Since 1996, the incidence of rickettsiosis has been increasing in Yucatán, Mexico, but recent prevalence data are lacking. This study aimed to determine exposure to the Spotted Fever Group (SFG) and Typhus Group (TG) in human serum samples suspected of tick-borne diseases (TBD) between 2015 and 2022. A total of 620 samples were analysed using indirect immunofluorescence assay (IFA) to detect IgG antibodies against SFG (Rickettsia rickettsii) and TG (Rickettsia typhi), considering a titer of ≥64 as positive. Results showed that 103 samples (17%) were positive for R. rickettsii and 145 (24%) for R. typhi, while 256 (41%) and 229 (37%) were negative, respectively. There was a cross-reaction in 244 samples (39%). Individuals with contact with vectors, such as ticks, showed significant exposure to fleas (p = 0.0010). The study suggests a high prevalence of rickettsiosis and recommends prospective studies to assess the disease burden and strengthen surveillance and prevention in Yucatán, considering factors like temperature and ecological changes.

Hand, foot and mouth disease (HFMD) is a contagious communicable disease, with a high incidence in children aged under 10 years. It is a mainly self-limiting disease but can also cause serious neurological or cardiopulmonary complications in some cases, which can lead to death. Little is known about the burden of HMFD on primary care health care services in the UK. The aim of this work was to describe trends in general practitioner (GP) consultations for HFMD in England from January 2017 to December 2022 using a syndromic surveillance network of GPs. Daily GP consultations for HFMD in England were extracted from 1 January 2017 to 31 December 2022. Mean weekly consultation rates per 100,000 population and 95% confidence intervals (CI) were calculated. Consultation rates and rate ratios (RR) were calculated by age group and sex. During the study period, the mean weekly consultation rate for HFMD (per 100,000 registered GP patients) was 1.53 (range of 0.27 to 2.47). In England, children aged 1–4 years old accounted for the largest affected population followed by children <1 years old. We observed a seasonal pattern of HFMD incidence during the non-COVID years, with a seasonal peak of mean weekly rates between months of September and December. HFMD is typically diagnosed clinically rather than through laboratory sampling. Therefore, the ability to look at the daily HFMD consultation rates provides an excellent epidemiological overview on disease trends. The use of a novel GP-in-hours surveillance system allowed a unique epidemiological insight into the recent trends of general practitioner consultations for HFMD. We demonstrate a male predominance of cases, the impact of the non-pharmaceutical interventions during the COVID-19 pandemic, and a change in the week in which the peak number of cases happens post-pandemic.

We studied severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination status among six ethnic groups in Amsterdam, the Netherlands. We analysed participants of the Healthy Life in an Urban Setting cohort who were tested for SARS-CoV-2 spike protein antibodies between 17 May and 21 November 2022. We categorized participants with antibodies as only infected, only vaccinated (≥1 dose), or both infected and vaccinated, based on self-reported prior infection and vaccination status and previous seroprevalence data. We compared infection and vaccination status between ethnic groups using multivariable, multinomial logistic regression. Of the 1,482 included participants, 98.5% had SARS-CoV-2 antibodies (P between ethnic groups = 0.899). Being previously infected and vaccinated ranged from 41.5% (95% confidence interval (CI) = 35.0–47.9%) in the African Surinamese to 67.1% (95% CI = 59.1–75.0%) in the Turkish group. Compared to participants of Dutch origin, participants of South-Asian Surinamese (adjusted odds ratio (aOR) = 3.31, 95% CI = 1.50–7.31)), African Surinamese (aOR = 10.41, 95% CI = 5.17–20.94), Turkish (aOR = 3.74, 95% CI = 1.52–9.20), or Moroccan (aOR = 15.24, 95% CI = 6.70–34.65) origin were more likely to be only infected than infected and vaccinated, after adjusting for age, sex, household size, trust in the government’s response to the pandemic, and month of study visit. SARS-CoV-2 infection and vaccination status varied across ethnic groups, particularly regarding non-vaccination. As hybrid immunity is most protective against coronavirus disease 2019, future vaccination campaigns should encourage vaccination uptake in specific demographic groups with only infection.

Cellulitis, a common subcutaneous infection, is influenced by host, pathogen, and environmental factors. Previous studies have shown seasonal patterns in adult cellulitis, suggesting temperature as a risk factor. This study investigated seasonal patterns in paediatric cellulitis in Jerusalem’s semi-arid climate. A single-center retrospective cohort study reviewed medical records of 2,219 hospitalized children under 18 with cellulitis between 1990 and 2020. Demographic, clinical, temperature, and humidity data were collected. Results revealed a significant sinusoidal pattern for limb cellulitis (LC) but for other body sites, with summer peaks and winter nadirs (P < 0.01). August showed the highest incidence, tripling that of February. Age groups 1-6 and 6-12 demonstrated the largest seasonal differences (P = 0.004, P = 0.008). Over three decades, paediatric hospitalized LC cases increased by 71% (P < 0.001), correlating with rising temperatures. Elevated ambient temperature seven days prior to diagnosis was a risk factor for LC development (OR = 1.02, P = 0.03). This study highlights the cyclic seasonal pattern of paediatric LC, peaking in summer. The significant increase in cases over time, coupled with rising temperatures, suggests climate change as a contributing factor. These findings could inform public health strategies for cellulitis prevention and management in children.

In February 2023, 52 cases of gastrointestinal illness were reported in customers of Takeaway A, South Wales. Shigella flexneri serotype 2a was the causative organism. An outbreak investigation was conducted to determine the extent and vehicle of the outbreak.

Following descriptive summary and environmental investigations, a case–control study was completed. Participants completed a telephone questionnaire on food, travel, and environmental exposures. A multivariable logistic regression model was built, including exposures with p-values < 0.2 and interactions identified on stratified analysis. Staff faecal samples were screened for Shigella sp.

Thirty-one cases and 29 controls were included in the study. Eighty-seven per cent of cases and 76% of controls ate from Takeaway A on 10 February 2023. Coleslaw was the main factor associated with illness (aOR: 200, 95% CI: 12–3220) and an interaction with cabbage was identified (aOR: 886, 95% CI: 26–30034). Shigella sp. were not detected in any staff samples.

Coleslaw was the most likely vehicle. Though the contamination route is unknown, a food handler is the most likely source. This large outbreak differs from recent European outbreaks, which primarily have been associated with sexual transmission. Although uncommon in the UK, S. flexneri should be considered as a cause of foodborne outbreaks.

Multiple osteoarticular tuberculosis (MOT) represents an uncommon yet severe form of tuberculosis, characterized by a lack of systematic analysis and comprehension. Our objective was to delineate MOT’s epidemiological characteristics and establish a scientific foundation for prevention and treatment. We conducted searches across eight databases to identify relevant articles. Pearson’s chi-square test (Fisher’s exact test) and Bonferroni method were employed to assess osteoarticular involvement among patients of varying age and gender (α = 0.05). The study comprised 98 articles, encompassing 151 cases from 22 countries, with China and India collectively contributing 67.55% of cases. MOT predominantly affected individuals aged 0–30 years (58.94%). Pulmonary tuberculosis was evident in 16.55% of cases, with spinal involvement prevalent (57.62%). Significant differences were noted in trunk, spine, thoracic, and lumbar vertebrae involvement, as well as type I lesions across age groups, increasing with age. Moreover, significant differences were observed in upper limb bone involvement and type II lesions across age groups, decreasing with age. Gender differences were not significant. MOT primarily manifests in China and India, predominantly among younger individuals, indicating age-related variations in osteoarticular involvement. Enhanced clinical awareness is crucial for accurate MOT diagnosis, mitigating missed diagnoses and misdiagnoses.

Current standard microbiological techniques are generally very time consuming, usually requiring 24–72 h to establish a diagnosis. Consequentially, contemporary clinical practices implement broad-spectrum antibiotic administration prior to pathogen detection, prompting the emergence of extremely dangerous antibiotic-resistant bacteria. Additionally, lengthy test-to-result turnover times can greatly exacerbate the rate of disease spread. Rapid point-of-care (POC) diagnostics has quickly gained importance since the SARS-CoV-2 pandemic; accordingly, we have developed a rapid four-channel POC plasmonic quantitative polymerase chain reaction (qPCR) machine (Kimera P-IV) to respond to the deficiencies in infection control. Utilizing gold nanorods (GNRs) as nano-heaters and integrating vertical cavity surface emitting lasers (VCSEL) to replace traditional Peltier blocks, the Kimera P-IV has also incorporated quantitative real-time fluorescent monitoring. Using Chlamydia trachomatis genetic material to evaluate the rapid thermocycling performance of the platform, we have generated positive amplicons in less than 13 min; however, to achieve these results, several biological reagent considerations needed to be taken into account, specifically primer design. The device can achieve a limit of detection (LoD) of <101 DNA copies, a PCR efficiency of 88.3%, and can differentiate positive from negative results with 100% accuracy. Moreover, it can also analyze C. trachomatis DNA spiked urine samples via a simple dilution, suggesting that a separate nucleic acid step may not be needed for diagnosing infections. In conclusion, the operation of the Kimera P-IV prototype places it in a unique position of POC devices to revolutionize infectious disease diagnosis.

The Flexible Farrington Algorithm (FFA) is widely used to detect infectious disease outbreaks at national/regional levels on a weekly basis. The rapid spread of SARS-CoV-2 alongside the speed at which diagnostic and public health interventions were introduced made the FFA of limited use. We describe how the methodology was adapted to provide a daily alert system to support local health protection teams (HPTs) working in the 316 English lower-tier local authorities. To minimize the impact of a rapidly changing epidemiological situation, the FFA was altered to use 8 weeks of data. The adapted algorithm was based on reported positive counts using total tests as an offset. Performance was assessed using the root mean square error (RMSE) over a period. Graphical reports were sent to local teams enabling targeted public health action. From 1 July 2020, results were routinely reported. Adaptions accommodated the impact on reporting because of changes in diagnostic strategy (introduction of lateral flow devices). RMSE values were relatively small compared to observed counts, increased during periods of increased reporting, and were relatively higher in the northern and western areas of the country. The exceedance reports were well received. This presentation should be considered as a successful proof-of-concept.