| 41. |
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| 42. |
- Holtenius, Jonas, et al.
(författare)
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The Spanish flu in Uppsala, clinical and epidemiological impact of the influenza pandemic 1918-1919 on a Swedish county
- 2014
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Ingår i: Infection Ecology & Epidemiology. - : Informa UK Limited. - 2000-8686. ; 4, s. 21528-
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION AND AIM: The Spanish flu reached Sweden in June 1918, and at least one-third of the population (then 5.8 million) became infected. Some 34,500 persons (5.9 per 1,000 people) died from influenza during the first year of the pandemic (when acute pneumonia is included, the number of deaths rose to 7.1 per 1,000 people). In this historical look back at the pandemic, our aim was to review the epidemiological impact on the Swedish county of Uppsala, the clinical outcomes and the economic impact on the regional hospital; a relevant backgound to consider the impact of a future virulent pandemic. We also focused on how the pandemic was perceived by the medical community and by health care authorities.METHODS: Health care reports, statistics, daily newspapers, medical journals, and records of patients treated for influenza at the Uppsala Academic Hospital from July 1918 to June 1919 were included in our review.RESULTS: An influenza related mortality rate of 693 persons (5.1 per 1,000 people) was reported in the Uppsala region from 1918-1919; from July 1918 to June 1919, 384 patients were treated for influenza at the Uppsala Academic Hospital. The first wave peaked in November 1918 with case fatality rates up to 30%; a second wave peaked in April 1919 with a lower rate of mortality. Of the patients treated, a total of 66 died. Of these, 60% were 20-29 years of age, and 85% were less than 40 years old. Autopsy reports revealed pneumonia in 89% of the cases; among these, 47% were hemorrhagic, 18% were bilateral, and 45% had additional extrapulmonary organ involvement. Signs of severe viral disease were documented, but secondary bacterial disease was the primary cause of death in the majority of cases.CONCLUSION: The epidemiologic and pathologic results were in accordance with other publications of this time period. The costs of running the hospital doubled from 1917 to 1920 and then reversed by 45%. Today, an influenza pandemic of the same virulence would paralyze health care systems and result in extremely high financial costs and rates of mortality.
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| 43. |
- Höjgård, Sören
(författare)
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Antibiotic resistance - why is the problem so difficult to solve?
- 2012
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Ingår i: Infection Ecology & Epidemiology. - 2000-8686. ; 2, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Antibiotic resistance has been increasing along with antibiotic use. At the same time, the supply of new drugs to replace those rendered inefficient by the development has been dwindling, leading to concerns that we may soon lack efficient means to treat bacterial infections. Though the problem has received considerable interest, there are no indications that the situation is about to change. The present review maintains that this is because the two objectives - preserving the efficiency of existing drugs and increasing the supply of new ones - are partly opposing. Hence, creating an incentive structure compatible with both of them is not easy. Nevertheless, it is suggested that levying a fee on the use of antibiotics, and earmarking the proceeds from this fee for subsidizing development of new antibiotics, would be an important step towards increasing incentives for a better antibiotic stewardship while preserving incentives to develop new substances.
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| 44. |
- Ingefors, Erik, et al.
(författare)
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Low 30-day mortality and low carbapenem-resistance in a decade of Acinetobacter bacteraemia in South Sweden
- 2022
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Ingår i: Infection Ecology and Epidemiology. - : Informa UK Limited. - 2000-8686. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to provide a descriptive account of carbapenem resistance and risk factors for mortality from invasive Acinetobacter infections in the south of Sweden.Methods: Blood isolates with growth of Acinetobacter species between 2010 and 2019 in Skåne county were subtyped using MALDI-TOF and subjected to susceptibility testing against clinically relevant antibiotics. Association between risk factors and 30-day mortality were analysed in univariate and multivariate logistic regression models.Results: There were 179 bacteraemia episodes in 176 patients included in the study. The 30-day all-cause mortality was 16%. In all, two percent of Acinetobacter strains were carbapenem resistant. Independent risk factors associated with 30-day mortality in the multivariate regression model were Acinetobacter growth in all blood cultures drawn at the day of bacteraemia onset (OR 5.0, 95% CI: 1.8 to 13.7, p= 0.002), baseline functional capacity (1-4 points, OR 2.0, 95% CI: 1.2 to 3.4, p= 0.010) and correct empiric antibiotics at time of culture (OR 3.5 95% CI: 1.0 to 11.8, p= 0.045).Conclusion: This study on Acinetobacter bacteraemia in South Sweden found low 30-day mortality and low carbapenem-resistance rates compared to previous international studies which may be due to a higher rate of contaminant findings.
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| 45. |
- Jansson, Desirée, et al.
(författare)
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Intestinal spirochaetes (genus Brachyspira) colonise wild birds in the southern Atlantic region and Antarctica
- 2015
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Ingår i: Infection Ecology & Epidemiology. - : Informa UK Limited. - 2000-8686. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The genus Brachyspira contains well-known enteric pathogens of veterinary significance, suggested agents of colonic disease in humans, and one potentially zoonotic agent. There are recent studies showing that Brachyspira are more widespread in the wildlife community than previously thought. There are no records of this genus in wildlife from the southern Atlantic region and Antarctica. Our aim was therefore, to determine whether intestinal spirochaetes of genus Brachyspira colonise marine and coastal birds in this region.METHOD: Faecal samples were collected from marine and coastal birds in the southern Atlantic region, including sub-Antarctic islands and Antarctica, in 2002, 2009, and 2012, with the aim to isolate and characterise zoonotic agents. In total, 205 samples from 11 bird species were selectively cultured for intestinal spirochaetes of genus Brachyspira. To identify isolates to species level, they were subjected to phenotyping, species-specific polymerase chain reactions, sequencing of partial 16S rRNA, NADH oxidase (nox), and tlyA genes, and phylogenetic analysis. Antimicrobial susceptibility tests were performed.RESULTS: Fourteen unique strains were obtained from 10 birds of three species: four snowy sheathbills (Chionis albus), three kelp geese (Chloephaga hybrida subsp. malvinarum), and three brown skua (Stercorarius antarcticus subsp. lonnbergi) sampled on the Falkland Islands, Tierra del Fuego in Argentina, South Georgia, South Shetland Islands, and the Antarctic Peninsula. Five Brachyspira strains were closely related to potentially enteropathogenic Brachyspira sp. of chickens: B. intermedia (n=2, from snowy sheathbills), and B. alvinipulli (n=3, from a kelp goose and two snowy sheathbills). Three strains from kelp geese were most similar to the presumed non-pathogenic species 'B. pulli' and B. murdochii, whereas the remaining six strains could not be attributed to currently known species. No isolates related to human strains were found. None of the tested strains showed decreased susceptibility to tiamulin, valnemulin, doxycycline, tylvalosin, lincomycin, or tylosin.CONCLUSIONS: This is the first report of intestinal spirochaetes from this region. Despite limitations of current diagnostic methods, our results, together with earlier studies, show that Brachyspira spp., including potentially pathogenic strains, occur globally among free-living avian hosts, and that this genus encompasses a higher degree of biodiversity than previously recognised.
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| 46. |
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| 47. |
- Johansson Wensman, Jonas, et al.
(författare)
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Bornaviruses in naturally infected Psittacus erithacus in Portugal: insights of molecular epidemiology and ecology
- 2019
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Ingår i: Infection Ecology & Epidemiology. - : Informa UK Limited. - 2000-8686. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: The genus Orthobornavirus comprises non-segmented, negative-stranded RNA viruses able to infect humans, mammals, reptiles and various birds. Parrot bornavirus 1 to 8(PaBV-1 to 8) causes neurological and/or gastrointestinal syndromes and death on psittacines. We aimed to identify and to produce epidemiologic knowledge about the etiologic agent associated with a death of two female Psittacus erithacus(grey parrot). Methods and Results: Both parrots were submitted for a complete standardised necropsy. Tissue samples were analysed by PCR. The findings in necropsy were compatible with bornavirus infection. Analysis revealed PaBV-4 related with genotypes detected in captive and in wild birds. The N and X proteins of PaBV-4 were more related to avian bornaviruses, while phosphoprotein was more related to variegated squirrel bornavirus 1 (VSBV-1). Within the P gene/phosphoprotein a highly conserved region between and within bornavirus species was found. Conclusions: Portugal is on the routes of the intensive world trade of psittacines. Broad screening studies are required to help understanding the role of wild birds in the emergence and spread of pathogenic bornaviruses. PaBV-4 phosphoprotein is closer to VSBV-1 associated with lethalencephalitis in humans than with some of the avian bornaviruses. The highly conserved P gene/phosphoprotein region is a good target for molecular diagnostics screenings.
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| 48. |
- Johansson Wensman, Jonas, et al.
(författare)
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Seroprevalence of Pestivirus in Eurasian tundra reindeer in Finland, Sweden, Norway, Iceland and Russian Federation.
- 2019
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Ingår i: Infection Ecology & Epidemiology. - : Informa UK Limited. - 2000-8686. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Reindeer herding is of great importance for the indigenous people of the Fennoscandia peninsula and northern Russia. There are also free-ranging feral populations of reindeer in Finland, Iceland, Norway and Russian Federation. The genus Pestivirus contains several viral species that infect ungulates and often show capacity to transmit between different host species. Sera from 520 Eurasian tundra reindeer (Rangifer tarandus tarandus) from Finland, Sweden, Norway, Iceland and Russian Federation were analysed and the prevalence of pestivirus-specific antibodies was determined. Seropositivity proportion was 48.5% for Sweden and 41.2% for Norway, but only 1.6% forIceland and 2.5% for Finland. All Russian reindeer investigated were seronegative. Pan-pestivirus RT-PCR of seronegative animals (n = 156) from seropositive herds confirmed their negative status. These results indicate unexpectedly non-uniform circulation of an as yet uncharacterised pestivirusin Eurasian reindeer populations. The high seroprevalence in some regions warrants further studies of pestivirus infection dynamics, effects on reindeer health and population dynamics.
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| 49. |
- Jonsson, Anna-Karin, et al.
(författare)
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A trial with IgY chicken antibodies to eradicate faecal carriage of Klebsiella pneumoniae and Escherichia coli producing extended-spectrum beta-lactamases
- 2015
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Ingår i: Infection Ecology & Epidemiology. - : Informa UK Limited. - 2000-8686. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae is an emerging therapeutic challenge, especially in the treatment of urinary tract infections. Following an outbreak of CTX-M-15 Klebsiella pneumoniae in Uppsala, Sweden, an orphan drug trial on IgY chicken antibodies was undertaken in an attempt to eradicate faecal carriage of ESBL-producing K. pneumoniae and Escherichia coli.METHODS: Hens were immunised with epitopes from freeze-dried, whole-cell bacteria (ESBL-producing K. pneumoniae and E. coli) and recombinant proteins of two K. pneumoniae fimbriae subunits (fimH and mrkD). The egg yolks were processed according to good manufacturing practice and the product was stored at-20°C until used. Using an internal database from the outbreak and the regular laboratory database, faecal carriers were identified and recruited from May 2005 to December 2013. The participants were randomised in a placebo-controlled 1:1 manner.RESULTS: From 749 eligible patients, 327 (44%) had deceased, and only 91 (12%) were recruited and signed the informed consent. In the initial screening performed using the polymerase chain reaction, 24 participants were ESBL positive and subsequently randomised and treated with either the study drug or a placebo. The study was powered for 124 participants. Because of a very high dropout rate, the study was prematurely terminated. From the outbreak cohort (n=247), only eight patients were screened, and only one was positive with the outbreak strain in faeces.CONCLUSIONS: The present study design, using IgY chicken antibodies for the eradication of ESBL-producing K. pneumonia and E. coli, was ineffective in reaching its goal due to high mortality and other factors resulting in a low inclusion rate. Spontaneous eradication of ESBL-producing bacteria was frequently observed in recruited participants, which is consistent with previous reports.
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| 50. |
- Jore, S., et al.
(författare)
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Spatial tick bite exposure and associated risk factors in Scandinavia
- 2020
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Ingår i: Infection Ecology and Epidemiology. - : Informa UK Limited. - 2000-8686. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Tick-borne diseases are emerging and re-emerging threats causing public health concerns in Europe and North America. Prevention and control requires understanding of human exposure and behaviour. The aim was to measure exposure to tick bites across Scandinavia, its spatial distribution and the associated risk factors. Methods We sent a web-based survey to a randomly chosen population and analysed answers by Principal Component Analysis and Chi-Square. Individual responses were aggregated at the municipality level to assess the spatial distribution of bites. Results Nearly 60% of adults reported bites at low levels (1-5 bites); however, the majority were not in their resident municipality. We found two spatial profiles: In their home municipalities, people were most often bitten in less, but not the least, urbanized areas. When visiting other municipalities, people were most frequently bitten in peri-urban areas. Running/walking in the forest, gardening, and paddling/rowing were activities most strongly associated with bites. Conclusion Tick bites affect the entire Scandinavian population, with a higher risk in Sweden compared to Denmark and Norway. The frequency of observation of ticks in the environment or on pets might be used as a proxy for the actual risk of exposure to tick bites.Our results indicates that urban-dwelling outdoor enthusiasts and inhabitants of rural areas must be equally targeted for prevention campaigns. © 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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