2020 年 2 月至 3 月，全球游轮新型冠状病毒肺炎次疫情的公共卫生反应。
- 作者列表："Moriarty LF","Plucinski MM","Marston BJ","Kurbatova EV","Knust B","Murray EL","Pesik N","Rose D","Fitter D","Kobayashi M","Toda M","Cantey PT","Scheuer T","Halsey ES","Cohen NJ","Stockman L","Wadford DA","Medley AM","Green G","Regan JJ","Tardivel K","White S","Brown C","Morales C","Yen C","Wittry B","Freeland A","Naramore S","Novak RT","Daigle D","Weinberg M","Acosta A","Herzig C","Kapella BK","Jacobson KR","Lamba K","Ishizumi A","Sarisky J","Svendsen E","Blocher T","Wu C","Charles J","Wagner R","Stewart A","Mead PS","Kurylo E","Campbell S","Murray R","Weidle P","Cetron M","Friedman CR","CDC Cruise Ship Response Team.","California Department of Public Health COVID-19 Team.","Solano County COVID-19 Team.
:An estimated 30 million passengers are transported on 272 cruise ships worldwide each year* (1). Cruise ships bring diverse populations into proximity for many days, facilitating transmission of respiratory illness (2). SARS-CoV-2, the virus that causes coronavirus disease (COVID-19) was first identified in Wuhan, China, in December 2019 and has since spread worldwide to at least 187 countries and territories. Widespread COVID-19 transmission on cruise ships has been reported as well (3). Passengers on certain cruise ship voyages might be aged ≥65 years, which places them at greater risk for severe consequences of SARS-CoV-2 infection (4). During February-March 2020, COVID-19 outbreaks associated with three cruise ship voyages have caused more than 800 laboratory-confirmed cases among passengers and crew, including 10 deaths. Transmission occurred across multiple voyages of several ships. This report describes public health responses to COVID-19 outbreaks on these ships. COVID-19 on cruise ships poses a risk for rapid spread of disease, causing outbreaks in a vulnerable population, and aggressive efforts are required to contain spread. All persons should defer all cruise travel worldwide during the COVID-19 pandemic.
: 估计每年在全球 3000万艘游轮上运送 272 名乘客 * (1)。游轮将不同的人群带到附近很多天，促进呼吸道疾病的传播 (2)。SARS-CoV-2，病毒导致冠状病毒病毒病 (alzheimer's disease，新型冠状病毒肺炎) 首次确认号，在十二月 2019，此后一直在全球范围内蔓延到至少 187 个国家和地区.游轮上广泛的新型冠状病毒肺炎传播也有报道 (3)。某些游轮航行的乘客年龄可能 ≥ 65 岁，这使他们面临SARS-CoV-2 感染严重后果的风险更大 (4)。在 2020 年 2 月至 3 月期间，与三艘游轮航行相关的新型冠状病毒肺炎次爆发已经在乘客和船员中造成了 800 多次实验室确诊病例，包括 10 人死亡。传输发生在几艘船的多次航行中。本报告描述了对这些船只上新型冠状病毒肺炎次疫情的公共卫生反应。游轮上的新型冠状病毒肺炎造成疾病快速传播的风险，导致弱势群体爆发，需要积极努力遏制传播。新型冠状病毒肺炎大流行期间，所有人都应推迟全球所有邮轮旅行。
METHODS::The antimicrobial functions of neutrophils are facilitated by a defensive armamentarium of proteins stored in granules, and by the formation of neutrophil extracellular traps (NETs). However, the toxic nature of these structures poses a threat to highly vascularized tissues, such as the lungs. Here, we identified a cell-intrinsic program that modified the neutrophil proteome in the circulation and caused the progressive loss of granule content and reduction of the NET-forming capacity. This program was driven by the receptor CXCR2 and by regulators of circadian cycles. As a consequence, lungs were protected from inflammatory injury at times of day or in mouse mutants in which granule content was low. Changes in the proteome, granule content and NET formation also occurred in human neutrophils, and correlated with the incidence and severity of respiratory distress in pneumonia patients. Our findings unveil a 'disarming' strategy of neutrophils that depletes protein stores to reduce the magnitude of inflammation.
METHODS::Pneumonia is a common respiratory infectious disease that involves the inflammation of the pulmonary parenchyma. Periodontal disease is widespread and correlated with pneumonia. However, the relationship between periodontal treatment and clinical infectious outcomes in patients with pneumonia has remained undetermined. The aim of this study was to investigate the association between periodontal treatment and the risk of pneumonia events in the Taiwanese population. A nationwide population-based cohort study was conducted using data from the Taiwanese National Health Insurance Research Database (NHIRD). A total of 49,400 chronic periodontitis patients who received periodontal treatment from 2001 to 2012 were selected. In addition, 49,400 healthy individuals without periodontal diseases were picked randomly from the general population after propensity score matching according to age, gender, monthly income, urbanization, and comorbidities. The Cox proportional hazard regression analysis was adopted to assess the hazard ratio (HR) of pneumonia between the periodontal treatment cohort and the comparison cohort. The average ages of the periodontal treatment and comparison groups were 44.25 ± 14.82 years and 44.15 ± 14.5 years, respectively. The follow up durations were 7.66 and 7.41 years for the periodontal treatment and comparison groups, respectively. We found 2504 and 1922 patients with newly diagnosed pneumonia in the comparison cohort and the periodontal treatment cohort, respectively. The Kaplan-Meier plot revealed that the cumulative incidence of pneumonia was significantly lower over the 12 year follow-up period in the periodontal treatment group (using the log-rank test, p < 0.001). In conclusion, this nationwide population-based study indicated that the patients with periodontal treatment exhibited a significantly lower risk of pneumonia than the general population.
METHODS:OBJECTIVE:To describe the treatment of community-acquired pneumonia (CAP) in children under five years in Tanzania. METHODS:Between January and December 2017, children aged 2-59 months with chest radiography-confirmed CAP were enrolled. The parents were interviewed to collect information on the patients and home-based medication. Clinical information was derived from the patient files. Nasopharyngeal swab and blood samples were collected for isolation of the causative pathogens. Swab samples were analysed by quantitative PCR whereas blood samples were tested using BacT/Alert 3D. RESULTS:Overall, 109 children with CAP were included in this analysis. Provision of care to most children was delayed (median = 4.6 days). A quarter (26.6%) were given unprescribed/leftover antibiotics at home. Only one child had positive bacterial culture. Referrals were associated with nasopharyngeal carriage of Streptococcus pneumoniae (p = 0.003) and Haemophilus influenzae (p = 0.004). Of all admitted children, more than a quarter (n = 29) did not need to be hospitalised and inappropriately received injectable instead of oral antibiotics. CONCLUSION:We found high rates of home treatment, particularly with antibiotics. Appropriate health care was delayed for most children because of home treatment. Efforts are needed at the community level to improve awareness of antimicrobial resistance.