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- 2015/16 I-MOVE/I-MOVE+ multicentre case control study in Europe: moderate vaccine effectiveness estimates against influenza A(H1N1)pdm09 and low estimates against lineage mismatched influenza B among childrenPublication . Kissling, Esther; Valenciano, Marta; Pozo, Francisco; Vilcu, Ana-Maria; Reuss, Annicka; Rizzo, Caterina; Larrauri, Amparo; Horváth, Judit Krisztina; Brytting, Mia; Domegan, Lisa; Korczyńska, Monika; Meijer, Adam; Machado, Ausenda; Ivanciuc, Alina; Višekruna Vučina, Vesna; van der Werf, Sylvie; Schweiger, Brunhilde; Bella, Antonino; Gherasim, Alin; Ferenczi, Annamária; Zakikhany, Katherina; O Donnell, Joan; Paradowska-Stankiewicz, Iwona; Dijkstra, Frederika; Guiomar, Raquel; Lazar, Mihaela; Kurečić Filipović, Sanja; Johansen, Kari; Moren, Alain; I-MOVE/I-MOVE+ study teamBackground:During the 2015/16 influenza season in Europe, the co-circulating influenza viruses were A(H1N1)pdm09 and B/Victoria, which was antigenically distinct from the B/Yamagata component in the trivalent influenza vaccine. Methods:We used the test negative design in a multicentre case–control study in twelve European countries to measure 2015/16 influenza vaccine effectiveness (VE) against medically-attended influenza-like illness (ILI) laboratory-confirmed as influenza. General practitioners swabbed a systematic sample of consulting ILI patients ainfluenza Vaccinend a random sample of influenza positive swabs were sequenced. We calculated adjusted VE against influenza A(H1N1)pdm09, A(H1N1)pdm09 genetic group 6B.1 and influenza B overall and by age group. Results: We included 11,430 ILI patients, of which 2272 were influenza A(H1N1)pdm09 and 2901 were influenza B cases. Overall VE against influenza A(H1N1)pdm09 was 32.9% (95% CI: 15.5-46.7). Among those aged 0–14, 15–64 and ≥65 years VE against A(H1N1)pdm09 was 31.9% (95% CI: -32.3-65.0), 41.4% (95%CI: 20.5-56.7) and 13.2% (95% CI: -38.0-45.3) respectively. Overall VE against influenza A(H1N1)pdm09 genetic group 6B.1 was 32.8% (95%CI: -4.1-56.7). Among those aged 0–14, 15–64 and ≥65 years VE against influenza B was -47.6% (95%CI: -124.9-3.1), 27.3% (95%CI: -4.6-49.4), and 9.3% (95%CI: -44.1-42.9) respectively. Conclusions: VE against influenza A(H1N1)pdm09 and its genetic group 6B.1 was moderate in children and adults, and low among individuals ≥65 years. VE against influenza B was low and heterogeneous among age groups. More information on effects of previous vaccination and previous infection are needed to understand the VE results against influenza B in the context of a mismatched vaccine.
- 2015/16 seasonal vaccine effectiveness against hospitalisation with influenza A(H1N1)pdm09 and B among elderly people in Europe: results from the I-MOVE+ projectPublication . Rondy, Marc; Larrauri, Amparo; Casado, Itziar; Alfonsi, Valeria; Pitigoi, Daniela; Launay, Odile; Syrjänen, Ritva K; Gefenaite, Giedre; Machado, Ausenda; Vučina, Vesna Višekruna; Horváth, Judith Krisztina; Paradowska-Stankiewicz, Iwona; Marbus, Sierk D; Gherasim, Alin; Díaz-González, Jorge Alberto; Rizzo, Caterina; Ivanciuc, Alina E; Galtier, Florence; Ikonen, Niina; Mickiene, Aukse; Gomez, Veronica; Kurečić Filipović, Sanja; Ferenczi, Annamária; Korcinska, Monika R; van Gageldonk-Lafeber, Rianne; I-MOVE+ hospital working group; Valenciano, MartaWe conducted a multicentre test-negative case-control study in 27 hospitals of 11 European countries to measure 2015/16 influenza vaccine effectiveness (IVE) against hospitalised influenza A(H1N1)pdm09 and B among people aged ≥ 65 years. Patients swabbed within 7 days after onset of symptoms compatible with severe acute respiratory infection were included. Information on demographics, vaccination and underlying conditions was collected. Using logistic regression, we measured IVE adjusted for potential confounders. We included 355 influenza A(H1N1)pdm09 cases, 110 influenza B cases, and 1,274 controls. Adjusted IVE against influenza A(H1N1)pdm09 was 42% (95% confidence interval (CI): 22 to 57). It was 59% (95% CI: 23 to 78), 48% (95% CI: 5 to 71), 43% (95% CI: 8 to 65) and 39% (95% CI: 7 to 60) in patients with diabetes mellitus, cancer, lung and heart disease, respectively. Adjusted IVE against influenza B was 52% (95% CI: 24 to 70). It was 62% (95% CI: 5 to 85), 60% (95% CI: 18 to 80) and 36% (95% CI: -23 to 67) in patients with diabetes mellitus, lung and heart disease, respectively. 2015/16 IVE estimates against hospitalised influenza in elderly people was moderate against influenza A(H1N1)pdm09 and B, including among those with diabetes mellitus, cancer, lung or heart diseases.
- Abundance and Updated Distribution of Aedes aegypti (Diptera: Culicidae) in Cabo Verde Archipelago: A Neglected Threat to Public HealthPublication . Da Veiga Leal, S.; Varela, I. B. F.; Gonçalves, A. A. L.; Monteiro, D. D. S.; Ramos de Sousa, C. M.; Mendonça, M. L. L.; De Pina, A. J.; Alves, M. J.; Osório, H. C.Background: Mosquito-borne viruses, such as Zika, dengue, yellow fever, and chikungunya, are important causes of human diseases nearly worldwide. The greatest health risk for arboviral disease outbreaks is the presence of the most competent and highly invasive domestic mosquito, Aedes aegypti. In Cabo Verde, two recent arbovirus outbreaks were reported, a dengue outbreak in 2009, followed by a Zika outbreak in 2015. This study is the first entomological survey for Ae. aegypti that includes all islands of Cabo Verde archipelago, in which we aim to evaluate the actual risk of vector-borne arboviruses as a continuous update of the geographical distribution of this species. Methods: In order to assess its current distribution and abundance, we undertook a mosquito larval survey in the nine inhabited islands of Cabo Verde from November 2018 to May 2019. Entomological larval survey indices were calculated, and the abundance analyzed. We collected and identified 4045 Ae. aegypti mosquitoes from 264 positive breeding sites in 22 municipalities and confirmed the presence of Ae. aegypti in every inhabited island. Results: Water drums were found to be the most prevalent containers (n = 3843; 62.9%), but puddles (n = 27; 0.4%) were the most productive habitats found. The overall average of the House, Container, and Breteau larval indices were 8.4%, 4.4%, and 10.9, respectively. However, 15 out of the 22 municipalities showed that the Breteau Index was above the epidemic risk threshold. Conclusion: These results suggest that if no vector control measures are considered to be in place, the risk of new arboviral outbreaks in Cabo Verde is high. The vector control strategy adopted must include measures of public health directed to domestic water storage and management.
- Accessing indoor fungal contamination by Aspergillus fumigatus complex using conventional and molecular methods in portuguese poultriesPublication . Viegas, C.; Malta-Vacas, J.; Sabino, R.; Viegas, S.; Veríssimo, C.Epidemiological studies showed increased prevalence of respiratory symptoms and adverse changes in pulmonary function parameters in poultry workers, corroborating the increased exposure to risk factors, such as fungal load and their metabolites. This study aimed to determine the occupational exposure threat due to fungal contamination caused by the toxigenic isolates belonging to the complex of the species of Aspergillus flavus and also isolates from Aspergillus fumigatus species complex. The study was carried out in seven Portuguese poultries, using cultural and molecular methodologies. For conventional/cultural methods, air, surfaces, and litter samples were collected by impaction method using the Millipore Air Sampler. For the molecular analysis, air samples were collected by impinger method using the Coriolis μ air sampler. After DNA extraction, samples were analyzed by real-time PCR using specific primers and probes for toxigenic strains of the Aspergillus flavus complex and for detection of isolates from Aspergillus fumigatus complex. Through conventional methods, and among the Aspergillus genus, different prevalences were detected regarding the presence of Aspergillus flavus and Aspergillus fumigatus species complexes, namely: 74.5 versus 1.0 % in the air samples, 24.0 versus 16.0 % in the surfaces, 0 versus 32.6 % in new litter, and 9.9 versus 15.9 % in used litter. Through molecular biology, we were able to detect the presence of aflatoxigenic strains in pavilions in which Aspergillus flavus did not grow in culture. Aspergillus fumigatus was only found in one indoor air sample by conventional methods. Using molecular methodologies, however, Aspergillus fumigatus complex was detected in seven indoor samples from three different poultry units. The characterization of fungal contamination caused by Aspergillus flavus and Aspergillus fumigatus raises the concern of occupational threat not only due to the detected fungal load but also because of the toxigenic potential of these species.
- Accuracy of prenatal culture in predicting intrapartum group B streptococcus colonization statusPublication . Florindo, C.; Damião, V.; Lima, J.; Nogueira, I.; Rocha, I.; Caetano, P.; Ribeiro, L.; Viegas, S.; Gomes, João Paulo; Borrego, M.J.Objective: To evaluate the positive predictive value (PPV) of group B Streptococcus (GBS) cultures at 35–37 weeks of gestation relative to GBS colonization status at delivery. Methods: Rectovaginal swabs from 221 women at labor in four Lisbon hospitals were collected for GBS screening according to the CDC guidelines. Results: The PPV was 24.4%. IAP was administered to 100% of prenatally GBS positive women. There was no case of early onset GBS disease (EOD). Conclusions: Poor accuracy of prenatal cultures in identifying true candidates for IAP highlights the need for Portuguese clinical and laboratory guidelines to prevent EOD and antibiotic overtreatment of pregnant women.
- Acquired antibiotic resistance among wild animals: the case of Iberian Lynx (Lynx pardinus)Publication . Sousa, M.; Gonçalves, A.; Silva, N.; Serra, R.; Alcaide, E.; Zorrilla, I.; Torres, C.; Caniça, Manuela; IgrejaS, G.; Poeta, P.The selective pressure generated by the clinical misuse of antibiotics has been the major driving force leading to the emergence of antibiotic resistance among bacteria. Antibiotics or even resistant bacteria are released into the environment and contaminate the surrounding areas. Human and animal populations in contact with these sources are able to become reservoirs of these resistant organisms. Then, due to the convergence between habitats, the contact of wild animals with other animals, humans, or human sources is now more common and this leads to an increase in the exchange of resistance determinants between their microbiota. Indeed, it seems that wildlife populations living in closer proximity to humans have higher levels of antibiotic resistance. Now, the Iberian Lynx (Lynx pardinus) is a part of this issue, being suggested as natural reservoir of acquired resistant bacteria. The emerging public health concern regarding microbial resistance to antibiotics is becoming true: the bacteria are evolving and are now affecting unintentional hosts.
- Acute gastroenteritis outbreak associated to norovirus GI.9 in a Portuguese army basePublication . Lopes-João, António; Mesquita, João R.; de Sousa, Rita; Oleastro, Mónica; Penha-Gonçalves, Carlos; Nascimento, Maria São JoséGastroenteritis is considered a major illness within the military settings being caused by foodborne enteric pathogens that are particularly easily spread in the crowded conditions of military camps. Gastroenteritis outbreaks caused by norovirus usually affect a great number of soldiers due to the low infectious dose, copious viral shedding, and environmental stability. The present study describes the investigation of an outbreak of acute gastroenteritis that occurred in April 2015 in a Portuguese army base, focusing on the study of the epidemiological curve, symptoms experienced by the affected soldiers, and results of food, water, and stool microbiological analysis. From a total of 938 military personnel stationed on the base 46 soldiers developed acute gastroenteritis. Stool analysis of seven cases showed to be positive for norovirus GI.9 that was the probable cause of the outbreak. This report shows that genogroup I norovirus can also cause considerable morbidity in healthy young soldiers, affecting the operational effectiveness on the military forces. J. Med. Virol. 89:922-925, 2017. © 2016 Wiley Periodicals, Inc.
- Acute gastroenteritis outbreak associated to norovirus GI.9 in a Portuguese army basePublication . Lopes-João, António; Mesquita, João R.; de Sousa, Rita; Oleastro, Mónica; Penha-Gonçalves, Carlos; Nascimento, Maria Sao JoséGastroenteritis is considered a major illness within the military settings being caused by foodborne enteric pathogens that are particularly easily spread in the crowded conditions of military camps. Gastroenteritis outbreaks caused by norovirus usually affect a great number of soldiers due to the low infectious dose, copious viral shedding, and environmental stability. The present study describes the investigation of an outbreak of acute gastroenteritis that occurred in April 2015 in a Portuguese army base, focusing on the study of the epidemiological curve, symptoms experienced by the affected soldiers, and results of food, water, and stool microbiological analysis. From a total of 938 military personnel stationed on the base 46 soldiers developed acute gastroenteritis. Stool analysis of seven cases showed to be positive for norovirus GI.9 that was the probable cause of the outbreak. This report shows that genogroup I norovirus can also cause considerable morbidity in healthy young soldiers, affecting the operational effectiveness on the military forces. J. Med. Virol. © 2016 Wiley Periodicals, Inc.
- Adaptation of Brucella melitensis Antimicrobial Susceptibility Testing to the ISO 20776 Standard and Validation of the MethodPublication . Tscherne, A.; Mantel, E.; Boskani, T.; Budniak, S.; Elschner, M.; Fasanella, A.; Feruglio, S.L.; Galante, D.; Giske, C.G.; Grunow, Roland; Henczko, Judit; Hinz, Christin; Iwaniak, Wojciech; Jacob, Daniela; Kedrak-Jablonska, Agnieszka; Jensen, Veronica K.; Johansen, Tone B.; Kahlmeter, Gunnar; Manzulli, Viviana; Matuschek, Erika; Melzer, Falk; Nuncio, Maria S.; Papaparaskevas, Joseph; Pelerito, Ana; Solheim, Margrete; Thomann, Susanne; Tsakris, Athanasios; Wahab, Tara; Weiner, Marcin; Zoeller, Lothar; Zange, Sabine; EMERGE AST Working GroupBrucellosis, mainly caused by Brucella (B.) melitensis, is associated with a risk of chronification and relapses. Antimicrobial susceptibility testing (AST) standards for B. melitensis are not available, and the agent is not yet listed in the EUCAST breakpoint tables. CLSI recommendations for B. melitensis exist, but they do not fulfill the requirements of the ISO 20776 standard regarding the culture medium and the incubation conditions. Under the third EU Health Programme, laboratories specializing in the diagnostics of highly pathogenic bacteria in their respective countries formed a working group within a Joint Action aiming to develop a suitable method for the AST of B. melitensis. Under the supervision of EUCAST representatives, this working group adapted the CLSI M45 document to the ISO 20776 standard after testing and validation. These adaptations included the comparison of various culture media, culture conditions and AST methods. A Standard Operation Procedure was derived and an interlaboratory validation was performed in order to evaluate the method. The results showed pros and cons for both of the two methods but also indicate that it is not necessary to abandon Mueller–Hinton without additives for the AST of B. melitensis.
- Adapting to COVID-19: Insights from Portuguese residents' home-based lifePublication . Aguiar, Ana; Soares, Patricia; Barbosa, Pedro; Duarte, Raquel; Pinto, MartaBackground: The COVID-19 pandemic led to widespread lockdowns and remote work and educational practices that have impacted the lives of many families. Objective: We aimed to investigate how parents and caregivers altered their routines due to online schooling and teleworking, exploring their association with increased anxiety and depression symptoms. Methods: We conducted an online cross-sectional study and collected data through snowball sampling. We asked questions about age, gender, dwelling area, educational level, and marital status, as well as an open-ended question about teleworking and homeschooling - "Did your routine change due to your children being forced to stay home and take online classes? If so, please explain how it has influenced your personal and professional life, both positively and negatively". Thematic analysis was used to analyse the responses. Results: A total of 181 respondents, primarily women (72.4%), averaging 36.6 years old, holding bachelor's degrees (44.2%), were included. About 78.5% reported routine adjustments. Four salient themes emerged: 1) Perceived changes in professional and personal life, 2) Perceived changes in learning methods, 3) Mental health issues and 4) Perceived advantages of working from home with children at online school. Regarding mental health, 25.4% exhibited symptoms of anxiety, and 7.7% displayed depression symptoms, predominantly linked (80%) to the pandemic's impact. Conclusion: Family routines were disrupted, causing stress. In future crises, policymakers, public health experts, and researchers must acknowledge these challenges to mitigate negative consequences. Simultaneously, they should focus on strategies that enhance the positive aspects of restrictive measures and related policies.