Epidemiology of Mpox Outbreaks and Implications for Surveillance in Imo State, Nigeria

Mpox disease is caused by a double-stranded DNA virus, genus Orthopoxvirus of the family Poxviridae. The incubation period is usually 6 to 13 days but can range from 5 to 21 days while symptoms and signs may persist for 2 to 5 weeks. Although, the clinical features are usually less severe when compared to the deadly smallpox, the disease can be fatal with case fatality rate between 1% and 10%. In Imo State, Nigeria, there has been a changing epidemiology of the disease in the last 6 years and the frequency and geographic distribution of cases have progressively increased. This study aims to conduct a review of the disease epidemiology between 2017 and 2023 and implications for surveillance in Imo State. Surveillance data from the Surveillance Outbreak Response and Management System (SORMAS) was extracted between January 2017 and December 2023 across the 27 Local Government Areas (LGAs) of Imo State. A line list of 231 suspected cases was downloaded into an excel template and analyzed using SPSS® version 20 software. Analysis was done using descriptive statistics and associations were tested using Fischer’s exact at 0.05 level of significance. Of the 231 suspected cases, 57.1% (132) were males, 42.9% (99) were females and the modal age group was between the ages of 0 - 4 (32.5%). Eight (8) LGAs (districts) accounted for 71% (n = 164) of all the suspected cases. 21.2% (49) were confirmed positive, 27 males (55.1%) and 22 females (44.9%) (p > 0.05). Modal age group was 20 - 24 (22.4%, n = 11), 18% (9) were children under 14 years, p > 0.05. Case fatality rate was 8% (n = 4). There was no significant association between mortality and age group. Five (5) LGAs accounted for about 60% (29) of all confirmed cases. These LGAs contribute only 20% to the total population in the State. Only 5.6% and 4% of suspected and confirmed cases, respectively, had knowledge of contact with an infectious source. The study described the epidemiology of Mpox outbreaks between 2017 and 2023 and the findings have significant implications on detection and outbreak response activities.

Epidemiological Characteristics and Spatiotemporal Distribution Patterns of Human Norovirus Outbreaks in China, 2012–2018

Objective To clarify the epidemiological characteristics and spatial distribution patterns of human norovirus outbreaks in China, identify high-risk areas, and provide guidance for epidemic prevention and control.Methods This study analyzed 964 human norovirus outbreaks involving 50,548 cases in 26 provinces reported from 2012 to 2018. Epidemiological analysis and spatiotemporal scanning analysis were conducted to analyze the distribution of norovirus outbreaks in China.Results The outbreaks showed typical seasonality, with more outbreaks in winter and fewer in summer, and the total number of infected cases increased over time. Schools, especially middle schools and primary schools, are the most common settings of norovirus outbreaks, with the major transmission route being life contact. More outbreaks occurred in southeast coastal areas in China and showed significant spatial aggregation. The highly clustered areas of norovirus outbreaks have expanded northeast over time.Conclusion By identifying the epidemiological characteristics and high-risk areas of norovirus outbreaks, this study provides important scientific support for the development of preventive and control measures for norovirus outbreaks, which is conducive to the administrative management of high-risk settings and reduction of disease burden in susceptible areas.

Differences in the US Mpox Outbreaks of 2003 and 2022: A Review

Objectives: This research aims to focus on the differences in mpox outbreaks that occurred in 2003 and 2022 in the United States. Methods: We searched the following databases Medline, Google Scholar, Gayle Power Search, PubMed, and Springerlink using the following search terms “mpox virus”, “MPX”, “mpox in the US”, “US mpox virus 2003”, “US mpox virus 2022”, “US mpox outbreak 2003” and US mpox outbreak 2022”. The only articles selected were those written between 2003 and 2022. Results: Findings showed more Mpox research was conducted during the first US Mpox outbreak in 2003 compared to the US Mpox outbreak in 2022. Findings also indicated that the mpox outbreak of 2003 consisted of more animal-to-human transmissions acquired from sick prairie dogs compared to more human-to-human from an infected international traveler from Nigeria to the US. Conclusion: Major differences in the mpox outbreaks in the US include the number, location of lesions, and transmission type. We recommend further research to increase awareness of the human-to-human transmission of mpox via sexual contact to assist healthcare professionals and public health leaders in providing prevention and wellness in US communities.

Setting up the Goal of Eliminating Outbreaks of Blue-green Alga, Innovating the Idea of Controlling the Taihu Lake, and Ensuring the Safety of Water Supply in the Taihu Lake

Since the water supply crisis in the Taihu Lake on May 29,2007,the control of the Taihu Lake has achieved remarkable results,and the eutrophication has been greatly reduced.Existing problems are as follows:outbreaks of blue-green alga still appear seriously every year,and there is no goal to eliminate outbreaks of blue-green alga;the load into the lake greatly exceeds the environmental capacity;reed wetlands are greatly reduced;there is still the possibility of a water supply crisis;the research of eliminating outbreak of blue-green alga is weak.In this paper,the experience of controlling the Taihu Lake is summarized,and the ultimate goals of eliminating eutrophication and outbreaks of blue-green alga and restoring wetlands and biodiversity are proposed.Control measures are proposed,such as deepening the promotion of the lake chief system,establishing the lake chief system in an all-round way,and increasing applied scientific and technological efforts and capital investment.The necessity and possibility of further controlling the Taihu Lake to eliminate outbreaks of blue-green alga should be recognized.Relying on controlling eutrophication alone cannot eliminate outbreaks of blue-green alga.The point that phosphorus control is the key to eliminate outbreaks of blue-green alga is not suitable for the Taihu Lake.The integration ideas of"three types"of technologies should be innovated.The first one is"double reduction and double increase"measures to eliminate eutrophication,of which"double reduction"is to reduce external point sources and non-point sources and internal blue-green alga in sediment;for external sources,the treatment standard of sewage plants should be paid special attention to.The second one is"double algae removal"measures to salvage blue-green alga,suppresses and kills algae.The blue-green alga on the surface,middle and bottom of water should be thoroughly salvaged and eliminated from various water areas.The third one is"double restoration"measures to restore wetlands and biodiversity.The area of wetlands should be restored to the area from the 1960s to the 1970s before outbreaks of blue-green alga,and vegetation coverage reaches 25%-30%.The Taihu Lake is controlled in different waters to ensure water supply safety in water sources.Five suggestions are proposed,such as revising the"Overall Plan for the Comprehensive Treatment of Water Environment in the Taihu Lake Basin"again,incorporating the goal of eliminating outbreaks of blue-green alga in the plan,setting up this research topic,greatly improving sewage treatment standards in local legislation.

Siberian silkmoth outbreaks surpassed geoclimatic barrier in Siberian Mountains

Siberian silkmoth(SSM,Dendrolimus sibiricus Tschetv.)is the most important defoliator of Siberian pine(Pinus sibirica Du Tour)and fir(Abies sibirica Ledeb.)stands.Warming-induced SSM outbreaks are one of the major driving factors of successions within the taiga zone.It is suggested that climate change impacted the SSM range and life cycle.We analyzed the migration of alpine and northerly SSM outbreak boundaries in Siberia and the impact of the climate variables and topography on the outbreak dynamics.We used time-series scenes(multispectral data,and vegetation indexes EVI and NDII)in combination with field studies,climate variables,and GIS techniques.We found that SSM outbreaks in the area of alpine boundary shifted about 370 m uphill since the mid of 1950.The outbreak onset was promoted by increased dryness and active temperatures and decreased root zone moisture content in the spring-early summer period.The terrain topography strongly affected SSM outbreak onset and dynamics.Initially,the outbreak was located at the middle elevations on the gentle concave southeastern slopes,which are the favorable insect habitats between outbreaks.Then the outbreak expanded uphill and downhill,to steeper slopes,and both concave and convex terrains.Alongside with elevation range expansion,SSM surpassed its northern historical outbreak boundary:the potential outbreaks’boundary moved about 300 km northward.Climate warming contributes to SSM migration into former outbreak free conifer stands located in highlands and at northern latitudes.

Present Situation and Control of Outbreaks of Algal Blooms in the Three Gorges Reservoir

After water storage in the Three Gorges Reservoir Region,there are no outbreaks of algal blooms in the main stream of the reservoir region,but the density of algae increases obviously. Outbreaks of algal blooms mainly appeared in the tributaries of the reservoir region such as the Xiangxi River,Daning River,Shennong River and Xiaojiang River,but they did not occur every year. The reasons for outbreaks of algal blooms in the tributaries are shown as follows: the existence of sources of algae(blue-green algae) in the Three Gorges Reservoir is the root cause,and the sources include sources existing and being produced in the reservoir and sources from upstream main stream and its tributaries and other related lakes and reservoirs,of which the sources are mainly from the Dianchi Lake; slight or moderate eutrophication of water is the basic condition;hydrologic and hydrodynamic conditions and suitable temperature are conducive to proliferation and aggregation of algae(blue-green algae) after the operation of the Three Gorges Reservoir until outbreaks of algal blooms appear. Outbreaks of algal blooms in the tributaries of the Three Gorges Reservoir Region mainly appear in backwater reaches; they mainly occur in the tributaries in the north of the reservoir region and near to the dam;they mainly appear from March to July; the dominant species of algae( blue-green algae) in the Three Gorges Reservoir are Pyrrophyta,Bacillariophyta and Chlorophyta,but they tend to change into blue-green algae and other algae. To control outbreaks of algal blooms in the tributaries of the Three Gorges Reservoir Region,it is needed to prevent water containing blue-green algae collected from the Dianchi Lake and other lakes and reservoirs from being input into the lower reaches,reduce pollution load flowing into the Three Gorges Reservoir,use enclosures to change hydrodynamic conditions of backwater reaches of the tributaries appropriately,and adopt biological measures such as culturing fish and planting plants to improve ecosystem of the tributaries and other measures to inhibit and eliminate algae and decrease eutrophication level.

Measles outbreaks in the Kyeongin area of the Republic of Korea,2013-2014:A single-center experience in a country of measles elimination

Objective: To identify the source of infection and determine the clinical features and laboratory finding of measles infection,Methods: In 27 measles patients,except for 3 adult patients,the rest of 24 pediatric measles cases were analyzed with regard to age,sex,immunization status,transmission routes and molecular genotyping of measles virus,Eighteen measles patients who admitted in isolation ward were set apart to investigate clinical findings and its correlation with laboratory characteristics,Retrospective analysis of cases was conducted in this study,Results: Of the 24 pediatric patients,23(95.8%) had not received any measles-containing vaccine(MCV),Sixteen of the patients(66.7%) were aged <12 months,The suspicious index case of a girl aged 34 months was not vaccinated with MCV1 and got measles after a trip to Philippines,and molecular genotype was revealed as B3,Measles outbreaks in the community such as a restaurant were followed by this one imported case,According to analysis of 18 patients admitted in isolation ward,the median level of C-reactive protein(CRP) was 0.38 mg/d L and that of lactate dehydrogenase(LDH) was 1 200 IU/L,All of the 18 patients had LDH levels above the normal range,Age correlated with CRP(ρ = 0.528,P = 0.024) and LDH(ρ = 0.501,P = 0.034),The duration of fever was correlated with the duration of fever before rash(ρ = 0.898,P < 0.01),The duration of hospitalization was correlated with CRP(ρ = 0.586,P = 0.011),The white blood cell counts were correlated with the levels of LDH(ρ = 0.505,P = 0.033),aspartate aminotransferase(ρ = 0.507,P = 0.032),and alanine aminotransferase(ρ = 0.481,P = 0.043),Conclusions: Early weaning of maternally derived measles antibodies therefore vaccination of MCV1 at a young age from 9 months to 12 months should be considered in situations of early exposure,Furthermore there is a call for consideration of scheduling an earlier age for the first dose of MMR vaccine in Europe,It is necessary for Korea to investigate the duration of the presence and quantitative analysis of maternal measles antibodies in infants and to reconsider the timing of MCV1.

Managing Delivery of Safeguarding Substances as a Mitigation Against Outbreaks of Pandemics

The optimum delivery of safeguarding substances is a major part of supply chain management and a crucial issue in the mitigation against the outbreak of pandemics.A problem arises for a decision maker who wants to optimally choose a subset of candidate consumers to maximize the distributed quantities of the needed safeguarding substances within a specic time period.A nonlinear binary mathematical programming model for the problem is formulated.The decision variables are binary ones that represent whether to choose a specic consumer,and design constraints are formulated to keep track of the chosen route.To better illustrate the problem,objective,and problem constraints,a real application case study is presented.The case study involves the optimum delivery of safeguarding substances to several hospitals in the Al-Gharbia Governorate in Egypt.The hospitals are selected to represent the consumers of safeguarding substances,as they are the rst crucial frontline for mitigation against a pandemic outbreak.A distribution truck is used to distribute the substances from the main store to the hospitals in specied required quantities during a given working shift.The objective function is formulated in order to maximize the total amount of delivered quantities during the specied time period.The case study is solved using a novel Discrete Binary Gaining Sharing Knowledge-based Optimization algorithm(DBGSK),which involves two main stages:discrete binary junior and senior gaining and sharing stages.DBGSK has the ability of nding the solutions of the introduced problem,and the obtained results demonstrate robustness and convergence toward the optimal solutions.

Epidemic Outbreaks in Plovdiv Region (Bulgaria) of Vaccine-Preventable Diseases: Measles, Mumps, Hepatitis A

Aim: To analyze the reasons for epidemic outbreaks of measles, mumps and viral hepatitis A and to propose measures to prevent them in future. Materials and methods: Тhe incidence of measles, mumps and hepatitis A in Plovdiv region was studied for the period 2006-2010. An analysis of the age structure of the patients was made, while taking into account the time for routine immunization performed against measles and mumps (first and second dose). Results: In 2006-2009 single cases of measles were found occasionally, but in 2010 they were 2787 (incidence 395/100,000). Most of them (51%) were for ages 13 months-12years, 27%-0-13 months and 11%-13 to 18 years. The incidence of mumps for 2006-2010 varied widely, and has increased significantly in 2007 (130/100,000) and 2008 (169/100,000). The majority of patients (over 34%) during the epidemics were aged 13 months-12years, and over 26% of them-13-19 years. For the period 2006-2010 the incidence of hepatitis A ranged from 2.98/100, 000 (2009) to 426/100,000 (2006). Over 50% of the cases involved children aged up to 9 years. For the three diseases over 80% of patients were individuals of Roma origin. Conclusions: 1. Epidemic spread of measles in 2010 was mainly due to shortcomings in the routine immunization carried as a prevention of the disease. 2. There are two reasons for the outbreak of mumps: А) Failure to administer the second vaccine dose at 12 years in Bulgaria until 2001. B) Shortcomings in routinely performed immunization. 3. The extremely high incidence of hepatitis A in 2006 (and in the rest of the years) is due to the lack of routine immunization. 4. Essential for the outbreaks in all three diseases are the poor hygienic living conditions, the low social status and the lack of health promotion of the population at risk 5. To prevent future outbreaks of the diseases hereby in question, we suggest it is appropriate: А) To introduce compulsory immunization against hepatitis A;B) To carry out periodic catch-up vaccination campaigns against measles and mumps.

Does overshoot in leaf development of ponderosa pine in wet years leads to bark beetle outbreaks on fine-textured soils in drier years?

Background： Frequent outbreaks of insects and diseases have been recorded in the native forests of western North America during the last few decades, but the distribution of these outbreaks has been far from uniform. In some cases, recent climatic variations may explain some of this spatial variation along with the presence of expansive forests composed of dense, older trees. Forest managers and policy makers would benefit if areas especially prone to disturbance could be recognized so that mitigating actions could be taken. Methods： We use two ponderosa pine-dominated sites in western Montana, U.S.A. to apply a modeling approach that couples information acquired via remote sensing, soil surveys, and local weather stations to assess where bark beetle outbreaks might first occur and why. Although there was a general downward trend in precipitation for both sites over the period between 1998 and 2010 （slope =-1.3, R2 = 0.08）, interannual variability was high. Some years showed large increases followed by sharp decreases. Both sites had similar topography and fire histories, but bark beetle activity occurred earlier （circa 2000 to 2001） and more severely on one site than on the other. The initial canopy density of the two sites was also similar, with leaf area indices ranging between 1.7-2.0 m2. m-2. We wondered if the difference in bark beetle activity was related to soils that were higher in clay content at site I than at site II. To assess this possibility, we applied a process-based stand growth model （3-PG） to analyze the data and evaluate the hypotheses. Results： We found that when wet years were followed by drier years, the simulated annual wood production per unit of leaf area, a measure of tree vigor, dropped below a critical threshold on site I but not on site II. Conclusion： We concluded that the difference in vulnerability of the two stands to beetle outbreaks can be explained largely by differences in gross photosynthesis attributed to the fact that an equivalent amount of stored water in the rooting zone （100 mm） is extracted less efficiently from fine-textured soils than from coarse-textured ones.

Study on Jellyfish Outbreaks and Their Monitoring and Control Technology in the Yellow Sea and the Northern East China Sea

Jellyfish outbreaks have become a new type of marine ecological disasters,and have great influence on the structure and function balance of marine ecosystems,fishery resources,production safety of coastal power plants,marine landscape and tourism.In recent years,the Yellow Sea and the northern East China Sea are the high risk areas of jellyfish outbreaks.In this paper,the research results of jellyfish outbreaks in the Yellow Sea and the northern East China Sea are summarized,and the species composition,distribution,life-history characteristics and hazards of jellyfish outbreaks are described.Meanwhile,the possible causes of jellyfish outbreaks are analyzed,and the monitoring and control technology of jellyfish disasters are discussed.It will provide a scientific basis for the monitoring,management,and emergency disposal of jellyfish disasters.

THE FUNDAMENTAL STRATEGY FOR THE CONTROL OF COTTON BOLLWORM OUTBREAKS IN CHINA

on the basis of the analysis of the factors causing the cotton bollworm outbreaks and control failure, the authors recommend that the fundamental strategy for solving the problem of cotton bollworms in China should be to conduct area-wide unified controls rather than depend on insecticides. The unified control system is the guarantee for Integrated Pest Management (IPM) for small-scale crop owners at present. So the authors call on policymakers to put stress on organizing individual growers to carry out area wide unified controls.

Viral outbreaks and communicable health hazards due to devastating floods in Pakistan

Pakistan is a developing country that has a population of 190 million people and faces a huge burden of viral diseases. Every year during monsoon season heavy rain fall and lack of disaster management skills potentially increase the transmission of waterborne diseases, vector borne diseases and viral outbreaks. Due to severe flooding, thousands of people lose their lives and millions are displaced each year. In most of the cases the children who lose their family members are forced into illegal professions of begging, child labor and prostitution which make them prone to sexually transmitted infections. Up to date, no scientific study has been conducted nationwide to illustrate epidemiological patterns of waterborne diseases, vector borne diseases and viral epidemics during flash flood. Mosquito sprays would not be a sufficient approach for dengue eradication; mass awareness, larvicide and biological control by Guppy fishes are also effective strategies to overcome dengue problem. International health bodies and non-governmental organizations must take note of this alerting situation and take adequate steps such as financial/medical aid in order to defeat the after-effects of flood.

Psychological Impacts of Coronavirus Outbreaks on Adults:A Rapid Evidence Review

A recent rapid review highlighted the negative psychological impacts of quarantining during coronavirus out-breaks on the public.However,to date,there has been no review of the psychological impacts of coronavirus on adults using research from community samples and not restricted to people quarantined during coronavirus.A rapid review was conducted to provide timely evidence about the mental health implications of coronavirus outbreaks on adults and to inform psychological research concerning the current COVID-19 outbreak.Three databases and Google Scholar were searched and a total of 27 studies were identified.Symptoms of anxiety and depression were identified during coronavirus outbreaks alongside concerns about becoming infected and family becoming infected.Those with pre-existing mental health conditions,young adults,women and those reporting physical symptoms appear to be vulnerable to negative psychological outcomes during coronavirus out-breaks.How people think about and understand coronavirus,and the coping strategies employed by people,may play a role in mitigating negative psychological outcomes.Results demonstrate the adverse psychological impacts of coronavirus outbreaks on adults and the need for continued investment in mental health services for the wider community during these times.Further longitudinal research is required to ascertain the long-term psychological consequences of coronavirus outbreaks.This review can be used to inform continued research on the psycholo-gical impacts of COVID-19 on adults.

Modelling Pathways for Outbreaks in Field Occupational Epidemiology

Background: The investigation of an occupational outbreak, once the index case has been identified, triggers a stress situation to epidemiologists. Modelling occupational outbreaks will be useful to guide the field investigation. Objective: To identify standard pathways for occupational epidemic outbreaks. Methods: In-depth critical appraisal of 57 occupational outbreaks. Standard pathways of occupational outbreaks were identified by analysing the similarity between out-breaks. The model’s accuracy and homogeneity were established through Fisher’s exact test and the Kappa Index. Results: The analysis allowed synthesizing the occupational outbreaks variability in 4 pathways. 92.98% of the analysed outbreaks could be allocated to one of those 4 types. The theoretical patterns showed a good adjustment with the analysed out-breaks: Type I (Kappa = 0.94 - 0.60), Type II (Kappa = 1.00), Type III (Kappa = 1.00 - 0.68) and Type IV (Kappa = 0.94 - 0.87). The probability of a given outbreak fitting with its three components in any of the theoretical pathways was 0.83. Conclusions: The incorporation of those pathways to the field occupational epidemiology will allow: 1) to provide early guidance to epidemiological, clinical and environmental studies focused on specific hypothesis of causality;2) to anticipate preventive measures;3) to contribute to an earlier and more efficient outbreak resolution.

Early 20^thCentury Climate-Driven Shift in the Dynamics of Forest Tent Caterpillar Outbreaks

Using tree-ring analysis, we show that the dynamics of forest tent caterpillar [Malacosoma disstria (Hbn.)] outbreaks in Alberta, Canada shifted at the turn of the 20th century from cyclic, synchronous behaviour 1850-1910 to complex, asynchronous behavior 1910-1993. This shift in dynamics coincided with the emergence in 1910 of a latitudinal gradient in outbreak stability and periodicity reflecting a similar gradient in the periodicity of winter temperatures. We postulate that the synchronizing strength of winter temperatures has diminished as a result of climate warming, and that any synchronizing strength due to inter-population migration has been superseded by regionalized patterns of periodic forcing caused by weak low-frequency variability in winter temperatures. We speculate that a decrease in polar vorticity at the start of the 20th century led to increased meridional jet stream flow and more frequent arctic weather anomalies, resulting in a loss of synchronous decadal periodicity in outbreak occurrence. These changes in insect disturbance probabilities, including rising uncertainty, have profound consequences for forest disturbance risk management.

Epidemiological Descriptive Analysis of Disease Outbreaks in 2019 in Sudan

Background: Sudan has often faced outbreaks of malaria, the life-threatening waterborne disease. In 2019, the country experienced an outbreak of six different infectious diseases, i.e., cholera, chikungunya, dengue fever, diphtheria, malaria, and Rift Valley fever. Objectives: The aim of this study was to perform an epidemiological descriptive analysis of data of these disease outbreaks to determine the spatial and temporal patterns of outbreaks and to estimate the magnitude of the diseases. Methods: The data consisted of the number of cases and deaths due to disease outbreaks of cholera, chikungunya, dengue fever, diphtheria, malaria, and Rift Valley fever. We analyzed the reports of an investigation conducted by the World Health Organization and the Federal Ministry of Health, Sudan. Descriptive statistics and case fatality rate (CFR) were used in this study. Results: The frequency of disease occurrence was as follows: cholera (344 cases), chikungunya (308 cases), dengue fever (4236 cases), diphtheria (105 cases), malaria (5,188,135 cases) and River Valley fever (567 cases). The CFRs for cholera, chikungunya, are diphtheria were 4.3%, 2.05%, and 9.5%, respectively. The mortality rate of malaria was 0.0013. The states most affected by outbreaks of these diseases in Sudan were the western states. Women were at a higher risk for all diseases, except River Valley fever. Conclusions: This study highlights the patterns of the outbreak of these diseases in Sudan and provides a basis for future scientific research.

Dengue outbreaks in northern Nigeria: Evaluating the recommended Takeda vaccine and future prevention strategies

Dengue fever,caused by the dengue virus(DENV),poses a significant public health challenge globally,with Nigeria experiencing sporadic outbreaks.A clear understanding of the dengue burden has not been achieved in Nigeria,just as in other African countries.Understanding the epidemiology and burden of dengue fever is essential for effective prevention and control strategies.This paper examines the recent dengue outbreaks in northern Nigeria,particularly in Sokoto state,and evaluates the recommended Takeda dengue vaccine(TDV)along with future prevention strategies.Despite limited surveillance and underreporting,dengue fever is endemic in Nigeria(with over 5 million cases and 5000 dengue-related deaths in 2023),with recent outbreaks indicating a growing concern.The TDV,a live attenuated tetravalent vaccine,has shown promise in preventing dengue fever,but challenges such as vaccine acceptance and access-ibility need to be addressed.Global urbanization contributes to the disease's spread,which is influenced by factors such as population density,cultural beliefs,water storage practices,hygiene,and water supply accessibility.Future prevention strategies must focus on government intervention,community practices,and innovative vector control measures to mitigate the spread of DENV in Nigeria.This study will serve as a valuable reference for policy-makers,researchers,and clinicians in the management and control of DENV in Nigeria and Africa as a whole.

Using Extreme Value Theory to Assess the Mortality Risk of Tornado Outbreaks

The majority of tornado fatalities occur during severe thunderstorm occurrences that produce a large number of tornadoes,termed tornado outbreaks.This study used extreme value theory to estimate the impact of tornado outbreaks on fatalities while accounting for climate and demographic factors.The findings indicate that the number of fatalities increases with the increase of tornado outbreaks.Additionally,this study undertook a counterfactual analysis to determine what would have been the probability of a tornado outbreak under various climatic and demographic scenarios.The results of the counterfactual study indicate that the likelihood of increased mortality increases as the population forecast grows.Intensified El Niño events,on the other hand,reduce the likelihood of further fatalities.La Niña events are expected to increase probability of fatalities.

Acute gastroenteritis outbreaks caused by human astrovirus,1978-2021:A systematic review

Human astrovirus(HAstV)is one of the main pathogens that cause sporadic cases of acute gastroenteritis,sometimes leading to outbreaks.This study aimed to elucidate the epidemiological and etiological character-istics of HAstV outbreaks worldwide.Literature on HAstV outbreaks published before January 2022 was retrieved from the China National Knowledge Infrastructure,WanFang,WeiPu,PubMed,and Web of Science databases.Date,region,population,settings,transmission modes,clinical symptoms,and etiological characteristics of the outbreaks were collected and analyzed.Thirty-one articles on 32 HAstV outbreaks reported between November 1978 and October 2018 were included.The outbreaks mainly occurred in autumn(14/32,43.75%),and more of them were reported in 1996,2004,and 2017.Outbreaks were primarily dis-tributed in the Northern Hemisphere and mainly occurred in nursery centers and kindergartens(9/29,31.03%),hospitals(5/29,17.24%),and schools(4/29,13.79%).Viral genotypes were identified during 19 outbreaks,and HAstV-1 was predominant(8/19,42.10%).Eleven outbreaks were caused by mixed infection,and norovirus(9/11,81.82%)and rotavirus(5/11,45.45%)were the most common mixed pathogens.The transmission routes were reported in 9 outbreaks of mixed infection,and most(7/9)were related to water-borne and foodborne transmission.Although HAstV outbreaks are infrequently reported,it is necessary to con-sider HAstV in norovirus-negative gastroenteritis outbreaks.In addition,local Centers for Disease Control and Prevention should have the capacity to handle HAstV outbreaks and identify pathogens.