Symptom persistence and recovery among COVID-19 survivors during a limited outbreak in Canterbury, New Zealand: a prospective cohort study.

BACKGROUND: In Canterbury, near complete identification of coronavirus disease 2019 (COVID-19) cases during a limited outbreak provides unique insights into sequelae. AIMS: The current study aimed to measure symptom persistence, time to return to normal activity, generalised anxiety and health-related quality of life (HrQoL) among COVID-19 survivors compared with uninfected participants. METHODS: The authors conducted a prospective cohort study of people tested for COVID-19 by reverse transcriptase polymerase chain reaction of nasopharyngeal swabs from 1 March to 30 June 2020. They enrolled participants who tested positive and negative at a 1:2 ratio, and administered community-acquired pneumonia, 7-item generalised anxiety disorder (GAD-7) and HrQoL (RAND-36) questionnaires. RESULTS: The authors recruited 145 participants, 48 with COVID-19 and 97 without COVID-19. The mean time from COVID-19 testing to completing the health questionnaire was 306 days. The mean age of patients was 46.7 years, and 70% were women. Four (8%) COVID-19-positive and eight (8%) COVID-19-negative participants required hospitalisation. Fatigue (30/48 [63%] vs 13/97 [13%]; P < 0.001), dyspnoea (13/48 [27%] vs 6/97 [6%]; P < 0.001) and chest pain (10/48 [21%] vs 1/97 [1%]; P < 0.001) were persistent in those with COVID-19. Fewer COVID-19-positive participants returned to normal activity levels (35/48 [73%] vs 94/97 97%; P < 0.001), with longer times taken (median 21 vs 14 days; P = 0.007). The GAD-7 and RAND-36 scores of both groups were similar across all anxiety and HrQoL subscales. CONCLUSIONS: Persistent symptoms and longer recovery times were found in COVID-19 survivors, but not impaired generalised anxiety levels or HrQoL compared with COVID-19-uninfected participants.

Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 during Border Quarantine and Air Travel, New Zealand (Aotearoa).

The strategy in New Zealand (Aotearoa) to eliminate coronavirus disease requires that international arrivals undergo managed isolation and quarantine and mandatory testing for severe acute respiratory syndrome coronavirus 2. Combining genomic and epidemiologic data, we investigated the origin of an acute case of coronavirus disease identified in the community after the patient had spent 14 days in managed isolation and quarantine and had 2 negative test results. By combining genomic sequence analysis and epidemiologic investigations, we identified a multibranched chain of transmission of this virus, including on international and domestic flights, as well as a probable case of aerosol transmission without direct person-to-person contact. These findings show the power of integrating genomic and epidemiologic data to inform outbreak investigations.

Grafting Using Rootstocks with Resistance to Ralstonia solanacearum Against Meloidogyne incognita in Tomato Production.

Root-knot nematodes (RKNs; Meloidogyne spp.) and Ralstonia solanacearum, the causal agent of bacterial wilt, are major soilborne pathogens in U.S. tomato production. Methyl bromide has been used for decades to effectively manage RKN but its phase-out and the high cost of other effective fumigants such as 1,3-dichloropropene has resulted in a need to develop sustainable alternatives. Many of the commercially popular varieties used by the tomato industry do not have resistance to RKNs and R. solanacearum. Recent studies worldwide have shown the potential for grafting using resistant rootstocks as a sustainable and ecofriendly practice for R. solanacearum management. However, the effectiveness of R. solanacearum-resistant rootstocks on RKN management is not known. In this study, three commercially available R. solanacearum-resistant tomato rootstocks ('RST-04-106-T', 'BHN 998', and 'BHN 1054') were evaluated for resistance to Meloidogyne incognita in field tomato production in four field trials conducted for two consecutive years in two geographical locations: Florida and Virginia. Grafting rootstocks onto 'BHN 602' a tomato scion susceptible to bacterial wilt and RKNs, significantly reduced root galling caused by RKNs in all four field trials and increased yield in two of the trials compared with the nongrafted treatment. This study demonstrates the potential of grafting for managing multiple soilborne pathogens using the same rootstocks.

Evaluation of ethanedinitrile (EDN) as a preplant soil fumigant in Florida strawberry production.

BACKGROUND: Ethanedinitrile (EDN) has shown promising efficacy against weeds, plant-parasitic nematodes and soil-borne pathogens. Field experiments were conducted for three strawberry (Fragaria× ananassa D.) seasons in Balm and Dover, FL, USA to evaluate the control efficacy of EDN applied through drip tape on various weed species and the fungus Macrophomina phaseolina, the causal agent of charcoal rot of strawberry. RESULTS: Results revealed that 224, 336, 448 or 560 kg ha-1 EDN, and 104 kg ha-1 1,3-dichloropropene (1,3-D) + 176 kg ha-1 chloropicrin (Pic) applied through drip tapes under totally impermeable film were safe for strawberry production, with no adverse effect on strawberry growth and yield. EDN rates at 224, 336, 448 and 560 kg ha-1 were highly efficacious and equally effective in reducing purple nutsedge (Cyperus rotundus L.) in two of three growing seasons. Compared with the efficacy on purple nutsedge, the evaluated EDN rates were generally less effective on various broadleaf and grass weeds emerging on the bare ground and planting holes, but at 560 kg ha-1 consistently exhibited similar levels of control as 1,3-D + Pic. For M. phaseolina, the evaluated EDN rates were more efficacious than 1,3-D + Pic and significantly reduced inoculum buried in different bed locations in plastic-mulched beds. CONCLUSION: EDN has potential to be an efficacious tool for soil disinfestation and weed control in plasticulture strawberry production. © 2019 Society of Chemical Industry.

Towards elimination of tuberculosis in New Zealand.

New Zealand could be the first country in the world to eliminate tuberculosis (TB). We propose a TB elimination strategy based on the eight-point World Health Organization (WHO) action framework for low incidence countries. Priority actions recommended by the WHO include 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) identify active TB and undertake screening for latent tuberculosis infection (LTBI) in recent TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. In New Zealand, central government needs to take greater responsibility for TB policy and programme governance. Urgent action is required to prevent TB in higher risk groups including Maori communities, and to enable immigration screening to detect and treat LTBI. Clinical services need to be supported to implement new guidelines for LTBI that enable better targeting of screening and shorter, safer treatment regimens. Access to WHO recommended treatment regimens needs to be guaranteed for drug-resistant TB. Better use of existing data could better define priority areas for action and assist in the evaluation of current control activities. Access to GeneXpert® MTB-RIF near the point of care and whole genome sequencing nationally would greatly improve clinical and public health management through early identification of drug resistance and outbreaks. New Zealand already has a world-class TB research community that could be better deployed to assist high-incidence countries through research and training.

Sampling for Estimating Frankliniella Species Flower Thrips and Orius Species Predators in Field Experiments.

The western flower thrips, Frankliniella occidentalis (Pergande), is a polyphagous pest that has been spread worldwide. The extensive use of insecticides in attempts to control its populations eliminates natural enemies and competitor flower thrips species, thereby increasing its populations. An unsustainable situation develops with concomitant resistant pest populations, secondary pest outbreaks, and environmental degradation. Integrated pest management utilizes knowledge of pest and natural enemy relationships to implement tactics that are environmentally friendly and sustainable. Minute pirate bugs are the most important worldwide predators of thrips. They can suppress and ultimately control Frankliniella species flower thrips. Flower samples taken at least weekly are needed to understand predator-prey dynamics. Shown here is the sampling of the flowers of fruiting vegetables and companion plants to estimate the densities of individual thrips and minute pirate bug species. Representative data illustrates how the protocol is used to determine the efficacy of management tactics over time and how to evaluate the benefits of predation by minute pirate bugs. The sampling protocol is similarly adaptable to sampling thrips and minute pirate bugs in other plant species hosts.

Student-led intervention to inNOvate hand hygiene practice in Auckland Region's medical students (the No HHARMS study).

BACKGROUND: Hand hygiene is important in reducing healthcare-associated infections. The World Health Organization has defined 'five moments' when hand hygiene compliance is required. During 2013, New Zealand national data showed poor compliance with these moments by medical students. AIM: To improve medical students' compliance with the five moments. METHODS: In this prospective student-led quality improvement initiative, student investigators developed, implemented and evaluated a multi-modal intervention comprising a three-month social media campaign, a competition and an entertaining educational video. Data on individual patient-medical student interactions were collected covertly by observers at baseline and at one week, six weeks and three months after initiation of the intervention. RESULTS: During the campaign, compliance improved in moment 2, but not significantly in moments 1, 3, 4 or 5. Statistical analysis of amalgamated data was limited by non-independent data points-a consideration apparently not always addressed in previous studies. CONCLUSIONS: The initiative produced improvements in compliance by medical students with one hand hygiene moment. Statistical analysis of amalgamated data for all five moments should allow for the non-independence of each occasion in which clinicians interact with a patient. More work is needed to ensure excellent hand hygiene practices of future doctors.