scholarly journals Decline of notified dengue infections in Indonesia in 2017: Discussion of the possible determinants

Narra J ◽  
2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Pandji Wibawa Dhewantara ◽  
Kurnia F. Jamil ◽  
Jonny Karunia Fajar ◽  
Panji Probo Saktianggi ◽  
Roy Nusa ◽  
...  

This study was conducted to quantify the trend in dengue notifications in the country in 2017 and to explore the possible determinants. Annual nation-wide dengue notification data were obtained from the National Disease Surveillance of Ministry of Health of Indonesia. Annual incidence rate (IR) and case fatality rate (CFR) in 2017 and the previous years were quantified and compared. Correlations between annual larva free index (LFI), implementation coverage of integrated vector management (IVM), El Niño Southern Oscillation (Niño3.4), Dipole Mode Index (DMI), Zika virus seropositivity and the percent change in IR and CFR of dengue were examined. The change of dengue IR and CFRs were mapped. In 2017, dengue IR was declined by 71% (22.55 per 100,000 population) compared to 2016 (77.96 per 100,000 population) while the CFR was slightly reduced from 0.79% to 0.75%. Reduction in IR and CFR occurred in 94.1% and 70.1% out of 34 provinces, respectively. The trend of dengue IR seems to be influenced by Niño3.4 but there is no clear evidence that Niño3.4 is the main reason for dengue reduction in 2017. It is difficult to elucidate that the reduction of dengue in 2017 was associated with previous Zika outbreaks. In conclusion, there was a significant reduction on dengue notifications in Indonesia in 2017. Further investigation is needed to look at the role of climate on the decline of dengue IR at finer temporal scale. In addition, study on the role of cross-protective immunity generated by Zika infection on dengue incidence is also warranted.

2020 ◽  
Author(s):  
Tomoki Yoshikawa ◽  
Satoshi Taniguchi ◽  
Hirofumi Kato ◽  
Naoko Iwata-Yoshikawa ◽  
Hideki Tani ◽  
...  

AbstractSevere fever with thrombocytopenia syndrome (SFTS) caused by Dabie bandavirus (formerly SFTS virus [SFTSV]) is an emerging hemorrhagic infectious disease with a high case-fatality rate. One of the best strategies for preventing SFTS is to develop a vaccine, which is expected to induce both humoral and cellular immunity. We applied a highly attenuated but still immunogenic vaccinia virus strain LC16m8 (m8) as a recombinant vaccine for SFTS. Recombinant m8s expressing SFTSV nucleoprotein (m8-N), envelope glycoprotein precursor (m8-GPC), and both N and GPC (m8-N+GPC) in the infected cells were generated. Both m8-GPC- and m8-N+GPC-infected cells were confirmed to produce SFTSV-like-particles (VLP) in vitro, and the N was incorporated in the VLP produced by the infection of cells with m8-N+GPC. Specific antibodies to SFTSV were induced in mice inoculated with each of the recombinant m8s, and the mice were fully protected from lethal challenge with SFTSV at both 103 TCID50 and 105 TCID50. In mice that had been immunized with vaccinia virus strain Lister in advance of m8-based SFTSV vaccine inoculation, protective immunity against the SFTSV challenge was also conferred. The pathological analysis revealed that mice immunized with m8-GPC or m8-N+GPC did not show any histopathological changes without any viral antigen-positive cells, whereas the control mice showed focal necrosis with inflammatory infiltration with SFTSV antigen-positive cells in tissues after SFTSV challenge. The passive serum transfer experiments revealed that sera collected from mice inoculated with m8-GPC or m8-N+GPC but not with m8-N conferred protective immunity against lethal SFTSV challenge in naïve mice. On the other hand, the depletion of CD8-positive cells in vivo did not abrogate the protective immunity conferred by m8-based SFTSV vaccines. Based on these results, the recombinant m8-GPC and m8-N+GPC were considered promising vaccine candidates for SFTS.Author SummarySevere fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever with a high case-fatality rate (approximately 5% to >40%). Indigenous SFTS has been reported in China, Japan, South Korea, and Vietnam. Thus, the development of an effective vaccine for SFTS is urgently needed. Vaccinia virus (VAC) was previously used as a vaccine for smallpox. Unfortunately, after these strains, the so-called second generation of VAC used during the eradication campaign was associated with severe adverse events, and the third generation of VAC strains such as LC16m8 (m8) and modified vaccinia Ankara (MVA) was established. m8 is confirmed to be highly attenuated while still maintaining immunogenicity. m8 is licensed for use in healthy people in Japan. At the present time, approximately 100,000 people have undergone vaccination with m8 without experiencing any severe postvaccine complications. At present, third-generation VAC strains are attractive for a recombinant vaccine vector, especially for viral hemorrhagic infectious diseases, such as Ebola virus disease, Lassa fever, Crimean-Congo hemorrhagic fever, and SFTS. We investigated the practicality of an m8-based recombinant vaccine for SFTS as well as other promising recombinant VAC-based vaccines for viral hemorrhagic infectious diseases.


2020 ◽  
Vol 10 (1) ◽  
pp. 1792620 ◽  
Author(s):  
Mohammad M. Hassan ◽  
Mohamed E. El Zowalaty ◽  
Shahneaz A. Khan ◽  
Ariful Islam ◽  
Md. Raihan K. Nayem ◽  
...  

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Héctor Gallegos ◽  
Pablo A. Rojas ◽  
Francisca Sepúlveda ◽  
Álvaro Zúñiga ◽  
Ignacio F. San Francisco

Abstract Objectives To establish the role of BCG instillations in the incidence and mortality of COVID-19. Patients and methods NMIBC patients in instillations with BCG (induction or maintenance) during 2019/2020 were included, establishing a COVID-19 group (with a diagnosis according to the national registry) and a control group (NO-COVID). The cumulative incidence (cases/total patients) and the case fatality rate (deaths/cases) were established, and compared with the national statistics for the same age group. T-test was used for continuous variables and Fisher's exact test for categorical variables. Results 175 patients were included. Eleven patients presented CIS (11/175, 6.3%), 84/175 (48.0%) Ta and 68/175 (38.9%) T1. Average number of instillations = 13.25 ± 7.4. One hundred sixty-seven patients (95.4%) had complete induction. Forty-three patients (cumulative incidence 24.6%) were diagnosed with COVID-19. There is no difference between COVID-19 and NO-COVID group in age, gender or proportion of maintenance completed. COVID-19 group fatality rate = 1/43 (2.3%). Accumulated Chilean incidence 70–79 years = 6.3%. Chilean fatality rate 70–79 years = 14%. Conclusions According to our results, patients with NMIBC submitted to instillations with BCG have a lower case-fatality rate than the national registry of patients between 70 and 79 years (2.3% vs. 14%, respectively). Intravesical BCG could decrease the mortality due to COVID-19, so instillation schemes should not be suspended in a pandemic.


Author(s):  
Paolo Pasquariello ◽  
Saverio Stranges

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 13.3% as of April 20, 2020, versus a global case fatality rate of 6.9%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.


2020 ◽  
Author(s):  
Lei Cao ◽  
Ting-ting Huang ◽  
Jun-xia Zhang ◽  
Qi Qin ◽  
Si-yu Liu ◽  
...  

Abstract The worst-hit area of coronavirus disease 2019 (COVID-19) in China was Wuhan City and its affiliated Hubei Province, where the outbreak has been well controlled. The case fatality rate (CFR) is the most direct indicator to evaluate the hazards of an infectious disease. However, most reported CFR on COVID-19 represent a large deviation from reality. We aimed to establish a more accurate way to estimate the CFR of COVID-19 in Wuhan and Hubei and compare it to the reality. The daily case notification data of COVID-19 from December 8, 2019, to May 1, 2020, in Wuhan and Hubei were collected from the bulletin of the Chinese authorities. The instant CFR of COVID-19 was calculated from the numbers of deaths and the number of cured cases, the two numbers occurred on the same estimated diagnosis dates. The instant CFR of COVID-19 was 1.3%-9.4% in Wuhan and 1.2%-7.4% in Hubei from January 1 to May 1, 2020. It has stabilized at 7.69% in Wuhan and 6.62% in Hubei since early April. The cure rate was between 90.1% and 98.8% and finally stabilized at 92.3% in Wuhan and stabilized at 93.5% in Hubei. The mortality rates were 34.5/100 000 in Wuhan and 7.61/100 000 in Hubei. In conclusion, this approach reveals a way to accurately calculate the CFR, which may provide a basis for the prevention and control of infectious diseases.


2018 ◽  
Vol 23 (16) ◽  
Author(s):  
Mirjam J Knol ◽  
Wilhelmina LM Ruijs ◽  
Laura Antonise-Kamp ◽  
Hester E de Melker ◽  
Arie van der Ende

The annual incidence rate of serogroup W invasive meningococcal disease in the Netherlands increased from < 0.05/100,000 (n < 10) before 2015 to 0.5/100,000 (n = 80) in 2017. Most isolates (94%) belong to clonal complex 11. The incidence rate is highest among  < 5 year-olds and 15–24 year-olds. The case fatality rate was 12% (17/138) in 2015–2017. From May 2018, MenACWY vaccination replaces MenC vaccination at age 14 months and from October 2018, 13–14 year-olds are offered MenACWY vaccination.


2020 ◽  
Author(s):  
Paolo Di Girolamo

Abstract The Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), which exploded in Wuhan (Hebei Region, China) in late 2019, has recently spread around the World, causing pandemic effects on humans. Italy, and especially its Northern regions around the Po Valley, has been facing severe effects in terms of infected individuals and casualties (more than 31.000 deaths and 255.000 infected people by mid-May 2020). While the spread and effective impact of the virus is primarily related to the life styles and social habits of the different human communities, environmental and meteorological factors also play a role. Among these, pollution from PM2.5/PM10 particles, which may directly impact on the human respiratory system or act as virus carrier, thus behaving as potential amplifying factors in the pandemic spread of SARS-CoV-2. Enhanced levels of PM2.5/PM10 particles in Northern Italy were observed over the two month period preceding the virus pandemic spread. Threshold levels for PM10 (<50 µg/m³) were exceeded on 20-35 days over the period January-February 2020 in many areas in the Po Valley, where major effects in terms of infections and casualties occurred, with levels in excess of 80 µg/m³ occasionally observed in the 1-3 weeks preceding the contagious activation around February 25th. Threshold values for PM2.5 indicted in WHO air quality guidelines (<25 µg/m³) were exceeded on more than 40 days over the period January-February 2020 in large portions of the Po Valley, with levels up to 70 µg/m³ observed in the weeks preceding the contagious activation. The evolution of particle matter concentration levels throughout the month of February 2020 was carefully monitored and results are reported in the paper.In this paper PM10 particle measurements are compared with epidemiologic parameters data. Specifically, a statistical analysis is carried out to correlate the infection rate, or incidence of the pathology, the mortality rate and the case fatality rate with PM concentration levels. The study considers epidemiologic data for all 110 Italian Provinces, as reported by the Italian Statistics Institute (ISTAT, 2020), over the period 20 February-31 March 2020. Corresponding PM10 concentration levels were collected from the network of air quality monitoring stations run by different Regional and Provincial Environment Agencies, covering the period 15-26 February 2020. The case fatality rate is found to be highly correlated to the average PM10 concentration, with a correlation coefficient of 0.89 and a slope of the regression line of (6.7±0.3)×10-3 m³/µg, which implies a doubling (from 3 to 6 %) of the mortality rate of infected patients for an average PM10 concentration increase from 22 to 27 μg/m³. Infection and mortality rates are also found to be correlated with PM10 concentration levels, with correlation coefficients being 0.82 and 0.80, respectively, and the slopes of the regression lines indicating a doubling (from 1 to 2 ‰) of the infection rate and a tripling (from 0.1 to 0.3 ‰) of the mortality rate for an average PM10 concentration increase from 25 to 29 μg/m³. Epidemiologic parameters data were also compared with population density data, but no clear evidence of a mutual correlation between these quantities was found. Considerations on the exhaled particles' sizes and concentrations, their residence times, transported viral dose and minimum infective dose, in combination with PM2.5/PM10 pollution measurements and an analytical microphysical model, allowed assessing the potential role of airborne transmission through virus-transmitting PM particles, in addition to droplet transmission, in conveying SARS-CoV-2 in the human respiratory system.


2020 ◽  
Vol 105 (12) ◽  
pp. 1180-1185 ◽  
Author(s):  
Shamez N Ladhani ◽  
Zahin Amin-Chowdhury ◽  
Hannah G Davies ◽  
Felicity Aiano ◽  
Iain Hayden ◽  
...  

ObjectivesTo assess disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared with adults during the first pandemic peak in England.SettingEngland.ParticipantsChildren with COVID-19 between January and May 2020.Main outcome measuresTrends in confirmed COVID-19 cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity rates in children compared with adults; community prevalence of SARS-CoV-2 in children with acute respiratory infection (ARI) compared with adults, case-fatality rate in children with confirmed COVID-19 and excess childhood deaths compared with the previous 5 years.ResultsChildren represented 1.1% (1,408/129,704) of SARS-CoV-2 positive cases between 16 January 2020 and 3 May 2020. In total, 540 305 people were tested for SARS-COV-2 and 129,704 (24.0%) were positive. In children aged <16 years, 35,200 tests were performed and 1408 (4.0%) were positive for SARS-CoV-2, compared to 19.1%–34.9% adults. Childhood cases increased from mid-March and peaked on 11 April before declining. Among 2,961 individuals presenting with ARI in primary care, 351 were children and 10 (2.8%) were positive compared with 9.3%–45.5% in adults. Eight children died and four (case-fatality rate, 0.3%; 95% CI 0.07% to 0.7%) were due to COVID-19. We found no evidence of excess mortality in children.ConclusionsChildren accounted for a very small proportion of confirmed cases despite the large numbers of children tested. SARS-CoV-2 positivity was low even in children with ARI. Our findings provide further evidence against the role of children in infection and transmission of SARS-CoV-2.


2020 ◽  
Vol 14 (4) ◽  
pp. e1-e2 ◽  
Author(s):  
Francesco Barone-Adesi ◽  
Luca Ragazzoni ◽  
Maurizio Schmid

AbstractCase-Fatality Rate (CFR) for COVID-19 in Italy is apparently much higher than in other countries. Using data from Italy and other countries we evaluated the role of different determinants of this phenomenon. We found that the Italian testing strategy could explain an important part of the observed difference in CFR. In particular, the majority of patients that are currently tested in Italy have severe clinical symptoms that usually require hospitalization and this translates to a large CFR. We are confident that, once modifications in the testing strategy leading to higher population coverage are consistently adopted in Italy, CFR will realign with the values reported worldwide.


2018 ◽  
Vol 11 (3) ◽  
pp. 311-320 ◽  
Author(s):  
A. Kamala ◽  
C. Shirima ◽  
B. Jani ◽  
M. Bakari ◽  
H. Sillo ◽  
...  

In June 2016, an outbreak of an unknown disease was reported to affect clusters of families in two regions of the central part of Tanzania. A rapid epidemiological survey was conducted in the affected villages, with a detailed house-to-house survey in selected households. A total of 68 cases occurred between 14 May and 14 November 2016, of which 20 died, making a case fatality rate of 30%. Over 50% of the cases were below the age of 15 years. The cases presented with jaundice (n=60), abdominal pain (n=59), vomiting (n=56), diarrhoea (n=34) and ascites (n=32). The responsible food item appeared to be home grown maize. The rate ratio indicated that the occurrence of illnesses was associated with ingestion of food contaminated with high levels of aflatoxins (contamination range: 10-51,100 μg/kg and 2.4-285 μg/kg for case and control households, respectively). Serum aflatoxin biomarker indicated that cases were more likely to have higher than 1000 pg/mg aflatoxin-albumin adduct level in their sera compared to controls (Odds Ratio = 13.5; 95% confidence intervals = 1.5-165.3; range of aflatoxin-albumin adduct level = 36- 32,800 pg/mg for cases and 10-4020 pg/mg for controls). Beside aflatoxins, maize samples were also contaminated with high levels of fumonisins (range of contamination; 945-12,630 μg/kg) with 8 of 10 samples analysed from case households co-contaminated with both toxins at levels above the maximum limit of 5 or 10 μg/kg set for AFB1or total aflatoxins and 2,000 μg/kg for fumonisins. Clinical presentation and high levels of aflatoxin in food samples coupled with high levels of serum aflatoxin-albumin adducts among the cases support the causal role of aflatoxins.


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