We report a familial cluster of 24 individuals infected with severe acute respiratory syndromecoronavirus-2 (SARS-CoV-2). The index case had a travel history and spent 24 days in the house before being tested and was asymptomatic. Physical overcrowding in the house provided a favourable environment for intra-cluster infection transmission. Restriction of movement of family members due to countrywide lockdown limited the spread in community. Among the infected, only four individuals developed symptoms. The complete genome sequences of SARS-CoV-2 was retrieved using next-generation sequencing from eight clinical samples which demonstrated a 99.99% similarity with reference to Wuhan strain and the phylogenetic analysis demonstrated a distinct cluster, lying in the B.6.6 pangolin lineage.

Introduction: Increased knowledge and improved attitudes about suicide are important factors for suicide-prevention strategies. Not only mental health professionals and public, but doctors and nurses working in other departments and general hospitals, especially in resource limited low-middle income country like Nepal, need to be knowledgeable identifying and making appropriate referrals for mental health issues and suicidal patients. This study was conducted to assess doctors and nurses’ literacy of suicide at a tertiary care government center in Nepal. Methods: A descriptive cross-sectional questionnaire-based study was conducted among doctors and nurses working at the hospital. Literacy of suicide scale was utilized to assess the status of literacy regarding suicide among 188 study participants. Descriptive statistics were applied. Results: The total mean literacy of suicide scale (LOSS) score was calculated to be 13.07 (SD=3.65). Higher number of participants, 117 (62.2%) scored above mean on total LOSS score.  Performance was the poorest on recognizing the signs of suicide while it was best on identifying the cause of suicide. People with relationship problems or financial problems have a higher risk of suicide was correctly identified by 89.9% of the participants. While only 60 (31.9%) participants correctly answered item “men are more likely to suicide than women” from the domain risk. Conclusions: Majority of nurses and doctors performed better on the literacy of suicide scale. Health professionals were found knowledgeable about suicide. Those with higher level of education, specialization and training in mental health scored higher. Future studies among various categories of population and association of level of literacy and attitude, practices is needed.

Dengue (DEN) is the most common cause of mosquito‐borne endemic viral diseases in the tropical and subtropical countries. DEN outbreaks associated with multiple dengue virus (DV) serotypes have been regularly reported in different parts of India. This study was done during DEN outbreaks in 2015 to 2016 in UP and Bihar where DEN‐2 was found as the only prevalent serotype. DV‐2 was the only serotype amplified in serotype‐specific reverse‐transcription polymerase chain reaction from sera of 210 (65.21%) out of 322 DV NS1 antigen‐positive patients. Further genetic analysis based on full‐length envelope (E) protein sequence derived from patient's sera as well as DV isolate showed the circulation of lineages I and III of DV‐2 cosmopolitan genotype during 2015 and lineage II during 2016. Finally, the phylogenetic analysis using the E gene sequence revealed that these DV‐2 strains have a close genetic relationship with the recently reported DV‐2 genotypes from DEN outbreaks reported from different parts of north India. These results showed the circulation of cosmopolitan genotype of DV‐2 in eastern Uttar Pradesh and western Bihar, India. The genetic database generated on circulating DV strains in this study will be useful as reference for disease surveillance and strengthening laboratory diagnosis protocols.

Recurrent or persistent positivity of SARS-CoV-2 RNA in clinically recovered COVID-19 patients have been reported worldwide. However, replication competent live viruses were not recovered beyond two to three weeks from onset of symptoms in mild to severe cases of COVID-19. End stage renal disease is characterized by uremia induced immune dysfunction that increases the risk of infectious diseases including COVID-19. The clinical implications of recurrent or persistently positive SARS-CoV-2 RNA in immunocompromised patients are difficult to be generalized to findings as in immunocompetent patients. We report a case of end stage renal disease with recent history of recovered COVID-19 pneumonia, who again presented with positive reverse transcriptase- polymerase chain reaction (RT-PCR) test for SARS-CoV-2 RNA.