RESUMO
In 2023, Africa experienced 180 public health emergencies, of which 90% were infectious diseases and 75% were related to zoonotic diseases. Testing capacity for epidemic-prone diseases is essential to enable rapid and accurate identification of causative agents, and for action to prevent disease spread. Moreover, testing is pivotal in monitoring disease transmission, evaluating public health interventions and informing targeted resource allocation during outbreaks. An online, self-assessment survey was conducted in African Union Member States to identify major challenges in testing for epidemic-prone diseases. The survey assessed current capacity for diagnosing priority epidemic-prone diseases at different laboratory levels. It explored challenges in establishing and maintaining testing capacity to improve outbreak response and mitigate public health impact. Survey data analysed diagnostic capacity for priority infectious diseases, diagnostic technologies in use, existing surveillance programmes and challenges limiting diagnostic capacity, by country. The survey result from 15 Member States who responded to the survey, showed high variability in testing capacity and technologies across countries and diverse factors limiting testing capacity for certain priority diseases like dengue and Crimean-Congo haemorrhagic fever. At the same time diagnostic capacity is better for coronavirus disease 2019 (COVID-19), polio, and measles due to previous investments. Unfortunately, many countries are not utilizing multiplex testing, despite its potential to improve diagnostic access. The challenges of limited laboratory capacity for testing future outbreaks are indeed significant. Recent disease outbreaks in Africa have underscored the urgent need to strengthen diagnostic capacity and introduce cost-effective technologies. Small sample sizes and differing disease prioritisation within each country limited the analysis. These findings suggest the benefits of evaluating laboratory testing capacity for epidemic-prone diseases and highlight the importance of effectively addressing challenges to detect diseases and prevent future pandemics.
Assuntos
Epidemias , Humanos , África/epidemiologia , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/epidemiologia , Inquéritos e Questionários , Laboratórios , Surtos de Doenças/prevenção & controle , COVID-19/diagnóstico , COVID-19/epidemiologia , Saúde PúblicaRESUMO
BACKGROUND: African swine fever (ASF) poses a threat to the global pig industry, leading to significant economic losses and widespread disruptions in pig farming and associated sectors. In September 2023, the first case of ASF in Swedish wild boar triggered immediate responses from authorities, including the establishment of restricted zones and culling measures. A new ASF certification programme for pig herds was initiated to improve biosecurity and proactive disease management. This survey aimed to assess the sentiments and actions of Swedish pig farmers six months post-outbreak, particularly regarding biosecurity measures. Such information is important to improve preparedness for future disease threats. A questionnaire was distributed to members of the Swedish pig producers' organisation. RESULTS: A total of 113 farmers responded (response rate 27%), with the majority considering the risk of ASF reappearing in Sweden as high. The estimated cost for connecting the farms to the ASF certification programme varied greatly, with a majority identifying cost as a substantial hurdle. While many farmers sought biosecurity advice from veterinarians, 43% had not implemented suggested measures. Over one third had not received concrete measures that would fit their farms, and 14% had not received any biosecurity advice from veterinarians at all. Discussions among farmers emphasized concerns about ASF outbreaks, transmission mechanisms, and regulatory compliance, highlighting the importance of ongoing communication and knowledge exchange to address the challenges posed by ASF effectively. Additionally, participants also mentioned the role of dense wild boar populations and shortcomings in municipal food waste management as important risk factors. CONCLUSIONS: The responding farmers expressed widespread concern about new ASF outbreaks. A majority identified cost as a substantial hurdle for joining the ASF certification programme. While many farmers consulted veterinarians for advice on biosecurity, a significant number had yet to implement suggested measures and one third had not received specific guidance suitable for their farms. Stakeholder conversations highlighted concerns about ASF outbreaks, transmission, and compliance. They also discussed the role of dense wild boar populations and issues with municipal food waste management as significant risk factors for ASF.
Assuntos
Febre Suína Africana , Criação de Animais Domésticos , Animais , Suécia , Suínos , Febre Suína Africana/prevenção & controle , Febre Suína Africana/epidemiologia , Criação de Animais Domésticos/métodos , Controle de Infecções/métodos , Inquéritos e Questionários , Biosseguridade , Fazendas , Fazendeiros/psicologia , Sus scrofa , Surtos de Doenças/veterinária , Surtos de Doenças/prevenção & controleRESUMO
Robust digital infrastructure is vital and the need of the hour, especially in the healthcare sector, for real-time data generation, analysis, and quick decision-making. Food- and water-borne illnesses represent a prominent cause of morbidity and mortality worldwide. India, a developing nation with diverse cultures and food practices, poses a high risk of food-borne diseases and outbreaks, yet is often underreported and ineffectively researched. Also, the unique socio-economic and environmental factors of the Northeast (NE) region contribute to the high burden of food-borne diseases. To address these trepidations, the Indian Council of Medical Research (ICMR) has undertaken a study for the surveillance of food-borne pathogens in NE India. The present study focuses on the development of a digital database system for the systematic surveillance of foodborne disease outbreaks, aiming to address the gaps in traditional surveillance methods and improve disease detection and response capabilities. The digital system integrates mobile applications, web-based platforms, and advanced analytics tools to enable real-time data collection, dissemination, and analysis of food-borne illness data. Additionally, the secure and scalable nature of the system enhances data accuracy and accessibility, making it a valuable tool for enhancing food-borne disease surveillance efforts in resource-constrained settings.
Assuntos
Surtos de Doenças , Doenças Transmitidas por Alimentos , Saúde Pública , Índia/epidemiologia , Humanos , Doenças Transmitidas por Alimentos/epidemiologia , Surtos de Doenças/prevenção & controle , Doenças Transmitidas pela Água/epidemiologia , Doenças Transmitidas pela Água/prevenção & controle , Aplicativos Móveis , Vigilância em Saúde Pública/métodosAssuntos
COVID-19 , Surtos de Doenças , Mpox , Vacinas Virais , Humanos , África/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/economia , Vacinas contra COVID-19/provisão & distribuição , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Mpox/epidemiologia , Mpox/prevenção & controle , Mpox/virologia , Vacinas Virais/economia , Vacinas Virais/provisão & distribuição , AprendizagemRESUMO
Cholera, an acute diarrheal infection from ingesting contaminated food or water, remains a significant public health threat in Nigeria, especially in areas lacking safe water and sanitation. Characterized by severe watery diarrhea, cholera can cause dehydration and death if untreated. Historical data shows cholera's endemic nature in Nigeria, with notable outbreaks since 1970, including major ones in 1991, 1999, 2010, 2018, and 2024. According to a descriptive study in Nigeria, the 1991 outbreak reported 59,478 cases and 7,654 deaths, with a Case Fatality Ratio (CFR) of 12.9%. In 2010, there were 41,787 cases and 1,716 deaths, with a CFR of 4.1% across 18 states, mainly affecting impoverished communities and children. The 2018 outbreak had 43,996 cases and 836 deaths, with a CFR of 2% in 20 states, a 240% increase from 2017. By mid-2024, there were 1,579 suspected cases and 54 deaths (CFR 3.4%) in 32 states. This paper evaluates cholera trends in Nigeria and proposes effective preventive and treatment strategies. Policy recommendations highlight the need for improved WASH infrastructure, enhanced surveillance, and rapid response mechanisms. Innovative approaches like case-area targeted interventions (CATI) and increased public health education are crucial for mitigating future outbreaks and achieving the goal of reducing cholera deaths by 90% by 2030.
Assuntos
Cólera , Surtos de Doenças , Nigéria/epidemiologia , Humanos , Cólera/epidemiologia , Cólera/prevenção & controle , Cólera/mortalidade , Surtos de Doenças/prevenção & controle , Política de Saúde , Saneamento , Saúde PúblicaRESUMO
Ebola virus disease kills more than half of people infected. Since the disease is transmitted via close human contact, identifying individuals at the highest risk of developing the disease is possible on the basis of the type of contact (correlated with viral exposure). Different candidates for post-exposure prophylaxis (PEP; ie, vaccines, antivirals, and monoclonal antibodies) each have their specific benefits and limitations, which we discuss in this Viewpoint. Approved monoclonal antibodies have been found to reduce mortality in people with Ebola virus disease. As monoclonal antibodies act swiftly by directly targeting the virus, they are promising candidates for targeted PEP in contacts at high risk of developing disease. This intervention could save lives, halt viral transmission, and, ultimately, help curtail outbreak propagation. We explore how a strategic integration of monoclonal antibodies and vaccines as PEP could provide both immediate and long-term protection against Ebola virus disease, highlighting ongoing clinical research that aims to refine this approach, and discuss the transformative potential of a successful PEP strategy to help control viral haemorrhagic fever outbreaks.
Assuntos
Surtos de Doenças , Vacinas contra Ebola , Doença pelo Vírus Ebola , Profilaxia Pós-Exposição , Doença pelo Vírus Ebola/prevenção & controle , Doença pelo Vírus Ebola/epidemiologia , Humanos , Profilaxia Pós-Exposição/métodos , Surtos de Doenças/prevenção & controle , Vacinas contra Ebola/uso terapêutico , Vacinas contra Ebola/administração & dosagem , Anticorpos Monoclonais/uso terapêutico , Antivirais/uso terapêutico , EbolavirusRESUMO
In response to the mpox outbreak in 2022 and 2023, widespread vaccination with modified vaccinia Ankara-Bavarian Nordic (MVA-BN, also known as JYNNEOS or Imvanex) was initiated. Here, we demonstrate that orthopoxvirus-specific binding and MVA-neutralising antibodies waned to undetectable levels 1â¯year post vaccination in at-risk individuals who received two doses of MVA-BN administered subcutaneously with an interval of 4â¯weeks, without prior smallpox or mpox vaccination. Continuous surveillance is essential to understand the impact of declining antibody levels.
Assuntos
Anticorpos Antivirais , Orthopoxvirus , Vacinação , Humanos , Anticorpos Antivirais/sangue , Orthopoxvirus/imunologia , Países Baixos/epidemiologia , Masculino , Adulto , Feminino , Vacina Antivariólica/administração & dosagem , Vacina Antivariólica/imunologia , Pessoa de Meia-Idade , Anticorpos Neutralizantes/sangue , Surtos de Doenças/prevenção & controle , Varíola/prevenção & controle , Infecções por Poxviridae/prevenção & controle , Mpox/prevenção & controle , Vaccinia virus/imunologia , Adulto Jovem , AdolescenteRESUMO
BACKGROUND: Since May 7 2022, mpox has been endemic in many countries which has attracted the attention of health authorities in various countries and made control decisions, in which vaccination is the mainstream strategy. However, the shortage of vaccine doses and the reduction of protective efficacy have led to unresolved issues such as vaccine allocation decisions and evaluation of transmission scale. METHODS: We developed an epidemiological model to describe the prevalence of the mpox virus in New York City and calibrated the model to match surveillance data from May 19 to November 3, 2022. Finally, we adjusted the model to simulate and compare several scenarios of non-vaccination and pre-pandemic vaccination. RESULTS: Relative to the status quo, if vaccination is not carried out, the number of new infections increases to about 385%, and the transmission time will be extended to about 350%, while if vaccinated before the epidemic, the number of new infections decreases to 94.2-96%. CONCLUSIONS: The mpox outbreak in New York City may be linked to the Pride event. However, with current vaccine coverage, there will be no more large-scale outbreaks of mpox, even if there is another similar activity. For areas with limited vaccines, priority is given to high-risk groups in the age group [34-45] years as soon as possible.
Assuntos
Surtos de Doenças , Humanos , Cidade de Nova Iorque/epidemiologia , Surtos de Doenças/prevenção & controle , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Criança , Idoso , Vacinação/estatística & dados numéricos , Pré-Escolar , Mpox/epidemiologia , Mpox/prevenção & controle , Lactente , Masculino , Feminino , Modelos Epidemiológicos , Idoso de 80 Anos ou mais , Vacinas contra Influenza/administração & dosagem , Recém-Nascido , Fatores Etários , PrevalênciaRESUMO
OBJECTIVE: 2022 - 2023 mpox outbreak necessitated rapid distribution of JYNNEOS vaccines from US Strategic National Stockpile to state and local public health agencies. New Hampshire's centralized public health structure required partnering with healthcare facilities to reach at-risk persons. Among the 67 organizations contacted to partner with, only 7 established public JYNNEOS vaccine clinics. The study objective was to identify barriers and resources needed for emergency public vaccination. METHODS: In March 2023, mixed-method surveys were developed and sent to 20 non-participating organizations and 7 participating organizations ("vaccine-partners"). RESULTS: 35% (7/20) of non-participating organizations and 100% (7/7) vaccine-partners responded. Non-participating organizations (n = 5) identified lack of staffing (100%) and insufficient provider time or clinical resources (80%) as the most common barriers. Staffing needs reported by non-participating organizations included: administrative (100%); medical doctor or advanced practice practitioner (67%); and registered nurse, medical assistant, or licensed nursing assistant (67%). Vaccine partners reported similar staffing requirements. Estimated additional monthly funding needs were $3,750 for non-participating organizations and $1,680 for vaccine-partners. CONCLUSIONS: A minority of NH healthcare facilities established public JYNNEOS vaccination clinics. The primary barrier was insufficient staffing; additional resources and funding needs were modest. Success of the next emergency vaccination campaign depends on sustained advocacy, resources, and partnership.
Assuntos
Surtos de Doenças , Humanos , New Hampshire , Inquéritos e Questionários , Surtos de Doenças/prevenção & controle , Vacinação/estatística & dados numéricos , Vacinação/métodosRESUMO
The time-varying effective reproduction number Re(t) is essential for designing and adjusting public health responses. Retrospective analysis of Re(t) helps to evaluate health emergency capabilities. We conducted this study to estimate the Re(t) of the Corona Virus Disease 2019 (COVID-19) outbreak caused by SARS-CoV-2 Omicron in Shenyang, China. Data on the daily incidence of this Corona Virus Disease 2019 outbreak between March 5, 2022, and April 25, 2022, in Shenyang, China, were downloaded from the Nationwide Notifiable Infectious Diseases Reporting Information System. Infector-infectee pairs were identified through epidemiological investigation. Re(t) was estimated by R-studio Package "EpiEstim" based on Bayesian framework through parameter and nonparametric method, respectively. About 1134 infections were found in this outbreak, with 20 confirmed cases and 1124 asymptomatic infections. Fifty-four infector-infectee pairs were identified and formed a serial interval list, and 15 infector-infectee pairs were included in the generation time table. Re(t) calculated by parameter and nonparametric method all peaked on March 17, 2022, with a value of 2.58 and 2.54 and decreased to <1 after March 28, 2022. There was no statistical difference in the Re(t) distribution calculated using the 2 methods (tâ =â 0.001, Pâ >â .05). The present study indicated that the decisive response of Shenyang, China, played a significant role in preventing the spread of the epidemic, and the retrospective analysis provided novel insights into the outbreak response to future public health emergencies.
Assuntos
COVID-19 , Surtos de Doenças , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , China/epidemiologia , Estudos Retrospectivos , Surtos de Doenças/prevenção & controle , Número Básico de Reprodução , Fatores de Tempo , Teorema de Bayes , IncidênciaRESUMO
Measles is a viral illness considered eliminated in the United States; however, outbreaks still occur even in this modern era where vaccines are readily available for every child under government-sponsored financing programs. The most recent measles outbreak was reported in March 2024 in Chicago, Illinois. Many of these patients were children younger than age 5 years with unvaccinated or unknown vaccine status, and this outbreak was associated with a migrant shelter. Measles bears a resemblance to other exanthemic diseases of childhood. In populations where there is high vaccine coverage, measles is less likely to be in the differential diagnosis for most physicians; however, cases of vaccine failure have been described, and populations have risk factors for developing complications associated with measles. Therefore, this quick review aims to describe an illustrative case, followed by epidemiology, clinical manifestations, complications, diagnosis, and vaccines associated with measles. By the end of this article, clinicians should be able to recognize a potential measles case, select the most appropriate test to confirm the diagnosis, and thus, prevent the spreading of this highly contagious disease. [Pediatr Ann. 2024;53(9):e345-e350.].
Assuntos
Vacina contra Sarampo , Sarampo , Humanos , Sarampo/epidemiologia , Sarampo/prevenção & controle , Sarampo/diagnóstico , Vacina contra Sarampo/administração & dosagem , Surtos de Doenças/prevenção & controle , Estados Unidos/epidemiologia , Pré-Escolar , Lactente , Masculino , VacinaçãoRESUMO
Hand, foot and mouth disease (HFMD) is a Class C infectious disease that carries particularly high risk for preschool children and is a leading cause of childhood death in some countries. We mimic the periodic outbreak of HFMD over a 2-year period-with differing amplitudes-and propose a dynamic HFMD model that differentiates transmission between mature and immature individuals and uses two possible optimal-control strategies to minimize case numbers, total costs and deaths. We parameterized the model by fitting it to HFMD data in mainland China from January 2011 to December 2018, and the basic reproduction number was estimated as 0.9599. Sensitivity analysis demonstrates that transmission between immature and mature individuals contributes substantially to new infections. Increasing the isolation rates of infectious individuals-particularly mature infectious individuals-could greatly reduce the outbreak risk and potentially eradicate the disease in a relatively short time period. It follows that we have a reasonable chance of controlling HFMD if we can reduce transmission in children under 7 and isolate older infectious individuals.
Assuntos
Número Básico de Reprodução , Surtos de Doenças , Doença de Mão, Pé e Boca , Conceitos Matemáticos , Modelos Biológicos , Estações do Ano , Doença de Mão, Pé e Boca/transmissão , Doença de Mão, Pé e Boca/epidemiologia , Doença de Mão, Pé e Boca/prevenção & controle , China/epidemiologia , Humanos , Número Básico de Reprodução/estatística & dados numéricos , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Pré-Escolar , Criança , Lactente , Fatores Etários , Simulação por Computador , Isolamento de Pacientes/estatística & dados numéricos , Modelos EpidemiológicosRESUMO
Washington D.C., 24 de julho de 2024 (OPAS) [Atualizado em 26 de julho de 2024] – Em julho deste ano, a Organização Pan-Americana da Saúde (OPAS) emitiu alerta epidemiológico sobre um aumento nos casos notificados do vírus Oropouche (OROV) em cinco países (Brasil, Bolívia, Peru, Cuba e Colômbia) na Região das Américas. Washington D.C., 24 de julio de 2024 (OPS) [Actualizado el 26 de julio de 2024] – En julio de este año, la Organización Panamericana de la Salud (OPS) emitió una alerta epidemiológica sobre un aumento de casos reportados del virus Oropouche (OROV) en cinco países (Brasil, Bolivia, Perú, Cuba y Colombia) de la Región de las Américas. Washington D.C., 24 July 2024 (PAHO) [Updated 26 July 2024] – In July this year, the Pan American Health Organization (PAHO) issued an epidemiological alert on an increase in reported cases of Oropouche virus (OROV) in five countries (Brazil, Bolivia, Peru, Cuba and Colombia) in the Region of the Americas.
Assuntos
Infecções por Bunyaviridae/virologia , Orthobunyavirus , Infecções por Bunyaviridae/epidemiologia , Infecções por Bunyaviridae/prevenção & controle , Surtos de Doenças/prevenção & controleRESUMO
BACKGROUND: Isolation of cases and quarantining of non-immune contacts are the mainstay of measles outbreak management in elimination settings. Serology testing of exposed contacts may not be feasible in large outbreaks; therefore, vaccination history is used as a proxy for determining immunity to measles and thus prevention of onward virus transmission. This study sought to investigate the risk of measles virus transmission from individuals with a history of one or two doses of measles-containing vaccine (MCV). METHODS: Retrospective analysis of data from measles cases reported to Auckland Regional Public Health Service during the 2019 Auckland region measles outbreak. Vaccination history was verified using patient records and the New Zealand National Immunisation Register. Onward transmission was determined through case interviews and assessment of exposed contacts. RESULTS: 1451 measles cases were assessed as eligible for vaccination at the time of measles outbreak. Of these, 1015 (70.0%) were unvaccinated, 220 (15.2%) had unknown vaccination status, 139 (9.6%) had received only one dose of MCV and 77 (5.3%) had received two doses of the vaccine. Compared to unvaccinated cases, the odds of onward transmission were lower among those with one dose only (OR 0.41, 95% CI: 0.20-0.75) or two doses of MCV (OR 0.44, 95% CI: 0.17-0.95). Median time since vaccination was longer among those with onward transmission compared to those without onward transmission for one and two doses of the vaccine, suggesting a potential effect of waning immunity among this cohort. CONCLUSION: These findings support the hypothesis that measles cases with a history of prior vaccination are less likely to transmit the virus to others compared to unvaccinated cases. Such information can be used to support decisions around quarantine requirements for vaccinated contacts in future measles outbreaks.
Assuntos
Surtos de Doenças , Vacina contra Sarampo , Vírus do Sarampo , Sarampo , Vacinação , Humanos , Sarampo/epidemiologia , Sarampo/prevenção & controle , Sarampo/transmissão , Nova Zelândia/epidemiologia , Surtos de Doenças/prevenção & controle , Masculino , Feminino , Vacina contra Sarampo/administração & dosagem , Vacina contra Sarampo/imunologia , Estudos Retrospectivos , Criança , Adolescente , Pré-Escolar , Vírus do Sarampo/imunologia , Adulto , Vacinação/estatística & dados numéricos , Adulto Jovem , Lactente , Pessoa de Meia-IdadeRESUMO
BACKGROUND: An outbreak of cholera was reported in the Middle East by the second half of 2022. Raising public awareness and vaccination against cholera represent critical factors in the preventive efforts. The current study aimed to assess the knowledge of cholera and attitude towards its vaccination among a sample of the general public residing in Jordan. METHODS: An online self-administered questionnaire was distributed to the residents in Jordan using a snowball convenience-based sampling approach. The questionnaire based on previously published studies included items to evaluate sociodemographic variables, knowledge about cholera symptoms, transmission, and prevention and the willingness to accept cholera vaccination. Additionally, four items based on the validated 5 C scale in Arabic were included to assess the psychological factors influencing attitude to cholera vaccination. RESULTS: The final study sample comprised 1339 respondents, of whom 1216 (90.8%) heard of cholera before the study. Among those who heard of cholera, and on a scale from 0 to 20, the overall mean cholera Knowledge score (K-score) was 12.9 ± 3.8. In multivariate analysis, being over 30 years old and occupation as healthcare workers or students in healthcare-related colleges were significantly associated with a higher K-score compared to younger individuals and students in non-healthcare-related colleges. Overall, the acceptance of cholera vaccination if cases are recorded in Jordan, and if the vaccine is safe, effective, and provided freely was reported among 842 participants (69.2%), while 253 participants were hesitant (20.8%) and 121 participants were resistant (10.0%). In linear regression, the significant predictors of cholera vaccine acceptance were solely the three psychological factors namely high confidence, low constraints, and high collective responsibility. CONCLUSIONS: In this study, the identified gaps in cholera knowledge emphasize the need to enhance educational initiatives. Although cholera vaccine acceptance was relatively high, a significant minority of the respondents exhibited vaccination hesitancy or resistance. The evident correlation between the psychological determinants and attitudes toward cholera vaccination emphasizes the need to consider these factors upon designing public health campaigns aimed at cholera prevention. The insights of the current study highlight the importance of addressing both knowledge gaps and psychological barriers to optimize cholera control strategies.