The study aimed to delve into the incidence and risk factors associated with myocarditis and pericarditis following SARS-COV-2-19 vaccination, addressing a notable gap in understanding the safety profile of vaccinations. Through meticulous data selection from the National Health Insurance System (NHIS) database of Korea, the researchers employed both a case-crossover study and a nested case-control design to analyze temporal patterns and risk factors related to carditis occurrences post-immunization. Key findings revealed a significant association between SARS-COV-2-19 vaccination and the occurrence of carditis, with a strong temporal correlation observed within 10 days post-vaccination. Noteworthy factors contributing to carditis risk included the duration between vaccination and carditis, specific comorbidities and medication use. The study concluded by recommending an extended post-vaccination surveillance duration of at least 10 days and underscored the importance of considering individual medical histories and concurrent medication use in assessing vaccine-induced carditis risk. This study might contribute to understanding vaccine safety profiles and emphasizes the significance of comprehensive post-vaccination monitoring protocols.

Leptospira are bacteria that cause leptospirosis in both humans and animals. Human Leptospira infections in Uganda are suspected to arise from animal–human interactions. From a nationwide survey to determine Leptospira prevalence and circulating sequence types in Uganda, we tested 2030 livestock kidney samples, and 117 small mammals (rodents and shrews) using real-time PCR targeting the lipL32 gene. Pathogenic Leptospira species were detected in 45 livestock samples but not in the small mammals. The prevalence was 6.12% in sheep, 4.25% in cattle, 2.08% in goats, and 0.46% in pigs. Sequence typing revealed that Leptospira borgpetersenii, Leptospira kirschneri, and Leptospira interrogans are widespread across Uganda, with 13 novel sequence types identified. These findings enhance the East African MLST database and support the hypothesis that domesticated animals may be a source of human leptospirosis in Uganda, highlighting the need for increased awareness among those in close contact with livestock.

This study examined global trends in influenza-associated lower respiratory infections (LRIs) deaths from 1990 to 2019 using data from the GBD 2019. The annual percentage change (APC) and average annual percentage change (AAPC) were used to analyze age-standardized death rates (ASDR). Globally, the ASDR of influenza-associated LRIs was 3.29/100,000 in 2019, which was higher in the African region (6.57/100,000) and among adults aged 70 years and older (29.88/100,000). The ASDR of influenza-associated LRIs decreased significantly from 1990 to 2019 (AAPC = −1.88%, P < 0.05). However, it was significantly increased among adults aged 70 years and older during 2017–2019 (APC = 2.31%, P < 0.05), especially in Western Pacific Region and South-East Asia Regions. The ratio of death rates between adults aged 70 years and older and children aged under 5 years increased globally from 1.63 in 1990 to 5.34 in 2019, and the Western Pacific Region experienced the most substantial increase, with the ratio soaring from 1.83 in 1990 to 12.98 in 2019. Despite a decline in the global ASDR of influenza-associated LRIs, it continues to impose a significant burden, particularly in the African, Western Pacific regions and among the elderly population.

The study aims were to present in vitro susceptibilities of clinical isolates from Gram-negative bacteria bloodstream infections (GNBSI) collected in China. GNBSI isolates were collected from 18 tertiary hospitals in 7 regions of China from 2018 to 2020. Minimum inhibitory concentrations were assessed using a Trek Diagnostic System. Susceptibility was determined using CLSI broth microdilution, and breakpoints were interpreted using CLSI M100 (2021). A total of 1,815 GNBSI strains were collected, with E. coli (42.4%) and Klebsiella pneumoniae (28.6%) being the most prevalent species, followed by P. aeruginosa (6.7%). Susceptibility analyses revealed low susceptibilities (<40%) of ESBL-producing E. coli and K. pneumonia to third-/fourth-generation cephalosporins, monobactamases, and fluoroquinolones. High susceptibilities to colistin (95.0%) and amikacin (81.3%) were found for K. pneumoniae, while Acinetobacter baumannii exhibited a high susceptibility (99.2%) to colistin but a low susceptibility to other antimicrobials (<27.5%). Isolates from ICUs displayed lower drug susceptibility rates of K. pneumoniae and A. baumannii than isolates from non-ICUs (all P < 0.05). Carbapenem-resistant and ESBL-producing K. pneumoniae detection was different across regions (both P < 0.05). E. coli and K. pneumoniae were major contributors to GNBSI, while A. baumannii exhibited severe drug resistance in isolates obtained from ICU departments.

The H3N2 canine influenza virus (CIV) emerged from an avian reservoir in Asia to circulate entirely among dogs for the last 20 years. The virus was first seen circulating outside Asian dog populations in 2015, in North America. Utilizing viral genomic data in addition to clinical reports and diagnostic testing data, we provide an updated analysis of the evolution and epidemiology of the virus in its canine host. CIV in dogs in North America is marked by a complex life history – including local outbreaks, regional lineage die-outs, and repeated reintroductions of the virus (with diverse genotypes) from different regions of Asia. Phylogenetic and Bayesian analysis reveal multiple CIV clades, and viruses from China have seeded recent North American outbreaks, with 2 or 3 introductions in the past 3 years. Genomic epidemiology confirms that within North America the virus spreads very rapidly among dogs in kennels and shelters in different regions – but then dies out locally. The overall epidemic therefore requires longer-distance dispersal of virus to maintain outbreaks over the long term. With a constant evolutionary rate over 20 years, CIV still appears best adapted to transmission in dense populations and has not gained properties for prolonged circulation among dogs.

Clostridiodes difficile’s epidemiology has evolved over the past decades, being recognized as an important cause of disease in the community setting. Even so, there has been heterogeneity in the reports of CA-CDI. Therefore, the aim of this study was to assess the epidemiologic profile of CA-CDI.

This systematic review and meta-analysis were conducted according to PRISMA checklist and Cochrane guidelines (CRD42023451134). Literature search was performed by an experienced librarian from inception to April 2023, searching in databases like MEDLINE, Scopus, Web of Science, EMBASE, CCRCC, CDSR, and ClinicalTrials. Observational studies that reported prevalence, incidence of CA-CDI, or indicators to calculate them were included. Pool analysis was performed using a binomial-normal model via the generalized linear mixed model. Subgroup analysis and publication bias were also explored. A total of 49 articles were included, obtaining a prevalence of 5% (95% CI 3–8) and an incidence of 7.53 patients (95% CI 4.45–12.74) per 100,000 person-years.

In conclusion, this meta-analysis underscores that among the included studies, the prevalence of CA-CDI stands at 5%, with an incidence rate of 7.3 cases per 100,000 person-years. Noteworthy risk factors identified include prior antibiotic exposure and age.

Due to the risk of Shiga-toxin producing Escherichia coli (STEC) transmission, current guidance advises excluding young children from childcare settings until microbiologically clear. Children can shed STEC for a prolonged period, and the cost-effectiveness of exclusion has not been evaluated. Our decision tree analysis, including probabilistic sensitivity analysis, estimated comparative health system costs and effects of exclusion until microbiological clearance versus return to childcare setting before this. Due to the risk of secondary cases, return before microbiological clearance resulted in the incremental loss of 0.019 QALYs, but savings of £156. Using the willingness-to-pay threshold of £20000 per QALY, the incremental net monetary benefit of exclusion until microbiological clearance was £215. Exclusion until microbiological clearance remained cost-effective if the total costs for managing the exclusion were below £576. Return before microbiological clearance may, therefore, become cost-effective in cases where the costs of managing exclusion until microbiological clearance are high and/or the risk of secondary cases is very low. Broadening the decision perspective, including the costs of exclusion to the families, may also impact the recommendation. Further research is needed to assess the risk of STEC transmission from children who have clinically recovered and the impact of STEC and exclusion on families of the affected children.

Children, adolescents, and young people living with HIV (CALWHIV), including those in resource-limited settings, may be at increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, poorer coronavirus disease 2019 (COVID-19) outcomes, and multisystem inflammatory syndrome (MIS). We conducted a repeat SARS-CoV-2 seroprevalence survey among CALWHIV in Europe (n = 493) and South Africa (SA, n = 307), and HIV-negative adolescents in SA (n = 100), in 2020–2022. Blood samples were tested for SARS-CoV-2 antibody, questionnaires collected data on SARS-CoV-2 risk factors and vaccination status, and clinical data were extracted from health records. SARS-CoV-2 seroprevalence (95% CI) was 55% (50%–59%) in CALWHIV in Europe, 67% (61%–72%) in CALWHIV in SA, and 85% (77%–92%) among HIV-negative participants in SA. Among those unvaccinated at time of sampling (n = 769, 85%), seroprevalence was 40% (35%–45%), 64% (58%–70%), and 81% (71%–89%), respectively. Few participants (11% overall) had a known history of SARS-CoV-2-positive PCR or self-reported COVID-19. Three CALWHIV were hospitalized, two with COVID-19 (nonsevere disease) and one young adult with MIS. Although SARS-CoV-2 seroprevalence was high across all settings, even in unvaccinated participants, it was broadly comparable to general population estimates, and most infections were mild/asymptomatic. Results support policy decisions excluding CALWHIV without severe immunosuppression from high-risk groups for COVID-19.

Our study aimed to describe the transmission dynamics and genotypic diversity of Mycobacterium tuberculosis in people deprived of liberty (PDL) in four Colombian prisons. Our cohort study included 64 PDL with bacteriologically confirmed pulmonary tuberculosis diagnosed in four Colombian prisons. The 132 isolates were genotyped using 24-mycobacterial interspersed repeated units-variable number tandem repeats (MIRUs-VNTR). A cluster was defined when ≥2 isolates from different PDL had the same genotype. Tuberculosis acquired in prison was considered when ≥2 persons were within the same cluster and had an epidemiological link. We mapped the place of residence before incarceration and within prisons. We assessed overcrowding and ventilation conditions in the prison that had clusters. We found that the most frequent genotypes were LAM (56.8%) and Haarlem (36.4%), and 45.3% of the PDL diagnosed with tuberculosis were clustered. Most PDL diagnosed in prison came from neighborhoods in Medellin with a high TB incidence. M. tuberculosis infection acquired in prison was detected in 19% of PDL, 9.4% had mixed infection, 3.1% reinfection, and 1.6% relapse. Clusters only appeared in one prison, in cell blocks with overcrowding >100%, and inadequate ventilation conditions. Prisons require the implementation of effective respiratory infection control measures to prevent M. tuberculosis transmission.

Bartonella is a widely distributed Gram-negative bacterium that includes species that are capable of causing illness in humans. Rodents represent one of the main reservoirs of zoonotic pathogens, and monitoring their populations can provide valuable insights into human health. We conducted a surveillance study of rodents from two north-western states of Mexico (Baja California and Chihuahua) to investigate the prevalence and genetic diversity of Bartonella by polymerase chain reaction (PCR) amplification and sequencing of the citrate synthase (gltA) gene. A total of 586 rodents belonging to 28 species were captured, and 408 were tested for Bartonella spp. The overall Bartonella spp. prevalence was 39.71%. The prevalence found in Chihuahua was higher (42.80%) than in Baja California (32.52%), and rodents such as Neotoma albigula, Neotoma mexicana, Peromyscus boylii, and Chaetodipus baileyi had the highest prevalence. The gltA sequences revealed seven genetic variants, some of which were obtained from Peromyscus and Dipodomys rodents and were associated with Bartonella species of human health concern, such as B. grahamii and B. vinsonii subsp. arupensis. In addition, a sequence obtained from a Peromyscus maniculatus was clustered with Candidatus Bartonella rudakovii, a previously unreported association. This study provides valuable data and new insight into the Bartonella-hosts interactions in rodent species in north-western Mexico.

Although SARS-CoV-2 vaccination reduces hospitalization and mortality, its long-term impact on Long-COVID remains to be elucidated. The aim of the study was to evaluate the different development of Long-COVID clinical phenotypes according to the vaccination status of patients. Clinical and demographic characteristics were assessed for each patient, while Long-COVID symptoms were self-reported and later stratified into distinct clinical phenotypes. Vaccination was significantly associated with the avoidance of hospitalization, less invasive respiratory support, and less alterations of cardiopulmonary functions, as well as reduced lasting lung parenchymal damage. However, no association between vaccination status and the development of at least one Long-COVID symptom was found. Nevertheless, clinical phenotypes were differently associated with vaccination status, as neuropsychiatric were more frequent in unvaccinated patients and cardiorespiratory symptoms were reported mostly in vaccinated patients. Different progression of disease could be at play in the different development of specific Long-COVID clinical phenotypes, as shown by the different serological responses between unvaccinated and vaccinated patients. A higher anti-Spike (S) antibody titre was protective for vaccinated patients, while it was detrimental for unvaccinated patients. A better understanding of the mechanism underlying the development of Long-COVID symptoms might be reached by standardized methodologies and symptom classification.

In 2015, the WHO African Region was responding to the largest Ebola virus disease outbreak in history while at the same time working to contain a wild poliovirus outbreak [1]. The 2030 Agenda for Sustainable Development had recently been endorsed, reflecting new global development priorities. By 2016, the Ebola outbreak was under control, and a new approach to reform and priority setting was in place in the region; the Transformation Agenda [2]. This agenda, introduced by the new Regional Director for Africa, Dr Matshidiso Moeti, set up a robust system for improving the efficiency and accountability of the WHO Secretariat for the African Region, which has been instrumental in the transformative changes that have been seen across the region in the past 10 years. This commentary discusses significant contributions to public health in the WHO African Region in the past decade, in the context of the Transformation Agenda, and the contributions of major investment in health security in the region. It is important to understand the need to sustain particular initiatives and elements of the transformative change that has taken place in the region.

We assessed the validity of serum total anti-nucleoprotein Immunoglobulin (N-antibodies) to identify SARS-CoV-2 (re)infections by estimating the persistence of N-antibody seropositivity and boosting following infection. From a prospective Dutch cohort study (VASCO), we included adult participants with ≥2 consecutive self-collected serum samples, 4–8 months apart, between May 2021–May 2023. Sample pairs were stratified by N-seropositivity of the first sample and by self-reported infection within the sampling interval. We calculated the proportions of participants with N-seroconversion and fold-increase (1.5, 2, 3, 4) of N-antibody concentration over time since infection and explored determinants. We included 67,632 sample pairs. Pairs with a seronegative first sample (70%) showed 89% N-seroconversion after reported infection and 11% when no infection was reported. In pairs with a seropositive first sample (30%), 82%–65% showed a 1.5- to 4-fold increase with a reported reinfection, and 19%–10% without a reported reinfection, respectively. After one year, 83% remained N-seropositive post-first infection and 93%–61% showed a 1.5-fold to 4-fold increase post-reinfection. Odds for seroconversion/fold increase were higher for symptomatic infections and Omicron infections. In the current era with limited antigen or PCR testing, N-serology can be validly used to detect SARS-CoV-2 (re)infections at least up to a year after infection, supporting the monitoring of COVID-19 burden and vaccine effectiveness.

Mediterranean spotted fever (MSF) is a rickettsial disease caused by Rickettsia conorii, transmitted by brown dog ticks, and endemic in the Mediterranean region. Its incidence is increasing, with varied presentations and potential complications because of delayed diagnosis. This study retrospectively included 173 adult patients hospitalized for MSF at La Rabta University Hospital, Tunis, from 2000 to 2020. Patients, predominantly male (67.6%) and averaging 40 years of age, mostly resided in urban areas (82.7%). Animal exposure was reported in 74.6%, and cases peaked during the hot season (68.8%), with no cases in winter months. The classic triad of fever, rash, and eschar was observed in 69.9%, with maculopapular lesions affecting palms and soles in 83.8%. Headache (64.5%), myalgia (60.7%), and arthralgia (57.2%) were also common. Laboratory findings included elevated white blood cell count (36.4%), thrombocytopenia (48%), and increased aspartate aminotransferase (50.9%). Treatment with doxycycline (n = 161) resolved fever within 2.8±1.3 [1–5] days. Complications, including encephalitis, chorioretinitis, anterior uveitis and vasculitis, occurred in 2.3% of cases, but all patients recovered without relapse. No significant risk factors for severe forms were identified. Improved awareness of MSF’s clinical features may be the key to an early diagnosis and successful treatment.

Dientamoeba fragilis (D. fragilis) is an intestinal protozoan parasite with uncertain pathogenic potential. In the United States, data on D. fragilis in the era of molecular detection are limited. The aim of this retrospective chart review was to evaluate the epidemiology and clinical characteristics of D. fragilis cases identified using polymerase chain reaction assays between 2016 and 2024 at our academic medical centre located in Utah. We identified 28 unique cases with varying gastrointestinal symptomatology including diarrhoea, abdominal pain, nausea, vomiting, and bloating. Approximately half (52%) of patients with follow-up data demonstrated improvement in symptoms following initial treatment for D. fragilis. The overall prevalence of D. fragilis was low among those tested (0.6% positivity). Additional research, including case-control studies, is needed to better describe the etiologic role of D. fragilis.

Group A streptococcal or Streptococcus pyogenes infections have been increasing post-COVID-19 pandemic. We describe the epidemiology of S. pyogenes pharyngitis and invasive disease in Alberta, Canada 2018–2023. Positive pharyngitis specimens were identified from throat swabs collected from pharyngitis patients. Invasive S. pyogenes was defined as the isolation of S. pyogenes from a normally sterile site or severe skin infection. S. pyogenes isolates were emm typed. Pharyngitis and invasive disease displayed seasonal trends preceding the COVID-19 pandemic followed by a sharp decrease during COVID-19 intervention measures. After the lifting of interventions, rates of pharyngitis and invasive disease rose. There were 182 983 positive pharyngitis specimens between 2018 and 2023 for a positivity rate of 17.6%. The highest rates occurred in the 0–9 age group in 2023 (41.5%). Invasive disease increased in 2022–2023 driven by emm1 and 12 types. M1UK strain was the most frequent M1 type associated with invasive disease (59% of M1 isolates sequenced). Notably, out of 182 983 pharyngitis cases, there were 111 cases of invasive S. pyogenes detected for an invasive disease rate of 0.06%. This descriptive epidemiology of S. pyogenes pharyngitis and invasive S. pyogenes disease highlights the rapid increase in cases of S. pyogenes occurring in western Canada and illustrates the critical need for a vaccine.

Spatial analysis and disease mapping have the potential to enhance understanding of tuberculosis (TB) dynamics, whose spatial dynamics may be complicated by the mix of short and long-range transmission and long latency periods. TB notifications in Nam Dinh Province for individuals aged 15 and older from 2013 to 2022 were analyzed with a variety of spatio-temporal methods. The study commenced with an analysis of spatial autocorrelation to identify clustering patterns, followed by the evaluation of several candidate Bayesian spatio-temporal models. These models varied from simple assessments of spatial heterogeneity to more complex configurations incorporating covariates and interactions. The findings highlighted a peak in the TB notification rate in 2017, with 98 cases per 100,000 population, followed by a sharp decline in 2021. Significant spatial autocorrelation at the commune level was detected over most of the 10-year period. The Bayesian model that best balanced goodness-of-fit and complexity indicated that TB trends were associated with poverty: each percentage point increase in the proportion of poor households was associated with a 1.3% increase in TB notifications, emphasizing a significant socioeconomic factor in TB transmission dynamics. The integration of local socioeconomic data with spatio-temporal analysis could further enhance our understanding of TB epidemiology.

Vaccination is one of the most cost-effective and successful public health interventions to prevent infectious diseases. Governments worldwide have tried to optimize vaccination coverage, including using vaccine mandates. This review of recent literature and policy aims to provide a comprehensive overview of Malaysia’s childhood vaccination landscape. The document analysis was used to identify and examine information from government policy documents, official government media statements, mainstream news content, and research papers. Content analysis was then employed to analyze the gathered information. Despite the successes of Malaysia’s National Immunization Programme, a resurgence of vaccine-preventable diseases has raised concerns about vaccine hesitancy and refusal. Several contributing factors have been identified, including a preference for alternative medicines, doubts about halal status, fear of vaccine injury, concerns about the vaccines’ contents, conspiracy theories, as well as convenience and access barriers. While various initiatives have been implemented, Malaysia may consider using vaccine mandates, as several countries have recently done, as a potential policy intervention to address these challenges. This review benefits policymakers, epidemiologists, as well as researchers involved in regional or global policy planning and advocacy efforts. It also offers comprehensive insights into designing effective interventions and making informed policy decisions regarding childhood vaccination programmes.

In August 2023, the Finnish Institute for Health and Welfare received reports of a potential cluster of pneumococcal pneumonia cases among shipyard employees in Turku, Finland. Considering a similar outbreak in the same shipyard in 2019, we initiated a case–control study to investigate individual and environmental risk factors specific to this occupational setting in order to inform targeted prevention measures. In total, 14 hospitalized cases were identified from 19 August to 15 October 2023. Streptococcus pneumoniae serotypes 4 and 9 V were isolated from blood cultures of seven cases. Eleven cases and 67 controls working at the shipyard were included in the case–control study. Compared with controls, cases were more likely to be living in an apartment/studio or a hotel/hostel, and less likely in a house or with family. Furthermore, cases were more likely to have a shorter duration of employment (< 1 year) at the shipyard compared to controls. Control measures, including an information and a vaccination campaign, were implemented. We emphasize shipyard-wide hygiene improvements and recommend nationwide consideration of expanding pneumococcal vaccination eligibility to all shipyard construction employees as an occupational high-risk group.

Malaria remains a major health challenge in developing countries, with climate change intensifying its impact. Pakistan is among the most vulnerable nations. This study examines the relationship between temperature and malaria cases in two highly affected districts, Bannu and Lakki Marwat, to inform climate-adaptive interventions.

We analyzed monthly malaria cases (2014–2022) from the Integrated Vector Control/Malaria Control Program in Khyber Pakhtunkhwa, combined with gridded meteorological data from Copernicus ERA5-Land. Time-series analysis using distributed lag nonlinear models and quasi-Poisson regression was applied to assess the associations.

The findings suggest that as temperatures exceed 22.4°C, malaria transmission increases by 9 to 10% for every 1°C rise in both districts. In Bannu, up to 39.8% of reported malaria cases could be attributed to heat, while in Lakki Marwat, 54.1% of cases were attributable to heat. Under high emission scenarios, heat-related malaria cases could increase by 0.8 to 3.5% by the 2060s. Relationship between temperature and malaria transmission is complex and is influenced by environmental factors such as precipitation and humidity.

Given Pakistan’s limited healthcare infrastructure, addressing climate-driven malaria risks is urgent. Recent severe floods and malaria surges highlight the need for climate adaptation measures and strengthened healthcare systems to enhance community resilience.