scholarly journals A Single Case Outbreak of Nipah Encephalitis From India in May–June 2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s104-s104
Author(s):  
Anup Warrier ◽  
Arun Wilson
Keyword(s):  
Respiratory Symptoms ◽  
Throat Swab ◽  
Close Contact ◽  
Single Case ◽  
Nipah Virus ◽  
Family Members ◽  
Contact Tracing ◽  
Surveillance Period ◽  
Standard Precautions ◽  
Close Family

Background: Nipah encephalitis outbreaks mostly involve multiple patients. We report a case of Nipah virus encephalitis (NVE), which had no documented secondary cases in spite of many having prolonged and close contact with the patient. Methods: A 21-year-old male was admitted with NVE on May 30, 2019. Before the confirmatory report, there was close contact with multiple healthcare workers (HCWs), defined as exposure for >1 hour to the patient or his immediate environment and/or exposure to body fluids. We conducted extensive contact tracing of all HCWs who had come into close contact with the proven NVE case from the time of admission to the time of discharge. This contact tracing included those who had nursed him before the diagnosis with usual standard precautions and those who had nursed him after the diagnosis with full PPE. These HCWs were reviewed daily for fever and respiratory symptoms. All those who developed these symptoms within the 3 weeks of exposure where tested for NEV with a throat swab using RT-PCR. This testing was conducted twice over 3 days to confirm negative results. For the close family contacts that were asymptomatic, both throat swab and serum for Nipah IgM were tested. Results: In total, 169 HCW contacts were identified at our hospital. Of these, 94 were at high risk according the predetermined criteria and others were low-risk contacts. Moreover, 7 HCWs developed fever and respiratory symptoms within the defined surveillance period; 5 had symptoms before the diagnosis (using only standard precautions) and 2 were in contact with full PPE after the diagnosis. All of these symptomatic contacts were tested for NEV (throat swab and serology), and all were negative. The family members of the patient (his mother and aunt) who had cared for him throughout his illness period of 12 days before the diagnosis were also tested and were seronegative for NEV. Conclusions: This NEV case had very low transmission capability; even close family members who cared for him for 12 days without any precautions and had exposure to urine (which was positive for NEV) did not contract the disease. The absence of overt respiratory involvement and young age of the affected patient could have contributed to low transmissibility both prior to hospitalization and during the hospitalization.Funding: NoneDisclosures: None

scholarly journals Experiential learnings from the Nipah virus outbreaks in Kerala towards containment of infectious public health emergencies in India

2020 ◽  
Vol 148 ◽  
Author(s):  
Rima R. Sahay ◽  
Pragya D. Yadav ◽  
Nivedita Gupta ◽  
Anita M. Shete ◽  
Chandni Radhakrishnan ◽  
...  
Keyword(s):  
State Government ◽  
Single Case ◽  
Point Of Care ◽  
Nipah Virus ◽  
Case Fatality ◽  
Control Measures ◽  
Contact Tracing ◽  
Effective Control ◽  
Hospital Infection Control ◽  
Kerala State

Abstract Nipah virus (NiV) outbreak occurred in Kozhikode district, Kerala, India in 2018 with a case fatality rate of 91% (21/23). In 2019, a single case with full recovery occurred in Ernakulam district. We described the response and control measures by the Indian Council of Medical Research and Kerala State Government for the 2019 NiV outbreak. The establishment of Point of Care assays and monoclonal antibodies administration facility for early diagnosis, response and treatment, intensified contact tracing activities, bio-risk management and hospital infection control training of healthcare workers contributed to effective control and containment of NiV outbreak in Ernakulam.

scholarly journals Contact tracing: a lesson from the Nipah virus in the time of COVID-19

2020 ◽  
Vol 50 (3) ◽  
pp. 174-175 ◽  
Author(s):  
Arun Wilson ◽  
Anup Warrier ◽  
Balram Rathish
Keyword(s):  
Single Case ◽  
Nipah Virus ◽  
Community Setting ◽  
Healthcare Setting ◽  
Daily Basis ◽  
World Health ◽  
Contact Tracing ◽  
The Public ◽  
Contact List ◽  
Health Organization

Without a vaccine or proven therapeutic options in COVID-19, the World Health Organization (WHO) recommends a combination of measures: rapid diagnosis and immediate isolation of cases; rigorous contact tracing; and precautionary self-isolation of close contacts to curb the spread of COVID-19. During a Nipah outbreak in Kerala, India in 2019, it was confined to a single case. The authors were involved in the in-hospital contact tracing. With a single patient producing a contact list of 98 in a healthcare setting, the implications in a community setting during a pandemic of the scale of COVID-19 are huge but it proves that early and rigorous tracing with quarantining is an effective strategy to limit clusters. We believe that if the public is encouraged to maintain their own contact list on a daily basis, it would help in significantly reducing the time and effort invested into contact tracing in the event of a person contracting COVID-19.

St Gregory of Nyssa

2018 ◽  
Author(s):  
John Anthony McGuckin
Keyword(s):  
Historical Context ◽  
Family Members ◽  
General Outline ◽  
Gregory Of Nyssa ◽  
Christian Leaders ◽  
Close Family

Chapter 1 gives Biographical background and studies the historical context(s) of Gregory of Nyssa and his close family members, situating them as aristocratic and long-established Christian leaders of the Cappadocian area. It offers along with the course of Gregory’s Vita a general outline of the main philosophical and religious controversies of his era, particularly his ecclesiastical involvement in the Neo-Nicene apologetical movement associated with the leadership of his brother Basil (of Caesarea), which he himself inherited in Cappadocia, with imperial approval, after 380. It concludes with a review of Gregory’s significance as author: in terms of his style as a writer, his work as an exegete, his body of spiritual teaching, and lastly, the manner in which his reputation waxed and waned from antiquity to the present.

Redefining the Circumstances in which Family Hardship Should Mitigate Sentence Severity

2019 ◽  
Author(s):  
Mirko Bagaric
Keyword(s):  
Family Members ◽  
Case Law ◽  
Financial Hardship ◽  
The Family ◽  
Family Connections ◽  
Criminal Penalties ◽  
Close Family

The hardship stemming from prison goes well beyond the pain experienced by offenders. The family and dependants of prisoners often experience significant inconvenience and hardship. Family members of prisoners have not engaged in wrongdoing and hence arguably their suffering should be a mitigating consideration in sentencing. However, this approach potentially unfairly advantages offenders with close family connections and undermines the capacity of courts to satisfy a number of important sentencing objectives, including the imposition of proportionate penalties. The courts and legislatures have not been able to find a coherent manner in which to reconcile this tension. There is conflicting case law regarding the circumstances in which family hardship can mitigate the severity of criminal penalties. This article examines these competing positions and proposes that family hardship should mitigate penalty severity only when incarcerating the offender would cause severe financial hardship to his or her dependants.

Subjects of Technology: An Auto-Archeology of Attention Deficit Disorder in Neoliberal Time(s)

2018 ◽  
Vol 19 (2) ◽  
pp. 105-115
Author(s):  
Joshua S. Hanan
Keyword(s):  
Learning Disability ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Family Members ◽  
The Body ◽  
The Self ◽  
Psychiatric Diagnoses ◽  
Critical Perspective ◽  
Close Family

This essay (re)presents my own experiences living with attention deficit disorder (ADD) as a child and adult to provide a radically historical, contextual, and critical autoethnographic conceptualization of this “learning disability.” Specifically, by building upon Ragan Fox’s “auto-archeological” method, a critical perspective that “unite[s] autoethnography and Foucault’s theories of discourse,” I draw upon institutional artifacts, psychiatric diagnoses, and interviews with close family members to show that ADD is a “technology of the self” that economizes the body in accordance with a distinctly neoliberal temporality. This temporalizing process, I show, is reinforced by a range of other neoliberal technologies of selfhood and ultimately cultivates the very “deficit framework” that ADD diagnoses are aimed at healing. The conclusion questions the legitimacy of ADD outside of the various technological interfaces that make the disability visible as a public problem and considers the intimate connections between neoliberalism, ableism, and the contemporary university.

scholarly journals Evaluation of the Nipah epidemic containment and multisectoral involvement in Kerala using an appropriate management framework

2020 ◽  
Vol 7 (7) ◽  
pp. 2813
Author(s):  
Asma A. Rahim ◽  
Sujina C. Muthukutty ◽  
Sabitha R. Jacob ◽  
Rini Ravindran ◽  
Jayakrishnan Thayyil ◽  
...  
Keyword(s):  
Health Personnel ◽  
Viral Infections ◽  
Nipah Virus ◽  
Disease Outbreaks ◽  
State Level ◽  
The State ◽  
Contact Tracing ◽  
Outbreak Response ◽  
Management Framework ◽  
The Government

Kozhikode district of North Kerala, India witnessed an outbreak of Nipah virus (NiV) in the month of May 2018. Two adjacent districts were affected leaving 17 patients dead out of the 19 confirmed. United Nations and WHO lauded the expeditious response of the state’s health system in the diagnosis and containment of the outbreak which was unprecedented. The authors being in the contact tracing and surveillance operation district team, had kept a record of timeline of events and actions at the state level, compiled the news clippings and tracked events. In the absence of an end‑of‑epidemic report for reference, these records served as a valuable tool for the present review. We used the Management science for health frame work tool (MSH framework) to evaluate the district and state coordinated actions which helped in curbing the outbreak. Though NiV outbreak in South India (2018) had similar epidemiological features to previous disease outbreaks, it stands out as the one to be detected and contained in a short span of time. As health personnel working in the government medical college of an affected district and directly involved in contact tracing operations and containment measures, exploring and sharing, what worked and how, in the context of multidisciplinary response and recovery attempts of the outbreak in the state may be beneficial to public health personnel and policy makers. This management framework may be replicated in the national and international context, particularly in South East Asian region under threat of emerging viral infections like COVID-19, lacking specific epidemic management frameworks for outbreak response and containment.

scholarly journals Transmission dynamics and the effects of non-pharmaceutical interventions in the COVID-19 outbreak resurged in Beijing, China: a descriptive and modelling study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047227
Author(s):  
Xiaoming Cui ◽  
Lin Zhao ◽  
Yuhao Zhou ◽  
Xin Lin ◽  
Runze Ye ◽  
...  
Keyword(s):  
Close Contact ◽  
Transmission Dynamics ◽  
Contact Tracing ◽  
Population Mobility ◽  
Wholesale Market ◽  
The People ◽  
Spatiotemporal Analyses ◽  
Epidemiological Characteristics ◽  
Pharmaceutical Interventions ◽  
Modelling Study

ObjectiveTo evaluate epidemiological characteristics and transmission dynamics of COVID-19 outbreak resurged in Beijing and to assess the effects of three non-pharmaceutical interventions.DesignDescriptive and modelling study based on surveillance data of COVID-19 in Beijing.SettingOutbreak in Beijing.ParticipantsThe database included 335 confirmed cases of COVID-19.MethodsTo conduct spatiotemporal analyses of the outbreak, we collected individual records on laboratory-confirmed cases of COVID-19 from 11 June 2020 to 5 July 2020 in Beijing, and visitor flow and products transportation data of Xinfadi Wholesale Market. We also built a modified susceptible-exposed-infected-removed model to investigate the effect of interventions deployed in Beijing.ResultsWe found that the staff working in the market (52.2%) and the people around 10 km to this epicentre (72.5%) were most affected, and the population mobility entering-exiting Xinfadi Wholesale Market significantly contributed to the spread of COVID-19 (p=0.021), but goods flow of the market had little impact on the virus spread (p=0.184). The prompt identification of Xinfadi Wholesale Market as the infection source could have avoided a total of 25 708 (95% CI 13 657 to 40 625) cases if unnoticed transmission lasted for a month. Based on the model, we found that active screening on targeted population by nucleic acid testing alone had the most significant effect.ConclusionsThe non-pharmaceutical interventions deployed in Beijing, including localised lockdown, close-contact tracing and community-based testing, were proved to be effective enough to contain the outbreak. Beijing has achieved an optimal balance between epidemic containment and economic protection.

Potential of ICT in India to Cater Pandemics in Healthcare Sector with Special Reference to Covid-19

2020 ◽  
Vol 9 (2) ◽  
pp. 11-17
Author(s):  
Zafar Majeed Rather ◽  
Magray Ajaz Ahmad
Keyword(s):  
Information And Communication Technologies ◽  
Virus Disease ◽  
Close Contact ◽  
Personal Data ◽  
The Body ◽  
Contact Tracing ◽  
Healthcare Sector ◽  
Infected People ◽  
Personal Data Protection ◽  
Corona Virus

Corona virus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome Corona virus 2 (SARS-CoV-2). The disease was first identified in December 2019 in Wuhan, the capital of China’s Hubei province, and has since spread globally, resulting in the ongoing 2019–20 corona virus pandemic. As of 9 June 2020, more than 7.12 million cases have been reported across 187 countries and territories, resulting in more than 406,000 deaths. More than 3.29 million people have recovered. The virus is primarily spread between people during close contact, often via small droplets produced by coughing, sneezing, or talking. The disease has been given official name as COVID-19[1]. Since its outbreak in china, infrared thermometers were used to check the body temperature in order to identify the infected people. Countries like China and Korea started the use of different technologies to detect, track and prevent the spread of this deadly virus. Among the major technologies used are Internet of Things (IoT), Artificial Intelligence (AI) and deep learning. With the invent of 5G technologies, we are able to transfer and process huge amounts of data on a real time basis. Health experts have argued that a key tool at governments’ disposal to contain the COVID-19 outbreak, and which was not around during the 1918 Spanish Flu, is the ability to harness digital technologies to track the spread. At the same time, deployment of contact tracing apps by governments or public health authorities has added to the debate on online privacy and personal data protection. In this research paper, we discuss the potential application of different information and communication technologies (ICT) like IoT, AI and 5G that can help in (i) Monitoring (ii) surveillance (iii) detection and prevention of COVID-19 and enhancing the healthcare to make it future-ready for any such diseases like COVID-19.

Compulsory Portion and Other Aspects of Family Protection in Austria

2020 ◽  
pp. 233-267
Author(s):  
Christiane Wendehorst
Keyword(s):  
Family Members ◽  
Major Reform ◽  
The Law ◽  
Law Of Succession ◽  
Austrian Law ◽  
Close Family ◽  
Consistent Approach

The Austrian law of succession boasts some rather strong mechanisms for overriding a will in the interest of surviving family members. Taken together, the law of compulsory portion, the various statutory legacies, and the maintenance claims significantly reduce a testator’s freedom to pass on his or her property as the testator deems appropriate. Yet, Austrian law does not necessarily ensure that all close family members obtain minimum levels of subsistence, as the group of individuals entitled to family protection benefits is small and more or less restricted to the surviving spouse or registered partner and descendants. The position of the surviving spouse or registered partner has been continuously strengthened over the years but there is still an unfortunate discrepancy between what a surviving spouse or partner is entitled to upon death as compared with the situation upon divorce. The existing patchwork of mechanisms does not seem to have created significant problems, but still it is fair to say that the Austrian law of family protection lacks a consistent approach. This is still true after major reform in 2015, which to some extent restricted entitlements under the law of compulsory portion but also introduced further compulsory benefits. Most conspicuously, the new ‘care legacy’ may entail sweeping changes for smaller estates, and it may well happen that the whole estate goes to one or several caring family members, with heirs possibly even having to pay out of their own pockets.

scholarly journals What Is the Experience of Practitioners in Health, Education or Social Care Roles Following a Death by Suicide? A Qualitative Research Synthesis

2019 ◽  
Vol 16 (18) ◽  
pp. 3293
Author(s):  
Hilary Causer ◽  
Kate Muse ◽  
Jo Smith ◽  
Eleanor Bradley
Keyword(s):  
Systematic Review ◽  
Qualitative Research ◽  
Health Education ◽  
Service User ◽  
Social Care ◽  
Family Members ◽  
Research Synthesis ◽  
Safe Practice ◽  
Cultural Contexts ◽  
Close Family

Recent research has highlighted that the number of people impacted by a death by suicide is far greater than previously estimated and includes wider networks beyond close family members. It is important to understand the ways in which suicide impacts different groups within these wider networks so that safe and appropriate postvention support can be developed and delivered. A systematic review in the form of a qualitative research synthesis was undertaken with the aim of addressing the question ‘what are the features of the experiences of workers in health, education or social care roles following the death by suicide of a client, patient, student or service user?’ The analysis developed three categories of themes, ‘Horror, shock and trauma’, ‘Scrutiny, judgement and blame’, and ‘Support, learning and living with’. The mechanisms of absolution and incrimination were perceived to impact upon practitioners’ experiences within social and cultural contexts. Practitioners need to feel prepared for the potential impacts of a suicide and should be offered targeted postvention support to help them in processing their responses and in developing narratives that enable continued safe practice. Postvention responses need to be contextualised socially, culturally and organisationally so that they are sensitive to individual need.

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