Salmonella Paratyphi A infection: implications for public health management of extra-intestinal presentations – case study of a neck abscess

This study explores the implications of unusual presentations of Salmonella enterica subsp. enterica ser. Paratyphi (S. Paratyphi) infection for public health management, through a literature review and case study. In 2016, a 36-year-old male presented with a five-day history of right sided painful neck swelling, coryza and a two-day history of fevers after arriving in Australia from India nine weeks earlier. S. Paratyphi A was isolated from a fine needle aspirate sample. A descriptive epidemiological review was performed of confirmed cases of S. Paratyphi notified in New South Wales between 2008 and 2017. S. Paratyphi was isolated in blood and/or faecal samples in 247 cases (98.4%). Only four specimens (1.6%) were from a focal site. A literature review of extraintestinal infections of S. Paratyphi A or B was performed. Of the 41 such cases reported, 16 (39%) had a clear history of a prior gastroenteritis and/or febrile illness, or information suggested this was highly likely. No preceding gastroenteritis or febrile illness occurred in 15 (37%) of the cases. Information was reviewed and presented with a public health lens, valuable for ‘evidence-informed’ public health risk assessment of contacts and exposures related to these types of S. Paratyphi infection. S. Paratyphi infection usually presents as an enteric fever illness. Our case illustrates the variable nature of infectious diseases and the importance of laboratory testing in obtaining a diagnosis. S. Paratyphi can have unusual presentations, which may require adjustment in the public health management of the case. Public health staff should keep an open mind when investigating possible sources and assessing risk. In Western Sydney, this disease is largely associated with residents travelling to high-incidence countries to visit family and friends, and receiving family visits from these countries. The increasing number of cases of S. Paratyphi (prior to COVID-19) in Western Sydney and the importance of awareness of the risk of enteric fever to travellers to endemic regions is highlighted.

Estimating relative abundance of two SARS-CoV-2 variants through wastewater surveillance at two large metropolitan sites

Monitoring SARS-CoV-2 variants of concern (VOCs) is critical for public health management of COVID-19. Case isolate sequencing is resource-intensive and not all isolates can be sequenced, and thus are not representative. However, since wastewater SARS-CoV-2 RNA concentrations correlate with COVID-19 case incidence in sewersheds, tracking VOCs through wastewater is appealing. We developed targeted digital RT-PCR assays to monitor abundance of select mutations in Alpha and Delta VOCs in wastewater settled solids, applied these to July 2020-August 2021 samples from two large metropolitan sewersheds, and compared results to estimates of variant abundance from case isolate sequencing. Wastewater measurements tracked closely with case isolate estimates at each site (rp= 0.82, 0.88 for Alpha and rp= 0.97 for Delta). Mutations were detected in wastewater measurements even at levels <5% of circulating virus and in samples available weeks before case isolate results. Therefore, wastewater variant monitoring should be strategically deployed to complement case isolate sequencing.

Turnover of SARS-CoV-2 Lineages Shaped the Pandemic and Enabled the Emergence of New Variants in the State of Rio de Janeiro, Brazil

In the present study, we provide a retrospective genomic epidemiology analysis of the SARS-CoV-2 pandemic in the state of Rio de Janeiro, Brazil. We gathered publicly available data from GISAID and sequenced 1927 new genomes sampled periodically from March 2021 to June 2021 from 91 out of the 92 cities of the state. Our results showed that the pandemic was characterized by three different phases driven by a successive replacement of lineages. Interestingly, we noticed that viral supercarriers accounted for the overwhelming majority of the circulating virus (>90%) among symptomatic individuals in the state. Moreover, SARS-CoV-2 genomic surveillance also revealed the emergence and spread of two new variants (P.5 and P.1.2), firstly reported in this study. Our findings provided important lessons learned from the different epidemiological aspects of the SARS-CoV-2 dynamic in Rio de Janeiro. Altogether, this might have a strong potential to shape future decisions aiming to improve public health management and understanding mechanisms underlying virus dispersion.

Some essential peculiarities of public health management in the Republic of Moldova

Articolul prezintă unele aspecte economice ale managementului din sectorul sanitar. Un bun management constă în optimizarea acţiunilor medicale din punct de vedere fi nanciar, organizaţional şi al calităţii. Informaţia privind caracterul adecvat al utilizării resurselor ne permite să discutăm despre politicile de sănătate

Naturopathic Medicine and Public Health Management in Ghana; A Mixed Questionnaire Study

Background: Naturopathic medicine is at its embryonic stage of development in Ghana and West Africa in entirety. In jurisdictions where Naturopathic medicine is well regulated, Naturopathic practitioners are well integrated into the primary healthcare delivery team. In Ghana, the case is quite different due to a myriad of issues. Objectives: This study examines the role of Naturopathic medicine in Public Health in Ghana and potential policy direction for adoption of Naturopathic protocols in global pandemic management, the challenges faced by Naturopathic Physicians in primary healthcare delivery, and the challenges of Naturopathic Medical Students on their clerkship at one of the designated government Hospitals. Methods: The study adopted a mixed questionnaires study engaged in integrated data analysis. The respondents in this study were selected Naturopathic Medical Students of the Nyarkotey College of Holistic Medicine, Ghana. Results: Out of a sample size of 28, 100% (28) believed that, there is a role of Naturopathic medicine in public health management. 95% asserted that very little naturopathic remedies have been employed in the fight against Covid-19 in Ghana. There was also a unanimous agreement (100%) that Ghana needs to adopt a National Policy on Naturopathic remedies in Public Health. Conclusion: Naturopathic medicine should be embraced fully into Ghanaian primary healthcare delivery. It is important to look at the best practices which exist in other jurisdictions such as China and India for adoption. It is time for the policy makers to speed up the passage of the Traditional and Alternative Medicine bill.

Prison health is a public health: Management of Sars-CoV-2 outbreak in an Italian prison

The Covid-19 emergency in prisons is a public health warming due to overcrowding, poor structural conditions,and life promiscuities.Worldwide a lot of prisoners were Sars-CoV-2 positive and in Italy several outbreaks occurred in many prisons.This paper examines, using a clinical audit, a Covid-19 outbreak occurred in an Italian prison during the spring2021.The study showed that the best measures to mitigate the outbreak negative consequences both in prisoners andin the staff are the preventive actions, the hygiene and disinfection of the common detention areas; the reductionof overcrowding; the stop of the working activities during the quarantine period.Only an improvement of living conditions inside the prisons may reduce the risk of infection among inmates.

Empowering People to Make Healthier Choices: A Critical Discourse Analysis of the Tackling Obesity Policy

In response to the heightened risk that coronavirus disease 2019 (COVID-19) poses to the health and lives of people with obesity, in 2020 the U.K. government launched a new package of policies intended to stimulate weight loss among the country’s population. In this article, I present a critical discourse analysis of the policy paper which announced these new measures. I identify the discourses that are used to represent things, people, and processes in this policy text. These discourses are interpreted in terms of broadly neoliberal ideologies of public health management. Taken together, the discourses identified contribute to a broadly neoliberal ideology of public health management. It is argued that the policy paper represents an instance of “lifestyle drift,” as it initially appears to engage with social and economic determinants of health but ultimately neglects these in favor of focusing on individual lifestyle factors, particularly in the shape of individuals’ “choices.”