scholarly journals COVID-19 hotspots through clusters analysis in France (may–October 2020): where should we track the virus to mitigate the spread?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guillaume Spaccaferri ◽  
Clémentine Calba ◽  
Pascal Vilain ◽  
Loïc Garras ◽  
Cécile Durand ◽  
...  

Abstract Background In France, the lifting of the lockdown implemented to control the COVID-19 first wave in 2020 was followed by a reinforced contact-tracing (CT) strategy for the early detection of cases and transmission chains. We developed a reporting system of clusters defined as at least three COVID-19 cases, within seven days and belonging to the same community or having participated in the same gathering, whether they know each other or not. The aim of this study was to describe the typology and criticality of clusters reported between the two lockdowns in France to guide future action prioritisation. Methods In this study we describe the typology and criticality of COVID-19 clusters between the two lockdowns implemented in France (between May and end of October 2020). Clusters were registered in a national database named “MONIC” (MONItoring des Clusters), established in May 2020. This surveillance system identified the most affected communities in a timely manner. A level of criticality was defined for each cluster to take into consideration the risk of spreading within and outside the community of occurrence, and the health impact within the community. We compared the level of criticality according to the type of community in which the cluster occurred using Pearson’s chi-square tests. Results A total of 7236 clusters were reported over the study period, particularly in occupational environment (25.1%, n = 1813), elderly care structures (21.9%, n = 1586), and educational establishments (15.9%, n = 1154). We show a shift over time of the most affected communities in terms of number of clusters. Clusters reported in occupational environment and the personal sphere had increased during summer while clusters reported in educational environment increased after the start of the school year. This trend mirrors change of transmission pattern overtime according to social contacts. Among all reported clusters, 43.1% had a high level of criticality with significant differences between communities (p < 0.0001). A majority of clusters had a high level of criticality in elderly care structures (82.2%), in disability care centres (56.6%), and health care facilities (51.7%). Conclusion These results highlight the importance of targeting public health action based on timely sustained investigations, testing capacity and targeted awareness campaigns. The emergence of new SARS-CoV-2 variants strengthen these public health recommendations and the need for rapid and prioritise vaccination campaigns.

2021 ◽  
pp. 145507252199570
Author(s):  
Marjut Salokannel ◽  
Eeva Ollila

Background: Use of snus and snus-like nicotine products is increasing, in particular among young people, in several Nordic countries and Estonia, while snus is legally on the market only in Sweden and Norway. Snus is available in a great variety of tastes and packaging particularly catering for young users. Recently, strong snus-resembling nicotine pouches have emerged on the market. This research investigates the regulatory means to counteract this development. Methods: European Union (EU) and national tobacco control legislation, case law of the European Court of Justice (CJEU) and relevant public health studies are analysed. Results: The research finds that the judgement of the CJEU relating to the sale of snus on Finnish ferries has not been enforced. Permitted large traveller imports for personal use have contributed to wide availability of snus in Finland. Even if the legislation in Sweden is in conformity with the exemption it obtained in the Accession Treaty, the public health impact of snus use for young people in its neighbouring countries has become considerable. Nicotine pouches, -which are not regarded as medical products in terms of medicine legislation, lack harmonised EU-wide regulation. Controlling smuggling across open borders is challenging. Conclusions: The legislation at the EU and national levels should be able to protect young people from new tobacco and nicotine products. It is urgent to harmonise regulation relating to new tobacco and nicotine products taking as a base a high level of protection of health as required in the Treaty on the Functioning of the EU.


2020 ◽  
Author(s):  
David Larsen ◽  
Rachel E. Dinero ◽  
Elizabeth Asiago-Reddy ◽  
Hyatt Green ◽  
Sandra Lane ◽  
...  

The SARS-CoV-2 pandemic exposed the inadequacy of infectious disease surveillance throughout the US and other countries. Isolation and contact tracing to identify all infected people are key public health interventions necessary to control infectious disease outbreaks. However, these activities are dependent upon the surveillance platform to identify infections quickly. A robust surveillance platform can also reinforce community adherence to behavioral interventions such as social distancing. In situations where contact tracing is feasible, all suspected cases and contacts of confirmed cases must be tested for a SARS-CoV-2 infection and effectively isolated. At the community level wastewater surveillance can identify areas where transmission is or is not occurring, and genetic sequencing of SARS-CoV-2 can help to elucidate the intensity of transmission independent of the number of known cases and hospitalizations. State and county public health departments should improve the infectious disease surveillance platform whilst the public is practicing social distancing. These enhanced surveillance activities are necessary to contain the epidemic once the curve has been sufficiently flattened in highly burdened areas, and to prevent escalation in areas where transmission is minimal.


2008 ◽  
Vol 13 (45) ◽  
Author(s):  
I Zuschneid ◽  
A Witschi ◽  
L Quaback ◽  
W Hellenbrand ◽  
N Kleinkauf ◽  
...  

Following the fatal invasive meningococcal disease in a Swiss student who had been visiting Berlin, several public health institutions on local, regional and national level cooperated to ensure that the appropriate measures such as contact tracing and post exposure prophylaxis were taken to prevent further cases. The incidence highlighted the importance of early disease notification and showed that if an infectious disease requiring public health action occurs in an international context, it is vital that relevant information is communicated to all levels of the public health systems of the countries involved.


Author(s):  
Jayshree Dave ◽  
C. Y. William Tong

Urethritis, characterized by inflammation of the urethra in men, is caused by Neisseria gonorrhoeae (gonococcus), Chlamydia trachomatis, Trichomonas vaginalis, and Mycoplasma genitalium. Other causes of non-gonococcal urethritis include ureaplasmas, adenoviruses, and herpes simplex viruses. The presence of urethritis is confirmed by the presence of five or more polymorphs in urethral smear by high-power microscopy. Symptoms can be minor to profound and vary from clear to mucopurulent discharge. Gonococcus is commoner in men who have sex with men (MSM) compared to heterosexuals, and high-risk activities such as chemsex parties increase spread with significant public health consequences. Antibiotic resistance in gonococcus has clinical and public health implications as three cases of extensively drug-resistant Neisseria gonorrhoeae with resistance to ceftriaxone (MIC = 0.5 mg/L) and high-level resistance to azithromycin (MIC > 256 mg/L) have been described compromising current treatment recommended by British Association for Sexual Health and HIV Guidelines (BASHH). In England an outbreak of high level azithromycin-resistant gonococcus has also been described by Public Health England (PHE), who alerted clinicians about the need for follow up and test of cure, contact tracing, and treatment failure. C. trachomatis infection can be treated with azithromycin 1g orally as a single dose or with seven days of oral doxycycline. Risk factors for chlamydia include age younger than twenty-five years, multiple sexual partners, and avoidance of barrier methods for contraception. Metronidazole 2g single dose or 400– 500mg twice daily for seven days is recommended for treatment of trichomonas, which can cause a moderate discharge in up to 60% of males. Resistance to azithromycin and doxycycline is common in M. genitalium strains and management of these patients with urethritis requires GUM referral for comprehensive investigation, contact tracing, and public health notification. Molecular methods are used for the diagnosis of these organisms and gonococcal culture is undertaken to obtain antimicrobial susceptibility data from patients with a previous diagnosis by molecular method, in GUM attendees, and their contacts. Herpes simplex infection results in a painful ulcer preceded by a vesicle. The diagnosis can be confirmed using polymerase chain reaction (PCR) tests of a swab taken from the vesicle or ulcer.


2020 ◽  
Vol 24 (23) ◽  
Author(s):  
Jonathan Lawler ◽  
Jay Lucidarme ◽  
Sydel Parikh ◽  
Lorna Smith ◽  
Helen Campbell ◽  
...  

In 2015, a suspected cluster of two invasive meningococcal disease (IMD) cases of serogroup W Neisseria meningitidis (MenW) occurred in elderly care home residents in England over 7 months; case investigations followed United Kingdom guidance. An incident control team reviewed epidemiological information. Phenotyping of case specimens informed public health action, including vaccination and throat swabs to assess carriage. Whole genome sequencing (WGS) was conducted on case and carrier isolates. Conventional phenotyping did not exclude a microbiological link between cases (case 1 W:2a:P1.5,2 and case 2 W:2a:NT). After the second case, 33/40 residents and 13/32 staff were vaccinated and 19/40 residents and 13/32 staff submitted throat swabs. Two MenW carriers and two MenC carriers were detected. WGS showed that MenW case and carrier isolates were closely related and possibly constituted a locally circulating strain. Meningococcal carriage, transmission dynamics and influence of care settings on IMD in older adults are poorly understood. WGS analyses performed following public health action helped to confirm the close relatedness of the case and circulating isolates despite phenotypic differences and supported actions taken. WGS was not sufficiently timely to guide public health practice.


Author(s):  
Mohammad Jabed Morshed Chowdhury ◽  
Md Sadek Ferdous ◽  
Kamanashis Biswas ◽  
Niaz Chowdhury ◽  
Vallipuram Muthukkumarasamy

Contact tracing has become a key tool for public health officials to effectively combat the spread of new diseases, such as the Covid-19 pandemic. Currently, this process is either manual or semi-manual and often very time consuming and inefficient. It largely relies of human memory and cannot be scalable to tackle pandemic like COVID-19. Researchers and practitioners around the world have turned into the technology based approaches to provide a scalable solution. Smartphone and associated digital technologies have the potential to provide a better solution due to its high level of penetration coupled with mobility. However, information like location or proximity associated with other personal data are very sensitive private information and can be used by the states to do surveillance over their citizen. Researchers have proposed different contact tracing protocols to overcome or limit those concerns. In this paper, we have critically reviewed these protocols and apps to identify the strength and weakness of each approaches. Finally, we have pen down our recommendations to make contact tracing mechanism more universally inter-operable and privacy preserving.


Author(s):  
Cemal Koçak

Background: COVID-19 was first declared as an international public health emergency and then a pandemic by the WHO. In this systematic review, the importance of isolation and contact tracing has been explained, and what kinds of practices exist in different countries are mentioned. Methods: A systematic review was conducted in accordance with the PRISMA and Cochrane guidelines by searching articles from major medical databases such as Google Scholar, PubMed/MEDLINE, Cochrane Library, EMBASE, CINAHL between Jan 1, 2020 and Apr 1, 2021. Observational and modeling studies written on contact tracing, screening, quarantine and isolation were included. Results: 27 observational and modeling studies were included. It was seen that rapid contact tracing to reduce the basic reproduction number (R0) from 3.11 to 0.21. Additionally, each new case requires an average of 36 people to be monitored. Since screening programs missed 75% of cases, high-level contact tracing should also be done simultaneously. Wide quarantine would prevent 79.27% deaths and 87.08% infections. Conclusion: Effective, rapid contact tracing is the cornerstone of an effective public health response in outbreaks. Its success depends on quickly identifying cases, gathering information from them about their last contacts, and tracing and isolating those contacts.


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