Epidemic intelligence data of Crimean-Congo haemorrhagic fever, European Region, 2012 to 2022: a new opportunity for risk mapping of neglected diseases.

BackgroundThe Epidemic Intelligence from Open Sources (EIOS) system, jointly developed by the World Health Organisation (WHO), the Joint Research Centre (JRC) of the European Commission and various partners, is a web-based platform that facilitate the monitoring of information on public health threats in near real-time from thousands of online sources.AimsTo assess the capacity of the EIOS system to strengthen data collection for neglected diseases of public health importance, and to evaluate the use of EIOS data for improving the understanding of the geographic extents of diseases and their level of risk.MethodsA Bayesian additive regression trees (BART) model was implemented to map the risk of Crimean-Congo haemorrhagic fever (CCHF) occurrence in 52 countries and territories within the European Region between January 2012 and March 2022 using data on CCHF occurrence retrieved from the EIOS system.ResultsThe model found a positive association between all temperature-related variables and the probability of CCHF occurrence, with an increased risk in warmer and drier areas. The highest risk of CCHF was found in the Mediterranean basin and in areas bordering the Black Sea. There was a general decreasing risk trend from south to north across the entire European Region.ConclusionThe study highlights that the information gathered by public health intelligence can be used to build a disease risk map. Internet-based sources could aid in the assessment of new or changing risks and planning effective actions in target areas.

Analysis of the drivers of ASF introduction into the officially approved pig compartments in South Africa and implications for the revision of biosecurity standards.

BACKGROUND: While African Swine Fever (ASF) virus has historically circulated in wild pigs and in Ornithodoros ticks in parts of South Africa, the virus has spread among domestic pigs throughout the country since 2019. South Africa's compartment system has been used as a mainstay approach to protecting the swine industry in the face of ASF. However, in 2020, two compartments broke down with ASF. The objectives of this study are to investigate the drivers for ASF introduction into the compartments, to categorize compartments by risk of ASF introduction, and to make corresponding recommendations. The relevance of risk factors for ASF introduction for each compartment were investigated among veterinarians and farm managers. The analysis of risk factors weighted according to an expert elicitation were used to categorize compartments into risk levels. RESULTS: Drivers of disease related to human behaviors and to domestic pig management are perceived by farm managers and veterinarians of the compartments to be critical for ASF introduction into compartments in South Africa. Twenty-four units were categorized as high risk, forty-seven as medium risk, and twenty-four as low risk. "Insufficient boot and clothing biosecurity by animal health personnel" was identified as a relevant risk factor in all high risk units. Other prominent risk factors were "insufficient boot and clothing biosecurity by external people," "underreporting of suspect ASF cases," "improper hunting/ culling of wild suids inside the compartment," "un-tested introductions into the herd," and "entry and contact with free-roaming pigs." The roles of wild pigs and competent vectors are considered minimal. There is a need for revision of the compartment standards and training of compartment personnel on the standards. The major gaps identified in the standards were absence of a monitoring programme to assess biosecurity implementation and suboptimal surveillance testing and audit strategies. CONCLUSIONS: The results of our study confirm that ASF is increasingly an anthropogenic problem. Updating the compartment standards and addressing gaps in the knowledge of compartment personnel on ASF are most critical. To enhance compliance with biosecurity measures and thus control the disease, close engagement with all stakeholders linked to the compartments is needed.

Is the COVID-19 pandemic impacting on the risk of African Swine Fever virus (ASFV) introduction into the United States? A short-term assessment of the risk factors.

African swine fever (ASF) is a contagious disease with high mortality in domestic and feral swine populations. Although it is not a zoonosis, its spread may have severe socio-economic and public health consequences. The activities of veterinary services are essential for controlling ASF outbreaks within a country, but also for diminishing its threat of spread to neighbouring countries, and for recognizing its entry into countries that are currently free. ASF requires quick responses and permanent monitoring to identify outbreaks and prevent spread, and both aspects can be heavily undercut during the COVID-19 pandemic. This paper analyses changing patterns of the main drivers and pathways for the potential introduction of ASFV into the United States during the COVID-19 pandemic, including international movements of people, swine products and by-products. Data on commercial flights and merchant ships was used as a proxy to indirectly assess the flow of illegal products coming from ASF affected countries. Results from this study highlight a decreasing trend in the legal imports of swine products and by-products from ASF affected countries (Sen's slope = -99, 95% CI: -215.34 to -21.26, p-value < 0.05), while no trend was detected for confiscations of illegal products at ports of entry. Additionally, increasing trends were detected for the monthly number of merchant ships coming from ASF affected countries (Sen's slope = 0.46, 95%CI 0.25-0.59), the monthly value of imported goods ($) through merchant ships (Sen's slope = 1513196160, 95%CI 1072731702-1908231855), and the monthly percentage of commercial flights (Sen's slope = 0.005, 95%CI 0.003-0.007), with the majority of them originating from China. Overall, the findings show an increased connection of the United States with ASF affected countries, highlighting the risk posed by ASF during a global public health crisis.

Integrating digital and field surveillance as complementary efforts to manage epidemic diseases of livestock: African swine fever as a case study.

SARS-CoV-2 has clearly shown that efficient management of infectious diseases requires a top-down approach which must be complemented with a bottom-up response to be effective. Here we investigate a novel approach to surveillance for transboundary animal diseases using African Swine (ASF) fever as a model. We collected data both at a population level and at the local level on information-seeking behavior respectively through digital data and targeted questionnaire-based surveys to relevant stakeholders such as pig farmers and veterinary authorities. Our study shows how information-seeking behavior and resulting public attention during an epidemic, can be identified through novel data streams from digital platforms such as Wikipedia. Leveraging attention in a critical moment can be key to providing the correct information at the right moment, especially to an interested cohort of people. We also bring evidence on how field surveys aimed at local workers and veterinary authorities remain a crucial tool to assess more in-depth preparedness and awareness among front-line actors. We conclude that these two tools should be used in combination to maximize the outcome of surveillance and prevention activities for selected transboundary animal diseases such as ASF.

Supporting control programs on African swine fever in Ukraine through a knowledge, attitudes, and practices survey targeting backyard farmers.

A Knowledge, Attitudes, and Practices (KAP) questionnaire was designed to collect information on farmers' knowledge of ASF and their practices surrounding that could impact the spread of the disease. The questionnaire was distributed, and data collected, from 233 backyard farmers from five selected Oblasts (Rivne, Kharkiv, Odessa, Zakarpattia and Kiev). Kruskal-Wallis tests were conducted to identify factors that could influence knowledge, and Dunn tests were performed to determine differences between groups when the Kruskal-Wallis tests were significant. Spearman tests were carried out to explore the association between knowledge and risky practices. Results show that comprehensive knowledge on ASF is not common in backyard farmers and that risky practices that influence the spread of ASF are regularly performed. Of the respondents, 47% felt well-informed about how ASF can be transmitted and 31.8% felt confident about recognizing clinical signs of ASF. The independent variable "Oblast" was identified as a significant factor (p = 0.0015) associated with differences in knowledge on clinical signs. We demonstrated statistically significant differences of knowledge between backyard farmers from different Oblasts. Knowledge of preventive measures was positively correlated with risky handling practices related to edible pork products (p = 0.0053) and non-edible pork products (p = 0.0417). In conclusion, our results show that backyard farmers have knowledge gaps on ASF and practice various risky behaviours that might favour the spread of the disease in Ukraine. There are regional differences in ASF knowledge and risky practices that should be taken into consideration in future evidence-based ASF prevention and control programs, including public awareness activities.

An Analysis of Rabies Incidence and Its Geographic Spread in the Buffer Area Among Orally Vaccinated Wildlife in Ukraine From 2012 to 2016.

The statistics of rabies cases in Volyn, Lviv, and Zakarpattia oblasts of Ukraine from 2012 to 2016 were analyzed to establish spatial-temporal distribution of rabies endemic outbreaks and to identify causes of widespread infections among wild and domestic animals. The occurrence of rabies outbreaks in wild and domestic animals in Ukraine was also assessed to determine the effectiveness of oral rabies vaccination (ORV) efforts. According to our analysis, parenteral vaccination of domestic animals and ORV campaigns in foxes have proved unsuccessful in providing a sustainable, long-term reduction in endemic rabies outbreaks. ORV campaigns in foxes were deemed ineffective based on our studies of the endemic rabies outbreaks in Volyn, Lviv, and Zakarpattia oblasts in 2012-2016. The current rabies prevention system (parenteral vaccination) failed to offer protection to domestic animals based on our review of the occurrence of endemic rabies outbreaks in dogs and cats. ORV campaign shortcomings and their causes must be identified in order to provide maximum rabies vaccine coverage for dogs and cats. Altogether, the results presented here provide information that can assist public health agencies to devise more effective disease control plans to curtail the spread of rabies in domestic animals and wildlife in Ukraine.

Genetic and spatial characterization of the red fox (Vulpes vulpes) population in the area stretching between the Eastern and Dinaric Alps and its relationship with rabies and canine distemper dynamics.

Information on the population dynamics of a reservoir species have been increasingly adopted to understand and eventually predict the dispersal patterns of infectious diseases throughout an area. Although potentially relevant, to date there are no studies which have investigated the genetic structure of the red fox population in relation to infectious disease dynamics. Therefore, we genetically and spatially characterised the red fox population in the area stretching between the Eastern and Dinaric Alps, which has been affected by both distemper and rabies at different time intervals. Red foxes collected from north-eastern Italy, Austria, Slovenia and Croatia between 2006-2012, were studied using a set of 21 microsatellite markers. We confirmed a weak genetic differentiation within the fox population using Bayesian clustering analyses, and we were able to differentiate the fox population into geographically segregated groups. Our finding might be due to the presence of geographical barriers that have likely influenced the distribution of the fox population, limiting in turn gene flow and spread of infectious diseases. Focusing on the Italian red fox population, we observed interesting variations in the prevalence of both diseases among distinct fox clusters, with the previously identified Italy 1 and Italy 2 rabies as well as distemper viruses preferentially affecting different sub-groups identified in the study. Knowledge of the regional-scale population structure can improve understanding of the epidemiology and spread of diseases. Our study paves the way for an integrated approach for disease control coupling pathogen, host and environmental data to inform targeted control programs in the future.

Seroprevalence of Rift Valley fever virus in cattle in the Democratic Republic of the Congo.

This study aimed at assessing the serological and virological status of Rift Valley fever virus (RVFV) in cattle from four climatically diverse zones of the Democratic Republic of the Congo (DRC). A total of 1675 sera samples collected between 2014 and 2015 from cattle without clinical manifestation of RVF infection were tested using competitive and capture enzyme ELISA to detect both IgG and IgM. RT-PCR was used for the detection of nucleic acid of RVFV. Out of the 1675 cattle sera tested, 203 were found to be IgG-positive, giving an overall true seroprevalence of 12.37% (95% CI 10.86-14.05). This seroprevalence varied between the four zones with a seroprevalence of 16.16% (95% CI 12.86-20.12), 14.70% (95% CI 11.72-18.29), 10.82% (95% CI 7.19-14.19), and 7.34% (95% CI 5.13-10.41) recorded in cattle sampled in the mountainous, humid savannah, dry savannah, and forest zones, respectively (p < 0.05, χ2 = 17.26). A higher true seroprevalence of 14.58% (95% CI 9.3-22.13) was found in animals aged 1 year compared to 10.43% (95% CI 8.12-13.30) and 13.16% (95% CI 11.19-15.42) in groups aged between 2-3 and > 3 years, respectively, although the difference was not statistically significant (p > 0.05, χ2 = 2.95). Similarly, no statistically significant difference (p > 0.05, χ2 = 0.04) was found between the sexes of the animals. Among the IgG-positive samples screened for anti-RVFV IgM, only 1.47% (3/203) was IgM-positive. One of the IgM-positive samples was positive by RT-PCR. These findings reveal country-wide distribution of RVF in the DRC for the first time.

Implementation of a Regional Training Program on African Swine Fever As Part of the Cooperative Biological Engagement Program across the Caucasus Region.

A training and outreach program to increase public awareness of African swine fever (ASF) was implemented by Defense Threat Reduction Agency and the Ministries of Agriculture in Armenia, Georgia, Kazakhstan, and Ukraine. The implementing agency was the company SAFOSO (Switzerland). Integration of this regional effort was administered by subject matter experts for each country. The main teaching effort of this project was to develop a comprehensive regional public outreach campaign through a network of expertise and knowledge for the control and prevention of ASF in four neighboring countries that experience similar issues with this disease. Gaps in disease knowledge, legislation, and outbreak preparedness in each country were all addressed. Because ASF is a pathogen with bioterrorism potential and of great veterinary health importance that is responsible for major economic instability, the project team developed public outreach programs to train veterinarians in the partner countries to accurately and rapidly identify ASF activity and report it to international veterinary health agencies. The project implementers facilitated four regional meetings to develop this outreach program, which was later disseminated in each partner country. Partner country participants were trained as trainers to implement the outreach program in their respective countries. In this paper, we describe the development, execution, and evaluation of the ASF training and outreach program that reached more than 13,000 veterinarians, farmers, and hunters in the partner countries. Additionally, more than 120,000 booklets, flyers, leaflets, guidelines, and posters were distributed during the outreach campaign. Pre- and post-ASF knowledge exams were developed. The overall success of the project was demonstrated in that the principles of developing and conducting a public outreach program were established, and these foundational teachings can be applied within a single country or expanded regionally to disseminate disease information across borders; overall, this method can be modified to raise awareness about many other diseases.

Assessment of biosecurity and control measures to prevent incursion and to limit spread of emerging transboundary animal diseases in Europe: An expert survey.

Decision-makers and risk managers are often called upon to prioritise on and recommend suitable measures to prevent the risk of introduction and spread of pathogens. The main objective of this study was to assess the perceptions of experts in Italy, Switzerland and the United Kingdom concerning the importance, effectiveness, feasibility, costs and acceptability of selected biosecurity measures to prevent the introduction and limit the spread of rabies, blue tongue (BT) and classical swine fever (CSF). After identifying the most relevant measures by the project team, an expert knowledge elicitation was implemented through a questionnaire. After preliminary descriptive analyses, a number of statistical calculations were performed such as weighted medians, Spearman rank correlation tests, Wilcoxon comparison tests and ranking of measures. Three experts from each country completed the questionnaires, one expert for each disease. The mean answer rates for CSF, BT and rabies were 73%, 100% and 99% respectively. "Tracing system for live animal trade" was highlighted as very relevant in all diseases. The implementation of a "restriction zone after a suspicion or confirmation" was also rated as a relevant measure, especially for CSF. We identified generally a small correlation between costs and the other criteria. Among the rabies experts, measures related to "zoonotic risk" were rated highly, supporting the idea of a One Health approach. Disagreement among experts concerned 43 measures for the three pathogens: the debated measures were "control of the wildlife CSF status", "arthropod-vector control" and "rabies vaccination for domestic animals". Facing budget restriction, decision-makers need to prioritise their actions and make efficient prevention choices. With this study, we aimed to provide elements for reflection and to inform priority setting. The results can be applied through the implementation of similar surveys or directly from the knowledge already gathered in this study.

Epidemiological Risk Factors for Animal Influenza A Viruses Overcoming Species Barriers.

Drivers and risk factors for Influenza A virus transmission across species barriers are poorly understood, despite the ever present threat to human and animal health potentially on a pandemic scale. Here we review the published evidence for epidemiological risk factors associated with influenza viruses transmitting between animal species and from animals to humans. A total of 39 papers were found with evidence of epidemiological risk factors for influenza virus transmission from animals to humans; 18 of which had some statistical measure associated with the transmission of a virus. Circumstantial or observational evidence of risk factors for transmission between animal species was found in 21 papers, including proximity to infected animals, ingestion of infected material and potential association with a species known to carry influenza virus. Only three publications were found which presented a statistical measure of an epidemiological risk factor for the transmission of influenza between animal species. This review has identified a significant gap in knowledge regarding epidemiological risk factors for the transmission of influenza viruses between animal species.

Genetic Adaptation of Influenza A Viruses in Domestic Animals and Their Potential Role in Interspecies Transmission: A Literature Review.

In December 2011, the European Food Safety Authority awarded a Grant for the implementation of the FLURISK project. The main objective of FLURISK was the development of an epidemiological and virological evidence-based influenza risk assessment framework (IRAF) to assess influenza A virus strains circulating in the animal population according to their potential to cross the species barrier and cause infections in humans. With the purpose of gathering virological data to include in the IRAF, a literature review was conducted and key findings are presented here. Several adaptive traits have been identified in influenza viruses infecting domestic animals and a significance of these adaptations for the emergence of zoonotic influenza, such as shift in receptor preference and mutations in the replication proteins, has been hypothesized. Nonetheless, and despite several decades of research, a comprehensive understanding of the conditions that facilitate interspecies transmission is still lacking. This has been hampered by the intrinsic difficulties of the subject and the complexity of correlating environmental, viral and host factors. Finding the most suitable and feasible way of investigating these factors in laboratory settings represents another challenge. The majority of the studies identified through this review focus on only a subset of species, subtypes and genes, such as influenza in avian species and avian influenza viruses adapting to humans, especially in the context of highly pathogenic avian influenza H5N1. Further research applying a holistic approach and investigating the broader influenza genetic spectrum is urgently needed in the field of genetic adaptation of influenza A viruses.

Influenza Virus Infection of Marine Mammals.

Interspecies transmission may play a key role in the evolution and ecology of influenza A viruses. The importance of marine mammals as hosts or carriers of potential zoonotic pathogens such as highly pathogenic H5 and H7 influenza viruses is not well understood. The fact that influenza viruses are some of the few zoonotic pathogens known to have caused infection in marine mammals, evidence for direct transmission of influenza A virus H7N7 subtype from seals to man, transmission of pandemic H1N1 influenza viruses to seals and also limited evidence for long-term persistence of influenza B viruses in seal populations without significant genetic change, makes monitoring of influenza viruses in marine mammal populations worth being performed. In addition, such monitoring studies could be a great tool to better understand the ecology of influenza viruses in nature.

Gold nanowired: a linear (Au25)(n) polymer from Au25 molecular clusters.

Au25(SR)18 has provided fundamental insights into the properties of clusters protected by monolayers of thiolated ligands (SR). Because of its ultrasmall core, 1 nm, Au25(SR)18 displays molecular behavior. We prepared a Au25 cluster capped by n-butanethiolates (SBu), obtained its structure by single-crystal X-ray crystallography, and studied its properties both experimentally and theoretically. Whereas in solution Au25(SBu)18(0) is a paramagnetic molecule, in the crystal it becomes a linear polymer of Au25 clusters connected via single Au-Au bonds and stabilized by proper orientation of clusters and interdigitation of ligands. At low temperature, [Au25(SBu)18(0)]n has a nonmagnetic ground state and can be described as a one-dimensional antiferromagnetic system. These findings provide a breakthrough into the properties and possible solid-state applications of molecular gold nanowires.

Electron transfer through 3D monolayers on Au25 clusters.

The monolayer protecting small gold nanoparticles (monolayer-protected clusters, MPCs) is generally represented as the 3D equivalent of 2D self-assembled monolayers (SAMs) on extended gold surfaces. However, despite the growing relevance of MPCs in important applied areas, such as catalysis and nanomedicine, our knowledge of the structure of 3D SAMs in solution is still extremely limited. We prepared a large series of monodisperse Au25(SCnH2n+1)18 clusters (n=2, 4, 6, 8, 10, 12, 14, 16, 18) and studied how electrons tunnel through these monolayers. Electron transfer results, nicely supported by 1H NMR spectroscopy, IR absorption spectroscopy, and molecular dynamics results, show that there is a critical ligand length marking the transition between short ligands, which form a quite fluid monolayer structure, and longer alkyl chains, which self-organize into bundles. At variance with the truly protecting 2D SAMs, efficient electronic communication of the Au25 core with the outer environment is thus possible even for long alkyl chains. These conclusions provide a different picture of how an ultrasmall gold core talks with the environment through/with its protecting but not-so-shielding monolayer.

Rabies and canine distemper virus epidemics in the red fox population of northern Italy (2006-2010).

Since 2006 the red fox (Vulpes vulpes) population in north-eastern Italy has experienced an epidemic of canine distemper virus (CDV). Additionally, in 2008, after a thirteen-year absence from Italy, fox rabies was re-introduced in the Udine province at the national border with Slovenia. Disease intervention strategies are being developed and implemented to control rabies in this area and minimise risk to human health. Here we present empirical data and the epidemiological picture relating to these epidemics in the period 2006-2010. Of important significance for epidemiological studies of wild animals, basic mathematical models are developed to exploit information collected from the surveillance program on dead and/or living animals in order to assess the incidence of infection. These models are also used to estimate the rate of transmission of both diseases and the rate of vaccination, while correcting for a bias in early collection of CDV samples. We found that the rate of rabies transmission was roughly twice that of CDV, with an estimated effective contact between infected and susceptible fox leading to a new infection occurring once every 3 days for rabies, and once a week for CDV. We also inferred that during the early stage of the CDV epidemic, a bias in the monitoring protocol resulted in a positive sample being almost 10 times more likely to be collected than a negative sample. We estimated the rate of intake of oral vaccine at 0.006 per day, allowing us to estimate that roughly 68% of the foxes would be immunised. This was confirmed by field observations. Finally we discuss the implications for the eco-epidemiological dynamics of both epidemics in relation to control measures.

Investigation of the inner environment of carbon nanotubes with a fullerene-nitroxide probe.

A fulleropyrrolidine bearing a nitroxide free radical has been inserted into single-walled carbon nanotubes with the aid of supercritical CO2. Thanks to the encapsulated paramagnetic probes, it has been possible to detect and characterize the resulting peapod-like structure through electron paramagnetic resonance (EPR) spectroscopy. In particular, the analysis of spectral parameters derived from extensive EPR studies has elucidated the orientation and the residual rotational dynamics of the molecules embedded in the nanotubes. A limited anisotropic rotational freedom of the encapsulated fullerene nitroxide reveals a rather strong interaction of the probe with the surrounding nanotube walls. The interaction seems to involve the fullerene cage (as confirmed by Raman spectroscopy) and not the nitroxide moiety, whose EPR spectral characteristics, such as the isotropic hyperfine constant and the g-tensor, remain unaltered after encapsulation.

Estrategias para el diseño sistematico de un PACS institucional / Strategies for the sistematic design of institutional PACS

Cuando se encara el diseño de un PACS (Picture Archiving and Communications Systems - Sistemas de Almacenamiento y Comunicacion de Imagenes Medicas), se debe tener claro que se trata de un sistema donde las especificaciones estan relacionados directamente con el lugar en donde sera instalado. Por este motivo es dificil encontrar plantillas o modelos que se puedan adaptar a distintas soluciones. Este trabajo intenta desarrollar un metodo sistematico de evaluacion de PACS instalados con el fin de asimilar y utilizar los logros de otros centros. Por otro lado, establece una forma estructurada de trabajo, para el dimensionamiento y descripcion de los requerimientos de un sistema. El metodo mencionado hace uso de relaciones de productividad y eficiencia adimensionales, caracteristica que le permite analizar los PACS, independizandose de la envergadura de este. Entre sus etapas contempla, el relevamiento de la institucion donde se implementara dicho sistema, el formulario de encuesta para la evaluacion de sistemas existentes, la investigacion de la tecnologia disponible en el mercado y un procedimiento de seleccion de dispositivos para obtener la mejor relacion costo / beneficio