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Extreme weather events are expected to increase due to climate change, which could pose an additional burden of morbidity and mortality. In recent decades, drought severity has increased in several regions around the world, affecting health by increasing the risk of water-, food-, and vector-borne diseases, malnutrition, cardiovascular and respiratory illness, mental health disorders, and mortality. Drought frequency and severity are expected to worsen across large regions as a result of a decrease in precipitation and an increase in temperature and atmospheric evaporative demand, posing a pressing challenge for public health. Variation in impacts among countries and communities is due to multiple factors, such as aging, socioeconomic status, access to health care, and gender, affecting population resilience. Integrative proactive action plans focused on risk management are required, and resources should be transferred to developing countries to reduce their vulnerability and risk.
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Secas , Saúde Pública , Humanos , Mudança ClimáticaRESUMO
African swine fever virus (ASFV) was first reported in eastern Europe/Eurasia in 2007. Continued spread of ASFV has placed central European countries at risk, and in 2014, ASFV was detected in Lithuania and Poland. Sequencing showed the isolates are identical to a 2013 ASFV from Belarus but differ from ASFV isolated in Georgia in 2007.
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Vírus da Febre Suína Africana/genética , Febre Suína Africana/epidemiologia , Febre Suína Africana/virologia , Variação Genética , Genótipo , Animais , Sequência de Bases , Europa (Continente)/epidemiologia , Evolução Molecular , Genes Virais , Dados de Sequência Molecular , Filogenia , Alinhamento de Sequência , SuínosRESUMO
South Africa (SA) is highly vulnerable to the effects of drought on the environment, economy, and society. However, its effect on human health remains unclear. Understanding the mortality risk associated with different types of droughts in different population groups and by specific causes would help clarify the potential mechanisms involved. The study aims to comprehensively assess the effect of droughts of varying time scales on cause-specific mortality (all; infectious and parasitic; endocrine, nutritional, and metabolic; cardiovascular; respiratory) in SA (from 2009-2016) and identify more vulnerable profiles based on sex and age. We also evaluated the urbanicity and district-level socioeconomic deprivation as potential risk modifiers. We used a two-stage time-series study design, with the weekly standardized precipitation-evapotranspiration index (SPEI) calculated at 1, 6, 12, and 15 months of accumulation to identify droughts of different duration (SPEI1, 6, 12, 15, respectively). We applied a quasi-Poisson regression adjusted by mean temperature to assess the association between each type of drought and weekly mortality in all district municipalities of SA, and then pooled the estimates in a meta-regression model. We reported relative risks (RRs) for one unit increase of drought severity. Overall, we found a positive association between droughts (regardless the time scale) and all causes of death analyzed. The strongest associations were found for the drought events more prolonged (RR [95%CI]: 1.027 [1.018, 1.036] (SPEI1); 1.035 [1.021, 1.050] (SPEI6); 1.033 [1.008, 1.058] (SPEI12); 1.098 [1.068, 1.129] (SPEI15)) and respiratory mortality (RRs varied from 1.037 [1.021, 1.053] (SPEI1) to 1.189 [1.14, 1.241] (SPEI15)). An indication of greater vulnerability was found in younger adults for the shortest droughts, in older adults for medium-term and long-term droughts, and children for very long-term droughts. However, differences were not significant. Further evidence of the relevance of urbanicity and demographic and socioeconomic conditions as potential risk modifiers is needed.
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Global warming and associated changes in atmospheric circulation patterns are expected to alter the hydrological cycle, including the intensity and position of moisture sources. This study presents predicted changes for the middle and end of the 21st century under the SSP5-8.5 scenario for two important extratropical moisture sources: the North Atlantic Ocean (NATL) and Mediterranean Sea (MED). Changes over the Iberian Peninsula-considered as a strategic moisture sink for its location-are also studied in detail. By the end of the century, moisture from the NATL will increase precipitation over eastern North America in winter and autumn and on the British Isles in winter. Moisture from the MED will increase precipitation over the southern and western portions of the Mediterranean continental area. Precipitation associated with the MED moisture source will decrease mainly over eastern Europe, while that associated with the NATL will decrease over western Europe and Africa. Precipitation recycling on the Iberian Peninsula will increase in all seasons except summer for mid-century. Climate change, as simulated by CESM2 thus modifies atmospheric moisture transport, affecting regional hydrological cycles.
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Global crop yields are highly dependent on climate variability, with the largest agricultural failures frequently occurring during extremely dry and hot years. Land-atmosphere feedbacks are thought to play a crucial role in agricultural productivity during such events: precipitation deficits cause soil desiccation, which reduces evaporation and enhances sensible heating from the land surface; the amplified local temperatures and moisture deficits can be detrimental to crop yield. While this impact of local land-atmosphere feedbacks on agricultural productivity has recently been reported, the dependency of crop yields on upwind regions remains understudied. Here, we determine the spatio-temporal origins of moisture and heat over the world's largest 75 rainfed breadbaskets, and illustrate the crop yield dependency on upwind regions. Further, we disentangle the role of local and upwind land-atmosphere interactions on anomalous moisture and heat transport during low-yield years. Our results indicate that crop failure increases on average by around 40% when both upwind and local land-atmosphere feedbacks cause anomalously low moisture and high heat transport into the breadbaskets. The impact of upwind land-atmosphere feedbacks on productivity deficits is the largest in water-limited regions, which show an increased dependency on moisture supply from upwind land areas. Better understanding these upwind-downwind dependencies in agricultural regions can help develop adaptation strategies to prevent food shortage in a changing climate.
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The terrestrial and oceanic origins of precipitation over 50 major river basins worldwide were investigated for the period 1980-2018. For this purpose, we used a Lagrangian approximation that calculates the humidity that results in precipitation from the entire ocean area (ocean component of the precipitation, PLO) and the entire land area (land component, PLT) as well as the sum of both components (Lagrangian precipitation, PL). PL and its components were highly correlated with precipitation over the basins, where PLT accounted for >50 % of the PL in most of them. This confirmed the importance assigned by previous studies to terrestrial recycling of precipitation and moisture transport within the continents. However, the amount of PLO in almost all North American river basins was highlighted. The assessment of drought conditions through the Standardized Precipitation Index (SPI) at a temporal scale of 1- and 3-months revealed the number of drought episodes that affected each river basin, especially the Amazon, Congo, and Nile, because of the lower number of episodes but higher average severity and duration. A direct relationship between the severity of drought episodes and the respective severity computed on the oceanic and terrestrial SPI series was also found for the majority of basins. This highlights the influence of the severity of the SPI of oceanic origin for most basins in North America. However, for certain basins, we found an inverse relationship between the severity of drought and the associated severity according to the SPI of oceanic or terrestrial origin, thus highlighting the principal drought attribution. Additionally, a copula analysis provided new information that illustrates the estimated conditional probability of drought for each river basin in relation to the occurrence of drought conditions of oceanic or terrestrial origin, which revealed the possible main driver of drought severity in each river basin.
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Secas , Rios , América do NorteRESUMO
PURPOSE: To determine and compare the prevalence of rhegmatogenous retinal detachment (RRD) in myopic eyes operated of posterior chamber phakic implantable collamer lens (ICL) with a control group of nonoperated myopic eyes over 10 years of follow-up. SETTING: Clinica Baviera, Madrid, Spain. DESIGN: Retrospective cohort study. METHODS: There were 2 study cohorts: one with patients operated with ICL and a control group of nonoperated patients. The primary outcome of RRD was measured retrospectively, first through chart review of ICL-operated patients with at least 10 years of follow-up, then secondarily through telephone questionnaires and specialist verification for those with incomplete follow-up. Prevalence and incidence were calculated and compared, as well as their possible association with other risk factors. RESULTS: 58 operated patients completed follow-up in our clinic. A survey of 3849 more patients was conducted for a total of 252 operated with a mean spherical equivalent (SEQ) of -12.6 diopters (D) and 221 nonoperated with a mean SEQ of -10.5 D. 7 eyes developed an RRD in the operated vs 5 eyes among the nonoperated (prevalence 1.71% vs 1.25%, respectively, P = .773). The equivalence tests, the two one-sided test and the null hypothesis test between groups, were within the 0.02 limits, confirming the null hypothesis, and compared survival curves did not show significant differences ( P = .59). CONCLUSIONS: ICL implantation surgery for high myopia did not affect the prevalence of RRD in operated eyes compared with similar nonoperated eyes, in this long-term study.
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Miopia , Lentes Intraoculares Fácicas , Descolamento Retiniano , Humanos , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Prevalência , Implante de Lente Intraocular/efeitos adversos , Lentes Intraoculares Fácicas/efeitos adversos , Seguimentos , Miopia/cirurgia , Refração OcularRESUMO
African swine fever (ASF) is a viral disease of swine with a huge impact due to its high mortality. Lately, the disease has actively spread around the world, affecting new areas from which it had been eradicated long ago. To date, ASF control is carried out by the implementation of strict biosecurity measures such as the early identification of infected animals. In this work, two fluorescent rapid tests were developed to improve the sensitivity of point-of-care diagnosis of ASF. For antigen (Ag) detection in blood, a double-antibody sandwich fluorescent lateral flow assay (LFA) was developed, employing a newly developed recombinant antibody to the VP72 of the virus. To complement the diagnosis, a double-recognition fluorescent LFA was developed using the VP72 for the detection of specific antibodies (Ab) in sera or blood. Both assays statistically improved the detection of the disease when compared to the commercial colorimetric assays INgezim® ASFV CROM Ag and INgezim® PPA CROM Anticuerpo, respectively, with higher statistical significance between 11 and 39 days post-infection. From the observation of results, it can be concluded that the combination of both Ag-LFA and Ab-LFA assays would facilitate the identification of infected animals, regardless of post-infection time.
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Introduction: African swine fever (ASF) is a contagious viral disease of pigs and wild boar that poses a major threat to the global swine industry. The genotype II African swine fever virus (ASFV) entered the European Union (EU) in 2014 and since then fourteen countries have been affected, Italy and North Macedonia being the last in 2022. While whole genome sequencing remains the gold standard for the identification of new genetic markers, sequencing of multiple loci with significant variations could be used as a rapid and cost-effective alternative to track outbreaks and study disease evolution in endemic areas. Materials and methods: To further our understanding of the epidemiology and spread of ASFV in Europe, 382 isolates collected during 2007 to 2022 were sequenced. The study was initially performed by sequencing the central variable region (CVR), the intergenic region (IGR) between the I73R and I329L genes and the O174L and K145R genes. For further discrimination, two new PCRs were designed to amplify the IGR between the 9R and 10R genes of the multigene family 505 (MGF505) and the IGR between the I329L and I215L genes. The sequences obtained were compared with genotype II isolates from Europe and Asia. Results: The combination of the results obtained by sequencing these variable regions allowed to differentiate the European II-ASFV genotypes into 24 different groups. In addition, the SNP identified in the IGR I329L-I215L region, not previously described, grouped the viruses from North Macedonia that caused the 2022 outbreaks with viruses from Romania, Bulgaria, Serbia and Greece, differentiating from other genotype II isolates present in Europe and Asia. Furthermore, tandem repeat sequence (TRS) within the 9R-10R genes of the multigene family 505 (MGF505) revealed eight different variants circulating. Discussion: These findings describe a new multi-gene approach sequencing method that can be used in routine genotyping to determine the origin of new introductions in ASF-free areas and track infection dynamics in endemic areas.
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INTRODUCTION: Human intestinal spirochetosis (HIE) is a poorly studied clinical entity with variable clinical manifestations. However, in recent years it has gained special relevance because an increasing number of cases have been described in people living with HIV (PWH) and in patients with a history of sexually transmitted infections (STI) or immunosuppression. METHODS: Retrospective review of all HIE cases identified in a tertiary level hospital (Hospital Universitario la Paz, Madrid) between 2014 and 2021. RESULTS: 36 Cases of HIE were identified. Most cases corresponded to males (94%) with a median age of 45 years. 10 patients (29.4%) were PWH and 20 (56%) were men who had sex with men. Although the clinical manifestations were very heterogeneous, the most frequent was chronic diarrhea (47%), and up to 25% of the subjects had clinical proctitis. 39% percent of patients had been diagnosed with an STI in the previous two years, this characteristic being more frequent in PWH (90% vs. 28%; pâ¯<â¯0.01) than in patients without HIV infection. The STI most frequently associated with a diagnosis of HIE was syphilis (31%). CONCLUSION: HIE is frequently diagnosed with other STIs and affects mostly men who have sex with men, which supports that this entity could be considered as a new STI.
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Pérez-Alarcón et al. [1] developed a comparative climatology of the outer radius of tropical cyclones (TCs) from several radial wind profiles. They showed that the Willoughby et al. (2006) (W06) profile can be used to reproduce the TC tangential wind speed; thus, this profile is skilful for estimating the TC outer radius. Here, we present a database of TC sizes estimated from the W06 radial wind profile in each cyclogenetic basin worldwide. The database incorporates the critical wind radii, where the tangential wind speed is approximately 17.5 ms-1 (R34), 26 ms-1 (R50), 33 ms-1 (R64), and 51 ms-1 (R100), estimated by the W06 profile. The database has a comma-delimited text format with six-hour information on the location, maximum wind speed, central pressure, and the different TC metrics mentioned above. This database has a similar structure to that of the Atlantic Hurricane Database (HURDAT2) of the National Hurricane Center. The database presented here is applicable to studies on TC storm surge risks as well as to the determination of the sources and sinks of atmospheric moisture related to tropical cyclogenesis processes.
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African swine fever virus p72 genotype IX, associated with outbreaks in eastern Africa, is cocirculating in the Republic of the Congo with West African genotype I. Data suggest that viruses from eastern Africa are moving into western Africa, increasing the threat of outbreaks caused by novel viruses in this region.
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Vírus da Febre Suína Africana/genética , Febre Suína Africana/epidemiologia , Surtos de Doenças/veterinária , Sus scrofa/virologia , Doenças dos Suínos/epidemiologia , Febre Suína Africana/virologia , Vírus da Febre Suína Africana/classificação , Vírus da Febre Suína Africana/isolamento & purificação , Animais , Congo/epidemiologia , DNA Viral/análise , DNA Viral/isolamento & purificação , Genótipo , Filogenia , Análise de Sequência de DNA , Suínos , Doenças dos Suínos/virologiaRESUMO
The role of the ancestral sylvatic cycle of the African swine fever virus (ASFV) is not well understood in the endemic areas of eastern Africa. We therefore analysed the ASF infection status on samples collected from 51 free-ranging warthogs (Phacocherus africanus) and 1576 Ornithodorus porcinus ticks from 26 independent warthog burrows at a single ranch in Kenya. Abattoir samples from 83 domestic pigs without clinical symptoms, originating from specific locations with no recent reported ASF outbreaks were included in this study. All samples were derived from areas of central Kenya, where ASF outbreaks have been reported in the past. Infection with ASFV was confirmed in 22â% of O. porcinus pools, 3.22â% of adult warthog serum samples and 49â% of domestic pig serum samples by using p72-based PCR. All of the warthog sera were positive for anti-ASFV antibodies, investigated by using ELISA, but none of the domestic pig sera were positive. Twenty O. porcinus-, 12 domestic pig- and three warthog-derived viruses were genotyped at four polymorphic loci. The ASFV isolates from ticks and domestic pigs clustered within p72 genotype X. By contrast, ASF viruses genotyped directly from warthog sera, at same locality as the tick isolates, were within p72 genotype IX and genetically similar to viruses causing recent ASF outbreaks in Kenya and Uganda. This represents the first report of the co-existence of different ASFV genotypes in warthog burrow-associated ticks and adult wild warthogs. The data from this and earlier studies suggest transfer of viruses of at least two different p72 genotypes, from wild to domestic pigs in East Africa.
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Vírus da Febre Suína Africana/genética , Febre Suína Africana/virologia , Carrapatos/virologia , Febre Suína Africana/epidemiologia , Animais , Quênia/epidemiologia , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase/veterinária , SuínosRESUMO
Three discrete regions of the African swine fever virus (ASFV) were analysed in the genomes of a wide range of isolates collected from wild and domestic pigs in Sardinia, over a 31-year period (1978-2009). The analysis was conducted by genotyping based on sequence data from three single copy ASF genes. The E183L gene encoding the structural protein p54 and part of the gene encoding the p72 protein were used to delineate genotypes, before intra-genotypic resolution of viral relationships by analysis of tetramer amino acid repeats within the hypervariable central variable region (CVR) of the B602L gene. The data revealed that these isolates did not show significant variation in their p72 and p54 sequence when compared between different isolates showing a remarkable genetic stability of these genome regions. In particular, the phylogeny revealed that all the Sardinian isolates belong to the same largest and most homogeneous p72 genotype I together with viruses from Europe, South America, the Caribbean and West Africa, and p54 genotype Ia which comprises viruses from Europe and America. The analysis of B602L gene revealed a minor difference in the number of tetramer repeats, placing the Sardinian isolates into two clusters, accordingly to their temporal distribution, namely sub-group III and sub-group X, this latter showing a deletion of 12 tetramer repeats located in the centre of the array. The genetic variation of this fragment suggests that one sub-group could be derived from the other supporting the hypothesis of a single introduction of ASFV in Sardinia.
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Vírus da Febre Suína Africana/genética , Vírus da Febre Suína Africana/isolamento & purificação , Febre Suína Africana/virologia , Variação Genética , Febre Suína Africana/epidemiologia , Vírus da Febre Suína Africana/química , Vírus da Febre Suína Africana/classificação , Sequência de Aminoácidos , Animais , Genótipo , Itália/epidemiologia , Dados de Sequência Molecular , Filogenia , Alinhamento de Sequência , Sus scrofa/virologia , Suínos , Proteínas Virais/química , Proteínas Virais/genéticaRESUMO
Precipitation is significantly influenced by the El Niño Southern Oscillation (ENSO), which is considered to be the most important factor that brings about climate variability. In this study, the asymmetry of the origin of continental precipitation anomalies during El Niño and La Niña events was investigated. An already validated Lagrangian approach was used to determine the proportion of the total Lagrangian precipitation that is of oceanic and terrestrial origin. Further, the role of these components of the Lagrangian precipitation in regions with significant precipitation anomalies during the ENSO was investigated. A two-phase asymmetric behavior of precipitation, particularly in tropical regions, was obtained. For some of these regions, precipitation anomalies based on other datasets were also calculated to confirm the observed changes, and for these regions, it was observed that in all cases, the calculated anomaly of Lagrangian precipitation agreed with the precipitation change. The percentage of precipitation of oceanic origin was higher in most of these regions. However, it was observed that an increase in the percentage of precipitation of oceanic origin did not bring about a general increase in precipitation for all the regions, revealing the importance of precipitation of terrestrial origin during both phases of the ENSO.
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Clima , El Niño Oscilação Sul , Modelos Teóricos , Oceanos e Mares , Tempo (Meteorologia) , Geografia , HumanosRESUMO
Most of the moisture transported in the globe has its origin in the well-known main moisture sources defined by Gimeno et al. [1]. They provide moisture for precipitation over continental areas in the world in different proportions. This paper presents the daily moisture contribution over each 0.5â¯×â¯0.5 continental gridded point from the three preferred moisture sources (primary, secondary, and tertiary) for continental extreme precipitation during the Peak Precipitation Month. The data consist of the moisture contribution ( | E - P < 0 | ) field by month from the three preferred sources obtained using an approach based on the Lagrangian particle dispersion model FLEXPART. The data here presented is directly related to the results presented in Vazquez et al. [2].
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This study aimed to compare the infection dynamics of three genotype II African swine fever viruses (ASFV) circulating in Europe. Eighteen domestic pigs divided into three groups were infected intramuscularly or by direct contact with two haemadsorbent ASFVs (HAD) from Poland (Pol16/DP/ OUT21) and Estonia (Est16/WB/Viru8), and with the Latvian non-HAD ASFV (Lv17/WB/Rie1). Parameters, such as symptoms, pathogenicity, and distribution of the virus in tissues, humoral immune response, and dissemination of the virus by blood, oropharyngeal and rectal routes, were investigated. The Polish ASFV caused a case of rapidly developing fatal acute disease, while the Estonian ASFV caused acute to sub-acute infections and two animals survived. In contrast, animals infected with the ASFV from Latvia developed a more subtle, mild, or even subclinical disease. Oral excretion was sporadic or even absent in the attenuated group, whereas in animals that developed an acute or sub-acute form of ASF, oral excretion began at the same time the ASFV was detected in the blood, or even 3 days earlier, and persisted up to 22 days. Regardless of virulence, blood was the main route of transmission of ASFV and infectious virus was isolated from persistently infected animals for at least 19 days in the attenuated group and up to 44 days in the group of moderate virulence. Rectal excretion was limited to the acute phase of infection. In terms of diagnostics, the ASFV genome was detected in contact pigs from oropharyngeal samples earlier than in blood, independently of virulence. Together with blood, both samples could allow to detect ASFV infection for a longer period. The results presented here provide quantitative data on the spread and excretion of ASFV strains of different virulence among domestic pigs that can help to better focus surveillance activities and, thus, increase the ability to detect ASF introductions earlier.
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Vírus da Febre Suína Africana , Febre Suína Africana , Doenças dos Suínos , Febre Suína Africana/epidemiologia , Vírus da Febre Suína Africana/genética , Animais , Genótipo , Sus scrofa , Suínos , VirulênciaRESUMO
A performance assessment of two different indices (the Standardized Precipitation Index (SPI) and the Standardized Precipitation Evapotranspiration Index (SPEI)) for monitoring short-term and short-medium-term drought impacts on daily specific-cause mortality in Spain was conducted. To achieve a comprehensive, nationwide view, a meta-analysis was performed using a combination of provincial relative risks (RRs). Moreover, the subdivisions of Spain based on administrative, climatic, and demographic criteria to obtain the measures of combined risks were also taken into account. The results of the SPEI and SPI calculated at the same timescale were similar. Both showed that longer drought events produced greater RR values, for respiratory mortality. However, at the local administrative level, Galicia, Castilla-y-Leon, and Extremadura showed the greatest risk of daily mortality associated with drought episodes, with Andalucía, País Vasco, and other communities being notably impacted. Based on climatic regionalization, Northwest, Central, and Southern Spain were the regions most affected by different drought conditions for all analyzed causes of daily mortality, while the Mediterranean coastal region was less affected. Demographically, the regions with the highest proportion of people aged 65 years of age and over reflected the greatest risk of daily natural, circulatory, and respiratory mortality associated with drought episodes.
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Algoritmos , Secas , Idoso , Eucariotos , Humanos , Mortalidade/tendências , Espanha/epidemiologiaRESUMO
There is little doubt about the effects of drought events on human health in the present climate. Projections of climate change indicate an increase in the occurrence and severity of droughts in the 21st century in a number of regions, thus it is likely that these types of hydrological extremes could have more of an impact if appropriate adaptation measures are not taken. The majority of studies on the effects of drought are focused on meteorological, agricultural, or hydrological contexts, but there are rather fewer assessments of the impacts of droughts on health. In particular, there have been hardly any attempts to compare different drought indices in order to identify and quantify the impacts of drought on health systems. In addition, rather better knowledge is needed on the mechanisms of vulnerability involved. In this paper, we attempt to describe the complexity of drought phenomena and the difficulty involved in quantifying the health risks linked to their occurrence. From an international perspective, we provide a brief review of the harmful effects of droughts on health in the context of climate change, as well as the vulnerability factors related to droughts. We make an assessment of aspects that have not yet been investigated, or which require further attention to be devoted to this topic. The principal aim of this paper is therefore to draw attention to the need to consider closely the relationship between drought indices and human health, in order to achieve a more fundamental understanding, and to propose specific courses or lines of action for future years, which could eventually be of use to healthcare providers and services.
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Mudança Climática , Secas , Aclimatação , Agricultura , HumanosRESUMO
After the extensive spread of the African swine fever virus (ASFV) genotype II in Eastern Europe, the first case of African swine fever (ASF) in Estonia was diagnosed in September 2014. By the end of 2019, 3971 ASFV-positive wild boars were found, and 27 domestic pig outbreaks were reported. A selection of ASFV isolates from wild boar and domestic pigs (during the period of September 2014-2019) was molecularly characterized using standardized genotyping procedures. One of the proven markers to characterize this virus is the central variable region (CVR) within the B602L gene. In summer 2015, a new ASFV genotype II CVR variant 2 (GII-CVR2) was confirmed in Estonia. The results suggest that the GII-CVR2 variant was only confirmed in wild boar from a limited area in southern Estonia in 2015 and 2016. In addition to GII-CVR2, a single nucleotide polymorphism (SNP) that resulted in amino acid change was identified within the genotype II CVR variant 1 (GII-CVR1). The GII-CVR1/SNP1 strain was isolated in Estonia in November 2016. Additional GII-CVR1/SNP1 cases were confirmed in two neighbouring counties, as well as in one outbreak farm in June 2017. Based on the available data, no GII-CVR2 and GII-CVR1/SNP1 have been reported by other affected European countries. The spread of variant strains in Estonia has been limited over time, and restricted to a relatively small area.