West Nile virus infections in Romania after the 2010 outbreak - a retrospective study in human and animal population

In this study the authors have made a retrospective analysis of West Nile virus infection in human and animals after 2010. Few studies have dealt with this arbovirosis in the last years and there is no analysis to correlate the evolution in animals and humans. To date it is considered that the largest outbreak of West Nile virus (WNV) encephalitis from Europe was registered in 1996 in Romania. Cases of encephalitis with WNV have been reported in our country before first in 1955 in Transylvania, followed by an outbreak in 1964 in Banat. The outbreak from 1996, ended with over 390 confirmed cases of encephalitis in humans the majority being registered in Bucharest and in the southern area of Romania. The epidemiological situation, after the implementation of a surveillance system for WNV in humans until 2010, was characterized by sporadic cases, WNV being reported yearly, except 2002. The infections were reported mostly in the south and south eastern area of the country. The age distribution in human cases recorded a majority in the group age over 65 years due to the senescence of the immune system and the associated diseases. The gender ratio was dominant for men, considering the occupational factor. In 2010 the second large outbreak of WNV was recorded and 47 confirmed cases of WNV infection were registered. After 2010, WNV encephalitis was recorded yearly and the area of detection was confined to eastern area and slowly to the to the whole country. Human cases were registered yearly in areas where the virus was detected in animals by serological screening. Considering the analyzed data, we can state that the main feature of WNV infection is the continuous virus spreading over the territory both in humans and animals. This can be determined by the climatic changes, that allow the surviving and multiplication of the competent vectors in new areas and maybe of the changes in the migratory routes of the birds- main amplifying hosts. Unfortunately, no statistical correlation between human and animal cases could be made. We can state that WNV is continuing to represent a threat for public health and more in depth research has to be made in order to characterize the evolution of the infection in our country and the causes of its endemisation

Diversity of nontuberculous mycobacteria isolated from animal samples

Limited data is available regarding the epidemiology of the nontuberculous mycobacteria (NTM) in Romania, in both human and veterinary medicine. The objective of the present study was the identification and characterization of the Mycobacterium avium complex species isolated from backyard poultry and ruminant samples. The molecular identification and genotyping was performed in ANSES, Laboratory for Animal Health, Maisons-Alfort, France, by real time PCR, with a wide range of targets: hsp65, IS6110, IS1081, IS1245, IS901 and MIRU-VNTR. M. avium avium and M. avium paratuberculosis were the two species identified. Five different profiles were obtained through genotyping, four of which had corresponding INMV (INRA Nouzilly MIRU-VNTR) profiles: INMV 2, INMV 67, INMV 99 and INMV 100. The technique differentiated between the M. avium paratuberculosis isolated from sheep and cattle and expressed a high discriminatory power, proving to be extremely useful for assessing the genetic diversity of the tested animal origin samples and providing comparable information on the general structure and main pathogens belonging to MAC

First Record of West Nile Virus Specific Seroconversion in Dogs From Eastern Romania

West Nile virus (WNV) infection causes diseases that vary in intensity from asymptomatic to fatal encephalitis in humans and animals. The etiological agent is a Flavivirus belonging to Japanesse Encephalitis complex. This zoonotic virus is maintained in nature in an enzootic cycle between mosquitoes and birds as amplifying hosts. Except birds, a wide variety of animals develop seroconversion caused by infection, and previous studies indicated that dogs may be considered as sentinel for WNV. The importance of studying this virus is caused by its zoonotic character, limited possibilities of active surveillance and real-time alertness of the infection’s presence in the human and animal populations. The aim of the study was to demonstrate and estimate the seroconversion in dogs within an area with confirmed cases in humans and animals. A total number of 76 serum samples were evaluated for the presence of specific anti WNV antibodies using a commercial competitive ELISA kit, for the detection of anti-pr-E antibodies (ID Screen® West Nile Competition Multi-species). The results indicated specific antibodies in 32 (42.1%) out of 76 samples tested. Positive results were recorded in all four counties from which samples were collected. Our preliminary results proved the circulation of WNV in dogs in areas where the infection was previously reported in animals and humans

Species diversity, host preference and arbovirus detection of Culicoides (Diptera: Ceratopogonidae) in south-eastern Serbia

BackgroundCulicoides (Diptera: Ceratopogonidae) is a genus of small biting midges (also known as no-see ums) that currently includes 1368 described species. They are proven or suspected vectors for important pathogens affecting animals such as bluetongue virus (BTV) and Schmallenberg virus (SBV). Currently little information is available on the species of Culicoides present in Serbia. Thus, the aim of this study was to examine species diversity, host preference and the presence of BTV and SBV RNA in Culicoides from the Stara Planina Nature Park in south-eastern Serbia.ResultsIn total 19,887 individual Culicoides were collected during three nights of trapping at two farm sites and pooled into six groups (Obsoletus group, Pulicaris group, Others group and further each group according to the blood-feeding status to freshly engorged and non-engorged). Species identification was done on subsamples of 592 individual Culicoides specimens by morphological and molecular methods (MALDI-TOF mass spectrometry and PCR/sequencing). At least 22 Culicoides species were detected. Four animal species (cow, sheep, goat and common blackbird) as well as humans were identified as hosts of Culicoides biting midges. The screening of 8291 Culicoides specimens in 99 pools for the presence of BTV and SBV RNA by reverse-transcription quantitative PCR were negative.ConclusionsThe biodiversity of Culicoides species in the natural reserve Stara Planina was high with at least 22 species present. The presence of C. imicola Kieffer was not recorded in this area. Culicoides showed opportunistic feeding behaviour as determined by host preference. The absence of SBV and BTV viral RNA correlates with the absence of clinical disease in the field during the time of sampling. These data are the direct outcome of a training programme within the Institutional Partnership Project AMSAR: Arbovirus monitoring, research and surveillance-capacity building on mosquitoes and biting midges funded by the programme SCOPES of the Swiss National Science Foundation

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake