SARS-CoV-2 infection characteristics among students and staffin a large high school COVID-19 outbreak and secondary transmission in households

Background:SARS-CoV-2 clinical presentation is associated with the patients’age group.Overall,young indi-viduals present higher proportions of asymptomatic or mild COVID-19 infection,compared to adults.Data on secondary COVID-19 transmission in households,according to the cases’age group,are accumulating.Methods:We performed a follow-up cohort study including all COVID-19 real-time polymerase chain reaction(RT-PCR)-confirmed cases(adolescent students and school staff)diagnosed in an epidemiological investigation of a large high school outbreak.We compared the adolescent and adult groups regarding clinical symptoms,time to negative COVID-19 RT-PCR tests,and infection transmission in households.Results:The study population included 817 persons.The confirmed COVID-19 RT-PCR outbreak cases(n=178)were followed(students aged 12-19 years,median age 14 years,n=153,school staffaged 24-67 years,median age 39 years,n=25)and the cases’household close contacts(n=639)were tested.The adolescents had lower symptomatic infection rates,shorter time to negative COVID-19 RT-PCR tests,and lower transmission rates to household members,compared to the adults.The general transmission rate among household contacts was 13.5%,(86/639)ranging from 8.6%in asymptomatic students’contacts to 27.3%in symptomatic staffcontacts.COVID-19 transmission rates were significantly higher in contacts of symptomatic cases compared to asymptomatic cases(odds ratio:2.06,95%CI 1.26-3.4)and higher in adults compared to adolescents(odds ratio:2.69,95%CI 1.43-4.89).Conclusions:Adolescents and adults diagnosed in an outbreak investigation differ as to COVID-19 clinical presen-tation and transmission.As adolescents may show mild or no symptoms,COVID-19 prevention in school settings is challenging.Implementing nonpharmaceutical measures and promoting vaccination programs in eligible staffand students should be considered.

Inflammatory bowel disease among first generation immigrants in Israel:A nationwide epi-Israeli Inflammatory Bowel Disease Research Nucleus study

BACKGROUND Israel has a high rate of Jewish immigration and a high prevalence of inflammatory bowel disease(IBD).AIM To compare IBD prevalence in first-generation immigrants vs Israel-born Jews.METHODS Patients with a diagnosis of IBD as of June 2020 were included from the validated epi-IIRN(Israeli IBD Research Nucleus)cohort that includes 98%of the Israeli population.We stratified the immigration cohort by IBD risk according to country of origin,time period of immigration,and age group as of June 2020.RESULTS A total of 33544 patients were ascertained,of whom 18524(55%)had Crohn’s disease(CD)and 15020(45%)had ulcerative colitis(UC);28394(85%)were Israel-born and 5150(15%)were immigrants.UC was more prevalent in immigrants(2717;53%)than in non-immigrants(12303,43%,P<0.001),especially in the<1990 immigration period.After adjusting for age,longer duration in Israel was associated with a higher point prevalence rate in June 2020(high-risk origin:Immigration<1990:645.9/100000,≥1990:613.2/100000,P=0.043;intermediate/low-risk origin:<1990:540.5/100000,≥1990:192.0/100000,P<0.001).The prevalence was higher in patients immigrating from countries with high risk for IBD(561.4/100000)than those originating from intermediate-/low-risk countries(514.3/100000;P<0.001);non-immigrant prevalence was 528.9/100000.CONCLUSION Lending support to the environmental effect on IBD etiology,we found that among immigrants to Israel,the prevalence of IBD increased with longer time since immigration,and was related to the risk of IBD in the country of origin.The UC rate was higher than that of CD only in those immigrating in earlier time periods.

Vitamin K supplementation to prevent hemorrhagic morbidity and mortality of newborns in India and China

Background?Vitamin K deficiencY bleeding(VKOBl can cause prolonged and bleeding(intracranial hemorrhage)ameng newborns.which can be life—threatening or lead to long-term morbidity.The aim of this review article is to reiterate empirical evidence to support the argument that vitamin K should be mandatory for newborns in India and China,as well as in other countries with a high burden of neonatal deaths.

Associations of Adolescence Exposure to Industrial Air Pollution with Cancer in Young Adults

There is substantial public concern about the health risks of proximity to petrochemical industries.In the Haifa Bay Area(HBA),which contains Israel’s densest industrial area,these concerns have been strengthened by elevated cancer mortality rates since the late 1960s.We studied the association between adolescent exposure to industrial air pollution in the HBA and adult-onset cancer.This is a historical cohort study.The study population comprised 2,187,317 subjects,using the Israeli medical corps data linked to the Israel National Cancer Registry with follow-up of up to 45 years.Exposure assessments were estimated by a spatial kriging interpolation model of SO2,serving as a marker for the dispersion of air pollution emitted from the complex during the study period.We found increased crude(HR=1.23,95%CI=1.17 to 1.29)and adjusted(HR=1.16,95%CI=1.10 to 1.21)risk of cancer with increased exposure to air pollution in HBA.The associations remained robust in analyses stratified by decade and socio-economic status.We found evidence of monotonically increased risk in five of 13 cancer categories(leukemia,melanoma,female breast,central nervous system,and thyroid tumors).Our findings strengthen the hypothesis that this exposure posed a carcinogenic risk during the study period.