13th World Congress on Infection Prevention and Control December 14-07, 2018 Rome, Italy

Tatiana Ometto has her expertise in emergent viruses in wild animals. Her experience involves work on field with wild animals, sampling, serological and molecular analyses in a BSL3+ laboratory. She has built this expertise after years working in different projects involving different emergent virus in Brazil

West Nile virus (WNV) has emerged in the last three decades as a significant burden to public health and a major veterinary concern in Europe and the Americas. The emergence of WNV, particularly the invasion into North America in 1999 and its subsequent spread throughout the Western Hemisphere, corroborates the view that the virus is moving southward, placing millions of individuals at risk for infection. The first report of WNV activity in South America surfaced in April 2006, when three horses died in Argentina. WNV seropositivity in horses in Brazil was reported in 2009, molecular positivity in two birds was found in 2010/2012 and the first clinical report of a human case occurs in 2014. Although, the established transmission foci in South America unknown. However, Brazil is a large tropical country with major ecological reserves and different biomes that provide ideal conditions for many arboviruses, including WNV. Brazil has the largest herd of horses in Latin America and the third largest in the world. The total population is approximately 8 million head, equaling US$3.2 billion including herd management costs. Following the introduction of WNV vaccinations for horses in the United States, the incidence of neuroinvasive disease in horses decreased, suggesting that the WNV vaccination had a substantial impact on equine health. Our discussion proposes that Brazil has a low prevalence of WNV antibodies in equids, therefore, the vaccination of horses should be discussed from an economic standpoint with a model of free demand by the owners, as the cost-benefit of the vaccination may be greater than that of treating the animals. Many questions regarding the potential for WNV spread in Brazil remain. The objective of this discussion was to address these questions by evaluating the importance of passive immunization in horses is to prevent a possible WNV outbreak in Brazil.

Ndabong Michael is a fourth year medical student at the University of Buea and currently carrying out research work on HIV/AIDS in West Africa.

Some degree of interaction has been demonstrated recently between HIV/AIDS and falciparum malaria co-infection in studies carried out in certain parts of Africa, although with conflicting results. However, not much has been done in Cameroon. In order to investigate the interaction, a clinical and laboratory study was carried out in the urban town of Yaoundé the capital city of Cameroon on 480 subjects (15-49 years of age) from March – September, 2015. Information on the knowledge of practices and attitudes towards both infections was also obtained. Analysis of the questionnaire indicated that participants generally had poor knowledge on HIV and malaria. The prevalence of malaria, HIV and co-infection was 78.8%, 11.7% and 7.9% respectively. The mean temperature of co-infected patients (37.5± 0.007) was higher compared with that of patients infected with HIV (36.7± 0.13). Co-infected patients were significantly more anaemic (t=2.275, p=0.026) and had low red blood cell counts (t=-2.681, p=0.001) than those with mono-infections. The mean parasite density was higher in co-infected patients (1630.97± 231.02) when compared with patients solely diagnosed with malaria (1217.44±67.07) (x2=7.65, p=0.0251). WBC count was lower in co-infected patients compared with patients infected with malaria or HIV only (x2=2.24, p=0.488). The mean CD4 count in co-infected subjects (317.94± 45.00cells/mm3) was lower than in those having HIV only (321.37±24.63cells/mm3), but this difference was not statistically significant (t=-1.521, p=0.265). The follow-up mean CD4 count (350.11 ±30.34) in co-infected patients increased compared with the initial count (31.6±17.82) (x2=-1.613, =0.069). The mean parasite density (109.09±41.08/µl) for co-infected patients after follow-up was significantly lower than the initial value (1630.79±23.102/µl) (t=6.12, p<0.001). Therefore HIV and malaria co-infection in the study site was generally associated with anaemia, high fever, high parasite density, lower RBC and WBC count and reduced CD4 counts.

Background: During the autumn 2015 the number of people seeking asylum in Sweden increased dramatically and region Jamtland/Harjedalen received over 3600 individuals. To give all these people a roof over their head it was necessary to increase the number of people living in each room, resulting in an overcrowded resident situation in some shelters comprising 1182 individuals. There is an increased risk for rapid spread of novel strains of influenza A in confined environment, such as refugee shelters. Universal influenza vaccination is a strategy to improve prevention by increasing vaccination coverage (VC) and providing indirect protection of adults by decreasing infection and transmission among children. Materials & Methods: 5 refugee shelters were considered overcrowded, housing between 87 to 638 individuals each. Specially trained vaccination teams visited each shelter after written information in English, Dari, Pashto, Amarinjo and Arabic about influenza infection and influenza vaccination had been distributed among all asylum seekers. The vaccination was free of charge. Results: VC among all refugees in age groups 0-65 years was 68%. In comparison, the VC among the older general population (65 years or older) in our region (county 2) was 33%, which was the 2nd lowest VC among 11 reporting counties in Sweden. During the influenza season 2015/2016, 88 cases of influenza A and 29 cases of influenza B were reported in our region (population 127 169). Among these, three individuals with influenza A and 2 with influenza B were reported that belonged to the refugee cohort. These cases were reported before the implementation of the vaccination campaign among the overcrowded asylum seekers. After the introduction of the influenza vaccination campaign no case of influenza A and B or outbreaks of influenza was reported from the vaccinated shelters. Conclusions: The high VC has probably had some impact on the spread of influenza and the burden of infection in the shelters. It is also possible that the high VC resulted in a protective effect for the unvaccinated individuals living in the shelters, as no case of influenza was reported from the shelters after the implementation of the vaccination campaign. This limited study also suggests that influenza vaccination free of charge, with easy access and preceded by direct adequate information regarding influenza and vaccination can result in an enhanced VC.

Staffan P E Sylvan is a senior expert in infectious diseases and communicable disease control and prevention. He has been the county Medical Officer for Uppsala County, Sweden. As such he was the Director of the local department of communicable disease control and prevention and was very active in undertaking campaigns concerning the containment of the spread of communicable diseases such as pandemic influenza, Chlamydia, HIV and hepatitis A, B and C. He has a long standing research career particularly in the area of Hepatitis Immunology. He has published more than 65 papers in reputed journals.