The COVID-19 pandemic has disrupted routine measles immunisation and supplementary immunisation activities (SIAs) in most countries including Kenya. We assessed the risk of measles outbreaks during ...the pandemic in Kenya as a case study for the African Region.
Combining measles serological data, local contact patterns, and vaccination coverage into a cohort model, we predicted the age-adjusted population immunity in Kenya and estimated the probability of outbreaks when contact-reducing COVID-19 interventions are lifted. We considered various scenarios for reduced measles vaccination coverage from April 2020.
In February 2020, when a scheduled SIA was postponed, population immunity was close to the herd immunity threshold and the probability of a large outbreak was 34% (8-54). As the COVID-19 contact restrictions are nearly fully eased, from December 2020, the probability of a large measles outbreak will increase to 38% (19-54), 46% (30-59), and 54% (43-64) assuming a 15%, 50%, and 100% reduction in measles vaccination coverage. By December 2021, this risk increases further to 43% (25-56), 54% (43-63), and 67% (59-72) for the same coverage scenarios respectively. However, the increased risk of a measles outbreak following the lifting of all restrictions can be overcome by conducting a SIA with ≥ 95% coverage in under-fives.
While contact restrictions sufficient for SAR-CoV-2 control temporarily reduce measles transmissibility and the risk of an outbreak from a measles immunity gap, this risk rises rapidly once these restrictions are lifted. Implementing delayed SIAs will be critical for prevention of measles outbreaks given the roll-back of contact restrictions in Kenya.
Pectenotoxins (PTXs) accumulate in shellfish feeding on dinoflagellates of the genus Dinophysis, so that humans can be exposed to these toxins through shellfish consumption. Some PTXs are toxic to ...experimental animals, whereas others are of much lower toxicity. Pectenotoxin-2, the most abundant PTX from most Dinophysis spp., is rapidly metabolized by most shellfish to a mixture of pectenotoxin-2 seco acid (2) and 7-epi-pectenotoxin-2 seco acid (1). A mixture of 1 and 2 was produced during purification of an extract from in vitro enzymatic hydrolysis of pectenotoxin-2. These were separated by preparative HPLC, and the structure of 1 was confirmed by one- and two-dimensional 1H and 13C NMR spectroscopy and LC-MS3 analyses. No toxic changes were recorded in mice injected intraperitoneally with 1 or 2 at a dose of 5000 microgram/kg. PTX seco acids are therefore unlikely to be of consequence to human consumers at the concentrations found in contaminated shellfish.
We have developed a simple and effective method for isolating pectenotoxin-2 (PTX-2) from
Dinophysis cells collected from a natural bloom. A two-step extraction procedure followed by two column ...chromatography steps produced PTX-2 in high purity suitable for use as an analytical standard and for toxicological studies. Incubation of purified PTX-2 with the supernatant from ultracentrifuged blue (
Mytilus edulis) or Greenshell
® (
Perna canaliculus) mussel hepatopancreas homogenate caused rapid conversion to pectenotoxin-2 seco acid (PTX-2 SA). Purification of PTX-2 SA was achieved by solvent extraction followed by column chromatography. PTX-2 and PTX-2 SA were fully characterized by LC–MS and NMR, and full
1H and
13C NMR assignments were obtained. Okadaic acid C
8-diol ester was isolated during the purification of PTX-2, and its identity confirmed by NMR and LC–MS analyses. Pectenotoxin-2 seco acid methyl ester, identified by LC–MS, was also produced during the hydrolytic procedure due to the presence of methanol. PTX-2 was acutely toxic to mice by i.p. injection (LD
50=219 μg/kg) but no effects were seen with PTX-2 SA at 5000 μg/kg. Neither PTX-2 nor PTX-2 SA was overtly toxic to mice by the oral route at doses up to 5000 μg/kg. No diarrhea was observed in mice dosed with either compound, suggesting that pectenotoxins do not belong in the diarrhetic shellfish poison group.
► Pinnatoxins were found in all samples from Rangaunu Harbour. ► Pinnatoxin levels correlated to mouse bioassay toxicity. ► Rangaunu Harbour Toxin (RHT) is most likely due to pinnatoxins. ► ...Brevetoxins indicated by mouse bioassay were not be confirmed by LC–MS. ► No human illnesses were associated with pinnatoxins in our study or in literature.
Recent studies showing the presence of pinnatoxins in a range of shellfish from New Zealand and Australia (
Selwood et al., 2010) prompted an investigation into historical mouse bioassay positives from Rangaunu Harbour, Northland, New Zealand. Eleven shellfish samples collected from the harbour between 1993 and 2008 were found to contain pinnatoxins as shown by liquid chromatography–mass spectrometric (LC–MS) analysis. Reanalysis of data from a quantitative mouse bioassay using an acetone extraction gave excellent correlation to pinnatoxin levels for seven of the nine samples tested. The cause of positive mouse bioassay results when using diethyl ether was not confirmed. A telephone survey of 22 Rangaunu Harbour residents confirmed that they had regularly consumed shellfish and other seafood collected from the harbour. Consumption was on average 2.6 times/week over 29 years. There were no reports of any associated illnesses.
A
bstract
The NA48/2 experiment at CERN reports the first observation of the
K
±
→
π
0
π
0
μ
±
ν
decay based on a sample of 2437 candidates with 15% background contamination collected in 2003–2004. ...The decay branching ratio in the kinematic region of the squared dilepton mass above 0.03 GeV
2
/
c
4
is measured to be (0.65 ± 0.03) × 10
−
6
. The extrapolation to the full kinematic space, using a specific model, is found to be (3.45 ± 0.16) × 10
−
6
, in agreement with chiral perturbation theory predictions.
The NA48/2 experiment at CERN reports the first observation of the $K^± → π^0π^0μ^±$ν decay based on a sample of 2437 candidates with 15% background contamination collected in 2003–2004. The decay ...branching ratio in the kinematic region of the squared dilepton mass above 0.03 GeV2/c4 is measured to be (0.65 ± 0.03) × 10–6. The extrapolation to the full kinematic space, using a specific model, is found to be (3.45 ± 0.16) × 10–6, in agreement with chiral perturbation theory predictions.
Isolation of cases and contact tracing is used to control outbreaks of infectious diseases, and has been used for coronavirus disease 2019 (COVID-19). Whether this strategy will achieve control ...depends on characteristics of both the pathogen and the response. Here we use a mathematical model to assess if isolation and contact tracing are able to control onwards transmission from imported cases of COVID-19.
We developed a stochastic transmission model, parameterised to the COVID-19 outbreak. We used the model to quantify the potential effectiveness of contact tracing and isolation of cases at controlling a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-like pathogen. We considered scenarios that varied in the number of initial cases, the basic reproduction number (R0), the delay from symptom onset to isolation, the probability that contacts were traced, the proportion of transmission that occurred before symptom onset, and the proportion of subclinical infections. We assumed isolation prevented all further transmission in the model. Outbreaks were deemed controlled if transmission ended within 12 weeks or before 5000 cases in total. We measured the success of controlling outbreaks using isolation and contact tracing, and quantified the weekly maximum number of cases traced to measure feasibility of public health effort.
Simulated outbreaks starting with five initial cases, an R0 of 1·5, and 0% transmission before symptom onset could be controlled even with low contact tracing probability; however, the probability of controlling an outbreak decreased with the number of initial cases, when R0 was 2·5 or 3·5 and with more transmission before symptom onset. Across different initial numbers of cases, the majority of scenarios with an R0 of 1·5 were controllable with less than 50% of contacts successfully traced. To control the majority of outbreaks, for R0 of 2·5 more than 70% of contacts had to be traced, and for an R0 of 3·5 more than 90% of contacts had to be traced. The delay between symptom onset and isolation had the largest role in determining whether an outbreak was controllable when R0 was 1·5. For R0 values of 2·5 or 3·5, if there were 40 initial cases, contact tracing and isolation were only potentially feasible when less than 1% of transmission occurred before symptom onset.
In most scenarios, highly effective contact tracing and case isolation is enough to control a new outbreak of COVID-19 within 3 months. The probability of control decreases with long delays from symptom onset to isolation, fewer cases ascertained by contact tracing, and increasing transmission before symptoms. This model can be modified to reflect updated transmission characteristics and more specific definitions of outbreak control to assess the potential success of local response efforts.
Wellcome Trust, Global Challenges Research Fund, and Health Data Research UK.
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