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Machado LC, Dezordi FZ, de Lima GB, de Lima RE, Silva LCA, Pereira LDM, da Silva AF, da Silva Neto AM, de Oliveira ALS, Armstrong ADC, Pessoa-e-Silva R, Loyo RM, Silva BDO, de Almeida AR, da Rocha Pitta MG, Santos FDADS, Mendonça Siqueira M, Resende PC, Delatorre E, Naveca FG, Miyajima F, Gräf T, do Carmo RF, Pereira MC, Campos TDL, Bezerra MF, Paiva MHS, Wallau GDL. Spatiotemporal transmission of SARS-CoV-2 lineages during 2020-2021 in Pernambuco-Brazil. Microbiol Spectr 2024; 12:e0421823. [PMID: 38651879 PMCID: PMC11237429 DOI: 10.1128/spectrum.04218-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/04/2024] [Indexed: 04/25/2024] Open
Abstract
SARS-CoV-2 virus emerged as a new threat to humans and spread around the world, leaving a large death toll. As of January 2023, Brazil is among the countries with the highest number of registered deaths. Nonpharmacological and pharmacological interventions have been heterogeneously implemented in the country, which, associated with large socioeconomic differences between the country regions, has led to distinct virus spread dynamics. Here, we investigate the spatiotemporal dispersion of SARS-CoV-2 lineages in the Pernambuco state (Northeast Brazil) throughout the distinct epidemiological scenarios that unfolded in the first 2 years of the pandemic. We generated a total of 1,389 new SARS-CoV-2 genomes from June 2020 to August 2021. This sampling captured the arrival, communitary transmission, and the circulation of the B1.1, B.1.1.28, and B.1.1.33 lineages; the emergence of the former variant of interest P.2; and the emergence and fast replacement of all previous variants by the more transmissible variant of concern P.1 (Gamma). Based on the incidence and lineage spread pattern, we observed an East-to-West to inner state pattern of transmission, which is in agreement with the transmission of more populous metropolitan areas to medium- and small-size country-side cities in the state. Such transmission patterns may be partially explained by the main routes of traffic across municipalities in the state. Our results highlight that the fine-grained intrastate analysis of lineages and incidence spread can provide actionable insights for planning future nonpharmacological intervention for air-borne transmissible human pathogens.IMPORTANCEDuring the COVID-19 pandemic, Brazil was one of the most affected countries, mainly due its continental-size, socioeconomic differences among regions, and heterogeneous implementation of intervention methods. In order to investigate SARS-CoV-2 dynamics in the state of Pernambuco, we conducted a spatiotemporal dispersion study, covering the period from June 2020 to August 2021, to comprehend the dynamics of viral transmission during the first 2 years of the pandemic. Throughout this study, we were able to track three significant epidemiological waves of transmission caused by B1.1, B.1.1.28, B.1.1.33, P.2, and P.1 lineages. These analyses provided valuable insights into the evolution of the epidemiological landscape, contributing to a deeper understanding of the dynamics of virus transmission during the early years of the pandemic in the state of Pernambuco.
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Affiliation(s)
- Lais Ceschini Machado
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Pernambuco, Brazil
| | - Filipe Zimmer Dezordi
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Pernambuco, Brazil
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Gustavo Barbosa de Lima
- Núcleo de Plataformas Tecnológicas (NPT), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Raul Emídio de Lima
- Núcleo de Plataformas Tecnológicas (NPT), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Lilian Caroliny Amorim Silva
- Núcleo de Plataformas Tecnológicas (NPT), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Leandro de Mattos Pereira
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Alexandre Freitas da Silva
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Pernambuco, Brazil
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | | | - André Luiz Sá de Oliveira
- Núcleo de Estatística e Geoprocessamento, Instituto Aggeu Magalhães (IAM)- Fundação Oswaldo Cruz Pernambuco- FIOCRUZ-PE, Recife, Brazil
| | | | - Rômulo Pessoa-e-Silva
- Suely-Galdino Therapeutic Innovation Research Center (NUPIT-SG), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Rodrigo Moraes Loyo
- Departamento de Parasitologia, Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Barbara de Oliveira Silva
- Suely-Galdino Therapeutic Innovation Research Center (NUPIT-SG), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Anderson Rodrigues de Almeida
- Suely-Galdino Therapeutic Innovation Research Center (NUPIT-SG), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Maira Galdino da Rocha Pitta
- Suely-Galdino Therapeutic Innovation Research Center (NUPIT-SG), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | - Marilda Mendonça Siqueira
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paola Cristina Resende
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Rio de Janeiro, Brazil
| | - Edson Delatorre
- Departamento de Biologia, Centro de Ciências Exatas, Naturais e da Saúde, Universidade Federal do Espírito Santo, Alegre, Espírito Santo, Brazil
| | - Felipe Gomes Naveca
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia (EDTA), Instituto Leônidas e Maria Deane, FIOCRUZ-Amazonas, Manaus, Amazonas, Brazil
| | - Fabio Miyajima
- Analytical Competence Molecular Epidemiology Laboratory (ACME), FIOCRUZ-Ceará, Fortaleza, Ceará, Brazil
| | - Tiago Gräf
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Paraná, Brazil
| | | | - Michelly Cristiny Pereira
- Suely-Galdino Therapeutic Innovation Research Center (NUPIT-SG), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Tulio de Lima Campos
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Matheus Filgueira Bezerra
- Departamento de Microbiologia, Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
| | - Marcelo Henrique Santos Paiva
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Pernambuco, Brazil
- Núcleo de Ciências da Vida, Universidade Federal de Pernambuco (UFPE), Centro Acadêmico do Agreste, Caruaru, Brazil
| | - Gabriel da Luz Wallau
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Pernambuco, Brazil
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
- Department of Arbovirology, Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases, Hamburg, Germany
| | - On behalf of Fiocruz COVID-19 Genomic Network
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Pernambuco, Brazil
- Núcleo de Bioinformática (NBI), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
- Núcleo de Plataformas Tecnológicas (NPT), Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
- Núcleo de Estatística e Geoprocessamento, Instituto Aggeu Magalhães (IAM)- Fundação Oswaldo Cruz Pernambuco- FIOCRUZ-PE, Recife, Brazil
- Colegiado de Medicina, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
- Suely-Galdino Therapeutic Innovation Research Center (NUPIT-SG), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Departamento de Parasitologia, Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
- Núcleo de Ciências da Vida, Universidade Federal de Pernambuco (UFPE), Centro Acadêmico do Agreste, Caruaru, Brazil
- Laboratory of Respiratory Viruses and Measles (LVRS), Instituto Oswaldo Cruz, FIOCRUZ-Rio de Janeiro, Rio de Janeiro, Brazil
- Departamento de Biologia, Centro de Ciências Exatas, Naturais e da Saúde, Universidade Federal do Espírito Santo, Alegre, Espírito Santo, Brazil
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia (EDTA), Instituto Leônidas e Maria Deane, FIOCRUZ-Amazonas, Manaus, Amazonas, Brazil
- Analytical Competence Molecular Epidemiology Laboratory (ACME), FIOCRUZ-Ceará, Fortaleza, Ceará, Brazil
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Paraná, Brazil
- Colegiado de Ciências Farmacêuticas, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
- Departamento de Microbiologia, Instituto Aggeu Magalhães (IAM), FIOCRUZ-Pernambuco, Recife, Pernambuco, Brazil
- Department of Arbovirology, Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases, Hamburg, Germany
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Ruuskanen O, Dollner H, Luoto R, Valtonen M, Heinonen OJ, Waris M. Contraction of Respiratory Viral Infection During air Travel: An Under-Recognized Health Risk for Athletes. SPORTS MEDICINE - OPEN 2024; 10:60. [PMID: 38776030 PMCID: PMC11111432 DOI: 10.1186/s40798-024-00725-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
Air travel has an important role in the spread of viral acute respiratory infections (ARIs). Aircraft offer an ideal setting for the transmission of ARI because of a closed environment, crowded conditions, and close-contact setting. Numerous studies have shown that influenza and COVID-19 spread readily in an aircraft with one virus-positive symptomatic or asymptomatic index case. The numbers of secondary cases differ markedly in different studies most probably because of the wide variation of the infectiousness of the infector as well as the susceptibility of the infectees. The primary risk factor is sitting within two rows of an infectious passenger. Elite athletes travel frequently and are thus prone to contracting an ARI during travel. It is anecdotally known in the sport and exercise medicine community that athletes often contract ARI during air travel. The degree to which athletes are infected in an aircraft by respiratory viruses is unclear. Two recent studies suggest that 8% of Team Finland members traveling to major winter sports events contracted the common cold most probably during air travel. Further prospective clinical studies with viral diagnostics are needed to understand the transmission dynamics and to develop effective and socially acceptable preventive measures during air travel.
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Affiliation(s)
- Olli Ruuskanen
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, PL 52, 20521, Turku, Finland
| | - Henrik Dollner
- Department of Clinical and Molecular Medicine, Children's Clinic, St. Olavs University Hospital, Norwegian University of Science and Technology, Trondheim, Norway
| | - Raakel Luoto
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, PL 52, 20521, Turku, Finland
| | | | - Olli J Heinonen
- Paavo Nurmi Centre and Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Matti Waris
- Institute of Biomedicine, University of Turku and Department of Clinical Virology, Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland.
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Jones DL, Rhymes JM, Green E, Rimmer C, Kevill JL, Malham SK, Weightman AJ, Farkas K. Poor air passenger knowledge of COVID-19 symptoms and behaviour undermines strategies aimed at preventing the import of SARS-CoV-2 into the UK. Sci Rep 2023; 13:3494. [PMID: 36859503 PMCID: PMC9976683 DOI: 10.1038/s41598-023-30654-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 02/27/2023] [Indexed: 03/03/2023] Open
Abstract
Air travel mediates transboundary movement of SARS-CoV-2. To prepare for future pandemics, we sought to understand air passenger behaviour and perceived risk during the COVID-19 pandemic. This study of UK adults (n = 2103) quantified knowledge of COVID-19 symptoms, perceived health risk of contracting COVID-19, likelihood of returning to the UK with COVID-19 symptoms, likelihood to obey self-quarantining guidelines, how safe air travellers felt when flying during the pandemic (n = 305), and perceptions towards face covering effectiveness.Overall knowledge of COVID-19 symptoms was poor. Men and younger age groups (18-44) were less informed than women and older age groups (44 +). A significant proportion (21%) of the population would likely travel back to the UK whilst displaying COVID-19 symptoms with many expressing that they would not fully comply with self-isolation guidelines. Overall, males and younger age groups had a reduced perceived personal risk from contracting COVID-19, posing a higher risk of transporting SARS-CoV-2 back to the UK. Poor passenger knowledge and behaviour undermines government guidelines and policies aimed at preventing SARS-CoV-2 entry into the UK. This supports the need for stricter, clearer and more targeted guidelines with point-of-departure viral testing and stricter quarantining upon arrival.
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Affiliation(s)
- David. L. Jones
- grid.7362.00000000118820937Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, LL57 2UW Gwynedd UK ,grid.1025.60000 0004 0436 6763SoilsWest, Centre for Sustainable Farming Systems, Food Futures Institute, Murdoch University, Murdoch, WA 6105 Australia
| | - Jennifer M. Rhymes
- grid.7362.00000000118820937Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, LL57 2UW Gwynedd UK ,grid.494924.60000 0001 1089 2266UK Centre for Ecology and Hydrology, Environment Centre Wales, Bangor, LL57 2UW Gwynedd UK
| | - Emma Green
- grid.7362.00000000118820937Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, LL57 2UW Gwynedd UK
| | - Charlotte Rimmer
- grid.7362.00000000118820937Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, LL57 2UW Gwynedd UK
| | - Jessica L. Kevill
- grid.7362.00000000118820937Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, LL57 2UW Gwynedd UK
| | - Shelagh K. Malham
- grid.7362.00000000118820937School of Ocean Sciences, Bangor University, Menai Bridge, LL59 5AB Anglesey UK
| | - Andrew J. Weightman
- grid.5600.30000 0001 0807 5670Microbiomes, Microbes and Informatics Group, School of Biosciences, Cardiff University, Cardiff, CF10 3AX UK
| | - Kata Farkas
- grid.7362.00000000118820937Centre for Environmental Biotechnology, School of Natural Sciences, Bangor University, Bangor, LL57 2UW Gwynedd UK ,grid.7362.00000000118820937School of Ocean Sciences, Bangor University, Menai Bridge, LL59 5AB Anglesey UK
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Rafferty AC, Bofkin K, Hughes W, Souter S, Hosegood I, Hall RN, Furuya-Kanamori L, Liu B, Drane M, Regan T, Halder M, Kelaher C, Kirk MD. Does 2x2 airplane passenger contact tracing for infectious respiratory pathogens work? A systematic review of the evidence. PLoS One 2023; 18:e0264294. [PMID: 36730309 PMCID: PMC9894495 DOI: 10.1371/journal.pone.0264294] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 01/18/2023] [Indexed: 02/03/2023] Open
Abstract
We critically appraised the literature regarding in-flight transmission of a range of respiratory infections to provide an evidence base for public health policies for contact tracing passengers, given the limited pathogen-specific data for SARS-CoV-2 currently available. Using PubMed, Web of Science, and other databases including preprints, we systematically reviewed evidence of in-flight transmission of infectious respiratory illnesses. A meta-analysis was conducted where total numbers of persons on board a specific flight was known, to calculate a pooled Attack Rate (AR) for a range of pathogens. The quality of the evidence provided was assessed using a bias assessment tool developed for in-flight transmission investigations of influenza which was modelled on the PRISMA statement and the Newcastle-Ottawa scale. We identified 103 publications detailing 165 flight investigations. Overall, 43.7% (72/165) of investigations provided evidence for in-flight transmission. H1N1 influenza A virus had the highest reported pooled attack rate per 100 persons (AR = 1.17), followed by SARS-CoV-2 (AR = 0.54) and SARS-CoV (AR = 0.32), Mycobacterium tuberculosis (TB, AR = 0.25), and measles virus (AR = 0.09). There was high heterogeneity in estimates between studies, except for TB. Of the 72 investigations that provided evidence for in-flight transmission, 27 investigations were assessed as having a high level of evidence, 23 as medium, and 22 as low. One third of the investigations that reported on proximity of cases showed transmission occurring beyond the 2x2 seating area. We suggest that for emerging pathogens, in the absence of pathogen-specific evidence, the 2x2 system should not be used for contact tracing. Instead, alternate contact tracing protocols and close contact definitions for enclosed areas, such as the same cabin on an aircraft or other forms of transport, should be considered as part of a whole of journey approach.
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Affiliation(s)
- Anna C. Rafferty
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
- National Incident Centre, The Australian Government Department of Health, Canberra, Australian Capital Territory, Australia
| | - Kelly Bofkin
- Qantas Airways Limited, Mascot, New South Wales, Australia
- Virgin Australia Airlines, South Brisbane, Queensland, Australia
| | - Whitney Hughes
- Qantas Airways Limited, Mascot, New South Wales, Australia
| | - Sara Souter
- Qantas Airways Limited, Mascot, New South Wales, Australia
- Virgin Australia Airlines, South Brisbane, Queensland, Australia
| | - Ian Hosegood
- Qantas Airways Limited, Mascot, New South Wales, Australia
| | - Robyn N. Hall
- National Incident Centre, The Australian Government Department of Health, Canberra, Australian Capital Territory, Australia
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Bette Liu
- School of Population Health, University of New South Wales, Kensington, New South Wales, Australia
| | | | - Toby Regan
- New Zealand Ministry of Health, Wellington, New Zealand
| | - Molly Halder
- New Zealand Ministry of Health, Wellington, New Zealand
| | - Catherine Kelaher
- National Incident Centre, The Australian Government Department of Health, Canberra, Australian Capital Territory, Australia
| | - Martyn D. Kirk
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
- National Incident Centre, The Australian Government Department of Health, Canberra, Australian Capital Territory, Australia
- * E-mail:
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Bode FI, Nastase I. Numerical Investigation of Very Low Reynolds Cross Orifice Jet for Personalized Ventilation Applications in Aircraft Cabins. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:740. [PMID: 36613062 PMCID: PMC9819846 DOI: 10.3390/ijerph20010740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
This study focuses on the numerical analysis of a challenging issue involving the regulation of the human body's microenvironment through personalized ventilation. We intended to first concentrate on the main flow, namely, the personalized ventilation jet, before connecting the many interacting components that are impacting this microenvironment (human body plume, personalized ventilation jet, and the human body itself as a solid obstacle). Using the laminar model and the large eddy simulation (LES) model, the flow field of a cross-shaped jet with very low Reynolds numbers is examined numerically. The related results are compared to data from laser doppler velocimetry (LDV) and particle image velocimetry (PIV) for a reference jet design. The major goal of this study is to evaluate the advantages and disadvantages of the CFD approach for simulating the key features of the cross-shaped orifice jet flow. It was discovered that the laminar model overestimated the global jet volumetric flow rate and the flow expansion. LES looks more suitable for the numerical prediction of such dynamic integral quantities. In light of the computational constraints, it quite accurately mimics the mean flow behavior in the first ten equivalent diameters from the orifice, where the mesh grid was extremely finely tuned. From the perspective of the intended application, the streamwise velocity distributions, streamwise velocity decay, and volumetric flow rate anticipated by the LES model are rather well reproduced.
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Affiliation(s)
- Florin Ioan Bode
- Mechanical Engineering Department, Technical University of Cluj-Napoca, Muncii Boulevard Nr. 103-105, D03, 400114 Cluj-Napoca, Romania
- Building Services Department, CAMBI, Technical University of Civil Engineering in Bucharest, 66 Avenue Pache Protopopescu, 020396 Bucharest, Romania
| | - Ilinca Nastase
- Building Services Department, CAMBI, Technical University of Civil Engineering in Bucharest, 66 Avenue Pache Protopopescu, 020396 Bucharest, Romania
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Steiner MC, Novembre J. Population genetic models for the spatial spread of adaptive variants: A review in light of SARS-CoV-2 evolution. PLoS Genet 2022; 18:e1010391. [PMID: 36137003 PMCID: PMC9498967 DOI: 10.1371/journal.pgen.1010391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Theoretical population genetics has long studied the arrival and geographic spread of adaptive variants through the analysis of mathematical models of dispersal and natural selection. These models take on a renewed interest in the context of the COVID-19 pandemic, especially given the consequences that novel adaptive variants have had on the course of the pandemic as they have spread through global populations. Here, we review theoretical models for the spatial spread of adaptive variants and identify areas to be improved in future work, toward a better understanding of variants of concern in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) evolution and other contemporary applications. As we describe, characteristics of pandemics such as COVID-19-such as the impact of long-distance travel patterns and the overdispersion of lineages due to superspreading events-suggest new directions for improving upon existing population genetic models.
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Affiliation(s)
- Margaret C. Steiner
- Department of Human Genetics, University of Chicago, Chicago, Illinois, United States of America
| | - John Novembre
- Department of Human Genetics, University of Chicago, Chicago, Illinois, United States of America
- Department of Ecology & Evolution, University of Chicago, Chicago, Illinois, United States of America
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7
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Wang F, You R, Zhang T, Chen Q. Recent progress on studies of airborne infectious disease transmission, air quality, and thermal comfort in the airliner cabin air environment. INDOOR AIR 2022; 32:e13032. [PMID: 35481932 PMCID: PMC9111434 DOI: 10.1111/ina.13032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/03/2022] [Accepted: 03/17/2022] [Indexed: 05/08/2023]
Abstract
Airborne transmission of infectious diseases through air travel has become a major concern, especially during the COVID-19 pandemic. The flying public and crew members have long demanded better air quality and thermal comfort in commercial airliner cabins. This paper reviewed studies related to the airliner cabin air environment that have been published in scientific journals since 2000, to understand the state-of-the-art in cabin air environment design and the efforts made to improve this environment. In this critical review, this paper discusses the challenges and opportunities in studying the cabin air environment. The literature review concluded that current environmental control systems for airliner cabins have done little to stop the airborne transmission of infectious diseases. There were no reports of significant air quality problems in cabins, although passengers and crew members have complained of some health-related issues. The air temperature in cabins needs to be better controlled, and therefore, better thermal comfort models for airliners should be developed. Low humidity is a major complaint from passengers and crew members. Gaspers are used by passengers to adjust thermal comfort, but they do not improve air quality. Various personalized and displacement ventilation systems have been developed to improve air quality and thermal comfort. Air cleaning technologies need to be further developed. Good tools are available for designing a better cabin air environment.
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Affiliation(s)
- Feng Wang
- Tianjin Key Laboratory of Indoor Air Environmental Quality ControlSchool of Environmental Science and EngineeringTianjin UniversityTianjinChina
- Department of Building Environment and Energy EngineeringThe Hong Kong Polytechnic UniversityKowloon, Hong Kong SARChina
| | - Ruoyu You
- Department of Building Environment and Energy EngineeringThe Hong Kong Polytechnic UniversityKowloon, Hong Kong SARChina
| | - Tengfei Zhang
- Tianjin Key Laboratory of Indoor Air Environmental Quality ControlSchool of Environmental Science and EngineeringTianjin UniversityTianjinChina
| | - Qingyan Chen
- Department of Building Environment and Energy EngineeringThe Hong Kong Polytechnic UniversityKowloon, Hong Kong SARChina
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8
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Aluko OO, Imbianozor GT, Jideama CO, Ogundele OV, Fapetu TE, Afolabi OT, Odewade OL. The perception and disposal practices of unused and expired medicines by households in an urban municipality, southwest Nigeria: A comparative cross-sectional study. WASTE MANAGEMENT (NEW YORK, N.Y.) 2022; 140:121-132. [PMID: 35078076 DOI: 10.1016/j.wasman.2022.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/22/2021] [Accepted: 01/16/2022] [Indexed: 06/14/2023]
Abstract
Unused, damaged, and expired medicines (UEMs) pose disposal challenges globally, despite their importance. The environmental disposal of UEMs portends public health consequences, hence, this study in high-density (HDS) and low-density (LDS) urban households in Southwest Nigeria. The comparative, cross-sectional study utilised multi-stage samplingto enrol 404 females, experienced in use and medicines safekeeping. The response rate was 93%. Data were analysed by IBM-SPSS, version 20. Continuous and categorical variableswere presentedin tables as mean(±SD), proportions (%), respectively while χ2 and logistic regression statistics determined differences between LDS and HDS (Pα > 0.05). 53.4% and 71.2% of respondents respectively had good knowledge and positive attitudes to safe disposal of UEMs. At least 31.5% of households don't stock medicines while antimalarial (57.3%), analgesics (52.7%) and antibiotics (49.7%) predominate in households and significantly different between LDS and HDS. 72.9% and 67.8%; 47.9% and 55.6% respondents in LDS and HDS, respectively, disposed of solid and liquid UEMs in storage bins, though 34.9% (LDS) and 16.7% (HDS) disposed of liquid UEMs in toilet/sink. There were significant differences in medicines abundance and disposal practices between LDS and HDS for solid and liquid medicines. 37.1% of respondents perceived consequences for the poor UEMs disposal, including accidental ingestion (76.6% vs 26.7%), land pollution (69.6% vs 36.7%), water pollution (72.4% vs 32.8%) and toxicity (58.3% vs 32.8%), respectively in LDS and HDS. Respondents' good knowledge and positive attitudes contrasted with poor UEMs disposal practices, which compromise public health. Legislation, compliance monitoring and enforcement are germane for incentive-driven UEMs recovery.
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Affiliation(s)
- O O Aluko
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - G T Imbianozor
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - C O Jideama
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - O V Ogundele
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - T E Fapetu
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - O T Afolabi
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - O L Odewade
- Department of Environmental Management, Faculty of Earth and Environmental Sciences, Bayero University, Kano, Nigeria
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9
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Personalized Ventilation as a Possible Strategy for Reducing Airborne Infectious Disease Transmission on Commercial Aircraft. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12042088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In the last decade, there has been an increase in ease and affordability of air travel in terms of mobility for people all around the world. Airplane passengers may experience different risks of contracting airborne infectious diseases onboard aircraft, such as influenza or severe acute respiratory syndrome (SARS-CoV-1 and SARS-CoV-2), due to nonuniform airflow patterns inside the airplane cabin or proximity to an infected person. In this paper, a novel approach for reducing the risk of contracting airborne infectious diseases is presented that uses a low-momentum personalized ventilation system with a protective role against airborne pathogens. Numerical simulations, supported by nonintrusive experimental measurements for validation purposes, were used to demonstrate the effectiveness of the proposed system. Simulation and experimental results of the low-momentum personalized ventilation system showed the formation of a microclimate around each passenger with cleaner and fresher air than produced by the general mixing ventilation systems.
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10
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Islamoglu MS, Cengiz M, Borku Uysal B, Ikitimur H, Demirbilek M, Dokur M, Seyhan S, Koc S, Yavuzer S. COVID-19 seroconversion in the aircrew from Turkey. Travel Med Infect Dis 2021; 44:102190. [PMID: 34743957 PMCID: PMC8556073 DOI: 10.1016/j.tmaid.2021.102190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 07/05/2021] [Accepted: 10/26/2021] [Indexed: 11/26/2022]
Abstract
Background Pneumonia due to Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) is spreading rapidly all over the world and air travel is the leading transmission route of the virus among countries. The aim of the study is to determine the frequency of SARS-CoV-2 Immunoglobulin G (IgG) antibodies in aircrew, to determine occupational exposure, and to understand the spread of immunity in social groups. Method The study was designed as a cross-sectional retrospective study. SARS-CoV-2 IgG levels were measured in patients who applied to between December 1, 2020 and January 13, 2021. Coronavirus disease-2019 (COVID-19) Reverse transcription polymerase chain reaction (RT-PCR) positivity was investigated before December 1, 2020. Results The patients were divided into three groups according to their jobs such as 313 aircrew; 451 healthcare workers; 4258 other patients. The PCR positivity rate was found to be 39% in the aircrew group, 32% in the healthcare workers and %20 other patient group (p < 0.001). The IgG antibody positivity rate was 46% in the aircrew, 41% in healthcare workers, and 35.3% in the other patient group (p < 0.001).The group with the highest IgG antibody titer is in the aircrew; there was a significant difference between the groups (p < 0.001). Conclusions In our study, it was observed that aircrew, similar to healthcare workers, are at serious risk against SARS-CoV-2. In this process, it is suggested that the vaccination processes included repeated doses of aircrew should be accelerated and protective measures and equipment should be increased in terms of reinfection.
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Affiliation(s)
- Mehmet Sami Islamoglu
- Department of Internal Medicine, Biruni University Medical Faculty, Istanbul, Turkey.
| | - Mahir Cengiz
- Department of Internal Medicine, Biruni University Medical Faculty, Istanbul, Turkey.
| | - Betul Borku Uysal
- Department of Internal Medicine, Biruni University Medical Faculty, Istanbul, Turkey.
| | - Hande Ikitimur
- Department of Pulmonary Diseases Biruni University Medical Faculty, Istanbul, Turkey.
| | | | - Mehmet Dokur
- Department of Emergency Medicine, Biruni University Medical Faculty, Istanbul, Turkey.
| | - Serhat Seyhan
- Department of Medical Genetics, Biruni University Medical Faculty, Istanbul, Turkey.
| | - Suna Koc
- Department of Anesthesiology and Reanimation, Biruni University Medical Faculty, Istanbul, Turkey.
| | - Serap Yavuzer
- Department of Internal Medicine, Biruni University Medical Faculty, Istanbul, Turkey.
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11
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Rosca EC, Heneghan C, Spencer EA, Brassey J, Plüddemann A, Onakpoya IJ, Evans DH, Conly JM, Jefferson T. Transmission of SARS-CoV-2 associated with aircraft travel: a systematic review. J Travel Med 2021; 28:taab133. [PMID: 34480171 PMCID: PMC8499932 DOI: 10.1093/jtm/taab133] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 12/26/2022]
Abstract
RATIONALE FOR THE REVIEW Air travel may be associated with viruses spread via infected passengers and potentially through in-flight transmission. Given the novelty of the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, transmission associated with air travel is based on transmission dynamics of other respiratory viruses. Our objective was to provide a rapid summary and evaluation of relevant data on SARS-CoV-2 transmission aboard aircraft, report policy implications and to highlight research gaps requiring urgent attention. METHODS We searched four electronic databases (1 February 2020-27 January 2021) and included studies on SARS-CoV-2 transmission aboard aircraft. We assessed study quality based on five criteria and reported important findings. KEY FINDINGS We included 18 studies on in-flight SARS-CoV-2 transmission (130 unique flights) and 2 studies on wastewater from aircraft. The quality of evidence from most published studies was low. Two wastewater studies reported PCR-positive samples with high cycle threshold values (33-39). Index case definition was heterogeneous across studies. The proportion of contacts traced ranged from 0.68 to 100%. Authors traced 2800/19 729 passengers, 140/180 crew members and 8/8 medical staff. Altogether, 273 index cases were reported, with 64 secondary cases. Three studies, each investigating one flight, reported no secondary cases. Secondary attack rate among studies following up >80% of passengers and crew (including data on 10 flights) varied between 0 and 8.2%. The studies reported on the possibility of SARS-CoV-2 transmission from asymptomatic, pre-symptomatic and symptomatic individuals. Two studies performed viral cultures with 10 positive results. Genomic sequencing and phylogenetic analysis were performed in individuals from four flights. CONCLUSION Current evidence suggests SARS-CoV-2 can be transmitted during aircraft travel, but published data do not permit any conclusive assessment of likelihood and extent. The variation in design and methodology restricts the comparison of findings across studies. Standardized guidelines for conducting and reporting future studies of transmission on aircraft should be developed.
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Affiliation(s)
- Elena C Rosca
- Department of Neurology, Victor Babes University of Medicine and Pharmacy, Piata Eftimie Murgu 2, Timisoara 300041, Romania
| | - Carl Heneghan
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK
| | - Elizabeth A Spencer
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK
| | - Jon Brassey
- Trip Database Ltd, Glasllwch Lane, Newport NP20 3PS, UK
| | - Annette Plüddemann
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK
| | - Igho J Onakpoya
- Department of Continuing Education, University of Oxford, Rewley House, 1 Wellington Square, Oxford OX1 2JA, UK
| | - David H Evans
- Li Ka Shing Institute of Virology, Edmonton Alberta T6G 2E1, Canada
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Alberta T6G 2E1, Canada
| | - John M Conly
- Departments of Medicine, Microbiology, Immunology & Infectious Diseases, and Pathology & Laboratory Medicine, Synder Institute for Chronic Diseases and O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary T2N 2T9, Canada
| | - Tom Jefferson
- Department of Continuing Education, University of Oxford, Rewley House, 1 Wellington Square, Oxford OX1 2JA, UK
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12
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Pang JK, Jones SP, Waite LL, Olson NA, Armstrong JW, Atmur RJ, Cummins JJ. Probability and estimated risk of SARS-CoV-2 transmission in the air travel system. Travel Med Infect Dis 2021; 43:102133. [PMID: 34182036 PMCID: PMC8233548 DOI: 10.1016/j.tmaid.2021.102133] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND As an emerging virus, SARS-CoV-2 and the risk of transmission during air travel is of high interest. This paper is a retrospective estimate of the probability of an infectious passenger in the air travel system transmitting the SARS-CoV-2 virus to a fellow passenger. METHODS Literature was reviewed from May-September 2020 to identify COVID-19 cases related to air travel. The studies were limited to publicly available literature for passengers; studies of flight crews were not reviewed. A novel quantitative approach was developed to estimate air travel transmission risk that considers secondary cases, the overall passenger population, and correction factors for asymptomatic transmission and underreporting. RESULTS There were at least 2866 index infectious passengers documented to have passed through the air travel system in a 1.4 billion passenger population. Using correction factors, the global risk of transmission during air travel is estimated at 1:1.7 million; acknowledging that assumptions exist around case detection rate and mass screenings. Uncertainty in the correction factors and a 95% credible interval indicate risk ranges from 1 case for every 712,000 travelers to 1 case for every 8 million travelers. CONCLUSION The risk of COVID-19 transmission on an aircraft is low, even with infectious persons onboard.
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13
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Abstract
Human respiratory virus infections lead to a spectrum of respiratory symptoms and disease severity, contributing to substantial morbidity, mortality and economic losses worldwide, as seen in the COVID-19 pandemic. Belonging to diverse families, respiratory viruses differ in how easy they spread (transmissibility) and the mechanism (modes) of transmission. Transmissibility as estimated by the basic reproduction number (R0) or secondary attack rate is heterogeneous for the same virus. Respiratory viruses can be transmitted via four major modes of transmission: direct (physical) contact, indirect contact (fomite), (large) droplets and (fine) aerosols. We know little about the relative contribution of each mode to the transmission of a particular virus in different settings, and how its variation affects transmissibility and transmission dynamics. Discussion on the particle size threshold between droplets and aerosols and the importance of aerosol transmission for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza virus is ongoing. Mechanistic evidence supports the efficacies of non-pharmaceutical interventions with regard to virus reduction; however, more data are needed on their effectiveness in reducing transmission. Understanding the relative contribution of different modes to transmission is crucial to inform the effectiveness of non-pharmaceutical interventions in the population. Intervening against multiple modes of transmission should be more effective than acting on a single mode.
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Affiliation(s)
- Nancy H L Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
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14
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Berruga-Fernández T, Robesyn E, Korhonen T, Penttinen P, Jansa JM. Risk Assessment for the Transmission of Middle East Respiratory Syndrome Coronavirus (MERS-Cov) on Aircraft: A Systematic Review. Epidemiol Infect 2021; 149:1-51. [PMID: 34108058 PMCID: PMC8220025 DOI: 10.1017/s095026882100131x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/08/2021] [Accepted: 05/26/2021] [Indexed: 11/07/2022] Open
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) causes a potentially fatal respiratory disease. Although it is most common in the Arabian Peninsula, it has been exported to 17 countries outside the Middle East, mostly through air travel. The Risk Assessment Guidelines for Infectious Diseases transmitted on Aircraft (RAGIDA) advise authorities on measures to take when an infected individual travelled by air. The aim of this systematic review was to gather all available information on documented MERS-CoV cases that had travelled by air, to update RAGIDA. The databases used were PubMed, Embase, Scopus and Global Index Medicus; Google was searched for grey literature and hand searching was performed on the EU Early Warning and Response System and the WHO Disease Outbreak News. Forty-seven records were identified, describing 21 cases of MERS that had travelled on 31 flights. Contact tracing was performed for 17 cases. Most countries traced passengers sitting in the same row and the two rows in front and behind the case. Only one country decided to trace all passengers and crew. No cases of in-flight transmission were observed; thus, considering the resources it requires, a conservative approach may be appropriate when contact tracing passengers and crew where a case of MERS has travelled by air.
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Affiliation(s)
- T. Berruga-Fernández
- Department of Medical Biochemistry and Microbiology (IMBIM), Uppsala University, Uppsala, Sweden
| | - E. Robesyn
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - T. Korhonen
- Emerging, Food- and Vector-Borne Diseases, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - P. Penttinen
- Vaccine Preventable Diseases and Immunisation, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - J. M. Jansa
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Stockholm, Sweden
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15
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De Angelis G, Lohmeyer FM, Grossi A, Posteraro B, Sanguinetti M. Hand hygiene and facemask use to prevent droplet-transmitted viral diseases during air travel: a systematic literature review. BMC Public Health 2021; 21:760. [PMID: 33879112 PMCID: PMC8056366 DOI: 10.1186/s12889-021-10814-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 04/12/2021] [Indexed: 01/09/2023] Open
Abstract
Background Transmission of viral diseases (e.g., influenza A H1N1) via respiratory droplets takes place mainly in confined spaces, including in aircraft during commercial air travel. The adoption of hygiene measures may help to prevent disease spread aboard aircraft. This review summarizes the evidence on hand hygiene and the use of facemasks as viral disease prevention measures in aircraft. Methods A literature search was performed in the PubMed, Scopus, and Web of Science databases up to 10 June 2020, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. A population, intervention, comparison, outcomes, and study design (PICOS) approach was used to define the review question. Results We included four studies published between 2007 and 2020, all targeting influenza virus disease, in the qualitative synthesis. Three studies used mathematical models to simulate single- or multiple-direction flights, and two of them showed that facemask (e.g., N95 respirator) use considerably reduced infection probability. In the third study, hand cleaning by 20 to 60% of people at any time in all airports (including on aircraft) reduced the measure of airports’ power to spread the disease across the globe by ~ 24 to 69%. The fourth study was a case-control study designed to trace an influenza outbreak in two flights during the 2009 influenza A H1N1 pandemic. The study showed that none (0%) of nine infected passengers compared to 15 (47%) of 32 healthy control passengers in the aircraft cabin during one of these flights wore a facemask (odds ratio, 0.0; 95% confidence interval, 0.0–0.7). In contrast, both case and control passengers appeared to be equally compliant in self-assessed hand hygiene. Conclusions Facemask use combined with hand hygiene may minimize the chance of droplet-transmitted virus spread by air travelers. Thus, it is necessary that hygiene measures become an integral part of standard procedures in commercial air travel. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10814-9.
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Affiliation(s)
- Giulia De Angelis
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | | | - Adriano Grossi
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Brunella Posteraro
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy. .,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
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16
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Harries AD, Martinez L, Chakaya JM. SARS-CoV-2: how safe is it to fly and what can be done to enhance protection? Trans R Soc Trop Med Hyg 2021; 115:117-119. [PMID: 33031556 PMCID: PMC7665738 DOI: 10.1093/trstmh/traa106] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/02/2020] [Accepted: 09/21/2020] [Indexed: 11/26/2022] Open
Abstract
With lockdown restrictions over coronavirus disease 2019 being relaxed, airlines are returning to the skies. Published evidence of severe acute respiratory syndrome (SARS) coronavirus 2 transmission on aircraft is limited, but in-flight transmission of respiratory infections such as tuberculosis, influenza and SARS has been well described. Risk factors include proximity to index patients and sitting in aisle seats. Personal protection on aircraft could be enhanced by always wearing a well-fitting face mask and face shield or sunglasses, wiping surfaces and hands with alcohol-based sanitizers, not touching the face, not queuing for washrooms, changing seats if nearby passengers are coughing and choosing a window rather than an aisle seat.
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Affiliation(s)
- Anthony D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France.,Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Leonardo Martinez
- Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Jeremiah M Chakaya
- International Union Against Tuberculosis and Lung Disease, Paris, France.,Department of Medicine, Therapeutics, Dermatology and Psychiatry, Kenyatta University, Nairobi, Kenya.,Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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17
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Khanh NC, Thai PQ, Quach HL, Thi NAH, Dinh PC, Duong TN, Mai LTQ, Nghia ND, Tu TA, Quang LN, Quang TD, Nguyen TT, Vogt F, Anh DD. Transmission of SARS-CoV 2 During Long-Haul Flight. Emerg Infect Dis 2020; 26:2617-2624. [PMID: 32946369 PMCID: PMC7588538 DOI: 10.3201/eid2611.203299] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
To assess the role of in-flight transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we investigated a cluster of cases among passengers on a 10-hour commercial flight. Affected persons were passengers, crew, and their close contacts. We traced 217 passengers and crew to their final destinations and interviewed, tested, and quarantined them. Among the 16 persons in whom SARS-CoV-2 infection was detected, 12 (75%) were passengers seated in business class along with the only symptomatic person (attack rate 62%). Seating proximity was strongly associated with increased infection risk (risk ratio 7.3, 95% CI 1.2-46.2). We found no strong evidence supporting alternative transmission scenarios. In-flight transmission that probably originated from 1 symptomatic passenger caused a large cluster of cases during a long flight. Guidelines for preventing SARS-CoV-2 infection among air passengers should consider individual passengers' risk for infection, the number of passengers traveling, and flight duration.
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18
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Pani SK, Lin NH, RavindraBabu S. Association of COVID-19 pandemic with meteorological parameters over Singapore. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 740:140112. [PMID: 32544735 PMCID: PMC7289735 DOI: 10.1016/j.scitotenv.2020.140112] [Citation(s) in RCA: 126] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/02/2020] [Accepted: 06/09/2020] [Indexed: 05/09/2023]
Abstract
Meteorological parameters are the critical factors affecting the transmission of infectious diseases such as Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS), and influenza. Consequently, infectious disease incidence rates are likely to be influenced by the weather change. This study investigates the role of Singapore's hot tropical weather in COVID-19 transmission by exploring the association between meteorological parameters and the COVID-19 pandemic cases in Singapore. This study uses the secondary data of COVID-19 daily cases from the webpage of Ministry of Health (MOH), Singapore. Spearman and Kendall rank correlation tests were used to investigate the correlation between COVID-19 and meteorological parameters. Temperature, dew point, relative humidity, absolute humidity, and water vapor showed positive significant correlation with COVID-19 pandemic. These results will help the epidemiologists to understand the behavior of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus against meteorological variables. This study finding would be also a useful supplement to help the local healthcare policymakers, Center for Disease Control (CDC), and the World Health Organization (WHO) in the process of strategy making to combat COVID-19 in Singapore.
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Affiliation(s)
- Shantanu Kumar Pani
- Department of Atmospheric Sciences, National Central University, Taoyuan 32001, Taiwan
| | - Neng-Huei Lin
- Department of Atmospheric Sciences, National Central University, Taoyuan 32001, Taiwan; Center for Environmental Monitoring and Technology, National Central University, Taoyuan 32001, Taiwan.
| | - Saginela RavindraBabu
- Center for Space and Remote Sensing Research, National Central University, Taoyuan 32001, Taiwan
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19
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Yao M, Zhang L, Ma J, Zhou L. On airborne transmission and control of SARS-Cov-2. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 731:139178. [PMID: 32388162 PMCID: PMC7198171 DOI: 10.1016/j.scitotenv.2020.139178] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 04/13/2023]
Abstract
The COVID-19 pandemic is creating a havoc situation across the globe that modern society has ever seen. Despite of their paramount importance, the transmission routes of SARS-Cov-2 still remain debated among various sectors. Evidences compiled here strongly suggest that the COVID-19 could be transmitted via air in inadequately ventilated environments. Existing experimental data showed that coronavirus survival was negatively impacted by ozone, high temperature and low humidity. Here, regression analysis showed that the spread of SARS-Cov-2 was reduced by increasing ambient ozone concentration level from 48.83 to 94.67 μg/m3 (p-value = 0.039) and decreasing relative humidity from 23.33 to 82.67% (p-value = 0.002) and temperature from -13.17 to 19 °C) (p-value = 0.003) observed for Chinese cities during Jan-March 2020. Besides using these environmental implications, social distancing and wearing a mask are strongly encouraged to maximize the fight against the COVID-19 airborne transmission. At no other time than now are the scientists in various disciplines around the world badly needed by the society to collectively confront this disastrous pandemic.
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Affiliation(s)
- Maosheng Yao
- College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
| | - Lu Zhang
- College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Jianxin Ma
- Center for Disease Control and Prevention of Chaoyang District of Beijing, Beijing 100020, China
| | - Lian Zhou
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, Jiangsu, China
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20
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Hoehl S, Karaca O, Kohmer N, Westhaus S, Graf J, Goetsch U, Ciesek S. Assessment of SARS-CoV-2 Transmission on an International Flight and Among a Tourist Group. JAMA Netw Open 2020; 3:e2018044. [PMID: 32809029 PMCID: PMC7435338 DOI: 10.1001/jamanetworkopen.2020.18044] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/14/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sebastian Hoehl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Onur Karaca
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Sandra Westhaus
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Jürgen Graf
- University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - Udo Goetsch
- Health Protection Authority, City of Frankfurt, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Health Protection Authority, City of Frankfurt, Frankfurt am Main, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology, Branch Translational Medicine und Pharmacology, Frankfurt, Frankfurt am Main, Germany
- German Centre for Infection Research, Deutsches Zentrum für Infektionsforschung, External Partner Site Frankfurt, Frankfurt am Main, Germany
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21
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Schwartz KL, Murti M, Finkelstein M, Leis JA, Fitzgerald-Husek A, Bourns L, Meghani H, Saunders A, Allen V, Yaffe B. Lack of COVID-19 transmission on an international flight. CMAJ 2020; 192:E410. [PMID: 32392504 DOI: 10.1503/cmaj.75015] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Kevin L Schwartz
- Infectious disease physician, Public Health Ontario, Toronto, Ont
| | - Michelle Murti
- Public health physician, Public Health Ontario, Toronto, Ont
| | | | - Jerome A Leis
- Infectious disease physician, Sunnybrook Hospital, Toronto, Ont
| | | | - Laura Bourns
- Associate medical officer of health, Region of Peel Public Health, Mississauga, Ont
| | - Hamidah Meghani
- Medical officer of health, Halton Region Health Department, Oakville, Ont
| | - Andrea Saunders
- Communicable diseases specialist, Public Health Ontario, Toronto, Ont
| | - Vanessa Allen
- Chief, Medical Microbiology, Public Health Ontario, Toronto, Ont
| | - Barbara Yaffe
- Associate chief medical officer of health, Ontario Ministry of Health, Toronto, Ont
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22
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Alnahas F, Yeboah P, Fliedel L, Abdin AY, Alhareth K. Expired Medication: Societal, Regulatory and Ethical Aspects of a Wasted Opportunity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030787. [PMID: 32012703 PMCID: PMC7037917 DOI: 10.3390/ijerph17030787] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/19/2020] [Accepted: 01/20/2020] [Indexed: 01/01/2023]
Abstract
A massive volume of expired medications amasses annually around the world because of pharmaceutical overprescription, combined with overproduction. The accumulation of pharmaceutical waste imposes ecological, economic and social/ethical burdens. Managing this presumed “waste” has developed into a global challenge due to the absence of specific regulations, unreasonable behavior of the patients, and an improper understanding of the concept of “expired medications” in general. This paper summaries, first, the recent literature reporting practices related to the disposal of unused medications. In this context, 48 papers from 34 countries with a total of 33,832 participants point towards a significant lack of public awareness regarding the appropriate disposal of such biologically potent chemicals. These findings are corroborated by a local survey on the disposal practices of unused medicines among pharmacy students at Saarland University. The regulatory aspects surrounding this topic, often based on the official guidelines for the disposal of expired medications and local waste management strategies, are then discussed in light of these findings. Finally, a closer inspection of the epistemic values of expired medications and different strategies for managing expired medications have been reviewed.
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Affiliation(s)
- Faez Alnahas
- Division of Bioorganic Chemistry, School of Pharmacy, Saarland University, 66123 Saarbruecken, Germany; (F.A.); (P.Y.); (A.Y.A.)
| | - Prince Yeboah
- Division of Bioorganic Chemistry, School of Pharmacy, Saarland University, 66123 Saarbruecken, Germany; (F.A.); (P.Y.); (A.Y.A.)
| | - Louise Fliedel
- UTCBS (Chemical and Biological Technologies for Health Group), Faculté de Pharmacie de Paris, Université de Paris, CNRS, INSERM, 75006 Paris, France;
| | - Ahmad Yaman Abdin
- Division of Bioorganic Chemistry, School of Pharmacy, Saarland University, 66123 Saarbruecken, Germany; (F.A.); (P.Y.); (A.Y.A.)
| | - Khair Alhareth
- UTCBS (Chemical and Biological Technologies for Health Group), Faculté de Pharmacie de Paris, Université de Paris, CNRS, INSERM, 75006 Paris, France;
- Correspondence:
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23
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Shaban RZ, Sotomayor-Castillo CF, Malik J, Li C. Global commercial passenger airlines and travel health information regarding infection control and the prevention of infectious disease: What's in a website? Travel Med Infect Dis 2020; 33:101528. [PMID: 31760126 PMCID: PMC7110852 DOI: 10.1016/j.tmaid.2019.101528] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Air travel has never been easier, cheaper or faster, with large volumes of people travelling around the world. These factors increase the risk of the spread of infectious diseases by air travel. Little is known, however, about the extent to which airlines provide information to passengers on infection control and measures to prevent the spread of infectious diseases. This study examined the websites of the global commercial passenger airlines to see if they contained information about infection control and prevention of infectious diseases and appraised the clinical usefulness of that information. METHOD A cross-sectional text-based analysis of the 73 airline websites from the six global commercial passenger airline conglomerates was performed to identify information about infection control and prevention of infectious between July and August 2019. RESULTS Of the 73 airline websites, less than half (n = 35, 28.6%) contained information deemed useful for passengers. While there was a range of general health advice within the websites, there was limited information about infection control and preventing infectious diseases. A minority of websites contained information about vaccination status prior to travel, and to a lesser extent handwashing and hand hygiene, with very few including disease-specific advice or preventive measures. CONCLUSIONS Airline websites are an underutilised source of information for infection control and the prevention of infectious diseases. Providing passengers with information on basic infection control and prevention measures may support the global efforts against the spread of infectious diseases.
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Affiliation(s)
- Ramon Z Shaban
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia; The University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead, NSW, 2145, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, 2145, Australia.
| | - Cristina F Sotomayor-Castillo
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia; The University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead, NSW, 2145, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, 2145, Australia
| | - Jeremy Malik
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia
| | - Cecilia Li
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia; The University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead, NSW, 2145, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, 2145, Australia
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24
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Thomas RE. Roger E. Thomas Comments. Am J Public Health 2019; 109:1784-1785. [PMID: 31693417 DOI: 10.2105/ajph.2019.305386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Roger E Thomas
- The author is with the Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
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25
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Talbot TR, Babcock HM. Respiratory Protection of Health Care Personnel to Prevent Respiratory Viral Transmission. JAMA 2019; 322:817-819. [PMID: 31479123 DOI: 10.1001/jama.2019.11644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Thomas R Talbot
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Hilary M Babcock
- Washington University School of Medicine in St Louis, St Louis, Missouri
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26
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Valtonen M, Waris M, Vuorinen T, Eerola E, Hakanen AJ, Mjosund K, Grönroos W, Heinonen OJ, Ruuskanen O. Common cold in Team Finland during 2018 Winter Olympic Games (PyeongChang): epidemiology, diagnosis including molecular point-of-care testing (POCT) and treatment. Br J Sports Med 2019; 53:1093-1098. [PMID: 31142472 PMCID: PMC6818521 DOI: 10.1136/bjsports-2018-100487] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2019] [Indexed: 12/25/2022]
Abstract
Objectives The common cold is the main cause of medical time loss in elite sport. Rapid diagnosis has been a challenge that may be amenable to molecular point-of-care testing (POCT). Methods We performed a prospective observational study of the common cold in Team Finland during the 2018 Winter Olympic Games. There were 44 elite athletes and 68 staff members. The chief physician recorded the symptoms of the common cold daily on a standardised form. Two nasal swabs were taken at the onset of symptoms. One swab was analysed within 45 min using a molecular POCT for respiratory syncytial virus and influenza A and B viruses. After the Games, the other swab was tested for 16 possible causative respiratory viruses using PCR in laboratory-based testing. Results 20 out of 44 (45%) athletes and 22 out of 68 (32%) staff members experienced symptoms of the common cold during a median stay of 21 days. Eleven (26%) samples tested virus-positive using POCT. All subjects with influenza (n=6) and 32 close contacts were treated with oseltamivir. The aetiology of the common cold was finally detected in 75% of the athletes and 68 % of the staff members. Seven virus clusters were identified. They were caused by coronaviruses 229E, NL63 and OC43, influenza B virus, respiratory syncytial virus A, rhinovirus and human metapneumovirus. The virus infections spread readily within the team, most commonly within the same sport discipline. Conclusions The cold was indeed a common illness in Team Finland during the Winter Olympic Games. POCT proved to be clinically valuable, especially for influenza. The aetiology of the common cold was identified in most cases.
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Affiliation(s)
| | - Matti Waris
- Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Clinical Virology, Turku University Hospital, Turku, Finland
| | - Tytti Vuorinen
- Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Clinical Virology, Turku University Hospital, Turku, Finland
| | - Erkki Eerola
- Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
| | - Antti J Hakanen
- Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
| | - Katja Mjosund
- Paavo Nurmi Centre and Unit of Health and Physical Activity, University of Turku, Turku, Finland
| | - Wilma Grönroos
- Paavo Nurmi Centre and Unit of Health and Physical Activity, University of Turku, Turku, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre and Unit of Health and Physical Activity, University of Turku, Turku, Finland
| | - Olli Ruuskanen
- Department of Paediatrics, Turku University Hospital Research Centre, Turku, Finland
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27
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Abstract
Knowledge about the infection transmission routes is significant for developing effective intervention strategies. We searched the PubMed databases and identified 10 studies with 14 possible inflight influenza A(H1N1)pdm09 outbreaks. Considering the different mechanisms of the large-droplet and airborne routes, a meta-analysis of the outbreak data was carried out to study the difference in attack rates for passengers within and beyond two rows of the index case(s). We also explored the relationship between the attack rates and the flight duration and/or total infectivity of the index case(s). The risk ratios for passengers seated within and beyond the two rows of the index cases were 1.7 (95% confidence interval (CI) 0.98-2.84) for syndromic secondary cases and 4.3 (95% CI 1.25-14.54) for laboratory-confirmed secondary cases. Furthermore, with an increase of the product of the flight duration and the total infectivity of the index cases, the overall attack rate increased linearly. The study indicates that influenza A(H1N1)pdm09 may mainly be transmitted via the airborne route during air travel. A standardised approach for the reporting of such inflight outbreak investigations would help to provide more convincing evidence for such inflight transmission events.
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28
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Allyn J, Brottet E, Antok E, Dangers L, Persichini R, Coolen-Allou N, Roquebert B, Allou N, Vandroux D. Case Report: Severe Imported Influenza Infections Developed during Travel in Reunion Island. Am J Trop Med Hyg 2017; 97:1943-1944. [PMID: 29016311 DOI: 10.4269/ajtmh.17-0278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We report two cases of severe influenza infection imported by tourist patients from their country of origin and developed during travel. While studies have reported cases of influenza infections acquired during travel, here we examine two cases of severe influenza infection contracted in the country of origin that led to diagnosis and therapeutic problems in the destination country. No international recommendation exists concerning influenza vaccination before travel, and few countries recommend it for all travelers. Our study suggests that travel should be canceled when infectious signs are observed before departure. Influenza is a very common infection that is often benign, but sometimes very severe. The most severe cases include shock, acute respiratory distress syndrome (ARDS), myocarditis, rhabdomyolysis, and multiple organ failure. Management can require exceptional therapies, such as extracorporeal membrane oxygenation. A number of studies have focused on influenza infection in travelers. Cases of influenza acquired during travel have been reported in this literature, but no study has examined cases of influenza imported from the country of origin and developed while abroad. The latter situation may lead to 1) diagnostic problems during the nonepidemic season or in places where diagnostic techniques are lacking and 2) therapeutic difficulties resulting from the unavailability of techniques for the management of severe influenza infection in tourist areas. Here, we report two cases of extremely severe influenza infection imported by tourists from their country of origin and developed during travel.
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Affiliation(s)
- Jérôme Allyn
- Réanimation polyvalente, Centre Hospitalier Universitaire La Réunion, Site Félix Guyon, Bellepierre, Saint-Denis, France
| | - Elise Brottet
- Santé publique France, French National Public Health Agency, Regional Unit (Cire) Océan Indien, La Réunion, France
| | - Emmanuel Antok
- Réanimation polyvalente, Centre Hospitalier Universitaire La Réunion, Site Sud, Saint-Pierre, France
| | - Laurence Dangers
- Réanimation polyvalente, Centre Hospitalier Universitaire La Réunion, Site Félix Guyon, Bellepierre, Saint-Denis, France
| | - Romain Persichini
- Réanimation polyvalente, Centre Hospitalier Universitaire La Réunion, Site Félix Guyon, Bellepierre, Saint-Denis, France
| | - Nathalie Coolen-Allou
- Pneumologie, Centre Hospitalier Universitaire La Réunion, Site Félix Guyon, Bellepierre, Saint-Denis, France
| | - Bénédicte Roquebert
- Laboratoire de virologie, Centre Hospitalier Universitaire La Réunion, Site Félix Guyon, Bellepierre, Saint-Denis, France
| | - Nicolas Allou
- Réanimation polyvalente, Centre Hospitalier Universitaire La Réunion, Site Félix Guyon, Bellepierre, Saint-Denis, France
| | - David Vandroux
- Centre René Labusquière, Institute of Tropical Medicine, Université de Bordeaux, Bordeaux, France.,Réanimation polyvalente, Centre Hospitalier Universitaire La Réunion, Site Félix Guyon, Bellepierre, Saint-Denis, France
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29
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Goeijenbier M, van Genderen P, Ward BJ, Wilder-Smith A, Steffen R, Osterhaus ADME. Travellers and influenza: risks and prevention. J Travel Med 2017; 24:taw078. [PMID: 28077609 PMCID: PMC5505480 DOI: 10.1093/jtm/taw078] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND Influenza viruses are among the major causes of serious human respiratory tract infection worldwide. In line with the high disease burden attributable to influenza, these viruses play an important, but often neglected, role in travel medicine. Guidelines and recommendations regarding prevention and management of influenza in travellers are scarce. Of special interest for travel medicine are risk populations and also circumstances that facilitate influenza virus transmission and spread, like travel by airplane or cruise ship and mass gatherings. METHODS We conducted a PUBMED/MEDLINE search for a combination of the MeSH terms Influenza virus, travel, mass gathering, large scale events and cruise ship. In addition we gathered guidelines and recommendations from selected countries and regarding influenza prevention and management in travellers. By reviewing these search results in the light of published knowledge in the fields of influenza prevention and management, we present best practice advice for the prevention and management of influenza in travel medicine. RESULTS Seasonal influenza is among the most prevalent infectious diseases in travellers. Known host-associated risk factors include extremes of age and being immune-compromised, while the most relevant environmental factors are associated with holiday cruises and mass gatherings. CONCLUSIONS Pre-travel advice should address influenza and its prevention for travellers, whenever appropriate on the basis of the epidemiological situation concerned. Preventative measures should be strongly recommended for travellers at high-risk for developing complications. In addition, seasonal influenza vaccination should be considered for any traveller wishing to reduce the risk of incapacitation, particularly cruise ship crew and passengers, as well as those participating in mass gatherings. Besides advice concerning preventive measures and vaccination, advice on the use of antivirals may be considered for some travellers.
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Affiliation(s)
- M Goeijenbier
- Institute for Tropical Diseases, Havenziekenhuis, Rotterdam, The Netherlands
| | - P van Genderen
- Institute for Tropical Diseases, Havenziekenhuis, Rotterdam, The Netherlands
| | - B J Ward
- Research institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - A Wilder-Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Institute of Public Health, University of Heidelberg, Germany
| | - R Steffen
- Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travelers Health, University of Zurich Travel Health Centre, Zurich, Switzerland
| | - A D M E Osterhaus
- ARTEMIS One Health Research Institute Utrecht, The Netherlands
- Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine, Hannover, Germany
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30
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Twitter Influenza Surveillance: Quantifying Seasonal Misdiagnosis Patterns and their Impact on Surveillance Estimates. Online J Public Health Inform 2016; 8:e198. [PMID: 28210419 PMCID: PMC5302465 DOI: 10.5210/ojphi.v8i3.7011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Influenza (flu) surveillance using Twitter data can potentially save lives and increase efficiency by providing governments and healthcare organizations with greater situational awareness. However, research is needed to determine the impact of Twitter users' misdiagnoses on surveillance estimates. OBJECTIVE This study establishes the importance of Twitter users' misdiagnoses by showing that Twitter flu surveillance in the United States failed during the 2011-2012 flu season, estimates the extent of misdiagnoses, and tests several methods for reducing the adverse effects of misdiagnoses. METHODS Metrics representing flu prevalence, seasonal misdiagnosis patterns, diagnosis uncertainty, flu symptoms, and noise were produced using Twitter data in conjunction with OpenSextant for geo-inferencing, and a maximum entropy classifier for identifying tweets related to illness. These metrics were tested for correlations with World Health Organization (WHO) positive specimen counts of flu from 2011 to 2014. RESULTS Twitter flu surveillance erroneously indicated a typical flu season during 2011-2012, even though the flu season peaked three months late, and erroneously indicated plateaus of flu tweets before the 2012-2013 and 2013-2014 flu seasons. Enhancements based on estimates of misdiagnoses removed the erroneous plateaus and increased the Pearson correlation coefficients by .04 and .23, but failed to correct the 2011-2012 flu season estimate. A rough estimate indicates that approximately 40% of flu tweets reflected misdiagnoses. CONCLUSIONS Further research into factors affecting Twitter users' misdiagnoses, in conjunction with data from additional atypical flu seasons, is needed to enable Twitter flu surveillance systems to produce reliable estimates during atypical flu seasons.
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