Defining County-Level Terrestrial Rabies Freedom Using the US National Rabies Surveillance System: Surveillance Data Analysis

Background: Rabies is a deadly zoonotic disease with nearly 100% fatality rate. In the United States, rabies virus persists in wildlife reservoirs, with occasional spillover into humans and domestic animals. The distribution of reservoir hosts in US counties plays an important role in public health decision-making, including the recommendation of lifesaving postexposure prophylaxis upon suspected rabies exposures. Furthermore, in surveillance data, it is difficult to discern whether counties have no cases reported because rabies was not present or because counties have an unreported rabies presence. These epizootics are monitored by the National Rabies Surveillance System (NRSS), to which approximately 130 state public health, agriculture, and academic laboratories report animal rabies testing statistics. Historically, the NRSS classifies US counties as free from terrestrial rabies if, over the previous 5 years, they and any adjacent counties did not report any rabies cases and they tested ≥15 reservoir animals or 30 domestic animals. Objective: This study aimed to describe and evaluate the historical NRSS rabies-free county definition, review possibilities for improving this definition, and develop a model to achieve more precise estimates of the probability of terrestrial rabies freedom and the number of reported county-level terrestrial rabies cases. Methods: Data submitted to the NRSS by state and territorial public health departments and the US Department of Agriculture Wildlife Services were analyzed to evaluate the historical rabies-free definition. A zero-inflated negative binomial model created county-level predictions of the probability of rabies freedom and the expected number of rabies cases reported. Data analyzed were from all animals submitted for laboratory diagnosis of rabies in the United States from 1995 to 2020 in skunk and raccoon reservoir territories, excluding bats and bat variants. Results: We analyzed data from 14,642 and 30,120 county-years in the raccoon and skunk reservoir territories, respectively. Only 0.85% (9/1065) raccoon county-years and 0.79% (27/3411) skunk county-years that met the historical rabies-free criteria reported a case in the following year (99.2% negative predictive value for each), of which 2 were attributed to unreported bat variants. County-level model predictions displayed excellent discrimination for detecting zero cases and good estimates of reported cases in the following year. Counties classified as rabies free rarely (36/4476, 0.8%) detected cases in the following year. Conclusions: This study concludes that the historical rabies freedom definition is a reasonable approach for identifying counties that are truly free from terrestrial raccoon and skunk rabies virus transmission. Gradations of risk can be measured using the rabies prediction model presented in this study. However, even counties with a high probability of rabies freedom should maintain rabies testing capacity, as there are numerous examples of translocations of rabies-infected animals that can cause major changes in the epidemiology of rabies

Amino Acid for Japanese Quails: Methodologies and Nutritional Requirement

The methodologies applied to chickens and laying hens, to determine the digestibility and requirement of protein and amino acids are used with quails, however, they need a more careful evaluation due to peculiarities inherent to the Coturnix genus, in order to provide consistent results. The nutritional requirements of the birds are determinate using the dose-response and the factorial method. Several mathematical models and techniques of diet formulation are allied to the dose-response method in determining nutritional requirements. The curvilinear (hyperbolic) models better portray population behaviour in response to increasing nutrient doses in diets. The reading model, allow a better estimation of the requirement, in relation to the mathematical models used in the dose-response method. The techniques of comparative slaughter and nitrogen balance are effective in determining the nutritional requirements of quails, however, the latter need to be corrected by the loss of nitrogen in the feathers in determining the requirements of crude protein and amino acids for maintenance. The protein-free diet, coupled with the industrial amino acid supplementation, provides more robust digestibility values, since it more effectively predicts the endogenous excretion pattern

Adesão e efeitos do exercício físico em pacientes cardiopatas

As doenças cardiovasculares têm prevalência elevada e são responsáveis por milhares de mortes todos os anos, promovendo impacto importante no sistema de saúde. Além disso, frequentemente causam limitação funcional do paciente, sendo fundamental nesse sentido, o uso da reabilitação cardiovascular logo após o incidente cardiológico. Objetivo: identificar a adesão e efeitos que os exercícios físicos provocaram no estado geral de saúde em pacientes cardiopatas. Metodologia: foi realizada uma pesquisa descritiva, transversal, com abordagem quantitativa, utilizando aplicação de questionários por meio de formulário eletrônico. Os dados foram coletados durante os meses de abril e maio de 2022. Os critérios de inclusão foram adultos de ambos os sexos, com 18 anos ou mais, necessariamente cardiopatas, que espontaneamente concordaram em participar depois de lerem e aceitarem o termo de consentimento livre e esclarecido. Resultados: foram obtidas 81 respostas de indivíduos de ambos os sexos, com um número ligeiramente superior correspondendo ao sexo feminino (50,6%). A faixa etária predominante foi entre 30 e 60 anos, com 62% de representatividade. Foi percebida também predominância quanto ao índice de massa corporal nos parâmetros definidos como sobrepeso e obesidade, com 76,5% dos indivíduos. Foi possível verificar que a maioria dos pacientes recebeu prescrição para realizar atividade física após o diagnóstico (90,1%) e, destes, 87% aderiram à essa recomendação. Conclusão: Foi possível verificar a concordância da conduta médica com as diretrizes da Sociedade Brasileira de Cardiologia em relação à prescrição da prática de atividade física para a maioria dos pacientes. Entre os indivíduos que incorporaram a realização de exercícios físicos em sua rotina, houve maior percepção de melhora refletindo em maior qualidade de vida

HPV-Positive Cervical Cancer Cells Show Generally Reduced Levels of IFN-Alpha

Cervical cancer is typically induced by the presence of Human papillomavirus (HPV), the most common viral sexually transmitted infection in the United States. The presence of HPV has been shown to reduce the body\u27s antiviral response by decreasing the levels of IRF-3, a transcription factor that controls the Interferon (IFN) antiviral proteins, within infected human cells. As an extension of these studies, we compared IFN-alpha levels in HPV-positive and HPV-negative cervical cancer cell lines. ELISA analysis was used to determine IFN-alpha protein levels in supernatants from cultured cell lines. Consistent trends suggest that HPV-positive cervical cancer cells show a reduction in IFN-alpha secreted when compared to HPV-negative cervical cancer cells, although significance was not found between the two cell lines. A reduction in IFN-alpha by HPV suggests HPV\u27s ability to evade a cell\u27s response to viral infections. Understanding this mechanism may provide further insight into the development of cervical cancer

Evaluation of country infrastructure as an indirect measure of dog-mediated human rabies deaths

BackgroundRabies is a neglected disease, primarily due to poor detection stemming from limited surveillance and diagnostic capabilities in most countries. As a result, there is limited ability to monitor and evaluate country, regional, and global progress towards the WHO goal of eliminating human rabies deaths by 2030. There is a need for a low-cost, readily reproducible method of estimating rabies burden and elimination capacity in endemic countries.MethodsPublicly available economic, environmental, political, social, public health, and One Health indicators were evaluated to identify variables with strong correlation to country-level rabies burden estimates. A novel index was developed to estimate infrastructural rabies elimination capacity and annual case-burden for dog-mediated rabies virus variant (DMRVV) endemic countries.FindingsFive country-level indicators with superior explanatory value represent the novel “STOP-R index:” (1) literacy rate, (2) infant mortality rate, (3) electricity access, (4) political stability, and (5) presence/severity of natural hazards. Based on the STOP-R index, 40,111 (95% CI 25,854–74,344) global human rabies deaths are estimated to occur in 2022 among DMRVV-endemic countries and are projected to decrease to 32,349 (95% CI 21,110–57,019) in 2030.InterpretationThe STOP-R index offers a unique means of addressing the data gap and monitoring progress towards eliminating dog-mediated human rabies deaths. Results presented here suggest that factors external to rabies programs influence the successes of rabies elimination, and it is now possible to identify countries exceeding or lagging in expected rabies control and elimination progress based on country infrastructure

Oral bait preferences and feasibility of oral rabies vaccination in Bangladeshi dogs

Oral rabies vaccination (ORV) can increase rabies vaccination coverage among dogs that are inaccessible to parenteral vaccination (i.e., inaccessible dogs). Because bait uptake can differ according to the bait attractant used and dog characteristics, we evaluated proportion of bait uptake and time to bait uptake using three bait formulations. We looked for associations between bait uptake and dog characteristics (temperament, age, and body condition) and assessed the efficiency of using these bait formulations, as measured by number of dogs vaccinated per hour. A total of 356 baits were offered to free roaming dogs in urban and peri-urban districts of Bangladesh. Fish baits were ignored by 86% (n = 122; 95% CI: 79–91%) of dogs, whereas 60% (n = 45; 95% CI: 49–70%) consumed egg baits and 89% (n = 124; 95% CI: 83–93%) consumed intestine baits. Among the consumed baits, dogs fully consumed 56% (n = 10; 95% CI: 34–75%) of fish baits, 84% (n = 38; 95% CI: 71–92%) of egg baits, and 98% (n = 122; 95% CI: 94–100%) of intestine baits. Among inaccessible dogs, no associations were found between bait uptake and dog characteristics in either bivariate or multivariate analyses. Bait consumption averaged 2 dogs per hour for fish baits, 10 dogs per hour for egg baits, and 18 dogs per hour for intestine baits. The absence of association between bait type preference and individual dog characteristics simplifies the process of choosing attractants for oral rabies vaccines. While intestine attractants achieved highest uptake, egg baits may prove a suitable compromise when considering biological and operational constraints. The efficiency of ORV was demonstrated when compared to parenteral vaccination of free-roaming dogs previously described

Rabies post-exposure healthcare-seeking behaviors and perceptions: Results from a knowledge, attitudes, and practices survey, Uganda, 2013.

BackgroundRabies is a viral disease of animals and people causing fatal encephalomyelitis if left untreated. Although effective pre- and post-exposure vaccines exist, they are not widely available in many endemic countries within Africa. Since many individuals in these countries remain at risk of infection, post-exposure healthcare-seeking behaviors are crucial in preventing infection and warrant examination.MethodologyA rabies knowledge, attitudes, and practices survey was conducted at 24 geographically diverse sites in Uganda during 2013 to capture information on knowledge concerning the disease, response to potential exposure events, and vaccination practices. Characteristics of the surveyed population and of the canine-bite victim sub-population were described. Post-exposure healthcare-seeking behaviors of canine-bite victims were examined and compared to the related healthcare-seeking attitudes of non-bite victim respondents. Wealth scores were calculated for each household, rabies knowledge was scored for each non-bitten survey respondent, and rabies exposure risk was scored for each bite victim. Logistic regression was used to determine the independent associations between different variables and healthcare-seeking behaviors among canine-bite victims as well as attitudes of non-bitten study respondents.ResultsA total of 798 households were interviewed, capturing 100 canine-bite victims and a bite incidence of 2.3 per 100 person-years. Over half of bite victims actively sought medical treatment (56%), though very few received rabies post-exposure prophylaxis (3%). Bite victims who did not know or report the closest location where PEP could be received were less likely to seek medical care (p = 0.05). Respondents who did not report having been bitten by a dog with higher knowledge scores were more likely to respond that they would both seek medical care (p = 0.00) and receive PEP (p = 0.06) after a potential rabies exposure event.ConclusionsThere was varying discordance between what respondents who did not report having been bitten by a dog said they would do if bitten by a dog when compared to the behaviors exhibited by canine-bite victims captured in the KAP survey. Bite victims seldom elected to wash their wound or receive PEP. Having lower rabies knowledge was a barrier to theoretically seeking care and receiving PEP among not bitten respondents, indicating a need for effective and robust educational programs in the country

Humoral and cellular immunogenicity and safety following a booster dose of a tetravalent dengue vaccine 5+ years after completion of the primary series in Singapore: 2-year follow-up of a randomized Phase II, placebo-controlled trial

10.1080/21645515.2020.1861875Human Vaccines & Immunotherapeutics1772107-211