Search Results (219)

Background: Zoonotic influenza viruses pose a significant and evolving public health threat. In response to the recent rise in H5N1 cross-species transmission, the World Health Organization (WHO) R&D Blueprint for Epidemics consultations have prioritized strengthening surveillance, candidate vaccines, diagnostics, and pandemic preparedness. Serological surveillance plays a pivotal role by providing insights into the prevalence and transmission dynamics of influenza viruses. Objective: This scoping review aimed to map the global research landscape on serological surveillance of zoonotic influenza in animals and exposed humans between 2017, the date of the last WHO public health research agenda for influenza review, and 2024, as well as to identify methodological advancements. Methods: Following PRISMA-ScR guidelines, we searched PubMed for English-language peer-reviewed articles published between January 2017 and March 2024. Studies were included if they reported serological surveillance in wild or domestic animals or occupationally exposed human populations, or novel methodologies and their technical limitations and implementation challenges. Results: Out of 7490 screened records, 90 studies from 33 countries, covering 25 animal species, were included. Seroprevalence studies were in domestic poultry and swine. Surveillance in companion animals, wild mammals, and at the human–animal interface was limited. Emerging serological methods included multiplex and nanobody-based assays, though implementation barriers remain. Conclusions: The review is limited by its restriction to one database and English-language articles, lack of quality appraisal, and significant heterogeneity among the included studies. Serological surveillance is a critical but underutilized tool in zoonotic influenza monitoring. Greater integration of serological surveillance into One Health frameworks, especially in high-risk regions and populations, is needed to support early detection and pandemic preparedness. Full article

Rapid vaccine availability is essential for effective epidemic and pandemic response. Building on the Coalition for Epidemic Preparedness Innovations (CEPI) 100 Days Mission, which aims to have new vaccines ready for initial authorization and manufacturing at scale within 100 days of recognition of a pandemic pathogen, the CEPI has developed a Chemistry, Manufacturing and Controls (CMC) Rapid Response Framework to define technical and logistical CMC requirements to enable rapid vaccine availability. Central to this framework is the availability of adaptable vaccine platforms that can be readily tailored to emerging pathogens. To support strategic decision-making and identify gaps in platform capabilities, CEPI has created the Platform Readiness Dashboard. This tool provides a structured, multi-dimensional initial assessment of platform maturity across six key categories: Adaptability, Compatibility, Suitability, Regulatory, Manufacturing, and Facility Readiness. Each category includes specific technical and operational considerations scored using a color-coded system to reflect outbreak response readiness level. This Dashboard aims to enable vaccine developers, manufacturers, funders, and outbreak response teams to evaluate platform strengths and limitations at any given time, informing funding, preparedness and response activities. By offering a dynamic view of essential platform readiness indicators, the dashboard can communicate progress supporting faster responses to future health emergencies. Full article

Arboviruses are a growing concern in many nations. Several reports of arboviral outbreaks have been recorded globally in the past decade alone. Repeated arboviral outbreaks in developing countries have consistently highlighted vulnerabilities in disease surveillance and response systems, exposing critical gaps in early detection, contact tracing, and resource allocation. The 2024 Dengue fever outbreak in Ghana, which recorded 205 confirmed cases out of 1410 suspected cases, underscored the urgent need to evaluate the country’s preparedness for arboviral outbreaks, given the detection of competent vectors in the country. A retrospective analysis of Ghana’s 2009–2013 pandemic influenza response plan revealed significant deficiencies in emergency preparedness, raising concerns about the country’s ability to manage emerging arboviral threats. This review assessed Ghana’s current arboviral outbreak response and preparedness by examining (a) the effectiveness of vector control measures, (b) the role of early warning systems in mitigating outbreaks, (c) laboratory support and diagnostic capabilities, and (d) community engagement strategies. It highlights the successes made in previous outbreaks and sheds light on several gaps in Ghana’s outbreak response efforts. This review also provides recommendations that can be implemented in many countries across Africa as they brace themselves for any arboviral outbreak. Full article

The COVID-19 pandemic has disrupted the progress toward Sustainable Development Goal 3, particularly in developing countries, exacerbating existing health disparities and creating new challenges for health systems worldwide. This study explores the role of university research in advancing SDG 3 targets in a post-pandemic context using the University of the Western Cape as a case study. Through qualitative data analysis of research titles and abstracts registered between 2020 and 2022, we applied the WHERETO model of McTighe and Bloom’s Taxonomy to categorize research according to the SDG 3 targets and indicators. This approach provides insight into which health priorities were addressed through scholarly research at UWC in alignment with the UN 2030 Agenda, particularly during pandemic recovery. Our findings indicate that research priorities largely corresponded with South Africa’s health challenges, with the highest concentration of studies addressing non-communicable diseases and mental health (Target 3.4), infectious diseases (Target 3.3), and medicine development (Target 3.b). These priorities align with the National Health Research Committee’s identified health priorities for disadvantaged communities in the Western Cape. Notably, research on mental health and emergency preparedness (Target 3.d) increased significantly during the pandemic period, reflecting shifting priorities in response to COVID-19. This study offers critical insights into how university research shifted priorities adapted during the pandemic and identifies areas requiring focused attention to support post-pandemic recovery. By highlighting research gaps and opportunities, our findings provide a foundation for developing more comprehensive approaches to health research that address the disparities exacerbated by COVID-19 while advancing the 2030 agenda. This model could inform research prioritization at other institutions facing similar challenges in both local and global contexts. Full article

Objectives: The objective of this study was to examine the impact of the COVID-19 pandemic on racialized communities and individuals in Canada. Methods: This review followed the Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR guidance on reporting scoping reviews. Ovid MEDLINE ALL, Embase Classic + Embase, CINAHL (Ebsco platform), PsycINFO, and Cochrane were searched for documents that were published after March 2020 and that reported on the social and economic impacts and health outcomes of the COVID-19 pandemic on generally healthy racialized populations that reside in Canada. Synthesis: A total of 39 documents were included in this review. Our results show racialized communities faced greater social, economic, and health impacts from the pandemic. These impacts were manifested in the form of high COVID-19 morbidity and mortality rates, increased discrimination, worsening mental health, difficulty in accessing healthcare, and challenges related to accessing food and basic necessities. Conclusion: Canadian racialized groups have been inequitably affected by the COVID-19 pandemic due to pre-existing inequalities and emerging discrimination. Responsive policy action and robust pandemic preparedness efforts are indispensable in adopting a proactive stance to prevent racialized populations from bearing a disproportionate burden of negative health crises in the future. This necessitates addressing pre-existing disparities and targeting social and economic vulnerability areas. By doing so, we can mitigate the reported social, economic, and health impacts experienced by racialized groups, including challenges related to accessing basic necessities, deteriorating mental health, and barriers to healthcare access. Full article

Introduction: The health emergency caused by the pandemic led to severe health issues in populations across many countries worldwide, including widespread morbidity and significant mortality. Nevertheless, several countries succeeded in keeping infection rates remarkably low before the approval of vaccines and the initiation of vaccinations in early 2021. We aim to identify the success factors of health policies in managing the impact of the health emergency across a selection of countries, focusing on how they protected their populations. Our study presents outcomes of sustainable health policy measures, along with health and social system challenges, and economic responses during the global health emergency. We sometimes found it difficult to define what counted as a success factor in some countries. Method: Our study draws upon a selection of reports and documents published by various ministries and economic, social, and health authorities, which we collected online. We structured our study into three phases to frame and contextualize the impact of health policy measures and countermeasures as follows: (i) observations and content analysis; (ii) empirical support through illustrative examples; and (iii) development of a health emergency toolkit of assessment. The documents were not always easy to compare because they differed in format and detail. Results: Our study outlines ten success factors for sustainable health policy measures and countermeasures: (i) preparedness; (ii) control; (iii) precaution; (iv) proactive decision-making; (v) synchronization; (vi) adequate legislation; (vii) goal fulfillment; (viii) digital health technology; (ix) empirical evidence; (x) ethical and moral virtues. Sometimes we struggled to separate what was ethical guidance from what was simply practical advice. Conclusion: We argue that the relevance of the health emergency toolkit of assessment outlined in our study demonstrates clearly that the success factors related to sustainable health policy measures and countermeasures can be applied and adapted to the societal conditions of individual countries. These factors may form a foundation for the development of a health emergency toolkit of assessment for future health emergencies. We also maintain that these factors may serve as a platform for establishing sustainable plans across health, social, and economic domains, with clear guidelines for implementation, management, and control. It is our hope that future health systems will make use of these findings before the next crisis emerges. Full article

The H5N1 avian influenza virus continues to evolve into genetically diverse and highly pathogenic clades with increased potential for cross-species transmission. Recent scientific advances have included the development of next-generation vaccine platforms, promising antiviral compounds, and more sensitive diagnostic tools, alongside strengthened surveillance systems in both animals and humans. However, persistent structural challenges hinder global readiness. Vaccine production is heavily concentrated in high-income countries, limiting equitable access during potential pandemics. Economic and logistical barriers complicate the implementation of control strategies such as vaccination, culling, and compensation schemes. Gaps in international coordination, public communication, and standardization of protocols further exacerbate vulnerabilities. Although sustained human-to-human transmission has not been documented, the severity of confirmed infections and the rapid global spread among wildlife and domestic animals underscore the urgent need for robust preparedness. International organizations have called for comprehensive pandemic response plans, enhanced multisectoral collaboration, and investment in targeted research. Priorities include expanding surveillance to asymptomatic animal hosts, evaluating viral shedding and transmission routes, and developing strain-specific and universal vaccines. Strengthening global cooperation and public health infrastructure will be critical to mitigate the growing threat of H5N1 and reduce the risk of a future influenza pandemic. Full article

Background/Objectives:H5N1 influenza viruses are spreading worldwide and threaten global public health. Preparedness is necessary to mitigate the worst-case scenario should an H5N1 influenza pandemic occur and justify the development of vaccines against circulating H5N1 viruses of concern. Methods: The production and characterization of egg-based split and inactivated H5Nx of three distinct monovalent antigens from clades 2.3.4.4b, 2.3.2.1c, and 2.3.4 were performed at an industrial scale. These antigens were formulated and their immune responses, when combined or not with IB160 squalene-based oil-in-water emulsion adjuvant in a rat model, were evaluated in a one- or two-dose immunization schedule. IgG antibodies, hemagglutination inhibitions, and microneutralization titers were measured for vaccine-induced immunity and cross-reactivity. Results: Three monovalent vaccines from clades 2.3.4.4b, 2.3.2.1c, and 2.3.4 were produced at an industrial scale and characterized. The immune responses against the monovalent vaccines showed a clade-specific antibody response and the need to combine with IB160 adjuvant for a required immune response. Conclusions: Considering the candidate vaccine viruses (CVVs) with the testing potency reagents available and that the antibody response obtained against the CVVs produced was clade-specific, IDCDC RG-71A is the indicated CVV for the predominant currently circulating H5N1 influenza virus of clade 2.3.4.4b and must be combined with adjuvant to induce a higher and efficacious immune response in a two-dose immunization protocol. Full article

Background/Objectives: Eurasian avian-like (EA) H1N1 swine influenza viruses, with their persistent evolution and zoonotic potential, seriously threaten both swine and human health. The objective was to develop an effective vaccine against these viruses. Methods: A cold-adapted, temperature-sensitive live-attenuated influenza vaccine (LAIV) candidate, GX18ca, was developed. It was derived from the wild-type EA H1N1 strain A/swine/Guangxi/18/2011 (GX18) through serial passaging in embryonated eggs at temperatures decreasing from 33 °C to 25 °C. Its characteristics were studied in mice, including attenuation, immune responses (mucosal IgA, serum IgG, IFN-γ+ CD4⁺/CD8⁺ T-cell responses), and protective efficacy against homologous (GX18), heterologous EA H1N1 (LN972), and human 2009/H1N1 (SC1) viruses. Results: GX18ca showed cold-adapted and temperature-sensitive phenotypes. In mice, it was attenuated, with viral titers in the nasal turbinates and lungs reduced 1000–10,000-fold compared to the wild-type strain, and it cleared by day 5 post infection. Intranasal immunization elicited strong cross-reactive immune responses. Mucosal IgA had broad reactivity, and serum IgG titers reached high levels. IFN-γ+ CD4^+/CD8⁺ T-cell responses were detected against all the tested viruses. A single dose of GX18ca fully protected against GX18 and LN972 challenges, and two doses significantly reduced SC1 lung viral loads, preventing mortality and weight loss. Conclusions: GX18ca is a promising LAIV candidate. It can induce broad immunity, addressing the cross-protection gaps against evolving EA H1N1 SIVs and zoonotic H1N1 variants, which is crucial for swine influenza control and pandemic preparedness. Full article

Background/Objectives: The present study aimed to analyze changes in symptom intensity during the recovery period of COVID-19 survivors and patients with post-COVID syndrome. Methods: Initially, we described a new remote patient monitoring system to track the intensity of specific symptoms in individuals’ home environments. Remote patient monitoring (RPM) was implemented over 15 days in a cohort of 133 individuals aged 20 to 78 years, divided into four groups: mild (MG, n = 40), Hospital Discharge Without Invasive Mechanical Ventilation (WIMV, n = 40), Hospital Discharge With Invasive Mechanical Ventilation (IMV, n = 13), and reinfected (RG, n = 40). Results: The most prevalent symptoms reported across all groups, based on average intensity, were shortness of breath, fatigue, cough, headache, and body pain. The WIMV group exhibited the highest average intensities in six symptoms (p < 0.01), while the IMV group reported the highest averages in four symptoms (p < 0.05). Fatigue was the symptom with the highest overall intensity, followed by memory lapses. The hospitalized groups demonstrated the highest intensities and most persistent symptoms (p < 0.05). Blood pressure was significantly higher in the MG group compared to the RG group (p < 0.0001), although all values remained within the normal range. Conclusions: These results provide novel insights, revealing distinct differences in the symptom profiles among the studied groups. These findings hold significant implications for developing more personalized care strategies and informing future pandemic preparedness and response efforts. Full article

Background/Objectives: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2), has resulted in 777 million cases worldwide. Various vaccines have been approved to control the spread of COVID-19, with mRNA vaccines (Pfizer and Moderna) being widely used in the USA. We conducted a prospective longitudinal study to analyze the immune response elicited by two/three and four doses of monovalent mRNA vaccines in both vaccinated individuals and those who experienced breakthrough infections. Participants were stratified into different age groups: 18–40, 41–60, and over 60 years. Methods: We assessed cross-variant neutralization responses in two cohorts—Cohort I: n = 167 (serum), Cohort II: n = 92 (serum and nasal swab) samples—using infectious virus microneutralization assay (MN) and antibody (IgG or IgA) binding ELISA titers to the spike protein receptor binding domain (RBD). Samples were collected from the Louisville Metro–Jefferson County Co-Immunity Project, a federally funded, population-based study for the surveillance of SARS-CoV-2 in Jefferson County, Kentucky during 2020–2022, involving both health care workers and a local community. Results: Individuals who received two doses of the mRNA vaccine exhibited reduced neutralization against Beta, Delta, and Omicron BA.1 variants compared to wildtype Wuhan, with further decline observed six months post-booster vaccination. However, individuals who experienced natural COVID-19 infection (breakthrough) after receiving two vaccine doses showed enhanced neutralization and antibody responses, particularly against Omicron BA.1. Following the 3rd dose, antibodies and neutralization responses were restored. Among triple-vaccinated individuals, reduced neutralization was observed against Omicron variants BA.1, BA.5, and BA.2 compared to Wuhan. Neutralization responses were better against BA.2 variant compared to BA.1 and BA.5. However, individuals who received three doses of vaccine and experienced a breakthrough infection (n = 45) elicited significantly higher neutralizing antibodies responses against all Omicron subvariants compared to vaccinated individuals. Interestingly, nasal swab samples collected from volunteers with breakthrough infection showed significantly elevated spike-reactive mucosal IgA antibodies and enhanced cross neutralization against BA.1, BA.2, and BA.5 compared to individuals who received only three vaccine doses. Conclusions: mRNA vaccination elicits a strong systemic immune response by boosting serum neutralizing antibodies (NAb), although this protection wanes over time, allowing new variants to escape neutralization. Breakthrough individuals have extra enrichment in nasal NAb offering protection against emerging variants. This longitudinal immune profiling underscores the strengthening of pandemic preparedness and supports the development of durable mucosal vaccines against respiratory infectious disease. Full article

The coronavirus (COVID-19) pandemic has profoundly affected public health and socio-economic structures globally. This research conducted a post-COVID-19 analysis of the role of fiscal support interventions on COVID-19 health regulations such as mandatory non-pharmaceutical interventions like face masks, social distancing, periodic lockdowns which include restrictions on movement, and socio-economic dimensions. This quantitative research obtained 302 responses from different households in the Eastern Cape, Gauteng, Kwa-Zulu Natal, and Limpopo Provinces in South Africa. The results reveal that the relief fund (R350 unemployment grant, unemployment insurance fund claim, and food parcel distribution, among others) mediated the relationship between COVID-19 health regulations and poverty levels and the relationship between COVID-19 health regulations and health and well-being. The relief fund also mediated the relationship between COVID-19 health regulations and employment levels. Support packages from the R500 billion government support, which included loan guarantees, job support, tax and payment deferrals and holidays, social grants, wage guarantees, health interventions, and municipalities support, moderate the relationship between COVID-19 health regulations and the family and social support. These results validate the impact of the fiscal support intervention by the government in mitigating its emergency intervention with COVID-19 health regulations. This strengthens the theory of intervention, highlighting that multiple dynamics make interventions complex as shown by mediation and moderation results. Furthermore, this study highlights intervention being central to the management of the crisis. The study highlights the importance of comprehensive intervention for future preparedness, thus advancing the crisis–intervention perspective. Advances in these areas are critical to mitigate the impact of the next pandemic or similar major events in society. This can be achieved through improved pandemic timely response with effective economic stimulus, social relief, strong legal framework, and anti-corruption policies. Full article

The interspecies transmission of avian influenza viruses remains a significant public health concern. H6 viruses have gained attention following the first human infection by a chicken-origin H6N1 virus (A/Taiwan/02/2013, Hu/13), highlighting their zoonotic potential. To understand the evolutionary trajectory and mammalian adaptation of this Taiwan lineage, we compared two avian isolates (A/Chicken/Taiwan/CF19/2009, Ck/09; A/Chicken/Taiwan/2267/2012, Ck/12) and Hu/13 in vitro and in vivo. Hu/13 exhibited enhanced replication in MDCK cells, producing larger plaques and higher viral titers than Ck/09 and Ck/12. In BALB/c mice, Hu/13 demonstrated the highest pathogenicity and mortality, followed by Ck/12, while Ck/09 induced minimal morbidity. Hu/13 and Ck/12 replicated efficiently in respiratory tissues, eliciting robust cytokine responses and severe pulmonary lesions. In ferrets, Hu/13 showed relatively efficient transmission, infecting all direct physical-contact and two out of three airborne-contact ferrets, whereas Ck/09 failed to transmit. Histopathology confirmed escalating lung pathology from Ck/09 to Ck/12 and Hu/13. Whole-genome sequencing identified adaptive mutations in Hu/13 during ferret replication, though no canonical mammalian-adaptive changes (e.g., PB2-E627K or HA-Q226L) were detected. These findings demonstrate progressive mammalian adaptation, replication efficiency, and transmissibility within the Taiwan H6N1 lineage. Enhanced surveillance is crucial to monitor mammalian-adaptive mutations, informing pandemic preparedness and public health strategies. Full article

The COVID-19 pandemic has accelerated digital transformation in various sectors, including higher education in South Africa. This study examines the readiness of information security functions in response to this rapid digital shift. Higher education institutions (HEIs) are transitioning to online platforms and digital tools, so the need to adapt security practices has become critical. The research investigates HEIs’ challenges in aligning their information security strategies with evolving digital initiatives. It explores how HEIs address technological change, staff awareness, and evolving security risks. By examining the relationship between digital transformation and information security, this study offers insights into strengthening the resilience and effectiveness of security functions within South African higher education. The findings highlight significant challenges, including the pace of technological change, inadequate staff training, and a lack of a security-conscious culture. Despite these hurdles, successful strategies such as promoting security awareness, policy adaptation, and improved governance frameworks are key to enhancing institutional preparedness. These insights can guide future efforts in improving information security practices in higher education, ensuring a more secure and resilient digital environment. Full article

Background/Objectives: The COVID-19 pandemic led to significant disruptions in healthcare systems, particularly impacting cancer care through delays in diagnoses and treatments. Quality indicators (QIs) are essential tools for monitoring healthcare performance, yet existing QIs may not be suited for crises. This study aimed to develop a set of hospital-based QIs tailored to assess the impact of care reorganization during health crises across four cancer types: breast cancer, hepatocellular carcinoma, gynecological cancers (excluding ovarian cancer), and peritoneal carcinomatosis. Methods: A multidisciplinary steering committee (SC) conducted a five-stage process, including a literature review, indicator selection, content validation via the RAND/UCLA method, final validation by the SC, and a pilot feasibility study. QIs were assessed based on clinical relevance, reproducibility, sensitivity to change, and feasibility. Expert panels evaluated and validated the indicators in two rounds of voting. Results: Among 150 initially identified QIs, 49 were validated: 12 for breast cancer, 11 for hepatocellular carcinoma, 8 for gynecological cancers, and 18 for peritoneal carcinomatosis. Most (92%) were process indicators, covering diagnosis, treatment, and care delays. Two common indicators were identified across all four cancers: multidisciplinary team meeting discussions and psychological support consultations. Conclusions: This study demonstrates the feasibility of developing crisis-responsive QIs to monitor cancer care during health system disruptions. Future work will focus on their real-time implementation, validation in international settings, and integration into healthcare policies to enhance crisis preparedness. Full article