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1.
Public Health Pract (Oxf) ; 8: 100521, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-39027345

RESUMEN

Background: COVID-19 (coronavirus disease 2019) outbreaks in workplace settings have been investigated to understand how transmission occurred. However, there is limited data looking at COVID-19 transmission in conference settings in England, particularly where an outbreak did not occur. The aim of this work was to investigate COVID-19 infection risk factors and control measures at a large conference, with a known case but no reported onward transmission to inform prevention of future outbreaks of respiratory infections in conferences and similar settings. Methods: This cross-sectional study was part of a wider COVID-19 Outbreak Investigation to Understand Transmission (COVID-OUT) study. A two-day in-person conference on SARS-CoV-2 transmission and environment was held at a university conference centre on 17-November 18, 2021, in England, with about 100 delegates. A questionnaire survey was conducted among 50 conference attendees to identify any confirmed cases and understand transmission, history of COVID-19 symptoms, testing and vaccination. Results: One person met the definition of a confirmed case at the conference. This case was most likely infectious when attending the conference, however there were no known secondary cases. All respondents reported receiving at least two doses of a COVID-19 vaccine before the conference and an increased frequency of handwashing/sanitising hands during the study period in comparison to before the pandemic. Prior to the conference, a COVID-19 risk assessment including a review of the ventilation at the site was completed. All attendees were advised to take an LFD test before travelling to the conference, wear face coverings, and maintain 1-m distance during the conference. Conclusion: A multipronged approach, encouraging attendee behaviours (regular hand washing, mask wearing, being vaccinated against COVID-19) and introducing control measures at the conference site (ventilation, sufficient spacing capacity, combined with prior knowledge of COVID-19 transmission, were effective in limiting the spread of COVID-19 in this setting.

2.
PLOS Glob Public Health ; 4(6): e0003393, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38913626

RESUMEN

After 2 years of no community outbreaks of COVID-19, the Falkland Islands (FI) reported their first community case in April 2022. Because of high vaccine coverage (88% of entire population), no specific control measures were instigated, and cases spread rapidly. We undertook a retrospective cohort study to determine the extent of transmission and the effectiveness of COVID-19 vaccine in a population with limited natural immunity. We extracted data on age, sex, and vulnerability for the FI registered population from a patient information system and linked to COVID-19 case line-list and vaccination datasets. Cases were individuals with positive SARS-CoV-2 PCRs or Lateral Flow Devices (LFDs), from 26 April to 30 June 2022. Univariable analyses compared case risk factors to non-cases. Relative vaccine effectiveness was calculated using Poisson regression with robust error variance, comparing against individuals with vaccination more than the 20 weeks prior to the outbreak. Models were adjusted for age, sex, extreme vulnerability, and previous infection. Of the 3,343 registered population, 44% (n = 1,467) were cases, with no COVID-19 hospitalisations or deaths. In univariable analysis, being female (RR 1.12, p = 0.004) and under 18 years (RR 1.70, p<0.001) were associated with increased COVID-19 risk. Relative vaccine effectiveness was 39.0% (95% CI, 1.03 to 62.5) and 33.0% (95% CI, 8.3 to 51.0) 1 to 9 weeks after receiving 2nd and 1st boosters respectively. We showed widespread transmission in a small island population with limited natural immunity, disproportionately affecting children and women, indicative of transmission in educational and household settings. Despite limited natural immunity, our findings suggested that vaccination was effective protecting against severe disease and booster doses provided additional short-term protection against infection. We would recommend optimizing coverage with boosters of vaccine in remote island populations such as FI. Follow-up would be needed to assess duration of protection after booster vaccination.

4.
Ann Work Expo Health ; 2024 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-38785326

RESUMEN

BACKGROUND: The public order and safety (POS) sector remains susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks, as workplace attendance is typically compulsory and close physical contact is often needed. Here, we report on a SARS-CoV-2 outbreak with an attack rate of 39% (9/23), which occurred between 19 and 29 June 2021 among a cohort of new POS recruits participating in a mandatory 18-week training programme in England. METHODS: The COVID-OUT (COVID-19 Outbreak investigation to Understand Transmission) study team undertook a multidisciplinary outbreak investigation, including viral surface sampling, workplace environmental assessment, participant viral and antibody testing, and questionnaires, at the two associated training facilities between 5 July and 24 August 2021. RESULTS: Environmental factors, such as ventilation, were deemed inadequate in some areas of the workplace, with carbon dioxide (CO2) levels exceeding 1,500 ppm on multiple occasions within naturally ventilated classrooms. Activities during safety training required close contact, with some necessitating physical contact, physical exertion, and shouting. Furthermore, most participants reported having physical contact with colleagues (67%) and more than one close work contact daily (97%). CONCLUSIONS: Our investigation suggests that site- and activity-specific factors likely contributed to the transmission risks within the POS trainee cohort. Potential interventions for mitigating SARS-CoV-2 transmission in this POS training context could include implementing regular rapid lateral flow testing, optimizing natural ventilation, using portable air cleaning devices in classrooms, and expanding use of well-fitted FFP2/FFP3 respirators during activities where prolonged close physical contact is required.

5.
Emerg Infect Dis ; 28(10): 2082-2086, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35960543

RESUMEN

After community transmission of monkeypox virus was identified in Europe, interviews of 45 case-patients from England indicated transmission in international sexual networks of gay and bisexual men since April 2022. Interventions targeting sex-on-premises venues, geospatial dating applications, and sexual health services are likely to be critical for outbreak control.


Asunto(s)
Infecciones por VIH , Mpox , Minorías Sexuales y de Género , Bisexualidad , Infecciones por VIH/epidemiología , Homosexualidad Masculina , Humanos , Masculino , Monkeypox virus , Conducta Sexual
6.
Euro Surveill ; 27(22)2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35656834

RESUMEN

Between 7 and 25 May, 86 monkeypox cases were confirmed in the United Kingdom (UK). Only one case is known to have travelled to a monkeypox virus (MPXV) endemic country. Seventy-nine cases with information were male and 66 reported being gay, bisexual, or other men who have sex with men. This is the first reported sustained MPXV transmission in the UK, with human-to-human transmission through close contacts, including in sexual networks. Improving case ascertainment and onward-transmission preventive measures are ongoing.


Asunto(s)
Mpox , Minorías Sexuales y de Género , Femenino , Homosexualidad Masculina , Humanos , Masculino , Mpox/diagnóstico , Mpox/epidemiología , Mpox/transmisión , Monkeypox virus/genética , Reino Unido/epidemiología
7.
BMC Fam Pract ; 21(1): 265, 2020 12 10.
Artículo en Inglés | MEDLINE | ID: mdl-33302884

RESUMEN

BACKGROUND: Up to 18% of genital Chlamydia infections and 9% of Gonorrhoea infections in England are diagnosed in Primary Care. Evidence suggests that a substantial proportion of these cases are not managed appropriately in line with national guidelines. With the increase in sexually transmitted infections and the emergence of antimicrobial resistance, their timely and appropriate treatment is a priority. We investigated feasibility and acceptability of extending the National Chlamydia Screening Programme's centralised, nurse-led, telephone management (NLTM) as an option for management of all cases of chlamydia and gonorrhoea diagnosed in Primary Care. METHODS: Randomised feasibility trial in 11 practices in Bristol with nested qualitative study. In intervention practices patients and health care providers (HCPs) had the option of choosing NLTM or usual care for all patients tested for Chlamydia and Gonorrhoea. In control practices patients received usual care. RESULTS: One thousand one hundred fifty-four Chlamydia/gonorrhoea tests took place during the 6-month study, with a chlamydia positivity rate of 2.6% and gonorrhoea positivity rate of 0.8%. The NLTM managed 335 patients. Interviews were conducted with sixteen HCPs (11 GPs, 5 nurses) and 12 patients (8 female). HCPs were positive about the NLTM, welcomed the partner notification service, though requested more timely feedback on the management of their patients. Explaining the NLTM to patients didn't negatively impact on consultations. Patients found the NLTM acceptable, more convenient and provided greater anonymity than usual care. Patients appreciated getting a text message regarding a negative result and valued talking to a sexual health specialist about positive results. CONCLUSION: Extension of this established NLTM intervention to a greater proportion of patients was both feasible and acceptable to both patients and HCP, could provide a better service for patients, whilst decreasing primacy care workload. The study provides evidence to support the wider implementation of this NLTM approach to managing chlamydia and gonorrhoea diagnosed in primary care.


Asunto(s)
Infecciones por Chlamydia , Chlamydia , Gonorrea , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , Femenino , Gonorrea/diagnóstico , Gonorrea/epidemiología , Humanos , Rol de la Enfermera , Atención Primaria de Salud , Teléfono
8.
BMC Infect Dis ; 20(1): 2, 2019 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-31892311

RESUMEN

BACKGROUND: Outbreaks of infectious gastroenteritis are common in care homes for the elderly. Norovirus can cause these outbreaks, but diagnosis is frequently based solely on clinical characteristics. Our objective in this study was to describe the epidemiology of norovirus and other gastrointestinal pathogens in these settings. METHODS: We analysed surveillance data from gastroenteritis outbreaks reported in North East England between 04 July 2016 to 01 July 2018. Stool samples taken during these outbreaks were tested for a range of viral and bacterial pathogens. We described the epidemiology of these outbreaks and explored the characteristics of norovirus outbreaks versus from other viral causes using multivariable logistic regression. RESULTS: From the 566 care home gastroenteritis outbreaks in this study, we found that norovirus was the pathogen most frequently isolated. Norovirus was detected in 64% of outbreaks with a pathogen identified. Sapovirus was found in 13%; rotavirus in 11%. We found that norovirus outbreaks were associated with higher attack rates (aOR 1.03, 95% CI 1.01-1.05) and fewer cases sampled (aOR 0.74, 95% CI 0.60-0.91), compared to outbreaks caused by other viral pathogens. CONCLUSIONS: These results are important as they quantify the contribution of norovirus to gastroenteritis outbreaks in care homes. Given this evidence, we emphasize the importance of non-specific outbreak interventions that can affect the impact of all such outbreaks. We further recommend that these findings are used to inform the implementation strategies of any norovirus-specific interventions such as a norovirus vaccine.


Asunto(s)
Infecciones por Caliciviridae/epidemiología , Gastroenteritis/epidemiología , Gastroenteritis/virología , Casas de Salud/estadística & datos numéricos , Infecciones por Rotavirus/epidemiología , Anciano , Infecciones por Caliciviridae/virología , Brotes de Enfermedades/estadística & datos numéricos , Inglaterra/epidemiología , Heces/virología , Gastroenteritis/microbiología , Humanos , Incidencia , Norovirus/aislamiento & purificación , Norovirus/patogenicidad , Rotavirus/aislamiento & purificación , Rotavirus/patogenicidad , Infecciones por Rotavirus/virología , Sapovirus/aislamiento & purificación , Sapovirus/patogenicidad
9.
Am J Infect Control ; 46(2): 238-240, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29031429

RESUMEN

We report an outbreak of invasive and noninvasive group A Streptococcus during April 2017 among people who inject drugs in southwest England. To date we have identified 14 cases linked to a specific town, all confirmed as group A Streptococcus emm94.0, a strain type not previously reported in the area. We have yet to identify a source for this ongoing outbreak. Actions described here may help reduce the burden of infection in vulnerable populations.


Asunto(s)
Brotes de Enfermedades , Infecciones Estreptocócicas/epidemiología , Infecciones Estreptocócicas/microbiología , Streptococcus pyogenes/genética , Streptococcus pyogenes/aislamiento & purificación , Abuso de Sustancias por Vía Intravenosa/complicaciones , Abuso de Sustancias por Vía Intravenosa/epidemiología , Adulto , Recolección de Datos , Inglaterra/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Encuestas y Cuestionarios , Adulto Joven
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