Hand, foot, and mouth disease (HFMD) shows spatiotemporal heterogeneity in China. A spatiotemporal filtering model was constructed and applied to HFMD data to explore the underlying spatiotemporal structure of the disease and determine the impact of different spatiotemporal weight matrices on the results. HFMD cases and covariate data in East China were collected between 2009 and 2015. The different spatiotemporal weight matrices formed by Rook, K-nearest neighbour (KNN; K = 1), distance, and second-order spatial weight matrices (SO-SWM) with first-order temporal weight matrices in contemporaneous and lagged forms were decomposed, and spatiotemporal filtering model was constructed by selecting eigenvectors according to MC and the AIC. We used MI, standard deviation of the regression coefficients, and five indices (AIC, BIC, DIC, R2, and MSE) to compare the spatiotemporal filtering model with a Bayesian spatiotemporal model. The eigenvectors effectively removed spatial correlation in the model residuals (Moran’s I < 0.2, p > 0.05). The Bayesian spatiotemporal model’s Rook weight matrix outperformed others. The spatiotemporal filtering model with SO-SWM was superior, as shown by lower AIC (92,029.60), BIC (92,681.20), and MSE (418,022.7) values, and higher R2 (0.56) value. All spatiotemporal contemporaneous structures outperformed the lagged structures. Additionally, eigenvector maps from the Rook and SO-SWM closely resembled incidence patterns of HFMD.

Post COVID-19 condition (PCC) refers to persistent symptoms occurring ≥12 weeks after COVID-19. This living systematic review (SR) assessed the impact of vaccination on PCC and vaccine safety among those with PCC, and was previously published with data up to December 2022. Searches were updated to 31 January 2024 and standard SR methodology was followed. Seventy-eight observational studies were included (47 new). There is moderate confidence that two doses pre-infection reduces the odds of PCC (pooled OR (pOR) 0.69, 95% CI 0.64–0.74, I2 = 35.16%). There is low confidence for remaining outcomes of one dose and three or more doses. A booster dose may further reduce the odds of PCC compared to only a primary series (pOR 0.85, 95% CI 0.74–0.98, I2 = 16.85%). Among children ≤18 years old, vaccination may not reduce the odds (pOR 0.79, 95% CI 0.56–1.11, I2 = 37.2%) of PCC. One study suggests that vaccination within 12 weeks post-infection may reduce the odds of PCC. For those with PCC, vaccination appears safe (four studies) and may reduce the odds of PCC persistence (pOR 0.73, 95% CI 0.57–0.92, I2 = 15.5%).

Gastrointestinal infections significantly impact African low- and middle-income countries, although, accurate data on acute gastrointestinal illness (AGI) for all ages are lacking. This study aimed to describe the epidemiology of AGI in Ethiopia, Mozambique, Nigeria, and Tanzania. A population survey was conducted in one urban and one rural site per country, from 01 October 2020 to 30 September 2021, using web-based and face-to-face tools (n = 4417). The survey tool was adapted from high-income countries, ensuring comparability through an internationally recommended AGI case definition. Ethiopia had the highest AGI incidence (0.87 episodes per person-year), followed by Mozambique (0.58), Tanzania (0.41), and Nigeria (0.34). Age-standardized incidence was highest in Mozambique (1.46) and Ethiopia (1.25), compared to Tanzania (0.58) and Nigeria (0.33). The 4-week prevalence was 6.4% in Ethiopia and 4.3% in Mozambique, compared to 3.1% in Tanzania and 2.6% in Nigeria. AGI lasted an average of 5.3 days in Ethiopia and 3.0 to 3.4 days elsewhere. Children under five had 4.4 times higher AGI odds (95% CI: 2.8, 6.7) than those aged 15-59. The study provides empirical data on the incidence and demographic determinants of AGI in these four countries.

We describe an outbreak of Legionnaires’ disease linked to an exclusive cold-water source in a private residential setting in Yorkshire. The cold-water source was identified following microbiological testing of clinical and environmental samples. Legionella pneumophila was only detected in the cold-water system. Three cases were identified over the course of the outbreak: two confirmed and one probable. Conditions favourable to bacterial growth included system ‘dead legs’ and significant heat transfer to the cold-water system. We describe challenges in implementing control measures at the venue and highlight the importance of using enforcement powers, where necessary, to reduce risk.

Leptospirosis in NZ has historically been associated with male workers in livestock industries; however, the disease epidemiology is changing. This study identified risk factors amid these shifts. Participants (95 cases:300 controls) were recruited nationwide between 22 July 2019 and 31 January 2022, and controls were frequency-matched by sex (90% male) and rurality (65% rural). Multivariable logistic regression models, adjusted for sex, rurality, age, and season—with one model additionally including occupational sector—identified risk factors including contact with dairy cattle (aOR 2.5; CI: 1.0–6.0), activities with beef cattle (aOR 3.0; 95% CI: 1.1–8.2), cleaning urine/faeces from yard surfaces (aOR 3.9; 95% CI: 1.5–10.3), uncovered cuts/scratches (aOR 4.6; 95% CI: 1.9–11.7), evidence of rodents (aOR 2.2; 95% CI: 1.0–5.0), and work water supply from multiple sources—especially creeks/streams (aOR 7.8; 95% CI: 1.5–45.1) or roof-collected rainwater (aOR 6.6; 95% CI: 1.4–33.7). When adjusted for occupational sector, risk factors remained significant except for contact with dairy cattle, and slaughter without gloves emerged as a risk (aOR 3.3; 95% CI: 0.9–12.9). This study highlights novel behavioural factors, such as uncovered cuts and inconsistent glove use, alongside environmental risks from rodents and natural water sources.

Temporal variability and methodological differences in data normalization, among other factors, complicate effective trend analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wastewater surveillance data and its alignment with coronavirus disease 2019 (COVID-19) clinical outcomes. As there is no consensus approach for these analyses yet, this study explored the use of piecewise linear trend analysis (joinpoint regression) to identify significant trends and trend turning points in SARS-CoV-2 RNA wastewater concentrations (normalized and non-normalized) and corresponding COVID-19 case rates in the greater Las Vegas metropolitan area (Nevada, USA) from mid-2020 to April 2023. The analysis period was stratified into three distinct phases based on temporal changes in testing protocols, vaccination availability, SARS-CoV-2 variant prevalence, and public health interventions. While other statistical methodologies may require fewer parameter specifications, joinpoint regression provided an interpretable framework for characterization and comparison of trends and trend turning points, revealing sewershed-specific variations in trend magnitude and timing that also aligned with known variant-driven waves. Week-level trend agreement corroborated previous findings demonstrating a close relationship between SARS-CoV-2 wastewater surveillance data and COVID-19 outcomes. These findings guide future applications of advanced statistical methodologies and support the continued integration of wastewater-based epidemiology as a complementary approach to traditional COVID-19 surveillance systems.

Human toxocariasis is a worldwide parasitic disease caused by zoonotic roundworms of the genus Toxocara, which can cause blindness and epilepsy. The aim of this study was to estimate the risk of food-borne transmission of Toxocara spp. to humans in the UK by developing mathematical models created in a Bayesian framework. Parameter estimation was based on published experimental studies and field data from southern England, with qPCR Cq values used as a measure of eggs in spinach portions and ELISA optical density data as an indirect measure of larvae in meat portions. The average human risk of Toxocara spp. infection, per portion consumed, was estimated as 0.016% (95% CI: 0.000–0.100%) for unwashed leafy vegetables and 0.172% (95% CI: 0.000–0.400%) for undercooked meat. The average proportion of meat portions estimated positive for Toxocara spp. larvae was 0.841% (95% CI: 0.300–1.400%), compared to 0.036% (95% CI: 0.000–0.200%) of spinach portions containing larvated Toxocara spp. eggs. Overall, the models estimated a low risk of infection with Toxocara spp. by consuming these foods. However, given the potentially severe human health consequences of toxocariasis, intervention strategies to reduce environmental contamination with Toxocara spp. eggs and correct food preparation are advised.

Early detection and active management of invasive group A Streptococcus (iGAS) infection outbreaks are essential. Here, we describe the changing epidemiology of outbreaks of iGAS in England between 2015 and 2019, a period of increasing incidence of iGAS infection. Data on iGAS infections were extracted from national public health management records and laboratory records. Outbreaks were described in size, duration, setting, and emm type. Overall, 194 outbreaks were identified, and reports increased each year, from 16 outbreaks in 2015 to 61 in 2019. The median outbreak size was 3 cases (n = 37; 19%), with 27% of outbreaks recording 4–10 cases (n = 53) and 7% recording more than 10 cases (n = 13). Outbreak duration ranged from 0 to 170 weeks (median 7). Settings of outbreaks changed over the study period, with increasing numbers observed in multiple settings. This study provides new insights into the changing burden of iGAS infection and outbreaks in England.

Previously, we reported the persistence of the bacterial pathogen Neisseria meningitidis on fomites, indicating a potential route for environmental transmission. The current goal was to identify proteins that vary among strains of meningococci that have differing environmental survival. We carried out a proteomic analysis of two strains that differ in their potential for survival outside the host. The Group B epidemic strain NZ98/254 and Group W carriage strain H34 were cultured either at 36 °C, 5% CO2, and 95% relative humidity (RH) corresponding to host conditions in the nasopharynx, or at lower humidities of 22% or 30% RH at 30 °C, for which there was greater survival on fomites. For NZ98/254, the shift to lower RH and temperature was associated with increased abundance of proteins involved in metabolism, stress responses, and outer membrane components, including pili and porins. In contrast, H34 responded to lower RH by decreasing the abundance of multiple proteins, indicating that the lower viability of H34 may be linked to decreased capacity to mount core protective responses. The results provide a snapshot of bacterial proteins and metabolism that may be related to normal fitness, to the greater environmental persistence of NZ98/254 compared to H34, and potentially to differences in transmission and pathogenicity.

Determining the factors that impact the risk for infection with SARS-CoV-2 is a priority as the virus continues to infect people worldwide. The objective was to determine the effectiveness of vaccines and other factors associated with infection among Canadian healthcare workers (HCWs) followed from 15 June 2020 to 1 December 2023. We also investigate the association between antibodies to SARS-CoV-2 and subsequent infections with SARS-CoV-2. Of the 2474 eligible participants, 2133 (86%) were female, 33% were nurses, the median age was 41 years, and 99.3% had received at least two doses of COVID-19 vaccine by 31 December 2021. The incidence of SARS-CoV-2 was 0.91 per 1000 person-days. Prior to the circulation of the Omicron variants, vaccine effectiveness (VE) was estimated at 85% (95% CI 1, 98) for participants who received the primary series of vaccine. During the Omicron period, relative adjusted VE was 43% (95% CI 29, 54), 56% (95% CI 42, 67), and 46% (95% CI 24, 62) for 3, 4, and ≥ 5 doses compared with those who received primary series after adjusting for previous infection and other covariates. Exposure to infected household members, coworkers, or friends in the previous 14 days were risk factor for infection, while contact with an infected patient was not statistically significant. Participants with higher levels of immunoglobulin G (IgG) anti-receptor binding domain (RBD) antibodies had lower rates of infection than those with the lowest levels. COVID-19 vaccines remained effective throughout the follow-up of this cohort of highly vaccinated HCWs. IgG anti-RBD antibody levels may be useful as correlates of protection for issues such as vaccine development and testing. There remains a need to increase the awareness among HCWs about the risk of contracting SARS-CoV-2 from contacts at a variety of venues.