Reliable methods to detect the presence of SARS-CoV-2 at venues where people gather are essential for epidemiological surveillance to guide public policy. Communal screening of air in a highly crowded space has the potential to provide early warning on the presence and potential transmission of SARS-CoV-2 as suggested by studies early in the epidemic. As hospitals and public facilities apply varying degrees of restrictions and regulations, it is important to provide multiple methodological options to enable environmental SARS-CoV-2 surveillance under different conditions. This study assessed the feasibility of using high-flowrate air samplers combined with RNA extraction kit designed for environmental sample to perform airborne SARS-CoV-2 surveillance in hospital setting, tested by RT-qPCR. The success rate of the air samples in detecting SARS-CoV-2 was then compared with surface swab samples collected in the same proximity. Additionally, positive RT-qPCR samples underwent viral culture to assess the viability of the sampled SARS-CoV-2. The study was performed in inpatient ward environments of a quaternary care university teaching hospital in Singapore housing active COVID-19 patients within the period of February to May 2020. Two types of wards were tested, naturally ventilated open-cohort ward and mechanically ventilated isolation ward. Distances between the site of air sampling and the patient cluster in the investigated wards were also recorded. No successful detection of airborne SARS-CoV-2 was recorded when 50 L/min air samplers were used. Upon increasing the sampling flowrate to 150 L/min, our results showed a high success rate in detecting the presence of SARS-CoV-2 from the air samples (72%) compared to the surface swab samples (9.6%). The positive detection rate of the air samples along with the corresponding viral load could be associated with the distance between sampling site and patient. The furthest distance from patient with PCR-positive air samples was 5.5 m. The airborne SARS-CoV-2 detection was comparable between the two types of wards with 60%–87.5% success rate. High prevalence of the virus was found in toilet areas, both on surfaces and in air. Finally, no successful culture attempt was recorded from the environmental air or surface samples.

While Coronavirus 2019 (COVID-19) typically presents with respiratory tract symptoms, atypical manifestations have been reported. We present a case of a 46-year-old man who presented with fever but no respiratory tract symptoms, and later develops bilateral parotitis. We review the literature for all other reported cases of parotitis and describe common features of these cases. It is important to consider COVID-19 in cases of parotitis, as this impacts patient management and ensures important infection control measures are undertaken.

Relative Bradycardia in Patients with Mild-to-Moderate Coronavirus Disease, Japan

In subjects with peculiar susceptibility to severe infections by common pyogenic bacteria, mutations of interleukin-1 receptor-associated kinase proteins (IRAK)1 and IRAK4 had been identified. The IRAK kinases function as downstream signal transductors following the activation of pathogen recognition receptors. In two patients with sequential or repeated invasive infections: herpes simplex virus-triggered hemophagocytic lymphohistiocytosis with tuberculosis, and Streptococcus pneumoniae bacteremia with candidemia respectively, novel mutations of IRAK2 were identified. These mutations compromised the capacity to ubiquinate (or functionally modify) the signal adaptor tumor necrosis factor receptor-associated factor 6. The result is impairment of the cytokine tumor necrosis factor-alpha production. This susceptibility to a varied range of pathogens underlines a potential central role played by IRAK2 in mediating host defense in infectious diseases. (c) 2024 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

Dengue remains a public health concern in Singapore, with endemic transmission and recurring outbreaks. This study presents results from a Singapore-focused subgroup of the Growth and Emerging Markets Knowledge, Attitudes, and Practices (GEMKAP) cross-sectional survey, which assessed public Knowledge, Attitudes, and Practices (KAP) levels related to dengue and prevention. A total of 400 adult respondents from Singapore participated in an online survey conducted between September and October 2022. Overall KAP scores were 48% (Knowledge), 61% (Attitudes), and 36% (Practices). Awareness of dengue transmission was widespread (96% identified mosquitoes as the vector and 97% recognised stagnant water breeding), while fewer respondents recognised the availability of a dengue vaccine (23%) or the absence of a medicinal cure (38%). Trust in the government’s dengue control efforts was high, though respondents practised an average of 5.1 out of 10 recommended prevention measures. Of the respondents, 25% had a high willingness to vaccinate against dengue. Multivariate analysis revealed that positive vaccine perceptions, past dengue experience, automatic motivation, and social opportunity were associated with willingness to vaccinate. Respondents supported a multi-pronged dengue management approach combining education, vector control, and vaccination. Future efforts should integrate behaviour change strategies, enhance multi-stakeholder collaboration, and empower communities to ensure sustainable impact.

Clostridium tetani, the causative organism of tetanus, is unusual in developed countries including Singapore and to our knowledge, only three known cases of Clostridium tetani bacteraemia have been reported worldwide. This case report describes a case of Clostridium tetani bacteraemia in a Singaporean patient without clinical manifestations of tetanus, likely arising from a sacral sore, highlighting the need for early recognition and targeted antimicrobial treatment for the condition and its complications.