REACT-1 round 15 interim report: High and rising prevalence of SARS-CoV-2 infection in England from end of September 2021 followed by a fall in late October 2021

Background: The third wave of COVID-19 in England coincided with the rapid spread of the Delta variant of SARS-CoV-2 from the end of May 2021. Case incidence data from the national testing programme (Pillar 2) in England may be affected by changes in testing behaviour and other biases. Community surveys may provide important contextual information to inform policy and the public health response. Methods: We estimated patterns of community prevalence of SARS-CoV-2 infection in England using RT-PCR swab-positivity, demographic and other risk factor data from round 15 (interim) of the REal-time Assessment of Community Transmission-1 (REACT-1) study (round 15a, carried out from 19 to 29 October 2021). We compared these findings with those from round 14 (9 to 27 September 2021). Results: During mid- to late-October 2021 (round 15a) weighted prevalence was 1.72% (1.61%, 1.84%) compared to 0.83% (0.76%, 0.89%) in September 2021 (round 14). The overall reproduction number (R) from round 14 to round 15a was 1.12 (1.11, 1.14) with increases in prevalence over this period (September to October) across age groups and regions except Yorkshire and The Humber. However, within round 15a (mid- to late-October) there was evidence of a fall in prevalence with R of 0.76 (0.65, 0.88). The highest weighted prevalence was observed among children aged 5 to 12 years at 5.85% (5.10%, 6.70%) and 13 to 17 years at 5.75% (5.02%, 6.57%). At regional level, there was an almost four-fold increase in weighted prevalence in South West from round 14 at 0.59% (0.43%,0.80%) to round 15a at 2.18% (1.84%, 2.58%), with highest smoothed prevalence at subregional level also found in South West in round 15a. Age, sex, key worker status, and presence of children in the home jointly contributed to the risk of swab-positivity. Among the 126 sequenced positive swabs obtained up until 23 October, all were Delta variant; 13 (10.3%) were identified as the AY.4.2 sub-lineage. Discussion: We observed the highest overall prevalence of swab-positivity seen in the REACT-1 study in England to date in round 15a (October 2021), with a two-fold rise in swab-positivity from round 14 (September 2021). Despite evidence of a fall in prevalence from mid- to late-October 2021, prevalence remains high, particularly in school-aged children, with evidence also of higher prevalence in households with one or more children. Thus, vaccination of children aged 12 and over remains a high priority (with possible extension to children aged 5-12) to help reduce within-household transmission and disruptions to education, as well as among adults, to lessen the risk of serious disease among those infected.

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Lockdowns, lives and livelihoods: the impact of COVID-19 and public health responses to conflict affected populations - a remote qualitative study in Baidoa and Mogadishu, Somalia

Conflict and Health ◽

10.1186/s13031-021-00382-5 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Dorien H. Braam ◽

Sharath Srinivasan ◽

Luke Church ◽

Zakaria Sheikh ◽

Freya L. Jephcott ◽

...

Keyword(s):

Public Health ◽

Qualitative Study ◽

Narrative Analysis ◽

Grey Literature ◽

Age Groups ◽

Research Approach ◽

Structured Interviews ◽

Or Education ◽

Public Health Response ◽

The Impact

Abstract Background Authorities in Somalia responded with drastic measures after the first confirmed COVID-19 case in mid-March 2020, closing borders, schools, limiting travel and prohibiting most group functions. However, the impact of the pandemic in Somalia thereafter remained unclear. This study employs a novel remote qualitative research method in a conflict-affected setting to look at how some of the most at-risk internally displaced and host populations were impacted by COVID-19, what determined their responses, and how this affected their health and socio-economic vulnerability. Methods We conducted a remote qualitative study, using Katikati, a 1-to-1 conversation management and analysis platform using short message service (SMS) developed by Lark Systems with Africa’s Voices Foundation (AVF), for semi-structured interviews over three months with participants in Mogadishu and Baidoa. We recruited a gender balanced cohort across age groups, and used an analytical framework on the social determinants of health for a narrative analysis on major themes discussed, triangulating data with existing peer-reviewed and grey literature. Results The remote research approach demonstrated efficacy in sustaining trusted and meaningful conversations for gathering qualitative data from hard-to-reach conflict-affected communities. The major themes discussed by the 35 participants included health, livelihoods and education. Two participants contracted the disease, while others reported family or community members affected by COVID-19. Almost all participants faced a loss of income and/or education, primarily as a result of the strict public health measures. Some of those who were heavily affected economically but did not directly experienced disease, denied the pandemic. Religion played an important role in participants’ beliefs in protection against and salvation from the disease. As lockdowns were lifted in August 2020, many believed the pandemic to be over. Conclusions While the official COVID-19 burden has remained relatively low in Somalia, the impact to people’s daily lives, income and livelihoods due to public health responses, has been significant. Participants describe those ‘secondary’ outcomes as the main impact of the pandemic, serving as a stark reminder of the need to broaden the public health response beyond disease prevention to include social and economic interventions to decrease people’s vulnerability to future shocks.

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Functional and molecular characterization of NHE3 expression during ontogeny in rat jejunal epithelium

AJP Cell Physiology ◽

10.1152/ajpcell.1997.273.6.c1937 ◽

1997 ◽

Vol 273 (6) ◽

pp. C1937-C1946 ◽

Cited By ~ 70

Author(s):

James F. Collins ◽

Hua Xu ◽

Pawel R. Kiela ◽

Jiamin Zeng ◽

Fayez K. Ghishan

Keyword(s):

Northern Blot ◽

Polyclonal Antibodies ◽

Membrane Vesicle ◽

Age Groups ◽

Fold Increase ◽

Jejunal Mucosa ◽

Mrna Levels ◽

Adult Rats ◽

Intestinal Brush Border Membrane ◽

Protein Levels

Ontogenic changes occur in intestinal brush-border membrane vesicle (BBMV) Na+/H+exchange activity. The present studies were designed to investigate ontogenic changes in Na+/H+exchanger (NHE) isoform 3 in rat jejunum. pH-dependent Na+ uptake was assayed in four age groups of rats in the presence of 0, 50, or 800 μM HOE-694, a specific NHE inhibitor with differential sensitivities for NHE2 [inhibition constant ( K i) = 5 μM in PS120 fibroblasts] and NHE3 ( K i = 650 μM). Results showed that NHE2 and NHE3 contribute to basal BBMV uptake at all ages. Uptake levels were highest in 6-wk-old rats, lower in adult rats, and lowest in 2-wk-old (suckling) and 3-wk-old (weanling) rats. NHE3 contribution ranged from 92% at 6 wk of age to 59% at 2 and 3 wk of age. NHE3 inhibition by 800 μM HOE-694 was 38–45%. Statistical analysis showed that HOE-694 had a significant effect at both concentrations at all ages and that differences were present between all ages except 2- and 3-wk rats (at all HOE-694 concentrations). Northern blot analyses of jejunal mucosa showed lowest NHE3 mRNA levels in 2-wk animals and higher levels in all other age groups. Polyclonal antibodies were developed against an NHE3 COOH-terminal fusion protein, and antiserum was characterized with NHE3-transfected PS120 cells and by immunohistochemistry. Western blot analyses showed lowest protein levels in 2-wk animals and higher levels in the other ages. Suckling rats were subcutaneously injected with methylprednisone (MP) for 2 days and killed 1 day later. Northern blot analyses showed a twofold increase in NHE3 mRNA expression with MP treatment. Immunoblot analyses showed a 2.5-fold increase in NHE3 immunoreactive protein levels with MP injection. Overall, these data suggest that NHE3 is regulated during ontogeny and that ontogenic changes are most apparent around the time of weaning. Furthermore, the data suggest that NHE3 is regulated at transcriptional and posttranscriptional levels during mammalian intestinal development.

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Recent Trends in the Prescribing of ADHD Medications in Canadian Primary Care

Journal of Attention Disorders ◽

10.1177/1087054717720719 ◽

2017 ◽

Vol 24 (2) ◽

pp. 301-308 ◽

Cited By ~ 3

Author(s):

Rachael Morkem ◽

Scott Patten ◽

John Queenan ◽

David Barber

Keyword(s):

Primary Care ◽

Age Groups ◽

Fold Increase ◽

Population Based ◽

Adhd Medication ◽

Fourfold Increase ◽

School Aged Children ◽

Medication Prescribing ◽

And Gender ◽

Adhd Medications

Objective: The aim of this study was to describe the prevalence and incidence of ADHD medication prescribing, by age and gender, from 2005 to 2015 in Canadian primary care. Method: A population-based retrospective cohort study was conducted to evaluate the prescribing of ADHD medications between 2005 and 2015 using electronic medical record data. Yearly prevalence and incidence of ADHD medication prescribing were calculated for preschoolers (up to 5 years old), school-aged children (6-17 years old), and adults (18-65 years old) along with a description of the types of ADHD medications prescribed between 2005 and 2015. Results: Between 2005 and 2015, there was a 2.6-fold increase in the prevalence of ADHD medication prescribing to preschoolers, a 2.5-fold increase in school-aged children, and a fourfold increase in adults. There was a corresponding rise in incidence of prescribing although this rise was moderate and estimates were much lower compared with prevalence. The most commonly prescribed medication was Methylphenidate (65.0% of all ADHD medications prescribed). Conclusion: Although the prevalence of ADHD has remained stable over time, this study found an increase in the prescribing of ADHD medications in all age groups between 2005 and 2015. Incidence of new prescriptions was small relative to prevalence, suggesting that longer term treatments are being adopted.

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Cumulative reproductive performance effect on overall lifetime productivity in Merino sheep

Animal Production Science ◽

10.1071/an17794 ◽

2018 ◽

Vol 58 (8) ◽

pp. 1470

Author(s):

J. S. Richards ◽

M. A. Sladek ◽

G. J. Lee

Keyword(s):

Reproductive Performance ◽

New South ◽

Dental Health ◽

Age Groups ◽

The South ◽

Performance Effect ◽

South West ◽

South Wales ◽

The Impact ◽

Effect Of Age

Reproduction is an important driver of profitability in commercial sheep flocks. Historically, Merino flocks have been run with a fixed age structure, ignoring individual merit and casting for age at a specific age. More recently, research has focussed on utilising the variation within age groups by keeping productive older ewes longer and culling less productive ewes earlier. Previous studies have also examined the effect of age on reproduction and the impact of reproduction status on productivity, but little research has been conducted on cumulative effects of reproductive performance on later productivity, reproduction and health. The present study examined the impact of higher lifetime reproduction on other key production and fitness traits in older ewes run under commercial conditions. Data were collected from two commercial wool-producing properties in the South West Slopes and the Central West Plains of New South Wales during 2009–2011. Reproduction, fleece measurements, bodyweight and condition and dental health were recorded during the study. The results showed that age had a bigger effect on productivity and dental health than did cumulative lifetime reproduction. Environment and genetics determined the level of impact, with minimal loss in productivity from increased age of animals occurring in the South West Slopes flock, whereas the Central West Plains flock would appear to require closer monitoring of productivity as ewes aged. The data collected did not allow separation of the genetic and environmental influences within the study. Retaining animals with a higher reproductive performance past normal culling age does not necessarily result in reduction of productivity or ewe health, but this must be monitored.

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Estimating individual risks of COVID-19-associated hospitalization and death using publicly available data

PLoS ONE ◽

10.1371/journal.pone.0243026 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0243026

Author(s):

Rajiv Bhatia ◽

Jeffrey Klausner

Keyword(s):

Risk Estimation ◽

Secondary Infection ◽

Case Fatality ◽

Infection Risk ◽

Individual Risk ◽

Incidence Data ◽

Household Transmission ◽

Contact Rates ◽

Time Period ◽

Public Data

We describe a method to estimate individual risks of hospitalization and death attributable to non-household and household transmission of SARS-CoV-2 using available public data on confirmed-case incidence data along with estimates of the clinical fraction, timing of transmission, isolation adherence, secondary infection risks, contact rates, and case-hospitalization and case-fatality ratios. Using the method, we estimate that risks for a 90-day period at the median daily summertime U.S. county confirmed COVID-19 case incidence of 10.8 per 100,000 and pre-pandemic contact rates range from 0.4 to 8.9 per 100,000 for the four deciles of age between 20 and 60 years. The corresponding 90-day period risk of hospitalization ranges from 13.7 to 69.2 per 100,000. Assuming a non-household secondary infection risk of 4% and pre-pandemic contact rates, the share of transmissions attributable to household settings ranges from 73% to 78%. These estimates are sensitive to the parameter assumptions; nevertheless, they are comparable to the COVID-19 hospitalization and fatality rates observed over the time period. We conclude that individual risk of hospitalization and death from SARS-CoV-2 infection is calculable from publicly available data sources. Access to publicly reported infection incidence data by setting and other exposure characteristics along with setting specific estimates of secondary infection risk would allow for more precise individual risk estimation.

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Evidence for Household Transmission of Rotavirus in the United States, 2011–2016

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piz004 ◽

2019 ◽

Vol 9 (2) ◽

pp. 181-187 ◽

Cited By ~ 3

Author(s):

Mary E Wikswo ◽

Umesh D Parashar ◽

Benjamin Lopman ◽

Rangaraj Selvarangan ◽

Christopher J Harrison ◽

...

Keyword(s):

Enzyme Immunoassay ◽

Age Groups ◽

The United States ◽

Surveillance Network ◽

Telephone Interviews ◽

Household Transmission ◽

Out Of Pocket Expenses ◽

Parental Interviews ◽

Significant Disease

Abstract Background Rotavirus is a leading cause of acute gastroenteritis (AGE) in children and is highly transmissible. In this study, we assessed the presence of AGE in household contacts (HHCs) of pediatric patients with laboratory-confirmed rotavirus. Methods Between December 2011 and June 2016, children aged 14 days to 11 years with AGE were enrolled at 1 of 7 hospitals or emergency departments as part of the New Vaccine Surveillance Network. Parental interviews, medical and vaccination records, and stool specimens were collected at enrollment. Stool was tested for rotavirus by an enzyme immunoassay and confirmed by real-time or conventional reverse transcription-polymerase chain reaction assay or repeated enzyme immunoassay. Follow-up telephone interviews were conducted to assess AGE in HHCs the week after the enrolled child’s illness. A mixed-effects multivariate model was used to calculate odds ratios. Results Overall, 829 rotavirus-positive subjects and 8858 rotavirus-negative subjects were enrolled. Households of rotavirus-positive subjects were more likely to report AGE illness in ≥1 HHC than were rotavirus-negative households (35% vs 20%, respectively; P < .0001). A total of 466 (16%) HHCs of rotavirus-positive subjects reported AGE illness. Of the 466 ill HHCs, 107 (23%) sought healthcare; 6 (6%) of these encounters resulted in hospitalization. HHCs who were <5 years old (odds ratio, 2.2 [P = .004]) were more likely to report AGE illness than those in other age groups. In addition, 144 households reported out-of-pocket expenses (median, $20; range, $2–$640) necessary to care for an ill HHC. Conclusions Rotavirus-associated AGE in children can lead to significant disease burden in HHCs, especially in children aged <5 years. Prevention of pediatric rotavirus illness, notably through vaccination, can prevent additional illnesses in HHCs.

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Hospital-Acquired Viral Respiratory Tract Infections in the Neonatal Unit: A Comparison with Other Inpatient Groups

Neonatology ◽

10.1159/000506427 ◽

2020 ◽

Vol 117 (4) ◽

pp. 513-516

Author(s):

Chiara Taylor ◽

Shin Tan ◽

Rebecca McClaughry ◽

Don Sharkey

Keyword(s):

Respiratory Tract ◽

Respiratory Tract Infections ◽

Viral Infections ◽

Age Groups ◽

Length Of Hospital Stay ◽

Fold Increase ◽

Hospital Inpatient ◽

Tract Infections ◽

Hospital Acquired ◽

Viral Respiratory

Background: Hospital-acquired viral respiratory tract infections (VRTIs) cause significant morbidity and mortality in neonatal patients. This includes escalation of respiratory support, increased length of hospital stay, and need for home oxygen, as well as higher healthcare costs. To date, no studies have compared population rates of VRTIs across age groups. Aim: Quantify the rates of hospital-acquired VRTIs in our neonatal population compared with other inpatient age groups in Nottinghamshire, UK. Methods: We compared all hospital inpatient PCR-positive viral respiratory samples between 2007 and 2013 and calculated age-stratified rates based on population estimates. Results: From a population of 4,707,217, we identified a previously unrecognised burden of VRTI in neonatal patients, only second to the 0–1-year-old group. Although only accounting for 1.3% of the population, half of the infections were in infants <1 year old and neonatal intensive care unit (NICU) patients. Human rhinovirus was the most dominant virus across the inpatient group, particularly in neonatal patients. Despite a two- to three-fold increase in the rate of positive samples in all groups during the colder months (1.1/1,000 October–March vs. 0.4/1,000 April–September), rates in the NICU did not change throughout the year at 4.3/1,000. Pandemic H1N1 influenza rates were 20 times higher in neonatal patients and infants <1 year old. Conclusion: Good epidemiological and interventional data are needed to help inform visiting and infection control policies to reduce transmission of hospital-acquired viral infections to this vulnerable population, particularly during pandemic seasons.

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Biology of littoral blenniid fishes on the coast of south-west England

Journal of the Marine Biological Association of the United Kingdom ◽

10.1017/s0025315400049912 ◽

1983 ◽

Vol 63 (1) ◽

pp. 223-237 ◽

Cited By ~ 36

Author(s):

P. Milton

Keyword(s):

Growth Rates ◽

Age Groups ◽

Food Chains ◽

Similar Treatment ◽

Food Items ◽

South West ◽

Abundant Food ◽

Competition For Food ◽

Littoral Species ◽

South West England

Observations in the field, and in the laboratory, of littoral fishes of south-west England during the period 1978–80 have shown that the three blenniid species found with any frequency on the shore constitute an important link in food chains. The occurrence, age, habitat and diet of Blennius (Lipophrys) pholis L., Coryphoblennius galerita L., and Parablennius gattorugine Brunnich have been considered; B. pholis was by far the most common of the three, with very few P. gattorugine being found intertidally. Of the latter, only age groups 0, 1 and 2 were represented in the littoral populations, whereas in the truly littoral species age groups 0–10 were found for B. pholis and 0–6 for C. galerita. Measurements of growth rates for the three species have been compared with growth rates of B. pholis and C. galerita at other sites, and a similar treatment has been afforded to dietary constituents. A discussion of the possible competition for food and refuge between the three species, and with other littoral teleosts, concludes that highly efficient partitioning of resources reduces competition to a minimum, with the exception of abundant food items which are (in any case) probably underexploited.

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Measuring vitamin B-12 bioavailability with [13C]-cyanocobalamin in humans

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa221 ◽

2020 ◽

Vol 112 (6) ◽

pp. 1504-1515 ◽

Cited By ~ 1

Author(s):

Sarita Devi ◽

Roshni M Pasanna ◽

Zeeshan Shamshuddin ◽

Kishor Bhat ◽

Ambily Sivadas ◽

...

Keyword(s):

Stable Isotope ◽

Low Dose ◽

Age Groups ◽

Fold Increase ◽

Compartment Model ◽

Radioactive Isotopes ◽

Vitamin B ◽

Before And After ◽

Vitamin B 12 ◽

The Mean

ABSTRACT Background Vitamin B-12 deficiency is widespread in many parts of the world, affecting all age groups and increasing with age. It is primarily due to a low intake of animal source foods or malabsorption. The measurement of bioavailability of vitamin B-12 is etiologically important in deficiency but is limited due to the use of radioactive isotopes like [57Co]- or [14C]-cyanocobalamin. Objectives The aim of this study was to measure the bioavailability of [13C]-cyanocobalamin in humans and to assess the effect of parenteral replenishment of vitamin B-12 on the bioavailability. Methods We synthesized a stable isotope-labeled vitamin B-12, [13C]-cyanocobalamin, using Salmonella enterica by providing [13C2]-ethanolamine as a sole carbon source. After purification and mass spectrometry–based characterization, its oral bioavailability was measured in the fasted state with high and low oral doses, before and after parenteral replenishment of vitamin B-12 stores, from the kinetics of its plasma appearance in a 2-compartment model. Results [13C]-cyanocobalamin was completely decyanated to [13C]-methylcobalamin describing metabolic utilization, and its plasma appearance showed early and late absorption phases. At a low dose of 2.3 µg, the mean bioavailability was 46.2 ± 12.8 (%, mean ± SD, n = 11). At a higher dose of 18.3 µg, the mean bioavailability was 7.6 ± 1.7 (%, mean ± SD, n = 4). Parenteral replenishment of the vitamin B-12 store in deficient individuals prior to the measurement resulted in a 1.9-fold increase in bioavailability. Conclusions Vitamin B-12 bioavailability is dose dependent and at a low dose that approximates the normal daily requirement (46%). The stable isotope method described here could be used to define the etiology of deficiency and to inform the dietary requirement in different physiologic states as well as the dose required for supplementation and food fortification. This trial was registered at the Clinical Trials Registry of India as CTRI/2018/04/012957.

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Epidemiological shift in the prevalence of pertussis in Taiwan: implications for pertussis vaccination

Journal of Medical Microbiology ◽

10.1099/jmm.0.46741-0 ◽

2007 ◽

Vol 56 (4) ◽

pp. 533-537 ◽

Cited By ~ 16

Author(s):

Yu-Chi Lin ◽

Shu-Man Yao ◽

Jer-Jea Yan ◽

Ying-Yan Chen ◽

Chuen-Sheue Chiang ◽

...

Keyword(s):

Young Adults ◽

Pertussis Vaccine ◽

Age Distribution ◽

Age Groups ◽

Fold Increase ◽

Acellular Pertussis Vaccine ◽

Older Age ◽

Surveillance Data ◽

Waning Immunity ◽

Low Incidence

In Taiwan, routine pertussis immunization has been implemented for more than 40 years and a low incidence of pertussis was maintained until an 80-fold increase in cases occurred in 1992. The unexpected increase emphasized the significance of pertussis. This study evaluated a total of 2452 reported cases of pertussis during 1993–2004 and surveillance data on incidence, age distribution and seasonality. The highest morbidity was in infants aged <1 year, and upward trends in the incidence of pertussis were significant for infants aged <1 year and adolescents aged 10–14 years. The highest mean number of cases was observed in August and upward trends were in colder months. This study indicates that the epidemiology of pertussis may have been changed by waning immunity in Taiwan. Increased surveillance activities, especially in older age groups, and additional booster doses of acellular pertussis vaccine for children aged 6–8 years and adolescents/young adults aged 15–20 years are necessary to control and prevent pertussis.

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