Differentiating Epidemic from Endemic or Sporadic Infectious Disease Occurrence

Interrogating Genomes and Geography to Unravel Multiyear Vesicular Stomatitis Epizootics

We conducted an integrative analysis to elucidate the spatial epidemiological patterns of the Vesicular Stomatitis New Jersey virus (VSNJV) during the 2014-15 epizootic cycle in the United States (US). Using georeferenced VSNJV genomics data, confirmed vesicular stomatitis (VS) disease cases from surveillance, and a suite of environmental factors, our study assessed environmental and phylogenetic similarity to compare VS cases reported in 2014 and 2015. Despite uncertainties from incomplete virus sampling and cross-scale spatial processes, patterns suggested multiple independent re-invasion events concurrent with potential viral overwintering between sequential seasons. Our findings pointed to a geographically defined southern virus pool at the US-Mexico interface as the source of VSNJV invasions and overwintering sites. Phylodynamic analysis demonstrated an increase in virus diversity before a rise in case numbers and a pronounced reduction in virus diversity during the winter season, indicative of a genetic bottleneck and a significant narrowing of virus variation between the summer outbreak seasons. Environment-vector interactions underscored the central role of meta-population dynamics in driving disease spread. These insights emphasize the necessity for location- and time-specific management practices, including rapid response, movement restrictions, vector control, and other targeted interventions.

How heterogeneous is the dengue transmission profile in Brazil? A study in six Brazilian states

Dengue is a vector-borne disease present in most tropical countries, infecting an average of 50 to 100 million people per year. Socioeconomic, demographic, and environmental factors directly influence the transmission cycle of the dengue virus (DENV). In Brazil, these factors vary between regions producing different profiles of dengue transmission and challenging the epidemiological surveillance of the disease. In this article, we aimed at classifying the profiles of dengue transmission in 1,823 Brazilian municipalities, covering different climates, from 2010 to 2019. Time series data of dengue cases were obtained from six states: Ceará and Maranhão in the semiarid Northeast, Minas Gerais in the countryside, Espírito Santo and Rio de Janeiro in the tropical Atlantic coast, and Paraná in the subtropical region. To describe the time series, we proposed a set of epi-features of the magnitude and duration of the dengue epidemic cycles, totaling 13 indicators. Using these epi-features as inputs, a multivariate cluster algorithm was employed to classify the municipalities according to their dengue transmission profile. Municipalities were classified into four distinct dengue transmission profiles: persistent transmission (7.8%), epidemic (21.3%), episodic/epidemic (43.2%), and episodic transmission (27.6%). Different profiles were associated with the municipality’s population size and climate. Municipalities with higher incidence and larger populations tended to be classified as persistent transmission, suggesting the existence of critical community size. This association, however, varies depending on the state, indicating the importance of other factors. The proposed classification is useful for developing more specific and precise surveillance protocols for regions with different dengue transmission profiles, as well as more precise public policies for dengue prevention.

Dengue is one of the fastest-growing vector-borne diseases in the world. Currently, vaccines are experimental and are not very effective, so prevention depends on the control of the mosquito Aedes aegypti. Health promotion campaigns aimed at encouraging people to reduce mosquito breeding sites have limited effect. In addition, the heterogeneity of the territories that have dengue becomes a major challenge for the epidemiological surveillance of the disease. Brazil has a territory of continental size, and single standardized surveillance is not very effective for monitoring this arbovirus. Classifying types of dengue dynamics based on features of the epidemiological cycle in each location has the potential to increase the precision of surveillance and control strategies. In our study, we were able to classify areas according to different dengue transmission profiles, ranging from episodic to persistent transmission. These results can provide tools to guide actions aimed at achieving the World Health Organization’s goals of eliminating neglected tropical diseases in countries that have the virus.

Atmospheric particulate matter effects on SARS-CoV-2 infection and spreading dynamics: A spatio-temporal point process model

Particulate matter (PM) may play a role in differential distribution and transmission rates of SARS-CoV-2. For public health surveillance, identification of factors affecting the transmission dynamics concerning the endemic (persistent sporadic) and epidemic (rapidly clustered) component of infection can help to implement intervention strategies to reduce the disease burden. The aim of this study is to assess the effect of long-term residential exposure to outdoor PM ≤ 10 μm (PM₁₀) concentrations on SARS-CoV-2 incidence and on its spreading dynamics in Marche region (Central Italy) during the first wave of the COVID-19 pandemic (February to May 2020), using the endemic-epidemic spatio-temporal regression model for individual-level data. Environmental and climatic factors were estimated at 10 km² grid cells. 10-years average exposure to PM₁₀ was associated with an increased risk of new endemic (Rate Ratio for 10 μg/m³ increase 1.14, 95%CI 1.04-1.24) and epidemic (Rate Ratio 1.15, 95%CI 1.08-1.22) infection. Male gender, older age, living in Nursing Homes and Long-Term Care Facilities residence and socio-economic deprivation index increased Rate Ratio (RR) in epidemic component. Lockdown increased the risk of becoming positive to SARS-CoV-2 as concerning endemic component while it reduced virus spreading in epidemic one. Increased temperature was associated with a reduction of endemic and epidemic infection. Results showed an increment of RR for exposure to increased levels of PM₁₀ both in endemic and epidemic components. Targeted interventions are necessary to improve air quality in most polluted areas, where deprived populations are more likely to live, to minimize the burden of endemic and epidemic COVID-19 disease and to reduce unequal distribution of health risk.

African Swine Fever (ASF) Trend Analysis in Wild Boar in Poland (2014–2020)

Simple Summary

African swine fever (ASF) has been present in Poland since 2014. The article describes and explains the changes in the ASF epidemic in the wild boar population in the period 2014–2020. In that relatively short time, the disease has spread to about half of the territory of Poland, affecting eastern and western provinces. Most ASF-positive animals were molecular/virus-positive, however, the observation of the increase of serologically positive animals (potential survivors) in successive years of the epidemic, especially in areas where the virus has been present for a longer time, may indicate the potential beginning of ASF endemicity in Poland.

Abstract

African swine fever (ASF) is a lethal hemorrhagic disease of Suidae, i.e., domestic pigs and wild boars. The disease was introduced to Poland in 2014 and is now present in the wild boar population. Appropriate ASF prevention requires further research for answers to fundamental questions about the importance of vectors in virus transmission, the impact of environmental factors on the presence of ASFV in wild boar habitats, and the role of survivors as potential virus carriers and their part in the potential endemicity of ASF. In order to analyze the changes in the molecular and serological prevalence of ASFV in wild boar population in Poland, real-time PCR and ELISA/IPT tests were conducted. In the analyzed period (2014–2020), most of the ASF-positive wild boars were molecular/virus-positive, however, over the years the percentage and the number of seropositive animals has increased. At the beginning of the epidemic, the disease was limited to a small area of the country. Since then, it has spread to new provinces of Poland. From the beginning and until today, most notifications of ASF-positive wild boars were for carcasses (passive surveillance), however, the number of serologically positive animals is still increasing. Despite the fact that notifications of ASF outbreaks are still being received near the eastern border of Poland, the old ASF area seems to be limited mainly to ASF serologically positive animals, which may indicate the beginning of ASF endemicity in Poland.

Molecular epidemiological analysis of Mycobacterium tuberculosis modern Beijing genotype strains isolated in Chiba Prefecture over 10 years

INTRODUCTION

The prevalence of the phylogenetic groups of Mycobacterium tuberculosis Beijing genotype has been reported to be similar in different areas of Japan. However, recent reports from rural areas of Japan show a low prevalence of modern Beijing strains, suggesting that the distribution of modern Beijing strains may have changed recently. Therefore, multi-locus variable number of tandem repeats analysis (MLVA) and draft whole genome sequence (DWGS) analysis were carried out to investigate the prevalence of particular genotype strains.

METHODS

Nine hundred and ninety modern Beijing strains were studied using minimum spanning tree (MST) analysis and neighbor-net analysis of MLVA and WGS data.

RESULTS

An MST of M. tuberculosis Beijing genotype strains reconstructed from 12 loci-MLVA data showed two large complexes with the J₁₂-0006 MLVA pattern. In one of the complexes, strains with the pECT07 pattern produced by 24 loci-MLVA and its SLVs were most prevalent. DWGS analysis was carried out for pECT07 and its SLV strains. Neighbor-net and MST analyses of the DWGS data showed that pECT07 and its SLV strains were grouped in separate clusters. When all the combinations of two of the tested strains were analyzed, MST analysis showed that only 9 (1.7%) of the 528 pairs of tested strains had 5 or less SNPs.

CONCLUSIONS

The results of this study suggested that pECT07 and its variants were prevalent among M. tuberculosis modern Beijing strains in Chiba Prefecture, but the prevalence of those strains may not have been due to an earlier large-scale latent outbreak.

Surveillance data for human leishmaniasis indicate the need for a sustainable action plan for its management and control, Greece, 2004 to 2018

Background

The World Health Organization (WHO) lists human leishmaniasis as a neglected tropical disease; it is not under surveillance at European level.

Aim

We present surveillance data for visceral (VL) and cutaneous (CL) leishmaniasis for the period 2004 to 2018 in Greece to assess their public health importance.

Methods

We extracted data from the mandatory notification system to analyse separately imported and domestic cases of VL and CL. A case was defined by clinical manifestations compatible with VL or CL and laboratory confirmation.

Results

Between 2004 and 2018, 881 VL (862 domestic, 19 imported) and 58 CL cases (24 domestic, 34 imported) were recorded. The mean annual notification rate of domestic VL was 0.5 per 100,000 (range: 0.12–1.43/100,000) with a statistically significant increasing trend (p = 0.013). Cases were reported by all regions. The highest notification rate occurred in the age group 0–4 years (1.3/100,000). Overall 24% (164/680) of the cases were immunocompromised and their proportion increased after 2010 (p < 0.001). The mean annual notification rate of domestic CL was 0.05 per 100,000 (range: 0.01–0.19/100,000) with the highest rate in the age group 5–14 years (0.03/100,000). Cases were recorded in six of the 13 regions. Among 34 imported CL cases, 29 were foreign nationals.

Conclusion

VL is endemic in Greece, with an increasing trend and a considerable burden of severe disease and young children being most affected. CL is rarely reported. A sustainable action plan is needed to reduce the burden of VL and prevent local transmission of CL.

Phylogeography of Human and Animal Coxiella burnetii Strains: Genetic Fingerprinting of Q Fever in Belgium

Q fever is a zoonotic disease caused by the bacteria Coxiella burnetii. Domestic ruminants are the primary source for human infection, and the identification of likely contamination routes from the reservoir animals the critical point to implement control programs. This study shows that Q fever is detected in Belgium in abortion of cattle, goat and sheep at a different degree of apparent prevalence (1.93%, 9.19%, and 5.50%, respectively). In addition, and for the first time, it is detected in abortion of alpaca (Vicugna pacos), raising questions on the role of these animals as reservoirs. To determine the relationship between animal and human strains, Multiple Locus Variable-number Tandem Repeat Analysis (MLVA) (n=146), Single-Nucleotide Polymorphism (SNP) (n=92) and Whole Genome Sequencing (WGS) (n=4) methods were used to characterize samples/strains during 2009-2019. Three MLVA clusters (A, B, C) subdivided in 23 subclusters (A1-A12, B1-B8, C1-C3) and 3 SNP types (SNP1, SNP2, SNP6) were identified. The SNP2 type/MLVA cluster A was the most abundant and dispersed genotype over the entire territory, but it seemed not responsible for human cases, as it was only present in animal samples. The SNP1/MLVA B and SNP6/MLVA C clusters were mostly found in small ruminant and human samples, with the rare possibility of spillovers in cattle. SNP1/MLVA B cluster was present in all Belgian areas, while the SNP6/MLVA C cluster appeared more concentrated in the Western provinces. A broad analysis of European MLVA profiles confirmed the host-species distribution described for Belgian samples. In silico genotyping (WGS) further identified the spacer types and the genomic groups of C. burnetii Belgian strains: cattle and goat SNP2/MLVA A isolates belonged to ST61 and genomic group III, while the goat SNP1/MLVA B strain was classified as ST33 and genomic group II. In conclusion, Q fever is widespread in all Belgian domestic ruminants and in alpaca. We determined that the public health risk in Belgium is likely linked to specific genomic groups (SNP1/MLVA B and SNP6/MLVA C) mostly found in small ruminant strains. Considering the concordance between Belgian and European results, these considerations could be extended to other European countries.

Molecular Detection Mapping and Analysis Platform for R (MDMAPR) facilitating the standardization, analysis, visualization, and sharing of qPCR data and metadata

Quantitative polymerase chain reaction (qPCR) has been used as a standard molecular detection tool in many scientific fields. Unfortunately, there is no standard method for managing published qPCR data, and those currently used generally focus on only managing raw fluorescence data. However, associated with qPCR experiments are extensive sample and assay metadata, often under-examined and under-reported. Here, we present the Molecular Detection Mapping and Analysis Platform for R (MDMAPR), an open-source and fully scalable informatics tool for researchers to merge raw qPCR fluorescence data with associated metadata into a standard format, while geospatially visualizing the distribution of the data and relative intensity of the qPCR results. The advance of this approach is in the ability to use MDMAPR to store varied qPCR data. This includes pathogen and environmental qPCR species detection studies ideally suited to geographical visualization. However, it also goes beyond these and can be utilized with other qPCR data including gene expression studies, quantification studies used in identifying health dangers associated with food and water bacteria, and the identification of unknown samples. In addition, MDMAPR’s novel centralized management and geospatial visualization of qPCR data can further enable cross-discipline large-scale qPCR data standardization and accessibility to support research spanning multiple fields of science and qPCR applications.