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Measles is a highly contagious, potentially fatal, but vaccine-preventable disease caused by measles virus. Symptoms include fever, maculopapular rash, and at least one of cough, coryza, or conjunctivitis, although vaccinated individuals can have milder or even no symptoms. Laboratory diagnosis relies largely on the detection of specific IgM antibodies in serum, dried blood spots, or oral fluid, or the detection of viral RNA in throat or nasopharyngeal swabs, urine, or oral fluid. Complications can affect many organs and often include otitis media, laryngotracheobronchitis, pneumonia, stomatitis, and diarrhoea. Neurological complications are uncommon but serious, and can occur during or soon after the acute disease (eg, acute disseminated encephalomyelitis) or months or even years later (eg, measles inclusion body encephalitis and subacute sclerosing panencephalitis). Patient management mainly involves supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhoea. There is no specific antiviral therapy for the treatment of measles, and disease control largely depends on prevention. However, despite the availability of a safe and effective vaccine, measles is still endemic in many countries and causes considerable morbidity and mortality, especially among children in resource-poor settings. The low case numbers reported in 2020, after a worldwide resurgence of measles between 2017 and 2019, have to be interpreted cautiously, owing to the effect of the COVID-19 pandemic on disease surveillance. Disrupted vaccination activities during the pandemic increase the potential for another resurgence of measles in the near future, and effective, timely catch-up vaccination campaigns, strong commitment and leadership, and sufficient resources will be required to mitigate this threat.

Outbreaks of enteroviral infections are associated with morbidity and mortality in susceptible individuals worldwide. There are still no antiviral drugs or vaccines against most circulating enteroviruses. Antibody-mediated immunity is crucial for preventing and limiting enteroviral infections. In this review, we focus on enteroviruses that continue to cause endemics in recent years, such as rhinovirus, enterovirus A71, coxsackievirus, and echovirus, and introduce a structural understanding of the mechanisms of virus neutralization. The mechanisms by which virus-specific antibodies neutralize enteroviruses have been explored not only through study of viral structures, but also through understanding virus-antibody interactions at the amino acid level. Neutralizing epitopes are predominantly mapped on the canyon northern rim, canyon inner surface, canyon southern rim, and twofold and threefold plateaus of the capsid, where surface-exposed loops are located. This review also describes recent progress in deciphering the virus-receptor complex and structural rearrangements involved in the uncoating process, providing insight into plausible virus neutralization mechanisms.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease, coronavirus disease 2019 (COVID-19), has caused a devastating pandemic worldwide. Here, we explain basic concepts underlying the transition from an epidemic to an endemic state, where a pathogen is stably maintained in a population. We discuss how the number of infections and the severity of disease change in the transition from the epidemic to the endemic phase and consider the implications of this transition in the context of COVID-19.

Blastomycosis is the fungal disease caused by thermally dimorphic fungi in the genus Blastomyces, with B dermatitidis complex causing most cases. It is considered hyperendemic in areas adjacent to the Great Lakes and along the St. Lawrence, Mississippi, and Ohio rivers, but definitive geographic distribution of blastomycoses remains obscure. Clinical presentation is variable. Disseminated blastomycosis with extrapulmonary manifestations is more common in immunosuppressed individuals. Culture positivity is required for definitive diagnosis, but compatible histology is often sufficient for presumptive diagnosis and initiation of treatment. Treatment should be provided to all symptomatic cases to prevent progression or recurrence.

Vertical transmission of Trypanosomacruzi is the cause of congenital Chagas disease, a re-emerging infectious disease that affects endemic and nonendemic regions alike. An early diagnosis is crucial because prompt treatment achieves a high cure rate, precluding evolution to symptomatic chronic Chagas disease. However, early diagnosis involves low-sensitive parasitologic assays, making necessary serologic confirmation after 9 months of life. With the aim of implementing early diagnostic strategies suitable for minimally equipped laboratories, a T. cruzi-loop-mediated isothermal amplification (LAMP) prototype was coupled with an automated DNA-extraction device repurposed from a three-dimensional printer (PrintrLab). The whole process takes3 hours to yield a result, with an analytical sensitivity of 0.1 to 2 parasite equivalents per milliliter, depending on the T. cruzi strain. Twenty-five blood samples from neonates born to seropositive mothers were tested blindly. In comparison to quantitative real-time PCR, the PrintrLab-LAMP dual strategy showed high agreement, while both molecular-based methodologies yielded optimal sensitivity and specificity with respect to microscopy-based diagnosis of congenital Chagas disease. PrintrLab-LAMP detected all 10 congenitally transmitted T. cruzi infections, showing promise for point-of-care early diagnosis of congenital Chagas disease.

Made available in DSpace on 2021-06-25T10:15:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Despite intense efforts, the number of new cases of leprosy has remained significantly high over the past 20 years. Host genetic background is strongly linked to the pathogenesis of this disease, which is caused by Mycobacterium leprae (M. leprae), and there is a consensus that the most significant genetic association with leprosy is attributed to the major histocompatibility complex (MHC). Here, we investigated the association of human leukocyte antigen (HLA) class I and II genes with leprosy in a Brazilian population encompassing 826 individuals from a hyperendemic area of Brazil; HLA typing of class I (-A, -B, -C) and class II (-DRB1, -DQA1, -DQB1, -DPA1, and -DPB1) loci was conducted. Initially, the associations were tested using the chi-square test, with p-values adjusted using the false discovery rate (FDR) method. Next, statistically significant signals of the associations were submitted to logistic regression analyses to adjust for sex and molecular ancestry data. The results showed that HLA-C*08, -DPB1*04, and -DPB1*18 were associated with protective effects, while HLA-C*12 and -DPB1*105 were associated with susceptibility to leprosy. Thus, our findings reveal new associations between leprosy and the HLA-DPB1 locus and confirm previous associations between the HLA-C locus and leprosy. Lauro de Souza Lima Institute São Paulo State University (UNESP) Medical School Graduate Program in Health Sciences School of Medicine Pontifícia Universidade Católica do Paraná Leprosy Laboratory Oswaldo Cruz Institute-Fiocruz Laboratory of Immunogenetics Department of Basic Health Sciences Maringá State University (UEM) São Paulo State University (UNESP) Medical School

Dengue is one of the endemic diseases in Indonesia. Dengue is being suffered by many people, regardless of their gender and age. Therefore, research about dengue based on dengue patients’ data was conducted. There was a lot of information written in that data regarding the corresponding patients and the dengue they had suffered, such as gender, age, how long the patients were hospitalized, the symptoms they experienced, and laboratory characteristics results. Diagnosis of each of the corresponding patients based on their symptoms and laboratory characteristics results were also written in that data. The diagnoses were classified into three different clinical degrees according to the severity level, which is DF as the mild level, DHF grade 1 as the intermediate level, and DHF grade 2 as the severe level. In this research, data of the patients on the third day of being hospitalized was analyzed, because, on the third day, dengue is entering a critical phase. The objectives of this research were: to evaluate the performance of the models that were used to predict the correct class within the given dataset developed using Artificial Neural Network (ANN) classifier and Random Forest (RF) classifier separately, and to find a classifier that yielded the best performance. The results obtained from this research will be used in the development of a Machine Learning model that can predict the clinical degree of dengue in the critical phase, if the laboratory characteristics results are known, using a classifier that yielded the best performance.

The use of life tables in age-graded mandibles of the endemic pygmy hippopotamus Hippopotamus minor from Aetokremnos Cyprus suggests that death occurred by natural causes such as accidents, genetic abnormalities and endemic diseases rather than catastrophic causes. Comparison of H. minor and modern Hippopotamus amphibius life tables suggests the birth of one offspring per female per year and the occurrence of mating and birth seasons. Hunting by prehistoric humans whose tools were found in proximity with the hippopotamus bones is not justified by the life tables that have been produced. The use of the wet rockshelter of Aetokremnos as a living area during the day, in the same way that extant H. amphibius use lake water, is instead proposed as a probable explanation for the extensive accumulation of bones.

Background In 1994, prevalence and incidence of epilepsy were high in the Itwara onchocerciasis focus (western Uganda), and cases of nodding and Nakalanga syndrome were documented. Onchocerciasis transmission was interrupted successfully in 2001. 17 years later, we re-investigated the epilepsy burden in this area. Methods From Dec 11 to Dec 15, 2018, a door-to-door survey was done in the three villages (Kabende Centre, Masongora South, and Rwesenene) with the highest epilepsy rates in 1994 to identify people with suspected epilepsy. Epilepsy diagnoses were confirmed by an interview and physical examination by a study clinician. The prevalence and incidence of epilepsy were measured using methods consistent with those used in 1994. Results from 2018 were compared with those from 1994. Findings The overall crude prevalence of epilepsy in the study villages decreased from 3.0% (35 of 1169) in 1994 to 1.2% (27 of 2325) in 2018 (p=0.0002), with a concomitant decrease in the proportion of people with epilepsy with unknown cause (p=0.037). Between 1994 and 2018, the overall incidence of epilepsy decreased from 418 cases per 100 000 personyears (95% CI 265-626) to 73 new cases per 100 000 person-years (32-114; p

Objectives Regarding severe acute respiratory syndrome coronavirus 2, it is known that a substantial percentage of the adult population does not become infected when exposed to this novel coronavirus. Several studies provide an initial indication of the possible role of pre-existing immunity, whether cross-immunity or not. The possible role of latent tuberculosis (TB) and malaria has been suggested to create innate cross heterogeneous immunity. In this study, we looked for the influence of these factors on coronavirus disease 2019 (COVID-19) mortality in malaria-endemic countries. Study design Eighty malaria-endemic countries were enrolled in this cross-sectional study. Data subjected to testing included TB prevalence, Bacillus Calmette-Guerin (BCG) vaccine coverage, malaria incidence, and COVID-19 mortality. Methods Hierarchical multiple regression type of analysis was used for data analyses. TB prevalence per 100,000 population standardized to BCG coverage rates was taken as a direct factor in the test. Malaria incidence per 1000 population was considered an intermediate factor. The outcome was COVID-19 mortality per million population. Results The results showed with robust statistical support that standardized TB prevalence was significantly associated with reduced COVID-19 mortality. Malaria had an additional effect in reducing COVID-19 mortality, with a highly significant association. Conclusions Malaria and standardized TB prevalence are statistically significant factors associated negatively with COVID-19 mortality.

Context Intracranial tuberculomas are rare yet lethal forms of tuberculosis. Diagnosis is often difficult because of its nonspecific symptoms and radiological findings. Aim This study aims to perform a literature review of multiple tuberculomas to improve disease recognition and management in immunocompetent patients along with presenting a case report on the topic. Data sources Scopus, LILACS, Ovid MEDLINE and EMBASE. Study selection Case reports and case series up to December 2018 in English, Spanish, and Portuguese focusing on intracranial tuberculomas in adult and pediatric immunocompetent patients. Data on presentation, diagnostic workup, and treatment was analyzed. Data extraction Cochrane Collaboration/Cochrane Handbook and PRISMA guidelines. Results Twenty reports involving 21 patients were included. Most patients were male (57.14%). The average age at diagnosis was 26.9 ± 14.9 years. Headache was the most common presenting symptom (52.4%; 11/21), followed by motor weakness (47.6%; 10/21) and vomiting (23.8%; 5/21). MRI was the most used image technique (17/21). Most lesions occurring in the cerebral hemispheres (16/21); we found five or more lesions in 66.6% (14/21) of the patients. The majority treated with anti-tuberculous drugs resulted in a favorable outcome. Conclusions Immunocompetent patients living in TB endemic areas whose clinical evaluation and neuroimaging findings are compatible with tuberculoma should undergo anti-tubercular treatment despite a lack of bacteriological confirmation.

A study on the occurrence of Dirofilaria immitis and its vectors was carried out in order to assess the prevalence of the disease in dogs in previously non-endemic areas of southern Italy. Blood samples (n = 385) and mosquitoes (n = 1540) were collected in two dog shelters and analysed by Knott’s test and duplex real-time PCR, respectively. Dirofilaria immitis was the most prevalent filarioid (44.2%), while Culex pipiens was the most prevalent mosquito species (68.8%). This high prevalence of D. immitis infection confirms this location as one of the most hyperendemic foci of dirofilariosis in Europe.

PurposeAnnual mass azithromycin distribution significantly reduces the prevalence of ocular Chlamydia trachomatis, the causative organism of trachoma. However, in some areas a decade or more of treatment has not controlled infection. Here, we compared multiple treatment arms from a community-randomized trial to evaluate whether increasing frequency of azithromycin distribution decreases prevalence in the short term.MethodsSeventy-two communities in Goncha Siso Enesie woreda in the Amhara region of Northern Ethiopia were randomized to 1 of 6 azithromycin distribution strategies: (1) delayed, (2) annual, (3) biannual, (4) quarterly to children only, (5) biennial, or (6) biennial plus latrine promotion. We analyzed data from the 60 communities in the delayed, annual, biannual, quarterly, and biennial distribution arms at the 12-month study visit. Communities in the annual and biennial distribution arm were combined, as they each had a single distribution before any 12-month retreatment. We assessed the effect of increased frequency of azithromycin distribution on ocular chlamydia prevalence.ResultsOcular chlamydia prevalence was significantly different across azithromycin distribution frequency in children (P < .0001) and adults (P&nbsp

Background Leptospirosis is a life-threatening zoonotic disease for which delayed treatment onset has been associated to poor prognosis. The purpose of the study was to identify the determinants of therapeutic delay in hospitalized leptospirosis cases. Patients and methods We carried out a retrospective multicenter study in the 4 public hospitals of Reunion Island, South Western Indian Ocean. Medical records of confirmed leptospirosis cases occurring in 2014–2015 were reviewed for socio-economic, demographic, geographic and medical data. The primary outcome measure was the therapeutic delay, defined as the time elapsed between the onset of symptoms and initiation of antibiotics. Results Of the 117 patients included, 107 were men, with an average age of 44.9 ± 15 years. The median therapeutic delay was 4 days (interquartile: 2–5 days) and this delay was not found to be associated with severity. The following were found to be at increased risk of having a longer therapeutic delay: cases occurring outside the epidemic period, or rainy season (OR 2.8 [1.08–7.3], P = 0.04) and cases with first medical evaluation in primary health care (OR 4.63 [1.43–14.93]; P = 0.01) instead of emergency unit. No socio-economic or geographic characteristics were found to be linked to a longer therapeutic delay. Conclusion Although delayed treatment was not associated to disease severity, our results indicate that leptospirosis awareness is needed all year in the subtropical area of Reunion Island and particularly in primary care.

Summary: Background: Nepal launched a visceral leishmaniasis (also known as kala-azar) elimination initiative in 2005. We primarily aimed to assess whether transmission of Leishmania donovani had decreased since the launch of the initiative. We also assessed the validity of the direct agglutination test (DAT) as a marker of infection, in view of future surveillance systems. Methods: We did a repeat survey in a population aged 2 years and older for whom baseline serological data were available from 2006. Data were from three districts in the eastern region of Nepal. The primary outcome of interest was prevalent infection with L donovani as measured with DAT (cutoff value ≥1:3200). We compared age group-specific and cluster-specific seroprevalences in 2016 with those in 2006, using χ2 tests, with a specific focus on the comparison of seroprevalences in children born between 1996 and 2005, and those born between 2006 and 2015. To estimate the overall adjusted risk ratio for being seropositive in 2016 compared with 2006, we fitted a Poisson model controlling for age, sex, and cluster. Findings: Between Oct 17, 2016, and Dec 26, 2016, we assessed 6609 individuals. DAT prevalence in children younger than 10 years was 4·1% (95% CI 3·2–5·4) in 2006 versus 0·5% (0·1–1·7) in 2016 (p

Objective To evaluate the use of a sequencing procedure for the entire rpoB gene of Mycobacterium tuberculosis to identify mutations pre-rifampicin resistance determining region (RRDR), within RRDR, and post-RRDR in isolates circulating in a region affected by tuberculosis (TB). Methods Five primers were designed, with which five DNA fragments of rpoB were obtained, sequenced by Sanger, and analysed in silico in order to identify mutations over the entire rpoB gene in rifampicin-sensitive and rifampicin-resistant TB. Results It was possible to analyse the entire rpoB gene in five rifampicin-sensitive and 15 rifampicin-resistant isolates. Thirty-six mutations were identified. Two mutations were found pre-RRDR, nine within-RRDR and 25 post-RRDR. The most frequent mutations within RRDR were S531L (53%), followed by S512T (20%), all of which were found in rifampicin-resistant isolates. Of the 25 mutations found post-RRDR, 14 were only in resistant isolates, and the most frequent was D853N, which was present in 85% of isolates. Mutations E818K, D836N and T882P were observed in 80% of the rifampicin-resistant and rifampicin-sensitive isolates. Conclusions The proposed sequencing method allowed identification of mutations in the entire rpoB gene. This procedure represents a useful tool for diagnosing rifampicin resistance. The number of mutations that were found raises new questions about the diversity of mutations in the rpoB gene and their role in rifampicin resistance in regions where TB is endemic.

The main objective of this commentary is to provide historical insight into the term endemicity and to demonstrate why framing COVID-19 as endemic in early 2022 is a misguided approach.The history of epidemiology as well as current data on COVID-19 as provided by the United States Centers for Disease Control, the World Health Organization, and the Johns Hopkins COVID-19 Resource Center was surveyed.Records of the Epidemiological Society of London for the period 1850-1900 were analyzed, and several key publications on how infectious diseases were considered endemic were identified.The term endemicity has a long and twisting history, changing from its meaning in the mid-nineteenth century until our use of it today. The concept has long been tied to historical patterns of colonialism.Framing COVID-19 as an endemic disease in early 2022 is a misguided attempt and a result of cultural and political forces.

Malaria is an important public health problem, caused by Plasmodium parasites which are transmitted by female Anopheles mosquitoes that bite humans to obtain blood. The aim of this work was to identify the blood feeding sources of Anopheles female mosquitoes and calculate their entomological indices in relation to Plasmodium transmission. Mosquitoes were collected in malaria endemic localities of the Bajo Cauca and Pacific regions of Colombia using human landing catch and barrier screens, from 18:00 to 24:00 hr, in 2018-2021. Animal censuses within a radius of ∼250 m were carried out at each sampling site. A total of 2018 Anopheles specimens were collected and the most abundant species were Anopheles (Nys.) darlingi and Anopheles (Nys.) nuneztovari. The highest human biting rate was 77.5 bites per person per night (b/p/n) for An. nuneztovari in Córdoba-Pacific and 17.5 b/p/n for An. darlingi in Villa Grande-Bajo Cauca. Both species were active mainly in indoor unwalled rooms of the houses. Only An. nuneztovari from Córdoba-Pacific was infected with Plasmodium, with an entomological inoculation rate of 91.25 infective bites per year. Detection of blood feeding sources demonstrate that humans were the most common host, however, An. nuneztovari showed a preference for feeding on dogs and An. darlingi on pigs, dogs and Galliformes, rather than humans. These results contribute to entomological surveillance information and provide valuable data that can be used to tailor effective control interventions to minimize human-vector contact in these malaria endemic regions.

Background Ross River virus (RRV) is a zoonotic alphavirus transmitted by several mosquito species. Until recently, endemic transmission was only considered possible in the presence of marsupial reservoirs. Methods RRV seroprevalence was investigated in placental mammals (including horses, cows, goats, pigs, dogs, rats, and mice) in Fiji, where there are no marsupials. A total of 302 vertebrate serum samples were collected from 86 households from 10 communities in Western Fiji. Results Neutralizing antibodies against RRV were detected in 28% to 100% of sera depending on the species, and neutralization was strong even at high dilutions. Conclusions These results are unlikely to be due to cross-reactions. Chikungunya is the only other alphavirus known to be present in the Pacific Islands, but it rarely spills over into non-humans, even during epidemics. The study findings, together with a recent report of high RRV seroprevalence in humans, strongly suggest that RRV is circulating in Fiji in the absence of marsupial reservoirs. Considering that all non-human vertebrates present in Fiji are pan-global in distribution, RRV has the potential to further expand its geographic range. Further surveillance of RRV and access to RRV diagnostics will be critical for the early detection of emergence and outbreaks.

Background The hepatitis B (HepB) vaccine is recommended for adults traveling to a country of high or intermediate endemicity. Methods Data from the 2016 and 2017 National Health Interview Surveys were pooled. Results The weighted prevalence of HepB vaccination initiation (≥1 dose) was 37.67% in 2016 (weighted number: 30,581,813/81,192,803) and 40.20% in 2017 (weighted number: 34,509,993/85,849,427). The weighted prevalence of HepB vaccination completion (≥3 doses) was 29.97% in 2016 (weighted number: 24,331,218/81,192,803) and 31.78% in 2017 (weighted number: 27,282,536/ 85,849,427). Characteristics independently associated with HepB vaccination initiation (in descending order by odds ratio) included age, receipt of influenza vaccine, education, ever having lived with someone with hepatitis, class of worker, number of physician visits in the past 12 months, ratio of family income to the poverty threshold, region, sexual orientation, gender, heath insurance, computer use, physical activity, and Hispanic ethnicity. Similar results were found in the analysis for HepB vaccination completion, except that subjects born in the United States showed a higher likelihood of HepB vaccination completion. Conclusions HepB vaccination initiation and completion were associated with a number of characteristics that can be utilized to develop strategies to increase HepB vaccination coverage among adults traveling to a country of high or intermediate endemicity.

The factors associated with Leishmania spp. infection in dogs are still poorly understood. This study aimed to identify such factors among domestic dogs from the Brazilian municipality of Rondonopolis, which recently emerged as an endemic area with intense transmission of human visceral leishmaniasis (VL). It was a household-based cross-sectional study conducted between 2016 and 2017. Interviews were conducted with 405 dog owners considering their socioeconomic characteristics, and environmental aspects of the household and its adjacent areas. In addition, 600 dogs were evaluated regarding physical characteristics, behavior, and care provided by the owner. Seropositive animals were those that showed reactivity in a rapid immunochromatographic test and enzyme-linked immunosorbent assay, which are currently recommended for canine visceral leishmaniasis (CVL) diagnosis in Brazil. A multivariable logistic regression analysis was employed to determine the associated factors. Low social class [OR = 2.0; 95% CI = (1.2–3.2)], presence of acerola tree ( Malpighia emarginata ) in the yard [OR = 2.2; 95% CI = (1.2–4.1)], presence of more than one dog in the household [OR = 2.0; 95% CI = (1.3–3.3)], horse and/or cattle breeding [OR = 12.0; 95% CI = (1.9–73.6)], existence of houses with yard adjacent to the home [OR = 4.0; 95% CI = (1.3–12.2)], presence of apparent signs consistent with CVL [OR = 10.6; 95% CI = (5.8–19.4)], dog staying mostly in the yard during the day [(OR = 4.8; 95% CI = (1.1–21.4)], and lack of cleaning of the dog's shelter [(OR = 1.9; 95% CI = (1.1–3.2)] were identified as the factors associated with Leishmania spp. infection. These results support the importance of socioeconomic and environmental aspects in the occurrence of Leishmania spp. infection. In addition, they may be useful in guiding control strategies in areas where zoonotic VL is endemic.

Aelurostrongylus abstrusus (Nematoda, Metastrongyloidea) is a worldwide occurring lungworm causing verminous pneumonia in cats. To date the Baermann method is the most used procedure to diagnose A. abstrusus infection by isolating first stage larvae from faeces, though its sensitivity and specificity can be impaired by several factors. An enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies against A. abstrusus has been recently developed as a diagnostic alternative. The present study evaluated the seroprevalence for A. abstrusus infection in cats from two endemic areas of Italy. Overall, 250 sera were sampled and tested for the presence of antibodies against A. abstrusus. Based on the results obtained from 20 cats proven to be infected by A. abstrusus using Baermann technique and molecular methods, and from 20 negative cats (Subset A), a cut off value of 0.347 optical density (OD) was determined, leading to a sensitivity of 95% and a specificity of 100%. Two-hundred and ten cats (142 and 68 from Abruzzo and Umbria regions, respectively) were included in Subset B (i.e. 202 negative by Baermann examination and 8 positive for Troglostrongylus brevior). Antibodies against A. abstrusus were detected in forty-five (21.4%, 95% CI: 16.1-27.6%) samples. This study confirms the occurrence of A. abstrusus in endemic areas of Italy and indicates that one-fifth of randomly selected cats have or had a lungworm infection with production of antibodies.

Lassa fever is an acute viral illness caused by Lassa virus (LASV), a rodent-borne pathogen. LASV is endemic to much of Sub-Saharan West Africa, where seasonal outbreaks cause significant morbidity and mortality. Increased global awareness of LASV has led to development of improved diagnostic tests, treatments and vaccines. As vaccine candidates are trialled, it is essential to assess the potential outcomes of introducing a LASV vaccination program in endemic regions. This study investigates the potential outcomes of routine and pulse vaccination strategies using a deterministic mathematical model that captures seasonal LASV transmission between rodents and humans. For plausible parameter values, we find that immunization of 40% of infants at 70% vaccine effectiveness achieves a population-level reduction in infectious case numbers of 30%, while coverage of 60% at 90% vaccine effectiveness achieves a 56% reduction. Similar reductions can be achieved more rapidly via population-wide pulse vaccination at 11% coverage (30% reduction at 70% effectiveness) or 23% coverage (56% reduction at 90% effectiveness) repeated every 10 years. Similar pulse vaccine doses delivered at reduced frequency, but increased coverage achieves a greater reduction in infectious cases. Findings around infant vaccination are sensitive to our assumption that immunity is life-long, while pulse-vaccination has only slightly reduced effect if immunity lasts 10–30 years. An effective LASV vaccination program would incorporate pulse vaccination in addition to routine childhood immunization to limit disease. Estimates of feasible vaccine coverage and effectiveness are needed to fully quantify the likely benefits of a vaccination program in LASV endemic regions.

In total, 95 Acinetobacter baumannii isolates recovered from patients from two hospitals in Cochabamba, Bolivia were studied. The presence of class D and B β-lactamases was investigated using polymerase chain reaction, and antimicrobial susceptibility testing was performed by agar dilution and broth microdilution. The resistance rate to carbapenems was 53.7%. All carbapenem-resistant A. baumannii (CRAb, n=51) and four carbapenem-susceptible isolates were further analysed by whole-genome sequencing. The resulting genome assemblies were used to identify the acquired resistome, and core genome multi-locus sequence typing (cgMLST) was used to determine their molecular epidemiology. All but one of the CRAb isolates (n=50) belonged to international clone (IC) 7 and they clustered into five sequence types; on cgMLST, they were found to be separated by ≥40 alleles. All CRAb isolates carried blaOXA-23 on transposon Tn2008. Metallo-β-lactamases were not detected. These data show that dissemination of several IC7 A. baumannii clones harbouring the carbapenem resistance determinant blaOXA-23 is occurring in these two hospitals in Cochambamba.

According to the World Health Organization, tuberculosis (TB) is the leading cause of death from infectious disease worldwide (WHO, 2017). While there is no effective vaccine against adult pulmonary TB, more than a dozen vaccine candidates are in the clinical trial pipeline. These include both pre-exposure vaccines to prevent initial infections and post-exposure vaccines to prevent reactivation of latent disease. Many epidemiological models have been used to study TB, but most have not included a continuous age structure and the possibility of both pre- and post-exposure vaccination. Incorporating age-dependent death rates, disease properties, and social contact data allows for more realistic modeling of disease spread. We propose a continuous age-structured model for the epidemiology of tuberculosis with pre- and post-exposure vaccination. We use uncertainty and sensitivity analysis to make predictions about the efficacy of different vaccination strategies in a non-endemic setting (United States) and an endemic setting (Cambodia). In particular, we determine optimal age groups to target for pre-exposure and post-exposure vaccination in both settings. We find that the optimal age groups tend to be younger for Cambodia than for the US, and that post-exposure vaccination has a significantly larger effect than pre-exposure vaccination in the US.

Zika virus (ZIKV) infection in human has been reported from Gujarat and Tamil Nadu states during the year 2016 and 2017 respectively. In paucity of complete genome data of ZIKV, the analysis and prediction were not possible. Zika cases were reported in Jaipur city, Rajasthan, India during the period of 21st September 2018 to 29th October 2018. In order to understand the circulating ZIKV strain in Rajasthan state about ten human serum samples from the positive cases of Jaipur city, Rajasthan state considering the locality and clustering variations were sequenced using next-generation sequencing (NGS) platform. Complete genome phylogenetic analysis of Jaipur city sequences with known GenBank ZIKV sequences revealed that the outbreak in Jaipur city was being caused by ZIKV belonging to Asian lineage. Partial genome sequencing revealed the presence of a pre-outbreak strain of ZIKV in Gujarat and current outbreak strain of Asian lineage in Tamil Nadu. Further sequence analysis of the five ZIKV positive samples of Jaipur revealed that the S139N and A188V mutations, linked to enhanced neurovirulence and transmission in animal models, were not found in the current outbreak strain. Whether this strain can cause birth defects and cause large outbreaks is not currently known, but they should be treated as such until more is known. With the identification of ZIKV in Gujarat, Tamil Nadu, and recent outbreaks of ZIKV in Rajasthan and Madhya Pradesh states alarm for India to enhance surveillance in other states and monitor the mutation and evolutionary changes in circulating Zika strains.

Summary Background Global migration from regions where strongyloidiasis and schistosomiasis are endemic to non-endemic countries has increased the potential individual and public health effect of these parasitic diseases. We aimed to estimate the prevalence of these infections among migrants to establish which groups are at highest risk and who could benefit from screening. Methods We did a systematic review and meta-analysis of strongyloidiasis and schistosomiasis prevalence among migrants born in endemic countries. Original studies that included data for the prevalence of Strongyloides or Schistosoma antibodies in serum or the prevalence of larvae or eggs in stool or urine samples among migrants originating from countries endemic for these parasites and arriving or living in host countries with low endemicity—specifically the USA, Canada, Australia, New Zealand, Israel, and 23 western European countries—were eligible for inclusion. Pooled estimates of the prevalence of strongyloidiasis and schistosomiasis by stool or urine microscopy for larvae or eggs or serum antibodies were calculated with a random-effects model. Heterogeneity was explored by stratification by age, region of origin, migrant class, period of study, and type of serological antigen used. Findings 88 studies were included. Pooled strongyloidiasis seroprevalence was 12·2% (95% CI 9·0–15·9%; I2 96%) and stool-based prevalence was 1·8% (1·2–2·6%; 98%). Migrants from east Asia and the Pacific (17·3% [95% CI 4·1–37·0]), sub-Saharan Africa (14·6% [7·1–24·2]), and Latin America and the Caribbean (11·4% [7·8–15·7]) had the highest seroprevalence. Pooled schistosomiasis seroprevalence was 18·4% (95% CI 13·1–24·5; I2 97%) and stool-based prevalence was 0·9% (0·2–1·9; 99%). Sub-Saharan African migrants had the highest seroprevalence (24·1·% [95% CI 16·4–32·7]). Interpretation Strongyloidiasis affects migrants from all global regions, whereas schistosomiasis is focused in specific regions and most common among sub-Saharan African migrants. Serological prevalence estimates were several times higher than stool estimates for both parasites. These data can be used to inform screening decisions for migrants and support the use of serological screening, which is more sensitive and easier than stool testing. Funding None.

Introduction Development of secondary haemophagocytic lymphohistiocytosis (sHLH) in the context of typhoid fever (TF) is a very rare but serious complication. Methods Description of the first pediatric case of typhoid fever acquired in a non-endemic area complicated by sHLH. A systematic literature review of sHLH in the context of TF was performed with extraction of epidemiological, clinical and laboratory data. Results The literature search revealed 17 articles (22 patients). Fifteen patients were eligible for data analysis (53.4% children). All patients had fever and pancytopenia. Transaminases and LDH were frequently elevated (46.6%). Salmonella typhi was detected mainly by blood culture (64.3%). All the patients received antibiotics whereas immunomodulation (dexamethasone) was used in two cases. Conclusions A high suspicion index for this condition is needed even in non-endemic areas. The addition of immunmodulation to standard antimicrobial therapy should be considered in selected cases.

In North America, Lyme disease (LD) is caused predominantly by the spirochete Borrelia burgdorferisensu stricto, and is transmitted by blacklegged ticks. Long Island, New York, is highly endemic for the disease. The C6 peptide (C6P) is currently used as a screening test for LD in our institution. Our objective was to examine how screening with C6P concorded with diagnosis of LD at the Veterans Affairs Medical Center, Northport, Long Island. A retrospective chart-review of 2558 C6P tests was performed during the period of 1/1/2010 to 12/31/2016. Patients were categorized by Lyme Disease (LD) or no LD groups. LD group was defined as having an erythema migrans (EM) rash, or ≥ 2 IgM bands or ≥ 5 IgG bands on immunoblot. Out of the 409 patients with positive or equivocal C6P, 181 patients with LD were based on presence of EM, or Western blot IgM and IgG test results; 228 did not have LD. The positive predictive value of C6P was 44.5%. EM was the most common presentation. In the LD group, history of tick bite (P: 0.0001), headache (P: 0.0036), joint swelling (P: 0.0086) and myalgias (P: 0.0005) were more likely to be present. Zip code mapping of our cases mirrored those previously reported in the Suffolk County Department of Health. In our review we encountered a significant number of false positive C6 assays. False positive C6P tests were ordered by primary care physicians (PCP) (37%) followed by neurologists (33%). A history of tick exposure and clinical findings of early Lyme disease such as headaches or joint aches were more likely to denote a true positive C6 peptide test. Rigorous education of physicians about Lyme disease and pitfalls of our available diagnostic tests are needed for their proper utilization.

Background Both malaria and mental disorders are associated with immune changes. We have previously reported the associations between malaria and mental disorders. We now report associations between malaria, mental disorders and immunity. Methods A household survey of malaria, mental disorders and immunity was conducted in a health and demographic surveillance system's site of 70,000 population in an area endemic for malaria in western Kenya. A random sample of 1190 adults was selected and approached for consent, blood samples and structured interview. Findings We found marginally raised CD4/CD3 ratios of participants with malaria parasites, but no difference in CD4/CD3 ratios for participants with common mental disorder (CMD) or psychotic symptoms. People with psychotic symptoms had increased levels of IL-6, IL-8, and IL-10, and lower levels of IL-1beta. People with CMD had higher levels of IL-8 and IL-10. People with malaria had higher levels of IL-10 and lower levels of TNF-alpha. At the bivariate level, CMD was associated with log TNF-α levels using unadjusted odds ratios, but not after adjusting for malaria. Psychotic symptoms were associated with log IL-10 and log TNF-α levels at the bivariate level while in the adjusted analysis, log TNF-α levels remained highly significant.. Interpretation This is the first population based study of immune markers in CMD and psychotic symptoms, and the first to examine the 3 way relationship with malaria. Our findings suggest that TNF-α may mediate the relationship between malaria and CMD. Fund The study was funded by UK Aid, Department for International Development , Kenya office.

The seropositivity and risk factors for Trypanosoma cruzi infection in dogs from a municipality of Cundinamarca, a central state of Colombia were studied. A total of 356 client-owned dogs from urban, peri-urban and rural areas of La Mesa municipality, (Cundinamarca, Colombia) were randomly selected. Blood samples were collected by venipuncture. Anti-T. cruzi antibodies were determined using the enzyme-linked immunosorbent assay (ELISA) method. Reactive ELISA sera were processed by indirect immunofluorescence to confirm the presence of anti-T. cruzi antibodies. Chi-square tests were conducted for statistical analysis. Serologic tests for T. cruzi infection showed a prevalence of 29.49% (105/356), the rural area show a highest T. cruzi infection pattern in comparison with the other zone locations. Two triatomine species were found through the study: Panstrongylus geniculatus (53.4%) and Rhodnius colombiensis (46.6%). The prevalence of positive vectors for parasite was of 52.1% (38/73). Additionally, a very close relation between triatomine bugs and dogs in the rural zone (1:3.1) was observed. These results are the first report of natural infection by T. cruzi in domestic dogs in La Mesa municipality. In conclusion, the presence of anti-T. cruzi antibodies in dogs in this area suggest vector transmission. There is a need for active surveillance programs throughout the La Mesa municipality and vector control strategies should also be implemented.

Sustained control of group A Streptococcus (GAS) infections in settings of poverty has proven to be challenging, and an effective vaccine may be the most practical long-term strategy to reduce GAS-related disease burden. Candidate GAS vaccines based on the J8 peptide have demonstrated promising immunogenicity in mice, however, less is known about the role of J8 antibodies in the human immune response to GAS infection. We analysed the stimulation of J8 antibodies in response to infection, and the role of existing J8 antibodies in protection against subsequent infection, using data collected in the Fijian population: (1) cross sectional population serosurvey; (2) paired serum collection for assessment of M-specific and J8 antibody responses; and (3) longitudinal assessment of GAS infection and immunity. Median J8 antibody concentrations peaked in the 5-14 year age group, but there was no sustained increase with age. J8 antibody concentration was neither a significant predictor of time to next infection, nor did it show any relationship to the time since last recorded skin infection. Similarly, J8 antibody fold changes over a defined period were associated neither with the time since last skin infection, nor the number of intervening skin infections. While strong M-specific antibody responses were observed for skin infection, similarly strong J8 antibody responses were not observed. There is no indication that antibodies to the J8 antigen would be useful as either a marker of GAS infection or a measure of population immunity, with J8 antibody responses to infection fleeting, if existent at all.

We introduce a new mathematical modeling framework that seek to improve our quantitative understanding of the influence of chronic brucellosis and culling control on brucellosis dynamics in periodic and non-periodic environments. We conduct both epidemic and endemic analysis, with a focus on the threshold dynamics characterized by the basic reproduction numbers. In addition, we also perform an optimal control study to explore optimal culling strategy in periodic and non-periodic environment.

Coronaviruses are a well-known cause of upper and lower respiratory disease, and since 2002 have been a recognized source of potential pandemic spread. Over the past two decades, since the Severe Acute Respiratory Syndrome (SARS) outbreak, a large body of research has accumulated on the virology, clinical symptoms and signs, and experimental treatments of Coronaviruses. In 2020, a new form of Coronaviruses (SARS-CoV-2) emerged and spread rapidly throughout the globe. Given the wide-ranging clinical presentations of those infected with SARS-CoV-2, other viruses might be overlooked when evaluating at-risk patients. Furthermore, due to suboptimal testing capabilities, an early clinical diagnosis is not always possible. Here, we present a case of a patient with pneumonia thought to be caused by SARS-CoV-2 only to be found to have another Coronavirus. This emphasizes the need to be vigilant when evaluating patients with viral-like respiratory infections.

In Morocco, cutaneous leishmaniasis (CL) is an endemic disease; it is considered a major public health problem caused by three species Leishmaniamajor, Leishmaniatropica, and the dermotropic variant MON-24 of Leishmaniainfantum. This species has three incriminated vectors named; Phlebotomus ariasi, Phlebotomus longicuspis and Phlebotomus perniciosus, with the dog as reservoir.The main aim of this review is to elucidate the current epidemiological pattern of CL due to L.infantum and to investigate the factors facilitating its propagation throughout the country. Therefore, the number of CL cases due to L.infantum, their repartition; the distribution of L.infantum vectors, as well as the factors affecting their abundance and spread were investigated. We showed a wide extension of this form of CL, from the north of Morocco to the Saharan areas, as well as an increase of reported cases. This extension of the disease has been accompanied by a juxtaposed spread and a high abundance of confirmed vectors of L. infantum, which are present in almost all bioclimatic zones. In this review, we have highlighted the impact of climate: temperature, humidity, precipitation; vegetation and human activities on the geographical expansion of L. infantum vectors. These abiotic and biotic factors constitute favorable conditions for the increase of vector populations, and their introduction into areas where they did not exist before, and subsequently raise the risk of introduction of this form of cutaneous leishmaniasis into previously free areas. To conclude, CL by L.infantum, traditionally evolving as a sporadic form, is changing to an endemic mode, which seeks more epidemiological studies, and more attention from the health authorities when implementing control programs.

Community-Directed Treatment with Ivermectin (CDTI) is the strategy of choice to fight onchocerciasis in Africa. In areas where loiasis is endemic, onchocerciasis control and/or elimination is hindered by severe adverse events (SAEs) occurring after ivermectin mass treatments. This study aimed at (i) investigating the impact of two decades of CDTI on L. loa clinical and parasitological indicators in the Ndikinimeki Health District, and (ii) assessing the risk of SAEs after this long-term preventive chemotherapy. A cluster-based cross-sectional survey was conducted in the six Health Areas of the Ndikinimeki Health District. All volunteers underwent day-time calibrated thick blood smears to search for L. loa microfilariae, as well as an interview to assess the history of migration of eye worm and Calabar swelling. The overall prevalence of L. loa microfilaraemia was 2.2 % (95% CI: 1.3-3.7%), and the proportions of individuals who had already experienced eye worm and/or Calabar swelling were 1.0% and 0.5%, respectively. The mean microfilarial density was 63.55 (SD: 559.17; maximum: 9220.0) mf/mL. These findings indicate that (i) the long-term ivermectin-based preventive chemotherapy against onchocerciasis significantly reduced L. loa clinical and parasitological indicators, and (ii) the risk of developing neurologic and potentially fatal SAE after ivermectin mass treatment is zero in the Ndikinimeki Health District.

There are many infectious diseases that can be spread by daily commuting of people and dengue fever is one of them. The absence of vaccine and irregularities in ongoing vector control programs make this disease the most frequent and persistent in many tropical and subtropical regions of the world. This paper targets to access the effects of daily commuting on dengue transmission dynamics by using a deterministic two-patch model fitted to observed data gathered in Cali, Colombia where dengue fever is highly persistent and exhibits endemo-epidemic patterns. The two-patch dengue transmission model with daily communing of human residents between patches (that is, between the city and its suburban areas) is presented using the concept of residence times, which certainly affect the disease transmission rates by inducing variability in human population sizes and vectorial densities at each patch. The same modeling framework is applied to two primary scenarios (epidemic outbreaks and endemic persistence of the disease) and for each scenario two coupling cases (one-way and asymmetric commuting) with different inflow and outflow intensities are analyzed. The concept of effective vectorial density, introduced in this paper, allows to explain in very simple terms why the daily commuting affects quite differently the dengue morbidity among human residents in both patches. In particular, residents of the patch with a greater share of incoming than outgoing commuters may actually "benefit" from inflow of daily commuter by avoiding a considerable number of infections. However, residents of the patch with a greater share of outgoing than incoming commuters, especially those who stay at home patch, incur more risk of getting infected. Additionally, the model shows that daily commuting enhance the total number of human infections acquired in both patches and may even provoke an epidemic outbreak in one patch while moderately lowering the level of the disease persistence in another patch.

Leishmaniases are endemic in Brazil, where Leishmania infantum has been detected in humans, dogs, cats, and phlebotomine vectors. Monitoring synanthropic vector populations is critical for leishmaniasis control-surveillance in such transmission-prone areas. Here, a suite of molecular approaches were used to assess Leishmania infection prevalence and to identify blood-meal sources in a large sample of sand flies collected in anthropic environments of a Leishmania-transmission area in Mato Grosso do Sul State (Rio Verde de Mato Grosso municipality), Central-West Brazil. We sampled sand flies monthly (January-June 2014 and 2016) in one peri-domestic site within each of six neighborhoods with recent records of human visceral and/or tegumentary leishmaniasis. kDNA-qPCR plus rDNA ITS-sequencing were used to detect and identify Leishmania in pooled female sand flies. Individual engorged females (n = 58) were used for blood-meal analyses through High-Resolution Melting (HRM) targeting the mtDNA cytb gene. Overall, 90.5% of 420 CDC trap-nights yielded vectors, for a total catch of 24,989 sand flies. We sub-sampled and identified 3088 sand flies of 12 species, including 2775 Lutzomyia longipalpis (the most abundant species at all sampling sites) and 297 Nyssomyia whitmani. Female sand flies (n = 1261) were grouped in 159 pools, of which 92 Lu. longipalpis (minimum infection rate [MIR] 8%) and 7 Ny. whitmani pools (MIR 7%) were Leishmania kDNA-positive. Most positive Lu. longipalpis were collected in the 2016 rainy season. Sequencing confirmed L. infantum in Lu. longipalpis samples. HRM analyses identified chicken DNA in 57 sand flies (98.3%), 37 of which were Leishmania DNA-positive (64.9%); human blood was found in just one (Leishmania-negative) female. Our data show ongoing risk of L. infantum transmission to humans in the study area, where Leishmania-infected sandfly vectors are common and heavily rely on chicken blood in the peri-domestic environment.

Introduction To date, very little data is available on the extensive, familiar, serological screening of Trypanosoma cruzi from infected-index cases. As it is a parasite with possibility of mother-to-child foetal transmission, the study of the offspring of chronically infected women has a special relevance. Methods An observational study using a capture-recapture method that evaluates the offspring serological status of women diagnosed with T. cruzi infection (positive serology) in the northern metropolitan area of Barcelona during 2005–2016. Results A total of 238 women with positive serology for T. cruzi were identified. Of these, 117 (49.2%) could be localised. Their offspring summarised 300 individuals, of which 192 (64%) had serology records, with 23 positive for T. cruzi (11.98%; CI95%: 8.1–17.3). Among the 53 children born within the study area, 5 (9.8%, CI95%: 4.2–20.9) cases of vertical transmission were recorded. All children born as of 2010 (the starting year of mother screening) had serological outputs. Conclusions Offspring of T. cruzi-seropositive women showed a high rate of seropositivity. The prevalence of vertical transmission is also remarkably high but comparable to that obtained in other European studies. The main source of loss was non-accessible women. It is reasonable to formally include extensive, familiar, serological assessment in Chagas screening guidelines. In order to avoid losses, any eventual screening should be implemented at the time of the maternal diagnosis.

Leishmania infantum infection was investigated in 202 wild carnivores, rodents and lagomorphs in Southeast Spain using a real-time PCR (rtPCR) in skin and organ samples, mostly spleen. Lesions compatible with leishmaniosis were not observed in any of the animals. Prevalence defined as the percentage of rtPCR-positive animals was 32% overall, and 45% in foxes (n = 69), 30% in rabbits (n = 80) and stone martens (n = 10), 19% in wood mice (n = 16), 0% in black rats (n = 10) and ranged between 0% and 100% in other minoritarian species including badgers, wild cats, wolves, raccoons, genets and hares. Most infected rabbits were rtPCR-positive in skin and not in spleen samples and the opposite was the case for foxes (p 0.05). L. infantum prevalence was lowest in spring following months of non-exposure to phlebotomine sand fly vectors, and spatially matched recently estimated Phlebotomus perniciosus vector abundance and the prevalence of subclinical infection in dogs and humans. Prevalence increased with altitude and was greater in drier and less windy South and West compared to the coastal Southeast of the study area (p 0.05). Genetic diversity of L. infantum from foxes, investigated by PCR-restriction fragment length polymorphisms of kinetoplast DNA, revealed B genotype in all animals, which is frequent in people and dogs in the Iberian Peninsula and Morocco. The study provides further evidence that subclinical L. infantum infection is widespread in wildlife with prevalence depending on environmental factors and that parasite tissue tropism may vary according to host species. Moreover, it suggests that sylvatic and domestic transmission cycles are closely interconnected.

Opisthorchis viverrini is a group 1 carcinogen that causes cholangiocarcinoma (CCA). Although opisthorchiasis is known to be severely endemic to several areas along the Mekong River in Lao PDR, the CCA status of residents of this region is still under investigation. In this study, we analyzed the results of abdominal ultrasonography (US) performed on 6113 residents in 9 provinces (Vientiane Municipality, Savannakhet, Phongsaly, Khammouane, Saravane, Champasak, Vientiane, Xieng Khuouang, and Luang Prabang provinces) of Lao PDR from 2007 to 2011. Overall, 51 cases (0.83%) were detected with suspected CCA. The CCA rates in Vientiane Municipality and in Savannakhet and Khammouane provinces were 1.45%, 1.58%, and 1.09%, respectively. However, in the other 6 provinces, the rate of CCA averaged only 0.26%. In the 3 provinces with higher rates of CCA, bile duct dilatation (grade ≥ 2) was also significantly more prevalent (P < 0.0001). These results are concordant with previous reports showing a higher endemicity of opisthorchiasis in Vientiane Municipality and in Savannakhet and Khammouane provinces.

Schistosomiasis is a snail-transmitted infectious disease caused by a long lasting infection with a blood fluke of the genus Schistosoma. S. haematobium and S. mansoni are the species endemic in Egypt. The country has been plagued and seriously suffered from schistosomiasis over the past 5000 years. Great strides had been done in controlling the disease since 1922. The history, epidemiology and the different control approaches were reviewed. Currently, Egypt is preparing towards schistosomiasis elimination by 2020. The new strategy depends on four main axes; large scale treatment in all areas of residual transmission by targeting entire populations with PZQ, intensified snail control, heath education and behavioral changes and expansion of the complementary public health interventions. While on the road towards elimination, we addressed here the important challenges, lessons and the key issues from the different control strategies to help the achievement of our goal. Notably, frangibility of the drug based control, emergence of resistance against PZQ, persistence of some hot spots areas, the need of further control efforts to the high risk individuals and community involvement in the control programs, reconsideration of diagnostic tests used in surveillance, and continous monitoring of the field to detect changes in the snail intermediate host. Importantly, the adaptation between the parasite and its intermediate snail host throughout water bodies in Egypt merits attention as Schistosoma infection can be introduced to the new reclaimed areas. This review may help supplying information for the policy makers to tailor control measures suitable to the local context that could help in the transfer from control to elimination.

We establish an SIS-UAU model to present the dynamics of epidemic and information spreading in overlay networks. The overlay network is represented by two layers: one where the dynamics of the epidemic evolves and another where the information spreads. We theoretically derive the explicit formulas for the basic reproduction number of awareness R0a by analyzing the self-consistent equation and the basic reproduction number of disease R0d by using the next generation matrix. The formula of R0d shows that the effect of awareness can reduce the basic reproduction number of disease. In particular, when awareness does not affect epidemic spreading, R0d is shown to match the existing theoretical results. Furthermore, we demonstrate that the disease-free equilibrium is globally asymptotically stable if R0d 1. Finally, numerical simulations show that information plays a vital role in preventing and controlling disease and effectively reduces the final disease scale.

As a member of the BamHI-A rightward transcripts family of the Epstein-Barr virus (EBV), RPMS1 expression has been confirmed in all EBV-associated tumors. However, few studies have investigated the single-nucleotide polymorphisms (SNPs) of RPMS1, and only one SNP site (g155391a) has been reported to be associated with nasopharyngeal carcinoma occurrence. The objective of this study was to investigate the polymorphism of RPMS1 in EBV-associated tumors (gastric carcinoma, nasopharyngeal carcinoma, and lymphoma). In this research, nested-PCR was performed to analyze DNA sequences of 420 EBV-associated samples. Phylogenetic analysis revealed four RPMS1 genotypes (RPMS1-A, RPMS1-B, RPMS1-C, and RPMS1-D). A significant difference (p 0.05) among northern and southern China samples was observed. Furthermore, there was a significant difference between EBV-associated tumors and healthy controls for RPMS1 (p 0.05). These findings demonstrated that RPMS1 variation was not only tumor-specific but also geographically restricted in EBV-associated samples.