Projecting vaccine demand and impact for emerging zoonotic pathogens

Despite large outbreaks in humans seeming improbable for a number of zoonotic pathogens, several pose a concern due to their epidemiological characteristics and evolutionary potential. To enable effective responses to these pathogens in the event that they undergo future emergence, the Coalition for Epidemic Preparedness Innovations is advancing the development of vaccines for several pathogens prioritized by the World Health Organization. A major challenge in this pursuit is anticipating demand for a vaccine stockpile to support outbreak response. We developed a modeling framework for outbreak response for emerging zoonoses under three reactive vaccination strategies. Annual vaccine regimen requirements for a population-wide strategy ranged from >670,000 (95% prediction interval: 0-3,630,000) for Lassa virus to 1,190,000 (95% PrI: 0-8,480,000) for Rift Valley fever virus, while the regimens required for ring vaccination or targeting healthcare workers (HCWs) were several orders of magnitude lower. For each pathogen and vaccination strategy, reactive vaccination typically prevented fewer than 10% of cases, because of their presently low R0 values. Targeting HCWs had a higher per-regimen impact than population-wide vaccination. Our framework provides a flexible methodology for estimating vaccine stockpile needs and the geographic distribution of demand under a range of outbreak response scenarios.

Download Full-text

An approach to the understanding of the clinical-etiopathological aspect of COVID-19 (SARS-CoV-2)

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl1.3094 ◽

2020 ◽

Vol 11 (SPL1) ◽

pp. 862-869

Author(s):

Meena Kumari ◽

Monika Agrawal ◽

Rakesh Kumar Singh ◽

Parameswarappa S Byadgi

Keyword(s):

World Health ◽

Apical Surface ◽

Therapy Assessment ◽

Differentiated Cells ◽

The World ◽

Polarized Epithelia ◽

Well Differentiated ◽

Novel Coronavirus ◽

Health Organization ◽

Epidemiological Characteristics

Currently, the world is facing a health and socioeconomic crisis caused by the novel coronavirus disease COVID-19. On 11 March 2020, the World Health Organization (WHO) has declared this disease as a pandemic. The condition (COVID-19) is an infectious disorder triggered by a newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2. Most of the COVID-19 infected patients will experience mild to moderate respiratory symptoms and recover without any unique therapy. Assessment of the clinical and epidemiological characteristics of SARS-CoV-2 cases suggests the infected patients will not be contagious until the onset of severe symptoms and affects the other organs. Well-differentiated cells of apical airway epithelia communicating with ACE2 were promptly infected to SARS-CoV-2 virus. But the expression of ACE 2 in poorly differentiated epithelia facilitated SARS spike (S) protein-pseudo typed virus entry and it is replicated in polarized epithelia and especially exited via the apical surface. Limiting the transmission of COVID-19 infection & its prevention can be regarded as a hierarchy of controls. In this article, we briefly discuss the most recent advances in respect to aetiology, pathogenesis and clinical progression of the disease COVID-19.

Download Full-text

Prevalence and Epidemiological Characteristics of Asymptomatic Malaria Based on Ultrasensitive Diagnostics: A Cross-sectional Study

Clinical Infectious Diseases ◽

10.1093/cid/ciy1005 ◽

2018 ◽

Vol 69 (6) ◽

pp. 1003-1010 ◽

Cited By ~ 20

Author(s):

Seble Girma ◽

James Cheaveau ◽

Abu Naser Mohon ◽

Dewdunee Marasinghe ◽

Ruth Legese ◽

...

Keyword(s):

Diagnostic Tests ◽

Cross Sectional Study ◽

Rapid Diagnostic Tests ◽

World Health ◽

Asymptomatic Malaria ◽

Global Public Health ◽

Sectional Study ◽

Cross Sectional ◽

Qrt Pcr ◽

Epidemiological Characteristics

Abstract Background As the global public-health objectives for malaria evolve from malaria control towards malaria elimination, there is increasing interest in the significance of asymptomatic infections and the optimal diagnostic test to identify them. Method We conducted a cross-sectional study of asymptomatic individuals (N = 562) to determine the epidemiological characteristics associated with asymptomatic malaria. Participants were tested by rapid diagnostic tests (CareStart, Standard Diagnostics [SD] Bioline, and Alere ultrasensitive RDT [uRDT]), loop-mediated isothermal amplification (LAMP), and quantitative reverse transcription polymerase chain reaction (qRT-PCR) to determine malaria positivity. Hemoglobin values were recorded, and anemia was defined as a binary variable, according to World Health Organization guidelines. Results Compared to reference qRT-PCR, LAMP had the highest sensitivity (92.6%, 95% confidence interval [CI] 86.4–96.5), followed by uRDT Alere Malaria (33.9%, 95% CI 25.5–43.1), CareStart Malaria (14.1%, 95% CI 8.4–21.5), microscopy (5.0%, 95% CI 1.8–10.5), and SD Bioline (5.0%, 95% CI 1.8–10.5). For Plasmodium falciparum specimens only, the sensitivity for uRDT Alere Malaria was 50.0% (95% CI 38.8–61.3) and SD Bioline was 7.3% (95% CI 2.7–15.3). Based on multivariate regression analysis with qRT-PCR as the gold standard, for every 3.2% increase in the prevalence of asymptomatic malaria, hemoglobin decreased by 1 gram per deciliter (prevalence ratio 0.968, 95% CI 0.940–0.997; P = .032). Deletions (4.8%) in hrp2 were noted. Conclusions While uRDT Alere Malaria has superior sensitivity to rapid diagnostic tests and microscopy in detecting asymptomatic malaria, LAMP is superior still. Ultrasensitive diagnostics provide the accurate prevalence estimates of asymptomatic malaria required for elimination.

Download Full-text

The First Lumpy Skin Disease Outbreak in Thailand (2021): Epidemiological Features and Spatio-Temporal Analysis

Frontiers in Veterinary Science ◽

10.3389/fvets.2021.799065 ◽

2022 ◽

Vol 8 ◽

Author(s):

Orapun Arjkumpa ◽

Minta Suwannaboon ◽

Manoch Boonrod ◽

Issara Punyawan ◽

Supawadee Liangchaisiri ◽

...

Keyword(s):

Skin Disease ◽

Temporal Analysis ◽

Space Time ◽

Effective Control ◽

Outbreak Response ◽

Lumpy Skin Disease ◽

Epidemiological Features ◽

Spatio Temporal ◽

Epidemiological Characteristics ◽

Cattle Farms

The first outbreak of lumpy skin disease (LSD) in Thailand was reported in March 2021, but information on the epidemiological characteristics of the outbreak is very limited. The objectives of this study were to describe the epidemiological features of LSD outbreaks and to identify the outbreak spatio-temporal clusters. The LSD-affected farms located in Roi Et province were investigated by veterinary authorities under the outbreak response program. A designed questionnaire was used to obtain the data. Space-time permutation (STP) and Poisson space-time (Poisson ST) models were used to detect areas of high LSD incidence. The authorities identified 293 LSD outbreak farms located in four different districts during the period of March and the first week of April 2021. The overall morbidity and mortality of the affected cattle were 40.5 and 1.2%, respectively. The STP defined seven statistically significant clusters whereas only one cluster was identified by the Poisson ST model. Most of the clusters (n = 6) from the STP had a radius <7 km, and the number of LSD cases in those clusters varied in range of 3–51. On the other hand, the most likely cluster from the Poisson ST included LSD cases (n = 361) from 198 cattle farms with a radius of 17.07 km. This is the first report to provide an epidemiological overview and determine spatio-temporal clusters of the first LSD outbreak in cattle farms in Thailand. The findings from this study may serve as a baseline information for future epidemiological studies and support authorities to establish effective control programs for LSD in Thailand.

Download Full-text

Novel Antiviral Activities of Obatoclax, Emetine, Niclosamide, Brequinar, and Homoharringtonine

10.20944/preprints201909.0128.v1 ◽

2019 ◽

Author(s):

Petter I. Andersen ◽

Klara Krpina ◽

Aleksandr Ianevski ◽

Nastassia Shtaida ◽

Eunji Jo ◽

...

Keyword(s):

Influenza A ◽

Rift Valley Fever Virus ◽

Antiviral Agents ◽

Viral Disease ◽

World Health ◽

Valley Fever ◽

The World ◽

Health Organization ◽

Hiv 1

Viruses are the major causes of acute and chronic infectious diseases in the world. According to the World Health Organization, there is an urgent need for better control of viral diseases. Re-purposing existing antiviral agents from one viral disease to another could play a pivotal role in this process. Here we identified novel activities of obatoclax and emetine against herpes simplex virus type 2 (HSV-2), human immunodeficiency virus 1 (HIV-1), echovirus 1 (EV1), human metapneumovirus (HMPV) and Rift Valley fever virus (RVFV) in cell cultures. Moreover, we demonstrated novel activities of emetine against influenza A virus (FluAV), niclosamide against HSV-2, brequinar against HIV-1, and homoharringtonine against EV1. Our findings may expand the spectrum of indications of these safe-in-man agents and reinforce the arsenal of available antiviral therapeutics pending the results of further in vivo tests.

Download Full-text

Differential pathogenesis of closely related 2018 Nigerian outbreak clade III Lassa virus isolates

PLoS Pathogens ◽

10.1371/journal.ppat.1009966 ◽

2021 ◽

Vol 17 (10) ◽

pp. e1009966

Author(s):

Derek R. Stein ◽

Bryce M. Warner ◽

Jonathan Audet ◽

Geoff Soule ◽

Vinayakumar Siragam ◽

...

Keyword(s):

Animal Models ◽

Lassa Fever ◽

Geographic Region ◽

World Health ◽

Limiting Factor ◽

Lassa Virus ◽

African Countries ◽

Animal Models Of Disease ◽

Medical Countermeasures

Nigeria continues to experience ever increasing annual outbreaks of Lassa fever (LF). The World Health Organization has recently declared Lassa virus (LASV) as a priority pathogen for accelerated research leading to a renewed international effort to develop relevant animal models of disease and effective countermeasures to reduce LF morbidity and mortality in endemic West African countries. A limiting factor in evaluating medical countermeasures against LF is a lack of well characterized animal models outside of those based on infection with LASV strain Josiah originating form Sierra Leone, circa 1976. Here we genetically characterize five recent LASV isolates collected from the 2018 outbreak in Nigeria. Three isolates were further evaluated in vivo and despite being closely related and from the same spatial / geographic region of Nigeria, only one of the three isolates proved lethal in strain 13 guinea pigs and non-human primates (NHP). Additionally, this isolate exhibited atypical pathogenesis characteristics in the NHP model, most notably respiratory failure, not commonly described in hemorrhagic cases of LF. These results suggest that there is considerable phenotypic heterogeneity in LASV infections in Nigeria, which leads to a multitude of pathogenesis characteristics that could account for differences between subclinical and lethal LF infections. Most importantly, the development of disease models using currently circulating LASV strains in West Africa are critical for the evaluation of potential vaccines and medical countermeasures.

Download Full-text

Epidemiological Surveillance To Establish Thresholds For Influenza Among Children In Satellite Cities Of A metropolitan area of Tokyo, Japan

10.21203/rs.3.rs-598195/v1 ◽

2021 ◽

Author(s):

Ayako Matsuda ◽

Kei Asayama ◽

Taku Obara ◽

Naoto Yagi ◽

Takayoshi Ohkubo

Keyword(s):

World Health Organization ◽

Metropolitan Area ◽

Seasonal Influenza ◽

Type A ◽

World Health ◽

Epidemiological Surveillance ◽

Influenza Epidemic ◽

The World ◽

Health Organization ◽

Epidemiological Characteristics

Abstract Background: Few reports have longitudinally investigated seasonal influenza epidemiological surveillance data of pediatric populations in the metropolitan areas of Japan. We aimed to provide descriptive characteristics of circulating influenza and to investigate the usefulness of setting thresholds for influenza in children (0–15 years old) in two satellite cities of a metropolitan area of Tokyo, Japan, for five consecutive seasons of the influenza epidemic.Methods: The survey was conducted annually during the influenza season, from 2014 to 2018 (ending March 2019), at preschools (kindergartens and nursery schools), elementary schools, and junior high schools located in Toda and Warabi cities, Saitama prefecture. We investigated the epidemiological characteristics and established thresholds using the World Health Organization method.Results: Of the 108,362 children (21,024 to 22,088 throughout five seasons) who received the questionnaire, 76,753 (70.8%; 14,652 to 15,808) responded. After exclusion of responses without basic information, 64,586 children were included in the analysis, of which 13,754 (21.3%) had tested positive for influenza. Influenza type A was generally dominant, whereas type B was responsible for a substantial share of all influenza cases (>40% in seasons 2015 and 2017, when type A circulated with low incidence). The weeks when the influenza epidemic peaked had no clear seasonal pattern among the surveyed years, i.e., the peaks appeared at week 51 (mid-December) or later, whereas the World Health Organization methods reported that the median period when a peak was observed was at 3 weeks (mid-January), regardless of school age group.Conclusions: The present information obtained from the epidemiological survey regarding seasonal influenza in children would be useful for general practitioners, health policymakers, and planners who establish prevention and control methods against influenza.

Download Full-text

Challenges Facing the Chinese Health Care System

Asia Pacific Journal of Public Health ◽

10.1177/1010539520968464 ◽

2020 ◽

pp. 101053952096846

Author(s):

Kaixuan Hu

Keyword(s):

Health Care ◽

Health Care System ◽

Disease Surveillance ◽

World Health ◽

Outbreak Response ◽

The Past ◽

Disease Surveillance System ◽

Rural And Urban ◽

Health Organization ◽

Care System

The purposes of this article are to explore the challenges the Chinese health care system will be facing in the next decade. The recent outbreak of coronavirus disease (COVID-19) having infected more than 90 000 persons in China (Source: World Health Organization, WHO Coronavirus Disease Dashboard) again reveals the weaknesses of the fragmental health care system. Over the past 3 decades, increasing out-of-pocket spending on health care, increasing mortality rate of chronic disease, growing disparities between rural and urban populations, the defectiveness of disease surveillance system, and disease outbreak response system have been pressing Chinese authorities for action. As this country has experienced an unprecedented economic growth along with an unparalleled development of health care system in the past 3 decades, the challenges ahead are unavoidably numerous and complex.

Download Full-text

Epidemiology and risk factors of pesticide poisoning in Malaysia: a retrospective analysis by the National Poison Centre (NPC) from 2006 to 2015

BMJ Open ◽

10.1136/bmjopen-2019-036048 ◽

2020 ◽

Vol 10 (6) ◽

pp. e036048

Author(s):

Nur Azzalia Kamaruzaman ◽

Yin-Hui Leong ◽

Mohd Hafiidz Jaafar ◽

Halilol Rahman Mohamed Khan ◽

Noor Afiza Abdul Rani ◽

...

Keyword(s):

Risk Factors ◽

Health Problem ◽

Suicide Attempts ◽

Public Health Problem ◽

World Health ◽

Case Report Form ◽

Pesticide Poisoning ◽

Poison Centre ◽

National Poison ◽

Epidemiological Characteristics

ObjectivePesticide poisoning is a global health problem, and its progressive deterioration is a major cause of concern. The objective of this study is to assess epidemiological characteristics and identify risk factors of pesticide poisoning in Malaysia.SettingPesticide poisoning database of Malaysia National Poison Centre (NPC) from 2006 to 2015.ParticipantsTelephone enquiries regarding pesticide poisoning were made by healthcare professionals. Information received by the NPC was entered into a retrievable database of standardised Poison Case Report Form, as adapted from the World Health Organization (WHO).OutcomesThe outcome of the study is to provide an overview of national epidemiological profile of pesticide poisoning. High-risk groups of people and their circumstances were also identified to ensure that appropriate measures are strategised.ResultsWithin the study period, a total of 11 087 pesticide poisoning cases were recorded. Sixty per cent of these cases were intentional in nature and most were found among male individuals (57%) of the Indian race (36.4%) aged between 20 and 29 years (25.5%), which occurred at home (90%) through the route of ingestion (94%). The highest number of poisoning was due to herbicides (44%) followed by agricultural insecticides (34%), rodenticides (9.9%), household insecticides (9.5%) and fungicides (0.5%). In addition, 93.6% of intentional pesticide poisoning cases were caused by suicide attempts. The results of this study show that there was an increasing trend in pesticide poisoning incidents over the 10-year duration. This indicates that pesticide poisoning is a prevalent public health problem in Malaysia, resulting in an average incidence rate of 3.8 per 100 000 population.ConclusionsDeliberate pesticide ingestion as a method of suicide has become a disturbing trend among Malaysians. Therefore, regulation of highly hazardous pesticides must be enforced to ensure controlled and limited access to these chemicals by the public.

Download Full-text

Clinical and epidemiological characterization of dengue hemorrhagic fever cases in northeastern, Brazil

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822010000400003 ◽

2010 ◽

Vol 43 (4) ◽

pp. 355-358 ◽

Cited By ~ 31

Author(s):

Luciano Pamplona de Góes Cavalcanti ◽

Ivo Castelo Branco Coelho ◽

Dina Cortez Lima Feitosa Vilar ◽

Susana Glória Silveira Holanda ◽

Kiliana Nogueira Farias da Escóssia ◽

...

Keyword(s):

Public Health Problem ◽

Hemorrhagic Fever ◽

Northeastern Brazil ◽

World Health ◽

Important Public Health Problem ◽

Susceptible Population ◽

Risk Of Progression ◽

Care Structure ◽

Health Organization ◽

Epidemiological Characteristics

INTRODUCTION: The dengue hemorrhagic dengue (DHF) remains an important public health problem in Brazil. The objective of this study was to analyze the epidemiological characteristics of DHF cases during the 2003 epidemic in Ceará. METHODS: Suspected DHF cases with onset of symptoms between January and December 2003 were investigated. RESULTS: 37,964 classic dengue cases and 291 DHF cases were reported. Among the cases discarded, 75.5% were serologically positive but did not meet the criteria recommended by the World Health Organization (WHO). The DHF patients' median age was 30 years (2 - 88). Among the hemorrhagic manifestations, petechiae were the most (32.6%) frequent. Cases of gastrointestinal bleeding, ascites, pericardial pleural effusion, hepatomegaly, hypotension and shock showed higher risk of progression to death (p <0.05). CONCLUSIONS: The introduction of a new serotype (DENV-3) in Ceará, which encountered a susceptible population and high vector density, may have been the primary agent responsible for the magnitude of the epidemic. Timely and appropriate medical care, along with an organized care structure are essential for reducing its lethality.

Download Full-text

Treatment of gestational trophoblastic disease: A 10-year experience

Medicinski pregled ◽

10.2298/mpns1206244l ◽

2012 ◽

Vol 65 (5-6) ◽

pp. 244-246 ◽

Cited By ~ 1

Author(s):

Biljana Lazovic ◽

Vera Milenkovic ◽

Spomenka Djordjevic

Keyword(s):

World Health Organization ◽

Pulmonary Metastases ◽

Descriptive Study ◽

Gestational Trophoblastic Disease ◽

World Health ◽

Trophoblastic Disease ◽

Multiple Factors ◽

Invasive Mole ◽

Health Organization ◽

Epidemiological Characteristics

A retrospective descriptive study about the presence of metastases, epidemiological characteristics and treatment of 104 patients suffering from gestational trophoblastic disease was performed in the period from 1st Jan, 2000 to 31st December, 2010. Of eleven patients who were found to have metastases (10.6%), 72.7% had pulmonary metastases, 27.3 had vaginal, and one patient had both pulmonary and brain metastases. The average age was 33.9. Antecedent molar pregnancy was recorded in 63.6% patients. Invasive mole was more frequent than choriocarcinoma (63.6%). According to the World Health Organization criteria, 7 patients (63.6%) had high risk score (the average World Health Organization score was 8.4). All patients were treated by chemotherapy, the average number of courses being 1.8. Complete remission was achieved in all patients. Treatment of metastatic disease depends on multiple factors. However, combined chemotherapy is the universally accepted treatment. If chemotherapy is individualized and applied on time, the prognosis is good, even in cases with cerebral metastases.

Download Full-text