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1.
West Afr J Med ; 37(5): 569-573, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33058134

RESUMO

The initial clinical manifestations of COVID 19 in Wuhan was fever, cough and shortness of breath but early reports in Italy and Spain preceded emerging literature of skin involvement. COVID19 was first reported in December, 2019 and after several observations of cutaneous involvement in patients with the disease there was need to document such in literature. The details of the clinical presentation and the pathophysiological mechanisms of these cutaneous lesions are, however, still poorly understood. This is a review of twenty-four published scientific articles summarizing the various cutaneous features observed by the frontline health care givers involved in the management of patients with Covid-19. Maculopapular exanthem was the most common pattern reported, accounting for 44.4% of skin manifestations. The pseudo-chilblain, urticarial, vesicular, livedoid and Kawasaki-like disease patterns accounted for 18.1%, 17.6%, 12.9%, 5.1% and 1.9% respectively. Anumber of the patients (9.5%) developed skin lesions at the time of diagnosis of Covid-19 or at the onset of Covid-19 respiratory symptoms while 75.1% developed the lesions after the onset of Covid-19 respiratory symptoms or after laboratory diagnosis of the disease had been made. There is no gainsaying that apart from the respiratory and other reported systems, Covid-19 also affects the skin. Clinicians, especially dermatologists, should therefore watch out for the already reported skin lesions and for possible yet to be discovered or reported skin lesions in patients with Covid-19. Dermatologists must bear in mind that patients presenting at skin clinics may actually be infected with Covid-19.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Pandemias , Pneumonia Viral/complicações , Dermatopatias/diagnóstico , Pele/patologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Dermatopatias/epidemiologia , Dermatopatias/etiologia
2.
J Prim Care Community Health ; 11: 2150132720966167, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33084483

RESUMO

PURPOSE: The study aimed to explore the prevalence and possible risk factors to prevent the face mask related adverse skin reactions during the ongoing COVID-19 after a recommendation of face mask wearing for public use in Thailand. RESULTS: The prevalence of face mask related adverse skin reactions was 454 cases (54.5%), of which acne was the most frequent (399; 39.9%), followed by rashes on the face (154; 18.4%), and itch symptoms (130; 15.6%). Wearing a surgical mask showed a higher risk of adverse skin reaction compared to a cloth mask, OR (95% CI) = 1.54 (1.16-2.06). A duration of face mask wearing of more than 4 hours/day and the reuse of face masks increased the risk of adverse skin reactions compared to changing the mask every day, adjusted OR(95% CI) = 1.96 (1.29-2.98), and 1.5 (1.11-2.02). CONCLUSION: Suggestions were made for wearing a cloth mask in non-health care workers (HCW) to decrease the risk of face mask related adverse skin reactions. This suggestion could potentially help in decreasing the demand of surgical masks which should be reserved for the HCW population during the ongoing COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Máscaras/efeitos adversos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Dermatopatias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários , Tailândia/epidemiologia , Adulto Jovem
3.
Psychiatr Danub ; 32(Suppl 2): 290-297, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32970649

RESUMO

INTRODUCTION: Sensitive skin has been described as a syndrome defined by the occurrence of unpleasant sensations (stinging, burning, pain, pruritus, and tingling sensations) in response to stimuli that normally should not provoke such sensations. Although often transient, and in many cases unaccompanied by visual dermatological responses, sensitive skin affects the quality of life. The aim of this survey was to assess the prevalence of sensitive skin and collect clinical data on sensitive skin in the population of Herzegovina-Neretva County. SUBJECTS AND METHODS: The survey included a total of 73 participants, 45 female and 28 male, aged 20 years and above, with a diagnosis of sensitive skin syndrome (SSS) confirmed by physicians. A dermatological exam assessing skin type, phototype and skin sensitivity was performed. The survey collected an assortment of information including demographics and included customized standardized questionnaires that closely examine skin sensitivity and the burden of sensitive skin. RESULTS: Findings concurred with existing evidence that individuals with sensitive skin represent almost half the examined population. The prevalence of perceived sensitive skin was significantly higher in females than in males. The main skin symptom was itching, followed by prickling, warmth and numbness. Our results clearly show that there is a burden of sensitive skin. CONCLUSION: This study investigated the prevalence of sensitive skin and the burden of sensitive skin in the population of Herzegovina-Neretva County. It is the first to focus on sensitive skin among Herzegovina-Neretva County population. Further studies are needed to bolster epidemiological data and physiological pathways of sensitive skin syndrome.


Assuntos
Dermatopatias/epidemiologia , Adulto , Bósnia e Herzegóvina/epidemiologia , Feminino , Humanos , Masculino , Dor/epidemiologia , Prevalência , Prurido/epidemiologia , Qualidade de Vida , Síndrome , Adulto Jovem
4.
BMC Infect Dis ; 20(1): 621, 2020 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-32831057

RESUMO

BACKGROUND: We aimed to describe an outbreak of cutaneous abscesses caused by Panton-Valentine leukocidin (PVL)-producing methicillin-susceptible Staphylococcus aureus (MSSA) among gold mine workers. METHODS: In February 2018, we retrospectively reviewed a random sample of 50 medical records from 243 cases and conducted face-to-face interviews using a structured questionnaire. Pus aspirates were sent to the National Institute for Communicable Diseases from prospectively-identified cases (November 2017-March 2018). Nasopharyngeal swabs were collected during a colonisation survey in February 2018. Staphylococcus aureus isolates were screened with a conventional PCR for lukS/F-PV. Pulsed-field gel electrophoresis (PFGE) was performed to determine the genetic relatedness among the isolates. A sample of isolates were selected for whole genome sequencing (WGS). We conducted an assessment on biological risks associated with mining activities. RESULTS: From January 2017 to February 2018, 10% (350/3582) of mine workers sought care for cutaneous abscesses. Forty-seven medical files were available for review, 96% were male (n = 45) with a mean age of 43 years (SD = 7). About 52% (24/46) were involved in stoping and 28% (13/47) worked on a particular level. We cultured S. aureus from 79% (30/38) of cases with a submitted specimen and 14% (12/83) from colonisation swabs. All isolates were susceptible to cloxacillin. Seventy-one percent of S. aureus isolates (30/42) were PVL-PCR-positive. Six PFGE clusters were identified, 57% (21/37) were closely related. WGS analysis found nine different sequence types. PFGE and WGS analysis showed more than one cluster of S. aureus infections involving closely related isolates. Test reports for feed and product water of the mine showed that total plate counts were above the limits of 1000 cfu/ml, coliform counts > 10 cfu/100 ml and presence of faecal coliforms. Best practices were poorly implemented as some mine workers washed protective clothing with untreated water and hung them for drying at the underground surface. CONCLUSIONS: PVL-producing MSSA caused an outbreak of cutaneous abscesses among underground workers at a gold mining company. To our knowledge, no other outbreaks of PVL-producing S. aureus involving skin and soft tissue infections have been reported in mining facilities in South Africa. We recommend that worker awareness of infection prevention and control practices be strengthened.


Assuntos
Abscesso/microbiologia , Dermatopatias/epidemiologia , Infecções dos Tecidos Moles/epidemiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/patogenicidade , Adulto , Toxinas Bacterianas/metabolismo , Surtos de Doenças , Eletroforese em Gel de Campo Pulsado , Exotoxinas/metabolismo , Feminino , Ouro , Humanos , Leucocidinas/metabolismo , Masculino , Meticilina/farmacologia , Pessoa de Meia-Idade , Mineradores , Estudos Retrospectivos , Dermatopatias/microbiologia , Infecções dos Tecidos Moles/microbiologia , África do Sul/epidemiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/genética , Staphylococcus aureus/metabolismo
5.
Acta Derm Venereol ; 100(15): adv00249, 2020 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-32812055

RESUMO

Only recently histopathological studies of patients with dermatosis and concomitant SARS-Cov-2 viral infection were published. Seven months into the COVID-19 pandemic, more skin biopsies of COVID-19 positive patients are taking place. We examined the histological features of 30 skin biopsies from two groups of patients: Ten specimens of patients tested positive for COVID-19 with an active systemic infection and associated dermatosis. Twenty specimens were from patients not considered COVID-positive (due to PCR swab negativity or not tested at all) with cutaneous lesions either showing viral infection symptoms (fever, cough, ageusia and severe immunocompromised condition due to HIV infection and malignancies), or presented a high risk of being infected (such as cohabitation with COVID-19 positive parents and siblings with simultaneous chilblains). This study analyses the histological and immunohistochemical (SARS-CoV-2 2019-nCoV nucleocapsid antibody) characteristics of the two groups and identifies 4 histopathological patterns. The histopathological features of the two groups present similar features that may help to identify an ongoing COVID-19 infection even in asymptomatic carriers with dermatosis.


Assuntos
Doenças Assintomáticas/epidemiologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Dermatopatias/patologia , Biópsia por Agulha , Estudos de Coortes , Comorbidade , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Masculino , Pandemias , Reação em Cadeia da Polimerase/métodos , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Dermatopatias/epidemiologia , Manejo de Espécimes
9.
PLoS One ; 15(7): e0235410, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726308

RESUMO

Patient satisfaction is an important indicator of health care quality, and it remains an important goal for optimal treatment outcomes to reduce the level of misdiagnoses and inappropriate or absent therapeutic actions. Digital support tools for differential diagnosis to assist clinicians in reaching the correct diagnosis may be helpful, but how the use of these affect patients is not clear. The primary objective of this feasibility study was to investigate patient experience and satisfaction in a primary care setting where general practitioners (GPs) used a visual clinical decision support system (CDSS) compared with standard consultations. Secondary objectives were diagnostic accuracy and length of consultation. Thirty-one patients with a dermatologist-confirmed skin diagnosis were allocated to consult GPs that had been randomized to conduct either standard consultations (SDR, n = 21) or CDSS (n = 16) on two separate study days one week apart. All patients were diagnosed independently by multiple GPs (n = 3-8) in both the SDR and CDSS study arms. Using the CDSS, more patients felt involved in the decision making (P = 0.05). In addition, more patients were exposed to images during the consultations (P = 6.8e-27), and 83% of those that were shown images replied they felt better supported in the consultation. The use of CDSS significantly improved the diagnostic accuracy (34%, P = 0.007), and did not increase the duration of the consultation (median 10 minutes in both arms). This study shows for the first time that compared with standard GP consultations, CDSS assist the GP on skin related diagnoses and improve patient satisfaction and diagnostic accuracy without impacting the duration of the consultations. This is likely to increase correct treatment choices, patient adherence, and overall result in better healthcare outcomes.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Sistemas Especialistas , Satisfação do Paciente , Dermatopatias/diagnóstico , Adulto , Erros de Diagnóstico/prevenção & controle , Estudos de Viabilidade , Feminino , Clínicos Gerais , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Encaminhamento e Consulta , Dermatopatias/epidemiologia , Dermatopatias/patologia
10.
J Am Acad Dermatol ; 83(4): 1118-1129, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32622888

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) has associated cutaneous manifestations. OBJECTIVE: To characterize the diversity of cutaneous manifestations of COVID-19 and facilitate understanding of the underlying pathophysiology. METHODS: Case series from an international registry from the American Academy of Dermatology and International League of Dermatological Societies. RESULTS: The registry collected 716 cases of new-onset dermatologic symptoms in patients with confirmed/suspected COVID-19. Of the 171 patients in the registry with laboratory-confirmed COVID-19, the most common morphologies were morbilliform (22%), pernio-like (18%), urticarial (16%), macular erythema (13%), vesicular (11%), papulosquamous (9.9%), and retiform purpura (6.4%). Pernio-like lesions were common in patients with mild disease, whereas retiform purpura presented exclusively in ill, hospitalized patients. LIMITATIONS: We cannot estimate incidence or prevalence. Confirmation bias is possible. CONCLUSIONS: This study highlights the array of cutaneous manifestations associated with COVID-19. Many morphologies were nonspecific, whereas others may provide insight into potential immune or inflammatory pathways in COVID-19 pathophysiology.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Sistema de Registros/estatística & dados numéricos , Dermatopatias/imunologia , Adolescente , Adulto , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/imunologia , Pneumonia Viral/virologia , Índice de Gravidade de Doença , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Dermatopatias/virologia , Adulto Jovem
11.
Niger J Clin Pract ; 23(7): 970-974, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620727

RESUMO

Background: Diabetes mellitus is one of the most common metabolic disorders with a rising prevalence. It cuts across all ages and socioeconomic status. Various skin lesions are frequently observed in diabetic patients. Aims: This study was carried out to determine the prevalence, pattern, and determinants of skin diseases in diabetic patients at the Barau Dikko Teaching Hospital, Kaduna, North West Nigeria. Materials and Methods: One hundred consecutive diabetic patients attending the clinic were included in the study. Results: Many of the patients had more than one skin condition at a time. The most prevalent skin diseases were idiopathic guttate hypomelanosis which was seen in 61% of patients, infections from fungal, bacterial, and viral causes occurred in 30% of patients, other skin disorders were diabetic dermopathy seen in 17% of patients, palmoplantar hyperpigmentation was seen in 13% of patients, while pruritus occurred in 12% of patients and xerosis was seen in 10% of patients. Conclusion: Skin disorders are common among diabetic patients at Barau Dikko Teaching Hospital, Kaduna, North West Nigeria.


Assuntos
Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Dermatopatias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Instituições de Assistência Ambulatorial , Estudos Transversais , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/patologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/patologia , Feminino , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Prurido/epidemiologia , Pele/patologia , Adulto Jovem
12.
J Travel Med ; 27(6)2020 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-32657340

RESUMO

BACKGROUND: Before the impact of the coronavirus disease 2019 pandemic, cruise travel had experienced exponential growth in the preceding decade. Travel medicine practitioners were increasingly called upon to provide pre-cruise travel advice and medical clearance. Demand for these services will return at some time in the future. METHODS: The clinical conditions seen in those presenting for care on six small-vessel scientific cruises to Antarctica were analysed. RESULTS: Personnel presented on 196 occasions resulting in 257 consultations (when initial plus all follow-up consultations were included). Personnel presented with a clinical condition at a rate of 17.9 per 1000 person-days at sea. The total consultation rate was 23.5 per 1000 person-days at sea. Injury accounted for 24% of all presentations at a rate of 4.3 per 1000 person-days at sea. Dermatological, soft tissue and musculoskeletal, general malaise and motion sickness were the four most common presentations. CONCLUSIONS: Pre-cruise advice for travellers planning small-vessel cruises to polar regions needs to include skin care, prevention and management of sea sickness and how to reduce the risk of injury. Those providing medical care on such cruises should be prepared to manage a wide range of clinical presentations.


Assuntos
Encaminhamento e Consulta/estatística & dados numéricos , Navios , Medicina de Viagem/estatística & dados numéricos , Regiões Antárticas , Humanos , Infecções/epidemiologia , Infecções/terapia , Enjoo devido ao Movimento/epidemiologia , Enjoo devido ao Movimento/terapia , Dermatopatias/epidemiologia , Dermatopatias/terapia , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/terapia
13.
Am J Emerg Med ; 38(9): 1715-1721, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32731141

RESUMO

The novel coronavirus disease of 2019 (COVID-19) is associated with significant morbidity and mortality. While much of the focus has been on the cardiac and pulmonary complications, there are several important dermatologic components that clinicians must be aware of. OBJECTIVE: This brief report summarizes the dermatologic manifestations and complications associated with COVID-19 with an emphasis on Emergency Medicine clinicians. DISCUSSION: Dermatologic manifestations of COVID-19 are increasingly recognized within the literature. The primary etiologies include vasculitis versus direct viral involvement. There are several types of skin findings described in association with COVID-19. These include maculopapular rashes, urticaria, vesicles, petechiae, purpura, chilblains, livedo racemosa, and distal limb ischemia. While most of these dermatologic findings are self-resolving, they can help increase one's suspicion for COVID-19. CONCLUSION: It is important to be aware of the dermatologic manifestations and complications of COVID-19. Knowledge of the components is important to help identify potential COVID-19 patients and properly treat complications.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pandemias , Pneumonia Viral/complicações , Dermatopatias/etiologia , Pele/patologia , Infecções por Coronavirus/epidemiologia , Saúde Global , Humanos , Incidência , Pneumonia Viral/epidemiologia , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia
15.
J Am Acad Dermatol ; 83(2): 486-492, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32479979

RESUMO

BACKGROUND: Increasing evidence suggests pernio-like lesions are cutaneous manifestations of coronavirus infectious disease 2019 (COVID-19). OBJECTIVE: To describe clinical and pathologic findings of pernio-like lesions in patients with confirmed or suspected COVID-19. METHODS: An international dermatology registry was circulated to health care providers worldwide through the American Academy of Dermatology, International League of Dermatologic Societies, and other organizations. RESULTS: We documented 505 patients with dermatologic manifestations associated with COVID-19, including 318 (63%) with pernio-like lesions. Patients with pernio-like lesions were generally young and healthy, with relatively mild COVID-19. Of 318 patients with confirmed or suspected COVID-19 by providers, 23 (7%) were laboratory-confirmed COVID-19 positive, and 20 others (6%) were close contacts of patients with confirmed COVID-19. Given current testing criteria, many patients lacked COVID-19 testing access. For 55% of patients, pernio-like lesions were their only symptom. In patients with other COVID-19 symptoms, pernio-like lesions typically appeared after other symptoms. Pernio-like lesions lasted a median of 14 days (interquartile range, 10-21 days). LIMITATIONS: A case series cannot estimate population-level incidence or prevalence. In addition, there may be confirmation bias in reporting. We cannot exclude an epiphenomenon. CONCLUSIONS: Pernio-like skin changes of the feet and hands, without another explanation, may suggest COVID-19 infection and should prompt confirmatory testing.


Assuntos
Betacoronavirus/isolamento & purificação , Pérnio/virologia , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Dermatopatias/virologia , Adolescente , Adulto , Viés , Pérnio/diagnóstico , Pérnio/epidemiologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Feminino , , Mãos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Sistema de Registros/estatística & dados numéricos , Índice de Gravidade de Doença , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Fatores de Tempo , Adulto Jovem
16.
An Bras Dermatol ; 95(4): 428-438, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32482550

RESUMO

BACKGROUND: Dermatology encompasses the management of many disorders of the skin and cutaneous appendages, making the analysis of epidemiological profiles relevant for health planning. OBJECTIVE: The study aims to describe the nosological profile of dermatological diseases in Florianopolis, analyzing the interrelation among the primary health care and dermatology services, from January 2016 to December 2017. METHOD: Descriptive study from records of medical visits from the primary health care and dermatology services, as well as records of reports issued by the teledermatology service. RESULTS: In primary health care, from 55,265 medical visits - 28,546 in 2016 and 26,719 in 2017, there was a higher prevalence of "Atopic dermatitis" (6.38%), "other disorders of skin and subcutaneous tissue" (5.10%), and "Scabies" (4.55%). In dermatology secondary care, from 19,964 visits - 10,068 in 2016 and 9626 in 2017, the most prevalent diagnoses were "Other malignant neoplasms of the skin" (14.75%) and "Skin changes due to chronic exposure to nonionizing radiation" (10.20%). STUDY LIMITATIONS: Some dermatological consultations in primary health care may have been under-registered due to the attribution of non-specific or overly broad diagnoses. CONCLUSION: This study presents different nosological profiles of skin diseases in primary health care and dermatology secondary care, reinforcing the importance of primary health care's role in the management of less complex conditions, referring more complex cases that require more specialized experience to dermatology services..


Assuntos
Dermatopatias/epidemiologia , Brasil/epidemiologia , Dermatologia , Humanos , Atenção Primária à Saúde , Encaminhamento e Consulta , Atenção Secundária à Saúde
19.
PLoS Comput Biol ; 16(6): e1007182, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32502148

RESUMO

Group A Streptococcus (GAS) skin infections are caused by a diverse array of strain types and are highly prevalent in disadvantaged populations. The role of strain-specific immunity in preventing GAS infections is poorly understood, representing a critical knowledge gap in vaccine development. A recent GAS murine challenge study showed evidence that sterilising strain-specific and enduring immunity required two skin infections by the same GAS strain within three weeks. This mechanism of developing enduring immunity may be a significant impediment to the accumulation of immunity in populations. We used an agent-based mathematical model of GAS transmission to investigate the epidemiological consequences of enduring strain-specific immunity developing only after two infections with the same strain within a specified interval. Accounting for uncertainty when correlating murine timeframes to humans, we varied this maximum inter-infection interval from 3 to 420 weeks to assess its impact on prevalence and strain diversity, and considered additional scenarios where no maximum inter-infection interval was specified. Model outputs were compared with longitudinal GAS surveillance observations from northern Australia, a region with endemic infection. We also assessed the likely impact of a targeted strain-specific multivalent vaccine in this context. Our model produced patterns of transmission consistent with observations when the maximum inter-infection interval for developing enduring immunity was 19 weeks. Our vaccine analysis suggests that the leading multivalent GAS vaccine may have limited impact on the prevalence of GAS in populations in northern Australia if strain-specific immunity requires repeated episodes of infection. Our results suggest that observed GAS epidemiology from disease endemic settings is consistent with enduring strain-specific immunity being dependent on repeated infections with the same strain, and provide additional motivation for relevant human studies to confirm the human immune response to GAS skin infection.


Assuntos
Dermatopatias/epidemiologia , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes , Animais , Austrália/epidemiologia , Austrália/etnologia , Número Básico de Reprodução , Modelos Animais de Doenças , Humanos , Camundongos , Modelos Teóricos , Dinâmica Populacional , Grupos Populacionais , Dermatopatias/imunologia , Dermatopatias/microbiologia , Dermatopatias/prevenção & controle , Infecções Estreptocócicas/imunologia , Infecções Estreptocócicas/prevenção & controle , Vacinas Estreptocócicas
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