Explore the vast range of titles available.

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated in Wuhan, China in late 2019, and its resulting coronavirus disease, COVID-19, was declared a pandemic by the World Health Organization on March 11, 2020. The rapid global spread of COVID-19 represents perhaps the most significant public health emergency in a century. As the pandemic progressed, a continued paucity of evidence on routes of SARS-CoV-2 transmission has resulted in shifting infection prevention and control guidelines between classically-defined airborne and droplet precautions. During the initial isolation of 13 individuals with COVID-19 at the University of Nebraska Medical Center, we collected air and surface samples to examine viral shedding from isolated individuals. We detected viral contamination among all samples, supporting the use of airborne isolation precautions when caring for COVID-19 patients.

BackgroundAerosol transmission of COVID-19 is the subject of ongoing policy debate. Characterizing aerosol produced by people with COVID-19 is critical to understanding the role of aerosols in transmission.ObjectiveWe investigated the presence of virus in size-fractioned aerosols from six COVID-19 patients admitted into mixed acuity wards in April of 2020.MethodsSize-fractionated aerosol samples and aerosol size distributions were collected from COVID-19 positive patients. Aerosol samples were analyzed for viral RNA, positive samples were cultured in Vero E6 cells. Serial RT-PCR of cells indicated samples where viral replication was likely occurring. Viral presence was also investigated by western blot and transmission electron microscopy (TEM).ResultsSARS-CoV-2 RNA was detected by rRT-PCR in all samples. Three samples confidently indicated the presence of viral replication, all of which were from collected sub-micron aerosol. Western blot indicated the presence of viral proteins in all but one of these samples, and intact virions were observed by TEM in one sample.SignificanceObservations of viral replication in the culture of submicron aerosol samples provides additional evidence that airborne transmission of COVID-19 is possible. These results support the use of efficient respiratory protection in both healthcare and by the public to limit transmission.

Building on our previous work showing that pooled urine testing can rapidly detect Schistosoma haematobium infections but has limited sensitivity in low-intensity settings or with large pool sizes, this study evaluated how urine volume, pool size, infection intensity, and diagnostic method affect the detection and quantification of S. haematobium eggs in pooled samples. Between July 2022 and April 2023, 2,134 urine samples from school-age children living in three regional states of Ethiopia were individually examined by deploying urine filtration microscopy (UFM). Subsequently, 5, 10, 20 and 40 individual samples were strategically pooled and examined by deploying UFM and Fluke Catcher (FC) and varying volumes of urine (10, 20 and 30 mL). UFM was significantly more sensitive than FC for detecting S. haematobium eggs in pooled urine samples ([Formula: see text] =0.83, p < 0.001). There were significant interactions between the mean log of urine egg count (UEC) and volume of urine ([Formula: see text] =0.01, p = 0.021) or pool size ([Formula: see text] =-0.02, p = 0.007) for detecting S. haematobium eggs in pooled samples. The odds of detecting eggs in pooled samples in which the mean UEC of individual samples equaled 10 eggs/mL were 0.78 (95% CI:0.67-0.90) and 0.60 (95% CI:0.51-0.76) times lower when 10 mL rather than 20 mL and 30 mL was examined, respectively. There was a moderate or strong positive correlation between the mean egg count of pooled samples and the average egg count of the individual samples making the pools when pool sizes were 5, 10 or 20 (r ≥ 0.5). The diagnostic sensitivity of pooled testing for diagnosing S. haematobium infection is affected by a complex interplay between the pool size, the volume of urine examined, the mean UEC and the diagnostic method. The sensitivity of the pooled testing strategy may increase with larger urine volumes, higher infection intensity, and when UFM (rather than FC) is used for testing. However, sensitivity could decrease as the pool size increases. Use of UFM, larger urine volumes and smaller to moderate pool sizes could improve detection of S. haematobium infection in surveillance and mass deworming programs in low-intensity settings.

Background. Ebola virus disease (EVD) in health workers (HWs) has been a major challenge during the 2014–2015 outbreak. We examined factors associated with Ebola virus exposure and mortality in HWs in Kenema District, Sierra Leone. Methods. We analyzed data from the Sierra Leone National Viral Hemorrhagic Fever Database, contact tracing records, Kenema Government Hospital (KGH) staff and Ebola Treatment Unit (ETU) rosters, and burial logs. Results. From May 2014 through January 2015, 600 cases of EVD originated in Kenema District, including 92 (15%) HWs, 66 (72%) of whom worked at KGH. Among KGH medical staff and international volunteers, 18 of 62 (29%) who worked in the ETU developed EVD, compared with 48 of 83 (58%) who worked elsewhere in the hospital. Thirteen percent of HWs with EVD reported contact with EVD patients, while 27% reported contact with other infected HWs. The number of HW EVD cases at KGH declined roughly 1 month after implementation of a new triage system at KGH and the opening of a second ETU within the district. The case fatality ratio for HWs and non-HWs with EVD was 69% and 74%, respectively. Conclusions. The cluster of HW EVD cases in Kenema District is one of the largest ever reported. Most HWs with EVD had potential virus exposure both inside and outside of hospitals. Prevention measures for HWs must address a spectrum of infection risks in both formal and informal care settings as well as in the community.

This study evaluated the performance of urine reagent strips (URSs) in detecting Schistosoma haematobium infection in individual and pooled urine samples. Between June 2022 and April 2023, 2634 urine samples (10 mL each) from school-age children (5–15 years) in 15 villages across Ethiopia’s Afar, Benishangul-Gumuz, and Gambella regions were tested using urine filtration microscopy (UFM) and URSs for blood, a marker of S. haematobium eggs. Pooled samples from 5, 10, 20, and 40 individuals (one positive, others negative) were examined with both methods. UFM results were used to calculate URSs’ sensitivity, specificity, and predictive values for detecting infection. A total of 2634 children were screened for S. haematobium infection. UFM detected S. haematobium eggs in 370 samples, while URSs identified infection in 414 children. URSs showed 64% sensitivity and 92% specificity for individual samples. The positive and negative predictive values for individual samples were 57% and 94%, respectively. Sensitivity for pooled samples ranged from 47% (pools of 40) to 53% (pools of 20). In pools with one positive sample, URSs misclassified 220 (50%), 109 (49.5%), 52 (47.0%), and 28 (50.9%) pools as negative for S. haematobium eggs for pool sizes 5, 10, 20, and 40, respectively. Sensitivity for individual samples was higher in children with heavy infection (92.5%) compared to light infection (55.9%), and sensitivity in pooled samples increased with infection intensity (p < 0.001). In conclusion, URSs may misclassify S. haematobium infection in children when samples are examined individually or in pools, potentially leading to unnecessary treatment or missed cases. However, URSs shows promise as a screening tool for detecting S. haematobium infection in areas with high infection intensity.

Abstract In this perspective, we discuss the importance of developing a vaccine to help curb transmission of severe acute respiratory syndrome coronavirus 2. The question remains: Once a safe and effective vaccine is developed, will the public be willing to get it? We present information from one of the first tracking polls to assess public attitudes and perceptions toward a possible coronavirus disease 2019 vaccine that suggests public hesitancy over a potential vaccine, concern regarding accelerating clinical trials, and unease over the vaccine approval process. Public health experts, government officials, advocates, and others in the scientific community should respect the signals of hesitancy and communicate sensitivity, applying lessons not only to how we message, but also in how we build this urgently needed vaccine if we are to have successful uptake once available.

Background/Objectives: Praziquantel is a cornerstone of schistosomiasis control and elimination efforts. Continued surveillance of praziquantel efficacy is needed to monitor for the development of resistance, as well as to help public health officials gauge the effect of mass praziquantel administration on schistosomiasis control in communities, since it is the only drug used in schistosomiasis control programs. The objective of this study was to assess the praziquantel cure rate and egg reduction rate against urogenital schistosomiasis. Methods: This study enrolled 977 children from 12 villages in Afar and Gambella, Ethiopia, who provided urine samples that were checked for Schistosoma haematobium infection at baseline using urine filtration microscopy. Infected individuals were provided a single dose of praziquantel (40 mg/kg body weight) and retested six weeks post-treatment. Results:S. haematobium was recovered from baseline urine specimens in 177 of 977 (18%) participating children. One hundred six of these children completed therapy and presented for subsequent evaluation at six weeks; 91 children were egg-free. The egg reduction rate was 97%; changes in egg burden among the 15 children who did not achieve cure varied widely. Cure rates were better among children with light-intensity infections. No significant differences in egg reduction rates were found based on the demographic variables examined. Conclusions: Standard praziquantel monotherapy remains an effective treatment against urogenital schistosomiasis in Ethiopia.

This quasi-experimental trial examined the relationship between Schistosoma haematobium infection and nutritional status, and the impact of single dose praziquantel (PZQ) therapy on undernutrition. A total of 353 children were examined, 112 of which were infected with S. haematobium and treated with PZQ. Children’s heights, weights, and mid-upper arm circumferences (MUAC) were measured at baseline and one month post-treatment. Infected children had significantly smaller mean BMI-for-age z-scores (BAZ) (−1.16 vs. 0.11, p < 0.01) and weight-for-age z-scores (WAZ) (−0.61 vs. −0.31, p = 0.03) than the uninfected ones at baseline. S. haematobium infection was associated with underweight (adjusted OR: 1.76, 95% CI: 1.63–1.90). One month after treatment, BAZ, WAZ, height for age z-scores (HAZ), and MUAC scores were comparable between treated and control children. However, there was a significant decrease in the prevalence of underweight among treated children, while no significant change was observed in the control group one month post-treatment. In conclusion, children infected with S. haematobium are likely to suffer from undernutrition; however, single dose PZQ therapy may not improve their nutritional status within one month of treatment. Future studies could have longer follow-up periods to better estimate the drug’s effect on nutrition.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.An amendment to this paper has been published and can be accessed via a link at the top of the paper.