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1.
BMC Public Health ; 20(1): 1486, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32998719

RESUMO

BACKGROUND: The state of Ceará (Northeast Brazil) has shown a high incidence of coronavirus disease (COVID-19), and most of the cases that were diagnosed during the epidemic originated from the capital Fortaleza. Monitoring the dynamics of the COVID-19 epidemic is of strategic importance and requires the use of sensitive tools for epidemiological surveillance, including consistent analyses that allow the recognition of areas with a greater propensity for increased severity throughout the cycle of the epidemic. This study aims to classify neighborhoods in the city of Fortaleza according to their propensity for a severe epidemic of COVID-19 in 2020. METHODS: We conducted an ecological study within the geographical area of the 119 neighborhoods located in the city of Fortaleza. To define the main transmission networks (infection chains), we assumed that the spatial diffusion of the COVID-19 epidemic was influenced by population mobility. To measure the propensity for a severe epidemic, we calculated the infectivity burden (ItyB), infection burden (IonB), and population epidemic vulnerability index (PEVI). The propensity score for a severe epidemic in the neighborhoods of the city of Fortaleza was estimated by combining the IonB and PEVI. RESULTS: The neighborhoods with the highest propensity for a severe COVID-19 epidemic were Aldeota, Cais do Porto, Centro, Edson Queiroz, Vicente Pinzon, Jose de Alencar, Presidente Kennedy, Papicu, Vila Velha, Antonio Bezerra, and Cambeba. Importantly, we found that the propensity for a COVID-19 epidemic was high in areas with differing socioeconomic profiles. These areas include a very poor neighborhood situated on the western border of the city (Vila Velha), neighborhoods characterized by a large number of subnormal agglomerates in the Cais do Porto region (Vicente Pinzon), and those located in the oldest central area of the city, where despite the wealth, low-income groups have remained (Aldeota and the adjacent Edson Queiroz). CONCLUSION: Although measures against COVID-19 should be applied to the entire municipality of Fortaleza, the classification of neighborhoods generated through this study can help improve the specificity and efficiency of these measures.


Assuntos
Infecções por Coronavirus/epidemiologia , Epidemias , Pneumonia Viral/epidemiologia , Características de Residência/estatística & dados numéricos , Brasil/epidemiologia , Cidades/epidemiologia , Humanos , Incidência , Pandemias
2.
F1000Res ; 9: 232, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32864101

RESUMO

Since the first identified case of COVID-19 in Wuhan, China, the disease has developed into a pandemic, imposing a major challenge for health authorities and hospitals worldwide. Mathematical transmission models can help hospitals to anticipate and prepare for an upcoming wave of patients by forecasting the time and severity of infections. Taking the city of Heidelberg as an example, we predict the ongoing spread of the disease for the next months including hospital and ventilator capacity and consider the possible impact of currently imposed countermeasures.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Modelos Teóricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Betacoronavirus , Cidades/epidemiologia , Alemanha/epidemiologia , Humanos , Pandemias
3.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(5): 576-581, 2020 May 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879110

RESUMO

OBJECTIVES: To explore and analyze the epidemic features of coronavirus disease 2019 (COVID-19) in Hunan Province from January 21, 2020 to March 14, 2020, as well as to investigate the COVID-19 epidemics in each city of Hunan Province. METHODS: The epidemic data was obtained from the official website of Hunan Province's Health Commission. The data of each city of Hunan Province was analyzed separately. Spatial distribution of cumulative confirmed COVID-19 patients and the cumulative occurrence rate was drawn by ArcGIS software for each city in Hunan Province. Some regional indexes were also compared with that in the whole country. RESULTS: The first patient was diagnosed in January 21, sustained patient growth reached its plateau in around February 17. Up to March 14, the cumulative confirmed COVID-19 patients stopped at 1 018. The cumulative occurrence rate of COVID-19 patients was 0.48 per 0.1 million person. The number of cumulative severe patients was 150 and the number of cumulative dead patients was 4. The mortality rate (0.39%) and the cure rate (99.6%) in Hunan Province was significantly lower and higher respectively than the corresponding average rate in the whole country (0.90% and 96.2%, Hubei excluded). The first 3 cities in numbers of the confirmed patients were Changsha, Yueyang, and Shaoyang. While sorted by the cumulative occurrence rate, the first 3 cities in incidence were Changsha, Yueyang, and Zhuzhou. CONCLUSIONS: The epidemic of COVID-19 spread out smoothly in Hunan Province. The cities in Hunan Province implement anti-disease strategies based on specific situations on their own and keep the epidemic in the range of controllable.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Betacoronavirus , China/epidemiologia , Cidades/epidemiologia , Humanos , Pandemias
4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1319-1323, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867443

RESUMO

Objective: To understand the characteristics of spatiotemporal clustering on hepatitis A in Gansu province and to provide evidence for hepatitis A prevention and control. Methods: Data related to hepatitis A were retrieved from National Notifiable Disease Report System, ArcGIS 10.3 and SaTScan 9.1 in Gansu province from 2004 to 2018. Results: The annual average report incidence rate of hepatitis A was 10.91/100 000, showing a descending trend with no periodic or seasonal features. After the implementation of national expanded immunization program, high annual incidence rates had been seen in Linxia Hui autonomous prefecture and Gannan Tibetan autonomous prefecture. From 2004 to 2012, the lowest RR value appeared in the 0-9 age group (P=0.000) while the highest RR value was in the over 60 age group during 2013-2018 except for the age 0-9 group in 2015. The annual average incidence rate was increasing from south to north and west to east, across the territory. Results from the temporal scanning program revealed that the incidence of hepatitis A was temporally aggregated from 2004 to 2018. For spatio-temporal scanning of 2004-2008, data showed one most likely cluster area (radius: 91.95 km, Time frame: 2004-2005), apparel mainly in Linxia and Longnan cities. Results from the spatio-temporal scanning program of 2009-2018 also showed that the most likely cluster areas (radius: 183.26 km, Time frame: 2009-2012) were in Gannan, Linxia, Dingxi and Longnan areas. Conclusions: The reported incidence rates of hepatitis A were declining, without significant periodic or seasonal pattern in Gansu province from 2004 to 2018. In the 0-9 years-old group, the incidence rate showed the lowest, while the highest was in the 60 year-olds group. Spatio-temporal clustering of hepatitis A was observed in Gansu province from 2004 to 2018. Strategies on prevention and control of the disease should be targeted in the southwest regions of the province.


Assuntos
Hepatite A/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Cidades/epidemiologia , Análise por Conglomerados , Humanos , Incidência , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Análise Espaço-Temporal
5.
Proc Natl Acad Sci U S A ; 117(39): 24180-24187, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32913057

RESUMO

Standard epidemiological models for COVID-19 employ variants of compartment (SIR or susceptible-infectious-recovered) models at local scales, implicitly assuming spatially uniform local mixing. Here, we examine the effect of employing more geographically detailed diffusion models based on known spatial features of interpersonal networks, most particularly the presence of a long-tailed but monotone decline in the probability of interaction with distance, on disease diffusion. Based on simulations of unrestricted COVID-19 diffusion in 19 US cities, we conclude that heterogeneity in population distribution can have large impacts on local pandemic timing and severity, even when aggregate behavior at larger scales mirrors a classic SIR-like pattern. Impacts observed include severe local outbreaks with long lag time relative to the aggregate infection curve, and the presence of numerous areas whose disease trajectories correlate poorly with those of neighboring areas. A simple catchment model for hospital demand illustrates potential implications for health care utilization, with substantial disparities in the timing and extremity of impacts even without distancing interventions. Likewise, analysis of social exposure to others who are morbid or deceased shows considerable variation in how the epidemic can appear to individuals on the ground, potentially affecting risk assessment and compliance with mitigation measures. These results demonstrate the potential for spatial network structure to generate highly nonuniform diffusion behavior even at the scale of cities, and suggest the importance of incorporating such structure when designing models to inform health care planning, predict community outcomes, or identify potential disparities.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Betacoronavirus , Cidades/epidemiologia , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde , Demografia , Disparidades nos Níveis de Saúde , Humanos , Modelos Estatísticos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Rede Social , Estados Unidos/epidemiologia
6.
Global Health ; 16(1): 85, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967691

RESUMO

OBJECTIVES: Restricting mobility is a central aim for lowering contact rates and preventing COVID-19 transmission. Yet the impact on mobility of different non-pharmaceutical countermeasures in the earlier stages of the pandemic is not well-understood. DESIGN: Trends were evaluated using Citymapper's mobility index covering 2nd to 26th March 2020, expressed as percentages of typical usage periods from 0% as the lowest and 100% as normal. China and India were not covered. Multivariate fixed effects models were used to estimate the association of policies restricting movement on mobility before and after their introduction. Policy restrictions were assessed using the Oxford COVID-19 Government Response Stringency Index as well as measures coding the timing and degree of school and workplace closures, transport restrictions, and cancellation of mass gatherings. SETTING: 41 cities worldwide. MAIN OUTCOME MEASURES: Citymapper's mobility index. RESULTS: Mobility declined in all major cities throughout March. Larger declines were seen in European than Asian cities. The COVID-19 Government Response Stringency Index was strongly associated with declines in mobility (r = - 0.75, p < 0.001). After adjusting for time-trends, we observed that implementing non-pharmaceutical countermeasures was associated with a decline of mobility of 10.0% for school closures (95% CI: 4.36 to 15.7%), 15.0% for workplace closures (95% CI: 10.2 to 19.8%), 7.09% for cancelling public events (95% CI: 1.98 to 12.2%), 18.0% for closing public transport (95% CI: 6.74 to 29.2%), 13.3% for restricting internal movements (95% CI: 8.85 to 17.8%) and 5.30% for international travel controls (95% CI: 1.69 to 8.90). In contrast, as expected, there was no association between population mobility changes and fiscal or monetary measures or emergency healthcare investment. CONCLUSIONS: Understanding the effect of public policy on mobility in the early stages is crucial to slowing and reducing COVID-19 transmission. By using Citymapper's mobility index, this work provides the first evidence about trends in mobility and the impacts of different policy interventions, suggesting that closure of public transport, workplaces and schools are particularly impactful.


Assuntos
Infecções por Coronavirus/prevenção & controle , Saúde Global , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Viagem/estatística & dados numéricos , Cidades/epidemiologia , Infecções por Coronavirus/epidemiologia , Sistemas de Informação Geográfica , Humanos , Pneumonia Viral/epidemiologia , Política Pública , Fatores de Tempo , Viagem/legislação & jurisprudência , Voluntários
7.
MMWR Morb Mortal Wkly Rep ; 69(37): 1319-1323, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32941418

RESUMO

Reports suggest that children aged ≥10 years can efficiently transmit SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1,2). However, limited data are available on SARS-CoV-2 transmission from young children, particularly in child care settings (3). To better understand transmission from young children, contact tracing data collected from three COVID-19 outbreaks in child care facilities in Salt Lake County, Utah, during April 1-July 10, 2020, were retrospectively reviewed to explore attack rates and transmission patterns. A total of 184 persons, including 110 (60%) children had a known epidemiologic link to one of these three facilities. Among these persons, 31 confirmed COVID-19 cases occurred; 13 (42%) in children. Among pediatric patients with facility-associated confirmed COVID-19, all had mild or no symptoms. Twelve children acquired COVID-19 in child care facilities. Transmission was documented from these children to at least 12 (26%) of 46 nonfacility contacts (confirmed or probable cases). One parent was hospitalized. Transmission was observed from two of three children with confirmed, asymptomatic COVID-19. Detailed contact tracing data show that children can play a role in transmission from child care settings to household contacts. Having SARS-CoV-2 testing available, timely results, and testing of contacts of persons with COVID-19 in child care settings regardless of symptoms can help prevent transmission. CDC guidance for child care programs recommends the use of face masks, particularly among staff members, especially when children are too young to wear masks, along with hand hygiene, frequent cleaning and disinfecting of high-touch surfaces, and staying home when ill to reduce SARS-CoV-2 transmission (4).


Assuntos
Creches , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Surtos de Doenças , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Adolescente , Adulto , Idoso , Betacoronavirus/isolamento & purificação , Criança , Pré-Escolar , Cidades/epidemiologia , Técnicas de Laboratório Clínico , Busca de Comunicante , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pandemias , Utah/epidemiologia , Adulto Jovem
8.
Proc Natl Acad Sci U S A ; 117(39): 24575-24580, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32887803

RESUMO

In the late stages of an epidemic, infections are often sporadic and geographically distributed. Spatially structured stochastic models can capture these important features of disease dynamics, thereby allowing a broader exploration of interventions. Here we develop a stochastic model of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission among an interconnected group of population centers representing counties, municipalities, and districts (collectively, "counties"). The model is parameterized with demographic, epidemiological, testing, and travel data from Ontario, Canada. We explore the effects of different control strategies after the epidemic curve has been flattened. We compare a local strategy of reopening (and reclosing, as needed) schools and workplaces county by county, according to triggers for county-specific infection prevalence, to a global strategy of province-wide reopening and reclosing, according to triggers for province-wide infection prevalence. For trigger levels that result in the same number of COVID-19 cases between the two strategies, the local strategy causes significantly fewer person-days of closure, even under high intercounty travel scenarios. However, both cases and person-days lost to closure rise when county triggers are not coordinated and when testing rates vary among counties. Finally, we show that local strategies can also do better in the early epidemic stage, but only if testing rates are high and the trigger prevalence is low. Our results suggest that pandemic planning for the far side of the COVID-19 epidemic curve should consider local strategies for reopening and reclosing.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Betacoronavirus , Cidades/epidemiologia , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Humanos , Modelos Estatísticos , Ontário/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Prevalência , Processos Estocásticos , Viagem
9.
PLoS One ; 15(9): e0239699, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32966344

RESUMO

The current outbreak of the coronavirus disease 2019 (COVID-19) is an unprecedented example of how fast an infectious disease can spread around the globe (especially in urban areas) and the enormous impact it causes on public health and socio-economic activities. Despite the recent surge of investigations about different aspects of the COVID-19 pandemic, we still know little about the effects of city size on the propagation of this disease in urban areas. Here we investigate how the number of cases and deaths by COVID-19 scale with the population of Brazilian cities. Our results indicate small towns are proportionally more affected by COVID-19 during the initial spread of the disease, such that the cumulative numbers of cases and deaths per capita initially decrease with population size. However, during the long-term course of the pandemic, this urban advantage vanishes and large cities start to exhibit higher incidence of cases and deaths, such that every 1% rise in population is associated with a 0.14% increase in the number of fatalities per capita after about four months since the first two daily deaths. We argue that these patterns may be related to the existence of proportionally more health infrastructure in the largest cities and a lower proportion of older adults in large urban areas. We also find the initial growth rate of cases and deaths to be higher in large cities; however, these growth rates tend to decrease in large cities and to increase in small ones over time.


Assuntos
Infecções por Coronavirus/transmissão , Pneumonia Viral/transmissão , Densidade Demográfica , Distribuição por Idade , Betacoronavirus , Brasil/epidemiologia , Cidades/epidemiologia , Serviços de Saúde/provisão & distribução , Serviços de Saúde/tendências , Humanos , Pandemias/estatística & dados numéricos , Fatores de Tempo
10.
Med Sci Monit ; 26: e925974, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32973126

RESUMO

BACKGROUND Coronavirus disease 2019 (COVID-19) is a new infectious disease, and acute respiratory syndrome (ARDS) plays an important role in the process of disease aggravation. The detailed clinical course and risk factors of ARDS have not been well described. MATERIAL AND METHODS We retrospectively investigated the demographic, clinical, and laboratory data of adult confirmed cases of COVID-19 in Beijing Ditan Hospital from Jan 20 to Feb 29, 2020 and compared the differences between ARDS cases and non-ARDS cases. Univariate and multivariate logistic regression methods were employed to explore the risk factors associated with ARDS. RESULTS Of the 130 adult patients enrolled in this study, the median age was 46.5 (34-62) years and 76 (58.5%) were male. ARDS developed in 26 (20.0%) and 1 (0.8%) death occurred. Fever occurred in 114 patients, with a median highest temperature of 38.5 (38-39)°C and median fever duration of 8 (3-11) days. The median time from illness onset to ARDS was 10 (6-13) days, the median time to chest CT improvement was 17 (14-21) days, and median time to negative nucleic acid test result was 27 (17-33) days. Multivariate regression analysis showed increasing odds of ARDS associated with age older than 65 years (OR=4.75, 95% CL1.26-17.89, P=0.021), lymphocyte counts [0.5-1×109/L (OR=8.80, 95% CL 2.22-34.99, P=0.002); <0.5×109/L(OR=36.23, 95% CL 4.63-2083.48, P=0.001)], and temperature peak ≥39.1°C (OR=5.35, 95% CL 1.38-20.76, P=0.015). CONCLUSIONS ARDS tended to occur in the second week of the disease course. Potential risk factors for ARDS were older age (>65 years), lymphopenia (≤1.0×109/L), and temperature peak (≥39.1°C). These findings could help clinicians to predict which patients will have a poor prognosis at an early stage.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pandemias , Pneumonia Viral/complicações , Síndrome do Desconforto Respiratório do Adulto/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Bacterianas/etiologia , China , Cidades/epidemiologia , Comorbidade , Infecções por Coronavirus/epidemiologia , Feminino , Febre/etiologia , Humanos , Modelos Logísticos , Linfopenia/etiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Fatores de Risco
11.
Rev Bras Epidemiol ; 23: e200061, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32785450

RESUMO

OBJECTIVES: This study aims to describe the actions carried out by the epidemiological surveillance system in Belo Horizonte to address the COVID-19 epidemic and the timeless of the data for detecting transmission in 2020. METHODS: The sources of information used by the epidemiological surveillance of the municipality for COVID-19 were identified and the temporal distribution and interval for detection of confirmed cases of the disease were analyzed. RESULTS: The city's epidemiological surveillance uses outpatient, hospital, public and private laboratory notifications as data sources. For reporting COVID-19 cases in official information systems, there is also an active search of laboratory results linked to suspected deaths investigated. From January to April 2020, 1,449 hospitalized cases of COVID-19 were reported, the first case being detected in late February 2020. Of the total 1,025 laboratory samples of cases hospitalized after the 8th epidemiological week, 87 (8.5%) of COVID-19 cases were confirmed. The median time between the onset of symptoms and the release of laboratory results was 12 days for the analyzed period. CONCLUSION: Epidemiological surveillance uses several data sources to monitor and analyze the transmission of COVID-19. The timeliness of this system to detect cases of the disease is compromised by the delay in the release of laboratory results, which has been a considerable challenge for adequate surveillance.


Assuntos
Infecções por Coronavirus/epidemiologia , Epidemias , Monitoramento Epidemiológico , Pneumonia Viral/epidemiologia , Vigilância da População , Brasil/epidemiologia , Cidades/epidemiologia , Infecções por Coronavirus/mortalidade , Humanos , Pandemias , Pneumonia Viral/mortalidade
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1063-1067, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741171

RESUMO

Objective: To analyze the epidemiological characteristics of human brucellosis (HB), evolution and origin feature of Brucella strains in Tongliao city, Inner Mongolia Autonomous Region during 2004-2018, and to provide evidence for strategy development against the disease. Methods: Data from the reports on HB in Tongliao during 2004-2018 were extracted from the China Information System for Disease Control and Prevention before being analyzed with software Excel 2016. Epidemiologic feature was described, using the number of cases, constituent ratio and related rates. Conventional biotypes methods were used for identification of species/biovars strains while species of six Brucella strains were further verified by AMOS-PCR. Cluster analyze on six Brucella strains were performed with Bio-Numerics 5.0 software and for examining and revealing the genetic characteristics of the related strains. Results: During 2004-2018, a total of 16 704 HB cases were reported, with the incidence rate as 35.41/100 000. The incidence rates appeared as 110.51/100 000 in Jarud Banner and 67.84/100 000 in Kulun flag, which were both higher than the other areas. Most of the cases were reported in the 40-54 year olds, which accounted for 48.75% (8 143/16 704). The number of HB in farmers appeared as 14 873, which counted for 89.04% (14 873/16 704) of all the cases. Male to female ratio of incidence was 2.40∶1. Most of the reported cases appeared between March to May, which accounted for 56.30% (9 405/16 704). Peak of the disease was seen in April. Using the conventional identification method, results showed that the available six strains all belonged to B. melitensis, including three of them as B. melitensis bv.1 and others three strains as B. melitensis bv. 3. Results from the amplified AMOS-PCR showed that all the strains were B. melitensis. The six strains clustered in two MLVA-11 genotypes (111 and 116) and all belonged to the Eastern Mediterranean lineage. Based on the MLVA-16 cluster analysis, results suggested that strains from this study were having close genetic relationship with B. melitensis strains that were from Jilin and Heilongjiang provinces. Conclusions: Human brucellosis identified in Tongliao area was with greater risk in spreading the disease to the vicinity. Our findings indicated that the programs on detection and control of the disease should be strengthened.


Assuntos
Brucelose/epidemiologia , Brucelose/microbiologia , Adulto , Brucella/genética , Brucella/isolamento & purificação , Brucelose/prevenção & controle , China/epidemiologia , Cidades/epidemiologia , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade
14.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(8): 817-821, 2020 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-32842308

RESUMO

COVID-19 is a public health emergency currently. In this study, a scale-free network model is established based on the Spring Migration data in 2020.The cities is clustered into three different modules. The epidemic of the cities in the black module was the most serious, followed by the red and the cyan. The black module contains 9 cities in Zhejiang province and 8 cities in Guangdong province, most of them located in the southeast coastal economic belt. These cities should be the key cities for epidemic prevention and control.


Assuntos
Planejamento de Cidades , Infecções por Coronavirus/prevenção & controle , Modelos Biológicos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , China/epidemiologia , Cidades/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
15.
Sci Rep ; 10(1): 13442, 2020 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-32778673

RESUMO

Delhi, a tropical Indian megacity, experiences one of the most severe air pollution in the world, linked with diverse anthropogenic and biomass burning emissions. First phase of COVID-19 lockdown in India, implemented during 25 March to 14 April 2020 resulted in a dramatic near-zeroing of various activities (e.g. traffic, industries, constructions), except the "essential services". Here, we analysed variations in the fine particulate matter (PM2.5) over the Delhi-National Capital Region. Measurements revealed large reductions (by 40-70%) in PM2.5 during the first week of lockdown (25-31 March 2020) as compared to the pre-lockdown conditions. However, O3 pollution remained high during the lockdown due to non-linear chemistry and dynamics under low aerosol loading. Notably, events of enhanced PM2.5 levels (300-400 µg m-3) were observed during night and early morning hours in the first week of April after air temperatures fell close to the dew-point (~ 15-17 °C). A haze formation mechanism is suggested through uplifting of fine particles, which is reinforced by condensation of moisture following the sunrise. The study highlights a highly complex interplay between the baseline pollution and meteorology leading to counter intuitive enhancements in pollution, besides an overall improvement in air quality during the COVID-19 lockdown in this part of the world.


Assuntos
Poluentes Atmosféricos/análise , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Material Particulado/análise , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Quarentena/métodos , Tempo (Meteorologia) , Aerossóis/análise , Poluição do Ar/análise , Cidades/epidemiologia , Infecções por Coronavirus/virologia , Monitoramento Ambiental/métodos , Humanos , Índia/epidemiologia , Ozônio/análise , Pneumonia Viral/virologia , Temperatura
16.
PLoS One ; 15(8): e0237714, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804961

RESUMO

Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem. There is limited information regarding the genetics of MRSA strains among the native Iraqi and incoming Syrian refugee communities. We aimed to characterize the genotypes and different virulence factors of MRSA in strains isolated from these two communities. Frozen MRSA strains (125) isolated from the native Iraqi and Syrian refugee communities were used in this study. PCR (singleplex and multiplex) and agr typing was used for the genotypic analysis of different virulence genes. We tested for the presence of virulence genes including pvl, arcA, tst, lukE/lukD, hla, hlb, eta, etb and agr. Prevalence of arcA MRSA in the Iraqi community (56.58%) was significantly higher (p = 0.008) than that in the Syrian refugee community (32.66%). Prevalence of lukE-lukD was also significantly higher (p = 0.001) in the Iraqi (82.89%) compared to that in the Syrian refugee community (57.14%). Further, prevalence of hla MRSA in the Iraqi community was (93.4%) and in the Syrian refugee community was (71.4%); (p = 0.0008). No significant differences were observed in the prevalence of pvl, tst, eta, etb and hlb. The most dominant agr types in both Iraqi (76.1% and 10.5%) and Syrian refugee (44.9% and 18.37%) communities were I and III. To sum up, no significant differences were observed between the groups for a majority of virulence factors. This is the first investigation of MRSA genotypes and virulence in both these communities. These results could be useful for further studies that assess the genetic relatedness of strains in the region for epidemiological and monitoring purposes, which would be crucial to limiting the spread of MRSA.


Assuntos
Resistência a Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Refugiados , Infecções Estafilocócicas/microbiologia , Fatores de Virulência/genética , Proteínas de Bactérias/genética , Proteínas de Bactérias/isolamento & purificação , Cidades/epidemiologia , Exotoxinas/genética , Exotoxinas/isolamento & purificação , Genes Bacterianos/genética , Técnicas de Genotipagem , Humanos , Iraque/epidemiologia , Meticilina/farmacologia , Meticilina/uso terapêutico , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Prevalência , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Síria , Transativadores/genética , Transativadores/isolamento & purificação , Fatores de Virulência/isolamento & purificação
17.
BMC Public Health ; 20(1): 1238, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795276

RESUMO

BACKGROUND: Standardized mortality surveillance data, capable of detecting variations in total mortality at population level and not only among the infected, provide an unbiased insight into the impact of epidemics, like COVID-19 (Coronavirus disease). We analysed the temporal trend in total excess mortality and deaths among positive cases of SARS-CoV-2 by geographical area (north and centre-south), age and sex, taking into account the deficit in mortality in previous months. METHODS: Data from the Italian rapid mortality surveillance system was used to quantify excess deaths during the epidemic, to estimate the mortality deficit during the previous months and to compare total excess mortality with deaths among positive cases of SARS-CoV-2. Data were stratified by geographical area (north vs centre and south), age and sex. RESULTS: COVID-19 had a greater impact in northern Italian cities among subjects aged 75-84 and 85+ years. COVID-19 deaths accounted for half of total excess mortality in both areas, with differences by age: almost all excess deaths were from COVID-19 among adults, while among the elderly only one third of the excess was coded as COVID-19. When taking into account the mortality deficit in the pre-pandemic period, different trends were observed by area: all excess mortality during COVID-19 was explained by deficit mortality in the centre and south, while only a 16% overlap was estimated in northern cities, with quotas decreasing by age, from 67% in the 15-64 years old to 1% only among subjects 85+ years old. CONCLUSIONS: An underestimation of COVID-19 deaths is particularly evident among the elderly. When quantifying the burden in mortality related to COVID-19, it is important to consider seasonal dynamics in mortality. Surveillance data provides an impartial indicator for monitoring the following phases of the epidemic, and may help in the evaluation of mitigation measures adopted.


Assuntos
Infecções por Coronavirus/mortalidade , Mortalidade/tendências , Pneumonia Viral/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cidades/epidemiologia , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Análise Espaço-Temporal , Adulto Jovem
18.
Public Health Rep ; 135(1_suppl): 138S-148S, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735193

RESUMO

OBJECTIVES: The impact of a syringe services program (SSP) policy on risk behaviors and its durability are not as well studied as the impact of the SSPs themselves. We examined whether trends in syringe sharing among persons who inject drugs (PWID) were associated with changes to syringe access policies in 3 US cities: Denver, New Orleans, and Philadelphia. METHODS: PWID were surveyed through National HIV Behavioral Surveillance System surveys in each city in 2005, 2009, 2012, and 2015. We assessed changes in syringe sharing from 2005 to 2015 by city. We used multivariable stepwise logistic regression analysis to measure the associations among syringe sharing and injection works sharing, time, and SSP access. RESULTS: From 2005 to 2015, syringe sharing decreased significantly from 49.1% to 33.1% in Denver (P < .001), increased significantly from 32.0% to 50.5% in New Orleans (P < .001), and remained unchanged in Philadelphia (30.4% to 31.5%; P = .87). Compared with persons who obtained syringes from any nonsterile source, the adjusted odds of syringe sharing among PWID were significantly lower in each city if syringes were obtained from sterile sources only: Denver adjusted odds ratio (aOR) = 0.23 (95% confidence interval [CI], 0.18-0.30; New Orleans aOR = 0.26 (95% CI, 0.19-0.35), and Philadelphia aOR = 0.43 (95% CI, 0.33-0.57). CONCLUSIONS: The lowest proportion of PWID reporting syringe sharing was in Philadelphia, which has a long-standing legal SSP. Implementation of a legal SSP in Denver in 2012 corresponded to a decrease in sharing, whereas the lack of a legal SSP in New Orleans corresponded to an increase in sharing. Universal long-term access to legal SSPs could further the progress made in HIV prevention among PWID.


Assuntos
Uso Comum de Agulhas e Seringas/estatística & dados numéricos , Programas de Troca de Agulhas/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adolescente , Adulto , Alcoolismo/epidemiologia , Cidades/epidemiologia , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Fatores Socioeconômicos , Abuso de Substâncias por Via Intravenosa/mortalidade , Estados Unidos/epidemiologia , Adulto Jovem
19.
Med Sci Monit ; 26: e925442, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32796810

RESUMO

BACKGROUND This population study aimed to investigate the demographic and clinical characteristics and outcome of cases of coronavirus disease 2019 in Lu'an City, China between January 22, 2020 and February 18, 2020 identified from the China Information System for Disease Control and Prevention (CISDCP). MATERIAL AND METHODS Laboratory-confirmed cases of COVID-19 reported in the CISDCP were included in this study. The distribution of cases, exposure history, clustered epidemic situation, and clinical manifestations, disease severity, and key time nodes were analyzed. Once the throat swab or sputum sample was positive for SARS-CoV-2 by real-time reverse transcriptase-polymerase chain reaction testing as confirmed cases. RESULTS There were 69 cases of COVID-19 that were confirmed between January 22 and February 18, 2020 reported. The onset time was concentrated on January 25, 2020 solstice to February 6, 2020 (71.0%), and the reporting dates were concentrated on January 31, 2020 and February 9, 2020 (69.6%). Nineteen cases (27.5%) had a history of sojourn in Hubei Province, and none of the cases reported after February 6, 2020 had a history of exposure in Hubei Province. There were 14 cluster outbreaks, and human-to-human transmission was the most common (78.6%). The most common symptoms were fever (56.5%), cough (37.7%), and self-conscious discomfort (14.5%). Besides, there were 9 severe cases (13.0%). CONCLUSIONS The epidemic prevention and control in Lu'an City has achieved phased results. Yet, new strict control measures need to be implemented to prevent a further outbreak, especially for those who will return to Lu'an City.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus/isolamento & purificação , China/epidemiologia , Cidades/epidemiologia , Técnicas de Laboratório Clínico , Análise por Conglomerados , Busca de Comunicante , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Geografia Médica , Humanos , Nasofaringe/virologia , Orofaringe/virologia , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Escarro/virologia , Análise de Sobrevida , Avaliação de Sintomas
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