Psychological Impact of Covid-19 on Dental Students' - An Interventional Study.

Background: COVID-19 pandemic impacts not only the physical health but also the mental health of every individual. Aim and Objectives: To assess the impact of the COVID-19 pandemic on the mental and physical health of college students. Method: An online survey was conducted using convenience sampling on 512 participants. The student's mental health was assessed by using DASS 21 analysis and sleep patterns were recorded on the PSQI scale. Result: The overall effect of the pandemic on the mental health of college students was affected to varying degrees. On comparing all variables of DASS analyses, it was found that of the 512 college students, 57.4% were depressed and 51.6% fell into the anxious category. Conclusion: It is concluded that young adults experienced increases in anxiety, stress, and depressive symptoms during this pandemic.

Work anxiety factors, coronavirus anxiety and job satisfaction of Polish nurses facing COVID-19 pandemic outbreak.

BACKGROUND: During the SARS-CoV-2 pandemic, as in past disasters and emergencies, nurses around the world play an important role. What is more, the unprecedented pressure exerted by the pandemic on healthcare systems in every country brings big challenges to nurses, which may affect their well-being, work efficacy and job satisfaction. OBJECTIVE: The main objective of the presented studies was to describe anxiety factors related to the work of nurses during the SARS-CoV-2 pandemic; to assess the intensity of coronavirus anxiety and job satisfaction experienced by nurses at that time; to assess predictors of job satisfaction of nurses during the COVID-19 pandemic; to assess the differences in the intensity of job satisfaction and coronavirus anxiety depending on the selected variables related to their experiences during the COVID-19 pandemic. DESIGN: Anonymous questionnaire surveys were conducted online among the participants between 23 June 2020 and 23 March 2022 in Poland. PARTICIPANTS: 433 nurses from 15 Polish provinces were included in the studies (age range 22-68; M = 41.63). Nursing seniority M = 18.6. METHODS: The studies were based on: Satisfaction with Job Scale (SSP), Coronavirus Anxiety Scale (CAS), and a self-report structured questionnaire. RESULTS: The most respondents indicated that they were afraid of becoming infected with SARS-CoV-2 (25.4 %), transmitting infection to the family (22.4 %), becoming sick with COVID-19 and experiencing health complications (6.7 %) and of excessive work responsibilities and physical fatigue (6.5 %). Based on the bivariate correlation, it can be concluded that job satisfaction of the respondents during the COVID-19 pandemic was on an average level (M = 19.9); coronavirus anxiety was on an average level (M = 4.9), and stress at work was on a high level (M = 7.1). Coronavirus anxiety did not constitute statistically significant predictors of job satisfaction of subjects studied during the pandemic (SE = 0,048; ß = 0,05; p = 0.942). CONCLUSIONS: Coronavirus anxiety wasn't associated with job satisfaction of nurses directly. Job satisfaction of nurses during the COVID-19 pandemic was likely to be shaped by a range of different factors. TWEETABLE ABSTRACT: In Polish nurses coronavirus anxiety was average and wasn't associated with their job satisfaction.

Prescriptive Analytics-Based SIRM Model for Predicting Covid-19 Outbreak.

Predicting the outbreak of a pandemic is an important measure in order to help saving people lives threatened by Covid-19. Having information about the possible spread of the pandemic, authorities and people can make better decisions. For example, such analyses help developing better strategies for distributing vaccines and medicines. This paper has modified the original Susceptible-Infectious-Recovered (SIR) model to Susceptible-Immune-Infected-Recovered (SIRM) which includes the Immunity ratio as a parameter to enhance the prediction of the pandemic. SIR is a widely used model to predict the spread of a pandemic. Many types of pandemics imply many variants of the SIR models which make it very difficult to find out the best model that matches the running pandemic. The simulation of this paper used the published data about the spread of the pandemic in order to examine our new SIRM. The results showed clearly that our new SIRM covering the aspects of vaccine and medicine is an appropriate model to predict the behavior of the pandemic.

What Factors Will Influence Chinese International Traveling for Leisure in the Post-COVID-19 Era: Role of Health Priorities and Health-Related Information Literacy.

China used to be the world's leading nation in terms of international (outward) tourism till the COVID-19 outbreak. However, due to the COVID-19 crisis, several new macro and micro-level factors might affect their international (outward) traveling behavior. The purpose of the current research was to examine the avoidance of international traveling for leisure in the Chinese population. The goal of the study was to highlight the importance of information self-efficacy and digital literacy as the key factors influencing tourists' traveling readiness. To achieve the goal, the study adapted the quantitative instruments from existing sources to map media exhaustion, information overload, and perceived health concerns, i.e., perceived effectiveness of health-protective measures, fear of new possible outbreaks, and pandemic crisis at source and destination. Chinese citizens' opinions were collected during the third quarter of the year 2022. Specifically, the quantitative survey from China collected a total number of 1308 respondents. This study used the statistical analysis software SPSS to analyze collected data. The findings conclude that the role of media is pivotal to shaping and predicting future trends in tourism preferences, perception of protective measures against COVID-19, and perceived seriousness of the pandemic crisis in the Chinese population. In addition, technology readiness (as hard self-efficacy) and health-related information literacy (soft self-efficacy) are critical to cope with the dark aspects of information exhaustion, overload, and pandemic seriousness in the post-truth era. The study is unique, as it examines the role of the seriousness of the pandemic at its source and destination and fear of new outbreaks simultaneously, underlining the potential future of immersive tourism (i.e., virtual reality, augmented reality, or mixed reality-based tourism). This study has drawn interesting theoretical and practical implications for researchers, policymakers, and academicians.

The 21st century disaster: The COVID-19 epidemiology, risk factors and control.

The 21st century will be indelible in the world as ruin of the outbreak of COVID-19 was arose in Wuhan, China has now spread all over the world, up to August 2020. This study was based on the factors affecting the epidemiology of this virus in human societies of global concern. We studied the articles published in journals on various aspects of nCoVID19. The Wikipedia and WHO situation reports have also been searched out for related information. Outcomes were followed up until 2020. The COVID-19 is a virus with pandemic potential which may continue to cause regular infection in human. The pandemic outbreak of COVID-19 threatened public health across the globe in form of system as reflected in the shape of emergency. Approximately 21 million humans are infected and 759,400 have lost their lives till 2020 in all over the world. We have described epidemiological features, reservoirs, transmission, incubation period, rate of fatality, management including recent clinical chemotherapeutic approach and preventive measurements and masses which are at risk of COVID19. This virus causes viral pneumonia when it attacks on respiratory system and multiple failure which can leads to life threatening complications. It is believed to be zoonotic importance although it is not clear from which animal and how it is transmitted. Zoonotic transmission of COVID-19 has not yet known by science. The current study will help to establish a baseline for early effective control of this rapidly spreading severe viral illness. The available data on COVID-19 indicates that older males with comorbidities would have been more infected, which can result in severe respiratory complications. Implementation of preventive measurements, investigation of proper chemotherapeutics and detection of cross species transmission agents must be ensured.

Environmental assessment of casual dining restaurants in urban and suburban areas of peninsular Malaysia during the COVID-19 pandemic.

Food waste has been considered a global problem due to its adverse impacts on food security, the environment, and the economy; hence needs urgent attention and action. Its generation is expected to increase as the world population grows rapidly, leading to more global waste. This study sought the impacts of the COVID-19 outbreak on the 1-week operation of selected casual dining restaurants in urban (Ampang, Kuala Lumpur) and suburban areas (Kota Bharu, Kelantan and Jasin, Melaka) of Peninsular Malaysia, as the local community adjusted to life with COVID-19. The food waste in this study was classified into three categories: preparation loss, serving loss, and customer's plate waste. Our material flow analysis revealed that the highest food loss at these locations came from preparation loss (51.37%), followed by serving loss (30.95%), and preparation loss (17.8%). Meanwhile, the total average electricity consumption and its carbon footprint for Ampang were 127 kWh and 13.87 kgCO2e, Kota Bharu 269.8 kWh and 29.47 kgCO2e, and Jasin 142.2 kWh and 15.54 kgCO2e, respectively. As for water, Ampang exhibited 22.93 m3 total average consumption and 7.91 kgCO2e greenhouse emissions from this source, Jasin consuming 17.11 m3 of water and releasing 5.88 kgCO2e of carbon footprint, while Kota Bharu emitted 20.21 kgCO2e of greenhouse gases from its 58.71 m3 water consumption. Our findings indicate a major 'food leak' at the preparation stage, from which the waste could be utilised as livestock feed, and that electricity consumption is a greater carbon emitter than water consumption, suggesting a need for improvement to the kitchen practices and equipment.

The lived experience of healthcare workers in quarantine: Findings of a systematic review, meta-synthesis and meta-summary.

AIMS: In pandemics, infection exposure and quarantine represent critical occupational risks for healthcare workers (HCWs). However, while the psychological consequences of HCWs' quarantine have been reviewed, other potential implications of quarantine on HCWs, such as those that are work-, professional-, social- and private-related, have not been summarised to date. Summarising quarantined HCWs' experiences in the current and past pandemics, as investigated with qualitative studies, might improve awareness of their needs, concerns, and the consequences of quarantine on their personal lives. Therefore, the lived experience of quarantined HCWs was reviewed and subjected to meta-synthesis and -summary. METHODS: A systematic review of qualitative studies followed by a meta-synthesis and -summary allowing an interpretative integration of the findings of qualitative studies, was performed. PubMed, CINHAL and Scopus databases were explored up to 31 January, 2021, without any limitation in time. The methodological quality of the studies was assessed using the Critical Appraisal Skills Programme. Methods and findings are reported according to the Enhancing transparency in reporting the synthesis of qualitative research statement. RESULTS: A total of 635 records were retrieved and five studies were included. Overall, five themes summarised the lived experience of quarantined HCWs: 1) Being emotionally challenged; 2) Living the quarantine limitations; 3) Losing freedom; 4) Accepting the quarantine; and 5) Staying away from me. The most frequent categories across studies were 'Feeling stressed' and 'Being constrained' (both 100%). The least frequent were 'Feeling sad' (20%), 'Enjoying my family' (20%) and 'Being refused as a family member' (20%). CONCLUSIONS: The lived experience of HCWs is multidimensional, the implications of which also affect private spheres of life: the immediate family and wider relatives. Understanding and learning from HCWs' lived experiences might support policymakers, public health authorities and managers with the goal of maintaining the highest physical and mental health of staff during outbreaks. Timely services supporting HCWs, both during and after episode(s) of quarantine, are suggested to prevent additional burdens on frontline professionals.

Study on the Localization of Fangcang Shelter Hospitals During Pandemic Outbreaks.

In the event of pandemic, it is essential for government authority to implement responses to control the pandemic and protect people's health with rapidity and efficicency. In this study, we first develop an evaluation framework consisting of the entropy weight method (EWM) and the technique for order preference by similarity to ideal solution (TOPSIS) to identify the preliminary selection of Fangcang shelter hospitals; next, we consider the timeliness of isolation and treatment of patients with different degrees of severity of the infectious disease, with the referral to and triage in Fangcang shelter hospitals characterized and two optimization models developed. The computational results of Model 1 and Model 2 are compared and analyzed. A case study in Xuzhou, Jiangsu Province, China, is used to demonstrate the real-life applicability of the proposed models. The two-stage localization method gives decision-makers more options in case of emergencies and can effectively designate the location. This article may give recommendations of and new insights into parameter settings in isolation hospital for governments and public health managers.

SARS-CoV-2 gained a novel spike protein S1-N-Terminal Domain (S1-NTD).

The clue behind the SARS-CoV-2 origin is still a matter of debate. Here, we report that SARS-CoV-2 has gained a novel spike protein S1-N-terminal domain (S1-NTD). In our CLuster ANalysis of Sequences (CLANS) analysis, SARS-CoV/SARS-CoV-2 S1-NTDs displayed a close relationship with OC43 and HKU1. However, in the complete and S1-NTD-free spike protein, SARS-CoV/SARS-CoV-2 revealed closeness with MERS-CoV. Further, we have divided the S1-NTD of SARS-CoV-2 related viruses into three distinct types (Type-I to III S1-NTD) and the S1-NTD of viruses associated with SARS-CoVs into another three classes (Type-A to C S1-NTD) using CLANS and phylogenetic analyses. In particular, the results of our study indicate that SARS-CoV-2, RaTG13, and BANAL-20-52 viruses carry Type-I-S1-NTD and other SARS-CoV-2-related-bat viruses have Type-II and III. In addition, it was revealed that the Pangolin-GX and Pangolin-Guangdong lineages inherited Type-I-like and Type-II-like S1-NTD, respectively. Then our CLANS study shows the potential for evolution of Type-I and Type-III S1-NTD from SARS-CoV-related viruses Type-A and Type-B S1-NTDs, respectively. Furthermore, our analysis clarifies the possibility that Type-II S1-NTDs may have evolved from Type-A-S1-NTD of SARS-CoV-related viruses through Type-I S1-NTDs. We also observed that BANAL-20-103, BANAL-20-236, and Pangolin-Guangdong-lineage viruses containing Type-II-like S1-NTD are very close to SARS-CoV-2 in spike genetic areas other than S1-NTD. Possibly, it suggests that the common ancestor spike gene of SARS-CoV-2/RaTG13/BANAL-20-52-like virus may have evolved by recombining the Pangolin-Guangdong/BANAL-20-103/BANAL-20-236-like spike gene to Pangolin-GX-like Type-I-like-S1-NTD in the unsampled bat or undiscovered intermediate host or possibly pangolin. These may then have evolved into SARS-CoV-2, RaTG13, and BANAL-20-52 virus spike genes by host jump mediated evolution. The potential function of the novel Type-I-S1-NTD and other types of S1-NTDs needs to be studied further to understand better its importance in the ongoing COVID-19 outbreak and for future pandemic preparedness.

Implications of quarantine among healthcare professionals: findings from a scoping review.

Although quarantine has been largely used in the recent period of novel coronavirus disease (COVID-19), there has to date been no summary of the available literature regarding its implications among health care workers (HCWs). A scoping review was performed, following The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review and the Joanna Briggs Institute Critical Appraisal Checklist. The CINAHL, PubMed, and SCOPUS databases were queried up to 31 January 2021. Nine studies ranging from low to high methodological quality, were included. These were conducted in diverse countries, predominantly regarding the Severe Acute Respiratory Syndrome and using cross-sectional designs. Quarantine was found to have multifaceted negative consequences that affected HCWs psychologically, professionally, personally, socially and economically. These findings could be useful as a framework for researchers while designing future study protocols, and for policy-makers or managers while establishing multidimensional effective strategies increasing HCWs' resilience and wellness.

Concerns and desires of healthcare workers caring for patients with COVID-19 in April and July 2020 in Japan: a qualitative study of open-ended survey comments.

OBJECTIVES: The prolonged effects of the COVID-19 pandemic continue to have a serious impact on healthcare workers. We described and compared the experiences of healthcare workers in Japan during the first wave of the COVID-19 pandemic from March to May 2020, and during the lull from June to July 2020. DESIGN: In this qualitative study, we used a web-based survey to obtain comments from healthcare workers about their experiences during the pandemic, and explored these using inductive content analysis. SETTING: A tertiary emergency hospital in Tokyo, in April and July 2020. PARTICIPANTS: Participants were staff in the hospital, including physicians, nurses, pharmacists, radiological technicians and laboratory medical technicians. Many, but not all, had directly cared for patients with COVID-19. RESULTS: In total, 102 participants in the first survey and 154 in the second survey provided open-ended comments. Three themes were extracted: concerns, requests and gratitude. There were four subthemes under concerns: the hospital infection control system, fear of spreading infection to others, uncertainty about when the pandemic would end and being treated as a source of infection. There were 53 requests in the first survey and 106 in the second survey. These requests were divided into seven subthemes: compensation, staffing, information, facilities, leave time, PCR tests and equitable treatment. The theme on gratitude had two subthemes: information and emotional support, and material support. The fears and desires of healthcare workers included two types of uncertainty-related concerns, and requests were very different across the two surveys. CONCLUSIONS: It is important to apply a balance of information to help staff adjust to their new work environment, as well as support to minimise the burden of infection and impact on their families.

An Insight Into Detection Pathways/Biosensors of Highly Infectious Coronaviruses.

The outbreak of COVID-19 pandemic and its consequences have inflicted a substantial damage on the world. In this study, it was attempted to review the recent coronaviruses appeared among the human being and their epidemic/pandemic spread throughout the world. Currently, there is an inevitable need for the establishment of a quick and easily available biosensor for tracing COVID-19 in all countries. It has been known that the incubation time of COVID-19 lasts about 14 days and 25% of the infected individuals are asymptomatic. To improve the ability to determine SARS-CoV-2 precisely and reduce the risk of eliciting false-negative results produced by mutating nature of coronaviruses, many researchers have established a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay using mismatch-tolerant molecular beacons as multiplex real-time RT-PCR to distinguish between pathogenic and non-pathogenic strains of coronaviruses. The possible mechanisms and pathways for the detection of coronaviruses by biosensors have been reviewed in this study.

Impact of the Severity of Liver Injury in COVID-19 Patients Admitted to an Intensive Care Unit During the SARS-CoV2 Pandemic Outbreak.

INTRODUCTION: The World Health Organization (WHO) identified a novel coronavirus, originating in Wuhan, China, in December 2019, as a pneumonia causing pathogen. Epidemiological data in Romania show more than 450.000 confirmed patients, with a constant number of approximately 10% admission in intensive care unit. METHOD: A retrospective, observational study was conducted from 1st March to 30th October 2020, comprising 657 patients, confirmed as having COVID-19, and who had been admitted to the intensive care unit of the Mures County Clinical Hospital, Tîrgu Mures, Romania, which had been designated as a support hospital during the pandemic. Patients who presented at admission or developed abnormal liver function tests in the first seven days of admission, were included in the study; patients with pre-existing liver disease, were excluded. RESULTS: The mean (SD) age of patients included in the study was 59.41 (14.66) years with a male: female ratio of 1.51:1. Survivor status, defined as patients discharged from the intensive care unit, was significantly associated with parameters such as age, leukocyte count, albumin level, glycaemia level (p<0.05 for all parameters.). CONCLUSIONS: Liver injury expressed through liver function tests cannot solely constitute a prognostic factor for COVID-19 patients, but its presence in critically ill patients should be further investigated and included in future guideline protocols.

The impact of COVID-19 outbreak on hotels' value compared to previous diseases: the role of ALFO strategy.

By using the Event Study Method (ESM), this paper aims to examine the effect of new coronavirus (SARS-CoV-2) disease (COVID-19) outbreak on the market performance of the hotel industry in the U.S. We also compare the impact of COVID-19 outbreak with three previous diseases outbreaks. The results show that there is a negative influence of the diseases outbreaks on stock returns of hotels in the U.S. However, the impact of COVID-19 is incomparably higher in magnitude compared to previous diseases. Furthermore, given the importance of following flexible corporate strategies to adapt to new and unpredicted situations, it is found that the ALFO (assets-light, fee-orientated) strategy acts as a mitigator for the predicted market value drop due to the pandemic.

Metal Organic Frameworks as Biosensing Materials for COVID-19.

The novel coronavirus disease (COVID-19) pandemic outbreak is the most startling public health crises with attendant global socio-economic burden ever experienced in the twenty-first century. The level of devastation by this outbreak is such that highly impacted countries will take years to recover. Studies have shown that timely detection based on accelerated sample testing and accurate diagnosis are crucial steps to reducing or preventing the spread of any pandemic outbreak. In this opinionated review, the impacts of metal organic frameworks (MOFs) as a biosensor in a pandemic outbreak is investigated with reference to COVID-19. Biosensing technologies have been proven to be very effective in clinical analyses, especially in assessment of severe infectious diseases. Polymerase chain reactions (PCR, RT-PCR, CRISPR) - based test methods predominantly used for SARS-COV-2 diagnoses have serious limitations and the health scientists and researchers are urged to come up with a more robust and versatile system for solving diagnostic problem associated with the current and future pandemic outbreaks. MOFs, an emerging crystalline material with unique characteristics will serve as promising biosensing materials in a pandemic outbreak such as the one we are in. We hereby highlight the characteristics of MOFs and their sensing applications, potentials as biosensors in a pandemic outbreak and draw the attention of researchers to a new vista of research that needs immediate action.

Healthcare systems and Covid19: Lessons to be learnt from efficient countries.

BACKGROUND: The novel coronavirus is rapidly spreading over the world and puts the health systems of countries under intense pressure. High hospitalization levels due to the pandemic outbreak have caused the intensive care units to work above capacity. PURPOSE: A data envelopment analysis (DEA) based modelling approach was developed to evaluate the effectiveness of regions (i.e. city, country or clinical commissioning groups) against the pandemic outbreak. The objective is to enable related authorities better manage the struggle against the outbreak and put in place the emergency action plans immediately. METHODOLOGY/APPROACH: DEA method was used to measure the efficiency scores of countries. Super efficiency DEA method was also applied to countries based on the level of efficiencies they have achieved. Sixteen countries were selected that have been facing with Covid19 pandemic outbreak for at least 5 consecutive weeks after their 100th confirmed case. RESULTS: A total of 80 DEA models were developed, that is, 16 DEA models for each week. The percentage of efficient countries decreased dramatically over time, from 43.75% in the first week to 25% in the fifth week. Unlike most European countries, China and South Korea increased their effectiveness after first week of implementing all the necessary measures. CONCLUSION: This study sheds light into better understanding the effectiveness of policies adopted by countries and their management strategy in dealing with Covid19 pandemic. Our model will enable political leaders to identify inadequate policies as quickly as possible and learn from their peers for more effective decisions.

Effects of Pandemic Outbreak on Economies: Evidence From Business History Context.

The coronavirus pandemic has highlighted the capitalist dysfunction showing that considering profit over people can be deadly. The study reveals the LME economies were more responsive toward the impact of the disease outbreaks as compared to the CME economies wherein the impact of the disease was moderated by the government involvement. This allows us to draw that the impact of the disease outbreaks can be moderated by increasing the involvement of the government authorities.

Aquagenic acrokeratoderma due to frequent handwashing during the COVID-19 pandemic outbreak.

Aquagenic acrokeratoderma (AK) is a rare, transient type of acquired palmoplantar keratoderma resulting from short-term contact with water and characterized by white, transparent papules and plaques usually localized in the palmar regions of the hand. The pathogenesis of aquagenic acrokeratoderma is not fully understood and is assumed to be related to an increased salt concentration in the epidermal cells with an increase in the ability of stratum corneum to bind water. This report of patients developing AK following increased frequencies of handwashing in the COVID-19 Pandemic Outbreak is intended to contribute to our understanding of the pathogenesis.

Seeking an ethical theory for the COVID-19 pandemic outbreak with special reference to Bangladesh's law and policy.

Globally, a traditional management model has generally been used to manage disaster situations, including in Bangladesh. In Bangladesh, the government mostly uses the preparedness policy for pandemic outbreak case management. With regard to the limitations arising from the pandemic outbreak the current research will investigate the following questions: when facing a devastating situation, what exactly is the nature of the pandemic outbreak management model incorporated at the governmental level? Keeping these questions in mind, the intention of the existing model is to provide smooth and appropriate assistance to recover from a pandemic outbreak, and to implement effective governance of the situation. This research will identify deficiencies in the current epidemic management policy in Bangladesh, and will assist in forming a new model and developing a systematic procedure for managing future pandemic outbreak situations. The main deficiency in Bangladesh's pandemic management is that the policy paper has failed to identify all hazardous events that may occur in a pandemic outbreak. In most cases, it has underestimated the issues of bioethical responsibility toward the different stakeholders affected during the devastating situation of a pandemic outbreak. The policy does not emphasize the bioethical model; therefore, it fails to encourage support for either public protection or an ethically friendly management system. The model proposed in this article demonstrates an appropriate way to reduce or, if possible, avoid potential damages and losses from a pandemic outbreak. The model aims to prioritize the problems that need assistance to recover from the outbreak.

Analytical insights of COVID-19 pandemic.

Coronavirus disease-19 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (2019-nCoV or SARS-CoV-2). Genomic analysis has revealed that bat and pangolin coronaviruses are phylogenetically related to SARS-CoV-2. The actual origin and passage history of the virus are unknown, but human-human transmission of the virus has been confirmed. Several diagnostic techniques have been developed to detect COVID-19 in this prevailing pandemic period. In this review, we provide an overview of SARS-CoV-2 and other coronaviruses. The origin, structure, current diagnostic techniques, such as molecular assays based on oligonucleotides, immunoassay-based detection, nanomaterial-based biosensing, and distinctive sample based detection are also discussed. Furthermore, our review highlights the admissible treatment strategies for COVID-19 and future perspectives on the development of biosensing techniques and vaccines for the diagnosis and prevention of the disease, respectively.