International Journal of Infectious Diseases最新文献

{"title":"The current landscape in antibiotic access and supply issues: a qualitative study with key experts and opinion leaders","authors":"Dr Esmita Charani , Dr Vrinda Nampoothiri , Dr Ritika Kondal , Dr Avaneesh Pandey , Dr Oluchi Mbamalu , Dr Jennifer Cohn , Dr Sanjeev Singh , Dr Nusrat Shafiq","doi":"10.1016/j.ijid.2024.107391","DOIUrl":"10.1016/j.ijid.2024.107391","url":null,"abstract":"<div><h3>Introduction</h3><div>There is an increasing lack of access to safe and effective antibiotics for human consumption. We investigated the main drivers for current antibiotic shortages and existing mitigation strategies undertaken in different regions.</div></div><div><h3>Methods</h3><div>Purposive sampling was used to identify stakeholders with expertise in antibiotic access and supply chains. Consented participants were interviewed using a piloted semi-structured interview guide that was developed using the PESTELI (political, economic, sociological, ecological, technological, legal, industry) framework. Analysis and data collection are iterative and recursive, using constant comparison. Theoretical sampling is being applied to develop categories until saturation is reached.</div></div><div><h3>Results</h3><div>Between August 2023 and March 2024, 14 key stakeholders with local, national, and global roles in supply chain management (South Africa-7, UK-2, Sweden- 2, Netherlands-1, Belgium-1, USA-1) were interviewed. Political engagement on antibiotic shortages is reported to facilitate effective mitigation strategies, especially in areas where there is strong evidence of government investment. Political support manifests as legal measures for example in the EU and UK in supporting the response to shortages, giving rights to pharmacists to intervene through protocolized measures to use alternative agents, and negotiating with pharmaceutical companies for greater transparency on the challenges in manufacturing. Economic incentives are required at all levels and are currently missing. There is increasing monopolization of active pharmaceutical ingredients and raw materials in the pharmaceutical industry with a lack of information, partly due to technological insufficiency to gather appropriate data at scale across sectors for example on procurement in the community, for key antibiotics at high risk of being impacted by shortages. Sociological impacts and drivers of shortages include adopting appropriate communication to not cause panic buying and hoarding by organisations when there is an impending shortage and recognising the important role of a multidisciplinary response. The key stakeholders identified for developing mitigation strategies included pharmaceutical manufacturers, policymakers and regulators, and global organisations such as WHO. Mitigation strategies included moving stock between pharmacies, pharmacists being assigned to monitor antibiotic supply and shortages at the hospital level, and implementation of serious shortage protocols in the UK which enable pharmacists to dispense alternate antibiotics in case of shortages.</div></div><div><h3>Discussion</h3><div>There is a need for improved communications regarding shortages from the suppliers and transparency about potential problems in the supply chain. We were not able to interview actors from the pharmaceutical industry due to their restrictions which was a limitation since ","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107391"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520315","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":"Advanced HIV as a Neglected Disease","authors":"Joe Jarvis","doi":"10.1016/j.ijid.2024.107379","DOIUrl":"10.1016/j.ijid.2024.107379","url":null,"abstract":"<div><div>Although HIV treatment coverage has increased substantially in recent years, the associated reductions in AIDS-related deaths have been smaller and slower than expected. The proportion of people with advanced HIV disease remains high: it is estimated that more than 4 million people have advanced HIV disease, and each year more than 600,000 of them are expected to die. Many of these deaths can be prevented. Until recently, advanced HIV was viewed as a problem of late presentation, so the solution was thought to be testing more people and diagnosing the disease earlier. Although late presentation remains problematic, however, advanced HIV is now predominantly seen among people who started care but were not effectively engaged or have disengaged, returning only when they're ill. This talk will discuss who is at risk for the worst outcomes; which infections lead to the greatest morbidity and mortality; new tools for diagnosing, preventing, and treating these conditions; and how systems could adapt to delivering these tools effectively.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107379"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520319","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":"First reports of urogenital schistosomiasis in the Ndikiniméki health district, Centre-Cameroon","authors":"Mr Bienvenu Balifeli","doi":"10.1016/j.ijid.2024.107444","DOIUrl":"10.1016/j.ijid.2024.107444","url":null,"abstract":"<div><h3>Introduction</h3><div>Schistosomiasis is still a public health problem in Sub-Saharan Africa, particularly in Cameroon. In this context, a cross-sectional study was carried out from June 2023 to July 2023 in the Ndikiniméki subdivision with the aim of knowing the status of this locality in relation to Schistosoma haematobium infection.</div></div><div><h3>Methods</h3><div>Parasitological analysis of S. haematobium eggs was carried out on urine samples using the sedimentation technique.</div></div><div><h3>Results</h3><div>A total of 402 urine samples were collected from households. The age range of participants was 1 to 96 years, with the most signified age group being 1 to 9 years. Women were the most represented, with a proportion of 56.47%. Of the 402 people examined, 18 (4.45%) were affected, with an average intensity of 54.43±85.30 eggs/10ml urine. Women were the most affected, with a prevalence and average parasite intensity of 3.73% and 53.10±131.27 eggs/10ml of urine. The most affected age group was 10 to 19-year-olds, with a prevalence and intensity of 4.60% and 49.49±67.00 eggs per 10 ml of urine, respectively. Of those infected, 72.22% were lightly infected and 27.28% were heavily infected.</div></div><div><h3>Conclusions</h3><div>This study indicates that this locality is a risk area for urinary schistosomiasis despite its low prevalence.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107444"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520495","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":"A comparative analysis of the impact of climate change on emergence of infectious diseases and outbreaks in remote areas of Sindh, Pakistan","authors":"Miss Hafsa Faruqui,&nbsp;Dr. Saeed Khan","doi":"10.1016/j.ijid.2024.107430","DOIUrl":"10.1016/j.ijid.2024.107430","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Remote areas in the Sindh province of Pakistan are characterized by challenging terrain, limited access to healthcare, and poor infrastructure. These regions often face a higher burden of infectious diseases due to the lack of proper healthcare facilities. Diagnostic surveillance plays a crucial role in monitoring disease prevalence since it enables early detection, timely intervention, and developing effective public health strategies. Among other factors, climate change also influences disease distribution and severely impacts the incidence of several illnesses. For instance, recent flooding in Sindh caused a surge in waterborne diseases, due to contaminated water sources and inadequate sanitation that act as breeding grounds for pathogens. Comparative analysis of disease surveillance pre- and post-floods can help in understanding the changes in disease dynamics which are instrumental in refining public health strategies and optimizing resource allocation in the face of environmental challenges. This study was designed to compare and analyze disease distribution before and after the 2022 floods in remote areas of Sindh, Pakistan. By comparing the two time periods, the study aimed to identify seasonal trends for infectious diseases to design effective strategies that minimize transmission rates and reduce healthcare burden.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;To access the rough terrain in the remote areas of Sindh, a USAID funded, fully-equipped BSL-2 mobile laboratory with a team of microbiologists from the Provincial Public Health Laboratory, Dow University of Health Sciences visited Ratodero, Aarija Taluka, Kambar, Nasirabad, Dokery, Sukkur, and Gadap. This study happened in two phases, before and after the 2022 floods. Diagnostic tests for HIV, malaria, hepatitis B, hepatitis C, typhoid, and COVID-19 antibody were performed, along with complete blood count.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 2858 tests were performed out of which 56% were males and 44% females. During phase I (pre-floods), 5.2% had malaria, 1.9% had HCV, and 12% were positive for COVID-19 antibody. During phase II (post-floods), 46.6% were positive for malaria, 31.7% for COVID-19 antibody, 9.2% for HCV, 8% COVID-19 antigen, and few cases of HIV, hepatitis B, and typhoid were also detected.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;This study highlights the pressing health challenges faced by remote areas in Sindh, Pakistan, exacerbated by climate change-induced events like floods. The comparative analysis of disease distribution before and after the 2022 floods underscores the vulnerability of these regions to infectious diseases like malaria and COVID-19.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Climate change poses a significant threat to low-income countries, especially remote areas, worsening the already considerable disease burden they face. Routine monitoring and surveillance of disease prevalence is crucial to create targeted","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107430"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520659","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":"Challenges in Managing Multidrug-Resistant Gram-Negative Infections","authors":"Dr George Varghese","doi":"10.1016/j.ijid.2025.107820","DOIUrl":"10.1016/j.ijid.2025.107820","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Multidrug-resistant Gram-negative infections pose significant challenges, particularly in developing countries where carbapenem-resistant organisms, such as Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa (CRE, CRAB, and CRPA), are prevalent. The World Health Organization has highlighted these as priority pathogens due to their high rates of resistance and the urgent need for new antibiotics to treat them. This talk will address the challenges in managing these infections and explore current treatment options through instructive case scenarios and literature reviews.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We performed a comprehensive review of current literature on the global epidemiology and management of carbapenem-resistant infections, particularly with polymyxin-based therapies and newer beta-lactam/beta-lactamase inhibitor (BL/BLI) combinations. The molecular mechanisms responsible for carbapenem-resistant infections, the uniqueness of different pathogens, and the distribution of resistance across geographical locations were examined. Clinical outcomes from recent studies and trials were analyzed to assess the effectiveness and limitations of available treatment options to help clinicians choose appropriate treatment strategies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In 2019, there were 4.95 million deaths related to global antimicrobial resistance (AMR), and it was projected that by 2050, there will be 10 million annual deaths attributable to AMR. Developing nations experience a disproportionately higher burden of AMR-related deaths. In India alone, 297,000 deaths in 2019 were attributable to AMR, with 1,042,500 deaths associated with it. Most AMR-associated deaths were due to three priority pathogens: Escherichia coli (152,700 deaths), Klebsiella pneumoniae (123,200 deaths), and Acinetobacter baumannii (103,500 deaths). ESBL resistance among Enterobacterales was around 80%, with carbapenem resistance rates of 40-50% and 70-80% among Klebsiella and Acinetobacter strains, respectively. Although treatment with Polymyxin-based therapies is a mainstay in developing countries, it presents significant challenges due to dosing issues, poor drug concentration, and nephrotoxicity. Newer BL/BLIs, such as ceftazidime-avibactam and meropenem-vaborbactam, are promising alternatives but come with poor availability and high costs. They are also less effective against metallo-beta-lactamase-producing organisms like NDM, which are common in South and Southeast Asia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The management of carbapenem-resistant infections varies significantly between developed and developing countries. Despite their limitations, polymyxin-based therapies are commonly prescribed in developing countries due to their accessibility and low cost. Newer BL/BLIs show promise but have limitations, such as cost, availability and efficacy. The efficacy of these treatment options is further complicated b","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107820"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520467","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":"Exploring challenges in implementing antimicrobial stewardship interventions across eight African nations: A multi case study","authors":"Ms Maxencia Nabiryo ,&nbsp;Miss Maxencia Nabiryo ,&nbsp;Dr Helena Rosado ,&nbsp;Miss Frances Garraghan ,&nbsp;Miss Claire Brandish ,&nbsp;Miss Victoria Rutter","doi":"10.1016/j.ijid.2024.107394","DOIUrl":"10.1016/j.ijid.2024.107394","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme, funded by the UK Department of Health and Social Care's Fleming Fund and managed by the Commonwealth Pharmacists Association (CPA) and Tropical Health and Education trust (THET), currently supports 24 health partnerships (HPs) developing and implementing antimicrobial stewardship (AMS) interventions in 73 health facilities across eight African countries: Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia. This study assesses the barriers and challenges experienced by HPs in designing and implementing AMS interventions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;A qualitative case-study design was adopted, with data collection undertaken between June 2023 and March 2024 by in-person (THET and CPA) visits. Data collection methods included non-participant observations, formal and informal feedback from key stakeholders, semi-structured interviews and focus groups. Interview guides were designed based on the Consolidated Framework for Implementation Research to encourage systematic data collection and reporting, track progress and identify barriers encountered during implementation of AMS interventions. Qualitative data underwent thematic analysis using NVivo 14®.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Since the introduction of CwPAMS, a total of 15 AMS committees, 52 Point Prevalence Surveys (PPS) on antimicrobial use, and 21 AMS action plans have been developed and established across 73 health facilities, with 884 healthcare professionals completing AMS training. Key barriers reported by HPs included: challenges in PPS data collection due to lack, or inadequacy, of electronic patient record systems; delays in permissions and approvals (e.g. ethical approval); competing priorities (e.g. institutional priorities vs quality improvement initiatives); limited funding; challenges with procurement of medicines/reagents; over-ambitious projects as well as monitoring and evaluation plans. Health facilities also reported obstacles in antibiogram development due to inadequate sample sizes, secondary to limited access to diagnostics, reagents and consumables. HPs reported issues such as inconsistent access to running water, costly laboratory reagents with short expiry dates, staff shortages, and antibiotic stockouts. Reluctance to behavior change (especially prescribing practices), as well as time required for behavior change while implementing AMS interventions, were also commonly cited as barriers by HPs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Buy-in from multiple stakeholders across all levels and scope of practices have facilitated change management and supported implementation of AMS interventions. In addition, realignment of project plans when and where needed, as well as efforts to secure additional funding and resources are underway to address the challenges identified.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Multi-case study an","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107394"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520318","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,&nbsp;Dr Geetha Nagaraj,&nbsp;Mrs MR Shincy,&nbsp;Dr KL Ravikumar","doi":"10.1016/j.ijid.2024.107405","DOIUrl":"10.1016/j.ijid.2024.107405","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Result&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;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":"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":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Infectious diseases are a significant cause of morbidity and mortality in children.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;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).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;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":"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}