Seroepidemiology of infection with Toxoplasma gondii in workers occupationally exposed to water, sewage, and soil in Durango, Mexico

Water, sewage, and soil are potential sources of infection for Toxoplasma gondii. Therefore, we sought to determine the prevalence of T. gondii infection and associated characteristics in 61 plumbers, 203 construction workers, and 168 gardeners in Durango City, Mexico. Participants were tested for T. gondii IgG and IgM antibodies with the use of enzyme-linked immunoassays. In addition, sociodemographic, clinical, and behavioral characteristics from each participant were obtained. IgG T. gondii antibodies were found in 4 (6.6%) plumbers, 17 (8.4%) construction workers, and 10 (6.0%) gardeners; T. gondii IgM antibodies were found in 3 (1.5%) construction workers and 4 (2.4%) gardeners, but in none of the plumbers. In the total population, the prevalence of T. gondii infection was significantly higher in workers living in suburban areas, without education, workers that consumed chorizo, and those who suffered from any disease (P < 0.05). In gardeners, prevalence of infection was significantly higher in those with blood transfusion, and memory impairment (P < 0.05). Multivariate analysis showed that T. gondii infection was positively associated with consumption of unwashed fruits (adjusted odds ratio [OR] = 2.41; 95% confidence interval [CI]: 1.13-5.13), and with raising animals (adjusted OR = 2.53; 95% CI: 1.00-6.37). This is the first report of contributing factors for T. gondii infection in workers occupationally exposed to water, sewage, and soil in a Mexican city, and results will contribute to the design of optimal preventive measures.     

Incidence of tuberculosis,hepatitis, brucellosis,and shigellosis in British medical laboratory workers.

A retrospective postal survey of 21 000 medical laboratory workers in England and Wales showed 18 new cases of pulmonary tuberculosis in 1971, a five-times increased risk of acquiring the disease compared with the general population. Technicians were at greatest risk, especially if they worked in morbid anatomy departments. Of the 35 cases of hepatitis, the technicians were again the occupational group most likely to acquire the disease. Microbiology staff were twice as likely to report shigellosis as those in other pathology divisions but only one case of brucellosis was reported in the whole laboratory population. A similar survey carried out in 1973 of 3000 Scottish medical laboratory workers corroborates the results from England and Wales. Medical laboratory workers continue to experience a considerable risk of developing an occupationally acquired infection. Improvements in staff safety and health care seem to be necessary.     

Preparing for an influenza pandemic: ethical issues

In the near future, experts predict, an influenza pandemic will likely spread throughout the world. Many countries have been creating a contingency plan in order to mitigate the severe health and social consequences of such an event. Examination of the pandemic plans of Canada, the United Kingdom and the United States, from an ethical perspective, raises several concerns. One: scarcity of human and material resources is assumed to be severe. Plans focus on prioritization but do not identify resources that would be optimally required to reduce deaths and other serious consequences. Hence, these plans do not facilitate a truly informed choice at the political level where decisions have to be made on how much to invest now in order to reduce scarcity when a pandemic occurs. Two: mass vaccination is considered to be the most important instrument for reducing the impact of infection, yet pandemic plans do not provide concrete estimates of the benefits and burdens of vaccination to assure everyone that the balance is highly favorable. Three: pandemic plans make extraordinary demands on health care workers, yet professional organizations and unions may not have been involved in the plans' formulation and they have not been assured that authorities will aim to protect and support health care workers in a way that corresponds to the demands made on them. Four: all sectors of society and all individuals will be affected by a pandemic and everyone's collaboration will be required. Yet, it appears that the various populations have been inadequately informed by occasional media reports. Hence, it is essential that plans are developed and communication programs implemented that will not only inform but also create an atmosphere of mutual trust and solidarity; qualities that at the time of a pandemic will be much needed.     

A Comparative Study of Clinical Presentation and Risk Factors for Adverse Outcome in Patients Hospitalised with Acute Respiratory Disease Due to MERS Coronavirus or Other Causes

Middle East Respiratory syndrome (MERS) first emerged in Saudi Arabia in 2012 and remains a global health concern. The objective of this study was to compare the clinical features and risk factors for adverse outcome in patients with RT-PCR confirmed MERS and in those with acute respiratory disease who were MERS-CoV negative, presenting to the King Fahad Medical City (KFMC) in Riyadh between October 2012 and May 2014. The demographics, clinical and laboratory characteristics and clinical outcomes of patients with RT-PCR confirmed MERS-CoV infection was compared with those testing negative MERS-CoV PCR. Health care workers (HCW) with MERS were compared with MERS patients who were not health care workers. One hundred and fifty nine patients were eligible for inclusion. Forty eight tested positive for MERS CoV, 44 (92%) being hospital acquired infections and 23 were HCW. There were 111 MERS-CoV negative patients with acute respiratory illnesses included in this study as “negative controls”. Patient with confirmed MERS-CoV infection were not clinically distinguishable from those with negative MERS-CoV RT-PCR results although diarrhoea was commoner in MERS patients. A high level of suspicion in initiating laboratory tests for MERS-CoV is therefore indicated. Variables associated with adverse outcome were older age and diabetes as a co-morbid illness. Interestingly, co-morbid illnesses other than diabetes were not significantly associated with poor outcome. Health care workers with MERS had a markedly better clinical outcome compared to non HCW MERS patients.     

HIV and Latino migrant workers in the USA

Abstract

Migrant workers from Latin America are an essential source of economic development in the US agricultural industry. A majority of migrants are from Mexico and are undocumented and they represent a vulnerable and marginalized group in American society. There is a growing concern for HIV disease in the migrant community. The HIV prevalence rate among migrants is higher than the average rates in USA and in countries of Latin America. There are many behavioural, social, cultural, and health care risk factors and barriers that place migrants at increased risk for HIV infection. Many migrant workers contract HIV while working and living in the USA, which has contributed to rising HIV infection rates in Mexico. In order to prevent an increasing epidemic of HIV disease in Latino migrant workers, there is an urgent call for new and improved health care policies at the international, federal, state, and local levels.     

SARS-CoV-2 seroprevalence in health care workers from 10 hospitals in Quebec,Canada: a cross-sectional study

Background:The COVID-19 pandemic has disproportionately affected health care workers. We sought to estimate SARS-CoV-2 seroprevalence among hospital health care workers in Quebec, Canada, after the first wave of the pandemic and to explore factors associated with SARS-CoV-2 seropositivity.Methods:Between July 6 and Sept. 24, 2020, we enrolled health care workers from 10 hospitals, including 8 from a region with a high incidence of COVID-19 (the Montréal area) and 2 from low-incidence regions of Quebec. Eligible health care workers were physicians, nurses, orderlies and cleaning staff working in 4 types of care units (emergency department, intensive care unit, COVID-19 inpatient unit and non-COVID-19 inpatient unit). Participants completed a questionnaire and underwent SARS-CoV-2 serology testing. We identified factors independently associated with higher seroprevalence.Results:Among 2056 enrolled health care workers, 241 (11.7%) had positive SARS-CoV-2 serology. Of these, 171 (71.0%) had been previously diagnosed with COVID-19. Seroprevalence varied among hospitals, from 2.4% to 3.7% in low-incidence regions to 17.9% to 32.0% in hospitals with outbreaks involving 5 or more health care workers. Higher seroprevalence was associated with working in a hospital where outbreaks occurred (adjusted prevalence ratio 4.16, 95% confidence interval [CI] 2.63–6.57), being a nurse or nursing assistant (adjusted prevalence ratio 1.34, 95% CI 1.03–1.74) or an orderly (adjusted prevalence ratio 1.49, 95% CI 1.12–1.97), and Black or Hispanic ethnicity (adjusted prevalence ratio 1.41, 95% CI 1.13–1.76). Lower seroprevalence was associated with working in the intensive care unit (adjusted prevalence ratio 0.47, 95% CI 0.30–0.71) or the emergency department (adjusted prevalence ratio 0.61, 95% CI 0.39–0.98).Interpretation:Health care workers in Quebec hospitals were at high risk of SARS-CoV-2 infection, particularly in outbreak settings. More work is needed to better understand SARS-CoV-2 transmission dynamics in health care settings.

The COVID-19 pandemic has disproportionately affected health care workers. In France, Spain, Italy, Germany and the United States, at least 10% of cases reported in spring 2020 were in health care workers.¹ In Quebec, 25% (14 177 of 56 565) of all cases declared during the first wave of the pandemic, from March to July 2020, were in health care workers,² about one-third of whom were working in acute care hospitals.¹ The Montréal area was the most affected region in Quebec and Canada during the first wave, reaching a COVID-19 incidence rate of 1336 per 100 000 population.²The number of COVID-19 cases reported among health care workers underestimated the number of those infected with SARS-CoV-2 during that period, given limited testing leading to undiagnosed asymptomatic or paucisymptomatic infections.³ Seroprevalence studies are an important tool to determine the proportion of people infected with SARS-CoV-2, both in the general population and among health care workers.⁴ After the first wave in Quebec, SARS-CoV-2 seroprevalence in adults aged 18–69 years was found to be low (3.1% in Montréal and 1.3% in less affected regions), but this proportion could be much higher among health care workers who had to work despite the general shutdown of social and economic activities, especially if they were exposed to major outbreaks.⁵Only 2 other Canadian studies provide SARS-CoV-2 seroprevalence estimates among health care workers, and both studies were from a single centre.^6,7 Outside Canada, most seroprevalence studies among health care workers include a single site and do not provide a representative estimate for a defined region.⁸ Several studies have reported a higher seroprevalence among health care workers from units treating patients with COVID-19 (COVID-19 units) compared with other units (non–COVID-19 units), emergency departments or intensive care units.^9,10 Other studies have not identified such associations.^11,12 In this study, we aimed to assess the seroprevalence of SARS-CoV-2 antibody among hospital health care workers from a variety of settings after the first pandemic wave in Quebec, and to explore factors associated with SARS-CoV-2 seropositivity.     

Infection Status of Endoparasites in Foreigner Workers Living in Cheonan City,Chungnam Province,Korea

At present, more than 500,000 foreigner workers, most of them from Asian countries with high parasitic infection rates, are working in Korea. Since investigation into the prevalence of parasitic infections in foreigner workers has not yet been conducted in Korea, the present study was performed to determine the parasitic infection status of foreigner workers living in Cheonan City, Chungcheongnam-do (Chungnam Province) and to plan, on that basis, effective control measures. From October to December 2013, the parasitic infection status of 231 foreigner workers employed at selected Cheonan-si small businesses was investigated by both stool examination and ELISA. A total of 60 individuals (26.0%) were found to be infected with parasites. The stool examination detected 14 positive cases (6.1%), and ELISA revealed 50 positive people (21.6%), for at least a kind of parasitic disease. The most common infection was cysticercosis (8.7%), followed by toxocariasis (7.8%) and clonorchiasis (7.4%). Since it was proved that parasitic infections were prevalent among foreigner workers living in Cheonan City, more comprehensive study is urgently needed in order to understand the nationwide status of parasitic infections in foreigner workers.     

Knowledge on HBV vaccine and vaccination status among health care workers of Hawassa University Comprehensive Specialized Hospital,Hawassa, southern Ethiopia: a cross sectional study

Objectives

The study was conducted to assess the knowledge on HBV vaccine and vaccination status among health care workers of Hawassa University Comprehensive Specialized Hospital.

Result

From the total 258 questionnaire prepared for the study participant, data was collected from 241 participants making the response rate of 93.4%. Regarding socio-demographic characteristics of respondents 98 (40.7%), and 159 (66%) were females and Bachelor of Science graduates respectively. Only 73 (30.3%) respondents reported that they are vaccinated for hepatitis B vaccine. But only 16 (21.9%) received three doses of Hepatitis B vaccine, which was 6.6% of the total health care workers. More than half 146 (60.6%) of the respondents had good knowledge about hepatitis B virus infection and 120 (49.8%) had good knowledge about hepatitis B vaccine. Regarding knowledge about hepatitis B virus infection prevention and control methods, 131 (28.5%) of the respondents have good knowledge.

     

Infection with the human T-lymphotropic virus type I. A review for clinicians.

The human T-cell lymphotropic virus type I (HTLV-I) is the first retrovirus identified in humans. It has been responsible for a number of clinical syndromes, most notably adult T-cell leukemia or lymphoma and tropical spastic paraparesis. In the United States, infection with this virus is most frequently found in specific subsets of our population, particularly in those who live in the southeastern states, have southern Japanese ancestry, or share intravenous drug paraphernalia. Understanding the epidemiology and clinical manifestations of this virus is necessary to properly diagnose and care for patients with HTLV-I infection.     

Detection of SEN virus in the general population and different risk groups in Slovakia

Sera of 426 adult persons were examined to assess the prevalence of SEN virus (SENV) infection in Slovakia and to determine the importance of different risk factors for parenteral transmission. SENV prevalence was determined by the PCR method using primers of SENV-D and SENV-H strains. Positive results were found in 10 of 37 patients with acute hepatitis of unknown etiology, 7 of 38 with acute hepatitis B, 17 of 44 with chronic hepatitis B, 29 of 102 with chronic hepatitis C, 36 of 72 hemodialysis patients, 2 of 33 health care workers and 24 of 100 persons from the control group. The highest prevalence of SENV was among hemodialysis patients, significantly higher than in the groups of health care workers, acute hepatitis B and controls. The lowest prevalence was in health care workers group, significantly lower also in comparison with groups of chronic hepatitis B and C. Among the possible risk factors of virus transmission the average duration of hemodialysis (1.15 vs. 0.50 years), number of surgeries (1.60 vs. 1.10) and transfusions (1.34 vs. 0.94) showed notable differences in terms of SENV infection. Bilirubin and aminotransferase levels did not differ between SENV-positive and -negative groups. No pathogenetic role of SEN virus in liver injury was confirmed.     

Risks faced by laboratory workers in the AIDS era.

Laboratory workers are at occupational risk of exposure to microrganisms that cause a wide variety of diseases, from inapparent to life-threatening ones. Principal routes of transmission include percutaneous and permucosal inoculation (comprising clinical inapparent cutaneous or mucosal exposure to blood or blood products), inhalation, and ingestion. The appearance of the Acquired Immunodeficiency Syndrome (AIDS) epidemic and the first reports of occupational Human Immunodeficiency Virus (HIV) infections in health care workers resulted in high anxiety among laboratory workers. Indeed, 21% of worldwide documented cases of occupational HIV infection occurred among laboratory workers. Research laboratories pose the highest risk of infection. Safe methods for managing infectious agents ("containment") in the laboratory setting include laboratory practice and technique, safety equipment, and facility design. Infection control in the laboratory setting should take into account adherence to guidelines (biosafety levels), education and training, and the development of safety products designed to reduce the risk of exposure.     

The pollution of incontinence and the dirty work of caregiving in a U.S. nursing home

In U.S. nursing homes, it is the job of nursing assistants to tend to residents' basic bodily needs, including elimination and incontinence care. Given their frequent contact with pollutants, aides are very much at risk of becoming "polluted people." In this article, I investigate how nursing assistants' continual contact with contaminating substances impacts their status within the workplace, their relationships with others, and their attitudes toward their work and themselves as workers. I also explore how aides manage their encounters with pollutants and their stigmatized role as "dirty workers." In doing so, I hope to explicate the meaning of elimination and of incontinence caregiving in the United States.     

红火蚁工蚁对绿僵菌侵染蛹的防御行为

研究了红火蚁工蚁感染绿僵菌后在蛹室的行为变化,以及健康工蚁对侵染蛹的行为保护机制.结果表明: 工蚁被绿僵菌侵染后,在蛹室的活动时间逐渐减少,由第1天的103.4 s降至第3天的38.5 s;而且育幼时间占蛹室活动时间的比例也下降,由第1天的13.6%降至第3天的3.5%.当蛹被绿僵菌侵染后,工蚁对侵染蛹的梳理总时间为对照组的5.3倍,每次梳理的平均持续时间为对照组的5.2倍.梳理行为能显著减少侵染蛹的体表分生孢子数量,在无工蚁、2只工蚁和10只工蚁存在条件下,蛹体表平均孢子数分别为103.1、51.6和31.3个.工蚁的存在能抑制蛹体表孢子的萌发,处理20 h后,无工蚁、2只工蚁和10只工蚁存在条件下,蛹体表孢子萌发率分别为95.1%、80.4%和59.9%.蛹的羽化率随着工蚁数量增加显著升高.红火蚁工蚁通过社会行为防御病原真菌侵染蛹的策略为种群的延续和发展提供了保障.     

Health Care Costs,Utilization and Patterns of Care following Lyme Disease

BackgroundLyme disease is the most frequently reported vector borne infection in the United States. The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome – a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease. Little is known about the impact of Lyme disease or post-treatment Lyme disease symptoms (PTLDS) on health care costs and utilization in the United States.Objectives1) to examine the impact of Lyme disease on health care costs and utilization, 2) to understand the relationship between Lyme disease and the probability of developing PTLDS, 3) to understand how PTLDS may impact health care costs and utilization.MethodsThis study utilizes retrospective data on medical claims and member enrollment for persons aged 0-64 years who were enrolled in commercial health insurance plans in the United States between 2006-2010. 52,795 individuals treated for Lyme disease were compared to 263,975 matched controls with no evidence of Lyme disease exposure.ResultsLyme disease is associated with $2,968 higher total health care costs (95% CI: 2,807-3,128, p<.001) and 87% more outpatient visits (95% CI: 86%-89%, p<.001) over a 12-month period, and is associated with 4.77 times greater odds of having any PTLDS-related diagnosis, as compared to controls (95% CI: 4.67-4.87, p<.001). Among those with Lyme disease, having one or more PTLDS-related diagnosis is associated with $3,798 higher total health care costs (95% CI: 3,542-4,055, p<.001) and 66% more outpatient visits (95% CI: 64%-69%, p<.001) over a 12-month period, relative to those with no PTLDS-related diagnoses.ConclusionsLyme disease is associated with increased costs above what would be expected for an easy to treat infection. The presence of PTLDS-related diagnoses after treatment is associated with significant health care costs and utilization.     

Occupational health problems among migrant and seasonal farm workers.

Migrant and seasonal farm workers are one of the most underserved and understudied populations in the United States. The total US population of such farm workers has been estimated at 5 million, of whom about 20% live or work in California. Farm workers perform strenuous tasks and are exposed to a wide variety of occupational risks and hazards. Low socioeconomic status and poor access to health care also contribute to existing health problems in this population. Potential farm work-related health problems include accidents, pesticide-related illnesses, musculoskeletal and soft-tissue disorders, dermatitis, noninfectious respiratory conditions, reproductive health problems, health problems of children of farm workers, climate-caused illnesses, communicable diseases, bladder and kidney disorders, and eye and ear problems. Few epidemiologic studies exist of these occupational health problems. No comprehensive epidemiologic studies have assessed the magnitude of occupational health problems among migrant and seasonal farm workers and their dependents. Although the migratory nature of this population makes long-term studies difficult, the development of standardized data collection instruments for health consequences and scientific assessment of farm work exposures and working conditions are vital to characterize and reduce the occupational health risks in farm workers.     

The acquired immune deficiency syndrome and epidemic of infection with human immunodeficiency virus: costs of care and prevention in an inner London district.

The epidemic of the acquired immune deficiency syndrome (AIDS) and infection with human immunodeficiency virus (HIV) necessitates early planning of services and allocation of resources. The use of hospital resources by patients with AIDS and the planned additional costs of clinical and preventive services for the epidemic of infection with HIV were calculated for an inner London health district that has treated 18% of the cases in the United Kingdom. Patients with AIDS required on average 50 days of inpatient hospital care each at an estimated current average lifetime cost of pounds 6800. These costs, however, underestimated the additional capital and revenue costs of planned new preventive and treatment services, estimated as being pounds 388,000 revenue and pounds 472,000 capital for 1986-7. It is important to invest now in preventive services throughout the United Kingdom to reduce the future social and financial costs of AIDS.     

Medical ethics: four principles plus attention to scope.

The "four principles plus scope" approach provides a simple, accessible, and culturally neutral approach to thinking about ethical issues in health care. The approach, developed in the United States, is based on four common, basic prima facie moral commitments--respect for autonomy, beneficence, nonmaleficence, and justice--plus concern for their scope of application. It offers a common, basic moral analytical framework and a common, basic moral language. Although they do not provide ordered rules, these principles can help doctors and other health care workers to make decisions when reflecting on moral issues that arise at work.     

Pesticide Risk Perceptions,Knowledge, and Attitudes of Operators,Workers, and Residents: A Review of the Literature

The literature on the risk perceptions, knowledge levels, and attitudes of operators, workers, and residents in relation to non-dietary exposure to agricultural pesticides is reviewed. No literature was identified in relation to bystander exposure. Research has primarily been conducted on participants in developing countries and migrant workers in the United States. For operators and workers, illiteracy, poverty, and a perception that exposure to pesticides is an inevitable part of their work results in limited adoption of safety precautions while using and storing pesticides. As a result, risk communication activities aimed at operator and workers need to take account of the wider socioeconomic and cultural conditions in which workers and operators are working and living. There is less research focused on residents’ and bystanders’ perceptions, attitudes, and behaviors. The lack of European data in general, and residents’ and bystanders’ data in particular, represents a knowledge gap that is pertinent to emerging EU legislation requiring residents’ and bystanders’ inclusion in pesticide risk assessment. This review provides a comprehensive overview that can assist policy-makers, and risk communicators in the development of targeted training and awareness-raising material for operators, workers, bystanders, and residents. Areas for future research are suggested.     

Age and Behavior of Honey Bee Workers,Apis mellifera,that Interact with Drones

Colony reproduction in honey bees involves complex interactions between sterile workers and reproductive castes. Although worker–queen interactions have been studied in detail, worker–drone interactions are less well understood. We investigated caste interactions in honey bees by determining the age and behavior of workers that perform vibration signals, trophallaxis, and grooming with drones. Workers of all ages could engage in the different interactions monitored, although workers that performed vibration signals on drones were significantly older than those engaging in trophallaxis and grooming. Only 3–8% of workers engaged in the different behaviors were monitored. Compared with workers that performed vibration signals only on workers (‘worker vibrators’), those that performed signals on both workers and drones (‘drone vibrators’) had greater movement rates inside the nest, higher vibration signaling rates, and were more likely to have an immediate association with foraging. Both worker vibrators and drone vibrators contacted drones of all ages as they moved through the nest. However, drone vibrators contacted drones at higher rates, contacted slightly, but significantly younger drones, and were more likely to engage in trophallaxis and grooming with drones, in addition to vibrating them. Taken together, our results suggest that tiny proportions of workers belonging to separate, but overlapping age groups provide most of the care received by adult drones, and that drone vibrators comprise a subset of signalers within a colony that have an increased tendency to contact and interact with drones. Vibratory, tactile signals are involved in colony reproductive and movement decisions in a number of species of bees, wasps and ants, and may provide valuable tools for investigating caste interactions in many insect societies.