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Jones DL, Bridgman M, Pellett C, Weightman AJ, Kille P, García Delgado Á, Cross G, Cobley S, Howard-Jones H, Chadwick DR, Farkas K. Use of wastewater from passenger ships to assess the movement of COVID-19 and other pathogenic viruses across maritime international boundaries. Front Public Health 2024; 12:1377996. [PMID: 39076415 PMCID: PMC11284076 DOI: 10.3389/fpubh.2024.1377996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 06/20/2024] [Indexed: 07/31/2024] Open
Abstract
Objective The worldwide spread of SARS-CoV-2 and the resulting COVID-19 pandemic has been driven by international travel. This has led to the desire to develop surveillance approaches which can estimate the rate of import of pathogenic organisms across international borders. The aim of this study was to investigate the use of wastewater-based approaches for the surveillance of viral pathogens on commercial short-haul (3.5 h transit time) roll-on/roll-off passenger/freight ferries operating between the UK and the Republic of Ireland. Methods Samples of toilet-derived wastewater (blackwater) were collected from two commercial ships over a 4-week period and analysed for SARS-CoV-2, influenza, enterovirus, norovirus, the faecal-marker virus crAssphage and a range of physical and chemical indicators of wastewater quality. Results A small proportion of the wastewater samples were positive for SARS-CoV-2 (8% of the total), consistent with theoretical predictions of detection frequency (4%-15% of the total) based on the national COVID-19 Infection Survey and defecation behaviour. In addition, norovirus was detected in wastewater at low frequency. No influenza A/B viruses, enterovirus or enterovirus D68 were detected throughout the study period. Conclusion We conclude that testing of wastewater from ships that cross international maritime boundaries may provide a cost-effective and relatively unbiased method to estimate the flow of infected individuals between countries. The approach is also readily applicable for the surveillance of other disease-causing agents.
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Affiliation(s)
- Davey L. Jones
- School of Environmental and Natural Sciences, Bangor University, Bangor, United Kingdom
| | - Mathew Bridgman
- School of Environmental and Natural Sciences, Bangor University, Bangor, United Kingdom
| | - Cameron Pellett
- School of Environmental and Natural Sciences, Bangor University, Bangor, United Kingdom
| | - Andrew J. Weightman
- Microbiomes, Microbes and Informatics Group, School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Peter Kille
- Microbiomes, Microbes and Informatics Group, School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Álvaro García Delgado
- School of Environmental and Natural Sciences, Bangor University, Bangor, United Kingdom
| | - Gareth Cross
- Science Evidence Advice Division, Health and Social Services Group, Welsh Government, Cardiff, United Kingdom
| | - Steve Cobley
- Science Evidence Advice Division, Health and Social Services Group, Welsh Government, Cardiff, United Kingdom
| | - Helen Howard-Jones
- School of Environmental and Natural Sciences, Bangor University, Bangor, United Kingdom
| | - David R. Chadwick
- School of Environmental and Natural Sciences, Bangor University, Bangor, United Kingdom
| | - Kata Farkas
- School of Environmental and Natural Sciences, Bangor University, Bangor, United Kingdom
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2
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Carlson KB, Dilley A, O'Grady T, Johnson JA, Lopman B, Viscidi E. A narrative review of norovirus epidemiology, biology, and challenges to vaccine development. NPJ Vaccines 2024; 9:94. [PMID: 38811605 PMCID: PMC11137017 DOI: 10.1038/s41541-024-00884-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 05/07/2024] [Indexed: 05/31/2024] Open
Abstract
Norovirus is a leading cause of acute gastroenteritis (AGE) globally. AGE resulting from norovirus causes significant morbidity and mortality in countries of all income levels, particularly among young children and older adults. Prevention of norovirus AGE represents a unique challenge as the virus is genetically diverse with multiple genogroups and genotypes cocirculating globally and causing disease in humans. Variants of the GII.4 genotype are typically the most common genotype, and other genotypes cause varying amounts of disease year-to-year, with GII.2, GII.3, and GII.6 most prevalent in recent years. Noroviruses are primarily transmitted via the fecal-oral route and only a very small number of virions are required for infection, which makes outbreaks of norovirus extremely difficult to control when they occur. Settings like long-term care facilities, daycares, and hospitals are at high risk of outbreaks and can have very high attack rates resulting in substantial costs and disease burden. Severe cases of norovirus AGE are most common in vulnerable patient populations, such as infants, the elderly, and immunocompromised individuals, with available treatments limited to rehydration therapies and supportive care. To date, there are no FDA-approved norovirus vaccines; however, several candidates are currently in development. Given the substantial human and economic burden associated with norovirus AGE, a vaccine to prevent morbidity and mortality and protect vulnerable populations could have a significant impact on global public health.
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Affiliation(s)
| | - Anne Dilley
- Epidemiologic Research & Methods, LLC, Atlanta, GA, USA
| | | | - Jordan A Johnson
- Epidemiologic Research & Methods, LLC, Atlanta, GA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ben Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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3
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Nolte T, Spieß F, Jacobs AK, Kemper N, Visscher C. Assessing concordance between Campylobacter prevalence in broilers and human cases before and during the COVID-19 pandemic in Lower Saxony, Germany, considering fresh chicken meat consumption patterns. Front Vet Sci 2024; 11:1392677. [PMID: 38784655 PMCID: PMC11112064 DOI: 10.3389/fvets.2024.1392677] [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: 02/27/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
As the most common foodborne disease, number of campylobacteriosis decreased in Germany with the beginning of the COVID-19 pandemic in 2020. As the consumption of fresh chicken meat is a major risk factor for human infection, this study investigated the relationship between Campylobacter contamination levels on chicken carcasses and human cases in Lower Saxony, Germany and observed fresh chicken meat consumption patterns between 2018 and 2021 including the time of the COVID-19 pandemic. Campylobacter levels in broilers and human cases were classified based on the median and descriptively analysed per week using contingency tables. Before the COVID-19 pandemic (2018 and 2019), high Campylobacter contamination levels on neck samples and many human cases were more present, whereas with the beginning of the COVID-19 pandemic (2020 and 2021), low contamination levels on chicken carcasses and few human cases were more present. Lowest concordance between both parameters was shown in 2018 (Cohen's cappa coefficient: 0.37) and 2020 (0.38). The highest concordance was examined in 2021 (0.69). The private consumption of fresh chicken meat in Lower Saxony increased significantly with the beginning of the COVID-19 pandemic in 2020 by 63.9 tonnes compared to 2019 to an average of 453.5 tonnes per week. Public health measures and a reduced number of medical treatments have undoubtedly had an impact on less reported human cases during the COVID-19 pandemic. However, number of human cases remained at a low level in Germany in 2023 while chicken meat consumption increased. Thus, further risk assessments regarding the risk of campyloabcteriosis due to chicken meat consumption should include the country of origin, as the level of contamination of chicken carcasses varies between European countries.
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Affiliation(s)
- Tobias Nolte
- Science and Innovation for Sustainable Poultry Production (WING), University of Veterinary Medicine Hannover, Foundation, Vechta, Germany
| | - Fabian Spieß
- Institute for Animal Nutrition, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Anne-Katrin Jacobs
- Science and Innovation for Sustainable Poultry Production (WING), University of Veterinary Medicine Hannover, Foundation, Vechta, Germany
| | - Nicole Kemper
- Science and Innovation for Sustainable Poultry Production (WING), University of Veterinary Medicine Hannover, Foundation, Vechta, Germany
- Institute for Animal Hygiene, Animal Welfare and Farm Animal Behaviour, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Christian Visscher
- Science and Innovation for Sustainable Poultry Production (WING), University of Veterinary Medicine Hannover, Foundation, Vechta, Germany
- Institute for Animal Nutrition, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
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4
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Maldonado-Barrueco A, García-Rodríguez J, Ruiz-Carrascoso G. Impact of the SARS-CoV-2 Pandemic on Prevalence and Incidence of Bacterial Gastroenteritis in Spain, 2019-2022. Foodborne Pathog Dis 2024; 21:279-287. [PMID: 38271584 DOI: 10.1089/fpd.2023.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
The aim of this study was to describe the impact of non-pharmaceutical interventions (NPIs) against SARS-CoV-2 on bacterial gastroenteritis illnesses (BGIs), including Campylobacter spp., Aeromonas spp., Salmonella spp., Shigella spp./enteroinvasive Escherichia coli (EIEC), and Yersinia enterocolitica, in outpatients, inpatients, and emergency departments (ED). Data of patients from a health care area in Madrid (Spain) with diarrhea and positive-real-time polymerase chain reaction (RT-PCR) were collected. The periods analyzed were prepandemic (P0, April 1, 2019 to March 31, 2020), first (P1, April 1, 2020 to March 31, 2021), and second (P2, April 1, 2021 to March 31, 2022) pandemic years. We compared the prevalence, median age, patient profile, and absolute incidence (AI) per 100,000 population during the study periods using Fisher's test (p < 0.05). One thousand eighty-one (13.9%, [95% confidence interval, CI: 13.1-14.6]) of the 7793 patients tested during P0, 777 (13.3%, [95% CI: 12.4-14.2]) of the 5850 tested during P1, and 945 (12.4%, [95% CI: 11.7-13.2]) of the 7606 patients tested were positive for some BGIs. The global prevalence showed a decreasing trend that was statistically significant in P2. During P1, there was an increase in BGIs in the ED with a decrease of median age (p > 0.05). However, during P2, the prevalence for outpatients increased (p < 0.05). The individual prevalence analysis over the three periods remained homogeneous for most of the BGIs (p > 0.05). The AI of most BGIs showed a decreasing trend at P1 and P2 with respect to P0 (p > 0.05). However, Shigella spp./EIEC was the only BGI with a decrease in prevalence, and AI showed statistically significant variation in P1 and P2 (p < 0.05). The prevalence and AI for BGIs mostly showed a slight decrease during the first 2 pandemic years compared with the prepandemic may be explained by the greater impact of foodborne transmission on BGIs. The significant decrease in Shigella spp./EIEC illnesses could explain the mainly person-to-person transmission and the reduction of bacterial load in fomites for NPIs. This retrospective study was approved by the Ethics Committee with the code: HULP PI-5700.
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Affiliation(s)
| | - Julio García-Rodríguez
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, Madrid, Spain
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5
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Parrón I, Carol M, Bes N, Izquierdo C, Godoy P, Barrabeig I, Sala MR, Minguell S, Ferras J, Rius C, Martínez AI, Domínguez À. The impact of COVID-19 pandemic on the incidence of acute gastroenteritis outbreaks in Catalonia (Spain). Epidemiol Infect 2023; 152:e10. [PMID: 38073577 PMCID: PMC10804134 DOI: 10.1017/s0950268823001851] [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: 05/01/2023] [Revised: 10/29/2023] [Accepted: 11/16/2023] [Indexed: 01/19/2024] Open
Abstract
We carried out a retrospective study of acute gastroenteritis (AGE) outbreaks reported between 1 January 2015 and 31 December 2021 in Catalonia (Spain) to compare the incidence from 2015 to 2019 with that observed from 2020 to 2021. We observed a higher incidence rate of outbreaks during the prepandemic period (16.89 outbreaks/1,000,000 person-years) than during the pandemic period (6.96 outbreaks/1,000,000 person-years) (rate ratio (RR) 0.41; 95% confidence interval (CI) 0.34 to 0.51). According to the aetiology of the outbreak, those of viral aetiology decreased from 7.82 to 3.38 outbreaks/1,000,000 person-years (RR 2.31; 95% CI 1.72 to 3.12), and those of bacterial aetiology decreased from 5.01 to 2.78 outbreaks/1,000,000 person-years (RR 1.80; 95% CI 1.29 to 2.52). There was a great reduction in AGE outbreaks in Catalonia. This reduction may have been due to the effect of the nonpharmaceutical measures applied to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the collapse of the healthcare system and epidemiological surveillance services may also have had a strong influence.
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Affiliation(s)
- Ignasi Parrón
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Mònica Carol
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Núria Bes
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | | | - Pere Godoy
- Facultat de Medicina, Universitat de Lleida, Spain
- Grup d’Epidemiologia Aplicada, Institut de Recerca Biomédica (IRBLleida), Lleida, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Irene Barrabeig
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - M. Rosa Sala
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Cristina Rius
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - Àngela Domínguez
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
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6
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Ondrikova N, Clough H, Douglas A, Vivancos R, Itturiza-Gomara M, Cunliffe N, Harris JP. Comparison of statistical approaches to predicting norovirus laboratory reports before and during COVID-19: insights to inform public health surveillance. Sci Rep 2023; 13:21457. [PMID: 38052922 PMCID: PMC10697939 DOI: 10.1038/s41598-023-48069-6] [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: 02/11/2023] [Accepted: 11/22/2023] [Indexed: 12/07/2023] Open
Abstract
Social distancing interrupted transmission patterns of contact-driven infectious agents such as norovirus during the Covid-19 pandemic. Since routine surveillance of norovirus was additionally disrupted during the pandemic, traditional naïve forecasts that rely only on past public health surveillance data may not reliably represent norovirus activity. This study investigates the use of statistical modelling to predict the number of norovirus laboratory reports in England 4-weeks ahead of time before and during Covid-19 pandemic thus providing insights to inform existing practices in norovirus surveillance in England. We compare the predictive performance from three forecasting approaches that assume different underlying structure of the norovirus data and utilized various external data sources including mobility, air temperature and relative internet searches (Time Series and Regularized Generalized Linear Model, and Quantile Regression Forest). The performance of each approach was evaluated using multiple metrics, including a relative prediction error against the traditional naive forecast of a five-season mean. Our data suggest that all three forecasting approaches improve predictive performance over the naïve forecasts, especially in the 2020/21 season (30-45% relative improvement) when the number of norovirus reports reduced. The improvement ranged from 7 to 22% before the pandemic. However, performance varied: regularized regression incorporating internet searches showed the best forecasting score pre-pandemic and the time series approach achieved the best results post pandemic onset without external data. Overall, our results demonstrate that there is a significant value for public health in considering the adoption of more sophisticated forecasting tools, moving beyond traditional naïve methods, and utilizing available software to enhance the precision and timeliness of norovirus surveillance in England.
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Affiliation(s)
- Nikola Ondrikova
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
- Institute for Risk and Uncertainty, University of Liverpool, Liverpool, UK.
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK.
| | - Helen Clough
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
| | - Amy Douglas
- National Surveillance Gastrointestinal Pathogens Unit, UK Health Security Agency, London, UK
| | - Roberto Vivancos
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Health Protection Operations, UK Health Security Agency, Liverpool, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
| | | | - Nigel Cunliffe
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
| | - John P Harris
- Health Protection Operations, UK Health Security Agency, Liverpool, UK
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7
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Zhong Y, Lu H, Jiang Y, Tan D, Pan Y, Liabsuetrakul T. Detection rates of norovirus gastroenteritis and factors associated with the infection before and during COVID-19 pandemic: a secondary analysis of surveillance data in Guangxi Zhuang Autonomous Region, Southern China. Infect Ecol Epidemiol 2023; 13:2278246. [PMID: 38187165 PMCID: PMC10769525 DOI: 10.1080/20008686.2023.2278246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/29/2023] [Indexed: 01/09/2024] Open
Abstract
Background: Changes in oral and hand hygiene behaviors have been reported during the COVID-19 pandemic in 2020 which may be associated with the incidence of the norovirus infection, a common cause of gastroenteritis. Objective: To estimate the trends of detection rates of norovirus gastroenteritis and associated factors before COVID-19 in 2015-2019 and during the COVID-19 in 2020 in Guangxi, China. Methods: A secondary analysis of Guangxi surveillance data of gastroenteritis patients was conducted. The detection rate in 2020 was predicted using an autoregressive integrated moving average modeland associated factors were analyzed using multiple logistic regression adjusted for interaction effects. Results: Of 7,903 gastroenteritis patients, the overall detection rate of norovirus gastroenteritis was 12.8%, (14.3% before and 6.1% during COVID-19). Detection rates gradually decreased from 2015 to 2020, of which the slope of predicted line was slightly flatter than the actual line. The odds ratios of detection were double to triple increase during COVID-19 in the younger age group and having food intake outside their homes. Tourist city, season, and types of food were independent associated factors. Conclusion: The detection rates were higher during the COVID-19 year among the population aged 45 years or less and those who consumed food outside their home.
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Affiliation(s)
- Yanxu Zhong
- Food Safety Monitoring and Evaluation Department, Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention (Guangxi CDC), Nanning, Guangxi Region, China
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Huan Lu
- Infectious Department, The Fourth People’s Hospital of Nanning, Nanning, Guangxi Region, China
| | - Yuyan Jiang
- Food Safety Monitoring and Evaluation Department, Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention (Guangxi CDC), Nanning, Guangxi Region, China
| | - Dongmei Tan
- Food Safety Monitoring and Evaluation Department, Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention (Guangxi CDC), Nanning, Guangxi Region, China
| | - Yuli Pan
- Food Safety Monitoring and Evaluation Department, Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention (Guangxi CDC), Nanning, Guangxi Region, China
| | - Tippawan Liabsuetrakul
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Kabue JP, Khumela R, Meader E, Baroni de Moraes MT, Traore AN, Potgieter N. Norovirus-Associated Gastroenteritis Vesikari Score and Pre-Existing Salivary IgA in Young Children from Rural South Africa. Viruses 2023; 15:2185. [PMID: 38005863 PMCID: PMC10674611 DOI: 10.3390/v15112185] [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: 09/21/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Norovirus (NoV) is the leading cause of viral gastroenteritis, mostly affecting young children worldwide. However, limited data are available to determine the severity of norovirus-associated AGE (acute gastroenteritis) and to correlate it with the NoV-specific IgA antibodies' level. Between October 2019 and September 2021, two hundred stool samples were randomly collected from symptomatic cases for the vesikari score and NoV-specific IgA assessment in young children from rural South Africa. Additionally, one hundred saliva specimens were concomitantly sampled within the same cohort to evaluate the NoV-specific salivary IgA levels. In addition, 50 paired saliva and stool samples were simultaneously collected from asymptomatic children to serve as controls. NoV strains in stool samples were detected using real-time RT-PCR, amplified, and genotyped with RT-PCR and Sanger sequencing. ELISA using NoV VLP (virus-like particles) GII.4 as antigens was performed on the saliva specimens. Dehydrated children were predominantly those with NoV infections (65/74, 88%; p < 0.0001). NoV-positive infections were significantly associated with the severe diarrhea cases having a high vesikari score (55%, 33/60) when compared to the non-severe diarrheal score (29.3%, 41/140; p < 0.0308). NoV of the GII genogroup was mainly detected in severe diarrhea cases (50.9%, 30/59; p = 0.0036). The geometric means of the NoV-specific IgA level were higher in the asymptomatic NoV-infected group (0.286) as compared to the symptomatic group (0.174). This finding suggests that mucosal immunity may not protect the children from the NoV infection. However, the findings indicated the contribution of the pre-existing NoV-specific IgA immune response in reducing the severity of diarrheal disease. A high vesikari score of AGE associated with the NoV GII genogroup circulating in the study area underscores the need for an appropriate treatment of AGE based on the severity level of NoV-associated clinical symptoms in young children.
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Affiliation(s)
- Jean-Pierre Kabue
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (R.K.); (A.N.T.); (N.P.)
| | - Ronewa Khumela
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (R.K.); (A.N.T.); (N.P.)
| | - Emma Meader
- Clinical Microbiology, Pathology Department, East Kent Hospitals University NHS Foundation Trust, Ashford TN24 OLZ, UK;
| | - Marcia Terezinha Baroni de Moraes
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Avenida Brazil, 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil;
| | - Afsatou Ndama Traore
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (R.K.); (A.N.T.); (N.P.)
| | - Natasha Potgieter
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (R.K.); (A.N.T.); (N.P.)
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9
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ŞİMSEK AÇ, BUZGAN T, BARAN AKSAKAL FN, BİRİNCİ Ş, ŞİRİN H. Positive effects of health behaviors acquired during the COVID-19 pandemic process on the prevention of other infectious diseases. Turk J Med Sci 2023; 53:1756-1766. [PMID: 38813503 PMCID: PMC10760558 DOI: 10.55730/1300-0144.5745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 12/12/2023] [Accepted: 10/12/2023] [Indexed: 05/31/2024] Open
Abstract
Background/aim It was aimed to evaluate the positive effects of health behaviors (general hygiene, wearing face masks, physical distancing, and travel restrictions) acquired during the coronavirus disease 2019 (COVID-19) pandemic on the prevention of other infectious diseases in Ankara Province, Türkiye. Materials and methods This study was designed retrospectively. Among the notifiable group A infectious diseases, acute intestinal infections (AIIs) with International Classification of Diseases, Tenth Revision diagnosis codes A09 (diarrhea and gastroenteritis presumed to be of infectious origin), R11 (nausea and vomiting), and K52 (other noninfectious gastroenteritis and colitis), as well as influenza, tuberculosis, measles, varicella, malaria, and meningococcal meningitis were included in the scope of this study.The data of the selected infectious diseases in Ankara Province for the last 2 years before the pandemic (January 2018-December 2019) and for the 2-year period of the pandemic (January 2020-December 2021) were analyzed after checking the data. The number of cases were presented as frequencies, the 1-sample chi-squared test was used in the statistical analysis and the statistical significance level (α) was taken as 0.05. Results The findings for each disease/disease group were discussed under separate headings. Comparing the prepandemic period (2018-2019) with the pandemic period (2020-2021), the decreases in the number of cases of selected infectious diseases, except influenza, were statistically significant. Conclusion Undoubtedly, the experience gained from the pandemic struggle will guide us in shaping our future lives. From this point forward, we should be aware that living in crowded environments and as a highly mobile population, that unhygienic habits are unfavorable for the spread of all infectious diseases, and we should take care to continuously apply the precautions for healthy living in our new lifestyle.
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Affiliation(s)
- Asiye Çiğdem ŞİMSEK
- Department of Public Health, Gulhane School of Medicine, University of Health Sciences, Ankara,
Turkiye
| | - Turan BUZGAN
- Department of Infectious Diseases, Faculty of Medicine, Yildirim Beyazit University, Ankara,
Turkiye
| | | | - Şuayip BİRİNCİ
- Ministry of Health, Republic of Turkiye, Ankara,
Turkiye
| | - Hülya ŞİRİN
- Department of Public Health, Gulhane School of Medicine, University of Health Sciences, Ankara,
Turkiye
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10
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Love NK, Douglas A, Gharbia S, Hughes H, Morbey R, Oliver I, Smith GE, Elliot AJ. Understanding the impact of the COVID-19 pandemic response on GI infection surveillance trends in England, January 2020-April 2022. Epidemiol Infect 2023; 151:e147. [PMID: 37622322 PMCID: PMC10540168 DOI: 10.1017/s095026882300136x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/13/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
Stepwise non-pharmaceutical interventions and health system changes implemented as part of the COVID-19 response have had implications on the incidence, diagnosis, and reporting of other communicable diseases. Here, we established the impact of the COVID-19 outbreak response on gastrointestinal (GI) infection trends using routinely collected surveillance data from six national English laboratory, outbreak, and syndromic surveillance systems using key dates of governmental policy to assign phases for comparison between pandemic and historic data. Following decreases across all indicators during the first lockdown (March-May 2020), bacterial and parasitic pathogens associated with foodborne or environmental transmission routes recovered rapidly between June and September 2020, while those associated with travel and/or person-to-person transmission remained lower than expected for 2021. High out-of-season norovirus activity was observed with the easing of lockdown measures between June and October 2021, with this trend reflected in laboratory and outbreak systems and syndromic surveillance indicators. Above expected increases in emergency department (ED) attendances may have reflected changes in health-seeking behaviour and provision. Differential reductions across specific GI pathogens are indicative of the underlying routes of transmission. These results provide further insight into the drivers for transmission, which can help inform control measures for GI infections.
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Affiliation(s)
- Nicola K. Love
- North East Field Services, Health Protection Operations, UK Health Security Agency, Newcastle upon Tyne, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
| | - Amy Douglas
- Gastrointestinal Infections and Food Safety (One Health) Division, UK Health Security Agency, London, UK
| | - Saheer Gharbia
- Gastrointestinal Infections and Food Safety (One Health) Division, UK Health Security Agency, London, UK
| | - Helen Hughes
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- Farr Institute@HeRC, University of Liverpool, Liverpool, UK
| | - Roger Morbey
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, King’s College London, London, UK
| | - Isabel Oliver
- Science Group, UK Health Security Agency, London, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation, Population Health Sciences, University of Bristol, Bristol, UK
| | - Gillian E. Smith
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, King’s College London, London, UK
| | - Alex J. Elliot
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, King’s College London, London, UK
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Ondrikova N, Harris JP, Douglas A, Hughes HE, Iturriza-Gomara M, Vivancos R, Elliot AJ, Cunliffe NA, Clough HE. Predicting Norovirus in England Using Existing and Emerging Syndromic Data: Infodemiology Study. J Med Internet Res 2023; 25:e37540. [PMID: 37155231 DOI: 10.2196/37540] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 11/28/2022] [Accepted: 02/19/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Norovirus is associated with approximately 18% of the global burden of gastroenteritis and affects all age groups. There is currently no licensed vaccine or available antiviral treatment. However, well-designed early warning systems and forecasting can guide nonpharmaceutical approaches to norovirus infection prevention and control. OBJECTIVE This study evaluates the predictive power of existing syndromic surveillance data and emerging data sources, such as internet searches and Wikipedia page views, to predict norovirus activity across a range of age groups across England. METHODS We used existing syndromic surveillance and emerging syndromic data to predict laboratory data indicating norovirus activity. Two methods are used to evaluate the predictive potential of syndromic variables. First, the Granger causality framework was used to assess whether individual variables precede changes in norovirus laboratory reports in a given region or an age group. Then, we used random forest modeling to estimate the importance of each variable in the context of others with two methods: (1) change in the mean square error and (2) node purity. Finally, these results were combined into a visualization indicating the most influential predictors for norovirus laboratory reports in a specific age group and region. RESULTS Our results suggest that syndromic surveillance data include valuable predictors for norovirus laboratory reports in England. However, Wikipedia page views are less likely to provide prediction improvements on top of Google Trends and Existing Syndromic Data. Predictors displayed varying relevance across age groups and regions. For example, the random forest modeling based on selected existing and emerging syndromic variables explained 60% variance in the ≥65 years age group, 42% in the East of England, but only 13% in the South West region. Emerging data sets highlighted relative search volumes, including "flu symptoms," "norovirus in pregnancy," and norovirus activity in specific years, such as "norovirus 2016." Symptoms of vomiting and gastroenteritis in multiple age groups were identified as important predictors within existing data sources. CONCLUSIONS Existing and emerging data sources can help predict norovirus activity in England in some age groups and geographic regions, particularly, predictors concerning vomiting, gastroenteritis, and norovirus in the vulnerable populations and historical terms such as stomach flu. However, syndromic predictors were less relevant in some age groups and regions likely due to contrasting public health practices between regions and health information-seeking behavior between age groups. Additionally, predictors relevant to one norovirus season may not contribute to other seasons. Data biases, such as low spatial granularity in Google Trends and especially in Wikipedia data, also play a role in the results. Moreover, internet searches can provide insight into mental models, that is, an individual's conceptual understanding of norovirus infection and transmission, which could be used in public health communication strategies.
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Affiliation(s)
- Nikola Ondrikova
- Institute of Infection, Ecological and Veterinary Sciences, University of Liverpool, Liverpool, United Kingdom
- National Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom
- Institute for Risk and Uncertainty, University of Liverpool, Liverpool, United Kingdom
| | - John P Harris
- Field Service, Health Protection Operations, United Kingdom Health Security Agency, Liverpool, United Kingdom
| | - Amy Douglas
- Gastrointestinal Infections and Food Safety (One Health) Division, United Kingdom Health Security Agency, London, United Kingdom
| | - Helen E Hughes
- National Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom
- Real-time Syndromic Surveillance Team, Health Protection Operations, United Kingdom Health Security Agency, Birmingham, United Kingdom
| | | | - Roberto Vivancos
- National Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom
- Field Service, Health Protection Operations, United Kingdom Health Security Agency, Liverpool, United Kingdom
- National Institute for Health and Care Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
| | - Alex J Elliot
- National Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom
- Real-time Syndromic Surveillance Team, Health Protection Operations, United Kingdom Health Security Agency, Birmingham, United Kingdom
| | - Nigel A Cunliffe
- Institute of Infection, Ecological and Veterinary Sciences, University of Liverpool, Liverpool, United Kingdom
- National Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom
| | - Helen E Clough
- Institute of Infection, Ecological and Veterinary Sciences, University of Liverpool, Liverpool, United Kingdom
- National Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom
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12
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Epidemiology and Economic Burden of Acute Infectious Gastroenteritis Among Adults Treated in Outpatient Settings in US Health Systems. Am J Gastroenterol 2023:00000434-990000000-00647. [PMID: 36728224 DOI: 10.14309/ajg.0000000000002186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/06/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Acute infectious gastroenteritis (AGE) is a common reason for outpatient visits and hospitalizations in the United States. This study aimed to understand the demographic and clinical characteristics, common pathogens detected, health care resource utilization (HRU), and cost among adult outpatients with AGE visiting US health systems. METHODS A retrospective cohort study was conducted using one of the largest hospital discharge databases (PINC AI Healthcare Database) in the United States. Adult patients (aged ≥18 years) with a principal diagnosis of AGE during an outpatient visit between January 1, 2016, and June 30, 2021, were included. Pathogen detection analysis was performed in those with microbiology data available. RESULTS Among 248,896 patients, the mean age was 44.3 years (range 18-89+ years), 62.9% were female, and 68.5% were White. More than half (62.0%) of the patients did not have any preexisting comorbidity, and only 18.3% underwent stool workup at the hospital. Most patients (84.7%) were seen in the emergency department, and most (96.4%) were discharged home. Within 30 days of discharge, 1.0% were hospitalized, and 2.8% had another outpatient visit due to AGE. The mean cost of the index visit plus 30-day AGE-related follow-up was $1,338 per patient, amounting to $333,060,182 for the total study population. Among patients with microbiology data available (n = 12,469), common pathogens detected were Clostridioides difficile (32.2%), norovirus (6.3%), and Campylobacter spp. (4.0%). DISCUSSION AGE is a common and costly disease affecting adults of all ages and more females than males, including individuals with or without baseline conditions in a hospital-based outpatient setting. C. difficile was the most common pathogen detected.
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Lindesmith LC, Boshier FAT, Brewer-Jensen PD, Roy S, Costantini V, Mallory ML, Zweigart M, May SR, Conrad H, O’Reilly KM, Kelly D, Celma CC, Beard S, Williams R, Tutill HJ, Becker Dreps S, Bucardo F, Allen DJ, Vinjé J, Goldstein RA, Breuer J, Baric RS. Immune Imprinting Drives Human Norovirus Potential for Global Spread. mBio 2022; 13:e0186122. [PMID: 36102514 PMCID: PMC9600701 DOI: 10.1128/mbio.01861-22] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/25/2022] [Indexed: 01/11/2023] Open
Abstract
Understanding the complex interactions between virus and host that drive new strain evolution is key to predicting the emergence potential of variants and informing vaccine development. Under our hypothesis, future dominant human norovirus GII.4 variants with critical antigenic properties that allow them to spread are currently circulating undetected, having diverged years earlier. Through large-scale sequencing of GII.4 surveillance samples, we identified two variants with extensive divergence within domains that mediate neutralizing antibody binding. Subsequent serological characterization of these strains using temporally resolved adult and child sera suggests that neither candidate could spread globally in adults with multiple GII.4 exposures, yet young children with minimal GII.4 exposure appear susceptible. Antigenic cartography of surveillance and outbreak sera indicates that continued population exposure to GII.4 Sydney 2012 and antigenically related variants over a 6-year period resulted in a broadening of immunity to heterogeneous GII.4 variants, including those identified here. We show that the strongest antibody responses in adults exposed to GII.4 Sydney 2012 are directed to previously circulating GII.4 viruses. Our data suggest that the broadening of antibody responses compromises establishment of strong GII.4 Sydney 2012 immunity, thereby allowing the continued persistence of GII.4 Sydney 2012 and modulating the cycle of norovirus GII.4 variant replacement. Our results indicate a cycle of norovirus GII.4 variant replacement dependent upon population immunity. Young children are susceptible to divergent variants; therefore, emergence of these strains worldwide is driven proximally by changes in adult serological immunity and distally by viral evolution that confers fitness in the context of immunity. IMPORTANCE In our model, preepidemic human norovirus variants harbor genetic diversification that translates into novel antigenic features without compromising viral fitness. Through surveillance, we identified two viruses fitting this profile, forming long branches on a phylogenetic tree. Neither evades current adult immunity, yet young children are likely susceptible. By comparing serological responses, we demonstrate that population immunity varies by age/exposure, impacting predicted susceptibility to variants. Repeat exposure to antigenically similar variants broadens antibody responses, providing immunological coverage of diverse variants but compromising response to the infecting variant, allowing continued circulation. These data indicate norovirus GII.4 variant replacement is driven distally by virus evolution and proximally by immunity in adults.
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Affiliation(s)
- Lisa C. Lindesmith
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Florencia A. T. Boshier
- Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Paul D. Brewer-Jensen
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sunando Roy
- Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Veronica Costantini
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael L. Mallory
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Mark Zweigart
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Samantha R. May
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Helen Conrad
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kathleen M. O’Reilly
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Daniel Kelly
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Cristina C. Celma
- Enteric Virus Unit, The Virus Reference Department, UK Health Security Agency, London, United Kingdom
| | - Stuart Beard
- Enteric Virus Unit, The Virus Reference Department, UK Health Security Agency, London, United Kingdom
| | - Rachel Williams
- Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
- Department of Genetics & Genomic Medicine, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Helena J. Tutill
- Department of Genetics & Genomic Medicine, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Sylvia Becker Dreps
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Filemón Bucardo
- Department of Microbiology, National Autonomous University of Nicaragua, León, León, Nicaragua
| | - David J. Allen
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Richard A. Goldstein
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - Judith Breuer
- Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
- Department of Microbiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Ralph S. Baric
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
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CAMPYAIR, a New Selective, Differential Medium for Campylobacter spp. Isolation without the Need for Microaerobic Atmosphere. Microorganisms 2022; 10:microorganisms10071403. [PMID: 35889122 PMCID: PMC9318433 DOI: 10.3390/microorganisms10071403] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 02/01/2023] Open
Abstract
Campylobacter spp. are considered the most frequent bacterial cause of acute gastroenteritis worldwide. Although the diarrhea produced by these bacteria is self-limiting, the pathogen has been associated with severe long-term sequelae following acute signs and symptoms of the illness. However, research on Campylobacter is hampered by costs and technical requirements for isolating and culturing the bacterium, especially in low and middle-income countries. Therefore, attempts have been made to simplify these culture methods and to reduce costs associated with conducting research on Campylobacter. Recently, a liquid medium which allows selective enrichment of Campylobacter using aerobic incubation has been described. However, a solid medium is also needed for the isolation of pure colonies, enumeration of bacterial populations, and other studies on the pathogen. Therefore, a new medium (CAMPYAIR) was developed, based on the formulation of the liquid medium. CAMPYAIR is a solid chromogenic medium that supports the growth of Campylobacter isolates within 48 h of incubation in aerobic atmospheres. Moreover, CAMPYAIR contains antibiotic supplements with an enhanced ability to recover Campylobacter from environmental samples that may also contain non-campylobacter bacteria. The addition of the indicator 2,3,5-triphenyltetrazolium (TTC) to the medium differentiates Campylobacter from other bacteria growing on the media. The findings from studies on CAMPYAIR suggest that the utilization of the new selective, differential medium could help to reduce the costs, equipment, and technical training required for Campylobacter isolation from clinical and environmental samples.
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Immunogenicity of a bivalent virus-like particle norovirus vaccine in children from 1 to 8 years of age: A phase 2 randomized, double-blind study. Vaccine 2022; 40:3588-3596. [PMID: 35595661 DOI: 10.1016/j.vaccine.2022.04.089] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Young children can suffer severe consequences of norovirus gastroenteritis. We performed a dose-finding study of a bivalent virus-like particle (VLP) vaccine candidate (TAK-214) in healthy 1-8-year-old children. METHODS In this phase 2 study two age cohorts (1-3 and 4-8 years of age inclusive, N = 120 per cohort) of children enrolled from Finland, Panama and Colombia were initially randomized 1:1:1:1 to four groups which were further split into two equal subgroups, to receive one or two intramuscular doses of four TAK-214 formulations containing 15/15, 15/50, 50/50 or 50/150 μg of GI.1/GII.4c genotype VLPs and 0.5 mg Al(OH)3 at 28 days interval. ELISA Pan-Ig and histoblood group antigen-blocking (HBGA) antibodies against each VLP were measured on days 1, 29, 57 and 210. Parents/guardians recorded solicited local and systemic adverse events (AE) and any unsolicited or serious AEs (SAE). RESULTS All formulations were well-tolerated across both age cohorts and dosage groups with no vaccine-related SAEs reported. Solicited AEs were mostly mild-to-moderate, resolved quickly, and did not increase after the second dose. Pan-Ig and HBGA responses induced after one dose were only slightly increased by the second dose. Across dose groups at Day 29 after one dose GI.1 Pan Ig seroresponse rates (SRR) were 82-97% and 81-96% and GII.4c SRR were 79-97% and 80-91% in 1-3 and 4-8 year-olds, respectively. Respective rates were to 92-93% and 73-92% for GI.1, and 77-100% and 62-83% for GII.4c at Day 57 following two doses. HBGA responses had similar profiles. Both Pan Ig and HBGA geometric mean titers persisted above baseline up to Day 210. CONCLUSIONS All dosages of TAK-214 displayed acceptable reactogenicity in 1-8-year-old children and induced robust, durable immune responses after one dose which are further increased after two doses.
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Chan MCW. Return of Norovirus and Rotavirus Activity in Winter 2020‒21 in City with Strict COVID-19 Control Strategy, Hong Kong, China. Emerg Infect Dis 2022; 28:713-716. [PMID: 35049493 PMCID: PMC8888229 DOI: 10.3201/eid2803.212117] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A rapid decrease in viral gastroenteritis during winter 2019-20 and a return of norovirus and rotavirus activity during winter 2020-21 were observed while multiple nonpharmaceutical interventions for coronavirus disease were in effect in Hong Kong. The initial collateral benefit of coronavirus disease countermeasures that reduced the viral gastroenteritis burden is not sustainable.
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Polkowska A, Räsänen S, Nuorti P, Maunula L, Jalava K. Assessment of Food and Waterborne Viral Outbreaks by Using Field Epidemiologic, Modern Laboratory and Statistical Methods-Lessons Learnt from Seven Major Norovirus Outbreaks in Finland. Pathogens 2021; 10:pathogens10121624. [PMID: 34959579 PMCID: PMC8707936 DOI: 10.3390/pathogens10121624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 11/17/2022] Open
Abstract
Seven major food- and waterborne norovirus outbreaks in Western Finland during 2014–2018 were re-analysed. The aim was to assess the effectiveness of outbreak investigation tools and evaluate the Kaplan criteria. We summarised epidemiological and microbiological findings from seven outbreaks. To evaluate the Kaplan criteria, a one-stage meta-analysis of data from seven cohort studies was performed. The case was defined as a person attending an implicated function with diarrhoea, vomiting or two other symptoms. Altogether, 22% (386/1794) of persons met the case definition. Overall adjusted, 73% of norovirus patients were vomiting, the mean incubation period was 44 h (4 h to 4 days) and the median duration of illness was 46 h. As vomiting was a more common symptom in children (96%, 143/149) and diarrhoea among the elderly (92%, 24/26), symptom and age presentation should drive hypothesis formulation. The Kaplan criteria were useful in initial outbreak assessments prior to faecal results. Rapid food control inspections enabled evidence-based, public-health-driven risk assessments. This led to probability-based vehicle identification and aided in resolving the outbreak event mechanism rather than implementing potentially ineffective, large-scale public health actions such as the withdrawal of extensive food lots. Asymptomatic food handlers should be ideally withdrawn from high-risk work for five days instead of the current two days. Food and environmental samples often remain negative with norovirus, highlighting the importance of research collaborations. Electronic questionnaire and open-source novel statistical programmes provided time and resource savings. The public health approach proved useful within the environmental health area with shoe leather field epidemiology, combined with statistical analysis and mathematical reasoning.
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Affiliation(s)
- Aleksandra Polkowska
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, 33100 Tampere, Finland; (A.P.); (P.N.)
| | - Sirpa Räsänen
- Pirkanmaa Hospital District, 33520 Tampere, Finland;
| | - Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, 33100 Tampere, Finland; (A.P.); (P.N.)
| | - Leena Maunula
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, 00100 Helsinki, Finland;
| | - Katri Jalava
- Department of Mathematics and Statistics, Faculty of Social Sciences, University of Helsinki, 00100 Helsinki, Finland
- Correspondence: ; Tel.: +44-73-4224-7186
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Lucero Y, Matson DO, Ashkenazi S, George S, O’Ryan M. Norovirus: Facts and Reflections from Past, Present, and Future. Viruses 2021; 13:v13122399. [PMID: 34960668 PMCID: PMC8707792 DOI: 10.3390/v13122399] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 02/07/2023] Open
Abstract
Human Norovirus is currently the main viral cause of acute gastroenteritis (AGEs) in most countries worldwide. Nearly 50 years after the discovery of the "Norwalk virus" by Kapikian and colleagues, the scientific and medical community continue to generate new knowledge on the full biological and disease spectrum of Norovirus infection. Nevertheless, several areas remain incompletely understood due to the serious constraints to effectively replicate and propagate the virus. Here, we present a narrated historic perspective and summarize our current knowledge, including insights and reflections on current points of interest for a broad medical community, including clinical and molecular epidemiology, viral-host-microbiota interactions, antivirals, and vaccine prototypes. We also include a reflection on the present and future impacts of the COVID-19 pandemic on Norovirus infection and disease.
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Affiliation(s)
- Yalda Lucero
- Microbiology and Mycology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile; (Y.L.); (S.G.)
- Hospital Dr. Roberto del Río Hospital, Department of Pediatrics and Pediatric Surgery (Northern Campus), Faculty of Medicine, Universidad de Chile, Santiago 8380418, Chile
- Clínica Alemana de Santiago, Faculty of Medicine, Universidad del Desarrollo-Clínica Alemana, Santiago 7650568, Chile
| | - David O. Matson
- Eastern Shore Health Department, Virginia Department of Public Health, Accomack County, VA 23301, USA;
| | - Shai Ashkenazi
- Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
- Department of Pediatrics A, Schneider Children’s Medical Center, Petach Tikva 49202, Israel
| | - Sergio George
- Microbiology and Mycology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile; (Y.L.); (S.G.)
| | - Miguel O’Ryan
- Microbiology and Mycology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile; (Y.L.); (S.G.)
- Correspondence:
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