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1.
Virology ; 599: 110208, 2024 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-39154629

RESUMEN

Barramundi aquaculture is at risk of severe disease outbreaks and massive production losses. Here we used bioinformatics to screen 84 farmed barramundi transcriptomes to identify novel viruses that could threaten barramundi aquaculture and to establish a barramundi aquaculture virome. We discovered five novel viruses: latid herpesvirus 1 (LatHV-1) from the Alloherpesviridae family, barramundi parvovirus 1 (BParV1) from the Parvoviridae family, barramundi calicivirus 1 (BCaV1) from the Caliciviridae family, and barramundi associated picorna-like virus 1 and 2 (BPicV1 and BPicV2) from the Picornaviridae family. LatHV-1, BCaV1, and BParV1 are closely related to pathogenic viruses found in other fish species that can cause mass mortality in farms. To aid in future viral surveillance, we also designed and successfully tested an RT-PCR assay for the detection of BCaV1. Overall, we discovered a range of pathogenic viruses in barramundi aquaculture, paving the way for developing effective detection methods to assist early outbreak management.

2.
Emerg Infect Dis ; 30(9): 1970-1972, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39174024

RESUMEN

Disseminated leishmaniasis is an emerging clinical form of Leishmania braziliensis infection. Evidence shows that co-infection by L. braziliensis and intestinal helminths does not affect clinical manifestations or response to therapy in cutaneous leishmaniasis patients. We evaluated whether co-infection was associated with those aspects in disseminated leishmaniasis patients in Brazil.


Asunto(s)
Coinfección , Helmintiasis , Parasitosis Intestinales , Humanos , Brasil/epidemiología , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/complicaciones , Parasitosis Intestinales/parasitología , Masculino , Femenino , Adulto , Helmintiasis/complicaciones , Helmintiasis/epidemiología , Helmintiasis/parasitología , Persona de Mediana Edad , Leishmania braziliensis/aislamiento & purificación , Adulto Joven , Adolescente , Animales , Anciano
3.
Adv Exp Med Biol ; 1458: 217-231, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39102199

RESUMEN

Climatic change, which influences population growth and land usage, has been theorized to be linked to the emergence and spread of new viruses like the currently unfolding COVID-19 pandemic. In this chapter, we explain how climate change may have altered the beginning, transmission, and maybe even the sickness consequences of the COVID-19 pandemic. Where possible, we also provide mechanistic explanations for how this may have occurred. We have presented evidence that suggests climate change may have had a role in the establishment and transmission of SARS-CoV-2 infection, and most possibly even in some of its clinical effects. Human activities bringing people into closer contact with bats and animals like pangolins that potentially represent the intermediate hosts, and evidence that climate-induced changes in vegetation are the main reservoir source of coronaviruses for human infection, are among the explanations. Although there are still unsubstantiated indications that the first viral pathogen may have escaped from a laboratory, it is possible that this encounter took place in the field or in marketplaces in the instance of COVID-19. We also present the argument that climate change is working to enhance transmission between diseased and uninfected humans, and this is true regardless of the source of the original development of the disease. Changes in temperature and humidity make it easier for viruses to survive, and the impacts of industrial pollution induce people to cough and sneeze, which releases highly infectious aerosols into the air. These three factors combine to make this a more likely scenario than it would otherwise be. We suggest that changes in climate are contributing to create conditions that are favorable for the development of more severe symptoms of illness. It is more difficult to build the argument for this circumstance, and much of it is indirect. However, climate change has caused some communities to adjust their nutritional habits, both in terms of the quantity of food they eat and the quality of the foods they consume. The effects frequently become apparent as a result of alterations that are imposed on the microbiome of the gut, which, in turn, influence the types of immune responses that are produced. The incidence of comorbidities like diabetes and animal vectors like bats that transmit other illnesses that modify vulnerability to SARS-CoV-2 are also two examples of the factors that have been affected by climate change. In order to curb the development of infectious illnesses caused by new viruses, it is necessary to understand the connection between environmental dynamics and the emergence of new coronaviruses. This knowledge should lead to initiatives aimed at reducing global greenhouse gas emissions.


Asunto(s)
COVID-19 , Cambio Climático , SARS-CoV-2 , COVID-19/epidemiología , COVID-19/transmisión , COVID-19/virología , Humanos , SARS-CoV-2/patogenicidad , Animales , Pandemias , Quirópteros/virología
4.
Vet Microbiol ; 298: 110217, 2024 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-39180796

RESUMEN

Crimean-Congo hemorrhagic fever virus (CCHFV) is an emerging tick-borne pathogen in different European countries. Since 2013, clinical and fatality cases associated with CCHFV infection have been reported in humans in Spain. During the last few years, endemic circulation of this virus has been detected in ticks and wild ungulates in this country, but the role of other sympatric wild species in the sylvatic cycle of this multi-host virus remains poorly understood. The aims of the present study were to assess exposure to CCHFV in wild lagomorphs in southern Spain, a CCHFV endemic area, and to determine the presence of the virus in ticks feeding on these species. Serum samples from 473 European wild rabbits (Oryctolagus cuniculus) and 162 Iberian hares (Lepus granatensis), and 120 ticks feeding on 85 of these wild lagomorphs were collected on 133 hunting grounds between 2018/2019 and 2021/2022 hunting seasons. The presence of antibodies against CCHFV was assessed in all serum samples using a commercial ELISA, whereas ticks were tested for the presence of CCHFV-RNA by a multiplex RT-qPCR that detects all known genotypes of this virus. None of the 635 (0.0 %; 95 %CI: 0.0-0.6) lagomorphs tested had anti-CCHFV antibodies and CCHFV-RNA was not found in any of the 120 (0.0 %; 95 %CI: 0.0-3.0) ticks analyzed. To the best of the authors knowledge, this is the first epidemiological study conducted on CCHFV in Iberian hare worldwide. Our findings indicate absence of exposure to CCHFV in European wild rabbit and Iberian hare populations, as well as in their ticks, which suggests that they do not seem to play a relevant role in the epidemiology of CCHFV in Mediterranean ecosystems of southern Spain.

5.
Artículo en Inglés | MEDLINE | ID: mdl-38965027

RESUMEN

The Spanish Society of Tropical Medicine and International Health (SEMTSI), the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Emergency Medicine (SEMES), the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Society of Family and Community Medicine (SEMFYC) have prepared a consensus statement on the diagnosis and management of patients with imported febrile illnesses. Twenty authors with different backgrounds and representing different healthcare perspectives (ambulatory primary care, travel and tropical medicine specialists, emergency medicine, hospital care, microbiology and parasitology and public health), identified 39 relevant questions, which were organised in 7 thematic blocks. After a systematic review of the literature and a thoughtful discussion, the authors prepared 125 recommendations, as well as several tables and figures to be used as a consulting tool. The present executive summary shows a selection of some of the most relevant questions and recommendations included in the guidelines.


Asunto(s)
Enfermedades Transmisibles Importadas , Fiebre , Humanos , Fiebre/etiología , Fiebre/diagnóstico , Enfermedades Transmisibles Importadas/diagnóstico , Enfermedades Transmisibles Importadas/terapia , Enfermedad Relacionada con los Viajes , España
6.
Heliyon ; 10(13): e33600, 2024 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-39071681

RESUMEN

Tick-associated diseases present challenges due to tridirectional interactions among host-specific responses, tick toxins and salivary proteins as well as microbes. We aimed to uncover molecular mechanisms in tick-bitten skin samples (cases) and contralateral skin samples (controls) collected simultaneously from the same participants, using spatial transcriptomics. Cases and controls analysed using NanoString GeoMx Digital Spatial Profiler identified 274 upregulated and 840 downregulated differentially expressed genes (DEGs), revealing perturbations in keratinization and immune system regulation. Samples of skin biopsies taken within 72 h post tick-bite DEGs had changes in protein metabolism and viral infection pathways as compared to samples taken 3 months post tick-bite, which instead displayed significant perturbations in several epigenetic regulatory pathways, highlighting the temporal nature of the host response following tick bites. Within-individual signatures distinguished tick-bitten samples from controls and identified between-individual signatures, offering promise for future biomarker discovery to guide prognosis and therapy.

8.
Iran J Public Health ; 53(5): 1047-1057, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38912133

RESUMEN

Background: Infectious outbreaks due to disrupted social and environmental conditions after climate change-induced events complicate disasters. This research aimed to determine the contentions of bioclimatic variables and extreme events on the prevalence of the most common Climate-Sensitive Infectious Disease (CSID); Malaria in Iran. Methods: The present narrative systematic review study was conducted on the bioclimatic variable impact on the prevalence of malaria, as a common CSID. The search was conducted in 3 sections: global climate change-related studies, disaster related, and studies that were conducted in Iran. The literature search was focused on papers published in English and Persian from Mar 2000 to Dec 2021, using electronic databases; Scopus, Web of Science, PubMed, Google Scholar, SID, Magiran, and IranDoc. Results: Overall, 41 studies met the inclusion criteria. The various types of climatic variables including; Temperature, rainfall, relative humidity, and hydrological events including; flood, drought, and cyclones has been reported as a predictor of malaria. The results of studies, inappropriately and often were inconsistent in both Iran and other parts of the world. Conclusion: Identifying malaria outbreak risks is essential to assess vulnerability, and a starting point to identify where the health system is required to reduce the vulnerability and exposure of the population. The finding of most related studies is not congruent to achieve reliable information, more extensive studies in all climates and regions of the country, by climatic models and high accuracy risk map, using the long period of bioclimatic variables and malaria trend is recommended.

9.
Infect Dis Poverty ; 13(1): 37, 2024 May 23.
Artículo en Inglés | MEDLINE | ID: mdl-38783378

RESUMEN

Natural, geographical barriers have historically limited the spread of communicable diseases. This is no longer the case in today's interconnected world, paired with its unprecedented environmental and climate change, emphasising the intersection of evolutionary biology, epidemiology and geography (i.e. biogeography). A total of 14 articles of the special issue entitled "Geography and health: role of human translocation and access to care" document enhanced disease transmission of diseases, such as malaria, leishmaniasis, schistosomiasis, COVID-19 (Severe acute respiratory syndrome corona 2) and Oropouche fever in spite of spatiotemporal surveillance. High-resolution satellite images can be used to understand spatial distributions of transmission risks and disease spread and to highlight the major avenue increasing the incidence and geographic range of zoonoses represented by spill-over transmission of coronaviruses from bats to pigs or civets. Climate change and globalization have increased the spread and establishment of invasive mosquitoes in non-tropical areas leading to emerging outbreaks of infections warranting improved physical, chemical and biological vector control strategies. The translocation of pathogens and their vectors is closely connected with human mobility, migration and the global transport of goods. Other contributing factors are deforestation with urbanization encroaching into wildlife zones. The destruction of natural ecosystems, coupled with low income and socioeconomic status, increase transmission probability of neglected tropical and zoonotic diseases. The articles in this special issue document emerging or re-emerging diseases and surveillance of fever symptoms. Health equity is intricately connected to accessibility to health care and the targeting of healthcare resources, necessitating a spatial approach. Public health comprises successful disease management integrating spatial surveillance systems, including access to sanitation facilities. Antimicrobial resistance caused, e.g. by increased use of antibiotics in health, agriculture and aquaculture, or acquisition of resistance genes, can be spread by horizontal gene transfer. This editorial reviews the key findings of this 14-article special issue, identifies important gaps relevant to our interconnected world and makes a number of specific recommendations to mitigate the transmission risks of infectious diseases in the post-COVID-19 pandemic era.


Asunto(s)
Accesibilidad a los Servicios de Salud , Zoonosis , Humanos , Animales , Zoonosis/epidemiología , COVID-19/transmisión , COVID-19/epidemiología , Enfermedades Transmisibles/epidemiología , Enfermedades Transmisibles/transmisión , SARS-CoV-2 , Geografía
10.
J Vet Diagn Invest ; 36(3): 338-345, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38693675

RESUMEN

We performed a diagnostic disease investigation on a cohort of coho salmon (Oncorhynchus kisutch) fingerlings in Alaska exhibiting anorexia, gaping mouths, anemia, and increased mortality. Histologic examination revealed mild-to-severe myocardial degeneration and lymphohistiocytic and neutrophilic myocarditis, moderate splenic histiocytosis, and mild renal histiocytosis. Piscine orthoreoviruses 1 and 3 were not detected by molecular methods, and no other viruses could be cultured on 3 common diagnostic fish cell lines. De novo assembly produced a viral genome of 10 linear segments with >80% homology to piscine orthoreovirus 2 (PRV2) encoding all 11 PRV2 proteins. An in situ hybridization probe using RNAscope was developed against 697 viral nucleotides identified by sequencing, which revealed viral genome in heart, spleen, gill, kidney, liver, blood, and the lamina propria of the intestines. Our findings are supportive of a novel piscine orthoreovirus most closely related to PRV2 associated with morbidity and mortality of coho salmon in the northeastern Pacific.


Asunto(s)
Enfermedades de los Peces , Oncorhynchus kisutch , Orthoreovirus , Infecciones por Reoviridae , Animales , Enfermedades de los Peces/virología , Enfermedades de los Peces/patología , Infecciones por Reoviridae/veterinaria , Infecciones por Reoviridae/virología , Orthoreovirus/genética , Orthoreovirus/aislamiento & purificación , Alaska , Oncorhynchus kisutch/virología , Filogenia , Genoma Viral , Distribución Tisular
11.
Infect Disord Drug Targets ; 24(4): 72-75, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38757699

RESUMEN

Background: With the emergence of vaccines for COVID-19, mortality and severity of disease have decreased. However, patients with certain comorbidities, such as immunosuppression, CKD, and renal transplant, still have higher mortality rates as compared to the general population. Current data suggests that the risk of developing COVID-19 among transplant patients was reported to be about 5%, which is significantly higher than the risk rate of 0.3% in the general population. Studies utilizing larger sample sizes (i.e., multiple cohorts, sites, hospitals) comparing COVID-19 outcomes among renal transplant patients with a control group are lacking.

Objective: The purpose of this descriptive study was to compare the mortality rate between vaccinated and unvaccinated kidney transplant recipients.

Methods: Participants were recruited at a community-based transplant clinic in West Texas.

Results: Among the group of participants who tested positive for COVID-19 between 2020 and 2022, higher mortality rates and longer hospital stays were noted among those unvaccinated (72% unvaccinated had greater than 5-day length of stay vs. 33% vaccinated).

Conclusion: Our study suggests that vaccination against COVID-19 decreases mortality rates in kidney transplant recipients.

.


Asunto(s)
COVID-19 , Trasplante de Riñón , Receptores de Trasplantes , Vacunación , Humanos , Masculino , COVID-19/prevención & control , COVID-19/mortalidad , COVID-19/epidemiología , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Receptores de Trasplantes/estadística & datos numéricos , Adulto , Anciano , Vacunas contra la COVID-19/administración & dosificación , Texas/epidemiología , SARS-CoV-2/inmunología , Tiempo de Internación/estadística & datos numéricos
13.
Sci Rep ; 14(1): 12582, 2024 05 31.
Artículo en Inglés | MEDLINE | ID: mdl-38822070

RESUMEN

Respiratory diseases, including influenza and coronaviruses, pose recurrent global threats. This study delves into the respiratory surveillance systems, focusing on the effectiveness of SARI sentinel surveillance for total and severe cases incidence estimation. Leveraging data from the COVID-19 pandemic in Chile, we examined 2020-2023 data (a 159-week period) comparing census surveillance results of confirmed cases and hospitalizations, with sentinel surveillance. Our analyses revealed a consistent underestimation of total cases and an overestimation of severe cases of sentinel surveillance. To address these limitations, we introduce a nowcasting model, improving the precision and accuracy of incidence estimates. Furthermore, the integration of genomic surveillance data significantly enhances model predictions. While our findings are primarily focused on COVID-19, they have implications for respiratory virus surveillance and early detection of respiratory epidemics. The nowcasting model offers real-time insights into an outbreak for public health decision-making, using the same surveillance data that is routinely collected. This approach enhances preparedness for emerging respiratory diseases by the development of practical solutions with applications in public health.


Asunto(s)
COVID-19 , Vigilancia de Guardia , Humanos , COVID-19/epidemiología , COVID-19/virología , Chile/epidemiología , SARS-CoV-2/aislamiento & purificación , Pandemias , Incidencia , Hospitalización/estadística & datos numéricos
14.
One Health ; 18: 100712, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38590630

RESUMEN

Brucellosis is an important zoonotic disease affecting animals and subsistence harvesters in the circumarctic. We investigated recent trends (2015-2022) of brucellosis seropositivity in caribou (Rangifer tarandus) and muskoxen (Ovibos moschatus) in the Central Canadian Arctic by using data from community-based wildlife health surveillance programs. The overall sample prevalence of Brucella antibodies was 10.0% (n = 271) in muskoxen and 15.5% (n = 277) in caribou. Sample seroprevalence in muskoxen varied geographically with an increasing trend of exposure on NW Victoria Island (from 0% to 36.8% between 2016 and 2022; Kendall tau = 0.283, p = 0.001). The presence of Brucella suis biovar 4 was confirmed by culture from clinical cases in this area. Our results indicate that Brucella suis biovar 4 continues to circulate in the Central Canadian Arctic in caribou and muskoxen and may be now circulating in muskoxen independently from caribou. These findings highlight the need to better understand the ecology and drivers of brucellosis emergence in Arctic multi-host systems.

15.
Artículo en Inglés | MEDLINE | ID: mdl-38584342

RESUMEN

AIMS: Current data suggest that SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) emerged from an animal source. However, to date, there is insufficient scientific evidence to identify the source of SARS-CoV-2 or to explain the original route of transmission to humans. A wide range of mammalian species have been shown to be susceptible to the virus through experimental infection, and in natural environments when in contact with infected humans. The main objective of this work was to provide a summary of the official data shared by countries on SARS-CoV-2 in animals with the World Organisation for Animal Health (WOAH), to highlight the role of WOAH as an international organization in coordinating scientific information actions and to discuss the implications and impact of these activities. METHODS AND RESULTS: Between January 2020 and December 2022, 36 countries in Europe, the Americas, Asia and Africa officially reported SARS-CoV-2 identification in 26 animal species. Affected countries were generally responsive in confirming the pathogen (median of 5 days after onset) and reporting to WOAH (median of 7 days after confirmation). CONCLUSIONS: During the pandemic, WOAH, supported by its network of experts, played a crucial role in collecting, analysing and disseminating veterinary scientific information, acting as the reference organization on these issues, thus avoiding misinformation and disinformation. Future perspectives to avoid new emerging threats are discussed.

17.
Life (Basel) ; 14(3)2024 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-38541673

RESUMEN

Bacillus anthracis is a well-known zoonotic pathogen that can cause disease in both animals and humans. Moreover, it has a high bioterrorism potential as its lethal spores are resistant to inactivation, are easy to produce in large quantities, and are easily spread over large areas. Anthrax cases occur in different parts of the world, including most European countries. Specific areas of Croatia are long known as anthrax districts, but with sporadically reported cases over the years. Here, we present a major outbreak of animal and human anthrax in the region of Lonjsko Polje in Croatia, a region not known to have anthrax cases in the past. The outbreak started in July 2022 and lasted several months, but most human and animal cases were reported in the first month. During the outbreak, there were 17 reported human cases of cutaneous anthrax and 29 laboratory-confirmed animal cases. However, due to issues in reporting in animals and the late finding of the carcasses, which made laboratory diagnostics challenging, the actual number of animal cases was probably significantly higher.

18.
Vet Clin North Am Food Anim Pract ; 40(2): 233-249, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38462420

RESUMEN

Transboundary animal diseases are defined by the Food and Agriculture Organization (FAO) of the United Nation's Emergency Prevention System as those diseases that are of significant economic, trade and/or food security importance, which can easily spread to other countries and reach epidemic proportions, and where control/management including exclusion requires cooperation among several countries. The Global Framework for the Progressive Control of Transboundary Animal Diseases represents a platform of the FAO and World Organisation for Animal Health to engage regional sub-regional organizations and national veterinary authorities in developing and monitoring progress in animal disease management efforts.


Asunto(s)
Enfermedades de los Animales , Animales , Enfermedades de los Animales/prevención & control , Enfermedades de los Animales/terapia , Control de Enfermedades Transmisibles , Salud Global , Medicina Veterinaria/organización & administración , Cooperación Internacional , Enfermedades Transmisibles/veterinaria , Enfermedades Transmisibles/terapia
19.
J Pept Sci ; 30(7): e3593, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38471710

RESUMEN

In recent decades, the global rise of viral emerging infectious diseases has posed a substantial threat to both human and animal health worldwide. The rapid spread and accumulation of mutations into viruses, and the limited availability of antiviral drugs and vaccines, stress the urgent need for alternative therapeutic strategies. Antimicrobial peptides (AMPs) derived from natural sources present a promising avenue due to their specificity and effectiveness against a broad spectrum of pathogens. The present study focuses on investigating the antiviral potential of oreochromicin-1 (oreoch-1), a fish-derived AMP obtained from Nile tilapia, against a wide panel of animal viruses including canine distemper virus (CDV), Schmallenberg virus (SBV), caprine herpesvirus 1 (CpHV-1), and bovine herpesvirus 1 (BoHV-1). Oreoch-1 exhibited a strong antiviral effect, demonstrating an inhibition of infection at concentrations in the micromolar range. The mechanism of action involves the interference with viral entry into host cells and a direct interaction between oreoch-1 and the viral envelope. In addition, we observed that the peptide could also interact with the cell during the CDV infection. These findings not only highlight the efficacy of oreoch-1 in inhibiting viral infection but also emphasize the potential of fish-derived peptides, specifically oreoch-1, as effective antiviral agents against viral infections affecting animals, whose potential to spill into humans is high. This research contributes valuable insights to the ongoing quest for novel antiviral drugs with the potential to mitigate the impact of infectious diseases on a global scale.


Asunto(s)
Antivirales , Animales , Antivirales/farmacología , Antivirales/química , Péptidos Antimicrobianos/farmacología , Péptidos Antimicrobianos/química , Humanos , Pruebas de Sensibilidad Microbiana , Chlorocebus aethiops , Internalización del Virus/efectos de los fármacos
20.
Heliyon ; 10(4): e25900, 2024 Feb 29.
Artículo en Inglés | MEDLINE | ID: mdl-38384562

RESUMEN

Background and objective: The Covid-19 pandemic could compromise the quality of care by impacting nurses' intention to provide care. Hence, investigating nurses' behavioral intentions when caring for patients during epidemics is essential. This research aims to assess the psychometrics of the "Nursing Care Behavior in Epidemics of Emerging Diseases" questionnaire, based on the constructs of the Theory of Planned Behavior. Methods: This cross-sectional study involved 311 nurses working in Covid-19 wards of selected hospitals in Ilam City, all of whom were enrolled through a census in 2021. The questionnaire underwent initial translation from English to Persian, followed by evaluations of its face, content, and construct validities. The nursing caring behavior questionnaire, comprising 46 items, was designed to assess behavioral beliefs, normative beliefs, control beliefs, behavioral attitudes, subjective norms, perceived behavioral control, and nurses' intentions to care for Covid-19 patients. Data were analyzed for face, content, and construct validity using the Theory of Planned Behavior and Pearson correlation. Reliability was determined by calculating the Cronbach's alpha coefficient. Results: The intention to care dimension demonstrated an inverse correlation with the behavioral attitude dimension (p < 0.001). The most robust correlations were observed between the following paired dimensions: behavioral attitude and perceived power (p < 0.001), subjective norms and intention to care (p < 0.001), perceived behavioral control and subjective norms (p < 0.001), care intention and behavioral beliefs (p < 0.001), behavioral beliefs and behavioral outcome evaluation (p < 0.001), and normative beliefs with motivation to comply (p = 0.001). The Cronbach's alpha coefficient of the instrument exceeded 0.75. Conclusion: According to the Theory of Planned Behavior, the nursing care behavior questionnaire proved to be a valid and reliable tool for evaluating nurses' care behaviors amidst emerging disease epidemics.

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