Preparedness and response to COVID-19 in Saudi Arabia: Building on MERS experience

Nearly four months have passed since the emergence of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), which caused the rapidly spreading Coronavirus Disease 2019 (COVID-19) pandemic. To date, there have been more than 2.3 million confirmed cases and more than 160,000 deaths globally caused by COVID-19. Chinese health authorities, where the virus emerged, have taken prompt strict public health measures to control and prevent the spread of the outbreak. In Saudi Arabia, unprecedented precautionary strict measures were applied to prevent virus entry to the country or to mitigate its impact when it arrives. Here, we review the response of Saudi Arabia to COVID-19 pandemic and how did the experience learned from the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic since 2012 has helped the country to be better prepared for the current COVID-19 pandemic. We also discuss the country readiness, improvement in research and development, and the unprecedented rapid precautionary measures that have been taken by the Saudi government thus far.

Research progress in sources, analytical methods, eco-environmental effects, and control measures of microplastics

Microplastics are plastic particles which are widely distributed in the environment. The pollution of microplastics in environment have attracted increasing attention in recent years. This paper reviews research progress in sources, analytical methods, eco-environmental effects and control in environment, and suggests relevant countermeasures in governance and research. Microplastics mainly originate from two sources: firstly, a significant direct input of primary microplastics; second, secondary microplastics generate from the fragmentations of larger plastic materials. The analysis and identification of microplastics are critical to other researches, and related instrument methods have also been applied to the analysis and identification of microplastics. The advantages and disadvantages of microplastics analytical methods were reviewed. The eco-environmental effects of microplastics can be divided into four aspects: adsorption, biological uptake, ecotoxicological and combined pollution. Control measures need to strengthen the systematic research of microplastics pollution control and management technology system from the aspects of organizational cooperation, technological research and development, laws and regulations. In the future, a unified quantitative analysis method for microplastics should be established, and more accurate traceability analysis techniques should be developed to further explore its environmental behavior and fate. To strengthen scientific research on microplastic pollution in terrestrial, freshwater and atmospheric environments, and develop more scientific and rational control policies. This paper aims to provide a theoretical basis for the prevention and control of microplastics pollution, and also provides insights for the next step of research.

Street vended food in developing world: hazard analyses

Street food vending has become an important public health issue and a great concern to everybody. This is due to widespread food borne diseases, due to the mushrooming of wayside food vendors who lack an adequate understanding of the basic food safety issues. Major sources contributing to microbial contamination are the place of preparation, utensils for cooking and serving, raw materials, time and temperature abuse of cooked foods and the personal hygiene of vendors. Various studies have identified the sources of food safety issues involved in street foods to be microorganism belonging to the genus Bacillus, Staphylococcus, Clostridium, Vibrio, Campylobacter, Listeria, Salmonella. Application of sound risk analysis policies is being advocated to provide a scientific base to the host of risk management option which India may need to explore to ensure public health and safety.

Foodborne transmission of Toxoplasma gondii infection in the last decade. An overview

Toxoplasmosis is a zoonotic disease of global distribution and importance. It is caused by the protozoan parasite Toxoplasma gondii, the only species in the Toxoplasma genus. This parasite can infect most warm-blooded animals, including humans and livestock. Main routes of transmission are by ingestion of tissue cysts in raw or undercooked meat of infected animals, ingestion of raw vegetables or water contaminated with T. gondii oocysts from cat feces, and transplacental. Around one-third of human beings are chronically infected with T. gondii. Most infections appear to be asymptomatic in immunocompetent persons, but toxoplasmosis can be fatal to the fetus and immunocompromised adults. Water and foodborne outbreaks have been caused by this parasite worldwide, but few are well documented. Importantly, T. gondii is a parasite of high importance in animal health, causing reproductive failure, particularly in small ruminants, and clinical toxoplasmosis in many species. This overview discusses the knowledge of T. gondii infections in the last decade focusing on the foodborne transmission of this parasite.

Eight challenges for network epidemic models

Networks offer a fertile framework for studying the spread of infection in human and animal populations. However, owing to the inherent high-dimensionality of networks themselves, modelling transmission through networks is mathematically and computationally challenging. Even the simplest network epidemic models present unanswered questions. Attempts to improve the practical usefulness of network models by including realistic features of contact networks and of host-pathogen biology (e.g. waning immunity) have made some progress, but robust analytical results remain scarce. A more general theory is needed to understand the impact of network structure on the dynamics and control of infection. Here we identify a set of challenges that provide scope for active research in the field of network epidemic models.

Future Scenarios for Plant Virus Pathogens as Climate Change Progresses

Knowledge of how climate change is likely to influence future virus disease epidemics in cultivated plants and natural vegetation is of great importance to both global food security and natural ecosystems. However, obtaining such knowledge is hampered by the complex effects of climate alterations on the behavior of diverse types of vectors and the ease by which previously unknown viruses can emerge. A review written in 2011 provided a comprehensive analysis of available data on the effects of climate change on virus disease epidemics worldwide. This review summarizes its findings and those of two earlier climate change reviews and focuses on describing research published on the subject since 2011. It describes the likely effects of the full range of direct and indirect climate change parameters on hosts, viruses and vectors, virus control prospects, and the many information gaps and deficiencies. Recently, there has been encouraging progress in understanding the likely effects of some climate change parameters, especially over the effects of elevated CO2, temperature, and rainfall-related parameters, upon a small number of important plant viruses and several key insect vectors, especially aphids. However, much more research needs to be done to prepare for an era of (i) increasingly severe virus epidemics and (ii) increasing difficulties in controlling them, so as to mitigate their detrimental effects on future global food security and plant biodiversity.

Contribution of plastic and microplastic to global climate change and their conjoining impacts on the environment - A review

Plastics are fossil fuel-derived products. The emissions of greenhouse gases (GHG) during different processes involved in the lifecycle of plastic-related products are a significant threat to the environment as it contributes to global temperature rise. By 2050, a high volume of plastic production will be responsible for up to 13 % of our planet's total carbon budget. The global emissions of GHG and their persistence in the environment have depleted Earth's residual carbon resources and have generated an alarming feedback loop. Each year at least 8 million tonnes of discarded plastics are entering our oceans, creating concerns regarding plastic toxicity on marine biota as they end up in the food chain and ultimately affect human health. The unsuccessful management of plastic waste and its presence on the riverbanks, coastlines, and landscapes leads to the emission of a higher percentage of GHG in the atmosphere. The persistence of microplastics is also a significant threat to the fragile and extreme ecosystem containing diverse life forms with low genetic variation, making them vulnerable to climatic change. In this review, we have categorically discussed the contribution of plastic and plastic waste to global climate change covering the current plastic production and future trends, the types of plastics and plastic materials used globally, plastic lifecycle and GHG emission, and how microplastics become a major threat to ocean carbon sequestration and marine health. The conjoining impact of plastic pollution and climate change on the environment and human health has also been discussed in detail. In the end, we have also discussed some strategies to reduce the climate impact of plastics.

A data-driven network model for the emerging COVID-19 epidemics in Wuhan, Toronto and Italy

The ongoing Coronavirus Disease 2019 (COVID-19) pandemic threatens the health of humans and causes great economic losses. Predictive modeling and forecasting the epidemic trends are essential for developing countermeasures to mitigate this pandemic. We develop a network model, where each node represents an individual and the edges represent contacts between individuals where the infection can spread. The individuals are classified based on the number of contacts they have each day (their node degrees) and their infection status. The transmission network model was respectively fitted to the reported data for the COVID-19 epidemic in Wuhan (China), Toronto (Canada), and the Italian Republic using a Markov Chain Monte Carlo (MCMC) optimization algorithm. Our model fits all three regions well with narrow confidence intervals and could be adapted to simulate other megacities or regions. The model projections on the role of containment strategies can help inform public health authorities to plan control measures.

Emissions of volatile organic compounds from crude oil processing - Global emission inventory and environmental release

Airborne Volatile organic compounds (VOCs) are known to have strong and adverse impacts on human health and the environment by contributing to the formation of tropospheric ozone. VOCs can escape during various stages of crude oil processing, from extraction to refinery, hence the crude oil industry is recognised as one of the major sources of VOC release into the environment. In the last few decades, volatile emissions from crude oil have been investigated either directly by means of laboratory and field-based analyses, or indirectly via emission inventories (EIs) which have been used to develop regulatory and controlling measures in the petroleum industry. There is a vast amount of scattered data in the literature for both regional emissions from crude oil processing and scientific measurements of VOC releases. This paper aims to provide a critical analysis of the overall scale of global emissions of VOCs from all stages of oil processing based on data reported in the literature. The volatile compounds, identified via EIs of the crude oil industry or through direct emissions from oil mass, are collected and analysed to present a global-scale evaluation of type, average concentration and detection frequency of the most prevalent VOCs. We provide a critical analysis on the total averages of VOCs and key pieces of evidence which highlights the necessity of implementing control measures to regulate crude oil volatile emissions (CVEs) in primary steps of extraction-to-refinery pathways of crude oil processing. We have identified knowledge gaps in this field which are of importance to control the release of VOCs from crude oil, independent of oil type, location, operating conditions and metrological parameters.

Causes of ozone pollution in summer in Wuhan, Central China

In August 2016, continuous measurements of volatile organic compounds (VOCs) and trace gases were conducted at an urban site in Wuhan. Four high-ozone (O₃) days and twenty-seven non-high-O₃ days were identified according to the China's National Standard Level II (∼100 ppbv). The occurrence of high-O₃ days was accompanied by tropical cyclones. Much higher concentrations of VOCs and carbon monoxide (CO) were observed on the high-O₃ days (p < 0.01). Model simulations revealed that vehicle exhausts were the dominant sources of VOCs, contributing 45.4 ± 5.2% and 37.3 ± 2.9% during high-O₃ and non-high-O₃ days, respectively. Both vehicle exhausts and stationary combustion made significantly larger contributions to O₃ production on high-O₃ days (p < 0.01). Analysis using a chemical transport model found that local photochemical formation accounted for 74.7 ± 5.8% of the daytime O₃, around twice the regional transport (32.2 ± 5.4%), while the nighttime O₃ was mainly attributable to regional transport (59.1 ± 9.9%). The local O₃ formation was generally limited by VOCs in urban Wuhan. To effectively control O₃ pollution, the reduction ratio of VOCs to NO_x concentrations should not be lower than 0.73, and the most efficient O₃ abatement could be achieved by reducing VOCs from vehicle exhausts. This study contributes to the worldwide database of O₃-VOC-NO_x sensitivity research. Its findings will be helpful in formulating and implementing emission control strategies for dealing with O₃ pollution in Wuhan.

A review of strategies for mitigating roadside air pollution in urban street canyons

Urban street canyons formed by high-rise buildings restrict the dispersion of vehicle emissions, which pose severe health risks to the public by aggravating roadside air quality. However, this issue is often overlooked in city planning. This paper reviews the mechanisms controlling vehicle emission dispersion in urban street canyons and the strategies for managing roadside air pollution. Studies have shown that air pollution hotspots are not all attributed to heavy traffic and proper urban design can mitigate air pollution. The key factors include traffic conditions, canyon geometry, weather conditions and chemical reactions. Two categories of mitigation strategies are identified, namely traffic interventions and city planning. Popular traffic interventions for street canyons include low emission zones and congestion charges which can moderately improve roadside air quality. In comparison, city planning in terms of building geometry can significantly promote pollutant dispersion in street canyons. General design guidelines, such as lower canyon aspect ratio, alignment between streets and prevailing winds, non-uniform building heights and ground-level building porosity, may be encompassed in new development. Concurrently, in-street barriers are widely applicable to rectify the poor roadside air quality in existing street canyons. They are broadly classified into porous (e.g. trees and hedges) and solid (e.g. kerbside parked cars, noise fences and viaducts) barriers that utilize their aerodynamic advantages to ease roadside air pollution. Post-evaluations are needed to review these strategies by real-world field experiments and more detailed modelling in the practical perspective.

Camelpox, an emerging orthopox viral disease

Camelpox is considered as emerging public health problem during this decade due to increased reported cases and outbreaks in camels. Camelpox is a contagious, often sporadic, and notifiable skin disease of camelids and is socio-economically significant as it incurs considerable loss in terms of morbidity, mortality, loss of weight and reduction in milk yield and confined to camel-rearing countries. The causative agent, camelpox virus (CMLV) is genetically closely related to variola virus and has gained much attention from researchers due to its recent emergence in human. The virus carrying genes responsible for host immune evasion mechanisms owing to the threat posed by potential bio-warfare agents. Although the disease can be diagnosed based on clinical features, the similar confounding skin lesions necessitate identification, detection and differentiation of the CMLV by molecular techniques. Vaccines are available in some countries and the available live attenuated vaccine provides long-lasting immunity. Further, novel highly sensitive and specific techniques would be useful in the identification of emerging and re-emerging virus, thereby therapeutic, prophylactic, preventive measures would be applied in time to curtail further spread of camelpox like other zoonotic diseases. This review provide overview of the camelpox particularly on its epidemiology, pathogenesis and biology of the disease, diagnostic approaches and control measures.

Public health responses during measles outbreaks in elimination settings: Strategies and challenges

In late September 2016, the Americas became the first region in the world to have eliminated endemic transmission of measles virus. Several other countries have also verified measles elimination, and countries in all six World Health Organization regions have adopted measles elimination goals. The public health strategies used to respond to measles outbreaks in elimination settings are thus becoming relevant to more countries. This review highlights the strategies used to limit measles spread in elimination settings: (1) assembly of an outbreak control committee; (2) isolation of measles cases while infectious; (3) exclusion and quarantining of individuals without evidence of immunity; (4) vaccination of susceptible individuals; (5) use of immunoglobulin to prevent measles in exposed susceptible high-risk persons; (6) and maintaining laboratory proficiency for confirmation of measles. Deciding on the extent of containment efforts should be based on the expected benefit of reactive interventions, balanced against the logistical challenges in implementing them.

Combined effects of increased O3 and reduced NO2 concentrations on short-term air pollution health risks in Hong Kong

The reduction of NO_x emissions in a VOC-limited region can lead to an increase of the local O₃ concentration. An evaluation of the net health effects of such pollutant changes is therefore important to ascertain whether the emission control measures effectively improve the overall protection of public health. In this study, we use a short-term health risk (added health risk or AR) model developed for the multi-pollutant air quality health index (AQHI) in Hong Kong to examine the overall health impacts of these pollutant changes. We first investigate AR changes associated with NO₂ and O₃ changes, followed by those associated with changes in all four AQHI pollutants (NO₂, O₃, SO₂, and particulate matter (PM)). Our results show that for the combined health effects of NO₂ and O₃ changes, there is a significant reduction in AR in urban areas with dense traffic, but no statistically significant changes in other less urbanized areas. The increase in estimated AR for higher O₃ concentrations is offset by a decrease in the estimated AR for lower NO₂ concentrations. In areas with dense traffic, the reduction in AR as a result of decreased NO₂ is substantially larger than the increase in AR associated with increased O₃. When additionally accounting for the change in ambient SO₂ and PM, we found a statistically significant reduction in total AR everywhere in Hong Kong. Our results show that the emission control measures resulting in NO₂, SO₂, and PM reductions over the past decade have effectively reduced the AR over Hong Kong, even though these control measures may have partially contributed to an increase in O₃ concentrations. Hence, efforts to reduce NOx, SO₂, and PM should be continued.

The effect of control measures on COVID-19 transmission in Italy: Comparison with Guangdong province in China

BACKGROUND

COVID-19 has spread all around the world. Italy is one of the worst affected countries in Europe. Although there is a trend of relief, the epidemic situation hasn't stabilized yet. This study aims to investigate the dynamics of the disease spread in Italy and provide some suggestions on containing the epidemic.

METHODS

We compared Italy's status at the outbreak stage and control measures with Guangdong Province in China by data observation and analysis. A modified autonomous SEIR model was used to study the COVID-19 epidemic and transmission potential during the early stage of the outbreak in Italy. We also utilized a time-dependent dynamic model to study the future disease dynamics in Italy. The impact of various non-pharmaceutical control measures on epidemic was investigated through uncertainty and sensitivity analyses.

RESULTS

The comparison of specific measures implemented in the two places and the time when the measures were initiated shows that the initial prevention and control actions in Italy were not sufficiently timely and effective. We estimated parameter values based on available cumulative data and calculated the basic reproduction number to be 4.32 before the national lockdown in Italy. Based on the estimated parameter values, we performed numerical simulations to predict the epidemic trend and evaluate the impact of contact limitation, detection and diagnosis, and individual behavior change due to media coverage on the epidemic.

CONCLUSIONS

Italy was in a severe epidemic status and the control measures were not sufficiently timely and effective in the beginning. Non-pharmaceutical interventions, including contact restrictions and improvement of case recognition, play an important role in containing the COVID-19 epidemic. The effect of individual behavior changes due to media update of the outbreak cannot be ignored. For policy-makers, early and strict blockade measures, fast detection and improving media publicity are key to containing the epidemic.

Overview of Zika infection, epidemiology, transmission and control measures

The current Zika virus outbreak in the Americas and the proposed link to increases in microcephaly and neurological disorders have prompted the World Health Organization to declare a Public Health Emergency of International Concern on February 1, 2016. The virus is transmitted by Aedes mosquitoes and potentially by transfusion, perinatal and sexual transmission. The potential for spread into countries where Aedes mosquitoes are endemic is high. Previously, cases tended to be sporadic and associated with mild, non-specific symptoms. Prior outbreaks occurred in Yap Island in Micronesia in 2007, the first time Zika arose outside of Africa and Asia, and in French Polynesia in 2013. A birth data review has confirmed that the latter outbreak was followed by an increase in microcephaly cases. A coordinated international response is needed to address mosquito control; expedite development of diagnostic tests, vaccines and specific treatments for Zika; and address the proposed link to microcephaly and neurological diseases.

West Nile fever in Israel: the reemergence of an endemic disease

BACKGROUND

As a crossroads for bird migration between Africa and Eurasia and with its long history of human infection, Israel has been a major focus of attention during the continuing global spread of West Nile fever (WNF). This article reviews the background and reemergence of WNF in Israel; the recent epidemiology of WNF among Israelis; and the disease-control strategies being used to combat the disease.

METHODS

Employing the comprehensive base of case data that are reported to the Ministry of Health, an epidemiological record was constructed that details the incidence and distribution of WNF cases in Israel in recent years.

RESULTS

After decades of small, intermittent outbreaks, nearly 1400 cases of WNF were reported in Israel between 2000 and 2012. Incidence was consistently highest in the coastal cities, among elderly patients, and in the late summer months and early autumn. A broad range of control measures to prevent human infection has been implemented, and attention has been given to issues such as the protection of the national blood bank and the occurrence of long-term sequelae.

CONCLUSIONS

The reemergence of WNF in Israel is likely the result of a combination of factors including past immunity to the virus among the human population, a marked increase in awareness of WNF among physicians, and more frequent requests for the laboratory testing of suspected cases. In the absence of effective vaccine to protect humans from WNF, the best disease-control strategies include intensive vector-control measures, the continued development of techniques to forecast outbreaks, and effective public education programs that are targeted toward the high-risk elderly population.

Characterization and source apportionment of particulate PAHs in the roadside environment in Beijing

The profiles of particulate polycyclic aromatic hydrocarbons (PAHs) near a major road and relative major sources were determined based on five 1-week intensive field campaigns in 2008 and 2009, and the impacts of temporary control measures on roadside PAHs during the Beijing Olympics are discussed. The annual average concentration of PAHs in the non-Olympic period was 42.3 ± 52.4 ng/m(3) and clear seasonal variation was present. Diesel vehicles, gasoline vehicles and coal combustion were identified as the three possible major sources of roadside PAHs using positive matrix factorization analysis. During the Olympics, the average total PAH concentration decreased to 4.8 ± 2.7 ng/m(3), which was attributed primarily to the reduction of local emissions. Temporary traffic control measures significantly changed the diurnal pattern of particulate PAHs at the roadside site. Diesel vehicle contribution, in particular, decreased to a negligible fraction because heavy-duty diesel vehicles were strictly banned.

Recent development in evaluation methods, influencing factors and control measures for freeze denaturation of food protein

Frozen storage is most widely adopted preservation method to maintain food freshness and nutritional attributes. However, at low temperature, food is prone to chemical changes such as protein denaturation and lipid oxidation. In this review, we discussed the reasons and influencing factors that cause protein denaturation during freezing, such as freezing rate, freezing temperature, freezing method, etc. From the previous literatures, it was found that frozen storage is commonly used to prevent freeze induced protein denaturation by adding cryoprotectants to food. Some widely used cryoprotectants (for example, sucrose and sorbitol) have been reported with higher sweetness and weaker cryoprotective abilities. Therefore, this article comprehensively discusses the new cryopreservation methods and providing comparative study to the conventional frozen storage. Meanwhile, this article sheds light on the freeze induced alterations, such as change in functional and gelling properties. In addition, this article could be helpful for the prolonged frozen storage of food with minimum quality related changes. Meanwhile, it could also improve the commercial values and consumer satisfaction of frozen food as well.

Experiences of carriers of multidrug-resistant organisms: a systematic review

OBJECTIVES

A comprehensive overview of the ways control measures directed at carriers of multidrug-resistant organisms (MDRO) affect daily life of carriers is lacking. In this systematic literature review, we sought to explore how carriers experience being a carrier and how they experience being subjected to control measures by looking at the impact on basic capabilities.

METHODS

We searched Medline, Embase and PsychINFO until 26 May 2016 for studies addressing experiences of MDRO carriers. Twenty-seven studies were included, addressing experiences with methicillin-resistant Staphylococcus aureus (n = 21), ESBL (n = 1), multiple MDRO (n = 4) and other (n = 1, not specified). We categorized reported experiences according to Nussbaum's capability approach.

RESULTS

Carriage and control measures were found to interfere with quality of care, cause negative emotions, limit interactions with loved ones, cause stigmatization, limit recreational activities and create financial and professional insecurity. Further, carriers have difficulties with full comprehension of the problem of antimicrobial resistance, thus affecting six out of ten basic capabilities.

CONCLUSIONS

Applying Nussbaum's capability approach visualizes an array of unintended consequences of control measures. Carriers experience stigmatization, especially in healthcare settings, and have limited understanding of their situation and the complexities of antimicrobial resistance.

Short-term forecasts of the COVID-19 pandemic: a study case of Cameroon

In this paper, an Ensemble of Kalman filter (EnKf) approach is developed to estimate unmeasurable state variables and unknown parameters in a COVID-19 model. We first formulate a mathematical model for the dynamic transmission of COVID-19 that takes into account the circulation of free coronaviruses in the environment. We provide the basic properties of the model and compute the basic reproduction number R 0 that plays an important role in the outcome of the disease. After, assuming continuous measurement of newly COVID-19 reported cases, deceased and recovered individuals, the EnKf approach is used to estimate the unmeasured variables and unknown COVID-19 transmission rates using real data of the current COVID-19 pandemic in Cameroon. We present the forecasts of the current pandemic in Cameroon and explore the impact of non-pharmaceutical interventions such as mass media-based sensitization, social distancing, face-mask wearing, contact tracing and the desinfection and decontamination of infected places by using suitable products against free coronaviruses in the environment in order to reduce the spread of the disease. Through numerical simulations, we find that at that time (i)R 0 ≈ 2.9495 meaning that the disease will not die out without any control measures, (ii) the infection from COVID-19 infected cases is more important than the infection from free coronaviruses in the environment, (iii) the number of new COVID-19 cases will still increase and there is a necessity to increase timely the surveillance by using contact tracing and sensibilisation of the population to respect social distancing, face-masks wearing through awareness programs and (iv) the eradication of the pandemic is highly dependent on the control measures taken by governments.

Relative impact of emissions controls and meteorology on air pollution mitigation associated with the Asia-Pacific Economic Cooperation (APEC) conference in Beijing, China

The Beijing government and its surrounding provinces implemented a series of measures to ensure haze-free skies during the 22(nd) Asia-Pacific Economic Cooperation (APEC) conference (November 10(th)-11(th), 2014). These measures included restrictions on traffic, construction, and industrial activity. Twelve hour measurements of the concentration and composition of ambient fine particulate matter (PM2.5) were performed for 5 consecutive months near the APEC conference site before (September 11(th)-November 2(nd), 2014), during (November 3(rd)-12(th), 2014) and after (November 13(th), 2014-January 31(st), 2015). The measurements are used in a positive matrix factorization model to determine the contributions from seven sources of PM2.5: secondary aerosols, traffic exhaust, industrial emission, road dust, soil dust, biomass burning and residual oil combustion. The source apportionment results are integrated with backward trajectory analysis using Weather Research and Forecast (WRF) meteorological simulations, which determine the relative influence of new regulation and meteorology upon improved air quality during the APEC conference. Data show that controls are very effective, but meteorology must be taken into account to determine the actual influence of the controls on pollution reduction. The industry source control is the most effective for reducing concentrations, followed by secondary aerosol and biomass controls, while the least effective control is for the residual oil combustion source. The largest reductions in concentrations occur when air mass transport is from the west-northwest (Ulanqab). Secondary aerosol and traffic exhaust reductions are most significant for air mass transport from the north-northwest (Xilingele League) origin, and least significant for northeast transport (Chifeng via Tangshan conditions). The largest reductions of soil dust, biomass burning, and industrial source are distinctly seen for Ulanqab conditions and least distinct for Xilingele League.

Role of hot water temperature and water system use on Legionella control in a tertiary hospital: An 8-year longitudinal study

Although measures to minimize Legionella colonization in sanitary hot water installations are well established, there is little evidence of their long-term effectiveness in hospital buildings. During an 8-year period, hot water in a large hospital building was sampled monthly in areas with suitable dimensioning and recirculation and in areas with dead legs and low-use taps. In the former areas, the percentage of Legionella-negative samples was 83.2% when the temperature was ≥55%, 64.9% when between 50.1 °C and 54.0 °C, and 51.6% when ≤50 °C (p for trend <0.001). In the highest temperature group, no samples with ≥10³ cfu/L were observed. In poorly designed areas, only 44.7% of samples were negative, and 28.9% presented ≥10³ cfu/L although reaching 55 °C. In these areas, multivariate analysis showed that if hot water supplies were not used daily, the risk of Legionella colonization was greater than two-fold (odds ratio: 2.84; 95% confidence interval: 1.26-6.41), and the risk of finding Legionella concentrations ≥10³ cfu/L was more than three-fold (odds ratio: 3.18; 95% confidence interval: 1.36-7.46), regardless the temperature. These findings indicate that the effectiveness of maintaining sanitary hot water at a minimum temperature of 55 °C is significantly better than that at 50 °C for the environmental control of Legionella but only in installations with suitable dimensioning and recirculation. In installations that do not meet these conditions, high temperatures alone result in insufficient control.

Balantioides coli

Balantioides coli (=Balantidium coli) is the only ciliate that parasitizes humans. Pigs are the main reservoir. Other species, as camels, cattle, donkey, sheep and goat have been also proposed as reservoirs for human infections. The parasite has a direct life cycle, being transmitted by the faecal-oral route. This type of cycle and the large number of host species imply an important potential for zoonotic transmission of the parasite. Infections are most commonly found in tropical and temperate regions, with prevalence up to 100% in pigs; high prevalence values have been also recorded in some non-human primates and camels. In humans, prevalence is usually under 10% in the population at risk. The main epidemiological factors involved in the transmission of this parasite include close contact with pigs, lack of basic sanitation infrastructures (water supply, wastewater disposal) and hygiene. Individual health status, intestinal microbiota and diet are also important for the onset of the infection. Outbreaks caused by this parasite are rare; those reported to date were related to poor hygienic conditions or to catastrophic natural disasters. Balantioides coli infections can be asymptomatic and symptomatic, which can be chronic (with intermittent diarrhoea), or acute (a dysenteric form which can be life-threatening). Efective treatments include tetracycline, iodoquinol and 5-nitroimidazole compounds (metronidazole, secnidazole). The main effective individual preventive measure is the use of disinfected water for drinking and other uses. Adequate water supply infrastructures, proper disposal of wastewater and animal faeces, and regular monitoring programs on farms will help limit transmission.

The methodologies to assess the effectiveness of non-pharmaceutical interventions during COVID-19: a systematic review

Non-pharmaceutical interventions, such as school closures and stay-at-home orders, have been implemented around the world to control the spread of SARS-CoV-2. Their effectiveness in improving health-related outcomes has been the subject of numerous empirical studies. However, these studies show fairly large variation among methodologies in use, reflecting the absence of an established methodological framework. On the one hand, variation in methodologies may be desirable to assess the robustness of results; on the other hand, a lack of common standards can impede comparability among studies. To establish a comprehensive overview over the methodologies in use, we conducted a systematic review of studies assessing the effectiveness of non-pharmaceutical interventions between January 1, 2020 and January 12, 2021 (n = 248). We identified substantial variation in methodologies with respect to study setting, outcome, intervention, methodological approach, and effectiveness assessment. On this basis, we point to shortcomings of existing studies and make recommendations for the design of future studies.