International Journal of Infectious Diseases最新文献

{"title":"Emerging infections in children","authors":"Prof Helena Maltezou","doi":"10.1016/j.ijid.2024.107378","DOIUrl":"10.1016/j.ijid.2024.107378","url":null,"abstract":"<div><h3>Introduction</h3><div>Infectious diseases are a significant cause of morbidity and mortality in children.</div></div><div><h3>Methods</h3><div>Recent studies were reviewed, and new epidemiological and clinical facts of the following emerging infectious diseases are discussed: vaccine-preventable diseases (VPDs), post-COVID syndrome, respiratory syncytial virus (RSV) infections, dengue, and Crimean-Congo hemorrhagic fever (CCHF).</div></div><div><h3>Results</h3><div>Vaccine-preventable diseases: A modelling study which quantified the impact of 50 years of the Expanded Programme on Immunization showed that vaccinations accounted for 40% of the reduction of infant mortality during 1974-2024. Measles vaccines accounted for most of the averted infant morbidity and mortality the past 50 years. Nevertheless, from 2018 onwards, vaccination rates in children have been decreasing in several countries globally, which resulted in local re-emergence of several VPDs and the onset of disruptive outbreaks. Regarding the second topic, post-COVID syndrome, a recent meta-analysis found a prevalence rate of 23.36% in children. Major symptoms in affected children are dyspnea, headache, fatigue, shortness of breath, abdominal pain, concentration difficulties, and sleep disorders. Post-COVID syndrome has a multifactorial pathogenesis, involves most systems, and has a negative impact on child's well-being, school attendance and educational activities. Regarding the third topic, RSV, a comparison of 1451 pediatric cases that occurred 2018-2019 with 1102 cases that occurred in 2023 in China, found that the post-COVID-pandemic group was significantly older, more frequently had fever and complications (acute otitis media, seizures), and more frequently had raised inflammation markers. Overall, the post-COVID RSV cases more frequently developed severe lower respiratory tract infection, were admitted to an intensive care unit, and received invasive mechanical intubation. Similarly, infants with RSV hospitalized in France during the COVID-19 pandemic more frequently received oxygen and remained in-hospital for longer periods compared to infants with RSV hospitalized in the pre-COVID era. A prospective cohort study showed that RSV remains a cause of substantial morbidity, leading to the hospitalization of one in every 56 healthy full-term infants in high-income countries. Regarding dengue, a large school-based cross-sectional serosurvey in Kerala, India among 5236 children 9-12 years old found an overall seroprevalence rate of 30.9%, with wide variation across districts. Advanced age and male sex were significantly associated with higher seroprevalence rates. Of note, 40% of children had IgG antibodies against multiple dengue virus serotypes. Lastly, although CCHF is considered a mild disease in children, a recent study from Turkey found that 12 children with CCHF hospitalized during 2020-2021 developed severe illness (all had hepatosplenomegaly) and highly impaired la","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107378"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking the Evolution and Antibiotic Resistance Patterns of Streptococcus pneumoniae in Indian Adult Populations through High-Throughput Genome Sequencing","authors":"Mr Varun Shamanna, Dr Geetha Nagaraj, Mrs MR Shincy, Dr KL Ravikumar","doi":"10.1016/j.ijid.2024.107405","DOIUrl":"10.1016/j.ijid.2024.107405","url":null,"abstract":"<div><h3>Introduction</h3><div>Streptococcus pneumoniae is a leading cause of respiratory infections, levying a substantial health burden, especially on children and the elderly. The introduction of pneumococcal conjugate vaccines (PCVs) and Pneumococcal Polysaccharide Vaccine (PPSV) has reduced invasive pneumococcal disease (IPD) as well as non-invasive diseases in various nations. Yet, there is apprehension that pneumococcal vaccine use could foster the development of drug-resistant S. pneumoniae strains.</div></div><div><h3>Methods</h3><div>This study analysed 254 S. pneumoniae isolates from Indian adults during 2022-2023. Disease and carriage S. pneumoniae isolates from 5 Indian states were sequenced using Illumina MiSeq.</div><div>The genomic analysis was carried out using the GPS Pipeline built specifically for S. pneumoniae. The pipeline performs an initial assessment based on the total bases in reads and the raw reads will be assembled using the Shovill assembler. Samples were further assessed based on assembly, mapping, and taxonomy. Virulence genes were screened using VFDB database.</div></div><div><h3>Result</h3><div>Out of the 254 isolates, 126 were disease and 128 were carriage isolates. The prevalent serotype in both categories were 19F, 19A, and 9V with a vaccine coverage of 66% and 73.8% to PCV13 and PPSV23 respectively among invasive isolates. A total of 53 distinct GPSCs were identified with GPSC 1, 10 and 6 dominating the population. Of 53 GPSCs, 29 (54 %) were VT lineages, 17 (32 %) were non-VT lineages and 6 (11 %) were lineages (GPSC 10, 6, 23, 9, 16, Novel) with both VT and non-VT isolates. Among sequence types, ST1192, 320 and 236 were common among 89 different STs. 67 isolates had elevated MIC value of ≥4 to penicillin, while 70% were multidrug-resistant (MDR). 34% of the isolates carried pili 1, but 20% had pili 2 and 19% of the isolates carried both pili1 and 2. The virulence genes cpsA, hysA, lytAB, nanAB, pavA, pce, ply, and psaA were present in both invasive and non-invasive strains without clone specificity, which are responsible for colonisation and immune system evasion. Virulence factors, cbpA and pitAB are clonally distributed in GPSC1 while ply and psaA are carried by all strains. Phylogenetic analysis showed, GPSC1 (18.3%), GPSC10 (14.3%), and GPSC6 (11.1%) as predominant invasive clone clusters, whereas GPSC10 (22.7%), GPSC1 (21.9%), and GPSC6 (7.8%) were prominent in commensals.</div></div><div><h3>Discussion</h3><div>The study underscores the ongoing prevalence of certain serotypes despite vaccination efforts, alarming levels of antimicrobial resistance, and the diverse genetic landscape. These findings emphasize the critical necessity for sustained surveillance and targeted intervention strategies in India.</div></div><div><h3>Conclusion</h3><div>Overall, these findings highlight the critical importance of continued surveillance efforts to monitor the emergence of new serotypes, track antimicrobial resista","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107405"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of a clinical helpline for mpox: comparison of the 2022 and 2024 experience in the UK","authors":"Dr Helen Callaby ,&nbsp;Dr Jane Osborne ,&nbsp;Dr Catherine F Houlihan ,&nbsp;Dr Tommy Rampling ,&nbsp;Dr Amy Belfield ,&nbsp;Dr Clare Warrell ,&nbsp;Dr Christina Petridou ,&nbsp;Dr Matthew Donati ,&nbsp;Dr Nicola C Gordon","doi":"10.1016/j.ijid.2024.107456","DOIUrl":"10.1016/j.ijid.2024.107456","url":null,"abstract":"<div><h3>Introduction</h3><div>The UK Imported Fever Service is run by the UKHSA Rare and Imported Pathogens Laboratory (RIPL). It provides a 24/7 helpline for clinicians managing patients with suspected High Consequence Infectious Diseases (HCIDs) and provides the UK portal for HCID risk assessment and testing, and advice on immediate management and infection.</div><div>In May 2022, the IFS assisted in diagnosing the first UK cases of clade II mpox. This was followed by a significant rise in the number of calls to the IFS, resulting in the establishment of a dedicated 24/7 mpox helpline, staffed by UKHSA physicians from microbiology, virology, GUM, infectious diseases and public health.</div><div>In 2024, the outbreak of clade I mpox in Central Africa resulted in the declaration by WHO of a Public Health Emergency of International Concern (PHEIC). As part of the UK's preparedness activities, data from the 2022 helpline experience was reviewed to inform readiness for a helpline in the event of importation of cases into the UK.</div></div><div><h3>Methods</h3><div>Telephone data were accessed for the initial outbreak period in 2022, and from the announcement of the PHEIC in 2024. The call logs were interrogated to understand the type of caller, reason for calls and what advice was given.</div></div><div><h3>Results</h3><div>During the first 2 weeks of the 2022 outbreak, calls to the IFS increased from approximately 20 calls/week to over 200 calls/week, prior to the activation of the dedicated mpox helpline. The 2022 helpline received over 1400 calls during the first 6 weeks of the outbreak. The majority of suspected cases were in males aged 20-60. The age/gender distribution of suspected cases was similar to the confirmed positive cases.</div><div>In 2024, calls to the IFS about suspected mpox increased to approximately 30 calls / week. Only a minority of suspected cases (33/177, 17%) had a relevant travel or exposure history for clade I mpox, and none tested positive. This was absorbed into the standard IFS working as there were no UK imported cases. However, based on the lessons learned from 2022, an SOP and Terms of Reference were drawn up in readiness for helpline establishment.</div></div><div><h3>Discussion</h3><div>There was a clear need to provide support and information for frontline clinicians early in the 2022 outbreak: this was addressed by the establishment of a dedicated helpline. Data from the calls, including age, gender and exposure history, provided early insights into the epidemiology and transmission of this mpox lineage, ahead of the analysis of confirmed cases. The 2022 experience was used to build resilience for the possibility of imported cases in 2024.</div></div><div><h3>Conclusion</h3><div>Data from helpline calls may provide early information on the transmission and exposure risk factors in outbreaks, and are a key mechanism for supporting frontline clinicians.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107456"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of COVID-19 Outbreaks with Whole Genome Sequencing by Oxford Nanopore Technology in a Tertiary Centre, Malaysia","authors":"Dr Siti Farah Nawi ,&nbsp;Norazimah Tajudin ,&nbsp;Associate Professor Seok Mui Wang ,&nbsp;Associate Professor Mariam Mohamad","doi":"10.1016/j.ijid.2024.107452","DOIUrl":"10.1016/j.ijid.2024.107452","url":null,"abstract":"<div><h3>Introduction</h3><div>The SARS-CoV-2 virus genome surveillance is important to monitor and track emerging variants. In a hospital setting, this will help identify both community and inter and intrahospital transmission and, if performed in real-time, will reduce the rate of the disease spread by immediately implementing infection control measures. The study aims to describe the COVID-19 outbreaks from the SARS-CoV-2 virus genomic surveillance by whole genome sequencing (WGS).</div></div><div><h3>Methods</h3><div>101 laboratory-confirmed clinical isolates belonging to patients with COVID-19 from June 2021 to June 2022 were subjected to WGS. The sequences were assembled using Bioinformatic tools EPI2ME software by the Oxford Nanopore technology (ONT). Based on the Q10 quality score, 86 isolates were subjected to phylogenetic tree analyses using the Maximum Likelihood method in MEGA 11 software. The sequencing process reached 100% coverage within 16 hours. The sociodemographic and clinical data were retrieved from both the hospital information systems (UNIMEDS) and patients’ medical records. Patients’ clinical presentations were categorized into mild and severe.</div></div><div><h3>Results</h3><div>Phylogenetic analysis revealed 7 clusters of COVID-19 outbreaks with 24 patients showing only mild symptoms. The first three clusters (Cluster I, II and III) were found to have circulated from June to July 2021 and belonged to Clade GK (Delta variant). Cluster I showed transmission from a father to his 2 sons. Cluster II involves transmission between the 2 siblings from different families. Cluster III suggested an intrahospital transmission between medical staff and medical students. Meanwhile, from February to April 2022, four clusters were detected within Clade GRA (Omicron Variant). Cluster IV involved 3 medical students who stayed in the same residential college. Cluster V involved a group of medical staff with 1 university student. Cluster VI also involved a group of 3 university students, indicating possible transmission within their residential area. Cluster VII involved infection between family members from mother to her child.</div></div><div><h3>Discussion</h3><div>In our study, we were able to track 1 intrahospital transmission, 1 inter-hospital and 5 community COVID-19 transmissions based on the phylogenetic tree. No new viral variants were found. The viral evolutions were of a similar pattern to what is being described globally. This WGS technique has been shown to give a faster turnaround time.</div></div><div><h3>Conclusion</h3><div>The WGS has enabled laboratory scientists and epidemiologists to detect the occurrence of COVID-19 outbreaks as well as genomic surveillance. Due to its robustness and rapid sequencing results, this technique could be used in real-time in the hospital setting to prevent further transmission of the infection.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107452"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence of the neutralizing antibody response one year after a single injection of a new Yellow fever vaccine in adults","authors":"Dr Emmanuel Feroldi,&nbsp;Prof Mark J Mulligan,&nbsp;Dr Kawsar Talaat,&nbsp;Dr Chen Sabrina Tan,&nbsp;Dr Kristopher Paolino,&nbsp;Prof Srilatha Edupuganti,&nbsp;Prof Matthew H Collins,&nbsp;Prof Sarah L George,&nbsp;Dr Matthew Davis,&nbsp;Dr Brandon Essink,&nbsp;Dr James Peterson,&nbsp;Dr David Fried,&nbsp;Dr Natalia Rodriguez Valero,&nbsp;Prof Michael Ramharter,&nbsp;Prof Odile Launay,&nbsp;Prof Anu Kantele,&nbsp;Prof Terapong Tantawichien,&nbsp;Prof Jenny Guek-Hong Low,&nbsp;Ms Sandrine Orlando,&nbsp;Ms Pascale Davaux,&nbsp;Dr Carina Frago","doi":"10.1016/j.ijid.2024.107447","DOIUrl":"10.1016/j.ijid.2024.107447","url":null,"abstract":"<div><h3>Introduction</h3><div>Yellow fever (YF) remains a major global health threat, complicated by climate change, vector expansion, and insufficient health system infrastructure in endemic regions. Recent shortages of licensed vaccines during regional outbreaks underscore the need for next-generation YF vaccines that retain safety and effectiveness standards while enhancing manufacturing efficiency. Grown in serum-free Vero cells, vYF is a live-attenuated YF vaccine developed to ensure a sustainable and robust global supply.</div></div><div><h3>Methods</h3><div>In two ongoing Phase II randomized, observer-blind, active-controlled, non-inferiority multicenter clinical trials of vYF in 18-60-year-old adults in the US (vs. YF-VAX – VYF02 study) or in Europe and Asia (vs. Stamaril – VYF03 study), the neutralizing antibody (NAb) responses are being measured by a YF microneutralization assay on day 29 (D29), month 6 (M6), and then annually from year 1 (Y1) until Y5. Seroprotection is defined as NAb titers ≥ 10 (1/dil). Interim analyses conducted one-month post-vaccination demonstrated that the vYF immune response was non-inferior to YF-VAX or Stamaril. Here, we report the immunogenicity up to Y1.</div><div>Adults were randomized 2:1 to receive one dose of vYF or YF active control: 568 in the US (VYF02) and 690 in Europe and Asia (VYF03).</div></div><div><h3>Results</h3><div>Twenty-eight days after a vYF dose administration, over 99% of YF-naive participants in the US, and over 98% in the EU and over 95% in Asia were seroprotected.</div><div>YF-naive recipients (FAS) exhibited D29 post-vaccination geometric mean titers (GMT) well above the seroprotective threshold: 2654, 1/dil, in the US; 2508, 1/dil, in EU; 1374, 1/dil, in Asia. As expected, GMTs waned after D29 but more than 97% of participants in the US, over 98% in Europe and more than 94% in Asia maintained titers above the threshold of protection at Y1, with GMTs of 401, 1/dil, in the US; 469, 1/dil, in EU; and 205, 1/dil, in Asia.</div></div><div><h3>Discussion</h3><div>Overall, 94% or more of YF-naive adults in US, EU and Asia were seroprotected 28 days after receiving vYF and remained seroprotected at Y1. Seroprotection rates and GMT values following administration of the control vaccines (YF-VAX or Stamaril) were in similar ranges at all evaluated timepoints. Despite lower NAb titers observed in Asia from D29, GMT values remain well above the threshold considered for protection in all regions.</div></div><div><h3>Conclusion</h3><div>Immunogenicity of vYF is non-inferior to YF-VAX and Stamaril, inducing seroprotective NAb responses in 18 to 60-year-old vaccinees to 1-year post-vaccination. Reduced NAb titers in Asia relative to the US and Europe did not diminish rates of seroprotection. These results are encouraging for addressing unmet public health needs during YF outbreaks.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107447"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical evaluation of a fully-human, quadrivalent-hantavirus polyclonal antibody derived from non-human source.","authors":"Dr Jay Hooper ,&nbsp;Dr Steve Kwilas ,&nbsp;Dr Rebecca Brocato ,&nbsp;Mr. Matthew Josleyn ,&nbsp;Ms. Lucia Principe ,&nbsp;Mr Joshua Shamblin ,&nbsp;Dr. Hua Wu ,&nbsp;Dr. Christoph Bausch ,&nbsp;Dr. Tom Luke ,&nbsp;Dr Priya Karmali ,&nbsp;Mr. Jerel Vega ,&nbsp;Dr Padmanabh Chivukaula ,&nbsp;Dr. Eddie Sullivan","doi":"10.1016/j.ijid.2024.107448","DOIUrl":"10.1016/j.ijid.2024.107448","url":null,"abstract":"<div><h3>Background</h3><div>Hantaviruses are rodent-borne viruses that can cause severe disease in infected humans. In the New World, major hantaviruses include Andes virus (ANDV) and Sin Nombre virus (SNV), and the disease is known as hantavirus pulmonary syndrome (HPS). In the Old World, major hantaviruses include Hantaan virus (HTNV) and Puumala virus (PUUV), and the disease is known as hemorrhagic fever with renal syndrome (HFRS). Previously, transchromsomic bovines (TcBs) were used and engineered to produce fully human antibodies to produce anti-HPS human polyclonal neutralizing antibody (SAB-400) that protected Syrian hamsters against lethal disease caused by ANDV and SNV; and anti-HFRS human polyclonal neutralizing antibody, SAB-159 and SAB-159P, that protected hamsters against infection with HTNV and PUUV, respectively.</div></div><div><h3>Methods &amp; Materials</h3><div>Here, the same approach was used to produce a candidate cGMP product (SAB-163) targeting both HFRS and HPS. Two TcB animals were produced and qualified for cGMP antibody manufacturing. One animal was vaccinated with a lipid nanoparticle (LNP)-formulated ANDV and a SNV M gene-based DNA vaccine and a second animal was vaccinated with LNP-formulated HTNV and PUUV DNA vaccine. The hantavirus M gene encodes the viral envelop glycoproteins. The resultant fully-human, polyclonal antibody purified from the combined plasma from the two TcBs was designated SAB-163.</div></div><div><h3>Results</h3><div>SAB-163 has potent neutralizing antibodies (PRNT50 &gt;200,000) against the four targeted hantaviruses, and cross-neutralization against several other heterotypic hantaviruses, albeit with lower titers. SAB-163 was tested for safety in a GLP toxicity study in rabbits and human tissue binding study and was found to be safe. SAB-163 was tested for efficacy in Syrian hamsters. At a dosage of 10 mg/kg, SAB-163 is bioavailable in hamsters out to 70 days post-treatment with a half-life of 10-15 days. At this same dosage, SAB-163 administered 1 day or out 5 days after exposure protected all hamsters from lethal disease caused by ANDV. At a higher dose, partial protection was achieved as late as day 6 in the ANDV model. SAB-163 also protected hamsters in the HTNV, PUUV, and SNV infection models when administered 1 day before or up to 3 days after challenge.</div></div><div><h3>Conclusion</h3><div>The candidate product is attractive because it is fully-human, polyclonal, safe and effective in animal models, and was produced from plasma collected within ∼100 days without the use of blood products from HFRS or HPS patients. Essentially, the virus sequence information was transformed into a candidate human polyclonal antibody product capable of protecting against prototype hantaviruses from Asia, Europe, and the Americas.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107448"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closing the equity gap – opportunities and challenges in unlocking the value of immunizing children","authors":"Rudzani Muloiwa","doi":"10.1016/j.ijid.2025.107822","DOIUrl":"10.1016/j.ijid.2025.107822","url":null,"abstract":"<div><div>Infection remains one of the greatest killers of children in the world. A large proportion of these deaths are due to infectious agents for which effective vaccines are already available.</div><div>Vaccination has been one the most successful and cost-effective public health interventions of the 20th century. Data indicates that the greatest return on investment from vaccination disproportionately accrues to the poorest communities. Unfortunately, access to vaccines is not equitable, with the most vulnerable least likely to receive them.</div><div>Using global data on the burden of disease, vaccination coverage, historical patterns of vaccine introduction and uptake, as well as access to currently available antigens, the talk will highlight the inequities in immunization practices and explore their causes. In addition, the talk will challenge the ethical framework that perpetuates these iniquities and suggests potential opportunities for addressing them.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107822"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Tract Infections at Mass Gatherings","authors":"Prof Jaffar Al-tawfiq","doi":"10.1016/j.ijid.2025.107819","DOIUrl":"10.1016/j.ijid.2025.107819","url":null,"abstract":"<div><h3>Introduction</h3><div>Large-scale events that bring people together, like music festivals, athletic competitions, and religious pilgrimages, can foster the spread of respiratory pathogens by drawing large crowds of people in close quarters. Planning and implementing public health interventions and plans effectively requires an understanding of the dynamics and effects of RTIs in these contexts.</div></div><div><h3>Methods</h3><div>A thorough literature review was done to look at reports and studies about RTIs at large gatherings. Using electronic databases like PubMed, Scopus, and Google Scholar, pertinent articles were found. \"Respiratory tract infections,\" \"mass gatherings,\" \"outbreaks,\" and associated keywords were among the search terms used. The review included studies that looked at the epidemiology, risk factors, transmission patterns, and interventions for RTIs in situations involving large crowds.</div></div><div><h3>Results</h3><div>The analysis produced a number of important conclusions. First off, respiratory viruses like influenza, respiratory syncytial virus (RSV), and coronaviruses are the main causes of RTIs, which are frequently observed during large crowds. Second, the quick spread of respiratory pathogens is facilitated by close contact between attendees, insufficient ventilation, and overcrowding. Third, elements including the length of the event, the type of activities, and the participants' demographics all have an impact on the risk of RTI transmission. Fourth, successful preventive initiatives have demonstrated encouraging outcomes in lowering the incidence of RTIs at large gatherings. These initiatives include vaccination campaigns, hand hygiene promotion, and respiratory etiquette.</div></div><div><h3>Discussion</h3><div>In order to lessen the impact of RTIs at large gatherings, it is crucial to conduct proactive surveillance, evaluate risks, and put preventive measures in place. Combining public health strategies like case isolation, early detection, and contact tracing can help manage outbreaks and reduce the spread of respiratory pathogens. Furthermore, the implementation of technology-driven monitoring platforms and crowd control techniques can facilitate the prompt detection and remediation of possible epidemics.</div></div><div><h3>Conclusion</h3><div>Since mass gatherings are high-density events, respiratory tract infections are a significant risk. To lessen the effects of RTIs and safeguard the public's and participants' health, thorough planning is necessary. This includes providing an appropriate healthcare infrastructure, communicating effectively, and implementing targeted preventive interventions. Subsequent investigations ought to concentrate on assessing the efficacy of interventions and improving tactics to augment respiratory infection control during large-scale assemblies.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107819"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Societal values for health inequality aversion via vaccine and non-vaccine interventions in Canada – a benefit trade-off analysis","authors":"Prof Beate Sander ,&nbsp;Dr Shehzad Ali ,&nbsp;Dr Sharmistha Mishra ,&nbsp;Dr Beate Sander","doi":"10.1016/j.ijid.2024.107454","DOIUrl":"10.1016/j.ijid.2024.107454","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Canada is committed to reducing avoidable health inequalities associated with infectious diseases. However, conventional economic evaluation, a critical component of health technology assessments informing health resource allocation, fails to account for health equity issues. Conducting equity-informative economic evaluation requires understanding the extent to which Canadians are averse to health inequalities. Therefore, the objective of our study was to elicit Canadians’ aversion to reduce health inequalities, and whether these preferences varied when evaluating interventions specific to infectious diseases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted three online surveys among representative samples of adult Canadians to elicit value judgements about reducing health inequality between populations with the highest and lowest income (i.e., household income quintiles) vs. improving overall health irrespective of its distribution (i.e., life expectancy). The first survey was specific to infectious diseases, and respondents were asked to choose between a universal and a tailored vaccination program. Tailored vaccination (e.g., special outreach for underserved populations) had a more equitable distribution of additional life years, while universal vaccination was more efficient. The second survey compared universal vs. tailored prevention programs. Finally, the third survey presented generic health programs (program A vs. program B). We used benefit trade-off analysis to estimate health inequality aversion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We recruited 3,000 adult Canadians (1,000 for each survey). Preferences for the vaccine, prevention, and generic programs were distributed as follows: minimizing inequalities (i.e., egalitarians): 54%, 55%, and 57%, respectively; maximizing the health of the population with the highest income (i.e., pro-rich): 31%, 22%, and 16% respectively; willingness to trade some health to reduce inequalities (i.e., weighted prioritarians): 13%, 19%, and 22% respectively; and maximizing total health, regardless of how life years were distributed (i.e., health maximizers): 2%, 3%, and 2%, respectively. The median respondent preferred minimizing health inequalities, across the three surveys. A stronger aversion for health inequality was observed among females, younger respondents (18-40 years old), and populations with lower income (&lt;$50,000 household income per year).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Preferences for reducing health inequality were impacted by the type of interventions being compared. When evaluating vaccine-specific programs, most respondents were located at the extremes of the distribution (i.e., pro-rich or egalitarians), while utilizing generic terminology (i.e., generic programs) reduced the proportion of inequality-seeking preferences. However, over half of the respondents were consistently willing to minimize health inequalities regardless of the cost to ","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107454"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Pillbox-enabled Self-administered Therapy Versus Standard Directly Observed Therapy for Tuberculosis Medication Adherence and Treatment Outcomes in Ethiopia: a Multicenter Randomized Controlled Trial","authors":"Dr Tsegahun Manyazewal ,&nbsp;Dr. Yimtubezinash Woldeamanuel ,&nbsp;Mr. Tewodros Getinet ,&nbsp;Ms Alison Hoover ,&nbsp;Dr Kidist Bobosha ,&nbsp;Mr Oumer Fuad ,&nbsp;Dr. Belete Getahun ,&nbsp;Prof. Abebaw Fekadu ,&nbsp;Dr. David Holland ,&nbsp;Prof. Vincent Marconi","doi":"10.1016/j.ijid.2024.107397","DOIUrl":"10.1016/j.ijid.2024.107397","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The prolonged and complex nature of anti-tuberculosis regimens contributes to suboptimal medication adherence, leading to poor treatment outcomes and drug resistance. Trials evaluating the effectiveness of digital adherence technologies are urgently needed. This study aimed to evaluate the effectiveness of pillbox-enabled self-administered therapy (SAT) compared to standard DOT on adherence to tuberculosis medication and treatment outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this multicenter, randomized controlled trial, adults diagnosed with new or previously treated, bacteriologically-confirmed, drug-sensitive pulmonary tuberculosis and eligible to commence anti-tuberculosis therapy were enrolled from 10 healthcare facilities across Ethiopia. Participants were allocated in a 1:1 ratio to either receive a 15-day supply of tuberculosis medication dispensed with an evriMED500® digital medication event reminder and monitor (MERM) device for self-administration and return every 15 days, or to undergo standard DOT. The MERM device integrates an electronic module and medication container, serving to record adherence, securely store medication, emit audible and visual alarms onboard to prompt patients for timely intake and refills, and facilitates healthcare providers in downloading data for monitoring adherence closely. Both groups were monitored throughout the standard two-month intensive treatment phase. The primary endpoints, analyzed following the intention-to-treat (ITT) principle, included were individual-level percentage adherence during the two-month intensive phase, and sputum smear conversion. Secondary endpoints were a negative IsoScreen urine isoniazid test, adverse treatment outcomes, and self-reported adherence. ClinicalTrials.gov: NCT04216420.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 337 patients underwent eligibility screening, with 114 randomly assigned and included in the final analysis (57 in the control group and 57 in the intervention group). Adherence to tuberculosis medication showed comparable rates between the intervention arm (geometric mean percentage [GM%] 99.01%, geometric standard deviation [GSD] 1.02) and the control arm (GM% 98.97%, GSD 1.04), falling within the predefined margin for non-inferiority [mean ratio (MR) 1.00 (95% CI 0.99-1.01); p=0.954]. Urine isoniazid testing was conducted on 443 (97%) samples obtained from 114 participants, revealing that 13 participants yielded at least one negative result. A negative test was more prevalent among the control group compared to the intervention group (p=0.008). There were no significant difference observed regarding smear conversion, adverse treatment outcomes, and self-reported non-adherence.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;In this randomized controlled trial involving patients with drug-susceptible pulmonary tuberculosis, self-administered therapy facilitated by the MERM device demonstrated treatment adherence comparable","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107397"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}