Extra-Pulmonary Complications in SARS-CoV-2 Infection: A Comprehensive Multi Organ-System Review

Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is typically presented with acute symptoms affecting upper and lower respiratory systems. As the current pandemic progresses, COVID-19 patients are experiencing a series of nonspecific or atypical extra-pulmonary complications such as systemic inflammation, hypercoagulability state, and dysregulation of the renin–angiotensin–aldosterone system (RAAS). These manifestations often delay testing, diagnosis, and the urge to seek effective treatment. Although the pathophysiology of these complications is not clearly understood, the incidence of COVID-19 increases with age and the presence of pre-existing conditions. This review article outlines the pathophysiology and clinical impact of SARS-CoV-2 infection on extra-pulmonary systems. Understanding the broad spectrum of atypical extra-pulmonary manifestations of COVID-19 should increase disease surveillance, restrict transmission, and most importantly prevent multiple organ-system complications.

Evaluation of the Kano State Lassa Fever Surveillance System, 2015-2018 – Nigeria

BackgroundLassa fever (LF) is one of the priority diseases under surveillance through the integrated disease surveillance and response system (IDSR). We evaluated the LF surveillance system against its set objectives and assessed its attributes. MethodsWe used cross-sectional study design. Forty-seven stakeholders involved in the surveillance system were interviewed using the Centers for Disease Control and Prevention’s Updated Guidelines for Evaluating Public Health Surveillance Systems. The LF surveillance data from January 2015 to December 2018 were also analyzed. The attribute and objectives of the system were evaluated. ResultsOut of the 76 suspected cases recorded in kano state during the study period, only 54 samples were laboratory tested, 11 of them were confirmed positive with 9 deaths (case fatality rate of 82%). Confirmed cases were predominantly in Tudun Wada LGA (63.6%), while the age-group 20-39 years constituted 55% of the confirmed cases. There was male preponderance of cases (73%). The predictive value positive (PVP) was 14.5%. The surveillance system was however meeting its objectives of determining LF burden and detecting and characterizing cases and outbreak.ConclusionLF surveillance system in Kano was simple, flexible, stable, acceptable and timely. However, data was not representative. We recommended improved reporting from private and tertiary facilities and more personnel training and support to improve the system.

Hunters’ Willingness to Pay to Avoid Processing Costs Associated with Harvesting Infected Game

We assessed hunters’ willingness to participate in a scheme to recover the costs associated with processing diseased game. The results indicated that fifty-one percent of the hunters in a region affected by chronic wasting disease are interested in such a scheme and willing to pay an average of $20 per animal. Their willingness to participate is affected by risk perception, hunting experience, use of processing services, and income. Further, establishing such a market-based scheme would be financially profitable to game processors and helpful to wildlife agencies interested in encouraging hunters’ harvest to reduce herds and facilitate effective disease surveillance.

Urinary Tract Infection Caused By Bacterial Pathogens of The Respiratory Tract In Children

Urinary tract infection (UTI) caused by bacterial pathogens of the respiratory tract such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis is rare and little is known about their characteristics and potential host risk factors. We conducted a retrospective descriptive study on pediatric UTI due to S. pneumoniae, Haemophilus spp., or M. catarrhalis at a tertiary-care pediatric hospital. Pediatric patients with diagnosed UTI between 2002 and 2020 were included. Patient demographics, laboratory data, and microbiological findings were extracted from their electronic medical records and the infectious disease surveillance system. Among 46,332 urine samples, 76 bacteriuria (0.16%) and 22 UTI (0.05%) events due to the targeted species were identified (S. pneumoniae [n=7] and Haemophilus spp. [n=15]). Of the patients, 17 (85%) had underlying urinary tract abnormalities and 13 (60%) had vesicocutaneous fistula. All the UTI episodes caused by S. pneumoniae and Haemophilus spp. occurred after cystostomy. All the patients had satisfactory clinical outcomes.Conclusion: Although S. pneumoniae and Haemophilus spp. are rare causes of UTI in children, they could be the true causative bacteria of UTI even when detected in urine specimens, particularly in the patients with urinary tract abnormalities and vesicocutaneous fistula.

Knowledge, Attitudes, Psychosocial Perspectives and Applied Epidemiology in the Control of Head Lice (pediculosis capitis) in Croatian Preschool Children: A Qualitative Study on Childcare Professionals and Health Coordinators

This study aimed to concurrently determine the perceived knowledge, attitudes and perspectives of childcare professionals working in kindergartens towards pediculosis capitis, a common ectoparasitic disease also known as head lice, as well as gain insights into procedures and control measures that are implemented in an outbreak setting. We used a qualitative approach with a problem-centered, semi-structured and three-part interview technique conducted in selected kindergartens of Varaždin and Međimurje counties of the Republic of Croatia. Based on a purposive (deliberate) sampling method, the study included both childcare professionals and on-site health coordinators aged between 21 and 56 years of age. Five main themes were put forth as a result of the conducted thematic analysis: prevention and control measures for managing head lice, information and knowledge, social issues, psychological issues and disease perception. Each of these themes also had specific emerging categories based on participants’ responses. Even though all respondents confirmed that the disease is continuously monitored only a few of them mentioned that a scalp examination was an inherent part of disease surveillance within the kindergarten community. Moreover, we found that information on pediculosis capitis is available to both parents and childcare professionals, but with a questionable uptake. Additionally, the majority of the respondents reported that parents tend to hide the infestation in their children due to shame and/or to avoid social stigma, and thus often fail to inform kindergarten teachers and health coordinators about the problem. In conclusion, our findings have implications for further practice and the introduction of tailored public health measures for the most vulnerable populations, most notably kindergarten children.

A Natural Language Processing Pipeline to Identify COVID-19 Outbreaks from Contact Tracing Interview Forms (Preprint)

BACKGROUND In Wisconsin, COVID-19 case interview forms contain free text fields that need to be mined to identify potential outbreaks for targeted policy making. We developed an automated pipeline to ingest the free text into a pre-trained neural language model to identify businesses and facilities as outbreaks. OBJECTIVE We aim to examine the performance of our pipeline. METHODS Data on cases of COVID-19 were extracted from the Wisconsin Electronic Disease Surveillance System (WEDSS) for Dane County between July 1, 2020, and June 30, 2021. Features from the case interview forms were fed into a Bidirectional Encoder Representations from Transformers (BERT) model that was fine-tuned for named entity recognition (NER). We also developed a novel location mapping tool to provide addresses for relevant NERs. The pipeline was validated against known outbreaks that were already investigated and confirmed. RESULTS There were 46,898 cases of COVID-19 with 4,183,273 total BERT tokens and 15,051 unique tokens. The recall and precision of the NER tool were 0.67 (95 % CI 0.66-0.68) and 0.55 (95 % CI: 0.54-0.57), respectively. For the location mapping tool, the recall and precision were 0.93 (95% CI: 0.92-0.95) and 0.93 (95% CI: 0.92-0.95), respectively. Across monthly intervals, the NER tool identified more potential clusters than were confirmed in the WEDSS system. CONCLUSIONS We developed a novel pipeline of tools that identified existing outbreaks and novel clusters with associated addresses. Our pipeline ingests data from a statewide database and may be deployed to assist local health departments for targeted interventions. CLINICALTRIAL Not applicable