnetii, L. monocytogenes, and CVV in abortions in small ruminants, and could be beneficial for developing more effective control strategies.

Our study aim was to identify high-risk areas of neonatal mortality associated with bacterial sepsis in the state of São Paulo, Southeast Brazil. We used a population-based study applying retrospective spatial scan statistics with data extracted from birth certificates linked to death certificates. All live births from mothers residing in São Paulo State from 2004 to 2020 were included. Spatial analysis using the Poisson model was adopted to scan high-rate clusters of neonatal mortality associated with bacterial sepsis (WHO-ICD10 A32.7, A40, A41, P36, P37.2 in any line of the death certificate). We found a prevalence of neonatal death associated with bacterial sepsis of 2.3/1000 live births. Clusters of high neonatal mortality associated with bacterial sepsis were identified mainly in the southeast region of the state, with four of them appearing as cluster areas for all birth weight categories (<1500 g, 1500 to <2500 g and ≥ 2500 g). The spatial analysis according to the birth weight showed some overlapping in the detected clusters, suggesting shared risk factors that need to be explored. Our study highlights the ongoing challenge of neonatal sepsis in the most developed state of a middle-income country and the importance of employing statistical techniques, including spatial methods, for enhancing surveillance and intervention strategies.

The rat lungworm Angiostrongylus cantonensis is a zoonotic metastrongyloid nematode currently considered an emerging pathogen. Originating in Southeast Asia, this nematode has spread to tropical and subtropical parts of the world via its invasive rodent and gastropod hosts.

On the island of Tenerife in the Canary archipelago, the A. cantonensis invasion was recognized more than a decade ago. The endemic lizard Gallotia galloti has been identified as a paratenic host of this nematode in the Canary Island ecosystem. Because this lizard species is the most abundant reptile in Tenerife, we tested its suitability as a possible sentinel for A. cantonensis presence. Lizards were captured alive in nine localities, spanning an environmental gradient across the island. Tail muscle tissue was obtained by provoked caudal autotomy and tested for the nematode infection by a species-specific qPCR. Infection intensities were assessed by detecting A. cantonensis DNA quantities based on a calibrated standard curve. Of the 129 samples tested, 31 were positive. The prevalence varied among localities, with the highest (63.6%) recorded in a humid laurel forest. Even though the prevalence in Valle San Lorenzo was the lowest, this is the first record of A. cantonensis from the arid south of Tenerife. Variation in prevalence at different localities was significantly and positively correlated with increasing vegetation cover and negatively correlated with seasonal variability of precipitation, as determined by Spearman correlation coefficients. Fisher’s exact test was used to determine the variation in the prevalence of A. cantonensis among adult males, females, and juveniles and showed no significant difference. Also, there was no significant difference in infection intensity between males and females (as determined by GEE-g). We demonstrated that provoking caudal autotomy can be an effective non-lethal method of A. cantonensis mapping in island ecosystems with abundant lizard species, particularly those with a sharp climatic and vegetation gradient, from xeric to humid conditions.

This study aimed to develop a predictive tool for identifying individuals with high antibody titers crucial for recruiting COVID-19 convalescent plasma (CCP) donors and to assess the quality and storage changes of CCP. A convenience sample of 110 plasma donors was recruited, of which 75 met the study criteria. Using univariate logistic regression and random forest, 6 significant factors were identified, leading to the development of a nomogram. Receiver operating characteristic curves, calibration plots, and decision curve analysis (DCA) evaluated the nomogram’s discrimination, calibration, and clinical utility. The nomogram indicated that females aged 18 to 26, blood type O, receiving 1 to 2 COVID-19 vaccine doses, experiencing 2 symptoms during infection, and donating plasma 41 to 150 days after symptom onset had higher likelihoods of high antibody titres. Nomogram’s AUC was 0.853 with good calibration. DCA showed clinical benefit within 9% ~ 90% thresholds. CCP quality was qualified, with stable antibody titres over 6 months (P > 0.05). These findings highlight developing predictive tools to identify suitable CCP donors and emphasize the stability of CCP quality over time, suggesting its potential for long-term storage.

High prevalence of long COVID symptoms has emerged as a significant public health concern. This study investigated the associations between three doses of COVID-19 vaccines and the presence of any and ≥3 types of long COVID symptoms among people with a history of SARS-CoV-2 infection in Hong Kong, China. This is a secondary analysis of a cross-sectional online survey among Hong Kong adult residents conducted between June and August 2022. This analysis was based on a sub-sample of 1,542 participants with confirmed SARS-CoV-2 infection during the fifth wave of COVID-19 outbreak in Hong Kong (December 2021 to April 2022). Among the participants, 40.9% and 16.1% self-reported having any and ≥3 types of long COVID symptoms, respectively. After adjusting for significant variables related to sociodemographic characteristics, health conditions and lifestyles, and SARS-CoV-2 infection, receiving at least three doses of COVID-19 vaccines was associated with lower odds of reporting any long COVID symptoms comparing to receiving two doses (adjusted odds ratio [AOR]: 0.69, 95% CI: 0.54, 0.87, P = .002). Three doses of inactivated and mRNA vaccines had similar protective effects against long COVID symptoms. It is important to strengthen the coverage of COVID-19 vaccination booster doses, even in the post-pandemic era.

Cervical cancer, closely linked to human papillomavirus (HPV) infection, is a major global health concern. Our study aims to fill the gap in understanding HPV vaccine awareness and acceptance in the Middle East, where national immunization programs are often lacking and cultural perceptions hinder acceptance. This systematic review and meta-analysis adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search across several databases was conducted on 5 September 2023. We included quantitative studies on HPV vaccine awareness and acceptance in Middle Eastern countries. Data extraction and quality assessment were conducted independently by multiple reviewers to ensure accuracy. Statistical analyses, including subgroup analyses, were performed using R to calculate pooled estimates, assess heterogeneity, and publication bias. We reviewed 159 articles from 15 Middle Eastern countries, focusing on 93,730 participants, predominantly female and healthcare workers. HPV vaccine awareness was found to be 41.7% (95% CI 37.4%–46.1%), with higher awareness among healthcare workers. The pooled acceptance rate was 45.6% (95% CI 41.3%–50.1%), with similar rates between healthcare and non-healthcare workers. Our study highlights the critical need for increased HPV vaccine awareness and acceptance in the Middle East, emphasizing the importance of integrating the vaccine into national immunization programs and addressing cultural and religious factors to improve public health outcomes.

Nontyphoidal Salmonella enterica infections are a leading cause of enteric disease in Canada, most commonly associated with foodborne exposures. Raw frozen breaded chicken products (FBCP) have been implicated in 16 Salmonella outbreaks between 2017 and 2019. This study quantified the impact of the 1 April 2019 requirement by the Canadian Food Inspection Agency (CFIA) for manufacturers to reduce Salmonella in raw FBCP. An intervention study approach utilizing the pre–post intervention data with a comparison group methodology was used to: (1) estimate the reduction in FBCP Salmonella prevalence using retail meat FoodNet Canada data; (2) estimate the reduction in the human salmonellosis incidence rate using data from the Canadian National Enteric Surveillance Program; and (3) estimate the proportion of reported cases attributed to FBCP if the human exposure to Salmonella through FBCP was completely eliminated. The FBCP Salmonella prevalence decreased from 28% observed before 1 April 2019 to 2.9% after the requirement implementation. The CFIA requirement was estimated to reduce the human salmonellosis incidence rate by 23%. An estimated 26% of cases during the pre-intervention period can be attributed to FBCP. The CFIA requirement was successful at significantly reducing Salmonella prevalence in retail FBCP, and at reducing salmonellosis burden.

Residual blood specimens collected at health facilities may be a source of samples for serosurveys of adults, a population often neglected in community-based serosurveys. Anonymized residual blood specimens were collected from individuals 15 – 49 years of age attending two sub-district hospitals in Palghar District, Maharashtra, from November 2018 to March 2019. Specimens also were collected from women 15 – 49 years of age enrolled in a cross-sectional, community-based serosurvey representative at the district level that was conducted 2 – 7 months after the residual specimen collection. Specimens were tested for IgG antibodies to measles and rubella viruses. Measles and rubella seroprevalence estimates using facility-based specimens were 99% and 92%, respectively, with men having significantly lower rubella seropositivity than women. Age-specific measles and rubella seroprevalence estimates were similar between the two specimen sources. Although measles seropositivity was slightly higher among adults attending the facilities, both facility and community measles seroprevalence estimates were 95% or higher. The similarity in measles and rubella seroprevalence estimates between the community-based and facility serosurveys highlights the potential value of residual specimens to approximate community seroprevalence.

To enhance the capacity for early and effective management of genital tract infections at primary and secondary levels of the healthcare system, we developed a prediction model, validated internally to help predict individual risk of self-reported genital tract infections (sGTIs) at the community level in Ghana. The study involved 32973 men and women aged 15–49 years from three rounds of the Ghana Demographic Health Survey, from 2003 to 2014. The outcomes were sGTIs. We applied the least absolute shrinkage and selection operator (LASSO) penalized regression with a 10-fold cross-validation model to 11 predictors based on prior review of the literature. The bootstrapping technique was also employed as a sensitivity analysis to produce a robust model. We further employed discriminant and calibration analyses to evaluate the performance of the model. Statistical significance was set at P-value <0.05. The mean±standard deviation age was 29.1±9.7 years with female preponderance (60.7%). The prevalence of sGTIs within the period was 11.2% (95% CI = 4.5–17.8) and it ranged from 5.4% (95% CI = 4.8–5.86) in 2003 to 17.5% (95% CI = 16.4–18.7) in 2014. The LASSO regression model retained all 11 predictors. The model’s ability to discriminate between those with sGTIs and those without sGTIs was approximately 73.50% (95% CI = 72.50–74.26) from the area under the curve with bootstrapping technique. There was no evidence of miscalibration from the calibration belt plot with bootstrapping (test statistic = 17.30; P-value = 0.060). The model performance was judged to be good and acceptable. In the absence of clinical measurement, this prediction tool can be used to identify individuals aged 15–49 years with a high risk of sGTIs at the community level in Ghana. Frontline healthcare staff can use this tool for screening and early detection. We, therefore, propose external validation of the model to confirm its generalizability and reliability in different population.

A scoping review was conducted to map out sources, types, characteristics of evidence that substantiate the existence of a community dividend arising from testing and treating hepatitis C virus (HCV) infection in people living in detention – where community dividend is defined as the benefit of prison-related intervention for general population health. Joanna Briggs Institute methodology guidance was used. Literature search was done in EMBASE, Scopus, ASSIA, UWE library, CINAHL Plus, and Medline to find studies published in any country, any language between January 1991 and June 2022. PRISMA ScR flow chart mapped out the number of records identified, included, and reasons for exclusion. Data were extracted and charted in Excel. The findings were systematically reported by charting table headings then synthesized in the discussion. Quality assessment was carried out. The descriptive analysis demonstrated economic, clinical, and epidemiological domains to the community dividend in long-term health expenditure savings, reduction in HCV-related disease sequelae, increase in survival, improvement in quality of life, and reduction in infection transmission, most of which are realized in the community following release. Therefore, targeting marginalized populations affected by HCV could expedite the elimination effort, reduce inequalities, and have a positive impact on the wider population.

This cohort study evaluated the associations of C-reactive protein-neutrophil to lymphocyte ratio (C-NLR) and lymphocyte-CRP ratio (LCR) with refractory Mycoplasma pneumoniae pneumonia (RMPP), and the predictive values of C-NLR and LCR for RMPP and prolonged fever in children based on 389 children with MPP. The associations of NLR, C-NLR, and LCR with RMPP and prolonged fever were evaluated by logistic regression analysis. C-NLR was correlated with an increased risk of RMPP in children [odds ratio (OR) = 3.459, 95% confidence interval (CI): 1.598–7.491]. A higher risk of RMPP was identified in the C-NLR > 29.9 group (OR = 2.885, 95% CI: 1.599–5.203). LCR > 1584.2 was associated with a decreased risk of RMPP (OR = 0.500, 95% CI: 0.282–0.887). Increased risk of prolonged fever in children was identified with the increase of C-NLR (OR = 5.913, 95% CI: 2.335–14.972) or NLR (OR = 2.413, 95% CI: 1.689–3.446). The AUCs of C-NLR, LCR, and NLR for predicting RMPP were 0.630, 0.623, and 0.608, respectively. In conclusion, C-NLR was associated with increased RMPP risk in children and had good value for predicting RMPP and prolonged fever in children.

Serogroup epidemiology of invasive meningococcal disease (IMD) is constantly evolving, varying by time and location. Surveillance reports have indicated a rise in meningococcal serogroup Y (MenY) in some regions in recent years. This systematic literature review explores the evolving epidemiology of MenY IMD globally based on review of recent articles and national surveillance reports published between 1 January 2010 and 25 March 2021. Generally, MenY incidence was low (<0.2/100,000) across all ages in most countries. The reported incidence was more frequent among infants, adolescents, and those aged ≥65 years. More than 10% of all IMD cases were MenY in some locations and time periods. Implementation of vaccination evolved over time as the rise in MenY IMD percentage occurred. Cases decreased in countries with quadrivalent vaccine programs (e.g., United Kingdom, the Netherlands, United States, and Australia), whereas the MenY burden increased and made up a large proportion of cases in areas without vaccine programs. Continuous monitoring of epidemiologic changes of IMD is essential to establish MenY burden and for implementation of prevention strategies.