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Protecting and improving public health requires multidisciplinary research into the determinants of health and disease, and large-scale solutions. Here we showcase work across these areas, including epidemiology, health policy, mathematical modelling, electronic health records research, and Registered Reports.
Maternal anti-SARS-CoV-2 antibodies can provide protection against severe COVID-19 in infants, but the relative protection conferred by maternal infection, vaccination, and hybrid immunity is unknown. Here, the authors use data from Israel and show that infants born to mothers with hybrid immunity had lowest rates of COVID-19 hospitalisation.
In this Perspective, the authors discuss the importance of preventing zoonotic spillover to prevent pandemics. They highlight mechanisms by which environmental changes can enable spillover, identify ecological interventions for spillover prevention and suggest policy frameworks through which interventions can be implemented.
Seasonal influenza vaccine effectiveness depends on including virus strains in the vaccine that closely match those circulating in the upcoming season. In this study, the authors develop a computational model of influenza virus evolution to predict future circulating strains and therefore support vaccine strain selection.
Identification of patients at high risk of methicillin-resistant Staphylococcus aureus (MRSA) infection could improve treatment outcomes by optimising antimicrobial therapy. Here the authors develop a deep learning model that uses electronic health record data from the United States to predict MRSA culture positivity.
An indirect impact of the COVID-19 pandemic was a decline in healthcare utilisation for other conditions. Here, the authors quantify this decline in the Netherlands and show that impacts were greater for individuals with lower household income, females, older people, and those with a migrant background.
Genomic surveillance has been important for tracking the evolution and spread of SARS-CoV-2. Here, the authors analyse ~300,000 SARS-CoV-2 genomes from two years of sequencing in the Latin America and Caribbean regions and describe the emergence and spread of different lineages over time.
Human Papillomaviruses (HPV) are classified in lineages based on their sequence. Here, the authors test neutralizing activity of sera from naturally infected women against vaccine-preventable HPV variants, delineating lineage-specific antibody responses.
Brazil has operated a conditional cash transfer program to support families living in precarious conditions since 2004. Here, the authors use linked administrative and health data to investigate the impacts of the program on HIV/AIDS-related outcomes, demonstrating strong positive associations.
Monitoring antimicrobial resistance in food animals is challenging due to limited surveillance systems. Here, the authors combine data from point prevalence surveys in lower- and middle-income settings to map resistance to seven antimicrobials and predict which are likely to exceed key resistance thresholds.
SARS-CoV-2 coinfections may lead to recombination events which could be important in the emergence of new variants. Here, the authors develop an automated bioinformatics pipeline to identify coinfections in genomic data and test it on >2 million publicly available raw read data sets collected globally.
Respiratory syncytial virus (RSV) causes a high burden of disease in children, particularly in lower- and middle-income countries. In this prospective household-based observational cohort study in South Africa, the authors estimate the incidence of RSV and identify risk factors for transmission.
The first known local mpox outbreak in Guangdong Province, China occurred in June 2023. Here, the authors perform phylogenetic and molecular evolution analysis of ten mpox virus genome sequences from this outbreak, and place them in the context of other samples detected in surrounding regions.
COVID-19 has impacted health systems unequally and widespread SARS-CoV-2 testing for community surveillance has been limited globally. This work in Malawi highlights how river and wastewater can be used to detect emerging SARS-CoV-2 waves, identify variants of concern, and provide an early warning system.
Novel indicators of infectious disease prevalence could improve real-time surveillance and support healthcare planning. Here, the authors show that sales data for non-prescription medications from a UK high street retailer can improve the accuracy of models forecasting mortality from respiratory infections.
The superspreading that characterized SARS and now COVID-19 can be rapidly quantified; however, its implications for outbreak control were never well understood. Recent studies point to its profound impact on outbreak dynamics and prospects for effective control of a future Disease X. These insights necessitate research into the mechanisms, impact and different modes of superspreading more widely.
The US COVID-19 Scenario Modeling Hub produced medium to long term projections based on different epidemic scenarios. In this study, the authors evaluate 14 rounds of projections by comparing them to the epidemic trajectories that occurred, and discuss lessons learned for future similar projects.
The relationship between circadian function and frailty is not well understood. Here, the authors show that disturbances in circadian rest-activity rhythms were associated with an elevated frailty risk and faster progress of frailty in older adults.
SARS-CoV-2-associated mortality estimates for sub-Saharan Africa are uncertain due to lack of comprehensive surveillance systems. Here, the authors analyse data from a detailed surveillance system in Kilifi, Kenya and find that excess mortality rates were relatively low, except for older adults.
Identification of areas with risk factors for spillover of viruses from animals to humans could assist with early detection of emerging infectious diseases. In this study, the authors characterise potential risks for spillover of SARS-like viruses from bats to humans and identify geographical regions in which multiple risk factors cluster together.
Digital proximity tracing apps were widely used during the COVID-19 pandemic but have not been thoroughly evaluated. Here, the authors use data from students in Leuven, Belgium and estimate that apps notified only ~4% exposed contacts, had a 1–2 day delay for notification, and identified fewer infected contacts than manual contact tracing.
In this study, the authors compare the viral kinetics of first and second SARS-CoV-2 infections using data from an occupational surveillance scheme in the National Basketball League. They find that second infections tend to have a faster clearance time, and that clearance times in first and second infections were positively correlated.
Rifampicin-resistant tuberculosis (RR-TB) requires longer, more toxic therapy than rifampicin-sensitive disease and is associated with a higher occurrence of long-term sequelae. In this mathematical modeling study, the authors estimate that incident RR-TB in 2020 will be responsible for ~6.9 million disability-adjusted life years; 44% due to post-tuberculosis sequelae.
In this study, the authors investigate the incidence and risk factors for post-COVID condition among people who had a mild initial SARS-CoV-2 infection in Norway. They use national linked registry data including ~215,000 individuals with a positive SARS-CoV-2 test who were not hospitalised and followed them up for 180 days after infection.
WHO guidelines for classification of malaria elimination in a country require that the risk of human infection from zoonotic, as well as nonzoonotic, malaria parasites is negligible. In this Comment, the authors discuss the implications of this policy for countries, such as Malaysia, with no recent reported nonzoonotic cases but ongoing zoonotic transmission.
Benefits of breastfeeding are well established, but a comprehensive study about its impacts on hospitalizations is lacking. Here, the authors use Korean nationwide birth cohort data (n = 1,608,540) and find that breastfeeding for at least 6 months was associated with a lower risk for subsequent hospital admissions.
The 21st Century has witnessed a series of global food crises, though little is known about how rising food prices affect child nutrition. The authors show that increases in the real price of food elevate the risk of a child being wasted, which in turn poses a serious risk for their survival.
Understanding the causal impact that risk factors have on healthcare cost is critical to evaluate healthcare interventions. Here, authors show that waist circumference, body mass index, and blood pressure have robust causal impact on healthcare cost.
With their misuse potential, there is a need to understand the global consumption of gabapentinoids. Here, authors show a + 17.20% worldwide average annual increase in consumption of gabapentinoids from 2008 to 2018.
Highly pathogenic avian influenza (HPAI) A/H5N1 has recently emerged in the Americas and has been implicated in mass die-off events of pelicans and sea lions. Here, the authors report sampling and characterisation of HPAI A/H5N1 genomes from five marine mammal and seabird species in Peru.
White-tailed deer are an important reservoir of SARS-CoV-2 in the USA and continued monitoring of the virus in deer populations is needed. In this genomic epidemiology study from Ohio, the authors show that the virus has been introduced multiple times to deer from humans, and that it has evolved faster in deer.
Measuring an individual’s level of exposure to COVID-19 is challenging, and it is therefore unclear whether high exposure may impact immunity. Here, the authors investigate this question using data from a correctional facility in Connecticut, USA, by comparing rates of infection in people who share cells, cellblocks, and with no known exposure.
The serial interval (time between symptom onset in an infector and infectee) is usually estimated from contact tracing data, but this is not always available. Here, the authors develop a method for estimation of serial intervals using whole genome sequencing data and apply it data from clusters of SARS-CoV-2 in Victoria, Australia.
Evaluation of the effectiveness of COVID-19 vaccines is increasingly challenging due to high levels of exposure to infection and vaccination. Here, the authors use a model-based approach incorporating these factors and estimate that using a variant-matched rather than ancestral booster could prevent nearly twice as many hospitalisations and deaths over one year.
Triple artemisinin-based combination therapies have shown high efficacy for treatment of malaria in preliminary studies. Here, the authors use mathematical modelling to assess whether these therapies could also delay the emergence and spread of antimalarial drug resistance when compared against frontline therapies.
The COVID-19 pandemic has been characterised by periods of dominance of different SARS-CoV-2 variants. In this mathematical modelling study, the authors investigate the epidemiological properties of successive variants in England until early 2022 and quantify the impacts of control measures.
An outbreak of Mpox in the UK began in May 2022 and peaked in July. In this modelling study, the authors show that the decline in cases was likely due to behavioural changes among high-risk populations, whilst vaccination could prevent a rebound.
The long-term natural history of long-COVID is not well understood. In this population-based cohort study from Scotland, the authors describe symptom prevalence and health-related quality of life up to 18 months after a positive SARS-CoV-2 test and compare with matched test-negative controls.
Sequencing malaria parasites from low density infections in small amounts of dried blood is important for large-scale genomic surveillance. Here, the authors develop and validate a highly multiplexed droplet digital PCR-based amplicon deep sequencing assay and apply it to data from Zanzibar, Tanzania.
Test-negative case control studies have been widely used to estimate COVID-19 vaccine effectiveness, but the accuracy of estimates may be impacted by bias and unmeasured confounding. Here, the authors investigate the these impacts by collecting additional data from individuals included in the first UK COVID-19 test negative study.
Plasmodium knowlesi is a zoonotic malaria parasite that can infect humans, but whether human-mosquito-human transmission occurs is not known. Here, the authors use data from Malaysia and show, through mathematical modelling, that sustained non-zoonotic transmission is unlikely to be occurring in this setting.
Global COVID-19 vaccine distribution has been inequitable. In this mathematical modelling study, the authors estimate the proportion of deaths that could have been averted in twenty low- and lower-middle-income countries if vaccines had been more widely available early in the pandemic.
SARS-CoV-2 testing rates have varied during the pandemic but the drivers of changes in testing behaviour are unclear. Here, the authors link national testing data from England to indicators of epidemic trends to describe how testing varies according to level of virus transmission, disease susceptibility/severity, public health measures, and risk perception.
Nigeria has the highest incidence of pneumococcal disease in Africa and introduced the 10-valent pneumococcal vaccine for infants between 2014 and 2016. Here, the authors conduct repeated cross-sectional surveys to analyse the impact of the vaccination campaign on pneumococcal carriage and serotype distribution.
The Amazonas region has been the most heavily affected by COVID-19 in Brazil. In this study, the authors conduct phylodynamic analyses to assess SARS-CoV-2 lineage replacement dynamics in the region and infer the impact of population immunity on the spread and severity of the Delta and Omicron variants.
Extending the interval between doses of mRNA Covid-19 vaccines has been linked with a reduced risk of myocarditis in children and adolescents, but impacts on vaccine effectiveness are not known. Here, the authors perform a nested case-control study using data from Hong Kong and find evidence of reduced risk of infection following a longer dosing interval.
Accurately estimating the burden of tuberculosis is challenging due to incomplete registration systems and the relationship with HIV. Here, the authors develop a Bayesian modelling strategy accounting for these factors that estimates age- and country-specific annual risks of infection and the proportion resulting from recent infection.
Rare but serious cardiac disease side effects have been linked to COVID-19 vaccinations, especially in young people. Here, the authors find very little evidence of an association between vaccination and mortality, except for in females after a non mRNA vaccine, but show an increased risk of death following COVID-19 infection
The timing of measles vaccination in infants affects the risk of infection in young children and the duration of protection provided. Here, the authors investigate optimal vaccination timing by characterising antibody kinetics following different vaccine schedules in two cohorts of children in southern China.