| 1. |
- Berruga-Fernández, Talia, et al.
(författare)
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Risk assessment for the transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) on aircraft : a systematic review
- 2021
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 149
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Forskningsöversikt (refereegranskat)abstract
- Middle East respiratory syndrome coronavirus (MERS-CoV) causes a potentially fatal respiratory disease. Although it is most common in the Arabian Peninsula, it has been exported to 17 countries outside the Middle East, mostly through air travel. The Risk Assessment Guidelines for Infectious Diseases transmitted on Aircraft (RAGIDA) advise authorities on measures to take when an infected individual travelled by air. The aim of this systematic review was to gather all available information on documented MERS-CoV cases that had travelled by air, to update RAGIDA. The databases used were PubMed, Embase, Scopus and Global Index Medicus; Google was searched for grey literature and hand searching was performed on the EU Early Warning and Response System and the WHO Disease Outbreak News. Forty-seven records were identified, describing 21 cases of MERS that had travelled on 31 flights. Contact tracing was performed for 17 cases. Most countries traced passengers sitting in the same row and the two rows in front and behind the case. Only one country decided to trace all passengers and crew. No cases of in-flight transmission were observed; thus, considering the resources it requires, a conservative approach may be appropriate when contact tracing passengers and crew where a case of MERS has travelled by air.
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| 2. |
- Bjork, J., et al.
(författare)
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Surveillance of COVID-19 vaccine effectiveness: a real-time case-control study in southern Sweden
- 2022
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Ingår i: Epidemiology and Infection. - : Cambridge University Press (CUP). - 0950-2688 .- 1469-4409. ; 150
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Tidskriftsartikel (refereegranskat)abstract
- The extensive register infrastructure available for coronavirus disease 2019 surveillance in Scania county, Sweden, makes it possible to classify individual cases with respect to hospitalisation and disease severity, stratify on time since last dose and demographic factors, account for prior infection and extract data for population controls automatically. In the present study, we developed a case-control sampling design to surveil vaccine effectiveness (VE) in this ethnically and socioeconomically diverse population with more than 1.3 million inhabitants. The first surveillance results show that estimated VE against hospitalisation and severe disease 0-3 months after the last dose remained stable during the study period, but waned markedly 6 months after the last dose in persons aged 65 years or over.
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| 3. |
- Blanco, N., et al.
(författare)
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A simple model for the total number of SARS-CoV-2 infections on a national level
- 2021
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Ingår i: Epidemiology and Infection. - : Cambridge University Press (CUP). - 0950-2688 .- 1469-4409. ; 149
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to identify an appropriate simple mathematical model to fit the number of coronavirus disease 2019 (COVID-19) cases at the national level for the early portion of the pandemic, before significant public health interventions could be enacted. The total number of cases for the COVID-19 epidemic over time in 28 countries was analysed and fit to several simple rate models. The resulting model parameters were used to extrapolate projections for more recent data. While the Gompertz growth model (mean R-2 = 0.998) best fit the current data, uncertainties in the eventual case limit introduced significant model errors. However, the quadratic rate model (mean R-2 = 0.992) fit the current data best for 25 (89%) countries as determined by R-2 values of the remaining models. Projection to the future using the simple quadratic model accurately forecast the number of future total number of cases 50% of the time up to 10 days in advance. Extrapolation to the future with the simple exponential model significantly overpredicted the total number of future cases. These results demonstrate that accurate future predictions of the case load in a given country can be made using this very simple model.
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| 4. |
- Brewer, T. F., et al.
(författare)
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Housing, sanitation and living conditions affecting SARS-CoV-2 prevention interventions in 54 African countries
- 2021
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Ingår i: Epidemiology and Infection. - : Cambridge University Press (CUP). - 0950-2688 .- 1469-4409. ; 149
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Tidskriftsartikel (refereegranskat)abstract
- The feasibility of non-pharmacological public health interventions (NPIs) such as physical distancing or isolation at home to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in low-resource countries is unknown. Household survey data from 54 African countries were used to investigate the feasibility of SARS-CoV-2 NPIs in low-resource settings. Across the 54 countries, approximately 718 million people lived in households with > 6 individuals at home (median percentage of at-risk households 56% (95% confidence interval (CI), 51% to 60%)). Approximately 283 million people lived in households where > 3 people slept in a single room (median percentage of at-risk households 15% (95% CI, 13% to 19%)). An estimated 890 million Africans lack on-site water (71% (95% CI, 62% to 80%)), while 700 million people lacked in-home soap/washing facilities (56% (95% CI, 42% to 73%)). The median percentage of people without a refrigerator in the home was 79% (95% CI, 67% to 88%), while 45% (95% CI, 39% to 52%) shared toilet facilities with other households. Individuals in low-resource settings have substantial obstacles to implementing NPIs for mitigating SARS-CoV-2 transmission. These populations urgently need to be prioritised for coronavirus disease 2019 vaccination to prevent disease and to contain the global pandemic.
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| 5. |
- Khalil, Hussein
(författare)
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Prevalence of Diarrheagenic Escherichia coli (DEC) and Salmonella spp. with zoonotic potential in urban rats in Salvador, Brazil
- 2020
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 149
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Tidskriftsartikel (refereegranskat)abstract
- Studies evaluating the occurrence of enteropathogenic bacteria in urban rats (Rattus spp.) are scarce worldwide, specifically in the urban environments of tropical countries. This study aims to estimate the prevalence of diarrhoeagenic Escherichia coli (DEC) and Salmonella spp. with zoonotic potential in urban slum environments. We trapped rats between April and June 2018 in Salvador, Brazil. We collected rectal swabs from Rattus spp., and cultured for E. coli and Salmonella spp., and screened E. coli isolates by polymerase chain reaction to identify pathotypes. E. coli were found in 70% of Rattus norvegicus and were found in four Rattus rattus. DEC were isolated in 31.3% of the 67 brown rats (R. norvegicus). The pathotypes detected more frequently were shiga toxin E. coli in 11.9%, followed by atypical enteropathogenic E. coli in 10.4% and enteroinvasive E. coli in 4.5%. From the five black rats (R. rattus), two presented DEC. Salmonella enterica was found in only one (1.4%) of 67 R. norvegicus. Our findings indicate that both R. norvegicus and R. rattus are host of DEC and, at lower prevalence, S. enterica, highlighting the importance of rodents as potential sources of pathogenic agents for humans.
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| 6. |
- Küchenhoff, Helmut, et al.
(författare)
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Analysis of the early COVID-19 epidemic curve in Germany by regression models with change points
- 2021
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 149, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- We analysed the coronavirus disease 2019 epidemic curve from March to the end of April 2020 in Germany. We use statistical models to estimate the number of cases with disease onset on a given day and use back-projection techniques to obtain the number of new infections per day. The respective time series are analysed by a trend regression model with change points. The change points are estimated directly from the data. We carry out the analysis for the whole of Germany and the federal state of Bavaria, where we have more detailed data. Both analyses show a major change between 9 and 13 March for the time series of infections: from a strong increase to a decrease. Another change was found between 25 March and 29 March, where the decline intensified. Furthermore, we perform an analysis stratified by age. A main result is a delayed course of the pandemic for the age group 80 + resulting in a turning point at the end of March. Our results differ from those by other authors as we take into account the reporting delay, which turned out to be time dependent and therefore changes the structure of the epidemic curve compared to the curve of newly reported cases.
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| 7. |
- Massad, Eduardo, et al.
(författare)
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Two complementary model-based methods for calculating the risk of international spreading of a novel virus from the outbreak epicentre. The case of COVID-19
- 2020
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 148
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Tidskriftsartikel (refereegranskat)abstract
- We present two complementary model-based methods for calculating the risk of international spread of the novel coronavirus SARS-CoV-2 from the outbreak epicentre. One model aims to calculate the number of cases that would be exported from an endemic country to disease-free regions by travellers. The second model calculates the probability that an infected traveller will generate at least one secondary autochthonous case in the visited country. Although this paper focuses on the data from China, our methods can be adapted to calculate the risk of importation and subsequent outbreaks. We found an averageR(0)= 5.31 (ranging from 4.08 to 7.91) and a risk of spreading of 0.75 latent individuals per 1000 travellers. In addition, one infective traveller would be able to generate at least one secondary autochthonous case in the visited country with a probability of 23%.
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| 8. |
- Mathabire Rücker, Sekai Chenai, et al.
(författare)
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Transmission of COVID-19 among healthcare workers : an epidemiological study during the first phase of the pandemic in Sweden
- 2022
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 150
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Tidskriftsartikel (refereegranskat)abstract
- During the first phase of the COVID-19 pandemic in 2020, concerns were raised that healthcare workers (HCWs) were at high risk of infection. The aim of this study was to explore transmission of COVID-19 among HCWs during a staff outbreak at an inpatient ward in Sweden 1 March to 31 May 2020. A mixed methods approach was applied using several data sources. In total, 152 of 176 HCWs participated. The incidence of COVID-19 among HCWs was 33%. Among cases, 48 (96%) performed activities involving direct contact with COVID-19 patients. Contact tracing connected 78% of cases to interaction with another contagious co-worker. Only a few HCWs cases reported contact with a confirmed COVID-19 case at home (n=6; 12%) or in the community (n=3; 6%). Multiple logistic regression identified direct care of COVID-19 patients and positive COVID-19 family contact as risk factors for infection (adjusted OR 8.4 and 9.0 respectively). Main interventions to stop the outbreak were physical distancing between HCWs, reinforcement of personal hygiene routines and rigorous surface cleaning. The personal protective equipment used in contact with patients was not changed in response to the outbreak. We highlight HCW-to-HCW transmission of COVID-19 in a hospital environment and the importance of preventing droplet and contact transmission between co-workers.
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| 9. |
- Mathabire Rücker, Sekai Chenai, et al.
(författare)
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Transmission of COVID-19 among healthcare workers - an epidemiological study during the first phase of the pandemic in Sweden
- 2022
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Ingår i: Epidemiology and Infection. - : Cambridge University Press (CUP). - 0950-2688 .- 1469-4409. ; 150
-
Tidskriftsartikel (refereegranskat)abstract
- During the first phase of the COVID-19 pandemic in 2020, concerns were raised that healthcare workers (HCWs) were at high risk of infection. The aim of this study was to explore the transmission of COVID-19 among HCWs during a staff outbreak at an inpatient ward in Sweden 1 March to 31 May 2020. A mixed-methods approach was applied using several data sources. In total, 152 of 176 HCWs participated. The incidence of COVID-19 among HCWs was 33%. Among cases, 48 (96%) performed activities involving direct contact with COVID-19 patients. Contact tracing connected 78% of cases to interaction with another contagious co-worker. Only a few HCW cases reported contact with a confirmed COVID-19 case at home (n = 6; 12%) or in the community (n = 3; 6%). Multiple logistic regression identified direct care of COVID-19 patients and positive COVID-19 family contact as risk factors for infection (adjusted OR 8.4 and 9.0 respectively). Main interventions to stop the outbreak were physical distancing between HCWs, reinforcement of personal hygiene routines and rigorous surface cleaning. The personal protective equipment used in contact with patients was not changed in response to the outbreak. We highlight HCW-to-HCW transmission of COVID-19 in a hospital environment and the importance of preventing droplet and contact transmission between co-workers.
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| 10. |
- Melotti, Roberto, et al.
(författare)
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Prevalence and determinants of serum antibodies to SARS-CoV-2 in the general population of the Gardena valley
- 2021
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 149
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Tidskriftsartikel (refereegranskat)abstract
- Estimating the spread of SARS-CoV-2 infection in communities is critical. We surveyed 2244 stratified random sample community members of the Gardena valley, a winter touristic area, amidst the first expansion phase of the COVID-19 pandemic in Europe. We measured agreement between Diasorin and Abbott serum bioassay outputs and the Abbott optimal discriminant threshold of serum neutralisation titres with recursive receiver operating characteristic curve. We analytically adjusted serum antibody tests for unbiased seroprevalence estimate and analysed the determinants of infection with non-response weighted multiple logistic regression. SARS-CoV-2 seroprevalence was 26.9% (95% CI 25.2-28.6) by June 2020. The bioassays had a modest agreement with each other. At a lower threshold than the manufacturer's recommended level, the Abbott assay reflected greater discrimination of serum neutralisation capacity. Seropositivity was associated with place and economic activity, not with sex or age. Symptoms like fever and weakness were age-dependent. SARS-CoV-2 mitigation strategies should account for context in high prevalence areas.
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| 11. |
- Rönnelid, Ylva, et al.
(författare)
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Norovirus and rotavirus in children hospitalised with diarrhoea after rotavirus vaccine introduction in Burkina Faso
- 2020
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Ingår i: Epidemiology and Infection. - : CAMBRIDGE UNIV PRESS. - 0950-2688 .- 1469-4409. ; 148
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Tidskriftsartikel (refereegranskat)abstract
- Several studies report norovirus as the new leading cause of severe gastroenteritis in children after the global introduction of rotavirus vaccines. Burkina Faso introduced general rotavirus vaccination with the oral pentavalent vaccine RotaTeq in November 2013 and quickly reached a vaccine coverage of >90%. This study describes detection rates, clinical profiles and the molecular epidemiology of norovirus and rotavirus infections in 146 children aged <5 years with severe acute gastroenteritis in Ouagadougou, consecutively enrolled from a hospital between January 2015 and December 2015. Virus detection was performed with an antigen test or real-time polymerase chain reaction (PCR) and genotyping was performed by nucleotide sequencing or multiplex PCR. Rotavirus was found in 14% and norovirus in 20% of faecal samples. Norovirus infection was significantly more associated with severe dehydration compared to rotavirus (P < 0.001). Among genotyped norovirus samples 48% (12/25) belonged to GII.4 which caused significantly more diarrhoeal episodes than non-GII.4 genotypes (P = 0.01). The most common rotavirus genotypes were G2P[4] (30%), G12P[6] (25%) and G12P[8] (20%). Fifty percent of the rotavirus positive children were infected with fully or partly heterotypic strains. In conclusion, this study found a higher proportion of norovirus causing more severe symptoms in children with diarrhoea in Burkina Faso after the introduction of rotavirus vaccination.
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| 12. |
- Säll, Olof, 1980-, et al.
(författare)
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Atypical presentation of Neisseria meningitidis serogroup W disease is associated with the introduction of the 2013 strain
- 2021
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 149
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Tidskriftsartikel (refereegranskat)abstract
- Since 2015, the incidence of invasive meningococcal disease (IMD) caused by serogroup W (MenW) has increased in Sweden, due to the introduction of the 2013 strain belonging to clonal complex 11. The aim of this study was to describe the clinical presentation of MenW infections, in particular the 2013 strain, including genetic associations. Medical records of confirmed MenW IMD cases in Sweden during the years 1995-2019 (n = 113) were retrospectively reviewed and the clinical data analysed according to strain. Of all MenW patients, bacteraemia without the focus of infection was seen in 44%, bacteraemic pneumonia in 26%, meningitis in 13% and epiglottitis in 8%, gastrointestinal symptoms in 48% and 4% presented with petechiae. Phylogenetic analysis was used for possible links between genetic relationship and clinical picture. The 2013 strain infections, particularly in one cluster, were associated with more severe disease compared with other MenW infections. The patients with 2013 strain infections (n = 68) were older (52 years vs. 25 years for other strains), presented more often with diarrhoea as an atypical presentation (P = 0.045) and were more frequently admitted for intensive care (P = 0.032). There is a risk that the atypical clinical presentation of MenW infections, with predominantly gastrointestinal or respiratory symptoms rather than neck stiffness or petechiae, may lead to delay in life-saving treatment.
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| 13. |
- Säll, Olof, 1980-, et al.
(författare)
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Prevalence and persistence of Neisseria meningitidis carriage in Swedish university students
- 2023
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 151
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Tidskriftsartikel (refereegranskat)abstract
- The bacterium Neisseria meningitidis causes life-threatening disease worldwide, typically with a clinical presentation of sepsis or meningitis, but can be carried asymptomatically as part of the normal human oropharyngeal microbiota. The aim of this study was to examine N. meningitidis carriage with regard to prevalence, risk factors for carriage, distribution of meningococcal lineages and persistence of meningococcal carriage. Throat samples and data from a self-reported questionnaire were obtained from 2744 university students (median age: 23 years) at a university in Sweden on four occasions during a 12-month period. Meningococcal isolates were characterised using whole-genome sequencing. The carriage rate among the students was 9.1% (319/3488; 95% CI 8.2-10.1). Factors associated with higher carriage rate were age ≤22 years, previous tonsillectomy, cigarette smoking, drinking alcohol and attending parties, pubs and clubs. Female gender and sharing a household with children aged 0-9 years were associated with lower carriage. The most frequent genogroups were capsule null locus (cnl), group B and group Y and the most commonly identified clonal complexes (cc) were cc198 and cc23. Persistent carriage with the same meningococcal strain for 12 months was observed in two students. Follow-up times exceeding 12 months are recommended for future studies investigating long-term carriage of N. meningitidis.
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| 14. |
- Björk, Jonas, et al.
(författare)
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Surveillance of COVID-19 vaccine effectiveness : A real-time case-control study in southern Sweden
- 2022
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 150
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Tidskriftsartikel (refereegranskat)abstract
- The extensive register infrastructure available for coronavirus disease 2019 surveillance in Scania county, Sweden, makes it possible to classify individual cases with respect to hospitalisation and disease severity, stratify on time since last dose and demographic factors, account for prior infection and extract data for population controls automatically. In the present study, we developed a case-control sampling design to surveil vaccine effectiveness (VE) in this ethnically and socioeconomically diverse population with more than 1.3 million inhabitants. The first surveillance results show that estimated VE against hospitalisation and severe disease 0-3 months after the last dose remained stable during the study period, but waned markedly 6 months after the last dose in persons aged 65 years or over.
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| 15. |
- Cederwall, S., et al.
(författare)
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Respiratory adenovirus infections in immunocompetent and immunocompromised adult patients
- 2020
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 147
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Tidskriftsartikel (refereegranskat)abstract
- Adenovirus (AdV) can cause severe respiratory infections in children and immunocompromised patients, but less is known about severe AdV pneumonia in immunocompetent adults. In this retrospective study, we compared respiratory tract infections and pneumonia caused by AdV in immunocompromised and immunocompetent adult patients regarding clinical presentation and severity of infection. The results show that AdV can cause severe infections in both immunocompetent and immunocompromised patients, and the clinical presentation and need for hospitalisation, mechanical ventilation and antiviral treatment were equal in both groups. No underlying risk factors for severe AdV infection in healthy individuals were identified.
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| 16. |
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| 17. |
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| 18. |
- Holmqvist, M., et al.
(författare)
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Risk of bacteremia in patients presenting with shaking chills and vomiting - A prospective cohort study
- 2020
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 148, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Chills and vomiting have traditionally been associated with severe bacterial infections and bacteremia. However, few modern studies have in a prospective way evaluated the association of these signs with bacteremia, which is the aim of this prospective, multicenter study. Patients presenting to the emergency department with at least one affected vital sign (increased respiratory rate, increased heart rate, altered mental status, decreased blood pressure or decreased oxygen saturation) were included. A total of 479 patients were prospectively enrolled. Blood cultures were obtained from 197 patients. Of the 32 patients with a positive blood culture 11 patients (34%) had experienced shaking chills compared with 23 (14%) of the 165 patients with a negative blood culture, p=0.009. A logistic regression was fitted to show the estimated odds ratio (OR) for a positive blood culture according to shaking chills. In a univariate model shaking chills had an OR of 3.23 (95% CI 1.35-7.52) and in a multivariate model the OR was 5.9 (95% CI 2.05-17.17) for those without prior antibiotics adjusted for age, sex and prior antibiotics. The presence of vomiting was also addressed, but neither a univariate nor a multivariate logistic regression showed any association between vomiting and bacteremia. In conclusion, among patients at the emergency department with at least one affected vital sign, shaking chills but not vomiting were associated with bacteremia.
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| 19. |
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| 20. |
- Solari, Hernán G., et al.
(författare)
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Stochastic model for COVID-19 in slums: interaction between biology and public policies
- 2021
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 149
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Tidskriftsartikel (refereegranskat)abstract
- We present a mathematical model for the simulation of the development of an outbreak of COVID-19 in a slum area under different interventions. Instead of representing interventions as modulations of the parameters of a free running epidemic we introduce a model structure that accounts for the actions but does not assume the results. The disease is modelled in terms of the progression of viremia reported in scientific works. The emergence of symptoms in the model reflects the statistics of a nation-wide highly detailed database consisting of more than 62000 cases (about a half of the confirmed by RT-PCR tests) with recorded symptoms in Argentina. The stochastic model displays several of the characteristics of COVID-19 such as a high variability in the evolution of the outbreaks, including long periods in which they run undetected, spontaneous extinction followed by a late outbreak and unimodal as well as bimodal progressions of daily counts of cases (second waves without ad-hoc hypothesis). We show how the relation between undetected cases (including the 'asymptomatic' cases) and detected cases changes as a function of the public policies, the efficiency of the implementation and the timing with respect to the development of the outbreak. We show also that the relation between detected cases and total cases strongly depends on the implemented policies and that detected cases cannot be regarded as a measure of the outbreak, being the dependency between total cases and detected cases in general not monotonic as a function of the efficiency in the intervention method. According to the model, it is possible to control an outbreak with interventions based on the detection of symptoms only in the case when the presence of just one symptom prompts isolation and the detection efficiency reaches about 80% of the cases. Requesting two symptoms to trigger intervention can be enough to fail in the goals.
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| 21. |
- Öberg, Jonas, et al.
(författare)
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Streptococcus bovis-bacteremia: subspecies distribution and association with colorectal cancer : a retrospective cohort study
- 2022
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 150
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to describe the incidence of Streptococcus bovis/Streptococcus equinus complex (SBSEC) bacteremia, distribution of the SBSEC subspecies, and their respective association with colorectal cancer (CRC). A population-based retrospective cohort study of all episodes of SBSEC-bacteremia from 2003 to 2018 in Skåne Region, Sweden. Subspecies was determined by whole-genome sequencing. Medical charts were reviewed. The association between subspecies and CRC were analysed using logistic regression. In total 266 episodes of SBSEC-bacteremia were identified and the average annual incidence was 2.0 per 100 000 inhabitants. Of the 236 isolates available for typing, the most common subspecies was S. gallolyticus subsp. pasteurianus 88/236 (37%) followed by S. gallolyticus subsp. gallolyticus 58/236 (25%). In order to determine the risk of cancer following bacteremia, an incidence cohort of 174 episodes without a prior diagnosis of CRC or metastasised cancer was followed for 560 person-years. CRC was found in 13/174 (7%), of which 9 (69%) had S. gallolyticus subsp. gallolyticus-bacteremia. In contrast to other European studies, S. gallolyticus subsp. pasteurianus was the most common cause of SBSEC-bacteremia. CRC diagnosis after bacteremia was strongly associated with S. gallolyticus subsp. gallolyticus-bacteremia. Identification of SBSEC subspecies can guide clinical decision-making regarding CRC work-up following bacteremia.
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