Search Results (816)

Introduction: Integrated One Health-based surveillance of pathogens in wastewater suggests its potential for monitoring community health and preventing the emergence and spread of infectious diseases. Despite the growing popularity of Wastewater Surveillance (WWS) and its clinical utility, its uniformity remains poorly understood, especially concerning its clinical evidence. This review systematically synthesizes evidence on the role of wastewater surveillance in early pathogen detection and outbreak preparedness, with particular emphasis on its implications for One Health surveillance. Methods: We systematically searched PubMed, EMBASE, ProQuest and EBSCO CINAHL databases. Retrieved articles were screened by two reviewers, and conflicts were resolved by a third reviewer. Initially, 539 studies were retrieved as potentially eligible published articles, of which 16 articles fulfilled the inclusion criteria. Results: Most pathogens identified in the included studies were associated with respiratory and gastrointestinal infections. Studies found a positive link between the presence of pathogens in wastewater and clinical cases, depicting potential exposure and transmission within the communities. A season-specific upsurge was observed among the identified pathogens in circulation. In addition, the duration and frequency of sample collection in socio-vulnerable areas provide early warning of disease outbreaks. Few studies have explicitly operationalized a One Health framework, highlighting the need for integrated human, animal, and environmental surveillance systems in future wastewater surveillance programmes. Conclusion: The review emphasized wastewater surveillance as a promising complementary approach for the early detection and tracking of pathogens. Future research is needed to standardize surveillance approaches and strengthen One Health integration across human, animal and environmental health systems. Full article

Sea turtles are increasingly regarded as indicators of coastal ecosystem health, as their clinical condition and disease profiles reflect prolonged exposure to environmental pressures in impacted marine habitats. Wildlife rehabilitation facilities play an important role in sea turtle conservation, although risk factors associated with mortality during rehabilitation are not well defined. This retrospective study evaluated clinical and infectious risk factors for death in 108 stranded sea turtles (including 70 green turtles, 19 olive ridley turtles, 16 hawksbill turtles, 2 loggerhead turtles, and 1 leatherback turtle) admitted to the rehabilitation facility at the National Museum of Marine Biology and Aquarium between 2018 and 2024. Data on buoyancy disorder, spirorchiid fluke infection, fibropapillomatosis and final disposition were analysed using univariate and multivariable logistic regression. Buoyancy disorder (adjusted OR = 9.96) and spirorchiid fluke infection (adjusted OR = 3.33) were associated with increased mortality, highlighting the need for careful monitoring and early detection of these conditions during rehabilitation. However, the retrospective design may inherently limit causal inference. Full article

Excitation–emission matrix (EEM) fluorescence spectroscopy, when combined with machine learning algorithms, has emerged as a highly promising tool for non-invasive biomedical diagnosis, demonstrating significant potential across various applications. This systematic review offers a comprehensive analysis of recent advancements in integrating EEM with chemometric techniques and machine learning models for the detection of infectious diseases, cancer, neurological, and metabolic disorders, as well as for monitoring bioactive compounds and hormonal contaminants. The review examines multivariate approaches alongside spectral preprocessing strategies, highlighting their ability to resolve overlapping signals and extract relevant information from complex biological matrices. The reviewed studies report promising high sensitivity, specificity, and accuracy values across diverse biological matrices and disease targets, supporting the scalability and versatility of this diagnostic platform. A critical evaluation of methodological approaches is also provided, identifying common pipeline-level challenges and drawing a constructive distinction between proof-of-concept studies, which establish the discriminative potential of EEM spectral data and studies aimed at clinical validation, a distinction that helps contextualize reported performance and guides future research design. Future perspectives focus on the development of open-access spectral databases, portable devices, standardized preprocessing protocols, and the integration of deep learning and explainable artificial intelligence, all of which represent concrete pathways toward the clinical translation of EEM-based diagnostics. This review confirms the value of EEM spectroscopy coupled with machine learning as a versatile, scalable, and high-impact platform for biomedical diagnostics, with significant potential for applications in public health and personalized medicine. Full article

This review examines the relationship between climate-driven heat stress (HS) and bovine mastitis in the Po Valley, a key European dairy region characterized by intensive production systems and increasing climatic vulnerability. It aims to contextualize how rising temperature–humidity index (THI) levels influence animal health and productivity. This study synthesizes the current literature on biometeorological conditions, epidemiological trends, and physiological mechanisms linking HS to mastitis. Evidence indicates that prolonged exposure to elevated THI impairs thermoregulation, disrupts endocrine and metabolic balance, and weakens immune function, thereby increasing susceptibility to intramammary infections. Epidemiological data reveal a clear seasonal pattern, with mastitis incidence peaking during summer months and a growing predominance of environmental pathogens. Additionally, HS negatively affects milk yield and quality, amplifying economic losses in dairy systems. The findings highlight that mastitis in this context is not merely an infectious disease but a multifactorial condition shaped by environmental, physiological, and management factors. Overall, this review underscores the need for integrated mitigation strategies, including improved housing, nutrition, genetic selection, and precision monitoring, to enhance resilience. In the face of ongoing climate change, adapting dairy production systems will be essential to safeguard animal welfare, maintain productivity, and ensure the long-term sustainability of the Po Valley dairy sector. Full article

Access to safe drinking water remains a global public health concern due to its role in the transmission of infectious diseases. Despite the 20th-century achievement of chlorine-based disinfection, drinking water systems face threats from aging infrastructure, climate-induced stressors, and emerging pathogens that evade traditional treatment. This bibliometric review maps three decades of research on microbial contamination in drinking water systems to explain its historical developments, current knowledge, and important updates. Only original and review articles retrieved on 13 April 2026 were screened for inclusion, requiring a focus on detecting, monitoring, or mitigating microbial contamination in drinking water systems. Analysis of 93 records identified a linear growth pattern, shifting from acute enteric pathogen monitoring to the management of opportunistic pathogens (OPs), antimicrobial resistance (AMR), and disinfection by-products (DBPs). Additionally, traditional fecal indicator bacteria (FIB), such as Escherichia coli, may not fully predict the presence of resilient pathogens protected within biofilms or free-living amoebae (FLA), which serve as environmental reservoirs for infection. To address these limitations, this review presents a conceptualization of waterborne pathogens by proposing formal case definitions and diagnostic criteria for critical contamination events (CCE) and chronic low-level exposure (CLLE). Lastly, knowledge gaps and open research questions relevant to future studies on microbial contamination in drinking water systems were identified and discussed. Full article

In recent years, with the significant decline in fine particulate matter (PM_2.5) concentrations, ozone (O₃) has emerged as a major composite air pollutant during the warm season in China, attracting increasing attention due to its associated health burden and economic costs. This study focuses on Tianjin, using ozone monitoring data from 2017 to 2023 combined with health statistics to assess the health impacts and economic losses attributable to ozone pollution. First, ozone exposure indicators and compliance criteria were constructed based on national air quality standards, and the interannual variation and spatial differences of O₃ levels were analyzed at both citywide and district scales. Second, multiple machine learning classification models, including logistic regression, decision tree, k-nearest neighbors, and gradient boosting, were developed using ozone and meteorological variables to predict the occurrence risks of five diseases: cardiovascular diseases, respiratory diseases, hand-foot-and-mouth disease (HFMD), influenza, and dengue fever. Finally, excess cases were estimated using health impact functions, and the associated economic losses were quantified by combining the value of a statistical life (VSL) with cost-of-illness and willingness-to-pay (WTP) approaches. The results showed that the annual evaluation value of ozone in Tianjin, defined as the 90th percentile of the daily maximum 8 h average O₃ concentration, exhibited a pattern of initially increasing, then decreasing, and subsequently rebounding. It peaked at 201 µg/m³ in 2018, declined to a minimum of 164 µg/m³ in 2021, and rebounded to 188 µg/m³ in 2023. Machine-learning results indicated that the logistic regression model showed relatively stable overall performance across predictions of different diseases, while the gradient boosting tree model also achieved high accuracy in predicting certain infectious diseases. Overall, ozone pollution exhibits significant heterogeneous effects across different disease types, and the associated health-related economic losses show stage-wise fluctuations in response to pollution levels. Based on these findings, it is recommended to implement refined control measures during periods of high ozone exceedance and in key regions, while strengthening protection for vulnerable populations such as the elderly, children, and patients with respiratory diseases, in order to achieve synergistic improvements in air quality management and public health outcomes. Full article

Background/Objectives: Emerging viral zoonoses represent a growing threat to global public health, with most newly emerging infectious diseases originating from animal reservoirs. Recent outbreaks of monkeypox, Ebola virus disease, Marburg virus disease, Rift Valley fever, and avian influenza highlight the capacity of zoonotic viruses to cross species barriers, spread internationally, and generate substantial health, social, and economic consequences. This review examines the ecological, epidemiological, and biological determinants of viral zoonotic emergence and transmission, with particular emphasis on vaccination and outbreak prevention strategies. Methods: A structured narrative review was conducted using a predefined literature search strategy across major scientific databases. Peer-reviewed epidemiological, clinical, and public health publications published between January 2000 and February 2026 were screened and selected according to predefined relevance criteria. Results: The emergence of viral zoonoses is driven by complex interactions among animal reservoirs, environmental and climatic changes, human behavior, and viral adaptation. Although transmission pathways and clinical outcomes differ among pathogens, common determinants of spillover and outbreak amplification were identified. Current evidence supports the importance of integrated surveillance, genomic monitoring, vaccination strategies, and community engagement as key components of preparedness and response. Emerging preventive approaches targeting pathogen transmission, including transmission-blocking strategies and vector-associated microbiota interventions, may provide additional opportunities for disease control. Conclusions: Strengthening preparedness for emerging viral zoonoses requires coordinated One Health approaches integrating human, animal, and environmental health. Future priorities include the development of next-generation vaccines, expansion of digital and genomic surveillance systems, improved equitable access to vaccines, and innovative interventions aimed at reducing zoonotic spillover and interrupting pathogen transmission. Full article

Background: Candidemia remains a significant public health challenge, with increasing resistance. Contemporary post-pandemic data from high-complexity Latin American hospitals are scarce. Methods: A retrospective study (2022–2023) was conducted in adults with candidemia at a high-complexity Colombian university hospital. Species identification and susceptibility were analyzed using VITEK^® 2 and Clinical and Laboratory Standards Institute (CLSI) criteria. Survival was estimated using Kaplan–Meier analysis. Results: Of 3483 blood cultures, 109 episodes were identified. The incidence was 1.13/1000 admissions (5.96/1000 in the Intensive care unit—ICU). Species other than Candida albicans predominated (61.5%), mainly C. tropicalis (22.9%) and C. parapsilosis (22.0%). Alarmingly, 28.6% of C. parapsilosis isolates were resistant to fluconazole. Consultation with an infectious diseases service was performed in 72.5% of cases, with a significantly higher rate among survivors (p < 0.05). Overall mortality was 52.3%, while 30-day mortality reached 42.2%. ICU patients had a cumulative mortality rate of 50% by day 30. Conclusions: Post-pandemic candidemia shows shifting species and high resistance. Key priorities include expert infectious disease consultation to optimize outcomes in non-neutropenic patients and strengthening laboratory capacity for identification and susceptibility testing to monitor rising resistance and guide effective institutional antifungal policies. Full article

Orchid plants, due to their high aesthetic qualities of large inflorescences, long flowering period, and ease of care, have high commercial potential; however, when grown industrially in factories, they are susceptible to infectious diseases. In this study, we isolated from Phalaenopsis spp. plants epiphytic, rhizospheric, and endophytic bacteria associated with soft rot symptoms. Twenty-nine isolates exhibiting pectolytic activity were identified as strains of the genera Bacillus, Klebsiella, Microbacterium, Paenibacillus, Paracidovorax, Pseudomonas, and Psychrobacillus based on 16S rRNA analysis. These isolates were tested for their ability to produce cellulase, amylase, sucrase, proteinase, and lipase; to form biofilms; and to exhibit motility (swimming and swarming). Potato microplants under in vitro conditions were used as a model object for initial screening of the strains’ potential phytotoxicity. Most strains were shown to inhibit plant growth, particularly root development. Injection of suspensions of these strains into orchid leaves caused symptoms of soft rot. Thus, we isolated Gram-positive bacteria for the first time from orchid tissues with soft rot symptoms and demonstrated an association of these strains with plant tissue maceration in potato and orchids. Gram-positive bacteria with pectolytic activity are not typical pathogens of orchid soft rot and may require changes in approaches to the monitoring of phytopathogens for this group of plants. Full article

COVID-19, caused by the SARS-CoV-2 virus, has become a global public health crisis with diverse clinical manifestations affecting multiple organ systems, including the integumentary system. One notable cutaneous manifestation, referred to as “COVID toes,” involves the development of pernio-like chilblains, characterized by red-to-violet macules, plaques, or nodules, primarily on toes and fingers. This characteristic clinical feature gained significant attention due to its apparent association with COVID-19, especially during the early stages of the pandemic when individuals with mild or asymptomatic cases exhibited these symptoms. Concurrently, digital platforms such as Google Trends have emerged as tools for tracking public interest in health-related topics, offering insights into real-time patterns of disease awareness. Previous research has demonstrated that Google Trends data may correlate with the incidence of infectious diseases, suggesting that search interest can be a proxy for disease outbreaks. In this study, we sought to explore the potential relationship between public interest in COVID toes, as reflected in Google Trends, and the incidence and mortality rates of COVID-19. Specifically, we examined whether peaks in search interest for “COVID toes” corresponded with surges in COVID-19 cases and deaths. By analyzing trends in search data, we aimed to assess the utility of digital platforms as an epidemiological tool for monitoring disease progression and public awareness. Our findings provide insights into the potential role of digital search data in forecasting outbreaks and highlight the interplay between public perception and the clinical burden of COVID-19, emphasizing the importance of real-time data in public health surveillance and response. Full article

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic relapsing inflammatory disorder characterized by epithelial barrier dysfunction, immune dysregulation, microbiota imbalance, and progressive tissue remodeling. Because the pathogenesis of IBD involves complex interactions among genetic, immunological, microbial, and environmental factors, experimental animal models have become indispensable tools for investigating disease mechanisms and evaluating therapeutic strategies. Various experimental colitis models have been developed to reproduce distinct pathological features of human IBD, including chemically induced models, genetically engineered systems, adoptive immune-transfer models, and infectious or microbiota-associated models. Rodent models remain the most widely used experimental platforms because of their accessibility, reproducibility, and well-established genetic manipulation technologies. These systems have significantly contributed to understanding inflammatory signaling pathways, epithelial barrier injury, immune cell dysregulation, and gut microbial crosstalk. However, important species-specific differences in intestinal anatomy, immune responses, microbiota composition, and pharmacokinetics limit direct translation of rodent findings into clinical applications. To overcome these limitations, increasing attention has been directed toward large-animal models, particularly pig and minipig systems, which more closely resemble human gastrointestinal anatomy, digestive physiology, immune regulation, and microbiome-related characteristics. Porcine models additionally support clinically relevant procedures, including repeated colonoscopy, serial biopsy sampling, pharmacokinetic evaluation, and longitudinal therapeutic monitoring. Recent advances in genome-editing technologies and multi-omics approaches have further enhanced the translational utility of porcine IBD models. This review summarizes major experimental colitis animal models, discusses their pathological and translational characteristics, and highlights the growing importance of pig and minipig systems as human-applicable platforms for preclinical therapeutic evaluation and translational IBD research. Full article

Feline Infectious Peritonitis (FIP) has been transformed from a fatal disease to a treatable condition following the introduction of GS-441524, a nucleoside analogue targeting feline coronavirus replication. However, the widespread use of unregulated compounded formulations and the absence of validated analytical tools for therapeutic drug monitoring (TDM) represent critical gaps in clinical FIP management. This study describes the development and full ICH M10-compliant validation of a high-throughput LC-MS/MS method for the quantification of GS-441524 in feline serum, incorporating an automated protein precipitation protocol and a PBS-BSA surrogate matrix in accordance with 3Rs principles. The method met all acceptance criteria across validated parameters, including linearity (0.1–50 µg/mL), accuracy (bias within ±12.5%), precision (CV ≤ 10.9%), selectivity, extraction recovery (87.5–107.9%), and stability under clinically relevant storage conditions. Matrix equivalence between PBS-BSA and authentic feline serum was confirmed, enabling routine calibration without animal-derived materials. The validated method was applied to clinical TDM in cats undergoing GS-441524 treatment for FIP, providing preliminary evidence of inter-individual pharmacokinetic variability. The compounded formulations administered to the TDM cohort were independently verified by LC-MS/MS, confirming drug content within ±15% of labelled claims and excluding pharmaceutical quality as a confounding factor in the interpretation of serum drug concentrations. Full article

Background: mRNA vaccines, first approved in December 2020, have been used globally to prevent infectious diseases, and those for treating cancers are being developed. Safety-related labelling changes of Comirnaty and Spikevax were made in June 2025; however, concerns remain. This study assessed the potential risks associated with mRNA vaccines on the indications previously approved, utilizing Real-World Data (RWD) of Adverse Events Following Immunization (AEFIs) derived from the Vaccine Adverse Event Reporting System (VAERS) and Academic Literature Databases (ALD). Methods: A Disproportionality Analysis (DPA) was performed using the Reporting Odds Ratio (ROR) and the Bayesian Confidence Propagation Neural Network (BCPNN) algorithm on spontaneous case reports from VAERS. Statistical positive signals were cross-validated with literature case reports from ALD to provide more comprehensive medical descriptions and clearer causal assessments, and compared with safety information documented in clinical trials and on vaccine labelling. Time-to-onset, stratified, and immunization schedule analyses were conducted to characterize the safety profiles of mRNA vaccines. Results: In total, 5,040,725 spontaneous case reports and 4,387 literature case reports were analyzed. In both VAERS and ALD, new signals involving blood and lymphatic system disorders (e.g., thrombotic thrombocytopenic purpura) and ear and labyrinth disorders (e.g., deafness) were detected from Comirnaty as Designated Medical Events (DMEs), while blood and lymphatic system disorders (e.g., thrombotic thrombocytopenic purpura) from Spikevax in ALD only. No new signals were detected from other vaccines on the DMEs list. In VAERS, Serious Adverse Events (SAEs) were more common in females, while death risk was higher in males. In ALD, SAEs were more common in males for most mRNA vaccines, except Comirnaty. Medical history emerged as a key risk factor for SAEs, particularly among older adults. Conclusions: Statistically significant safety signals were detected across all mRNA vaccines based on five-year cumulative RWD, indicating the need of intensified monitoring of specific populations, including older adults and individuals with medical histories, alongside further optimization of vaccination strategies. Full article

Background: Hospital-acquired infections (HAIs) represent the most significant complications in patients hospitalized for severe burn injuries, after the immediate post-burn resuscitation phase, and are associated with substantial morbidity and mortality. Methods: This is a narrative review. Evidence was extracted mainly with an in-depth search of MEDLINE, focusing on guidelines, randomized controlled trials, and relevant observational studies published in the last 25 years. The reference lists of the most relevant publications were screened to retrieve additional relevant information. Results: Wound infections, bloodstream infections, pneumonia, and urinary tract infections account for the majority of infectious complications. Their diagnosis can be challenging, particularly in the context of wound infections and sepsis. Burn severity and the resulting disruption of tissue and organ homeostasis can alter the pharmacokinetic and pharmacodynamic (PK/PD) properties of antibiotics, rendering standard dosing and administration strategies inadequate. Higher doses, prolonged or continuous infusions, and therapeutic drug monitoring may be required to optimize antibiotic exposure. The emergence of multidrug-resistant (MDR) pathogens (particularly MDR Gram-negative bacilli) has been widely reported across diverse epidemiological settings and occurs frequently in patients with prolonged hospitalization, further complicating treatment. As a result, the use of broad-spectrum antibiotics is substantial, both for empirical therapy and for targeted treatment. Although antimicrobial stewardship programs can promote more appropriate antibiotic use, evidence on how to effectively implement these strategies in Burn Intensive Care Units remains limited. Conclusions: HAIs in burn patients represent a highly complex clinical scenario. Clinical severity is often significant, diagnosis can be challenging, and MDR pathogens are very prevalent, with high consumption of broad-spectrum antibiotics. Moreover, PK/PD properties of antibiotics can be altered. Antimicrobial stewardship can promote appropriate antimicrobial use, but implementation in this setting has not been adequately studied. Close multidisciplinary collaboration between burn specialists and infectious diseases physicians is essential to ensure effective patient management. Full article

Background and Objectives: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disorder characterized by persistent or relapsing fatigue lasting at least six months, not alleviated by rest and not previously present. It is accompanied by post-exertional symptom exacerbation and non-restorative sleep. Fatigue is often disabling and reduces daily activity by more than 50%. This study aimed to evaluate the long-term frequency of somatic and psychiatric disorders in women previously diagnosed with ME/CFS and to describe the long-term clinical course, laboratory findings, and fatigue-related changes during a 16-year follow-up period. Materials and Methods: Sixteen years ago, 40 women diagnosed with ME/CFS according to then-current CDC criteria were enrolled at the Clinic for Infectious Diseases and the Center for Laboratory Medicine, University Clinical Center of Vojvodina. All participants provided informed consent. After 16 years, 20 women agreed to follow-up evaluation. At both time points, participants underwent structured questionnaires, clinical examination, psychological assessment, and comprehensive laboratory testing, including hematological, biochemical, endocrinological, and virological analyses. Fatigue severity was assessed using the FibroFatigue Scale (FFS) and the Multidimensional Assessment of Fatigue (MAF) scale. Results: During follow-up, 15% of participants were diagnosed with rheumatoid arthritis, 10% with cervical or breast cancer, 5% experienced premature myocardial infarction, 5% developed bronchial asthma, and 20% were diagnosed with clinical depression. Progression of ME/CFS was observed in 15%, while 5% reported infertility. Additionally, 15% developed arterial hypertension. Only 15% of participants did not report symptom worsening or new diagnoses. Conclusions: Over the 16-year follow-up, 85% of women with ME/CFS developed significant somatic or psychiatric conditions. These findings suggest that women diagnosed with ME/CFS may experience substantial long-term somatic and psychiatric disease burden, supporting the need for continued clinical monitoring and individualized follow-up. Full article