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Romaní Vidal A, Vaughan A, Innocenti F, Colombe S, Nerlander L, Rachwal N, Ciancio BC, Mougkou A, Carvalho C, Delgado E, Mook P, de Muylder G, Peeters M, Tenev T, Golkocheva-Markova E, Vorobieva Solholm Jensen V, Koch A, Figoni J, Brouard C, Nikolopoulou G, Zisouli A, Murphy N, Broderick A, Goldberg L, Rich R, Hecht Sagie L, Tosti ME, Suligoi B, Joosten R, Pijnacker R, Fjeldheim I, Heen E, Stępień M, Polański P, Tato Marinho R, Vieira Martins J, Varela C, Avellón A, Andersson E, Jansson Mörk M, Mandal S, Watson C, Coughlan L, Chand M, Neill C, Bradley DT, Li K, O'Leary M, McInnes N, Williams CJ, Moore C, Gjini A, Duffell E, Pebody R. Hepatitis of unknown aetiology in children - epidemiological overview of cases reported in Europe, 1 January to 16 June 2022. Euro Surveill 2022; 27. [PMID: 35929429 PMCID: PMC9358403 DOI: 10.2807/1560-7917.es.2022.27.31.2200483] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Following the report of an excess in paediatric cases of severe acute hepatitis of unknown aetiology by the United Kingdom (UK) on 5 April 2022, 427 cases were reported from 20 countries in the World Health Organization European Region to the European Surveillance System TESSy from 1 January 2022 to 16 June 2022. Here, we analysed demographic, epidemiological, clinical and microbiological data available in TESSy. Of the reported cases, 77.3% were 5 years or younger and 53.5% had a positive test for adenovirus, 10.4% had a positive RT-PCR for SARS-CoV-2 and 10.3% were coinfected with both pathogens. Cases with adenovirus infections were significantly more likely to be admitted to intensive care or high-dependency units (OR = 2.11; 95% CI: 1.18–3.74) and transplanted (OR = 3.36; 95% CI: 1.19–9.55) than cases with a negative test result for adenovirus, but this was no longer observed when looking at this association separately between the UK and other countries. Aetiological studies are needed to ascertain if adenovirus plays a role in this possible emergence of hepatitis cases in children and, if confirmed, the mechanisms that could be involved.
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Affiliation(s)
| | - Aisling Vaughan
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Francesco Innocenti
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Soledad Colombe
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Lina Nerlander
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Natalia Rachwal
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Aikaterini Mougkou
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Carlos Carvalho
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Enrique Delgado
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Piers Mook
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | - Michael Peeters
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre for Hepatitis Viruses, Brussels, Belgium
| | - Tencho Tenev
- National Reference Laboratory Hepatitis viruses, NCIPD-Virology, Sofia, Bulgaria
| | | | | | - Anders Koch
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Julie Figoni
- Santé Publique France, the National Public Health Agency, Saint-Maurice, France
| | - Cécile Brouard
- Santé Publique France, the National Public Health Agency, Saint-Maurice, France
| | | | | | - Niamh Murphy
- Health Service Executive HPSC surveillance scientist on the National IMT for hepatitis, Dublin, Ireland
| | | | | | - Rivka Rich
- Israel Ministry of Health, Jerusalem, Israel
| | | | - Maria Elena Tosti
- National Centre for Global Health - Istituto Superiore di Sanità, Rome, Italy
| | - Barbara Suligoi
- Infectious Disease Department - Istituto Superiore di Sanità, Rome, Italy
| | - Rosa Joosten
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Roan Pijnacker
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Ingvild Fjeldheim
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Eli Heen
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Małgorzata Stępień
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Piotr Polański
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Rui Tato Marinho
- Gastroenterology and Hepatology Department, Hospital S. Maria; Medical School of Lisbon; National Programme for Viral Hepatitis, Portugal Ministry of Health, Lisbon, Portugal
| | - João Vieira Martins
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - Carmen Varela
- National Centre of Epidemiology, Carlos III Institute of Health, CIBERESP, Madrid, Spain
| | - Ana Avellón
- National Centre of Microbiology, Carlos III Institute of Health, CIBERESP, Madrid, Spain
| | | | | | - Sema Mandal
- United Kingdom Health Security Agency Epidemiology Cell, London, United Kingdom
| | - Conall Watson
- United Kingdom Health Security Agency Epidemiology Cell, London, United Kingdom
| | - Laura Coughlan
- United Kingdom Health Security Agency Epidemiology Cell, London, United Kingdom
| | - Meera Chand
- United Kingdom Health Security Agency Incident Director, London, United Kingdom
| | - Claire Neill
- Public Health Agency Northern Ireland, Belfast, United Kingdom
| | | | - Kathy Li
- Regional Virology Laboratory Belfast Health and Social Care Trust, Northern Ireland, Belfast, United Kingdom
| | - Maureen O'Leary
- Clinical and Protecting Health Directorate, Public Health Scotland, Glasgow, United Kingdom
| | - Neil McInnes
- West of Scotland Specialist Virology Centre, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | | | | | | | - Erika Duffell
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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Ingram C, Chen Y, Buggy C, Downey V, Archibald M, Rachwal N, Roe M, Drummond A, Perrotta C. Development and validation of a multi-lingual online questionnaire for surveying the COVID-19 prevention and control measures used in global workplaces. BMC Public Health 2022; 22:74. [PMID: 35022018 PMCID: PMC8753024 DOI: 10.1186/s12889-022-12500-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/31/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Despite widespread COVID-19 vaccination programs, there is an ongoing need for targeted disease prevention and control efforts in high-risk occupational settings. This study aimed to develop, pilot, and validate an instrument for surveying occupational COVID-19 infection prevention and control (IPC) measures available to workers in diverse geographic and occupational settings.
Methods
A 44-item online survey was developed in English and validated for face and content validity according to literature review, expert consultation, and pre-testing. The survey was translated and piloted with 890 workers from diverse industries in Canada, Ireland, Argentina, Poland, Nigeria, China, the US, and the UK. Odds ratios generated from univariable, and multivariable logistic regression assessed differences in ‘feeling protected at work’ according to gender, age, occupation, country of residence, professional role, and vaccination status. Exploratory factor analysis (EFA) was conducted, and internal consistency reliability verified with Cronbach’s alpha. Hypothesis testing using two-sample t-tests verified construct validity (i.e., discriminant validity, known-groups technique), and criterion validity.
Results
After adjustment for occupational sector, characteristics associated with feeling protected at work included being male (AOR = 1.88; 95% CI = 1.18,2.99), being over 55 (AOR = 2.17; 95% CI = 1.25,3.77) and working in a managerial position (AOR = 3.1; 95% CI = 1.99,4.83). EFA revealed nine key IPC domains relating to: environmental adjustments, testing and surveillance, education, costs incurred, restricted movements, physical distancing, masking, isolation strategies, and areas for improvement. Each domain showed sufficient internal consistency reliability (Cronbach’s alpha ≥0.60). Hypothesis testing revealed differences in survey responses by country and occupational sector, confirming construct validity (p < 0.001), criterion validity (p = 0.04), and discriminant validity (p < 0.001).
Conclusions
The online survey, developed in English to identify the COVID-19 protective measures used in diverse workplace settings, showed strong face validity, content validity, internal consistency, criterion validity, and construct validity. Translations in Chinese, Spanish, French, Polish, and Hindi demonstrated adaptability of the survey for use in international working environments. The multi-lingual tool can be used by decision makers in the distribution of IPC resources, and to guide occupational safety and health (OSH) recommendations for preventing COVID-19 and future infectious disease outbreaks.
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