The Prevalence and Clinical Implications of Rectal SARS-CoV-2 Shedding in Danish COVID-19 Patients and the General Population

Background: SARS-CoV-2 has resulted in a global pandemic since its outbreak in Wuhan, 2019. Virus transmission primarily occurs through close contact, respiratory droplets, and aerosol particles. However, since SARS-CoV-2 has been detected in fecal and rectal samples from infected individuals, the fecal-oral route has been suggested as another potential route of transmission. This study aimed to investigate the prevalence and clinical implications of rectal SARS-CoV-2 shedding in Danish COVID-19 patients.Methods: Hospitalized and non-hospitalized adults and children who were recently tested with a pharyngeal COVID-19 test, were included in the study. A rectal swab was collected from all participants. Hospitalized adults and COVID-19 positive children were followed with both pharyngeal and rectal swabs until two consecutive negative results were obtained. RT-qPCR targeting the envelope gene was used to detect SARS-CoV-2 in the samples. Demographic, medical, and biochemical information was obtained through questionnaires and medical records.Results: Twenty-eight of 52 (53.8%) COVID-19 positive adults and children were positive for SARS-CoV-2 in rectal swabs. Seven of the rectal positive participants were followed for more than 6 days. Two of these (28.6%) continued to test positive in their rectal swabs for up to 29 days after the pharyngeal swabs had turned negative. Hospitalized rectal positive and rectal negative adults were comparable regarding demographic, medical, and biochemical information. Furthermore, no difference was observed in the severity of the disease among the two groups.Conclusions: We provided evidence of rectal SARS-CoV-2 shedding in Danish COVID-19 patients. The clinical importance of rectal SARS-CoV-2 shedding appears to be minimal.

Incidence of common infectious diseases in Japan during the COVID-19 pandemic

Recent reports indicate that respiratory infectious diseases were suppressed during the novel coronavirus disease-2019 (COVID-19) pandemic. COVID-19 led to behavioral changes aimed to control droplet transmission or contact transmission. In this study, we examined the incidence of common infectious diseases in Japan during the COVID-19 pandemic. COVID-19 data were extracted from the national data based on the National Epidemiological Surveillance of Infectious Diseases (NESID). Common infectious diseases were selected from notifiable infectious diseases under the NESID. The epidemic activity of the diseases during 2015–2020 was evaluated based on the Infectious Disease Weekly Reports published by the National Institute of Infectious Diseases. Each disease was then categorized according to the route of transmission. Many Japanese people had adopted hygienic activities, such as wearing masks and hand washing, even before the COVID-19 pandemic. We examined the correlation between the time-series of disease counts of common infectious diseases and COVID-19 over time using cross-correlation analysis. The weekly number of cases of measles, rotavirus, and several infections transmitted by droplet spread, was negatively correlated with the weekly number of cases of COVID-19 for up to 20 weeks in the past. According to the difference-in-differences analysis, the activity of influenza and rubella was significantly lower starting from the second week in 2020 than that in 2015–2019. Only legionellosis was more frequent throughout the year than in 2015–2019. Lower activity was also observed in some contact transmitted, airborne-transmitted, and fecal-oral transmitted diseases. However, carbapenem-resistant Enterobacteriaceae, exanthema subitum, showed the same trend as that over the previous 5 years. In conclusion, our study shows that public health interventions for the COVID-19 pandemic may have effectively prevented the transmission of most droplet-transmitted diseases and those transmitted through other routes.

Detection of enteroparasites in foliar vegetables commercialized in street- and supermarkets in Aparecida de Goiânia, Goiás, Brazil

Foliar vegetables contaminated with fecal residues are an important route of transmission of intestinal parasites to humans. The aim of this study was to evaluate the presence of parasitic forms of protozoa and helminths on lettuces (Lactuca sativa) and collard greens (Brassica oleracea) sold in street- and supermarkets in the city of Aparecida de Goiânia, Goiás, Brazil. A total of 30 samples of each vegetable (15 samples from each supermarkets and street markets) was analyzed. All samples were processed by spontaneous sedimentation method and centrifugal flotation. In 45% of the samples, immature forms of intestinal parasites were identified with 66.7% helminths eggs and 33.3% protozoan cysts or oocysts. Significantly more lettuce samples were contaminated with eggs, cysts or oocyst of at least one parasite than collard green samples (U=216; Z=-3.45; P <0.001). The parasitic forms were identified morphologically up to the family level with eggs of Ancylostomatidae, Strongyloididae, Ascarididae and Taeniidae, or oocysts of Eimeriidae, to the genus with Cystoisospora sp. and Toxocara sp., and to the species level with Cystoisospora canis, Dipylidium caninum and Hymenolepis nana. The presence of these infective agents in lettuce and collard green from both street- and supermarkets highlights the high risk of spreading parasites by eating raw vegetables sold in Aparecida de Goiânia.

Environmental Vulnerability: Theoretical Study of SARSCoV-2 Control During Team Water Sports / Vulnerabilidade ambiental: Estudo teórico do controle do SARSCoV-2 durante esportes aquáticos coletivos

This paper analyzes possible chains of transmission of SARS CoV-2 during water sports practice and discuss control measures of COVID-19 adopted through specific national and international health protocols, more specifically related to the insertion of interventions in the city to propitiate the development of aquatic activities. This is explorative research of technical literature review to present the current state of knowledge regarding the occurrence, persistence and possibility of virus transmission during the practice of collective water sports and related activities. National and International health protocols were analyzed in terms of their safety, functionality and premises. The protocols and studies examined emphasize concerns that the airways are the route of transmission with the highest rate of contamination through respiratory droplets and contact with contaminated surfaces. The research confirmed the hypothesis that the current preventive measures established in health protocols to mitigate the spread of COVID-19 in aquatic environments if observed, are sufficient to prevent the transmission of the disease in these locations. More specifically, to control the spread of the new coronavirus, it is necessary to avoid close contact with another individual without facial protection, crowds, and places with poor ventilation.

Prevalence of Parasitic Infections in a Tertiary Hospital in China: A 12-Year Retrospective Study

BackgroundParasitic infections represent a worldwide public health issue in many developing countries. Few epidemiological studies regarding parasitic infections and the evolution of infection spectrum in China have been reported up to date. It is necessary to investigate the epidemiological feature of parasitic infection during recent years.MethodsThree hundred and thirty-six cases of parasitic infections were retrospectively enrolled and analyzed. Electronic medical records of the enrolled parasitic patients from January 1, 2010 to May 31, 2021 were retrieved from the Electronic Medical Record System of a tertiary hospital in China. Demographic characteristics and data of laboratory tests were exported in Excel and analysis were performed using Graphpad Prism 5.ResultsOverall, seventeen species of parasites were detected in 336 admissions with a total number of infected individuals reached the peak in 2018. Moreover, the regions of patients distributed mainly included: Shanghai (40.48%), Zhejiang (18.45%), Anhui (6.85%), Jiangsu (6.25%) and Jiangxi (4.76%). Two hundred and eighty-eight cases were diagnosed with single species of parasitic infection and 47 cases were found mixed species infection. Foodborne parasites (FBPs) were the primary species of parasites and the top 4 were clonorchis sinensis (24.70%), sparganum mansoni (16.07%), paragonimus westermani (20.83%) and cysticercus (17.86%). Obvious eosinophil elevation was found in 56.54% enrolled patients. Patients with periods of infection before the time of diagnosis lasted longer than 6 months includes four parasites: sparganum mansoni (28.30%, 15/53), paragonimus westermani (38.57%, 27/70), cysticercus (25.00%, 15/60).ConclusionsOur study demonstrated the prevalence of parasitic infection over the latest 12 years in a single center of China. The trend of parasitic infection rate reached the peak in 2018 with the dominating parasitic species changed from soil origin to foodborne. Furthermore, with the emergence of various dietary habits and the development of living conditions, unclean diets especially eating raw meat had become the main route of transmission for parasites, which alarmed that food safety education for public should be strengthened and enlarged. Although eosinophil elevation and IgE is reliable indicators for initiating screening of parasitic infection but enough for diagnosis, novel diagnostic kits for parasites should be devepoled.

Survival and detection of bivalve transmissible neoplasia from the soft-shell clam Mya arenaria (MarBTN) in seawater

Many pathogens can cause cancer, but cancer itself does not normally act as an infectious agent. However, transmissible cancers have been found in a few cases in nature: in Tasmanian devils, dogs, and several bivalve species. The transmissible cancers in dogs and devils are known to spread through direct physical contact, but the exact route of transmission of bivalve transmissible neoplasia (BTN) has not yet been confirmed. It has been hypothesized that cancer cells could be released by diseased animals and spread through the water column to infect/engraft into other animals. To test the feasibility of this proposed mechanism of transmission, we tested the ability of BTN cells from the soft-shell clam (Mya arenaria BTN, or MarBTN) to survive in artificial seawater. We found that BTN cells are highly sensitive to salinity, with acute toxicity at salinity levels lower than those found in their environment. BTN cells also survive longer at lower temperatures, with >48% of cells surviving a week in seawater at temperatures from 4°C to 16°C, and 49% surviving for more than two weeks at 4°C. With one clam donor, living cells were observed for more than eight weeks at 4°C. We also used qPCR of environmental DNA (eDNA) to detect the presence of BTN-specific DNA in the environment. We observed release of BTN-specific DNA into the water of aquaria from tanks with highly BTN-positive clams, and we detected BTN-specific DNA in seawater samples collected from BTN-endemic areas, although the level detected was much lower. Overall, these data show that BTN cells can survive well in seawater, and they are released into the water by diseased animals, supporting the hypothesis that BTN is spread from animal-to-animal by cells through seawater.

Interruption of mother-to-child transmission and detection and treatment of children of infected mothers as a contribution to eradicate Chagas disease in Europe

Chagas disease is grouped among the Neglected Tropical Diseases (NTD), according to the classification of WHO and among the Neglected Infectious Diseases susceptible to be eliminated according to PAHO (EID). Chagas disease is the most common NTD (or EID) in wide areas of South and Central America where the vector – an insect, which transmits the parasite Trypanosoma cruzi via its bite – and the great majority of patients live. However, due to population movements, this disease has now become a global problem, especially in the USA and Spain. The control of transmission by the vector or by blood transfusions has progressed considerably. However, transmission by other routes, namely oral and mother-to-child are still a challenge in regards of control and access to health care. In the countries where transmission by the vector doesn’t take place, vertical transmission is the main route of transmission. Taking into account that there is a huge gap in diagnosing and treating patients suffering from Chagas disease, early diagnosis and treatment of infected women in childbearing age, pregnant women and children, as well as asymptomatic infected people, is an important contribution towards the control of this disease which is potentially fatal if left untreated. Aiming for this objective, all available tools should be optimized and implemented. There are several countries and regions already implementing this strategy in this particular group of women and children. The advances achieved are a good example of the collaboration between organizations and institutions in the public and private sectors, although a greater political commitment is needed in order to achieve Chagas elimination as a public health problem by 2030 as promoted by the ETMI-Plus strategy established by PAHO, the new WHO-NTD road map, the UN sustainable development goals (SDG) and the program “No baby with Chagas” launched by the SEGIB.

Epidemiological, clinical and laboratory differences between male urethral infections due to Haemophilus spp. and those due to Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and Ureaplasma urealyticum: A descriptive study

Objective: To describe the epidemiological, clinical and laboratory characteristics of male patients diagnosed with Haemophilus spp. urethral infection and to compare them with the characteristics of male patients diagnosed with N. gonorrhoeae, C. trachomatis, M. genitalium and U. urealyticum urethral infection. Over the past 2 years, an increase in urethral infections due to Haemophilus spp. was observed. Materials and methods: All male patients who attended our Department of Sexually Transmitted Infections between January 2018 and February 2019 were retrospectively studied; they underwent conventional bacteriological and multiplex PCR studies in the urethra at the same time. Results: Of the 86 patients studied, a unique microorganism was detected in 76 cases, N. gonorrhoeae in 24, Haemophilus spp. in 21 (16 H. parainfluenzae and 5 H. influenzae), C. trachomatis in 19, M. genitalium in 8 and U. urealyticum in 4; 10 cases presented more than one microorganism. In case of multiple aetiological agents, sexual partnership was multiple. In the Haemophilus group, 81% reported only unprotected oral insertive sex; symptoms lasted for more than one week in 62% of the patients. Conclusions: Haemophilus is an aetiological agent of non-gonococcal urethritis whose incidence is clearly increasing; the main route of transmission is oral sex. The most common reason for consultation is dysuria and testicular pain, while urethral discharge was predominant for the other causes of urethral infection. Due to the high frequency of antibiotic resistance in the Haemophilus group, it is necessary to confirm eradication by performing a test of cure.

Prolonged Detection of SARS CoV2 RNA in Extracellular Vesicles in Nasal Swab RT-PCR Negative Patients

Background: There is a prolonged RT PCR positivity seen in COVID-19 infected patients up to 2 to 3 months. It is assumed that this virus is usually non-infective but there are hardly any study on the reactivation of this virus within the respiratory tract. We aim to investigate the presence of viral particles inside Extracellular vesicles (EV) and its role in underlying liver disease patients. Methods: SARS CoV2 nasal and throat swab RT-PCR positive n=78 {n=24(66.6%) chronic liver disease (CLD); n=52 (81.3%) non liver disease} n=5 RT PCR negative subjects (HC) were studied. SARS CoV2 patients were also followed up for day (d) 7, 14 and 28. Nasal swab [collected in viral transport media (VTM)] and plasma samples were investigated at each time point. Extracellular vesicles were isolated using differential ultracentrifugation. SARS CoV2 RNA was measured using qRT-PCR by Altona Real Star kit. Cellular origin of EV was confirmed using epithelial cells (Epcam+ CK19+ CDh1+), endothelial cells (CD31+CD45-), and hepatocytes (ASGPR+) surface markers by Flow cytometry. Results: The COVID19 patients {Mean age 54±23 years; 41 males} were having severity between moderate to severe. In patients with cirrhosis, the most common aetiology of liver disease was alcohol (MELD 22±8). In baseline RT-PCR positive patients, SARS-CoV2 RNA inside the EV was present in 64/74 (82%) patients with comparable viral load between VTM and EV (mean 1/CT 0.033±0.005 vs. 1/CT 0.029±0.014, p=ns). On follow-up at day 7, of the 24 patients negative for COVID19, 10 (41%) had persistence of virus in the EV (1/CT 0.028±0.004) and on day 14, 14 of 40 (35%) negative RT-PCR had EVs with SARS CoV2 RNA (1/CT 0.028±0.06). The mean viral load decreased at day7 and day14 in nasal swab from baseline (p=0.001) but not in EV. SARS-CoV2 RNA otherwise undetectable in plasma, was found to be positive in EV in 12.5% of COVID19 positive patients. Interestingly, significantly prolonged and high viral load was found in EV at day 14 in CLD COVID19 patients compared to COVID19 alone (p=0.002). The high cellular injury was seen in CLD COVID19 infected patients with significant high levels of EV associated with endothelial cells and hepatocytes than COVID19 alone (p=0.004; 0.001). Conclusion: Identification of SARS-CoV2 RNA in EV, in RT-PCR negative patients indicates persistence of infection for and likely recurrence of the infection. It is suggestive of another route of transmission as EV harbour SARS CoV2 RNA. EV associated RNA may determine the ongoing inflammation and clinical course of subjects with undetectable SARS-CoV2 virus and this may also have relevance in management of chronic liver disease patients.

A STUDY TO ASSESS THE KNOWLEDGE AND PREVENTIVE BEHAVIOR RELATED TO COVID -19 AMONG HEALTH CARE PROFESSIONALS

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Most people infected with the virus will experience mild to moderate respiratory illness and recover without requiring special treatment. However, some will become seriously ill and require medical attention. The best way to prevent and slow down transmission is to be well informed about the disease and how the virus spreads. Protect yourself and others from infection by staying at least 1 metre apart from others, wearing a properly tted mask, and washing your hands or using an alcohol-based rub frequently. Get vaccinated when it's your turn and follow local guidance. The disease is highly infectious, and further studies identied that the most important route of transmission to humans occurred via respiratory droplets or direct contact, with an incubation period ranging from 2 to 14 days. Healthcare providers are the primary individuals in contact with patients who are the main source of infections; thus, they are at high risk of becoming infected themselves. Their knowledge and risk perception on covid 19 plays an important role in preventing them from acquiring the disease themselves. In the present study we are trying to assess the knowledge and preventive behavior followed by the medical professionals from NRI medical college, sangivalasa.