BACKGROUND:The World Health Organization declared the outbreak of coronavirus disease to be a public health emergency of international concern on January 30, 2020. The first SARS-CoV-2 infection was subsequently detected in Luxembourg on February 29, 2020. Representative population-based data, including asymptomatic individuals for assessing the viral spread and immune response was, however, lacking worldwide. METHODS:Using a panel-based method, we recruited a representative sample of the Luxembourgish population based on age, gender and residency for testing for SARS-CoV-2 infection and antibody status in order to define prevalence irrespective of clinical symptoms. Participants were contacted via email to fill an online questionnaire before biosampling at local laboratories. Participants provided information related to clinical symptoms, epidemiology, socioeconomic and psychological assessments and underwent biosampling, rRT-PCR testing and serology for SARS-CoV-2. RESULTS:A total of 1862 individuals were included for our representative sample of the general Luxembourgish population. We detected an ongoing SARS-CoV-2 infection based on rRT-PCR in 5 participants. h Four of the SARS-CoV-2 infected participants were oligosymptomatic and one was asymptomatic. Overall, 35 participants (1.97%) had developed a positive IgG response, of whom 11 self-reported to have previously received a positive rRT-PCR diagnosis of SARS-CoV-2 infection. Our data indicate a prevalence of 0.3% for active SARS-CoV-2 infection in the Luxembourgish population between 18 and 79 years of age. CONCLUSIONS:Luxembourgish residents show a low rate of acute infections after 7 weeks of confinement and present with an antibody profile indicative of a more recent immune response to SARS-CoV-2. All infected individuals were oligo-or asymptomatic. Bi-weekly follow-up visits over the next 2 months will inform about the viral spread by oligo-and asymptomatic carriers and the individual changes in the immune profile.

Background To accompany the lifting of COVID-19 lockdown measures, Luxembourg implemented a mass screening (MS) programme. The first phase coincided with an early summer epidemic wave in 2020. Methods rRT-PCR-based screening for SARS-CoV-2 was performed by pooling of samples. The infrastructure allowed the testing of the entire resident and cross-border worker populations. The strategy relied on social connectivity within different activity sectors. Invitation frequencies were tactically increased in sectors and regions with higher prevalence. The results were analysed alongside contact tracing data. Findings The voluntary programme covered 49% of the resident and 22% of the cross-border worker populations. It identified 850 index cases with an additional 249 cases from contact tracing. Over-representation was observed in the services, hospitality and construction sectors alongside regional differences. Asymptomatic cases had a significant but lower secondary attack rate when compared to symptomatic individuals. Based on simulations using an agent-based SEIR model, the total number of expected cases would have been 42·9% (90% CI [-0·3, 96·7]) higher without MS. Mandatory participation would have resulted in a further difference of 39·7% [19·6, 59·2]. Interpretation Strategic and tactical MS allows the suppression of epidemic dynamics. Asymptomatic carriers represent a significant risk for transmission. Containment of future outbreaks will depend on early testing in sectors and regions. Higher participation rates must be assured through targeted incentivisation and recurrent invitation. Funding This project was funded by the Luxembourg Ministries of Higher Education and Research, and Health.

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Continuing conflicts near the borders led to massive population flows, Turkey has followed an open door policy and accepted them as "guest". Turkey is currently hosting the largest number of Syrian refugees in the World.According to the official numbers 2,726,980 (Aug 2016) Syrians are staying at Turkey but it is difficult to give the exact numbers (1). Nearly half of them are children, and 152,000 Syrian refugees were born in Turkey (Feb 2016). A limited number of refugees (269,672; Sep 2016) are sheltered in 26 camps located around the border cities, and others are living throughout Turkey (2). Camps are coordinated by Prime Ministry Disaster and Emergency Management Authority of the Republic of Turkey which provide accommodation, health, food, education, and other services. Local hospitals have been enlarged and equipped to cover the most acute needs.A lot of legal, administrative and institutional arrangements have been made, some are underway. Currently, each registered Syrian refugee has free access to healthcare services under the Ministry of Health like as Turkish citizen. Emergency healthcare is provided free to unregistered Syrians and to all migrants. Recently, 85 Migrant Health Units have been organized in 16 provinces. In general, preventive health services to refugees are delivered by Public Health Directorates.Active surveillance for cutaneous leishmaniasis and malaria is initiated. According to the data of Ministry of Health; 825 cases of cutaneous leishmaniasis were detected in 2015. Totally 1022 cases of tuberculosis were diagnosed and treated between 2012-2015 years. Tuberculosis prevalence rate was found as 18.7/100000, similar to Turkish population. Any malaria case was not detected. Syndromic surveillance for food-and waterborne diseases is being conducted at the camps. Syrian children were also affected recent measles outbreak due to interruption of vaccination on civil war condition. Considering the polio cases in Syria, measles and polio vaccination campaign were launched promptly. All the Syrian children are included into the national childhood immunization programme of Turkey.Nevertheless there are still some problems to access to health care services resulting from communication barriers and cultural differences. Educational activities for healthcare workers and Syrians are in progress.

Background Infections with SARS-CoV-2 have a pronounced impact on the gastrointestinal tract and its resident microbiome. Clear differences between severe cases of infection and healthy individuals have been reported, including the loss of commensal taxa. We aimed to understand if microbiome alterations including functional shifts are unique to severe cases or a common effect of COVID-19. We used high-resolution systematic multi-omic analyses to profile the gut microbiome in asymptomatic-to-moderate COVID-19 individuals compared to a control group. Results We found a striking increase in the overall abundance and expression of both virulence factors and antimicrobial resistance genes in COVID-19. Importantly, these genes are encoded and expressed by commensal taxa from families such as Acidaminococcaceae and Erysipelatoclostridiaceae, which we found to be enriched in COVID-19-positive individuals. We also found an enrichment in the expression of a betaherpesvirus and rotavirus C genes in COVID-19-positive individuals compared to healthy controls. Conclusions Our analyses identified an altered and increased infective competence of the gut microbiome in COVID-19 patients.

Objectives: Infections with SARS-CoV-2 have a pronounced impact on the gastrointestinal tract and its resident microbiome. Clear differences between severe cases of infection and healthy individuals have been reported, including the loss of commensal taxa. We aimed to understand if microbiome alterations including functional shifts are unique to severe cases or a common effect of COVID-19. Design: We used high-resolution systematic multi-omic analyses to profile the gut microbiome in asymptomatic-to-moderate COVID-19 individuals compared to a control group. Results: We found a striking increase in the overall abundance and expression of both virulence factors and antimicrobial resistance genes in COVID-19. Importantly, these genes are encoded and expressed by commensal taxa from families such as Acidaminococcaceae and Erysipelatoclostridiaceae, which we found to be enriched in COVID-19 positive individuals. We also found an enrichment in the expression of a betaherpesvirus and rotavirus C genes in COVID-19 positive individuals compared to healthy controls. Conclusion: Our analyses identified an altered and increased infective competence of the gut microbiome in COVID-19 patients.

Recent studies have identified a new genus of the Orthomyxoviridae family, Influenza D virus (IDV). This virus was shown to infect farm animals including swine and cattle, and to efficiently replicate and transmit in ferrets, the animal model of choice for transmission of influenza A virus to humans. This partnering grant on IDV addressed the need for capacity building at EU level to improve the EU's scientific assessment capacity and international competitiveness. We have promoted cross‐disciplinary cooperation between the partner institutes representing six Member States (BE, FR, IT, LU, NL and SE). We have shown that the available antigen and genome test systems allow reliable influenza D diagnostics in partners laboratories, while for a few of the applied antibody testing methods adjustments are recommended. Tools were developed to study virus‐host range, with a gain of knowledge on host and tissue tropism of IDV in farm animals but also in wild life and very preliminary data was generated on human tissues. Serological results in European cattle suggest that influenza D virus is enzootic. Virus diversity is still unfolding: new virus introductions were identified, as well as new reassortants whose differential clinical impact or cross‐protection levels are still poorly understood. Considering drivers of emergence, IDV was in the top five in comparison with 29 other diseases. The main risk factors of IDV in cattle are related to the animal density, presence of respiratory clinical signs in cattle and contact rates between animals. Simplified quantitative IDV risk assessment exposure model indicated a possible infection of human by IDV through aerosols in cattle farms. Further studies are warranted to fully assess the risk of IDV for both animal and Human health in Europe.