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The scientific community has come together in a mass mobilization to combat the public health risks of COVID-19, including efforts to develop a vaccine. However, the success of any vaccine depends on the share of the population that gets vaccinated. We designed a survey experiment in which a nationally representative sample of 3,133 adults in the USA stated their intentions to vaccinate themselves and their children for COVID-19. The factors that we varied across treatments were: the stated severity and infectiousness of COVID-19 and the stated source of the risk information (White House or the Centers for Disease Control). We find that 20% of people in the USA intend to decline the vaccine. We find no statistically significant effect on vaccine intentions from the severity of COVID-19. In contrast, we find that the degree of infectiousness of the coronavirus influences vaccine intentions and that inconsistent risk messages from public health experts and elected officials may reduce vaccine uptake. However, the most important determinants of COVID-19 vaccine hesitancy seem to be distrust of the vaccine safety (including uncertainty due to vaccine novelty), as well as general vaccine avoidance, as implied by not having had a flu shot in the last two years.

Overwhelming evidence shows that not only public health, but also society and the economy benefit greatly from reducing cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. [...]low case numbers save jobs and businesses. Making the case for the economic and social benefits of reducing case numbers will, if clearly communicated, greatly foster public cooperation.

Neglected tropical diseases blight the lives of a billion people worldwide and threaten the health of millions more. These close companions of poverty weaken impoverished populations, frustrate the achievement of health in the Millennium Development Goals and impede global public health outcomes. Wider recognition of the public health significance of neglected tropical diseases and better knowledge of their epidemiology have stimulated necessary changes in public health thinking to approach and achieve control. This report presents evidence to demonstrate that activities undertaken to prevent and control neglected tropical diseases are producing results Ц and that achievements are being recognized.By 2008, preventive chemotherapy had reached more than 670 million people in 75 countries.

The Ebola virus epidemic has topped media and political agendas for months; several countries in west Africa have faced the worst Ebola epidemic in history. At the beginning of the disease outbreak, European Union (EU) policies were notably absent regarding how to respond to the crisis. Although the epidemic is now receding from public view, this crisis has undoubtedly changed the European public perception of Ebola virus disease, which is no longer regarded as a bizarre entity confined in some unknown corner in Africa. Policy makers and researchers in Europe now have an opportunity to consider the lessons learned. In this Personal View, we discuss the EU's response to the Ebola crisis in west Africa. Unfortunately, although ample resources and opportunities for humanitarian and medical action existed, the EU did not use them to promote a rapid and well coordinated response to the Ebola crisis. Lessons learned from this crisis should be used to improve the role of the EU in similar situations in the future, ensuring that European aid can be effectively deployed to set up an improved emergency response system, and supporting the establishment of sustainable health-care services in west Africa.

IntroductionHand hygiene (HH) related illnesses such as diarrhoea and respiratory diseases, contribute to the burden of disease and are included in the top five causes of mortality in children under 5 years in South Africa. Children attending preschools are more susceptible to these infections due to the higher number of children in preschools. HH interventions have shown to reduce HH-related diseases by improving HH practices. In South Africa, there are no documented HH interventions or studies in children under 5 years. The purpose of the study is to determine whether an HH intervention can reduce HH-related diseases among 4–5-year-old preschool children and to improve HH practices in these children, their caregivers and their parents.Methodology and analysisThis is a protocol for a controlled intervention study to be conducted at preschools in Kempton Park, City of Ekurhuleni, Gauteng, South Africa. Preschools will be randomly distributed into control and experimental groups (n=70). The intervention includes interactive simulation learning, educational emails and education and poster reminders obtained from the WHO and the Global Handwashing Day website. Data collection, including the intervention, will take place during the calendar year as this coincides with the school year. Data will be analysed both preintervention and postintervention in the experimental group as well as between the experimental and control group. Data collected by means of questionnaires, observations, disease registers, hygiene inspections, semi-structured interviews and hand swabs will be analysed to determine these outcomes.Ethics and disseminationPermission has been obtained from the University of Johannesburg Ethics Committee and Ministerial Consent for Non-Therapeutic Research on Minors from the Department of Health National Ethics Research Council. Permissions for use of copyright protected materials has been obtained. Results of the study will be disseminated through peer-reviewed publications, and feedback within relevant structures through conference proceedings.

The infection fatality rate of COVID-19 is several-fold higher than that of seasonal influenza,2 and infection can lead to persisting illness, including in young, previously healthy people (ie, long COVID).3 It is unclear how long protective immunity lasts,4 and, like other seasonal coronaviruses, SARS-CoV-2 is capable of re-infecting people who have already had the disease, but the frequency of re-infection is unknown.5 Transmission of the virus can be mitigated through physical distancing, use of face coverings, hand and respiratory hygiene, and by avoiding crowds and poorly ventilated spaces. PK reports personal fees from Kymab, outside the submitted work; PK also has a patent ‘Monoclonal antibodies to treat and prevent infection by SARS-CoV-2 (Kymab)’ pending and is a scientific advisor to the Serology Working Group (Public Heath England), Testing Advisory Group (Department of Health and Social Care) and the Vaccines Task force (Department for Business, Energy and Industrial Strategy). CS reports grants from BMS, Ono-Pharmaceuticals, and Archer Dx (collaboration in minimal residual disease sequencing technologies), outside the submitted work; personal fees from Bristol Myers Squibb, Roche-Ventana, Ono Pharmaceutical, GlaxoSmithKline, Novartis, Celgene, Illumina, MSD, Sarah Canon Research Institute, Genentech, Bicycle Therapeutics, and Medicixi, outside the submitted work; personal fees and stock options from GRAIL and Achilles Therapeutics, outside the submitted work; and stock options from Epic Biosciences and Apogen Biotechnologies, outside the submitted work.

Measles is a highly contagious, potentially fatal, but vaccine-preventable disease caused by measles virus. Symptoms include fever, maculopapular rash, and at least one of cough, coryza, or conjunctivitis, although vaccinated individuals can have milder or even no symptoms. Laboratory diagnosis relies largely on the detection of specific IgM antibodies in serum, dried blood spots, or oral fluid, or the detection of viral RNA in throat or nasopharyngeal swabs, urine, or oral fluid. Complications can affect many organs and often include otitis media, laryngotracheobronchitis, pneumonia, stomatitis, and diarrhoea. Neurological complications are uncommon but serious, and can occur during or soon after the acute disease (eg, acute disseminated encephalomyelitis) or months or even years later (eg, measles inclusion body encephalitis and subacute sclerosing panencephalitis). Patient management mainly involves supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhoea. There is no specific antiviral therapy for the treatment of measles, and disease control largely depends on prevention. However, despite the availability of a safe and effective vaccine, measles is still endemic in many countries and causes considerable morbidity and mortality, especially among children in resource-poor settings. The low case numbers reported in 2020, after a worldwide resurgence of measles between 2017 and 2019, have to be interpreted cautiously, owing to the effect of the COVID-19 pandemic on disease surveillance. Disrupted vaccination activities during the pandemic increase the potential for another resurgence of measles in the near future, and effective, timely catch-up vaccination campaigns, strong commitment and leadership, and sufficient resources will be required to mitigate this threat.

AbstractObjectivesTo outline which infectious diseases in the pre-covid-19 era persist in children and adolescents in China and to describe recent trends and variations by age, sex, season, and province.DesignNational surveillance studies, 2008-17.Setting31 provinces in mainland China.Participants4 959 790 Chinese students aged 6 to 22 years with a diagnosis of any of 44 notifiable infectious diseases. The diseases were categorised into seven groups: quarantinable; vaccine preventable; gastrointestinal and enteroviral; vectorborne; zoonotic; bacterial; and sexually transmitted and bloodborne.Main outcome measuresDiagnosis of, and deaths from, 44 notifiable infectious diseases.ResultsFrom 2008 to 2017, 44 notifiable infectious diseases were diagnosed in 4 959 790 participants (3 045 905 males, 1 913 885 females) and there were 2532 deaths (1663 males, 869 females). The leading causes of death among infectious diseases shifted from rabies and tuberculosis to HIV/AIDS, particularly in males. Mortality from infectious diseases decreased steadily from 0.21 per 100 000 population in 2008 to 0.07 per 100 000 in 2017. Quarantinable conditions with high mortality have effectively disappeared. The incidence of notifiable infectious diseases in children and adolescents decreased from 280 per 100 000 in 2008 to 162 per 100 000 in 2015, but rose again to 242 per 100 000 in 2017, largely related to mumps and seasonal influenza. Excluding mumps and influenza, the incidence of vaccine preventable diseases fell from 96 per 100 000 in 2008 to 7 per 100 000 in 2017. The incidence of gastrointestinal and enterovirus diseases remained constant, but typhoid, paratyphoid, and dysentery continued to decline. Vectorborne diseases all declined, with a particularly noticeable reduction in malaria. Zoonotic infections remained at low incidence, but there were still unpredictable outbreaks, such as pandemic A/H1N1 2009 influenza. Tuberculosis remained the most common bacterial infection, although cases of scarlet fever doubled between 2008 and 2017. Sexually transmitted diseases and bloodborne infections increased significantly, particularly from 2011 to 2017, among which HIV/AIDS increased fivefold, particularly in males. Difference was noticeable between regions, with children and adolescents in western China continuing to carry a disproportionate burden from infectious diseases.ConclusionsChina’s success in infectious disease control in the pre-covid-19 era was notable, with deaths due to infectious diseases in children and adolescents aged 6-22 years becoming rare. Many challenges remain around reducing regional inequalities, scaling-up of vaccination, prevention of further escalation of HIV/AIDS, renewed efforts for persisting diseases, and undertaking early and effective response to highly transmissible seasonal and unpredictable diseases such as that caused by the novel SARS-CoV-2 virus.