Background Nipah virus (NiV) is 1 of 10 potential causes of imminent public health emergencies of international concern. We investigated the NiV outbreak that occurred in May 2018 in Kerala, India. Here we describe the longitudinal characteristics of cell-mediated and humoral immune responses to NiV infection during the acute and convalescent phases in 2 human survivors. Methods Serial blood samples were obtained from the only 2 survivors of the NiV outbreak in Kerala. We used flow cytometry to determine the absolute T-lymphocyte and B-lymphocyte counts and the phenotypes of both T and B cells. We also detected and quantitated the humoral immune response to NiV by virus-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) enzyme-linked immunosorbent assay. Results Absolute numbers of T lymphocytes remained within normal limits throughout the period of illness studied in both survivors. However, a marked elevation of activated CD8 T cells was observed in both cases. More than 30% of total CD8 T cells expressed Ki67, indicating active proliferation. Proliferating (Ki-67+) CD8 T cells expressed high levels of granzyme B and PD-1, consistent with the profile of acute effector cells. Total B-lymphocyte, activated B-cell, and plasmablast counts were also elevated in NiV survivors. These individuals developed detectable NiV-specific IgM and IgG antibodies within a week of disease onset. Clearance of NiV RNA from blood preceded the appearance of virus-specific IgG and coincided with the peak of activated CD8 T cells. Conclusions We describe for the first time longitudinal kinetic data on the activation status of human B- and T-cell populations during acute NiV infection. While marked CD8 T-cell activation was observed with effector characteristics, activated CD4 T cells were less prominent.

Background: COVID-19 transmission was significant among Healthcare workers worldwide. In March 2020, Qatar started reporting numbers of COVID-19 positive cases among workers in Primary Health Care Corporation (PHCC). The study estimates the burden of the aforementioned infections and examines the demographic characteristics associated with the recorded positivity rates.Method: A cross-sectional descriptive study was conducted among Primary healthcare workers between March 1st and October 31st, 2020. The study examined the positivity rate of the different types of Primary healthcare workers and, analyzed the demographic characteristics of the infected persons.Results: 1,048 (87.4%) of the infected Health Care Workers (HCWs) belonged to the age group below 45 years, and 488 (40.7%) HCWs were females. 450 (37.5%) were HCWs clinical staff working in one of the 27 PHCC Health Centers (HCs) Despite the increased patient footfall and risk environment, the COVID dedicated HCs had an attack rate of 10.1%, which is not significantly different from the average attack rate of 8.9% among staff located in other HCs (p = 0.26). Storekeepers, engineering & maintenance staff, housekeeping staff, support staff, and security staff (outsourced non-clinical positions) had the highest positivity rates, 100, 67.2, 47.1, 32.4, and 29.5% respectively.Conclusion: The elevated risk of infection among outsourced non-clinical healthcare workers can be explained by environmental factors such as living conditions. Furthermore, better containment within clinical healthcare workers can be attributed to strict safety training and compliance with preventative measures which is recommended to be implemented across all settings.

Scrub typhus is associated with outbreaks of acute encephalitis syndrome in Uttar Pradesh, India. A case-control study indicated that children residing, playing, or visiting fields; living with firewood stored indoors; handling cattle fodder; and practicing open defecation were at increased risk for scrub typhus. Communication messages should focus on changing these behaviors.

Objectives: To assess the efficacy of self-collected vaginal samples compared with physician-collected cervical samples for the detection of HPVDNA. Methods: A hospital-based cross-sectional study was carried out among patients with newly diagnosed cervical cancer attending . Consenting patients collected their vaginal samples, followed by cervical sample collection by the clinician. The paired samples were transported at 4-8 °C to the laboratory. Amplification of LCR/E6/E7 regions of the HPV genome was done by polymerase chain reaction (PCR). The agreement level between paired samples was assessed by the Kappa index.Results: Among the 114 cervical cancer patients enrolled in the present cross-sectional study, the prevalence of HPV DNA was 78.1% (95% confidence interval [CI] 69.2%-85%) in cervical samples and 77.2% in vaginal samples (95% CI 68.7%-83.9%). The overall agreement between the two sampling methods was 93.9% and the kappa value was 0.82 (P<0.001). The sensitivity of HPV detection using vaginal samples was 98.9% (95% CI 93.9%-99.8%) and the specificity was 100% (95% CI 86.7%-100%) with cervical sampling as the gold standard. By Kappa index, an almost perfect agreement for HPV DNA detection between self-collected and physician-collected samples was observed. Conclusion:Self-collection of vaginal samples ensures equity of cervical cancer screening in low-income countries such as India. K E Y W O R D S

Introduction COVID-19 transmission was significant amongst Qatar’s working population during the March–July 2020 outbreak. The study aimed to estimate the risk of exposure for COVID-19 across various workplace settings and demographics in the State of Qatar. Methods A cross-sectional study was conducted utilizing surveillance data of all workplaces with 10 or more laboratory-confirmed cases of COVID-19. These workplaces were categorized using a mapping table adapted from the North American Industry Classification System (NAICS) codes, 2017 version. The data was then analyzed to estimate and compare the positivity rate as an indicator of the risk of developing COVID-19 infection across various workplace settings in the State of Qatar. Results The highest positivity rate was reported amongst the Construction & Related (40.0%) and the Retail & Wholesale Trade sectors (40.0%), whereas, the lowest positivity rate was attributed to the healthcare workplace setting (11.0%). The highest incidence of COVID-19 infections occurred in South Asian nationalities and in the male gender. The private funded sector employees have seen higher positivity rate than employees of the governmental funded sector. Conclusion The elevated risk of infection in Construction and Retail & Wholesale Trade is probably due to environmental and educational vulnerabilities. The predominant labor force of those workplace categories is South Asian craft and male manual workers. Alternatively, the better containment of the healthcare workplace setting can be attributed to the enforcement of infection control and occupational safety measures. These findings imply the importance of using preventive and surveillance strategies for high-risk workplace settings appropriately.

Background: COVID-19 transmission was significant amongst Healthcare workers worldwide. Aim: This study aims to estimate the risk of exposure for COVID-19 across Primary Healthcare workers in the State of Qatar. Methods: A cross-sectional descriptive study was conducted to study the burden of COVID-19 among staff working at PHCC during the COVID-19 pandemic from March 1 to October 31, 2020. Results: 1,048 (87.4%)of the infected HCWs belonged to the age group below 45 years, and 488 (40.7%) HCWs were females. 450 (37.5%) were HCWs clinical staff working in one of the 27 PHCC HCs; Despite the increased patient footfall and risk environment, the COVID HCs had an attack rate of 10.1%, which is not significantly different from the average attack rate of 8.9% among staff located in other HCs (p-value =0.26). Storekeepers, engineering & maintenance staff, housekeeping staff, support staff, and security staff (outsourced positions) had the highest positivity rates, 100%, 67.2%, 47.1%, 32.4%, and 29.5% respective positivity rates. Conclusions: The elevated risk of infection amongst outsourced healthcare workers can be explained by environmental factors such as living conditions. On the other hand, better containment within clinical healthcare workers can be attributed to strict safety training and compliance with preventative measures which is recommended to be implemented across all settings.

Background:WHO has recommended Visual Inspection with Acetic acid (VIA) or Human Papillomavirus (HPV) DNA testing if feasible, for cervical cancer screening in low income countries. However, the number of women undergoing screening is very low as a result of limited information, inadequate infrastructure and invasive nature of sampling. Methods:A cross sectional study was carried out comparing HPV DNA detection by Polymerase Chain Reaction (PCR) in paired cervical and urine samples procured from histologically confirmed cervical cancer cases. Results:Amongst the samples collected from 114 cervical cancer cases, HPV DNA was tested positive in cervical samples of 89 (78.1%) and urine samples of 55 (48.2%) patients. The agreement between the two sampling methods was 66.7% and the kappa value was 0.35 indicating a fair agreement. The sensitivity of HPV detection using urine samples was 59.6% (95% confidence interval 49.16%-69.15%) and the specificity was 92% (95% confidence interval 75.0%-97.8%). Conclusion:Even though not acceptable as an HPV DNA screening tool due to low sensitivity, the urine sampling method is inexpensive and more socially acceptable for large epidemiological surveys in developing countries to estimate the burden.

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