Epidemiologia

Background/Objectives: Tick-borne encephalitis virus (TBEV) is an emerging vector-borne pathogen in Europe, yet it may be potentially underrecognized in countries reporting few clinical cases. Despite the small number of reported TBE cases, evidence of TBEV circulation in Romania has increased in recent years. Awareness and clinical practices among infectious disease physicians remain insufficiently characterized. This study evaluated changes in knowledge and clinical practices regarding TBEV infection among infectious disease physicians in Romania between 2019 and 2025, following the introduction of TBE vaccination. Methods: We conducted a repeated cross-sectional survey using the same questionnaire in two independent cohorts of infectious disease physicians in Romania (2019, n = 164; 2025 n = 140). Knowledge of tick-borne diseases, TBEV global and local epidemiology, diagnosis, and clinical practice was evaluated and compared. Results: Recognition of TBEV cases in Romania increased significantly from 95/164 (57.9%) in 2019 to 108/140 (77.1%) in 2025 (p = 0.004), while awareness of vaccination as a preventive measure increased from 37.8% to 65.7% (p < 0.001). However, increased awareness did not translate into increased diagnostic testing: TBEV testing remained limited (25.6% in 2019 vs. 20.0% in 2025) and lack of access to serological testing was the most frequently reported diagnostic barrier (65.5% in 2019 vs. 82.1% in 2025). Awareness of alimentary transmission through unpasteurized dairy products also remained limited. Conclusions: Romanian infectious disease physicians’ awareness regarding TBEV improved between 2019 and 2025, but diagnostic practice did not improve accordingly. The persistent gap between awareness and testing capacity may contribute to under recognition of TBE and highlights the need to strengthen diagnostic access alongside physician education and vaccination strategies.

Background/Objectives: The rising volume of fluoroscopy-guided interventions poses an occupational safety challenge for healthcare workers (HCWs) exposed to chronic low-dose ionizing radiation (LDR), which carries stochastic risks of bone marrow suppression and radiation-induced cytopenias. Real-world longitudinal evidence validating the efficacy of modern protection standards on specific peripheral hematological parameters remains limited. This study aims to evaluate the peripheral hemogram profiles of interventional HCWs exposed to LDR, compared to those of a non-exposed control cohort, from baseline (T0) to follow-up (T1). Methods: A longitudinal matched case-control study evaluated the complete blood count with differential leukograms of 136 interventional HCWs exposed to LDR compared to those of 272 matched non-exposed controls from baseline (T0) to follow-up (T1), stratifying by role, seniority, and cumulative ionizing radiation dose. Results: The mean annual radiation dose was 0.22 mSv, and the mean cumulative radiation dose was 4.11 mSv. Hemogram indicators showed no significant differences between cases and controls at T0 and T1 (p > 0.05). Stratification by length of service (<10 vs. >10 years), and radiation dose (<3 vs. ≥3 mSv) demonstrated no significant variations in erythrocyte, leukocyte, or platelet counts. Regression analysis confirmed no association between hematological parameters and job seniority or radiation dose. All radiation doses remained below mandatory limits. Conclusions: The findings provide objective evidence of the effectiveness of current safety measures countering radiation-induced hematotoxicity in hospital settings. Longitudinal tracking confirms the absence of adverse hematological shifts, suggesting that structured training and strict personal protective equipment (PPE) use mitigate hematotoxicity risks among interventional staff exposed to ionizing radiation in healthcare settings. Safety protocols should maintain strict PPE compliance and safety training. Occupational health policy needs to prioritize continuous dosimetry monitoring, as routine hematological screening may not show early low-dose exposure effects.

Background/Objectives: Postpartum depression is a major public health concern in South Korea, where fertility is among the world’s lowest. We examined whether self-reported acquisition of perinatal knowledge is associated with perinatal depressive symptoms and whether these symptoms are related to intention for a further birth. Methods: We analyzed 3278 women from the nationally representative Korean Early Childhood Education & Care Panel Study, assessed with the Korean Edinburgh Postnatal Depression Scale (K-EPDS; screen-positive ≥ 11) at mid-pregnancy, late pregnancy, one month postpartum and the first annual follow-up (median child age 6 months). Acquisition of perinatal knowledge in four domains was self-reported at that follow-up. Associations were examined with logistic and linear regression and generalized estimating equations. Results: Screen-positive prevalence rose from 10.68% to 28.08% across the four assessments (OR 1.46 per assessment, 95% CI 1.41–1.53). Absence of reported knowledge on maternal–neonatal interaction was associated with screen-positive status in unadjusted analysis (OR 1.47, 95% CI 1.06–2.04) but not after adjustment for antenatal symptoms, social support and sociodemographic covariates (adjusted OR 1.10, 95% CI 0.67–1.80; n = 2037). Social support was inversely associated with screen-positive status (adjusted OR 0.64 per point, 95% CI 0.54–0.76). Among 2236 women with complete data, intention for a further birth was reported by 38.69% of never-symptomatic women, 35.92% with antenatal symptoms only, 28.68% with postpartum-onset symptoms and 23.51% with persistent symptoms (χ² = 36.40, p < 0.0001). Conclusions: Social support, not reported perinatal knowledge, was independently associated with postpartum depressive symptoms, and postpartum-onset and persistent symptoms were associated with lower intention for a further birth. These findings support screening that begins in pregnancy and continues beyond the early postpartum period, together with strengthening social support; they do not establish that perinatal education prevents depressive symptoms.