Search Results (647)

Since the COVID-19 pandemic, wastewater monitoring has become an additional tool in the surveillance of infectious diseases. Many EU countries put wastewater surveillance systems (WSS) in place to track SARS-CoV-2 and its variants and other pathogens, such as the influenza virus or Respiratory syncytial virus (RSV). In Germany, several research and pilot projects funded by the EU, the Federal Ministry of Education and Research, the Federal Ministry of Health, and projects at Federal State level have been launched in the last four years. In Germany, wastewater monitoring was not implemented as a public health tool before the COVID-19 pandemic, but in September 2022, it has been legally determined in the German infection protection act (Infektionsschutzgesetz, IfSG). As Germany is a federal state, competencies in epidemic management partly belong to the 16 federal states (“Länder”). In the federal states, the local health authorities at the county (“Kreise”) level also have specific risk management and communication competencies. Furthermore, WSS has been incorporated into the revised Urban Wastewater Treatment Directive (EU) 2024/3019. For this reason, the federal states and local health authorities play a pivotal role in successfully implementing wastewater monitoring as a supplementary component of disease surveillance in Germany. Between November 2021 and August 2022, the federal state of Thuringia, Germany, supported a pilot study to implement a surveillance system for SARS-CoV-2-RNA in wastewater of 23 wastewater treatment plants in 17 counties in Thuringia. Here, we describe the study design and the system behind the logistics and the planning, and we provide an overview of the options for involving the public health service. Furthermore, the possibilities for IT concepts and approaches to innovative AI solutions are shown. We also aim to explore the feasibility and potential barriers to further implementing wastewater surveillance as a supplementary public health tool in Thuringia. Full article

The COVID-19 pandemic and subsequent non-pharmaceutical interventions (NPIs) significantly disrupted the epidemiology of pediatric respiratory viruses. This study compared infection patterns among 3658 hospitalized children in South Korea during the pandemic (2020–2022) and the post-emergency phase (2023–2024), following the relaxation of mandatory NPIs. Of 4419 eligible tests, the most frequently detected viruses overall were rhinovirus/enterovirus (HRV/HEV) (27.9%), influenza (14.5%), and respiratory syncytial virus (RSV, 11.9%). The post-emergency phase was marked by a dramatic surge in influenza virus (IFV), which surged dramatically (5.5% → 28.2%), and a more than two-fold increase in adenovirus (ADV) (5.7% → 12.5%) (p < 0.001). (p < 0.001). Conversely, parainfluenza virus (PIV) detection rates declined significantly (15.4% → 11.3%, p < 0.001). Demographically, post-emergency phase patients were significantly older (mean 4.9 vs. 3.5 years) and experienced a shorter hospital stays (3.2 vs. 4.3 days) (p < 0.001). Crucially, age-specific susceptibility shifts were evident. IFV rebounded across all pediatric ages but spiked severely in school-aged children and adolescents, while HRV/HEV demonstrated a clear proportional shift towards older age groups. These results demonstrate a substantial reconfiguration of the pediatric respiratory landscape, necessitating age-stratified surveillance and flexible public health strategies to mitigate the future infectious disease burden. Full article

End-stage chronic kidney disease markedly increases susceptibility to infections due to compromised immune function and other physiological alterations. Bacteremia is responsible for higher mortality rates in hemodialysis patients compared to the general population. Our study aimed to investigate the incidence and clinical outcomes among patients with end-stage CKD and associated infections. The study retrospectively analyzed admitted patients between 1 January 2023 and 31 May 2025. Among 56 hospitalized patients with CKD and infection (30 hemodialysis [HD], 26 non-HD), baseline comorbidity profiles were broadly comparable. Microbiology was frequently positive (46/56, 82.1%), dominated by Staphylococcus aureus (25/98, 25.5%), Klebsiella pneumoniae (19.98, 19.4%), and Escherichia coli (15/98, 15.3%). Crude in-hospital mortality was higher in HD (46.7% vs. 15.4%; p = 0.012; RR 3.03). In multivariable logistic regression, HD remained independently associated with death (adjusted OR 38.22, 95% CI 1.55–940.53; p = 0.026), alongside hypotension (OR 17.55, 1.46–210.92; p = 0.024) and male sex (OR 4.41, 1.29–15.11; p = 0.018); model performance was strong (AUC 0.867). In this single-center cohort of infected patients with end-stage CKD, maintenance hemodialysis was independently associated with higher in-hospital mortality, even after adjustment for age, sex, comorbidity burden, hypotension, and length of stay; hypotension and male sex were additional risk factors. LOS and most presenting features did not differ meaningfully by dialysis status. Our findings also emphasize the urgent necessity for heightened surveillance of local antimicrobial resistance patterns and underscore the profound vulnerability of hemodialysis patients to severe infectious outcomes, which is exacerbated by immunosuppressive conditions and the limited efficacy of available therapeutic options against resistant pathogens. Full article

Along with the growing demands for personalized medicine and public health surveillance, diagnostic technologies capable of rapid and accurate pathogen nucleic acid testing in home settings are becoming increasingly crucial. Paper-based microfluidic chips (μPADs) have emerged as a potential core platform for enabling molecular testing at home, owing to their advantages of low cost, portability, and independence from complex instrumentation. However, significant challenges remain in the current μPADs systems regarding nucleic acid extraction efficiency, isothermal amplification stability, and signal readout standardization, which hinder their practical and large-scale application. This review systematically summarizes recent research progress in μPADs for home-based nucleic acid testing from four key aspects: extraction–amplification–detection system integration, with a particular focus on the synergistic effects and development trends of critical technologies such as material engineering, fluid control, signal transduction, and intelligent readout. We further analyze typical application cases of this technology in the rapid screening of infectious disease. Promising optimization pathways are proposed, focusing on standardized manufacturing, cold-chain-independent storage, and AI-assisted result interpretation, aiming to provide a feasible framework and forward-looking perspectives for constructing home-based molecular diagnostic systems. Full article

The emergence and dissemination of antimicrobial resistance (AMR) are driven by complex, interconnected mechanisms involving microbial communities, environmental factors, and human activities, with climate change playing a pivotal and accelerating role. Rising temperatures, altered precipitation patterns, and other environmental disruptions caused by climate change create favorable conditions for bacterial growth and enhance the horizontal gene transfer (HGT) of antibiotic resistance genes (ARGs). Thermal stress and environmental pressures induce genetic mutations that promote resistance, while ecosystem disturbances facilitate the stabilization and spread of resistant pathogens. Moreover, climate change exacerbates public and animal health risks by expanding the range of infectious disease vectors and driving population displacement due to extreme weather events, further amplifying the transmission and evolution of resistant microbes. Livestock agriculture represents a critical nexus where excessive antibiotic use, environmental stressors, and climate-related challenges converge, fueling AMR escalation with profound public health and economic consequences. Environmental reservoirs, including soil and water sources, accumulate ARGs from agricultural runoff, wastewater, and pollution, enabling resistance spread. This review aims to demonstrate how the Mediterranean’s strategic position makes it an ideal living laboratory for the development of integrated “One Health” frameworks that address the mechanistic links between climate change and AMR. By highlighting these interconnections, the review underscores the need for a unified approach that incorporates sustainable agricultural practices, climate mitigation and adaptation within healthcare systems, and enhanced surveillance of zoonotic and resistant pathogens—ultimately offering a roadmap for tackling this multifaceted global health crisis. Full article

Background/Objectives: This study presents a comprehensive and updated epidemiological and public health assessment of human immunodeficiency virus (HIV) in Romania during 2022–2024, situated within the wider European context. Methods: For this retrospective descriptive study, we analyzed national surveillance data from the National Institute of Infectious Diseases “Prof. Dr. Matei Balș” and European Centre for Disease Prevention and Control (ECDC) reports, between 1985–2024, focusing especially on 2022–2024 period. Key indicators included incidence, mortality, transmission routes, age and gender distribution, and treatment coverage. Comparative analyses were performed between Romania and European Union (EU)/Eastern Europe data. Results: Between 1985 and 2024, Romania registered a cumulative total of 28,793 HIV cases, with 18,768 individuals living with HIV (PLHIV) as of 2024. In that year, 810 new HIV cases were diagnoses, indicating a modest uptick compared with 2022–2023. Heterosexual transmission continued to predominate (59.4%), followed by cases among men who have sex with men (MSM) (30.5%) and intravenous drug users (IDUs) (5.2%). Men represented more than three-quarters of all new infections. Mortality displayed considerable year-to-year variability, increasing from 125 HIV-related deaths in 2023 to 193 in 2024. Despite this, treatment coverage improved steadily, with 16,464 individuals receiving antiretroviral therapy (ART) by the end of 2024. At 2.51 cases per 100,000 population, Romania’s incidence remained below the European average of 3.5 per 100,000. Nonetheless, the proportion of infections attributable to MSM transmission rose sharply—from 3.91% in 2007 to 32% in 2024—bringing Romania’s epidemiological profile increasingly in line with broader trends observed in Eastern Europe. Conclusions: These findings suggest that although Romania maintains a comparatively lower HIV incidence than the European average, the evolving transmission dynamics—most notably the substantial increase in MSM-related cases—signal a shifting epidemiological landscape that warrants strengthened, population-specific prevention measures and continued investment in comprehensive treatment and monitoring frameworks. Full article

Background: Zoonotic spillover events with pandemic potential are increasingly associated with environmental change, ecosystem disruption, and intensified human–animal interactions. Although the specific origin and timing of future pandemics remain uncertain, there is a clear need to complement traditional preparedness strategies with approaches that support earlier anticipation and prevention. Objectives: This study aims to propose a conceptual approach to reframe pandemic preparedness toward proactive surveillance and spillover prevention. Methods: We introduce a tachyon-inspired conceptual approach, using a thought experiment based on hypothetical faster-than-light particles to illustrate anticipatory observation of pandemic emergence. The framework is informed by interdisciplinary literature on emerging infectious diseases, One Health surveillance, predictive epidemiology, and public-health preparedness. Results: The proposed approach highlights the importance of proactive, integrated surveillance systems that combine human, animal, and environmental data. Key elements include the use of advanced analytical tools such as neural networks, early characterization of population risk profiles, strengthened public-health infrastructure, coordinated governance, adaptable financial resources, and a resilient healthcare workforce. The integration of animal welfare considerations, translational research, and planetary health principles is emphasized as central to reducing spillover risk. Conclusions: Tachyon-inspired thinking offers a conceptual tool to support a shift from reactive pandemic response toward proactive anticipation and prevention. Embedding integrated surveillance and One Health principles into public-health systems may enhance early detection capacity and contribute to mitigating the impact of future pandemics. Full article

Following the normalization of the COVID-19 pandemic, the focus of wastewater-based epidemiology (WBE) must be broadened from SARS-CoV-2 to encompass surveillance of other major infectious diseases, particularly for pathogens where conventional clinical monitoring systems exhibit inherent surveillance gaps. In this study, we conducted a continuous two-year WBE study (January 2023 to December 2024) across three high-population-density cities in Guangdong, China to establish epidemiological baselines for enteric diarrheal viruses. We analyzed monthly raw wastewater samples from major treatment plants using advanced molecular methods, including digital PCR (ddPCR) for viral load quantification and targeted high-throughput sequencing (tNGS) for genotypic analysis. Our findings revealed diverse circulation patterns among the monitored enteric viruses. Astrovirus (AstV) had the highest detection rate (100%), reflecting its broad endemic distribution, while Norovirus genogroup II (NoV GII) exhibited relatively high viral loads (median 4 × 10⁴ copies/mL) and presented explosive seasonal peaks (significant upward trend in spring.), highlighting its epidemic potential. Furthermore, distinct spatiotemporal patterns were observed, with Sapovirus showing a significant summer peak in Foshan city, contrasting with the winter/spring peaks in the other cities. The tNGS results demonstrated similar sensitivity to RT-PCR in virus detection, and sequencing analyses uncovered the co-circulation and periodic shifts in dominant viral genotypes, such as the emergence of multiple NoV and AstV lineages. This longitudinal WBE surveillance successfully established critical baseline data and demonstrated significant regional heterogeneity in viral circulation, providing essential, complementary data to inform public health strategies for preventing diarrheal outbreaks in urban settings. Full article

Calcium deposition within soft tissues is a significant pathological process, bearing significant implications for animal and human health. It is classified into four categories, including dystrophic, metastatic, idiopathic, and iatrogenic. It involves multiple molecular mechanisms. Vascular calcification includes medial artery mineralization, siderocalcinosis in equine cerebral arteries, and vitamin D-induced arterial mineralization in multiple species. Renal and urinary mineralization occurs with kidney disease, uremic gastropathy, and ethylene glycol toxicity. Calcinosis cutis is associated with renal insufficiency and systemic fungal infections and is commonly observed in dogs with hyperadrenocorticism, while calcinosis circumscripta occurs at pressure points secondarily to trauma. Multiple pathogens are responsible for soft tissue calcification; they can be zoonotic and include Mycobacterium spp., Brucella spp., Toxoplasma gondii, and Echinococcus granulosus, underscoring the translational role of veterinary medicine surveillance from a public health standpoint. In addition, the placental chorioallantois is frequently affected by idiopathic or infection-induced calcification, highlighting the convergence of metabolic dysregulation and infectious mechanisms. Tissue calcifications provide valuable insights into disease mechanisms and diagnostic challenges, with comparative pathology serving as a powerful tool to enhance our understanding of these processes from a One Health standpoint. Full article

Migratory birds have been implicated in the spread of diverse emerging infectious pathogens, including West Nile virus, Usutu virus, Avian influenza viruses, Salmonella, Campylobacter, antimicrobial-resistant (AMR) bacteria, and antibiotic resistance genes (ARGs). Beyond their roles as vectors and reservoirs, migratory birds are also susceptible hosts whose own health may be compromised by these infections, reflecting their dual position in the ecology of pathogens. As facilitators of pathogen transmission during their long-distance migrations, often spanning thousands of kilometres and connecting ecosystems across continents, these birds can easily cross-national borders and circumvent traditional biosecurity measures, thereby acting as primary or secondary vectors in the transmission of cross-species diseases among wildlife, livestock, and humans. Africa occupies a pivotal position in global migratory bird networks, yet comprehensive data on pathogen carriage remain limited. Gaps in knowledge of pathogen diversity constrain current surveillance systems, resulting in insufficient genomic monitoring of pathogen evolution and a weak integration of avian ecology with veterinary and human health. These limitations hinder early detection of novel pathogens and reduce the continent’s preparedness to manage outbreaks. Therefore, this review provides a holistic assessment of these challenges by consolidating existing knowledge concerning the pathogens transmitted by migratory birds in Africa, while recognizing the adverse effect of pathogens, which potentiates population decline, extinction, and ecological imbalance. It further advocates for the adoption of a comprehensive One Health-omics approach that not only strengthens surveillance and technological capacity but also prioritizes the protection of avian health as an integral component of ecosystem and public health. Full article

Zinc (Zn) is an essential trace element that plays a key role as a cofactor for over 300 enzymes involved in metabolic processes, protein synthesis, and gene expression regulation. Zn supplementation is used in the prevention and treatment of infectious, dermatological, and reproductive system diseases. Legal regulations allow for a relatively wide range of mineral content in this product category (from −20% to +45% of the declared value). The study aimed to analyze the quality of food supplements containing Zn—compliance with declared Zn content was assessed. The study included 80 preparations. The preparations varied in terms of declared Zn content, pharmaceutical form, chemical form of Zn, composition, and primary mode of action. Zn content was determined by atomic absorption spectrometry after prior mineralization of the samples in concentrated nitric acid in a closed microwave system. It was estimated that 70% of food supplements contained Zn within the acceptable range. It should be emphasized that 23.75% of the preparations contained more Zn than the permissible range of Zn content, and 6.25% contained less—both of these groups of preparations may be associated with a health risk. From a regulatory perspective, these results highlight the need for continuous surveillance of the food supplement market to improve consumer safety. Full article

Thalassogenic diseases are human infections associated with exposure to marine environments. This review explores the occurrence of Cryptosporidium spp., Giardia duodenalis, and Blastocystis sp. in seawater and shellfish and their implications for public health. Between 2015 and 2026, multiple studies reported the presence of these parasites in shellfish and seawater. Cryptosporidium spp. was found at average concentrations of 5.5 × 10¹ oocysts/g in shellfish and up to 3.7 × 10¹ oocysts/L in seawater. Giardia duodenalis reached 9.1 × 10¹ cysts/g in shellfish, close to the infectious dose, and 3.5 × 10¹ cysts/L in seawater. Blastocystis sp. showed prevalence rates of 33.82% in shellfish and 17.3% in seawater. These findings highlight a potential infection risk for bathers and seafood consumers, emphasizing the need to determine the specific species (or subtypes) involved and assess their viability to accurately evaluate public health implications. The persistence of these parasites in the environment needs improved monitoring. Future strategies should integrate next-generation sequencing (NGS) or use of various fecal indicators to enhance environmental surveillance and reduce health risks in coastal regions. Full article

Background and clinical significance: Idiopathic hypertrophic pachymeningitis (IHPM) is a rare inflammatory disorder characterized by diffuse or focal dural thickening and heterogeneous presentations. We report a corticosteroid-responsive IHPM with elevated anti-thyroglobulin (anti-Tg) antibodies despite oncologic control after thyroidectomy. This case suggests that systematic assessment for autoimmunity should be a standard component of the IHPM work-up. Case presentation: A 77-year-old woman presented with recurrent vertigo, imbalance, and headaches. Brain MRI showed diffuse pachymeningeal thickening with mild heterogeneous enhancement, radiologically stable over >2 years. Extensive evaluation excluded infectious, neoplastic (including paraneoplastic), cerebrospinal fluid hypotension and systemic autoimmune causes; findings did not support IgG4-related disease. Thyroid work-up revealed hypothyroidism with multinodular goiter; total thyroidectomy was performed, and there was no indication for adjuvant radioiodine therapy. Despite oncologic control, anti-Tg antibodies remained markedly elevated, while anti-thyroid peroxidase antibodies (anti-TPO) declined. Symptoms repeatedly improved with oral methylprednisolone and recurred on taper; adverse effects were mild and manageable. The patient remains under clinical and oncologic surveillance with symptom-guided steroid re-challenge. Conclusions: IHPM may exhibit a dissociation between clinical response and radiologic course. Persistently elevated anti-Tg after thyroidectomy can coexist with IHPM and may signal ongoing autoimmunity rather than active cancer. Full article

Background: The COVID-19 pandemic significantly altered the circulation of respiratory viruses, including influenza. This study aimed to compare the epidemiology and clinical characteristics of paediatric influenza before, during, and after the pandemic. Methods: We retrospectively analysed 553 children aged 0–18 years hospitalised with laboratory-confirmed influenza at a paediatric infectious disease centre in Bydgoszcz, Poland, between September 2017 and August 2025. Patients were stratified into pre-pandemic (A), pandemic (B), and post-pandemic (C) periods. Epidemiological indicators, influenza type, age, sex, and hospital stay duration were assessed using χ² and non-parametric tests. Results: Hospitalisations varied across seasons, lowest in 2021/22 (n = 18) and highest in 2024/25 (n = 175). Seasonal peaks occurred January–March in groups A and C, whereas group B showed a bimodal pattern in December and March–April. Influenza type A predominated in all periods, though less during the pandemic (56.7% vs. 89.2% pre-pandemic and 73.2% post-pandemic). Median hospital stay decreased from 5 days pre-pandemic to 4 days during and after the pandemic. None of the hospitalised children were vaccinated. Conclusions: The COVID-19 pandemic influenced influenza seasonality, virus type distribution, and hospitalisation patterns in children. Observed shifts highlight the importance of ongoing surveillance and targeted vaccination strategies to mitigate influenza burden in the post-pandemic period. Full article

Background/Objectives: The USAID STOP Spillover project in Cambodia aimed to reduce the risk of zoonotic virus spillover from bats to humans in bat guano farming communities. Methods: Using participatory tools, such as Outcome Mapping and Trials of Improved Practices, a team of local experts and community members collaboratively designed, tested, and refined biosafety and hygiene practices that are acceptable and sustainable to mitigate the risk of bat-borne disease spillover. We tracked progress and rolled out interventions to promote the adoption of safe behaviors that strengthen the understanding of zoonotic disease and reinforce the adoption of safety practices among bat guano producers and their neighbors. The intervention’s effectiveness was evaluated after three-month trials. Results: An improvement in knowledge, attitudes, and risk reduction practices was observed among participants. The primary motivators for adopting these measures were fear of disease, families’ well-being, cost savings, and experience of the COVID-19 pandemic. Conclusions: The community-driven approach fostered a sense of ownership, enabling participants to find the best solutions for their circumstance for long-term sustainability of the intervention. The findings recommended continued community engagement, improved access to biosafety and hygiene resources, and reinforced routine zoonotic disease surveillance. This model can be applied to mitigate emerging infectious disease spillover risks in similar contexts. Full article