Quarantine-related traumatic stress, views, and experiences during the first wave of Coronavirus pandemic: A mixed-methods study among adults in Saudi Arabia

Purpose Mental health is a significant problem following exposure to a traumatic event. This study aimed to examine quarantine-related experiences, traumatic stress, and coping strategies among adults quarantined in Saudi Arabia due to coronavirus disease 2019 (COVID-19) exposure or travel history. Methods Individuals aged ≥ 18 years who were quarantined in Saudi Arabia due to COVID-19 exposure or travel history were included. We used a sequential mixed methods design, using an online survey followed by in-depth individual telephonic interviews. The Impact of Event Scale-Revised (IES–R) was used to measure post-traumatic stress disorder (PTSD) symptoms after the quarantine. To identify factors associated with significant symptoms (IES–R score ≥ 33), prevalence ratios (PR) with 95% confidence intervals were computed using Poisson regression with robust error variance. In the next phase, a subset of the participants (n = 26) were interviewed to elicit their quarantine-related experiences and coping responses. Major themes and subthemes were identified. Results Of the 111 adults who completed the survey, 32 (28.8% [95% CI, 21.1–38.0%]) had significant PTSD symptoms (IES–R score ≥ 33) and 27 (24.3% [95% CI, 17.2–33.3%]) had severe symptoms (IES–R score > 37). Marital status was the only variable that was significantly associated with significant PTSD symptoms (P = 0.028). Significant symptoms were twice as prevalent in married adults than among other marital groups (PR 2.00, 95% CI, 1.08–3.72). Participants reported negative emotions such as overwhelming fear, helplessness, anxiety, and disgust. Participants utilized both problem-centered coping (e.g., use of social support) and emotion-centered coping (e.g., use of positive diversionary activities) during the quarantine period. Conclusion PTSD symptoms were present in one out of every four quarantined persons. The quarantine experience is viewed negatively. These findings highlight the need for increased awareness about stress-related disorders among quarantined individuals. Efforts are needed to detect and manage these symptoms early while making the quarantine experience more satisfying for the involved individuals and groups.

The End of Flying: Coronavirus Confinement, Academic (Im)mobilities and Me

This chapter focuses on how the coronavirus pandemic disrupted ‘normal’ academic life and travel through an analysis of my own travel history over the past decade. After contextualising the ways in which quarantines and confinement radically decreased travel, the chapter has three parts. In the first part, I document my own curriculum vitae of academic travel over the past decade and quantitatively measure my estimated CO2 emissions. Next, I seek to situate the value of such academic travel in both quantitative and qualitative terms, through extrinsic measures such as publications and impact and through intrinsic values such as the experience of different cultures and places. Lastly, I look at the transition to virtual events and my own participation in online events during the past nine months and consider the relation between physical and virtual meetings within academic practices. Insofar as the pandemic demonstrated our ability to transform academic travel and accelerate the use of remote meetings within academic practices, a pressing concern is how to find ways of extending this into the post-pandemic phase. Among the questions I ask in conclusion are: What possibilities are there for more seriously extending remote no-fly meetings to address the climate emergency? And what are the implications of such changes, both positive and negative?

Estimating the transmissibility of SARS-CoV-2 VOC 202012/01 in Japan using travel history information

<abstract> <p>Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has rapidly spread across the globe. The variant of concern (VOC) 202012/01 (B.1.1.7, also known as the alpha variant) bearing the N501Y mutation emerged in late 2020. VOC 202012/01 was more transmissible than existing SARS-CoV-2 variants and swiftly became dominant in many regions. More than 150 cases of VOC 202012/01 were reported in Japan by 26 February 2021. During the very early stage of introduction, only a subset arose from domestic transmission. If the reproduction number <italic>R</italic> (i.e., the average number of secondary transmission events caused by a single primary case) is greater than 1, the corresponding proportion should converge to 1 in a short period of time, and thus it is critical to understand the transmissibility of VOC 202012/01 based on travel history information. The present study aimed to estimate <italic>R</italic> of VOC 202012/01 using overseas travel history information. A mathematical model was developed to capture the relationship between travel history and <italic>R</italic>. We obtained travel history data for each confirmed case of VOC 202012/01 infection from 26 December 2020 to 26 February 2021. Maximum likelihood estimation was used to estimate <italic>R</italic>, accounting for right censoring during real-time estimation. In the baseline scenario, <italic>R</italic> was estimated at 2.11 (95% confidence interval: 1.63, 2.94). By 26 February 2021, an average of nine generations had elapsed since the first imported case. If the generation time of VOC 202012/01 was assumed to be longer, <italic>R</italic> was increased, consistent with estimates of <italic>R</italic> from case data. The estimated <italic>R</italic> of VOC 202012/01 in Japan exceeded 1 on 26 February 2021, suggesting that domestic transmission events caused a major epidemic. Moreover, because our estimate of <italic>R</italic> was dependent on generation time and ascertainment biases, continuous monitoring of contact tracing data is crucial to decipher the mechanisms of increased VOC 202012/01 transmissibility.</p> </abstract>

Low Malaria Transmission in Rosso, an Irrigated Rice-Growing Area in Mauritania

The construction of dams along the Senegal River resulted in an increase in irrigated land areas and changes in the epidemiology and transmission of water-related diseases. The objective of this study was to update epidemiological data on malaria in Rosso, one of the major Mauritanian cities along the Senegal River. Febrile patients (n = 318) were screened for malaria using a rapid diagnostic test (RDT) for malaria and microscopic examination of blood smears. Diagnosis was later confirmed by polymerase chain reaction (PCR). The mean age of 318 febrile patients was 25.1 (range 1–80 years). Only 7 (2.2%) and 2 (0.6%) had a positive RDT and thick smear, respectively. PCR confirmed the diagnosis in two Plasmodium vivax-infected patients. Most participants (198/318, 62.3%) had no recent travel history outside Rosso. The majority of the febrile patients (90%, 284/311) owned at least one insecticide-treated net (ITN). The frequency of the use of ITNs was not significantly associated with season (rainy vs. dry seasons; p = 0.9) or with the number of ITNs per household (rs = 0.07; n = 285; p = 0.19). Of 285 individuals with ITNs, only two (0.7%) with no travel history were PCR-positive for malaria. Despite the presence of mosquito breeding sites related to rice irrigation, malaria transmission in Rosso remained very low, possibly due to the high coverage and frequent use of bed nets. Regular entomological surveillance for possible changes in the prevalence of Anopheles mosquito species and their behavioural aspects should be implemented.

Systemic lupus erythematosus presenting with lymphoid interstitial pneumonia as an initial manifestation

A 25-year-old woman with an extensive travel history developed chronic cough and multiple lung nodules. The lung biopsy revealed lymphoid interstitial pneumonia. The patient later developed cervical lymphadenopathy, arthritis and livedo reticularis, then systemic lupus erythematosus was diagnosed with positive double-stranded DNA and low complement. The patient’s symptoms responded to prednisolone and azathioprine.

SARS-CoV-2 variants of concern dominate in Lahore, Pakistan in April 2021

The SARS-CoV-2 pandemic continues to expand globally, with case numbers rising in many areas of the world, including the Indian sub-continent. Pakistan has one of the world’s largest populations, of over 200 million people and is experiencing a severe third wave of infections caused by SARS-CoV-2 that began in March 2021. In Pakistan, during the third wave until now only 12 SARS-CoV-2 genomes have been collected and among these nine are from Islamabad. This highlights the need for more genome sequencing to allow surveillance of variants in circulation. In fact, more genomes are available among travellers with a travel history from Pakistan, than from within the country itself. We thus aimed to provide a snapshot assessment of circulating lineages in Lahore and surrounding areas with a combined population of 11.1 million. Within a week of April 2021, 102 samples were sequenced. The samples were randomly collected from two hospitals with a diagnostic PCR cutoff value of less than 25 cycles. Analysis of the lineages shows that the Alpha variant of concern (first identified in the UK) dominates, accounting for 97.9 % (97/99) of cases, with the Beta variant of concern (first identified in South Africa) accounting for 2.0 % (2/99) of cases. No other lineages were observed. In depth analysis of the Alpha lineages indicated multiple separate introductions and subsequent establishment within the region. Eight samples were identical to genomes observed in Europe (seven UK, one Switzerland), indicating recent transmission. Genomes of other samples show evidence that these have evolved, indicating sustained transmission over a period of time either within Pakistan or other countries with low-density genome sequencing. Vaccines remain effective against Alpha, however, the low level of Beta against which some vaccines are less effective demonstrates the requirement for continued prospective genomic surveillance.

TOURISM AND VACCINE HESITANCY

Vaccine hesitancy is one of the main obstacles facing the tourism industry in its recovery from the COVID-19 pandemic. Many people are sceptical about the COVID-19 vaccine and decide not to get vaccinated. Our research aims to test the effectiveness of using travel-related incentives to overcome vaccine hesitancy. We investigate (1) whether travel-related beliefs and behaviours are associated with vaccination willingness, and (2) whether alerting people to travel-related freedoms linked to vaccination can increase vaccination willingness. Our results indicate that (1) there is a significant association between people’s international travel history, their desire to travel internationally in the future and vaccination willingness, and (2) this association cannot, however, be leveraged to further increase vaccination willingness as vaccine-related beliefs (safety and efficacy) are the primary drivers of vaccination willingness.

Tandem Use of OvMANE1 and Ov-16 ELISA Tests Increases the Sensitivity for the Diagnosis of Human Onchocerciasis

The current serological test for human onchocerciasis relies on IgG4 reactivity against the parasite Ov-16 antigen, with reported sensitivities of only 60–80%. As control programs move from control to elimination, it is imperative to identify novel molecules that could improve the serodiagnosis reliability of this disease. In this study we compared the sensitivity of total IgG against OvMANE1—a chimeric antigen previously identified as a potential biomarker of human onchocerciasis—with that of an Ov-16 antibody test to detect an Onchocerca volvulus infection in persons presenting with microfilaria in skin snips. One hundred and ninety serum samples were obtained from persons with epilepsy in an onchocerciasis-endemic area at Ituri in the Democratic Republic of Congo where ivermectin has never been distributed. Fifty-nine (31.1%) samples were from individuals with a positive skin snip test; 41 (69.5%) of these 59 samples were positive with the OvMANE1 test and 41 (69.5%) with the Ov-16 test; 30 (50.8%) samples were positive for both tests and in 52 (88.1%) at least one of the tests was positive. Testing the 131 sera from persons with a negative skin snip result revealed that 63 (48.1%) were positive exclusively with the OvMANE1 test, 13 (9.9%) exclusively with the Ov-16 test and 25 (19.1%) with both tests. Nine European samples from individuals without past travel history in onchocerciasis endemic zones and 15 samples from Rwanda, a hypoendemic country for onchocerciasis were all negative for the OvMANE1 and Ov-16 tests. However, the specificity of both tests was difficult to determine due to the lack of a gold standard for antibody tests. In conclusion, the tandem use of OvMANE1 and Ov-16 tests improves the sensitivity of detecting Onchocerca volvulus seropositive individuals but, the OvMANE1 test needs to be further evaluated on samples from a population infected with other helminths to cautiously address its specificity.

Mumps in Vaccinated Children and Adolescents: 2007–2019

BACKGROUND Despite a &gt;99% reduction in US mumps cases after the introduction of mumps vaccine in 1967, outbreaks have occurred in schools and other settings involving vaccinated children and adolescents since 2006. METHODS We analyzed mumps cases reported by US health departments to the National Notifiable Diseases Surveillance System. We present the incidence and vaccination status of pediatric cases (age &lt;18 years) during 2007–2019 and describe demographic, clinical, and vaccination characteristics of pediatric cases reported during the most recent resurgence in 2015–2019. RESULTS During 2007–2019, 9172 pediatric cases were reported, accounting for a median of 32% of all cases reported each year (range: 13%–59%). A median of 87% (range: 81%–94%) of pediatric patients each year had previously received ≥1 measles, mumps, and rubella (MMR) vaccine dose. During 2015–2019, of 5461 pediatric cases reported, only 2% of those with known import status (74%) were associated with international travel. One percent of patients had complications and 2% were hospitalized. Among patients aged ≥1 year with known vaccination status (72%), 74% of 1- to 4-year-olds had received ≥1 MMR dose and 86% of 5- to 17-year-olds had received ≥2 MMR doses. Since 2016, pediatric mumps cases have been reported in most US states each year (range: 38–45 states). CONCLUSIONS Since 2007, one-third of US reported mumps cases occurred in children and adolescents, the majority of whom were vaccinated. Clinicians should suspect mumps in patients with parotitis or mumps complications, regardless of age, travel history, and vaccination status.

Molecular detection of Hepatozoon species infections in domestic cats living in Germany

Objectives Three species of protozoal Hepatozoon species ( H felis, H canis and H silvestris) are known to infect cats in Europe. The objective of this study was to determine the prevalence of Hepatozoon species in samples from cats living in Germany that were submitted to a veterinary laboratory. Methods The study included cats tested for Hepatozoon species by PCR between 2007 and 2020 by the Laboklin laboratory. Travel history and haematological results were documented for cats with positive test results. From 2018 onwards, a partial 18S rRNA Hepatozoon gene fragment was sequenced from cats with positive PCR results. Results Sixty-four of 931 cats (7%) tested positive for Hepatozoon species. Sex and age did not have a statistically significant impact. Sequencing was carried out for 16 samples and revealed H felis in all cases. All cats with positive test results and a relevant travel history had been imported from the Mediterranean or south-eastern Europe. There were no autochthonous infections with Hepatozoon species. Leukocytosis, haemoconcentration and anaemia were the most common haematological abnormalities. Conclusions and relevance Although infections with Hepatozoon species in cats are usually subclinical, it may be useful to screen cats imported from the Mediterranean and south-eastern Europe for these pathogens to prevent local transmission cycles. There was no evidence of autochthonous infections in Germany; however, further investigations regarding a possible transmission of Hepatozoon species from infected cats to blood-feeding arthropods in Germany may be of interest. To avoid potential spread of the pathogens, ectoparasite prophylaxis is advisable.