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ABSTRACTIn the midst of the Covid‐19 pandemic, ethicists, researchers, and journalists have recommended studies that deliberately infect healthy volunteers with the coronavirus as a scientific means of expediting vaccine development. In this essay, we trace the history of infection challenge experiments and reflect on the Nuremberg Code of 1947, issued in response to brutal human experiments conducted by Nazi investigators in concentration camps. We argue that the Code continues to offer valuable guidance for assessing the ethics of this controversial form of research, with respect particularly to the acceptable limits to research risks and the social value of research necessary to justify exposing human participants to these risks.

Controlled human malaria infection (CHMI) studies deliberately infect healthy participants with malaria to test interventions faster and more efficiently. Some argue the study design and high payments offered raise ethical concerns about participants' understanding of risks and undue inducement. We conducted baseline and exit interviews with 16 CHMI study participants to explore these concerns. Participants described themes including decision-making tension with friends and family, mixed motivations for participating, low study risks but high burdens, fair compensation, sacrificing values, deceiving researchers, and perceived benefits. Our findings do not support concerns that high payments limit understanding of study risks, but suggest participants may lack appreciation of study burdens, withhold information or engage in deception, and experience conflict with others regarding study participation.

Gastrointestinal infections are among the most common infectious diseases found all over the world, varying depending on the etiological agent. Symptoms usually include diarrhea, vomiting, and abdominal pain. Water and electrolyte imbalance is the main consequence of gastrointestinal infections. Most of them are cured or self-limited in few days, but at the same time, for a specific population such as immunocompromised, elderly patients or new-borns, these infections are potentially severe. In this context, it is very important to identify the etiological agents of acute diarrhea for the appropriate treatment and infection control measures. While routine laboratory diagnosis of parasitic diarrhea still depends largely on microscopic examination of fecal samples, immunological and molecular methods are becoming increasingly commercially available and, in well-resourced settings, will ultimately displace traditional methods. The present paper presents some of the most common and well-known pathologies of this type, being a brief presentation of the variety of gastrointestinal diseases, each with characteristic clinical manifestations and diagnosis.

Human infection challenge studies involving the intentional infection of research participants with a disease-causing agent have recently been suggested as a means to speed up the search for a vaccine for the ongoing coronavirus disease 2019 (COVID-19) outbreak. Calls for challenge studies, however, rely on the expected social value of these studies. This value represents more than the simple possibility that a successful study will lead to the rapid development and dissemination of vaccines but also some expectation that this will actually occur. I show how this expectation may not be realistic in the current political moment and offer potential ways to make sure that any challenge trials that arise actually achieve their goals.

In Lao People's Democratic Republic (PDR), we detected 7 patients infected with Centrocestus formosanus (1��122 adult specimens) after praziquantel treatment and purgation, together with several other trematode species including Opisthorchis viverrini and Haplorchis taichui. The patients were all men, 23��42 yr-of-age. Three subjects were from Vientiane Municipality and 1 each were from Khammouane, Saravane, Champassak, and Xiengkhouang Province. The patients had frequently eaten raw freshwater fish and were experiencing variable degrees of epigastric pain and indigestion accompanied by occasional diarrhea, although the relationship of these symptoms with C. formosanus infection was unclear. Centrocestus formosanus specimens were ovoid, 0.46 mm (0.41��0.52 mm) long, and 0.18 mm (0.16��0.20 mm) wide (n = 10) and were equipped with 32 circumoral spines on the oral sucker. The uterine eggs were 33.2 關m long (31.8��34.9 關m) and 18.5 關m wide (17.4��19.8 關m) (n = 20). Analysis of the nucleotide sequence of the 18S ribosomal RNA gene of our specimens (Laotian isolate) revealed 100% homology with that of an isolate from the United States reported in GenBank. Several species of freshwater fish collected from Xiengkhouang Province revealed a 17.0% prevalence (9 of 53 fish examined) for C. formosanus metacercariae. The results suggest that human C. formosanus infections have been masked by other trematode infections. ; open

Abstract Background Women having multiple sex partners are reportedly at an increased risk of HPV infection. However, the prevalence and risk factors of HPV infection in female sex workers (FSWs) vary considerably across racial/ethnic, socioeconomic, and geographic groups. This study aimed to determine the prevalence and risk factors of HPV infection in FSWs in Northeast China. Methods A total of 309 FSWs identified and approached through a local police office and 1000 healthy subjects from a single factor undergoing annual gynecological examinations in Shenyang were recruited. A liquid-based ThinPrep Pap test and the Hybrid Capture II-based high-risk HPV DNA test, with or without a colposcopic examination, were performed on both FSWs and control subjects. Data on HPV infection and histological and cytological lesions of the cervix were obtained and analyzed. A questionnaire survey was administered to all 309 FSWs with their socio-demographic and behavioral information collected. The association of various socio-demographic and behavioral variables with HPV infection was assessed. Results HPV was significantly more prevalent in FSWs (61.90 %) than in healthy control subjects (21.00 %) ( P < 0.01), so were cervical lesions ( P < 0.01). HPV prevalence in our sample of FSWs fell in the upper range of reported values in FSWs across different countries, and was similar to that for FSWs in the southeast Chinese city of Huzhou but higher than that for FSWs in southwest China, Guangxi, as compared with data from other studies within China. HPV infection in FSWs was significantly associated with the age at first sexual intercourse (OR 0.699, 95 % CI 0.492–0.992) and post-menopause (OR 2.928, 95 % CI 1.099–7.800) ( P < 0.05). Conclusions FSWs are at a substantially high risk of HPV infection and cervical dysplasia development as compared with healthy control subjects in Shenyang, China. Age of first sexual intercourse and post-menopause are two independent risk factors for HPV infection in this special group of population. Intensified and coordinated efforts from government, public health sector, communities and families are needed to reduce the risk of HPV infection in this specific group of population.

Objective: This article provides a review of areas that present significant challenges in infection prevention and control and describes human factors engineering (HFE) approaches that have been applied successfully to these areas. In addition, implications and recommendations for HFE use in future research are discussed. Background: Infection prevention and control aims to prevent patients and health care personnel from acquiring preventable infections in healthcare. Effective infection control practices of healthcare-associated infections have recently become even more critical with the emergence of life-threatening infections. HFE could benefit infection prevention and control in addressing older and more recent challenges, but uptake has been limited. Method/Results: This literature review is an integration and synthesis of recently published research that describes HFE-based approaches in infection prevention and control to address the challenges for three specific topics. The results of the review suggests that HFE is in a position to support work in infection prevention and control and improve overall healthcare safety. Conclusion: HFE provides conceptual frameworks and methods that have significant potential to improve infection prevention and control. Application: The work reviewed can provide potential solutions for current infection prevention and control challenges by applying HFE based recommendations.

Natural outbreaks of transboundary infectious diseases and pandemics are global threats posing international challenges of medical, veterinary, social, and economic character. These diseases have their specific sources and are driven by a range of factors and mechanisms that ensure their transboundary spread. The main driver of transnational spread of infectious diseases is human activity that violates and distorts ecological and climate balance. This disbalance leads to emergence of new pathogens and to expansion of geographical areas of already known diseases and of the range of their host organisms that increasingly include humans. Understanding these aspects is critical for countering existing and future outbreaks of transboundary infections. There is also a risk that infectious potential of microorganisms may be used by armed actors, including parties to politicalmilitary conflicts and terrorists, for their own purposes. While emergence and spread of transboundary infections give rise to a number of problems that reduce the effectiveness of measures for preventing and eliminating them, adequate knowledge about transboundary infections makes it possible to develop a strategy for the management of such diseases at the international level.