With climate change, the geographic distribution of some VBDs has expanded, highlighting the need for adaptation, and managing the risks associated with emergence in new areas. We conducted a questionnaire survey on the knowledge, attitudes, and practices (KAP) about vector-borne diseases (VBDs) among sample of Finnish residents. The questions were scored and the level of KAP was determined based on scoring as poor, fair, good, or excellent. Binary logistic regression analysis was used to evaluate the associations of different KAP levels with sex, age, education, and possible previous VPD infection. We received 491/1995 (25%) responses across the country and detected generally good knowledge, but only fair practices towards VBDs. Sex and age of the respondents were most often significantly associated with the level of KAP ( > 0.05). Despite the generally good knowledge, we detected major gaps, especially regarding the distinction of tick-borne encephalitis and Lyme borreliosis (LB), risk of disease, and protective measures. Additionally, many respondents thought the vaccination protects against LB or tick bites. This calls for awareness raising on disease risk and prevention measures. With increasing cases and the effects of climate change, surveillance of VBDs communication to the general public should be strengthened.

Surveillance of antimicrobial consumption (AMC) is essential to anticipate and inform policies and public health decisions to prevent and/or contain antimicrobial resistance (AMR). This manuscript shares the experience on AMC data collection in Latin American & Caribbean (LAC). The WHO GLASS-AMC methodology for AMC surveillance was used for data registration during the period 2019-2022. Focal points belonging to each country were contacted and trained for AMC source of information detection, managing registration tools, and data analysis. Thirteen countries were enrolled with significant heterogeneity in the AMC results (range 2.55-36.26 DID-AMC). This experience reflects the heterogeneity of realities in LAC countries; how each one of the nations selected the best sources to collect AMC data, which were the main problems in applying the WHO-AMC collection tool, and the approach that each country gave to the analysis of its data. Finally, some examples are provided on the use of AMC information in making the best decision-making related to AMR control policies at the national level.

are opportunistic pathogens which can cause mastitis in dairy cattle. mastitis often has a poor cure rate and can lead to the development of chronic infection, which has an impact on both health and production. However, there are few studies which aim to fully characterize by whole-genome sequencing from bovine mastitis cases. Here, isolates associated with mastitis in dairy cattle were identified using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) and whole-genome sequencing. Furthermore, whole-genome sequence data were used for phylogenetic analyses and both virulence and antimicrobial resistance (AMR) prediction, in parallel with phenotypic AMR testing. Forty-two isolates identified as were subject to whole-genome sequencing, with 31 multi-locus sequence types being observed, suggesting the source of these isolates was likely environmental. Isolates were examined for key virulence determinants encoding acquired siderophores, colibactin, and hypermucoidy. The majority of these were absent, except for (encoding yersiniabactin) which was present in six isolates. Across the dataset, there were notable levels of phenotypic AMR against streptomycin (26.2%) and tetracycline (19%), and intermediate susceptibility to cephalexin (26.2%) and neomycin (21.4%). Of importance was the detection of two ESBL-producing isolates, which demonstrated multi-drug resistance to amoxicillin-clavulanic acid, streptomycin, tetracycline, cefotaxime, cephalexin, and cefquinome.

Highly pathogenic avian influenza (HPAI) outbreaks have repeatedly occurred in two districts of Kerala state, India, over the last few years. The outbreaks in the wetland areas coincided with the arrival of migratory birds. At the time, the factors responsible for local transmission in ducks were not known. This study aimed to identify the socio-economic factors responsible for spatial variation in the occurrence of HPAI outbreaks in the two districts using Bayesian network modelling (BNM) and Stochastic Partial Differential Equation (SPDE) model. Further, information was collected on the duck rearing practices in rice paddy fields to identify the risk factors for local - spread of the outbreaks. We found that the SPDE model without covariates explained variation in occurrence of outbreaks. The number of rice paddy fields used by the duck farmers was identified as risk factor. We concluded based on BNM and SPDE that the infected migratory birds were the source of infection for the first few duck farms in the wetland areas and subsequent transmission was driven by shifting of ducks from one rice paddy field to other fields. There is a probability of persistent and recurrent infections in the ducks and possible spill over to humans. Hence, it is important to have surveillance in ducks to prevent recurrent outbreaks in the region.

In September 2023, the UK Health Security Agency's (UKHSA) South West Health Protection Team received notification of patients with perichondritis. All five cases had attended the same cosmetic piercing studio and a multi-disciplinary outbreak control investigation was subsequently initiated. An additional five cases attending the same studio were found. Seven of the ten cases had isolates available for Variable Number Tandem Repeat (VNTR) typing at the UKHSA national reference laboratory. Clinical and environmental isolates from the patients, handwash sink, tap water and throughout the wall-mounted point-of-use water heater (including outlet water) were indistinguishable by VNTR typing (11,6,2,2,1,3,6,3,11). No additional cases were identified after control measures were implemented, which included replacing the sink and point-of-use heater.The lack of specific recommendations to control for within Council-adopted ear-piercing byelaws or national guidance means that a cosmetic piercing artist could inadvertently overlook the risks from this bacterial pathogen despite every intention to comply with the law and follow industry best practice advice. Clinicians, Environmental Health Officers and public health professionals should remain alert for single cases of perichondritis infections associated with piercings and have a low threshold for notification to local health protection teams.

The strategy of tuberculosis (TB) contact investigation is essential for enhancing disease detection. We conducted a cross-sectional study to evaluate the yield of contact investigation for new TB cases, estimate the prevalence of TB, and identify characteristics of index cases associated with infection among contacts of new cases notified between 2010 and 2020 in São Paulo, Brazil. Out of 186466 index TB cases, 131055 (70.3%) underwent contact investigation. A total of 652286 contacts were screened, of which 451704 (69.2%) were examined. Of these, 12243 were diagnosed with active TB (yield of 1.9%), resulting in a number needed to screen of 53 and a number needed to test of 37 to identify one new TB case. The weighted prevalence for the total contacts screened was 2.8% (95% confidence interval [CI]: 2.7%-2.9%), suggesting underreporting of 6021 (95% CI: 5269-6673) cases. The likelihood of TB diagnosis was higher among contacts of cases identified through active case-finding, abnormal chest X-ray, pulmonary TB, or drug resistance, as well as among children, adults, women, individuals in socially vulnerable situations, and those with underlying clinical conditions. The study highlights significant TB underreporting among contacts, recommending strengthened contact investigation to promptly identify and treat new cases.

Hepatitis E virus (HEV) is one of the most common causes of viral hepatitis. We examined HEV seroprevalence and associations of sociodemographic and lifestyle characteristics with HEV immunoglobulin G (IgG) seropositivity in the Arab population. A cross-sectional single-centre study was conducted among adults in the Nazareth area during 2022. Blood samples were tested using the Altona Real-Star HEV-RNA and the Wantai IgG assays. Data on sociodemographics, health status, and lifestyle were collected using structured questionnaires.Overall, 490 individuals (55.9% males) aged 18 - 96 (mean = 53.2, SD = 28.0) were enrolled. HEV IgG seropositivity was estimated at 21.4% (95% CI 17.9-25.3). No samples were HEV-RNA positive. The correlates of HEV IgG seropositivity were older age (prevalence ratio (PR) 1.07, 95% CI 1.04-1.09,  < 0.001) and consuming beef frequently (PR 2.81, 95% CI 1.40-5.63,  = 0.003). No associations were found between Arab religious groups (Muslim, Christian or Druze, representing different socioeconomic status and dietary habits) or pork consumption and HEV IgG seropositivity. In conclusion, HEV seropositivity was high in the Arab population, and assessing HEV in Ruminants, particularly cows, is warranted.

In July 2022, a genetically linked and geographically dispersed cluster of 12 cases of Shiga toxin-producing (STEC) O103:H2 was detected by the UK Health Security Agency using whole genome sequencing. Review of food history questionnaires identified cheese (particularly an unpasteurized brie-style cheese) and mixed salad leaves as potential vehicles. A case-control study was conducted to investigate exposure to these products. Case food history information was collected by telephone. Controls were recruited using a market research panel and self-completed an online questionnaire. Univariable and multivariable analyses were undertaken using Firth Logistic Regression. Eleven cases and 24 controls were included in the analysis. Consumption of the brie-style cheese of interest was associated with illness (OR 57.5, 95% confidence interval: 3.10-1,060). Concurrently, the production of the brie-style cheese was investigated. Microbiological sample results for the cheese products and implicated dairy herd did not identify the outbreak strain, but did identify the presence of genes and STEC, respectively. Together, epidemiological, microbiological, and environmental investigations provided evidence that the brie-style cheese was the vehicle for this outbreak. Production of unpasteurized dairy products was suspended by the business operator, and a review of practices was performed.

Hand, foot and mouth disease (HFMD) is a contagious communicable disease, with a high incidence in children aged under 10 years. It is a mainly self-limiting disease but can also cause serious neurological or cardiopulmonary complications in some cases, which can lead to death. Little is known about the burden of HMFD on primary care health care services in the UK. The aim of this work was to describe trends in general practitioner (GP) consultations for HFMD in England from January 2017 to December 2022 using a syndromic surveillance network of GPs. Daily GP consultations for HFMD in England were extracted from 1 January 2017 to 31 December 2022. Mean weekly consultation rates per 100,000 population and 95% confidence intervals (CI) were calculated. Consultation rates and rate ratios (RR) were calculated by age group and sex. During the study period, the mean weekly consultation rate for HFMD (per 100,000 registered GP patients) was 1.53 (range of 0.27 to 2.47). In England, children aged 1-4 years old accounted for the largest affected population followed by children <1 years old. We observed a seasonal pattern of HFMD incidence during the non-COVID years, with a seasonal peak of mean weekly rates between months of September and December. HFMD is typically diagnosed clinically rather than through laboratory sampling. Therefore, the ability to look at the daily HFMD consultation rates provides an excellent epidemiological overview on disease trends. The use of a novel GP-in-hours surveillance system allowed a unique epidemiological insight into the recent trends of general practitioner consultations for HFMD. We demonstrate a male predominance of cases, the impact of the non-pharmaceutical interventions during the COVID-19 pandemic, and a change in the week in which the peak number of cases happens post-pandemic.

Since 1996, the incidence of rickettsiosis has been increasing in Yucatán, Mexico, but recent prevalence data are lacking. This study aimed to determine exposure to the Spotted Fever Group (SFG) and Typhus Group (TG) in human serum samples suspected of tick-borne diseases (TBD) between 2015 and 2022. A total of 620 samples were analysed using indirect immunofluorescence assay (IFA) to detect IgG antibodies against SFG () and TG (), considering a titer of ≥64 as positive. Results showed that 103 samples (17%) were positive for and 145 (24%) for , while 256 (41%) and 229 (37%) were negative, respectively. There was a cross-reaction in 244 samples (39%). Individuals with contact with vectors, such as ticks, showed significant exposure to fleas (p = 0.0010). The study suggests a high prevalence of rickettsiosis and recommends prospective studies to assess the disease burden and strengthen surveillance and prevention in Yucatán, considering factors like temperature and ecological changes.

In 2023, Bangladesh experienced its largest and deadliest outbreak of the Dengue virus (DENV), reporting the highest-ever recorded annual cases and deaths. Historically, most of the cases were recorded in the capital city, Dhaka. We aimed to characterize the geographical transmission of DENV in Bangladesh. From 1 January-31 December 2023, we extracted and analyzed daily data on dengue cases and deaths from the Management Information System of the Ministry of Health and Family Welfare. We performed a generalized linear mixed model to identify the associations between division-wise daily dengue counts and various geographical and meteorological covariates. The number of dengue cases reported in 2023 was 1.3 times higher than the total number recorded in the past 23 years (321,179 vs. 244,246), with twice as many deaths than the total fatalities recorded over the past 23 years (1705 vs. 849). Of the 1,705 deaths in 2023, 67.4% ( = 1,015) died within one day after hospital admission. The divisions southern to Dhaka had a higher dengue incidence/1000 population (2.30 vs. 0.50,  <0.01) than the northern divisions. Festival-related travel along with meteorological factors and urbanization are likely to have contributed to the shift of dengue from Dhaka to different districts in Bangladesh.