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Objective To identify the multilocus sequence typing (MLST) sequence types of Borrelia burgdorferi from Ixodes scapularis in Ontario, Canada. Results One hundred and eighty-five I. scapularis ticks were submitted from 134 dogs via participating clinics from April 1, 2019, to March 31, 2020. Seventeen MLST sequence types of B. burgdorferi were detected from fifty-eight cultured isolates from 21 ticks. The most common MLST sequence types were 12 and 16. Mixed infections of two MLST sequence types were detected in four ticks. Three sequence types (48, 317, 639) were new detections in Ontario.

Background In the Americas, sand flies of the Lutzomyia genus are the vectors of pathogens of human and animal health significance. Lutzomyia shannoni is suspected to transmit vesicular stomatitis virus, along with Leishmania mexicana and Leishmania infantum (causative agents of leishmaniases). Despite the suspected vector potential of Lu. shannoni , significant knowledge gaps remain, including how ongoing climate changes could facilitate their range expansion. The objectives of this study were to predict the current and future ecological suitability of regions across North America for Lu. shannoni and to identify variables driving ecological suitability. Methods Occurrence records were obtained from the Global Biodiversity Information Facility, Disease Vectors Database, the National Museum of Natural History (Smithsonian Institution) and published literature on Lu. shannoni surveillance and capture. Historical climate data from 1991–2020, along with projection data for Shared Socioeconomic Pathways 2–4.5 and 3–7.0 were obtained. An additional terrestrial ecoregions layer was applied. The ecological niche model was created using maximum entropy (MaxEnt) algorithms to identify regions which currently are or may become ecologically suitable for Lu. shannoni . Results Currently, regions in eastern, western and southern Mexico, along with the Midwest, southeastern and eastern regions of the USA are ecologically suitable for Lu. shannoni . In the future, ecological suitability for Lu. shannoni is expected to increase slightly in the northeastern regions of the USA and in Atlantic Canada, and to decrease in the southeastern reaches of Mexico. Degree-days below 0 °C (spring and autumn), precipitation as snow (summer and winter), terrestrial ecoregions, number of frost-free days (summer), Hargreaves climatic moisture deficit (summer), degree-days above 5 °C (autumn) and Hogg’s climatic moisture index (summer) were all identified as predictors of ecological suitability. Conclusions The findings from this study identified climate and environmental variables driving the ecological suitability of regions for Lu. shannoni and can be used to inform public health professionals of high-risk regions for exposure at present and into the future. Graphical abstract

Background The blacklegged tick (BLT) is a vector for the bacterium Borrelia burgdorferi (Bb), which causes Lyme disease. Range expansion of the BLT in Canada is related to an increased risk of Lyme disease in many regions. Current literature, such as the 2018 American College of Veterinary Internal Medicine consensus statement, suggests that there may be differences in the approaches of veterinarians who encounter dogs exposed to Bb and dogs with Lyme disease. Objectives To determine current knowledge, attitudes, and practices of Canadian veterinarians regarding Lyme disease in dogs. Animals None. Methods An online survey was distributed to Canadian veterinarians through veterinary associations and industries. Survey responses were analyzed using descriptive statistics, spatial analysis, Fisher's exact tests, and univariable logistic regression. Results At the completion of the survey, 192 responses were received from veterinarians practicing in all 10 Canadian provinces. Answers to short scenario and treatment questions reflected a wide variety of clinical approaches taken by veterinarians. Regional differences were seen in reported tick distribution and clinical approaches. Conclusions and Clinical Importance Regional differences and generalized differences were found in approaches used by responding Canadian veterinarians with regard to managing Bb exposure and Lyme disease in dogs. We identified areas for future research and knowledge mobilization for veterinarians.

Numerous tick species are undergoing significant range expansion in Canada, including several Dermacentor spp Koch (Acari: Ixodidae). With the recent description of Dermacentor similis Lado in the western United States, additional research is required to determine the current range of this species. Five hundred ninety-eight Dermacentor spp. were collected from companion animals in the western Canadian provinces of British Columbia, Alberta, and Saskatchewan. Ticks were morphologically identified to species, followed by PCR and gel electrophoresis of the ITS-2 partial gene target (n = 595). Ninety-seven percent (n = 579/595) generated valid banding patterns. The banding pattern for the majority (74%, n = 206/278) of Dermacentor spp. from southern British Columbia was consistent with D. variabilis (Say), while 26% (n = 72/278) was consistent with D. andersoni Stiles. For samples from Alberta, 38% (n = 3/8) had banding patterns consistent with D. variabilis and 63% (n = 5/8) with D. andersoni. All (n = 293) ticks from Saskatchewan had banding patterns consistent with D. variabilis. After the description of D. similis was published, DNA sequencing of mitochondrial (16S rDNA gene, COI gene) and nuclear (ITS-2) markers was used to confirm the identity of 40 samples. Twenty-seven samples that had banding patterns consistent with D. variabilis from British Columbia were confirmed to be D. similis. One sample from Alberta and five from Saskatchewan were confirmed to be D. variabilis and seven samples from British Columbia were D. andersoni. The ITS-2 amplicons were not useful for differentiating between D. variabilis and D. similis. These results provide evidence of D. similis in western Canada and highlight that sequences of the mitochondrial genes are effective for distinguishing D. andersoni, D. variabilis, and D. similis.

Background The reporting of surgical instrument errors historically relies on cumbersome, non-automated, human-dependent, data entry into a computer database that is not integrated into the electronic medical record. The limitations of these reporting systems make it difficult to accurately estimate the negative impact of surgical instrument errors on operating room efficiencies. We set out to determine the impact of surgical instrument errors on a two-hospital healthcare campus using independent observers trained in the identification of Surgical Instrument Errors. Methods This study was conducted in the 7 pediatric ORs at an academic healthcare campus. Direct observations were conducted over the summer of 2021 in the 7 pediatric ORs by 24 trained student observers during elective OR days. Surgical service line, error type, case type (inpatient or outpatient), and associated length of delay were recorded. Results There were 236 observed errors affecting 147 individual surgical cases. The three most common errors were Missing+ ( n  = 160), Broken/poorly functioning instruments ( n  = 44), and Tray+ ( n  = 13). Errors arising from failures in visualization (i.e. inspection, identification, function) accounted for 88.6% of all errors (Missing+/Broken/Bioburden). Significantly more inpatient cases (42.73%) had errors than outpatient cases (22.32%) ( p  = 0.0129). For cases in which data was collected on whether an error caused a delay (103), over 50% of both IP and OP cases experienced a delay. The average length of delays per case was 10.16 min. The annual lost charges in dollars for surgical instrument associated delays in chargeable minutes was estimated to be between $6,751,058.06 and $9,421,590.11. Conclusions These data indicate that elimination of surgical instrument errors should be a major target of waste reduction. Most observed errors (88.6%) have to do with failures in the visualization required to identify, determine functionality, detect the presence of bioburden, and assemble instruments into the correct trays. To reduce these errors and associated waste, technological advances in instrument identification, inspection, and assembly will need to be made and applied to the process of sterile processing.

Rift Valley fever (RVF) is a re-emerging vector-borne zoonotic disease that causes outbreaks in humans and animals across Africa. To better understand RVF at human–animal interfaces, a prospective longitudinal survey of people, livestock, and mosquitoes was conducted from 2016 to 2018, in two regions of Tanzania, with distinct climatic zones (Iringa and Morogoro). Molecular and serological tools for testing (RT-qPCR and IgM/IgG ELISA) for RVF virus (RVFV) were used to assess infection and exposure in people and animals. Mosquitoes were collected quarterly from 10 sentinel locations. In total, 1385 acutely febrile humans, 4449 livestock, and 3463 mosquito pools were tested. In humans, IgM seroprevalence was 3.75% (n = 52/1385), and overall seroprevalence (IgM and/or IgG positive) was 8.30% (n = 115/1385). People from Iringa had a higher exposure risk than those from Morogoro (aOR 2.63), and livestock owners had an increased risk compared to non-owners (aOR 2.51). In livestock, IgM seroprevalence was 1.09%, while overall seroprevalence was 10.11%. A total of 68.4% of herds had at least one seropositive animal. Sentinel animal follow-up revealed that the probability of seroconversion was significantly higher in Morogoro. Low-level RVFV RNA was detected in 8 human and 22 mosquito pools. These findings indicate active transmission among vectors, livestock, and people during the study period, highlighting the need for One Health surveillance approaches for RVFV and other arboviruses.

Chronic symptoms reported following an infection with SARS-CoV-2, such as cognitive problems, overlap with symptoms included in the definition of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). To evaluate the prevalence of ME/CFS-like illness subsequent to acute SARS-CoV-2 infection, changes in ME/CFS symptoms through 12 months of follow-up, and the association of ME/CFS symptoms with SARS-CoV-2 test results at the acute infection-like index illness. This prospective, multisite, longitudinal cohort study (Innovative Support for Patients with SARS-CoV-2 Infections Registry [INSPIRE]) enrolled participants from December 11, 2020, to August 29, 2022. Participants were adults aged 18 to 64 years with acute symptoms suggestive of SARS-CoV-2 infection who received a US Food and Drug Administration-approved SARS-CoV-2 test at the time of illness and did not die or withdraw from the study by 3 months. Follow-up surveys were collected through February 28, 2023. COVID-19 status (positive vs negative) at enrollment. The main outcome was the weighted proportion of participants with ME/CFS-like illness based on the 2015 Institute of Medicine clinical case definition using self-reported symptoms. A total of 4378 participants were included in the study. Most were female (3226 [68.1%]). Mean (SD) age was 37.8 (11.8) years. The survey completion rates ranged from 38.7% (3613 of 4738 participants) to 76.3% (1835 of 4738) and decreased over time. The weighted proportion of participants identified with ME/CFS-like illness did not change significantly at 3 through 12 months of follow-up and was similar in the COVID-19-positive (range, 2.8%-3.7%) and COVID-19-negative (range, 3.1%-4.5%) groups. Adjusted analyses revealed no significant difference in the odds of ME/CFS-like illness at any time point between COVID-19-positive and COVID-19-negative individuals (marginal odds ratio range, 0.84 [95% CI, 0.42-1.67] to 1.18 [95% CI, 0.55-2.51]). In this prospective cohort study, there was no evidence that the proportion of participants with ME/CFS-like illness differed between those infected with SARS-CoV-2 vs those without SARS-CoV-2 infection up to 12 months after infection. A 3% to 4% prevalence of ME/CFS-like illness after an acute infection-like index illness would impose a high societal burden given the millions of persons infected with SARS-CoV-2.

While much of the focus on long COVID (LC; defined as developing new, persistent symptoms lasting 3 months or longer after SARS-CoV-2 infection) has been on health status and quality of life, the impact on individual work productivity and financial distress are less well established. To assess differences in work and financial outcomes among individuals with current, resolved, and no LC up to 3 years after initial infection. This prospective, multisite, longitudinal cohort study enrolled adult participants (age ≥18 years) with at least 1 reported SARS-CoV-2 infection from December 7, 2020, to August 29, 2022. Follow-up electronic surveys were collected through April 2, 2024. Data were analyzed from January 20 to February 4, 2025. Self-reported resolved or current LC and vaccination status. Financial toxicity was measured using Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy (FACIT-COST), and work impact was measured using the Work Productivity & Activity Impairment questionnaire (version 2.0). Of 3663 participants (mean [SD] age, 40.2 [14.2] years; 2429 [66.3%] female), 994 (27.1%) reported current LC, 2604 (71.1%) never had LC, and 65 (1.8%) had resolved LC. Participants with current LC reported more overall work impairment due to health (mean [SD], 17.7% [25.3%] of total hours worked per week) compared with those who never had LC (mean [SD], 3.2% [11.8%] of total hours) and resolved LC (mean [SD], 5.6% [12.2%] of total hours), with significantly increased odds of any work impairment compared with those who never had LC (adjusted odds ratio [aOR], 7.24; 95% CI, 5.68-9.21). The current LC group had increased odds of missing work due to their health (aOR, 2.62; 95% CI, 1.93-3.57) and of experiencing work impairment (aOR, 11.82; 95% CI, 8.90-15.70) compared with the group who never had LC. Individuals with current LC had increased odds of having moderate to high FACIT-COST scores compared with those who never had LC (aOR, 5.20; 95% CI, 3.92-6.89) and compared with those with resolved LC (aOR, 3.16; 95% CI, 1.19-8.41). Participants who were vaccinated had lower overall work impairment (aOR, 0.71; 95% CI, 0.55-0.92), impairment while working (aOR, 0.66; 95% CI, 0.50-0.87), impairment of nonwork activities (aOR, 0.74; 95% CI, 0.57-0.96), and financial toxicity (least-squares mean difference, 1.07; 95% CI, 0.19-1.95) compared with those who were not vaccinated. In this prospective cohort study of adults with SARS-CoV-2 infection, participants with current self-reported LC reported worse work impairment, missed work, and financial distress compared with those who never had LC, while vaccination was associated with improved work outcomes and less financial distress even among individuals with LC. These data underscore the need for postpandemic assistance programs, as well as vaccination to decrease societal harms.

Abstract Background While prior work examining severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern focused on hospitalization and death, less is known about differences in clinical presentation. We compared the prevalence of acute symptoms across pre-Delta, Delta, and Omicron. Methods We conducted an analysis of the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE), a cohort study enrolling symptomatic SARS-CoV-2-positive participants. We determined the association between the pre-Delta, Delta, and Omicron time periods and the prevalence of 21 coronavirus disease 2019 (COVID-19) acute symptoms. Results We enrolled 4113 participants from December 2020 to June 2022. Pre-Delta vs Delta vs Omicron participants had increasing sore throat (40.9%, 54.6%, 70.6%; P < .001), cough (50.9%, 63.3%, 66.7%; P < .001), and runny noses (48.9%, 71.3%, 72.9%; P < .001). We observed reductions during Omicron in chest pain (31.1%, 24.2%, 20.9%; P < .001), shortness of breath (42.7%, 29.5%, 27.5%; P < .001), loss of taste (47.1%, 61.8%, 19.2%; P < .001), and loss of smell (47.5%, 55.6%, 20.0%; P < .001). After adjustment, those infected during Omicron had significantly higher odds of sore throat vs pre-Delta (odds ratio [OR], 2.76; 95% CI, 2.26–3.35) and Delta (OR, 1.96; 95% CI, 1.69–2.28). Conclusions Participants infected during Omicron were more likely to report symptoms of common respiratory viruses, such as sore throat, and less likely to report loss of smell and taste. Trial registration NCT04610515.