Recurrent Plasmodium vivax Cases of Both Short and Long Latency Increased with Transmission Intensity and Were Distributed Year-Round in the Most Affected Municipalities of the RACCN, Nicaragua, 2013-2018.

The characteristics of P. vivax recurrent episodes were examined using a centralized secondary source of malaria records in Nicaragua and in the two most affected municipalities in the RACCN. The study of 36,787 malaria cases due to P. vivax or P. falciparum revealed that, nationwide, 3624 patients had at least one recurrent infection. This was achieved by matching names, gender, age, community/municipality, ethnicity, etc. P. vivax was responsible for 88% of recurrent infections of 25-450 days of latency (51.9% were women and 48.1% were men), and these were assumed to be relapse episodes. Of them, 88.2% and 4.4% occurred in the municipalities of Puerto Cabezas and Rosita, respectively. The proportion of P. vivax patients having presumed relapse episodes rose with elevated transmission rates in both municipalities, reaching 7% in Rosita (2017) and 14.5% in Puerto Cabezas (2018). In both areas, relapse episodes were evident over time and were characterized by the production of a continuous stippling pattern with a slope evolving from one transmission peak to the next. During the dry season, short-latency relapse episodes were more robust, while long-latency ones increased just before the P. vivax transmission season began, with a high proportion of long-latency relapses during this period. The abundance of recurrent P. vivax infections, the wide range of relapse latency lengths, and temporal distribution tended to favor year-round transmission. It is necessary to evaluate compliance with and the effectiveness of primaquine treatment and contemplate the use of an alternative drug, among other actions.

African Swine Fever in Smallholder Sardinian Farms: Last 10 Years of Network Transmission Reconstruction and Analysis.

African swine fever (ASF) is a viral disease of suids that frequently leads to death. There are neither licensed vaccines nor treatments available, and even though humans are not susceptible to the disease, the serious socio-economic consequences associated with ASF have made it one of the most serious animal diseases of the last century. In this context, prevention and early detection play a key role in controlling the disease and avoiding losses in the pig value chain. Target biosecurity measures are a strong strategy against ASF virus (ASFV) incursions in farms nowadays, but to be efficient, these measures must be well-defined and easy to implement, both in commercial holdings and in the backyard sector. Furthermore, the backyard sector is of great importance in low-income settings, mainly for social and cultural practices that are highly specific to certain areas and communities. These contexts need to be addressed when authorities decide upon the provisions that should be applied in the case of infection or decide to combine them with strict preventive measures to mitigate the risk of virus spread. The need for a deeper understanding of the smallholder context is essential to prevent ASFV incursion and spread. Precise indications for pig breeding and risk estimation for ASFV introduction, spread and maintenance, taking into account the fact that these recommendations would be inapplicable in some contexts, are the keys for efficient target control measures. The aim of this work is to describe the 305 outbreaks that occurred in domestic pigs in Sardinia during the last epidemic season (2010-2018) in depth, providing essential features associated with intensive and backyard farms where the outbreaks occurred. In addition, the study estimates the average of secondary cases by kernel transmission network. Considering the current absence of ASF outbreaks in domestic pig farms in Sardinia since 2018, this work is a valid tool to specifically estimate the risk associated with different farm types and update our knowledge in this area.

A Brief History of Ebolavirus Disease: Paving the Way Forward by Learning from the Previous Outbreaks.

In this review, Ebolavirus Disease (EVD) outbreaks have been comprehensively reviewed from their beginning until now. It chronologically discusses how each outbreak was tackled, national and international actions taken, diagnostic methods applied, the infection control procedures put in place, and the lessons learnt from each epidemic for the control of subsequent epidemics. Data for this review were obtained from literature published between 1967 and 2016 in key medical databases, the official websites of various governmental organisations, international public health agencies, and regulatory bodies. Despite major developments in the field of EVD, there has been little progress in its specific therapy or prevention. Historically, individuals who recovered from EVD acted as a source of fresh frozen plasma (containing IgG) that has been used to treat other acutely ill patients, however this therapeutic modality has limitations due to the risk of transmission of blood-borne infections. With the use of advanced and efficient purification methods the incidence of unwanted side effects following immune serum therapy has currently been greatly reduced. Creation of a safe plasma pool that covers immunoglobulins against all strains of EVD is now a research priority. Recommendations on how future EVD outbreaks can be better managed have been discussed.