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OBJECTIVE: Circulation patterns of influenza and other respiratory viruses have been globally disrupted since the emergence of coronavirus disease (COVID-19) and the introduction of public health and social measures (PHSMs) aimed at reducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. METHODS: We reviewed respiratory virus laboratory data, Google mobility data and PHSMs in five geographically diverse regions in Australia and New Zealand. We also described respiratory virus activity from January 2017 to August 2021. RESULTS: We observed a change in the prevalence of circulating respiratory viruses following the emergence of SARS-CoV-2 in early 2020. Influenza activity levels were very low in all regions, lower than those recorded in 2017-2019, with less than 1% of laboratory samples testing positive for influenza virus. In contrast, rates of human rhinovirus infection were increased. Respiratory syncytial virus (RSV) activity was delayed; however, once it returned, most regions experienced activity levels well above those seen in 2017-2019. The timing of the resurgence in the circulation of both rhinovirus and RSV differed within and between the two countries. DISCUSSION: The findings of this study suggest that as domestic and international borders are opened up and other COVID-19 PHSMs are lifted, clinicians and public health professionals should be prepared for resurgences in influenza and other respiratory viruses. Recent patterns in RSV activity suggest that these resurgences in non-COVID-19 viruses have the potential to occur out of season and with increased impact.

Human respiratory syncytial virus (RSV) is an important cause of acute respiratory infection with the most severe disease in the young and elderly. Non-pharmaceutical interventions and travel restrictions for controlling COVID-19 have impacted the circulation of most respiratory viruses including RSV globally, particularly in Australia, where during 2020 the normal winter epidemics were notably absent. However, in late 2020, unprecedented widespread RSV outbreaks occurred, beginning in spring, and extending into summer across two widely separated regions of the Australian continent, New South Wales (NSW) and Australian Capital Territory (ACT) in the east, and Western Australia. Through genomic sequencing we reveal a major reduction in RSV genetic diversity following COVID-19 emergence with two genetically distinct RSV-A clades circulating cryptically, likely localised for several months prior to an epidemic surge in cases upon relaxation of COVID-19 control measures. The NSW/ACT clade subsequently spread to the neighbouring state of Victoria and to cause extensive outbreaks and hospitalisations in early 2021. These findings highlight the need for continued surveillance and sequencing of RSV and other respiratory viruses during and after the COVID-19 pandemic, as mitigation measures may disrupt seasonal patterns, causing larger or more severe outbreaks.

: Introduction: New South Wales (NSW) has one of the world's highest uptake rates of HIV pre‐exposure prophylaxis (PrEP). This uptake has been credited with sharp declines in HIV transmission, particularly among Australian‐born gay and bisexual men. Concerns have been raised around the potential for the emergence of tenofovir (TFV) and XTC (lamivudine/emtricitabine) resistance in settings of high PrEP use. Such an emergence could also increase treatment failure and associated clinical outcomes among people living with HIV (PLHIV). Despite low levels of nucleoside reverse‐transcriptase inhibitor (NRTI) resistance relating to PrEP use in clinical settings, there are few published studies describing the prevalence of NRTI resistance among people newly diagnosed with HIV in a setting of high PrEP use. Methods: Using HIV antiretroviral drug resistance data linked to NSW HIV notifications records of people diagnosed from 1 January 2015 to 31 December 2021 and with HIV attributed to male‐to‐male sex, we described trends in TFV and XTC resistance. Resistance was identified using the Stanford HIV Drug Resistance genotypic resistance interpretation system. To focus on transmitted drug resistance, resistance prevalence estimates were generated using sequences taken less than 3 months post‐HIV diagnosis. These estimates were stratified by timing of sequencing relative to the date of diagnosis, year of sequencing, birthplace, likely place of HIV acquisition, and stage of HIV at diagnosis. Results: Among 1119 diagnoses linked to HIV genomes sequenced less than 3 months following diagnosis, overall XTC resistance prevalence was 1.3%. Between 2015 and 2021, XTC resistance fluctuated between 0.5% to 2.9% and was 1.0% in 2021. No TFV resistance was found over the study period in any of the sequences analysed. Higher XTC resistance prevalence was observed among people with newly acquired HIV (evidence of HIV acquisition in the 12 months prior to diagnosis; 2.9%, p = 0.008). Conclusions: In this Australian setting, TFV and XTC resistance prevalence in new HIV diagnoses remained low. Our findings offer further evidence for the safe scale‐up of PrEP in high‐income settings, without jeopardizing the treatment of those living with HIV., INTRODUCTION Australia has made remarkable progress in its effort to meet the UNAIDS 2030 target of ending AIDS as a public health threat with HIV diagnoses attributed to male‐to‐male sex [...]

Responses to the early (February-July 2020) COVID-19 pandemic varied widely, globally. Reasons for this are multiple but likely relate to the healthcare and financial resources then available, and the degree of trust in, and economic support provided by, national governments. Cultural factors also affected how different populations reacted to the various pandemic restrictions, like masking, social distancing and self-isolation or self-quarantine. The degree of compliance with these measures depended on how much individuals valued their needs and liberties over those of their society. Thus, several themes may be relevant when comparing pandemic responses across different regions. East and Southeast Asian populations tended to be more collectivist and self-sacrificing, responding quickly to early signs of the pandemic and readily complied with most restrictions to control its spread. Australasian, Eastern European, Scandinavian, some Middle Eastern, African and South American countries also responded promptly by imposing restrictions of varying severity, due to concerns for their wider society, including for some, the fragility of their healthcare systems. Western European and North American countries, with well-resourced healthcare systems, initially reacted more slowly, partly in an effort to maintain their economies but also to delay imposing pandemic restrictions that limited the personal freedoms of their citizens.

BackgroundTransition to psychosis is among the most adverse outcomes of clinical high-risk (CHR) syndromes encompassing ultra-high risk (UHR) and basic symptom states. Clinical risk calculators may facilitate an early and individualized interception of psychosis, but their real-world implementation requires thorough validation across diverse risk populations, including young patients with depressive syndromes.MethodsWe validated the previously described NAPLS-2 (North American Prodrome Longitudinal Study 2) calculator in 334 patients (26 with transition to psychosis) with CHR or recent-onset depression (ROD) drawn from the multisite European PRONIA (Personalised Prognostic Tools for Early Psychosis Management) study. Patients were categorized into three risk enrichment levels, ranging from UHR, over CHR, to a broad-risk population comprising patients with CHR or ROD (CHR|ROD). We assessed how risk enrichment and different predictive algorithms influenced prognostic performance using reciprocal external validation.ResultsAfter calibration, the NAPLS-2 model predicted psychosis with a balanced accuracy (BAC) (sensitivity, specificity) of 68% (73%, 63%) in the PRONIA-UHR cohort, 67% (74%, 60%) in the CHR cohort, and 70% (73%, 66%) in patients with CHR|ROD. Multiple model derivation in PRONIA-CHR|ROD and validation in NAPLS-2-UHR patients confirmed that broader risk definitions produced more accurate risk calculators (CHR|ROD-based vs. UHR-based performance: 67% [68%, 66%] vs. 58% [61%, 56%]). Support vector machines were superior in CHR|ROD (BAC = 71%), while ridge logistic regression and support vector machines performed similarly in CHR (BAC = 67%) and UHR cohorts (BAC = 65%). Attenuated psychotic symptoms predicted psychosis across risk levels, while younger age and reduced processing speed became increasingly relevant for broader risk cohorts.ConclusionsClinical-neurocognitive machine learning models operating in young patients with affective and CHR syndromes facilitate a more precise and generalizable prediction of psychosis. Future studies should investigate their therapeutic utility in large-scale clinical trials.

Japanese encephalitis virus (JEV) is a single-stranded, positive-sense, RNA flavivirus endemic to tropical regions of South and Southeast Asia and is the most common cause of vaccine-preventable encephalitis in the [...]

The coronavirus disease pandemic was declared in March 2020, as the southern hemispheres winter approached. Australia expected co-circulation of severe acute respiratory syndrome coronavirus 2, influenza and other seasonal respiratory viruses. However, influenza notifications were 7,029 (March-September) compared with an average 149,832 for the same period in 2015-2019 [corrected], despite substantial testing. Restrictions on movement within and into Australia may have temporarily eliminated influenza. Other respiratory pathogens also showed remarkably changed activity in 2020.

The coronavirus pandemic has resulted in increased use of face masks worldwide. Here, we examined the effect of wearing a face mask on the ability to recognise facial expressions of emotion. In a within-subjects design, 100 UK-based undergraduate students were shown facial expressions of anger, disgust, fear, happiness, sadness, and neutral expression; these were either posed with or without a face mask, or with a face mask artificially imposed onto them. Participants identified the emotion portrayed in the photographs from a fixed choice array of answers and rated their confidence in their selection. While overall accuracy was higher without than with masks, the effect varied across emotions, with a clear advantage without masks in disgust, happiness, and sadness; no effect for neutral, and lower accuracy without masks for anger and fear. In contrast, confidence was generally higher without masks, with the effect clear for all emotions other than anger. These results confirm that emotion recognition is affected by face mask wearing, but reveal that the effect depends on the emotion being displayed--with this emotion-dependence not reflected in subjects' confidence. The disparity between the effects of mask wearing on different emotions and the failure of this to be reflected in confidence ratings suggests that mask wearing not only effects emotion recognition, but may also create biases in the perception of facial expressions of emotion of which perceivers are unaware. In addition, the similarity of results between the Imposed Mask and Posed Mask conditions suggests that prior research using artificially imposed masks has not been deleteriously affected by the use of this manipulation.

: Objective: Western Sydney Local Health District (WSLHD) measured the utility and validity of rapid molecular point‐of‐care testing (POCT) in aged care facilities (ACFs) experiencing influenza‐like illness (ILI) outbreaks against routine laboratory testing. Methods: A descriptive epidemiological study into 82 respiratory outbreaks reported across 63 ACFs within WSLHD supporting approximately 6,500 residents aged ≥65 years and staffed by ∼6,500 employees, from 1 August 2018 to 31 December 2019. Results: WSLHD Public Health Unit performed on‐site testing at 27 ACF outbreaks (34%), while 53(66%) ACFs conducted only routine laboratory testing. The Xpert®Xpress Flu/RSV molecular PCR provided a sensitivity and specificity of 100%. Those with on‐site testing, antiviral prophylaxis was prescribed at 75% of facilities within 24 hours of testing, as opposed to 32% of those using laboratory testing (p Conclusions: On‐site ACF testing is reliable and practical for early identification of influenza, enabling timely use of antiviral treatment and prophylaxis, and was associated with decreased hospitalisation. Public health implications: Enhanced respiratory surveillance and on‐site testing should be strongly considered as part of routine management of respiratory outbreaks in ACFs and may reduce outbreak severity., Respiratory viruses are highly infectious agents that adversely affect the health of adults aged ≥65 years.[sup.1] In closed population settings such as aged care facilities (ACFs) in particular, respiratory viruses [...]

Background Pilgrimages and travel to religious mass gatherings (MGs) are part of all major religions. This narrative review aims to describe some characteristics, including health risks, of the more well-known and frequently undertaken ones. Methods A literature search was conducted using keywords related to the characteristics (frequency of occurrence, duration, calendar period, reasons behind their undertaking and the common health risks) of Christian, Muslim, Hindu, Buddhist and Jewish religious MGs. Results About 600 million trips are undertaken to religious sites annually. The characteristics vary between religions and between pilgrimages. However, religious MGs share common health risks, but these are reported in a heterogenous manner. European Christian pilgrimages reported both communicable diseases, such as norovirus outbreaks linked to the Marian Shrine of Lourdes in France, and non-communicable diseases (NCDs). NCDs predominated at the Catholic pilgrimage to the Basilica of Our Lady of Guadalupe in Mexico, which documented 11 million attendees in 1 week. The Zion Christian Church Easter gathering in South Africa, attended by ~10 million pilgrims, reported mostly motor vehicle accidents. Muslim pilgrimages such as the Arbaeen (20 million pilgrims) and Hajj documented a high incidence of respiratory tract infections, up to 80% during Hajj. Heat injuries and stampedes have been associated with Hajj. The Hindu Kumbh Mela pilgrimage, which attracted 100 million pilgrims in 2013, documented respiratory conditions in 70% of consultations. A deadly stampede occurred at the 2021 Jewish Lag BaOmer MG. Conclusion Communicable and NCD differ among the different religious MGs. Gaps exists in the surveillance, reporting and data accessibility of health risks associated with religious MGs. A need exists for the uniform implementation of a system of real-time monitoring of diseases and morbidity patterns, utilizing standardized modern information-sharing platforms. The health needs of pilgrims can then be prioritized by developing specific and appropriate guidelines. [ABSTRACT FROM AUTHOR]

: Introduction: In May 2020, The Communicable Diseases Network of Australia (CDNA) case definition introduced serological criteria to support the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). We present findings that support the utility of SARS‐CoV‐2‐specific serology for public health investigations. Methods: From 24 January to 31 July 2020, the following information was collected from individuals with positive SARS‐CoV‐2‐specific immunofluorescence antibody tests: history of contact with COVID‐19 cases; recent travel; symptoms consistent with COVID‐19; and SARS‐CoV‐2 nucleic acid testing (NAT) results. Individuals were classified as confirmed or probable by CDNA criteria or additionally as possible (SARS‐CoV‐2‐specific IgG positive with compatible symptoms or epidemiologic risk) or indeterminate (SARS‐CoV‐2‐specific IgA/IgM positive only) cases. Results: A total of 10,595 individuals were tested in the six‐month period. Of these, 9.8% (1,037) individuals had positive SARS‐CoV‐2‐specific serology of which 566 (53.6%) were NAT‐confirmed COVID‐19 cases and 286 (27.6%) were part of a cruise ship outbreak sero‐survey. The remaining 185 individuals (NAT negative) were individually classified as serologically confirmed (4, 0.4%), probable (72, 6.9%) possible (66, 6.4%) and indeterminate (38, 3.7%) cases. Maternal antibody transfer was inferred in one infant and four were unclassified. Conclusion: SARS‐CoV‐2‐specific serology is a key diagnostic tool for retrospective identification of COVID‐19 infection. Implications for public health: SARS‐CoV‐2 specific serology can enhance the ability to find cases, link missing cases in clusters of infection and identify the epidemiological extent of SARS‐CoV‐2 outbreaks. A combination of epidemiological criteria, clinical criteria and a quantitative serological test can be used as an adjunct to classify SARS‐CoV‐2 cases. Our study confirms the low level of community transmission in NSW during the first year of the COVID‐19 pandemic, By 31 July 2020, 3,600 confirmed infections of severe acute respiratory syndrome‐coronavirus‐2 (SARS‐CoV‐2), the virus that causes coronavirus disease 2019 (COVID‐19), had been recorded in New South Wales (NSW), Australia.[sup.1] [...]

Authors of the March WHO report into how COVID-19 emerged warn that further delay makes crucial inquiry biologically difficult. Authors of the March WHO report into how COVID-19 emerged warn that further delay makes crucial inquiry biologically difficult., Author(s): Marion Koopmans, Peter Daszak, Vladimir G. Dedkov, Dominic E. Dwyer, Elmoubasher Farag, Thea K. Fischer, David T. S. Hayman, Fabian Leendertz, Ken Maeda, Hung Nguyen-Viet, John Watson Author Affiliations: [...]