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Background European countries are focusing on testing, isolation, and boosting strategies to counter the 2022/2023 winter surge due to SARS-CoV-2 Omicron subvariants. However, widespread pandemic fatigue and limited compliance potentially undermine mitigation efforts.Methods To establish a baseline for interventions, we ran a multicountry survey to assess respondents' willingness to receive booster vaccination and comply with testing and isolation mandates. Integrating survey and estimated im-munity data in a branching process epidemic spreading model, we evaluated the effectiveness and costs of current protocols in France, Belgium, and Italy to manage the winter wave.Findings The vast majority of survey participants (N = 4594) was willing to adhere to testing (>91%) and rapid isolation (>88%) across the three countries. Pronounced differences emerged in the declared senior adherence to booster vaccination (73% in France, 94% in Belgium, 86% in Italy). Epidemic model results estimate that testing and isolation protocols would confer significant benefit in reducing transmission (17-24% reduction, from R = 1.6 to R = 1.3 in France and Belgium, to R = 1.2 in Italy) with declared adherence. Achieving a mitigating level similar to the French protocol, the Belgian protocol would require 35% fewer tests (from 1 test to 0.65 test per infected person) and avoid the long isolation periods of the Italian protocol (average of 6 days vs. 11). A cost barrier to test would significantly decrease adherence in France and Belgium, undermining protocols' effectiveness.Interpretation Simpler mandates for isolation may increase awareness and actual compliance, reducing testing costs, without compromising mitigation. High booster vaccination uptake remains key for the control of the winter wave.Funding The European Commission, ANRS-Maladies Infectieuses emergentes, the Agence Nationale de la Recherche, the Chaires Blaise Pascal Program of the ile-de-France region.Copyright (c) 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). The European Commission, ANRS–Maladies Infectieuses Émergentes, the Agence Nationale de la Recherche, the Chaires Blaise Pascal Program of the Île-de-France region. We thank all participants in the surveys. We thank Daniel Levy-Bruhl, Isabelle Parent, and Isabelle Bonmarin for useful comments and discussions on this study. This study was partly supported by: Agence Nationale de la Recherche projects COSCREEN (ANR-21-CO16-0005) and DATAREDUX (ANR-19-CE46-0008-03) to VC; ANRS–Maladies Infectieuses Émergentes project EMERGEN (ANRS0151) to VC; EU Horizon 2020 grants MOOD (H2020-874850, paper 071) and RECOVER (H2020- 101003589) to VC, PANDEM-2 (883285) to DP, EpiPose (101003688) to DP, LH, NH; Horizon Europe VERDI (101045989) to VC, NH, DP; the haires Blaise Pascal Program of the Île-de-France region to JSW.

European countries are focusing on testing, isolation, and boosting strategies to counter the 2022/2023 winter surge due to Omicron subvariants. However, widespread pandemic fatigue and limited compliance potentially undermine mitigation efforts. To establish a baseline for interventions, we ran a multicountry survey to assess respondents’ willingness to receive booster vaccination and comply with testing and isolation mandates. The vast majority of survey participants (N=4,594) was willing to adhere to testing (>91%) and rapid isolation (>88%) across the three countries. Pronounced differences emerged in the declared senior adherence to booster vaccination (73% in France, 94% in Belgium, 86% in Italy). Next, we inferred the vaccine-induced population immunity profile at the winter start from prior vaccination data, immunity waning, and declared booster uptake. Integrating survey and estimated immunity data in a branching process epidemic spreading model, we evaluated the effectiveness and costs of current protocols in France, Belgium, and Italy to manage the winter wave. Model results estimate that testing and isolation protocols would confer significant benefit in reducing transmission (17-24%) with declared adherence. Achieving a mitigating level similar to the French protocol, the Belgian protocol would require 30% fewer tests and avoid the long isolation periods of the Italian protocol (average of 6 days vs. 11). A cost barrier to test would significantly decrease adherence in France and Belgium, undermining protocols’ effectiveness. Simpler mandates for isolation may increase awareness and actual compliance, reducing testing costs, without compromising mitigation. High booster vaccination uptake remains key for the control of the winter wave.

ObjectivesNeurocysticercosis (NCC) is a parasitic disease caused by the larval stage of the tapeworm Taenia solium. NCC mainly occurs in Africa, Latin America and South-East Asia and can cause a variety of clinical signs/symptoms. Although it is a rare disease in Europe, it should nonetheless be considered as a differential diagnosis. The aim of this study was to describe clinical characteristics and management of patients with NCC diagnosed and treated in Europe.MethodsWe conducted a systematic search of published and unpublished data on patients diagnosed with NCC in Europe (2000–2019) and extracted demographic, clinical and radiological information on each case, if available.ResultsOut of 293 identified NCC cases, 59% of patients presented initially with epileptic seizures (21% focal onset); 52% presented with headache and 54% had other neurological signs/symptoms. The majority of patients had a travel or migration history (76%), mostly from/to Latin America (38%), Africa (32%) or Asia (30%). Treatment varied largely depending on cyst location and number. The outcome was favorable in 90% of the cases.ConclusionsManagement of NCC in Europe varied considerably but often had a good outcome. Travel and migration to and from areas endemic for T. solium will likely result in continued low prevalence of NCC in Europe. Therefore, training and guidance of clinicians is recommended for optimal patient management.

International audience; The isolation of infectious individuals is a key measure of public health for the control of communicable diseases. However, involving a strong perturbation of daily life, it often causes psychosocial distress, and severe financial and social costs. These may act as mechanisms limiting the adoption of the measure in the first place or the adherence throughout its full duration. In addition, difficulty of recognizing mild symptoms or lack of symptoms may impact awareness of the infection and further limit adoption. Here, we study an epidemic model on a network of contacts accounting for limited adherence and delayed awareness to self-isolation, along with fatigue causing overhasty termination. The model allows us to estimate the role of each ingredient and analyze the tradeoff between adherence and duration of self-isolation. We find that the epidemic threshold is very sensitive to an effective compliance that combines the effects of imperfect adherence, delayed awareness and fatigue. If adherence improves for shorter quarantine periods, there exists an optimal duration of isolation, shorter than the infectious period. However, heterogeneities in the connectivity pattern, coupled to a reduced compliance for highly active individuals, may almost completely offset the effectiveness of self-isolation measures on the control of the epidemic.

A simple and selective new technique for atomic hydrogen flux measurements in a hydrogen plasma environment is introduced and demonstrated in this work. This technique works by measuring the etching rate of an amorphous carbon film and translating this to an incoming hydrogen radical flux through a well-defined carbon etch yield per radical. Ions present in the plasma environment have a much higher etch yield than radicals do. For that reason, suppression of the ion flux toward the carbon film is crucial to ensure that the observed carbon etch rate is dominated by atomic hydrogen etching. It is demonstrated that this can be achieved using a simple cylindrical pipe (hereinafter "chimney") in which a bend is introduced to enforce ion-wall collisions, neutralizing the ions. The chimney is made out of Macor, a material with low catalytic surface activity, to preserve the incoming atomic hydrogen flux while effectively suppressing ions. Ultimately, the etching sensor is deployed in a radio frequency inductively coupled hydrogen plasma operated at low pressure (1-10 Pa). Atomic hydrogen fluxes are measured and compared with heat flux sensor and vacuum ultraviolet absorption spectroscopy measurements in the same setup. All sensors agreed within a factor 4 in the atomic hydrogen flux range 10

A simple and selective new technique for atomic hydrogen flux measurements in a hydrogen plasma environment is introduced and demonstrated in this work. This technique works by measuring the etching rate of an amorphous carbon film and translating this to an incoming hydrogen radical flux through a well-defined carbon etch yield per radical. Ions present in the plasma environment have a much higher etch yield than radicals do. For that reason, suppression of the ion flux toward the carbon film is crucial to ensure that the observed carbon etch rate is dominated by atomic hydrogen etching. It is demonstrated that this can be achieved using a simple cylindrical pipe (hereinafter “chimney”) in which a bend is introduced to enforce ion-wall collisions, neutralizing the ions. The chimney is made out of Macor, a material with low catalytic surface activity, to preserve the incoming atomic hydrogen flux while effectively suppressing ions. Ultimately, the etching sensor is deployed in a radio frequency inductively coupled hydrogen plasma operated at low pressure (1-10 Pa). Atomic hydrogen fluxes are measured and compared with heat flux sensor and vacuum ultraviolet absorption spectroscopy measurements in the same setup. All sensors agreed within a factor 4 in the atomic hydrogen flux range 1019 to 1021 m−2 s−1.

Single brain enhancing lesions (SEL) are the most common presentation of neurocysticercosis (NCC) observed on neuroimaging in people presenting with epileptic seizures not only on the Indian sub-continent and in travelers returning from cysticercosis-endemic regions, but also globally. The aim of this study, which consisted of a systematic review (CRD42019087665), a meta-analysis and an expert group consultation, was to reach consensus on the best anti-seizure medication and anti-inflammatory treatment for individuals with SEL NCC. Standard literature review methods were used, including the Cochrane risk of bias random effects model, meta-analyses were performed and the quality of the body of evidence was rated using GRADE tables. The expert committee included 12 gender and geographically balanced members and recommendations were reached by applying the GRADE framework for guideline development. The 1-1.5-year cumulative incidence of seizure recurrence, cyst resolution or calcification following anti-seizure medication (ASM) withdrawal was not statistically different between ASM of 6, 12 or 24 months. In contrast, in persons whose cyst calcified post treatment, longer ASM decreased seizure recurrence. The cumulative incidence ratio (CIR) 1-1.5 years after stopping ASM was 1.79 95% CI: (1.00, 3.20) for patients given 6 versus 24 months treatment. Duration of treatment had no effect on seizure recurrence in patients whose cyst did not calcify. Anti-inflammatory treatment with corticosteroids in patients treated with ASM compared to patients treated with ASM only showed a statistically significant beneficial effect on seizure reduction (CIR 0.44, 95% CI 0.23, 0.85) and cyst resolution (CIR 1.37, 95%CI: 1.07, 1.75). Our results indicate that ASM in patients with SEL NCC whose cysts resolved can be withdrawn, while patients whose cysts calcified seem to benefit from prolonged anti-seizure medication. Additional corticosteroid treatment was found to have a beneficial effect both on seizure reduction and cyst resolution.