scholarly journals Estimating SARS-CoV-2 prevalence from large-scale wastewater surveillance: insights from combined analysis of 44 sites in England

2021 ◽  
Author(s):  
Mario Morvan ◽  
Anna Lo Jacomo ◽  
Celia Souque ◽  
Matthew Wade ◽  
Till Hoffmann ◽  
...  
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Viral Infections ◽  
Infection Prevalence ◽  
Clinical Testing ◽  
Considerable Variability ◽  
Prevalence Estimation ◽  
Testing Data ◽  
Flow Rate Influence ◽  
Traditional Surveillance

Abstract Accurate surveillance of the COVID-19 pandemic can be weakened by under-reporting of cases, particularly due to asymptomatic or pre-symptomatic infections, resulting in bias. Quantification of SARS-CoV-2 RNA in wastewater (WW) can be used to infer infection prevalence, but uncertainty in sensitivity and considerable variability has meant that accurate measurement remains elusive. Data from 44 sewage sites in England, covering 31% of the population, shows that SARS-CoV-2 prevalence is estimated to within 1.1% of estimates from representative prevalence surveys (with 95% confidence). Using machine learning and phenomenological models, differences between sampled sites, particularly the WW flow rate, influence prevalence estimation and require careful interpretation. SARS-CoV-2 signals in WW appear 4–5 days earlier in comparison to clinical testing data but are coincident with prevalence surveys suggesting that WW surveillance can be a leading indicator for asymptomatic viral infections. Wastewater-based epidemiology complements and strengthens traditional surveillance, with significant implications for public health.

scholarly journals Infection Testing at Scale: An Examination of Pooled Testing Diagnostics

2021 ◽  
Vol 46 (1) ◽  
pp. 13-26
Author(s):  
Tarun Jain ◽  
Bijendra Nath Jain
Keyword(s):  
Public Health ◽  
Infection Rate ◽  
Large Scale ◽  
Early Stage ◽  
Infection Prevalence ◽  
Additional Time ◽  
Pooled Testing ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Wide Testing

Executive Summary In pandemics or epidemics, public health authorities need to rapidly test a large number of individuals without adequate testing kits. We propose a testing protocol to accelerate infection diagnostics by combining multiple samples, and in case of positive results, re-test individual samples. The key insight is that a negative result in the first stage implies negative infection for all individuals. Thus, a single test could rule out infection in multiple individuals. Using simulations, we show that this protocol reduces the required number of testing kits, especially when the infection rate is low, alleviating a key bottleneck for public health authorities in times of pandemics and epidemics such as COVID-19. Our proposed protocol is expected to be more effective when the infection rate is low, which suggests that it is better suited for early stage and large-scale, population-wide testing. However, the managerial trade-off is that the protocol has costs in additional time for returning test results and an increased number of false negatives. We discuss applications of pooled testing in understanding population-wide testing to understand infection prevalence, to diagnose infections in high-risk groups of individuals, and to identify disease cold spots.

The Swiss Prison Study (SWIPS): Protocol for Establishing a Public Health Registry of Prisoners in Switzerland (Preprint)

2020 ◽  
Author(s):  
Thomas Gaisl ◽  
Naser Musli ◽  
Patrick Baumgartner ◽  
Marc Meier ◽  
Silvana K Rampini ◽  
...  
Keyword(s):  
Public Health ◽  
Medical History ◽  
Large Scale ◽  
International Classification Of Diseases ◽  
Disease Prevalence ◽  
Vulnerable Population ◽  
International Classification ◽  
Classification Of Diseases ◽  
Health Registry

BACKGROUND The health aspects, disease frequencies, and specific health interests of prisoners and refugees are poorly understood. Importantly, access to the health care system is limited for this vulnerable population. There has been no systematic investigation to understand the health issues of inmates in Switzerland. Furthermore, little is known on how recent migration flows in Europe may have affected the health conditions of inmates. OBJECTIVE The Swiss Prison Study (SWIPS) is a large-scale observational study with the aim of establishing a public health registry in northern-central Switzerland. The primary objective is to establish a central database to assess disease prevalence (ie, International Classification of Diseases-10 codes [German modification]) among prisoners. The secondary objectives include the following: (1) to compare the 2015 versus 2020 disease prevalence among inmates against a representative sample from the local resident population, (2) to assess longitudinal changes in disease prevalence from 2015 to 2020 by using cross-sectional medical records from all inmates at the Police Prison Zurich, Switzerland, and (3) to identify unrecognized health problems to prepare successful public health strategies. METHODS Demographic and health-related data such as age, sex, country of origin, duration of imprisonment, medication (including the drug name, brand, dosage, and release), and medical history (including the International Classification of Diseases-10 codes [German modification] for all diagnoses and external results that are part of the medical history in the prison) have been deposited in a central register over a span of 5 years (January 2015 to August 2020). The final cohort is expected to comprise approximately 50,000 to 60,000 prisoners from the Police Prison Zurich, Switzerland. RESULTS This study was approved on August 5, 2019 by the ethical committee of the Canton of Zurich with the registration code KEK-ZH No. 2019-01055 and funded in August 2020 by the “Walter and Gertrud Siegenthaler” foundation and the “Theodor and Ida Herzog-Egli” foundation. This study is registered with the International Standard Randomized Controlled Trial Number registry. Data collection started in August 2019 and results are expected to be published in 2021. Findings will be disseminated through scientific papers as well as presentations and public events. CONCLUSIONS This study will construct a valuable database of information regarding the health of inmates and refugees in Swiss prisons and will act as groundwork for future interventions in this vulnerable population. CLINICALTRIAL ISRCTN registry ISRCTN11714665; http://www.isrctn.com/ISRCTN11714665 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/23973

scholarly journals Public Health Workforce Burnout in the COVID-19 Response in the U.S.

2021 ◽  
Vol 18 (8) ◽  
pp. 4369
Author(s):  
Kahler W. Stone ◽  
Kristina W. Kintziger ◽  
Meredith A. Jagger ◽  
Jennifer A. Horney
Keyword(s):  
Public Health ◽  
Health Workforce ◽  
Work Experience ◽  
Large Scale ◽  
Health Workers ◽  
Public Health Workforce ◽  
Cross Sectional Survey ◽  
Public Health Response ◽  
Cross Sectional ◽  
The U.S

While the health impacts of the COVID-19 pandemic on frontline health care workers have been well described, the effects of the COVID-19 response on the U.S. public health workforce, which has been impacted by the prolonged public health response to the pandemic, has not been adequately characterized. A cross-sectional survey of public health professionals was conducted to assess mental and physical health, risk and protective factors for burnout, and short- and long-term career decisions during the pandemic response. The survey was completed online using the Qualtrics survey platform. Descriptive statistics and prevalence ratios (95% confidence intervals) were calculated. Among responses received from 23 August and 11 September 2020, 66.2% of public health workers reported burnout. Those with more work experience (1–4 vs. <1 years: prevalence ratio (PR) = 1.90, 95% confidence interval (CI) = 1.08−3.36; 5–9 vs. <1 years: PR = 1.89, CI = 1.07−3.34) or working in academic settings (vs. practice: PR = 1.31, CI = 1.08–1.58) were most likely to report burnout. As of September 2020, 23.6% fewer respondents planned to remain in the U.S. public health workforce for three or more years compared to their retrospectively reported January 2020 plans. A large-scale public health emergency response places unsustainable burdens on an already underfunded and understaffed public health workforce. Pandemic-related burnout threatens the U.S. public health workforce’s future when many challenges related to the ongoing COVID-19 response remain unaddressed.

New TAVR item added to cart for large scale clinical testing

2021 ◽  
Vol 98 (2) ◽  
pp. 380-381
Author(s):  
Jorge A. Belardi ◽  
Pablo M. Lamelas
Keyword(s):  
Large Scale ◽  
Clinical Testing

scholarly journals Targeting Viral Surface Proteins through Structure-Based Design

Viruses ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1320
Author(s):  
Yogesh B Narkhede ◽  
Karen J Gonzalez ◽  
Eva-Maria Strauch
Keyword(s):  
Public Health ◽  
Viral Infections ◽  
Respiratory Viruses ◽  
Surface Proteins ◽  
Host Cells ◽  
Viral Fusion ◽  
Health It ◽  
Viral Particles ◽  
Pathogenic Viruses ◽  
Viral Surface

The emergence of novel viral infections of zoonotic origin and mutations of existing human pathogenic viruses represent a serious concern for public health. It warrants the establishment of better interventions and protective therapies to combat the virus and prevent its spread. Surface glycoproteins catalyzing the fusion of viral particles and host cells have proven to be an excellent target for antivirals as well as vaccines. This review focuses on recent advances for computational structure-based design of antivirals and vaccines targeting viral fusion machinery to control seasonal and emerging respiratory viruses.

scholarly journals Salmonella in Captive Reptiles and Their Environment—Can We Tame the Dragon?

2021 ◽  
Vol 9 (5) ◽  
pp. 1012
Author(s):  
Magdalena Zając ◽  
Magdalena Skarżyńska ◽  
Anna Lalak ◽  
Renata Kwit ◽  
Aleksandra Śmiałowska-Węglińska ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Detection Rate ◽  
Large Scale ◽  
Isolation And Identification ◽  
Epidemiological Analysis ◽  
High Occurrence ◽  
Salmonella Serovars ◽  
Floor Surfaces

Reptiles are considered a reservoir of a variety of Salmonella (S.) serovars. Nevertheless, due to a lack of large-scale research, the importance of Reptilia as a Salmonella vector still remains not completely recognized. A total of 731 samples collected from reptiles and their environment were tested. The aim of the study was to assess the prevalence of Salmonella in exotic reptiles kept in Poland and to confirm Salmonella contamination of the environment after reptile exhibitions. The study included Salmonella isolation and identification, followed by epidemiological analysis of the antimicrobial resistance of the isolates. Implementation of a pathway additional to the standard Salmonella isolation protocol led to a 21% increase in the Salmonella serovars detection rate. The study showed a high occurrence of Salmonella, being the highest at 92.2% in snakes, followed by lizards (83.7%) and turtles (60.0%). The pathogen was also found in 81.2% of swabs taken from table and floor surfaces after reptile exhibitions and in two out of three egg samples. A total of 918 Salmonella strains belonging to 207 serovars and serological variants were obtained. We have noted the serovars considered important with respect to public health, i.e., S. Enteritidis, S. Typhimurium, and S. Kentucky. The study proves that exotic reptiles in Poland are a relevant reservoir of Salmonella.

Current State of (Dis)Integration: Public Health and Fusion Centers

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
Cody Minks ◽  
Anke Richter
Keyword(s):  
Public Health ◽  
Law Enforcement ◽  
Information Sharing ◽  
Homeland Security ◽  
Large Scale ◽  
Ad Hoc ◽  
Limiting Factor ◽  
Fusion Centers ◽  
Public Health Emergencies ◽  
Public Health Information

AbstractObjectiveResponding to large-scale public health emergencies relies heavily on planning and collaboration between law enforcement and public health officials. This study examines the current level of information sharing and integration between these domains by measuring the inclusion of public health in the law enforcement functions of fusion centers.MethodsSurvey of all fusion centers, with a 29.9% response rate.ResultsOnly one of the 23 responding fusion centers had true public health inclusion, a decrease from research conducted in 2007. Information sharing is primarily limited to information flowing out of the fusion center, with little public health information coming in. Most of the collaboration is done on a personal, informal, ad-hoc basis. There remains a large misunderstanding of roles, capabilities, and regulations by all parties (fusion centers and public health). The majority of the parties appear to be willing to work together, but there but there is no forward momentum to make these desires a reality. Funding and staffing issues seem to be the limiting factor for integration.ConclusionThese problems need to be urgently addressed to increase public health preparedness and enable a decisive and beneficial response to public health emergencies involving a homeland security response.

scholarly journals A large-scale investigation into the role of classical HLA loci in multiple types of severe infections, with a focus on overlaps with autoimmune and mental disorders

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ron Nudel ◽  
Rosa Lundbye Allesøe ◽  
Wesley K. Thompson ◽  
Thomas Werge ◽  
Simon Rasmussen ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Psychiatric Disorders ◽  
Large Scale ◽  
Viral Infections ◽  
Human Leukocyte ◽  
Severe Infection ◽  
Small Sample ◽  
Disease Etiology ◽  
Hla Alleles ◽  
Severe Infections

Abstract Background Infections are a major disease burden worldwide. While they are caused by external pathogens, host genetics also plays a part in susceptibility to infections. Past studies have reported diverse associations between human leukocyte antigen (HLA) alleles and infections, but many were limited by small sample sizes and/or focused on only one infection. Methods We performed an immunogenetic association study examining 13 categories of severe infection (bacterial, viral, central nervous system, gastrointestinal, genital, hepatitis, otitis, pregnancy-related, respiratory, sepsis, skin infection, urological and other infections), as well as a phenotype for having any infection, and seven classical HLA loci (HLA-A, B, C, DPB1, DQA1, DQB1 and DRB1). Additionally, we examined associations between infections and specific alleles highlighted in our previous studies of psychiatric disorders and autoimmune disease, as these conditions are known to be linked to infections. Results Associations between HLA loci and infections were generally not strong. Highlighted associations included associations between DQB1*0302 and DQB1*0604 and viral infections (P = 0.002835 and P = 0.014332, respectively), DQB1*0503 and sepsis (P = 0.006053), and DQA1*0301 with “other” infections (a category which includes infections not included in our main categories e.g. protozoan infections) (P = 0.000369). Some HLA alleles implicated in autoimmune diseases showed association with susceptibility to infections, but the latter associations were generally weaker, or with opposite trends (in the case of HLA-C alleles, but not with alleles of HLA class II genes). HLA alleles associated with psychiatric disorders did not show association with susceptibility to infections. Conclusions Our results suggest that classical HLA alleles do not play a large role in the etiology of severe infections. The discordant association trends with autoimmune disease for some alleles could contribute to mechanistic theories of disease etiology.

scholarly journals COVID-19 public health measures: a reduction in hospital admissions for COPD exacerbations

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-216083
Author(s):  
Jing Yuan Tan ◽  
Edwin Philip Conceicao ◽  
Liang En Wee ◽  
Xiang Ying Jean Sim ◽  
Indumathi Venkatachalam
Keyword(s):  
Public Health ◽  
Clinical Outcomes ◽  
Hospital Admissions ◽  
Viral Infections ◽  
Significant Morbidity ◽  
Common Cause ◽  
Copd Exacerbations ◽  
Health Measures ◽  
Acute Exacerbations ◽  
Respiratory Viral Infections

Hospitalisations for acute exacerbations of COPD (AECOPD) carry significant morbidity and mortality. Respiratory viral infections (RVIs) are the most common cause of AECOPD and are associated with worse clinical outcomes. During the COVID-19 pandemic, public health measures, such as social distancing and universal masking, were originally implemented to reduce transmission of SARS-CoV-2; these public health measures were subsequently also observed to reduce transmission of other common circulating RVIs. In this study, we report a significant and sustained decrease in hospital admissions for all AECOPD as well as RVI-associated AECOPD, which coincided with the introduction of public health measures during the COVID-19 pandemic.

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