Exposure Patterns Driving Ebola Transmission in West Africa:A Retrospective Observational Study

BackgroundThe ongoing West African Ebola epidemic began in December 2013 in Guinea, probably from a single zoonotic introduction. As a result of ineffective initial control efforts, an Ebola outbreak of unprecedented scale emerged. As of 4 May 2015, it had resulted in more than 19,000 probable and confirmed Ebola cases, mainly in Guinea (3,529), Liberia (5,343), and Sierra Leone (10,746). Here, we present analyses of data collected during the outbreak identifying drivers of transmission and highlighting areas where control could be improved.Methods and findingsOver 19,000 confirmed and probable Ebola cases were reported in West Africa by 4 May 2015. Individuals with confirmed or probable Ebola ("cases") were asked if they had exposure to other potential Ebola cases ("potential source contacts") in a funeral or non-funeral context prior to becoming ill. We performed retrospective analyses of a case line-list, collated from national databases of case investigation forms that have been reported to WHO. These analyses were initially performed to assist WHO's response during the epidemic, and have been updated for publication. We analysed data from 3,529 cases in Guinea, 5,343 in Liberia, and 10,746 in Sierra Leone; exposures were reported by 33% of cases. The proportion of cases reporting a funeral exposure decreased over time. We found a positive correlation (r = 0.35, p ConclusionsAchieving elimination of Ebola is challenging, partly because of super-spreading. Safe funeral practices and fast hospitalisation contributed to the containment of this Ebola epidemic. Continued real-time data capture, reporting, and analysis are vital to track transmission patterns, inform resource deployment, and thus hasten and maintain elimination of the virus from the human population

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Effect of two different hypocaloric diets in transaminases and insulin resistance in nonalcoholic fatty liver disease and obese patients Efecto de dos dietas hipocalóricas en los niveles de transaminasas y resistencia a la insulina en pacientes obesos con hígado graso no alcohólico

Objective: The aim of our study was to examine the changes in hypertransaminasemia after weight reduction in obese patients with and without NAFLD and the relation with insulin resistance. Research Methods: A population of 162 obese patients was randomly allocated to two groups: a) diet I (low fat) and b) diet II (low carbohydrate), dieting along 3 months. Patients were classified as group I (n=112) when serum ALT activity was normal or group II (NAFLD, n=30) when serum ALT activity was ( > or = 43 UI/L). Results: In control group with diet I, BMI, weight, fat mass, waist to hip ratio, waist circumference, systolic pressure, total cholesterol, LDL cholesterol, HOMA and insulin levels decreased. In NAFLD group with diet I improved the same parameters and glucose, triglycerides, ALT, AST, gamaglutamine transferase levels, too. In control group with diet II, BMI, weight, fat mass, waist to hip ratio, waist circumference, systolic pressure, total cholesterol, LDL cholesterol, HOMA and insulin levels decreased. In NAFLD group with diet II improved the same parameters and glucose, triglycerides, ALT and gamaglutamine transferase levels, without statistical changes in AST. Conclusion: We showed that weight reduction secondary to two hypocaloric diets was associated with improvement in hipertransaminasemia and insulin resistance in NAFLD patients.Objetivo: El objetivo de nuestro trabajo fue evaluar los cambios en las transaminasas tras la perdida de peso en pacientes obesos con y sin esteatohepatitis no alcohólica (EHNA) y su relación con la resistencia a la insulina. Material y métodos: Se aleatorizó una muestra de 162 pacientes obesos en dos grupos: a) dieta I (baja en grasa) y b) dieta II (baja en hidratos de carbono), siguiendo al dieta durante 3 meses. Los pacientes se clasificaron como grupo I (n=112), con unos niveles de ALT normales y grupo II (EHNA, n=30) con unos niveles de ALT superiores a 43 UI/L. Resultados: En el grupo I con la dieta I disminuyó el IMC, peso, masa grasa, índice cintura cadera, circunferencia cintura, presión sistólica, colesterol LDL, colesterol total, HOMA e insulina. En el grupo NASH con la dieta I disminuyeron los mismos parámetros además de la glucosa, triglicéridos, ALT, AST y gamaGT. En el grupo control con la dieta II disminuyó el IMC, peso, masa grasa, índice cintura cadera, circunferencia de la cintura, presión sistólica, colesterol total, LDL colesterol, HOMA e insulina. En el grupo NASH con la dieta II disminuyeron los mismos parámetros junto a la glucosa, triglicéridos, ALT y gama GT sin cambios en os niveles de ALST. Conclusión: La perdida de peso con dos dietas hipocalÓricas diferentes mejora los niveles de tranasminasas y la resistencia a la insulina en pacientes con NASH