RESUMO
To describe the prevalence of long COVID in children infected for the first time (n = 332) or reinfected (n = 243) with Omicron compared with test-negative children (n = 311). Overall, 12%-16% of those infected with Omicron met the research definition of long COVID at 3 and 6 months after infection, with no evidence of difference between cases of first positive and reinfected (Pχ2 = 0.17).
Assuntos
COVID-19 , Síndrome de COVID-19 Pós-Aguda , Humanos , Criança , Reinfecção , SARS-CoV-2RESUMO
INTRODUCTION: Very little is known about possible clinical sequelae that may persist after resolution of acute COVID-19. A recent longitudinal cohort from Italy including 143 patients followed up after hospitalisation with COVID-19 reported that 87% had at least one ongoing symptom at 60-day follow-up. Early indications suggest that patients with COVID-19 may need even more psychological support than typical intensive care unit patients. The assessment of risk factors for longer term consequences requires a longitudinal study linked to data on pre-existing conditions and care received during the acute phase of illness. The primary aim of this study is to characterise physical and psychosocial sequelae in patients post-COVID-19 hospital discharge. METHODS AND ANALYSIS: This is an international open-access prospective, observational multisite study. This protocol is linked with the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) and the WHO's Clinical Characterisation Protocol, which includes patients with suspected or confirmed COVID-19 during hospitalisation. This protocol will follow-up a subset of patients with confirmed COVID-19 using standardised surveys to measure longer term physical and psychosocial sequelae. The data will be linked with the acute phase data. Statistical analyses will be undertaken to characterise groups most likely to be affected by sequelae of COVID-19. The open-access follow-up survey can be used as a data collection tool by other follow-up studies, to facilitate data harmonisation and to identify subsets of patients for further in-depth follow-up. The outcomes of this study will inform strategies to prevent long-term consequences; inform clinical management, interventional studies, rehabilitation and public health management to reduce overall morbidity; and improve long-term outcomes of COVID-19. ETHICS AND DISSEMINATION: The protocol and survey are open access to enable low-resourced sites to join the study to facilitate global standardised, longitudinal data collection. Ethical approval has been given by sites in Colombia, Ghana, Italy, Norway, Russia, the UK and South Africa. New sites are welcome to join this collaborative study at any time. Sites interested in adopting the protocol as it is or in an adapted version are responsible for ensuring that local sponsorship and ethical approvals in place as appropriate. The tools are available on the ISARIC website (www.isaric.org). PROTOCOL REGISTRATION NUMBER: osf.io/c5rw3/ PROTOCOL VERSION: 3 August 2020 EUROQOL ID: 37035.
Assuntos
COVID-19/diagnóstico , COVID-19/psicologia , Colômbia , Gana , Humanos , Itália , Estudos Longitudinais , Noruega , Estudos Prospectivos , Fatores de Risco , Federação Russa , África do Sul , Reino UnidoRESUMO
Unplanned housing in developing countries is often located on steep slopes. Frequently no building code is enforced for such housing and mains water is provided with no drainage provision. Both of these factors can be particularly significant in terms of landslide risk if, as is so often the case, such slopes lack any planned drainage provision. There is thus a need to develop a model that facilitates the assessment of slope stability in an holistic context, incorporating a wide range of factors (including surface cover, soil water topographic convergence, slope loading and point source water leakage) in order that appropriate advice can be given as to the general controls on slope stability in such circumstances. This paper outlines a model configured for this specific purpose and describes an application to a site in St. Lucia, West Indies, where there is active slope movement in an unplanned housing development on relatively steep topography. The model findings are in accord with the nature of the current failure at the site, provide guidance as to the significance of slope drainage and correspond to inferences drawn from an application of resistance envelope methods to the site. In being able to scenario test a uniquely wide range of combinations of factors, the model structure is shown to be highly valuable in assessing dominant slope stability process controls in such complex environments.
Assuntos
Desastres , Modelos Teóricos , Países em Desenvolvimento , Fenômenos Geológicos , Geologia , Habitação , Solo , Índias OcidentaisRESUMO
We report the clinical, microbiological, and epidemiological features of an emerging serotype, Shigella boydii 20. We interviewed patients about symptoms, and history of travel and visitors during the week before illness onset. Seventy-five per cent of the 56 patients were Hispanic. During the week before illness onset, 18 (32%) travelled abroad; 17 (94%) had visited Mexico. Eight (21%) out of 38 who had not travelled had foreign visitors. There were eight closely related patterns by PFGE with XbaI. S. boydii 20 may be related to travel to Mexico and Hispanic ethnicity. Prompt epidemiological investigation of clusters of S. boydii 20 infection may help identify specific vehicles and risk factors for infection.
Assuntos
Disenteria Bacilar/epidemiologia , Disenteria Bacilar/microbiologia , Shigella boydii/classificação , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Disenteria Bacilar/etiologia , Feminino , Humanos , Lactente , Masculino , México , Pessoa de Meia-Idade , Fatores de Risco , Estações do Ano , Sorotipagem , Viagem , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: In January 1996, an outbreak of diarrhea caused by Salmonella Enteritidis occurred in children attending a Komodo dragon exhibit at a metropolitan zoo. We sought to determine the extent of the outbreak and mode of transmission. STUDY DESIGN: A case-control study was conducted. Controls were randomly selected from zoo membership lists and matched to patients by age group and date of exhibit visit. RESULTS: Of 65 patients identified, 39 had confirmed and 26 had suspected cases. The median age was 7 years (range, 3 months to 48 years); 55% were enrolled in the case-control study. No patients and two (4%) controls reported touching a dragon; however, 83% of patients but only 52% of controls touched the wooden barrier that surrounded the dragon pen (odds ratio = 4.0, 95% CI 1.2 to 13.9). Washing hands at the zoo after visiting the dragons was highly protective (OR = 0.14, 95% CI 0.03 to 0.7). Cultures from the patients, one dragon, and the exhibit barriers yielded Salmonella Enteritidis, phage type 8. On the basis of an attack rate of 4.3% among exhibit attendees under 13 years old on whom data were collected, we estimate that 315 additional cases of salmonellosis occurred among visitors in this age group. CONCLUSION: This large outbreak demonstrates the importance of environmental contamination in the transmission of Salmonella from reptiles, and the protective value of hand washing. Recommendations regarding reptile exhibits and reptilian pets should emphasize this indirect route.
Assuntos
Animais de Zoológico/microbiologia , Surtos de Doenças , Gastroenterite/epidemiologia , Répteis/microbiologia , Infecções por Salmonella/epidemiologia , Infecções por Salmonella/transmissão , Salmonella enteritidis/isolamento & purificação , Adolescente , Adulto , Animais , Estudos de Casos e Controles , Criança , Pré-Escolar , Colorado/epidemiologia , Métodos Epidemiológicos , Desinfecção das Mãos , Humanos , Lactente , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
In the study of the operational aspects of the food handlers' clinics and the distribution of food handlers' permits in Manchester, the medical examination of attendants was ascertained, taking into consideration the methods and techniques used to process food handlers. The problems faced by the staff in the various clinics in processing food handlers were investigated. A structured questionaire was administered to gain information regarding the problems experienced by the Public Health Inspector in charge of each clinic. (AU)