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Background We describe the epidemiological trends and report and review the public health restrictions implemented during the first wave of the COVID-19 pandemic in Ireland. Methods The study reviewed confirmed cases of COVID-19 notified from 1 March to 18 July 2020. Data were obtained from the national COVID-19 Data Hub, the National Health Protection Surveillance Centre, the National Contact Management Programme and the European Centre for Disease Prevention and Control. Results A total of 25 617 cases were notified during the study period. Weekly cases and deaths peaked in mid-April 2020 at 5701 and 316, respectively. Mean number of close contacts per case was lowest at 0.7 in April, rising to 6.6 by July. Outbreak settings shifted from travel and workplace in March, to healthcare in April. Restrictions implemented on 12 March extended to full lockdown on 27 March. Phased relaxation of restrictions commenced 18 May. Effective suppression of community transmission of COVID-19 was achieved by June 2020. Conclusion Lockdown is a crude population-level restriction effective in controlling COVID-19. Phased relaxation of restrictions in Ireland, however, led to an immediate increase in mean number of contacts per case, which facilitates viral transmission unless individual-level restrictions are adhered to. This demonstrates a limitation of lockdown as a long-term mechanism of pandemic control. [ABSTRACT FROM AUTHOR]

Background: The serial interval is the period of time between the onset of symptoms in an infector and an infectee and is an important parameter which can impact on the estimation of the reproduction number. Whilst several parameters influencing infection transmission are expected to be consistent across populations, the serial interval can vary across and within populations over time. Therefore, local estimates are preferable for use in epidemiological models developed at a regional level. We used data collected as part of the national contact tracing process in Ireland to estimate the serial interval of SARS-CoV-2 infection in the Irish population, and to estimate the proportion of transmission events that occurred prior to the onset of symptoms.Results: After data cleaning, the final dataset consisted of 471 infected close contacts from 471 primary cases. The median serial interval was 4 days, mean serial interval was 4.0 (95% confidence intervals 3.7, 4.3) days, whilst the 25th and 75th percentiles were 2 and 6 days respectively. We found that intervals were lower when the primary or secondary case were in the older age cohort (greater than 64 years). Simulating from an incubation period distribution from international literature, we estimated that 67% of transmission events had greater than 50% probability of occurring prior to the onset of symptoms in the infector.Conclusions: Whilst our analysis was based on a large sample size, data were collected for the primary purpose of interrupting transmission chains. Similar to other studies estimating the serial interval, our analysis is restricted to transmission pairs where the infector is known with some degree of certainty. Such pairs may represent more intense contacts with infected individuals than might occur in the overall population. It is therefore possible that our analysis is biased towards shorter serial intervals than the overall population. [ABSTRACT FROM AUTHOR]

Using an experiential qualitative design, this study explored 11 female prisoners' perspectives of problems living in prison. The findings reflected the immediate impact of the physical, social, and institutional environment. Problems with drug detoxification and bullying were prevalent. Prisoners were outward-looking and future-focused. Some feared substance-abuse relapse on release while mothers persistently worried about family outside prison. Many used maladaptive strategies to cope with their problems and most used activities to remain occupied. The study recommended creating supportive prison environments and interventions that enable women to manage the everyday problems they experience living in prison. [ABSTRACT FROM AUTHOR]

A correction is presented to the article "Epidemiology of COVID-19 and public health restrictions during the first wave of the pandemic in Ireland in 2020."

There is limited evidence on the risk of in-flight transmission of SARS-CoV-2. This study estimated the extent of in-flight SARS-CoV-2 transmission on international flights arriving in Ireland during December 2020. This was a cross-sectional analysis. National surveillance data identified all notified cases of COVID-19 who were infectious while travelling on international flights to Ireland during December 2020. Close contacts of cases were tested for SARS-CoV-2, and the results were collated to estimate the pooled secondary attack rate across all flights. Laboratory and epidemiological data were obtained from the Health Service Executive Covid Care Tracker, a national database of COVID-19 cases in Ireland. A total of 165 infectious cases of COVID-19 were identified on 134 incoming flights; 40.0% were symptomatic on board. There were 2099 flight close contacts identified, of whom 40.9% had results of a SARS-CoV-2 polymerase chain reaction test within 14 days of arrival. The pooled secondary attack rate for these contacts was 7.0% and was higher among those on flights of ≥5-hour duration (P = 0.008). More than half (59.1%) of close contacts had no SARS-CoV-2 test result recorded; the reasons included incorrect or absent contact details (26.5%) and no response when contacted (17.8%). In this national study investigating transmission of SARS-CoV-2 from international flights arriving into Ireland, the pooled secondary attack rate was 7.0%. International travel is likely to have contributed to the third wave of SARS-CoV-2 infections in Ireland in early 2021. Application of non-pharmaceutical interventions remains central to mitigating the risk of in-flight transmission. [ABSTRACT FROM AUTHOR]

Purpose: To examine if changes in hemodynamic measures during an orthostatic challenge were associated with progression of age-related macular degeneration (AMD) over a 4-year period in The Irish Longitudinal Study on Ageing., Methods: Participants with AMD who underwent an active stand (AS) test at wave 1 (2009/2010) and retinal photographs at both wave 1 and wave 3 (2014/2015) were included (N = 159: 121 with no AMD progression and 38 with progression). Beat-to-beat hemodynamic data were non-invasively collected using a Finometer MIDI device during the AS at wave 1, recording systolic blood pressure (sBP), diastolic blood pressure (dBP), mean arterial pressure (MAP), and heart rate. Cardiac output, stroke volume, and total peripheral resistance (TPR) were derived from these measures. Baseline characteristics were compared between groups with and without AMD progression. Mixed-effects linear regression models were used to assess the association between changes in hemodynamic parameters during the AS and AMD progression, controlling for known AMD-associated risk factors., Results: At baseline, increasing age and lower dBP were significantly associated with AMD progression. Mixed-effects models for the period between standing and 10 seconds post-stand revealed significant associations with AMD progression with a steeper drop in dBP and a slower drop in TPR. Between 10 and 20 seconds post-stand, AMD progression was significantly associated with less pronounced reduction in heart rate., Conclusions: These observational data suggest that impaired hemodynamic responses within the first 20 seconds of orthostasis may be associated with the progression of AMD.

Background: Contact tracing is conducted with the primary purpose of interrupting transmission from individuals who are likely to be infectious to others. Secondary analyses of data on the numbers of close contacts of confirmed cases could also: provide an early signal of increases in contact patterns that might precede larger than expected case numbers; evaluate the impact of government interventions on the number of contacts of confirmed cases; or provide data information on contact rates between age cohorts for the purpose of epidemiological modelling. We analysed data from 140,204 close contacts of 39,861 cases in Ireland from 1st May to 1st December 2020., Results: Negative binomial regression models highlighted greater numbers of contacts within specific population demographics, after correcting for temporal associations. Separate segmented regression models of the number of cases over time and the average number of contacts per case indicated that a breakpoint indicating a rapid decrease in the number of contacts per case in October 2020 preceded a breakpoint indicating a reduction in the number of cases by 11 days., Conclusions: We found that the number of contacts per infected case was overdispersed, the mean varied considerable over time and was temporally associated with government interventions. Analysis of the reported number of contacts per individual in contact tracing data may be a useful early indicator of changes in behaviour in response to, or indeed despite, government restrictions. This study provides useful information for triangulating assumptions regarding the contact mixing rates between different age cohorts for epidemiological modelling., (© 2021. The Author(s).)

Syphilis remains a disease of public health importance, with considerable health effects if not treated. Concurrent infection with syphilis and untreated HIV facilitates HIV transmission. The incidence of syphilis in Europe has been increasing, particularly among men who have sex with men (MSM) and in MSM with HIV. However, there is heterogeneity among countries in the case definition used for syphilis and in reported syphilis notification rates. In Ireland, we have undertaken a number of refinements of the national syphilis surveillance system since 2014, including refinement of the laboratory thresholds for notification (rapid plasma reagin 1:16 and/or positive IgM). This article outlines the steps taken and some of the challenges we faced. Our current case definition now accurately reflects the epidemiology of syphilis in Ireland and our current surveillance provides timely information for action, while not reducing the sensitivity of the system too much. For countries where surveillance is driven mainly by laboratory reporting and where obtaining clinical details is challenging, these thresholds for notification may be a pragmatic solution.

Background: A measles outbreak occurred in age-appropriately vaccinated children in a school in a town in the South East of Ireland in September-November 2013., Aims: The purpose of this study was to investigate the risk factors associated with catching measles during the outbreak., Methods: Ninety-five children (4-5 years) in three classes, in the first year of primary school, were included in the study. Immunisation records on the South East Child Health Information System for first Measles Mumps and Rubella (MMR) vaccine for the 95 children were reviewed. Data collected included age at MMR, date of administration of MMR, MMR brand and batch number, and the General Practice at which MMR was administered. The risk factors analysed included age at vaccination, time of vaccination, class and the GP practice where MMR was administered. Statistical analysis was performed using Epi info 7 and SPSS v24., Results: Thirteen children in the cohort developed measles during the outbreak. All children in the cohort were age-appropriately vaccinated, with one dose of MMR vaccine. Analysis demonstrated statistically significant differences in the relative risk of developing measles according to the class a child was in, and the General Practice at which they were vaccinated., Conclusions: The reason for intense measles activity in one class was not established. Although a concurrent investigation into cold chain and vaccine stock management did not identify a cause for the high relative risk of measles in children vaccinated, recommendations were made for improving cold chain and vaccine stock management in General Practices.

Background/aims: Age-related macular degeneration (AMD) is estimated to affect 196 million people >50 years old globally. Prevalence of AMD-associated genetic risk factors and rate of disease progression are unknown in Ireland., Methods: Prevalence of AMD-associated genetic risk variants, complement factor H (CFH) rs1061170, age-related maculopathy susceptibility 2 (ARMS2) rs10490924, component 3 (C3) rs2230199, complement factor B (CFB) rs641153 and superkiller viralicidic activity 2-like (SKIV2L) rs429608 and 4-year progression data in a population-representative cohort (The Irish Longitudinal study on Ageing (TILDA)) were assessed. 4473 participants ≥50 years were assessed. 4173 had no disease n=1843; 44% male and n=2330; 56% female, mean age 60±9.0, 300 had AMD n=136; 45% male and n=164; 55% female, mean age 64±9.0. A 4-year follow-up was undertaken with 66% of AMD cases attending. Progression and regression from early to late AMD were measured. Genetic association as indicators of disease and as predictors of progression were assessed by multinomial logistic regression., Results: Older age and the presence of CFH and ARMS2 risk alleles are two main risk factors associated with the prevalence of AMD in the TILDA cohort. 23% progressed to a higher grade of AMD. Carriers of CFH risk allele showed a strong association for disease progression. Heterozygosity for ARMS2 risk allele predicted progression to late AMD. 75% of those who progressed from early to late disease had soft drusen and hyperpigmentation at baseline., Conclusions: The prevalence of risk-associated genes and 4-year progression rates of AMD in this Ireland cohort are comparable with other Caucasian populations. CFH Y402H is associated with disease progression, with soft drusen and hyperpigmentation as high-risk features., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)