The challenge of emerging and re-emerging infectious diseases

Cocrystallization of amantadine hydrochloride with nutrient: Insights into directed self- assembly and optimized biopharmaceutical character by integrating theory and experiment

In order to make full use of the advantages of phenolic acid nutraceutical p-coumaric acid (COA) in cocrystallizing with antiviral medication amantadine hydrochloride (ADH), further get innovative insights into assembling ADH-nutraceutical cocrystal and optimizing biopharmaceutical characters of ADH by combining experiment with theory, a novel cocrystal, ADH-COA, is prepared and structurally characterized. Single-crystal X-ray diffraction confirms that the cocrystal consists of COA and ADH molecules in a 1:2 ratio, building a three-dimensional supramolecular network strengthened by charge-assisted hydrogen bonds and tightly packed patterns, which is distinguished by two distinct conformations H-1 and H-2 arising from neutral COA molecules with different counter-ions of ADH within the lattice. These features endow the cocrystal with promoting charge dispersion and polarity reduction, resulting in 37.11 ∼ 41.39 % solubility reduction under different pH conditions versus raw ADH, contributing to mitigating side effects associated with excessive solubility of ADH. Such change of in vitro property, in turn, optimizes in vivo pharmacokinetics, showcasing the lengthened half-life and enhanced 1.45-fold bioavailability. Emphatically, these experimental findings are corroborated by DFT-based theoretical models, demonstrating some positive correlations between macroscopic properties and microstructures of the cocrystal. Thereby, the dual-optimization of in vivo/vitro properties of ADH allows to be fulfilled through the cocrystallization-driven strategy.

The impact of an innovative payment model on the direct economic burden of infectious disease inpatients: evidence from a pilot City in central China

BACKGROUND

Timely treatment of infectious diseases is essential to prevent transmission and protect public health. However, the substantial direct economic burden often impedes infectious disease patients from accessing timely treatment. Currently, China has implemented an innovative payment model called Diagnosis-Intervention Packet (DIP) in 71 pilot cities. This study aims to evaluate the impact of DIP on the direct economic burden of infectious disease inpatients.

MATERIALS AND METHODS

The dataset comprises 724,489 inpatient reimbursement records from City A spanning from January 2019 to June 2023. We conducted an interrupted time series analysis (ITSA) on six outcomes for a total of 2384 inpatients, with the top six being high-incidence Category B infectious diseases in City A. Further robustness analyses focusing on inpatients covered by Rural Residents Basic Medical Insurance (URRBMI), as well as those hospitalized for HBV and TB, were conducted to support our findings.

RESULTS

Following the implementation of DIP, we observed downward trends in average inpatient expenditure (β3 = -237.96, P < 0.01), average drug expenditure (β3 = -164.21, P < 0.01), average inpatient out-of-pocket expenditures (OOPs) (β3 = -124.58, P < 0.05), and the proportion of OOPs (β3 = -0.31, P < 0.01). These correspond to monthly decreasing slopes of ¥237.96, ¥164.21, ¥124.58, and 0.31%, respectively. When analyzing the proportion of OOPs by catalog status, a significant decline was observed only for non-catalog items, with a decreasing slope of 0.19% (β3 = -0.19, P < 0.01). The reintroduction of ITSA focusing on URRBMI inpatients, as well as HBV and TB inpatients, demonstrated the robustness of the results.

CONCLUSION

The DIP appears to contribute to reducing the direct economic burden for patients with infectious diseases. On the one hand, DIP seems to facilitate a reduction in inpatient medical expenditures, particularly by containing drug expenditures, which constitute a major component of spending for infectious disease patients. On the other hand, the decline in the proportion of OOPs is primarily concentrated in out-of-catalog items, suggesting that the DIP model may help limit doctors' tendencies to shift costs onto patients.

Developing cholera outbreak forecasting through qualitative dynamics: Insights into Malawi case study

Cholera, an acute diarrheal disease, is a serious concern in developing and underdeveloped areas. A qualitative understanding of cholera epidemics aims to foresee transmission patterns based on reported data and mechanistic models. The mechanistic model is a crucial tool for capturing the dynamics of disease transmission and population spread. However, using real-time cholera cases is essential for forecasting the transmission trend. This prospective study seeks to furnish insights into transmission trends through qualitative dynamics followed by machine learning-based forecasting. The Monte Carlo Markov Chain approach is employed to calibrate the proposed mechanistic model. We identify critical parameters that illustrate the disease's dynamics using partial rank correlation coefficient-based sensitivity analysis. The basic reproduction number as a crucial threshold measures asymptotic dynamics. Furthermore, forward bifurcation directs the stability of the infection state, and Hopf bifurcation suggests that trends in transmission may become unpredictable as societal disinfection rates rise. Further, we develop epidemic-informed machine learning models by incorporating mechanistic cholera dynamics into autoregressive integrated moving averages and autoregressive neural networks. We forecast short-term future cholera cases in Malawi by implementing the proposed epidemic-informed machine learning models to support this. We assert that integrating temporal dynamics into the machine learning models can enhance the capabilities of cholera forecasting models. The execution of this mechanism can significantly influence future trends in cholera transmission. This evolving approach can also be beneficial for policymakers to interpret and respond to potential disease systems. Moreover, our methodology is replicable and adaptable, encouraging future research on disease dynamics.

Modeling and analysis of infectious diseases based on behavioral game theory on two-layered networks under media coverage

The spread of infectious diseases poses significant threats to public health, the economy, and society as a whole. Despite governmental control measures over individual behavior, the public might still be influenced by factors such as costs, expected benefits, and the behavior of others, leading to incomplete adherence to disease control measures. Therefore, this paper proposes a behavioral game theory based infectious disease model on two-layer networks. First, considering the dynamic interaction between individual awareness behavior and disease spreading, a two-layer coupled network of individual behavioral awareness and disease spreading is established. Second, game theory is used to describe the impact of relevant factors on individual awareness behavior. The first layer represents the individual protective behavior game layer, while the second layer represents the disease spreading layer. Government intervention in individual behavior is also considered in the two-layer network model, according to the situation of infectious disease spreading, a threshold model is introduced to control individual protective behavior. Finally, MMCA is used to analyze the disease spreading threshold, and the proportion of the final population state and the spreading threshold under different model parameters are analyzed. The results show that by reducing personal protective costs, increasing individual attention to disease information, and enhancing governmental adjustments to disease control measures, the outbreak threshold of disease spreading can be effectively increased.

Silver Nanoparticles (AgNPs) as Potential Antiviral Agents: Synthesis, Biophysical Properties, Safety, Challenges and Future Directions─Update Review

AgNPs have gained significant attention due to their unique physicochemical properties, making them valuable across a range of fields including medicine, textiles, and household products. With their strong antimicrobial and antiviral properties, AgNPs have shown promise in treating infections, particularly in wound care management. This review explores the mechanisms underlying the antiviral activities of AgNPs, as well as the methods used for their synthesis, which include physical, chemical, and biological approaches. The review also addresses the potential limitations of AgNPs, including their cytotoxicity to humans and the environment. The interaction between AgNPs and microorganisms, particularly viruses, varies based on synthesis methods and particle morphology. As viral infections, including resistant strains, present major global health challenges, there is a growing need for alternative antiviral therapies. Metal nanoparticles like AgNPs offer potential advantages over conventional antiviral drugs due to their broad target range, which reduces the likelihood of resistance development. This review highlights AgNPs' effectiveness against a variety of viruses, such as HIV, hepatitis B, and respiratory syncytial virus, and discusses their potential for use in novel antiviral treatments. The review also examines AgNPs' toxicity, offering insights into their future therapeutic roles.

Mothers and mosquitoes: climate change contributes to the spread of vector-borne pathogens posing a substantial threat to pregnant women

Infectious diseases have threatened individuals and societies since the dawn of humanity. Certain population groups, including pregnant women, young children and the elderly, are particularly vulnerable to severe infections. Over the past few centuries, advances in medical standards and the availability of vaccines have reduced infection-related mortality and morbidity rates in industrialized countries. However, the global rise in temperatures and increased precipitation present a new challenge, facilitating the broader distribution of disease vectors, such as mosquitoes, bugs and ticks, to higher altitudes and latitudes. Consequently, epidemic and pandemic outbreaks associated with these vectors, such as Zika, West Nile, dengue, yellow fever, chikungunya and malaria, are increasingly impacting diverse populations. This review comprehensively examines how infections associated with climate change disproportionately affect the health and well-being of pregnant women and their unborn children. There has been a noticeable emergence of vector-borne diseases in Europe. Consequently, we stress the importance of implementing measures that effectively protect pregnant women from these increasing infections globally and regionally. We advocate for initiatives to safeguard pregnant women from these emerging threats, beginning with enhanced education to raise awareness about the evolving risks this particularly vulnerable population faces.

Promote citizen engagement with warnings - an empirical examination of government social media accounts during public health crises

BACKGROUND

Effective warnings are important for preventing the spread of disease during the early stages of outbreaks. Social media serves as a valuable platform for disseminating warning messages. The success of warnings issued through government social media accounts (GSMAs) depends on citizen engagement. However, an incomplete understanding of the relationship between warning messages and audience responses has hindered the design of crisis communication strategies.

METHODS

We investigated the factors affecting citizen engagement with warnings on GSMAs during public health crises. Drawing on the Elaboration Likelihood Model (ELM) and the Crisis and Emergency Risk Communication (CERC) framework, model was developed to analyze the effects of central routes (content features) and peripheral routes (microstructural and source features) on citizen engagement, as well as the moderating effect of disease type. Data were collected from 38 Sina Weibo accounts of government agencies in China during two public health crises: COVID-19 and H1N1. Logit regression analysis was conducted to test the hypothesized relationships.

RESULTS

The results indicate that (1) positive emotional tendencies and more warning elements are associated with citizen engagement; (2) the relationship between message length and citizen engagement follows an inverted U-shape; (3) media richness and information style variety significantly enhance citizen engagement; and (4) disease type (emerging vs. reemerging infectious diseases) moderates the relationships between media richness, information style variety, source influence, and citizen engagement.

CONCLUSIONS

Given that issuing warnings is critical to emergency management, our findings provide significant theoretical and practical insights, particularly for improving early government-public communication through social media platforms.

TRIAL REGISTRATION

Not applicable.

A central role for CCR2 in monocyte recruitment and blood-brain barrier disruption during Usutu virus encephalitis

Usutu virus (USUV) is an emerging neurotropic flavivirus capable of causing encephalitis in humans. Here, our main goal was to characterize the innate immune response in the brain during USUV encephalitis and to identify strategies to control disease severity. Using an immunocompetent mouse model of USUV encephalitis, we showed that microglia activation, blood-brain barrier (BBB) disruption and inflammatory monocyte recruitment are hallmarks of disease 6 days post infection. Activated microglia were in close association to USUV-infected cells, concomitantly with elevated levels of IL-6, IFN-γ, CCL2, CCL5, CXCL10 and CXCL1 in the brain. Monocyte recruitment was CCR2-dependent and driven by IFN-γ and CCL2 production beneath the brain vasculature. Moreover, CCR2 deficiency inhibited microglia activation and BBB disruption, showing the central role of CCR2 in USUV encephalitis. Accordingly, treatment with dexamethasone prevented pro-inflammatory mediator production and reduced leukocyte recruitment significantly, restraining encephalitis severity. Concluding, USUV encephalitis is driven by CCR2-mediated monocyte recruitment and BBB disruption, and blocked therapeutically by glucocorticoids.

Research Progress of Electrochemical Biosensors for Diseases Detection in China: A Review

Disease diagnosis is not only related to individual health but is also a crucial part of public health prevention. Electrochemical biosensors combine the high sensitivity of electrochemical methods with the inherent high selectivity of biological components, offering advantages such as excellent sensitivity, fast response time, and low cost. The generated electrical signals have a linear relationship with the target analyte, allowing for identification and concentration detection. This has become a very attractive technology. This review offers a summary of recent advancements in electrochemical biosensor research for disease diagnosis in China. It systematically categorizes and summarizes biosensors developed in China for detecting cancer, infectious diseases, inflammation, and neurodegenerative disorders. Additionally, the review delves into the fundamental working principles, classifications, materials, preparation techniques, and other critical aspects of electrochemical biosensors. Finally, it addresses the key challenges impeding the advancement of electrochemical biosensors in China and examines promising future directions for their development.

Serosurveillance Identifies Bourbon Virus-Neutralizing Antibodies in Bobcats, Coyotes, and Red Foxes in Missouri

Background: Bourbon virus (BRBV) is an emerging pathogen that can cause severe and fatal disease in humans. BRBV is vectored by Amblyomma americanum (lone star ticks), which are widely distributed across the central, southern, and eastern United States. Wildlife species are potentially important for the maintenance and transmission of BRBV, but little is known about which species are involved, and what other factors play a role in their exposure to BRBV. Methods: To assess the exposure risk to BRBV among wildlife in the St. Louis, Missouri, area, we collected sera from 98 individuals, representing 6 different mammalian species from two locations in St. Louis County: Tyson Research Center (TRC) and WildCare Park (WCP) from fall 2021 to spring 2023. The sera were used in a BRBV neutralization assay to detect neutralizing antibodies and RT-qPCR for viral RNA analysis. We also sampled and compared the abundance of A. americanum ticks at the two locations and modeled which factors influenced BRBV seropositivity across species. Results: In TRC, we observed a high rate of seropositivity in raccoons (Procyon lotor, 23/25), and white-tailed deer (Odocoileus virginianus, 18/27), but a low rate in opossums (Didelphis virginiana, 1/18). Neutralizing antibodies were also detected in sampled TRC bobcats (Lynx rufus, 4/4), coyotes (Canis latrans, 3/3), and a red fox (Vulpes vulpes, 1/1). The virological analysis did not detect BRBV RNA in any serum samples. In contrast to TRC, all sera screened from WCP were negative for BRBV-specific neutralizing antibodies, and significantly fewer ticks were collected at WCP (31) compared with TRC (2316). Conclusions: Collectively, these findings suggest that BRBV circulates in multiple wildlife species in the St. Louis area and that tick density and host community composition may be important factors in BRBV ecology.

Portable molecular diagnostic platform for rapid point-of-care detection of mpox and other diseases

The World Health Organization's designation of mpox as a public health emergency of international concern in August 2024 underscores the urgent need for effective diagnostic solutions to combat this escalating threat. The rapid global spread of clade II mpox, coupled with the sustained human-to-human transmission of the more virulent clade I mpox in the Democratic Republic of Congo, highlights a critical gap in point-of-care diagnostics for this emergent disease. In response, we developed Dragonfly, a portable molecular diagnostic platform for point-of-care use that integrates power-free nucleic acid extraction (<5 minutes) with lyophilised colourimetric LAMP chemistry. The platform demonstrated an analytical limit-of-detection of 100 genome copies per reaction for monkeypox virus, effectively distinguishing it from other orthopoxviruses, herpes simplex virus, and varicella-zoster virus. Clinical validation on 164 samples, including 51 mpox-positive cases, yielded 96.1% sensitivity and 100% specificity for orthopoxviruses, and 94.1% sensitivity and 100% specificity for monkeypox virus. Here, we present a rapid, accessible, and robust point-of-care diagnostic solution for mpox, suitable for both low- and high-resource settings, addressing the global resurgence of orthopoxviruses in the context of declining smallpox immunity.

Repeated detection of SARS-CoV-2 in pet dogs in Ibadan, Oyo State, Nigeria: a cause for vigilance

BACKGROUND

The COVID-19 pandemic of 2020 was unprecedented in its devastating impact on the global economy, public health, travel and tourism, education, sports, religion, and social lives. Studies conducted thereafter on the disease and its causative agent, SARS-CoV-2, have highlighted the need for effective and sustainable public health interventions.

METHODS

This study investigated the prevalence and endemicity of SARS-CoV-2 infection in pet dogs using immunochromatography assay (IC) and quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR) of their blood, rectal swabs, and nasal swabs in Ibadan, Oyo State, Nigeria between 2022 and 2024.

KEY FINDINGS

For the IC, positivity rates of 11.7% (23/197), 85.7% (6/7), and 100% (3/3) were recorded for 2022, 2023 and 2024 while for the RT-qPCR, positivity rates of 37.9% (11/29), 33.3% (2/6) and 100% (3/3) were recorded for 2022, 2023 and 2024. This repeated detection of SARS-CoV-2 in three of the dogs tested over the three-year period suggests continuous shedding of the virus by these animals and indicates endemicity of the virus in the study area. Findings highlight the urgent need for optimized SARS-CoV-2 rapid diagnostic tools tailored for veterinary applications to ensure rapid and reliable detection of the virus, especially in resource-constrained settings.

CONCLUSION

Considering the zoonotic nature of SARS-CoV-2 and its potential for mutation into more virulent strains that can be transmissible to humans, the findings of this study have significant implications for public health and implementation of One Health strategies by policymakers, and highlight the need for robust SARS-CoV-2 surveillance in domestic animals to mitigate potential zoonotic risks.

Neuropsychiatric sequelae in an experimental model of post-COVID syndrome in mice

The global impact of the COVID-19 pandemic has been unprecedented, and presently, the world is facing a new challenge known as post-COVID syndrome (PCS). Current estimates suggest that more than 100 million people are grappling with PCS, encompassing several manifestations, including pulmonary, musculoskeletal, metabolic, and neuropsychiatric sequelae (cognitive and behavioral). The mechanisms underlying PCS remain unclear. The present study aimed to: (i) comprehensively characterize the acute effects of pulmonary inoculation of the betacoronavirus MHV-A59 in immunocompetent mice at clinical, cellular, and molecular levels; (ii) examine potential acute and long-term pulmonary, musculoskeletal, and neuropsychiatric sequelae induced by the betacoronavirus MHV-A59; and to (iii) assess sex-specific differences. Male and female C57Bl/6 mice were initially inoculated with varying viral titers (3x103 to 3x105 PFU/30 μL) of the betacoronavirus MHV-A59 via the intranasal route to define the highest inoculum capable of inducing disease without causing mortality. Further experiments were conducted with the 3x104 PFU inoculum. Mice exhibited an altered neutrophil/lymphocyte ratio in the blood in the 2nd and 5th day post-infection (dpi). Marked lung lesions were characterized by hyperplasia of the alveolar walls, infiltration of polymorphonuclear leukocytes (PMN) and mononuclear leukocytes, hemorrhage, increased concentrations of CCL2, CCL3, CCL5, and CXCL1 chemokines, as well as high viral titers until the 5th dpi. While these lung inflammatory signs resolved, other manifestations were observed up to the 60 dpi, including mild brain lesions with gliosis and hyperemic blood vessels, neuromuscular dysfunctions, anhedonic-like behavior, deficits in spatial working memory, and short-term aversive memory. These musculoskeletal and neuropsychiatric complications were exclusive to female mice and prevented after ovariectomy. In summary, our study describes for the first time a novel sex-dependent model of PCS focused on neuropsychiatric and musculoskeletal disorders. This model provides a unique platform for future investigations regarding the effects of acute therapeutic interventions on the long-term sequelae unleashed by betacoronavirus infection.

Drug repositioning as a promising approach for the eradication of emerging and re-emerging viral agents

The global impact of emerging and re-emerging viral agents during epidemics and pandemics leads to serious health and economic burdens. Among the major emerging or re-emerging viruses include SARS-CoV-2, Ebola virus (EBOV), Monkeypox virus (Mpox), Hepatitis viruses, Zika virus, Avian flu, Influenza virus, Chikungunya virus (CHIKV), Dengue fever virus (DENV), West Nile virus, Rhabdovirus, Sandfly fever virus, Crimean-Congo hemorrhagic fever (CCHF) virus, and Rift Valley fever virus (RVFV). A comprehensive literature search was performed to identify existing studies, clinical trials, and reviews that discuss drug repositioning strategies for the treatment of emerging and re-emerging viral infections using databases, such as PubMed, Scholar Google, Scopus, and Web of Science. By utilizing drug repositioning, pharmaceutical companies can take advantage of a cost-effective, accelerated, and effective strategy, which in turn leads to the discovery of innovative treatment options for patients. In light of antiviral drug resistance and the high costs of developing novel antivirals, drug repositioning holds great promise for more rapid substitution of approved drugs. Main repositioned drugs have included chloroquine, ivermectin, dexamethasone, Baricitinib, tocilizumab, Mab114 (Ebanga™), ZMapp (pharming), Artesunate, imiquimod, saquinavir, capmatinib, naldemedine, Trametinib, statins, celecoxib, naproxen, metformin, ruxolitinib, nitazoxanide, gemcitabine, Dorzolamide, Midodrine, Diltiazem, zinc acetate, suramin, 5-fluorouracil, quinine, minocycline, trifluoperazine, paracetamol, berbamine, Nifedipine, and chlorpromazine. This succinct review will delve into the topic of repositioned drugs that have been utilized to combat emerging and re-emerging viral pathogens.

Virucidal and Bactericidal Properties of Biocompatible Copper Textiles

The COVID-19 pandemic highlights the global threat posed by emerging viruses, emphasizing the critical need for effective strategies to combat pathogen transmission. Moreover, alongside emerging viruses, the increasing threat of antimicrobial resistance further reinforces the need to develop novel methods for infection control. Anti-pathogenic coatings on textiles offer a promising solution; in this study, three electroless copper-plated fabrics are evaluated for their antipathogenic properties following International Standards Organisation (ISO) standards. Prior to electroless plating, materials are activated either by immersion in a Pd catalyst solution (material A) or by ink-jet printing Cu/Ag catalyst along the weft (material B) or warp thread (material C). This study demonstrates that activation method influences the materials antipathogenic performance, with all materials achieving complete bactericidal/fungicidal neutralization within 30 min of incubation. Material B exhibits up to 4-log virucidal effects within 1 h against viruses such as coronavirus (OC43, 229E), Influenza A (H1N1), and Rotavirus A. Furthermore, biocompatibility testing indicates that material B exhibited low in vitro cytotoxicity. Textile B demonstrates strong antibacterial results even after one year of accelerated aging with no significant difference (P = 0.74) in efficiency against MRSA, highlighting promising applications for infection control in clinical settings reducing pathogen transmission, nosocomial infections and the associated economic burden.

Association of childhood obesity or weight change with early-onset follicular occlusion triad in children

BACKGROUND

The effects of childhood obesity or weight gain on the development of early-onset follicular occlusion triad (FOT), which includes hidradenitis suppurativa (HS), acne conglobata (AC) and dissecting cellulitis of the scalp (DCS) in children, remain unknown.

OBJECTIVES

To investigate the association between body mass index (BMI) and changes in BMI and the development of early-onset FOT in children.

METHODS

This nationwide population-based longitudinal cohort study included a cohort of 2 012 928 Korean children who underwent two consecutive health examinations at 30-36 months and 42-48 months of age, respectively, between 2009 and 2020. BMI and changes in BMI were derived during these health screenings. We performed multivariate Cox proportional hazards regression analyses to estimate the risk of early-onset FOT, including HS, AC and DCS.

RESULTS

During follow-up, 1283 FOT events, including 143 cases of HS, 1068 cases of AC and 72 cases of DCS, were identified. Children with obesity had an elevated risk of early-onset FOT than those with a normal weight [FOT: adjusted hazard ratio (aHR) 1.49, 95% confidence interval (CI) 1.21-1.84; HS: aHR 2.30, 95% CI 1.39-3.82; AC: aHR 1.36, 95% CI 1.07-1.73]. BMI gain was correlated with an elevated risk of early-onset FOT, particularly HS, whereas BMI loss was linked to a decreased risk of early-onset FOT, especially HS. Children who developed obesity had an increased risk of early-onset FOT (aHR 1.51, 95% CI 1.07-2.14) vs. those who maintained a normal weight. Children with obesity who reduced to a normal weight exhibited a decreased risk of early-onset FOT [FOT: aHR 0.41, 95% CI 0.17-0.96 (Ptrend = 0.02); HS: Ptrend = 0.05] than children with obesity who retained their weight.

CONCLUSIONS

Childhood obesity is associated with an elevated risk of early-onset FOT, including HS and AC. Weight gain is correlated with an increased risk of early-onset FOT, especially HS, while weight loss is associated with a decreased risk of early-onset FOT, particularly HS. Implementing purposeful weight-reduction strategies may be helpful in preventing the development of early-onset FOT.

Multiplexed detection of respiratory virus RNA using optical pH sensors and injection-molded centrifugal microfluidics

The application is demonstrated of injection-molded centrifugal microfluidic chips with integrated optical pH sensors for multiplexed detection of respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A, and influenza B RNA. The optical pH sensors generated sensitive fluorescent readouts from diagnostic reverse transcription loop-mediated isothermal amplification (RT-LAMP) reactions; limits of detection for influenzas A and B, and SARS-CoV-2 of 89, 245, and 38 RNA copies per reaction, respectively, were attained. Results were obtainable within 44 min for SARS-CoV-2 and influenza A, and 48 min for influenza B. We implemented a data processing strategy based on numerical derivatives of the fluorescence curves that allowed for reliable, quantitative thresholds for deciding reaction outcomes and enabled 100% specificity. This work demonstrates the utility of optical pH sensors and injection-molded centrifugal microfluidics for multiplexed infectious disease diagnostics with point-of-care applications.

Phylogeographic Characterization of Aedes albopictus (Skuse, 1894) in Algeria

PURPOSE

Aedes albopictus, known as the Asian tiger mosquito, is an extensively studied mosquito species recognized for its rapid global expansion and its capacity to transmit a range of viruses such as dengue, chikungunya, Zika, and yellow fever viruses. In 2010, Ae. albopictus was observed for the first time in Tizi-Ouzou, Algeria, and since then has colonized all the northern part of the country until the semi-arid areas. The present study was devoted to the molecular characterization of Ae. albopictus in Algeria.

METHODS

A total of 20 selected mosquitos,originated from collected eggs in five different districts of northern Algeria weretested by PCR amplification and sequencing of the Cytochrome c oxidase subunit 1 a (COIa).

RESULTS

Pairwise alignment of the obtained sequences with representative Ae. albopictus available COIasequences of the world exhibit 117 different haplotypes. The Algerian sequences are grouped in 1 haplotype shared with Morroco, Madagascar and Mauritius in Africa and 3 other continents (Asia, Europe and America). Asia expresses the highest genetic and nucleotidic diversity (Hd = 0.828;π = 0.0144). In China two new species not described in the literature and confused with Ae. albopictus are detected.

CONCLUSION

These results could be used as preliminary data to study and develop targeted control strategies to prevent this vector from spreading in Algeria.

Thiol-terminated N-halamine ligands to photothermal gold nanorods for synergistically combating antibiotic-resistant bacteria

Bio-friendly antibacterial N-halamine polymers were used to modify gold nanorods (GNR@pAMPS-Cl), which showed excellent antimicrobial activity against antibiotic-resistant bacteria and accelerated the healing of MRSA-infected wounds. This work provides a new strategy for the preparation of nanoscale antibacterial materials.

Physics-informed deep learning for infectious disease forecasting

Accurate forecasting of contagious illnesses has become increasingly important to public health policymaking, and better prediction could prevent the loss of millions of lives. To better prepare for future pandemics, it is essential to improve forecasting methods and capabilities. In this work, we propose a new infectious disease forecasting model based on physics-informed neural networks (PINNs), an emerging area of scientific machine learning. The proposed PINN model incorporates dynamical systems representations of disease transmission into the loss function, thereby assimilating epidemiological theory and data using neural networks (NNs). Our approach is designed to prevent model overfitting, which often occurs when training deep learning models with observation data alone. In addition, we employ an additional sub-network to account for mobility, vaccination, and other covariates that influence the transmission rate, a key parameter in the compartment model. To demonstrate the capability of the proposed model, we examine the performance of the model using state-level COVID-19 data in California. Our simulation results show that predictions of PINN model on the number of cases, deaths, and hospitalizations are consistent with existing benchmarks. In particular, the PINN model outperforms the basic NN model and naive baseline forecast. We also show that the performance of the PINN model is comparable to a sophisticated Gaussian infection state space with time dependence (GISST) forecasting model that integrates the compartment model with a data observation model and a regression model for inferring parameters in the compartment model. Nonetheless, the PINN model offers a simpler structure and is easier to implement. In summary, our results show that the proposed forecaster could potentially serve as a new computational tool to enhance the current capacity of infectious disease forecasting.

Risk assessment of emerging infectious diseases in China under the One Health framework

Background

Emerging infectious diseases (EIDs) pose significant public health challenges due to increasing interactions between humans, animals, and the environment. The One Health framework, an interdisciplinary and collaborative approach, plays a critical role in the risk assessment of EIDs. The study aims to systematically review the risk assessment of EIDs in China under the One Health framework, covering policy support, monitoring and assessment systems, and implementation methods.

Methods

Relevant literature and official documents between 1997 and 2024 were retrieved from Web of Science, PubMed, Scopus, China National Knowledge Infrastructure, Wan Fang, China Science and Technology Journal Database, and government websites. Data were synthesized to analyze progress, challenges, and gaps.

Results

There were 43 academic studies and 31 official documents included in this review. The study found that risk assessment systems existed across human, animal, and environmental health sectors in China, and the government was advancing intelligent monitoring and fostering inter-departmental cooperation. However, several challenges remain in risk assessment of EIDs, including inadequate monitoring systems for unknown EIDs, limited capacity building for risk assessment in ecosystems and environmental systems, insufficiently detailed risk assessment guidance at the county level, and barriers to cross-sectoral information sharing at the international and county levels.

Conclusion

The findings highlighted the need to enhance risk assessment of EIDs at the local level, expand the scope of disease surveillance including aquatic and wild animals, and strengthen inter-departmental data sharing to improve early warning capabilities under the One Health framework.

The mental health impact of repeated COVID-19 enforced lockdowns in England: evidence from the UK Household Longitudinal Study

BACKGROUND

Research shows initial COVID-19 lockdowns increased population mental distress. Yet, the mental health impact of repeated lockdowns in England remains unknown.

AIMS

To: (a) explore changes in population mental health symptoms over the COVID-19 pandemic period (March 2020 to March 2021) in England, comparing this with trends from a decade before (2009-2019) as well as after (2021-2023); (b) compare the mental health impact of each of the three lockdowns in England with periods of eased restrictions, determining who was most affected; (c) examine the impact of demographics and distinct time periods on the prevalence of mental health symptoms.

METHOD

A secondary analysis of a national longitudinal cohort study, utilising data from Waves 1-13 of the UK Household Longitudinal Study and from Waves 1-9 of the COVID-19 Survey. Mental health was assessed using the 12-item General Health Questionnaire. Student t-tests and logistical regressions were conducted.

RESULTS

There was a significant increase in the prevalence of self-reported symptoms of mental health during England's pandemic period, encompassing three lockdowns, compared with the average of rates from 10 years before. Rates of reported mental health symptoms were not significantly different across each lockdown, but were significantly higher than pre-pandemic rates, declining with eased restrictions. Rates from the end of lockdown to May 2023 revealed elevated mental health symptoms compared with pre-pandemic. Elevated symptoms were observed for women, people homeworking, those with health conditions, individuals aged 30-45 years and those experiencing loneliness.

CONCLUSION

Repeated lockdowns in England had a substantial impact on mental health, indicating requirements for ongoing mental health support.

Dietary diversity and opportunistic infections among adults living with human immunodeficiency virus on antiretroviral therapy in Kumasi metropolis; a facility-based cross-sectional study

BACKGROUND

Despite advances in antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS) continue to face heightened susceptibility to opportunistic infections (OIs). Adequate nutrition remains an essential factor that positively influences disease progression and the occurrence of OIs. In Ghana, no study has evaluated the association between dietary diversity and OI occurrence among adults with HIV. This study aimed to evaluate the association between dietary diversity and the presence of OIs among HIV-positive adults receiving ART.

METHODS

A facility-based cross-sectional study was conducted among 291 HIV-positive adults receiving ART from February 2023 to April 2023 at Kumasi South Hospital, Ghana. The study participants were selected using a convenient sampling method. A pre-tested questionnaire and review of electronic health records were used to collect sociodemographic, nutritional and clinical data. Binary logistic regression analyses were conducted to identify variables significantly associated with the study outcome and hierarchical multivariable logistic regression was used to evaluate the association between dietary diversity and the occurrence of OIs while controlling for confounders at p-value < 0.05.

RESULTS

The mean age and dietary diversity were 46.2 ± 10.9 years and 4.0 (IQR: 3.0 to 6.0) food groups, respectively. Out of 291 respondents, 152 (52.2%) had inadequate dietary diversity and 39 (13.4%) had at least one OI. The respondents with inadequate dietary diversity were three times more likely to have an OI than their peers with adequate dietary diversity [AOR 3.03, (95% CI: 1.20 to 7.64), p = 0.019].

CONCLUSION

This study revealed that inadequate dietary diversity is a significant nutritional problem and dietary diversity was associated with the presence of OIs among PLWHA on ART at the study site. Hence, there is the need to enhance the intake of diversified diets based on locally available foods. This could decrease the occurrence of OIs and eventually reduce HIV-related morbidity/mortality.

Determinants of viral haemorrhagic fever risk in Africa's tropical moist forests: A scoping review of spatial, socio-economic, and environmental factors

BACKGROUND

Viral haemorrhagic fevers (VHFs) are identified by international health authorities as priorities for research and development, as they pose a threat to global health and economy. VHFs are zoonotic diseases whose acute forms in humans present a haemorrhagic syndrome and shock, with mortality rates of up to 90%. This work aims at synthetizing existing knowledge on spatial and spatially aggregable determinants that support the emergence and maintenance of VHFs in African countries covered by tropical moist forest, to better identify and map areas at risk.

METHODOLOGY/PRINCIPAL FINDINGS

Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA-ScR) guidelines, extension for scoping reviews, we searched the PubMed, Embase, CAB Abstracts, and Scopus databases. English and French peer-reviewed documents were retrieved using Boolean logic and keyword search terms. The analysis of 79 articles published between 1993 and 2023 offers a comprehensive overview of the complex interactions among abiotic, biotic, demographic, socio-economic, cultural, and political risk factors in driving the emergence and maintenance of VHFs in African countries covered by tropical moist forests. Human-to-human transmission is mainly driven by socio-economic, political, and demographic factors, whereas zoonotic spillover is determined by almost all groups of factors, especially those of an anthropogenic nature.

CONCLUSIONS/SIGNIFICANCE

Many questions remain unanswered regarding the epidemiology of VHFs in tropical forests. By elucidating spatially relevant determinants which have already been studied, this review seeks to advance VHFs hotspot predictions, risk mapping for disease surveillance and control systems improvement.

Role of artificial intelligence in early diagnosis and treatment of infectious diseases

Infectious diseases remain a global health challenge, necessitating innovative approaches for their early diagnosis and effective treatment. Artificial Intelligence (AI) has emerged as a transformative force in healthcare, offering promising solutions to address this challenge. This review article provides a comprehensive overview of the pivotal role AI can play in the early diagnosis and treatment of infectious diseases. It explores how AI-driven diagnostic tools, including machine learning algorithms, deep learning, and image recognition systems, enhance the accuracy and efficiency of disease detection and surveillance. Furthermore, it delves into the potential of AI to predict disease outbreaks, optimise treatment strategies, and personalise interventions based on individual patient data and how AI can be used to gear up the drug discovery and development (D3) process.The ethical considerations, challenges, and limitations associated with the integration of AI in infectious disease management are also examined. By harnessing the capabilities of AI, healthcare systems can significantly improve their preparedness, responsiveness, and outcomes in the battle against infectious diseases.

Climate Change and Emerging Infectious Diseases: A Precarious Relationship

Climate change is apparent. Temperatures are rising. Floods are more frequent and devastating. Climate changes can favor the development of emerging infectious diseases. The number of animal reservoirs and vector hosts can increase, further spreading pathogens. Many emerging infectious diseases were not historically considered major threats in US but have become a major concern in US territories and various states. In June 2024, the Centers for Disease Control and Prevention issued a Health Alert Network advisory about an increase in local transmission of dengue fever. Preventing the transmission of emerging infectious diseases has become a focus of regulatory agencies. Nurse education at all levels should include infectious diseases and be coordinated with local, state, and regional institutions. Emerging infectious diseases are now formidable challenges to health care.

A randomized, triple-blinded, placebo-controlled clinical trial evaluating immune responses of Typhim Vi and PPSV23 vaccines in healthy adults: The PREP study

Rapid and early identification of emergent infections is essential for delivering prompt clinical care. To advance the development of algorithms for the clinical management of infection identification, we performed a vaccination clinical trial to investigate the potential of using vaccination as a model for studying mild inflammation responses associated with different infections (NCT05346302). We collected data at various time points over 4 weeks from blood samples, wearable devices, and questionnaires. Following a 2-week baseline period, 210 healthy participants, aged 18-40 years, were administered either a Pneumococcal Polysaccharide vaccine (PPSV23), Typhoid Vi Polysaccharide vaccine (Typhim Vi), or placebo. In longitudinal analyses of blood biomarkers, we found that CRP was significantly higher at 2 days post-vaccination, whereas basophils, IL-10, IL-12p40, and MIG were significantly higher at 7 days post-vaccination in the PPSV23 group compared to both other groups (all p < 0.05). MIP-1β was significantly lower in the PPSV23 group than in the placebo group, while monocytes and MPV were significantly lower in the Typhim Vi group than in the placebo group at 7 days post-vaccination (all p < 0.05). The PPSV3 group showed a higher inflammatory profile, suggesting that PPSV23 induces a stronger immune response compared to Typhim Vi. The distinct immune responses induced by the two vaccines indicate the potential for utilizing vaccines as models for studying inflammation responses associated with different infectious pathogens.

Evolution of microneedle applicators for vaccination: the role of the latch applicator in optimizing dissolving microneedle-based immunization

INTRODUCTION

Dissolving microneedles (DMN) offer advantages in vaccine delivery, such as enhanced immunogenicity and simplified administration, by targeting immune-rich layers of the skin. However, these benefits require precise and consistent delivery, which poses practical challenges. To address this, specialized applicators are essential for ensuring the accurate deployment of DMNs, making this technology a viable alternative to traditional methods, particularly in low- and middle-income countries (LMICs), where healthcare infrastructure is limited.

AREAS COVERED

In this review, we examine the advancements in DMN-based vaccination and applicator design, focusing on their joint effort. These innovations have improved the precision and efficiency of DMN vaccine delivery. Complex and costly early-stage applicators have evolved into simpler and more cost-effective designs. We highlight these developments in this review, with the latch applicator as a key example of a feature that enhances vaccine delivery.

EXPERT OPINION

Although applicator development has advanced DMN-based vaccination toward practical use, challenges remain. Key areas for further optimization include user friendliness, cost, packaging volume, and wear time. Once optimized, DMN vaccination may become a highly effective and accessible tool for global immunization, supporting efforts to achieve worldwide vaccine equality.

Climate change, its impact on emerging infectious diseases and new technologies to combat the challenge

ABSTRACTImproved sanitation, increased access to health care, and advances in preventive and clinical medicine have reduced the mortality and morbidity rates of several infectious diseases. However, recent outbreaks of several emerging infectious diseases (EIDs) have caused substantial mortality and morbidity, and the frequency of these outbreaks is likely to increase due to pathogen, environmental, and population effects driven by climate change. Extreme or persistent changes in temperature, precipitation, humidity, and air pollution associated with climate change can, for example, expand the size of EID reservoirs, increase host-pathogen and cross-species host contacts to promote transmission or spillover events, and degrade the overall health of susceptible host populations leading to new EID outbreaks. It is therefore vital to establish global strategies to track and model potential responses of candidate EIDs to project their future behaviour and guide research efforts on early detection and diagnosis technologies and vaccine development efforts for these targets. Multi-disciplinary collaborations are demanding to develop effective inter-continental surveillance and modelling platforms that employ artificial intelligence to mitigate climate change effects on EID outbreaks. In this review, we discuss how climate change has increased the risk of EIDs and describe novel approaches to improve surveillance of emerging pathogens that pose the risk for EID outbreaks, new and existing measures that could be used to contain or reduce the risk of future EID outbreaks, and new methods to improve EID tracking during further outbreaks to limit disease transmission.

Emergence of infectious diseases and role of advanced nanomaterials in point-of-care diagnostics: a review

Infectious outbreaks are the foremost global public health concern, challenging the current healthcare system, which claims millions of lives annually. The most crucial way to control an infectious outbreak is by early detection through point-of-care (POC) diagnostics. POC diagnostics are highly advantageous owing to the prompt diagnosis, which is economical, simple and highly efficient with remote access capabilities. In particular, utilization of nanomaterials to architect POC devices has enabled highly integrated and portable (compact) devices with enhanced efficiency. As such, this review will detail the factors influencing the emergence of infectious diseases and methods for fast and accurate detection, thus elucidating the underlying factors of these infections. Furthermore, it comprehensively highlights the importance of different nanomaterials in POCs to detect nucleic acid, whole pathogens, proteins and antibody detection systems. Finally, we summarize findings reported on nanomaterials based on advanced POCs such as lab-on-chip, lab-on-disc-devices, point-of-action and hospital-on-chip. To this end, we discuss the challenges, potential solutions, prospects of integrating internet-of-things, artificial intelligence, 5G communications and data clouding to achieve intelligent POCs.

Helminth diversity and seasonality of Angiostrongylus cantonensis in hedgehogs from Mallorca

Sentinel surveillance plays a critical role in monitoring pathogen circulation, assessing potential threats for species conservation, and evaluating the risk of spillover to human populations. This study provides a comprehensive exploration of helminth parasites in the Mediterranean-distributed hedgehog species Atelerix algirus in Mallorca, Balearic Islands. Using an integrated approach that combines necropsies and morphological and molecular identifications using the COI gene, we identified 11 helminth taxa in 135 hedgehogs, representing half of those that died at the local wildlife hospital in Mallorca between 2019 and 2022. We report an overall A. cantonensis prevalence of 11.5% and confirm the first case of a subclinical neuroangiostrongyliasis infection in a wildlife host. Infection prevalences over the year revealed that only two species, the nematode A. cantonensis and the cestode Mathevotaenia sp., had a seasonal pattern, with most A. cantonensis cases occurring in autumn and, to a lesser extent, Mathevotaenia sp. cases in winter. This pattern is probably due to the higher abundance and greater activity of snails and slugs (intermediate hosts) during these seasons, with important implications for public health and strategies for prevention of neuroangiostrongyliasis. Other key findings include a high prevalence (88.1%) of the lungworm Crenosoma striatum and detection of the acanthocephalan Moniliformis saudi for the first time in A. algirus. We anticipate that our study will facilitate surveillance efforts and clarify species identities in future studies. Given the lethal effects of A. cantonensis infection in hedgehogs, further studies are needed to evaluate the threat this parasite represents to European wildlife.

Large-scale genomic analysis of Elizabethkingia anophelis

The recent emergence of Elizabethkingia anophelis as a human pathogen is a major concern for global public health. This organism has the potential to cause severe infections and has inherent antimicrobial resistance. The potential for widespread outbreaks and rapid global spread highlights the critical importance of understanding the biology and transmission dynamics of this infectious agent. We performed a large-scale analysis of available 540 E. anophelis, including one novel strain isolated from raw milk and sequenced in this study. Pan-genome analysis revealed an open and diverse pan-genome in this species, characterized by the presence of many accessory genes. This suggests that the species has a high level of adaptability and can thrive in a variety of environments. Phylogenetic analysis has also revealed a complex population structure, with limited source-lineage correlation. We identified diverse antimicrobial resistance factors, including core-genome and accessory ones often associated with mobile genetic elements within specific lineages. Mobilome analysis revealed a dynamic landscape primarily composed of genetic islands, integrative and conjugative elements, prophage elements, and small portion of plasmids emphasizing a complex mechanism of horizontal gene transfer. Our study underscores the adaptability of E. anophelis, characterized by a diverse range of antimicrobial resistance genes, putative virulence factors, and genes enhancing fitness. This adaptability is also supported by the organism's ability to acquire genetic material through horizontal gene transfer, primarily facilitated by mobile genetic elements such as integrative and conjugative elements (ICEs). The potential for rapid evolution of this emerging pathogen poses a significant challenge to public health efforts.

Association of modifiable risk factors and infectious diseases among individuals with hypertension: a prospective cohort study

BACKGROUND

A comprehensive assessment of combined modifiable risk factors in relation to infectious diseases among individuals with hypertension is lacking, and the potential mechanisms of these associations remain unclear. To investigate the prospective associations of a combination of lifestyle behaviors and cardiometabolic factors with the risk of infectious diseases among individuals with hypertension and to estimate whether and to what extent blood biomarkers mediate these associations.

METHODS

This cohort study included 147,188 participants with hypertension and complete data on modifiable risk factors from the UK Biobank. Health score was constructed from eight modifiable risk factors, including four lifestyle behaviors (diet, physical activity, smoking, and sleep duration) and four cardiometabolic factors (body mass index, blood lipids, blood glucose, and blood pressure). Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the health score and infectious diseases. The mediation analysis was performed to assess the potential intermediation effects of blood biomarkers.

RESULTS

Over a median follow-up of 12.5 years, 27,398 participants with infectious diseases were documented, with 960 respiratory infectious diseases and 7940 digestive infectious diseases. After adjusting for potential confounders, the HR (95% CI) for the highest versus the lowest quartile of health score was 0.64 (0.62, 0.66) for infectious diseases, 0.72 (0.60, 0.86) for respiratory infectious diseases, and 0.66 (0.62, 0.71) for digestive infectious diseases. Stratified factors including duration of hypertension did not modify the associations between the health score and infectious diseases. In addition, biomarkers including inflammation and renal function collectively explained 46.60% of the associations between the combined lifestyle factors and infectious disease risk among individuals with hypertension.

CONCLUSIONS AND RELEVANCE

Ideal management of combined modifiable risk factors was associated with lower risks of infectious diseases and might produce profound changes in blood biomarkers among individuals with hypertension. Additionally, specific biomarkers appeared to serve as an intermediate between combined lifestyle factors and infectious diseases. These insights highlighted the important role of a combination of healthy lifestyle and favorable cardiometabolic status in reducing disease burden and facilitated the understanding of biological mechanisms underlying modifiable risk factors with infectious diseases.

Exploratory actor mapping of social interactions within tick risk surveillance networks in France

Ticks are important zoonotic disease vectors for human and animal health worldwide. In Europe they are the principal vector of public health importance, responsible for Lyme disease, the most prevalent and widespread tick-borne disease (TBD). Tick presence and TBD incidence are increasing, questioning the effectiveness of existing surveillance systems. At the European level TBD burden is likely underestimated as surveillance differs amongst and within countries. France created its first national public health policy in 2016 to tackle TBDs, prompted by growing concern from the public, medical professionals and the scientific community for the lack of knowledge on tick-borne pathogen risk on the population. With global changes, France currently faces risk for TBD emergence (e.g. Crimean-Congo hemorrhagic fever) and re-emergence (e.g. tick-borne encephalitis), in addition to increasing Lyme disease cases. We conducted 13 semi-structured interviews with French tick risk surveillance actors to characterize how the national surveillance system functions. Qualitative descriptive analysis was conducted on interview transcripts to create actor maps and identify the barriers and levers for actor interactions. We identified four tick risk surveillance processes: surveillance-oriented research, risk evaluation, policy creation and policy application, to which interdisciplinary, intersectoral and multi-level actor interactions contribute. Actors express a pervasive need to reinforce intersectoral interactions between human, animal and environmental sectors for early risk detection, as well as multi-level interactions to accurately estimate risk and disseminate prevention information. Transdisciplinary, social-ecological system approaches may offer an adaptive framework for locally relevant surveillance activities in diverse social-ecological contexts.

Identification of environmental, socioeconomic, water, sanitation, and hygiene (WaSH) factors associated with COVID-19 incidence in the Philippines: A nationwide modelling study

Despite the implementation of non-pharmaceutical interventions, the threat of coronavirus disease 2019 (COVID-19) remains significant on a global scale. Identifying external factors contributing to its spread is crucial, especially given the World Health Organization's recommendation emphasizing access to water, sanitation, and hygiene as essential in curbing COVID-19. There is a notable discrepancy in access to sanitation facilities, particularly evident in low- and middle-income countries. However, there is a lack of quantitative assessments regarding these factors. This study examines various environmental, socioeconomic, water, sanitation, and hygiene factors and their associations with COVID-19 incidence. All regions in the Philippines were categorized into clusters based on socioeconomic factors. A conceptual structural equation model (SEM) was developed using domain knowledge. The best-fitting SEM for each cluster was determined, and associations between factors and COVID-19 incidence were estimated. The correlation analysis revealed that rainfall, minimum temperature, and relative humidity were positively correlated with weekly COVID-19 incidence in urban regions. Maximum temperature, mean temperature, wind speed, and wind direction were negatively correlated with weekly COVID-19 incidence in rural regions, with time lags of 0, 3, and 7 weeks. In urban regions (Cluster 1), factors such as urbanization rate (1.00), area (-0.93), and population (0.54) were found to be associated with weekly COVID-19 incidence. Conversely, in rural regions (Cluster 2), factors including area (0.17), basic sanitation (0.84), and wind direction (0.83) showed associations with weekly COVID-19 incidence. These factors were causally associated with a latent variable reflecting the hidden confounders associated with COVID-19 incidence. It is important to note that sanitation factors were associated only in rural regions. Improving access to sanitation facilities in rural regions of the Philippines is imperative to effectively mitigate disease transmission in future pandemics. Identification of the causal effect of unobserved confounders with COVID-19 incidence is recommended for future research.

Sample-to-answer centrifugal microfluidic droplet PCR platform for quantitation of viral load

Droplet digital polymerase chain reaction (ddPCR) stands out as a highly sensitive diagnostic technique that is gaining traction in infectious disease diagnostics due to its ability to quantitate very low numbers of viral gene copies. By partitioning the sample into thousands of droplets, ddPCR enables precise and absolute quantification without relying on a standard curve. However, current ddPCR systems often exhibit relatively low levels of integration, and the analytical process remains dependent on elaborate workflows for up-front sample preparation. Here, we introduce a fully-integrated system seamlessly combining viral lysis, RNA extraction, emulsification, reverse transcription (RT) ddPCR, and fluorescence readout in a sample-to-answer format. The system comprises a disposable microfluidic cartridge housing buffers and reagents required for the assay, and a centrifugal platform that allows for pneumatic actuation of liquids during rotation, enabling automation of the workflow. Highly monodisperse droplets (∼50 μm in diameter) are produced using centrifugal step emulsification and automatically transferred to an integrated heating module for target amplification. The platform is equipped with a miniature fluorescence imaging system enabling on-chip read-out of droplets after RT-ddPCR. We demonstrate sample-to-answer detection of SARS-CoV-2 N and E genes, along with RNase P endogenous reference, using hydrolysis probes and multiplexed amplification within single droplets for concentrations as low as 0.1 copy per μL. We also tested 14 nasopharyngeal swab specimens from patients and were able to distinguish positive and negative SARS-CoV-2 samples with 100% accuracy, surpassing results obtained by conventional real-time amplification.

Nanomaterial-mediated host directed therapy of tuberculosis by manipulating macrophage autophagy

Tuberculosis (TB), induced by Mycobacterium tuberculosis (Mtb) infection, remains a major public health issue worldwide. Mtb has developed complicated strategies to inhibit the immunological clearance of host cells, which significantly promote TB epidemic and weaken the anti-TB treatments. Host-directed therapy (HDT) is a novel approach in the field of anti-infection for overcoming antimicrobial resistance by enhancing the antimicrobial activities of phagocytes through phagosomal maturation, autophagy and antimicrobial peptides. Autophagy, a highly conserved cellular event within eukaryotic cells that is effective against a variety of bacterial infections, has been shown to play a protective role in host defense against Mtb. In recent decades, the introduction of nanomaterials into medical fields open up a new scene for novel therapeutics with enhanced efficiency and safety against different diseases. The active modification of nanomaterials not only allows their attractive targeting effects against the host cells, but also introduce the potential to regulate the host anti-TB immunological mechanisms, such as apoptosis, autophagy or macrophage polarization. In this review, we introduced the mechanisms of host cell autophagy for intracellular Mtb clearance, and how functional nanomaterials regulate autophagy for disease treatment. Moreover, we summarized the recent advances of nanomaterials for autophagy regulations as novel HDT strategies for anti-TB treatment, which may benefit the development of more effective anti-TB treatments.

Climate change linked to vampire bat expansion and rabies virus spillover

Bat-borne pathogens are a threat to global health and in recent history have had major impacts on human morbidity and mortality. Examples include diseases such as rabies, Nipah virus encephalitis, and severe acute respiratory syndrome (SARS). Climate change may exacerbate the emergence of bat-borne pathogens by affecting the ecology of bats in tropical ecosystems. Here, we report the impacts of climate change on the distributional ecology of the common vampire bat Desmodus rotundus across the last century. Our retrospective analysis revealed a positive relationship between changes in climate and the northern expansion of the distribution of D. rotundus in North America. Furthermore, we also found a reduction in the standard deviation of temperatures at D. rotundus capture locations during the last century, expressed as more consistent, less-seasonal climate in recent years. These results elucidate an association between D. rotundus range expansion and a continental-level rise in rabies virus spill-over transmission from D. rotundus to cattle in the last 50 years of the 120-year study period. This correlative study, based on field observations, offers empirical evidence supporting previous statistical and mathematical simulation-based studies reporting a likely increase of bat-borne diseases in response to climate change. We conclude that the D. rotundus rabies system exemplifies the consequences of climate change augmentation at the wildlife-livestock-human interface, demonstrating how global change acts upon these complex and interconnected systems to drive increased disease emergence.

Pattern of bioterrorism in ancient times: lessons to be learned from the microbial and toxicological aspects

The current research aimed to analyze the history of bioterrorism in antiquity and to adapt the data to modern medical knowledge. To this end, a thorough evaluation of the literature related to the ancient history of bioterrorism and modern data was done using the Web of Sciences, Science Direct, Scopus, PubMed, and Google Scholar. Results showed that knowledge of bioterrorism has existed since antiquity in different civilizations. Biological and toxicological agents were used as an instrument of legal execution, as a warfare tool in battles, or to eliminate political rivals across nations. Ancient people researched bioterrorism to apply it against enemies and at the same time provide countermeasures in favor of themselves and allies. Despite the existence of the principles of bioterrorism since ancient times, adaptation of the data to modern research can assist in planning countermeasure efforts, preventive actions, and treatments in the framework of modern counterterrorism medicine.

Fruit-frugivore dependencies are important in Ebolavirus outbreaks in Sub-Saharan Africa

Ebolaviruses have the ability to infect a wide variety of species, with many African mammals potentially serving either as primary reservoirs or secondary amplifying hosts. Previous work has shown that frugivorous bats and primates are often associated with spillover and outbreaks. Yet the role that patterns of biodiversity, either of mammalian hosts or of common fruiting species such as Ficus (figs, fruit resources used by a wide variety of species), play in driving outbreak risk remains unclear. We investigated what factors most directly influence Ebolavirus outbreak risk in Sub-Saharan Africa by using a phylogenetically informed path analysis to compare a wide array of potential models (path diagrams) of spatial dynamics. We considered mammalian frugivore richness, cercopithecid and hominid primate richness, richness of pteropodid (fruit) bats, the spatial distribution of species that have tested positive for Ebolavirus antibodies in the wild, Ficus habitat suitability, and environmental conditions (mean annual and variability in temperature and rainfall). The proximate factors that most influenced whether a given host species range contained a site of a previous outbreak event were 1) habitat suitability for Ficus and 2) the diversity of cercopithecid primates. Frugivore richness overall (including bats, primates, and a few other mammals) and the richness of bats in the family Pteropodidae had a strong effect on which species tested positive for Ebolavirus antibodies, but did not influence outbreak risk directly in pathways explored. We interpret this as evidence that foraging around Ficus and frugivorous mammals (such as cercopithecid primates which are commonly hunted for food) play a prominent role in driving outbreaks into human communities, relative to other factors we considered which influence outbreak risk more indirectly.

Knowledge, attitude and practice of healthcare workers on infection prevention and control in Ethiopia: A systematic review and meta-analysis

INTRODUCTION

Infectious diseases remain the leading causes of death in low and middle-income countries including Ethiopia. The existence of emerging, re-emerging, and drug-resistant infectious agents maximizes the importance of infection prevention and control. Healthcare workers are the key actors in the prevention and control of infection. As a result assessing the knowledge, attitude, and practice of healthcare workers toward infection prevention and control is very critical in the prevention and control of infectious diseases. Therefore, this systematic review and meta-analysis aimed to assess the knowledge, attitude, and practice of healthcare providers toward infection prevention in Ethiopia.

METHOD

PubMed, Scopus, SEMANTIC SCHOLAR, Google Scholar, and Addis Ababa University Digital Library were systematically searched for relevant literature until November 18/2023. The quality of the included studies was assessed using the Joanna Briggs Institute quality appraisal tool. Data were abstracted using a Microsoft Excel spreadsheet and analyzed using STATA version 11. A random-effects model was used to estimate the pooled prevalence. Heterogeneity among reported studies was assessed by Forest plot, Cochran's Q-statistics, and I2 test. Publication bias was checked using funnel plots, and Egger's regression test. In addition, sub-group and sensitivity analyses were conducted.

RESULT

A total of 7,681 articles were retrieved of which 19 studies with 5,650 healthcare workers were included in this systematic review and meta-analysis. About 74.5% (95% CI, 65.88, 83.12), 66.71% (95% CI 55.15, 78.28), and 55.2% (95% CI 48.22, 62.18) of healthcare workers were knowledgeable, had positive attitudes, and good standard of practice on infection prevention respectively.

CONCLUSION

Despite acceptable knowledge and attitude, about half of the healthcare workers have unsafe infection prevention and control practices in Ethiopia. Hence, serious attention should be given to healthcare workers' application of infection prevention standards in their working environment.

Fighting fire with fire: using infectious agents to treat persistent infection

Infectious diseases lead to significant morbidity and mortality. Often, resolution of the acute stage of the disease leads to microbial persistence, resulting in chronic debilitating disease. Management of persistent infections frequently requires lifelong therapy with antimicrobial agents. These infections could be chronic viral infections like HIV, hepatitis B or chronic bacterial persistent infections like prosthetic joint infections caused by multi-drug resistant organisms. Bacteriophages have been designed specifically to target recalcitrant bacterial infections, such as prosthetic joint infections with varying success. In this review, we describe the historic evolution of scenarios and risks associated with innovative therapy using infectious agents to treat other persistent infections.

A systematic review on current approaches in bat virus discovered between 2018 and 2022

Zoonotic viruses are widely seen as the primary threat for future pandemics. Bats are the most diverse group of mammals, with more than 1400 species distributed across most habitats on Earth. So far, 31 known virus families were associated with bats, although the understanding of most viruses were insufficient. Continuous efforts to discover, understand and monitor these bats viruses, is thereby an area of public health interest. This systematic review was designed to catalogue publications reporting novel bat virus discoveries within PubMed, SCOPUS, and Web of Science databases, within a 5-year period from 2018 to 2022. Various experimental parameters, including sampling locations, methodology, bat species diversity, similarity to known viruses, species demarcation of new viruses, and genomic sequencing strategies, were extracted from 41 publications and analyzed. In total, 72 novel viruses from 19 virus families were identified between 2018 and 2022, particularly from Genomoviridae (DNA viruses) and Coronaviridae (RNA viruses). That said, only a limited number of bat families featured extensively despite noticeable shift towards next generation sequencing methods and metagenomics pipeline for virus identification across different sampling methods. This review aims to provide a comprehensive analysis of the global efforts made over the past five years to identify and characterize emerging viruses in bat species, and to provide a detailed overview of the current technologies and methodologies used in these studies.

The First Isolation of Insect-Specific Alphavirus (Agua Salud alphavirus) in Culex (Melanoconion) Mosquitoes in the Brazilian Amazon

Advances in diagnostic techniques coupled with ongoing environmental changes have resulted in intensified surveillance and monitoring of arbovirus circulation in the Amazon. This increased effort has resulted in increased detection of insect-specific viruses among hematophagous arthropods collected in the field. This study aimed to document the first isolation of Agua Salud alphavirus in mosquitoes collected within the Brazilian Amazon. Arthropods belonging to the family Culicidae were collected within a forest fragment located in the Environmental Protection Area of the metropolitan region of Belem. Subsequently, these specimens were meticulously identified to the species level. Afterward, the collected batches were macerated, and the resulting supernatant was then inoculated into C6/36 and Vero cell cultures to facilitate viral isolation. The presence of arboviruses within the inoculated cell cultures was determined through indirect immunofluorescence analysis. Furthermore, positive supernatant samples underwent nucleotide sequencing to precisely identify the viral strains present. Notably, a batch containing Culex (Melanoconion) mosquitoes was identified to be positive for the genus Alphavirus via indirect immunofluorescence. This study is the first report on insect-specific alphavirus isolation in Brazil and the first-ever description of Agua Salud alphavirus isolation within Amazon Forest remnants.

A novel immunoassay technique using principal component analysis for enhanced detection of emerging viral variants

Rapid diagnostics are critical infectious disease tools that are designed to detect a known biomarker using antibodies specific to that biomarker. However, a way to detect unknown disease variants has not yet been achieved in a paper test format. We describe here a route to make an adaptable paper immunoassay that can detect an unknown biomarker, demonstrating it on SARS-CoV-2 variants. The immunoassay repurposes cross reactive antibodies raised against the alpha variant. Gold nanoparticles of two different colors conjugated to two different antibodies create a colorimetric signal, and machine learning of the resulting colorimetric pattern is used to train the assay to discriminate between variants of alpha and Omicron BA.5. By using principal component analysis, the colorimetric test patterns can pick up and discriminate an unknown variant that it has not encountered before, Omicron BA.1. The test has an accuracy of 100% and a potential calculated discriminatory power of 900. We show that it can be used adaptively and that it can be used to pick up emerging variants without the need to raise new antibodies.

Paper substrate designed with TEMPO-oxidized cellulose nanofibers/cationic guar gum hydrogel and its application in a colorimetric biosensor for rapid bacteria detection

The monitoring of foodborne bacterial contamination requires simple and convenient biosensors. This work describes a novel paper-based colorimetric biosensor for the rapid and sensitive bacteria detection. The biosensor was constructed via the encapsulation of D-alanyl-D-alanine capped gold nanoparticles (DADA-AuNPs) in a modified paper that was fabricated by the freeze-drying of TEMPO-oxidized cellulose nanofibers/cationic guar gum composite hydrogel-modified filter paper. The results indicated that the size of DADA-AuNPs largely determined the color of their aqueous system and they exhibited light red to dark red as their size increased from around 6 to 36 nm. All these different sized DADA-AuNPs turned into colorless when encountered with either S. aureus or E. coli. In particular, the smaller the DADA-AuNPs size, the faster the discoloration. The encapsulation of DADA-AuNPs into modified paper negligibly changed their responsiveness towards bacteria. In comparison to the original filter paper and oven-dried hydrogel-modified filter paper, the freeze-dried hydrogel-modified paper was demonstrated to be a better substrate for the encapsulation of DADA-AuNPs since they could be loaded with a larger amount of DADA-AuNPs in a faster way and showed a better perceivable color. This work demonstrated a promising paper-based colorimetric biosensor for the facile and rapid detection of bacteria.

Genome resequencing reveals population divergence and local adaptation of blacklegged ticks in the United States

Tick vectors and tick-borne disease are increasingly impacting human populations globally. An important challenge is to understand tick movement patterns, as this information can be used to improve management and predictive modelling of tick population dynamics. Evolutionary analysis of genetic divergence, gene flow and local adaptation provides insight on movement patterns at large spatiotemporal scales. We develop low coverage, whole genome resequencing data for 92 blacklegged ticks, Ixodes scapularis, representing range-wide variation across the United States. Through analysis of population genomic data, we find that tick populations are structured geographically, with gradual isolation by distance separating three population clusters in the northern United States, southeastern United States and a unique cluster represented by a sample from Tennessee. Populations in the northern United States underwent population contractions during the last glacial period and diverged from southern populations at least 50 thousand years ago. Genome scans of selection provide strong evidence of local adaptation at genes responding to host defences, blood-feeding and environmental variation. In addition, we explore the potential of low coverage genome sequencing of whole-tick samples for documenting the diversity of microbial pathogens and recover important tick-borne pathogens such as Borrelia burgdorferi. The combination of isolation by distance and local adaptation in blacklegged ticks demonstrates that gene flow, including recent expansion, is limited to geographical scales of a few hundred kilometres.

Population dynamics of the Lyme disease bacterium, Borrelia burgdorferi, during rapid range expansion in New York State

Recent changes in climate and human land-use have resulted in alterations of the geographic range of many species, including human pathogens. Geographic range expansion and population growth of human pathogens increase human disease risk. Relatively little empirical work has investigated the impact of range changes on within-population variability, a contributor to both colonization success and adaptive potential, during the precise time in which populations are colonized. This is likely due to the difficulties of collecting appropriate natural samples during the dynamic phase of migration and colonization. We systematically collected blacklegged ticks (Ixodes scapularis) across New York State (NY), USA, between 2006 and 2019, a time period coinciding with a rapid range expansion of ticks and their associated pathogens including Borrelia burgdorferi, the etiological agent of Lyme disease. These samples provide a unique opportunity to investigate the population dynamics of human pathogens as they expand into novel territory. We observed that founder effects were short-lived, as gene flow from long-established populations brought almost all B. burgdorferi lineages to newly colonized populations within just a few years of colonization. By 7 years post-colonization, B. burgdorferi lineage frequency distributions were indistinguishable from long-established sites, indicating that local B. burgdorferi populations experience similar selective pressures despite geographic separation. The B. burgdorferi lineage dynamics elucidate the processes underlying the range expansion and demonstrate that migration into, and selection within, newly colonized sites operate on different time scales.