Abstract
Post-acute sick leave is an underexplored indicator of the societal burden of SARS-CoV-2. Here, we report findings about self-reported sick leave and risk factors thereof from a hybrid ...survey and register study, which include 37,482 RT-PCR confirmed SARS-CoV-2 cases and 51,336 test-negative controls who were tested during the index- and alpha-dominant waves. We observe that an additional 33 individuals per 1000 took substantial sick leave following acute infection compared to persons with no known history of infection, where substantial sick leave is defined as >1 month of sick leave within the period 1–9 months after the RT-PCR test date. Being female, 50–65 years, or having certain pre-existing health conditions such as obesity, chronic lung diseases, and fibromyalgia each increase risk for taking substantial sick leave. Altogether, these results may help motivate improved diagnostic and treatment options for persons living with post-Covid conditions.
During 2010-2018 in Denmark, 638 patients had Vibrio infections diagnosed and 521 patients had Shewanella infections diagnosed. Most cases occurred in years with high seawater temperatures. The ...substantial increase in those infections, with some causing septicemia, calls for clinical awareness and mandatory notification policies.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Analysis of wastewater is used in many settings for surveillance of SARS-CoV-2, but it remains unclear how well wastewater testing results reflect incidence. Denmark has had an extensive wastewater ...analysis system that conducts 3 weekly tests in ≈200 sites and has 85% population coverage; the country also offers free SARS-CoV-2 PCR tests to all residents. Using time series analysis for modeling, we found that wastewater data, combined with information on circulating variants and the number of human tests performed, closely fitted the incidence curve of persons testing positive. The results were consistent at a regional level and among a subpopulation of frequently tested healthcare personnel. We used wastewater analysis data to estimate incidence after testing was reduced to a minimum after March 2022. These results imply that data from a large-scale wastewater surveillance system can serve as a good proxy for COVID-19 incidence and for epidemic control.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Foodborne outbreaks represent a significant public health burden. Outbreak investigations are often challenging and time-consuming, and most outbreak vehicles remain unidentified. The ...development of alternative investigative strategies is therefore needed. Automated analysis of Consumer Purchase Data (CPD) gathered by retailers represents one such alternative strategy. CPD-aided investigations do not require trawling questionnaires to create a hypothesis and can provide analytical measures of association by direct data analysis. Here, we used anonymized CPD from 920,384 customers enrolled in Norway’s largest supermarket loyalty program to simulate foodborne outbreaks across a range of different parameters and scenarios. We then applied a logistic regression model to calculate an odds ratio for each of the different possible food vehicles. By this method, we were able to identify outbreak vehicles with a 90% accuracy within a median of 6 recorded case-patients. The outbreak vehicle identification rate declined significantly when using data from only one of two retailers involved in a simulated outbreak. Performance was also reduced in simulations that restricted analysis from product ID to the product group levels accessible by trawling questionnaires. Our results show that—assuming agreements are in place with major retailers—CPD collection and analysis can solve foodborne outbreaks originating from supermarkets both more rapidly and accurately than than questionnaire-based methods and might provide a significant enhancement to current outbreak investigation methods.
sequence type 410 (ST410) has been reported worldwide as an extraintestinal pathogen associated with resistance to fluoroquinolones, third-generation cephalosporins, and carbapenems. In the present ...study, we investigated national epidemiology of ST410
isolates from Danish patients. Furthermore,
ST410 was investigated in a global context to provide further insight into the acquisition of the carbapenemase genes
and
of this successful lineage. From 127 whole-genome-sequenced isolates, we reconstructed an evolutionary framework of
ST410 which portrays the antimicrobial-resistant clades B2/H24R, B3/H24Rx, and B4/H24RxC. The B2/H24R and B3/H24Rx clades emerged around 1987, concurrently with the C1/H30R and C2/H30Rx clades in
ST131. B3/H24Rx appears to have evolved by the acquisition of the extended-spectrum β-lactamase (ESBL)-encoding gene
and an IncFII plasmid, encoding IncFIA and IncFIB. Around 2003, the carbapenem-resistant clade B4/H24RxC emerged when ST410 acquired an IncX3 plasmid carrying a
carbapenemase gene. Around 2014, the clade B4/H24RxC acquired a second carbapenemase gene,
, on a conserved IncFII plasmid. From an epidemiological investigation of 49
ST410 isolates from Danish patients, we identified five possible regional outbreaks, of which one outbreak involved nine patients with
- and
-carrying B4/H24RxC isolates. The accumulated multidrug resistance in
ST410 over the past two decades, together with its proven potential of transmission between patients, poses a high risk in clinical settings, and thus,
ST410 should be considered a lineage with emerging "high-risk" clones, which should be monitored closely in the future.
Extraintestinal pathogenic
(ExPEC) is the main cause of urinary tract infections and septicemia. Significant attention has been given to the ExPEC sequence type ST131, which has been categorized as a "high-risk" clone. High-risk clones are globally distributed clones associated with various antimicrobial resistance determinants, ease of transmission, persistence in hosts, and effective transmission between hosts. The high-risk clones have enhanced pathogenicity and cause severe and/or recurrent infections. We show that clones of the
ST410 lineage persist and/or cause recurrent infections in humans, including bloodstream infections. We found evidence of ST410 being a highly resistant globally distributed lineage, capable of patient-to-patient transmission causing hospital outbreaks. Our analysis suggests that the ST410 lineage should be classified with the potential to cause new high-risk clones. Thus, with the clonal expansion over the past decades and increased antimicrobial resistance to last-resort treatment options, ST410 needs to be monitored prospectively.
Abstract
Background
Burden of disease studies measure the public health impact of a disease in a society. The aim of this study was to quantify the direct burden of COVID-19 in the first 12 months of ...the epidemic in Denmark.
Methods
We collected national surveillance data on positive individuals for SARS-CoV-2 with RT-PCR, hospitalization data, and COVID-19 mortality reported in the period between 26
th
of February, 2020 to 25
th
of February, 2021. We calculated disability adjusted life years (DALYs) based on the European Burden of Disease Network consensus COVID-19 model, which considers mild, severe, critical health states, and premature death. We conducted sensitivity analyses for two different death-registration scenarios, within 30 and 60 days after first positive test, respectively.
Results
We estimated that of the 211,823 individuals who tested positive to SARS-CoV-2 by RT-PCR in the one-year period, 124,163 (59%; 95% uncertainty interval (UI) 112,782–133,857) had at least mild symptoms of disease. The total estimated disease burden was 30,180 DALYs (95% UI 30,126; 30,242), corresponding to 520 DALYs/100,000. The disease burden was higher in the age groups above 70 years of age, particularly in men. Years of life lost (YLL) contributed with more than 99% of total DALYs. The results of the scenario analysis showed that defining COVID-19-related fatalities as deaths registered up to 30 days after the first positive test led to a lower YLL estimate than when using a 60-days window.
Conclusion
COVID-19 led to a substantial public health impact in Denmark in the first full year of the epidemic. Our estimates suggest that it was the the sixth most frequent cause of YLL in Denmark in 2020. This impact will be higher when including the post-acute consequences of COVID-19 and indirect health outcomes.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
It is not well-described how the acute symptoms of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) differ by variant, vaccination, sex and age. A cross-sectional ...questionnaire study linked to national testing- and registry data was conducted among 148,874 SARS-CoV-2 first time reverse transcription polymerase chain reaction (RT-PCR) test-positive individuals and corresponding date-matched symptomatic test-negative controls. Major SARS-CoV-2 variants (Index/wild type, Alpha, Delta and Omicron) were defined using periods of predominance. Risk differences (RDs) were estimated for each of 21 predefined acute symptoms comparing: (1) test-positive and -negative individuals, by variant period, (2) vaccinated and unvaccinated test-positives, by variant period, (3) individuals tested positive during the Omicron and Delta periods, by vaccination status, and (4) vaccinated Omicron test-positive and -negative individuals, by age and sex. Compared to pre-Omicron, RDs between test-positive and test-negative individuals during the Omicron period were lower for most symptoms. RDs for altered sense of smell (dysosmia) and taste (dysgeusia) were highest for Delta (RD = 50.8 (49.4–52.0) and RD = 54.7 (53.4–56.0), respectively) and lowest for Omicron (RD = 12.8 (12.1–13.5) and RD = 11.8 (11.1–12.4), respectively). Across variants, vaccinated individuals reported fewer symptoms. During Omicron, females and 30–59 year-old participants reported more symptoms.
PurposeTo follow SARS-CoV-2-infected persons up to 18 months after a positive test in order to assess the burden and nature of post acute symptoms and health problems.ParticipantsPersons in Denmark ...above 15 years of age, who were tested positive for SARS-CoV-2 during 1 September 2020 to 21 February 2023 using a RT-PCR test. As a reference group, three test-negative individuals were selected for every two test-positive individuals by matching on test date.Findings to dateIn total, 2 427 913 invitations to baseline questionnaires have been sent out and 839 528 baseline questionnaires (34.5%) have been completed. Females, the age group 50–69 years, Danish-born and persons, who had received at least one SARS-CoV-2 vaccination booster dose were more likely to participate. Follow-up questionnaires were sent at 2, 4, 6, 9, 12 and 18 months after the test, with response rates at 42%–54%.Future plansNew participants have been recruited on a daily basis from 1 August 2021 to 23 March 2023. Data collection will continue until the last follow-up questionnaires (at 18 months after test) have been distributed in August 2024.
One Health has become a popular approach, and scientific advancements in the field should be easily findable and accessible to a wide range of relevant audiences, from researchers to policymakers, ...and across sectors. We conducted a systematic narrative review of available scientific publications concerning One Health in the setting of Denmark that were retrievable using “One Health” as the key search term. Three searches in two databases yielded 30 retrieved publications, 13 of which were included in the review. The included publications had been published between 2015 and 2021. Twelve of the included publications were co-authored in collaboration across institutes from different sectors. Three of the included publications had focus on antimicrobial resistance, three on disease surveillance and/or control, and five were assessments or evaluations. The overall number of publications identified by a search using “One Health” as the key search term was small, and the search identified some publications that were not relevant to One Health. Our work thus highlights a missed scientific and communication opportunity of signposting articles as relevant to One Health. Using the expression “One Health” as keyword could help making One Health research more easily findable and thereby obtaining an overview of research in the field.
Background. Norovirus (NoV) is the predominant cause of foodborne disease outbreaks. Virus contamination may occur during all steps of food processing, from production to preparation and serving. The ...relative importance of these different routes of contamination is unknown. Methods. The purpose of this study was to estimate the proportions of outbreaks caused by asymptomatic and symptomatic food handlers (FHs). Reports of foodborne NoV and sapovirus outbreaks (n = 191) that occurred over a 7-year period were extracted, reviewed, and categorized according to the available evidence for source of contamination. Results. In 64 (34%) of the outbreaks, contamination from FHs took place during preparation or serving of food. In the majority of these outbreaks (n = 41; 64%), the FHs were asymptomatic during food handling. Some had been in contact with ill household members before handling the food and remained asymptomatic; others developed symptoms shortly after or were post-symptomatic. In 51 (27%) of the outbreaks, contamination occurred during production of the food, and in 55 (29%) of the outbreaks, contamination had supposedly occurred after serving a guest at a self-serve buffet. Conclusions. Guidelines regarding exclusion of FHs where household members suffer from gastroenteritis could limit the number of outbreaks.
PDF
