scholarly journals Retrospective screening of routine respiratory samples revealed undetected community transmission and missed intervention opportunities for SARS-CoV-2 in the United Kingdom

2021 ◽  
Vol 102 (6) ◽  
Author(s):  
Joseph G. Chappell ◽  
Theocharis Tsoleridis ◽  
Gemma Clark ◽  
Louise Berry ◽  
Nadine Holmes ◽  
...  
Keyword(s):  
Sequence Data ◽  
Infected Individual ◽  
Case Definition ◽  
Case Definitions ◽  
Risk Area ◽  
High Risk Area ◽  
Epidemiological Risk ◽  
Distinct Lineage ◽  
The Uk ◽  
Archival Specimens

In the early phases of the SARS coronavirus type 2 (SARS-CoV-2) pandemic, testing focused on individuals fitting a strict case definition involving a limited set of symptoms together with an identified epidemiological risk, such as contact with an infected individual or travel to a high-risk area. To assess whether this impaired our ability to detect and control early introductions of the virus into the UK, we PCR-tested archival specimens collected on admission to a large UK teaching hospital who retrospectively were identified as having a clinical presentation compatible with COVID-19. In addition, we screened available archival specimens submitted for respiratory virus diagnosis, and dating back to early January 2020, for the presence of SARS-CoV-2 RNA. Our data provides evidence for widespread community circulation of SARS-CoV-2 in early February 2020 and into March that was undetected at the time due to restrictive case definitions informing testing policy. Genome sequence data showed that many of these early cases were infected with a distinct lineage of the virus. Sequences obtained from the first officially recorded case in Nottinghamshire - a traveller returning from Daegu, South Korea – also clustered with these early UK sequences suggesting acquisition of the virus occurred in the UK and not Daegu. Analysis of a larger sample of sequences obtained in the Nottinghamshire area revealed multiple viral introductions, mainly in late February and through March. These data highlight the importance of timely and extensive community testing to prevent future widespread transmission of the virus.

scholarly journals Retrospective screening of routine respiratory samples revealed undetected community transmission and missed intervention opportunities for SARS-CoV-2 in the United Kingdom

2020 ◽  
Author(s):  
Joseph G Chappell ◽  
Theocharis Tsoleridis ◽  
Gemma Clark ◽  
Louise Berry ◽  
Nadine Holmes ◽  
...  
Keyword(s):  
Sequence Data ◽  
Infected Individual ◽  
Case Definition ◽  
Case Definitions ◽  
Risk Area ◽  
High Risk Area ◽  
Epidemiological Risk ◽  
Distinct Lineage ◽  
The Uk ◽  
Archival Specimens

In the early phases of the SARS coronavirus type 2 (SARS-CoV-2) pandemic, testing focused on individuals fitting a strict case definition involving a limited set of symptoms together with an identified epidemiological risk, such as contact with an infected individual or travel to a high-risk area. To assess whether this impaired our ability to detect and control early introductions of the virus into the UK, we PCR-tested archival specimens collected on admission to a large UK teaching hospital who retrospectively were identified as having a clinical presentation compatible with COVID-19. In addition, we screened available archival specimens submitted for respiratory virus diagnosis, and dating back to early January 2020, for the presence of SARS-CoV-2 RNA. Our data provides evidence for widespread community circulation of SARS-CoV2 in early February 2020 and into March that was undetected at the time due to restrictive case definitions informing testing policy. Genome sequence data showed that many of these early cases were infected with a distinct lineage of the virus. Sequences obtained from the first officially recorded case in Nottinghamshire - a traveller returning from Daegu, South Korea - also clustered with these early UK sequences suggesting acquisition of the virus occurred in the UK and not Daegu. Analysis of a larger sample of sequences obtained in the Nottinghamshire area revealed multiple viral introductions, mainly in late February and through March. These data highlight the importance of timely and extensive community testing to prevent future widespread transmission of the virus.

Measles

2016 ◽  
Author(s):  
David Baxter ◽  
Gill Marsh ◽  
Sam Ghebrehewet
Keyword(s):  
Public Health ◽  
Single Case ◽  
Background Information ◽  
Post Exposure Prophylaxis ◽  
Mmr Vaccine ◽  
Case Definitions ◽  
Risk Area ◽  
Public Health Response ◽  
High Risk Area ◽  
The Public

This chapter describes a case of measles in a school child who contracted measles following travel to a high-risk area. The case resulted in a measles outbreak in the school and further cases in the community. Background information on the epidemiology and clinical features of measles and the public health response to a single case, an outbreak of measles in a school, and measles exposure in a healthcare setting are discussed. Case definitions risk assessment, identification of close contacts including priority groups and the required public health actions including post exposure prophylaxis (PEP) with Human Normal Immunoglobulin (HNIG) and/or MMR vaccine, are described in detail. ‘Top tips’ are given to provide practical tips for the reader to think through the public health management of the case study, and ‘tools of the trade’ list the laboratory and epidemiological components of the investigation. Finally, the chapter encourages exploration of other potential scenarios, including the possibility of measles transmission in a nursery.

scholarly journals Further description of bovine tuberculosis trends in the United Kingdom and the Republic of Ireland, 2003–2015

2018 ◽  
Vol 183 (23) ◽  
pp. 717-717 ◽  
Author(s):  
Simon J More ◽  
Erik Houtsma ◽  
Liam Doyle ◽  
Guy McGrath ◽  
Tracy A Clegg ◽  
...  
Keyword(s):  
Bovine Tuberculosis ◽  
Evidence Base ◽  
Effective Control ◽  
Risk Area ◽  
High Risk Area ◽  
Republic Of Ireland ◽  
Country Level ◽  
The Republic ◽  
The Uk ◽  
Low Prevalence

Extending on earlier work, trends in bovine tuberculosis (bTB) from 2003 to 2015 are described for the countries of the UK and the Republic of Ireland using standardised definitions and measures. Based on measures of animal and herd incidence, there remains a stable situation of extremely low prevalence in Scotland and the Low Risk Area of England, and a higher but ongoing reduction in prevalence in the Republic of Ireland. In Northern Ireland, there has been a rising bTB trend during 2010–2015, although not to levels experienced during 2002–2004. In the High Risk Area and Edge Area of England during 2010–2015, the rising bTB trends have continued but with some recent evidence of stabilisation. In Wales, prevalence has fallen subsequent to a peak in 2008. The paper considers country-level differences in the light of key policy changes, which are presented in detail. This work is unique, and will assist policymakers when critically evaluating policy options for effective control and eradication. Ongoing updates of this analysis would be useful, providing an evidence base for country-level comparison of bTB trends into the future. The use of multivariable analytical methods should be considered, but will rely on substantial sharing of raw data across the five countries.

Increasing prevalence and incidence rates of multiple sclerosis in Kuwait

2013 ◽  
Vol 20 (5) ◽  
pp. 543-547 ◽  
Author(s):  
R Alroughani ◽  
SF Ahmed ◽  
R Behbehani ◽  
R Khan ◽  
A Thussu ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Incidence Rates ◽  
Case Definition ◽  
Population Census ◽  
Sectional Study ◽  
Risk Area ◽  
Cross Sectional ◽  
High Risk Area ◽  
Male Ratio ◽  
Mcdonald Criteria

Background: Kuwait was considered as low to intermediate risk area for MS. Objectives: To determine the prevalence and incidence rates of MS among Kuwaiti nationals based on 2011 population census. Methods: This cross-sectional study was conducted between October 2010 and April 2013 using the newly developed national MS registry in Kuwait. Patients with a diagnosis of MS according to 2010 revised McDonald criteria were identified. The crude, age- and sex-specific prevalence and incidence rates among Kuwaiti patients were calculated. Results: 1176 MS patients were identified of which 927 (78.8%) were Kuwaitis and 249 (21.2%) were expatriates. Among Kuwaiti patients, female to male ratio was 1.8:1 with a mean age of 35.40 ± 10.99 years. The prevalence rate of MS was 85.05 per 100,000 persons (95% CI: 82.80 – 87.04). There was a peak in prevalence among patients aged 30–39 years. The incidence of MS was 6.88 per 100,000 persons (95% CI 5.52–8.55). Between 2003 and 2011, the incidence increased 3.22 and 2.54 times in women and men respectively. Conclusion: Kuwait is considered a high-risk area for MS. The significant increase in prevalence and incidence rates may represent a true increase despite the improvement in case ascertainment and case definition.

Periodic monitoring of vampire bats and rabies: a new framework for animal restoration projects in the Neotropics

2020 ◽  
Author(s):  
Fernando Gonçalves ◽  
Daniel G. Streicker ◽  
Mauro Galetti
Keyword(s):  
Disease Transmission ◽  
Lessons Learned ◽  
Multidisciplinary Teams ◽  
Risk Area ◽  
Food Web Structure ◽  
Land Bridge ◽  
High Risk Area ◽  
Restoration Project ◽  
Vampire Bats

Nowadays, restoration project might lead to increased public engagement and enthusiasm for biodiversity and is receiving increased media attention in major newspapers, TED talks and the scientific literature. However, empirical research on restoration project is rare, fragmented, and geographically biased and long-term studies that monitor indirect and unexpected effects are needed to support future management decisions especially in the Neotropical area. Changes in animal population dynamics and community composition following species (re)introduction may have unanticipated consequences for a variety of downstream ecosystem processes, including food web structure, predator-prey systems and infectious disease transmission. Recently, an unprecedented study in Brazil showed changes in vampire bat feeding following a rewilding project and further transformed the land-bridge island into a high-risk area for rabies transmission. Due the lessons learned from ongoing project, we present a novel approach on how to anticipate, monitor, and mitigate the vampire bats and rabies in rewilding projects. We pinpoint a series of precautions and the need for long-term monitoring of vampire bats and rabies responses to rewilding projects and highlighted the importance of multidisciplinary teams of scientist and managers focusing on prevention educational program of rabies risk transmitted by bats. In addition, monitoring the relative abundance of vampire bats, considering reproductive control by sterilization and oral vaccines that autonomously transfer among bats would reduce the probability, size and duration of rabies outbreaks. The rewilding assessment framework presented here responds to calls to better integrate the science and practice of rewilding and also could be used for long-term studying of bat-transmitted pathogen in the Neotropical area as the region is considered a geographic hotspots of “missing bat zoonoses”.

74 Improving Handover Between Doctors and Nurses on An Elderly Care Ward

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
K Suseeharan ◽  
T Vedutla
Keyword(s):  
High Risk ◽  
Patient Care ◽  
Positive Impact ◽  
Elderly Care ◽  
Task Completion ◽  
Risk Area ◽  
High Risk Area ◽  
Staff Members ◽  
Care Ward ◽  
Doctors And Nurses

Abstract Background The Royal College of Physician guidelines (2011) identified handover as a “high risk step” in patient care, especially in recent times within the NHS where shift patterns lead to more disjointed care with a high reliance on effective handover by all staff members. Introduction At Cannock Chase hospital, Fairoak ward is an elderly care rehabilitation ward where there is a large multi-disciplinary team. While working on the ward as doctors we noticed that handover between the MDT was poor. Anecdotal evidence from both doctors and nurses felt that this was a high risk area in need of improvement. Aim to improve handover between doctors and nurses on this elderly care ward. Method To measure the quality of current handover practice we did a questionnaire. A total of 12 questionnaires were completed which showed that 92% of staff felt that handover on the ward was very poor and 50% preferred both written and verbal handover. We measured the number of tasks verbally handed over between doctors and nurses over 3 days. On average 65% of the tasks were completed. We then made the below interventions and re-audited to see if there was any improvement. Interventions over 3 week period: Results Questionnaire: Measuring task completion after interventions; Conclusion This project has made a positive change qualitatively and quantitatively to the ward handover practice. Staff satisfaction regarding handover has improved and the number of “handed over” tasks completed daily has significantly improved. The written handover sheet had poor utilisation by staff but in 4 months we are going to re-audit and trial the handover sheet again to further improve service delivery. We hope this improvement will have a positive impact on patient care on this elderly care ward.

scholarly journals Our Evolving Understanding of ME/CFS

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 200 ◽  
Author(s):  
Kenneth J. Friedman ◽  
Modra Murovska ◽  
Derek F. H. Pheby ◽  
Paweł Zalewski
Keyword(s):  
Active Phase ◽  
Case Definitions ◽  
Diagnostic Laboratory ◽  
Biochemical Pathways ◽  
Patient Organizations ◽  
Clinical Consequences ◽  
Potential Benefits ◽  
Multiple Case ◽  
Use Of The Internet ◽  
The Uk

The potential benefits of the scientific insights gleaned from years of treating ME/CFS for the emerging symptoms of COVID-19, and in particular Longhaul- or Longhauler-COVID-19 are discussed in this opinion article. Longhaul COVID-19 is the current name being given to the long-term sequelae (symptoms lasting beyond 6 weeks) of SARS-CoV-2 infection. Multiple case definitions for ME/CFS exist, but post-exertional malaise (PEM) is currently emerging as the ‘hallmark’ symptom. The inability to identify a unique trigger of ME/CFS, as well as the inability to identify a specific, diagnostic laboratory test, led many physicians to conclude that the illness was psychosomatic or non-existent. However, recent research in the US and the UK, championed by patient organizations and their use of the internet and social media, suggest underlying pathophysiologies, e.g., oxidative stress and mitochondrial dysfunction. The similarity and overlap of ME/CFS and Longhaul COVID-19 symptoms suggest to us similar pathological processes. We put forward a unifying hypothesis that explains the precipitating events such as viral triggers and other documented exposures: For their overlap in symptoms, ME/CFS and Longhaul COVID-19 should be described as Post Active Phase of Infection Syndromes (PAPIS). We further propose that the underlying biochemical pathways and pathophysiological processes of similar symptoms are similar regardless of the initiating trigger. Exploration of the biochemical pathways and pathophysiological processes should yield effective therapies for these conditions and others that may exhibit these symptoms. ME/CFS patients have suffered far too long. Longhaul COVD-19 patients should not be subject to a similar fate. We caution that failure to meet the now combined challenges of ME/CFS and Longhaul COVID-19 will impose serious socioeconomic as well as clinical consequences for patients, the families of patients, and society as a whole.

S2031 Socioeconomic Status in Relation to Esophageal Cancer in a High-Risk Area of Iran

2008 ◽  
Vol 134 (4) ◽  
pp. A-301 ◽  
Author(s):  
Farhad Islami ◽  
Farin Kamangar ◽  
Dariush Nasrollahzadeh ◽  
Masoud Sotoudeh ◽  
Christian C. Abnet ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Esophageal Cancer ◽  
High Risk ◽  
Risk Area ◽  
High Risk Area
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